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MSK 1 > Extremities Red Flags > Flashcards

Extremities Red Flags Flashcards

1
Q

positioning/purpose of the olecranon-manubrium percussion test

A

elbows flexed at 90 across the chest
stethoscope over manubrium
olecranon percussed

UE fx

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2
Q

findings associated with radial head fx

A

elbow jt effusion
tender to palpation
elbow in loose packed position (70° flex and 10° supination)
restricted, painful supination/pronation

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3
Q

what are the amsterdam wrist rules

A

determines a pt’s need for radiographs

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4
Q

characteristics of a distal radius fx

A

increased age
swelling in wrist
visible deformation
painful to palpation
pain on ballottement test

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5
Q

what decreases the likelihood of a distal radius fx

A

pain in ulnar deviation

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6
Q

what is the ballottement test

A

stabilization of either the radius or ulna
moving the other bone

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7
Q

what are characteristics of a wrist fx

A

increased age
male
swelling of wrist / snuffbox
tender palpation
pain on radial deviation

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8
Q

carpal bone most often fx

A

scaphoid

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9
Q

imaging for carpal bone fx

A

radiographs - can miss 5-20%
MRI - hidden fx or avascular necrosis
CT

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10
Q

what is a big concern for scaphoid fxs

A

avascular necrosis due to the retrograde nature of blood supply

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11
Q

who is most at risk for a pancoast tumor

A

males over 50 who smoke

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12
Q

findings of a pancoast tumor

A

horner’s
shoulder/scapula pain
– may radiate into head, neck, chest
mimicking thoracic outlet syndrome
weakness/atrophy of hand muscle

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13
Q

what can cause Horner’s syndrome

A

carotid artery dissection
pancoast tumor
cervical spine injury

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14
Q

signs of horner’s

A

ptosis - drooped eyelid
miosis - pupil constriction
anhidrosis - no sweating
enophthalmos - sinking of eyeball

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15
Q
A
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16
Q

what causes CRPS-1? what type of pain is present?

A

injury w/o nerve involvement
after MI, CVA, disease of abdominal or thoracic viscera
nocioceptive pain

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17
Q

what causes CRPS-2? what type of pain will be present?

A

after injury with nerve involvement
neuropathic pain

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18
Q

sensory changes associated with CRPS1

A

allodynia
hypo/hyperalgesia
hypo/hyperesthesia

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19
Q

trophic changes from CRPS

A

changes to the
skin
hair
nail

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20
Q

autonomic changes due to CRPS

A

swelling
edema
sweating

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21
Q

motor changes due to CRPS

A

weakness
contractures
atrophy

22
Q

causes of acute compartment syndrome

A

trauma or exertional

23
Q

what can acute compartment syndrome lead to

A

permanent muscle / nerve damage

24
Q

findings of acute compartment syndrome

A

palpable tenderness/tension
severe pain out of proportion
paresthesia, paralysis, pulselessness
– more later

25
Q

history of septic arthritis

A

insidious onset of pain localized at a joint
IV drug use / infection
diabetes
trauma

26
Q

findings of septic arthritis

A

tenderness over jt
limited mvmt at jt
swelling at jt
fever

27
Q

symptoms of periprosthetic infection

A

local erythema
intense, persistent pain
non-healing incision
sudden change in <ROM and/or >pain

28
Q

is a referral warranted for
septic arthritis
periprosthetic infection

A

yes - immediate

29
Q

what is the female athlete triad

A

changes in energy levels w or w/o ED
changes in menstrual cycle
osteoporosis

30
Q

history of femoral head osteonecrosis

A

long-term corticosteroid use
hx of avascular necrosis in contra hip
hx of trauma

31
Q

findings of femoral head osteonecrosis? what motions would be restricted?

A

gradual onset of pain that is worse with weight bearing

restrictions of IR, Flex, add @ hip

32
Q

typical pt hx of femoral neck fx

A

older females (>70)
female athletes

33
Q

findings of femoral neck fx

A

severe, constant pain / > mvmt
stress fx
displaced fx

34
Q

what would make you suspect a femoral neck fx to be a stress fx

A
  • discomfort with hip A/PROM
  • pain with percussion over greater trochanter
35
Q

what would make you suspect a femoral neck fx to be a displaced fx

A

leg held in abduction and ER
with shortening

36
Q

types of stress fx

A

insufficiency fx
fatigue fx

37
Q

what is an insufficiency fx

A

abnormal bone broken under normal force

38
Q

what is a fatigue fx

A

normal bone put under extreme force

39
Q

difference in populations when comparing insufficiency and fatigue fx?

A

insufficiency - older people
fatigue - those partaking in high intensity activities

40
Q

common sites for stress fx

A

tibia
femur
pelvis

41
Q

tests for femoral stress fx

A

fulcrum test
patellar pubic percussion

42
Q

characteristics of legg-calve perthes disease

A

5-8 y/o
male > female
insidious onset of hip, groin, thigh pain
antalgic gait
decreased abduction, IR

43
Q

what causes legg-calve perthes

A

avascular necrosis

44
Q

characteristics of a SCFE

A

10-16 y/o
male > female
obese
antalgic gait
leg held in ER, prefer to sit with affected limb across the other

45
Q

what is SCFE

A

slipped capital femoral epiphysis

46
Q

what is a klein line

A

line drawn along the superior edge of femoral neck
should intersect the lateral aspect of superior femoral epiphysis

47
Q

how does the energy of trauma effect imaging in those with pelvis/hip fx

A

high - CT
low - routine radiograph with advanced imaging

48
Q

what are the names of the knee fx rules

A

ottawa
pittsburgh

49
Q

ankle portion of the ottawa foot and ankle rules

A

bone tenderness at posterior edge of lateral and/or medial malleolus

50
Q

foot portion of the ottawa foot and ankle rules

A

bone tenderness at either:
base of 5th metatarsal
navicular

51
Q

what is used to assess DVT

A

Well’s Test

52
Q

gold standard of DVT diagnosis

A

contrast venography

MSK 1 (8 decks)

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