Unit 4 Clinical Aspects Flashcards
Developmental Dyspasia
- Congenital dislocation of the hip
- More common in females
- Results in Ligamentous Laxity and Femoral Anteversion/twisting of the femur
Prepatellar Bursitis
AKA: Housemaid’s Knee
Caused by friction between the skin and the patella
Suprapatellar Bursitis
Causes by bacteria from an abrasion or a pentrating wound
Subcutaneous Bursitis
Caused by excessive friction between the skin and the tibial tuburcle
Acquired/Traumatic Dislocation
- Posterior is most common
- Anterior is rare
- Anterior dislocation affects the Obturator nerve.
- Posterior dislocation affects the Sciatic nerve
What nerve is affect with a posterior acquired/traumatic hip dislocation?
Sciatic Nerve
What nerve is affect with a anterior acquired/traumatic hip dislocation?
Obturator Nerve
What ligaments are affected in an “Unhappy Triad?”
- Medial Collateral Ligament
- Anterior Cruciate Ligament
- Medial Meniscus
What the most commonly injured ligament of the knee joint?
The Medial Collateral ligament
If large parts of the medial meniscus and even the menisci in general are removed, what clinical condition can be caused?
Hint: forces will be transmitted to the condyles of the tibia, possibly damaging the articular cartilage.
Osteoarthritis
An injury that produces a condition in which the tibia can be pulled excessively forward under the femur is referred to as what?
Positive Anterior Drawer Test
An injury that produces a condition in which the tibia can be pulled/moved excessively backward under the femur is referred to as what?
Positive Posterior Drawer Test
What the heck is Osgood-Schlatter’s Disease?
An avulsion injury of the secondary center of ossification of the tibial tuberosity.
Also known as an “Apophyseal Injury” or a “Traction Injury”
How many centers of ossification does the Tibia have?
4
An Os Trigonum occurs when a secondary ossification center develops where?
The lateral tubercle
What is it called when the lateral tubercle of the talus fails to unite with the body of the talus and ossifies independently?
Os Trigonum
Where does a fracture of the talus usually occur, and during what movement?
At the neck during sever dorsal flexion of the ankle
Fractures of the calcaneus may disrupt which joint?
The Subtalar Joint
Where are stress fractures commonly found?
- Shaft of the Tibia
- 2, 3, 4 Metatarsals
- Navicular Bone
What can cause a pathological stress fracture?
- Drugs
- Osteoporosis
- Metabolic Disorder
Is trauma (burns, fractures, ER visit stuff) more likely to cause acute or chronic compartement syndrome?
Acute Compartement Syndrome
What causes Chronic Compartment Syndrome?
Exercise
Which compartments of the leg are most frequently affected from cronic compartment syndrome?
Anterior and Deep Posterior
A patient presents with aching, squeezing, or sharp pain in the anterior part of the leg, but says it goes away when they stop what they are doing. This is most likely what?
Chronic Compartment Syndrome (AKA: External Compartment Syndrome)
Pain along the tibia that usually involves the tibialis anterior is refered to as what?
Shin Splints or Medial Tibial Stress Syndrome
What term is used to describe compression neuropathy of the deep fibular nerve at the tibia?
Ski Boot Syndrome
Sensory loss of the deep fibular nerve will cause loss of sensation in which part of the foot? Be specific.
The web space between digits 1 & 2
Motor loss of the deep fibular nerve will cause what?
- Loss of dorsal flexion of the foot
- Loss of toe extension
- Diminished INversion of the foot
An ankle spain can cause a traction injury of which nerve?
Superficial Fibular Nerve
Do humans walk more inverted or everted? Which muscles contribute to this?
- Everted
- Fibularis Longus & Brevis
What type of bone is a fabella? Where is it found?
- Sesamoid Bone
- The lateral head of the gastrocnemius and it articulates with the lateral condyle of the femur (the posterior knee)
Which joint is involved in a high ankle sprain?
The Inferior Tibiofibular Joint
The Calcaneal Tendon Reflex tests for segmental innervation of what nerves?
S1 & S2
Damage to the tibial nerve can cause what issues?
- Unable to flex/bend toes
- Weakened plantar flexion
- Weakened inversion of the foot
An occlusive peripheral artery disease characterized by painful leg cramps which develop during walking and disappear with rest is known as what?
Intermittent Claudication
Which ligament is the most vulnerbale to ankle sprains? Which ligament may also be damaged (the second most damaged)?
The Anterior Talofibular Ligament is the most vulnerable but the Calcaneofibular ligmanet can also be damaged.
Is an ankle sprain more commonly an INversion or EVersion type of injury?
Inversion
Where does a high ankle sprain occur?
The Inferior Talofibular Joint
What clinical term do we call a fracture that occurs when the foot is forcibly everted (externally rotated)?
A Pott’s Fracture
What 3 things can a Pott’s Fracture cause?
- Tear of the deltoid ligament
- Fracture of the shaft of the fibula
- Fracture of the lateral malleolus
“First Step Pain” is usually associated with what clinical condition?
Plantar Fasciitis?
Patients who experience plantar fasciitis will complain of pain at what part of the calcaneous?
The medial aspect of the calcaneous.
An overuse injury that causes pain on the medial aspect of the calcaneus and along the medial longitudinal arch is refered to as what clinical name?
Plantar Fasciitis
Which nerves does the plantar nerve reflex test for?
L4, L5, S1, S2
Which nerves are involved in Tarsal Tunnel Syndrome?
- Tibial Nerve
- Medial Plantar Nerve
Which nerves do the Babinski Response test for?
L4, L5, S1, S2
A positive babinski response abducts digits ____ and extends digit ____.
- Abducts digits 2 - 5
- Extends digit 1
Morton’s Neuroma usually affects which nerves?
Nerves in the spaces between digits 3 & 4
Hallux Valgus is characterized by lateral deviation of which joint?
The MP joint of digit 1
What is hallux rigidis?
Where a sesamoid bone gets stuck between the heads of the 1st and 2nd metatarsals, causing the joint to “lock”
What is a bunion?
Growth of new bone over the medial aspect of the 1st metatarsal, causing the surrounding soft tissue to swell
What is a corn…other than a tasty vegetable?
A callus; a thickening of the keratin layer of the skin
Hammer Toe is a common deformity of which digits?
Digits 2 & 3
What happens to cause hammertoe?
- The MP & DIP joints are hyperextended
- The PIP joint is flexed
Turf Toe is a hyperextension injury at the ___ joint of digit ___.
MP joint of digit 1
Which ligament is damaged from turf toe?
The Plantar Capsular Ligament
What bone is affected by club foot?
The talus bone
It is usually malformed, leading to shortening and contracture of muscles and ligaments.
What term is used for someone with a normal foot and normal arches?
Pes Rectus
A foot where the medial longitudinal arch becomes depressed and collapses is refered to as what?
Pes Planus
What clinical term is used to describe flat feet?
Pes Planus
Name the clinical term where the foot arch is lacking during weight bearing but appears normal when not weight bearing.
Flexible Flat Foot
What do we call a foot that lacks an arch when both weight bearing and not weight bearing?
Rigid Flat Foot
What is acquired flat foot? (AKA: Fallen Arches)
A clinical term for a consequence of damaging a ligament (spring ligament) or atrophy of a muscle (tibialis posterior).
Are fallen arches more common in younger or older people?
Older People dur to weight gain or arthritis
What do we call a condition in which the medial longitudinal is uniquely high? (Name both terms).
- Pes Cavus
- Clawfoot
Which of the following does the image show?
A. Pes Rectus
B. Pes Planus
C. Pes Cavus
A. Pes Rectus
Which of the following does the image show?
A. Pes Rectus
B. Pes Planus
C. Pes Cavus
B. Pes Planus
Which of the following does the image show?
A. Pes Rectus
B. Pes Planus
C. Pes Cavus
C. Pes Cavus
What condition may lead to the formation of a bunion?
Hallux Valgus
A bumper fracture is commonly found in which bone?
The tibia
What is the clinical term for a compoun fracture that is common from direct trauma?
Bumper Fracture
A fracture of the fibula may damage which nerve?
Common fibular nerve
Where is the fibula commonly fractured?
Just proximal to the lateral malleolus or distal to the head of the fibula
What artery is involved in peripheral arterial disease?
AKA: Intermittent Claudication
Posterior Tibial Artery
