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MSK elective surgery and general trauma formative Flashcards

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1
Q

Name a tendon which needs surgical repair

A

Patellar tendon- need it to function

achilles, rotator cuff, long head of biceps, distal biceps can be managed conservatively

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2
Q

Do upper or lower limb fractures heal quicker?

A

Upper limb - better blood supply

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3
Q

Name a bone which is very slow to heal

A

Tibia

Fractures typically take 16 weeks, can take up to a year!

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4
Q

Nerve damaged in humeral shaft fracture?

A

Radial

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5
Q

Nerve damaged in colles (distal radial) fracture?

A

Median nerve

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6
Q

Nerve damaged in anterior dislocation of shoulder?

A

Axillary nerve

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7
Q

Cardinal sign of compartment syndrome?

A

Increased pain on passive stretching of the involved muscle

  • the limb will be tensely swollen and the muscle is usually tender to touch
  • Loss of pulses is a feature of end stage ischemia and the diagnosis has been made too late
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8
Q

Volkmanns contracture

A
  • Can occur following compartment syndrome

- fibrotic contracture

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9
Q

A complete transection of a nerve requiring surgical repair for any chance of recovery of function

A

Neurotmesis

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10
Q

A temporary conduction defect from compression or stretch and will resolve over time with full recovery

A

Neurapraxia

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11
Q

Nerve injury sustained due to compression or stretch from a higher degree of force with death of the long nerve cell axons distal to the point of injury die

A

Axonotmesis

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12
Q

GCS that implies loss of airway control?

A
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13
Q

Can be associated with hypertrophic non-union when the fracture is not properly stabilised

A

2ndry bone healing

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14
Q

Involves an inflammatory response and laying down of immature bone

A

2ndry bone healing

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15
Q

Occurs in anatomically reduced fractures fixed rigidly with plates and screws

A

Primary bone healing

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16
Q

Occurs with a fracture gap of less than 1mm

A

Primary bone healing

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17
Q

Blow to the lateral aspect of the knee (“Bumper injury”) can result in damage to which nerve?

A

Common peroneal

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18
Q

Posterior dislocation of the hip could damage which nerve?

A

Sciatic

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19
Q

Salter Harris intra-articular fractures?

A

III and IV

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20
Q

Most common salter harris fracture?

A

II

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21
Q

Which type of salter harris cannot be diagnosed on x-ray?

A

Type V

These are compression injuries (with subsequent growth arrest)

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22
Q

Occur due to torsional forces acting on the bone. These fractures are most unstable to rotational forces but can also angulate

A

Spiral fracture

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23
Q

Occur when bone is exposed to a shearing force (e/g/ fall from height, deceleration). There is a risk of shortening and angulation with these fractures as they’re inheritently unstable

A

Oblique fracture

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24
Q

Occur when a pure bending force is applied to a bone. The cortex on one side fails in compression and the cortex on the other side fails in tension

A

Transverse fracture

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25
Tendons that need managed surgically?
Patellar Hip adductor Quadriceps
26
Good for end stage ankle arthritis
Arthrodesis
27
Good for end stage wrist arthritis
Arthrodesis
28
Good for hallux rigidus (OA of the first MTP)
Arthrodesis
29
Artery to watch out for in shoulder dislocation?
Axillary artery
30
Artery to watch out for in knee dislocation?
Popliteal artery
31
Artery to watch out for in paediatric supracondylar fracture?
Brachial artery
32
Maximum GCS
15
33
Minimum GCS
3
34
Treatment for mallet finger
Mallet splint holding the DIPJ extended | -worn for a minimum of four weeks
35
Avascular necrosis can occur in which part of scaphoid?
Proximal pole (as blood supply comes distally from a branch of the radial artery)
36
Treatment for displaced scaphoid fracture?
Special compression screw sunk into the bone to avoid non-union
37
Mortality from hip fracture?
10% at 1 month 20% at 4 months 30% at 1 year
38
Criteria to clinically clear a C-spine
No history of loss of consciousness, GCS 15 with no alcohol intoxication No significant distracting injury (such as head injury, chest trauma or other fractures including more distal spinal fractures) No neurological symptoms in the upper or lower limbs No midline tenderness on palpation of the c-spine, No pain on gentle active neck movement (ask the patient to gently flexed forward, then rotate to each side)
39
Name a tendon which needs surgical repair
Patellar tendon- need it to function | achilles, rotator cuff, long head of biceps, distal biceps can be managed conservatively
40
Do upper or lower limb fractures heal quicker?
Upper limb - better blood supply
41
Name a bone which is very slow to heal
Tibia | Fractures typically take 16 weeks, can take up to a year!
42
Nerve damaged in humeral shaft fracture?
Radial
43
Nerve damaged in colles (distal radial) fracture?
Median nerve
44
Nerve damaged in anterior dislocation of shoulder?
Axillary nerve
45
Cardinal sign of compartment syndrome?
Increased pain on passive stretching of the involved muscle - the limb will be tensely swollen and the muscle is usually tender to touch - Loss of pulses is a feature of end stage ischemia and the diagnosis has been made too late
46
Volkmanns contracture
- Can occur following compartment syndrome | - fibrotic contracture
47
A complete transection of a nerve requiring surgical repair for any chance of recovery of function
Neurotmesis
48
A temporary conduction defect from compression or stretch and will resolve over time with full recovery
Neurapraxia
49
Nerve injury sustained due to compression or stretch from a higher degree of force with death of the long nerve cell axons distal to the point of injury die
Axonotmesis
50
GCS that implies loss of airway control?
51
Can be associated with hypertrophic non-union when the fracture is not properly stabilised
2ndry bone healing
52
Involves an inflammatory response and laying down of immature bone
2ndry bone healing
53
Occurs in anatomically reduced fractures fixed rigidly with plates and screws
Primary bone healing
54
Occurs with a fracture gap of less than 1mm
Primary bone healing
55
Blow to the lateral aspect of the knee ("Bumper injury") can result in damage to which nerve?
Common peroneal
56
Posterior dislocation of the hip could damage which nerve?
Sciatic
57
Salter Harris intra-articular fractures?
III and IV
58
Most common salter harris fracture?
II
59
Which type of salter harris cannot be diagnosed on x-ray?
Type V | These are compression injuries (with subsequent growth arrest)
60
Occur due to torsional forces acting on the bone. These fractures are most unstable to rotational forces but can also angulate
Spiral fracture
61
Occur when bone is exposed to a shearing force (e/g/ fall from height, deceleration). There is a risk of shortening and angulation with these fractures as they're inheritently unstable
Oblique fracture
62
Occur when a pure bending force is applied to a bone. The cortex on one side fails in compression and the cortex on the other side fails in tension
Transverse fracture
63
Tendons that need managed surgically?
Patellar Hip adductor Quadriceps
64
Good for end stage ankle arthritis
Arthrodesis
65
Good for end stage wrist arthritis
Arthrodesis
66
Good for hallux rigidus (OA of the first MTP)
Arthrodesis
67
Artery to watch out for in shoulder dislocation?
Axillary artery
68
Artery to watch out for in knee dislocation?
Popliteal artery
69
Artery to watch out for in paediatric supracondylar fracture?
Brachial artery
70
Maximum GCS
15
71
Minimum GCS
3
72
Treatment for mallet finger
Mallet splint holding the DIPJ extended | -worn for a minimum of four weeks
73
Avascular necrosis can occur in which part of scaphoid?
Proximal pole (as blood supply comes distally from a branch of the radial artery)
74
Treatment for displaced scaphoid fracture?
Special compression screw sunk into the bone to avoid non-union
75
Mortality from hip fracture?
10% at 1 month 20% at 4 months 30% at 1 year
76
Criteria to clinically clear a C-spine
No history of loss of consciousness, GCS 15 with no alcohol intoxication No significant distracting injury (such as head injury, chest trauma or other fractures including more distal spinal fractures) No neurological symptoms in the upper or lower limbs No midline tenderness on palpation of the c-spine, No pain on gentle active neck movement (ask the patient to gently flexed forward, then rotate to each side)
77
Criteria to clinically clear a C-spine
No history of loss of consciousness, GCS 15 with no alcohol intoxication No significant distracting injury (such as head injury, chest trauma or other fractures including more distal spinal fractures) No neurological symptoms in the upper or lower limbs No midline tenderness on palpation of the c-spine, No pain on gentle active neck movement (ask the patient to gently flexed forward, then rotate to each side)
78
Deformity in which plane is not well tolerated and requires manipulation and possible fixation?
Rotational deformity
79
Most common site for proximal humerus fracture?
Surgical neck of the humerus
80
Osgood Schlatters
Inflammation of the tibial tubercle
81
Sinding Larsen Johanssen disease
Inflammation of the inferior pole of the patella
82
Risk factors for patello-femoral dysfunction
The aetiology is unclear and may be due to muscle imbalance, ligamentous laxity and subtle skeletal predisposition (genu valgum, wide hips, femoral neck anteversion)
83
Talipes equinovarus (club foot) is more common in which gender?
- Boys - around 50% of cases are bilateral - may be genetic link with positive family history - low amniotic fluid - breech presentation
84
Often the first sign of Perthes?
Loss of internal rotation -common in very active boys of short stature haha - loss of internal rotation - then loss of abduction - then positive trendelenberg test
85
Patients with SUFE, proportion that are bilateral?
1/3
86
Loss of primitive reflexes
1-6 months
87
Head control
2 months
88
Speaking a few words
9-12 months
89
Eats with fingers, uses spoon
14 months
90
Stacks four blocks
18 months
91
Understands 200 words, learns around 10 words a day
18-20 months
92
Potty trained
2-3 years
93
Approx how many patients with a dislocated patellar will dislocate it again in the future?
20%

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