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MSK > Clinical Conditions > Flashcards

Clinical Conditions Flashcards

1
Q

What is the role of the coracoacromial arch in the event of a FOOSH?

A

Prevents displacement of clavicle and dislocation of shoulder

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2
Q

Which nerve is most at risk in dislocation of the humeral head from the glenoid cavity?

A

Axillary Nerve

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3
Q

How would one test for damage to the axillary nerve following humeral dislocation?

A

Test shoulder abduction as deltoid innervated by Ax.N.

Test sensation in regimental badge area

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4
Q

State two common causes of Posterior Dislocation of the humerus

A

Electric shock

Seizure

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5
Q

What is the pathophysiology of calcific tendonitis?

A

Calcium hydroxyapatite deposit associate with tendon

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6
Q

Name a common symptom of impingement

A

Low painful arc

or tender over tuberosity

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7
Q

Which test is often used to diagnose impingement of supraspinatus?

A

Hawkins Test

Will be positive with impingement

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8
Q

List 3 treatments for impingement

A

Physio
Steroids
Surgical decompression

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9
Q

What other condition can give signs of impingement?

A

Rotator cuff tear

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10
Q

Which 4 tests will show abnormalities in event of rotator cuff tear?

A

Supraspinatus test (weak)
Infraspinatus (weak)
Subscapularis lift-off (weak)
Belly press (weak)

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11
Q

What form of surgery is used to repair RC tears?

A

Open repair - augmentation with allograft

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12
Q

In which group is RC arthropathy most common?

A

The Elderly

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13
Q

What action is taken in the event of RC Arthropathy if athritis is present and the cuff is irreparable?

A

Reverse anatomy shoulder replacement

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14
Q

What symptoms might someone with AC Osteoarthritis experience?

A

Majority are asymptomatic but may have a high painful arc and joint tenderness

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15
Q

Which test will be positive in AC Osteoarthritis?

A

Scarf test

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16
Q

What pharmaceutical interventions are possible for AC Osteoarthritis?

A

NSAIDS and steroid injections

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17
Q

What surgical intervention can be indicated for AC Osteoarthritis?

A

Excision of lateral clavicle

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18
Q

What would a person with GH Osteoarthritis experience?

A

Progressive pain and stiffness over the years

Crepitus

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19
Q

List 3 treatments for GH Osteoarthritis

A

Analgaesia and exercises
Steroid injections
Joint replacement

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20
Q

What does an elbow dislocation usually follow?

A

FOOSH!

It’s a good acronym, say it again!

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21
Q

What is the initial management for elbow dislocation?

A 
Sling (point to elbow, people, it's not that hard) 
Splintage 
Analgesia 
NVT Assessment 
X-Ray
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22
Q

What definitive management is carried out for elbow dislocations?

A

Closed reduction under sedation/anaesthesia
Reassess NVT and stability
Cast for 2 weeks
Re-X-Ray

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23
Q

What does a supracondylar fracture usually follow?

A

FOOSH!

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24
Q

List some NVT assessments you might perform following a supracondylar fracture of the distal humerus

A

Parasthaesia
OK Sign
Radial pulse
Capillary return

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25
Q

Which 2 surgical procedures may be performed following supracondylar #?

A

Manipulation Under Anaesthesia (MUA)

Open reduction

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26
Q

Which is the most common elbow fracture?

A

Radial head/neck

27
Q

As an occult fracture, what sign might one look for when diagnosing radial head/neck fractures?

A

Fat pad sign

28
Q

What can cause subluxation of the radial head/Pulled elbow/Nursemaid’s elbow?

A

Longitudinal traction along extended arm

29
Q

What will parents notice if their larva has a pulled elbow?

A

It won’t use or move the arm very much

30
Q

What 2 treatment methods can be used for pulled elbow?

A

Closed reduction

Sling - spontaneous resolution

31
Q

What’s the more impressive term for tennis elbow?

A

Lateral Epicondylitis

32
Q

What are the common causes of lateral elbow tendinopathy?

A

Manual work
Sports
–Repetitive activity

33
Q

What is the suggested treatment for tennis elbow?

A

Activity modification, brace, physiotherapy, various injections, surgery

34
Q

Of what should one be aware when diagnosing lateral epicondylitis?

A

Could be radiating pain from neck or shoulder

35
Q

What is the less impressive term for golfer’s elbow?

A

Medial epicondylitis

36
Q

What is medial epicondylitis?

A

Degenerative tendinopathy of the common flexor origin

Or etymologically, inflammation of the medial epicondyle, but that’s a semantic argument…

37
Q

What is a common extra-articular manifestation of Rheumatoid Arthritis?

A

Rheumatoid nodules

38
Q

What treatment is available for rheumatoid nodules?

A

DMARDs (Disease-Modifying Anti-Rheumatic Drugs) eg methotrexate
Biologics

39
Q

What is olecranon bursitis?

A

Inflammation of olecranon bursa due to trauma or friction

40
Q

What are the characteristics of olecranon bursitis?

A

Soft, cystic, transilluminatory swelling

41
Q

How might one treat olecranon bursitis?

A

Aspiration

Surgery

42
Q

What is gouty tophi?

A

Disorder of nucleic acid metabolism leading to hyperuicaemia and subsequent urate crystal deposits

43
Q

What does gouty tophie affect?

A

Joints - recurrent attacks of arthritis

Soft tissues - ear, elbows, achilles tendon

44
Q

What are the two types of # of the distal radius?

A

Colles’ - dorsal displacement and angulation, FOOSH

Smith’s - palmar displacement and anulation

45
Q

What complication can occur following a scaphoid #?

A

Avascular necrosis of proximal segment

46
Q

Where will a patient likely experience tenderness with scaphoid #?

A

Anatomical snuffbox

47
Q

What is the problem with diagnosis scaphoid #s from X-rays?

A

Delayed presentation on X-ray

48
Q

What treatments can be used for scaphoid #s?

A

Cast - 2-3 months

Surgery if unstable, displaced, or delayed/non-union

49
Q

What is cubital tunnel syndrome?

A

Compression of ulnar nerve at elbow

50
Q

What might a person with cubital tunnel syndrome experience?

A

Paraesthesia, numbness, and weakness as well as a hypersensitive ‘funny bone’

51
Q

What is tenosynovitis of the 1st dorsal compartment?

A

Swelling of sheath surrounding tendon of abductor pollicis longus and extensor pollicis brevis

52
Q

What diagnostic test can be performed to diagnose tenosynovitis?

A

Finkelstein’s test

53
Q

What treatments are available for tenosynovitis?

A

Steroid injections
Splint
Surgery

54
Q

What is Dupuytren’s disease?

A

Functional deficit caused by proximal interphalangeal joint contracture of >30 degrees (often genetic but can be due to diabetes, alcoholic liver disease, or epilepsy_

55
Q

What treatments can be used for carpal tunnel syndrome?

A 
Splint
Steroids
Surgery 
NSAIDs
Physio
56
Q

Which meniscus of the knee is most commonly torn?

A

Medial

57
Q

What is the unhappy triad?

A

ACL, medial collateral ligament, and medial meniscus all torn
Commonly caused by twisting with a planted foot

58
Q

Why might a ‘locked’ knee present with meniscal tears?

A

Femur ‘catches’ on tibia preventing smooth articulation

59
Q

What is housemaid’s knee?

A

Prepatellar bursitis caused by prolonged periods of genuflection

60
Q

What is Clergyman’s knee?

A

Infrapatellar bursitis cause by prolonged periods of genuflection

61
Q

Why are shortening and external rotation found in a patient with an intertrochanteric fracture of the femur?

A

Gluteus medius and minimus, piriformis, obturator internus and externus, and gemelli muscles attach to greater trochanter which pull the femur upward and laterally.

62
Q

What causes shortening and internal rotation of the leg in posterior hip dislocations?

A

Internal rotation from gluteus medius and minimus

Locked into shortened position by gluteus maximus and hamstrings

63
Q

Why might hemiarthroplasty not be effective for intracapsular femoral fractures?

A

Avascular necrosis may cause head of femur to die and fixation would fail

MSK (8 decks)

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