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Clinical Lower Limb
MSK
| Question | Answer |
|---|---|
| -Patient should be relaxed -Strike Patella tendon -Observe knee extension | Patellar tendon 'Knee jerk' reflex |
| Tests L3-L4 spinal nerves | Patellar tendon 'Knee jerk' reflex |
| -Patient should be relaxed -Strike Achilles tendon -Observe for plantar flexion | Achilles tendon reflex |
| Tests S1 Spinal nerve | Achilles tendon reflex |
| -Blockage of arteries resulting in ischemia of muscles -Produces cramp-like pain w/exercise -W/rest pain disappears until exercise restarted | Intermittent Claudication |
| Can be bypassed by cruciate and trochanteric anastomosis | Proximal Blockage of Femoral Artery |
| Can be bypassed by perforating branches of deep femoral artery, descending branch of lateral femoral circumflex anastomosing w/articular and muscular branches of popliteal arteries | Blockage of Femoral Artery in Adductor canal |
| Insufficient valves in superficial veins and perforating branches leads to blood flow from deep veins (higher pressure) to superficial veins (lower pressure) | Varicose veins |
| Pressure in superficial veins rises leading to mechanical injury of small vessels, inflammation, and fibrosis and could cause venous ulcers | Venous ulcers |
| can be treated surgically w/ venous stripping of superficial veins | Varicose veins |
| Formed by medial edge of femoral neck and inferior edge of superior pubic ramus | Shenton's line |
| -Disruption of cortical bone -Shenton's line disrupted -Damages the retinacular arteries -Compromises blood supply to head of femur -Risk of avascular necrosis -Can result in external rotation of leg w/some shortening | Intra-capsular- Femoral Neck Fracture |
| flattening of weight-bearing upper portion against acetabulum and sclerosis (increased density- necrosis and calcification) | Avascular necrosis of femoral head |
| Partial hip replacement- possible treatment for fracture of femur neck | Hemiarthroplasty |
| -Fracture line rune btw the two trochanters -Fracture does not involve femoral head and neck -Does not affect blood supply to joint -Can result in external rotation of leg w/shortening | Extra-capsular- Intertrochanteric Fracture |
| possible treatment for intertrochanteric fractures | Dynamic hip screw |
| -Most common -Ischiofemoral ligament is weak -Shortening and medially rotating the affected limb -Can injure sciatic nerve | Posterior Dislocation of Hip Joint |
| Collection of fluid from knee joint or a bursa forming a sac in the popliteal space | Baker's Cyst |
| -Supracondylar fracture of femur -Seen in high velocity collisions -Pain & inability to bear weight -Risk of compartment syndrome (uncommon) -Popliteal artery and vein damage | Distal Femoral Fractures |
| -Comminuted fracture of shaft of tibia -Can lead to compartment syndrome -Vessels and nerves of compartment damaged | Tibial Fractures |
| -Half caused by tibial fractures -Can be anterior, lateral, or posterior -6 Ps of acute limb ischemia: • Pain • Paresthesia's • Pallor • Paresis (weakness / paralysis) • Pulselessness • Poikilothermia (cold) | Compartment syndrome |
| tissue pressure in a closed space rises above the perfusion pressure of microvasculature causing compromise of tissue circulation and function. Surgical treatment is release by incising the deep fascia with a fasciotomy | Compartment syndrome |
| -Paralysis of muscles of posterior leg and intrinsic muscles in sole of foot -Unable to plantarflex ankle -Loss of sensation on posterior lateral leg and sole of foot | Tibial Nerve Injury in Popliteal Fossa |
| -Patients can still plantarflex the ankle and inversion is not affected. • Functions of the intrinsic joints of the feet will be lost (with the exception of extension) • Loss of sensation on the sole of the foot | Tibial Nerve Injury in Tarsal Tunnel |
| -Paralysis of muscles of lateral & anterior compartments. -Foot drop is result of loss of dorsiflexion -Lower limb becomes ‘too long’ so, person will use a high stepping gait or swing out leg - Loss of sensation on lower anterior leg & dorsum of foot | Common Fibular Nerve Injury |
| -Paralysis of the muscles of the anterior compartment. -Foot drop is the result of loss of dorsiflexion -high stepping gait and/or swing out the leg -Loss of sensation in the first web space | Deep Fibular Nerve Injury |
| • Paralysis of muscles of the lateral compartment. • There will be loss of eversion of the foot • Loss of sensation on the inferior-anterior leg and dorsum of foot except the first web space | Superficial Fibular Nerve Injury |
Created by:
Zariea
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