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Flashcards in Clinically important Deck (24):
1

Pelvic fractures usually occur in ______ b/c bony pelvis is a united ring of bones

Occur in pairs

  • 2 fractures; or
  • fracture+joint dislocation

2

Why do pelvic fractures have a high morbidity and mortality associated with them?

ALWAYS assume that ______ and ______ are also damaged with pelvic fracture

  • corresponding hemorrhagic shock
  • organ damage
  • ALWAYS assume that bladder and urethra are also damaged with pelvic fracture

3

Most common hip fracture location among elderly

  • Femoral neck; subcapital fracture (distal to head of femur, within fibrous capsule of joint)
  • greater incidence in women b/c of osteoporosis

4

Patellar reflex test

quadriceps femoris tendon

L2, L3, L4

5

Fracture to head of femur: why lead to avascular necrosis?

  • Fracture at neck of the femur--> damage to retinacular arteries --> inadequate blood supply to bone

6

Common complication of chronic swelling of the knee

(due to any of the three posterior bursa commincating directly with knee joint's synovial cavity)

Baker's cyst

7

What type of radiograph provides the best visualization of the joint space around the ankle joint?

tenon and mortise formation; patient should internally rotate foot

8

What is commonly used as a vessel for coronary artery bypass surgery? Why?

  • Great saphenous vein
  • longest vein of the body
  • Coronary artery bypass surgery is a surgical procedure in which segments of a patient’s great saphenous vein are frequently used to construct a vascular bypass around a site of coronary arterial occlusion.  The great saphenous vein is commonly used for coronary artery bypass surgery because:

  1. it can be readily resected from the leg,

  2. its diameter closely approximates that of the coronary arteries and their major branches, and

  3. its wall bears a comparatively high content of elastic tissue.

9

What is the most common cause of sciatica?

  • Herniation of lumbar intervertebral discs
  • Most common 4th and 5th lumbar
  • Sciatic nerve (L4, L5, S1, S2, S3)

_______

L4 disc herniation: impinges L5-dinished extension of big toe

L5 disc hernation: impinges S1-diminshed achilles tendon reflex

10

Sciatica symptom: which disc is herniated?

  • impinges L5
  • dinished extension of big toe

L4 disc

11

Sciatica symptom: which disc is herniated?

  • impinges S1-
  • diminshed achilles tendon reflex

L5 herniation

12

What is the most frequently broken bone in the human body? Why?

  • Clavicle
  • First bone to ossify
  • FOOSH in elderly (fall on outstretched hand)
  • 80% occur in middle third of clavicle
  • Presentation: upper limb hangs or is medially dropped across chest

13

Patient has a clinical presentation such that upper limb hangs or is medially dropped across chest. What's wrong?

  • Broken Clavicle
  • First bone to ossify
  • FOOSH in elderly (fall on outstretched hand)
  • 80% occur in middle third of clavicle

14

Where do most clavicle fractures occur?

80% occur in middle third of clavicle

15

Patient has a clinical presentation such that shoulder drops medially across chest

shoulder dislocation

  • Simple sprain: AC and CC space widths in normal range: Grade1
  • Subluxation (partial dislocation): AC space width is 50% greater than normal/CC is normal: Grade2
  • Dislocation: Both AC and CC are at least 50% greater than normal: Grade3

16

Nerve affected: fracture of midshaft of humerus

Radial nerve

17

Nerve affected: practure of medial epicondyle of humerus

Ulnar nerve

18

Nerve affected: Fracture of surgical neck of humerus or dislocated shoulder

Axillary nerve

19

Cubital fossa does not contain which arm nerve?

ulnar nerve

20

Tenderness in the anatomical snuffbox with pain in the lateral part of the wrist with a recent fall (fall on outstretched hand) (FOOSH) is suggestive of?

What is another common FOOSH injury?

scaphoid fracture

___________

Other common FOOSH injury: fracture to distal radius

21

Severe case of carpal tunnel has what complication?

  • Sever median nerve at wrist
  • Fingers can still flex; thumb cannot oppose; thenar eminence is flattened
  • Thus, unable to pick up using thumb

22

Klumpke's palsy. Cause and complication?

  • Cause: reaches out to grab something and falls
  • Affects C8 and T1; T1 usually tears out of spinal cord
  • Paralysis of ALL hand muscles (combination claw and ape hand)
  • Still able to pull on hand and cause torque due to extensor tendons being intact (C7 and C8)

23

Median nerve injury:

  • Diagnosis
  • Clinical presentation
  • Clinical association

A image thumb
24

Deep ulnar nerve injury:

  • Diagnosis
  • Clinical presentation
  • Clinical association

A image thumb