Final Flashcards
(179 cards)
1
Q
Red flags thoracic
A
CA Steroid Trauma Infection Drug/alcohol abuse
2
Q
Adams test
A
Structural vs functional scoliosis
3
Q
High scapula
A
Sprengels deformity
4
Q
Buffalo hump
A
Fat buildup with Cushing or long term steroid use
5
Q
Dowagers hump
A
Compression fracture
6
Q
Hyperkyphosis in adolescents
A
Scheuermanns
Postural problems
7
Q
What specific ROM does facet syndrome interfere with
A
Hyper extension
8
Q
What tests are done for facet syndrome
A
Hyperextension
Kemps
9
Q
Scheuermanns disease
A
Increased kyphosis
Anterior wedging greater than 5 degrees in 3 consecutive vertebra
Decreased disc height and end plate irregularity
Prone extension test
10
Q
Prone extension test
A
For scheuermanns
Of persistence of kyphosis then structural
11
Q
Osteoid osteoma MC found where
A
Metaphyseal region of long bones
On concave side
12
Q
DDX of osteoid osteoma
A
Osteoblastoma ABC Facet arthrosis Missing pedicle Contralateral pars defect
13
Q
Missing pedicel ddx
A
Congential Destructive 1. Tumor (lytic mets MC or ABC/osteoblastoma) 2. ST tumor (neurofibromas) 3. Infection Surgical
14
Q
Reasons for decreased disc height
A
Joint disease
Metabolic
Developmental
Infection
15
Q
Hypokyphosis assocaite with what and hyper with what
A
Hypo: scoliosis
Hyper: scheuermanns
16
Q
What is used to determine rotation in curvature in scoliosis
A
Nash moe method
17
Q
MRI and old vs new compression fracture
A
Dark T1, bright T2
18
Q
What angle is used to measure scoliosis
A
Cobb angle
19
Q
Spontaneous pneumothorax
A
Usually in young patient under 35
Vesicle visceral pleura
Radiolucent compared to other lung
20
Q
What is the most sensitive indicator of cauda equine
A
Urinary retention
21
Q
What is the best indicator of whether it is a disc or referred pain
A
Pain below knee is likely disc
22
Q
L5 NR lesion s/s
A
Weakness of dorsiflexion of great toe and numbness on lateral side of lower leg
Difficulty toe walking
23
Q
Absent Achilles reflex
A
S1 NR
24
Q
Weakness on dorsiflexion of big toe
A
L5 NR
25
Weakness if plantarflexion NOF big toe
S1 NR
26
Midline/parade trail disc herniation s vs foraminal herniations lumbar
Midline: compress NR below
L5-S1 hernation compress S1 NR (traversing)
Foraminal: involve NR at same level
L5/S1 disc compress L5 disc
27
Toe walking
S1 NR
| L5/S1 disc
28
Heel walking
L5 NR
| L4/L5 disc
29
Patellar reflex
L4 NR
30
Hadley S curve
Facet imbrication
31
Normal canal size for lumbar and stenosis measurements
Normal: 15mm
12 relative
10 absolute stenosis
32
Isn’t ic spondy
MC at L5
Young
Stress fracture at pars
33
Degenerative spondy
L4
| Older
34
Send out AAA larger than
3.5cm
35
Tumors that expand neural arch
ABC
| Osteoblastoma
36
Rugger jersey
HPT
37
Common referral places from c2/3 and c5/6
Head and neck
| Shoulder pain
38
Tests for meningitis
Kernigs
| Brudzinskis
39
ULTT for?
Rule out cervical radiculopathy
+ when reproduced with s/s on side contralateral to cervical bending
40
C6
Brachioradialis
| Wrist extension
41
C7
Triceps
Finger extension
Wrist flexion
42
C8
Finger flexors
43
Lhermittes
Spinal cord involvement
44
Canal in cervical
Less than 13= concern
| 11: stenosis
45
Radiographic features of a sever sprain
Interspinous distance widening
Loss of parallelism between facets
Horizontal displacement more than 3.5mm
46
Tietze’s syndrome
Female 50+
Moderate to severe pain in chest (2-3 costochondral junction)
Inflammatory reaction
47
Meniscus sign
Pleurisy
48
Ddx for hilar enlargement
Infection
Tumor
Vascular
Sarcoidosis (non-infection)
49
Air bronchogram sign
Airspace pathology
| Usually pneumonia or pulmonary edema
50
S sign of golden
Collapse of RUL and superior migration of horizontal fissure MC due to hilar mass
51
Silhouette sign and determining if touching heart or not
Loss of boarder of heart
If touching—will obliterate that boarder on xray
Not touching—can see boarder
52
Consolidation
Anything that fills alveoli with substance
ill-defined homogenous opacity obscuring vessels
Air bronchogram sign
Pneumonia
53
Interstitial
Involvement of supporting tissue of lung parenchyma
Fine or course reticular opacities or small nodules
54
Four types of interstitial lung patterns
Linear
Reticular (mesh-like)
Modular
Reticulonodular
55
Kerley lines
Linear interstitial pattern
Thickening of interlobular septa
MC cause= pulmonary edema
56
What are most SPN
Granulomas
Lung CA
Hamartomas
57
MC location for SPN
RUL
58
Reasons for granuloma
TB
Histoplasmosis
Coccidioidomycosis
Sarcoidosis
59
What type of pneumonia usually presents with more wheezing
Viral
60
Lobar pneumonia uncommon in what
Viral
61
Ranke complex
TB
Ghon lesion: calcified parenchyma tuberculoma
With ipsilateral calcified hilar node
62
Bronchiogenic carcinoma categories
NSCLC (80%)
- squamous cell
- adenocardinoma
- large cell carcinoma
SCLC (20%)
- MC to cause SVC obstruction
- oat cell carcinoma
63
Blue bloaters
C. Bronchitis
64
Pink puffers
Emphysema
65
Xray of emphysema
```
Flattened hemidiaphragm
Lung hyperinflation
Small heart
Barrett chest
Saber-sheath trachea (coronal narrowing of intrathoracic trachea)
```
66
Horner;s syndrome
Mitosis
Anhydrous is (lack of sweating)
Ptosis
67
Where are the 3 common sites of compression for TOS
Scalene triangle
Costoclavicular space
Subpectoral space (pec minor and coracoid)
68
When are HA a red flag
Onset 50+ years
| Temporal arteritis or a mass lesion
69
HA associated with exertion...
Underlying tumor or vascular weakness
70
Food triggers for migraines
```
Chocolate
Caffeine
Nitrates
Cheese
Nuts
Wine
```
71
HA that has a band distribution
Tension
72
HA that often has decreased ROM to one side
Cervicogenic
73
5D and 3N
```
Dizziness
Diplopia
Drop attach
Dysarthria
Dysphasia
Ataxia
Numbness
Nausea
Nystagmus
```
74
Stroke vs Bells Palsy: can raise both eyebrows
Facial nerve in tact and stroke consideration
75
Papilledema
Optic disc swelling secondary to intracranial pressure
76
What intracranial structures are sensitive to pain
```
Meningeal arteries
Prox. Part of cerebral artery
Dura at base of brain
Venous sinuous
Cranial N 5,7,9,10, 1,2,3
```
77
Altered perception of touch or pressure, arm or leg weakness on one side of body, or confusion with left and right sides of body are linked to a tumor where
Frontal or parietal lobe
78
Inability to look upward associated with tumor where
Pineal gland
79
Lactation and altered periods and growth in hands nad feet tumor where
Pituitary
80
MC brain tumor types in adults
Gliomas
| Meningiomas
81
Mc tumor in children
Astrocytoma
Medulloblastoma
Ependymoma
82
Normal size of sella
```
16x12mm across x deptth
Empty
Tumor
Normal
Aneurysm
```
83
Progressively worsening Ha which seems worse in the morning. Also complains of gradual but progressive vision loss. Primary concern?
Mass lesion
84
Increased heel pad thickness seen with what
Acromegaly
85
Mc skull fracture
Linear
86
What motion associated with medial and lateral epicondylitis
Medial: flexion
Lateral: extension
87
Locking or crepitus in young patient elbow suggestive of. Old?
osteochondritis desiccans
Older: degenerative
88
Muscles involved in lateral epicondylitis
Extensor carpi radialis brevis
Extensor digitorum communis
Extensor carpi radialis longus
89
Sail sign
Supracondylar fracture of humerus
90
Monteggia fx
Ulnar shaft fracture with proximal dislocated radius
91
Galeazzi fracture
Fracture of distal radius and dislocated distal radial ulnar articulation
92
Colles fracture
Distal radius fracture with dorsal and radial angulation
93
Smith fracture
Fracture of distal radius with volar/palmer/anteriorly angulation
94
Keinbocks disease
AVN of lunate
95
Aka for AVN of lunate
Keinbocks
Collapse of lunate on xray
96
Terry Thomas sign
Increase space between lunate and scaphoid
97
Scapholunate disassociation
Terry Thomas sign (increased space between lunate and scaphoid)
Signet ring sign
98
Signet ring sign
Scapholunate disassociation
99
Scapholunate instability vs instability with rotatory subluxation
Instability only: terry Thomas sign
Subluxation too: signet ring and terry Thomas sign
100
Posterior perilunate dislocation
Lunate in tact—rest of the carpals posteriorly shifted
101
Anterior lunate dislocation
Lunate anterior—carpals intact
| Pie sign
102
Pie sign
Anterior lunate dislocation
103
De quervians muscles
EB and AL
Extensor pollicis brevis
Abductor pollicis longus
104
Median nerve entrapment
CTS
| Pronator syndrome
105
Ulnar nerve entrapment
Cubital tunnel
| Tunnel of guyon
106
Radial nerve entrapment
Radial tunnel syndrome
107
Flick sign
CTS
| Done when s/s are at their worst
108
Pronator syndrome/median nerve entrapment
Complain of volar forearm pain
Repetitive wrist flexion
Provocation: elbow extended, wrist flexed and resisted pronation
Compressed/entrapped MC btwn two heads
109
Ulnar nerve entrapment
Cubital tunnel syndrome
Complain of medial forearm pain
May be compressed in tunnel of guyon
110
Mallet finger/baseball finger
Avulsion of base of distal phalanx
111
Bennetts fracture
Oblique intra-articular fracture at base of thumb with radial deviation of distal fragment
112
Rolandos fracture
Comminuted Bennett’s fracture
| Fracture at the base of the 1st metacarpal
113
Gamekeepers thumb
Avulsion at base of proximal phalanx of 1st digit
Aka skier’s thumb
114
Psoriatic arthritis
```
Seronegative
DIP*** and PIP
Tuft erosions
Mouse ears
Sausage digit
Mimics RA but less symmetrical
```
115
Mouse ears
Psoriatic
| -
116
Bare area erosions
RA
117
Haygarths nodes
ST swelling at MCP
| RA
118
Rat bite or marginal erosions
RA
119
OA vs RA
OA distal to prox
RA: prox to distal
120
Anterior shoulder pain ddx
```
Fracture
Dislocation
Subacromial bursitis
Capsular sprain
Rupture of long head of biceps
Labrum tear
```
Impingement
Subcoracoid impingement
Biceps tendonitis
Subscapularis tendinitis
121
Lateral shoulder pain ddx
Contusion
Supraspinatus rupture
Referral from C or BP
Impingement
Deltoid strain
Supraspinatus tear/rupture
122
Super shoulder pain
AC joint separation
Distal clavicular fracture
Shoulder pointer
OA
Osteolysis of distal clavicle
123
Posterior shoulder pain ddx
Scap fx
Post dislocation
```
Posterior impingement
Infraspinatous/teres minor strain/tendonitis
Posterior deltoid staring
Triceps strain
Suprascapular nerve entrapment
```
124
Tests for impingement shoulder
Neer: passive forward flexion end rage pain
Hawkins-Kennedy: internal rotation
Painful arc: increase pain 60-120
Pain worse with overhead activities
125
Xray of chronic rotator cuff arthropathy with shoulder impingement
```
Elevation of humerus
Erosion of inferior aspect of a Romain
Sclerosis
Osteophytes
Cystic changes
```
126
Normal subacromial space height
9-10mm
127
Empty can test
Suprascapular
128
Lift off test
Subscapularis
129
External rotation test
Infraspinatous strength test
Tendinopathy or tear
130
Lag sign
Infraspinatous/teres minor
131
Subdeltoid bursitis test
Tenderness found anterior to AC joint on passive extension of shoulder
132
Calcification over humeral head/bursa
HADD
133
Linear ca++ paralleling humeral head-thing
Chondrocalcinosis
MC due to CPPD
134
Many densities in shoulder girdle
SOCM
135
Tests for glenoid labrum
Crank test and O’Brien sign (arm internally rotated and brough 15 degrees midline with pressure downward) again supinated. Pain felt in first position and no pain second
136
Normal AC width
x<5mm
<2-3mm bilateral diff
137
Normal distance between coracoid and clavicle
11-13mm
<5mm bilateral diff
138
Grade 2 AC separation
AC ligament torn
| Coracoclavicular lig intact
139
MOI of anterior shoulder dislocation
Abducted and externally rotated
95%
140
Bankart lesion
Osseous fragment at inferior aspect of glenoid fossa
141
Hill Sachs
Impaction fracture at superior lateral humeral head
142
Labral tears tests
Crank test
O’Brien’s test
Biceps load 2 test
143
Rotator cuff tests
```
Empty can
Lift off
Lag
Infraspinatous muscle test
Drop arm
Hawkins
```
144
Widening of AC joint with destructive change of clavicle but no elevation
Post traumatic osteolysis
145
MOI of ACL and PCL
ACL: hyperextension
PCL: hyperflexion
146
Ottawa rules for acute trauma LE
55+
Tender at patella or fibula head
Unable to flex knee 90
Unable to bear weight immediately after
147
O-donoghues triad
Rotatory component
ACL, medial meniscus and MCL
148
Segonds fracture
Fragment on lateral margin of lateral tibial plateau
149
Pain location in neurogenic vs vascular claudication
Neurogenic: back, thigh, claves, RARE BUTT
Vascular: BUTT, thigh, calves
150
Salter type 1
Shear across GP
151
Salter type 2
Physis and metaphysis
152
Salter type 3
Epiphysis and physis
153
Eversion injury
Oblique fracture fibular
| Avulsion of medial malleolus
154
MOI transverse lateral malleolar fracture
Inversion
155
Jones/dancer fracture vs normal
Jones: transverse fracture
Normal: vertical
156
Sunburst periosteal reaction
| Diametaphyseal
Osteosarcoma
157
Is DJD in patellofemoral joint normal? Cause?
No
| CPPD
158
Ca++ of medial collateral ligament
Pellegrini stieda
| HADD
159
Onions skin
Ewing sarcoma
160
Brim sign
Pagets
161
MC hip fracture
Intra-capsular
| Worse
162
Putt is triad
Small absent epiphysis
Lateral displacement of femur
Increased inclination of acetabular roof
163
Hilgenreiner’s line at birth
Less than 28
164
Perkins line
Epiphysis should be seen in inferiomedial quadrant
165
Small epiphysis
Developmental dysplasia
SCFE
AVN
166
MC hip dislocation
Posterior
Flexed abducted hip
Xray: superior to acetabulum
167
Xray of anterior hip dislocation
Anterior and medial to acetabulum
168
Kleins line
SCFE
If line ok and small epiphysis —AVN
169
femoral acetabular impingment syndrome
Sharp deep pain
Pain anteriorly
Flexion and internal rotation limited
C-sign (gripping)
170
Pincer impingment
Middle aged women
| Excessive coverage by anterior acetabular rim
171
Cam impingment
Young men avg 32 years
Abnormalities of the femur/bony protrusion
172
Femoral neck buttressing
DJD
173
Cam deformity aka
Pistol grip
174
Kohlers line
Acetabular protrusion
175
Rind sign
Fibrous dysplasia
176
ASIS Avulsion
Sartorious
177
AIIS avulsion
Rectus femoris
178
Lesser trochanter avulsion
Iliopsoas
179
Normal TDD
9-11
<2mm bilateral diff
Septic arthritis
