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Ortho Path 300 > Quiz 4 > Flashcards

Quiz 4 Flashcards

(85 cards)

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1
Q

Whiplash

A

Acceleration-deceleration

Cervical flexion-extension sprain-strain

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2
Q

QTF Whiplash classification

A

Grade 1: Pain but no physical signs

Grade 2: Neck complaints, pain, decreased ROM, point tenderness

Grade 3: Like Grade 2 with neurological symptoms

Grade 4: Like Grades 2/3, with bone injury (fracture, dislocation, spinal cord injury)

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3
Q

Torticollis

A

Abnormal positioning of the head and neck, relative to the body (Wry Neck)

Can be:
Acute acquired
Congenital
Spasmodic

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4
Q

Acute acquired torticollis

A

Painful, unilateral shortening of the neck muscles (esp SCM) resulting in abnormal head position.

Usually sudden onset. Pain, especially with movement .
Also tinnitus, nausea, lacrimation, referred pain

Can be caused by activation of latent TrPs, sublux of C1-2 (!!?!), infection or inflammation, pain from DJD or DDD

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5
Q

Congenital torticollis

A

Umm.. congenital.
Unilateral contracture of SCM.
Idiopathic. Maybe birth trauma, maybe malposition in utero

Palpable mass in muscles.
Can cause compression on cranial nerves and arteries; TMJ issues; C-spine DDD and OA.

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6
Q

Spasmodic Torticollis

A

Localized dystonia resulting in torticollis. Worse under stress. Can be recurring. Twitchy.

Idiopathic.

Can be due to CNS lesions, C0-C1 issues, postural dysfunction, trauma, iatrogenic causes.

Improved by certain positions

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7
Q

Cervical Rib

A

Extra bone that articulates with the TVP of one or more cervical vertebrae (most commonly C5/6/7)
More common in females

Often asymptomatic until middle age when shoulders begin to droop

May result in TOS

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8
Q

C1 Fracture

A

AKA Jefferson Fracture

Fall on head from height (yeesh)

Occipital condyles may spit or burst the ring of atlas

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9
Q

C7 Fracture

A

AKA Clay Shoveler’s fracture

Avulsion (of SP) fracture due to hyperflexion injury

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10
Q

TMJ dysfunction

A

Disorder of the muscles of mastication, TM joint, associated structures

Temporalis, masseter, pterygoids, digastric, mylohyoid, geniohyoid, infrahyoid.

More common in women; onset typically between 20-50

Can be caused by muscle imbalances and/or overuse, C-spine or cranial misalignment, posture, stress, etc. etc.

Contributing factors include playing instruments and chewing gum.

Can present with decreased ROM, catching/locking, ear dysfunction, tinnitus, inflammation, lacrimation, paresthesia, DJD

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11
Q

Pectus excavatum

A

Most common deformity of the chest wall.

AKA funnel chest

Congenital

Midline depression of sternum

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12
Q

Pectus carinatum

A

AKA pigeon chest

Congenital

anterior protrusion of the sternum

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13
Q

Barrel chest

A

Acquired increase in the AP dimensions of chest wall.

Most commonly associated with emphysema

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14
Q

Dowager’s hump

A

Excessive curvature of the upper T spine; most commonly a result of osteoporosis; also DJD

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15
Q

Wedge compression fracture

A

Decreased height of anterior portion of vertebral body, most commonly T12-L1

Most common L spine fracture

Usually due to trauma and/or pathology; commonly associated with osteoporosis

S/S include hyperkyphosis, decreased stature, neurological symptoms

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16
Q

Straight Back Syndrome

A

Reduced thoracic kyphosis

Decreased AP chest dimensions

Heart and mediastinal structures compressed between T spine and sternum

Functional heart murmur

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17
Q

Flat Back Syndrome

A

Decreased lumbar lordosis

Flattened appearance to low back; posterior pelvic tilt

May be due to slouching, and accompany hyperkyphosis

May result in pain due to overstretched PLL and decreased shock absorption

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18
Q

Hyperlordosis

A

Increase in normal lumbar lordotic curve with increased anterior pelvic tilt.

May be concurrent with spondyloisthesis
May lead to compensatory hyperkyphosis, head forward posture.

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19
Q

Reduced thoracic kyphosis

A

Straight back syndrome

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20
Q

Decreased lumbar lordosis

A

Flat back syndrome

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21
Q

Increase in lumbar lordotic curve

A

Hyperlordosis

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22
Q

Stenosis

A

Narrowing of the spinal canal

Can be primary (congenital) or secondary (due to DJD, sublux, edema, etc.)

Symptoms can include bowl and bladder changes, numbness, tingling, weakness in LB. Bilateral

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23
Q

Spondylolysis

A

Pars defect.
Interruption of the pars interarticularis, usually L5-S1

Idiopathic – congenital, traumatic, degenerative, pathologic
May be asymptomatic

May lead to spondylolsthesis

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24
Q

What is the pars interarticularis?

A

Portion of the spine that joins together the upper and lower facet joints

Lies between lamina and pedicle

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25
Spondylolisthesis
Gap in pars defect widens L5 shifts anteriorly on sacrum May be asymptomatic; may cause pain, hyperlordosis or neurological symptoms
26
Degenerative disc disease
Degenerative joint changes (of volume, shape, structure and composition) at the intervertebral disc With age, nuclear pulposis breaks down, inner annulis expands. Common musculoskeletal condition, most often in L spine. Can be asymptomatic; may be painful due to tears in annulus fibrosis; radicular pain
27
Herniation
Disc injury that results from the rupture of annular fibres Mostly L4/5, L5/S1 MOI flexion and torsional force Bulges disc posterior or posteriolaterally - may compress nerve roots
28
Four stages to disc herniation
1. Degeneration 2. Prolapse 3. Extrusion 4. Sequestration
29
Lumbarization
Nonfusion of the first and second segment of the sacrum One additional articulated vertebrae (L6) One fewer sacral vertebrae
30
Sacralization
S1 fused with L5 | Leads to extra long sacrum and four lumbar vetebrae
31
Cauda Equina Syndrome
Compression of the cauda equina Nerve roots caudal to the levell of spinal cord termination at L2 Trauma, infection, tumour, AS, DJD, idiopathic Pain, numbness and tingling, mm weakness, poor reflexes, saddle anaesthesia, positive babinski
32
Sciatica
Pain felt in low back and along distribution of sciatic nerve DJD, compression, trauma, piriformis syndrome
33
Klippel-Feil Syndrome
Failure of vertebral segmentation of C-spine Synostosis of of 2 or more cervical vertebrae Rare. Idiopathic. Neck is short, stiff and webbed. Head tilted, high scapula (Sprengel's deformity) Associated with scoliosis, Spina bifida, heart defects.
34
Synostosis
Congenital fusion of two bones.
35
GH hypermobility
Due to physiological laxity of CT Usually in individuals involved in overhead throwing or lifting.
36
Shoulder fractures are commonly associated with injuries of what nerve?
Radial
37
Shoulder dislocation
GH joint | Most commonly anterior dislocation
38
Shoulder separation
AC joint Can be partial or complete ligamentous injury due to forceful trauma. Shows up as step deformity.
39
Three types of step deformity
Type 1: strain of AC ligament Type 2: rupture of AC ligament; involvement of conoid and trapezoid ligaments Type 3: rupture of AC, conoid and trapezoid ligaments
40
Subdeltoid and subacromial bursitis
Due to wear and tear on joint Acute: symptoms same as supraspinatus tendonitis
41
Rotator cuff injuries
Most common in athletes die to vigorous circumduction, most common at supraspinatus tendon
42
Impingement Syndrome
Space decreased, usually between acromion and humeral head. (Between AC and GH jts). Repetitive overhead movements, or blow or stretch injury. Impingement between four SITS tendons, bursa and cartilage. Symptoms: aching, pain (abduction, reaching behind in car), catching sensation. Painful arc
43
Stages of Impingement Syndrome
Stage 1: Edema, hemorrhage into subacromial bursa Stage 2: tendonitis and fibrosis Stage 3: tendonitis rupture (complete or incomplete).
44
Infraspinatus tendonitis
Occurs near Musculotendinous junction Painful arc with overhead or forward motions Can be asymptomatic. Pain can refer to deltois and triceps.
45
Bicipital tendonitis/tenosynovitis
Degenerative changes in the tendon of the long head of the biceps. Common with overhead activities Symptoms: local tenderness, pain with passive abduction and resisted elbow flexion.
46
Possible causes of winging scapula
Loss of serratus anterior function (may be issue with long thoracic nerve) Loss of trapezius muscle function (may be spinal accessory nerve) Weakness of scapular stabilizers (esp in muscular dystrophy) Injury to scapular suspensory ligaments (coracoclavicular and acromioclavicular) -- GH jt injury Shoulder instability Pain at GH jt Brachial plexus injury
47
Radial nerve injury
Symptoms: impaired sensation yo back of arm, forearm, hand. Variations include crutch palsy, Saturday night palsy
48
Erb's (Duchenne's) Palsy
AKa brachial plexus injury (C5-6) Often occurs in newborns due to birth trauma Symptoms include waiters tip, paralysis of shoulder and arm
49
Olecranon bursitis
"Students elbow" Constant pain at Olecranon. Swelling, limited mobility. May result from trauma, constant pressure, inflammatory conditions (EA, PA, gout)
50
Lateral epicondylitis
Tennis elbow Degeneration of CET Pain at lateral epicondyle, referring down forearm.
51
Medial epicondylitis
Golfers elbow Inflammation of CFT Often associated with ulnar nerve issues.
52
Radial nerve lesions
Continuation of brachial plexus Affects elbow, wrist and extrinsic finger extensors (plus abductor poll long) Crutch palsy, supinator syndrome
53
Symptoms of radial nerve lesion
``` Wrist drop (complete nerve lesion) Flaccid wrist extensors Muscle wasting Sensation dysfunction (posterior arm, thumb, digits 2, 3 half of 4) Anesthesia in web space ```
54
Ulnar nerve lesions
Medial chord of brachial plexus Travels under pec minor, through ulnar groove on medial elbow, deep to FCU, over carpal tunnel and through tunnel of Guyon Affects FCU, FDP,, 3rd and 4th lumbricals, hypothenar, interossei, add poll
55
Tunnel of Guyon
Aka ulnar tunnel Between hook of hamate and pisiform
56
Symptoms of ulnar nerve lesion
Claw hand (digits 4 & 5 don't extend after flexion) Froment's sign -- weak pincer grasp (weak add poll) so use FPL to flex at IP Muscle wasting Altered sensation on ulnar side of hand
57
Tunnel of Guyon
Aka ulnar tunnel Between hook of hamate and pisiform, transverse and posthaste ligaments.
58
Symptoms of ulnar nerve lesion
Claw hand (digits 4 & 5 don't extend after flexion) Froment's sign -- weak pincer grasp (weak add poll) so use FPL to flex at IP Muscle wasting Altered sensation on ulnar side of hand
59
Ulnar tunnel (Tunnel of Guyon) syndrome
Handlebar syndrome Numbness, pain, tingling on ulnar side of hand.
60
Median nerve lesion
Median nerve innervates flexor muscles of forearm and hand Originates from brachial plexus. Travels with axillary artery and goes through carpal tunnel. Susceptible to compression by pronator teres, FCR and FDS Innervates pronator Teres, FCR, FDS, FDP, PL, FPL, PQ, thenars, lumbricals 1&2
61
Symptoms of median nerve lesions
1. Ape hand (thumb can't adduct) | 2. Pope's blessing/hand of benediction/ oath hand (cannot fleet digits 1&2 because of lumbricals)
62
What passes through the carpal tunnel?
``` Nine tendons (4 x fdp; 4 x fds; 1 x FPL) Median nerve ```
63
Carpal tunnel syndrome
Compression of median nerve where it passes through carpal tunnel. Most common entrapment syndrome in the arm. Weakness numbness pain Problem with fine motor movement of hand Wasting of thenar eminence Tests: phalens and reverse phalens.
64
Complications of lunate dislocation
Often anterior dislocation Avascular necrosis (Keinbock's) Median nerve compression DJD
65
Mallet finger
Avulsion injury to DIP (extensor dig,) Can extend entire finger except DIP.
66
Boxer's/Brawler's fracture
Fracture of 5th MC
67
Bennett's fracture
Fracture-dislocation of first carpal-metacarpal joint.
68
Reverse Bennetts Fracture
Fracture-dislocation of fifth carpalmetacarpal joint
69
Scaphoid fracture
High incidence of complication, including delayed Union, nonunion, avascular necrosis and DJD
70
Smith's Fracture
Reverse Colles Fracture of radius with ventral displacement. (Spoon)
71
Colles fractures
Fracture of distal radius with dorsal displacement.
72
Madelung's deformity
Deformity of radius typically affecting distal radius (ulnar side) Radius grows palmarly and radially.
73
Ganglion cyst
Thin walled synovial-lined lesion Commonly on dorsal hands and feet Can cause local discomfort and compress median and ulnar nerve d
74
Trigger finger
Thickening of fibrous sheath that surrounds flexor tendons (deep and superficial) --> stenosis --> contracture Idiopathic and spontaneous. Unable to actively extend Passive extension and active flexion "snap"
75
Gamekeepers thumb
Tear or rupture of ulnar collateral ligament at the 1st MCP joint Due to abduction and extension
76
Adhesive capsulitis
Frozen shoulder More often women than men Restrictions usually in ER and Abduction Idiopathic
77
Stages of Adhesive Capsulitis
1. Acute stage. Freezing/painful/first stage - up to 9 months - inflammation and progressive stiffness 2. Subacute/frozen/stiffening/second phase - stiffness in abduction, IR, ER 3. Chronic/thawing/resolution/third phase
78
Nursemaids elbow
Sublux of radial head from annular ligament.
79
Olecranon Bursitis
Students elbow
80
Keinbock's disease
Idiopathic avascular necrosis of lunate Osteochondrosis Can lead to permanent loss of grip strength and wrist motion.
81
Dupuytren's contracture
Progressive fibrous tissue contracture of palmar fascia on medial hand. Abnormal collagen composition and fibroblast activity. Can involve feet Most common in men over 50 Usually presets as contracture of digits 4&5 at MCP and PiP Can develop secondary co fractures and DJD
82
Claw hand (ulnar)
Inability to extend digits 3 & 4 Due to ulnar damage --> third and fourth lumbricals don't work
83
Ape hand
Inability to abduct and oppose thumb Distal median nerve dysfunction --> paralysis of thenar muscle.
84
Pope's hand/oath hand/ hand of benediction
Cannot flex digits 4 & 5 at PIP Median nerve dysfunction Loss of lateral lumbricals action.
85
Froments sign
Ulnar nerve compromise | Cannot pinch paper with thumb because adductor pollicis not working. IP flexion instead because FPL compensates.

Ortho Path 300 (7 decks)

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