Clinical Medicine Exam 1 MSK Flashcards

Question

Sprain

Answer 1

Stetched or torn ligament

Answer 2

FOOSH Typically unstable This is a fracture that is best NOT immobilized due to possible loss of ROM

Answer 3

Inflammation of a synovial membrane with purulent effusion into the joint capsule, due to infection Knee mostly IV drugs, bacterimia, diabetes, RA joint surgery, HIV Infection symptoms Antibiotics (vanc, cef)

Answer 4

Students elbow Enlarged bursa in elbow (point of elbow) Swelling, pain ROM not really affected RICE

Answer 5

Compact bone (osteons)

Answer 6

III = Tear all muscle fibers, fascia still intact Pain with weakness and loss of function

Answer 7

Usually prolapsed intervertebral disk and low back strain or Sciatica Imaging not usual initially nsaids, rest, PT/OT, fitness surgery last resort

Answer 8

``` Hemorrhage DIC Neurologic injury Vascular injury Compartment syndrome ```

Answer 9

``` PT/OT nsaids methotrexate steroids sulfa antimalarials ```

Answer 10

``` Podagra (big toe gout) small joints (toes, ankles, wrist, fingers) earlier in men, Rare in childhood Meat seafood beer worsen red, swollen, tophi ``` negatively birefridgerantly needle shaped crystals RICE, nsaids, colchicine, steroids, indomethacine no thiazides or ASA

Answer 11

III = Complete Tear with laxity and instability of joint Protected motion, possible, likely repair needed

Answer 12

layer of hyaline cartilage that covers joint surface allows the joint to move moe freely (at the ends of long bones) (covers the "head")

Answer 13

Knee dislocation with vascular compromise (not patella) Amputation Spinal fracture Open fractures

Answer 14

decompression allowing room for nerve root exit Spinal stenosis

Answer 15

I = Tear a few muscle fibers with fascia intact Pain, very little weakness or loss of function

Answer 16

Bony lumps in the second distal joint of phlange (middle joint or PIP) can cause pain and inflammation

Answer 17

AP Lateral Mortise Oblique

Answer 18

Humpback, curve of spine Congenital, traumatic or acquired

Answer 19

Occur on overlying skin due to swelling Appear as early as 6 hours post injury Usually clear fluid – if hemorrhagic, worse prognoses

Answer 20

``` Thinnest, most fragile part of the femur Very common (blood supply can be interuppeted) avascular necrosis can occur usually surgical ```

Answer 21

Steroid injection Glucosamine Hyaluronic acid

Answer 22

is a chronic autoimmune disease characterized by an inflammatory polyarthritis that preferentially affects the small joints. Anti-cyclic citrullinated peptide (anti-CCP or ACPA) is more specific and 95% of patients. Low in early disease. Erythrocyte Sedimentation rate (ESR) and C-reactive protein are elevated. RF is positive in 80 of patients but nonspecific

Answer 23

Most common primary tumor of bone 45% of all bone tumors over 40 Bone pain, increased protein, anemia, hypercalcemia, acute renal failure "punched out" lesions on imaging

Answer 24

2 types Intertrochanteric Fracture Area between the greater and lesser trochanters (blood supply ususally intact) Femur Neck “surgical neck” Thinnest, most fragile part of the femur Very common (blood supply can be interuppeted)

Answer 25

Comminuted fractures have > 2 bone fragments. Comminuted fractures include segmental fractures (2 separate breaks in a bone). i.e. shattered

Answer 26

Medial = golfers elbow Pain on inside of elbow repetitive stress MRI useful surgery rare

Answer 27

inflammation and pain below patella relieved by rest patellar tendon pulls on growth plate of tibia repeatedly imaging not necessary self limiting once growth plate ossifies Nsiads, RICE pediatric disease overuse injury

Answer 28

gonadla steroid deficiency estrogen deficiency in postmenopausal women (lower bone mass than men) Men can experience this too

Answer 29

Lewy bodies are a characteristic feature present in the brains of patients with Parkinson's disease and Lewy body dementia.

Answer 30

Stress fractures | ie shin spints

Answer 31

Most common joint dislocation, 95% of dislocations loss of rounded appearance of shoulder

Answer 32

Segmental fractures are broken completely into seperate pieces i.e. an island

Answer 33

AP hips Frog Leg

Answer 34

Medullary cavity on diaphysis or shaft of long bone

Answer 35

reserved for patients with radicular pain, or unstable spine and other options have not been effective. Long recovery. Spinal stenosis

Answer 36

Open Reduction Internal Fixation (ORIF) – surgical procedure with use of plates, rods, screws, pins, staples.

Answer 37

club foot internal rotation of foot contracted achilles tendon (plantar flexion)

Answer 38

Osteoarthritis Articular cartilage softens and degenrates Bone spurs can develop Cracking and crepitus progressive loss of cartilage

Answer 39

CREST Calcinosis (Calcium deposits in skin) Raynauds Esophageal dysfunction Sclerodactyly (thickend collagen on fingers) Telangiectasias (dilation of capillaries on skin) (redness)

Answer 40

Oblique fractures occur at an angle.

Answer 41

fracture of the pars interarticularis

Answer 42

Schistocytes are fragmented pieces of red blood cells. These are commonly found in patients with hemolytic anemia or microangiopathic diseases, such as disseminated intravascular coagulation.

Answer 43

Osteoblasts seek out microcracks They then secret RANKL RANKL binds with monocytes This causes them to form osteoclasts Osteoclasts secrete enzymes (dissolves and creates holes in bone This causes the hydroxyapatite to break down in calcium and phosphate releasing it into the blood Osteoblasts then begin to secrete osteoprogenrin that deactivates RANKL This slows the osteoclast activity Calcium and phosphate deposit on the seams, some osteoblasts get trapped in the lacunae and turn into osteocytes

Answer 44

Osteonecrosis blood supply is cut off Bone & tissue die MRI without a contrast agent continues to be the "gold standard

Answer 45

hematoma fibrocartilaginous callus forms Bony callus forms Bone remodeling

Answer 46

bone density has decreased but is not considered dangerous yet precursor to osteoporosis

Answer 47

lamina removed, plates and screws replace Spinal stenosis

Answer 48

At the ends of long bone epiphysis and metaphysis lattice of bone slivers of bone called spicules thin plates of bone call trebeculae spaces filled with red marrow very few osteons (no central canals) provides strength with minimal weight

Answer 49

Exercise and stretching much is the result of being sedintary and under use

Answer 50

I = Partial tear but no instability of joint Symptomatic treatment only

Answer 51

Virus caused Skin lesions-palpable purpura, and livedo reticularis Fever, anorexia, weight loss, abd pain, peripheral neuropathy, arthralgias, HTN, edema, uremia, oliguria HEp b antigen, ESR & CRP elevated, proteinuria steroids, cytotoxic drugs 10-20% die (GI / CV issues)

Answer 52

distal end of radius with dorsal angulation | FOOSH Most common type

Answer 53

large joints not uric acid (calcium pyrophosphate crystals) Painful, red, swollen but no tophi Rhomboid shaped crytals positively birefridgerant RICE, nsaids, colchicine, steroids, indomethacine

Answer 54

impacted fractures, bone fragments are driven into each other, shortening the bone; these fractures may be visible as a focal abnormal density in trabeculae or irregularities in bone cortex.

Answer 55

Age related Muscle loss ``` Reduced satellite cells loss of muscel mass increased adipose tissue fiber types transition from fast toslow twitch fibers reduced number of mitochondria calcium deficits/release ```

Answer 56

distal 3rd of the 5th metacarpal

Answer 57

Standard deviations from the mean for young adults DEXA Scan Normal = 1 or less Osteopenia = between 1 & 2.5 Osteoporosis = more than 2.5 Severe osteoporosis = more than 2.5 w/ Fx

Answer 58

Bursa -fibrous sac filled with synovial fluid Tendon sheath -elongated cylindrical bura wrapped around a tendon Meniscus -moon shaped cartilage in the knee

Answer 59

ID patient and right/left Bone and Joint Alignment Joint spaces Cortical outline Bone texture Soft tissues

Answer 60

``` DVT Infection PE Muscle atrophy Psychiatric disorders ``` Geriatrics are increased risk

Answer 61

1 High uric acid levels 2 Acute gout 3 intercritical gout (remission periods) 4 Chronic gout

Answer 62

Many types females, 3rd decade knee, distal radius, sacrum large effusion, painful surgery

Answer 63

Type A = clears debris Type B = produce components of synovial fluid

Answer 64

Hematoma formation Soft callus forms Hard callus forms Bone Remodeling

Answer 65

Elevated BP, Blood sugar, Chloesterol increased body fat around waist

Answer 66

Chronic inflammatory disease of the axial skeleton human leukocyte antigen (HLA)- B27 surface antigen found in 88 to 96% of patients. It is thought that the combo of this antigen and an exogenic component (Klebsiella or Chlamydia) trigger disease process Imaging = bamboo spine 30 degree forward lean (posture) nsaids, bracing, swiming PT for posture may need surgery

Answer 67

it causes the bones to harden in children this is called ricketts in adults it can be osteomalcia without it you end up with soft bones

Answer 68

Reiters syndrome (rare) Can't see, cant pee, cant climb a tree vision (conjunctivitis), urinary issues, arthritis STI of Chlamydia urethritis or gastroenteritis HLA-b27 antigen 80% positive PT, nsaids, antibiotics

Answer 69

``` Stable Open, compund Transverse Oblique Comminuted Compression Stress ```

Answer 70

Fibrous 3 fibrous are suture, gomphosis, syndemosis Cartilaginous synchondroses (connected by hyaline cartilage) ribs and sternum and symphyses (connected by fibrocartilage) ie intervertebral discs Synovial

Answer 71

filter paper is placed inside lower eyelid eyes closed for 5 mins paper is then measured for moisture

Answer 72

Median neuropathy Compression of median nerve as it crosses under the flexor retinaculum at wrist Tinel test, phalen sign nsaids, splinting, may need surgery

Answer 73

Teeth grinding

Answer 74

``` Location Direction Alignment Open vs closed Displaced ```

Answer 75

Russell bodies are the accumulation of immunoglobulin in plasma cells: a characteristic finding in patients with multiple myeloma

Answer 76

Dislocations that reduce spontaneously require immobilization for 2-4 weeks then ROM activity then return to normal activity

Answer 77

Excellent blood supply Heal without immobilization Think about a pneumothorax with high impact injury (Sports, osteoporosis, cancer)

Answer 78

Spiral fractures result from a rotatory mechanism; on x-rays, they are differentiated from oblique fractures by a component parallel to the long axis of bone in at least 1 view

Answer 79

Autoimmune disorder characterized by inflammation, positive ANA level and involvement of multiple organs. ANA 99%, also Anti-dsDNA, anti-Smith antibody women, AA unkown cause, maybe genetic, environmental, dietary Malar rash, fatigue, fever, UV sensitivity, hair loss, joint issues Sun protection, hydroxychloroquine

Answer 80

Lateral = Tennis elbow Pain on outside of elbow Most common elbow injury 4th decade surgery rare

Answer 81

Periosteum

Answer 82

bone density decreases | age, postmenopausal women

Answer 83

Most common site – anterior compartment of lower leg pain increases or seems out of proportion to known injury ``` 5 P's Pain Pallor Pulselessness Parasthesia Paralysis ```

Answer 84

Stress, teeth grinding Restricted ROM, pain, click/pop normal xray

Answer 85

One third is organic matter Osteoblasts synthesize collagen, carbohydrate protein complexes, two thirds is inorganic matter 85% hydroxyapatite (crystalized calcium salts) 10% calcium carbonate other misc minerals

Answer 86

the ability to adapt to stress (plasticity of bone) Increase the stress to a bone, it will increase bone density Decreasing the stress will reduce the density

Answer 87

Laminectomy – most common, removal of lamina, bone spurs Laminoplasty – lamina removed, plates and screws replace Foraminotomy - decompression allowing room for nerve root exit Interspinous Process Spacers – spacers placed between spinous processes to create room, also involves a partial laminectomy Spinal fusion – reserved for patients with radicular pain, or unstable spine and other options have not been effective. Long recovery.

Answer 88

Compression 1pt Burst 2pts Translation / rotation 3pts Distraction 4pts

Answer 89

90% are from falls Women 2-3 times more likely Types= Subcapital neck fx (top of neck) Transcervial neck fx (mid neck) intertrochanteric fx (below neck)(through trochanter) Subtrochanteric fx (top of shaft below trochanter) Greater trochanter fx lesser trochanter fx

Answer 90

Usually asymptomatic | x ray

Answer 91

Notorious for having a poor blood supply, particularly at the junction of the middle and distal thirds Very prone to nonunion

Answer 92

1200 for women 1000 for men ages 51-70 1200 for all over 70

Answer 93

Signs of inflammation | Swelling around fracture site

Answer 94

Synarthroses (no movement) ie sutures in skull Amphiarthroses (small amount of movement) ie pubic symphysis Diarthroses (freely movable) ie regular joints

Answer 95

Trauma to muscle or musclotendinous unit

Answer 96

Muscles to bone

Answer 97

Calcitirol | PTH (parathyroid hormone)

Answer 98

Bone to bone

Answer 99

Spongy bone | filled with red bone marrow

Answer 100

MRI is gold standard Nsaids, rest, steroid injection, PT, strength exercises Can need surgical repair

Answer 101

I = Tear a few muscle fibers with fascia intact II = Tear moderate amount of muscle fibers fascia is intact III = Tear all muscle fibers, fascia still intact IV = Tear all muscle fibers, Fascia is disrupted

Answer 102

Musculotendinuos unit injury | pulled muscle

Answer 103

In an adult when the growth plate is closed (line of compact bone between the epiphysis and the metaphysis)

Answer 104

``` Tendonitis (inflammed) Tendinosis (tiny tears, still intact) Tendon rupture (tears) ``` NO STEROIDS INJECTIONS Usual surgery for rupture MRI

Answer 105

II = Tear moderate amount of muscle fibers fascia is intact Pain with weakness, no loss of function

Answer 106

3-4 hours changes are reversible 6 hours muscle damage 8 hours irreversible muscle damage

Answer 107

OLD ACID O Open or closed L Location D degree (Complete vs incomplete) (broken in 2 parts) A Articular extenision (joint involvement) C Comminuted (shattered?) I Intrinstic bone quality (pathology) D Displacement?

Answer 108

Disc herniation Assist in identifying patients most likely to benefit from surgery The presence of 3 or more Waddell signs is associated with poor outcomes due to underlying psychosocial issues. Signs are: superficial and non—atomic tenderness, axial loading and acetabular rotation simulation, distraction, regional sensory disturbance and weakness, overreaction

Answer 109

50% temporal arteritis over 50 associated with Giant cell arteritis ESR levels are markedly elevated. Temporal artery biopsy if suspected GCA steroids long term (2 years)

Answer 110

Injuries to ligaments

Answer 111

A "starry sky" pattern is seen in patients with Burkitt's lymphoma as a result of macrophages engulfing cellular debris.

Answer 112

AP Lateral Lower limbs might also add weight bearing and non weight bearing

Answer 113

They give the tendon (muscle) something to adhere to on the bone

Answer 114

Nerve and vascular bundle | perforating canals branch off periodically to spread supply around to bone

Answer 115

Hip is a joint not a bone Hip = Ball of the femur and acetabular socket of the pelvis Irony – neither a fracture of the ball of the femur (femoral head) or the acetabular socket is considered a “hip fracture”

Answer 116

WBC attack muscles (auto immune) unknown cause Trunk and torso higher in females ``` gradual skeletal muscle weakness (usually painless), Dysphagia Malar skin rash Polyarthralgias Muscle atrophy ``` CPK and aldolase levels are elevated steroids, methotrexate 5% die (usually due to cardiopulmonary complications)

Answer 117

a type of arthritis spurred by wear and tear to the spine. It happens when discs and joints degenerate, when bone spurs grow on the vertebrae, or both. Can also cause referred pain in the shoulder

Answer 118

Most spinal compression fractures are due to osteoporosis ``` no history of trauma dowagers hump (loss of height and rounded back ``` vertebral body collapse anlagesic, brace, possible surgery red flag is neuro compromise, bladder dysfunction

Answer 119

A state of Low bone mass

Answer 120

Diseased and Weakened bone ie osteoporosis hip/tochanter fractures microfractures in bones

Answer 121

Perforating (sharpeys) fibers (collagen fibers) | External sheath

Answer 122

Assess neuro function of injured limb Before and after every intervention i.e. immobilization, patient movement, pre and post op, on daily rounds, while waiting for radiology etc.

Answer 123

Can be seen as a haze or shading around bone

Answer 124

Insidious onset of pain in lower back, buttocks and heels Symptoms improve with activity during the day, and return in the evening Earliest changes – sacroiliac joints, proceeds up spine Loss of motion Lordosis of cervical and lumbar spine Synovitis, progressive fibrosis and ankylosis of joints Spinal kyphosis

Answer 125

greenstick fractures (cracks in only 1 side of the cortex) are childhood fractures.

Answer 126

``` Confirm Name and date Search for old films for comparision Identify bones and joints Is skeleton mature? Soft tissue injury or swelling Fractures, dislocations, joint ```

Answer 127

pars fracture or defect (seen on oblique view)

Answer 128

Excess rotation of femur Medial most comon usually with other ligament injury MRI gold standard Mcmurray test

Answer 129

Mostly due to OA & RA

Answer 130

Spondylosis is the most common condition affecting the cervical spine.

Answer 131

Salter Harris Fx

Answer 132

Direct bone breaks at site of impact or force indirect force occurs at a distance from wear fracture occurs ie twisting, spiral, bending, tension

Answer 133

a disc herniation will have a clinical presentation based upon where the herniation occurs L4/5 , L5/S1 most common Age, genetic inheritance, occupational and recreational injury, smoking, obesity Pain and symptoms worse in forward flexion, better in extension MRI Surgery not always required 90% spontaneous resolution in 12 weeks nsaids PT rest, oral steroids

Answer 134

Etiology: hypertrophic degenerative processes and spondylolisthesis compressing the cord, cauda equina, individual nerve roots, arterioles and capillaries No need for plain radiographs – lead to no change in treatment CT and MRI are helpful to guide intervention via injection or surgery nsaids, gaba, lyrica, PT, epidural, possible surgery

Answer 135

Dry eyes, mouth Autoimmune disorder that destroys the salivary and lacrimal glands RF is present in over 70% ANA in 60% Anti-Ro (SS-A) antibodies in 60% Anti-La (SS-B) antibodies in 40% Artificial tears, hydration, cyclosporin

Answer 136

Simple Bone Cyst usually from child hood fracture aspiration with steroid injection

Answer 137

Femoral head 5th metatarsal (jones Fx) Scaphoid Fx

Answer 138

Medullay cavity | filled with yellow bone marrow

Answer 139

interdigital neuroma pain in third web space between thrid and fourth metatarsals, radiating to third and fourth toes Ice, massage, inserts, nsaids

Answer 140

Sarcopenia Loss of muscle mass over time and age ``` fibers decrease water in tendons decreases grip strength decreases heart muscle declines metabolism slows lipids increase ``` Muscle replaced by adipose tissue

Answer 141

In children this is where the bone is elongating | thin layer of hyaline cartilage between epiphysis and metaphysis

Answer 142

spacers placed between spinous processes to create room, also involves a partial laminectomy Spinal stenosis

Answer 143

Enlarged ends of long bone | strengthen joint and anchor ligaments and tendons

Answer 144

Lateral = Tennis elbow Pain on outside of elbow Medial = golfers elbow Pain on inside of elbow

Answer 145

excess thickened collagen raynauds is symptom females 4 to 1, 30-50 Chronic and rare autoimmune systemic vascular and connective tissue disease localized or systemic ANA is present in 90% with diffuse scleroderma PPIs for GI, CCB for raynauds, immunosuppressive

Answer 146

Malunion – healing occurs but not in correct anatomical position Factors contributing to malunion – poor skill of clinician, inadequate blood flow, loss of reduction

Answer 147

Sunken chest Fatigue Shortness of breath/decreased exercise tolerance Chest pain Fast heart rate (tachycardia)

Answer 148

Torus fractures (buckling of the bone cortex) Bulging

Answer 149

Long bone fractures occur in 3 days from injury Tachypnea PE Confusion Petechial rash

Answer 150

Osteoarthritis

Answer 151

S P I N E ``` Saddle anaesthesia Pain incontinence Numbness Emergency ``` Emergent condition

Answer 152

IV = Tear all muscle fibers, Fascia is disrupted Pain with weakness and loss of function Complete rupture

Answer 153

Anterior and posterior acl more common than pcl women more affected Lachman, anterior drawer test MRI

Answer 154

Transverse fractures are perpendicular to the long axis of a bone.

Answer 155

``` SITS Supraspinatis Infraspinatie Teres Minor Subscapularis ```

Answer 156

Slipped capital femoral epiphysis Males, AA, athletes, 12-14 years pain, altered gait obese teen, dull nonradiating aching pain in hip, groin, thigh or knee, no trauma trendelenburg gait (pimp stroll) Urgent ortho eval Acute = under 2 weeks Chronic over 2 weeks will eventually progress to other side 30-60%

Answer 157

displaced = bone is not in normal alignment non displaced = bone is still in anatomical position Angulated = i.e. broken "v" angle Bayonetted = bone overlaps longitudinally Distracted = Bones are seperated by a Gap between Bones (segmented)

Answer 158

Mineral content decreases crush fractures of spine can occur less water in cartilage connective tissues lose elasticity

Answer 159

Types I and II

Answer 160

Arthritis found in people with psoriasis

Answer 161

Narrowing of any part of the lumbar spine – spinal canal, nerve root canal and intervertebral foramina usually in 60's, degenerative, CT or MRI Low back pain, pain in legs while walking similar to claudication RICE, nsaids, PT, steroid inection, possible surgery

Answer 162

Bone density decrease

Answer 163

not a true spinal cord syndrome instead it effects lumbar, sacral and coccygeal nerve roots Numerous etiologies – trauma, degenerative changes, vascular, Iatrogenic, neoplastic Diagnostic – high post-void residual, MRI Emergent condition

Answer 164

Closed = doesnt break skin open =breaks skin

Answer 165

Type I collagen is found in bones and skin Type II collagen is the main collagen in cartilage

Answer 166

``` Split Stretch Avulsion Tear Cut ```

Answer 167

Shaft of long bone (provides leverage)

Answer 168

FOOSH Most common type is Colles

Answer 169

``` immobilize, reduce sweling RICE Nsaids possible sedation, anesthesia, blocks possible surgery ```

Answer 170

Stabalize neck CT or MRI whichever is fast perform neuro exam, get Neuro consult

Answer 171

``` Hip Fx's Ankle Proximal humerus Distal radius Vertebral compresion Fx ``` all more common in women

Answer 172

Spurring femur bone Degenerated articular cartilage Spurring tibia bone Females, age

Answer 173

Non-union – failure of the fractured ends to bond, heal back together Factors influencing non-union – smoking, venous stasis disease, atherosclerosis, malnutrition

Answer 174

AP shoulder view | True AP = shows GH joint

Answer 175

Strain is tendon Sprain is ligament Most common ankle injury inversion on injury of the Anterior Talofibular ligamnet (sprain) (ATL) Anterior drawer test RICE, PT, xray to r/o Fx

Answer 176

Typically begin with plain radiograph CT to see bone well MRI to see tissue well Lot’s of exceptions!

Answer 177

Probably the injury that is the worst of all of the possible knee injuries 4 bones meet at knee

Answer 178

Fracture not involving a joint – plain X-ray Fracture involving joint – plain X-ray if NO ligamentous injury on clinical exam, MRI if joint function impaired or suspected injury Complex fractures requiring reconstruction – CT, spiral CT – think tri-malleolar ankle fracture, pelvic crush injury. Spine – typically MRI, especially if neurological deficit exists Back pain – typically does not require X-ray in younger adult with no history of injury

Answer 179

Complete misalignment of the bones and joint

Answer 180

``` RA = women 3 to 1 20-40 weeks to months symmetry improves with usage fatigue malaise ``` ``` OA= older years asymmetry Worse with use no additional symptoms ```

Answer 181

Reduction – the action of re-aligning fractured pieces of bone or placing a dislocated joint back into correct anatomical position

Answer 182

Bone infection Staph most common salmonella, pseudomonas, strep, e.coli etc Infection symptoms, fever, fatigue etc. xray, ct, mri, ultrasound (MRI is best) Woundcare, antibiotics (VANC)

Answer 183

Second most common bone tumor Aggressive malignancy with high rate of metastasis 5-25 y/o, males femur, pelvis, tibia, humerus, scapula “Hair on end” appearance, “onionskin”, Chemo, surgery

Answer 184

Superior and inferior rami – non-weight-bearing areas Typically occur in geriatric patients, trauma or demineralizing conditions Do not require surgery, can not be immobilized Curtail weight-bearing only for pain management Get patient up and mobilizing as soon as pain is tolerable Refer to Physical Therapy

Answer 185

Can.. alleviate pain relieve tension on nerves and vessels eliminating risk of conversion to open restores circulation to pulseless ext.

Answer 186

PARS defects are small stress fractures resulting from over-use, typically in a young athlete, results from repetitive hyperextension. rest, strength, streching splint Scotty dog sign with collar

Answer 187

Calcitonin

Answer 188

Articular cartilage (hyaline cartilage) Joint cavity Articular capsule Synovial fluid 3 possible reinforcing ligaments (capsular, intracapsular, extracapsular) Rich nerve and blood supply

Answer 189

Area between the greater and lesser trochanters (blood supply ususally intact) surgical fixation is common

Answer 190

Functional Joints | Structural Joints

Answer 191

Common Difficult ot see on film (might need MRI/Bone scan) avascular necrosis possible if untreated pain, swelling, bruising over snuff box THumb psica csat

Answer 192

I hate multiple meds causing queer problems IHMMCQP ``` INH Hydralazine Minocycline Methyldopa Chlorpromazine Quinidine Procainamide ```

Answer 193

Spongy bone (long bone) epiphysis

Answer 194

Developmental dysplasia of hip ball of hip comes out of socket can be due to shallow socket (acetabulum) can be comletely dislocated or subluxed (partial,loose) Tends to run in family usually left hip girls, first born, breech baby, low amniotic fluid (oligohydramnios) Legs differnet lenghts, skin folds uneven,, limb, Barlows test, ortalanis test May need pavlik harness or spica cast possible surgery

Answer 195

II = Partial tear with some instability and laxity of joint Protected motion, full healing expected

Answer 196

Avulsion fractures are caused by a tendon or ligament dislodging a bone fragment.

Answer 197

Persistent treatment in spite of a reasonable course of nonoperative treatment Profound or progressive motor deficit Cauda Equina Syndrome Intractable pain Patient preference

Answer 198

Sprains are uncommon in children with open growth plates. This is because the physis is weaker than the ligaments and the physis may fail before the ligament does Salter-Harris fractures & Avulsion fractures are more likely

Answer 199

Pain stiffness fatigue non restorative sleep

Answer 200

Injury Repetitive stress pathology

Answer 201

Strong blood supply Most managed conservatively with “figure 8” brace or sling of arm on fx side Out of activity ~ 8 weeks – 4 in a sling, 4-6 out Weight restriction to a few pounds May return to full weight training/physical work at 3 months Need radiographic confirmation of healing prior to returning to full activity

Answer 202

A connective tissue disorder, which causes skeletal defects. Is typically recognized by long limbs and ‘spider-like’ fingers, chest abnormalities and spine curvature

Answer 203

Below the ephyiseal line and above the diaphysis

Answer 204

``` 5 types All involve growth plate adult cannot have a SH Fx Type II is most common Worst prognosis is TYpe V ```

Answer 205

Teardrop-shaped erythrocytes (dacrocytes) are commonly present in patients with myelofibrosis, myeloid metaplasia, and beta-thalassemia major.

Answer 206

Inflammation of the plantar fascia heel pain, walking, weightbearing middle age, women, lots of walking, runner, poor flexion RICE, nsaids, stretches, inserts

Answer 207

Inflammation of two tendons and the sheath that controls thumb movement Women, 30-50, pregnancy lifestyles with frequent wrist movement Finklestein sign (thumb in fist, pain over thumb) nsaids, spica, PT/OT, Steroid inj, surg decompression

Answer 208

Tree trunk looking like bone cells (compact bone) concentric rings of osseus tissue Contain dark spots which are osteocytes ``` Parts include osteocytes, lacuna (lake around dark spots or osteocytes), canalculi, central canal, Lamella ```

Answer 209

a vertebra shifts due to instability can be degenerative or traumatic

Answer 210

External fixation – the use of an external brace to maintain alignment during healing

Answer 211

lateral curve of spine idiopathic, cogenital, neuromuscular admas test, forward bend test 25% is significant Bracing, surgery

Answer 212

Associated with HLA-27 surface antigen Progressive First radiologic sign – increased SI joint space Classic radiographic sign – “Bamboo Spine” Multi – system disease Hereditary component Loss of Kyphotic curve, plantar fasciitis, inflamed costosternal joints – typical triad, though not all will be present in all patients

Answer 213

Mneumonic SALTR (in relation to growth plate) Type = I = Straight (parallel and inside growth plate) II = Above III = Lower IV = Through (vertically through growth plate) V = Rammed together (crushed)

Answer 214

Young adult male Late teens to late twenties Better with activity, worse with rest Pain fluctuates Low back pain, SI pain, buttock pain Morning stiffness

Answer 215

both are used for compression fractures of spin Kypho a ballon is used, then cement Vertbro, imaging is used then cement (no ballon)

Answer 216

AC seperation, seperated shoulder 6 types Type 1 Ligament stretched Type 2 Partial rupture Type 3 Complete rupture Type 4 Clavicle is displaced over acromion process Type 5 Clavicle is displaced up, just under skin Type 6 Clavicle is displced uner acromion process(very rare)

Answer 217

Caused by disc herniation Compression of the L4 nerve Pain from lower back down to knee Compression of S1 nerve pain can go all the way to ankle Or can be caused by piriformis syndrome swollen piriformis muscle compresses nerve

Answer 218

a NORMAL appearance of the lumbar spine when seen on oblique view

Answer 219

Occurs with eccentric overload (Throwing objects), underlying glenohumeral instability, poor muscle strength and training errors. impingement of the supraspinatus tendon as it passed beneath the subacromial arch.

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Clinical Medicine Exam 1 MSK Flashcards

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