Ortho Flashcards
(120 cards)
1
Q
how is displacement of a # described
A
direction of translation of the distal fragment
ant, post, med, lat
2
Q
describing displacement of a # if in forearm or hand
A
ant = volar post = dorsal med = ulnar lat = radial
3
Q
what is angulation of a #
A
the direction the distal frag points towards
4
Q
varus angulation of a lower limb #
A
distal fragment points TOWARDS midline
5
Q
valgus angulation of a lower limb #
A
distal fragment points AWAY from midline
6
Q
general Mx of open #
A
clean wound, excise non-viable tissue
external fixation for # stability
7
Q
general Mx of displaced stable #
A
closed reduction + plaster
8
Q
general Mx of non-displaced stable #
A
plaster cast
9
Q
general Mx of displaced unstable #
A
ORIF
10
Q
salter-harris classification of childrens #
A
S = straight through growth plate A = through growth plate and Above into metaphysis L = through growth plate and Lower into epiphysis T = Through both metaphysis and epiphysis R = goes Round physis
11
Q
green-stick #
A
incomplete #, bone bent
12
Q
median nerve S and M function
A
S = 2nd & 3rd fingers M = LOAF muscles
13
Q
LOAF muscles
A
Lateral 2x lumbricals
Opponens pollicis
Abductor pollicis brevis
Flexor pollicis brevis
14
Q
radial nerve S and M function
A
S = dorsal 1st web space M = extensor muscles
15
Q
ulnar nerve S and M function
A
S = little finger M = abduction/ adduction finger power
16
Q
Way of assessing neurovascular status in children
A
rock (median)
paper (ulnar)
scissors (radial)
17
Q
what is a nightstick #
A
isolated # of ulna shaft
18
Q
monteggia # dislocation
A
of ulna + dislocation of the radial head at the elbow
19
Q
galeazzi # dislocation
A
of the radius + dislocation of the distal ulna
20
Q
Colles #
A
distal radius #
FOOSH with wrist extended
causes dorsal displacement or angulation
21
Q
Neurovascular injury risk in colles #
A
median nerve / carpal tunnel syndrome
22
Q
Late complication of colles #
A
rupture of extensor pollicis longus tendon
23
Q
smith #
A
distal radius #
FOOSH with wrist flexed
causes ventral displacement or angulation
24
Q
barton’s #
A
intra-articular radial #
25
carpal bones
```
Some = scaphoid
Lovers = lunate
Try = triquetrum
Positions = pisiform
That = trapezium
They = trapezoid
Can't = capitate
Handle = hamate
```
26
classic Hx od scaphoid #
young male in high energy contact sport, FOOSH
| tenderness in anatomical snuffbox
27
neurovascular injury risk in scaphoid #
radial artery (retrograde blood supply)
28
how many x-ray views in scaphoid #
4 (AP, lat, x2 oblique)
| x-ray may be normal until days after injury
29
area most common for proximal humerus #
SURGICAL neck
| anatomical neck v rare
30
what is a garth view
axial oblique view used when evaluating shoulder trauma
31
most common - ant or post shoulder dislocation
anterior
32
bankart lesion
injury to anterior glenoid labrum due to anterior shoulder dislocation
33
hill-sachs lesion
impaction # of post humeral head due to anterior shoulder dislocation
34
neurovascular injury risk in shoulder dislocation
axillary nerve
35
sign of posterior shoulder dislocation on xray
lightbulb sign
36
Mx clavicle # or ACJ #
sling for a few weeks
37
neurovascular injury risk in humeral shaft #
radial nerve (in spiral groove) - wrist drop
38
Mx humeral shaft #
functional humeral brace if not displaced
| ORIF if displaced
39
child, heavy fall onto outstretched hand - #?
supracondylar # (distal humerus)
40
Mx of supracondylar #
reduction under anaesthesia, fix with pins
| + collar and cuff with arm in flexion
41
neurovascular injury risk in supracondylar #
```
median nerve (unable to make OK sign)
brachial artery
```
42
spinal shock
complete loss of sensation motor and reflexes below level of injury
psychologic response to injury
resolves in 24h
43
neurogenic shock
blockage of sympathetic outflow
| priapism
44
complete cord injury
no sensory or motor function below injury level
45
central cord injury presentation
corticospinal tract affected
| Arms > Legs
46
anterior cord injury presentation
corticospinal and spinothalamic affected
| dorsal column preserved
47
posterior cord injury presentation
loss of dorsal column
48
brown-sequard syndrome
cord hemisection
ipsilateral dorsal column & corticospinal
contralateral spinothalamic
49
Mx intra-capsular hip #
hemiarthroplasty or THR
50
Mx extra-capsular hip #
DHS
51
proximal femur # (incl sub-trochanteric)
IM nail
52
posterior hip dislocation presentation
shortened, internally rotated
53
anterior hip dislocation presentation
no shortening, externally rotated
54
Holding Mx of femur #
thomas splint
55
Mx of femoral shaft #
IM nail
56
Mx of femoral shaft # in child <18m
Gallows Traction (think NAI)
57
Mx of femoral shaft # in child 2-6 y
Thomas splint
58
Mx of femoral shaft # in child 6-12y
flexible IM nail
59
Mx of femoral shaft # in child >12y
adult IM nail
60
neurovascular injury risk in patella dislocation
common peroneal nerve - foot drop
61
old man falls @ home, # of L inferior and superior pubic rami but femur intact - Mx?
analgesia and active mobilisation
62
Mx fibula #
mostly can leave alone BUT if above level of syndesmosis then Tx
63
Mx tibia #neurovascular injury risk in
IM nail
64
Toddler's #
undisplaced spiral # of tibial shaft
65
pilon #
intra-articular distal tibia #
66
Mx pilon #
plate fixation
67
bimalleolar # Mx
ORIF
68
talar shift
widening of space between talus and medial malleolus
| seen in ankle #
69
obese 32 y/o tripped on kerb - eversion of R foot , displaced # of medial malleolus and # of fibula above level of tibio-fibular joint - Mx?
ORIF
70
Lisfranc #
of midfoot
71
bones composing midfoot
cuboids and cuneiform
72
Jone's #
of base of 5th metatarsal
73
neurovascular injury risk in posterior hip dislocation
sciatic nerve
74
impingement syndrome
pain at 60-120 degrees of abduction
| impingement of rotator cuff tendons (usually supraspinatus)
75
Mx impingement syndrome
NSAIDs, physio, steroid inj into subacromial space
76
presentation rotator cuff tear
difficulty initiating abduction (as usually supraspinatus affected)
77
Mx rotator cuff tear
conservative - physio, injection
or
surgery
78
test for cubital tunnel
froment's test - grip test of thumb on paper (weak adductor pollicis, so patient flexes their flexor pollicis longus to maintain grip strength)
79
test for carpal tunnel
tinels test (tap median nerve)
phalen's test (hyper-flex wrist to reproduce pain)
80
tennis elbow
lateral epicondylitis
| due to wrist always EXTENDED
81
golfers elbow
medial epicondylitis
| due to wrist always FLEXED
82
de Quervain's tenosynovitis
inflammation of two tendons that control thumb movement
83
test for de Quervain's tenosynovitis
Finkelstein's test - sharp ulnar deviation reproduces pain
84
sign of AVN on x-ray
hanging rope sign
85
knee extensor mechanism
tibial tuberosity, patellar tendon, patella, quadriceps tendon, quadriceps muscle
86
body builder, heavy lifting caused sudden leg pain - Dx?
extensor mechanism rupture (most probably patella), assumed chronic steroid abuse
87
carpet fitter, has swelling and pain in knee - Dx ?
bursitis
88
mulder's click test
for morton's neuroma - squeezing the forefoot produces a click
89
predispositions to achilles tendonitis
quinolone Abx, RA, gout
90
simmond's test positive
achilles tendon rupture
| squeezing the calf muscles doesn't cause plantarflexion of the foot
91
Mx plantar fasciitis
rest, physio, steroid injection
92
Man with high BMI was running and now has pain in foot - Dx?
gastrocneumius tendon tear
93
inheritence of osteogenesis imperfecta
AD
94
defect in marfans
fibrillin gene
95
defect in ehler's danlos
elastin and collagen
96
inheritence of DMD
x-linked recessive
97
erb's palsy
high brachial plexus injury (C5,6)
| knocks out everything except subscapularis - unopposed internal rotation
98
"waiter's tip posture"
erbs palsy
99
klumpke's palsy
low brachial plexus injury (C8 & T1)
| paralysis of intrinsic hand muscles and finger flexors +/- horner's syndrome
100
Ortolani's test
reducing a dislocated hip by abduction and anterior displacement
101
Barlow's test
dislocataBle hip by pushing the hip Back when flexed
102
Ix for DDH if Ortolani or Barlow +ve
USS
103
presentation transient synovitis
reluctance to weight bear on affected side, restricted ROM, post viral
104
Mx transient synovitis
NSAIDs, rest
105
presentation Perthe's
pain and limp, loss of int rotation, +ve Trendeleberg test
106
Mx perthes
regular x-ray avoid physical activity
107
SUFE presentation
can present with pain purely in groin or knee, loss of int rotation
108
Mx SUFE
pinning of femoral head
109
Mx AVN of femoral head
bone not collapsed - drilling to relieve pressure
| bone collapsed - joint replacement
110
Ix osteomyelitis
MRI
111
presdisposing conditions to osteomyelitis
```
sickle cell anaemia
DM
IVDU
immunocompromised
alcohol
```
112
Mx osteomyelitis
fluclox 6 weeks
113
Pavlick harness
Mx of DDH
114
Ponseti technique
Mx of club foot
115
Mx intertrochanteric hip #
DHS (extracapsular #)
116
low back pain worse on walking - Dx?
spinal stenosis
117
Ix spinal stenosis
MRI
118
drug that can be used for spasticity in CP
baclofen
119
most common cause of osteomyelitis
s. aureus
120
cause of osteomyelitis in sickle cell pts
salmonella
