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Medicine Year 5 > Orthopaedics > Flashcards

Orthopaedics Flashcards

1
Q

motor to knee extension and hip extension
sensory to anterior/medial thigh and lower leg

A

Femoral nerve

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2
Q

cause of femoral nerve lesions

A

hip/pelvic fractures
stab/gun wounds

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3
Q

loss of patella reflex

A

femoral nerve

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4
Q

motor to hip adduction
sensory to medial thigh

A

obturator nerve

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5
Q

cause of obturator nerve lesion

A

anterior hip doslocation

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6
Q

sensory to lateral and posterior thigh

A

lateral cutaneous nerve of the thigh

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7
Q

burning pain in the lateral thigh due to compression of the lateral cutaneous nerve at the ASIS

A

meralgia paraesthesia

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8
Q

motor to foot inversion and plantarflexion
sensory to sole of foot

A

tibial nerve

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9
Q

cause of tibial nerve lesion

A

posterior knee dislocation / popliteal laceration

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10
Q

motor to foot eversion and dorsiflexion and to extensor hallucis longus
sensory to foot dorsum and lower lateral leg

A

common peroneal nerve

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11
Q

cause of common peroneal nerve lesion

A

neck of fibula injury
tight plaster cast

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12
Q

nerve lesion which causes foot drop

A

common peroneal nerve

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13
Q

motor to hip abduction

A

superior gluteal nerve

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14
Q

causes of superior gluteal nerve lesion

A

posterior hip dislocation
pelvic fracture
hip surgery
misplaced IM injection

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15
Q

nerve lesion which would show a positive trendelenbergs

A

superior gluteal nerve

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16
Q

motor to hip extension and lateral rotation

A

inferior gluteal nerve

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17
Q

presentation of inferior gluteal nerve lesion

A

can’t move from seated / jump / climb stairs
alongside sciatica

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18
Q

weakness in ankle dorsiflexion and numbness in calf and foot

A

injury to lumbosacral trunk

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19
Q

nerve root injury:
sensory loss over anterior thigh
weak quadriceps
reduced knee reflex
positive femoral stretch

A

L3

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20
Q

nerve root injury:
sensory loss over anterior knee
weak quadriceps
reduced knee reflex
positive femoral stretch

A

L4

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21
Q

nerve root injury:
sensory loss over foot dorsum
weak dorsiflexion of foot and big toe
intact reflexes
positive sciatic stretch
foot drop

A

L5

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22
Q

nerve root injury:
sensory loss over posterolateral leg and lateral foot
weak foot plantarflexion
reduced ankle reflex
positive sciatic stretch

A

S1

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23
Q

weak knee flexion and foot movements
numbness from gluteal region to ankle

A

sciatic nerve lesion

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24
Q

what dislocation causes a sciatic nerve lesion

A

posterior hip dislocation or total hip replacement

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25
Q

signs of posterior hip dislocation

A

leg internally rotated and short

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26
Q

management of sciatica

A

trial of analgesia and physio
refer after 6w

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27
Q

isolated lateral hip/thigh pain
tenderness over greater trochanter

A

trochanteric bursitis

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28
Q

cause of knee pain in runners

A

iliotibial band syndrome

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29
Q

knee pain after exercise
locking and clunking

A

osteochondritis dissecans

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30
Q

NOF fracture leg signs

A

LEG SHORTENED AND EXTERNALLY ROTATED

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31
Q

analgesia in NOF fracture

A

iliofascial nerve block

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32
Q

management of intracapsular (intratrochanteric) NOF fracture

A

undisplaced: internal fixation if fit, hemiarthroplasty if unfit
displaced: arthroplasty/hemiarthroplasty

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33
Q

management of extracapsular (intertrochanteric) NOF fracture

A

stable: dynamic hip screw
other: intramedullary device

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34
Q

twisting force to a bent knee whilst playing sports
loud crack and rapid swelling

A

Ruptured anterior cruciate ligament

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35
Q

management of ruptured ACL

A

physio/surgery

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36
Q

hyperextension and a paradoxial anterior draw test

A

Ruptured posterior cruciate ligament

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37
Q

knee unstable in valgus position

A

ruptured medial collateral ligament

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38
Q

rotational/twisting sports injury with delayed swelling and joint locking
can be associated with chronic effusion after minor trauma

A

Menisceal tear

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39
Q

test for menisceal tear

A

mcmurray

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40
Q

management of menisceal tears

A

MRI and NSAIDs

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41
Q

teenage girl presents with pain walking down the stairs and at rest after a knee injury
quadriceps wasting

A

chondromalacia patellae

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42
Q

traumatic injury causing severe contraction of the quadriceps
knee stretched in valgus and externally rotated
associated with osteochondral fracture

A

patella dislocation

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43
Q

xray for patella dislocation

A

skyline views

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44
Q

2 types of patella fracture

A

avulsion fracture
undisplaced fragments

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45
Q

management of a patella fracture if the extensor system is intact

A

non-operative

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46
Q

knee forced into valgus/varus but the bone fractures before the ligaments rupture

A

tibial plateau fracture
- varus is medial plateau
- valgus is lateral plateau

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47
Q

demographic of tibial plateau fracture

A

elderly or significant trauma in the young

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48
Q

classification of tibial plateau fracture

A

schatzer classification

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49
Q

most common reason for total hip replacement revision surgery

A

aseptic loosening of the joint

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50
Q

risk of long term steroid use

A

avascular necrosis

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51
Q

osteonecrosis on pelvix xray

A

crescent sign

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52
Q

hip/groin pain with a snapping sensation

A

acetabular labral tear

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53
Q

bimalleolar fracture from forced foot eversion

A

Potts fracture

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54
Q

most common site for a metatarsal stress fracture

A

2nd metatarsal

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55
Q

cause of a 5th metatarsal fracture

A

forced inversion of the foot and ankle

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56
Q

pop in ankle followed by pain in the calf

A

achilles tendon rupture

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57
Q

what is simmonds triad

A

for achilles tendon rupture
1. palpation
2. examine ankle of delination
3. thompson test (calf squeeze)

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58
Q

imaging for achilles tendon rupture

A

USS

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59
Q

RF for achilles tendon rupture

A

ciprofloxacin

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60
Q

inverted and plantarflexed foot which is not passively correctable

A

clubfoot

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61
Q

imaging for ligament injuries

A

MRI

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62
Q

signs of acromioclavicular joint injury

A

prominent clavicle and a step deformity

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63
Q

management of a grade 1-2 acromioclavicular joint injury

A

rest and sling

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64
Q

sign of a glenohumeral joint dislocation

A

Hill sachs lesion

65
Q

motor to elbow flexion and supination (biceps)
sensory to lateral forearm

A

musculocutaneous nerve

66
Q

nerve root for musculocutaneous nerve

A

C5-C7

67
Q

motor to shoulder abduction (deltoid)
sensory to inferior deltoid

A

axillary nerve

68
Q

nerve root for axillary nerve

A

C5 C6

69
Q

humeral neck fracture/dislocation damaged which nerve

A

axillary

70
Q

motor to forearm, wrist, finger and thumb extension
sensory to dorsal webspage of thumb and index

A

radial nerve

71
Q

nerve root for radial nerve

A

C5-C8

72
Q

humeral midshaft fracture damages which nerve

A

radial

73
Q

wrist drop is a sign of which nerve lesion

A

radial

74
Q

motor to the LOAF muscles and sensory to palmar lateral 3 1/2 fingers

A

median

75
Q

nerve root for median nerve

A

C6 C8 T1

76
Q

what are the LOAF muscles

A

Lateral 2 Lumbricles
Opponens pollices
Abductor pollicies brevis
Flexor pollices brevis

77
Q

paralysis of thenar muscles and opponens pollices with carpal tunnel

A

wrist lesion affecting the median nerve

78
Q

loss of forearm pronation and wrist flexion

A

elbow lesion affecting the median nerve

79
Q

motor to the serratus anterior

A

long thoracic nerve

80
Q

nerve root for long thoracic nerve

A

C5-C7

81
Q

winged scapula after rib injury or mastectomy from injury of which nerve

A

long thoracic nerve

82
Q

arm hanging and internally rotated with the elbow extended

A

erbs palsy

83
Q

nerve root damaged in erbs palsy

A

C5-C6

84
Q

cause of erbs or klumpke palsy

A

shoulder dystocia

85
Q

sudden upward jerk of the arm causing horners and weakness of the intrinsic hand muscles

A

klumpke palsy

86
Q

nerve root damaged in klumpke palsy

A

C8 and T1

87
Q

which nerve is affected in carpal tunnel

A

median

88
Q

management of carpal tunnel

A

wrist split and steroids

89
Q

what happens to sensory and motor action potentials in carpal tunnel

A

prolonged

90
Q

painful and stiff active and passive movement
loss of external rotation and abduction

A

adhesive capsulitis (frozen shoulder)

91
Q

2 RF for adhesive capsulitis

A

middle aged and diabetics

92
Q

rotator cuff injury causing a painful arc at 60-90 degrees

A

supraspinatus tendonitis (subacromial impingement)

93
Q

pain to 90 degrees abduction

A

supraspinatus tear

94
Q

pain on radial styloid/wrist

A

dequarveins tenosynovitis

95
Q

what is kanevel’s sign used for

A

flexor tendon sheath infection
(fixed flexion, pain on extension, swelling)

96
Q

RF for dupytrens

A

phenytoin

97
Q

fall on extended outstretched hand causing a dinner fork deformity

A

colle’s fracture

98
Q

3 findings in colles

A
  1. transverse radial fracture
  2. proximal to radio-carpal joint
  3. dorsal displacement and anulation
99
Q

fall backwards onto outstretched hand with the wrists flexed and a garden spade deformity

A

smiths fracture (reverse colles)

100
Q

impact on flexed metacarpal causing an intraarticular fracture of the thumb base

A

bennetts fracture

101
Q

FOOSH with forced pronation and dislocation of the proximal radioulnar joint

A

monteggias fracture

102
Q

fall on hand with rotation causing fracture of the radial shaft with distal radio-ulnar joint dislocation and bruising over lower forearm

A

galeazzi fracture

103
Q

xray of galaezzi fracture

A

displaced radius and prominent ulnar head

104
Q

distal radius fracture (colle/smith) with radiocarpal dislocation from fall on extended and pronated wrist

A

bartons fracture

105
Q

FOOSH in young adults with tenderness over radial head, reduced elbow movement and sharp pain on extreme of pronation and supination

A

radial head fracture

106
Q

carpal fracture due to FOOSH/blow to palm with swelling and tenderness in the anatomical snuffbox or on longitudinal compression of the thumb

A

Scaphoid fracture

107
Q

which artery is at risk in scaphoid fractures

A

dorsal carpal branch of radioulnar artery

108
Q

xray of scaphoid

A

ulnar deviation in AP film

109
Q

management of scaphoid fractures in ED

A

immbolise with splint and backslab –> review

110
Q

management of uncomplicated scaphoid fractures

A

cast for 6-8w

111
Q

when do you need surgery for a scaphoid fracture

A

when the fracture is to the proximal pole

112
Q

mechanism of injury in subluxation of the radial head

A

a child who has been pulled

113
Q

management of subluxation of the radial head

A

passive supination of the elbow whilst flexed to 90 degrees

114
Q

both sides of the cortex breeched

A

complete fracture

115
Q

oblique tibial fracture in infants

A

toddlers fracture

116
Q

unilateral cortical breech

A

greenstick fracture

117
Q

stress on bone causing deformity with no cortical disruption

A

plastic deformity

118
Q

incomplete cortical disruption causing periosteal haematoma

A

Buckle ‘forus’ fracture

119
Q

management of open fractures

A

delay surgery until the soft tissue has recovered

120
Q

what are the 5 salter harris fractures

A

see image

121
Q

acute hip pain post viral infection in 2-10 years

A

transient synovitis

122
Q

management of transient synovitis

A

rest and analgesia

123
Q

barlow and ortalani positive, unequal leg length and skin folds

A

DDH

124
Q

weeks of hip pain with a limp, stiffness and reduced range of movement in 4-8y male

A

perthes

125
Q

pathophys of perthes

A

avascular necrosis of the femoral head

126
Q

xray findings in perthes

A

increased joint space and flat femoral head

127
Q

knee/thigh pain and reduced internal rotation in 10-15y obese male following trauma or chronic

A

SUFE

128
Q

pathophys of SUFE

A

displaced femoral head

129
Q

xray views for SUFE

A

AP and frog leg

130
Q

2 - in juvenile idiopathic arthritis

A

under 16 years
more than 3m

131
Q

most common type of JIA

A

pauciarticular

132
Q

joints affected in paucarticular arthritis

A

knee ankle and elbow
swelling and limp

133
Q

which antibody is positive in JIA

A

ANA (associated with anterior uveitis)

134
Q

acute hip pain and systemically unwell

A

septic arthritis

135
Q

management of xray suggesting sarcoma

A

immediate 48hr referral

136
Q

pain at rest with high calcium and ALP

A

metastatic bone tumour

137
Q

asymptomatic fluctuant swelling behind knee

A

bakers cyst

138
Q

what is parsonage turner syndrome

A

peripheral neuropathy after a virus

139
Q

presentation of iliopsoas abscess

A

fever and back pain

140
Q

imaging for iliopsoas abscess

A

CT abdo

141
Q

common demographic for osteomyelitis

A

IVDU

142
Q

imaging for osteomyelitis

A

MRI

143
Q

sepsis and changing lower limb neurology

A

epidural abscess

144
Q

first line medication for back pain

A

NSAID

145
Q

red flag back pain

A

thoracic

146
Q

back pain and haemodynamic compromise

A

AAA

147
Q

management of discitis due to staph aureus

A

ECHO for endocarditis

148
Q

bilateral sciatica found in what

A

cauda equina

149
Q

imaging for cauda equina

A

MRI spine in 6 hours

150
Q

pain worse when walking down hill

A

spinal stenosis

151
Q

imaging for spinal stenosis

A

MRI

152
Q

association with spinal stenosis

A

mets

153
Q

presentation of syringomyelia

A

spinothalamic
reduced pain and temperature

154
Q

sudden onset back pain after bending with normal straight leg raise test

A

facet joint pain

155
Q

sudden onset back pain after bending with abnormal straight leg raise test

A

disc prolapse

156
Q

patient needing excessive breakthrough analgesia then suspect

A

compartment syndrome

157
Q

what medication worsens compartment syndrome

A

anticoagulants

158
Q

2 hand findings in osteoarthritis

A

squaring of the thumbs
swelling of DIPs (heberdens nodes)

159
Q

3 factors in Leriche syndrome

A
  1. claudication of thigh and buttocks
  2. leg muscle atrophy
  3. impotence (L1 paralysis)
    (males)

Medicine Year 5 (27 decks)

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