ortho1_n Flashcards
(217 cards)
1
Q
if positive obrien and crank test with pain and popping, what next step?
A
arthrogram MRI
2
Q
What were the conclusions of Beacher et al. (2016) study in the SEER database regarding BMP in spine surgery?
A
BMP not a/w cancer
3
Q
If patient under 10 with curve over 20 degrees what get?
A
MRI
4
Q
where is the incision for the hamstring graft in acl reconstruction?
A
level of tibial tubercle, 6cm below medial joint line
5
Q
what is a bony bridge between the proximal radius and ulna known as?
A
radioulnar synostosis
6
Q
what can you do to a knee effusion prior to closed reduction for proximal tibial physeal fracture?(2)
A
aspiration and inject anesthetic
7
Q
RVAD > 20 degrees, phase 2 rib-vertebra relationship and cobb angle over 30 predicts what?
A
progression of IS
8
Q
what are components of neuro exam?(3)
A
sensory, motor, reflexes
9
Q
what covers the iliacus muscle?
A
iliopectineal fascia
10
Q
what vessels should be ligated medially when entering the deep inguinal ring in the ilioinguinal approach?
A
inferior epigastric artery/vein
11
Q
what can happen to nondystrophic scoliosis in NF that in terms of change?
A
can transform to the dystrophic type
12
Q
what get if someone has asymmetric abdominal reflex?
A
MRI
13
Q
what sciolemeter measurement used for scoliosis detection?
A
7 degrees
14
Q
how many windows does the ilioinguinal approach create?
A
3
15
Q
which lumbar curve sizes progress over time?
A
over 40 degrees
16
Q
when do the radius and ulna split from one another?
A
7 weeks in utero
17
Q
Obesity, poor cardio, failure to comply with treatment all predictors of what for TOS?
A
failure of nonop management
18
Q
what does skin look like in third degree frost bite?
A
grayish blue
19
Q
what size OCD do you do fixation for?
A
> 2cm in size
20
Q
how treat flexion instability in TKA?
A
revision to posterior stabilized design
21
Q
160 degrees of scaptation, axial load and internal/external rotation is what shoulder test?
A
crank test
22
Q
how good does your reduction have to be in midshaft BB forearm fx in a kid with less than 2 year growth remaining?
A
anatomic
23
Q
posterior capsule tightiness in pitcher predisposes to what tear in the shoulder?
A
type II SLAP tear
24
Q
what muscle do you strip off the ilium in the ilioinguinal approach to the acetabulum?
A
iliacus
25
how does exercise induced compartment usually resolve?
rest
26
tibia vara, procurvatum, and internal torsion are a/w what condition in kids?
blount's
27
how are vertebrae shaped in dystrophic NF scoliosis?(2)
wedged/scalloped
28
what part of the patella does the mpfl insert?
proximal
29
what part of the TFCC is avascular?
central
30
Where in the foot does OCD occur most often?
talus
31
What kind of supplementation in the knee do AAOS not support
viscosupplementation with hyaluronic acid
32
In the knee where do most OCD occur?
posterolateral aspect of medial femoral condyle
33
how long cast stay on for proximal tibial physeal fractures? (range)
4 to 6 weeks
34
what thoracic curve direction more common for juvenile scoly?
right
35
why triangular block made for patella in harvest for acl?
avoid fracture
36
what is the first step in imaging for TOS?
radiographs of c spine and the chest
37
how much can flex neck for the cookie test and still be vaid?
45 degrees
38
which acetabulum quadrant is safe zone?
the posterosuperior one
39
...., PT, and NSAIDs used to treat painful os trigonum
immobilization
40
NSAIDs, self management, weight loss, and activity modification recommended by what body for initial management of TKA?
AAOS
41
how can compartment syndrome affect the kidneys?
acute renal failure
42
what is normal thoracic kyphosis?(range)
20-45 degrees
OB
43
what inserts superior the gracilis or semitendinouss?
gracilis
44
how would you treat a congenital radial head dislocation that gets painful with restricted range of motion of the elbow?
radial head resection
45
how is antigravity muscle function assessed in a kid in the upper extremity?
hand to mouth
46
what structure lies superficially anteriorly to the MPFL and inserts on the anterior third?
VMO(vastus medialis obliquus)
47
why get EMG/nerve conduction study when assessing for lumbar stenosis?
looking for peripheral neuropathy
48
what is most important aspect of PIPJ stability after injury?
percentage of middle phalanx articular surface fractured
49
what angle does scoly measurement of 7 degrees supposed to correspond to?
20 degrees
50
what is it called when UCL of the thumb incarcerated superficial to the underlying adductor aponeurosis?
stener lesion
51
What joint is the most common site of OCD?
knee
52
what abdominal structure can be located in the femoral canal in some people?
a hernia
53
What is scoly 3-10?
juvenile scoly
54
what is the space between the pubic symphysis and the bladder known as?
cave of retzius
55
why get ABI when working up lumbar stenosis?
looking for vascular claudication
56
This angle measures inclination of weight bearing zone of acetabulum?
tonnis angle
57
what is the width of the mpfl?
12mm
58
what do you want to avoid in a hinge prosthesis for TKA concerning the patella position?
patella baja
59
when fail cookie test lead to referral?
3 months
60
what does satisfactory result of lisfranc injury result from?
accuracy of reduction
61
What do obrien and crank test assess?
labral injuries in the shoulder
62
This is the name for pathologic lesion affecting articular cartilage and subchondral bone with variable manifestations?
osteochondritis dissecans
63
how does the forearm start out in utero?
single cartilaginous anlage
64
what approach use for a k line negative OPLL?
anterior approach
65
10 degree angulation and 1cm bayonet apposition acceptable for midshaft radius/ulna fx in what age group?
female >8, male >10 with over 2 year growth remaining
66
how deep does third degree frost bite go?
down to the subQ level
67
what is most common level of disc herniation?
L5-S1
68
what imaging modality can be used for tissue perfusion in frostbite?
technetium 99m bone scan
69
What might be persistent gap between the tibial tuberlce and the metaphysis indicate?
interposed periosteum
70
when micro surgery for BPP agewise?
best around 6 months
71
Anastamosis bw the obturator vessels and the inferior epigastric vessels is what?
corona mortis
72
signs of pelvic discontinuity: 1) fx through ilioischial line, 2) medial migration of inferior hemipelvis 3) ***
asymmetry of the obturator ring
73
why apply mold above the patella for tibial tubercle fracture?
minimize pull of the quadriceps
74
how often radioulnar synostosis bilateral?
60%
75
which half of acetabulum is danger zone for THA?
anterior half
76
Rim avulsion is what hohl and moore type?
3
77
condyle fracture extending to the contralateral tibial side of tibial spine is what Hohl and moore type?
2
78
what approach used to treat a k line positive OPLL?
posterior approch
79
how stabilize unstable proximal tibial physeal fracture?
crossing percutaneous smooth pins
80
how do you get a tunnel view of the knee?
flex it 30-50 degrees
81
if tibial stress fracture is seen in the posterior cortex how can it be treated?
nonoperatively with nonweightbearing
82
What zone of the physis closest to the epiphysis?
reserve(germinal) zone
83
what do to cast for proximal tibial physeal fracture after putting it on?
univalve or bivalve for swelling
84
this window in the ilioinguinal approach gives you access to the superior pubic ramus and the symphysis?
medial window
85
Do you want to release syndactyly early or what for the bones to form?
early
86
why extend the elbows a little in the roos test?
eliminate ulnar nerve compression as factor
87
How is a TOS test considered positive?
symptoms reproducible
88
What pain medication category recommended by AAOS for knee osteoarthritis?
NSAIDs
89
what is stage III of nonop management for TOS?
muscle strengthening
90
What is normal lumbar lordosis?
30-60 degrees
91
if electrically positive TOS what advanced imaging should you get?(2)
CT or MRI
92
when does adolescent blount's disease present?
after 10 years
93
How long do patients hold arms and close hands in and out in roos test?
3 min
94
What is a type 4 hohl and moore?
rim depression
95
which form of blount's more likely to have distal femoral vara?
adolescent
96
what does the middle window in the ilioinguinal approach give you access to?
quadrilateral plate
97
what tissue layer covers the gracilis and semitendinosus?
sartorial fascia
98
what good surgical option for treating thumb trapezometacarpal arthritis that has failed conservative management?
arthrodesis
99
where is the physis defective in blount's?
posteromedial proximal tibial physis
100
what is a positive fovea sign in tfcc tear?
tenderness soft spot bw ulnar styloid and FCU tendon
101
what is asymmetric abdominal reflex a/w in the spinal cord?
syrinx
102
which occupation at risk for recurrent herniation after surgery for lumbar disc?
heavy lifting
103
Elevating shoulder to 90, adducting 10-15 and then supinating and pronating the forearm and providing downward compression is what test?
o'brien
104
the vas deferens and the testicular artery are in what structure?
spermatic cord
105
what deficit in the forearm can shoulder abduction overcome?
decreased pronation
106
what is a type I in the hohl moore classification?
coronal split
107
what appearance on XR indicates worse prognosis for OCD?
sclerosis
108
Besides leg, what else treat in stress fracture?(2)
vitamin D, bone mineral density check
109
How figure out quadrants of acetabulum?
draw line from ASIS to the center of the acetabulum and then another line perpendicular to that
110
what bone is the iliopectineal fascia attached to?
pubic bone
111
Where in elbow does OCD occur most often?
capitellum
112
what annular defect size is a/w a recurrent lumbar disc herniation after discectomy?
>6mm
113
Medial tibia pain occurs beginning of activity and improves, diffuse tenderness is what condition?
medial tibia stress syndrome
114
what is the load at which the ligament breaks?
failure load
115
what are the first changes to be seen in electrodiagnostic studies for TOS?
changes in EMG
116
how often neural axis abnormality in JIS kid?
20-25%
117
how much rib pencilling a/w progression of scoliosis?
>3
118
what type of chromosome duplication is a/w radioulnar synostosis?
sex chromosome
119
In general, how treat a tibia stress fracture of the anterior cortex?
surgical fixation
120
how much bone block do you want for acl surgery?
~25mm
121
when curve magnitude get MRI of JIS (scoliosis) patient?
when curve over 20 degrees
122
where in relation to the physis does the MPFL insert?
distal
123
what is wilson test used to assess?
OCD of the knee
124
the slope of the initial load deformation curve is what?
stiffness
125
how much patellar tendon do you want for acl surgery?
~10mm
126
what nerve watch out for during paramedian incision in knee for acl harvest?
saphenous
127
how deep does fourth degree frostbite go?
down to muscle, tendon, bone
128
which patient population gets recurrent disc herniation after lumbar discectomy?
younger
129
the lateral window of the ilioinguinal approach is lateral to what structure?
iliopsoas
130
where does the surgeon stand for getting access to the medial window in the ilioinguinal approach?
opposite side of the table
131
What appearance on MRI indicates worse prognosis for OCD?
synovial fluid behind the lesion
132
How many Lumbar disc herniations are surgical candidates?
less than 10%
133
What kind of fixation want for host allograft junction in patellar tendon repair?
rigid
134
what activity difficult for those with TFCC tear?
turning key
135
In what position do you tension a graft used to treat patellar tendon disruption?
extension
136
when do you consider doing harvest on contralateral hamstring or augment hamstring autograft with allograft?
if diameter < 8mm
137
failure to achieve antigravity biceps function by what age would argue for surgical microexploration of the plexus?
3 to 4 months
138
what is the k line in the cervical spine?
vertical line drawn on lateral image at midpoint of spinal canal @ C2 to C7
139
The middle window in the ilioinguinal approach is between the iliopsoas and the ....
femoral artery and vein
140
In younger patient, what correlated to success in nonop treatment for OCD? (ie knee OCD)
open distal femoral physes
141
what view can help visualize a cervical rib?
apical lordotic view of the chest
142
why get flex/ex films for working up lumbar stenosis?
see if there is lumbar spondylolisthesis
143
arms elevated to the side, wrists dorsiflexed and head tilted away is what test?
upper limb tension test
144
what makes o'brien's test positive?
deep pain with resistance and forearm pronated
145
what muscle has attachments to the medial head of the gastrocnemius in hamstring graft harvest for acl?
semitendinosus
146
what type of fusion for dystrophic scoly a/w decreased pseudarthrosis?
anterior and posterior fusion
147
signs of pelvic discontinuity: 1) ***, 2) medial migration of inferior hemipelvis 3) asymmetry of the obturator ring
fx through ilioischial line
148
what part of the tendon do you harvest for patellar tendon in acl reconstruction?
central
149
how many types in the king-moe classification?
5
150
Using achilles tendon bone block allograft or whole extensor mechanism allograft used to treat disruption of what tendon after TKA?
disruption of patellar tendon
151
if positive what does o'brien's test show?
SLAP tear
152
flexion instability and varus/valgus instability is known as what after TKA?
global instability
153
which joints do kids with radioulnar synostosis compensate through?(2)
shoulder and wrist
154
why get hip xr when assessing for lumbar stenosis?
see if there is hip OA
155
what landmark is the mpfl insert just distal to on the femur?
adductor tubercle
156
what is the MOI in traumatic TFCC tear?
fall on extended wrist with forearm pronation
157
what is the underlying pathophysiology of frostbite?
lower tempature, blood more viscous leading to thrombosis of vessels
158
which of the following is a/w point tenderness at the tibia, stress syndrome or stress fracture?
stress fx
159
what is the normal tonnis angle?
<10 degrees
160
Is glucosamine and chondroitin recommended by the AAOS?
no
161
what is deformity in the spine more than 10 degrees known as?
scoliosis
162
how many juvenile idiopathic scoly kids progress?
>95%
163
How often do symptoms related to lumbar disc herniations improve over time?
90%
164
doing valgus stress in thumb extension tests what ligament (specifically)?
accessory ulnar collateral ligament
165
when would you consider radial head resection age-wise for someone with a congenital dislocation if they are symptomatic?
adult
166
how do you take tension off the femoral n when doing the ilioinguinal approach to the acteabulum?
flex the hip
167
what is the top of the slope where it starts to change in the load deformation curve?
yield load
168
when is the k line positive in the cervical spine?
OPLL does not extend past the k line
169
why retract femoral sheath gingerly in ilioinguinal approach to the acetabulum?
prevent DVT
170
how treat minimally displaced proximal tibial epiphyseal fracture?
long leg cast with some knee flexion
171
why treat anterior cortex tibial stress fracture with surgery?
tension side so high risk of nonunion
172
how does the forearm divide into the radius and ulna direction wise?
from distal to proximal
173
which shoulder motion can pitchers have less of?
internal rotation
174
what is toughness?
amount of energy absorbed from initial loading to failure
175
when treat dystrophic scoliosis?
early fusion
176
what type of contracture get in subacute compartment syndrome?
progressive flexion contracture
177
which acetabular approach is used to treat both column injuries?
extended iliofemoral
178
what kind of knee implant want for gross MCL incompetence?
hinged, rotating-platform construct
179
what is the first goal in treating TOS nonop?
relieve pain and control progression of symptoms
180
what layer does the medial patellofemoral ligament lie between?
between the medial retinaculum and the joint surface deeply
181
which line is disrupted in a posterior column fracture?
ilioischial line
182
when brace juvenile scoly?
when over 20 degrees
183
what is recommended for working up neurogenic TOS to rule out distal nerve compression?
electrodiagnostic studies
184
doing valgus stress in 30 degree of thumb flexion tests what ligament (specifically)?
proper ulnar collateral ligament
185
which approach to the acetabulum allows access to the posterior column and posterior wall?
kocher-langenbeck
186
what is the area under the load deformation curve equal to?
toughness
187
what is the main medial soft tissue restraint in the knee
medial patellofemoral ligament
188
what seperates first and second degree frostbite?
blistering, vesicle formation
189
what is the time window for releasing compartment in CS?
4 to 6 hours
190
what is considered rapid scoly progression?
more than 1 degree per month
191
How do OCD in lateral femoral condyle and patella do?
poorer prognosis
192
what is stage II of nonop management for TOS?
muscle balance for better posture
193
besides PE maneuvers what else can you do to help diagnose TOS ?
scalene injection
194
what can you do to reduce amputation overgrowth besides disarticulation?
capping distal end with autologous osteocartilaginous graft
195
what vessel besides the obturator can the inferior epigastric vessels have an anastamosis with?
external iliac vessels
196
Is the posterior cortex of the tibia tension side?
no, non-tension side
197
what is a type 5 hohl and moore?
four part fracture
198
What is scoliosis less than 3?
infantile
199
when is the k line negative in the cervical spine?
when OPLL goes dorsal to the k line
200
why gently adduct a leg with a valgus proximal tibial physeal fracture?
decrease risk of injury to the peroneal nerve
201
what chest issue look for in total plexus lesions?
diaphragm for phrenic dysfunction
202
What is the false positive rate for scoliometer measure over 7 degrees?
50 percent
203
what is o'brien's test also known as?
active compression test
204
T/F: AAOS standards of professionalism include activities related to expert testimony, advertising practice, and relationship to industry
TRUE
205
the layers of muscle in the ilioinguinal approach go from external oblique to internal oblique to ....
transversalis m
206
how long is the mpfl?
58mm
207
if electrically negative TOS what CT should you get?
you don't get one
208
what should you do to decrease risk of physeal injury when reducing proximal tibial physeal fractures?
apply traction
209
what causes frostbite?
exposure to tempature low enough to cause crystal formation in tissue
210
signs of pelvic discontinuity: 1) fx through ilioischial line, 2) *** 3) asymmetry of the obturator ring
medial migration of inferior hemipelvis
211
what muscle do you divide 1cm proximal to the pubic symphysis in the ilioinguinal approach?
rectus abdominis
212
How do wilson's test?
pain when internal rotation of tibia and extension from 90 relieved by tibial external rotation
213
what percentage of disc herniations are symptomatic?
4-6%
214
what is yield load force a/w in terms of affect on soft tissue?
microdamage to ligament
215
What were the conclusions of Carragee et al(2013) regarding use of BMP in lumbar arthrodesis? what dose a/w this increased risk? (2)
high dose (40mg) of BMP a/w increase incidence of cancer
216
What is the 90 degree abduction external rotation test, stick up test, elevated arm stress test also known as?
roos test
217
Hip dysplasia with femoral head uncovering a/w increased or decreased tonnis angle?
increased
