MSK 05
Terms
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- coxa valga
- when the femoral head neck angle is more than 135 degrees
- coxa vara
- when the femoral head neck angle is less than 120 degrees
- femoral anteverson
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- when the angle of the neck with the head is greater than 15 degrees
- this person will walk with an intoeing gate - femoral retroversion
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- when the angle of the neck with the head is less than 5 degrees
- this person will walk with an out-toeing gate - fractures of the proximal femur
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- in elderly women
- may be intracapsular neck or extracapsuar intertrochanteric region
- either one makes the limb appear shortened and externally rotated - Trendelenburg sign
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- weakness of gluteus medius and minimus
- sagging of the contralateral side when standing ont he affected side - external hip rotators
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- gluteus maximus
- obturators
- gemelli
- piriformis
- quadratus femoris - internal hip rotators
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- anterior gluteus medius
- tensor fascia lata - thigh abduction contractures
- affected limb appears longer
- thigh adduction contractures
- affected limb appears shorter
- how are the MCL and LCL oriented
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- stretched most tightly in extension
- oppose lateral rotation - how is the ACL oriented?
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- upward and backward, lateral
- taght in full extension, so they rotate tibia laterally - how is the PCL oriented?
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- upward and forward, medial
- taght in full extension, so they rotate tibia laterally - besides hinge movement, what goes on with leg extension
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- femur slides back
- lateral rotation (lateral condlye exhausts surface first), so tighening of collateral ligaments - besides hinge movement, what goes on with leg flextion
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- its preceded by medial rotation by the popliteus
- relexes the stretched colateral ligaments - all about the anterior leg compartment
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- dorsiflex ankle, extend toes
- via deep fibular nerve
- supplied by anterior tibial artery - all about the posterior leg compartment
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- plantar flex ankle, flex toes, invert foot
- via tibial nerve
- supplied by posterior tibial artery - all about the lateral leg compartment
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- eversion of the foot
- via superficial fibular nerve
- no artery proper to it - pes cavus
- too tall arch
- pes plaus
- flat foot
- femoral nerve
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- L2-4, anterior to pelvis
- gets quads, sartorius
- cutaneous anterior thigh and medial leg - obturaor nerve
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- L2-4, anteiror to pelvis
- gets adductors
- cutaneous medial thigh - superior gluteal nerve
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- L4-5
- gets medius and minimus, tensor fascia lata - inferior gluteal nerve
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- L5-S2
- maximus - sciatic nerve
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- posterior thigh
- turns into tibial and fibular - what nerves supply the foot?
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- medial plantar and lateral plantar
- from the tibial nerve - what nerve supplies the leg skin?
- saphenous nerve, from the femoral nerve
- what artery supplies the femoral head?
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- retinacular arteries
- from the medial circumflex of the profunda femoris - where does the great saphenous vein drain
- medial leg
- where does the small saphenous vein drain
- lateral, posteior leg
- where in the leg are anastamoses not sufficient for an occlusion?
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- around the knee joint
- bad if femoral or popliteal artery is occluded - antalgic limp
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- from pain
- shortened stance phase on affected side
- if pain from hip joint (coxalgia), lurch of trunk toward painful side in stance - abductor lurch
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- weakened medius
- trunk lurches toward weakened side to move the center of gravity - gluteus maximus lurch
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- trunk lurches backwards at heal strike
- this is b/c it begins to contract at heal strike to slow forward motion - gait w/ paralyzed quad
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- can walk b/c leg acts as pendulum to extend the knee before heel strike
- cant run or walk on rough surfaces - calcaneus gait
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- gait w/ calf muscles paralyzed
- can't push off
- extension of hip by maximus and hamstring - gait w/ different limb lengths
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- lowering of shoulder on the shorter side in stace
- shift in trunk to short side in stance