Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

FINALS (not specialities) > MSK/Orthopaedics > Flashcards

MSK/Orthopaedics Flashcards

1
Q

What are the classic signs of osteoarthritis on x-ray?

A

Loss of joint space
Subchondral sclerosis
Subchondral cysts
Osteophytes at joint margins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Give 4 differentials for a hot, swollen joint

A

Septic arthritis
Osteomyelitis
Gout
Charcot joint (diabetics)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is a Charcot joint?

A

A joint which has become badly disrupted and damaged secondary to a loss of sensation (usually due to diabetes)

Red, swollen and warm
Less painful that would be expected for such a disrupted joint due to the sensory loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Define a sprain. What is the most likely mechanism of injury in the ankle?

A

A stretching, partial or complete tear of a ligament. Usually due to inversion if in the ankle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How would a posterior hip dislocation present?

A

The affected leg is shortened, adducted, and internally rotated

Most common!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How would an anterior hip dislocation present?

A

abducted and externally rotated.

No leg shortening.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Give 4 complications of a hip dislocation

A

Sciatic or femoral nerve injury

Avascular necrosis

Osteoarthritis: more common in older patients.

Recurrent dislocation: due to damage of supporting ligaments

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the management of a hip dislocation?

A

Short term =
A to E and Analgesia
Reduction under general anaesthetic within 4 hours to reduce the risk of avascular necrosis.

Long-term =
Physiotherapy to strengthen the surrounding muscles.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How would a fractured neck of femur present?

A

Typically elderly females

pain
shortened and externally rotated leg
patients with non-displaced or incomplete neck of femur fractures may be able to weight bear

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Describe the difference between intra and extracapsular hip fractures

A

Intra = edge of the femoral head to the insertion of the capsule of the hip joint

extra= these can either be trochanteric or subtrochanteric (the lesser trochanter is the dividing line)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Which classification system is the one for fractured NOFs?

A

Garden

Vascular compromise associated with type 3&4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the management of intracapsular NOF fractures?

A

Undisplaced = internal fixation, or hemiarthroplasty if unfit.

Displaced = replacement arthroplasty

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

In terms of replacement arthroplasty for displaced hip fractures, when is a total hip replacement favoured over a hemiarthroplasty?

A

IF PATIENTS CAN:

Walk independently out of doors with no more than the use of a stick AND

No cognitive impairment AND

are medically fit for anaesthesia and the procedure.

Basically TRH if they’re healthy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the management of an extracapsular hip fracture?

A

dynamic hip screw

OR

if reverse oblique, transverse or subtrochanteric: intramedullary device

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Give 6 ‘things’ that can occur due to falling on an outstretched hand

A

Wrist = scaphoid, colles

Forearm = Monteggia, Galeazzi (+dislocations)

Shoulder = dislocation of the humerus, clavicle fracture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

which fracture occurs by falling on a flexed wrist? Describe the fracture

A

Smith’s fracture

fracture of the distal radius + volar angulation (wrist is flexed)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

describe a colles fracture

A

FOOSH + elderly

distal radius fracture + dorsal angulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what complication can occur due to a scaphoid fracture and why?

A

avascular necrosis as the blood supply runs distal to proximal

can predispose osteoporosis in later life (young people get scaphoid fractures)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

describe a Monteggia fracture

A

Man Utd

Monteggia = ulna

Fracture of the ulnar shaft + dislocation of the proximal radial head

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

describe a Galeazzi fracture

A

Glasgow Rangers

Rangers = Radius

Fracture of the radial shaft and dislocation of the radioulnar joint

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

When does a supracondylar fracture occur and what is a complication of it?

A

FOOSH in a child

Can get damage to the brachial artery and therefore ischaemia to the forearm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How do anterior and posterior dislocations of the humeral head present?

A

anterior = more common.
Abducted and externally rotated

Posterior = seizure/electrocution
internally rotated and abducted

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What structure can be damaged in a humeral head dislocation and what are the effects of this?

A

Axillary nerve

loss of sensation to the regimental badge

loss of innervation to the deltoid = unable to abduct

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Which structure can be damaged due to a fracture to the surgical neck of the humerus?

A

axillary nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Which structure can be damaged due to a fracture of the humeral shaft and what can occur as a result?
Radial nerve + profunda brachii artery Wrist drop = unopposed flexion of the wrist due to loss of extension from the triceps Loss of sensation to the dorsum of the hand and the later 3.5 digits
26
Where is the clavicle most commonly fractured and what happens to the fragments as a result?
middle 1/3 medial 1/3 gets pulled superiorly due to sternocleidomastoid lateral 2/3 gets pulled inferiorly due to pec major
27
Name the 4 muscles of the rotator cuff from superior to inferior and give their action
SUPRAspinatus = ABduction to 15 degrees INFRAspinatus = external rotation Teres minor = external rotation Subscapularis = internal rotation external rotation sandwich
28
How does a rotator cuff tear present?
pain over the lateral aspect of shoulder can't abduct the arm above 90 degrees
29
what is the management of a rotator cuff tear?
conservative = analgesia + physio. ? corticosteroid injections surgical if >2 weeks since injury or symptomatic despite conservative = arthroscopic or open repair
30
What is the main complication of a rotator cuff tear?
adhesive capsulitis Glenohumeral joint capsule becomes contracted and adherent to the humeral head = pain and loss of range of movement analgesia, physio, ?steroid injection ?surgery
31
What are the causes of carpal tunnel?
MEDIAN TRAP ``` Myxoedema (hypothyroid) oEdema Diabetes mellitus Idiopathic Acromegaly Neoplasia ``` Trauma Rheumatoid arthritis Amyloidosis Pregnancy
32
What are the 2 tests for carpal tunnel?
Tinnels Test (tap the median nerve) Phalen's Test (hold wrist in full flexion for one minute = parasthesia)
33
How does carpal tunnel present?
pain, numbness, and/or paraesthesia throughout the median nerve distribution sx usually worse at night wasting of the thenar evidence weakness of thumb abduction
34
How would an ACL tear present?
Hx of twisting the knee whilst weight bearing Rapid joint swelling Can't weight pain Pain +++
35
Which tests can be done to identify ACL damage?
Anterior draw (flex knee at 90 degrees + apply force anteriorly) Lachman (flex knee 30 degrees + pull tibia forward) MRI scan is gold standard
36
How would a meniscal tear present?
Tearing sensation in knee Sudden onset pain +++ Slow swelling Knee locking joint line tenderness
37
Which tests can be done to identify meniscal damage?
McMurray's
38
What is the classification system used for lateral malleolus fractures?
Weber's a = below syndesmosis + usually transverse B = at the level of the syndesmosis + usually spiral C = above level of syndesmosis more proximal = increased risk of instability
39
What are the Ottawa rules?
if there is diagnostic uncertainty in ankle fractures e.g. can mobilise and has no deformity presence of: bone tenderness at posterior edge/tip of lateral OR medial malleolus can't weight bear for 4 steps = get a plain radiograph
40
When should surgical management be used in a patient with an ankle fracture?
Displaced bimalleolar or trimalleolar fractures Weber C fractures Weber B fractures with talar shift Open fractures
41
What is the surgical management of osteoarthritis and when should it be offered?
Osteotomy, joint fusion or joint replacement if conservative and medical interventions don't manage the condition
42
What is compartment syndrome?
a critical pressure increase within a confined compartmental space fascial compartments are rigid and can't distend so excess fluid = increase in intracompartmental pressure compresses veins and nerves compromises arterial inflow = ischaemia
43
How does compartment syndrome present?
5Ps Parasthesia + paralysis Pain (disproportionate to injury and not improved with analgesia) Pallor Perishingly Cold Pulselessness
44
How is compartment syndrome managed?
A-E Remove splints/casts/etc Analgesia Monitor renal function URGENT FASCIOTOMY
45
What is septic arthritis?
Infection of a joint, usually due to staph aureus Bacteria seeds to the joint from a bacteraemia, direct inoculation or spreading from near osteomyelitis
46
What are the risk factors for septic arthritis?
``` non-modifiable: age >80 pre-existing joint disease e.g. RA diabetes/immunosuppressed chronic renal failure ``` modifiable: IVDU Joint prosthesis
47
How does septic arthritis normally present?
Red, swollen, hot joint pain on active and passive joint movement pyrexia can't wait bear
48
Which investigations should be done to manage septic arthritis?
Bed - a-e Bloods - FBC, U&E, CRP, Urate, Blood cultures Imaging - plain radiograph xray Other - joint aspiration!!! Before abx. if have joint prosthesis then do it in theatre
49
What is the management of septic arthritis?
Empiral abx ASAP. give these IV and long term Surgical irrigation and debridement for native joints Washout and revision surgery for prosthetic
50
Give 2 complications of septic arthritis
Osteoarthritis and osteomyelitis
51
What is osteomyelitis and how is it caused?
Infection of the bone haematogenous spread direct inoculation direct spread from nearby infection usually bacterial by staph aureus pseudomonas in IVDU salmonella in sickle cell
52
How does osteomyelitis present?
Severe pain low grade fever tender to palpate + overlying erythema and swelling Long bones normally infected in children
53
What are the risk factors for osteomyelitis?
Non modifiable: Immunosuppressed Diabetes mellitus modifiable: alcohol excess IVDU
54
How should osteomyelitis be investigated?
Normal bloods MRI = definitive diagnosis Gold standard = bone biopsy when derided
55
What is the management of a patient with osteomyelitis?
Long term IV abx curettage if deteriorate
56
What are 3 complications of osteomyelitis?
SEPSIS + DEATH Septic arthritis growth disturbance in children can become chronic
57
What counts as a tetanus prone wound?
Needs surgery but has been delayed for >6 hours Significant degree of devitalised tissue/Puncture-type injury Foreign body in situ/ significant contact with spores likely to contain tetanus e.g. manure or soil Compound fractures Systemic sepsis is present (Give these all tetanus immunoglobulin)
58
Which abx prophylaxis is required for an infected wound?
Contaminated = co-amoxiclav Clean = Flucloxacillin *** swab wound before abx
59
How does adhesive capsulitis normally present?
Middle aged women external rotation is affected more than internal rotation or abduction both active and passive movement are affected
60
What is Paget's disease of bone?
increased bone turnover + remodelling defective mineralisation
61
Give 3 investigations for Paget's disease of bone?
Xrays of affected areas serum calcium, phosphate and alk phos serum hydroxyproline
62
What is the management of Paget's disease of bone?
Analgesia and rest bisphosphonates

FINALS (not specialities) (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions