Anatomy Test 4: Clinical

Front 1

Symptoms of Osteoarthritis

Back 1

characterized by pain, edema, limited movement
erosion of articular cartilage

Front 2

Hip Replacement

Back 2

metal prosthesis can replace femoral head and neck
plastic or teflon socket to replace acetabulum

Front 3

Hip/Thigh contusion

Back 3

bleeding from ruptured capillaries
infiltration of blood into muscles, tendons, and soft tissue

Front 4

Hip Pointer

Back 4

contusion of iliac crest
can also be an avulsion of bony muscle attachments (avulsion fracture)

Front 5

Charley Horse

Back 5

cramping of thigh muscles because of Ischemia (low blood amount)

Front 6

Epiphysis of femoral head

Back 6

head slips away from neck due to weakened epiphyseal plate
caused by acute trauma or repetitive microtraumas

Front 7

Loss of blood supply to Femoral Head

Back 7

avascular necrosis may occur
can be caused by compression of head or slippage of epiphyseal plate

Front 8

Congenital Dislocation of Femoral Head

Back 8

femoral head slips out of joint
much more common than acquired dislocation
car accident injury where hip is flexed, adducted, medially rotated and knew strikes dash board

Front 9

Superior Gluteal Nerve Injury

Back 9

more loss w/ weakened abduction of thigh
compensation by moving center of gravity over supporting limb, impairing medial rotation of thigh

Front 10

Trendelenburg Test

Back 10

patient w/ paralysis of sup. gluteal N asked to stand on one leg
pelvis on unsupported side descends, indication loss of function
may also be fracture of greater trochanter

Front 11

Sciatic Nerve Block

Back 11

result of injection of anesthetic agent inferior to midpoint of PSIS and greater trochanter
paresthesia can radiate inferior to foot

Front 12

Sciatic Nerve Injury
"Piriformis Syndrome"

Back 12

compression by Piriformis, resulting in pain in buttocks
common in those that use gluteus (climbers, cyclists)
often runs THROUGH piriformis, becoming entrapped

Front 13

Complete loss of Sciatic Nerve

Back 13

leg is useless, extension and flexion of hip is impaired
no movement of ankle possible

Front 14

Injections of Gluteal Region

Back 14

safe side=lateral side
danger side=medial side
sciatic nerve on medial side
always inject Sup. to line b/t PSIS and greater trochanter

Front 15

Herniated Nucleus Puplposes
HNP

Back 15

lower back pain and motor weakness of lower limbs

Front 16

Myelography for HNP

Back 16

contrast injected into theca sac b/t L2-3
outlines of lower SN can be seen

Front 17

Herniation of Disc

Back 17

through anterior annulus
may or may not pass through posterior longitudinal ligament

Front 18

Symptoms of Herniated Disc

Back 18

movement of area where herniation is causes pain
secondary increased pressure of spinal fluid through coughing, sneezing can cause pain

Front 19

Sciatica

Back 19

irritation of SN root from L4-S3
painful sensory disturbance from buttock to lateral thigh
can cause reflex loss, weakness

Front 20

L5-S1 herniation:
regions of pain

Back 20

sciatic (back of leg, buttock)
weak plantar flexion and achilles tendon reflex

Front 21

L4-L5 herniation:
regions of pain

Back 21

numbness over dorsum of foot
weak dorsiflexion of ankle and big toe

Front 22

L5 root compression:
regions of pain

Back 22

pain over dorsum of toes 1-3
no knee jerk reflex

Front 23

S1 root compression:
regions of pain

Back 23

pain on lateral surface of foot to dorsum of toes 4-5
weakness of foot flexion

Front 24

Radicular Pain Onset

Back 24

can be sudden, shooting pain down buttocks, leg

Front 25

Radicular Pain Position

Back 25

flexed and leaned toward side of pain
hip and knee flexed when standing
reduces stretch of sciatic nerve

Front 26

Straight Leg Test

Back 26

used to assess radicular pain and HNP
lies flat on back with leg/knee fully extended
leg is slowly raised
pain will present on back of leg if positive

Front 27

Femur neck: angle of inclination

Back 27

normally around 126 degrees
varies w/ age and gender

Front 28

Femur neck angle of inclination:
Coxa Valga

Back 28

increase in angle of inclination
allows greater mobility
increases strain on neck of femur

Front 29

Femur neck angle of inclination:
Coxa Vara

Back 29

decrease in angle of inclination
causes shortening of lower limb
limits abduction

Front 30

angle of Anteversion (forward tilting)

Back 30

occurs b/t neck and shaft

Front 31

Femoral Neck Fractures

Back 31

can result from traumatic force to foot or ankle
rare in contact sports due to young age of participants

Front 32

Femoral Neck Fractures:
Subcapital

Back 32

completely intracapsular (within capsule)
can endanger blood supply of femoral head

Front 33

Femoral Neck Fractures:
Transcervical

Back 33

transects neck of femur
intracapsular, along a line that crosses mid neck of femur
can cause capsular tear involving medial and lateral circumflex aa

Front 34

Femoral Neck Fractures:
Pertrochanteric Fractures

Back 34

through trochanter
Greater: direct blow or strong muscular pull
Lesser: result from strong pull of Iliopsoas during abduction

Front 35

Femoral Neck Fractures:
Intertrochanteric

Back 35

b/t greater and lesser trochanters
"extracapsular"
fast healing, due to well nourished spongy bone

Front 36

Importance of Medial Circumflex Artery

Back 36

supplies blood to head and neck of femur
often torn when femoral neck is fracture or hip dislocated

Front 37

Femoral Shaft Fractures:
General Features

Back 37

very long heal time, up to one year
displacement of bones depends on muscular pulls

Front 38

Femoral Shaft Fractures:
Upper 1/3

Back 38

proximal fragment pulled anterior, rotated lateral, and abducted

Front 39

Femoral Shaft Fractures:
Middle 1/3

Back 39

proximal fragment segment abducted, causing it to lateral to distal segment

Front 40

Femoral Shaft Fractures:
Lower 1/3, Supracondylar

Back 40

gastrocnemious pulls shaft, displacing distal segment posteriorly

Front 41

Femoral Shaft Fractures:
Lower 1/3, Intracondylar

Back 41

T-Type
two distal articular surfaces of femur are separated

Front 42

Retroperitoneal Pyogenic infection of abdomen

Back 42

if pus passes b/t psoas and fascia to inguinal/thigh region
pain can refer to hip, thigh, or knee joint
could be result of edema of proximal thigh

Front 43

Paralyzed Quadraceps Femoris

Back 43

cant extend leg against resistance
inadvertent flexion of knee can occur during walking

Front 44

Innervation of Biceps Femoris

Back 44

both heads have different innervating branches of the psiatic N
injury can paralyze one head but not the other

Front 45

Hamstring Length Variation

Back 45

Short: can prevent from touching toes when knees are straight
Long: easily touch toes, can do high kicks

Front 46

Hamstring Injuries

Back 46

common in sports with strong muscular exertion
can cause tearing of proximal tendinous insertions from ischial tuberosity

Front 47

Tear of Proximal Tendinous Insertion of Hamstring

Back 47

more common than quadriceps strains
usually accompanied by contusion/tearing of muscle fiber and rupture of blood vessel
can result from inadequate warmup

Front 48

Hurdlers Injury
Avulsion of tuberosity at Proximal attachment of Biceps Femoris and Semitendinosus

Back 48

results from forcible flexion of hip with knee extended (ball kicking)

Front 49

Adductor Longus Strain
"Riders Strain"

Back 49

Ossification of accessory bone may occur in tendons due to great Adduction of Thigh

Front 50

Femoral Artery Palpation

Back 50

can occur w/ supine patient
inferior to midpoint of inguinal ligament
can also compress here

Front 51

Cannulation of Femoral Artery

Back 51

occurs at base of Femoral Triangle
for left cardinal angiography, catheter is inserted into femoral artery, then run up to heart

Front 52

Areas of Vulnerability of Femoral Artery

Back 52

very superficial in femoral Triangle

Front 53

Aberrant Obturator Artery

Back 53

closely related to free margin of lacunar ligament and neck of a femoral hernia
must be careful during endoscopic repair of hernia for this common variant

Front 54

Femoral Hernia

Back 54

appears as mass in the femoral triangle
can pass inferiorly into saphenous opening
strangulation can occur through femoral ring

Front 55

Ankle Sprain

Back 55

torn ligaments
common at Talocrural joint (no side-side motion)

Front 56

Eversion Ankle Sprain

Back 56

medial malleolus usually broken before tearing deltoid ligament

Front 57

Inversion Ankle Sprain

Back 57

most often anterior talofibular ligament
most common type of sprain

Front 58

High ankle sprain

Back 58

tear of the anterior tibiofibular ligament
takes longer to heal

Front 59

Plantar Fasciitis

Back 59

pain in the plantar aponeurosis, may involve inflammation
thought to be an overuse injury
worse at beginning of day, better in middle, worse at end

Front 60

Stress Fracture

Back 60

calcaneal stress fracture may present as plantar fasciitis

Front 61

Infection of Central Compartment of Foot

Back 61

the thick plantar aponeurosis can cause internal pressure to form in infection rather than external swelling

Front 62

Accessory Bones of the Feet

Back 62

fairly common, often asymptomatic
most common are accessory naviculars, can cause chronic or acute pain

Front 63

Auricular Tags and Ear Pits

Back 63

absence of 1 or more hillocks (Treacher Collins Syndrome) causes malformation of auricle
failure to fuse completely may result in "ear pit" (prearicular cyst)

Front 64

Insufficient Migration of Neural Crest Cells:
First Arch-Teacher-Collins Syndrome

Back 64

underdeveloped zygomatic and mandible bone
hearing loss from underdeveloped malleus and incus
malformed external ear

Front 65

Insufficient Migration of Neural Crest Cells:
First Arch-Robin Sequence

Back 65

underdeveloped mandible
tongue posteriorly placed in mouth
unfused palate
ear malformation

Front 66

Deletion of Chromosome 22 long arm:
DiGeorge Syndrome

Back 66

cardiac defects, conotruncal malformation
abnormally wide face
cleft palate
hypocalcemia

Front 67

Deviated Septum

Back 67

usually result of injury
can obstruct breathing
can lead to sinusitis

Front 68

What is the overlying factor in facial and palatal defects in Development?

Back 68

failure of neural crest cells to migrate or proliferate

Front 69

Cleft Lip General Features

Back 69

more common in men, left side, and asian descent
Orbicularis oris muscle fibers curve upward in parallel to cleft, rather than ending at angle to it

Front 70

Cleft Lip: Unilateral

Back 70

maxillary prominence and medial nasal prominence fail to fuse

Front 71

Cleft Lip: Bilateral

Back 71

result of anterior displacement of intermaxillary segment

Front 72

Cleft Palate: Anterior

Back 72

anterior to incisive foramen
may split maxilla from premaxilla all the way up

Front 73

Cleft Palate: Posterior

Back 73

posterior to incisive foramen
-palatine shelves too small to fuse
-palatine shelves fail to elevate
-Tongue doesnt drop and palatine shelves cant fuse

Front 74

Facial Clefts:
Median Cleft Lip

Back 74

bifid nose and lip
result of Shh mutation
can also have CNS problems: no fusion of lateral ventricles of brain

Front 75

Facial Clefts:
Lower Cleft Lip

Back 75

can result from Van Der Woude Syndrome, failure of 1st arch to form

Front 76

Facial Clefts:
Oblique Facial Cleft

Back 76

maxillary process doesnt fuse w/ lateral nasal process
cleft occurs along course of nasolacrimal duct

Front 77

Facial Clefts:
Lateral Facial Cleft

Back 77

this is when mouth is too wide b/c maxillary prominences havent grown

Front 78

Microstomia

Back 78

tongue doesnt drop, palatal shelves cant fuse

Front 79

Injury to Middle Meningeal artery

Back 79

located directly under pterion of skull, very thin
blow to the head here may lacerate artery
nowhere to drain, increases cranial pressure
unconsciousness and death

Front 80

Importance of Pterygoid plexus of veins

Back 80

due to their connections w/ cavernous sinus via the deep facial, inferior ophtalmic and emissary veins in the sphenoid
facial infections can lead to meningitis

Front 81

what is the most common area for nasopharyngeal carcinoma?

Back 81

pharyngeal recess

Front 82

what muscle is commonly involved in pharyngeal carcinoma, and where is it commonly detected?

Back 82

levator veli palatine
enlarged cervicale lymph nodes

Front 83

what are the reasons for a tonsillectomy, and what are complications?

Back 83

obstruction of airway
unstoppable bleeding from lingual artery

Front 84

Bell’s palsy

Back 84

lesion of facial nerve leading to unilateral paralysis of face
distortion of facial features

Front 85

Trigeminal neuralgia

Back 85

Paroxysmal pain along course of Trigeminal
relieved by sectioning sensory root of V

Front 86

Corneal blink reflex

Back 86

Bilateral contraction of orbicularis oculi
Reflex arc efferent limb – facial nerve
Afferent limb – nasociliary nerve of V1

Front 87

Horner’s syndrome

Back 87

constriction of the pupil, drooping of upper eyelid, retraction of eyeball, absence of sweating

Front 88

III Nerve Palsy

Back 88

Ptosis: eye drop
Loss of upward, downward and medial movement of the affected eye
eye is in a 'down and out' position

Front 89

IV Nerve Palsy

Back 89

Eye movement inferior laterally
can no longer look down and out

Front 90

VI Nerve Palsy

Back 90

double vision due to lateral rectus loss
if left is affected, double vision occurs when looking right

Front 91

clinical eye movement tests

Back 91

Inward: Medial rectus
Outward: Lateral rectus
Upward and outward: Superior rectus
Downward and outward: Inferior rectus
Upward and Inward: Inferior oblique
Downward and inward: Superior oblique

Front 92

what is the integrity test for IX?

Back 92

gag reflex