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Anatomy Final
Injuries of the thigh and hip joint
19
Anatomy
Professional
12/05/2008

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Cards

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?
Definition
1.) coxa valga
2.) coxa vara passively limits abduction of the hip
3.) 115-140 degrees
4.) 126 degrees
Term
What is the angle of anteversion?
Definition
An angle (about 45 degrees) between neck and shaft of femur where neck emerges from medial side of shaft anteromedially.
Term
What is more common, a femoral head dislocation or a femoral neck fracture? What may be endangered in each case?
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).
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?
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
Term
What causes a lesser pertrochanteric fracture?
Definition
A strong muscular pull from the iliopsoas while thigh is hyperextended and abducted.
Term
A 70 year old woman has osteoporosis. She has a grandson that plays lacrose. What fracture do they both share a propensity for?
Definition
Femoral neck fracture
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?
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.
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?
Definition
Gastrocnemius pulls sital shaft posterior.
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?
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
Term
Which ligaments prevents hyperextension of hip joint? Which one restricts abduction? Which one is the strongest ligament in the body?
Definition
1.) Iliofemoral and ischiofemoral restrict hyperextension. 2.) Pubofemoral restricts abduction. 3.) Iliofemoral is strongest ligament in body
Term
Patient cannot extend leg against resistance and presses on distal end of thigh to prevent inadvertent flexion. What is most likely wrong.
Definition
Trauma or arthritis of knee joint that damages vasuts medialis or lateralis (quadriceps)
Term
What position must the hip be forced into for the more rare anterior hip dislocation to occur?
Definition
It must be extended, abducted, and laterally rotated.
Term
What is the most common cause of medial dislocations of the hip? What can be a later complication of coxa vara?
Definition
1.) congenital 2.) avulsed epiphysis of femoral head
Term
Where is the correct location for a sciatic nerve block?
Definition
A few cm below midpoint between PSIS and greater trochanter. Lateral side is safer than medial side
Term
What nerves are affected with weak plantar flexion of foot and weak ankle jerk?
Definition
L5-S1
Term
What nerves are damaged with numbness over the dorsum of foot and weak dorsiflexion of ankle and big toe.
Definition
L4-L5
Term
What nerve has a lesion when pain is felt over the dorsum of toes 1-3 and there's difficulty walking on heels?
Definition
L5 root
Term
What nerve has a lesion if pain is felt on the lateral surface of the foot extending over dorsum and toes 4-5?
Definition
S1 root compression
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?
Definition
1. sciatica 2. straight leg test
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