Trauma - CORTEXT

Question 1

true or false: when spinal shock occurs, loss of motor function and sensation occurs above the level of the injury

Answer 1

false

occurs below the level of the injury

Question 2

what normal body reflex is absent in spinal shock?

Answer 2

bulbocavernosus reflex

Question 3

describe complete spinal cord injury

Answer 3

no sensory or voluntary motor function below the level of injury

Question 4

describe incomplete spinal cord injury

Answer 4

some neurologic function present distal to the level of injury

Question 5

true or false: the presence of sacral spinal cord sparing in spinal cord injury suggests a better prognosis

Answer 5

true

Question 6

in which age groups are pelvic fractures more common?

Answer 6

young patients (high energy trauma)

old patients (osteoporosis)

Question 7

name the bones that form the pelvic ring

Answer 7

sacrum
ilium
ischium
pubic bones

Question 8

how is the pelvic ring like a polo mint?

Answer 8

if it breaks in one place, it will also break in another

Question 9

what happens in a lateral compression fracture of the pelvis?

Answer 9

one half of the pelvis is displaced medially

Question 10

what happens in a vertical shear fracture of the pelvis?

Answer 10

one half of the pelvis is displaced superiorly

Question 11

what happens in an anteroposterior compression injury of the pelvis?

Answer 11

disruption of the pubic symphysis

Question 12

what neurovascular structures are at risk in pelvic fractures?

Answer 12

branches of the internal iliac artery
venous plexus
lumbosacral plexus

Question 13

true or false: a PR exam is mandatory in pelvic fractures

Answer 13

true

to assess sacral nerve root function and to check for blood

Question 14

what is the most common mechanism of injury in proximal humerus fractures?

Answer 14

low energy osteoporotic injury due to FOOSH

Question 15

what does FOOSH stand for?

Answer 15

fall onto out stretched hand

Question 16

which part of the proximal humerus is most commonly fractured?

Answer 16

the surgical neck

Question 17

in which direction does the humeral shaft usually displace in proximal humerus fractures and why?

Answer 17

medially

due to the pull of pectoralis major

Question 18

what is the mainstay of treatment for proximal humerus fractures?

Answer 18

sling immobilisation

internal fixation if there is recurrent displacement

Question 19

which direction of shoulder dislocation is most common?

Answer 19

anterior

Question 20

what is a Bankart lesion?

Answer 20

anterior shoulder dislocation that causes detachment of the glenoid labrum and capsule

Question 21

what is a hill-sachs lesion?

Answer 21

posterior humeral head impacts the anterior glenoid

causes an impaction fracture of the posterior humeral head

Question 22

which nerve is at risk in shoulder dislocation?

Answer 22

axillary nerve

nerves of the brachial plexus

Question 23

what is the characteristic sign on an x-ray of a posterior shoulder dislocation?

Answer 23

lightbulb sign

Question 24

what is the principle sign of axillary nerve injury?

Answer 24

loss of sensation in a badge-patch area

Question 25

what is the mainstay of treatment for anterior shoulder dislocation?

Answer 25

closed reduction under sedation sling for two to three weeks

Question 26

describe the relationship between risk of recurrent shoulder dislocation and the age of the patient

Answer 26

under 20 = 80% | over 30 = 20%

Question 27

what is involved in Bankart repair?

Answer 27

reattach the torn labrum and the capsule via arthroscopy or open repair

Question 28

how do injuries of the ACJ usually occur?

Answer 28

fall onto the point of the shoulder

Question 29

in subluxation of the ACJ, what is usually ruptured?

Answer 29

the acromioclavicular ligaments

Question 30

in dislocation of the ACJ, what is usually ruptured?

Answer 30

the coracoclavicular ligaments

Question 31

up to how many degrees of angulation is accepted in a humeral shaft fracture and why?

Answer 31

30 the mobility of the shoulder and elbow joint aid union

Question 32

which nerve is susceptible to injury in humeral shaft fractures?

Answer 32

radial nerve

Question 33

what pathology can be caused by damage to the radial nerve?

Answer 33

wrist drop | loss of sensation in the first dorsal web space

Question 34

how are intra articular fractures usually treated?

Answer 34

open reduction, internal fixation (ORIF)

Question 35

describe the usual mechanism of injury in olecranon fractures

Answer 35

fall onto point of the elbow | contraction of the triceps

Question 36

which direction of elbow dislocation is most common?

Answer 36

posterior

Question 37

the forearm acts as a ring due to the ligaments around the radio-ulnar joints, what does this mean for fractures?

Answer 37

if one bone fractures, there is usually a fracture in the other bone too

Question 38

what is a nightstick fracture?

Answer 38

fracture of the ulnar shaft

Question 39

how is a diaphyseal fracture of both forearm bones treated?

Answer 39

ORIF with plates and screws IM nail if very unstable

Question 40

what is ORIF?

Answer 40

open reduction and internal fixation

Question 41

describe a monteggia fracture

Answer 41

fracture of the ulna | dislocation of the radial head at the elbow

Question 42

describe a galeazzi fracture

Answer 42

fracture of the radius | dislocation of the ulnar at the distal radioulnar joint

Question 43

what is the usual mechanism of injury in distal radial fractures?

Answer 43

FOOSH

Question 44

describe a colles fracture

Answer 44

extra articular fracture of the distal radius (within an inch of the articular surface), with dorsal displacement

Question 45

which nerve can be damaged in colles fractures?

Answer 45

median nerve

Question 46

describe a smith's fracture

Answer 46

extra-articular fracture of the distal radius with volar displacement

Question 47

what treatment should be done for all smith's fractures?

Answer 47

ORIF with plate and screws

Question 48

describe a barton's fracture

Answer 48

intra articular fracture of the distal radius where carpal bones sublux

Question 49

what is another name for a dorsal barton's fratcure?

Answer 49

intra articular colles fracture

Question 50

what is another name for a volar barton's fracture?

Answer 50

intra articular smith's fracture

Question 51

name two clinical signs of a scaphoid fracture

Answer 51

tender anatomical snuffbox | pain on compressing the thumb metacarpal

Question 52

how many x-ray views are taken of a suspected scaphoid fracture?

Answer 52

four | AP, lateral and two oblique views

Question 53

how are undisplaced scaphoid fractures usually treated?

Answer 53

plaster cast for six to twelve weeks

Question 54

how do fractures of the fifth metacarpal usually occur?

Answer 54

punching injury | hence why they are called boxer's fractures

Question 55

how many degrees of angulation can be tolerated in a boxer's fracture?

Answer 55

up to 45

Question 56

what is the most common cause of hip fractures in the elderly?

Answer 56

osteoporosis

Question 57

true or false: the majority of hip fractures occur in males

Answer 57

false

Question 58

true or false: nearly all patients with hip fractures have surgery

Answer 58

true

Question 59

what are the two broad categories of hip fractures?

Answer 59

intracapsular | extracapsular

Question 60

what is the blood supply to the head of the femur?

Answer 60

branch of the obturator artery

Question 61

what is the blood supply to the neck of the femur?

Answer 61

femoral circumflex artery

Question 62

true or false: the arterial supply of the femoral head is more at risk of disruption in extracapsular fractures

Answer 62

false

Question 63

describe the position of an intracapsular hip fracture

Answer 63

above the trochanteric line

Question 64

what is the mainstay of treatment for intracapsular hip fractures?

Answer 64

hemiarthroplasty | THR

Question 65

true or false: extracapsular hip fractures can be repaired with internal fixation

Answer 65

true if there is a high union rate and low risk of AVN

Question 66

which type of embolism can occur with femoral shaft fractures?

Answer 66

fat embolism

Question 67

which type of splint is recommended for femoral shaft fractures?

Answer 67

Thomas splint

Question 68

true or false: a knee injury is a surgical emergency

Answer 68

true due to high risk of neurovascular injury

Question 69

which direction do the vast majority of patellar dislocations occur in?

Answer 69

lateral

Question 70

true or false: patellar dislocation is more common in females

Answer 70

true

Question 71

are proximal tibia fractures intra or extra articular?

Answer 71

intra

Question 72

which nerve could be damaged in proximal tibia fractures?

Answer 72

common fibular nerve

Question 73

which fracture is the most common cause of compartment syndrome after trauma?

Answer 73

tibial shaft fracture

Question 74

what is the extent of displacement and angulation acceptable for conservative management of tibial shaft fractures?

Answer 74

up to 50% displacement and 5% angulation

Question 75

what is the most common method for surgical stabilisation of tibial shaft fractures?

Answer 75

IM nail

Question 76

what is another name for a distal tibia fracture?

Answer 76

pilon fracture

Question 77

how are pilon fractures generally treated?

Answer 77

ORIF

Question 78

what is the most common mechanism of injury in ankle fractures?

Answer 78

inversion injury

Question 79

name the lateral ankle ligaments

Answer 79

anterior talofibular posterior talofibular calcaneofibular

Question 80

what is another name for a midfoot fracture?

Answer 80

lisfranc fracture

Question 81

describe a lisfranc fracture

Answer 81

fracture of the base of the 2nd metatarsal with/without dislocation of other metatarsals at the TMJ's

Question 82

which tendon is involved in an avulsion fracture of the 5th metatarsal?

Answer 82

peroneus brevis