New update solution for LE Ortho Exam 2 2022
the following are *red flags* for what condition -
- age over 50 yrs
- bowel disturbances (e.g. rectal bleeding or black stools)
- unexplained weight loss
- Hx of cancer in immediate family
- pain unchanged by position or movement - CORRECT ANSWER colon cancer
the following are *red flags* for what condition -
- older women (>70 yrs) with hip, groin or thigh pain
- Hx of a fall from a standing position
- Severe, constant pain that is worse with movement
- A shortened and externally rotated LE - CORRECT ANSWER pathological Fx of
femoral neck
the following are *red flags* for what condition -
- Hx of long-term corticosteroid use (e.g. in pt's with RA, systemic lupus
erythematosus, or asthma)
- Hx of avascular necrosis (AVN) of the contralateral hip
- trauma - CORRECT ANSWER Osteonecrosis (of the femoral head) (AVN)
____________ sources of pain include the internal organs and the heart muscle.
- this type of pain is *not well localized*
,- Description of the pain: knife-like quality of stabbing from the inside out, boring,
deep ache
- Pain pattern: constant (may come in waves), gradually progressive (cyclical), Sx
unrelieved by rest or change in position
- cannot alter, provoke, alleviate, eliminate, or aggravate Sx
- intervention does not change the outcome (or client gets worse) - CORRECT
ANSWER visceral
(visceral pain is not well localized due to:
- innervation of the viscera is multisegmental
- there are few nerve receptors in these structures)
(visceral pain slide info comes from the 2018 Diff Dx book pages 104-106)
common patterns of pain related to problems at the ____________ joint include:
- pain in the groin
- point deep in the joint
- buttock pain
- pain in the anterior/posterior/medial thigh
- knee pain - CORRECT ANSWER acetabulo-femoral
what are the 3 primary purposes/functions of the pelvis - CORRECT ANSWER
support (bowel/bladder and reproductive organs), weight transmission (weight of
trunk in sitting or forces through LE in standing), muscle attachment (mm. of the
LE and trunk)
Hip angles during gait -
,~______ degrees of flexion at the end of terminal swing
~_______ degrees of extension in preswing
~_____ degrees by toe-off - CORRECT ANSWER 30 (terminal swing), 10 (preswing),
0 (toe-off)
The (male/female) pelvis has a more v-shaped pubic arch and their pelvic opening is
smaller, whereas the (male/female) pelvis has a more u-shaped pubic arch and their
pelvic opening is larger/less obstructed - CORRECT ANSWER male, female
this structure surrounds the rim of the acetabulum in the hip joint
-composed of fibrocartilage
- function: *deepen the socket of the hip joint* (which provides addition stability),
*absorbs shock* (distributes force)
- contributes to the strong suction seal of the femur (neg. atmospheric pressure;
prevents first 1-2mm of distraction)
- elastic nature of tissue better for mobility than osseous barrier - CORRECT
ANSWER acetabular labrum
Normal femoral version/torsion:
Anteversion/Antetorsion:
Retroversion/Retrotorsion: - CORRECT ANSWER 15-20 deg (normal), 30+
(antetorsion; more likely to cause a person to toe-in/pigeon toe), less than 15 deg
(retrotorsion; more likely to toe-out)
Normal angle of inclination of the hip:
, Coxa Vara:
Coxa Valga:
Normal value for *infants*: - CORRECT ANSWER 125 (normal), less than 125
(coxa vara - can cause medial strain/stretch, lateral compression; knock knees),
+125 (coxa valga - can cause lateral strain/stretch, medial compression; bow legged),
150 (normal for infants)
How to differentiate between hip anteversion/retroversion vs tibial torsion: Look at
the ________
If they are straight ahead: good femoral alignment and the problem is likely at the
tibias
If pointing towards each other: femoral component to deviation - CORRECT
ANSWER knees
Femoral acetabular impingement can be caused by the head and neck of femur not
being shaped correctly, this deformity is referred to as a ____________ deformity
- abnormality at the level of the *anterior femoral head*, or the *head-neck
junction*, resulting in a non-spherical head and increased femoral neck/head-
acetabular rim contact
- more *common in young athletic men*
- may be an acquired phenomenon during the second growth spurt; highly
influenced by exercise-related loads applied to hip during adolescents
- has been associated with development of hip OA - CORRECT ANSWER CAM
(femoral head deformation)
the following are *red flags* for what condition -
- age over 50 yrs
- bowel disturbances (e.g. rectal bleeding or black stools)
- unexplained weight loss
- Hx of cancer in immediate family
- pain unchanged by position or movement - CORRECT ANSWER colon cancer
the following are *red flags* for what condition -
- older women (>70 yrs) with hip, groin or thigh pain
- Hx of a fall from a standing position
- Severe, constant pain that is worse with movement
- A shortened and externally rotated LE - CORRECT ANSWER pathological Fx of
femoral neck
the following are *red flags* for what condition -
- Hx of long-term corticosteroid use (e.g. in pt's with RA, systemic lupus
erythematosus, or asthma)
- Hx of avascular necrosis (AVN) of the contralateral hip
- trauma - CORRECT ANSWER Osteonecrosis (of the femoral head) (AVN)
____________ sources of pain include the internal organs and the heart muscle.
- this type of pain is *not well localized*
,- Description of the pain: knife-like quality of stabbing from the inside out, boring,
deep ache
- Pain pattern: constant (may come in waves), gradually progressive (cyclical), Sx
unrelieved by rest or change in position
- cannot alter, provoke, alleviate, eliminate, or aggravate Sx
- intervention does not change the outcome (or client gets worse) - CORRECT
ANSWER visceral
(visceral pain is not well localized due to:
- innervation of the viscera is multisegmental
- there are few nerve receptors in these structures)
(visceral pain slide info comes from the 2018 Diff Dx book pages 104-106)
common patterns of pain related to problems at the ____________ joint include:
- pain in the groin
- point deep in the joint
- buttock pain
- pain in the anterior/posterior/medial thigh
- knee pain - CORRECT ANSWER acetabulo-femoral
what are the 3 primary purposes/functions of the pelvis - CORRECT ANSWER
support (bowel/bladder and reproductive organs), weight transmission (weight of
trunk in sitting or forces through LE in standing), muscle attachment (mm. of the
LE and trunk)
Hip angles during gait -
,~______ degrees of flexion at the end of terminal swing
~_______ degrees of extension in preswing
~_____ degrees by toe-off - CORRECT ANSWER 30 (terminal swing), 10 (preswing),
0 (toe-off)
The (male/female) pelvis has a more v-shaped pubic arch and their pelvic opening is
smaller, whereas the (male/female) pelvis has a more u-shaped pubic arch and their
pelvic opening is larger/less obstructed - CORRECT ANSWER male, female
this structure surrounds the rim of the acetabulum in the hip joint
-composed of fibrocartilage
- function: *deepen the socket of the hip joint* (which provides addition stability),
*absorbs shock* (distributes force)
- contributes to the strong suction seal of the femur (neg. atmospheric pressure;
prevents first 1-2mm of distraction)
- elastic nature of tissue better for mobility than osseous barrier - CORRECT
ANSWER acetabular labrum
Normal femoral version/torsion:
Anteversion/Antetorsion:
Retroversion/Retrotorsion: - CORRECT ANSWER 15-20 deg (normal), 30+
(antetorsion; more likely to cause a person to toe-in/pigeon toe), less than 15 deg
(retrotorsion; more likely to toe-out)
Normal angle of inclination of the hip:
, Coxa Vara:
Coxa Valga:
Normal value for *infants*: - CORRECT ANSWER 125 (normal), less than 125
(coxa vara - can cause medial strain/stretch, lateral compression; knock knees),
+125 (coxa valga - can cause lateral strain/stretch, medial compression; bow legged),
150 (normal for infants)
How to differentiate between hip anteversion/retroversion vs tibial torsion: Look at
the ________
If they are straight ahead: good femoral alignment and the problem is likely at the
tibias
If pointing towards each other: femoral component to deviation - CORRECT
ANSWER knees
Femoral acetabular impingement can be caused by the head and neck of femur not
being shaped correctly, this deformity is referred to as a ____________ deformity
- abnormality at the level of the *anterior femoral head*, or the *head-neck
junction*, resulting in a non-spherical head and increased femoral neck/head-
acetabular rim contact
- more *common in young athletic men*
- may be an acquired phenomenon during the second growth spurt; highly
influenced by exercise-related loads applied to hip during adolescents
- has been associated with development of hip OA - CORRECT ANSWER CAM
(femoral head deformation)
