General Flashcards
(76 cards)
What are some questions that should be asked when gathering history from an ortho visit?
What’s your profession? Should there be work restrictions? How much time till retirement? How long do you work every week? Is workers comp involved?
Describe the pain (type, where and when, deep or superficial, how often, aggravating and alleviating, was there an injury and when)
How’s therapy going? How far along are you in therapy? How many times per week?
Any numbness or tingling in the extremities?
What’s your hand/arm/leg dominance?
What made you come in today?
RC insertions include:
Supraspinatous = sup > post aspect of greater trochanter
Infraspinatous = post aspect of greater trochanter
Teres Minor = post aspect o greater trochanter (inf to infra)
Subscapularis = anterior aspect of lesser trochanter
How do you test the strength of the rotator cuff?
Supraspinatous = empty can test (pt abd to 90 deg at 60 deg, have pt resist as you push down)
Infraspinatous = external rotation (arm at side and elbow flexed at 90 deg, resist pt’s external rotation)
Subscap (sup) = hand on stomach (have pt resist you pushing AP on their elbow)
Subscap (inf) = hand on back (resist pt lifting off back)
What can arthritis in joints lead to?
Bone spurs
Who determines heart health prior to surgery?
PCP, assesses medical history (vascular and cardiac dx) and an ECG, if the patient has a cardiologist they may be contacted for final approval
What may cause a bone cyst?
Tendon rupture, the bone is no longer stressed at the insertion point allowing the bone to weaken, this makes that area of bone susceptible to an infiltration
What type of drugs should be avoided in orthopedic repair procedures?
NSAIDs
- tNSAIDs (traditional, COX inh, reversible) = ibuprofen, Naproxen (Aleve), Diclofenac (Voltaren gel), Indomethacin
- Coxibs (COX-2 specific inh) = Celecoxib
- Salicylates = ASA (COX inh, irreversible)
Should slings be worn when sleeping?
Yes! This is a period where the body may move without conscious input, which endangers a non-secured healing shoulder or knee, etc.
A repaired tendon that looks very healthy is referred to as what?
“Native tendon”
What are the insertions of the biceps tendons?
Long head: inserts into the labrum surrounding the glenoid after passing through the intertubercular groove of the humerus
Short head: coracoid process of the scapula
What’s a duplex scan?
Painless ultrasound exam that captures images of the major arteries in the arms, legs, and neck
What is a popliteal cyst also called?
Baker’s Cyst
What’s dull/throbbing pain in the knee most likely? Painful?
Arthritis
Meniscal tear
What’s the most popular muscle relaxant prescribed?
Cyclobenzaprine (10mg) po TID PRN
What’s generally more effective in an orthopedic setting for NSAID delivery?
Gels > oral
What should be done with leftover opioids/narcotics?
Drop-offs at police stations
What is a physician always looking to achieve?
Standard of care
Ex: the standard of care is that you have a better knee brace
What disease state can cause someone to not get bone surgery?
Osteoporosis
If a shoulder is crunchy it’s? If a shoulder isn’t crunchy it’s?
Arthritis
Adhesive capsulitis (Frozen shoulder)
What is the goal of therapy in some cases?
To reduce the swelling of a joint
How long after a work-related injury can a person re-open a case for surgery? What’s the risk?
7 years
Risk is that a work-related injury may receive more push-back the longer out someone chooses to address it
What does lateral pain usually indicate?
A meniscal tear
What should a physician always be considering?
I’d like to be responsible with both your money and time
What’s a treatment that can restore the lubrication within the knee? What is it? Is it a permanent fix? What’s it treat?
Orthovasc, synthetic lubricant injection that can decrease pain d/t friction, 3 injections one every week for 3 weeks
Not a permanent fix, buys time till knee replacement
- replacing the engine oil
DJD treatment
