Intro to Ortho Flashcards Preview

MED: Ortho/Rheum > Intro to Ortho > Flashcards

Flashcards in Intro to Ortho Deck (24):
1

patients presenting with MSK problems usually have one of the following:

1. pain
2. deformity
3. weakness/parathesia

2

What does a PE include for ortho?

IPRSSN
inspect
palpate
ROM
strength
stability/special exams
neurovasuclar status

3

Presence of swelling:
effusion = ?
softe tissue swelling =?
bursa=

effusion = intraarticular
soft tissue swelling - extraarticular
bursa= "goose egg"

4

how should you measure ROM?

with a goniometer

5

describe the manual muscle 5 point scale:

5 - normal
4+= submax agaisnt resistance
4= mod against resistance
4-= slight against resistance
3= movement against gravity, but not resistance
2= movement with gravity eliminated (hand turned to side)
1= flicker of movement

0 = no movment

6

when is neuromuscular status particularly important?

during trauma.

7

long bone imaging should include the joints ____ and ____ injury

above and below the injury

8

images should be obtained in at least ____ planes _____ to each other

two planes perpendicular to each other

9

When do you use radiography? when do you not use radiography?

Indications
o Injury or deformity of a bone or joint
o Inability to use the extremity or joint
o Unexplained pain and localized tenderness in a bone or joint
o Follow-up of MSK disease


Radiography CONTRAINDICATIONS:
o Musculoskeletal conditions that involve primarily soft tissues in early stages or that produce minimal to no changes in the bone
• e.g. patellar chondromalacia
o Pregnancy

10

what is radiolucent?
radioopaque?

o Radiolucent: Descriptive term indicating permeability of the x-ray beam through a structure
• Soft tissues
• Air/Gases
o Radiopaque: Descriptive term indicating impermeability of x-rays through a structure
• Bone
• Metallic Hardware

11

What is MRI good for?

superior contrast resolution
good for soft tissues

**gadolinium--> safer than iodine based dyes and can be used in renal insufficiency
- GOOD FOR MARROW (m= marrow, mri)
NO RADIATION

12

What are the limitations of an MRI?

- prone to more artifact such as motion blur and metal scatter

MAGNET IS NOT COMPATIBLE WITH PACEMAKERS, HEART VALVES, METAL FB IN EYE, TATTOOS
- can take a long time
-costly
-small machine

13

What is T1 and T2?

t1= anatomy
t2= swelling/pathology

14

Describe CTs:

uses X-rays to produce slices.
radiation exposure

15

What are the advantages of CTs:

higher contrast resolutions
lower cost than MRI
produces good images of the lung and bone
can be turned digital

16

what are the limitations of CT?

produces a variety of artifacts
soft tissue contrast is not as good as MRI
requires large physical space
exposure to radiation

17

What is a bone scan?

a form of nuclear medicine imaging
radioisotope labled IV drug acts as tracer of biologic activity
drug distributes itself according to targeted metabolic mechanisms.

18

how does a bone scan distribute?

1. intial (transient)
2. blood pool
3. delayed --> at least 2-4 hours
(tracer accumulates in tissues with active phosphate turnover--> bone undergoing turnover or growth).

19

what does a negative bone scan exclude?

fractures, metastases and osteomyelitis

20

when might you use orthography:

- rotator cuff tear
-interosseous ligament tears at the wrist
- meniscal tears
-labrum tears

21

what are the two categories that a musculoskeletal injury has been classified into?

1. traumatic
2. overuse

22

what are the two main oral anti-inflammatory medicines used in MSK injuries?

NSAIDs
and
corticosteroids

23

who should corticosteroids NEVER been injected into?

1. young athlete's joints
2. major joints if NO degenerative changes exist
3. major load bearing tendons (achilles, patellar)

24

what are cortiocsteroid injection indications

1. muscle trigger points
2. bursae
3. small, non weight bearing joints
4. muscular attachments to bone
5. tendon sheath
6. degenerative joint in older athlete