A swelling in the leg

A swelling in the leg

1. Anatomy

   • compartments of the thigh
   • Anterior compartment : (flexors of the hip)
     • psoas major
     • pectineus
     • sartorius
     • iliacus
     • they are all supplied by the femoral neve
   • Anterior compartment: Quadratus femoris
     • extensors of the knee
     • vastus medialis
     • vastus lateralis
     • vastus intermedius
     • rectus femoris
   • patella
     • has 2 main functions
       • . Leg extension – Enhances the leverage and, increase efficiency of the quadriceps muscle
       • Protection –of the knee joint from physical trauma
   • posterior compartment
     • muscles
       • common action:
         • flexion of knee
         • extension of hip
       • nerve supply: sciatic nerve
     • blood supply
       • sciatic artery (branch Of inferior gluteal)
       • 1st, 2nd, 3rd perforating arteries
     • popliteal fossa
       • contents:
         • Popliteal artery. & its branches
         • Popliteal vein & its tributaries.
         • Medial popliteal (tibial) nerve & its branches
         • Lateral popliteal (common peroneal) nerve & its branches
         • Popliteal lymph nodes
         • Fat
   • dermatome and cutaneous nerves

2. bone tumors

   • osteoma
     • Bone tumor, benign
     • occurs mainly in males
     • around ages 40-50
     • Bones with intramembranous ossification.
     • round/oval ivory-white, exophytic sessile x
   • osteoid osteoma
     • Bone tumor, benign
     • 2nd - 3rd decades of life
     • affects the metaphysis of long bone
     • more in males
     • Small central density.
     • Small round mass
   • Osteoblastoma
     • Bone tumor, benign
     • 2nd-3rd decades
     • affects the Vertebral column
     • Small central density
     • Rounded mass
   • treatment of bone tumors
     • surgery
       • Surgery is the usual treatment for bone cancer. The surgeon removes the entire tumor with negative margins
         • Dramatic improvements in surgical techniques and preoperative tumor treatment have made it possible for most patients with bone cancer to avoid radical surgical procedures
     • Chemotherapy
       • Chemotherapy is the use of anticancer drugs to kill cancer cells.
     • radiotherapy
       • Radiation therapy involves the use of high-energy x-rays to kill cancer cells and may be used in combination with surgery
     • Targeted therapy
       • Targeted therapy is the use of a drug that is designed to interact with a specific molecule involved in the growth and spread of cancer cells.

3. Osteosarcoma

   • can be classified as primary or secondary
   • affects mainly males
   • 2nd decade of life
   • 3 microscopic presentations: osteoblastic, chrondroblastic and fibroblastic
   • sun-burst appearance
   • mutation in retinoblastoma gene
   • affects the metaphysis of long bones (mostly around knee)

4. radiographic differences between benign and malignant

5. Adolescents reactions to illness

   • Body image issues:
     • Teens focus on physical changes happening in their bodies. E.g - visible surgical scars.
   • Independence:
     • Interferes with a teen's comfort in becoming less dependent on parents
   • Relationships with peers:
     • Illness interfere with time spent with peers or in the school setting.
   • Anxiety regarding relapse.
   • could lead to an adjustment disorder
     • definition
       • persistent emotional or behavioural reaction within several months of an identifiable stressful event or change in a person’s life.

6. Principles of Ethics in Medicine:

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