Joints of Lower Limb Flashcards Preview

Anatomy - BB Exam 2 > Joints of Lower Limb > Flashcards

Flashcards in Joints of Lower Limb Deck (56)
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1
Q

angle of Wiberg

A

angle b/w vertical and the plane of the acetabular rim - decreases may indicate joint instability

2
Q

what can cause fractures of femoral neck?

A
  • high energy impacts when lower limb is extended and force of impact is transmitted to hip joint
  • osteoporosis in older people, mostly women
3
Q

what do fractures of femoral neck cause?

A
  • lateral rotation of the lower limb

- disrupted blood supply to head of femur -> aseptic vascular necrosis

4
Q

osteoarthritis of hip joint

A

pain, edema, limitation of motion, erosion of articular cartilage -> causes disability

5
Q

surgical hip replacement

A
  • metal shaft into the femur w/ bone cement to replace femoral head
  • plastic socket to replace acetabulum
6
Q

what can separation of the superior femoral epiphysis cause in children?

A

post-traumatic avascular necrosis of femoral head

7
Q

congenital dislocation of hip joint

A

inability to abduct thigh when femoral head is not properly located in acetabulum - affected limb appears shorter
-positive Trendelenburg sign

8
Q

acquired dislocation of hip joint

A

uncommon b/c articulation is strong/stable

9
Q

most common dislocation of hip joint

A

posterior dislocation - femoral head forced out of acetabulum, joint capsule ruptures inferiorly and posteriorly - causes shortening and medial rotation of limb

10
Q

what nerve may be injured in posterior dislocation of hip joint?

A

sciatic nerve

11
Q

what causes anterior dislocation of hip joint?

A

violent injury that forces the hip into extension, abduction, and lateral rotation - moves femoral head inferior to acetabulum and can cause fracture of acetabular margin

12
Q

Q angle

A

angle b/w tibia and femur

13
Q

which sex usually has larger Q angle?

A

adult females - b/c wider pelves

14
Q

what does it mean to be bowlegged?

A

genu varum - decreased Q angle that causes weight-bearing line to fall medial to center of knee
-excess stress on medial meniscus

15
Q

what does it mean to be knock-kneed?

A

genu valgum - increased Q angle that causes weight-bearing line to fall lateral to center of knee
-excess stress on lateral meniscus

16
Q

what direction does the patella almost always dislocate?

A

laterally

17
Q

what can cause abnormal tracking of the patella and chronic patellar pain?

A

imbalance of the lateral pull on the patella and the mechanisms resisting it

18
Q

patellofemoral syndrome

A

pain from repetitive microtrauma from abnormal tracking of the patella relative to the patellar surface of the femur

19
Q

most common knee injury in contact sports

A

ligament sprain

20
Q

what does a TCL tear often also result in?

A

tear of medial meniscus - b/c of firm attachment of TCL to this meniscus

21
Q

unhappy triad

A

tear of ACL, TCL, medial meniscus

22
Q

anterior drawer sign

A

free tibia slides anteriorly under the fixed femur - seen in ACL tear - tested by Lachman test

23
Q

what do PCL tears usually occur in conjunction with?

A

TCL or FCL tears

24
Q

posterior drawer sign

A

free tibia to slide posteriorly under the fixed femur - seen in PCL tears

25
Q

which meniscus usually tears?

A

medial

26
Q

pain in medial and lateral meniscus tears?

A

medial: pain on medial rotation of the tibia
lateral: pain on lateral rotation of the tibia

27
Q

why are some meniscus tears left to heal and some surgically repaired or removed?

A

only the periphery of meniscus has good enough blood supply to heal on its own

28
Q

arthroscopy of knee

A

endoscopic examination of the interior of the knee joint

29
Q

debridement

A

excision of devitalized articular cartilaginous material

30
Q

joint effusions

A

escape of fluid from blood or lymphatic vessels- causing increased fluid into joint cavity

31
Q

how is the needle inserted for aspiration of a knee joint?

A

Pt sitting on table w/ knee flexed - use three bony points for landmarks:

  • anterolateral tibial (Gerdy) tubercle
  • lateral epicondyle of the femur
  • apex of the patella
32
Q

what causes prepatellar bursitis?

A

friction b/w the skin and patella

33
Q

housemaid’s knee

A

chronic prepatellar bursitis that causes bursa to become distended w/ fluid and form a swelling anterior to knee

34
Q

what causes subcutaneous infrapatellar bursitis?

A

excessive friction b/w the skin and the tibial tuberosity

35
Q

clergyman’s knee

A

edema over the proximal end of the tibia from subcutaneous infrapatellar bursitis

36
Q

swelling in deep infrapatellar bursitis

A

b/w the patellar ligament and the tibia, superior to tibial tuberosity

37
Q

suprapatellar bursitis

A

an infection caused by bacteria entering the suprapatellar bursa from torn skin

38
Q

Baker cysts

A

popliteal cysts - abnormal fluid-filled sacs of synovial membrane in the region of the popliteal fossa
-almost always a complication of chronic knee joint effusion

39
Q

total knee replacement arthroplasty

A

insertion of an artificial knee joint in people w/ diseased knees

40
Q

what is the most frequently injured major joint in the body?

A

ankle

41
Q

most common ankle injuries?

A

ankle sprains - torn fibers of ligaments caused by inversion injuries

42
Q

what are lateral ligament sprains more common than medial ligament sprains?

A

lateral ligament is weaker than the medial ligament and is the ligament that resists inversion of the talocrural joint

43
Q

which ligament is most vulnerable and most commonly torn during ankle sprains?

A

anterior talofibular ligament (part of lateral ligament) -> instability of ankle joint

44
Q

what do shearing injuries fracture?

A

the lateral malleolus at or superior to the ankle joint

45
Q

what do avulsion fractures break?

A

malleolus inferior to the ankle joint - fragment of bone is pulled off by the attached ligaments

46
Q

Pott fracture-dislocation of the ankle

A

when foot is forcibly everted

  • torn posterior tibiofibular ligament
  • fractures fibula
  • fractured medial malleolus
47
Q

tarsal tunnel syndrome

A

entrapment and compression of the tibial nerve by the flexor retinaculum -> heel pain

48
Q

hallux valgus

A

lateral deviation of the big toe caused by pressure from footwear and degenerative joint disease
-causes bunion and hard corns (inflamed areas of thick skin)

49
Q

hammer toe

A
  • proximal phalanx is permanently and markedly dorsiflexed (hyperextended) at the MP joint
  • middle phalanx is strongly plantarflexed at prox IP joint
50
Q

claw toes

A

hyperetension of the MP joints and flexion of the distal IP joints involving lateral 4 toes

51
Q

types of pes planus

A

flexible flatfeet: flat, lacking a medial arch when weight-bearing but normal w/o weight (more common)

rigid flatfeet: flat even when not bearing weight

52
Q

cause of flexible flatfeet

A

loose or degenerated intrinsic ligaments (inadequate passive arch support)

53
Q

cause of rigid flatfeet

A

from a bone deformity, such as fusion of adjacent tarsal bones

54
Q

acquired flatfeet

A

fallen arches - likely secondary to dysfunction of tibialis posterior (dynamic arch support) from trauma, degeneration

55
Q

clubfoot

A

foot that is twisted out of position - all congenital

56
Q

common type of clubfoot

A

talipes equinovarus - involves the subtalar joint

  • foot inverted
  • ankle plantarflexed
  • forefoot is adducted (abnormally turned toward midline)