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Lower leg1

Higgins lower leg notes

inferior tibiofibular syndesmosis w/ no articular cartilage or synovium, ant and post talofibular ligaments prevents seperation to tib and fib, w/ DF talar head seperates this joint w/ force, DF, IR, ER, the talofibular ligaments are stressed
Compartments anterior, superficial posterior, deep posterior, lateral
Anterior compartment Anterior Tibialis, Extensor digitorum longus, extensor hallicus, deep peroneal nerve, anterior tibial artery and vein,
lateral compartment superficial peroneal nerve, short and long peroneal muscle
Superficial posterior compartment soleus muscle, plantaris, gastroc tendons
deep posterior compartment posterior tibial muscle, flex digitorum longus, flexor hallicus longus, peroneal artery and vein, tibial nerve, posterior tibial artery and vien
Anterior tibiofibular runs downward and inward from distal fibula to the distal tibia, prevents seperation of syndesmosis
posterior tibiofibular runs downward and inward from the distal fibula to the distal tibia, prevents syndesmosis
Interosseous membrane runs the length of the tibi and fibula , connecting the two leg bones, prevents seperation of tibia and fibula
percussion/bump and compression test used when fx is suspected, percussion test is a blow to the tib, fib, or heel to cause vibration that resonates in fx causing p!, compression test-compression of tib &fib either above or below site of concern
Syndesmotic sprain etiology-torn w/ increased ER or DF, injured in conjunction w/ med and lat ligaments, may require extensive repair time ,
Syndesmotic sprainSX pt and swelling localized over ant and post tibiofibular ligaments, bilateral compression increase p!, walk on toes, inability to push off
Syndesmotic sprain TX ICER, immobilization usually for period of 2-3 wks depends on severity of mortise sprain, NSAIDs
Acute leg Fx causes:direct blow or indirect trauma, fib fx seen w/ tib fx or as a result of direct trauma, sigs-p!, swelling, soft tissue insult, leg will look hard and swollen(Volkmans contracture), deformity-maybe open or closed
Stress fx of tib and fib cause-common overuse, particularly w/ structural & biomechanics insuffecencies, result of repetative loading during training & conditioning, signs-p! w/ activity, p! increased after exercise, pt difficulty discerning bone&soft tissuep!, bone scan results
Medial Tibial Stress syndrome causes of injury p! ant/post shin, stress fx, muscle strains, chronic ant comp synd periosteum irritation, repetative microtrauma, weak muscles, improper footwear, training errors, varusfoot, tight heelcord, hypermobile/pronated feet, stress fx &exertional comp synd
MTSS signs of injury difuse p! in disto-med aspect of lower leg, in bad cases ambulationmaybe p!, morning p! and stiffness may also increase, can progress to stress fx
Anterior etiology-result of hard heelstike w/ landing phase of running, overuse of DF occurs, presentation-p!lat to tib, w/ increased ex, over ant comp, dull ache
posterior etiology-associatd w/ inflam to post tib tendon &long toe hallux toe, hyperpronationof foot during midstance, presentation-p! over med border of distal tib, w/ increased ex, dull ache, pronated subtalar joint
Compartment syndrome cause-rare acutetraumatic syndrome caused by direct blow, can be acute, acute exertional, chronic, signs-excessive swelling, compresses muscles blood supply&nerves, deep achin p! tightness, weakness w/ footand toe ext, numbness in doralreagion of foot
achilles tendonitis etiology p! and inflammation of achilles tendon usuall 2-5cm proximal to calcaneus, weak gastroc soleus comples, overuse, decreased DF, pronation
achilles tendonitis presentation p! w/ activity, decrease p! w/ rest, p! and decreased DF, crepitation, tightness in achilles, p! w/ PF
Achilles tendonitis cause of injury inflammatory condition, sheath or paratenon, tendon overloaded due to extensive stress, gradual onset and worsens w/ continued use, decreased flexibility exacerbates condition
Achilles tendonitis signs of injury generalized p! and stiffness, localized proximal to calcaneal insertion, warmth p! w/ palpation, thickened, mayprogress to morning stiffness
Achilles tendon rupture cause-suddent stop &go, forcefull PF w/ knee moving to ext, seen mor ein ath 30+, history chronic inflammation signs-sudden snap(shot in leg), instant p!, pt, swelling, discoloration, decreased ROM, indentation, + thompson test
Shin contusion Cause-direct blow to lower leg-impacting periosteum anteriorly), Signs-intense p!, rapid forming hematoma w/ jelly like consistency, increased warmth
Created by: jwebst1
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