MSK elective surgery and general trauma formative Flashcards Preview

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Flashcards in MSK elective surgery and general trauma formative Deck (93):
1

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)

2

Do upper or lower limb fractures heal quicker?

Upper limb - better blood supply

3

Name a bone which is very slow to heal

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

4

Nerve damaged in humeral shaft fracture?

Radial

5

Nerve damaged in colles (distal radial) fracture?

Median nerve

6

Nerve damaged in anterior dislocation of shoulder?

Axillary nerve

7

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

8

Volkmanns contracture

-Can occur following compartment syndrome
-fibrotic contracture

9

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

Neurotmesis

10

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

Neurapraxia

11

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

12

GCS that implies loss of airway control?

13

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

2ndry bone healing

14

Involves an inflammatory response and laying down of immature bone

2ndry bone healing

15

Occurs in anatomically reduced fractures fixed rigidly with plates and screws

Primary bone healing

16

Occurs with a fracture gap of less than 1mm

Primary bone healing

17

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

Common peroneal

18

Posterior dislocation of the hip could damage which nerve?

Sciatic

19

Salter Harris intra-articular fractures?

III and IV

20

Most common salter harris fracture?

II

21

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

Type V
These are compression injuries (with subsequent growth arrest)

22

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

Spiral fracture

23

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

24

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

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%