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Block 4 > Week 4 > Flashcards

Week 4 Flashcards

1
Q

Name structures

A

Tibia: Medial malleolus, Inferior articular surface (for trochlea of talus), Fibular notch

Fibula: Lateral malleolus, Ligaments Interosseous membrane, Anterior and posterior tibiofibular ligament

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2
Q

Muscle that pass in the front of malleolus?

Muscules that pass in the back of malleolus?

A

Dorsiflexion

Plantar flexors

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3
Q

Name compartments

A

Anterior

Lateral

Posterior deep

Posterior superficial

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4
Q

Posterior superficial compartment muscles?

A

Gastrocenmius

Soleus

Plantaris

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5
Q

Deep posterior compartment muscles?

Function?

A

Tibialis posterior

Flexor digitorum longus

Flexor Hallucis Longus

Popliteus

Invertors and plantarflexors / unlocking the knee

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6
Q

Anterior compartment?

Function?

A

Extensor digitorum longus, extensor hallucis longus, Tibialis anterior

dorsiflexion, Tibialis anterior - inversion

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7
Q

Lateral Compartment muscles?

A

Fibularis (peroneus) lonugs

Fibularis ()peroneus) brevis

Plantar flexors and everters

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8
Q

Nerve supply to the leg?

Posterior?

Anterior?

Lateral?

A

Tibial n

Fibular n

Fibular n

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9
Q

What is the continuation of anterior tibial?

What artery supplies lateral muscles in a leg?

A

Dorsalis pedis

Perforating branches of fibular

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10
Q

Tendon Sheaths and Retinacula

A
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11
Q

Name the vessels in flexor retinaclum

A

Tibialis posterior

Flexor digitorum longus

Posterior tibial atery and nerve

Flexor hallucis longus

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12
Q

Name structures in dorsal side of the foot

A
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13
Q

What innervates dorsal side of the foot (muscles)?

What supplies dorsal compartment of the foot?

What supplies plantar compartment of the foot?

A

Fibular nervew

Dorsalis pedis (anterior tibial)

LKateral plantar artery forms arch

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14
Q

Cutaneous nerve supply to leg

A

Lateral sural cutaneous nerve

Superficial fibular (peroneal) nerve

Sural never via lateral dorsal cutaneous branch

Deep fibular (peroneal) nerve

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15
Q

First layer of the plantar comparment

A

Plantar aponeurosis

Abductor digiti minimi

Flexor digitorum brevis

Abductor hallucis

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16
Q

Second layer of foot muscles on plantar side

A

Lumbricals

Flexor hallucis longus

Flexor digitorum longus

Quadratus plantae (flexor accessorius)

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17
Q

Third layer muscles

A

Flexors

Adductor hallucis transverse and/oblique head

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18
Q

Fourth layers of foot

A

Plantar and dorsal interossi

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19
Q

Innervation of the plantar foot

Lateral Plantar Nerve?

Medial Plantar Nerve?

A

Lateral Plantar Nerve-(like the ulnar) All intrinsic muscles except the thenar equivalents, the lumbrical to the functional midline on the medial side, and the flexor digitorum brevis (like the flexor digitorum superficialis)

Medial Plantar Nerve innervates the above named exceptions -(like the median)

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20
Q

Nerve innervation to foot

A
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21
Q

Bone is the foot

A
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22
Q

Ligaments

A
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23
Q

Posterior ligaments

A
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24
Q

Joints in the foot?

A

Subtalar joint

Transverse tarsal joint

Tarsometatarsal joint

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25
Q

Ligaments attached to lateral malleolus

Injury?

A

Posterior talofibular ligament

Anterior talofibular ligament

Calcaneofibular ligament

Angkle spains (inversion injury, anterior talobiular ligament)

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26
Q

Medial Malleolus ligaments

A

Deltoid ligament

Pott’s fracture-dislocation, eversion injury

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27
Q

Two arches of the foot?

What holds them?

Dynamic changes provided by tendonds of?

A

Longituinal arch, transverse arch

Bones/ligaments

Peroneus longus, tibialis anterior, flexor hallucis longus, flexor digitorum longus (also tibialis posterior)

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28
Q

Ligaments that mantain arches

A

Spring ligament (Plantar Calcaneonavicular)

Long and short plantar (calcaneocuboid) ligaments

Plantar aponeurosis

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29
Q

What tendons specifically support the transverse curvature?

A

Tendons of the Fibularis longus and Tibialis posterior

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30
Q

Pes Planus

When normal? Why?

A

Flatfoot

before 3yo, fat in foot

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31
Q

Distal Femur Sturctures

A
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32
Q

Tibia and Fibula Structures

A
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33
Q

Ligaments of knee joint

A
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34
Q

Name the ligaments on opposite medial/lateral side of knee joint?

Comparison?

A

Medial meniscus, C-shaped, attached to tibial collateral ligament

Lateral meniscus, O-shaped, not attached to fibular collateral ligament

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35
Q

Popliteal Cyst

A

Popliteal cysts are fluid-filled herniations of the synovial membrane of the knee joint

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36
Q

Name structures

A

Adductor magnus tendon (AM)

Superior attachments of lateral & medial heads

of gastrocnemius (with underlying bursae)

Tibial collateral ligament (TC)

Fibular collateral ligament (FC)

Semimembranosus tendon (SM)

Biceps femoris tendon (BF)

Popliteus muscle (P)

37
Q

Drawer Test

A

Test for anterior cruciate ligament

38
Q

Acetabulum structures

A

Acetabulum

Margin (limbus)

Lunate surface

Acetabular notch

39
Q

Femur

A

Head

Fovea for ligament of head

Neck

Greater & lesser trochanter

Shaft

Lateral & medial epicondyle

40
Q

Ligaments in hip joint

A

Iliofemoral ligament (IF)

Ischiofemoral liagment (IsF)

Pubofemoral ligament (PF)

Ligament of head of femur

41
Q

Where does the blood supply to femur comes from?

A

Major blood supply to the femoral head and neck are from the femoral circumflex arteries especially medial

42
Q

Varus / Genu Varum

Valgus / Genu Valgum

A

Angulation towards the midline

Angulation away from the midline

43
Q

Comminuted

Subluxation

A

Crushed

Partial dislocation

44
Q

Normal limb development

A

Varus -> Valgus

45
Q

Fracture description

Pattern

Location

Other?

A

Transverse, Oblique, Sprial, comminuted

Metaphysis, diaphytsis, epiphysis

Displacement, angulation, intra vs. extra articular involvment

46
Q

Bone fracture healing stages?

A

Hematoma - hematoma formation

Cartilage - callus formation

Woven bone - callus ossification

Dense bone - bone remodeling

Inflammatory -> Reparative -> Remodeling

47
Q

Green stick fracture

A

A greenstick fracture occurs when a bone bends and cracks, instead of breaking completely into separate pieces.

48
Q

What nerve might be affected in compartment syndrome in the leg?

A

Peroneal

49
Q

Intramedullary Rod

A

The nail sticked into the medulla of the bone

50
Q

—Septic tenosynovitis

A

Inflammation of a tendon and its sheath

51
Q

Orthopedic Emergencies

A

—Fractures: open, neurovascular injury
—Compartment syndrome
—Dislocations: hip, knee, shoulder, elbow, ankle
—Infection: septic joints
—Septic tenosynovitis

52
Q

What things should be asked during fracture presentation?

A

History (mechanism of injury), PMH, meds/allergies;

PE: ABCDE

Touching

Looking for brusing, lacerations, deformit, pain

Neurovascular: nerve, pulses, capillary refil

X-ray

53
Q

ABCDE

A

Airway maintenance with cervical spine protection

Breathing and ventilation

Circulation with hemorrhage control

Disability/Neurologic assessment

Exposure and environmental control

54
Q

Imagining techniques

A

X-rays in orthogonal planes

CT scan (for complex intra-articular injuries)

MRI (ligaments, meniscus, soft tissue injuries)

Ultrasonography

55
Q

Why bone in immobalized?

A

Prevent neurovascular compromise / tissue necrosis

Decrease bleeding, stabilize hematoma

Pain relief

Ease of transport

56
Q

Arthroplasty

A

The surgical reconstruction or replacement of a joint.

57
Q

5P’s of compartment syndrome

A
  • *—Pain** – out of proportion
  • *—Paresthesia** - tingling
  • *—Palor** - whiteness
  • *—Paralysis** – muscle not working
  • *—Pulselessness** – pressure so high that disrupts blood flow
58
Q

Exertional Compartment Syndrome

A
59
Q

Septic Arthritis

What is it?

Pathophysiology?

Common agents?

Complications?

RFs?

Symptoms?

Diagnosis?

A

—Infectious agent inside synovial cavity

—Damage to the articular cartilage from chondrocyte proteases, hyaluronidase, cytokines from WBC’s

Staph aureus, nisseria gonorrhea (sexual) salmonella, SCA

Avascular necrosis due to excessive pressure

Trauma, surgey, IVDA, DM, SCA, immunosup, sex activity

Joint pain, swelling, stiffness, fever, chills

Fluid analysis

60
Q

Joint Fluid Analysis (4 C’s)

A
  • *—Cell count**- elevated WBC
  • *—Culture**- aerobic and anerobic with gram stain
  • *—Crystals**- uric acid, calcium pyrophosphate
  • *—Chemistry**- glucose, protein
61
Q

Virchow’s Triad

A

Thromboembolism

Statis of blood flow

Endothelial injury

Hypercoagulability

62
Q

What provides both rotational and anterior stability?

A

ACL

63
Q

Where is

Patellar tendon

Quadriceps tendon

Hamstrings tandom

Popliteus Tendon

A

Inferior to patella

Anterior

Posterior

Lateral of humerus

64
Q

Synovium

A

Synovial membrane

65
Q

Evaluation of limb

A

Pain (character/mechanism/location)

Tenderness

Swelling

Inability to bear weight

Loss of motion

Range of motion

Instability

Deformiy

Crepetus

66
Q

Lachman exam

A

Drawer exam (ACL)

15 degree bend, then anterior/posterior

67
Q

Pivot Shift Test

A

Rotation test (ACL)

68
Q

What causes blood in the knee?

A

Intrasynovial ligament

ACL or PCL

69
Q

How these are treated?

Fracture

Meniscus

Aricular surface

Ligament tear/spain

A

Splint it

Repair/cut

Smooth it out

Repair/let heal

70
Q

Articular cartilage damage

problems?

A

Difficult to diagnose - microfracture

71
Q

Why excise meniscus?

A

Poor blood suplly

72
Q

Tanner Stages

A

Prepubestent - T1,2 - B6-10,G5-9

Early pubescent - T3, sex characterstics

Midpubescent - rapid growth

Latepubescent - rate declines

73
Q

Physes

Apophyses

A

Growth of the bone

Attachement of the bone

74
Q

Osgood-Schlatter Disease (Adolesent)

What is it??

Treatment

A

Secondry to repetitve microtrauma

Traction apophysitis tibial tubercle

Rest, ice, NSAIDs

75
Q

Salter Harris Classification (Adolesent)

I and II (non displaced)

II displaced

II and IV

A

Classification of bone breaks

long leg cast for 4-6 wk

Closed or open reduction, pin

Open anatomic reduction, epiphyselal foxation

76
Q

Tibial tubercle fracture (Adolesent)

Most common in who?

Cause?

Adult?

Position of tubercle?

Growtg disturbance?

A

Boys 12-17

Rapid contraction in jumping

Patellar tendon

Slightly off to lateral (need X ray with interal rotation)

Uncommon

77
Q

Tibial Spine fracture (Adolesent)

A

A fracture of the bony attachment of the ACL on the tibia

78
Q

Patellar Sleeve Fracture (Adolesent)

Ages?

Treatment

A

8-12 yo

reduction and suture fixation

79
Q

Are fractures around knees common in children?

A

Less comon

Proximal tibial physeal injuries - hyperextension force across the knee

80
Q

Meniscal injuries (Adolesent)

Function?

Associated with?

A

Stability

Ligametnous instability

81
Q

What can cause knee pain? (Adolesent)

A

Hip fracture

82
Q

Slipped Capital Femoral Epiphysis SCFE (Adolesent)

A
83
Q

Bimodal Incidence of Hip fracture

Types of them?

Treatment?

Reoperation rate?

Types?

One Year morataility?

A

Elderly (chronic)

Intracapsular (neck. subcapital transcervical) 45% / Extracapsular 55% - better outcome / Subtrochanteric

Depends of age e.g. young-no metal, older patients-mobilize and lower discrease complications, young - spare fermmoral head and deformity prevent AVN

20-50%

Stable/Unstable

14-50% (commorbidities), Venous Thromboembolism

84
Q

Blood supply to hip

A

Lateral epiphyseal atetry (terminal MFC) predominant to head

Inferior metaphyseal atery (acending LFC)

Obturator (through ligamentum teres)

85
Q

Shoulder

Instability (pathological)

Laxity (non-pathological)

A

Inability to mantain humeral head centerd in the glenoid fossa

Humeral head can be transalted or rotated from a refrence position (full range of functional motion)

86
Q

Shoulder

Static stabilizers?

Dynamic?

A

Articular anatomy, capsuligamenous structures

Rotator cuff, Long head of biceps

87
Q

Capsoligamentous

A

superior glenohumeral lig - primary - adducted,

middle glenohumeral - poorly defined - abduction,

inferior - important -ABDUCTION/EXTENSION

Capsule

Anteior - tight in external rotation

Postierior - tight in internal rotation

88
Q

Shoulder tests

A

Apprehension test

89
Q

Anteior instability of shoulder

Posterior instability

Multidirectional instability

A

Force anterior on arm or shoulder

Acute or overuse (baseball pitcher)

Positive apprehension/relocation

Rare

Traumatic: Seizure or Electric shor

Externally rotated prominal humeral head on the posterior

Atraumatic: wieght liften

Different than both

Rotator cuff weakness

Block 4 (4 decks)

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