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Clinical Medicine LAB - Professor Sample > MS II > Flashcards

MS II Flashcards

1
Q

Anterior dislocation occurs with ?

A

external rotation and abduction

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2
Q

Humeral head lies inferiorly and medial to the glenoid ( and anterior ) for what ?

A

Anterior dislocation dislocation fo shoulder

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3
Q

What is most common shoulder dislocation ?

A

anterior

  • *this does not alway happen but we see this when patients have had dislocations in the past
  • *
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4
Q

Hill-Sachs deformity (more common according to sample) ?

A

Indentation on the posterosuperior portion of the humeral head

** “on top of the hill”
when it goes down and inferior it strikes the glenoid process **

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5
Q

Bankart deformity ?

A

Bony irregularity or fragment of the glenoid

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6
Q

What is the bets view for shoulder dislocation ?

A

✪ Best view- transscapular view (“Y” view)

scapula and the humeral head should be in the center of the Y or when the glenoid process, acromiun process ( know the three parts of the Y)

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7
Q

AC separation grades ?

A

1 - strain

2 - tear

3- dislocation ( complete separation of the clavicle from the acroimun process)

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8
Q

AC separation ?

A

when someone falls onto a shoulder it is a high impact injury (fall down hard) ATV or dirt bike accident

cartilage and ligament that attack clavicle to acronym and when you tear them then you get separation and cause the clavicle to lie superiorly to the acromium process

weight bearing films ( it pulls down on the humeral head and acromium process and makes the dislocation look more obvious ( weight bearings films are the Gold standard!)

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9
Q

Elbows we want to remember to look for ?

A

fat pads

sometimes we dont see the fractures so we look for these fat pad signs

fat pad by the posterior part of the distal humorous

fracture causes bleeding in the joint pushes the fat pad out of the joint and we can see it in the fat pad (“ blown out cell”)

xray with no obvious fracture but we see a fat pad sign then we are going to treat it like a fracture and splint it and everything etc .

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10
Q

Elbow: fat pad sign normal location ?

A

Normally posterior fat pad is tucked into the olecranon bursa

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11
Q

Elbow: fat pad sign occurs cause the fat pad is displaced by ?

A

bleeding fracture

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12
Q

what is the “sail sign” ?

A

bowed anterior fat pad

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13
Q

By your elbow the ulna is ___ and the radius is _____

A

big

small

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14
Q

Bennett fracture occurs in the ?

A

hand

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15
Q

Bennett fracture occurs where?

A

Base of the thumb into the carpometacarpal joint.

**fracture at the base of the thumb at the carpal and metacarpal joint - almost always needs surgery cause it goes into the intraacular joint **

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16
Q

Bennett fracture almost always requires ?

A

surgical fixation

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17
Q

Comminuted bennett fracture ?

A

Rolando fx.

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18
Q

Mallet Finger is in the ?

A

hand

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19
Q

Mallet Finger is a ________ injury at the base of the _____ phalanx

A

Avulsion

distal

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20
Q

Mallet Finger is a ______ tendon injury

A

extensor

** the extensor tendon is snapped ( jams finger really hard) cant straighten it out ( when it snapped it takes a chunk of bone off the distal phalanx) evulsion injury which sometime fluxation

you need to separate the joints when examine the fingers ( **

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21
Q

Jersey finger is a _______ tendon injury

A

flexor

** they can keep it in extension but the cannot flex it **

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22
Q

Gamekeeper’s thumb is an ________ on the _____ aspect of the ______ MCP joint

A

Avulsion

ulnar

1st

***when people used t filed dress a rabbit and peeling the skin back forcefully and get there thumb caught ans snap there thumb back

it creates an injury at the base of the thumb ( it is in evulsionn injury cause the tendon is pulling part of the bone)

aka Skiers thumb**

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23
Q

Boxer’s fracture caused by ?

A

punching mechanism

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24
Q

Boxer’s fracture is of the ?

A

4th or 5th metacarpals

  • *typically 5th metacarpal distal portion and usually the next ( maybe the 4th )
  • *

**look for sissoring of the fingers when the make a fist the pinky moved inward and gets stuck under the ring finger **

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25
Boxer’s fracture can sometimes involve the ?
Sometimes 2nd and 3rd are included in the diagnosis.
26
Hand bones ?
Trapezium Trapezoid Capitate hamate triquetrum lunate scaphoid pisiform
27
Lunate/Perilunate Dislocation occurs when?
ligaments between the lunate and the capitate are disrupted
28
Lunate/Perilunate Dislocation best view ?
lateral view
29
Lunate/Perilunate Dislocation different in the way the bone is ?
situated perilunate - complete dislocation of the capitate off the lunate lunate - looks like a spilled tea cup
30
Scaphoid Fracture tx?
clinically
31
Scaphoid Fracture is frequently missed on ?
XR
32
Scaphoid Fracture: cast wrist and repeat XR in __ wk?
1
33
Scaphoid Fracture has a high risk of ?
avascular necrosis **avascular necrosis and loss of function of the rest ( cause blood supply goes distally and the comes back proximally ) **
34
Triquetral Fracture best seen on a ?
lateral view XR
35
Triquetral Fracture is a?
Small chip off of the dorsum of the wrist
36
What is the most common fracture of the forearm ?
Colles Fracture
37
What is a Colles Fracture ?
Fracture of the distal radius +/- ulna with dorsal displacement **dinner fork deformity , dorsally displaced ** ** C and D are next to each other in the alphabet ( collet dorsal)**
38
What fracture of the forearm is less common?
Smith Fracture
39
Smith Fracture is a ?
Fx of the distal radius +/- ulna with volar displacement
40
Monteggia Fracture is a fx. of the ____ with ________ radius disolcation
ulna proximal **big bone breaks and the little bone becomes displace** ** the ulna breaks and the radial head displaces if someone has knee pain look at ankle and hip **
41
What can be missed if the elbow is not examined ?
Monteggia Fracture
42
Galeazzi Fracture is a fx. of the ______ with ______ ulna displacement ?
radius distal **Ulna its little at the wristband is displaced here ,you can have breaks w/o the displacement b**
43
Neck facts ?
vertebral prominences can see the space when the spine is and if the space is smaller then it could be something wrong with the disc normal lordosis - straightening of lordosis can be from spasms in the neck on both sides causes the neck to be lordotic
44
Lateral C-spine XR?
line along the anterior and posterior part of the verterbrae and down the middle the lines should line up nicely in the lateral view and the lines should not be squiggly
45
Jefferson fracture involves the ?
C-spine
46
Jefferson fracture is a split of the bony ring of ?
C1 **breaking one side of a ring bone the other side breaks as well secondary to a blow to the top of the head someone who is ina car accident and hits the windshield or falls and hits top of head and they can shatter the C1 lateral displacement of the lateral masses ( the right pic the right mass is more displaced) you know it is broken when you see lateral displacement **
47
Jefferson fracture is usually a ________ to the top of the head?
2/2 blow
48
Jefferson fracture view ?
Odontoid view
49
Jefferson fx. make sure to order a ?
Order CT scan
50
Clay-shoveler fracture is of the __ or __ spinous processes?
C6 C7
51
Clay-shoveler fracture is a ________ injury ?
Avulsion **staining to pull shover out of clay and snap neck back vertebral process fracture ( not dangerous cause does not involve the cord or disc) it is essential an evulsion fracture **
52
Hangman fracture caused by ?
hyperextension and distraction (ie; hitting head on dashboard) **hyperextended and backwards ,hitting head on dashboard **
53
Hangman fracture is a fx of ?
the posterior elements of C2
54
Hangman fracture can also involve ?
+/- displacement of C2 body anterior to C3
55
Spondylolysis - just the fracture with no _________ Spondylolisthesis ?
slipping this one moves **allows slipping forward and backward it is pretty common when a disc squishes and the caused the disc to bulge and then this cause inflammation and hits a nerve - rediculoapathy (herinated disc) leg pain - from my but down to my left **
56
Spondylolysis/Spondylolisthesis views ?
oblique view for this a scotty dog leg connected to a scotty dogs back
57
Knee views ?
sunrise view or tunnel view or merchant view on the right - great view of patellar fracture ( if you suspect tendon rupture then you need to get this sunrise view) AP and lateral view for just normal knee exam weight bearing views good for arthritis or narrowing of the joint space - helpful cause it can show you a degree of narrowing in a real life situation instead of them lying down and comparing one knee to the other
58
Osgood-Schlatter is from ? and causes a ?
Patellar tendon pulling on the tibial tubercle bump
59
Osgood-Schlatter own notes ?
younger athletes tibial tubercle is not sealed to the tibia - really active kids get swelling of areas and causes inflammation and pain on the tibial tubercle and the get a bump there over time may heal and ossify and get a permanent bump
60
Tibial plateau fracture best view ?
Best seen on lateral but may be difficult to find **best seen on lateral view and it is difficultt to find *( they are inside the joint) patients do not want to bear weight this is a surgical knee **
61
Tibial plateau fracture imaging to better at distinguishing extent ?
CT MRI ** if they cant bear weight do a CT scan **
62
Patellar tendon rupture appears as a __________________ on films ?
“high riding patella” **typically cannot flex **
63
Patellar tendon rupture results in ?
Unopposed traction on the patella ** the unopposed traction on the patella will cause the patella to get pulled up by the quadriceps tendon **
64
patella fracture can be missed on a AP view but not so much on a _______ view ?
sunrise
65
Pronation is ?
inversion
66
Supination is ?
eversion
67
Ankle XR viewing ?
important to look at the clear space clear space on the right pic is from ligamentous fracture and it is unstable and a surgical ankle the spaces should be less the 5 mm in width indicating a disruption of the ankle mortise
68
Malleolar Fracture is usually an ________ injury from ________ or inversion of the ankle
avulsion eversion “rolling the ankle” injury **portion of the lateral malleolus the ligament pulled on the end of bone and pulled it off - evulsion injury this is the most common **
69
Maissoneuve Fracture ?
proximal fibula fracture you can have a distal fracture which causes a proximal fracture ( pic on right is the proximal portion - oblique ) if anke is hurt then look at knee and toes ( check neurovascular relfex, cap refill etc of the toes)
70
Pilon fracture any fracture of the ______ ______ that involves that articular surfaces of the ______ plafond
distal tibial tibial **ankle fracture of the distal tibia that involve the plafond which is just the articular surface pilon means the fracture is communicating with ta articular surface **
71
Lisfranc fx ?
Medial border of the 2nd metatarsal should align with the medial border of the 2nd cuneiform
72
Lisfranc own notes ?
a ligamentous disruption with the ligaments int he foot and when they get tore you can have displacement in different ways know that if you have a widening of the metatarsal it will signify you have a ligamentous disruptions and a lisfranc jump from a high surface and land on feet and split ligaments - pain will just not go away its for months and months standing view you can see
73
Torus fracture aka ?
“buckle” fracture
74
Torus fracture is from ?
Force causes bowing of the pliable bone
75
Torus fracture ?
force that cause pliable bone to bow not unilateral force causing bending it is more falling forward and landing on hands etc and cause compression of hand bones and the y can buckle lateral view you can deff see the buckling
76
Pediatric fractures ?
Torus fracture Greenstick fractures Salter-Harris
77
Greenstick fractures is ?
Bowing on one side with an incomplete fracture on the other side **pliable bone that breaks on one side and bends on the other **
78
Salter-Harris is a fracture of ?
Epiphyseal plate
79
Salter-Harris: what are radiopaque ?
Epiphysis metaphysis
80
Salter-Harris: what is radiolucent ?
Cartilaginous growth plate
81
A 12 year old presents to the family practice c/o right knee pain. He is active and plays many sports. On PE, there is a tender raised area near the right tibial tubercle. What is the best diagnostic test to order?
get a xray of knee osgood slaughter see the what being pulled away from the tubercle best seen on lateral view will not see it that much on AP
82
A 42 year old female presents with neck pain after being falling and striking her forehead against a coffee table. PE shows midline tenderness of the cervical spine. Which cervical spine view will give you the best diagnostic information?
dashboard on she has some extraction and hyper extension and at risk for hang man so the best view is lateral and we will see anterior displacement of C2 from C3
83
A 17 year old presents with right shoulder pain after falling off of an ATV…while it was moving. PE reveals tenderness along the clavicle and AC joint. What test would you order?
best initial test is xray of shoulder ( AP and lateral views of shoulder ) this is same pic as last slide but this is weight bearing this is just called AC separation
84
A 60 year old female FOOSH after slipping on black ice in the parking lot. Now c/o right wrist pain. She has no NV deficit.
fell on outstretched hand colles we see fracture of the distal radius that is comminuted with distal displacement of the hand
85
A 2 year old is brought in by mother with concerns that the patient will not move her left arm and keeps crying. States that it began after she picked her up out of the bath tub by her arms. PE seems to reveal pain at the elbow. What next?
nurse maids elbow hypersupinate and the flex wth pressure on the radial head and it should pop back into place ( you can try reduction before xray) dislocate or sublux the radial head ( slips out of the pocket easily) if the fall or have built trauma then get an xray but if there is a good history and you know it is nuse maids elbow then you dont need xray
86
Salter Harris own notes ?
fracture of epiphyseal plate and classify them by how the look above - above the epiphyseal plate 5 types - be careful cause it works when looking at a bone in front of you like tibia, but the wrist when you are talking about above it actually looks below low goes through the epiphysis and the plate

Clinical Medicine LAB - Professor Sample (36 decks)

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