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Orthopedics > Exam 1 Review > Flashcards

Exam 1 Review Flashcards

1
Q

A patient comes in complaining they have fallen on an outstretched hand; you see their hand and notice it looks like a “silver fork deformity”; based on this information, what do you think this patient has? How would you treat this patient?

A
  1. Colles Fx

2. Reduce it then 6 weeks cast: First a LAC then a SAC

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2
Q

What is the hook of hamate the point of attachment for? And why is this important?

A
  1. Point of attachment for the hypothenar muscles
  2. when fractured through the base, these muscles alternately stress the fx in different directions, pre-disposing to non-union
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3
Q

What is the most common way to get a wrist fx?

A 
FOOSH
Fall 
On 
Outstretched 
Hand
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4
Q

What is a Colles Fx?

A

When a piece of the distal radius breaks off and goes dorsally

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5
Q

A 64 year old Grandma Moses presents with pain in her anatomical snuffbox and a swollen wrist. She states she fell on her outstreched hand. Based on this info, what does she have? Where would you suspect this fx to be specifically?

A

Scaphoid Fx involving the waist (adult)

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6
Q

Han Solo is a professional baseball player. He recently tripped and fell while holding a baseball in his hand. He is complaining of pain with flexion of his little finger. Based on this, what do you Solo has?

A

A hook of Hamate fx

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7
Q

A child comes in with wrist swelling, and pain in their anatomical snuffbox. She fell on her outstretched hand. Based on this, what do you think this child has?

A

Scaphoid Fx involving the distal pole (child)

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8
Q

Where does the blood supply to the scaphoid come from?
A. Proximal pole
B. Waist
C. Distal pole

A

C. Distal Pole

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9
Q

What is a secondary role of the hook of hamate?

A

as a trochlea for the flexor tendons of the small finger

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10
Q

What is mallet finger (simple definition)?

A

A terminal extensor avulsion

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11
Q

What does a chronic mallet finger lead to?

A

Swan neck deformity

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12
Q

Surface irregularities or chronic inflammation can result in what?

A
  1. Flexor tendon rupture
  2. Ulnar neuritis
  3. Ulnar artery occlusion in Guyon’s canal
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13
Q

What is another nickname for mallet finger?

A

baseball finger

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14
Q

What is Jersey finger?

A

terminal flexor avulsion

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15
Q

What is the standard treatment for a hook of hamate fx?

A

excision of the hook fragment and smoothing the base to prevent future tendon chafing

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16
Q

What is Mallet finger? And how will the patient present?

A
  • It is a rupture of the intrinsic (EDC) on the dorsum of the base of the distal phalanx.
  • The patient will be unable to extend their DIP
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17
Q

Describe some features or characteristics of a metacarpal fx.

A

Transverse and short oblique fx

Usually stable after closed reduction

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18
Q

How long do you keep a Mallet finger in a splint?

A

8 weeks!!!!!! (Made a big deal about this in class!)

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19
Q

What is the max solar angulation that a Boxer Fx can accept?

A

40 degrees

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20
Q

What is a Boxers Fx?

A

injury to the 5th metacarpal

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21
Q

What is a “seymour fx”?

A

a crush injury of the DISTAL phalanx where the nail bed gets smushed down by a crushing object–may develop a hematoma under the nail bed (beware: may present like mallet finger)

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22
Q

If a patient has a subungual hematoma, should you put them on antibiotics?

A

Yuuuuuppp!!

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23
Q

How would someone get a Boxers fx? (What is the mechanism?)

A

Impaction force exerted through the distal end of the metacarpal in closed fist position
-Fx occurs at the neck of the 5th metacarpal

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24
Q

Brittany Llama-face has just suffered a crush injury to their distal phalax and developed a sublingual hematoma. She is wondering if her nail is going to come back normal or all fugly. What should you tell her?

A

Wait 6 months: if it comes back ok–than the nail will be ok.

If it comes back fugly or not at all, then she is out of luck! Fugly nail is there to stay…

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25
Q

What functional test could you do for someone with a suspected Boxers fx?

A

percussion

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26
Q

T/F: Middle phalanx fractures take longer to heal because of the cortical bone.

A

True

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27
Q

What is the difference in treatment for a middle phalanx fx that is oblique and spiral VS. an intraarticular fx?

A

For an oblique/spiral fx, internal fixation is treatment

For an intraarticular fx, anatomic reduction is treatment

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28
Q

What is a Boutonniere deformity?

A

a central slip rupture

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29
Q

Fill in the blank in reference to Boutonnieres deformity:
PIP: ? (flexed or extended)
DIP: ?

A

PIP: Flexed
DIP: Extended

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30
Q

What is the result of a volar plate rupture at the PIP and is often accompanied by triangular ligament rupture?

A

Swan Neck deformity

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31
Q

During a Swan neck deformity, what is causing the hyperextension at the PIP joint?

A

The lateral bands drift dorsally and exacerbate the hyperextension at the PIP joint

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32
Q

What central slip tendon is disrupted in Boutonnieres deformity?

A

Exten. Dig. Comm tendon

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33
Q

Your friend who is a geologist has no idea what a Dupuytren’s contracture is, but she has one! How would you explain to her what this is?

A
  • -It is a disorder of the skin and underlying tissue on the PALM of the hand.
  • -Thick, scarring tissue forms under the skin of the palm and may extend into the fingers, pulling them towards the palm and restricting motion.
  • -Usually occurs in mid-life and is idiopathic; although it tends to run in families
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34
Q

What muscle and nerve are being tested with Froment’s test?

A

ADDuctor pollicis longus and the ulnar nerve

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35
Q

What are some complications to a trigger finger surgery?

A
  1. infection
  2. scar
  3. stiffness
  4. nerve damage
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36
Q

When is surgery considered in a Duputren’s contracture? What type of incision is used? And what other method of treatment besides surgery is approved for this contracture?

A
  • -When the contracture is 30 degrees at the MCP and 10 degrees at the PIP joint
  • -a Z incision is used
  • -collagenage is approved
37
Q

What is the most common cause of trigger finger?

A

tenosynovitis

38
Q

After trigger finger surgery, when can daily activities be resumed?

A

1 week

39
Q

What is a felon?

A

pus in the pulp of the finger

40
Q

What is a common way someone can get septic flexor tenosynovitis?

A

Cat bites

41
Q

After trigger finger surgery, when can athletic activities be resumed?

A

3-4 weeks

42
Q

Regina walks in with the pulp of his finger swollen. You begin to drain it but it is clear–what do you suspect this is?

A

Herpetic Witlow

43
Q

What are the two ways to treat a trigger finger?

A
  1. Injection of steroid AROUND the tendon

2. Surgery (only done if the injection does not work)

44
Q

How would you distinguish between a Herpetic Witlow and a felon?

A

Herpetic Witlow: clear fluid in the pulp of the finger

Felon: PUS in the pulp of the finger

45
Q

T/F: Trigger finger can occur in any finger.

A

True

46
Q

What is going on with a patient who has septic tenosynovitis?

A
  • fusiform swelling of the digit
  • the hand or the digit is held in a semi-rigid position
  • any movement of the finger is painful
  • tenderness tends to be the greatest over the proximal portion of the tendon sheath*
47
Q

What is another name for Froment’s sign?

A

Key pinch test

48
Q

What causes trigger finger?

A

trigger finger is caused by a thickening on the tendon catching as it runs in and out of the sheath

49
Q

What test is the “OK” sign testing for?

A

Median nerve

50
Q

Which finger joint dislocation is most common?

A

PIP is most common

51
Q

How do you treat a finger joint dislocation?

A

Reduce after x-ray

splint then buddy tape

52
Q

What test is the opposite of the “OK” sign?

A

Froment’s sign; testing for Ulnar nerve

53
Q

What mechanism is behind most finger joint dislocations?

A

hyperextension stress

54
Q

How do DIP dislocations typically occur?

A

often by open injury

55
Q

Where do the MCP dislocations usually occur?

A

The index or small finger

56
Q

T/F: the PIP dorsal dislocations are RARE and involve the volar plate.

A

FALSE: dorsal dislocations are COMMON and usually involve the volar plate

57
Q

Which PIP dislocations are RARE?

A

Volar and rotary; Rotary is the rarest!

58
Q

Which finger dislocation usually needs an open reduction? and why?

A

MCP dislocation

Often irreducible closed secondary to interposed volar plate

59
Q

Which finger dislocation is often open injury and easy to reduce and often stable post reduction?

A

DIP dislocation

60
Q

If a patient has dislocated finger, what determines their stability?

A

stability is dependent on collateral ligament injury

61
Q

If a patient was experiencing Ulnar nerve compression, how would they present?

A

pain and paraesthesia of the ulnar 1.5 fingers

62
Q

What is the cubital tunnel?

A

The cubital tunnel is a space of the dorsal medial elbow which allows passage of the ulnar nerve around the elbow.
–It is bordered medially by the medial epicondyle of the humerus, laterally by the olecranon process of the ulna

63
Q

What causes Radial Tunnel Syndrome?

A

It is caused by increased pressure on the radial nerve as it travels from the upper arm (the brachial plexus) to the hand and wrist

64
Q

What do “jamming” dislocations cause?

A

Swan Neck deformity

65
Q

T/F: MCP joint dislocations are usually irreducible.

A

True

66
Q

If there is a fracture of the base of the first metacarpal–what is this caused and how does this usually happen?

A
  1. Bennet’s Fx

2. Caused by a punch or falling on an ABducted thumb

67
Q

What is the treatment for a Bennet’s fx?

A

immobilization and rehab

68
Q

What causes a scathe-lunate dissociation?

A

Tear of the scapho-lunate ligament that causes rotary subluxation

69
Q

An archaic carpenter who only uses an old fashioned hammer and nail presents with pain in his wrist. Based on this info, what does this dude have?

A

Intersection syndrome

70
Q

What is a rupture of the central slip with a subluxed lateral band (in the hand(?

A

Boutonnieres deformity

71
Q

Tony the Tiger got his finger caught in his jersey; to top everything off, he also hit that same finger on the tip–what would be a common injury with these events?

A

Mallet finger/Baseball finger

72
Q

Biceps rupture occurs secondary to what?

A

biceps tendonitis

73
Q

T/F: Biceps ruptures usually heal on their own

A

True

74
Q

Central stenosis of the spinal canal

A

neurogenic claudication

75
Q

How do you diagnose neurogenic claudication?

A

MRI/CT

76
Q

What is the treatment for neurogenic claudication?

A
  1. Rest
  2. Exersize
  3. NSAIDS
  4. lumbar epidural
77
Q

In a nutshell, what is frozen shoulder?

A

significant ROM decrease in the glenohumoral joint

78
Q

What are some common causes of frozen shoulder?

A
  1. Rotator cuff tendonitis
  2. Acute subacromial bursitis
    o Fractures of humeral head and neck
    o Paralytic stroke
79
Q

What disorder may accompany frozen shoulder?

A

reflex sympathetic dysrophe

80
Q

T/F: Pain in the thoracic spine is ok.

A

F: Any pain in the thoracic spine is BAD; refer to specialist.

81
Q

Regina Llama-Face presents with thoracic back pain with circumferential radiating pain to their thorax. She states it gets worse when she coughs or sneezes. Based on this info, what do you think she has?

A

HNP

82
Q

What test do you NOT perform with patients suffering from cervical myelopathy?

A

Spurlings maneuver

83
Q

What is DISH?

A

diffuse idiopathic skeletal hyperosteosis: a rheumatic disease characterized by a significant association with metabolic alterations with as an impaired lipid profile.

84
Q

What clinical signs do you see in DISH?

A

a hardening of tendons and ligaments that commonly affects the spine

85
Q

What is cheiroarthropathy?

A

Diabetic hand syndrome: a disorder in which the skin on the hands becomes waxy and thickened; eventually finger movement is limited

86
Q

Which type of Diabetics have a higher chance of getting osteoporosis?

A

Type I diabetics

87
Q

Which type of Diabetics have a higher chance of getting osteoarthritis?

A

Type II diabetics (likely due to obesity)

88
Q

T or F: People who have had diabetes for a long time have a higher chance of getting Dupuytren contracture.

A

True

Orthopedics (3 decks)

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