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Gross final - PCC
Gross final
| Question | Answer |
|---|---|
| A patient sufferinf from pain in the anterior leg and a loss of sensation in the webspace of digit 1 and 2 may have damage to what? | Deep fibular nerve |
| The articulating surface of the acetabulum is deficient ____. This is know as the what? | 1. Inferiorily 2. Acetabular notch |
| Hip joint is deepedned by a what? It increases articulating area by ___? | 1. Acetabular labrum 2 10% |
| Part of the labrum that bridges the acetabular notch. | Transverse acetabular ligament |
| Capsular ligament of the hip | 1. Strong but loose 2. Allows for great movement, but needs help from other ligament to maintain its integrity. |
| Strongest ligament in the body | Iliofemoral ligament |
| Os trigonum is and extra ossification center where? | Lateral tubercle of the talus |
| Attachement of the iliofemoral ligament | ASIS to intertrochanteric line |
| Characteristic of the iliofemoral ligament when we stand up... straight. | It screws the head of the femur into the acetabulum |
| Strain is put on the iliofemoral ligament when? | WHen we bend forward or backwardes...muscles must come into play to support the joint |
| When bending backwards, what is brought inot play to keep from falling backwards? | Anterior hip and abdominal muscles |
| When bending foward, what comes into play? | Glutes, hanstrings and spinal muscles |
| The iliofemoral ligament is __ and acts like a ___. | 1. Extrinsic 2. Rope |
| Pubofemoral ligament: Ext vs Intrisic, rope vs wall, attachements, prevents what movement? | 1. Extrinsic 2. Rope 3. Superior ramus of pubis to intertrochanteric line 4. Abduction of hip |
| The pubofemoral ligament reinforces the hip are what? | 1. Anteriorly 2. Inferiorly |
| Ischiofemoral ligament: attachments, ext vs intrinsic, rope vs wall, prevents what? | 1. Body of ischium 2. Extrinsic 3. Rope 4. Abduction |
| Ischiofemoral ligament reinforces the capsule ____. | Posteriorly |
| This ligament converts the acetabular notch into a tunnel through which blood vessels and nerves enter the joint. | Transverse acetabular ligament (intrinsic) |
| Ligament whose function is to conduct blood vessels to the head of the femur. | Capitis femoris ligament (intrinsic) |
| Nerve supply to the ip joint | Sciatic, femoral and obturator |
| When leg is flexed, hip flexion is prevented by what? When leg is extended, hip flexion is prevented by what? | 1. Anterior thigh hitting abdominal wall 2. Hamstring muscles |
| 4 clinical aspects of developmental dysplasia | 1. FOund in 1.5 out of 1000 live births 2. Bilateral in half the cases 3. 8 times more common in females 4. Lax ligaments |
| If developmental dysplasia is not corrected, the following may occur (6) | 1. Pain 2. Abnormal gait 3. Unequal leg lenght 4. Osteoarthritis 5. Twisting of femur 6. Contracture of hip muscles |
| What is femoral anteversion? | Twisting of the femur |
| Dislocation of the hips are ___? Most common dislocation? May injure what structure? | 1. Rare 2.Posterior 3. Sciatic |
| Sometimes a posterior dislocation of the femur can cause a fracture in the femur or acetabulum. What is this called? | Fracture dislocation |
| Anterior dislocations of the hip may occur. What may be damaged? | Obturator nerve |
| Largest most superficial joint in the body | The knee |
| Anterior lef muscles are supplied by what nerve? | Deep fibular |
| Three articulations of the knee joint | 1. Patella and femur 2. Lateral condyles of femur and tibia 3. Medial condyles of femur and tibia |
| Joint classification of the knee. It has some degree of rotation when? | 1. Ginglymus 2. When it is flexed |
| Joint classification between patella and femur? | Plane gliding |
| Another name for the articular surfaces of the tibia | Tibial plateaus |
| Bursea that allows the skin to slide over the patella? It lies between the patella and the skin. | Subcutaneous prepatellar bursae |
| Knee bursea that ies between the tibial tuberosity and the skin? | Subcutaneous infrapatellar |
| Bursea found between the ligamentum patella and tibial tuberosity? | Deep infrapatellar |
| Bursae that lies between the femur and the common tnedon of insertion of the quads? | Suprapatellar |
| Extrinsic ligaments of the knee (4) ? | 1. Ligament patella 2. Collateral ligaments (medial and lateral) 3. Oblique 4. Arcuate popliteal |
| The ligamentum patella maintains allignment of the patella relative to what? What are its attachments? | 1. Articular surfaces of femur 2. Apex of patella to tibial tuberosity |
| The collateral ligament of the knee are taught when fully ____ thus contribute to the stability when ____. | 1. Extended 2. Standing |
| Lateral collateral ligament: rope vs wall, attachments, prevents what? | 1. Wall 2. Lateral epicondyle of femur to head of fibula 3. Prevents lateral movement of joint |
| Medial collateral ligment: Attachements (2), ropve vs wall, what does it prevent? | 1. Attaches to the medial meniscus. Medial epicondyle of femur to medial shaft of the tibia. 2. wall 3. medial movement of joint |
| What other structure may be damaged in MCL injuries? | Medial meniscus |
| Oblique and arcuate popliteal ligaments are both found where? Rope or wall? What do they prevent? | 1. Posterior aspect of knee 2. walls 3. Hyperextension |
| The oblique popliteal ligament develops form a muscle, which one? | Semimembranosous |
| Intrinsic ligament of the knee (2) | Cruciate and menisci (semilunar cartilage) |
| Which cruciate ligament is stronger? | PCL |
| ACL: Attachements, rope vs wall, what does it do? | 1. Anterior intercondylar area of tibia to lateral condyle of femur 2. Rope 3. Prevents anterior displacement of tibia |
| PCL: Attachements, rope vs wall, what does it do? | 1.Posterior intercondylar area of tibia to medial condyle of femur 2. Rope 3. Posterior displacement of tibia |
| What is the main stabilizing factor for the femur when walking downhill? (wieght bearing flexed knee) | PCL |
| Menisci AKA what? | Semilunar cartilage |
| Three main functions of the menisci? | 1. Deepen the articulating surfaces 2. Shock absorber 3. Contain mechanoreceptors for the knee |
| Which menisci are C shaped as opposed to circular? Which menisci is less freely moveable on the tiba and why? | 1. Medial lemniscus 2. Medial lemniscus because the tibial collateral ligament is attached to the medial lemniscus |
| Ligaments associated with the joint capsule of the knee that hold the menisci in place. | Coronary ligaments |
| Ligaments that allow the two menisci to work together. | Transverse ligament of the knee# |
| Nerve supply of the knee joint (4) | 1. Femoral 2. Obturator 3. Common fibular 4. Tibial |
| The popliteus muscle contracts to rotate the tibia ___ thus unlocks the knee in order to flex. | Medially |
| Bursitis cause by friction between the skin and patella that occurs form a direct blow or falling on flexed knee. Aterior swelling of the knee is common. | Housemaid's knee (prepatellar) |
| Bursitis caused by bacterial from an abraision or penetrating wound. Local redness and enlarged lymph nodes are common. | Suprapatellar |
| Bursitis cause by excessive friction between skin and tibial tuberosity. AKA what? Common in roofers | 1. Subcutaneous infrapatellar 2. Clergyman's knee |
| Bursitis cause by friction between patellar ligament and structures posterior to it. Obliterates dimples on either side of patellar ligament when leg is extended du to swelling. | Deep infrapatellar |
| Knee injury that occurs when the foot is fixed on the ground and forces are applied to the knee. | Ligament strains |
| The structures in the unhappy triad. Results from what kind of injury? | 1. MCL, ACL, medial meniscus 2. Results from a blow to the lateral aspect of the joint |
| Most commonly injured ligament due to rotational forces or a blow to the latreal aspect of leg | MCL |
| More vulnerable of the two menisci? | Medial |
| True or false: If the medial menisci are removed due to injury, movement of the joint can be restored with no loss of mobility? | True, however, articulation will now be over the bare condyles of the tibia which may lead to osteoarthritis |
| Three common cause of ACL damage | 1. Direct blow 2. Deceleration forces such as twisting or pivoting 3. Hyperextension |
| ACL injuries are usually accompanied by a ___. One often feels as if the knee has done what? | Snap or pop... knee came appart |
| Describe a positive anterior drawer test. Indicitive of an injury to what? | 1. Condition where the tibia can be pulled excessively forward under the femu 2. ACL injury |
| The less common PCL injury can be assessed by what? | Positive posterior drawer test |
| Knee replacements are made of what which mimics the smoothness of cartilage on cartilage? Life span of knee prosthetic? | 1. Metal and plastic 2. 15 to 20 years |
| Proximal articulations with tibia? Distal articulations of tibia? | 1. Condyles of femur and head of fibula 2. Talus and distal end of fibula |
| Main function of fibula | Provides muscle attachments and helps form the ankle |
| Ossifications of the tiba. | 1. Primary: Shaft, proximal end, distal end 2. Secondary: Tibial tuberosity |
| Order of primary ossification centers for tibia | Shaft, proximal end, distal end |
| Which fuses first on the tibia... proximal end or distal end? | Distal end |
| Describe Osgood-Schlatter's disease | Disruption of the epiphyseal plate of the tibial tuberosity that occurs aroud puberty in active adolescents. |
| Osgood-Schlatter's is known as what kind of injury? Describe the injury. | 1. Apophyseal injury (traction apophysitis) 2. Injusry of a secondary center of ossification |
| 6 clinical aspects of Osgood Schlatter's | 1. Bilateral in half of those affected 2. Seen in jumpers 3. Pain around the tibial tuberosity 4. Pain increases with activity 5. Avulsion fractures common 6. One or two years to run its course |
| Apearance of fibular ossification centers: earliest to latest. Distal or proximal end first? | 1. Shaft, distal end, proximal end 2. Distal end |
| WHy is there minimal displacement of a fractured tibia or fibula? | Because the other one acts as a splint |
| Two bones used in bone grafts | Tibia and fibula |
| How many tarsal bones? How many phalanges? | 1. 7 2. 14 |
| 2 bones the calcaneus articulates with? | Talus and cuboid |
| Features of calcaneus: Tuberosity provides attachment for what? Fibular trochlea notch seperates what? Subtentaculum tali is on what aspect of the bone? | 1. Achilles tendon 2. Fibularis longus and brevis 3. Medial |
| The talus consists of what 3 parts? What does the talus articulate whit? Are there any muscles that attach to the tallus? | 1.Head, neck and body 2. Tibia and fibula, calcaneous and navicular 3. No |
| A secondary center of ossification may develop from lateral tubercle of the talus. What is this called? | Os trigonium |
| Navicular tuberosity is on what aspect of the bone? What does it articulate with? | 1. Medial 2. Talus, cuboid and cuneiforms |
| Bone on the lateral aspect of the foot? Articulations? | 1. Cuboid 2. Calcaneus, 4th and 5th metatarsal, lateral cuneiforms, navicular |
| Unlike the carpal bones, the tarsals ossify when? Only tarsal bone to have a secondary center of ossification? | 1. Before birth 2. Calcaneous |
| Order of ossification of tarsals | Calcaneous, talus, cuboid, 1st, 2nd, 3rd cuneiform, navicular |
| Fractures of the talus usually occur through the ___ of the bone during severe ___ of the ankle. | 1. Neck 2. Dorsiflexion |
| When a person is pression extremely hard on a brake pedal suring a head on collision, what may be fractured? | Talus |
| Comminuted fractures resulting from a hard fall on the heel can concern what bone? | Calcaneus |
| Largest metatarsal? Longest metatarsal? Metatarsal with large tubercle for fibularis brevis attachement? | 1.First 2. Second 3. Fifth |
| Hairline fractures that appear without evidence of soft tissue damage. Common areas fractured in runner, walkers and high impact sports. | 1. Stress fractures 2. Runners: shaft of tibia Walkers: 2,3,4 metatarsal High impact: Navicular |
| Two types of stress fractures | 1. Bone is normal but is overloaded due to sudden increase in activity 2. Bone is abnormal often as a result of osteoporosis or drugs |
| What is the most common symptom of a stress fracture? | Pain |
| What is the best line of defense in preventing stress fractures? | Proper footwear |
| Three other aspects that will reduce risks of stress fractures. | 1. Increase training gradually 2. Run on soft surfaces 3. Get enough calcium |
| Term used to designate deep and superficial fascia of the leg | Crural fascia |
| Superior and inferior retinaculum prevent tendons from bowstringing when the foot is what? | Dosal flexed |
| Muscles of the deep posterior leg are bound down by what? | Flexor retinaculum |
| A large opening on the proximal end of the interosseus membrane allows what to pass through to the anterior compartment of the leg? | Tibial artery |
| Two functions of the interosseus membrane | 1. Surface for muscle attachement 2. Stabilizes tibia and fibula |
| The ankle joint consists of what bones? | Tibia, fibula and talus |
| Eversion and inverstion are carried out by what joint? This joint includes what bones? | 1. Subtalar 2. Talus and calcaneus |
| Plantar and dorsiflexion happen at what joint? | Ankle joint |
| Muscles of the anterior leg? What are they innervated by? | 1. Tibialis anterior, extensor digitorum longus, extensor hallicis longus and fibularis tertius 2. Deep fibular nerve |
| In compartement syndrome, ischemia and pain are common. Why? | Muscles in the compartment swell due to overuse. This edema and inflammation will cut off the blood supply to the muscles |
| Fractures, crush injuries or burns can cause ___ compartement syndrome | Acute |
| Chronic compartement syndrom AKA what? Occurs in what kind of people? | 1. External compartement syndrome 2. Runners or walkers with no history of trauma |
| The compartments most frequently affected by external compartment syndrome | Anterior and deep posterior leg compartements |
| Patients which ECS complain of aching, squeezing or sharp pains that are almost always releived by what? | Sesation of activity |
| 3 factors contributing to ECS? | 1. Increase in intensity of exercise 2. More time spent in hard surfaces 3. use of new shoes |
| An increase pf __ to ___ mmHG is diagnostically ECS? | 12-20 |
| Shin splints AKA ___ is characterized by pain where involving what muscles? | 1. Medial tibial stress syndrome 2. Medial aspect of tibia 3. Tibialis anterior muscle |
| Fractures of head of the fibula may damage what nerve? | Common fibular nerve |
| What is the larger branch of the sciatic nerve? Segemental innervation of the common fibular nerve? | Tibial Nerve, L4, L5, S1, S2 |
| The common fibular nerve divides into what? 3 branches from the common fibular nerve? | 1. Superficial and deep fibular 2. Sural communicating, lateral sural cutaneous of calf and articular to knee joint |
| Plaster casts, prolonged kneeling or squating and lostus position may damage what nerve? | Common fibular |
| Clinical features present when the common fibular nerve is damages? | 1. All anterior and lateral lef muscles involved 2. Foot drop 3. Loss of eversion 4. Loss of extension of toes 5. Diminished inversion 6. Loss of sensation of ant and lat aspect of the leg and dorsum of foot |
| Segmental innervation of the deep fibular nerve? What structur does it run with? | 1. L4, L5, S1 2. Anterior tibial artery |
| 3 branches of the deep fibular nerve | Muscular branch, articular to tib-fib joint and ankle joint, cutaneous |
| What is the cutaneous supply of the deep fibular nerve? | Small area of skin in the web between the first and second digit |
| Skiboot syndrom or anyone with tight fitting shoes may entrap what nerve? | Deep fibular nerve |
| The anterior tibial artery enters the anterior leg from the popliteal artery via what? | The opening in the proximal portion of the interosseous membrane |
| After the anterior tibial artery passes the extensor retinaculum, it is called what? | The dorsal pedis artery |
| Segmental innervation of the superficial fibular nerve? What 2 muscles does it pass between? | 1. L4, L5, S1 2. Fibularis longus and brevis |
| 2 branches of the superficial fibular nerve? What do they supply? | 1. Motor and cutaneous 2. Motor: fibularis longus and brevis Cutaneous: Distal anterior leg and dorsum of foot except where the deep fibular and sural nerves supply |
| Ankle sprains may cause __ injuries to the superficial fibular never | Traction |
| Damage of the superficial fibular nerve may cause paresthisia where? | Lateral side of leg and dorsum of ankle |
| The lateral leg compartement has no blood supply directly in it. How does it get its blood supply? | Branches of tibial and fibular artery penetrates the connective tissue which surrounds the compartement |
| Fibularis longus and brevis go ___ the lateral maleolus? | Behind |
| Three muscles supplied by the tibial nerve? | Gastrocnemius, Soleus, plantaris |
| Gastrocnemius + Soleus = ? | Triceps surae |
| Anchilles tendon or tendon calcaneus attaches where? | Tuberosity of calcaneus |
| Sesamoid bone assocites with the lower leg? Where is it located? | 1. Fabella 2. Proximal lateral head of the gastrocnemius |
| Where does achillies tendonitis usually occur? | Proximal to its attachment to the calcaneus |
| Most common symptom of achillies tendonitis? | Pain while walking or running |
| People with what kind of feet are more prone to achillies tendonitis? | Flat |
| Reasons for achillies tendonitis | 1. Inapropriate footwear 2. Sudden increase in activity 3. Sudden change in duration or frequency of activity 4. a quick return to activity after a prolonged break 5. running on a steep incline or uneven terrain |
| The achillies tendon can be ruptured during forcefull ___? When the knee is __? | Plantar flexion when the knee is extended |
| The calcaneal tendon reflex is taken where? Its test for the segmental innervation of what? | 1. Just proximal to the calcaneal tuberosity 2. S1, S2 |
| High heeled shoes may cause ___ of calf muscles. Pain may be experience when? | 1. Contracture 2. Walking in flat shoes or bare feet |
Created by:
LrB
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