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/ lymed Welcome to LY Med, where I go over everything you need to know for the USMLE STEP 1, with new videos every day.
Follow along with First Aid, or with my notes which can be found here: www.dropbox.com/sh/ces0j7obod...
We finished the anatomy, physiology, and pathology of the upper limb in our previous vid. Now onto the anatomy, physio and path of the lower limb! Again, we'll start from the top down - going from the hips, to the knees, and finally the ankles and feet.
Common hip pathologies include hip dislocations. Posterior dislocations are commonly from car accidents. You can also have hip fractures, especially with older age or osteoperosis. These are less common in children. Instead, kids can develop things such as dyslasia of the hip (shallow acetabulum), or slipped capital femoral epiphysis. Other disorders include Legg-Calve-Perthe, which is avascular necrosis of the femoral head.
Moving on to the knee, a common complaint is patellar tendon pain, which manifest itself as pain in the tibial tuberosity. This is caused by overuse and is called Osgood Schlatter Disease. Athletes are at risk of this, as well as tears to their ligaments. We will discuss all the ligaments of the knee as well as the physical exam of the knee, including the:
ACL (anterior drawer test and Lachman Test)
PCL (posterior drawer test)
MCL/LCL (passive abduction and adduction)
And the menisci. While the meniscus aren't ligaments, but rather shock pads, they are incredibly important. They can be tested with the McMurray test.
Tears to these ligaments are common. You can have one tear or multiple tears. A common group of tears is called the unhappy triad, which tears the ACL, MCL and medial meniscus.
Other pathologies include bursitis and cysts in around the knee. The common ones are pre-patellar bursitis, which is an enlarged bursa around the anterior knee. If theres a bump on the posterior knee, it's likely a Bakers cyst.
Lastly, the feet and ankle! Ankle sprains are super common and are often from the anterior talofibular ligament. Treatment is conservative. Another common disorder is plantar fasciitis, which is inflammation of the plantar fascia, which supports the arch of the foot. Common with overuse, treatment again is usually conservative although surgery may be reserved for more problematic cases.
Last one is Charcot joint, or neuropathic arthropathy, which is the degeneration and destruction of weight bearing joints. This is commonly seen in diabetics and likes to affect the feet. You may know it as Charcot foot!