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Q4 EM Surg > Exam 3 UE Ortho Emergencies > Flashcards

Exam 3 UE Ortho Emergencies Flashcards

1
Q

Ortho injury basic rules? (4)

A

Compare injured to non-injured
Assess neurovasc above and below
Assess joint above and below
Multiple views for all XRays

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2
Q

Clavicle Fxr C in what population?

U from what motion?

A

kids

fall onto outstretched hand

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3
Q

Clavicle Fxr of Proximal 1/3 from what?

Middle 1/3?

Distal 1/3?

A

Direct blow

Most C

Direct blow to top of shoulder

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4
Q

Clavicle Fxr diagnostics?

A

XRay

Note angle of deformity and placement of fxr

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5
Q

Clavicle Fxr tx?

Repeat XRay when?

U heals how?

A

Arm sling
Immobilizer
Figure 8 brace
Refer to ortho

Repeat XRay 1-2 wks

U heals w/ deformity but fxn is normal

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6
Q

Scapular Fxr C in what population?

C associated injuries?

A

Young men but still very rare fxr
Takes extreme force

1st rib fxr
Hemo/Pneumothorax

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7
Q

Scapular Fxr diagnostics?

Scapular Fxr in kids suspicious for?

A

XRay

Abuse

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8
Q

Scapular Fxr tx? (4)

A

Depends on type
U hospitalize to watch for pneumothorax
Refer to Ortho if Hemo
Ice, immob, analgesic

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9
Q

Proximal Humerus Fxr C in what population?

A

Old ladies

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10
Q

Proximal Humerus Fxr locations? (4)

A

Anatomic neck
Greater tuberosity
Lesser tuberosity
Surgical neck

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11
Q

Proximal Humerus Fxr presentation? (3)

A

Mod to severe soft tissue swelling
Ecchymosis
Tender to palp

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12
Q

Proximal Humerus Fxr tx?

A

Minimal displacement = ice, clam shell, sling

Refer to Ortho to preserve ROM

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13
Q

Humeral Shaft Fxr U a/w injury to what?

A

Radial nn

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14
Q

Humeral Shaft Fxr exam, important to document what?

A

Extension of wrist, thumb, fingers BEFORE manipulation

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15
Q

Humeral Shaft Fxr tx?

A

Ortho
Hanging cast
Sugar tong, Clamshell, Sling

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16
Q

Shoulder dislocation U where?

Result of?

A

Anterior

Abduction + external rotation

If posterior, U cause by seizure

17
Q

Shoulder dislocation presentation? (3)

A

Pt hold arm at slight abduction w/ opp hand
Prominent acromion
Should looks “squared off”

18
Q

Shoulder dislocation XRay views?

Always look for?

A

AP
Lateral
Y-View

Associated fxr of humeral tubers and glenoid

19
Q

Shoulder dislocation tx? (5)

A 
Immediate reduction
Counter traction
Post-reduction XRays
Sling
Refer to Ortho
20
Q

Shoulder dislocation reduction steps? (4)

A

1) Pt supine w/ elbow @ 90°
2) Shoulder in 20° forward flex
3) Shoulder externally rotate until forearm in coronal plane
4) Arm internally rotates until forearm in adduction (across belly)

21
Q

Supracondylar Fxr C in what population?

Result of what motion?

a/w injury to what? (3)

A

< 15 yo

Fall on outstretched hand (FOOSH) w/ elbow locked ->
causes posterior displacement of distal fragment of humerus

Brachial aa, Median nn, Tricep

22
Q

Supracondylar Fxr exam must include assessment of what?

A

Motor/Sensory Fxn of:
Ulnar, Median, Radial nn

Distal pulses

23
Q

Supracondylar Fxr w/ abrasions/lacerations require what?

A

Early surgery

24
Q

Supracondylar Fxr XRay findings?

Always look for?

A

Fluid accumulation POSTERIOR to distal humerus pushes fat pad out = Sail Sign

Associated dislocations
Olecranon

25
Q

Supracondylar Fxr tx?

Non-displaced?

A

Early Ortho for ROM preservation

Splint ok

26
Q

Nursemaid Elbow C in what population?

Result of what motion?

A

2-6 yo

Pulling on arm or falling ->
Subluxation of radial head

27
Q

Nursemaid Elbow presentation? (4)

A

Pt holds arm slight flex/pronation
Guards arm
No swelling, bruising or focal tender
P wrist/forearm pain

28
Q

Nursemaid Elbow tx?

A

Full extension in supination ->
Hold wrist ->
Thumb over radial head ->
Arm into flexion

Should be using arm in 5-10 min

29
Q

Forearm Fxrs result of what motion?

Uncommon forearm fxr?

A

FOOSH
Direct blow

Isolated Ulnar
(think direct blow/abuse)

30
Q

Forearm Fxrs presentation?

A

Local tender

Little swelling/ecchy

31
Q

Monteggia Fxr is?

Presentation?

A

Proximal 1/3 of ulna w/ disolcation of radial head
“M is More proximal”

Very painful
Short extremity
Radial head palpable in antecubital fossa

32
Q

Galeazzi Fxr is?

A

Fxrd radius w/ distal radioulnar joint disruption at wrist

33
Q

Colles’ Fxr is?

U a/w what other fxr?

A

Wrist Fxr causing Dorsal deformity of Distal Radius (dinner fork)
Result of FOOH

Ulnar

34
Q

Smiths’ and Barton Fxrs are?

A

Wrist fxrs causing Volar (palm) deformity of Distal Radius

Result of falling on back of hand

35
Q

Wrist Fxr tx?

A

Ortho
Non-displaced = Sugar tong or volar splint
Displaced = open/closed reduction
Immob 6-8 wks

36
Q

Scaphoid Fxr caused by what motion?

Presentation? (4)

A

(aka Navicular)
FOOSH

Anatomic snuff tender, esp w/ ulnar deviation
Min/No swelling/bruising
+/- painful thumb ROM
FREQUENTLY not visible on XRay

37
Q

Scaphoid Fxr tx?

A

+ hx w/ tenderness = long arm thumb splint

Ortho to prevent avascular necrosis

Q4 EM Surg (27 decks)

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