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Orthopaedics > Upper extremities > Flashcards

Upper extremities Flashcards

(76 cards)

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1
Q

what is the most commonly dislocated joint of the body?

A

the shoulder

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2
Q

which is the most common direction of dislocation of the shoulder joint?

A

Anterior (96%)

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3
Q

which part of the clavicle is most prone to fx?

A

Mid 3rd

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4
Q

what mechanism most likely causes clavicle fx?

A

fall onto the affected shoulder

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5
Q

what adjacent structures may be affected in clavicle fx?

A

brachial plexus, subclavian vessels, apex of lung

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6
Q

what will the patient w/ clavicle fx be like?

A
  • splinting
  • arm adducted across the chest and supported by the contralateral hand
  • proximal end tents the skin
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7
Q

how to detect an apical lung injury leading to ipsilateral pneumothorax?

A

listen to breath sounds

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8
Q

how to treat minimally displaced clavicle fx?

A
  1. comfort and pain relief
  2. immobilization(4-6wks): sling/figure of 8 bandages
  3. active ROM
  4. radiographs
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9
Q

what worring consequence may skin tenting in clavicle fx lead to?

A

Open fx

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10
Q

what may be the complications of clavicle fx?

A
  1. neurovascular compromise
  2. malunion
  3. nonunion
  4. posttraumatic arthritis
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11
Q

standard trauma series of the shoulder

A

AP, scapular-Y, axillary view

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12
Q

ligaments that maintain stability of the AC joint

A
  • AC lig

- coracoclavicular lig(conoid, trapezoid)

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13
Q

which dislocation of SC joint is more common?

A

Ant

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14
Q

which dislocation of SC joint is associated w/ pulm / neurovascular injuries?

A

Post

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15
Q

comolli sign

A

triangle swelling of the post thorax overlying the scapula and is suggestive of hematoma resulting in increased compartment p

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16
Q

sup shoulder suspensory complex(SSSC)

A

bone-soft tissue ring:

  • glenoid process
  • coracoid process
  • coracoclavicular lig
  • distal clavicle
  • AC joint
  • acromion process
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17
Q

floating shoulder

A

double disruptions of sup shoulder suspensory complex(SSSC)

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18
Q

bankart lesion

A

avulsion of anterioinferior labrum off the glenoid rim

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19
Q

hill sachs lesion

A

a posterolateral head defect is caused by an impression fx on the glenoid rim [ant. dislocation]

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20
Q

shoulder dislocation associated w/ rotator cuff tear is commonly seen in _______ individuals.(older/younger)

A

older

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21
Q

which imaging technique is used for rotator cuff tear?

A

US

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22
Q

how will patients w/ ant. shoulder dislocation present?

A

injured shoulder held in slight abduction and external rotation;
painful

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23
Q

which nerves may ant. shoulder dislocation injure?

A

axillary n.

musculocutaneous n.

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24
Q

positive apprehension test

A

if not in acute pain, passive movement of the shoulder in the provacative position (abduct, exten, extern rotat) reproduces the patient’s sense of instability and pain

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25
closed reduction of ant. shoulder dislocation
traction-countertraction
26
a shorter period of immobilization (ant. shoulder dislocation)may be used for patients > 40yr because
stiffness of the ipsilateral hand, wrist, elbow, and shoulder
27
the most common commplication after dislocation is
recurrent dislocation
28
electric shock / convulsive mechanisms may produce ______ (ant/post) dislocation
post
29
the position of post. shoulder dislocation
internal rotation and adduction
30
signs suggestive of post. shoulder dislocation (AP view)
- absence of the nl elliptic overlap - vacant glenoid sign(>6mm) - trough sign(reverse hill-sachs) - loss of profile of humeral neck (full int. rota) - void in the sup/inf glenoid fossa
31
glenohumeral dislocations are most readily on the _____ view
axillary
32
which shoulder dislocation will present in a salute fashion?
inferior
33
most common humerus fx
proximal
34
what may be considered if an older individual gets a prox humerus fx after a simple fall?
osteoporosis
35
fx fragments displaced by the pull of muscles on proximal humerus
1. humeral head 2. lesser tuberosity 3. greater tuberosity 4. humeral shaft
36
nerve injuries noted in proximal humerus fx
axillary n
37
what will anatomic humerus neck fx lead to?
osteonecrosis
38
surgery for proximal humerus fx
ORIF / arthroplasty
39
chronic unreduced fx-dx and repeated closed recuct may lead to
myositis ossificans
40
humeral shaft
pectoralis major insertion to supracondylar ridge
41
nerve function noted in humersl shaft fx
radial n
42
what should be considered when extreme swelling in the affected arm is encountered?
- serial neurovascular exam | - compartment pressures
43
complications of extraarticular supracondylar fx
1. volkmann ischaemic contracture 2. loss of elbow ROM 3. hetertopic bone formation
44
which is the most common elbow dislocation?
post
45
during elbow dislocatin, the capsuloligamentous structures of the elbow are injured in a ___ to ____ fashion.
lateral; medial (hori cycle)
46
which structures should be repaired for elbow stability?
trochlear notch, radial head, LCL (rarely MCL)
47
complications of elbow dislocation
- loss of motion(stiffness) - ulnar n - brachial a. - compartment syn(volkmann contracture) - persist instab/redislocat - arthrosis - heterotopic bone/myositis ossificans
48
monteggia fx
proximal ulnar fx w/ radial head dislocation
49
nightstick fx
results from direct trauma to the ulna along its subcutaneous border
50
galeazzi fx
distal radial fx w/ distal radioulnar joint disruption
51
which is more common, monteggia fx / galeazzi fx?
galeazzi fx
52
colles fx
distal radial fx : dorsal angula "dinner fork"
53
smith fx
distal radial fx : volar angula
54
bartons fx
distal radial intraarticular fx disloc/sublux
55
which distal radial fx is indicated for closed reduction?
all
56
why extreme wrist flexion should be avoided in distal radial fx?
cause it increases carpal canal pressure and digital stiffness
57
which nerve may distal radial fx damage?
median n
58
tendon that ruptures in distal radial fx
extensor pollicis longus
59
carpal bones
distal: Tm-Td-C-H proximal: S-L-T-P
60
the 0 degree capitolunate angle
Lateral(neutral position): | a straight line drawn down the third metacarpal shaft, c, l, and shaft of radius
61
watson shift test
painful dorsal scaphoid displacement as the wrist is moved from ulnar to radial deviation w/ palm press on the tuber
62
___ scaphoid fx is prone to nonunion and osteonecrosis
proximal
63
blood supply of scaphoid
distal 20%-30%: volar scaphoid branches | proximal 70-80%: dorsal scaphoid branches
64
most commonly fractured carpal bone
scaphoid
65
carpal keybone
lunate
66
"spilled tea cup sign"
volar dislocation of the lunate (lateral)
67
Terry Thomas Sign
widening of the scapholunate space >3mm (nl<2mm)
68
contracture of soft tissues begin around ___ hrs following hand injuries.
72
69
protected splinting position of metacarpal head
MCP flex>70
70
Bennett fx
1MC base intraarticular fx dislocation (abductor pollicis longus)
71
Rolando fx
comminuted Bennett fx
72
Boxer's fx
fx of the metacarpal neck with volar angulation of the distal fragment
73
Gamekeeper's Thumb (skier's thumb)
disruption of the ulnar collateral ligament of the 1 | MCPJ, oft w/ a fx of the base of the prox phalanx
74
dx of Carpal tunnel syndrome
EMG
75
fracture of the hook of the hamate can damage ____ nerve
ulnar
76
MRI of Carpal tunnel syndrome
thickening of the median n proximal to the carpal tunnel, flattening of the median n in the

Orthopaedics (4 decks)

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