• Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

Card Range To Study

through

image

Play button

image

Play button

image

Progress

1/56

Click to flip

Use LEFT and RIGHT arrow keys to navigate between flashcards;

Use UP and DOWN arrow keys to flip the card;

H to show hint;

A reads text to speech;

56 Cards in this Set

  • Front
  • Back
Anterior compartment leg?
TA
EHL
EDL
Peroneus tertius
Posterior compartment leg?
superficial and deep, separated by transverse intermuscular septum
Superficial posterior compartment?
Gastrocnemius
Soleus
Plantaris
Deep Posterior compartment
FHL
FDL
Tib Post
Popliteus
Lateral Compartment leg - separated from other compartments by..., and composed of...?
-separated by ant and posterior intermuscular septum
2 muscles: peroneus brevis (inserts on base of 5th MT)
-peroneus longus (corsses plantar surface of foot to insert in medial cuneiform 1st MT base
phases of gait?
Stance
Swing
Stance phase gait?
begins w heel-strike and ends w toe-off
faster run = less time spent in stance phase
Swing phase gait?
begins w toe-ff and ends w heel-strike, 28% cycle
amount of axial load the proximal tib-fib joint takes?
1/6
PTFJ anatomy
Anterior joint capsule composed of three ligamentous bands which pass obliquely upward and attach to the lateral tibial condyle
-Posterior tibiofibular ligament composed of two broad, thick ligamentous bands which pass obliquely from the fibular head to the posterior aspect of the tibial condyle
reinforced by the popliteus tendon
Additional stabilizers to the PTFJ besides capsule?
LCL
arcuate ligament
fabellofibular ligament
popliteofubular ligament
popliteus
biceps femoris tendon
PTFJ injury mechanism?
-occurs w knee in flexion
ankle internally rotated and plantar-flexed
-activities w aggressive twisting knee motions
PE for PTFJ injury?
-pain, swelling
-may be unable to bear weight
-transient peroneal nerve palsy, esp w posteromedial and superior dislocations
Anterolateral PTFJ dislocation?
-fall on flexed knee w foot inverted/plantar flexed
-most common pattern (>85%)
-ankle motion exacerbates knee pain
**Posteromedial PTFJ dislocation?
-10% of all types, least common
-direct trauma from car bumper or horseback riding striking knee on post
**Superior PTFJ dislocation?
-2% of all types
-ass
d w high-energy ankle injury amd superior migration of ENTIRE FIBULA
-**interosseous membrane disrupted
PTFJ imaging?
-AP/lat xray 72% sensitive
-comparison xrays to opposite side sensitivity 82%
-CT if dx is equivocal
Rx PTFJ subluxation?
-nonsurgical
-casting x 2-3 weeks
-strap 1cm below fibular head
-avoid knee flexion activities
PTFJ dislocation treatment?
-closed reduction w knee in 80-110 deg flexion
-ankle dorsiflexed and ER
-reverse injury
-reassess knee stability/LCL once relocated
indications for ORIF for PTFJ dislocation?
-failed closed red attempt
-posteromedial and superior dislocations
-stabiliz reduction w temp screw/ K wire
-immobilize x 6 weeks
When do overuse injuries occur?
-When athlete changes mode, intensity, or duration of training - "principle of transition"
-mismatch between overload and recovery can lead to breakdown on all levels.
Shin Splints?
Medial Tibial Stress Syndrome
-length of attachments vary anatomically in muscles, considerable overlap
Primary etiology of MTSS?
**Excessive pronation of feet**
runners, joggers
Mechanism of MTSS?
Excessive pronation causes eccentric contraction of soleus and periostitis
MTSS PE?
-tenderness distal 1/3 posteromedial border of tibia
-pain w resisted foot plantarflexion or standing on tip-toe
When and where is radionuclide uptake visible for MTSS?
1/3+ length of tibia w variable intensity
**tracer uptake only visible on delayed-phase images
Rx MTSS?
**REST**
also, if excessive pronation prescribe orthotics
"CECS" def?
Chronic Exertional Compartment Syndrome
typically in a runner w no Hx trauma
CECS most affected?
-Anterior 50-60%
-deep posterior 20-30%
-other 20% divided evenly among lateral and posterior, and compartment around tib post
%fascial hernia in CECS?
25-46%
**Diagnostic standards for CECS compartment pressures?
1)resting pressure exceeding 15mm Hg before exercise
2) 1-minute post-exercise pressure exceeding 30mm Hg
Nonoperative Rx and CECS?
only nonoperative Rx is cessation of athletic participation.
**must have surgery to continue athletics
% return to play after CECS fasciotomies?
60% returned to their highest level of sport, alghough 33% reported continued pain
% bilaterality in tibial stress fx's?
11-23%
Sullivan article on etiology of stress fx's?
-all occurred within 12 weeks of a change in training program
-most common change was increased training mileage
Tibial stress fx's more common in male or female?
10-12x more common in women
assn menses w stress fx?
high association of irregular menses w tibial stress fx
When is bone scan positive in tibial stress fx's?
3-5 days after onset of pain.
progression of stress fx on MRI?
periosteal edema-->progressive marrow involvement--> ultimate frank cortical stress fx
Imaging test preference for stress fx's?
***MRI***
healing stress fx?
most heal w rest
recurrence rate stress fx?
10%
most common nerve entrapment for leg?
common peroneal nerve,
second is sup peronel n.
saphenous n
sup peroneal n entrapment occurs in...?'
Rx?
dancers and body builders,
Rx is typically surgical
surgical treatment stress fx/'s?
fasciotomy sufficient in most cases ( w external neurolyses) and resection osteophytes, ganglion cysts
What clinical entity can mimic CECS?
vascular causes, eg popliteal artery entrapment syndrome (PAES)
sine qua non for poplieteal entrapment syndrome?
paradoxical claudication w calf cramping during walking but with the subject remaining asympromatic during running!
"Tennis Leg"?
partial tear a the MT jct of medial gastrocnemius muscle
Symptoms tennis leg?
-occurs with extgended knee and ankle in max dorsiflexion
-feels like leg hit by stick or tennis ball
-sometimes "pop"
-20% with 1-2 day prodromal calf pain
-ambulation produces intense pain
Tennis leg PE?
-palpable defect in medial belly of gastroc just above MT jct
-swelling mayt obscure defect for days
-xrays not indicated
management tennis leg?
ice/elevation x 24-48 h
NOT anticoag (->hematoma!)
complications include DVT dute to extrinsic compression
-nonoperative, conservative
-
When consider removal of myositis ossificans?
-wait between 6-12 months
-only removed if it interferes with joint motion or if it is irritating a nerve
18yo runner w 1 year Hx lower let pain while running. Only runs 7 minutes prior to onset of Sx, then Sx resolve p 30 minutes after cessation of running.At rest her comp pressures in ant, lat, sup post, and deep post are 19,17,13, and 9 respectively. next step in management?
decompressive fasciotomy.
has chronic exertional comp in ant and lat comp, which are most commonly affected.
Midshaft tib/fib fx in football player. Mech?
struck from the front while making a tackle. based upon ant butterfly frag seen on xray p 495
Complications tib tubercle avulsion fx in 10yo?
athlete is at risk for recurvatum deformity of tibia in future
48yo dance instructor w activity related lower leg and dorsal foot pain worse w exercise and dance.Failed conserv Tx, next step?
selective fascial release (p 496) pt has superficial peroneal nerve compression