Term
| What is an increase in the angle of between the head and neck of the femur called? What is a decrease called & what does it passively limit? What is the normal range? What is the mean? |
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Definition
1.) coxa valga
2.) coxa vara passively limits abduction of the hip
3.) 115-140 degrees
4.) 126 degrees |
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Term
| What is the angle of anteversion? |
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Definition
| An angle (about 45 degrees) between neck and shaft of femur where neck emerges from medial side of shaft anteromedially. |
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Term
| What is more common, a femoral head dislocation or a femoral neck fracture? What may be endangered in each case? |
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Definition
1.) femoral neck fracture is more common
2.) medial & lateral circumflex arteries along with branches of obturator artery (blood supply to head and neck of femur) in either case (medial circumflex femoral most important). |
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Term
| What are the types of femoral neck fractures, Which one(s) is/are intracapsular, How long does each take to heal, & Where is the location of the fracture? |
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Definition
1.) Subcapital fractures- intracapsular, (healing time not mentioned), below head of femur.
2.)transcercial fracture- intracapsular, healing time depends on any arteries that may have been lacerated, transects neck of femur
3.) pertrochanteric- extracapsular (?), healing time (?), fracture of greater trochanter or lesser.
4.) Intertrochanteric- extracapsuler most of the time, 2-4 months healing time, between lesser and greater trochanters.
5.) spiral fracture- healing from 20 weeks to one year and may be broken into several pieces |
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Term
| What causes a lesser pertrochanteric fracture? |
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Definition
| A strong muscular pull from the iliopsoas while thigh is hyperextended and abducted. |
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Term
| A 70 year old woman has osteoporosis. She has a grandson that plays lacrose. What fracture do they both share a propensity for? |
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Definition
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Term
| What happens to the upper and lower halves of the femoral shaft when the upper 1/3 is fractured? When the middle 1/3 is fractured? When the lower segment is fractured? |
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Definition
1.) Proximal fragment pulled anteriorly, rotated laterally, and abducted.
2.) proximal segment lies abducted (lateral) to distal segment
3.) proximal part adducted and medial to distal fragment. |
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Term
| Why does the distal segment of the femoral shaft displace posteriorly after a supracondylar fracture? What type of fracture results in separation of distal articular surfaces? |
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Definition
| Gastrocnemius pulls sital shaft posterior. |
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Term
| What are all the muscles of the hip joint act by flexion? of extension? of abduction? of adduction? of lateral rotation? of medial rotation? |
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Definition
1.) flexion- iliopsoas (iliacus and psoas); sartorius; tensor fascia lata; rectus femoris; pectineus; all adductors (anterior part of magnus).
2.) extension- gluteus maximus; hamstrings (long head of biceps femoris, semitendonosis, semimembranosus); and adductor magnus (posterior part)
3.) abduction- gluteus medius and minimus and tensor fascia lata.
4.) adduction- pectineus; gracilis; obturator externus; all adductors
5.) Lateral rotation- piriformis; obteratus internus and externus; both gemelli; quadratus femoris; and gluteus maximus
6.) medial rotation- gluteus medius, gluteus maximus, & tensor fascia lata |
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Term
| Which ligaments prevents hyperextension of hip joint? Which one restricts abduction? Which one is the strongest ligament in the body? |
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Definition
| 1.) Iliofemoral and ischiofemoral restrict hyperextension. 2.) Pubofemoral restricts abduction. 3.) Iliofemoral is strongest ligament in body |
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Term
| Patient cannot extend leg against resistance and presses on distal end of thigh to prevent inadvertent flexion. What is most likely wrong. |
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Definition
| Trauma or arthritis of knee joint that damages vasuts medialis or lateralis (quadriceps) |
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Term
| What position must the hip be forced into for the more rare anterior hip dislocation to occur? |
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Definition
| It must be extended, abducted, and laterally rotated. |
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Term
| What is the most common cause of medial dislocations of the hip? What can be a later complication of coxa vara? |
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Definition
| 1.) congenital 2.) avulsed epiphysis of femoral head |
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Term
| Where is the correct location for a sciatic nerve block? |
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Definition
| A few cm below midpoint between PSIS and greater trochanter. Lateral side is safer than medial side |
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Term
| What nerves are affected with weak plantar flexion of foot and weak ankle jerk? |
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Definition
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Term
| What nerves are damaged with numbness over the dorsum of foot and weak dorsiflexion of ankle and big toe. |
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Definition
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Term
| What nerve has a lesion when pain is felt over the dorsum of toes 1-3 and there's difficulty walking on heels? |
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Definition
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Term
| What nerve has a lesion if pain is felt on the lateral surface of the foot extending over dorsum and toes 4-5? |
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Definition
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Term
| What may be the cause of sudden, dramatic, and frequent pain, especially when performing actions such as bending over? How does a doctor check for this lesion? |
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Definition
| 1. sciatica 2. straight leg test |
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