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Orthopedics > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

Where is the groove for the biceps tendon

A

between the greater and lesser tuberosities of the humerus

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2
Q

what are the trauma views of the shoulder

A

AP with external rotation, AP with internal rotation, axillary/scapular Y

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3
Q

What does the AP with shoulder in external rotation visualize

A

greater tuberosity in profile

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4
Q

What does the AP with shoulder in internal rotation visualize

A

lesser tuberosity in profile

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5
Q

what is the axillary view of the shoulder good for diagnosing

A

posterior dislocations

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6
Q

What are the 4 sites of proximal humerus fracture

A

Surgical neck, anatomic neck, greater tuberosity, lesser tuberosity

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7
Q

which is the most common site of proximal humerus fracture

A

surgical neck

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8
Q

describe the location of the anatomical neck of the humerus

A

end of the humeral head cartilage and where the capsule attaches

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9
Q

what type of fracture commonly coexists with a humeral anatomical neck fracture

A

surgical neck

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10
Q

what are the two mechanisms of injury for a greater tuberosity of the humerus fracture

A

direct blow (young patient) or dislocation (older patient)

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11
Q

which type of proximal humerus fracture is rarely found in isolation

A

anatomical neck and lesser tuberosity

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12
Q

what two injuries commonly occur with an anterior GH dislocation

A

Fracture of glenoid/labral tear (Bankart), posterolateral fracture of humeral head (Hill Sachs)

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13
Q

what is the most common mechanism of injury for a posterior shoulder dislocation

A

Seizure/electrocution

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14
Q

what is the radiographic challenge of a posterior GH dislocation

A

the shoulder is locked in internal rotation so it may be missed on AP views; axillary view is needed

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15
Q

Bankart fracture AKA

A

glenoid fracture

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16
Q

Labral tear aka

A

Bankart tear

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17
Q

Hill Sachs fracture

A

posterolateral humeral head

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18
Q

Neer classification

A

1-4 part based on number of displaced segments

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19
Q

what is the most common shoulder dislocation

A

anterior

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20
Q

inferior GH dislocation aka

A

luxatio erecta

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21
Q

inferior GH dislocation presentation

A

arm is locked above their head

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22
Q

grade 1 AC separation

A

tenderness over the AC joint, normal x-rays

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23
Q

grade 2 AC separation

A

AC joint is torn but coracoclavicular ligament is intact (AC joint is separated but clavicle isn’t elevated)

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24
Q

grade 3 AC separation

A

AC joint and coracoclavicular ligaments are torn (joint is separated and clavicle is elevated)

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25
Q

grade 4 AC separation

A

something goes posterior

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26
Q

grade 5 AC separation

A

Clavicle is tenting skin

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27
Q

common fracture sites of clavicle

A

mid clavicle, distal, and AC joint

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28
Q

what is challenging about a medial third clavicle fracture

A

difficult to see on x-ray

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29
Q

radiograph views for elbow

A

AP, lateral, oblique

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30
Q

which view of elbow is most important

A

lateral

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31
Q

where does the radial head articulate

A

capitulum

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32
Q

what do the fat pads look like in a normal elbow radiograph

A

anterior is visible but flat and posterior is obscured

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33
Q

what do the fat pads look like in an elbow radiograph with effusion

A

anterior: sail sign, posterior: visible

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34
Q

what do signs of an elbow effusion usually mean in an adult

A

radial head fracture

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35
Q

what do signs of an elbow effusion usually mean in a child

A

supracondylar fracture

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36
Q

what is the normal mechanism of injury for an olecranon process fracture

A

direct blow due to fall

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37
Q

why are olecranon process fractures usually displaced

A

the bone fragment is pulled away by the triceps (olecranon process is attachment point)

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38
Q

Nightstick fracture

A

exception to the ring rule, isolated fracture to distal ulna due to sharp blow

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39
Q

If the distal radius is fractured, what is dislocated?

A

distal radioulnar joint

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40
Q

if the proximal ulna is fractured, what is dislocated?

A

radiocapitular joing

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41
Q

if the radial head is comminuted, what is dislocated?

A

distal radioulnar joint

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42
Q

name for proximal ulnar fracture and radiocapitular dislocation

A

Monteggia

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43
Q

name of distal radius fracture and DRUJ dislocation

A

Galeazzi

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44
Q

name for comminuted radial head and DRUJ dislocation

A

Essex lopresti

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45
Q

most common fractures of the wrist

A

distal radius and ulnar styloid

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46
Q

clinical presentation of scaphoid fracture

A

snuffbox tenderness

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47
Q

best view for scaphoid fracture

A

ulnar deviation (navicular)

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48
Q

what can happen if a scaphoid fracture is missed

A

nonunion, AVN, and arthritis

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49
Q

what if scaphoid fracture is suspected but negative x-ray

A

splint and re-image in 1-2 weeks

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50
Q

what is normal position of ulna

A

slightly negative variance (shorter than radius)

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51
Q

what can happen with positive ulnar variance

A

ulna is longer than radius, can cause triangular fibrocartilage tears with cartilage loss and cystic changes (ulnar impaction into lunate)

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52
Q

what can happen with negative ulnar variance

A

puts stress on lunate and can cause osteonecrosis

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53
Q

Keinboch’s disease

A

AVN to lunate caused by negative ulnar variance

54
Q

what is the most common MOI for distal radius injuries

A

FOOSH

55
Q

method of characterizing distal radius injuries

A

Fryckman classification

56
Q

Name for a distal radius fracture with dorsal angulation

A

Colles fracture

57
Q

Name for a distal radius fracture with volar angulation

A

Smith’s fracture

58
Q

which distal radius fracture is more likely to need hardware, Smith’s or Colles

A

Colles

59
Q

What is a Barton fracture

A

an intraarticular distal radius fracture that only involves a fragment of the bone but can appear as a dislocation on x ray because its displacement drags carpal bones along with it

60
Q

name for radial styloid fracture

A

Hutchinson/Chauffeurs

61
Q

X-ray finding for scapholunate dissociation

A

wide gab between scaphoid and lunate (David Letterman sign)

62
Q

major risk with scapholunate dissociation

A

wrist won’t move as a unit (SLAC) wrist and will lead to arthritis if untreated

63
Q

x-ray views for hand

A

AP/lateral/oblique

64
Q

what is a boxers fracture

A

5th metacarpal neck

65
Q

what is a Bennett fracture

A

intraarticular fracture at the base of the first metacarpal (at carpal-metacarpal joint)

66
Q

what is a Rolando fracture

A

a comminuted fracture at the same location as Bennett fracture

67
Q

what is major sequelae of Rolando fracture

A

early arthritis

68
Q

what is Gamekeeper’s thumb

A

ulnar collateral ligament tear of first MCP joint

69
Q

imaging considerations for gamekeeper’s thumb

A

may have normal radiograph with or without fracture

70
Q

MOI for gamekeepers thumb

A

hand stuck on pole plant when skiing, pulling thumb back

71
Q

AVN consideration for scaphoid fracture

A

in the scaphoid waist, the more proximal the fracture, the more likely to get AVN of the proximal pole and subsequent nonunion

72
Q

Most common carpal fracture

A

triquetral

73
Q

which view to use to see triquetral fracture

A

lateral

74
Q

what is a tuft fracture

A

a blunt crushing injury to the tip of the finger, generally nondisplaced

75
Q

treatment consideration with tuft fracture

A

if nailbed is injured, it is an open fracture with infection risk

76
Q

distal and middle phalanx lip fractures considerations

A

flexor/extensor tendons may be avulsed and splinting must take tension off

77
Q

which pathogen is most common in dog bites

A

pasteurella canis

78
Q

what causes Boutouneirre deformity

A

PIP flexion and DIP extension, can be caused by laceration involving the tendons, direct blow to DIP joint, osteoarthritis. Proximal phalanx buttonholes between the bands of the extensor tendon

79
Q

combination of what forces to cause an anterior shoulder dislocation

A

abduction, extension, external rotation

80
Q

combination of what forces to cause a posterior shoulder dislocation

A

adduction, extension, internal rotation

81
Q

articulation of olecranon process

A

trochlea and olecranon fossa

82
Q

physical exam findings of Monteggia fracture

A

radial head displacement into AC space

83
Q

torus/buckling fracture force

A

compression

84
Q

most common elbow fracture in adults

A

radial head fracture

85
Q

what view is necessary for triquetral fracture

A

lateral

86
Q

4 muscles of rotator cuff

A

supraspinatus, infraspinatus, subscapularis, teres minor

87
Q

radiograph finding of GH arthritis

A

“goat’s beard” osteophyte off inferior humerus

88
Q

presentation of AC arthritis

A

pain with cross-body adduction, tenderness over AC joint, bony prominences over AC joint

89
Q

operative treatment for AC arthritis

A

distal clavicle resection

90
Q

presentation of adhesive capsulitis

A

loss of internal rotation in abduction, gradual loss of flexibility

91
Q

imaging findings of adhesive capsulitis

A

x-rays are often normal, MRI shows lack of axillary recess and soft tissue scarring and contracture w/o known cause

92
Q

risk factors of adhesive capsulitis

A

diabetes, thyroid conditions

93
Q

conservative treatment for adhesive capsulitis

A

PT with elbow at the side, NSAIDs, steroid injections

94
Q

advanced treatment for adhesive capsulitis

A

manipulation under anesthesia, arthroscopic release

95
Q

imaging findings for rotator cuff tear

A

x-rays often normal, bright spot in rotator cuff on mri

96
Q

sequelae of rotator cuff tear

A

cuff tear arthropathy

97
Q

presentation of rc tear

A

pain with overhead motion and at night

98
Q

post-surgical recovery time of rc tear

A

8-12 weeks

99
Q

what percentage of rc tear pts improve with PT

A

75%

100
Q

infraspinatus test

A

elbows flexed to 90, external rotation

101
Q

subscapularis test

A

elbows flexed to 90, internal rotation

102
Q

supraspinatus test

A

Jobe’s test

103
Q

supraspinatus tear test

A

drop-arm test (snow angel, arm will drop)

104
Q

supraspinatus impingement tests

A

Neers, Hawkins

105
Q

test for biceps tendon or labral pathology

A

press down on flexed, straight arm while pt tries to bring wrist to shoulder (Speeds test)

106
Q

labral tear test

A

arm outstretched with thumb down, resist downward pressure, repeat with thumbs up (Obriens)

107
Q

teres minor test

A

horblowers test

108
Q

imaging finding for calcific tendonosus

A

fluffy white cloud on x-ray

109
Q

pathology of calcific tendonosus

A

deposition of calcium in rotator cuff

110
Q

sulcus sign

A

odd contour of shoulder present with shoulder dislocation

111
Q

significance of continued instability after shoulder dislocation immobilization

A

likely bankart lesion

112
Q

how long to immobilize dislocated shoulder

A

several days

113
Q

pathology of multidirectional instability of shoulder

A

ligament laxity

114
Q

presentation of multidirectional instability of shoulder

A

anterolateral shoulder pain with clicks and pops

115
Q

imaging of multidirectional shoulder instability

A

x-rays are usually normal, extra fluid may be seen in joint capsule on MRI

116
Q

treatment for multidrectional shoulder instability

A

PT (no surgery)

117
Q

Presentation of AC separation

A

tenderness over AC joint and abnormal shoulder contour

118
Q

treatment for AC separation

A

if grade 1-2, immobilize in sling for 3 weeks

119
Q

MOI for AC separation

A

direct blow to shoulder

120
Q

operative treatment for AC separation

A

grade 3-6, ORIF or ligament reconstruction

121
Q

recovery from AC separation surgery

A

no ROM for 6 weeks, full use at 6 months

122
Q

imaging for clavicle fracture

A

AP radiograph

123
Q

treatment for clavicle fracture

A

sling 2-4 weeks if stable, ORIF if unstable, open, comminuted, displaced

124
Q

Imaging for scapular fracture

A

AP, scapular, axillary radiographs

125
Q

treatment for scapular fracture

A

sling for 2 weeks with early ROM

126
Q

nerve damage in proximal humerus fractures

A

axillary nerve (possibly brachial plexus if high energy)

127
Q

nerve damage in midshaft humeral fractures

A

radial nerve

128
Q

nerve damage in distal humerus fractures

A

ulnar nerve

129
Q

tx for proximal humerus fractures

A

sling and PT

130
Q

tx for midshaft humerus fractures

A

coaptation splint

131
Q

tx for distal humerus fractures

A

requires surgery

132
Q

presentation of biceps tendonitis

A

anterior shoulder pain, tenderness at biceps groove

Orthopedics (3 decks)

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