Part 3 Podiatry exam Flashcards

Question

A Jones fracture occurs

Answer 1

Metaphyseal/diaphyseal junction

Answer 2

r pain out of proportion

Answer 3

a tissue graft from a donor of the same species as the recipient but not genetically identical.

Answer 4

osteogenesis osteoconduction immogenicity individual of same species but different genertic background

Answer 5

The process of making the fixator more flexibleDyn

Answer 6

Sagittal axis - passes horizontally from posterior to anterior and is formed by the intersection of the sagittal and transverse planes. Frontal axis - passes horizontally from left to right and is formed by the intersection of the frontal and transverse planes. Vertical axis - passes vertically from inferior to superior and is formed by the intersection of the sagittal and frontal planes.

Answer 7

- Complex composed of dorsal (weakest) Plantar (strongest) and interosseus ligaments - 2nd TMT joint is the keystone of the arch - No interosseus ligament between 1st and 2nd MT

Answer 8

High density to Low Cortical cancellous muscle nerve tendon ligament fat air

Answer 9

Perikarya Axon Dendrite Oligodentrocytes Schwann Cell Myelin Ganglia Nuclei Nissl bodies Node of Ranvier

Answer 10

**Head** ## Footnote **Land**-underside of head **shank**- only in cancellous screw **run out**- weakest point of screw-starts at the beginning of the threads **pitch**-distance between threads **rake angle**- thread to axis angle **core diameter**-diameter of the screw between the threads **thread diameter**- describes the screw size(ie: 2.7mm has a2.7 mm thread diameter **tip angle**- tip to axis

Answer 11

baby prone, legs adducted and extended look for asymmetry of thigh and gluteal fold more fold on the dislocated side

Answer 12

rare genetic disorder of glycogen metabolism. It is caused by the deficient activity of the glycogen-branching enzyme, resulting in accumulation of abnormal glycogen in the liver, muscle, and/or other tissues. The disease is inherited as an autosomal recessive trait.

Answer 13

1- **Opoids**- **Fentanyl**- Short-term analgesia during anesthetic periods, premedication, induction and maintenance; and in the immediate postoperative periods as need arises. **Morphine**- Serves to alleviate periop pain and decrease somatic and autonomic response to airway manipulation, improve hemopdynamic stability, lower req for inhales anes and decrease anxiety. Older **Demerol**-(meperidine) Induces amnesia and controls post anesthetic shivering. Can casue tachycardia and caution with pts with heartt ireg. like narcotics SE: N&V, constipation (vistaril used in conjunction) **2- IV Pain management** 1-**Toradol** NSAID reduce post op pain, however risk of bleed 2- **Acetaminiophen** (IV Ofirmev) deecrease risk of bleed

Answer 14

PRESSURE SQUEEZINF, IMPENDING DOOM LOCATION- ARM AND JAW TIME-15 MINUTES CAUSE: CAD\<\<\< TREATMENT: NITROGLYCERIN

Answer 15

Diseases that cause selective damage that affect voluntary movement and rarely attack other path in S.C **Poliomyelitis** Symp: malaise & Myalgias- flu-like symptoms, low grade fever muscle tightness in hamstring, thigh and back LMN weakness or parylsis\>\>gradual tightening muscle spasm, muscle weakness **Amyotrophic Lateral Sclerosis (Lou Gerhigs )** Lateral colum and anterior gray matter which are close connect with SC **ALS** involves voluntary motor system inv/ degeneration of corticospinal tracts and alpha motor neurons Presents with both UMN and LMN

Answer 16

information about pain and temperature.touch

Answer 17

Nitrates- CA+ channel blockers B Blockers

Answer 18

**Indication::**Venous thrombosis, DVT/PE/A-FIB WITH EMBOLI/MI, SURGICAL PROPHYLAXIS **TYPES**:HEPARIN:LMWH-ENOXAPRIN(LEVENOX =COUMADIN Production Vit K dependent factors-II,VII,IX,X **Contraindication:** Allergy//active bleed, CNS sx//eye ex//Severe HTN, Ulcer Heparin-works faster then warfarin-injectable **Warfarin**-Slows down process in liver that use Vit K to make certain Proteins (clotting factor) that causes clotting Coumadin-oral outpatient-stop 5 days prior to Sx

Answer 19

**Class Ia** NA channel blocker-Quinidine Procainamide Disopyramide **Class 1b** Weak NA channel blockers-Lidocaine Phenytoin **Class 2** Beta blockers vent arrhythmias **Class 3** K channel blocker Amiodarone Sotol Btretylium **Class 4** L-type CA channel blocker Verapamil

Answer 20

**ASA** (-) Cox 2) **PDEinhibito**r Persantine-PDE III inhibitor \>\>decrease cAMP\>\>decrease platelet aggregation **Pletal(**clopidiel) PDE III inhibitor\>\>decreases cAMP\>\>decreases platelet aggregation 3**)Ticlid**-250Mg PO BID 4)**Trental** (pantoxyfilline) alters rheology RBC\>\>increase flexibility\>\>decrease blood viscosity by decrease RBC\>\>decrease elevated plasma level of fibrogen\>\>and release plasminogen activator thereby promoting fibrinolysis

Answer 21

Duplex ultrasound-8-10 hx of U/S triphasic-faster Q wave form resemble a teepee biphasic may be normal in patients with diabetes monophasic-slow Q indicates signaficant abnormal

Answer 22

ruputure of C-F ligament is always associated with the ATFL with dye flowing into the anterior and lateral malleolus

Answer 23

ASA- **PS1** Healthy non smoker **PS2**-Mild dz without substantive func limits. ie: smoker, well controlled DM/HTN mild lung disease (30 **PS3** Severe systemic dz with substantive functional limitation. 1 or more moderate to severe disease ie: poor controleed dm, HTN,COPD (BMI\>40), acute hepatitis, reduction of ejection fraction **PS4** Incapacitating Systemic dz-threat to life ie; \< MI,CVA,TIA or CAD/stents, severe reduction ejection fraction **PS5** Moribund patient not expected to live ie; ruptured abdominal/thoracic aneuysm **PS6** Declared brain dead **PS7** If procedure is an emergency, physical status is followed by E

Answer 24

Osteochondritis of the 1st metatarsal

Answer 25

Reduce resp tract secretion protect reflex bradycardia, decrease gastric secretion _Used gen+endotracheal tube insertion_ **_SE:_** Dry sore mouth, poor visual, relax lower spincter bofy temp rise if use with preanesesthetic combo with atropine and meperidine **GLLCOPYRROLLATE**-MORE POP BC NO CNS EFFECT **ANTODOTE:PHYSOSTIGMINE**

Answer 26

a. osteoconduction b. osteoinduction c. viable osteocytes

Answer 27

oeteogenesis osteoconduction osteoinduction

Answer 28

An autograft is a bone or tissue that is transferred from one spot to another on the patient's body

Answer 29

thumb on lesser trochanter and middle finger of the same hand is on the greater trochanter The dislocated hio become displaced with a palpable clunk as the head slips over the posterior aspect of the acetabulum

Answer 30

Huntingtons Chorea Sydenhams Chorea (St Vitus Disease ``` Parkingtons Disease (PARK) Wilson Disease ```

Answer 31

**Basophilia**- Polycythemia, chronic myelogenous leukemia chicken pox- hypothyroid myxoderma Renal DZ **Bands increase-**shift to the left-- acute bacterial infection **Platelet Count**- 140-340,000 Increased Vascular Dz, iron def, acute infection, cardiac Dz, malignancy, PCV, cancer, RA,

Answer 32

TREAT RF ABNORMALITIES (MET ADDUCTUS) USE AFTER SERIAL CASTING FOR MET ADDUCTUS

Answer 33

osteochongral autogenous graphs

Answer 34

Beta blockers, also known as beta-adrenergic blocking agents, are medications that reduce your blood pressure. Beta blockers work by blocking the effects of the hormone epinephrine, also known as adrenaline. Beta blockers cause your heart to beat more slowly and with less force, which lowers blood pressure. ## Footnote atenolol (Tenormin) and metoprolol (Toprol,Lopressor) **Side effects----** Dizziness. Headaches. Flushing of your face and neck. Upset stomach or throwing up. Low blood pressure (hypotension) Irregular heart rhythms (arrhythmia

Answer 35

Intravenous reghional anesthesia

Answer 36

.1-1.3 ## Footnote Is breakdown of HGB Catabolism of HGB and breakdown myoglobin,cytochromes,catalose **Unconjugated** (indirect) is lipid soluable and doesn't spill into the urine **BREAKDOWN**- occurs in Kupffer cells using cytochrome P450 to breakdown heme **INCREASED**- Bile duct obstruction hemolytic anemia,hepatocellar damage, Crigler-Najjar Syndrome/Gilbets disease,XS destruction of RBC or Liver unable to excrete noram amt produced **DECREASED-M**EDS:PENICILLIN/SULFONAMIDES Conjugated (direct) increase is obstructive Jaundice Increase in Unconjugates (indirect) destruction of RBC **\>\>3 jaundice**

Answer 37

rupture of the deltoid ligament instead of medial malleolar fracture. More unstable than actual fracture of the medial malleolus

Answer 38

is the measure of microbial contamination levels on or in a product. Bioburden can be introduced from the raw materials used in the manufacturing process, or be introduced via the workforce or manufacturing environment.

Answer 39

indirect healing

Answer 40

_Nature and synthetic_ _absorable and non absorable_ _monofilament and multifilament_ **Synthetic** materials cause less rxn with less inflam rxn **Absorable** applies to a wound that heals quickly and need minimal temp support. **ITS PURPOSE TO ALLEVIATE TENSION ON WOUND EDGES** New synthetic sutures retain their strength until the absorption process starts Non-absorable sutures offer longer mechanical support Mono-filament less drag thru tissue but susceptible to instrumentation damage.Infection is avoided unlike braided multifilimant can cause sustain bacterial inocula

Answer 41

b. Excisional biopsy using 2 semi-elliptical incisions c. Dimensions should be 3 to 1 width of the lesion d. Full thickness, including fat

Answer 42

bisect heel and extend line distally to see where it falls on the toes **Normal**-2-3rd toe **Mild**-line to 3rd toe **Moderate**- line thru 3-4th toe **Severe**-Line thru 4-5th toe

Answer 43

2-9 Minutes Bleeding Time 3 - 4 INR measure the primary phase of hemostasis, the ineraction of the platelets with the blood vessel wall and the formation of the hemostatic plug Forearm scratch Increased--Von Willibrand,Thrombocytopenia DIC Platelet dysfunction and ASA/ NAIAD therapy

Answer 44

Solubility of an agent, speed of induction ## Footnote The blood:gas partition coefficient is an important determinant of the speed of anesthetic induction and recovery. It describes the partition of an agent between a gaseous phase, such as alveolar air, and the blood. The greater the blood:gas partition coefficient, the greater the solubility in blood. **High BGC=**more soluble=more agent needed in blood before equilibrium is met **High BGC**=More potent, slower induction **MIC=**amount of inhaled at 1 ATM that prevents movement and response to noxious stimulus in 5-% pts

Answer 45

Creatine kinase( CK or CPK) 6-30 **Cardiac ezymes- CK-MB 20% Cardiac-**hi during 48 hrs MI and flip LDH-DX made **CK-BB brain 90%** **CK-MM-80% cardiac muscle,** high in skeletal muscle injury **Myoglobin-** sensitive indicator muscle injury **Troponin** increase 3-12 hour after injury **Aldolase-**glycolytic involved in metabolism of glucose Increase AST and LDH w/n 1-2 days after episode chest apin=Pulmonary infact

Answer 46

OSTEOCHONDROSIS OF MEDIAL PORTION PROXIMAL EPIPHYSEAL OSSIFICATION CENTER IN TIBIA CAUSING BOWLING OF LEGS SYMPTOMS INCLUDE LIMPING, LARERAL BOWING RADIOGRAPH- SCLEROTIC MEDIAL CORTEX WITH SPURRING BEFORE 6 YEARS OLD CAUSE EARLY WALKING AND OBESITY

Answer 47

true tibial varum progressive tibial varum disruption of the medial capital ephiphysis

Answer 48

BMI \<25 Desirable 26-27 Mild obese 28-29 Moderately obese \>30 Morbid obese

Answer 49

Autogenous bone grafts provide both osteoconductive and osteoinductive properties

Answer 50

Alkaline Phosphatase 30-85 Calcium 8.5-11 Phosphous 3-4.5

Answer 51

Increased blood flow 3rd phase of affected limb reveals increased periarticular activity

Answer 52

technetium-99m (commonly Tc-99m-methylene diphosphonate (MDP)) as the active agent. The study has 4 phases which follow intravenous injection of the tracer. Sometimes a fourth (delayed/delayed) phase is performed. The scan is positive for osteomyelitis if images show progressively increasing lesion to background activity ratios over time. **1st Phase** ====Dynamic **2nd**- Blood pool image and 5 minutes after injection **3rd-** after 3 hours when urinary excretion has decreased the amount of the radionuclide in soft tissues. **4th**- after 24 hours

Answer 53

An oligotrophic nonunion.

Answer 54

avulsion fracture of the fibula from the PITFL

Answer 55

**Type I**=shortening of 1st metatarsal only **Type II-**Shortening of 1 or 2 lesser metatarsal (usually 3rd or 4th) **Type III**-Shortening of the 1st and one or more of the lesser metatarsals **Type IV-**shortening of all the metatarsals

Answer 56

- Ankle is dorsiflexed, with leg internally rotated 30 degrees - X-ray beam is cephalic tilt of 10-40 degrees

Answer 57

rare form of osteomyelitis. It involves a subacute or chronic infection of the bone with development of a localized abscess, usually within the metaphysis of long bones. The tibia is the most common bone involved and staphylococcus aureus is the most common organism identified.

Answer 58

**Type A**-Medial STJ disloc-AKA basket-ball or acquired clubfoot,calcaneus medial to talus **Type B**-Lateral STJ dislocation,calcaneus lateral to talus **Type C-** Anterior & posterior STJ dislocation

Answer 59

inflam changes small and medium vessels 20:1 Raynauds phenomenon common Decrease pulse Inflammatory occlusions more distal Patient usually have HLA-A9,,HLA-B5

Answer 60

10-20% End produce of amino group removal in degrdation of amino acids Measure urea produce in liver Measure of liver function and kidney excretion INCREASED-Renal DZ/Dehydration/ High protein diet/DM DECREASED-Severe Liver damage,ie: poison//hepatits BUN alone not reliable indicator of renal function because it depends on many extra renal factos

Answer 61

Osteochondritis of the cuneiforms

Answer 62

R.A, Reiters Ankylosing Spondylitis Psoriatic OA Hyperparathyroidism Lipid dermata OA

Answer 63

45 % extra articular 8-10 y.o Pain localized to the area of coalition decrease ROM STJ and MTJ **MEDIAL OBLIQUE**- calc and nav are close proximity or connet **LATERAL VIEW** shows classic elongated ant process of calc-**ANTEATER SIGN** **TX-** Resection and place the EDB belly in void **(Cowell procedure)**

Answer 64

8.5-11 98% stored in skeletal and teeth acts main resevoir for maintaining blood levels needed for muscle contraction kidney important regulation of calcium Any condition causing bone deminerization or atrophy\>\>\>increase Ca Level **Hypo**-Hypoparthyroidism,Vit D dif, renal failure secondary alkalosis **Hyper**-cancer,hyperparathyroidism,Iatrognic, multiple myeloma parathyroidism,m sarcoidosis, acidosis(CHIMPS), Lymphoma

Answer 65

Compensated FF varus and valgus RF equinus abducted and adducted foot neutrophic feet muscle imbalance PTT rupture Ligamentous laxity (ehler-danlos, Marfans, osteogenesis imperfecta) Calcaneal valgus Enlarged or accessory navicular

Answer 66

elevated arch primary sagittal plane deformity less surface area touching the ground painful callous may develop under met heads chronic ankle sprains CIA-norm 20-25 in cavus-\>30 degrees **Angle od meary** 0 in cavus \>6 **Angle of Hibbs** 135-140 cavus \>150

Answer 67

usually congenitial due to failure of segmentation of primitive mesenchyme **TYPES** **1-**Syndesmosis-fibrous **2**-Synchondrosis-cartilaginous **3**-Synostosis-osseous

Answer 68

neuromuscular ie: spina bifida, CMT, Friedreich ataxia polio, spinal cord tumors, myelomeningocele CP, infection, stphillis, trauma and S.C. lesions

Answer 69

**Cole**-DF osteotomy Cuneiform-Nav Jt **Japas**- V osteotomy thru entire forefoot, apex usually at the navicular **Devries**-DF fusion at MTJ **Dwyer**- Lateral closing wedge or open medial wedge calcaneal **McElvenny-Caldwell Procedure**- DF fusion 1st metatarsal-medial cuneiform JT, if severe nav-cuneiform jt **DFWO**- DF wedge osteotomy 1sr metatarsals or all of the metatarsals **Jahss**- DF wedge osteotomy across tarsometatarsal joint

Answer 70

**Plantar fasciotomy** **Steindler Stripping-** plantar fascia with long plantar lgt, abductor hallucis,FDB, abd digiti quinti are stripped **Jones tenosuspension** **Heyman procedure**- transfer all 4 extensor tendons to their met heads **Hibbs procedure** **Splitt T.A..T (STATT)** **Peroneus longus tendon transfer** **TPT transfer**

Answer 71

Shoe modification extra depth shoes with metatarsal abr Young patient passive stretching, manipulation

Answer 72

**Measure total # of White cells in blood** ## Footnote **HGB**--Male 13.5-17 female 12.5-16 **HCT**- Male 40-50 Femal 37-47 **RBC** Male 5.4- Female-4.8 **WBC** 5,000-10,000

Answer 73

WBC Granulocytes ( 5,000-10,000) Neutrphils (40-60%) Eosinphiles (1-5%) Basophils( .1%) Bands Lymphocytes 20-40% Monocytes 4-8%

Answer 74

For type 1 DM toe infections

Answer 75

Cerebellar-**smooth** coordination of voluntary, **skilled movements.** Helps maintain normal posture, balance and unconscience propioception Contibutes to vestibular function\>\>\>maintains equilibrium Cerebellar lesion \>\>\>awkwardness and uncoordination of voluntary movements

Answer 76

**PATTING TEST;** ASSESES THE INTEGRITY OF EPS OR SPINOCEREBELLAR TRACT Alternative tap the heel and toe and ask to maintain heel against floor and abduct, the adduct foot **Heel-Knee Test-** Asses integrity of EPS or spinocerebellar tract\*\*MOST RELIABLE OF CEREBELLAR FUNCTION OF LOWER EXTREMITY **Romberg's Test**-test propioception. ability sense where one is-propioception 2 tracts- conscience proprioception on the dorsal column unconscience propioception spinocerebellar Cerebellar and dorsal column-Eyes open and eyes closed= sway Cerebellar if Eyes open steady and eyes closed sway **Clinical Muscle testing**-0=absent- no evidence of contractility 1=Trace-evidence of slight contracture-no joint motion 2=Poor-complete ROM w/ gravity eliminated 3-Fair-Complete ROM against gravity 4-Good-complete ROM vs gravity with some resistance 5=Normal ROM vs gravity with full resistance

Answer 77

**Asthenia**- muscle tiring easy **Hyporeflexia** decease DTR **Dysmetria**-loss of ability to gauge distance, speed, power or movements **Speech**- slurred, jerky or explosive in nature **Intention tremor**- with initiation of voluntary movement often intesifies as goal is neared **Nystagmus**- dancing eye

Answer 78

Non-progressive neuromuscular disorder from brain damage Spastic CP- most common 25% Athetoid CP-20% Ataxic CP-10% Rigidity CP Tremor CP Atonic CP SCISSOR GAIT SECONDARY TO SPASTIC ADDUCTOR MUSCLES. Speech defect, retardation, seizures, visual defects, ankle equinus TX-PT-OT-Splinting-Bracing

Answer 79

cavus foot type, decreased distal sensation, decreased distal muscle power and decreased nerve conduction velocity

Answer 80

1. Signs of muscle weakness in your arms, legs, hands and feet 2. Decreased muscle bulk in your lower legs, resulting in an **inverted champagne bottle appearance** 3. Reduced reflexes 4. Sensory loss in your feet and hands 5. Foot deformities, such as high arches or hammertoes 6. Other orthopedic problems, such as mild scoliosis or hip dysplasia provide information about the ext... PERIPHERAL NERVE DISORDER

Answer 81

**Phenol**- 89% X 3 for 30 seconds **Sodium hydrozide**-1980 no neutralizer\>\>\>flush with alcohol 10% NaOH X 2 15 seconds each longer shelf life neutralizer-5 % acetic acid recurrence 5-10% d/t old phenol or inadeq application LOW or not removing enoug nail-need to remove nail matrix is integral to prevent recurrence

Answer 82

98-109 major excellular acid/base balance depletes with massice loss of G.I, fluid Hypo-N&V, Ulcerative colitis,severe burns heat exhaustion, DM ketoacidosis Hyper-Dehydration,XS IV fluid, kidney disease

Answer 83

LESS THEN 180 L=LOUSY LDL= IF HIGH...BAD HDL= DIRTY======TRIGLYCERIDES-fat in blood from food we eat

Answer 84

A rapid (chorea) or slow (athetosis) involuntary movements of the fingers or toes (flexion–extension, adduction–abduction, writhing, sometimes piano-playing movements) which are irregular, nonrhythmic, and purposeless (Fahn, 1997).

Answer 85

**TYPE 1** **Flexible**- FF will crrect past neutral into slight over correction **TYPE II** **Partial Flexible** (doesn't correct to neutral actively, but does passively) **Type III** **Rigid (**doesn't correct to neutral)

Answer 86

**Type 1**-(MMost common)-Zyngodactyly- partial or complete webbing 2.3rd toes **Type II**- Synpolydactyly- 1 soft tissue mass covering 4th, 5th and 6th toe **Type III\_**ass/ with metatarsal fusion

Answer 87

1-ASO 2-Deep thrombophlebitis of tibial, popliteal or femoral veins 3-Popliteal entrapement 4-Sciatica 5-Femoral or popliteal arterial calcification 6-Anemia (hypochromic, microcytic, sickle cell, thalassemia

Answer 88

Mondors sign back pain between T12 and L2 Compartment syndrome Hoffa's sign- less taut Achilles tendon Lateral wall blowout

Answer 89

6p's Pain out of proportion Paresthesia Pallor Pulselessness Paresis Paralysis Pressure

Answer 90

Nutcracker sign: pain with forced ankle PF

Answer 91

Plantar ecchymosis sign Apprehension sign: with FF DF and abduction Stress exam of midfoot: unstable TMTJ with pronation and eversion RULE OUT COMPARTMENT SYNDROME

Answer 92

the medical term for an abnormally bent or curved finger. The affected finger abnormally curves to the side and may overlap other fingers. While the condition is relatively rare among the general population (3 percent), it affects one in four children born with Down syndrome (trisomy 21).

Answer 93

Normal Club foot Kite angle 20-40 0-15 Calc Inclination angle 20-25 17 Talar neck Add 10-20 80-90 Plantarflex 25-30 45-65

Answer 94

Active plantarflexion of the medial forefoot by the peroneus longus in conjunction with loss of strength in the anterior tibial muscle

Answer 95

Progrfessive Multifocal Leukoencephalopathy CMV Cerebral Toxoplasmosis Multiple Sclerosis Tabes Dorsalis

Answer 96

**Extrinsic Pathway**- Activated by external trauma cause blood to escape from vascular system **Intrinsic Pathway**- Activated by trauma inside vessel system and activated by plaelet, exposed endothelium,or chemical Cell injury..Vessel constrict..platelet adhesion\>\>stabilization and reinforcement of plug by intrinsic and extrinsic system\>\>\>\>Fibrinolysis **Phase I** Generation of tissue thromboplastin (factorIII) intrinsic **Phase II**-Activation of thromplastin end product of intrinsic and extrinsic **FINAL COMMON ATHWAY BEGINS WITH ACTIVATION OF FACTOR X** **Phase 3- Concersion prothrombin\>\>\>thrombin by factor Xa** **Phase 4- Conversion of fibrogen into fibrin by thrombin which stabilzed by factor XIII**

Answer 97

**Intrinsic**- III + VII + VIIa\>\>\>\>activates X\>\>\>Xa **Extrinsic** XII\>\>\>XIIa by surface contact\>\> XI\>XIa\>IX\>IXa\>VIIIa\>\>X\>\>Xa Factors require Vit K Heparin intrinsic

Answer 98

periosteal elevation and spicules formation represents tumor extensions into the perisoteum and calcification

Answer 99

Cohort studies are a type of medical research used to investigate the causes of disease and to establish links between risk factors and health outcomes. The word cohort means a group of people. These types of studies look at groups of people.

Answer 100

**1**-R.A. **6**-Giants Cell Arteritis **2**-SLE **7**-Erythema nodosum **3**-Systemic Sclerosis **8**-Erythema Induratum **4**-Polymyositis **9**-Nodular Vasculitis **5**-Polyarteritis nodosum **10**-Nonsuppurative panniculitis

Answer 101

**Yellow**-Addisonsdz- Diabetes **Blue**-Cyanosis **Red**-Cancer **Green**-Pseudomonas-Candida **Black/brown**-Normal-Addison Dz-Junctional nevi, melanoma- **White**-heredity-anemia-fungal infection **White lines**-Arsenic poison pr drug toxicity **White spots**- Injury-psoriasis **White & Pink**- Anemia of chronic dz-nephrotic syndrome

Answer 102

L4-L5-S1 Sensory & Muscular Vulnerable to external compression injury--**NEUROPRAXIA**-crossing leg c/p paresthesia,hyperesthesia, entrapement more unusual **Diagnosis**: NC studies; radiculopathy L5\>\>EMG IN GLUTEAL AND PARASPINAL **Clinical signs**\>\> weakness TA& EH muscles\>\>\>\>DROP FOOT weakness of anrterior muscle group (NC Studies) Radiculopathy-L5 EMG

Answer 103

non-portion weight bearing of the knee Restores hyaline cartilage

Answer 104

A predictable, recurrent, well-localized pain relieved by rest.

Answer 105

dorsiflexion, adbuction, evrsion

Answer 106

-Medial clear space: \>4mm abnormal -Tib fib clear space: greater than or equal to 6mm abnormal. MOST RELIABLE - Inversion stress view Talocrural angle

Answer 107

3 months of age most procedure posterior release and reduction of the talonavicular joint 3-6 years-extra articular arthrodesis (Green-Grice type) \>6 wait until 10-14 when bones mature

Answer 108

females, usually occurs 2 weeks after birth children with older siblings, breech, joint laxity, first born Classic signs in older children-- limited abduction asymmetric thigh fold, (+) trendelenburg test, externaslly rotates foot Waddling gait. when dislocation occurs, femeral head posterior and superior to the acetabulum Assc/ with met adductus, calcaneal valgus gohydramnios, torticollis

Answer 109

congenital covex pes planovalgus assoc wi arthrogyrosis, right foot more common reverse clubfoot, persian slipper, rockerbottom flatfoot The talus is perpendicular so severly the navicular dislocated dorsally ontot he talus neck, locking the talus Forefoot is abducted and DF at the MTJ and Calc is in valgus **Rgidity is the hallmark of this** gastroc soleus is contracted, spring lgt is elongated usually are B/L/STJ facet abnormal/ Talus --Anterior absent/middle hypoplastic, posterior malformed

Answer 110

Inability of heart to pump blood throughout body orrequiring elevated filling pressure in oprder to pump effectively. The pooling of blood leads to congestion in body tissue ## Footnote **Cause**-famaliar-infection, alcohol,anemia,thyrotoxicosis, arrhythmia and HTN Plaque, stress, smoking, age. no exercise, overwork heart, obesity S/S-Pulm edema,,peripheral edema, enlarged or pulsatile liver/ JVD(jugular vein distension) **NEVER USE PNEUMATIC COMPRESSION DEVICES** **Treatment**- maintaining a euvolemic state\>\>\>diuretics\>\>vasodilator agents and positive inotropes **Delaying** the progression\>\>\>ACE inhibitors, beta blocker and aldosterone antagonist(diurectics) **Angiotensin** converting enzyme inhibitors (ACE inhibitors) are medications that slow (inhibit) the activity of the enzyme ACE, which decreases the production of angiotensin II. As a result, blood vessels enlarge or dilate, and blood pressure is reduced.

Answer 111

stretch and manipulation prior to casting apply TOB to skin 2" cast applied, ussually long cast correction *n order* 1-ADDUCTION (A.V.E) 2-VARUS 3-EQUINUS

Answer 112

interposition of PTT prevents reduction of medial malleolar fragment

Answer 113

adductor tendon, suspensory ligament, tenotomy of the lateral head of FHB, excision of the fibular sesamoid

Answer 114

correct torsional abnormalities several hinges allow greater frredom of motion BEST TOLERATED SPLINT, ALLOW UNENCUMBERED CRAWLING

Answer 115

_140-Age x weight (kg)_==male 97-137 72 X Serum= female 88-128 Creatinine found in muscle increase in age up too 20 yo CLINICAL MARKER FOR KIDNEY MOST SENSITIVE MARKER OF GFR\>\>\>DOSING MEDICATION

Answer 116

involves looking at data from a population at one specific point in time. The participants in this type of study are selected based on particular variables of interest.

Answer 117

**axial** and **coronal** because facet lies at 45 degree and is equidistant from both planes

Answer 118

ANGINA PECTORIS- MYOCARDIAL INFARCTION DISSECTING ANEURYSM ESOPHAGITIS GERD TIETZE'S PERICARDITIS GALLBLADDER CHOLECYSTITIS

Answer 119

- Anterior break (pronated)- TN joint over CC - Posterior break (supinated)-TN joint posterior to CC

Answer 120

**Incomplete**-webbing doesn't extend to the distal toes **Complete**- extends to distal toes **Complicated**-phalanges involved

Answer 121

**Group 1-**Non inflammatory ## Footnote DJD,trauma,osteochondritis charcot, hyperparathyroid Pulm OA,Pigmented villous nodular **Group 2-I**nflammatory condition-RA-Gout-Pseudogout **Group 3-**Septa OA secondary to Bacterial Infection **Hemathrosis-**results in hemorrahgic Jt fliud speciman caused by hemophilia and other bleeding diathesis, lgt with and without FX, neuropathis arthropathy, Pigmented Syn, hemangioma

Answer 122

**Anterior tibial nerve`** SENSORY AND MOTOR **Supplies** TA,EDL,EHL,PT,EDB resonsible for DF and frontal plane movement Innervates lateral halklux and medial aspect 2nd toe **Anterior Tarsal Tunnel Sdyndrome**-BLUNT TRAUMA to ant ankle///entrapped under ext ret or irriated by superior edge of Inf ext Ret (**tarsal spur)** compresses the DPN over ankle (max point of contact) **Clinical Finding:** paresthesia dorsum of foot with numbness 1st met space//nocturnal pain relieve by movement d/t motor innervation of EDB DX- distal motor latencies woth NCS \>7ms (5 norm) also reproduce sym PF of ankle with ext toes\>\>palpate the N of the ant ankle medial to dorsalis pedis

Answer 123

4+ associated with clonus 3+ Hyper-reflexic 2+ average 1+ low normal-hypo-reflex' 0 Absent Patella DTR-L3 & L4 knee slight extend Achilles S1 & S2 foot plantarflex

Answer 124

- Triangular wedge of tibia that drives the rest of a pilon fracture

Answer 125

Decortication and stabilization of the fragments

Answer 126

2-6 months post

Answer 127

treat met adductus convex pes planovalgus bar is screwed or riveted on shoes

Answer 128

**Amberry**-Davis+removal of base of proximal phalanx **McKeever**-resection of 1/2-2/3 of 5th met **Reverse Hohmann**-transverse osteotomy in neck **L. Oblique Dista**l -Weil osteotomy like cut at the MT neck

Answer 129

removal of lateral plantar condyle

Answer 130

-EDL stlips combined and transferred to lateral cuneiform

Answer 131

transfer of EHL to 1st MT head

Answer 132

1) Avulsion fracture due to lateral band of plantar fascia or PB contractures 2) Jones fracture due to ground reactive force with failure of the foot to evert 3) Diaphyseal fracture due to chronic stress, and repetitive distractive forces

Answer 133

-Sectioning of plantar fascia, 1st layer of plantar muscles, long plantar ligament Disadvantage::::can active Charcot

Answer 134

-TA split proximally and rerouted through medial cuneiform. Tenodesed to PTT **Disadvantage**- sacrifices major inverter/adductor of the foot

Answer 135

transfer EDL to met necks

Answer 136

1) Extra-articular Jones fracture 2) Intra-articular non comminuted fracture 3) Extra-articular avulsion fracture (PB) 4) Intra-articular comminuted fracture 5) Apophysis fracture

Answer 137

-Reroute TA through Keyhole in the Navicular with insertion still intact

Answer 138

Type I: acute injury Type 2: delayed union Type 3: Nonunion

Answer 139

**1**-Hyperglycemia and duration of disease ## Footnote Small unmyelinated C fibers compose autonomic and sensory axons that transmit thermal perception and sympathetic function -sensory changes do not correlate with N conduction deficits **2-**presents prominent paresthesias and ANS with presence of orthostatic hypotension, resting tacycardia, and distal andydrosis **3**-**Large myelinated-** (motor and sensory)- symptoms are tingling, burning, numbness, allodynia or deep lancinating pain DTR attenuated or absent with possible distal motor wearkness Neuopathy develps distal-proximal (**Stocking & Glove)** which is a cause of ulceration in 85%

Answer 140

**Capasaicin-** to target P baciophen, muscle relax, TCA, anti-seizure meds **GAPAPENTIN-** **Neurontin (900mg)**initial,\>\>(1 tab)300mg\>\>(2 tbs)600mg\>\>900mg(3tabs) **Amytriptiline( 25mg @pm dose**. if neurontin does work) +DOPA and NE receptor **OD-**dizzy, drousy.. , Excrete unaltered\>\>no kidney stress

Answer 141

1-Light microscope-needle like crystal piercing WBC yellow needle crystals appear negatively birefrignant.Parallel to axis of lens and blue when perpendicular 2-X-Ray Rat bites, cloud sign, punched out lesions 3-Martel sign (overhanging margins)

Answer 142

more common in female

Answer 143

CNS DEPRESSES AND REDUCE ANXIETY ## Footnote **IV DIAZEPAM**- PAIN BUT ORAL REACHES HIGHER BLD LEVEL **LORAZEPAM**- 8 HR AMNESIA BC NO PRE-MED GIVEN TO OUT PT **VERSED**= HIGHER % ANTEROGRADE AMNESIA-GREAT FOR ANXIOUS PT (POP) **KETAMINE** DISSOCIATIVE SEDATION CAN BE COMBINE WITH VERSED OR VALIUM/ IF ADMIN ALONE-NIGHTMARES AND DELUSION \*\*MOA FACILITATES GABA ACTION BY INCREASE GREQ OF CL CHANNEL OPENING **ANTIDOTE: FLUMAZENZIL** DOPERIDOL+FENTANYL=NEUROLEPTIC ANESTHESIA=LIGHT GENERAL ANESTHESIA OR COGNATIVE DISS

Answer 144

medial: cup (PIMP CUP) lateral: wafer

Answer 145

SHARP KNIFE LIKE SEVERE RIPPING ## Footnote **LOCATION-**GENERALIZE **TIME**-\>15 MIN **CAUSE-**VARIES\>\>STROKE **TREATMENT-**SURGERY AND PREVENTION

Answer 146

Entrapment distal segments of the prox Tib N ## Footnote **Medial Plantar Nerve**=JOGGERS FOOT SEONDARY TO COMPRESSION INTO THE PLANTAR B/C NAVICULAR TUBEROSITY AND ABDUCTOR HALLUC BELLY **Lateral plantar Nerve**-1st branch to abductor digit M.Q. (BAXTERS NERVE) Enrtrap between quadratus plantar &Abductor Hallucis is accos with chronic heel spur synd and is **MOST COMMON TYPE DISTAL TARSAL** **TUNNEL SYNDROME** Give S/S post static dyskinesia and described as **afterburn**

Answer 147

Atrophy of intrinsic musculature\>\>\> digit contracture plantar prominence of metatarsal abnormal distribution of the weight bearing load with ambulation Advanced stages\>\>foot drop secondary gastroc complex lost its antagonist muscle group

Answer 148

Profound vasodilation **presents::**warm, erythematous and dry\>\>Increase blood flow \>\>\>\>\>deminerization of bone\>\>\>\>"wash away" CHARCOT JOINT DISEASE

Answer 149

Sensory doesn't always correlate with Nerve conduction studies **DTR**-attenuated or absent with possible distal motor weakness Devlops in legth dependent fashion\>\>**STOCKING GLOVE** Decrease sensory loss\>\>\>ulceration or breakdown LOSS OF VIBRATORY AND POSITION SENSE\>\>\>Ulcer CAUSE-Oxidative stress\>\>breakdown intraneural glucose

Answer 150

**Small ummyelinated** C fibers composed autonomic & sensory axons that transmit thermal perception and sympathetic function SEEN EARLY -Prominent paraesthesia + ANS dysfunction ie:orthostatic hypotension resting tachycardia distal anhidrosis **Large myelinated** axons-both motor & sensory---conducts propioception, light touch & pain Sensory does not correlate with nerve conduction deficit **Symptons:**Tingling,burning, numbness, allodynia, deep lacinatying paon

Answer 151

**Isoniazid**-pyrodoxidine def is major side effect **Rifampin-**cytoP50---will decrease effectiveness of co-administered drugs,::protein inhibitor, BCP, warfarin,quindine,zidovudine,itraconazole, lfluconazolw and ketakononazole **Pyrazinamide** **Ethambutol or Streptomycin**

Answer 152

DMD) is a severe type of muscular dystrophy that primarily affects boys. Muscle weakness usually begins around the age of four, and worsens quickly. Muscle loss typically occurs first in the thighs and pelvis followed by the arms. ## Footnote GOWERS SIGNS-pathognomonic where child rises from sitting position by climbing on her legs

Answer 153

The process of making the fixator more flexible

Answer 154

Sodium (NA) 135-145 Potassium(3.5-5.5) Chloride-(98-109) CO2

Answer 155

low frequency magnetic fields. Magnetic fields are created by electricity flowing through wires

Answer 156

Aquaphor Calamine Cetaphil Eucerin Lac-Hydrin Lanolin Moisturel

Answer 157

**Definition**-compression neuroapathy to gradual contriction anatomic structures about anerve **S/S**- insidious & mil;d; motor and sensory changes painful **DX**: EMG and NCV **TX** Surgical decompression

Answer 158

Intra-articular calcaneal fracture **type 1**-tongue fx d/t vertical fall primary line exist plantar secondary fx line exist posterior **Type 2-**joint depression fx d/t posterior fall, primary line exist plantar and 2nd fx line posteriorsuperiorly(dorsally)

Answer 159

- most injuries in Dorsal direction - Forced abduction - Twisting with an **axial** loading of a PF foot - Motor vehicle accident

Answer 160

-Shepard's or cedell fractures occur with forced PF of the foot. Steida process: intact medial tubercle

Answer 161

procedure best treats a flat foot with a severe transverse plane abduction deformity

Answer 162

Cotton test/hook test- best test for syndesmosis injury

Answer 163

135-155 infant 120-135 Adults

Answer 164

Same as Denis-Browne Bar except the bar clamps to sole of pts shoes Need rigid shoes

Answer 165

Flexible Rigid + Hubscher manuever (-) + Resupination test (-) NOT PAINFUL PAINFUL LA arch on weight bearing coalition, vertical talus

Answer 166

DYNAMIC SPLINT CONSIST OF A BELT AROUND THE POSTERIOR HEEL ALLOWING MOTION IN ALL PLANES EXCEPT INTERNAL ROTATION INDICATED FOR INTERNAL TIBIAL TORSION

Answer 167

**Chambers**-raise the posterior facet of the STJ using a bone graph **Baker**- Osteotomy inferior to the STJ post facet with bone graph **Selakovich**- open wedge osteotomy of the sustentaculum tali with bone graph which restricts abnormal STJ motion **Gleich**- Oblique osteotomy displaced anterior- help to increase cal-inc.angle **Silver**- Lateral opening wedge with graph **Koutsogiannis**- Medial side calcaneal osteotomy **Triple Arthrodesis**- reserved for salvage **Grice-Green Extra-articular Subtalar arthrodesis** -bone graph inserted laterally in sinus tarsi bewteen the talus and calc. good for children. Provides excellent stability

Answer 168

also known as Allis sign hip and knees flexed, supine position dislocated hip results in lower knee positiob on affected side

Answer 169

1/2 life 78.3 hours diagnose if you have certain types of cancer, such as Hodgkin's disease, lymphoma, or lung cancer. identifies the cells that are dividing most quickly in your body. It can help detect some cancer cells. It can also help show cells that are rapidly reproducing or responding to an infection somewhere in your body. People with lymphoma (cancer of the lymph system) may need gallium scans. principal organs that localize gallium are the liver, spleen, and bone marrow.

Answer 170

1st splint to treat combo foot and leg disorders Similiar to Denis-Browne If treating internal rotation, bar placed bewteen RF plates If treating external rotation, place bar forefoot plate

Answer 171

1- **Induction** Begins with induction agent and ends with loss of consciousness. The patient can still feel pain in this stage **Stage 2**-Hyperexcitable state. The time where the patient looses consciousness and when they regain autonomic stability. The patient losses the ability to maintain temperature, blood pressure and may experience irregular breathing, uncontrolled movement, GI issues (vomiting). This stage last a very short amount of time. 2-**Maintenace**- **Stage 3-**This is desirable state or target debt of anesthesia. Patient regains autonomic stability Plane 1-eye rolling which progresses to eyeball centrally fixed Plane 2- Loss of corneal and laryngeal Plane 3- Pupils dilate and loss of light reflex Plane 4-Intercostal paralysis, Short shallow abdominal respiration (diaphragmatic respiration) **Stage 4** Overdose. Autonomic instability will begin to reemerge. Loss of BP, decrease breathing, circ failure **Emergence**-Starts at stage 3 surgical anaesthesia) thru stage 2\>\>\> stage 1 conscience awake

Answer 172

**A-IV short acting** Other induction agents\>\>**Fentanyl**\>\>\>**Sulfematil**\>\>\>\>**Alfemtanil** (uses narcotic as induction reduces need for pre-medication)----SIDE EFFECT--RESP DEPRESSION\>\> USE **NALOXONE** **B-Barbituate-** 1- **Thiopental**-(3-5MG)-short act depress. **SE** long recovery\>metaboloze in liver, **PORPHYRIA** 2- **Methohexital** (Brevital)short acting, faster return to consc **SE:** cough/singultus/ **PORPHYRIA**/cardiac failure/ not used with recent MI or air obstruct or severe liver damage 3 **Propofol**(Diprivan)-\*\* sedative-hypnotic- metabolized fast in liver. Rapid return to clear head **SE: cause greater CV and resp depression** 4- **Ketamine-** IV/IM great for un coop Kids **( SE dissociative anesthesia**- pt appears awake eyes open but pt is unaware of surrounding) **C- Benzodiazepine** 1-**Midazolam-No analgesia\>\>Resp depression\>\>decrease BP-shortest act** D- **Butyrophenone** 1-**Droperidol** -if combined with other narcotic like fentanyl\>\>Neuroleptic Anesthesia

Answer 173

This tumor usually affects patients in their 2nd and 4th decade of life. It has a predilection for the female population. Symptoms are often a dull ache that is intermittent in nature and may be accompanied by a palpable mass. The areas most commonly affected are the distal radius, proximal tibia and the distal femur. Radiographically one may see an expansile lesion, a central area of radiolucency, destructive, and can extend to the articular surface of the bone. What is

Answer 174

Insertion of a fully-threaded lag screw requires drilling a glide hole in the near cortex, on the same axis as the thread hole in the far cortex. Glide hole: The cortex under the screw head is drilled to the size of thread diameter so that the thread gets no purchase. Thread hole: A drill hole which is the same diameter as the core of the screw is drilled, and a tap is used to cut the spiral groove that receives the thread of the screw. The result is a thread hole. One can drill both cortices with the thread hole sized drill and then overdrill the near cortex. Alternatively, the gliding hole is drilled first, and a drill sleeve is placed within it to direct the drill bit for the thread hole in the far cortex

Answer 175

The first screw should be placed centrally and perpendicular to the long axis of the bone. The secondary screw should be placed perpendicular to the fracture line and placed on either side of the first screw

Answer 176

Affect peripheral joints, esp 1st MPJ Monosodium crystals forms Supersatuated hyperuricemic body fluid crytalizes UA Crystals in joints from xs breakdown or overproduction of purines CLASSIC BEGINS: evening or early morning **S/S**=Asymmetrical monarticular OA Sudden onset: red hot swollen with possible low fever Joint sparing, but in chronic, joint destructive Usually 1st attacks 1st MPJ Crunchy tophi in ears

Answer 177

contact, prolpulsion

Answer 178

Present in renal tubular epithelium and in liver sensitive to detect chronic alcohol consumption

Answer 179

dan**G**thrapist ## Footnote sysmetrical motor and sensory paresis Schwann cell surface membrane targeted frequest infection organism---Camphlobacter jejuni **Pathology** Edema of nerve--degeneration of nerve and myelin sheath **S/S=**distal limb first (weakness)\>\>decrease tednon reflex\>\>inv ANS\>\>motor and sensory weakness **TX-** Plamsa phoresis with immunomodulation via infusion IgG shortens DZ

Answer 180

prominent metatarsal head \*hypermobility of the 1st ray ( usually insufficient) \* callus hammer toe on 2nd digit \*rearfoot valgus deformity \*gait evaluation- overpronation arch collapse (VERY MUCH SO) {\*the peroneus longus tendon is stretched with collapsed arch. } \*1st MTPJ: 60 degree ROM, 45/15 ( should be under 25 and 15) may also see ingrown nail.

Answer 181

**Keller** **Implant arthroplasty** **Stone**-oblique osteotomy resects 1/4 of met head leaves plantar condyle **Mayo**-excise 5mm met head **Mckeever**=1st MPJ arthrodesis-df 5-10 degrees **Valenti-**V shape osteotomy **Lapidus**-fusion of the MC joint

Answer 182

Cheilectomy kessel & Bonney Regnauld-Mexican hat prox phalanx- shorten 1st ray Waterman Waterman-Green-shorten and PF met head Youngswick Van-Ness-PF wedge base 1st met Cotton-Open base wedge Labrinudi-PF wedge correct met primus elevatus

Answer 183

Leprosy is caused by infection with the bacterium Mycobacterium leprae. It mainly affects the skin, eyes, nose and peripheral nerves. Symptoms include light colored or red skin patches with reduced sensation, numbness and weakness in hands and feet. Leprosy can be cured with 6-12 months of multi-drug therapy. Early treatment avoids disability.

Answer 184

views medial and posterior STJ facets -great for coalitions

Answer 185

Non displace vertical fracture talar neck 1 of the3 bllod supplies is disrupted artery of the sinus tarsi 15% avascular necrosis

Answer 186

Displaced vertical fracture of the talar neck with dislocation of the STJ 2 out of 3 main blood supplies to the talar body is disrupted AA sinus tarsi and tarsal canal **AVN 15-50%**

Answer 187

Displaced vertical fracture talar neck with STJ and ankle joint dislocation All 3 main blood supplied to the talar body is disrupted AA sinus tarsi, tarsal canal and deltoid artery **AVN 91%**

Answer 188

Displaced vertical fracture of the talar neck with dislocation of the STJ, AJ and TNJ All main blood supply to the talar body is disrupted AA sinus tarsi, tarsal canal and deltoid artery **100% AVN**

Answer 189

Indices of RBC info of size and HGB content of RBC MCHC-is the average concentration of hemoglobin in your red blood cells. Protein in RBC help carry O2 throught the body **\>\>18**-Polycythemia, increase Bld viscosity\>\>\>hi risk of thrombosis **\<\<\<\<11** anema

Answer 190

**Male 40-50** **Female 37-47** Integral part of persons CBC Is the % Volume of RBC in a sample of anticoagulated whole blood **High-**Packed cells vol, PCV, CHF COMA Dehydration/ shocl **Low**-Anemia and blood loss

Answer 191

nail bed laceration and distal phalanx FX

Answer 192

Dangt**H**rapist ## Footnote **Type I** **CMT** segental demyelination **Type II**-Neuronal degeneration and onset distal limb weakness **Type III-Dejerine Sottas DZ-**hypertrophic neuropathy\>\>onion bulb- affect ability to move **Type IV-Refsum Disease-**lipid storage disorder with increase excretion of phytanic acid, connect to CMT overlap sensory and spinal path _Symptoms_-repeat attacks and remisiion distal motor and sensory loss hands and feet, absent pain and Temp sense _Clinical_: enlarged nerve sheath resembles Dejerine-DSottas DZ **Type V-**spastic paraplegia **Type VI** optic atrophy and hyperthrophic neuropathy type I **Type VII**- clinical picture type I with complication retinitis pigmentosum

Answer 193

dislocated hip will be femoral head outer upper quadrant

Answer 194

- beam at 10 degrees - to measure RF coronal plane axis

Answer 195

recommended for 2-4 years, then dennis brown bar for 2 years

Answer 196

face and neck 2-5 days dorsum foot-7 days plantar 10-14 retention site 3 weeks-6 weeks

Answer 197

3 incisions are used. - medial to **1st** met - in **2nd** interspace - in **4th** interspace ORIF used to achieve arthrodesis of 1st-3rd TMTJ Do not fuse 4 and 5 because they are essential joints.

Answer 198

Over time collagen fibers in aa and arteriole wall increase\>\>bld vessels stiffer and with reduced elasticity\>\> Arterial BP **Path**-Inability of kidney to excrete sodium An overactive renin/angiotension system leads to vasoconstriction and retension of sodium and water Overactive sympathetic NS\>\>\>increased stress response **Complication**- CVA MI Cardiomyopathy Hypertensive retinopathy **Accelerated HTN**-SBP \>\>240 without signs of end organ damage **Hypertensive emergencies-** when end organ damage is ongoing without intracaniel pp **Malignant hypertension**-late phase with headaches, blurred vision, increased intracraniel pressure **Diagnostic Evaluation**-\*\*KIDNEY FUNCTION: SERUM CREATININE AND BUN ARE ELEVATED PROTEINURIA, ELEVATED K+, EKG AND CXR

Answer 199

BASAL GANGLIA DISORDER ## Footnote Degenerativr CNS by involuntary movement, progressive dementia, psychiatric and behavior distubances Associated chromosone 4 Autosomal dominant pattern---Men=Women **Athetosis** usually freq in hands and feet **Athetosis** is a symptom characterized by slow, involuntary, convoluted, writhing movements of the fingers, hands, toes, and feet and in some cases, arms, legs, neck and tongue. Movements typical of athetosis are sometimes called athetoid movements. **Hemmiballism** characterized by violent involuntary limb movements, on one side of the body, and can cause significant disability. Essential tremor and choreoathetotic gait **Choreoathetotic gait-** as rapid (chorea) or slow (athetosis) involuntary movements of the fingers or toes (flexion–extension, adduction–abduction, writhing, sometimes piano-playing movements) which are irregular, nonrhythmic, and purposeless Treatment-Haloperidol and phenothiazine suppress the chorea

Answer 200

**Halothane**- .75 MAC///BGC= 2.3. Most potent rapid smooth induction and recovery. low irritability to resp tract non emetic, non flammable, BRONCHODILATOR EXCELLENT PEDS\> asthmatic **Disadvantage**:: Decrease BP by reduce cardiac contract//sensitize myocardium ot catecholamine\>\>dysrhymias myocardium depression\>Halothane hepaitis\> postop shiver decreases HR\>\>hepatic necrosis] **DON'T ADMIN W/N 3 MONTHS BECAUSE SLOW LIVER METAB\>\>HALOTHANE HEPATIC NECROSIS** **Isoflurance-BGC 1.4 MAC=1.5 l**ow bld solub so fastest response and recovery, bronchodilator non flam, good muscle relax, maintains cardian rhym, compatible with epi, doesn't sensitize heart to catecholamine _Disadv_: depress CVS, shiver post op, poss acute or delayed lover injury **ENFLURANE**- BGC 1.7 MAC Pleasant smell\> rapid induction/recovery, non-irriate/ bronchodilator,Maintain CVS, non-emetic. comp with epi\>\>skeletal muscles\> enhances nondepolorizing NM blocking agent _Disadv:Cardiac depresses..metabolize renal (caution) less potent then halothan_ **Methoxyfluranne**_-_ MOST POTENT- least volatile. great margin of safety, good relax, non inflam **NEPROTOXIC** **SEVOFLURANE-** BGC=.65 MAC 1.7-CAN be deep sedative with local or general **Desflurance-BGC .45-** MAC 6- good for same day out pt sx

Answer 201

Cholesterol turns into plaque **NORMAL FLOW-Lamina** flow\>\>bullet shape, its is concentric layers of blood in parallel down length of blood vessels **Blood flow**--hits a curve(bifurcationor trifurcation)...turbulent flow and shacks out the solid element **(** lipid-plaque**)\>\>\>\>lamina flow** **STENTS\>\>\>go around curve**

Answer 202

\>\>\>\>140/90 if DM or kidney dz\>\>130/80 considered a risk **Systolic** **Diastolic** Stage 1 140-159 90-99 Stage 2 160-179 100-109 Stage 3 180-209 110-119 Stage 4 \>\>210 \>\>129

Answer 203

Latency period, Distraction period, Consolidation period

Answer 204

Psoriatic OA hyperparathyroidism ( hi calcium) R.A. Reiters Ankylosing Spondylitis

Answer 205

An indium-111 WBC scan is used to look for a suspected infection. The scan involves the injection of radioactive white blood cells into the vein through a small needle, followed by a gamma camera scan to confirm or exclude a clinically suspected infection. ## Footnote In can be used as a label for red cells, platelets, and leukocytes. 1/2 life is 67.2 hours

Answer 206

**Infectious** ## Footnote **TB Leprosy**- multiple nerve palsies **Neurosyphillis** T Pallidum 25% with 3rd syphilis **Poliomyelitis**-RNS virus starts as flu--meningitis\>\>faccid paraysis **T**x Vaccine **Herpes Zoster-**vessicles, segmental weakness **Lyme disease-**meningeal distribution with cranial neuritis, motor or sensory radiculoneuriti**s**

Answer 207

A-**Gaseous** Nitrous oxide- least potent and common for sedation. B- **Volatile Liquids** **Halothane** (fluothane)-rarely used.SE irreg heartbeat, resp depression liver problems. Dont use if PORPHYRIA OR MALIGNANT HYPERTHERMIA **Isoflurance** (forane) SE resp depression, similar to halothane. Can cause coronary aa vasodilation\>\>Coronary artery steal syndrome. Decrease BP **Desflurane** (Suprane) same as Sevoflurane/MOST RAPID ONSET AND OFFSET. Contra for arrhythmia can trigger _malignant hyerthermia_ Previous MI \< 6 months perioperative re-infarction 10X if older then 6 months

Answer 208

**Deep peroneal N-**--EDB & EHB **Medial plantar Nerve-**Abductor hallucis & FDB &FHB **Medial plantar nerve, proper digital branch to the hallux**- FHB **Medial plantar nerve, first common digital branch** 1st Lumbricals **Lateral plantar nerve, trunk** Quadratus Plantaw & Abductor digiti minimi **Lateral Plantar Nerve,superficial**---Flexir digiti minimi brevis 3rd plantar interosseus 4th dorsal interosseous **Lateral plantar Nerve, deep-** 2nd, 3rd,4th Lumbricals &Adductor halluxis (both heads) 1st & 2nd inerossei & 1st,2nd and 3rd dorsal interossei

Answer 209

ANTI-ADDUCTUS ORTHOTIS TYPE 2 INDICATED METATARSAL ADDUCTUS

Answer 210

b. A dynamic compression plate has oblong holes with sloped slots. c. In a long bone, the convex side is the tension side, and the concave side is the compression side. d. Examples of dynamic compression implants are tension band plate, dynamic compression plate, and circlage wiring. e. In tension band wiring, the band is place on the concave, or compression side, of the fracture.

Answer 211

is a genetic disorder characterized by foot abnormalities and the premature fusion of certain bones of the skull (craniosynostosis), which prevents further growth of the skull and affects the shape of the head and face.

Answer 212

The most common method of reinforcing reflexes is the Jendrassik maneuver. In 1885, Erno Jendrassik reported that having the patient “hook together the flexed fingers of his right and left hands and pull them apart as strongly as possible” while the clinician taps on the tendon enhances the reflexes of normal patients.

Answer 213

b. Subtalar joint ROM is about 16 degrees in the sagittal and 42 degrees in the transverse plane. c. The oblique midtarsal joint has nearly equal ROM in the transverse and sagittal plane. d. Ankle ROM is about 82 degrees in the sagittal and 30 degrees in the frontal plane

Answer 214

benign enlargement medil plantar digital nerve located medial aspect of the 1st MPJ hallux Cause biomechanical

Answer 215

Compression or entrapement medial plantar digitial proper Nerve ## Footnote **Symptoms**-Numbness & Pain infer-medial 1st metatarsal-phalangeal joint Etiology: pronation\>\>\>apropulsive gait with medial roll-off

Answer 216

- posterior facet of talus abuts calcaneal floor and occludes sinus tarsi - sign of maximum pronation - opposite of bullet hole sinus tarsi Kirby sign. parallel pitch line. tests for HAglunds deformity. fowler phillp angle. normal is between 44 and 69. chauveaux- liet angle. calcaneal pitch minus the angle of the most posterior point of the greater tuberosity and the apex of the postero=ior superior crest angled to a vertical line. normal is 0-12, greater than 12 is abnormal=haglunds deformity from radiopaedia online.

Answer 217

BOYS\<\< NAV BECOMES SCLEROTIC AND FLATTENED (COIN ON EDGE OR SILVER DOLLAR SIGN) SELF LIMITING

Answer 218

mild form of spinal muscular dystrophy

Answer 219

predislocation sysndrome

Answer 220

A **lag screw** is used to compress fracture fragments. It is threaded into the opposite cortex, and slides through a hole in the near cortex. Tightening the screw presses the screw head against the near cortex, compressing the fracture fragments. Optimally, a lag screw should be perpendicular to the fracture plane. Some screws are designed as lag screws. They are partially threaded so this screw threads into the far cortex, and the smooth shaft slides in the near cortex. The result is the same as if the near cortex were overdrilled. Partially threaded lag screws are often used to compress fractures in cancellous bone. Their threads must lie completely beyond the fracture line to achieve good interfragmentary compression. Allows compression across the osteotomy site. the head **IE: 2.7mm into cortical bone** drill thread hole (2.0mm bit) near near and far cortex drill glide hole-2.7mm drill bit--near cortex counter sink measure tap using 2.7mm flush insert 2.7 mm screw

Answer 221

Screws positioned perpendicular to the long axis of the bone functions to provide resistance to axial loading.

Answer 222

Osteochondritis of the cuboid

Answer 223

Supination External Rotation 1-AITFL syndesmotic rupture or avulsion of it insertion 2-the talus dispaces and fractures the fibula oblique or Sprial fracture**(weber b**) long, posterior spike on lateral x-ray 3-PITFL syndesmoptic rupture or avulsion of its insertion or fracture posterior malleolus 4-tear of Deltoid ligament or transverse avulsion fracture of medial malleolus

Answer 224

**Pronation Abduction** 1-Transverse avulsion FX medial malleolus/deltoid rupture 2-AITFL syndesmotic rupture or avulsion of its insertion//or WF fracture 3-Short oblique lateral malleolus fracture (**DWB Butterfly fragment)** transverse X-ray

Answer 225

PER 1-Transverse avulsion FX medial malleolus/ deltoid rupture 2-AITFL syndesmotic rupturer avulsion of its insertion 3-Oblique or spiral fibular fracture above the talotibial joint (Weber C) 4-Involement of the PITFLor Posterior malleolus fracture

Answer 226

**Supination Adduction** **1**-LRupture of the AITF/PITF lgt tear,or avulsion fibular fracture(weberA) **2**-Spiral fracture of the fibula **DWB POSTERIOR SPIKE ON LATERAL XRAY** **3-** Volkmans fracture or PITF rupture **4-** Rupture of the deltoid lgt/ transverse fracture of the medial malleolus

Answer 227

lateral cortical motor pathway include spastic paresis and hyperreflexia.

Answer 228

Catalyses lactic acid to pyruvic acid in the citric acid cyscle(**Glycolytic Cycle)** **M**any in tissue, liver kidney myocardium and muscle Inceeased 12-24 hrs after MI Increased in CVA//Hepatitis?CA/Hemolytic anemia/skeletal muscle necrosis **FALSE FLIPS**-LDH1\>\>LDH2\>\>\>\>\>MI LDH3 Pulmonary LDH4-Liver disease

Answer 229

Osteochondrosis of the femoral head Males\>\>\>females Limping, pain to groin with stiffnes 3-12 years of age MOST COMON FORM OF OSTEOCHONDRITIS SYMPTOMS-INSIDIOUS ONSET, LIMPING, GROIN PAIN REFERRED PAIN TO KNEE childhood condition that occurs when blood supply to the ball part (femoral head) of the hip joint is temporarily interrupted and the bone begins to die. This weakened bone gradually breaks apart and can lose its round shape.

Answer 230

take perpendicular of a line passing thru lateral base of 5th and medial base of the 1st metatarsal and compare with the 2nd

Answer 231

Osteochondritis of the distal tibia

Answer 232

Lateral closing wedge anterior osteotmy calcaneal

Answer 233

a. The Wagner frame b. The Ilizarov frame c. The Oxford frame d. The Orthofix frame

Answer 234

LDH-38-62 SGOT/AST-10-50 SGPT/ALT-10-50 GTT-2-65 Alkaline Phosphatase/ ALP (30-85) Bilirubin (.1-1.2) Cholesterol

Answer 235

**Epiphysis** Chrondroblastoma, Giant cell tumor post growth plate **Metaphysis** Osteogenic sarcoma fibrosarcoma unicarmeral bone cyst giant cell tumor non ossifying fibroma **Diaphysis** **m**yeloma, ewing tumor, reticulum cell sarcoma

Answer 236

1) Reabsorption of 15% of filtered water and 25% of the filtered load of Na+ 2) Production of a dilute (hypo-osmotic) filtrate entering the distal tubule 3) Development of a hypertonic interstitum in the medullary regions of the kidney (via Countercurrent Multiplication) 4) Recovery of H20 & NACL from urine

Answer 237

Calve-Legg Perthes Disease

Answer 238

MANNITOL,CARBONIC INHIBITORS **LOOP DIURETIC**- TYPES-FURSOSEMIDE-LASIX ADVERSE EFFECT-CAUSES INCREASE IN K+ LOSS **THIAZIDES DIURETICS-**ADVERSE EFFECTS **K SPARING DIURETICS**- SPIRINOLACTONE, AMIODARONE Adverse effects **Beta Blockers-**decrease HR, CO and SBP\>\>\>\>hypoglucose,hyper TG's and ppt CHF and angina **A2 agonst-** Clonidine\>\>\>not cause reflex tachycardia **A antagonist**- Phentolamine and Phenoxybenzamine **Post-ganglionic sympatholytics-** Reserpine, Guanadrel **Direct vasodilators-**Apresozide, hydralazioine, Minoxidil, Diozozide,Nanitroprusside, Nitroglycerin infusion **Ace inhibotors-**PRILS-\>cough and hyperkalemia via its inhibition of aldoserone that cause hypoK+ & hyper NA **Angiotensin receptor antag-**artans--blocks the angiotensin 2 receptors, has no cough

Answer 239

LMN lesions present with muscle atrophy, fasciculations (muscle twitching), decreased reflexes, decreased tone, negative Babinsky sign, and flaccid paralysis. ORIGNATE SPINAL CORD ANTERIOR HORNS WEAKNESS amyotrophic lateral sclerosis,// progressive bulbar palsy, //primary lateral sclerosis,// progressive muscular atrophy, spinal muscular atrophy,// Kennedy's disease, and post-polio syndrome. Guillame Barre Syndrome

Answer 240

Typical symptoms include fever, headache, fatigue, and a characteristic skin rash called erythema migrans. ## Footnote Lyme disease causes a rash, often in a bull's-eye pattern, and flu-like symptoms. Joint pain and weakness in the limbs also can occur. Most people with Lyme disease recover completely with appropriate antibiotic treatment. For those who develop syndromes after their infection is treated, pain medications may provide symptomatic relief.

Answer 241

2nd greatest intracellular cation deficiency can cause leg muscle fatigue

Answer 242

fracture of the proximal fibula corresponding with PER III syndesmotic screw at distal fibula will reduce proximal fibular fracture

Answer 243

ill defined or absent margins cortical erosion onion peeling codman triange

Answer 244

rare muscle disorder. In this disease, the muscle cells can't break down a complex sugar called glycogen. It is part of a group of diseases called glycogen storage diseases. Another name for McArdle disease is glycogen storage disease type 5 (GSD 5 or GSD V).

Answer 245

talo-first metatarsal angle) was measured as the angle between the line originating from the center of the body of the talus, bisecting the talar neck and head, and the line through the longitudinal axis of 1st metatarsal.

Answer 246

line drawn medial proximal aspect of the 1st metatarsal base and medial distal aspect of T-N articulation 2nd line-between lateral prox asp 4th metatarsal base and lateral distal aspect of the C-C joint 3rd Line- between the bisection to 2 lines 4-perpendicular line to the 3rd line down the shaft of the 2nd metatarsal Metatarsal adductus angle a\>\>20 is adducted MTA at birth 25-30 degree

Answer 247

associated with infra-calcaneal heel spur syndrome

Answer 248

Bacterial- H.flu, meningitides//DX lumbar puncture TX PCN G or Ampicillin C**occidioidomycosis-** **Cryptococcus** Neoformans-pigeons---dissemination to CNS-menigitis **Brudzinski's sign** is one of the physically demonstrable symptoms of meningitis. Severe neck stiffness causes a patient's hips and knees to flex when the neck is flexed. Indicates meningeal irritation **Kernig Sign** people with meningitis weren’t able to extend their knees past a 90˚ angle without pain.

Answer 249

examination of data from a number of independent studies of the same subject, in order to determine overall trends:

Answer 250

adductus of the FF at the TMJ affects 1 in 1,000 male=females 55% are B/L **CAUSE** Intrauterine position Tight abductor hallucis muscle Absent or hypoplastic medial cuneiform Abnormal insertion of anterior tibial tendon

Answer 251

8 y.o and older **Berman and Gartland**-crescentric osteotomy 1-5 **Lepird**-closing wedge 1-5 base **Johnson Osteochondrotomy**-closing abductory-Closing abductory base wedge 1st met 2.5mm from the lesser metatarsals **Fowler**-Opening wedge osteotomy of medial cuneiform with insertion bone graph **Peabody-Muro**-Excise base metatarsal 2,3,4 with osteotomy 5th metatarsal mobilize 1st met-cun joint **Steytlier and Van Der Walt**-Oblique osteotomies all metatarsals **McCormick and Blount-**Arthrodesis of 1st metatarsal-cuneiform joint

Answer 252

**Heyman, hernon,Strong**- release all soft tissue at lis franc except plantar lateral lgt **Thompson Procedure**- Resection of abductor hallucis and release medial head FHB **Lange**- Capsulotomy of 1sr met-cuneiform joint/ division of the abductor hallucis **Licthlau**- Sectioning of hyperactive abductor hallucis

Answer 253

N/V DIAPHORESES **LOCATION** SIMILAR TO ANIGINA **TIME**\>\>15 MINUTES **CAUSE**--ANGINA MAY PRECEDE **TREATMENT**: NITRATES,ASA, B-BLOCKERS, CA+ ANTAGONIST, HEPARIN, THROMBOLYTIC TX, PCTA

Answer 254

The minimum alveolar concentration (MAC) is the minimum concentration of an inhaled anesthetic at 1 atm of pressure that prevents skeletal muscle movement in response to a surgical incision in 50% of patients. ## Footnote **A lower MAC value represents a more potent volatile anesthetic.**

Answer 255

- is a form of arteriosclerosis or vessel hardening, where calcium deposits are found in the muscular middle layer of the walls of arteries (the tunica media). - results in increase ankle ischemic indices

Answer 256

benign arteriosclerosis results in extensive calcium deposits in tunica media layer of medium size arteries

Answer 257

**Monocytosis** Leukemia Hodgkins Bacterial Endocarditis Collagen Vascular disease, sarcoidosis **Eosinophilia**- Allergy, asthma, eczema parasitic inf, scarlet fever, Pernicious Anemia **Eosinophenia**- Cushing DZ, XS ACTH, chronic steroid post opstate, shock labot

Answer 258

Least reactive

Answer 259

ADJUNCT MINIMIZE PAIN NOT FOR OUT PT SX\ ADR-Prolong analgesia Hypotension, Res depression, pruritis N&V **ANTIDOTE** :**NALOXONE**(**NARCAN**) OR **NALMEFENE**) **SULFENTANIL** AND **ALFENTANIL**-SYNTHETIC ANALOG OF FENTANYL MORE POTENT **REMIFENTANIL**-NEW AND VERY FAST ACTING OPOID FOR MINOR PROCEDURE

Answer 260

Cortical bone destruction bone marrow edema low signal T1 Reactive surface well defined Adjacent rim, well define T2 increased signal

Answer 261

Low intensity T1 linear zone poorly defined T2 linear is dark

Answer 262

silent palpable click that patient feels while squuzing metatarsal heads together

Answer 263

**1-SUCCINYLCHOLINE** (ANECTINE)-RAPID ONSET DEPOLARIZING MR WITH STRONG EFFECT, RAPID ONSET PREVENT ASPIRATION SE: POST MYALGIA UP TO 4 DAYS POST OP RAPID INJECTION\>\>CARDIAC ARRYTHMIA **ANTIDOTE**: ANTICHOLINESTERASE AGENTS-**NEOSTIGMINE** (PROSTIGMIN) **PYRIDOSTIGMINE**(MESTINON **2-ATRACURIUM**(TRACRIUM) **3-VECURONIUM** (NORCURON) BOTH non-depolaring interm. Acting MR\>\>slower onset then Succiny 50-75 minutes DOA Atracurium 20-30 Min DOA Vecuronium

Answer 264

progressive weaknes and degeneration of sketetal muscles Symtoms-progressive weakness, atrophy, loss of DTR, secondary contracture and deformities 1-Duchennes-2-5 yo- most rapid progression- toe walk, diff climbing stairs, waddling gait, gower sign 2-Becker's-5-25 3-Emery-Dreifuss-5-15 4-Facioscapulohumeral-7-20 5-Limb-Girdle-10-30

Answer 265

AUTOIMMUNE DISORDER CAUSED BY PRODUCTION OF AUTOANTIBODIES TO ACH RECEPTOR ON MOTOR END PLATE ASSOCIATED WITH THYMIC HYPERPLASIA OR THYMONA neuromuscular disorder that causes weakness in the skeletal muscles, which are the muscles your body uses for movement. It occurs when communication between nerve cells and muscles becomes impaired.

Answer 266

**Anonychia**-no nail, congenital-ischemia-toxins raynauds, darier dz-lichen planus **Paronychia**-infection+IGTM-staph-candida **Beau's Line-transverse** ridges .1-.5mm widex1mm deep d/t sudden arrestin Fx of nail plate-inf-typhus-syphyllis leprosy-DM-psoriasis-vasc dz ACTH, hyperthyroidism, alopecia, exf dermatatis **Clubbed-bulbous deformity**---Lovibond angle\>\>160 degrees-CH defects, resp, lung ca SBE **Darier White Dz**-red and white longitudinal streak on nail **Mee's lines**- Horizontal striation on nail d/t arsenic & thallium poisoning **Eczema**-atrophic and contact dermatitis nail colour yellow,green, gray or black **Glomus tumor**-Neoplasm or AV shunts in nail beds (glomus bodies) purplish tumor & pain **Keratocantoma**-subungual ulcerated lesion resembles SCC **Leukonychia**- white Transverse striation, spots or total nail psoriasis, toxic metal poison, scleroderma, leprosy-anemia-cancer, hodgkins dz- darrier dz **Malignant melanoma**-acral lentiginous melanoma most dreadful, MELANOTIC WHITLOW-elevation of nail **Atrophy**-Lichen planus **Periungal fibroma**-acq or congenital ass/ tuberous sclerosis, mental retard-seizure-adenomasebaceum

Answer 267

Cold steel indicated for chronic reoccuring IGTN, failed chemical procedures **Frost**- inverse L shape-nail, matrix and hypertrophic ungual labia: suture **Whitney**-B/L frost; Mendelsohn & smith suturing **Winograd** 1/4 of nail edge is removed along with matrrix and bed: snip nail fold wedge to the bone; suture **Zadik**-remove nail plate & matrix c/o shortening: forced on nail matrixl; excised skin over base of nail bed prox to lunula & matrix; skin flap advanced & suture to distal nail bed **Terminal Symes**-Removal entire nail plate, bed and matrix, resect 1/2 distal phalnx & close defect with plantar skin flap DISADV: shortens digit, bulbous terminal stub, slough of flap, scar, nail depth **Kaplan**-stressed removal of both nails matrix and bed, H incision carried out at 2 depth **Suppan**-free the eponychial fold & remove the nail, allow visual of prox nail matrix, cut lateral & ant border and remove prox attachment Plastic lip-excise pie shape wedge of tissue from side of toe, use for hypertrophy of ungualabia **complication** -recurrenc4, xs drain & bleeding, infection, exuberant granulation tissue, insuff amt removed soft tissue migration up to dorsum of toe

Answer 268

good for b/l dislocation imaginary line connect the A.I. Spine to tuberosity of the ischium if tip of the greater trochanter is palpable distal to this line\>\>\>hip is dislocated

Answer 269

_most important initial studies for children with chronic progressive ataxia_ used changes in blood flow or chemistry to examine parts of the brain active while normal adults perform tasks. These studies have provided a general picture of where cognitive and emotional processing is carried out by the brain

Answer 270

**Houser Neuroma** 1st plantar intermetatarsal nerve **Morton Neuroma**- 3rd IMS **Heuters Neurom**-2nd IM nerve **Islen's Neuroma**- 4th plantar IM nerve

Answer 271

**Neuropraxia** is the mildest form of traumatic peripheral nerve injury. It is characterized by focal segmental demyelination at the site of injury without disruption of axon continuity and its surrounding connective tissues. This condition results in blockage of nerve conduction and transient weakness or paresthesia. **Radiculopathy** describes a range of symptoms produced by the pinching of a nerve root in the spinal column. The pinched nerve can occur at different areas along the spine (cervical, thoracic or lumbar). Symptoms of radiculopathy vary by location but frequently include pain, weakness, numbness and tingling.

Answer 272

**Neutrophilia**-Bacterial infection, necrosis Pain acute infection, rigious exercise post convulsion **Neutrophenia**-Overwhelming infection marrow depression autoimmunity antimetabolite **Lymphocytosis-**Viral inf, measles, hepatitis, chronic TB, Lymphocytic leukemia

Answer 273

**Ethilon**-monofil nylon-low tissue reactivity-more plaible when wet 9-0 10-0 microsx **Nerolon**-braided nylon- coated to improve handling **Mersilene**-multifilament polyester-minimal tissue rxn, MOST ACEPTABLE FOR VASC SYN PROCESSES **Ethibond** excel-polyester braid- coated with polybutalate **prolene**-relatively biolically inert, use minimal suture sx (ie:infection) **Dermabond**- sterile liquid- in 3 minutes provides the same strength as healed tissue at 7 days **Steri-strips-** hypoallergenic **Staples**-fast method and least tissue reaction

Answer 274

Nitrous Oxide-BGC .47 MAC 1.6 30X more soluble then NO in blood More beneficial if used with volatile agent like halothane, enflurane ETC MUST GIVE 100% O2 END OF SX TO PREVENT DIFFUSION HYPOXIA CAN CAUSE CARDIA DEPRESSION OVER LONG PERIOD\>\>BONE MARROW DEPRESSION

Answer 275

**1-**1Segmental pneumatic plethysmography **(l**arge vessel wall reactivwly ro pulsa**)** ## Footnote **2**-Segmental pressure **(i**ndicated presence of normal to decreased heads of pressure, depending on the degree of stenosis**)** **3-**Doppler isolation of arteries **(**demonstrate normal dynamic flow VS aberrant eddy current ditsal to thrombic lesion**s)** **4-**Digital photocell plethysmohraphy **(**demonstates pulsatility of end arteriole comprimising the glomus in the pulp of the toe**)** **5-Di**gitial pressure **(**asses the head of pressure in the digital arteries**)** **6-**Thermography, skin thermometry and percutaneous oximetry (reflecs the degree of cutaneous perfusion

Answer 276

22-25 degrees

Answer 277

da**N**gthrapist _Restless leh syndrome"Ekbom's Syndrome_ **_D_**ecrease Zinc and folate, Vit B12 neuropathy **Clinical-**persistant urge to wiggle and associated with fibromyalgia Uncomfortable, crawling, painful grabbing sensation--Primary in L.E. Can also have **PLMS-** painful limb movement sleep _**TX-Dopamine agonst Pergolide (**antiparkinson drug)_ BZD (valium)/anticonvulsabt/opoids/dopaminergic that work on cns may help

Answer 278

osteochondral autograft transfer system

Answer 279

Itraconazole (sporanox) Ketoconazole(Nizoral) Amphorericin B (Abelcet, Fungizone) Terbinafine (Lamisil) Griseofulvin Gentain Violet

Answer 280

1-baby supine, hips and knees flexed at 90 degrees 2-grap baby thigh with middle finger over greater trochanter and lifting and abducting the thigh while stabilizing the pelvis and opposite leg witht he other hand + when a palpable click is felt as the femoral head is made to enter the acetabalum

Answer 281

OSTEOCHONDROSIS OF THE TIBIAL TUBEROSITY CAUSES BY EXCESSIVE TRACTION OF THE PATELLAR LIGAMENT SELF-LIMITING

Answer 282

s a condition that develops in joints, most often in children and adolescents. It occurs when a small segment of bone begins to separate from its surrounding region due to a lack of blood supply \*\*most comon femoral condyle

Answer 283

**1- Riley-Day Syndrome AKA Familail Dysautonomia**- indifference to pain Ashkenazi jews, high breech presentation//weak absent suck and poor tone emotional, **self mutilation,** absent or hyporeflex DTR **2-Rousy-Levy Syndrome-Hereditary arcreflex dystasia** form of frust CMT- pes cavus, Absent DTR,**POSITIVE ROMBERG SIGN-(**balance with eyes closed) **3-Friedreich Ataxia AKA Spinocerebellar Ataxia**- most common inherited ataxias, involving, spinocerebellar and corticospinal tract, post column D/T protein Frataxin decreased (CNS,heart,pancrease) have abnormal high iron in cardiac tissue\>\> react with O2 to produce free radicals Slowly progressive scoliosis in thoracic region **LE Finding-** feet cavus, wide unsteady gait..absent DTR, +romberg sign shin ataxia\>\>**Cardiac failure** **4-Dejerine-Sottas-Progressive hypertrophic polyneuritis** paresthersia and lightning-like pain in extremities\>\>\>\>wheelchair confined **Clincical-**all sensory modalities affected, stocking glove distribution ie: light touch & pinprick\>\>+Romberg//like CMT slow progressive weakness reflex diminished **TX**-Accomodative

Answer 284

Shuffling with short, hurried steps

Answer 285

Loss pf dopamine neurons from substantia nigra 55-60 Yo **Classic**=rigidity, bradykinesia and disturbance in gait **PILL ROLLING RESTING TREMOR** **AKINESIA- LACK OF POVERTY OF MOVEMENT AND COGWHEEL RIGIDITY** **FESTINATING GAIT** **BRADYKINSIA-SLOWNESS AND FATIGUING OF VOLUNTARY MOVEMENT** **ALL SYMPTOMS PROGRESS TO MASKED FACIES** TREATMENT:LEVODOPA COMBO LEVODOPA & CARBIDOPA (Sinemet) Dopamine agonist, AMANTADIN, Anticholinergics COMT inhibitor which inc/ entacapone & tolcapone\>\>breaksdown levodopa in periphery and may increase CNS delivery of dopamine

Answer 286

Austin Reverdin Reverdin Green Reverdin Laird Reverdin Todd Peabody Hohman Drato Ludloff

Answer 287

**Babinski sign-** \<2 yo, stropke lateral prox to distal\>\>\>+ extension/dorsiflex of great toe with flex fanning toes Normal\>\>In adults the hallux moves up slow response plantar withdrawal response to that of tickling **Chaddocks Sign**\_ stroke lateral foot about lateral malleoli moving distally\>\>extension of hallux **Oppenheim Sign-** use thumb and index finger as caliper to squeeze tibial creat\>\>hallux extends if deficit cause pyramidial tract **Gordon Sign**- squeeze posterior calf\>\>hallux extends and dorsiflexs **Rossolimos Sign- tap** balls or distal pulp of toes\>\>_++ if toes Plantar flex_

Answer 288

Ostiderm roll on Xerac Drysol Bromi-lotion Dr Scholl's antiperspirant

Answer 289

Sharp and generalized Varies Inflammation between the visceral and pericardium **Treatment**-Sitting up and forwrd

Answer 290

Sedation\>\>no analgesia\>\>RELIEVE APPREHENSION MINIMAL RESP DEPRESISON CAUSTION IF PT HAS PORPHYRIA (DECREASE HEME)

Answer 291

1-1.5cm medially

Answer 292

**DANGTHRAPIST** ## Footnote 1-Diabetic peripheral neuropathy 2-Alcoholic 3-Nutrional 4-Guillame-Barre Barre 5-Toxic 6-Herditary 7-Reccurrent 8-Amyloidosis 9-Porphyria 10-Infections 11-Systemic 12-Tumors

Answer 293

CMT 1- demyelination form, degeneration of post colunm of spinal cord ## Footnote loss anterior horns and degeneration spinocerebellar tract Slow nerve conduction velocities CMT 2-neuronal form by axonal degeneration of peripheral nerve Male\>\>\>female **Clinical**-muscle atrophy symtrical and distal: peroneals and intrinsic muscles of the feet 1st\>\>lose ability to evert becasue invertors mechanical advantage. Cavus type foot Early sym varus and high arch with atrophy TA,EHL,EDL\>\>cavus& clawing **Finding:** plumb thigh, slender legs "ostrich or stork" **Inverted chanpagne bottle**

Answer 294

Detect deep vein valvular incompetence Place tounaquet mid thighelevated leg 60mm to occlude superficial venous flow patient walks to asses muscle pumping function of deep veins **Competent valves-** blood flows thru deep veins back to heart **Valve incompetence-** blood reflx thru incompetent commicators to superficial and enlarges below tournaquet If patient feels pain on walking, could be deep venous claudication

Answer 295

**Transverse plane**-abduction FF on RF **Frontal Plane**=RF eversion with decrease 1st met declination angle **Sagittal plane**-sagging midfoot-Nav-cuneiform breech//TDA increase

Answer 296

**1st** immediate and seen in a few seconds **2nd** is blood pool phase 2-5 minutes and represents regional blood flow **3rd** delayed or static and can take 2-3 hours and represents bone uptake and urinary excretion

Answer 297

3-4.5 controlled by parathyroid hormone intracellular PTH\>\>Increase Ca\>\>increae resorption Ca from bone\>\>suppress loss into urine **Hyper**-Tissue trauma(hemolysis), burns, renal failure, healing bone **Hypo**-Vomit N&D, Diuretic, starvation Serum calcium and phosphorus\>\>\>dependant greatly level of PTH

Answer 298

frontal and transverse

Answer 299

Abductor hallucis( medial plantar Nerve) Flexor digitorum brevis( Medial plantar nerve) Abductor digital minimi(Lateral plantar nerve)

Answer 300

Sharp pain associated with respiration **Location-**Generalized **Time**\>15 minutes **Causes**-can be seen-pneumonia **Treatment**-Control infection

Answer 301

Polyarteritis nodosa (PAN), is a systemic necrotizing inflammation of blood vessels (vasculitis) affecting medium-sized muscular arteries, typically involving the arteries of the kidneys and other internal organs but generally sparing the lungs' circulation

Answer 302

**Polymyositis** is a type of muscle disease called an inflammatory myopathy. It inflames your muscles and their related tissues, like the blood vessels that supply them. It can cause muscle weakness Eventually, people with polymyositis have trouble when rising from a sitting position, climbing stairs, lifting objects, or reaching overhead.

Answer 303

serial casting weekly percutaneous tendoachiles tenotomy once corrected abduction foot orthotics 12 weeks then at night until age 4 Complication= metatarsal adductus heel varus pes plano-valgus rockerbottom foot AVN or talar head flatening because infant connetive tissue stronger then bone Navicular subluxation

Answer 304

pain hemorrahage hernia

Answer 305

Vibratory sensation proprioception

Answer 306

**POSTERIOR** ## Footnote reflic origin abductor hallacis and plantar fascia z-plasty achilles tendon release posterior , medial and lateral ankle joint release posterior, medial and lateral STJ,--posterior talofib and calcfib lgts are severed **MEDIAL RELIEASE** Z-PLASTY OF PTT, SO SPRING LGY AND HENRY KNOT IS SEVERED release entire medial STJ, inc/ superficial deltoid **Lateral release** thruSTJ release interosseous talocalc lgt release bifurcate lgt and release lateral STJ

Answer 307

3-12 cm above the medial malleolus

Answer 308

**3.5-5.5** ## Footnote Major intracellular and only 2% total body K is extracellular **Decreased-**-lead to arrythemia, depressed T wave High-N&V, dehydration, Mulpiple myeloma and malignancy Increased and decrease\>\>profound effect NMS\>\>apathy, weakness,paralysis,MI When hypo\>\> exam serum bicarbonate

Answer 309

Distinct marker for protein synthesis

Answer 310

using pain killers and nerve blocks pre-op to decrease pain post op

Answer 311

**Barbituates**- Pentobarbital(nembutal) Secobarbital (seconal) **Benzodiazpines/Sedative hynotic** Diazepam (valium) Lorazepam(ativan) Midazolam (versed) **Narcotic/Opiods** Morphine Meperidine (demerol) 1/10morphine Fentanyl (100x more potent then morphine **Anticholinergic(belladona derivative)** Atrophine sulfate (inhib parasympath-blocks ACY) Scopolamine Glycopyrrolate

Answer 312

1-**Sedatives**- (anti-anxiety/hyponotic) **Diazepams** (valium)--sedation and amnesia. Can be given PO 1-2 hr before Sx(5-10mg) **Lorazepam** (ativan) 1-2 hours pre surgery 2-4mg **Midazolam** (versed) pre-op +/or induction agent. Rapid onset with short duration when IV works w/n 5 minutes. effect last between 1-6 hours **Hydroxyzine** (vistaril) sedative primary, also anti-histaminic, antiemetic and bronchodilator. Good premed **2-Anticholinergic (Belladonna)-** **Atropine**-before anesthesia to decrease resperation secretion. Keep heart rate normal during. prevents asystolic and bradycardia in presence of halothane and vagolytic agents **Scopolamine**-Used as a preanesthetic because it produces mild respiratory stimulation and it inhibits salivary secretion. In reversing paralysis it is used to reduce parasympathetic hyperactivity.

Answer 313

Purpose: 1-Reduce anxiety 2-Produce some sedation/amnesia 3- Reduce gastric PH as well as volume 4-Reduce bronchial secretion 5-Prevent N&V

Answer 314

**_1-Lateral fenoral cutaneous nerve L2,L3_ SENSORY** 1st sensory nerve of lumar plexus- supplies skin lateral/anterior thigh, Posterior branch\>\>lat/posterior thigh **2-Femoral Nerve L2, L3 &L4 SENSORY AND MUSCULAR-exits**vertebral canal\>\>inervates psoas & iliacus **Sensory branches**\>\>ant/medial thigh medial calf **Muscular branch\>**\>pectineus,sartarius and quad femoris **Movements:**Iliopsoas\>\>hip flexion\>\>flexion of thigh:quad femoris\>\>\>extend of leg at knee **3-Saphenous N-** largest and longest sensory branch femoral nerve\>\>innervate skin medial thigh, leg and foot _course_\>\>accompanies femoral AA in femoral triangle, descends and divides medially under sartorius muscle\>\>terminal with greater saphenous VV\>\>medial calf at medial malleolus to medial foot\>\>1st MPJ Entrapped as it exit subsartorial canal **(Hunter's canal)** proximal to knee\>\>no motor weakness b/c its sensory **4-Obturator Nerve** (L2,L3,L4) _SENSORY AND MOTOR_ **Anterior branch\>**adductor longus, brevis and greacilis **Posterior branch**-obturator externus and 1/2 adductus magnus **Sensory fibers**-cutaneous sensation upper medial thigh & anastomose with Saphenous N **Movement**\>\>adductor longus,brevis and gracilis _(INTERNAL ROTATES LEG\>\>\>adduct thigh_ _Obturator externus\>\>external rotates thigh & 1/2 adductor magnus muscle\>\>adduct, flex&extend thigh_

Answer 315

Triple Arthrodesis

Answer 316

6-8 ## Footnote Albumin is a protein in liver that halps maintain normal distribution of water in body and transport blood constituents Total blood mostly refers to Albumin 50-60% Non-Albumins is referred to a globulin A/G ratio diagnosis condition multiple myeloma (Bence-Jones Pr) Increased= elevation of globulins as collagen Vascular DZ Total Protein= 3gm globulin + 4gm Albumin====7 gm total protein

Answer 317

Entrapment medial and lateral branch ribial N, under lacinate Lgt (flex retinaculum) **Anatomy** NVS passes thru lacinate lgt **Vascular-**med & post tibial N well supplied with AA. Regenerate well and susceptible ischemic injuryor aa insuffiiency\>\>\>TARSAL TUNNEL SYNDROME **_BIOMECHANICAL_**-compression medial & lateral plantar Nas they enter foot/seen with enlarged ABH bellies or osteophytic spurring of medial arch\>\>pronation syndrome\>\>extreme PF & adduction of talus during ambulation enlarged navicular tuberosities D/T osseous impingement of insertion PTT **Clinical**\_ Buring, tireness in foot, pain totates proximally==**VALLEIX PHENOMENON** REPRODUCEWITH PERCUSSION OF PTT NERVE AT LEVEL OF LACINATE LGT **DX: ELECTRO-DX** distal latency (millisec) greater latency value distal latency medial N abnormal\>\>6.1 lateral plantar nerve abnormal\>\>6.7 PTN stim just proximal to lacinate lgt ABH muscle for Medial plantar Nerve and Abductor digit quinti to test Lateral PLantar N

Answer 318

11-16 seconds measure extrinsic Increased Vit K def//Biliary obstruction//Liver disease//**Coumadin** tx//deficiency in extrinsic or common pathway factors

Answer 319

25-35 # of seconds to clot Intrinsic pathway--M 3 stages of coagulation except factor VII Increased- Hemophilia A factor VIII Hemophilia B Christmas tree ( Factor IX Von Willebrand DZ DIC Deficiency in intrinsic pr common pathway factors Liver DZ Heparin TX

Answer 320

PATHWAY TO SPINAL NERVE ROOTS AS EXIT SPINAL SOLUMN THRU VERTEBRAL FORAMINA DISC HERNIATION, DEGENERATIVE JOINT DISEASE AND OTHER ARTHRITIEED AFFECTING THE SPINE ACUTE TRAUMA

Answer 321

high frequency electromagnetic radiation due to the use of wireless equipment, devices and data transmission.

Answer 322

Lateral view-witha second the foot plantarflexed showing the talo-navicular relationship doesn't change Navicular not evident on x-ray until age 3 line bisecting the talus is parrallet to the tibia TC angle on A/P is increased to \>\>40 degrees Talar neck hypoplastic may have hourglass shape and flat surface Navicular articulates witht he dorsal talus Negative hubscher maneuver

Answer 323

**Phenomenon** is episodic digial palloring with paresthesias, followed by cyanosis and finally presenting with rubor and warmth with thrombing sensation **Syndrome**- repeated presentation of phenomenon under coldness or anxiety and associated with collagen disorder **Disease**-trilogy of colors ass/ symptoms noted for 2 years without definition of underlying collagen disease

Answer 324

Male 5.4- Female 4.8 Provides info about HGB content and size of RBC **Mean Corpuscular Vol**= **Normocytic** -82-92//**Macrocytic**//95-150//**Miccocytic**-50-80 **Mean Corpuscular HGB**= **Normocytic**-25-30//**Macrocytic**//30-50//**Microcytic** 12-25 **Mean Corpuscular HGB Concentration**= **Normcytic** 32-36/**Macrocytic**-32-36//**Microcytic** 25-30 **Microcytic Anemia**\<\<\<\<80 is iron deficiency, Thalasemia, blood loss, poisoning **Normocytic Anemia**-(80-100) isChronic DZ, Bone marrow failure,,hemolysis **Macrocytic Anemia**(\>\>\>100 is Folate acid & Vit B12 def, Liver DZ, drugs like phenytoin

Answer 325

infusion-related reaction peculiar to **vancomycin** [3]. It typically consists of pruritus, an erythematous rash that involves the face, neck, and upper torso. Less frequently, hypotension and angioedema can occur.

Answer 326

(hereditary motor sensory neuropathy type IV, heredopathia atactica polyneuritiformis) is an autosomal recessive disorder the clinical features of which include retinitis pigmentosa, blindness, anosmia, deafness, sensory neuropathy, ataxia and accumulation of phytanic acid in plasma- and lipid-

Answer 327

Osteochondritis of the tibia sesamoid

Answer 328

Diameter **X** Velocity**X**Density**/**Viscosity is the ratio of inertial forces to viscous forces within a fluid which is subjected to relative internal movement due to different fluid velocities. A region where these forces change behavior is known as a boundary layer, such as the bounding surface in the interior of a pipe.

Answer 329

**ErythrocyteSedimentation Rate ESR** RBC settle out of unclotted bld Increased\>\>\> Infection, R.A Maignancy..A.S.Acute gout Inflammation, Septic OA metastasis **C-Reactive Protein \<** Rises before ESR and normal after NSAID,ASA Steroid produced during acute imflam phase Increased RA, Strep Infection **ANA** appears month after connective tissue DZ More accurate then LE Cell test\>\>unaffected by steroids Lupus.99///Scleroderma\>\>73 RZ\>\>60...Sjogrens.43 **Uric acid 7-9 males** Increased in gout, malignancy, renal DZ, familial hyperuricemia _MARTINI SIGN--MONOSODIUM URATE CRYTALS NEEDLE SHAPE_

Answer 330

osteochondritis of the fibular head

Answer 331

**1A**- Fx of the medial tuberosity **1b**-Fx of the sustentaculum tali **1C**-Fx of the anterior process -mc of avulsion fx of the bificate ligament

Answer 332

2A- Beak fx no ACH involvement 2B-Avulsion tx of Tendo achilles NO INVOLDE THE STJ

Answer 333

**Type 3**-extraarticular oblique fx of calcaneal body not involving STJ

Answer 334

Type 4-Fx involving STJ w/o joint depression or comminution

Answer 335

Type 5-comminuted fx of STJ w/ central or severe depression

Answer 336

**Type Ia** - tuberosity fx; beak/medial avulsion fx, vertical/horizontal body fx. (Rowe types I and II) **Type Ib** - calcaneo-cuboid joint involvement **Type IIa** - undisplaced STJ fx, secondary fx line exits posteriorly through calcaneus. **Type IIb** - displaced STJ fx, secondary fx line exits dorsally through calcaneus and a fragment dislocates.

Answer 337

Talo--1st met angle\> 15 & talo-calc angle \< 15= TN dislocation

Answer 338

a femoral torsion angle of 10 degree in a 6 year old female.

Answer 339

**Superior L4,L5, S1** (Muscular)- innervate gluteus medius, minimus and TFL **Inferior Gluteal L5,S1,S2**-gluteus maximus _Superior gluteal_ Abducts and internal rotation thigh _Inferior N_\>\>extension,abduction and external rotation of thigh **Sciatic Nerve**-L4,L5,S1,S2\> MOTOR\>\>peroneal component short head bicep femoris and portion add magnus, tibial branch to post thigh, hamstrings\>\>\>**\>SCIATICA\>\>**\>PAIN DOWN LOWER LIMB **TIBIAL NERVE-(POST TIBIAL)** **sensory & motor-** bifurcates w/n popliteal fossa\>\>medial popliteal N\>\>tibial _motor innerv_ muscle superficial/deep sural muscle **(grastroc/soleus)** _superior_ 1/2 motor to deep post group :ie Tibial posterior, FHL,FDL enters foot between medial malleolus and flex retinaculum under the reticulum splits to\>\>\>medial and lateral plantar Nerves after giving off 1st small calcenal branch **Medial Plantar N\>\>with medial plantar AA\>\>motor 4 muscles (LAFF), ANH,FDB,FHB,1st Lumbrical** **Cutaneous innv medial distal 2/3 plantar foot, plantar digits 1-3 & medial 4th digit** **Lateral plantar Nerve- lateral to heel and lateral plantar surface** **innerv\>\>all other intrinsics &motor innerv sensory lateral aspect of sole & lateral 4th & entire 5th toe**

Answer 340

transverse

Answer 341

**Lowman**- Plantarflex T-N wedge arthrodesis with TAL and TA tendon rerouted under the navicular **Cotton-**Open dorsal wedge 1st cuneiform transplanting TPT under the navicular **Hoke**-Plantar based wedge arthrdesis of the nav-& medial cuneiform perform TAL **Miller-Nav-**1st cuneiform and 1st metarsal fusion PTT and spring Lgt advanced using an odteoperiosteal flap **Young (keyhole technique)-** reroute the TA tendon thu keyhole in the navicular

Answer 342

S.A.L.T. ER

Answer 343

S.A.L.T.ER

Answer 344

Elevate LE, arteriole rubor to palor pedal skin, while venogenic dependent rubor convert to normal coloration

Answer 345

number and position of the posterior facet fracture line on a coronal section

Answer 346

Branch of the femoral Parallels the great saphaneous vein Gives off branches to the medial crural nerve

Answer 347

from the femoral and it is the only branch branches to the medial crural nerves'

Answer 348

**Cortical**-fully threaded fine threads with small pitch to anchor the cortical bone **cancellous**-partially threaded (historically), usually lag. threads are coarser with hugh pitch inted to engage medullary bone

Answer 349

Series of enzymatic protein cobine antigen-antibody complex and effect lysis when antigen is an intact cell **ASO-Anti-streptilysin**-AB against streptolysin O and group A Strep 80% acuteR\>F\> or other strep infection **HL-A\_B27-**90% A.S\>//Reiters 75%//P.A &Juveline RA **HL.A B15-**33%. in SLE **Calcium Pyrophosphate-** crystals are rhomboid

Answer 350

Osteochondrosis of the calcaneus cause by excellive traction of the achilles tendon 6-12 years old more common with equinus radiograph are difficult TX- Rice NSAIDS, eliminate sports, heel lift, achilles stretch exercise

Answer 351

10-50 When heart or liver damage, SGOT spills into blood and the amount is directly related to the damage cells More specific for cardiac necrosis **INCREASED**- MI,Liver(HEPATITIS) disease DZ, Skeltetal muscle, after strenous exercise **DECREASED-U**ncontrolled DM, Beriberi Bone disease wont cause elevation AST

Answer 352

10-50mu High in hepatitis and after strenous exercise **Found** high concentration in **liver**\>kidney.\>heart catylyzes amino group between alanine & alpha ketoglut Bone disease wont cause elevated levels of ALT

Answer 353

line from femeral neck to obturator foramen witrh hip dislocation, obturator foramen is too low

Answer 354

Simon rule of 15 talus, calcaneus and 1st metatarsal longitudinallt bisect on A/P xray in max corrected position clubfoot talo-calc angle \<\<15 Talo-1st metatarsal angle \>\>15

Answer 355

1-Adducted forefoot 2-normal midfoot 3-valgus hindfoot 4-Increase calc-cuboid angle (norm 0-5) usually acquired from comp of a metatarsal varus, develops with wt. bearing or inproper manipulation and casting

Answer 356

A 12 year old obese male who was sitting with his left leg externally rotated rises and begins to walk. His gait remains severely externally rotated on the left side with a trunk-shift limp to the right side.

Answer 357

group 1- Transchondral or compression FX to talar dome including osteochondritis dessicans

Answer 358

Coronal, sagital or horizontal shearing fracture of entire talar body Cause-severe DF with compression forces when talus is sandwiched b/t tibia & calcaneus **Type 1** Coronal or sagittal fx- **1a**-non-displaced **1B**-displace of trochlear articular surface **1C**-displacement of trochlear art surface with STJ discloca **1D**-total displacement of talar body with Displace STJ/AJ **TYPE 2 horizontal FX** **2a-**non-displaced fx dividing talar body into sup/inf halve **2b**-displaced fx superior portion shifts on inf halve

Answer 359

fracture posterior tubercle(**most common)** **d/t** severe plantarflex force (DDX steida process or shepaers fx, os trigonum) pain posterior ankle causes limited rom reproduced on FHL movement

Answer 360

Fx lateral process of talus **2nd most common talar body fracture** **AKA** Snowboard FX eversion injury with lateral process caught b/t fibula and calcaneus

Answer 361

Crush Fx Comminuted of talar body

Answer 362

NA 135-145 Major cation in extracellular fluid maintains osmotic PP in acid-base balance Low-Dehydration, cushings Dz High-Severe burns, N&V, excess IV, Addison DZ/ CHF Convulsion&seizures\>\>Traid of low NA, Low HCT, Low BUN ADH-Arginine vasopressin-tells kidneys how much water to conserve

Answer 363

wedge shape

Answer 364

Both, requires lower volume of anesthetic agent than epidural anesthesia and difficult to control the level of anesthesia are correct.

Answer 365

Incomplete closure of 1 or more vertebral arches only L5 &S1

Answer 366

**NERI'S SIGN**-TAKES SMALL STEPS WITH KNEE SEMI-FLEX TO PREVENT STRETCHING OF N ROOT **Minors Sign**- patient rises from seated position, pt places wt on unaffected side with one hand on his back Lumbar lordosis or thopracic kyphosis **Pseudoclaudication**-relieved by flexing spine **Straight leg raise test**- supine and hip passively flex with knee in full extension, should be non painful **Lasegues Test-**reproduce pain when patinet leg is elevated less then 30 degree and foot DF **Bowstring**-to differentiate lumbosacral ilian pain--patient supine in full extension, if nerve pain when knee is flexed pain goes away **Gaenslens Test-** DDX lumbosacral from sacral ilian pain- patient supine with 1 leg in full extension and the other is lowered off the sideof the table, the twisting of the pelvis causes sacro-iliac pain **Valsalva Manuever-**DDX space occupying lesion or herniated disc; b/l compression of jujular vn results in increase intra spinal PP and reproduces radicular pain **EMG Studies**

Answer 367

Ankle set 90 degree various neuromuscular disorder may cause equinus

Answer 368

Avg axis position to sagittal plane= 16 degrees Avg axis position to the transverse plane = 42 degrees

Answer 369

infARCTION resorption revascularization remodeling

Answer 370

1-Conduction eficit without axonal destruction 2- Axon is severed without reaching neural tube.(Wallerian degeneration) with regeneration 3-Degeneration of axon with destruction of fascicle with irregular regeneration 4-Destruction of axon and fascicle and no destruction of nerve truck 5- Complete loss, neuroma likely and spontaneous recovery is rare

Answer 371

Common peroneal nerve within the tunnel of the P.L and neck of the fibula upper part innervate the P.L. and PB supplies most of anterior skin to ankle and dorsum

Answer 372

AKA Musclulo-cutaneous N (SENSORY. MUSCULAR INNERVATED PL AND PB\>\>EVERT AND PF DESCENDS INF BETWEEN PERONEAL MUSCLES\>\>INFERIOR INTO MEDIAl and INTERMEDIATE DORSAL CUTANEOUS NERVE (**SENSORY** BRANCHES\>\>ANT AND EXT RETINCULUM SUPPLY ANT-LAT ASPECT OF LOWER 1/2 LEG AND DORSUM OF FOOT & TOE **MOST COMMON NERVE INJURY TO FOOT** **injury and entrapement**-exits the fascia w/c the calf approx 10cm about the lateral malleolus. Intermediate dorsal cutaneous N (LAMONTS N) couring just medial to the sinus tarsi; severe inversion injuries\>\>\>\>stretched Nerve & injury **DX-1-** LOCAL INFILTRATE REPRODUCES TO CONFIRM WITH FOOT DORSAL FLEX AND EVERT AGAINST RESISTANT **DX 2**- PASSIVE FOOT PF ABND INVERSION PLACING NERVE ON STRETCH **DX 3**- DIRECT PERCUSSION FOOT HELP PF AND INVERSION 2-

Answer 373

Divides into (2)medial and intermediate (1) dorsal cutaneous nerve medial dorsal cutaneous nerve divides into 2 dorsal digital Nerve-1-**Medial proper dorsal digital nerve to the hallux(skin)** **2-Common dorsal digital nerve**-innervates skin 2nd & 3rd toe **3-Intermediate dorsal cutaneous nerve**-splits into 2 digits nerve 3rd & 4th IDS

Answer 374

From medial sural nerve (tibial) and sural commincating branch (common peroneal) ## Footnote orgnates from inferior popliteal fossa b/t bellies gatroc\>\>inf & distally,post fibular malleolus Cutaneous Innervation\>\>post-lateral distal leg/ lateral aspect of foot Terminal branches..divides lateral and medial\>medial supplies cutaneous innervation to dorsal skin of base 4th metatarsal; communicated with intermediate dorsal cutaneous nerve **Terminal branch of the sural nerve most accessible sensory nerve of the foot and NERVE OF CHOICE\>BIOPSY** **INJURY AND ENTRAPMENT-**ANKLE IS MINIMAL SENSORY DEFICIT

Answer 375

Strictly cutaneous Forms in leg by combining branches tibial and common peroneal Nerve Medial sural cutaneous branch is branch of tibial nerve Sural comminicating branchof the peroneal N at fibula head As Sural enter the foot\>\>lateral dorsal cuntaneous nerve0

Answer 376

1- Medial hockey stick 2-Cincinnati incision

Answer 377

natural fibers

Answer 378

BASAL GANGLIA DISORDER Major Dx R.F. Can occur up to 6 months following Group A beta-hemolytic strep infection Indication to intiate prophylactic antibiotic therapy to prevent subq development of other manisfestation of RF **Clinical**-aimless involuntary movement, impaired coordination and muscular weakness with reduced muscle tone. Movements are worse when trying to repress **Treatment**-Phenothiazine or haloperidol can control the chorea anti-microbial tx Penicillin or erythromycin if pen allergy Usually resolves 3-6 weeks

Answer 379

- Material: no difference between stainless steel and titanium - Size: No difference between 3.5 and 4.5. 4.5 easier to remove but also causes greater irritation - number of cortices: 1 screw across 4 cortices will have higher chance of fracture. 2 screws across 3 cortices have better stability, better physiological movement - When to remove: at 3-4 months - Side effects: limitation of ankle ROM, broken screw, pain , screw removal, syndesmosis diastasis.

Answer 380

6.5 mm screw & K-wire posterior to anterior

Answer 381

Idiopathic, Positional, Syndromic,Terotologic

Answer 382

2% usally asyptomatic if painful usually around 3-5 y.o. CC: bump pain from shoe pressure Lateral x-ray shows absence of Cyma line **TX-** correct medial prominence

Answer 383

45% and almost all the middle facet starts around 12-14 y.o. pain usually over the sinus tarsi decrease ROM STJ and MTJ **X-RAY-** Lateral and Harris-beath best views TC on lateral C sign or halo sign _(this C chape is a line formed from medial outline of talar dome and inf outline of Sust tali._ thiis C shape is specific May be absent STJ middle facet and diminished facet Talar beaking Medial oblique- shortening talar neck/ dysmorphic sust tali (or ovoid shape) Talus in ankle mortise more rounded (ball and socket)

Answer 384

abnormal bridge bewteen tarsal bones 1% AND 50% ARE BILATERAL most common cause of peroneal spastic flatfoot, secondary to spasm of STJ Males\>\>\>females TC=CN and account for over 90% **CT scan is gold standard** TX- conservative by decrease motion of inv/ joints with shoe modification or braces, casting , splints, RICE & NSAIDS

Answer 385

Flexor retinaculum medial/posterior calcaneus and posterior aspect of the talus Distal tibia and medial malleolus-anteriorly

Answer 386

used to detect a wide range of conditions including injuries, infections, tumours, heart disease, thyroid abnormalities, kidney conditions and also to guide some cancer procedures. ## Footnote HMPAO-hexylmethyl propylene amids Oxide 1/2 life is 6 hours

Answer 387

Week one is characterized by edema, erythema, and callus formation. b. During week two, vascularity and fibroblastic proliferation continue. c. Gentle range of motion exercises starting in week 3 will lead to increased strength of the tendon. d. Passive range of motion exercises during week 4 helps realign the collagen fibers to allow optimum strength

Answer 388

**Hubcheur Manuever**-PF 1st ray will cause STJ to supinate and re-create arch if flex **Trunk Twist**- STJ flexibility for supination and pronation **Jack test-**Pt on heels, heels will invert, check the PT tendon

Answer 389

caused by toxin Clostridium tetani--affect CNS Spore\>\>release bacteria\>\>multiply and produce\>\>neurotin\>\> **Tetanospasmin**

Answer 390

paratenon, epitenon

Answer 391

Uniaxial, triplanar not pronatory/supinatory

Answer 392

is a broad framework that describes how the entire research project is carried out. Basically, there can be three types of research designs – exploratory research design, descriptive research design, and experimental (or causal) research design.

Answer 393

Plantarflexion of the 1st metatarsal during 1st MTP dorsiflexion

Answer 394

Osteochondritis epiphyseal ossification center of the phalanges

Answer 395

Rupture of the Achilles tendon

Answer 396

Sharp, Costochondritis, tender at pressure points **Location**-Chest wall **Time**\>days to weeks **Causes**\>Inflam of costoconfral joints **Treatment**-Benign, assoc with aniety

Answer 397

avulsion fracture of the tibia from the AITFL

Answer 398

\>55mm Hg Healing 45-55 Hg Range of uncertainty \<45 No wound healing NEED AT LEAST 30MM HG REQUIRED FOR HEALINH OF A WOUND ON THE DIGIT

Answer 399

Efinaconazle (jublia) tavaborale (Kerydin) Ciclopirox (penlac) Tolfanate (Formula 3) Underclenic (Tineacide) Tolcylen

Answer 400

Common pediatric fracture at the transitional zone between the metaphysis and diaphysis

Answer 401

6-8 ## Footnote Formed in liver to maintain normal distribution of water **(** colloidal osmotic pp**)** and transport bld constiuent Usually referred to Albumin because bld protein 60% albumin Non-albulmin referred to a globulin A?G ratio A/G ratio diagnosis multiple myeloma/(Bence-Jones protein is a globulin) **Increased-**Hyperproteinmia,N&V,Mutiple myeloma/Malignancy **Decreased-**Hypoproteinemia//chronic liver DZ//Severe burns Total protein**=**3 gram%globulin+4gm%albumin=**=**=7gm total

Answer 402

dang**T**hrapist ## Footnote **Heart and HBP**-Amiodarone Hydralazine perhexilline **Fight cancer**: Vincristine, Cisplatin **Infetions**:Metronidazole (flagyl) Nitrifurantoin, Thalidomide (leprosy) IND (isoniazid),(TB) **Skin conditions**-Dapsone **Antoconvulsants** -Phenytoin **Anti drugs and alcohol**-Disulfram **Fight HIV-**Zisovudine(retrovir,AZT),Didanosine (Videx) Stavudine (Zerit) Zalcitabine (Hivid) Ritonavir (norvir), Amprenavir (agenerase)

Answer 403

**1-Arsenic-**cause whitr striae on nail\>\>Mees band ## Footnote **TX**-BAL chelating agent **2-Barium**-can lower lserum K\>\>clinical paraylsis **3-Lead**-vasculopathy-edematous fluid surrounds abnorm permeable capillary **S/S** convulsice seizures **4-Mercury-3 forms** 1- Inorganic salts and 2 metallic\>\> **S/S**=neurological comp **Mad Hatter Syndrome** include tremors, personality tremor of the limb 3-Organomercurial exposure\>\>paresthesia limbs, visual, dysarthria tremor, incordination large expsure could be permanent TX:BAL and EDTA for chelation **5-Lithium** **6-Manganese** - rigidity and hypokinsia can manage with L-dopa **7-Urate**

Answer 404

**Evans**-open osteotomy of calc 1.5cm to CCjoint with insertion of bone graph **Kidner**-remove prominent nav tuberosity and transplant TPT underside of navicular

Answer 405

**Evan's**-calcaneal osteotomy 1.5cm proximal to the C-C jt with insert bone graph to lengthen lateral column and put PT on stretch to increease supinatory motion **Kidner**-removal prominant tuberosity(acc navicular) transpose PT plantar **C-C Joint distraction arthrodesis**

Answer 406

Inserted posterior lateral to anterior medial, inserted 2-3 cm above the syndesmosis, and inserted with the foot neutral to slightly dorsiflexed

Answer 407

Immediate ORIF and Closed reduction followed by ORIF when patient is stable

Answer 408

Increase the deformity, distract the toe, then reduce the deformity.

Answer 409

Rigid glucose control **Superfical Nerve pain**-Capaicin **Deep Nerve pain**-tricyclic anti depressants (amytriptyllene) or anti seizure (gabapentin) Tegretol (anti-seizure) Gabapentin-(post-herpectic neuroligia req titration) OD- dizzyness and Drousy Neurontin-900mg///300mg//600\>\>\>900mg Amytrptiline if neurontin doesn't work

Answer 410

a. Restoration of fibula length b. Anatomic reduction of articular defect c. Bone grafting of metaphyseal defect d. Medial tibial buttress plating e. All of the answers are correct

Answer 411

**DDX deep and superficial venous incompetence** Elevate leg to empty venous Tounaquet upper thigh 30-60mm Hg to occlude superficial venous flow Then stand-if varicosities fill within 20-30 seconds\>\>deep and perforation disease is present If varicositie promp return\>\>\>superficial system

Answer 412

Osteochondritis of the fibular sesamoid

Answer 413

cables around waist inside pant leg CONTROLS DEGREE OF ABDUCTION AT HEEL CONTACT TREAT SCISSOR GAIT OF CP PATIENTS

Answer 414

Axial compression fracture with an oblique pattern from dorsal-lateral to plantar-medial

Answer 415

Inhalation agents ## Footnote **Chloroform**-rapaid induction/recovery, nonflammable, good muscle relaxation _Disadvant_\>not in use, myocardial depresion, hepatoxic **Diethyl ether-** reliable anesthesia depth-resp stimulated, bronchodilator, circ not depressed, goof muscle relax _Disadv_\>not in use-prolonged induction, flammable and explosive N.O.- little effect of HR myocardial contractility,resp,BP, liver or kidney metabolism VERY HIGH MAC DISADV\> LEAST POTENT 100%\> MUST BE GIVEN AT ERMINATION OF SX TO PREVENT DIFFUSION HYPOXIA\> no muscle relaxation, ?? bone marrow depression, fatal agranulocytosis

Answer 416

Same as denis brown bar except has ball and socket joint beneath each foot tighten for varus position (preventing STJ and MTJ subluxation) elimninating the need to bend the bar

Answer 417

BRAIN MOTOR COMPONANT OF CNS PYRAMIDAL AND EXTRAPYRAMDIAL SYMPTOMS USUALLY RIGID muscle hypotonia and flaccid Lou Gehrig's disease (amyotrophic lateral sclerosis, or ALS) Primary lateral sclerosis (PLS) Traumatic brain injury. Spinal cord injury. Multiple sclerosis. Stroke. Huntington's disease.

Answer 418

1.5-7mg End product of purine-not useful indicator of renal failure U.A levels most common used to evaluate renal fsilure, gout and leukemia **ELEVATED-**Renal failure Gout Leukemia Alcoholism Lead Poisoning **Decreased**-uricosuric agents, Fanconi sign/ Wlson DZ

Answer 419

Mostly in males During a gouty attack levels are normal 90% acute gout\>\>\>\>\>\>1st MPJ (Podagra) 2) Soft tissue 3) Ankle joint Tophi in ears\>\>B/C lowerTemp\>\>\>UA less soluable **Solubility** of UA= 37C -6.8\>\>30% 4.5\>\>Ankle Jt 29C Crystalization

Answer 420

**1-Stasis** (arrythmias, MI,CHF,heart failure, immobiliation, besity , varicose veins, dehydration **2-Blood vessel injury** (trauma, fractures) **3-Hypercoagulability** (neoplasm, oral contraceptives,pregnancy,surgery,polycythemia these are the 3 stages of formation of thombi

Answer 421

avulsion fracture of the tibia from the PITFL

Answer 422

condition in which the body cannot break down glycogen. Glycogen is a form of sugar (glucose) that is stored in the liver and muscles. It is normally broken down into glucose to give you more energy when you need it. Von Gierke disease is also called Type I glycogen storage disease (GSD I).

Answer 423

dislocated hip, the line bisects the ASIS

Answer 424

avulsion fracture of the fibula from the AITFL

Answer 425

Dorsal avulsion lip fracture (most common) 40% Plantarflexion & forced inversions causes avulsion Fx via dorsal TN lgt plantarflexion-eversion causes avulsion via dorsal TN LGT TX short leg cast immboile 6-8 weeks

Answer 426

Transverse tracture of body (29%) with dorsal fragment dislocation vertical or horizontal from fall from height longitudinal force along the ray when ankle PF Horizontal plane FX-long dorsal deformity

Answer 427

Stress FX of middle 1/3 in young atheletes Differentiate from overuse syndrome

Answer 428

Tuberosity fracture (24%) forceful eversion avulsion fracture from the PT tendon R/O tibiale externumor MTJ subluxation TX short leg cast NWB 4-6 weeks

Answer 429

5,000-10,000 ## Footnote **Leukocytosis** in acute infection, metabolic acidosis, gout, heavy metal toxin, tissue necrosis, burns gangrene and inflammation **Leukopenia**- decrease reduction of W.C in blood\>\>\>various DZ,, adverse RX to druga and certain severe infection

Answer 430

Daptomycin

Answer 431

- Clindamycin - Bactrim - Linezolid - Tetracycline

Answer 432

- Fortaz - Aminoglycosides - Timentin - Ciprofloxacin - Imipenem - Atreonam - Zosyn

Answer 433

- Flexor or extensor percutaneous tenotomy - Extensor tendon lengthening, Z-lengthening - Capsulotomy - Flexor tendon transfer

Answer 434

**Weil**-cut distal dorsal to proximal plantar Complications of **Weil**- - Transfer lesions - --recurrence - --floating toe/flail toe - --Dorsal contracture * *Weil+plantar plate repair** - **Jacoby-**V cut to PF or DF - **Duvries-** Plantar condylectomy on both sides of the joint - **Chevron-**removal of bone to shorten the met - **DFWO-**same as the waterman

Answer 435

- Incision from Distal Medial to Proximal Laterl - Z-plasty or V-Y pasty - tendon lengthening

Answer 436

Just as there are three planes of motion, there are three axes of rotation: the anterior-posterior axis, the mediolateral axis, and the longitudinal axis. Joints rotate in these axes, allowing movement to occur in the planes.

Answer 437

1. Inflammatory – first 48-72 hours (up to 10 days) 2. Proliferative – from ~day 3 (lasts 3 - 6 wks) 3. Remodeling – from ~day 9 (lasts 6 wks to 12 mths)

Answer 438

1) To get rid of stagnant bacteria 2) Promote new blood flow to the area with growth factors and neutrophils 3) Allows for even growth of the wound bed, and keeps callouses from forming

Answer 439

It begins with disruption of normal tissue physiology It ends with complete removal of the wound debris Initial Vasoconstriction – with the role of limiting blood loss Followed by vasodilation –Hemostatic response –Vascular response –Cellular response –Immune response

Answer 440

1) periosteal plexus 2) nutrient artery 3) metaphyseal/epiphyseal arteries

Answer 441

Ruedi and Allgower. AO classification

Answer 442

- Stewart classification - Torg classification - Lawrence and Bott classification

Answer 443

Harcastle - Quenu and Kuss - Nunley

Answer 444

Intra-compartmental : \>30mmhg Extra-compartmental: within 10-30mmHg of diastolic BP

Answer 445

Physiological: Proliferative, granulation, fibroblastic or repair phase Clinical: Subacute phase Management: Controlled motion phase •It ends when –Fibroblasts activity / collagen production returns to baseline levels –Fibroblast-rich granulation tissue is replaced by scar tissue

Answer 446

Physiological: Remodeling phase Clinical: Chronic phase Management: Return-to-Function phase –The ends point for this phase is unclear as the rate of tissue remodeling may return to baseline before biomechanical properties are recovered.

Answer 447

- Leukocytosis - increased wound healing time - hyperglycemia - hypopigmentation

Answer 448

* *-Girdlestone Taylor**- bisect the tendon - flexor reattached dorsally and sutured together to make a sling over proximal phalan **-Kuwada/Dockery-**reroute the tendon to the distal drill hole **-Schuberth**-reroute the tendon thru the proximal drill hole

Answer 449

Chlostridium histolytica

Answer 450

**Gustilo and Anderson-** 1- Opening in the skin \<1cm 2- Opening in the skin between 1-5cm 3A: Greater than 5 cm with great soft tissue coverage 3B: Greater than 5cm with periosteal stripping 3C: Greater than 5 cm with arterial damage3

Answer 451

A locking plate provides no compression of any sort -great for osteoporosis, bone deficits and comminution

Answer 452

**Strain**-used to describe physical damage to “active” soft tissues (muscle, tendon, myofascia). Usually tear of muscle or tendon **Sprain**: Term used to describe physical damage to “passive” soft tissues (esp. ligament and joint capsule).

Answer 453

- Weak anterior muscles: EDL/EHL overpowers intrinsics during swing phase of gait - Cavus foot- EDL in position to overpower lumbricals just by passive stretch - Equinus: extensors overworked to prevent tripping on forefoot During the Swing phase of gait

Answer 454

- Failure of PTT to resupinate the foot results in overpronation. - Extrinsics (FHL/FDL) fire earlier/longer/stronger to grasp ground during midstance Midstance phase of gait

Answer 455

Supinated foot with weak posterior muscle (achilles tendon) unable to PF foot during propulsion. PT, FHL, FDL overpower to lumbricals Propulsive phase of gait

Answer 456

142 degrees

Answer 457

When the body of the talus is removed, the foot is fused in 15 degrees dorsiflexion. This procedure is used for AVN of the talus

Answer 458

progressive loss of articular cartilage accompanied by - attempted repair of articular cartilage, - remodelling, and - sclerosis of subchondral bone, and in many instances the formation of - subchondral bone cysts and - marginal osteophytes.

Answer 459

Etiology: axial load+ hyper dorsiflexion. Aviators Astralagus -Canale X-ray view-AP view with foot PF, pronated 15 degrees to view angular deformity of talar neck

Answer 460

Plantar plate serves as a stabilizer during WB and has very poor healing potential

Answer 461

Hypersegmented neutrophils

Answer 462

perpendicular

Answer 463

1) Arthroplasty 2) Extensor tenotomy 3) Extensor hood release 4) Extensor Tendon lengthening 5) Flexor tendon transfer

Answer 464

ischemic necrosis causes muscular contracture

Answer 465

in the epineurium

Answer 466

Tendon twist 90 degrees lateral

Answer 467

bisphosphonates

Answer 468

Pizogenic sign which is fat papule herniations

Answer 469

Coleman block test

Answer 470

used for metatatsal adductus alternative to serial casting

Answer 471

Additional AK piece is design to lock into BK component Knee flexed at 90 degrees prevent twisting of femur or hip and allowing isolated unilateral tx of tibial torsion

Answer 472

forefoot adductus rearfoot varus equinus

Answer 473

Sites of bifurcation 1-Distal abdominal aorta 2-Common iliac 3-Common fermerol 4-Popliteal 5-Trifurcation into tibial and peroneal trunks

Answer 474

Elevation of creatine Kinase

Answer 475

Structural Functional

Answer 476

achilles tendon over taking the degenerative PTT

Answer 477

develops hammertoes

Answer 478

- Watershed area of inraosseous blood supply to the metaphyseal region - Mechanical pull of PB

Answer 479

because it is in direct opposition to PB, expendable, and proximity to PTT

Answer 480

if femoral head is inadequately, wil develop DJD this test reveals how much DJD will develop treatment: aligning the femoral head in the actabulum and holding it there

Answer 481

BASAL CELL DISORDER ## Footnote Juvenile patient, symp to parkinsons cooper-binding ceriloplasmin leading to accumulation of cooper in tissue **KAYSER-FLEISCHER RINGS-PATHOGNOMONIC OF APPEAR COOPER** CHILDREN EXHIBIT SCHIZOPHRENIC BEHAVIOR, MULTIPLE MOVEMENT DISORDER **TREATMENT**-D PENICILLSMINE

Answer 482

Normal Flatfoot Meary's angle 0 degree 1-15 and \>\>15 severe CIA 20-25 degrees \<15 degrees A/P T/C angle \<25 \>25 degrees T-N angle \<50 60-70 degrees

Answer 483

Space between 1st and 2nd MT should be equal inspace with medial and intermediate cuneiform - Drop in arch - Fleck sign

Answer 484

**Shenton's lines**: line continues with spur of lateral malleolus with tibial plafond **Dime sign**: assesses fibular length and talocrural angle

Answer 485

use of electric current to coaguate vessels

Answer 486

To lengthen the metatarsal, the cut should be proximal-medial to distal-lateral.

Answer 487

extend head and flex the neck for anesthesia

Part 3 Podiatry exam Flashcards

(532 cards)