BBC Exam 2
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| What is a "pulled groin"? | Strain, stretching, and possible tearing of the proximal attachments of the anteromedial thigh muscles (usually the flexor and adductors)
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| What is rider's strain? | Muscle strains of the adductor longus from horseback riding producing pain
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| Where can you find the femoral pulse? | Midway between the ASIS and pubic symphysis
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| What is the usual site for a femoral hernia? | Femoral ring
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| Why are femoral hernias more common in women? | Because of their wider pelvis
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| MOI for avulsion of the ischial tuberosity in a hamstring strain? | Forcible flexion of hip with knee extended
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| What is piriformis syndrome? | Compression of sciatic nerve by piriformis causing pain
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| In regards to the sciatic nerve, what is the "safe side" and what is the "dangerous side"? | Safe side = Lateral side
Dangerous side = Medial side
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| What quadrant is it safe to give gluteal injections in? | Superolateral quadrant or anterolateral part of thigh (TFL)
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| Which direction do popliteal abscesses spread? | Superiorly and inferiorly
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| How do you find the popliteal pulse? | With person in prone with knee flexed to relax popliteal fascia and hamstrings. Best felt in inferior part of fossa
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| What is a popliteal aneurysm? | abnormal dilation of all or part of the popliteal artery
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| How can popliteal aneurysms be distinguished from other masses? | By palpable pulsations and abnormal arterial sounds
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| Is injury to the tibial nerve common? Why or why not? | No, because of its deep and protected position in the popliteal fossa
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| What would severance of the tibial nerve produce? | Paralysis of the flexor muscles of the leg and intrinsic muscles of the sole of the foot
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| Where would loss of sensation occur if the tibial nerve was damaged? | Sole of the foot
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| What action would people be unable to do if the tibial nerve was damaged? | PF ankle or flex toes
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| Is genu varum associated with a small or large Q-angle? | Small
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| Is genu valgum associated with a small or large Q-angle? | Large
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| Which direction does the patella usually dislocate? | Lateral
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| What is another name for patellofemoral syndrome and why? | Runners knee - results from excessive running, especially downhill
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| What is patellofemoral syndrome? | Pain resulting from repetitive microtrauma caused by abnormal tracking of the patella relative to the patellar surface of the femur
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| What is the most common knee injury in contact sports? | Ligament sprains, when foot is fixed in the ground
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| Which meniscus is more susceptible to tearing and why? | Medial because it is less mobile
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| Do meniscal repairs always need to be done? | No - because of the generous blood supply to this area
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| What is arthroscopy? | Endoscopic examination that allows visualization of the interior of the knee joint cavity with minimal disruption of the tissue
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| What is joint effusion? | Escape of fluid from blood or lymphatic vessels, results in increased amounts of fluid in the joint cavity
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| What three bony points are used as landmarks for needle insertion while aspirating a knee? | Gerdy's tubercle
Lateral epicondyle of femur
Apex of patella
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| Which bursa of the knee can be ruptured by friction between skin and patella? | Prepatellar bursa
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| Which bursa of the knee can be injured by excessive friction between the skin and tibial tuberosity? | Subcutaneous infrapatellar bursa
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| which bursa injury results in edema between the patellar ligament and the tibia, superior to the tibial tuberosity? | Deep infrapatellar bursa
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| Which bursa may be injured from abrasions or penetrating wounds? | Suprapatellar bursitis
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| What is another name for popliteal cyst? | Baker cysts
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| What are popliteal cysts? | Abnormal fluid filled sacs of synovial membrane in the region of the popliteal fossa
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| What is a popliteal cyst almost always a complication of? | Chronic knee joint effusion
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| What are shin splints? | Edema and pain the area of the distal 2/3 of the tibia
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| What do shin splints result from? | Result from repetitive microtrauma of TA which causes small tears in the periosteum covering the shaft of the tibia and/or fleshy attachments to overlying deep fascia of the leg
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| What features are unique about the human foot? | Medial migration of distal attachment of fibularis longus across sole of foot and fibularis tertius attachment to the base of the 5th MT
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| What nerve winds subcutaneously around the fibular neck? | Common fibular nerve
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| What is ski boot syndrome? | Compression of deep fibular nerve
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| What can be responsible for recurrent stretching of the superficial fibular nerve causing pain along the lateral side of the leg and dorsum of ankle and foot? | Chronic ankle sprains
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| What is the fabella and where is it located? | Sesamoid bone in the proximal portion of the lateral head of the gastroc
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| What nerve roots does the calcaneal tendon reflex test? | S1 and S2
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| What is another name for a gastroc strain? | Tennis leg
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| What is calcaneal bursitis caused by? | Excessive friction on the bursa as the tendon continuously slides over it
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| If someone has an accessory soleus where does it appear? | As a distal belly medial to the calcaneal tendon
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| Where can the posterior tibal pulse be palpated? | Between the psoterior surface of the medial malleolus and the medial border of the calcaneal tendon
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| What position should you have the patient in to palpate the posterior tibial pulse and why? | Inversion of the foot to relax the flexor retinaculum
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| When is intermittent claudication present? | During walking, but disappears after rest
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| What is intermittent claudication characterized by? | Leg pain and cramps
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| What is is intermittent claudication caused by? | Narrowing or occlusion of leg arteries
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| Where can point tenderness be felt with plantar fasciitis? | Porximal attachment of the plantar aponeurosis to the medial tubercle of the calcaneus and on the medial surface of this bone
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| What actions cause pain with plantar fasciitis? | Passive extension of the great toe and DF of ankle and/or WB
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| What can a contusion of the extensor digitorum brevis muscle be confused with and why? | A severely sprained ankle because a contusion and tearing of these muscle fibers result in a hematoma that produces edema anteromedial to the lateral malleolus
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| What nerve roots are associated with the plantar reflex? | L4, L5, S1, S2
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| If one has medial plantar nerve entrapment where is a good place to check this? | Medial side of the sole and in the region of the navicular tuberosity
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| What position should the patient be in to feel the dorsalis pedis pulse? | Slight DF
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| What are the 5 P's of acute arterial occlusion? | Pain
Pallor
Paresthesia
Paralysis
Pulselessness
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| What vasculature can a puncture wound to the sole of the foot affect? | Deep plantar arch and it's branches
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| What is the foot deformity caused by pressure from footwear and DJD | Hallux valgus
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| What is hallux valgus characterized by? | Lateral deviation of great toe
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| What is the bursa called that forms from the pressure and friction against the shoe? | Bunion
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| What are corns? | Inflamed areas of thick skin
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| What is the foot deformity in which the proximal phalanx is permanently and markedly dorsiflexed (hyperextended) at the MTPJ and middle phalanx strongly PF at PIP? (Similar to swan neck deformity of hand) | Hammer Toe
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| What foot deformity is characterized by hyperextension of MTPJ and flexion of the DIP? | Claw toes
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| What is another name for flatfeet? | Pes Planus
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| Is pes planus normal in children under three? | Yes
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| What does it mean to have flexible flatfeet? | Flat, lacking a medial arch when WB but normal in appearance when NWB
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| What does it mean to have rigid flatfeet? | Flat even when NWB
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| What is flexible flatfeet a result of? | Loose or degenerated intrinsic ligaments (inadequate passive arch support)
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| What is rigid flatfeet a result of? | Bone deformity
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| What are acquired flatfeet (fallen arches)? | Secondary to dysfunction of TP (dynamic arch support) owing to trauma, degeneration with age or denervation
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| What is another name for clubfoot? | Talipes equinovarus
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| What is the foot deformity that refers to a foot that is twisted out of position? | Clubfoot
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| What are all types of clubfeet caused by? | They are congenital
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| Who is clubfoot more present in? | Boys
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| How is clubfoot characterized? | Foot is inverted, ankle PF, forefoot adducted
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| Where is a person with clubfoot experiencing shortness and tightness of muscles? | Medial side and posterior aspect of foot and ankle
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