NPTE Study Practice > MSK Patho LE > Flashcards

MSK Patho LE Flashcards

(48 cards)

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1
Q

Pathology of AVN of the hip

A
  • Multiple etiologies resulting in an impaired blood supply to the femoral head
  • Hip ROM decreased in flexion, IR, and abduction
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2
Q

Symptoms of AVN of the hip

A
  • Pain in the groin and/or thigh
  • Tenderness with palpation at the hip joint
  • Coxalgic gait
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3
Q

Medications for management of AVN of the hip

A
  • Acetaminophen for pain
  • NSAIDs for pain and/or inflammation
  • Corticosteroids contraindicated since they may be a causative factor
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4
Q

What might cause coxa vara/valga

A
  • Coxa vara usually results for a defect in ossification of head of femur
  • Coxa vara/valga may result from necrosis of femoral head occurring with septic arthritis
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5
Q

MOI and common symptoms of greater trochanteric pain syndrome/gluteal tendinopathy/trochanteric bursitis

A
  • MOI: excessive hip adduction and IR with weight bearing tasks
  • Pain over greater trochanter that may extend down lateral thigh
  • Worsens with laying on side, prolonged standing/walking, and stairs
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6
Q

Pathology of IT band tightness/friction disorder

A
  • Tight ITB, abnormal gait
  • Results in inflammation of trochanteric bursa
  • Noble compression test and/or Ober’s test may be positive
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7
Q

Function of the Piriformis muscle

A
  • Hip ER at <60º hip flexion
  • Hip IR and abductor at 90º hip flexion
  • Tightness or spasm of piriformis muscle can result in compression of sciatic nerve and/or sacroiliac dysfunction
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8
Q

Signs and symptoms of Piriformis syndrome

A
  • Restriction in IR
  • Pain with palpation of piriformis muscle
  • Referral of pain to posterior thigh
  • Weakness in ER, positive piriformis test
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9
Q

What are the 2 types of FAI (femoroacetabular impingement)

A
  • CAM: impingement of a large aspherical femoral head in a constrained acetabulum
  • Pincer: over-coverage of the femoral head by a prominent acetabular rim
  • Frequently associated with acetabular labral tears
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10
Q

Pathology of groin pain in athletes (sports hernia)

A
  • Common in sports requiring kicking, rapid acceleration/deceleration, & sudden change of direction
  • May be related to pathology of adductor, iliopsoas, inguinal, or pubic
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11
Q

Signs and symptoms of a sports hernia

A
  • Acute or gradual onset
  • Symptoms and painful weakness localized to structures involved
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12
Q

What are the degree classifications for knee ligament injuries

A
  • 1st degree: little or no instability
  • 2nd degree: minimal to moderate instability
  • 3rd degree: extreme instability
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13
Q

What is the “unhappy triad” of the knee

A
  • Injury to the MCL, ACL, and medial meniscus resulting from a combination of valium, flexion, and ER forces at the knee while the foot is planted
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14
Q

MOI of meniscal and articular cartilage injuries

A
  • Result from a combination of forces to include tibiofemoral joint flexion, compression, & rotation which places abnormal shear stresses on the meniscus
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15
Q

Symptoms of a meniscus/articular cartilage injury

A
  • Lateral and/or medial joint pain
  • Effusion
  • Joint popping
  • Knee giving way
  • Limitations in movement
  • Joint locking
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16
Q

Describe patella alta

A
  • Malalignment in which patella tracks superiorly in femoral intercondylar notch
  • May result in chronic patellar subluxation and also possibly patellar tendon rupture
  • Positive camel back sign (2 bumps, one being the tibial tuberosity and the other being the patella)
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17
Q

Describe patella baja

A
  • Malalignment in which patella tracks inferiorly in femoral intercondylar notch
  • Results in restricted knee extension with abnormal cartilaginous wear, resulting in DJD and also possibly quadriceps tendon rupture
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18
Q

Pathology of patellofemoral pain syndrome (PFPS)

A
  • Prescence of retropatellar or peripatellar pain
  • Reproduction of pain with squatting, stair climbing, prolonged sitting
  • Exclusion of all other conditions that may cause anterior knee pain
  • Common dysfunction that is the result of elevated patellofemoral joint loading caused by trauma, biomechanical factors, and/or muscle tightness & weakness
  • May be associated with patellar tendinopathy and/or chondromalacia patellae
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19
Q

Pathology of patellar tendinopathy/tendonosis (Jumper’s knee)

A
  • Degenerative condition of the patellar tendon typically of the deep aspect
  • May be related to overload and/or jumping activities
  • May also be interrelated to PFPS
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20
Q

What are the typical causes of pes anserine bursitis

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A
  • Typically caused by overuse or a contusion
21
Q

Which femoral condyle is most often involved in a fracture due to it’s anatomical design

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A
  • Medial femoral condyle
22
Q

Common MOI for a tibial plateau fracture

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A
  • Combination of valgum & compression forces to knee when knee is flexed
  • Often occurs in conjunction with a medial collateral ligament injury
23
Q

MOI for an epiphyseal plate fracture in the knee

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A
  • Frequently a weight bearing torsional stress
  • Presents more frequently in adolescents where an ACL injury would occur in an adult
24
Q

Most common MOI for a patella fracture

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A
  • Direct blow to patella due to a fall
25
Pathology of acute compartment syndrome
- Elevated compartment (anterior, lateral, posterior) pressure that results in local ischemic condition - Usually the result of direct trauma and/or fracture
26
What are the 6 P's of compartment syndrome
- Pain - Palpable tenderness - Paresthesia - Paresis - Pallor (unhealthy pale appearance) - Pulselessness
27
What is chronic external compartment syndrome and its symptoms
- Result of elevated compartment (anterior, lateral, posterior) pressure that restricts blood flow to muscles - Symptoms depend on compartment but anterior is most common resulting in pain in the anteriolateral leg region but may also present with paresthesia
28
Pathology of medial tibial stress syndrome
- Overuse injury of posterior tibialis and/or the medial soleus resulting in periostea inflammation at the muscular attachments - Etiology is thought to be excessive pronation - Pain elicited with palpation of the distal posteromedial border of the tibia
29
What muscles make up the triceps surae
- Soleus - Gastrocnemius - Plantaris muscles
30
Pathology of lower leg stress fractures
- Overuse injury resulting most often in micro fracture of tibia or fibula - Tibia is more commonly involved than fibula - 3 common etiologies: abnormal biomechanical alignment, poor conditioning, & improper training methods
31
What is the grading system for ankle ligament sprains
- Grade I: no loss of function, minimal tearing of the anterior talofibular ligament - Grade II: some loss of function, partial disruption of the anterior talofibular & calcaneofibular ligaments - Grade III: complete loss of function, complete tearing of anterior talofibular & calcaneofibular ligaments and partial tear of posterior talofibular ligament
32
Pathology of Achilles tendonosis/tendonopathy
- Degenerative condition of the Achilles tendon - Clinical examination including Thompson's test helps to identify this condition
33
What are the 3 fracture types of the ankle
- Unimalleolar: involves the medial or lateral malleolus - Bimalleolar: involves the medial and lateral malleoli - Trimalleolar: involves the medial & lateral malleoli and the posterior tubercle of the distal tibia
34
Pathology of tarsal tunnel syndrome
- Entrapment of the posterior tibial nerve or one of its branches within the tarsal tunnel - Over/excessive pronation, overuse problems resulting in tendonitis of the long flexor & posterior tibialis tendon, & trauma may compromise space in the tarsal tunnel
35
Symptoms of tarsal tunnel syndrome
- Pain, numbness & paresthesias along the medial ankle to the plantar surface of the foot
36
What population is flexor hallucis tendonopathy commonly seen in
- Commonly seen in ballet performers
37
How is a pes cavus (hollow foot) deformity observed
- Increase height of longitudinal arches - Dropping of anterior arch - Metatarsal heads lower than hind foot - Plantar flexion and splaying of forefoot - Claw toes
38
Pathology of equinus
- Etiology can include congenital bone deformity, neurological disorders ( Cerebral palsy), contracture of gastrocnemius and/or soleus muscles, trauma, or inflammatory disease - Deformity observed is a PF foot - Compensation 2ndy to limited DF includes subtalar or midtarsal pronation
39
Pathology of hallux valgus
- Etiology is varied to include biomechancial malalignment (excessive pronation), ligamentous laxity, heredity, weak muscles, & footwear that is tight - Observed deformity: medial deviation of head of 1st metatarsal from midline; metatarsal & base of 1st phalanx move medially while distal phalanx then moves laterally
40
What is a normal metatarsophalangeal angle
- 8-20º
41
What are the Salter-Harris Fracture Classifications for the foot/ankle
- Type I: entire epiphysis; very few complications to growth of bone - Type II: entire epiphysis & portion of metaphysis; may cause decreases bone growth but limited negative impact on long-term function - Type III: portion of the epiphysis; may lead to long-term problems 2ndy to fracture - Type IV: portion of epiphysis & portion of metaphysis; may lead to deformity of the joint - Type V: compression injury of the epiphyseal plate; poor functional prognosis
42
Etiologies of metatarsalgia
- Mechanical: tight triceps surae group and/or Achilles tendon, collapse of transverse arch, short 1st ray, pronation of forefoot - Structural changes in transverse arch possible leading to vascular and/or neural compromise in tissues of forefoot - Changes in footwear
43
What is the frequently heard complaint with metatarsalgia
- Pain at 1st and 2nd metatarsal heads after long periods of weight bearing
44
Pathology of Charcot-Marie-Tooth disease
- Slowly progressive disorder with varying degrees of involvement depending on degree of genetic dominance - Peroneal muscular atrophy that affects motor and sensory nerves - May begin in childhood or adulthood - Initially affects muscles in lower leg/foot and progresses to muscles of the hands/forearms
45
Deformity observed with rear foot varus (subtalar varus, calcaneal varus)
- Abnormal mechanical alignment of tibia, shortened rear foot soft tissues, or malunion of calcaneus - Rigid inversion of calcaneus when subtalar joint is in neutral position
46
Pathology of rearfoot valgus
- Abnormal mechanical alignment of the knee (genu varum) - Deformity observed: eversion of calcaneus with a neutral subtalar joint - Due to increased mobility of hind foot, fewer musculoskeletal problems develop form this deformity than with rear foot varus
47
Pathology of forefoot varus
- Congenital abnormal deviation of head and neck of talus - Deformity observed: inversion of forefoot when subtalar joint is in neutral
48
Pathology of forefoot valgus
- Congenital abnormal development of head and neck of talus - Deformity observed: eversion of forefoot when the subtalar joint is in neutral
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