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Musculoskeletal I > Intro to Orthopedics > Flashcards

Intro to Orthopedics Flashcards

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1
Q

tenorrhaphy:

A

suture of a tendon / tendon grafts (plantaris /
palmaris longus)

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2
Q

Factors affecting healing:

A
  • Vascularity
  • Extent of injury
  • Age
  • Nutrition
  • Comorbidities
  • Stress
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3
Q

ligament grade II healing time:

A

3 weeks to 3 months

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4
Q

RESPECT NATURE, immobilization may be necessary sometimes. What may be some side effects from bed rest?

A
  • Atrophy
  • osteoporosis,
  • thrombosis
  • pressure sores
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5
Q

What diagnostic test is good for for identifying failing THR/TKR. (More bone formation to protect the prosthesis)?

A

Bone scan

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6
Q

Cancellous bone is less dense than cortical bone and thus appears_____ than the cortical bone on the radiograph

A

darker

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7
Q

Gold standart diagnostic test for pulmonary embolism?

A

Computed Tomography (CT scan)

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8
Q

left upper quadrant pain that begins as abdominal pain and radiates to mid-back (L2 region). Pain is sudden in onset and intensifies with time.

A

pancreatitis (high morbidity & mortality)

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9
Q

Inflammation of connective tissue under skin + fever, headache, nausea, redness around infected area:

A

cellulitis

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10
Q

Three infectious diseases:

A
  1. Acute Hematogenous Osteomyelitis (AHO)
  2. Septic Arthritis
  3. Cellulitis
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11
Q

Fasciotomy:

A

cut fascia

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12
Q

GI/GU (genitourinary) RED FLAGS:

A
  1. Abdominal pain,
  2. heartburn,
  3. nausea,
  4. vomiting,
  5. changes with bladder function,
  6. menstrual cycle
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13
Q

ligament graft healing time:

A

2 months to 2 years

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14
Q

What is the Dx of osteorthritis?

(diagnosis)

A
  • Swelling,
  • pain,
  • crepitus,
  • limited ROM,
  • X- ray films,
  • stiffness.
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15
Q

What is the Tx of cellulitis?

A
  • rest,
  • cleaning of wound if present
  • and antibiotics.
  • Rarely surgery
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16
Q

HISTORY AND PHYSICAL EXAM
2 main purposes

A

-Most important aspect of the healthcare provider/patient interaction

-Establishes a rapport with the patient

-History provides important clues that subsequently guides the clinical exam

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17
Q

What are the risks of surgery?

A
  • Infection
  • Fracture
  • DVT/PE
  • Anesthesia
  • Arthritis
  • Loss of reduction
  • Nerve damage
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18
Q

Etiology of Acute Hematogenous Osteomyelitis:

A
  1. staphylococcus,
  2. streptococcus,
  3. pneumococcus
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19
Q

How strong is the link between tissue damage and
impairment and impairment and function?

A

Poor.

  • Ex: some with massive knee destruction due to OA have little pain; whereas others with minimal OA have major pain
  • Ex: spinal ROM is not correlated to overall function
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20
Q

CARDIOVASCULAR red flags:

A
  1. Shortness of breath,
  2. dizziness,
  3. chest pain,
  4. pulsating pain,
  5. swelling of the feet
  6. painful or discolored feet.
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21
Q

Which are the two most common laboratory tests in orthopedics?

What does a negative result of these test mean?

A
  1. C-reactive protein (levels rise in response to inflammation)
  2. Erythrocyte sedimentation rate (help detect inflammation)
  • Negative result can usually rule out systemic origin (like lupus)
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22
Q

billateral swelling without injury in a 40 y/o female:

A

could be remauthoid arthritis

older person and unillateral: osteoarthritis

could also be the first sign of lupus.

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23
Q

Perceived pain is often at

A

a site distal or adjacent to injury site

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24
Q

What does a bone scan detects?

A

Osteoblastic activity

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25
Other red flags:
* Fever or night sweats * Severe emotional disturbances * joint sweling wihtout injury * pregnancy
26
Cardinal signs vertebral artery dysfunction (Stroke): (5D’s, 3N’s)
1. Dizziness 2. Dysarthria 3. Dysphagia 4. Diplopia 5. Drop attack 6. Nystagmus 7. Numbness 8. Nausea
27
what is the Tx of **osteoarthritis**?
* Psychological support (loosing indepence?) * Meds * Splints/braces * PT * Surgery: osteotomy, arthroplasty, arthrodesis, mosaicplasty, microFx
28
Which diagnostic test is the gold standard for pulmonary embolism?
**CT Scans**
29
Treatment of DVT:
* Anti-coagulants * NSAIDS * Compression stockings, movement
30
Stress decreases healing?
yes
31
evaluation is the level of judgment necessary to make sense of the findings in order to identify a relationship between the
**symptoms** reported and the **signs** of disturbed function.
32
Ligamentous reconstruction:
use graft to make new ligament Ex. ACL reconstruction
33
MRI is Predominantly used for what?
Shot tissue lesions: 1. **Rotator cuff tears** 2. **Meniscal tears** 3. **ACL tears**
34
Degeneration of articular cartilage disease:
**osteoarthritis**, AKA degenerative joint disease
35
Tenolysis:
free tendon from scar tissue
36
What is **smudging** of the homunculus?
The homunculus for the painful region expands into adjacent regions
37
Neurological red flags:
* preoblems with hearing, swallowing, or speech * severe headaches * blurry vision * problems with balance * drop attacks * sudden weakness
38
degenerative joint disease AKA
Osteoarthritis (OA)
39
Pain **not** altered by position or motion may come from where?
a visceral source
40
Tendinitis healing time:
3 to 7 weeks
41
Which infection can extend the periosteum causing elevation
Acute Hematogenous Osteomyelitis (AHO)
42
bone healing times:
5 weeks to 3 months
43
Complications of AHO:
* death * abscess formation * septic arthritis * chronic osteomyelitis * pathological Fx
44
Treatment of AHO
* Immediate Tx * Antibiotics * Rest, analgesics * IV fluids * Surgical decompression after 24 hr * Antibacterial Tx for 3-4 weeks
45
Computed tomography (CT Scan) provides 3-D info that radiographs can not and is **extremely useful** for detecting which Fx?
1. Tibial plateaus Fx 2. Scapula fractures 3. Ankle fractures 4. Spine
46
MRI is useful for which bony lesions?
1. **Ostemyelitis** 2. **Osteonecrosis** 3. **Stress fractures (gold standart)**
47
What is **Septic Arthritis?** ## Footnote **Tx?**
* Cartilage destruction, capsule thinning * Usually the result of osteomyelitis or surgery * Tx: arthroscopy or arthrotomy and irrigation combined with drainage
48
Clinical and medical diagnosis of DVT:
* **Clinically** – Homan’s sign, Wells CPR * **Medically** – Doppler, CT, Venogram ## Footnote A Doppler ultrasound is a noninvasive test that can be used to estimate your blood flow through blood vessels
49
Tendon rupture healing time:
5 weeks to 6 months
50
Which imaging tool is good for identifying loos THR/TNR?
bone scan
51
Tenotomy:
tendon lengthening: **cut tendon**
52
MRI T1 weighted and T2 weighted are used for what?
* T1 for anatomy * T2 for pathology
53
Gold standart diagnostic test for stress fractures:
MRI
54
CANCER red flags:
1. night pain (constant) 2. constant pain, 3. weight loss, 4. appetite loss, 5. fatigue, 6. history of Ca (single best predictor)
55
What is the **sensitivity** of Homan's sign?
* 40% * 60% chance of getting a **false negative**
56
What is the difference between **ligamentous repair** and **ligamentous reconstruction?**
* Ligamentous repair: suture ligament * Ligamentous reconstruction: use graft to make new ligament
57
Do PT treat pts with cellullitis?
no, only after cellullitis resolves and have sweeling and decreased ROM
58
Redness, swelling, heat, pain, loss of function:
S & S of infection
59
Choose diagnostic tests (imaging studies) that are...
1. Safe for the pt 2. Cost effective 3. diagnostic
60
tendon transfer:
move tendon
61
Ligamentous repair:
suture ligament
62
POSTOPERATIVE CARE:
* Distal neurologic and vascular exam * Pain management * Deep vein thrombosis/pulmonary embolus (check this) * Immobilization/healing times (explain times)
63
Pathology of **Acute Hematogenous Osteomyelitis:**
* Infection spreads causing osteolysis, enters circulation (septicemia: malaise, anorexia, fever) * When the infected area is within the synovium results to **septic arthritis**
64
Grade I ligament time:
4 days to 4 weeks
65
single best predictor of cancer?
a previous history of cancer
66
ligament grade III healing time:
5 weeks to 6 months
67
Osteoarthritis results from what? (why do you get OA?)
* overuse, * injury, * idiopathic (genetic) * obesity, * joint infections, * congenital abnormalities, * malalignment
68
The most common type of osteomyelitis, an **infection** of bone, that occurs in children?
**acute hematogenous osteomyelitis.**
69
**Bed rest** for low back pain?
"No, no" Dr. M activity as tolerated is better than bed rest.
70
Most common form of inflammatory arthritis; polyarticular, symmetrical involvement:
Rheumatoid arthritis
71
Upper cervical spine is commonly involved in RA. Sometimes ca result in:
* **brain stem compression** * Tx: protection during exacerbation, activity during remission, C1-C2 arthrodesis
72
RA - **Pathology:**
* Synovial membrane * Pannus leads to cartilage necrosis * Ankylosis * Rheumatoid nodules * Morning stiffness * Joint effusion, deformity
73
Clinical features of RA:
* Pain, swelling, limited ROM , progressive deformities, loss of function * Morning stiffness, stiffness with inactivity * Generalized malaise and fatigue can be present at onset of disease * Diagnosis based on at least 4/7 findings that continue 6 weeks (ARA) * No laboratory study is diagnostic but 80% will have elevated Rh factors of IgM IgG
74
Medical management of RA:
* NSAIDS: GI and renal complications * Disease modifing RA drugs: prevent activation of inflammatory processs * Glucosamine: safe * Injections: cortisone, hyaluronic acid (improves synovial viscosity) * Braces
75
Pain, swealing in the foot due to accumulation of uirc acid:
Gout
76
Gout leads to
osteoarthritis

Musculoskeletal I (8 decks)

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