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Finals Studying - Condensed > Ortho > Flashcards

Ortho Flashcards

1
Q

how is displacement of a # described

A

direction of translation of the distal fragment

ant, post, med, lat

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2
Q

describing displacement of a # if in forearm or hand

A 
ant = volar 
post = dorsal 
med = ulnar 
lat = radial
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3
Q

what is angulation of a #

A

the direction the distal frag points towards

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4
Q

varus angulation of a lower limb #

A

distal fragment points TOWARDS midline

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5
Q

valgus angulation of a lower limb #

A

distal fragment points AWAY from midline

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6
Q

general Mx of open #

A

clean wound, excise non-viable tissue

external fixation for # stability

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7
Q

general Mx of displaced stable #

A

closed reduction + plaster

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8
Q

general Mx of non-displaced stable #

A

plaster cast

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9
Q

general Mx of displaced unstable #

A

ORIF

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10
Q

salter-harris classification of childrens #

A 
S = straight through growth plate 
A = through growth plate and Above into metaphysis 
L = through growth plate and Lower into epiphysis 
T = Through both metaphysis and epiphysis 
R = goes Round physis
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11
Q

green-stick #

A

incomplete #, bone bent

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12
Q

median nerve S and M function

A 
S = 2nd & 3rd fingers 
M = LOAF muscles
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13
Q

LOAF muscles

A

Lateral 2x lumbricals
Opponens pollicis
Abductor pollicis brevis
Flexor pollicis brevis

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14
Q

radial nerve S and M function

A 
S = dorsal 1st web space 
M = extensor muscles
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15
Q

ulnar nerve S and M function

A 
S = little finger 
M = abduction/ adduction finger power
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16
Q

Way of assessing neurovascular status in children

A

rock (median)
paper (ulnar)
scissors (radial)

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17
Q

what is a nightstick #

A

isolated # of ulna shaft

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18
Q

monteggia # dislocation

A

of ulna + dislocation of the radial head at the elbow

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19
Q

galeazzi # dislocation

A

of the radius + dislocation of the distal ulna

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20
Q

Colles #

A

distal radius #
FOOSH with wrist extended
causes dorsal displacement or angulation

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21
Q

Neurovascular injury risk in colles #

A

median nerve / carpal tunnel syndrome

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22
Q

Late complication of colles #

A

rupture of extensor pollicis longus tendon

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23
Q

smith #

A

distal radius #
FOOSH with wrist flexed
causes ventral displacement or angulation

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24
Q

barton’s #

A

intra-articular radial #

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25
Q

carpal bones

A 
Some = scaphoid 
Lovers = lunate 
Try = triquetrum 
Positions = pisiform
That = trapezium 
They = trapezoid 
Can't = capitate
Handle = hamate
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26
Q

classic Hx od scaphoid #

A

young male in high energy contact sport, FOOSH

tenderness in anatomical snuffbox

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27
Q

neurovascular injury risk in scaphoid #

A

radial artery (retrograde blood supply)

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28
Q

how many x-ray views in scaphoid #

A

4 (AP, lat, x2 oblique)

x-ray may be normal until days after injury

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29
Q

area most common for proximal humerus #

A

SURGICAL neck

anatomical neck v rare

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30
Q

what is a garth view

A

axial oblique view used when evaluating shoulder trauma

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31
Q

most common - ant or post shoulder dislocation

A

anterior

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32
Q

bankart lesion

A

injury to anterior glenoid labrum due to anterior shoulder dislocation

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33
Q

hill-sachs lesion

A

impaction # of post humeral head due to anterior shoulder dislocation

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34
Q

neurovascular injury risk in shoulder dislocation

A

axillary nerve

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35
Q

sign of posterior shoulder dislocation on xray

A

lightbulb sign

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36
Q

Mx clavicle # or ACJ #

A

sling for a few weeks

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37
Q

neurovascular injury risk in humeral shaft #

A

radial nerve (in spiral groove) - wrist drop

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38
Q

Mx humeral shaft #

A

functional humeral brace if not displaced

ORIF if displaced

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39
Q

child, heavy fall onto outstretched hand - #?

A

supracondylar # (distal humerus)

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40
Q

Mx of supracondylar #

A

reduction under anaesthesia, fix with pins

+ collar and cuff with arm in flexion

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41
Q

neurovascular injury risk in supracondylar #

A 
median nerve (unable to make OK sign) 
brachial artery
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42
Q

spinal shock

A

complete loss of sensation motor and reflexes below level of injury
psychologic response to injury
resolves in 24h

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43
Q

neurogenic shock

A

blockage of sympathetic outflow

priapism

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44
Q

complete cord injury

A

no sensory or motor function below injury level

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45
Q

central cord injury presentation

A

corticospinal tract affected

Arms > Legs

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46
Q

anterior cord injury presentation

A

corticospinal and spinothalamic affected

dorsal column preserved

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47
Q

posterior cord injury presentation

A

loss of dorsal column

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48
Q

brown-sequard syndrome

A

cord hemisection
ipsilateral dorsal column & corticospinal
contralateral spinothalamic

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49
Q

Mx intra-capsular hip #

A

hemiarthroplasty or THR

50
Q

Mx extra-capsular hip #

A

DHS

51
Q

proximal femur # (incl sub-trochanteric)

A

IM nail

52
Q

posterior hip dislocation presentation

A

shortened, internally rotated

53
Q

anterior hip dislocation presentation

A

no shortening, externally rotated

54
Q

Holding Mx of femur #

A

thomas splint

55
Q

Mx of femoral shaft #

A

IM nail

56
Q

Mx of femoral shaft # in child <18m

A

Gallows Traction (think NAI)

57
Q

Mx of femoral shaft # in child 2-6 y

A

Thomas splint

58
Q

Mx of femoral shaft # in child 6-12y

A

flexible IM nail

59
Q

Mx of femoral shaft # in child >12y

A

adult IM nail

60
Q

neurovascular injury risk in patella dislocation

A

common peroneal nerve - foot drop

61
Q

old man falls @ home, # of L inferior and superior pubic rami but femur intact - Mx?

A

analgesia and active mobilisation

62
Q

Mx fibula #

A

mostly can leave alone BUT if above level of syndesmosis then Tx

63
Q

Mx tibia #neurovascular injury risk in

A

IM nail

64
Q

Toddler’s #

A

undisplaced spiral # of tibial shaft

65
Q

pilon #

A

intra-articular distal tibia #

66
Q

Mx pilon #

A

plate fixation

67
Q

bimalleolar # Mx

A

ORIF

68
Q

talar shift

A

widening of space between talus and medial malleolus

seen in ankle #

69
Q

obese 32 y/o tripped on kerb - eversion of R foot , displaced # of medial malleolus and # of fibula above level of tibio-fibular joint - Mx?

A

ORIF

70
Q

Lisfranc #

A

of midfoot

71
Q

bones composing midfoot

A

cuboids and cuneiform

72
Q

Jone’s #

A

of base of 5th metatarsal

73
Q

neurovascular injury risk in posterior hip dislocation

A

sciatic nerve

74
Q

impingement syndrome

A

pain at 60-120 degrees of abduction

impingement of rotator cuff tendons (usually supraspinatus)

75
Q

Mx impingement syndrome

A

NSAIDs, physio, steroid inj into subacromial space

76
Q

presentation rotator cuff tear

A

difficulty initiating abduction (as usually supraspinatus affected)

77
Q

Mx rotator cuff tear

A

conservative - physio, injection
or
surgery

78
Q

test for cubital tunnel

A

froment’s test - grip test of thumb on paper (weak adductor pollicis, so patient flexes their flexor pollicis longus to maintain grip strength)

79
Q

test for carpal tunnel

A

tinels test (tap median nerve)

phalen’s test (hyper-flex wrist to reproduce pain)

80
Q

tennis elbow

A

lateral epicondylitis

due to wrist always EXTENDED

81
Q

golfers elbow

A

medial epicondylitis

due to wrist always FLEXED

82
Q

de Quervain’s tenosynovitis

A

inflammation of two tendons that control thumb movement

83
Q

test for de Quervain’s tenosynovitis

A

Finkelstein’s test - sharp ulnar deviation reproduces pain

84
Q

sign of AVN on x-ray

A

hanging rope sign

85
Q

knee extensor mechanism

A

tibial tuberosity, patellar tendon, patella, quadriceps tendon, quadriceps muscle

86
Q

body builder, heavy lifting caused sudden leg pain - Dx?

A

extensor mechanism rupture (most probably patella), assumed chronic steroid abuse

87
Q

carpet fitter, has swelling and pain in knee - Dx ?

A

bursitis

88
Q

mulder’s click test

A

for morton’s neuroma - squeezing the forefoot produces a click

89
Q

predispositions to achilles tendonitis

A

quinolone Abx, RA, gout

90
Q

simmond’s test positive

A

achilles tendon rupture

squeezing the calf muscles doesn’t cause plantarflexion of the foot

91
Q

Mx plantar fasciitis

A

rest, physio, steroid injection

92
Q

Man with high BMI was running and now has pain in foot - Dx?

A

gastrocneumius tendon tear

93
Q

inheritence of osteogenesis imperfecta

A

AD

94
Q

defect in marfans

A

fibrillin gene

95
Q

defect in ehler’s danlos

A

elastin and collagen

96
Q

inheritence of DMD

A

x-linked recessive

97
Q

erb’s palsy

A

high brachial plexus injury (C5,6)

knocks out everything except subscapularis - unopposed internal rotation

98
Q

“waiter’s tip posture”

A

erbs palsy

99
Q

klumpke’s palsy

A

low brachial plexus injury (C8 & T1)

paralysis of intrinsic hand muscles and finger flexors +/- horner’s syndrome

100
Q

Ortolani’s test

A

reducing a dislocated hip by abduction and anterior displacement

101
Q

Barlow’s test

A

dislocataBle hip by pushing the hip Back when flexed

102
Q

Ix for DDH if Ortolani or Barlow +ve

A

USS

103
Q

presentation transient synovitis

A

reluctance to weight bear on affected side, restricted ROM, post viral

104
Q

Mx transient synovitis

A

NSAIDs, rest

105
Q

presentation Perthe’s

A

pain and limp, loss of int rotation, +ve Trendeleberg test

106
Q

Mx perthes

A

regular x-ray avoid physical activity

107
Q

SUFE presentation

A

can present with pain purely in groin or knee, loss of int rotation

108
Q

Mx SUFE

A

pinning of femoral head

109
Q

Mx AVN of femoral head

A

bone not collapsed - drilling to relieve pressure

bone collapsed - joint replacement

110
Q

Ix osteomyelitis

A

MRI

111
Q

presdisposing conditions to osteomyelitis

A 
sickle cell anaemia 
DM 
IVDU 
immunocompromised 
alcohol
112
Q

Mx osteomyelitis

A

fluclox 6 weeks

113
Q

Pavlick harness

A

Mx of DDH

114
Q

Ponseti technique

A

Mx of club foot

115
Q

Mx intertrochanteric hip #

A

DHS (extracapsular #)

116
Q

low back pain worse on walking - Dx?

A

spinal stenosis

117
Q

Ix spinal stenosis

A

MRI

118
Q

drug that can be used for spasticity in CP

A

baclofen

119
Q

most common cause of osteomyelitis

A

s. aureus

120
Q

cause of osteomyelitis in sickle cell pts

A

salmonella

Finals Studying - Condensed (22 decks)

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