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Orthopedics > Exam 2 > Flashcards

Exam 2 Flashcards

1
Q

3 fused bones of pelvis

A

pubic bone, ilium, ischium

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2
Q

iliopectineal line

A

from ilium to pubic bone

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3
Q

ilioischial line

A

from ilium to ischium

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4
Q

Shenton’s line

A

from femoral neck to obturator ring

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5
Q

best way to evaluate SI joint

A

CT or Judet view

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6
Q

what do the arcuate lines on the sacrum represent

A

foramina where sacral spinal nerves exit

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7
Q

best way to evaluate sacrum

A

CT (obscured by gas and stool)

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8
Q

what type of joint is pubic symphysis

A

synchondrosis

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9
Q

what attaches to ASIS

A

sartorius

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10
Q

what attaches to AIIS

A

rectus femoris

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11
Q

3 locations for femoral neck fractures

A

subcapital, transcervical, basicervical

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12
Q

what inserts on greater trochanter

A

gluteus medius, gluteis minimus

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13
Q

what inserts on lesser trochanter

A

iliopsoas

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14
Q

what is the most common location for proximal femur fractures

A

intertrochanteric region

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15
Q

what occurs at the metaphysis in peds

A

growing bone matures into adult bone

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16
Q

what increases risk for femoral head AVN

A

the closer the fracture is to the femoral head

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17
Q

rotation in femur fractures

A

distal fragment tends to externally rotate

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18
Q

what does white areas around bone indicate

A

sclerotic, bone is healing

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19
Q

insufficiency fracture

A

normal stress on abnormal bone

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20
Q

what group more commonly experiences avulsion fractures and why

A

pediatrics; tendons are stronger than bone

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21
Q

what is a diastasis

A

pubic symphysis and SI joints are pulled apart

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22
Q

when does pelvic diastasis occur

A

vertical shear injury

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23
Q

why are pelvic diastasis life-threatening

A

blood loss

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24
Q

most common hip dislocation

A

posterior

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25
Q

what is a common cause of hip dislocation

A

MVC

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26
Q

what injury is commonly associated with hip dislocation

A

acetabular fracture

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27
Q

what causes an anterior or inferior hip dislocation

A

externally rotated hip with force along femur

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28
Q

common pelvis avulsion sites for peds

A

ASIS, AIIS

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29
Q

pediatric hip on x-ray

A

lucency around iliac crest and ischia

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30
Q

what is an apophysis

A

a growth plate in an area that doesn’t articulate with anything (greater trochanter)

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31
Q

best way to view ilium in pediatrics

A

false profile (60 degree rotation)

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32
Q

pathological process of osteoarthritis

A

damage to cartilage leads to damage to bone (microfractures) allowing synovial fluid to leak in (subchondral cysts) and osteophytes as bone tries to repair itself

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33
Q

hallmarks of osteoarthritis on imaging

A

osteophytes, asymmetric joint space loss, subchondral cysts, subchondral sclerosis

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34
Q

pathological process of inflammatory arthritis

A

inflammatory reaction in synovium leads to erosions that start at the edge of the bone and uniform thinning of cartilage. Increased bloodflow leads to increased osteoclast activity and osteoporosis

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35
Q

hallmarks of inflammatory arthritis on imaging

A

erosions, concentric/symmetric joint space loss, soft tissue swelling, osteoporosis

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36
Q

coxa profunda

A

femoral head pushes into acetabulum and pelvis, causing loss of iliopectineal line. Seen in inflammatory arthritis

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37
Q

causes of sacroiliitis

A

ankylosing spondylitis, IBD, septic joint, RA, psoriatic arthritis, reactive arthritis

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38
Q

where does ankylosing spondylitis start

A

SI joints

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39
Q

signs of sacroiliitis on imaging

A

sclerosis and symmetric SI joint widening

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40
Q

most common pediatric fracture

A

distal forearm

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41
Q

SH 1

A

through the growth plate, can look normal if nondisplaced

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42
Q

SH 2

A

through the growth plate and metaphysis

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43
Q

SH 3

A

through physis, epiphysis, and into joint

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44
Q

SH 4

A

metaphysis, physis, epiphysis

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45
Q

SH 5

A

crush injury to growth plate

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46
Q

most common SH fracture

A

type II

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47
Q

treatment for SH fracture

A

splinting, then casting, usually heals without complications

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48
Q

when to call ortho for SH fracture

A

type 3 and above

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49
Q

seq of SH 3

A

angular deformity due to premature closure of growth plate on one side

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50
Q

seq of SH 4

A

can cause angular deformity or cupping

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51
Q

seq of SH 5

A

premature growth plate closure causing limb length discrepancy

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52
Q

Tillaux fracture

A

ligamentous avulsion of tibia (pediatric version of ankle sprain)

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53
Q

what type of SH fracture is a Tillaux

A

3

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54
Q

how to image peds ankle fractures

A

CT

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55
Q

what is a toddler fracture

A

spiral fracture of tibia from learning to walk

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56
Q

what type of SH fracture is a SCFE

A

displaced type 1

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57
Q

imaging for SCFE

A

AP pelvis frog leg

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58
Q

ischium insertion

A

hamstrings

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59
Q

avulsion fracture of lesser trochanter

A

kickers

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60
Q

risk factor for developmental dysplasia of the hip

A

breech presentation

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61
Q

fractures seen in child abuse

A

metaphyseal corner fractures (avulsion fracture due to flailing limbs), rib fractures, skull fractures

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62
Q

how much angulation can a pediatric wrist fx have without needing surgery

A

45 degrees

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63
Q

phase 1 of fracture healing timeline

A

hematoma, 1 week

64
Q

phase 2 of fracture healing timeline

A

soft callus (2-3 weeks)

65
Q

phase 3 of fracture healing timeline

A

hard callus (4-16 weeks)

66
Q

phase 4 fracture healing timeline

A

remodelling (17 weeks)

67
Q

signs of SCFE

A

pain to groin, knee, thigh, antalgic gait, external rotation of the foot/hip and shortening

68
Q

osgood schlatter aka

A

tibial tubercle apophysitis

69
Q

osgood schlatter cause

A

stress to extensor mechanism (jumping)

70
Q

osgood schlatter presentation

A

pain to tibial tubercle, worse with activity, pain with extension against resistance, enlarged tibial tubercle

71
Q

osgood schlatter workup

A

AP/lateral knee radiographs

72
Q

osgood schlatter treatment

A

NSAIDs, rest, ice, activity modification, sleeves PRN. Or 6 weeks in extension cylinder cast OR ossicle excision

73
Q

common LCP population

A

males age 4-8

74
Q

LCP presentation

A

insidious onset of painless limp with intermittent hip/knee/groin/thigh pain

75
Q

LCP imaging

A

AP lateral pelvis frog leg

76
Q

LCP radiograph findings

A

medial joint space widening, crescent sign, sclerotic appearance

77
Q

LCP treatment, nonoperative

A

limit weight-bearing, activity restriction, maintain femoral head until ossification

78
Q

LCP treatment, operative

A

femoral osteotomy until old enough for hip replacement

79
Q

nursemaids elbow mechanism

A

sudden longitudinal traction applied to hand with elbow extended and forearm pronated

80
Q

nursemaids elbow pathophys

A

annular ligament becomes trapped between radial head and capitellum

81
Q

nursemaids elbow presentation

A

child holding arm flexed and pronated, heard pop, pain over lateral aspect of elbow with supination

82
Q

nursemaids elbow x-ray findings

A

radius is not in line with capitellum

83
Q

nursemaids elbow reduction

A

hold arm supinated and apply pressure over radial head and maximally flex arm

84
Q

clubfoot aka

A

congenital talipes equinovarus

85
Q

most common musculoskeletal birth defect

A

clubfoot

86
Q

clubfoot CAVE

A

cavus, adductus, varus, equinus

87
Q

treatment of clubfoot

A

Ponseti serial casting, new cast q 1-2 weeks

88
Q

causes of acute onset limp in peds

A

fracture, soft tissue injury, foreign body

89
Q

causes of insidious onset limp in peds

A

osgood-schlatter, stress fracture, chondromalacia patella, chondritis dessicans

90
Q

diagnosis for osteomyelitis

A

MRI

91
Q

diagnosis for bone malignancy

A

MRI

92
Q

symptoms of bone malignancy

A

pain at night, palpable mass

93
Q

signs of leukemia

A

neutropenia, decreased platelet count, anemia, night pain

94
Q

x-ray findings for leukemia

A

moth-ridden bone

95
Q

SI joint infection sign

A

positive FABER (flexion, abduction, external rotation)

96
Q

classic sign for septic arthritis

A

won’t bear weight

97
Q

septic arthritis diagnosis

A

ultrasound and joint aspiration

98
Q

SI joint infection diagnosis

A

MRI

99
Q

psoas abscess sign

A

psoas sign (pain with hip flexion)

100
Q

Barlow

A

adduct the hip while applying posterior force

101
Q

Ortolani

A

abduct the hip while applying anterior force

102
Q

sign of hip joint effusion

A

hip flexed, abducted, externally rotated

103
Q

when does bone malignancy occur

A

peds over 10

104
Q

3 types of femoroacetabular impingement

A

pincer, cam, combined

105
Q

pincer impingement

A

extra bone grows over the normal rim of the acetabulum, so the labrum gets crushed under the more prominent acetabulum. More common in middle-aged women

106
Q

cam impingement

A

femoral head isn’t round and doesn’t rotate well within the acetabulum and grinds the cartilage. young, athletic men

107
Q

mechanism of hip impingement

A

repeated overloading of structures, labral degeneration, osteoarthritis

108
Q

symptoms of hip impingement

A

groin pain worsened by hip flexion, difficulty sitting, limping, mechanical symptoms, gluteal or trochanteric pain

109
Q

test for hip impingement

A

Fadir test (flex the hip and internally rotate)

110
Q

treatment for hip impingement

A

activity modification, NSAIDs, PT, hip replacement

111
Q

trochanteric bursitis presentation

A

lateral hip/thigh pain, point tenderness over bursa over greater trochanter with bogginess, erythema, crepitus

112
Q

trochanteric bursitis mechanism

A

tight IT band, overexertion, trauma

113
Q

trochanteric bursitis treatment

A

NSAIDs, IT band stretching, PT, injections

114
Q

IT band syndrome presentation

A

pain over greater trochanter distal to lateral knee

115
Q

IT band syndrome mechanism

A

repetitive use

116
Q

IT band syndrome treatment

A

RICE, PT, massage, injections

117
Q

test for IT Band syndrome

A

Obers test (put leg behind off side of bed)

118
Q

AVN symptoms

A

asymptomatic, deep groin pain, eventual joint collapse

119
Q

AVN treatment pre-collapse

A

core decompression, vascularized fibular graft

120
Q

femoral neck stress fracture mechanism

A

repetitive loading of bone with microfractures and no opportunity to heal

121
Q

femoral neck stress fracture symptoms

A

insidious onset, improves with rest, benign physical exam

122
Q

radiograph findings of femoral neck stress fracture

A

may find linear lucency if late

123
Q

imaging for femoral neck stress fracture

A

MRI

124
Q

treatment for femoral neck stress fracture

A

NWB or percutaneous screw fixation if severe

125
Q

Maisonneuve fracture

A

fracture of fibula with ankle sprain

126
Q

fracture with highest risk of femoral head AVN

A

femoral neck, closer to the femoral head

127
Q

artery compromised in femoral neck fracture

A

medial circumflex

128
Q

artery potentially compromised in intertrochanteric fracture

A

lateral circumflex

129
Q

anterior dislocation of knee causes what

A

possible popliteal artery compromise

130
Q

bones of ankle

A

tibia, fibula, talus

131
Q

achilles tendon attachment

A

calcaneus

132
Q

talus articulates with

A

navicular

133
Q

calcaneus articulates with

A

cuboid

134
Q

navicular articulates with

A

cuneiforms

135
Q

what fracture is associated with inversion

A

lateral talus

136
Q

attachment of peroneus tendon

A

base of 5th metatarsal

137
Q

extensor complex components

A

quad muscles/tendon, patella, patellar tendon, tibia

138
Q

acl

A

prevents tibia from sliding anteriorly relative to the femur

139
Q

test for acl injury

A

lachman, anterior drawer

140
Q

pcl

A

prevents tibia from sliding posteriorly relative to femur

141
Q

pcl injury mechanism

A

direct impact to tibia or forced hyperextension

142
Q

test for LCL injury

A

varus

143
Q

test for MCL injury

A

valgus

144
Q

what is attached to MCL

A

medial meniscus

145
Q

treatment for MCL

A

hinge knee brace

146
Q

terrible triad

A

ACL, MCL, medial meniscus

147
Q

test for meniscus

A

McMurray

148
Q

knee tendon rupture sign

A

cannot extend knee against gravity and cannot resist flexion

149
Q

treatment for knee tendon rupture

A

urgent surgical repair, NWB, immobilize knee in extension

150
Q

quad tendon rupture mechanism

A

sudden heavy load on partially flexed knee

151
Q

patella dislocation mechanism

A

rapid change of direction, usually displaces laterally

152
Q

patella dislocation treatment

A

PT, RICE, NSAIDs, braces, possible MPFL reconstruction

153
Q

patella dislocation test

A

patellar apprehension sign, J tracking

154
Q

when is surgery indicated for tibial plateau fractures

A

more than 3 mm displacement

155
Q

knee dislocation meaning

A

femur and tibia have dislocated

156
Q

ottawa ankle rules

A

pain near malleoli AND age over 55, unable walk 4 steps, bone tenderness at posterior edge of either malleolus

157
Q

when to get ankle-brachial index

A

knee dislocations

Orthopedics (3 decks)

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