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Anatomy LE Blue Pages
Blue Pages from Moore Clinically Oriented Anatomy
82
Anatomy
Graduate
09/12/2016

Additional Anatomy Flashcards

 


 

Cards

Term
Epiphysial Plates
Definition

discs of hyaline cartilage b/w metaphysis and epiphysis of mature long bone that permits bone to grow longer

 

Term
Hip Fracture
Definition

Term for fractures to femoral head, neck or trochanters

 

Occur @ apophyses (bony projection that lacks secondary ossification center)

 

Avulsion factures

Term
Coxa Vara of Hip
Definition

Angle of Inclination b/w long axis of femoral neck and shaft is DECREASED, >15 degrees

 

knock kneed

Term
Coxa Valga of Hip
Definition

Increased angle of inclination

 

Knock-kneed

Term
Dislocated Epiphysis of Femoral Head
Definition

In older children and adolescence

 

Epyphysis of femoral head may slip away from femoral neck because of weakened ephiphysial plate

 

Slowly results in progressive coxa vara

Term
Femoral Fractures
Definition

Neck most frequently fractured (lies at angle to pull of gravity)

 

Proximal femoral fractures = direct trauma

 

Inferior/distal femur = result in missalignment of knee joint, comproise blood supply to leg, can hemmorage popliteal artery

Term
Tibial Fractures
Definition

Tibial shaft narrowest @ middle and inf 1/3 junction (area has poorest blood supply)

Because bone is subcutaneous, site common for compound fracture

Transverse march fracture = stress fracture, common in people who take long hikes before being conditioned

Term
fractures of epiphysial plates
Definition

continued normal growth of bone compromised

 

may cause inflammation of tibial tuberosity and chronic recurring pain

 

OSGOOD-SCHLATTER disease

Term
Fibular Fractures
Definition

occur 2-6 cm proximal to distal end of lateral malleolus

 

associated w/ fracture-dislocations of ankle joint

 

foot forced into excessive inverted position, ankel ligs tear forcibly tilting talus against lateral malleolus and may shear it off

Term
Bone Grafts
Definition

Fibula is common source (neutrient artery and periosteum are generally removed with piece of bone so graft can grow)

 

remaining fib does not regenerate

 

Anterior tib is subcutaneous so it is accessible for obtaining bone for grafting in children

Term
Calaneal Fractures
Definition

often comminuted fracture

 

disabeling because it disrupts subtalar joint

Term
Fracture of Talar Neck
Definition
occur during severe dorsiflexion of ankle
Term
Fracture of Metatarsals
Definition

occur from crushing

 

common in dancers

 

fatigue fractures can happen from prolonged walking

 

foot suddenly and violently inverted, tuberosity of 5th MT may be avulsed by fibularis brevis

Term
Os Trigonum
Definition

during ossification of talus, secondary ossification center (which becomes lateral tubercle of talus) fails to unite w/ body of talus

 

fully ossified center may fracture and progress to non-union

 

occurs in 14- 25% of adults

Term
Hip and Thigh Contusions
Definition

"hip pointer" = contusion of iliac crest that occurs @ ASIS, can also mean avulsion of bony m. attachments

 

contusions cause bleeding from ruptured cappilaries and infiltration of blood into m. tend, and soft tissue

 

"charley horse" : cramping of thigh muscle because of ischemia or contusion forms hematoma -- most common site of thigh hematoma is in quadriceps

Term
Psoas Abscess
Definition

abscess passes b/w psoas and its fascia to inguinal and prox thigh regions, severe pain is refered to hip, thigh or knee

 

edema occurs in proximal part of thigh

Term
Paralysis of Quariceps
Definition
leg doesnot extend against resistancce and person usually presses on distal end of thigh during walking to prevent inadvertent flexion of knee
Term
Chondromalacia Patellae
Definition

common for runners

 

soreness and aching around or deep to patella from quadriceps imbalance

Term
Patellar Fractures
Definition
Transverse patellar fractures from blow to knww or sudden contration of quadriceps
Term
Abnormal Ossification of Patella
Definition

patella is cartilagenous @ birth

 

ossifies during 3rd - 6th years

 

more than one ossification center, if they do not join you can have a bipartite or tripartite patella

 

ossification abnormalities are almost always bi lateral

Term
Patellar Tendon Reflex
Definition

Tendon's reflex tests the integrity of the femoral n. and the L2 - L4 spinal cord segments

 

Dimunition or abscence of patellar tendon reflex may result from leision that interrupts innervation of quadriceps

 

 

Term
Transplantation of Gracillis
Definition

Gracillis is relativly weak and can be removed w/o noticable loss of action on leg

 

can be transplanted to replace damabed muscle (often in hand)

 

can also be relocated and repositioned to replace nonfunctional external anal sphincter

Term
Groin Pull
Definition
involves flexor and adductor thigh m.s  who have proximal attachments in groin region
Term
Injury to Adductor Longus
Definition
Muscle strains of adductor longus may occur in horseback riders "rider's strain"
Term
Palpation, Compression and Cannulation of Femoral Artery
Definition

femoral pulse can be palpated w /person in supine b/w ASIS and pubic symphysis

 

normal pulse is strong

 

if common or external iliac arteries are partially occluded, pulse may be diminished

Term
Laceration of Femoral Artery
Definition

anastomosis of branches of femoral a. w/ other a.s that cross hip joint may supply blood to lower limb

 

cruciate anastomosis is 4 way common meeting of medial and lateral circumflex femoral a. w/ inf gluteal artery and 1st perforating artery

Term
Saphenous Varix
Definition

localized dialation of terminal part of great saphenous vein

 

may cause edema in femoral triangle

 

should be considered w/ other varicsoe veins present in lower limb

Term
Cannulation of Femoral Vein
Definition
To secure blood samples from chambers of r. side of heart and/or pulmonary artery long cathter inserted into femoral vein as it passes through femoral triangle
Term
Femoral Hernias
Definition

"femoral ring" is usual originating site for femoral hernia

 

initally small because it is contained in fascia but it can travel posteriorly to saphenous opening

 

more common in females because of wider pelvis

Term
Replaced or accessory obturator artery
Definition

 enlarged pubic branch of inferior epigastric artery takes place of obturator artery (replaced)

 

or

 

joins obturator a. as accessory obturator artery

 

in 20 % of people

Term
Trochanteric Bursitis
Definition

inflammation of trochanteric bursa

results from repetitive actions

movements involve glut max and move over superior tendinous fibers repeatedly back and forth over bursae of greater trochanter

 

causes deep diffuse pain in lat thigh

Term
Ischial Bursitis
Definition

fricition bursitis resulting from excessive friction b/w ischial bursae and ischial tuberosities

 

pain over bursae, and increasing pain w/ mvmnt of glut max

 

CALCIFICATION can occur with chronic bursitis

Term
Hamstring Injuries
Definition

commin in runners and kickers

 

tears proximal tendinous attachments of hamstrings to ischial tuberosity

 

2x as common as quad strains

 

avulsion fractures can occur @ prox attach of semi tendinosus and biceps femoris

Term
Injury to Superior Gluteal N
Definition

in standing on one leg, pelvis drops on opp side (positive Trendelenburg test

results in characteristic motor loss resulting in disabling glut med limp to compensate for weakened abd of thigh

or

gluteal gait: compensatory list of body to weakened sd

medial rotation is also impaired

gluteal gait (waddling)

steppage gait

swing-out gait (compinsate for foot drop)

Term
Trendelenburg's Test
Definition

caused by

 

paralysis of superior gluteal n.

 

fracture of greater trochanter

 

dislocation of hip

 

"hip drop when standing on one leg"

Term
Anesthetic Block of Sciatic N
Definition
injection point a few cm inferior to midpoint of line joining PSIS and superior border of greater trochanter
Term

Injury to Sciatic N

 

Definition

"piriformis syndrome" compression of siatic by piriformis

women are more likely to have p syn

 

complete section of sciatic n in uncommon but if it happens, leg is useless - ext of hip impaired, flexion of leg impaired, all ankel and foot mvmnts lost

Term
Intragluteal Injections
Definition

m. are thick, lg, and provide substantial volume for absorption of injected substances by intramuscular veins

 

safe only in superior lateral quadrant of butt or on anterolateral part of thigh into tensor fascia latae

Term
Popliteal Abscess and Tumor
Definition

deep pop fascia is strong and limits expansion of abscess or tumor

 

pain is severe

 

spreads superiorly and inferiorly because of toughness of poplitieal fascia

Term
Poplitieal Pulse
Definition
Weakening or loss of popliteal pulse is sign of femoral artery obstruction
Term
Popliteal Aneuryms and Hemmorhage
Definition

causes edema in popliteal fossa

ID'd with stethoscope

pain refered to skin overlying medial aspect of calf, ankle or foot

can be caused by fractures of femur and joint capsule

"arteriovenous fistula" communication b/w artery and vein

 

 

Term
Injury to Tibil N.
Definition

uncommon because it is deep

injured by deep lascerations to popliteal fossa or posterior dislocation of knee joint

 

unable to plantarflex ankle or flex toes

 

loss of sensation on sole of foot

 

Term
Containment and Spread of Compartmental Infections of Leg
Definition

suppuration: "formation of pus" increases intracompatmental pressure

 

spread in didstal direction

purulent (pus forming) infection in lateral compartment of leg can ascend proximally into pop fossa

 

fasciotomy may be necessary to relieve pressure and debride

Term
Tibialis Anterior Strain (shin splints)
Definition

result from repeated microtrauma of ant tib

 

causes small tears in periosteum

 

mild form of the anterior compartment syndrome

Term
Injury to Common Fibular N. and Footdrop
Definition

common fib n is most often injured in lower limb

 

results in flacid paralysis of all m in ant and lat compartments of leg

 

causes foot drop

 

waddling gait (hip hiking), swing-out gait (swung laterally to clear toes), high-steppage gait (hip and knee raise)

Term
Deep Fibular Nerve entrapment
Definition

can be caused by tight shoes

 

pain in dorsum of foot and radiates to web space in b/w 1st and 2nd toes

Term
Superficial Fibular N Entrapment
Definition

chronic ankle sprains may produce recurrent streching of s.f.n.

 

pain along lat sd of leg and the dorsum of ankle and foot

 

numbness and parasthesia present and increases w/ activity

Term
Fabella in Gastroc
Definition

"fabella" sesamoid bone close to lat head of gastroc prox attachment.

 

fabella articulates w/ lateral femoral condyle

 

found in 3-5% of people

Term
Calcaneal Tendinitis
Definition

Inflammation of calcaneal tendon

 

foud in 9 - 18% of running injuries

Term
Ruptured Calcaneal Tendon
Definition

gap is palpable

 

most severe acute m. problem of leg

 

individuals cannot plantarflex against resistance, can't raise onto heel and balance

passive dorsiflexion is excessive!! (normally only 20 degrees)

Walking only possible when limb is laterally rotated

Term
Calcaneal Tendon Reflex
Definition

tests S1 and S2 n. roots

 

if S1 nerve root is injured or ompressed, ankle reflex is virtually absent

Term
Absence of Plantarflexion
Definition
those attempting to walk w/out PF rotate foot as far laterally as possible during stancce phase to disable passive dorsiflexion and allow more effective pushoff through hip and knee extension exerted @ midfoot
Term
Accessory Soleus
Definition

present in approx 3% of people

 

appears as distal belly medial to calcaneal tendon

 

associated w/ pain and swelling during prolonged exercise

Term
Posterior Tibial Pulse
Definition

palpated b/w post surface of medial malleolus and medial border of calcaneal tendon

 

helps find "occlusive peripheral arterial disease"

Term
Plantar Fasciitis
Definition

inflammation of plantar fascia caused by an overuse mech

 

most common hindfoot problem in runners

 

Term
Plantar Reflex
Definition
Slight fanning of lateral four toes and dorsiflexion of great toe is abnormal response = babinski sign, indicates brain injury or cerebral disease (not in infants)
Term
Signs of Acute Arterial Occclusions
Definition

Pain

Pallar

Parasthesia

Paralysis

Pulselessness

Term
Bipedalism and congruity of articular surfaces of hip joint
Definition

hip joint most stable when bearing weight

angle of wiberg - decreases in degree to which ilium overlies femoral head - may indicate joint instability

 

rarely is more than 40% of available articular surface of femoral head in contact with acetablulum

Term
fractures of femoral neck
Definition

uncommon in people less than 40, only result from high-energy impact

most common in people over 60, mostly women

 

often intracapsular and realighnment of neck fragments require internal fixation

cause lateral rotation of lower limb and often dissrupt blood supply to head of femur

Term
Necrosis of Femoral Head in Children
Definition

Trauma to hip - dislocaations - disrupt artery to head of femur

 

inadequate blood supply to femoral head

 

results in incongruency of joint surfaces and growth at epiphysis is slowed

most common in children 3-9 y.o.

Term
Congenital dislocations of hip
Definition

common in neonates, occurs bilaterally, 8 x more in girls than boys

effected limp acts and appears shorter

results in positive trendelenbergs test

Term
Acquired dislocation of hip
Definition

uncommon

may occur durring automobile accident when hip is flexed, abducted and medially rotated (riding in car)

Term
Posterior dislocations of hip
Definition

MOST COMMON

may effect sciatic nerve which can result in paralysis of hamstrings and m.'s distal to knee supplied by sciatic n.

Term
Anterior dislocations of hip
Definition

results from violent injury that forces hip into ext, abd and lat rotation (catching ski tip when skiing)

 

acatabular margin often fractures producing a fracture - dislocation of the hip joint

Term
Genu Valgum and Genu Varum
Definition

Valgum = knees together, tibial collateral lig overstreched, beight hearing falls lateral to center of knee, excess stress on lateral condyles, patella pulled even further laterall

 

Varum = femur abnormally vertical, q angle is small, bowleged, weighbearing in medial knee, fibular collateral lig is overstreched

Term
Patellar Dislocation
Definition

nearly always dislocates laterally

 

more common in woman due to Greater Q angle (represents pull of quadriceps)

Term
Patellofemoral Syndrome
Definition

repetitive microtrauma caused by abnormal tracking of patella relative to patellar surface of femur or direct blow or osteoarthritis

Corrected by strengthening of Vastus Medialis

weakness of vastus med predisposes individual to patellofemoral dysfunction and patellar dislocation

Term
Ligament Sprain of Knee
Definition

Most common knee injury

occurs when foot is fixed on ground

tearing of TCL also results in tearing of medial meniscus

Can also tear the ACL

Term
ACL Tears
Definition

hyperextension and severe force directed anteriorly against femur w/ knee semiflexed may tear ACL

 

causes free tibia to slide anteriorly under fixed femur "anterior drawer sign" - lachman test

 

tears comm in midportion of ligament

Term
PCL Tears
Definition

occur when player lands on tibial tuberosity w/ knee flexed

occur in conjunction w/ tib or fib lig tears

 

PCL ruptures allow free tibia to slide posteriorly under fixed femur (posterior drawer syndrome)

Term
Meniscal tears
Definition

usually on medial meniscus (laerial is more mobile, less tears)

pain on lateral rotation = lateral meniscus tear

pain on medial rotation = medial meniscus tear

 

most occur w/ ACT or TCL tears

can be repaired or heal w/ good blood supply, but w/out they are removed

Term
Aspiration of Knee Joing
Definition
Fractures of distal end of femur or lascerations of anterior thigh may involve suprapatellar bursa and result in infection of knee joint
Term
Bursitis in Knee Region
Definition

Prepatellar bursitis (friction b/w skin and patella)

Subcutaneous infrapatellar bursitis (skin and tibial tuberosity)

Deep intrapatellar bursitis (patellar ligament and tibia)

Suprapatellar bursitis (infection caused by bacteria entering suprapatellar bursa from torn skin)

Term
Poplitieal Cysts
Definition

fluid filled sac of synovial membrane in region of popliteal fossa

almost always complication of chronic knee joint effusion

can be large, extending as far as mid calf

 

may interfere w/ knee movements

Term
Ankle Injuries
Definition

ANKLE IS MOST COMMONLY INJURED MAJOR JOINT IN BODY

 

ankle sprains are the most common

Term
Ankle Sprain
Definition

Almost always INVERSION injury

Lateral Ligament sprains, lat lig is much weaker

anterior talofibular ligament is most vulnerable and most commonly torn during ankle sprains

Calcaneofibular ligament may also be torn

in severe sparins, lateral malleolus can be fractured

avulsion fractures can happen

Term
Medial (eversion) sprain of ankle
Definition

less common

Pott fracture dislocation: foot is forcibly everted

pulls on extreemly strong medial ligament

often causes tri-malleolar fracture

 

Term
Tibial N. Entrapment
Definition

occurs w/ edema and tightness in ankle involving synovial sheaths of tendons of m.s in post compartment

 

TARSAL TUNEL SYNDROME

occurs b/w medial malleolus to calcaneus

Term
Hallux Valgus
Definition

caused by pressure from footwear and degenerative joint disease

characterized by lateral deviation of great toe (can overlap 2nd toe)

Decreases medial longitudinal arch

 

inflamed bursae called BUNION

CORNS: inflamed thick skinalso form over interphalengeal jts, pinki

Term
Hammer Toe
Definition

prox phalanx permanetly dorsiflexed@ MTP joint

middle phalanx strongly plantar flexed @ PIPJ

Distal phalanx often hyperextended

 

may resuslt from weakness of lumbercal and interosseous m. which flex MTP jts and extend IP joints

Term
Claw Toes
Definition

hyperextension of mtp joints

flexion @ distal IP joints

 

Lateral 4 toes

 

Term
Pes Planus (Flatfeet)
Definition

flat foot normal @ age 3

flexible (normal whn not WB) or rigid (flat when not WB)

flexible = more common - results from loose or degeneraged intrinsic ligaments

rigid = bone deformity

"aquired flatfeet" (fallen arches) secondary to dysfunctiono of tibialis posterior

Common in old folks w/ a lot of standing or wgt gain

 

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