cortext notes

Question 1

why might pain produced in groin/hip radiate to the knee?

Answer 1

both supplied by obbturator nerve –> referred pain

Question 2

secondary causes of AVN

Answer 2

alcohol abuse
steroids
hyperlipidaemia
thrombophilia

Question 3

imaging of AVN

Answer 3

early changes may only show on MRI

xray - lytic zone gives rise to hanging rope sign

Question 4

management of AVN

Answer 4

(pre-collapse)
->drill holls into femoral neck of abnormal area to relieve pressure

(collapse) = total hip replacement

Question 5

what ages do patellar tendon ruptures typically occur?

Answer 5

under 40s

Question 6

what age do quadriceps tendon ruptures typically occur?

Answer 6

over 40s

Question 7

what should be avoided in the management of extensor mechanism tendonitis?

Answer 7

steroid injections

Question 8

which antibiotics can predispose tendonitis?

Answer 8

quinolones - ciprofloxacin etc

also rheumatoid arthritis, gout

Question 9

lumbar spine red flgs

Answer 9

back pain in <20yrs
NEW back pain in >60
constant, severe, worse at night
systemic upset

Question 10

saddle anaesthesia, bilateral symptoms, altered bowel habits, initial investigation?

Answer 10

PR !! then MRI

cauda equina

Question 11

ortho probs in downs

Answer 11

recurrent patella dislocation

atlanto-axial dislocation

Question 12

inheritance of duchennes

Answer 12

x-linked RECESSIVE

Question 13

which has a worse prognosis duchennes or beckets muscle dystrophy

Answer 13

duchennes

beckers live longer

Question 14

spastic cerebral palsy

Answer 14

commonest 70%
upper motor neurons
scissor gate
hypertonia, tight/stiff muscles

Question 15

dyskinetic cerebral palsy

Answer 15

(athenoid)
basal ganglia
random, involuntary movement
chorea - dance like movements

Question 16

ataxic cerebral palsy

Answer 16

cerebellum
shaky, uncoordinated
problems with precise movement

Question 17

Mx of cerebral palsy

Answer 17

baclofen - injected into subarachnoid space

botox injections

Question 18

hemiplegia

Answer 18

arm + leg on same side

Question 19

diplegia

Answer 19

just legs

arms a lil

Question 20

what babies are at risk of obsteric brachial plexus palsy

Answer 20

big babies, diabetes, twins

Question 21

erbs palsy in babies

Answer 21

waiters tip hand
upper C5+C6 damage

prognosis - return of biceps at 6 months, 80-90% go away

Question 22

Klumpke’s

Answer 22

obsteric brachial pleuxus palsy
C8 + T1
worse prognosis than erbs, 50% recover

wrist extended but like dropped also ?

Question 23

flexible vs rigid flat feet

Answer 23

flexible = arch on dorsiflexion

rigid = remains flat - underlying -> tarsal coalition

Question 24

ponseti method

Answer 24

talipes

–>after corrected, boots+bar till 3/4yrs so doesnt reoccur

Question 25

in a myelomeningocele, what does the herniation contain?

Answer 25

cerebrospinal fluid meninges spinal cord/cauda equina

Question 26

polio

Answer 26

virus enters GI, flu-like illness, motor neurons affected, typically manifesting as weakness of group muscle withi a single limb, sesation preserved motor anterior horn cells affected residual paralysis, shortening of limbs

Question 27

ligament ruptured in patellar dislocation

Answer 27

medial patello-femoral ligament | lateral disloaction, medial ligament tear

Question 28

commonest cause of paediatric hip pain

Answer 28

transient synovitis

Question 29

mildest form of spina bifida

Answer 29

spina bifida occulta high arched foot, clawing toes, neurological symtpoms

Question 30

varus/valgus derformities throughout growth

Answer 30

birth - varus neutrally aligned by 14months progressing to 10/15 degrees valgus by age 3 regress to physiological 6 degrees valgus by 7-9

Question 31

back pain worse on coughing

Answer 31

acute disc tear | -> outer annulus fibrosis of disc, periphery is richly innervated (super sore)

Question 32

who are at greater risk of atraumatic cervical spine instbility

Answer 32

rheumatoid arthritis + downs atlanto-axial (C1/C2) subluxation

Question 33

acute angular defority seen in sagittal plane

Answer 33

(from side) Gibbus

Question 34

peripheral arterial disease VS spinal stenosis

Answer 34

pad = calf pain is worse on walking uphill spinal stenosis = worse DOWNHILL

Question 35

which nerve would be impinged in a lateral L4/L5 prolapse

Answer 35

exiting L4 nerve

Question 36

which nerve would be impinged in a paracentral L4/L5 disc prolapse

Answer 36

L5 nerve (travesing)