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JL Musculoskeletal > Week 6 > Flashcards

Week 6 Flashcards

1
Q

What are soft tissue injuries well demonstrated by?

A

MRI and US

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2
Q

What can image tendons really well?

A

US

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3
Q

Name three typical sites of impacted fractures of the lower lib?

A
  1. Femoral neck
  2. Tibial plateau
  3. Calcaneus
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4
Q

What energy status are pelvic ring fractures in young people?

A

High energy

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5
Q

What two methods are pelvic ring fractures typically due to?

A

RTA and fall from height

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6
Q

What is the primary imaging technique in all polytrauma patients?

A

CT

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7
Q

What energy status are pelvic ring fractures in elderly patients with osteoporosis?

A

Low energy

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8
Q

What is the imaging of choice for low energy pelvic ring fractures?

A

MRI

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9
Q

Give two features of a typical hip dislocation?

A
  1. Posterior

2. With acetabular rim fracture

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10
Q

What is the most useful fracture classification?

A

Intra versus extracapsular

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11
Q

What type of proximal femoral fracture interferes with blood supply to femoral head, is prone to femoral head AVN or non-union and is treated by hemiarthroplasty, unless undisplaced or young patient where reduction may be tried?

A

Intra-capsular

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12
Q

How are extra-capsular fractures of proximal femor treated?

A

By internal fixation using DHS

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13
Q

What two things are at risk with a femoral shaft fracture?

A

Blood loss

Fat embolus

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14
Q

What is a specific sign of an intra-articular fracture of knee?

A

Lipohaemarthrosis collecting in suprapatellar recess

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15
Q

What parts of extensor mechanism injury can be easily clarifeid by US?

A

quadriceps and patellar tendon tears

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16
Q

What can excessive inversion or eversion of the ankle cause?

A

Talar dome margin fracture

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17
Q

What does calcaneal fracture usually follow?

A

Axial compression - fall from height

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18
Q

In adolescents what does the 5th metatarsal have at its base?

A

Longitudinal accessory ossification centre

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19
Q

What is the os trigonum?

A

An accessory ossification centre commonly seen posterior to talus

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20
Q

Name three things which predispose to tendon rupture?

A

Diabetes, RA and steroid use

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21
Q

Name the three forms of blood supply to femoral head?

A
  1. Intramedullary artery of shaft of femur
  2. Medial and lateral circumflex branches of profunda femoris
  3. Artery of ligamentum teres
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22
Q

Give two signs of a proximal femoral fracture?

A
  1. Shortening

2. External rotation

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23
Q

Give three steps in secondary bone healing

A
  1. Fracture gap fills with granulation tissue
  2. Then cartilage (soft callus)
  3. Then bone (enchondral ossification, hard callus)
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24
Q

If a high energy fracture - what should be done first?

A

Resuscitation - ABCD

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25
What type of fracture happens with bending force?
Transvere
26
What type of fracture happens with axial loading?
Oblique
27
How should open fractures be managed?
Antiseptic cover, tetanus, early debridement and operative stabilisation
28
For femoral shaft fracture - what alagesia should be used and what splintage?
Femoral nerve block | Thomas splint
29
What is the term for intra=articular distal tibial fractures?
Pilon fractures
30
In humeral shaft fractures what nerve is risked?
Radial nerve in spiral groove
31
If the radius is fractured in isolation, suspect a dislocation of DRUJ - otherwise knwon as?
Galeazzi
32
If the ulna is fractured in isolation, suspect a dislocation of the radial head - otherwise known as?
Monteggia fracture
33
Name four complications of colles fracture?
1. Median nerve compression 2. EPL rupture 3. CRPS 4. Loss of grip strenght
34
What fracture results from a fall onto back of hand?
Smiths - extra-articular, volar displacement and angulation
35
Give two features of first degree nerve injury - neurapraxia?
1. Temporary conduction block/demyelination | 2. Should resolve within 28 days
36
Give three features of 2nd degree nerve block - axonotmesis?
1. Nerve cell axon dies distally from point of injury = wallerian degeneration 2. Structure of nerve (endoneurial tubes) intact 3. Regenerates at 1mm per day
37
Give two features of 3rd degree nerve injury - neurotmesis?
1. Nerve transected | 2. No recovery without surgery
38
In childrens fractures what immobilisation do diaphyseal fractures need?
Above and below joint
39
In childrens fractures what immobilisation do metaphyseal fractures need?
Just the adjacent joint
40
What can be a cause of decreased conscious level and how can it be treated?
Hypoglycaemia - give dextrose orally or IV, IM glucagon
41
What is the term for angulation of the first MT towards the midline (varus) increasing the distance between 1st and 2nd MTs?
Primus varus
42
What is the condition where there is lateral angulation (valgus) of the great toe?
Hallux valgus
43
What is hallux valgus often associated with?
A bunion
44
What is hallux rigidis?
OA of the first MTPJ
45
What is lesser metatarsalgia and what does it feel like?
Painful lesser MT heads (2-5) - feels like walking on marbles
46
What is a swelling of one of the intermetatarsal nerves where the patient describes shooting/burning pain or numbness?
Morton's neuroma
47
What is the term for flattening of the medial arch and what does it suggest?
Pes planus | Suggests RA/ tib post dysfunction
48
What is pes cavus?
Increased height of medial arch - think neurological condition
49
Name a medial ligament of the foot and ankle?
Deltoid
50
Name a lateral ligament of the foot and ankle?
Talofibular
51
What is tendo-achilles made up from and what does it do?
Plantar-flexes foot | Tendinous extension of gastrocnemius and soleus
52
What is the term for inflammation of the sheath covering two tendons of the wrist (1st dorsal compartment)?
De Quervains tenosynovitis
53
What two tendons are involved in De Quervains tenosynovitis
ABductor pollicis longus | Extensor pollicis brevis
54
How could a shoulder be anteriorly dislocated?
Fall with shoulder in external rotation
55
What assessment needs to be done on an anterior shoulder dislocation?
Regimental badge area sensory assessment for axillary nerve
56
How can a shoulder be posteriorly dislocated?
Fall with shoulder in internal rotation
57
For a posterior shoulder dislocation what sign is seen on x-ray?
Light bulb sign
58
What is the mechanism of interphalangeal joint dislocation?
Hyperextension injury, direct axial blow - ball sports
59
What way does the patella always dislocate?
Laterally
60
Name two things which increase the Q angle making patella dislocations more common?
1. Genu valgum | 2. Increased femoral neck anteversion
61
What does lateral collateral ligament injury and peroneal nerve injury suggest?
Dislocation of knee

JL Musculoskeletal (35 decks)

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