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Flashcards in musculoskeletal Deck (46)
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1

MC fractured carpal bone

scaphoid

2

scaphoid fractures - presentation

pain at the radial wrist proximal to the base of the thumb
examination: tenderness in the shallow depression
- risk of osteonecrosis

3

scaphoid fractures - management

initial x-rays can be normal in nondisplaced fractures
if scaphoid fracture is suspected: CT or MRI to confirm or repeat x-ray in 7-10 d.

4

scaphoid fractures - treatment

Displaced fractures --> surgical intervention
nondisplaced --> wrist immobilization (but monitor with serial x-ray to rule out osteonecrosis)

5

ganglion cysts - age and area

age 15-40
arise in most cases due to repetitive stress or inflammation

6

all patients with clavicular fracture should have

a careful neurovascular examination to rule out injury to the underlying brachial plexus and subclavian artery
- if bruise is heard --> angiogram to rule out injury of vessel

7

MC clavicle fractures are at ... (area) / how to treat every area

midline 3rd
fractures of the middle 3rd: nonoperatively with a brace, rest and ice
fractures of the lateral 3rd: open reduction and internal fixation

8

clavicular fractrues - presentation

pain + immobility of the affected arm
the contralateral hand is classically used to support the weight of the affected arm
- the affected shoudler is displaced inf + posteriorly

9

Meniscal tears - etiology

younger: rotational force on planted foot
older: degeneration of meniscal cartilage

10

meniscal tears - symptoms

1. acute popping sensation
2. catching, locking, reduced range of motion
3. slow onset joint effusion

11

meniscal tears - examination

1. joint line tenderness
2. pain or catching in provocative tests (Thessaly, McMurray

12

medical tears - diagnosis

MRI
arthroscopy

13

medical tears - management

mild symptoms, older: rest, activity modification
persistent symptoms, impaired activity: surgery

14

meniscus injury - effusion

not immediately because is not perfused very well
in several hours

15

Thessaly test

- patient stands on 1 leg with knee flexed 20 degrees
- then internally and externally rotates on flexed knee

16

succinylcholine - mechanism of action and severe SA

depolarizing neuromuscular blocker that can cause life-threatening hyperkalemia in patients with a condition leading to upregulation of postynaptic ACE receptors (eg. skeletal muscle trauma, atrophy, burn injury, stroke) or prior hyperkalemia (muscle trauma)
Nondepolrizing neuromuscular blocking agents should be used with these patients

17

situations that increase the risk for hyperkalemia in succinylochine use

upregulation of postsynaptic ACE receptors (skeletal muscle truama, atrophy, burn injury, stroke, denervation

18

hip fracture - how can we wait for the surgery

72 hours (if needed to undress unstable medical cormobitity)

19

supracondylar fracture of the humerus - mechanism

fall on an outstretched hand most common

20

supracondylar fracture of the humerus - complications (MC)

1. Brachial artery injury (MC)
2. median nerve injury (MC)
3. cubitus varus deformity
4. compartment syndrome (rare: less than 1%)
5. volkman ischemic contracture (due to ischemia and infraction from compartment syndrome)

21

acute collateral ligament tear - acute effusion/hematthrosis?

uncommon unless there is concurrent inury to the anterior crciate ligament

22

medial collateral ligament - treatment

uncomplicated: nonoperatively with rest, ice, compression + elecation and analgesics

23

fat embolism syndrome - etiology

1. fracture of marrow-contaning bone
2. orthopedic surgery
3. PANCREATITIS

24

fat embolism syndrome - clinical presentation

24-72 h following inciting event:
triad: resp distress, neurologic, petechial rash

25

Fat embolism syndrome - diagnosis

based on clinical presentation

26

Fat embolism syndrome - prevention + treatment

ealy immobilization of fracture
2. supportive care (eg. mechanical ventilation)

27

trochanteric bursitis

middle age adult, unilateral hip pain that is exacerbated by external pressure to the upper lateral thigh (as when lying on the affected side in bed)
superficial pain

28

hip osteoarthritis - pain exacerbated by

internal rotation
deep pain

29

athrocentesis in recommended to

evaluate unexplained joint effusion

30

chronic exertional compartment syndrome

increased pressure within a muscle group during exercise --> young athletes (no point tenderness)