Lower Limb Injuries

Front 1

Fibula is a common source of

Back 1

bone for grafting.

• Some examples of when this is necessary would be congenital bone defects, trauma or excision of a malignant tumor

Front 2

Common (fibular) peroneal nerve injury or deep fibular nerve results in?

Back 2

o tibialis anterior is paralyzed
o the foot drops (it falls into plantar flexion when it is raised off the ground).

Front 3

"Shin splints":

Back 3

lay person's expression for a painful condition of the anterior compartment of the leg that follows vigorous and/or lengthy exercise.

Front 4

Anterior tibial muscles swell from sudden overuse causes? (shin splints)

Back 4

- swollen muscles in the anterior compartment reduce the blood flow
- Cramps may develop if use of the muscles is continued.
- Muscles are painful and tender to pressure.

Front 5

Shin splints may also occur

Back 5

in trained athletes who do not warm up ad¬equately or cool down sufficiently.

Front 6

A injury that could occur during running and games such as squash which require quick starts; could also occur if someone is startled

Back 6

Inflammation, strain, or rupture of the tendo calcaneus or calcaneal (Achilles) tendon

Front 7

Inflammation, strain, or rupture of the tendo calcaneus or calcaneal (Achilles) tendon occurs?

Back 7

o Often occurs during running and games which require quick starts.
- frequently at the start of a 100-meter dash, squash, startled person

Front 8

Complete rupture of the tendo calcaneus may result in?

Back 8

1) abrupt pain in the posterior aspect of the leg.
2) unable to use the extremity
3) lump or increase in the prominence of the calf, owing to shortening of the gastrocnemius and soleus
4) foot can be dorsiflexed to a greater extent than normal
• patient is unable to plantar flex their foot against resistance

Front 9

ankle reflex (ankle jerk):

Back 9

is the twitch of the triceps surae muscle, which is induced by striking the tendo calcaneus with a reflex hammer.

Front 10

S1 and S2 segments of the spinal cord, are the reflex center for what trait?

Back 10

ankle relfex

Front 11

"Tennis leg"

Back 11

a painful calf injury resulting from partial tearing of the medial belly of the gastrocnemius at or near its musculotendinous junction.

Front 12

fairly common injury in long distance runners because of excessive friction?

Back 12

• Inflammation and swelling of the tendo calcaneus (TC) or bursa (Calcneal bursitis), as the TC continuously slides over it

Front 13

Vericose Veins

Back 13

• Distended perforating and superficial vv

Front 14

“Calf Pump” helps to produce what effect?

Back 14

When standing, the venous return of the leg depends largely on muscular activity, especially of the triceps surae muscle. When the calf muscles contract, blood is pumped superiorly in the deep veins.

Front 15

o "calf pump” is improved

Back 15

by the tight deep fascia covering these muscles

Front 16

If these venus valves of the lower leg become incompetent?

Back 16

• blood is forced into the superficial veins during contraction of the triceps surae muscles and by hydrostatic pressure when straining or standing.
• The distended perforating and superficial veins are called varicose veins.

Front 17

plantaris muscle rupture my be injured by?

Back 17

sudden dorsiflexion of the ankle joint may rupture the long slender tendon of this feeble muscle.

Front 18

In most cases of apparent rupture of the plantaris tendon results in?

Back 18

muscle fibers of the triceps surae are also torn.

Front 19

pain so severe that the person is unable to bear weight on the foot.

Back 19

plantaris tendon rupture

Front 20

plantaris muscle rupture is common in

Back 20

basketball players, sprinters, and ballet dancers

Front 21

long tendon of the plantaris muscle is

Back 21

commonly used in reconstructive surgery of the tendons of the hand

Front 22

lacerations in the popliteal fossa and posterior dislocations of the knee joint may damage this nerve

Back 22

tibial nerve

Front 23

tibial nerve injury may produce?

Back 23

paralysis of all muscles in the posterior compartment of the leg and the intrinsic muscles in the sole of the foot.

Front 24

When the plantar flexors (tibial n. injury) of the foot are paralyzed

Back 24

• patient is unable to curl the toes or stand on them
• loss of sensation in the sole of the foot
• vulnerable to the development of pressure sores.

Front 25

Sudden dorsiflexion of ankle may rupture tendon

Back 25

Plantaris M.

Front 26

(cramps in the calf brought on by exercise and relieved by rest):

Back 26

intermittent claudication

Front 27

intermittent claudication can be caused by?

Back 27

- ischemia of the leg muscles owing to arteriosclerotic stenosis of the leg arteries.
- characterized by leg cramps that develop during walking and disappear soon after rest.

Front 28

pulse of the posterior tibial artery can usually be palpated about

Back 28

halfway between the posterior surface of the medial malleolus and the medial border of the tendo calcaneus.

Front 29

o Dorsalis pedis pulse

Back 29

usually be felt on the dorsum of the foot, where the artery passes over the navicular and cuneiform bones just lateral to the extensor hallucis longus tendon

Front 30

arterial insufficiency can be evaluated at the

Back 30

dorsalis pedis pulse by a decreased or absent pulse.

• In 14% of people the dorsalis pedis artery is absent or is too small to palpate, or it may not be in its usual position.

Front 31

Caused by ischemia of leg muscles due to arteriosclerotic stenosis of leg arteries.

Back 31

intermittent claudication

Front 32

Fx’s close to the femoral head often

Back 32

disrupt the blood supply to the head of the femur.

Front 33

aseptic necrosis

Back 33

(death in the absence of infection).

Front 34

If the ligament that inserts through the femur head is disrupted in a Fx

Back 34

the fragment of bone may receive no blood and undergo aseptic necrosis

Front 35

o Because the femoral, sciatic, and obturator nerves also supply the knee joint...

Back 35

hip disease may cause referred pain to the knee.

Front 36

Because of the close relationship of the sciatic nerve to the hip joint, it may be injured (stretched and/or compressed) during?

Back 36

posterior dislocations or fracture-dislocations of the hip joint.

Front 37

during posterior dislocations or fracture-dislocations of the hip joint may result in?

Back 37

paralysis of the hamstring muscles and those muscles distal to the knee supplied by the branches of the sciatic nerve.

o Sensory changes may also occur in the skin over the post/lat aspects of the leg and over much of the foot.

Front 38

Patellar reflex;

Back 38

With the leg flexed, the patellar ligament is struck to elicit a knee jerk.

- This patellar reflex results in extension of the leg.

Front 39

patellar reflex results in

Back 39

extension of the leg.

Front 40

the patellar reflex may be blocked by damage to...

Back 40

the femoral nerve which supplies the quadriceps muscle.

o Or damage to reflex centers in the spinal cord (L2, L3, and L4)

Front 41

Complete tears of the fibular collateral ligament may result in?

Back 41

- stretching of the common peroneal nerve.
- affects the muscles of the ant/lat compartments of the leg and
- may produce foot drop: due to paralysis of the dorsiflexor and eversion muscles of the foot.

Front 42

injury to the tibial collateral ligament frequently results in?

Back 42

concomitant (accompanying especially in a subordinate or incidental way) injury to the medial meniscus.

Front 43

Rupture of the tibial collateral ligament, often associated with?

Back 43

tearing of the medial meniscus and the anterior cruciate ligament, is a common type of football injury.

• The damage is frequently caused by a blow to the lateral side of the knee.

Front 44

When considering soft tissue injuries of the knee, always think of the three C’s which indicate those structures that may be damaged

Back 44

Collateral ligaments
Cruciate ligaments
Cartilages (menisci).

Front 45

three C’s

Back 45

Collateral ligaments
Cruciate ligaments
Cartilages (menisci).

Front 46

Prepatellar bursitis

Back 46

is a friction bursitis caused by friction between the skin and the patella.

Front 47

“housemaid’s knee,”

Back 47

Prepatellar bursitis: If the inflammation is chronic, the bursa becomes distended with fluid and forms a soft, fluctuant swelling anterior to the knee.

Front 48

relatively weak anterior cruciate ligament may be torn when?

Back 48

when the tibial collateral ligament ruptures after the knee is hit hard from the lateral side while the foot is fixed (e.g., in the ground).

Front 49

First the tibial collateral ligament ruptures

Back 49

2) opening the joint on the medial side.
3) This may tear the medial meniscus
4) and the anterior cruciate ligament

Front 50

anterior cruciate ligament may also be torn when

Back 50

(1) the tibia is driven anteriorly on the femur
(2) the femur is driven posteriorly on the tibia
(3) the knee joint is severely hyperextended.

Front 51

The posterior cruciate ligament may be injured when

Back 51

when the superior part of the tibia is struck with the knee flexed.

Front 52

This kind of injury may occur when an automobile passenger's leg is driven against the dashboard.

Back 52

posterior cruciate ligament; tibia is driven posteriorly on the femur, if the femur is driven anteriorly on the tibia, or if the knee joint is severely hyperflexed, the posterior cruciate lig¬ament may be torn.

Front 53

o The flexed knee is unstable when?

Back 53

the posterior cruciate ligament is torn.

Front 54

o A blow on the lateral side of the knee when a person is bearing weight on the leg stresses the?

Back 54

tibial collateral ligament

Front 55

sprained tibial collateral ligament.

Back 55

fibers are stretched and some of them may be torn

Front 56

o When the blow is severe, all the fibers may be torn partially or completely. This is called a?

Back 56

torn tibial collateral ligament

Front 57

the tear in a torn tibial collateral ligament usually occurs near?

Back 57

near its attachment to the medial epicondyle of the femur.

Front 58

Meniscus Injury (Knee-Cartilage Injury) is characterized by?

Back 58

Localized tenderness and pain in the flexed knee on the medial side of the patellar ligament, just proximal to the medial tibial plateau, suggests injury to the medial meniscus.

Front 59

o medial me¬niscus injury results from?

Back 59

a twisting strain that is applied to the knee joint when it is flexed.

Front 60

medial meniscus is firmly adhered to

Back 60

the tibial collateral ligament

Front 61

twisting strains of the tibial collateral ligament may?

Back 61

tear and/or detach the medial meniscus from the fibrous capsule.

Front 62

Part of the torn cartilage medial meniscus may

Back 62

become displaced toward the center of the joint and become lodged between the tibial and femoral condyles; "locks the knee"

Front 63

internal edges of the menisci

Back 63

are poorly supplied with blood, tears in them heal poorly. Tears near the peripheral margin, which are vascularized by genicular branches of the popliteal artery, usually heal well.

Front 64

weight is borne by the flexed knee joint, a sudden twist of the knee may also rupture

Back 64

the medial meniscus, usually splitting it longitudinally. This in¬jury is common in athletes who twist their flexed knees while running (e.g., in football and basketball).