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Flashcards in Orthopedic Deck (106):
1

Name the Salter-Harris fracture:

1) Halfway through the growth plate

2) Straight through the growth plate

3) Breaks the epiphyseal plate in half

4) Crush injury - crushing the growth plate

5) Breaks halfway through the growth plate into the epiphysis and metaphysis

1) Type II (M)
2) Type I
3) Type III (E)
4) Type V
5) Type IV (ME)

2

Name the cervical spine fracture:

1) Result of flexion injury in the lower cervical spine in which the spinous process is broken or fractured.

2) Occurs frequently in a motor vehicle accident or in hangings. It is a bilateral pedicle fracture with anterior displacement of C2.

3) Caused by heavy object falling directly on head or hitting head while diving. Consists of at least two fractures of C1.

1) Clay Shoveler's
2) Hangman's
3) Jefferson's

3

Name the thoracolumbar spine fracture:

1) Horizontal fracture of a vertebra, usually result of a motor vehicle accident where the seat belt immobilizes the pelvis but the upper body is thrust forward.

2) Horizontal fracture of a vertebra, usually result of a motor vehicle accident where the seat belt immobilizes the pelvis but the upper body is thrust forward.

3) Defect in the pars interarticularis, appears as a collar on the “Scottie dog”. Best seen on oblique view.

4) Bilateral pars interarticularis defect.

1) Chance
2) Burst/Compression
3) Spondylolysis
4) Spondylotisthesis

4

Name the wrist fracture:
1)Distal radial fracture posteriorly displaced.

2)Distal radial fracture anteriorly displaced.

3)Most common fractured carpal bone, may give rise to avascular necrosis.
Pain in the anatomical snuffbox!

1) Colles’
2) Smith's
3) Scaphoid

5

Name the hand fracture:
1) Fracture of the base of the proximal phalanx of the thumb.

2) Fracture through the base of the first (thumb) metacarpal

3) Fracture of the 5th metacarpal.

4) Fracture of the 3rd metacarpal.

1) Gamekeeper’s Thumb or Skier’s Thumb
2) Bennett’s Fracture
3) Boxer's Fracture
4) Bar room/Brawler's Fracture

6

Name the Pelvis fracture:

1) Fracture through ischiopubic rami on one side and fracture of SI joint on the other side.

2) Fracture through the ischiopubic rami and SI joint on the same side.

3) A small piece of bone is separated from the origin or insertion site of a tendon.

1) Bucket Handle Fracture
2) Malgaine Fracture:
3) Avulsion Fracture

7

Name the Elbow fracture:

1) difficult to see, but look for anterior and posterior fat pad signs.

2) Caused by receiving a blow when protecting onself, dislocation of radial head and fracture of the ulna.

3) Caused by falling on outstretched hand and dislocating the distal radio-ulnar joint and fracturing the distal radius.

1) Radial Head fracture
2) Monteggia Fracture-dislocation (night-stick)
3) Galeazzi Fracture-dislocationElbow

Mnemnonic:
Policeman Radii Galeazzi tried to hit thief Ulna Monteggia for stealing his bike. Ulna Monteggia blocked the blow to his forarm and tripped Policeman Radii Galezzi who fell on his outstretched hand.

8

Name the Upper Limb injuries:

1) Diagnosed with X-ray taken with patient holding weights, 3 grades.

2) occurs most frequently in the middle third of the bone.

1) AC Joint Separation
2) Clavicular fracture

9

Indications for a bone scan - radiographic tracer Tcn99m phosphate or gallium 67 citrate

Osteomyelitis
Bony neoplasm/METS
Occult vertebral fracture

10

What are the disadvantages of bone scan?

False pos in older people w/ OA

False neg with diffuse bony METS and mult myeloma

11

What are the disadvantages of bone scan?

False pos in older people w/ OA

False neg with diffuse bony METS and mult myeloma

12

What is the MC muscular dystrophy in children? MC in adults?

Duchenne's
Myotonic

13

What are SSX of Duchenne's MD?

Muscle replaced by fat/pseudo-hypertorphy of calves.

Gower's sign +

14

What test is used to diagnose Myasthenia gravis?

Tensilon test

Antibodies to ACH receptors

15

What test is used to diagnose Myasthenia gravis?

Tensilon test

Antibodies to ACH receptors

16

MC benign bone tumor

Osteochondroma - risk of chondrosarcoma w/ multiple lesions

17

Osteitis deformans or Paget's dz presents with what SSX?

Lytic mixed with sclerotic areas - esp skull, bowing femur/tibia, OA, pathological fracture

18

Term: Demineralization of bone

Osteomalacia

19

What is the MC primary malignant bone tumor (age)? What is the second MC primary malignant bone tumor (age)? What is the more common bone tumor in the young?

Chondrosarcoma (middle age)
Osteosarcoma (elderly)
Ewing's sarcoma

20

With unilateral joint inflammation, what two conditions are high on your DDX?

Gouty and infectious arthritis

21

Which arthritis conditions are HLA B27+?

Psoriatic, Enteropathogenic, and Reactive arthritis

22

What are some ominous signs of bone/musculoskeletal pain?

Pt > 50 yo
Hx of CA
Trauma
Systemic symptoms of inflammation
Not better lying down/rest
Osteoporosis
Neurological ssx (bowel/bladder incontinence)
Referred pain

23

What is mandatory in a febrile pt with joint effusion?

Arthrocentesis

24

What is the work-up for suspected RA?

RF and ANA antibody

25

What does Adam's sign detect?

Scoliosis
Have patient bend forward

26

What does Adson's test detect?

TOS
Taking radial pulse and lifting arm to see if pulse is still detected

27

What does Braggard's test detect?

Sciatica
During SLR - flex foot

28

What does Betcherew's test detect?

Sciatica
Extending knees while seated

29

What does East or Roos' test detect?

TOS
Hands up, open/close hands for 3 min

30

What are two test for Malingering?

Hoover's and Burn's Bench tests

31

What does Kemp's test detect?

Disc Herniation
Rotate, extend flex, push on lumbar SP

32

What does Kernig's test detect?

Meningitis
Flex knee then extend

33

What does SLR test detect?

Disc herniation or sciatica

34

What does Linder's test detect?

Sciatica
Supine, flex neck

35

What does Milgram's test detect?

Disc herniation
Supine, raise extended legs for 30 sec

36

What does Minor's sign detect?

Sciatica
Sit then stand and put one hand on back

37

What does Shoulder depression test detect?

Brachial plexus lesion
Apply pressure down on shoulder, flex the head

38

What does Soto-Hall's test detect?

Disc herniation
SLR + flex head

39

What does valsalva detect?

space occ lesion
bear down

40

What does Wright's test detect?

TOS
Palpate both radial pulses, raise arm

41

What does Apley's scratch test detect?

Rot cuff tear, tendonitis
Touch fingertips to middle of back

42

What does drop arm test detect?

Rot cuff tear
abduct both arms to 180, adduct

43

What does Glenohumoral apprehension test detect?

Disloc shoulder
Cross painful arm, push elbow toward painful shoulder

44

What does Impingement test detect?

Shoulder lesion
Abduct arm, rotate medially + passively elevate it

45

What does Lippman's scratch test detect?

Bicip tendonitis
Palpate bicipital groove

46

What does speed's test detect?

Bicip tendonitis
Resisted shoulder flexion

47

What does Yergason's test detect?

Bicip tendonitis
Flex elbow, resist supination/lat rot

48

What does Cozen's test detect?

Lat epicondylitis/ext tendonitis (tennis elbow)
Resist wrist extension in prontated/flexed arm

49

What does Finkelstein's test detect?

De quervain's
Hold thumb in hand and ulnar deviate

50

What does Mill's test detect?

Lat epicondylitis/ext tendonitis (tennis elbow))
Palpate lateral epicondyle

51

What does Phalen's test detect?

Carpal tunnel
Backwards prayer

52

What does Retinacular's test detect?

Tight retinacular lig or capsule
Hold PIP, flex DIP - Fled Pip, fled DIP

Likely to be a distractor

53

What does Tinel's sign detect?

Carpal tunnel
Tap on median n

54

What does valgus/varus stress test detect?

Med/lat collateral lig instability
Valgus = Medial (6 letters each)
Varus = Lateral

55

What does Ely's test detect?

Tight rec fem, lumbar lesion, contracture of TFL, osseus hip lesion
Prone, flex knee to butt

56

What does Gaenslen's test detect?

SI lesion, hip path, likely L4 lesion
Supine, one leg off table, bring other knee to chest

57

What does Hibb's test detect?

Spondylolisthesis, facet syndrome, SI lig sprains
Prone, flex knee, move leg laterally

58

What does Nachla's test detect?

Tight rect fem, upper lumbar lesion
Prone knee bending

59

What does Ober's test detect?

Contracture of TFL
Lateral decubitus, affected leg up, flex knee, raise leg, let if fall

60

What does Ortolani click test detect?

Congenital hip dislocation

61

What does Patrick Faber's test detect?

Hip arthritis, bursitis, leg sprain
Cross legs

62

What does Pelvic rock test detect?

SI lesion
Rock the pelvis

63

What does telescoping test detect?

Congenital hip dislocation
Move legs like you're adjusting a telescope

64

What does Thomas' test detect?

Tight hip flexor
Bring knee to chest while supine

65

What does Trendelenburg test detect?

Gluteus medius weakness
Stand, flex one knee

66

What does Yeoman's test detect?

SI joint dysfunction
Prone, extend hip with knee extended/flexed

67

What does Yeoman's test detect?

SI joint dysfunction
Prone, extend hip with knee extended/flexed

68

What does Anterior/Posterior drawer test detect?

ACL/PCL Tear
Sit on foot, pull push flexed eg

69

What does Apley's compression/distraction test detect?

Med/Lat Meniscus tear
Compression = meniscus
Distraction = ligament
Push ankle while knee is flexed in prone

70

What does Apprehension test detect?

Patellar dislocation
Press patella laterally

71

What does Bounce home's test detect?

Torn meniscus
Passively extend knee "bounce home"

72

What does Lachman's test detect?

ACL injury
Move tibia toward femur

73

What does McMurray test detect?

Meniscus fragment in joint
Flex patient hip/knee, internally/externally rotate the knee

74

What does Patellar femoral grinding test detect?

Chondromalacia patella
Press on patella while patient contracts quad
Younger/growing pts

75

What does reduction click detect?

Menisci fragment in joint (same as McMurray)

76

What does valgus/varus stress test detect?

MCL/LCL sprians
Valgus = Medial
Varus = Lateral

77

What does ballot and bulge tests detect?

Bulge - minor effusion
milk medial side of patella, then stroke lateral side

Ballot - major effusion

78

What does anterior/posterior drawer test detect?

Med/Lat Talofibular lig lesion
Excess motion on side the ankle turns away from

79

What does Forefoot adduction test detect?

Structural foot detect (INFANTS only)
Excessive forefoot adduction, try to bring foor to neutral position

80

What does Dorsiflexion test detect?

Gastrocnemius/soleus hypertonicity
Dorsiflex ankle

81

What does Forefoot squeeze test detect?

Stress fracture or neuroma
Squeeze metatarsal bones together

82

What does Homan's sign detect?

DVT
Dorsiflex pt foot

83

What does talor tilt test detect?

Torn calcaneofibular ligament
Talus is tilted from side to sdie

84

What does test for rigid or supple flat feet detect?

Obs in 3 pos: stand, sit, standing on toes
Rigid: no arch present
Supple: arch present while standing

85

What does Thompson's test detect?

Ruptured achilles tendon
Squeeze gastroc toward midline

86

What does Tibial torsion test detect?

Measures angles between malleoli
Toe-in or toe-out torsion

87

Alpha stim indications and contraindications?

Chronic pain, cranial for depression/insomnia/addiction
CI: pacemaker, CA lesion, uterus

88

Electroacupuncture indications and contraindications?

Pain
CI: pacemaker, arrhythmia, seizures, anxiety attacks

89

TENS indications and contraindications?

Pain, ST use
CI: eyes, fractures, metallic implants, uterus

90

Sine wave indications and contraindications?

LMN lesions, spasm, other nerve problems
Constitutional hydrotherapy tx

91

Interferential indications and contraindications?

Deep/large joint problems, muscles spasms

92

Infrared phototherapy indications and contraindications?

Arthritis, infection, spasm, inc circulation
CI: CA

93

Iontophoresis indications and contraindications?

Calcium - adhesive capsulitis
CuSo4 - fungal infx
MgSo4 - bursitis, edema, OA, RA, spasms

94

Low voltage galvanism indications and contraindications?

Denervated muscle, LMN lesion, decreased motion, pain

95

High voltage galvanism indications and contraindications?

Pain (neuralgia, sciatica strain/sprain)

96

Phonophoresis indications and contraindications?

Inflammation (anti-inflammatory substances)

97

Therapeutic ultrasound indications and contraindications?

Micromassage, adhesions, chronic inflammation
Penetrates deeply, does not affect adipose

98

Diathermy indications and contraindications?

Inflammation/infections
(Bursitis, tendinitis, bronchitis, prostatitis)
CI: Long-term use, areas of low vascularity

99

Ultraviolet phototherapy indications and contraindications?

Psoriasis or other skin issues
CI: Eye, genitals, sunburns, CA

100

Colon irrigation indications and contraindications?

Constipation, detox
CI: Active UC, diverticulitis, children

101

Hyperthermia baths indications and contraindications?

Immune booster, inc circulation

102

Contrast hydrotherapy indications and contraindications?

Immune, inflam, infection, arthritis
Very safe, good for many conditions

103

Constitutional hydrotherapy indications and contraindications?

Immune boost, nourishing, healing

104

External cold application indications and contraindications?

Acute inflammation

105

External heat application indications and contraindications?

Chronic inflammation

106

Osseous manipulations indications and contraindications?

Specific body part has pain or fixation
CI: CA, fracture, osteoporosis