MSK Flashcards
1
Q
What are the functions of the skeletal system?
A
-Support
-Protection
-Movement
-Mineral Homeostasis
-Blood Cell production (red bone marrow)
-Triglyceride storage (yellow bone marrow)
2
Q
Four types of bones?
A
-Long bones
-Short bones
-Flat bones
-Irregular bones
3
Q
What are the parts of long bone?
A
-Diaphysis= the shaft
-Epiphyses= ends of the long bone
-Metaphyses= contains the “growth plate” and is located between the shaft and end of bone
4
Q
What are the cells of bone?
A
-Osteoblasts: bone building cells
-Osteocytes: maintain bone; exchange nutrients and wastes with blood; are osteoblasts encased in matrix they build
-Osteoclasts: Digest bone matrix for normal bone turnover
5
Q
What are the types of joints?
A
-Fibrous
-Cartilaginous
-Synovial
6
Q
What are fibrous joints?
A
No cavity, just dense irregular connective tissue
7
Q
What are cartilaginous joints?
A
No cavity, bones are held together by cartilage
8
Q
What are synovial joints?
A
Have synovial cavity and many other components such as ligaments
9
Q
What are synovial joints?
A
Have synovial cavity and many other components such as ligaments
10
Q
What are the functions of ligaments?
A
-Composed of connective tissue
-Found throughout the skeletal system
-Function to connect bone to bone
-Commonly injured by spraining or tearing
11
Q
What are the functions of tendons?
A
-Tough band of fibrous connective tissue
-Function to connect muscle to bone: skeletal muscles contracts and moves bones via tendons; very dense and more capable of withstanding tension
12
Q
What is the function of cartilage?
A
-Covers ends of bones
-Absorbs shock
-Reduces friction
(cartilage is in the joint, but it is NOT a cartilaginous joint)
13
Q
What is the function of bursa?
A
-Decreases friction
14
Q
What are the different types of musculature in the body?
A
-Skeletal Muscle
-Cardiac Muscle
-Smooth Muscle
15
Q
What are the major functions of the muscle systems?
A
-Produce body movements
-Stabilize body positions
-Store and move substances
-Produce heat
16
Q
Define flexion.
A
Decrease in the angle between articulating bones
17
Q
Define extension.
A
Increase in angle between articulating bones
18
Q
Define Hyperextension.
A
Bending beyond 180 degrees, such as moving humerus backwards behind the anatomical plane
19
Q
Define Abduction.
A
Movement of bone away from the midline
20
Q
Define Adduction.
A
Movement of bone toward the midline
21
Q
Define Circumdunction.
A
Movement of distal end in a circle
22
Q
Define Rotation.
A
Bone revolves around its own longitudinal axis
23
Q
Define Inversion.
A
Movement of the soles of the foot medially
24
Q
Define Eversion.
A
Movement of the soles of the foot laterally
25
Define Dorsiflexion.
Bending foot toward the dorsum (standing on heels)
26
Define plantarflexion.
Bending the foot toward the plantar surface (standing on toes)
27
Describe the strength scale.
-Zero - No evidence of muscle function (including muscle twitch)
-Trace - Muscle contraction but no or very limited joint motion
-Poor - Complete range of motion with gravity eliminated
-Fair - Complete range of motion against gravity
-Good - Complete range of motion against with some resistance
-Normal - Complete range of motion with full or normal resistance
28
What are the regions of the vertebral column?
-Cervical (7 vertebrae)
-Thoracic (12 vertebrae)
-Lumbar (5 vertebrae)
-Coccyx (4 fused vertebrae)
29
How many normal curves are there?
There are four normal curves which help to increase strength, help balance, and absorb
shock.
29
How many normal curves are there?
There are four normal curves which help to increase strength, help balance, and absorb
shock.
30
Thoracic vertebrae
(1) T1- T12
(2) Larger than cervical vertebrae
(3) Have facets for rib articulation
31
Lumbar vertebrae
(1) L1- L5
(2) Largest, strongest
(3) Spinous processes are short, thick
32
Sacrum
(1) S1- S5 fused into one unit
(2) Foundation for pelvic girdle
(3) Contain sacral foramina for nerves and blood vessels
33
Coccyx
Four coccygeal vertebrae fused into one
34
What are the bones of the thorax?
-Sternum
-Manubrium
-Body
-Xyphoid process
-Ribs
-R1-R7 are true ribs
(a) Costal cartilage articulates directly with the sternum
-R8-R10 are false ribs
(a) Articulate with the sternum bi cartilage of Rib 7
-R11- R12 are floating ribs
(a) Do not articulate with the sternum at all
35
Name the bones of the pectoral girdle?
-Clavicle
-Scapula
-Coracoid
36
DESCRIBE the anatomy of the ligaments of the pectoral girdle.
-Acromioclavicular ligament
-Coracoclavicular ligament
-Coracoacromial ligament
37
What is the function and anatomy of the labrum?
a. The glenoid cavity is shallow, allowing only about 25% of humeral head to make contact.
(1) Articulates with the head of the humerus to form the shoulder joint
b. The glenoid labrum forms a ring around this shallow cavity
(1) Deepens the glenoid and provides more stability to the joint
38
What muscles make up the rotator cuff?
-supraspinatus
-infraspinatus
-teres minor
-subscapularis
(SITS)
39
Describe the action of the supraspinatus?
Assists deltoid in abduction of the humerous at the shoulder
40
Describe the action of the infraspinatus?
External rotation of the humerus at the shoulder joint
41
Describe the action of the teres minor?
Extends arm at shoulder and rotation of the arm externally
42
Describe the action of the subscapularis?
Internal rotation of the arm at the shoulder.
43
Describe the action of the deltoid?
Abducts, flexes, and rotates arm at shoulder joint
44
Describe the action of the trapezius?
Multiple fibers in this large muscle move the scapula multi-directionally
45
Describe the action of the levator scapula?
Elevates scapula and rotates downward
46
Describe the action of the rhomboid major?
-Elevates and adducts scapula and rotates downward
-Stabilizes scapula
47
Describe the action of the pectoralis major?
-Adducts and rotates arm medially at the shoulder
-Flexes arm at the shoulder joint
48
Describe the action of the latissimus dorsi?
-Extends, adducts, and rotates arm medially at the shoulder joint
-Draws arm downward and backward
49
Describe the action of the teres major?
-Extends arm at the shoulder joint
-Assists with adduction and rotation of arm medially
50
Describe the action of the coracobrachilis?
Flexes and adducts arm at shoulder
51
What are the bones of the elbow?
-Humerus
-Radius
-Ulna
52
Describe the action of the biceps brachii?
-Flexes arm at the shoulder
-Flexes and supinates forearm at the elbow
53
Describe the action of the brachialis?
-Flexes forearm at the elbow joint
54
Describe the action of the brachioradialis?
-Flexes forearm at the elbow joint
55
Describe the action of the triceps brachii?
-Extends forearm at the elbow joint
-Extends arm at shoulder
56
Describe the action of the supinator?
-Supinates forearm
57
Describe the action of the pronator teres?
-Pronates forearm
58
What are the names of the bones in the hand?
Carpals
(1) Scaphoid
(2) Lunate
(3) Triquetrium
(4) Pisiform
(5) Trapezium
(6) Trapezoid
(7) Capitate
(8) Hamate
59
DESCRIBE the action of the muscles: flexor carpi radialis.
Flexes and abducts hand at wrist
60
DESCRIBE the action of the muscles: flexor carpi ulnaris.
Flexes and adducts hand at wrist
61
DESCRIBE the action of the muscles: palmaris.
Weakly flexes hand at wrist joint
62
DESCRIBE the action of the muscles: flexor digitorum superficialis
-Flexes hand at wrist
-Flexes phalanges of each finger at the PIP joint
63
DESCRIBE the action of the muscles: flexor digitorum profundus
-Flexes hand at wrist
-Flexes phalanges of each finger at DIP
64
DESCRIBE the action of the muscles: Extensor carpi radialis longus
Extends and abducts hand at the wrist joint
65
DESCRIBE the action of the muscles: Extensor carpi ulnaris
Extends and adducts hand at the wrist joint
66
DESCRIBE the action of the muscles: Extensor digitorum
-Extends hand at wrist joint
-Extends phalanges of each finger
67
What is the ulnar nerve distribution to the hand?
(1) Motor supply to most of the intrinsic hand muscles
(a) Excludes thenar muscles and two lumbricals on radial aspect
(2) Sensation to little finger and ½ of ring finger
68
What is the median nerve distribution to the hand?
Palmar and dorsal aspect of first 3 and ½ fingers
69
What is the radial nerve distribution to the hand?
Dorsum of the hand and lateral first three fingers and one half of fourth finger
70
A prominent scapular spine and loss of lateral shoulder contour indicates what?
Atrophy of the supraspinatus / infraspinatus
71
What is Neer's Impingement Sign used for?
Used to diagnose shoulder impingement or rotator cuff tears
72
What is Hawkin's Impingement Sign used for?
Reinforces a positive Neer sign for impingement (Used to diagnose shoulder impingement or rotator cuff tears)
73
What is a dropped arm test used for?
Detects tears in the rotator cuff tear (supraspinatus)
74
What is the Speed's test used for?
Helpful in diagnosing biceps tendonitis
75
What are the special tests for assessing an acromioclavicular (AC) joint impingement?
Neer, Hawkins, Cross-Body
76
What special tests are used to assess for ulnar nerve compression or damage?
Elbow Flexion Test, Tinel Sign at Elbow, Froment Sign, Flexor Digitorum Profundus
77
What structure is located in the anatomical snuff box and why is tenderness a concern?
Scaphoid and tenderness is a concern for fracture (often missed on initial radiograph
and heals poorly)
78
What are the special tests for labral damage or injury?
Apprehension Sign (anterior labral tear), Jobe Relocation Test (anterior labral tear),
Sulcus Sign (inferior labral tear), Jerk Test (posterior labral tear), O’Brien Test
(Superior Labral tear from Anterior to Posterior-SLAP lesion.
79
Type I: Acromioclavicular (AC) Injury
Acromioclavicular (AC) ligaments partially disrupted and Coracoclavicular (CC) ligaments are intact. No superior separation of clavicle from acromion.
80
Type II: Acromioclavicular (AC) Injury
AC ligaments are torn and CC ligaments are intact
resulting in partial separation of the clavicle from acromion.
81
Type III: Acromioclavicular (AC) Injury
AC and CC ligaments are completely disrupted resulting I complete separation of the clavicle from acromion.
82
Type IV: Acromioclavicular (AC) Injury
AC and CC ligaments are completely disrupted with superior and prominently posterior displacement.
83
Type V: Acromioclavicular (AC) Injury
AC and CC ligaments are completely disrupted with CC interspace more than twice as large as opposite shoulder.
84
Type VI: Acromioclavicular (AC) Injury
Uncommon. Clavicular periosteum and/or deltoid and trapezius muscle are torn resulting in wide displacement. Clavicle lies in either the subacromial space or subcoracoid space.
85
How long do you sling an AC injury?
I-III: 24-48 hrs
IV-VI: Until evaluated by Ortho
86
Which AC injuries require referral to Ortho?
III-VI
87
What is the most common bony injury?
Clavicle fracture
88
What is the most common location of a clavicle fracture?
Middle third
89
What special test would you use for a clavicle fracture?
Cross-body test
90
What confirms most clavicle fractures?
AP and 10 degree cephalic tilt radiographic views
91
What is the treatment for clavicle fx?
(1) Ice
(2) Analgesics (consider narcotic-level pain control)
(3) Orthopedic consult
(4) Mid-shaft fracture with minimal displacement and no neurovascular injury
(a) Figure-of-8 strap for 6-8 weeks
92
The glenohumeral joint provides multiple and extreme degrees of functional motion
that greatly depend on the rotator cuff muscles to do what?
properly seat the humeral head into
the glenoid fossa to provide stability
93
What does SIS stand for?
Shoulder impingement syndrome
94
What special tests are used for Shoulder impingement syndrome (SIS)?
Neer's and Hawkin's
95
Narrowing of sub acromial space suggests what in a radiograph?
long standing rotator cuff tear
96
What special tests are used for rotator cuff tears?
Drop arm and empty can
97
When is a bicep tendon rupture suspected?
if there was a single injury (a “pop”) with
ecchymosis and swelling
98
What special test is used for bicep tendon injury/rupture?
Speed's
99
What allows shoulder mobility?
A shallow glenoid and loose capsule
100
What is instability?
anterior, posterior, inferior or multidirectional glenohumeral laxity due to traumatic or atraumatic pathology
101
What is subluxation?
humeral head partially slips out of socket with spontaneous reduction
102
What is dislocation?
humeral head completely slips out of glenoid fossa with spontaneous reduction or sometimes requiring manual manipulation
103
What is TUBS?
Traumatic unilateral dislocations with a Bankart lesion that can be successfully treated with surgery
104
What is AMBRI?
Atraumatic multidirectional instability that is commonly bilateral and is often successfully treated with rehabilitation and occasionally an
inferior capsular shift (surgery)
105
What is the most common direction of dislocation in shoulder?
Anterior dislocation
106
What are the special tests used for shoulder instability?
Sulcus, apprehension test, anterior & posterior drawer, jerk test
107
How do you reduce acute dislocation of shoulder?
(a) Stimson technique- gravity assisted with patient lying on stomach
(b) Longitudinal traction- elbow at 90 degrees flexion while longitudinal
traction is applied to the humerus. Gently rotate arm.
(c) Valium maybe be required to relax muscle structures to allow for reduction
(d) Re-evaluate axillary nerve function after reduction
108
What is the Fibrocartilaginous ring attached to outer surface of glenoid?
Labrum
109
What does the Labrum do?
(1) Give depth to the shoulder joint
(2) Increases area of contact between humeral head and glenoid
(3) Also serves as point of contact for several ligaments and tendons
110
What do Superior labrum anterior posterior (SLAP) lesions involve?
Injury to the superior glenoid labrum and the biceps anchor complex
111
What special tests are recommended for SLAP injury?
Obrien's and Speed's
112
“A condition of varying severity characterized by the gradual development of
global limitation of active and passive shoulder motion where radiographic
findings other than osteopenia are absent.” is what?
Adhesive Capsulitis
113
What is another name for adhesive capsulitis?
Frozen shoulder
114
What are diseases that are associated with adhesive capsulitis?
Diabetes, thyroid disease, autoimmune disorders, stroke, Parkinsons, HIV medication use
115
Concern for adhesive capsulitis is raised when a patient with history of shoulder injury
complains of what?
-Severe pain that is worse at night
-Nagging pain
116
What is another name for lateral tendinosis?
Tennis elbow
117
What is another name for medial tendinosis?
Golfer's elbow/bowler's elbow
118
What is medial epicondylitis?
An overuse injury involving excessive use of the flexor and pronator muscles just distal to the medial epicondyle
119
Where is the olecranon bursa located?
superficially located on extensor side of elbow
120
What diagnostic tests are used for olecranon bursitis?
(1) Aspiration maybe be diagnostic and therapeutic
(a) Laboratory testing of aspirate for WBC count, crystals, gram stain and culture
(2) Radiographs needed to rule out fracture of olecranon process
121
Compression of the ulnar nerve is what?
Cubital tunnel syndrome
122
With acute onset patient will describe a “pop” while throwing is seen in what injury?
Ligamentous Injury
123
What is the most common dislocation in children and third most common in adults?
Elbow dislocation
124
An elbow dislocation results from what?
Fall on an outstretched hand (FOOSH)
125
What is the most common neuropathy of the upper extremity?
Carpal Tunnel Syndrome.
126
A patient with carpal tunnel experiences numbness/tingling where?
Numbness and tingling into radial three digits of the hand (1st, 2nd and 3rd digits)
127
What special tests are used for a patient with carpal tunnel?
Phalen maneuver and Tinel Sign
128
What is de Quervain Tenosynovitis?
Swelling or stenosis of the sheath that surrounds the abductor pollicis longus and extensor
pollicis brevis tendon at the wrist.
129
What special test is used for de Quervain Tenosynovitis?
Finkelstein Test
130
What is the treatment for a scaphoid fracture?
Thumb spica splint
131
What is a ganglion of the wrist?
Cystic structure that arises from capsule of a joint or a tendon synovial sheath
132
What is a "Jersey Finger?"
-Rupture of the flexor digitorum profundus tendon from its distal attachment
-Flexed DIP joint is suddenly and forcefully hyperextended
133
What is a mallet finger?
-Rupture, laceration or avulsion of the insertion of the extensor tendon and base of distal
phalan
-Direct blow to the finger causing sudden forced flexion of the DIP/distal phalanx
134
How long is a mallet finger splinted for?
6-8 weeks
135
What is a boutonniere deformity?
-Extensor tendon rupture at insertion on middle phalanx
-Splint 3-6 weeks
136
What are the bones of the pelvic girdle?
Ilium, Ischium, Pubis
137
What is the largest most superior part of the pelvis?
Ilium
138
What is the lowest posterior part of the pelvis?
Ischium
139
What does the acetabulum form?
The socket for the head of the femur
140
What is formed by articulation of the ischium and pubis and is the largest foramen in the body?
Obturator foramen
141
DESCRIBE the action of the muscles: Psoas major
Flexes and rotates thigh laterally
142
DESCRIBE the action of the muscles: Iliacus
Flexes and rotates thigh laterally
143
DESCRIBE the action of the muscles: Gluteus maximus
-Extends and rotates thigh laterally
-Helps lock knee in extension
144
DESCRIBE the action of the muscles: Gluteus medius
Abducts and rotates thigh medially
145
DESCRIBE the action of the muscles: Tensor fascia latae
-Flexes and abducts thigh at hip joint
-Helps lock knee in extension
146
DESCRIBE the action of the muscles: Adductor longus
Adducts, rotates, and flexes thigh at hip joint
147
DESCRIBE the action of the muscles: Adductor magnus
Adducts, flexes, rotates, and extends thigh at the hip joint
148
DESCRIBE the action of the muscles: Piriformis
External rotation of thigh laterally and abducts
149
DESCRIBE the action of the muscles: Pectineus
Flexes and adducts thigh
150
What is the strongest bone in the body?
femur
151
What is the projection from the femur at the side of the hip?
Greater trochanter
152
What is the attachment site for the patella ligament?
Tibial tuberosity
153
What bone attaches to the tibia via the interosseous membrane?
Fibula
154
What strengthens the medial aspect of the knee?
Medial Collateral Ligament (MCL)
155
What strengthens the lateral aspect of the knee?
Lateral Collateral Ligament (LCL)
156
What extends posteriorly and laterally from the tibia to femur and limits hyperextension of the knee and prevents anterior sliding of the tibia on the femur?
Anterior Cruciate Ligament (ACL)
157
What extends anteriorly and medially from the tibia to the femur and Prevents posterior sliding of the tibia on the femur?
Posterior Cruciate Ligament (PCL)
158
What are sac filled structures filled with fluid and reduce friction?
Bursae
159
DESCRIBE the action of the muscles: Gracilis
-Adducts and medially rotates thigh
-Flexes leg at the knee
160
DESCRIBE the action of the muscles: adductor magnus
Adducts the femur
161
DESCRIBE the action of the muscles: adductor longus
Adducts the femur
162
DESCRIBE the action of the muscles: pectineus
Adducts the femur
163
DESCRIBE the action of the muscles: rectus feoris
-Extends the knee
-Flexes the hip
-Located anterior to other quadriceps muscles
164
DESCRIBE the action of the muscles: vastus lateralis
Extends the knee
165
DESCRIBE the action of the muscles: medialis
Extends the knee
166
DESCRIBE the action of the muscles: Intermedius
Extends the knee
167
DESCRIBE the action of the muscles: sartorius
-Flexes the knee
-Weakly flexes the hip
-Abducts and laterally rotates the thigh
168
DESCRIBE the action of the muscles: biceps femoris (hamstrings)
-Extends thigh at the hip
-Flexes the leg at the knee joint
169
DESCRIBE the action of the muscles: semitendinosis
-Extends the thigh at the hip
-Flexes leg at the knee
170
DESCRIBE the action of the muscles: semimembranosis
-Extends the thigh at the hip
-Flexes leg at the knee
171
What bone is formed by distal end of tibia and fibula?
Ankle mortis
172
How many bones does the ankle have?
7
173
What are the 7 bones of the ankle?
-Large talus
-Calcaneus
-Cuboid
-Navicular
-Cuneiforms
-Metatarsals
-Phalanges
174
What ligament extends from the talus to fibula?
Anterior talofibular ligament (ATFL)
175
What ligament extends from the calcaneus to fibula
Calcaneofibular ligament (CFL)
176
What extends from talus to fibula?
Posterior talofibular ligament (PTFL)
177
DESCRIBE the action of the muscles: tibialis anterior
Dorsiflexes and inverts the foot
178
DESCRIBE the action of the muscles: Extensor digitorum longus
-Dorsiflexes and everts the foot
-Extends toes
179
DESCRIBE the action of the muscles: Fibularis longus
Plantarflexes foot and everts foot
180
DESCRIBE the action of the muscles: gastrocneumius
-Plantar flexes foot
-Flexes leg at the knee
181
DESCRIBE the action of the muscles: Soleus
Plantarflexes foot
182
DESCRIBE the action of the muscles: Tibialis posterior
Plantarflexes and inverts foot
183
DESCRIBE the action of the muscles: Flexor digitorum longus
-Plantar flexes foot
-Flexes toes
184
What detects gluteus medius muscle weakness?
Trendelenburg test
185
When doing Lachman's test the absence of a firm end point is indicative of what?
anterior cruciate ligament tear.
186
What is the most common hip dislocation?
Posterior dislocation
187
Patient presents with affected limb short, hip is fixed in adducted and internally rotated
position what is the diagnosis?
Posterior hip dislocation
188
What type of fracture is associated with many severe, life threatening injuries?
Femoral shaft fracture
189
Patient reports vague pain in anterior groin or thigh exacerbated by activity and weight bearing
Relieved with rest and Story of increasing activity prior to pain onset. What's the dx?
Stress Fracture of the Femoral Neck
190
Pain in groin area with attempted weight bearing;
Sensation of “coming apart” at the hip with bearing weight; High energy fractures. Probable dx?
Fracture of pelvis
191
What is another name for prepatellar bursitis?
Housemaid's knee
192
What is a dense, fibrous band of tissue that originates from the anterior superior
iliac spine region, extends down the lateral portion of the thigh and inserts on the lateral
tibia at the Gerdy tubercle?
Iliotibial band (IT Band)
193
What are fibrocartilaginous pads that function as shock absorbers between the femoral condyles and tibial plateaus?
The medial and lateral menisci
194
Anterior knee pain is a hallmark of what?
Quadriceps / Patellar Tendinitis
195
Popliteal Cyst is also called what?
Bakers cyst
196
Muscles of the lower leg are divided into four compartments by what?
fibrous septa
197
What are the 7 P's for compartment syndrome?
-Pain
-Pallor
-Parasthesias
-Paresis
-Poikilothermia
-Pressure
-Pulselessness
198
Acute compartment syndrome is a medical emergency and requires what?
Fasciotomy
199
What treatment is contraindicated for compartment syndrome?
Ice is considered contraindicated because of its constricting properties
200
What is the largest tendon in the body?
Achilles tendon
201
What forms the achilles tendon?
Gastrocnemius and Soleus muscles converge to form the Achilles tendon
202
What medication is a risk factor for achilles tendon rupture?
Fluoroquinolone antibiotic use associated
203
What special test is used for achilles tendon rupture?
Thompson test
204
A bunion creates what kind of deviation from the toe?
Hallux valgus
205
Patient reports feeling as though they are "walking on a marble" or that there is "a wrinkle in my socks" what's the probable dx?
Morton Neuroma
206
What is a long fibrous band like tissue that arises from the medial tuberosity of the calcaneus and extends to the proximal phalanges?
Plantar fascia
207
Hyperextension injury of the first metatarsal is what?
Turf toe
208
Non-radicular, non-focal neck pain from the base of the skull to the cervicothoracic junction is a symptom of what?
Cervical strain
209
What is the most common cancer to metastasize to bone?
1) Breast
2) Prostate
3) Lung
4) Kidney
5) Thyroid
210
Lateral curvature of the spine that is more than 10 degrees in an adult is what?
Scoliosis
211
When is scoliosis disqualifying?
Lumbar scoliosis greater than 20 degrees or thoracic scoliosis greater than 30 degrees is disqualifying
212
What is parallel to cricoid cartilage?
C6
213
What is parallel to thyroid cartilage?
C4
214
When Chest pain is said to be “reproducible” and Able to exacerbate pain with palpation on physical exam, what is the suspected diagnosis?
Costochondritis
215
Destruction of joint cartilage due to "wear and tear" is what?
Osteoarthritis
216
What is the ACR criteria for rheumatoid arthritis?
-Morning stiffness (1 hour for 6 weeks)
-Arthritis (>/= 3 joints for 6 weeks)
-Swelling of hand joints (6 weeks)
-Symmetrical joint swelling (6 weeks)
-Rheumatoid nodules
-Positive RF factor
-Erosions or osteopenia in hand XR
-May have myelopathy with C1-C2 involvement
217
What labs are taken for RA?
1) Rheumatoid Factor (RF)
2) Antibody to cyclic citrullinated peptide (Anti-CCP)
3) C-reactive Protein (CRP)
4) Erythrocyte Sedimentation Rate (ESR)
218
What medication is given for RA?
1) NSAID/Tylenol
2) DMARD (Disease-Modifying Anti- Rheumatic Drug)
a) -Ab, , etanercept, methotrexate, hydroxychloroquine, cyclosporine
219
Spondylarthropathy that is preceded and precipitated by infection in the body is what?
Reactive arthritis
219
Spondylarthropathy that is preceded and precipitated by infection in the body is what?
Reactive arthritis
220
What is dactylitis?
"sausage digits"
221
Ankylosing Spondylitis is also called what?
Bamboo spine
222
Monosodium urate crystal deposition in joints and tissues (tophi) is what?
Gout
223
What labs are taken for gout?
(a) Uric acid
(b) Chem Panel
(c) TSH, Iron Panel
(d) WBC
(e) NEEDLE SHAPED, NEGATIVE BIREFRINGENT
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What is the treatment for gout?
(a) NSAID (Indomethacin)
(b) Colchicine (n/v/d; bone marrow suppression, neuropathy)
(c) Steroids
225
What is the prophylaxis for gout?
(a) Allopurinol (overproducers)
(b) Probenecid (underexcreters; UA <600mg/day)
226
What foods should be avoided in a patient with gout?
1) Meat
2) Seafood
3) Alcohol
4) High-fructose corn syrup
227
Pseudogout and gout are differentiated based on lab analysis of joint aspiration. What is the difference
Gout is needle shaped crystals while pseudogout rhomboid shaped crystals
228
What is the most common cause of septic arthritis?
Staphylococcus aureus
229
What is the treatment for septic arthritis?
(1) Supportive if having shock (IV, monitors, O2, VS, bolus of IVF)
(2) IV antibiotics (ceftriaxone, vancomycin)
(3) MEDEVAC
230
Virchow Triad
(1) Hypercoagulability
(2) Venous Stasis
(3) Endothelial Damage
231
What is an open fracture?
Obvious bone through the skin or break in the skin with suspected fracture
(ANY break in skin near fracture site is open fx)
232
What is a non-displaced fracture?
in anatomic alignment
233
What is a displaced fracture?
not in anatomic alignment; described as a percentage
234
What is a bayonetted fracture?
distal fragment overlaps proximal fragment
235
What is a distracted fracture?
Fragments are separated
236
What is an angulation fracture?
Deviation at an angle
237
What are the three "R's" for treatment of a fracture?
(a) Recognition
(b) Reduction
(c) Retention of reduction while achieving union
(d) Rehabilitation
