ORTHO/NMS

Question 1

Describe type A fracture

Answer 1

Rotationally and vertically stable

Question 2

Describe type A1 fractures

Answer 2

Fractures of the pelvis not involving the ring

Question 3

Describe type A2 fractures

Answer 3

Stable, minimally displaced fractures of the ring

Question 4

Describe type A3 fractures

Answer 4

Transverse sacral or coccyx fractures

Question 5

Treatment for type A pelvic fractures

Answer 5

Bed rest until pain subsides (usually 3/52)
Pt mobilized PWB, NWB or FWB according to pain

Question 6

Describe type B fractures

Answer 6

Rotationally unstable and vertically stable

Question 7

Describe type B1 fractures

Answer 7

“Open book”
External rotation injury
Antero-posterior compression fractures
Causing separation of the public symphysis and widening or one or both sacroiliac joints

Question 8

Treatment for type B fractures

Answer 8

If anterior gap is less than 2.5 cm then bedrest for 4/52 the mobilize according to pain

If anterior gap is bigger than 2.5cm external fixator for 6/52 or plates across public symphysis
Start mobilizing PWB

Question 9

Describe type B2 fracture

Answer 9

Internal rotation injury
Ipsilateral compression
Causing the public bones to fracture and override

Question 10

Describe type B3 fracture

Answer 10

Contraleteral compression injury
Resulting in public rami fractures on one side and compression sacroiliac joint injury on the other side

Question 11

Treatment for B type fracturs

Answer 11

B2 and B3 (unstable)
ORIF/traction/ex-fix

Question 12

CI & precaution for type B

Answer 12

No excessive hip external rotation
No sitting higher than 45 degrees hip flexion for 4/52

Question 13

Describe type C pelvic fracture

Answer 13

Rotationally and vertically unstable
The pelvic ring is completely displaced at 2 or more points

Question 14

Ligaments affected with C2

Answer 14

Posterior sacroiliac ligament
Sacrospinous ligament
Sacrotuberous ligament

Question 15

Define spinal tumor

Answer 15

A growth of cells (mass) within or surrounding the spinal cord

Question 16

Where can spinal tumors occur ?

Answer 16

Intramedullary
Extramedullary
Intradural
Extradural

Question 17

Signs and symptoms of TB tumor

Answer 17

Back and neck pain
Numbness
Tingling and weakness in either arms
Clumsiness
Difficulty in walking
Incontinence

Question 18

Treatment for spinal tumor

Answer 18

Steroids
Chemotherapy
Surgery
Radiotherapy

Question 19

Signs and symptoms of TB

Answer 19

Appetite loss
Night sweats
Chest pains
Fever
Weight loss
Shortness of breath

Question 20

Signs and symptoms of Pott’s disease

Answer 20

Fever
Night sweats
Localized back pain
Pain and stiffness
Paralysis of the lower limbs

Question 21

Late complications of spinal tumor

Answer 21

Severe kyphosis
Vertebral collapse
Spinal cord compression
Sinus formation

Question 22

Clinical complications of polytrauma

Answer 22

Haemorrhagic shock
Neurogenic shock
Multiple bone fractures
Primary or secondary head injury
Spinal cord injury
Auditory and visual damage
Unhealed wounds (sepsis)
Chest complications
Thoracic injuries

Question 23

List anterior oblique sling muscles

Answer 23

Pectoralis
External oblique
Internal oblique
Abductors
(Provide stability in multidirections. Accelerating, rotating and decelerating body during change in direction)

Question 24

List posterior oblique slings

Answer 24

Latissmus dorsi
Contralateral gluteus max and biceps femoris
Connected but thoracolumbar fascia
(Provides stability during gait)

Question 25

List longitudinal slings

Answer 25

Multifidus
Deep layer of thoracolumbar fascia
Long head of biceps femoris
(Encourages SIJ to be in its close packed position)

Question 26

List lateral sling muscles

Answer 26

Gluteus med
Abductors
Quadratus lamborum
(Provides pelvofemoral stability)

Question 27

Why are thoracic disc lesions uncommon

Answer 27

Relatively thin disc
Mobility of the disc is limited by splinting of the ribcage
ALL, PLL and ligamentum flavum eell developed to provide stability
Nucleus Pulposus is more anterior than in other regions

Question 28

Indications for spinal surgery

Answer 28

Instability
Stenosis
Failure of conservative management
Infections or tumors
Abnormal curvature of the spine

Question 29

Name cervical tests you can do

Answer 29

Cervical AROM and PROM
cervical spine distraction test
Cervical spine spurling test