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Specialty Medicine > Fractures and dislocations > Flashcards

Fractures and dislocations Flashcards

1
Q

What is used as the midline in the hand when describing movements?

A

middle finger

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2
Q

How is angulation described in regards to bone fractures?

A

Direction of the apex (tip of triangle formed pointing toward or away from midline)

Medial angulation can be termed ‘varus’, and lateral angulation can be termed ‘valgus’.

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3
Q

How is displacement described in regards to bone fractures?

A

Relative to midline (toward or away)

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4
Q

What is the “correct” terminology for naming fingers in regard to orthopedic language?

A

Name the common name of the digit–not the number (?)

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5
Q

How do you correctly state direction in the forearm?

A

Whether it’s radial or ulnar displaced

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6
Q

What is the key history bit that is needed when seeing an arm/hand injury?

A

Dominant hand?

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7
Q

What are the four key things that should be checked if there is an extremity injury?

A

Circulation
Motion
Sensation

Look at joints above and below

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8
Q

What is the epiphysis?

A

End of a long bone

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9
Q

What is the diaphysis?

A

Shaft of a long bone

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10
Q

How are trabeculations arranged in long bones?

A

Along the lines of stress

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11
Q

Which is stronger: a solid or tubular bone?

A

Tubular

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12
Q

Where does the blood supply come through the bone?

A

Through the periosteum

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13
Q

What is the technical term for the growth plate?

A

Physis or epiphyseal plate

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14
Q

What is a type 1 fracture in children?

A

Runs along the metaphyseal plate

http://radiopaedia.org/articles/salter-harris-fractures

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15
Q

What is a type 2 fracture in children?

A

Runs along the metaphyseal plate, but then exits before it is completely transected, and heads away from the epiphysis

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16
Q

What is a type 3 fracture in children?

A

Fracture that begins in the metaphyseal plate, but then immediately exits toward the epiphysis

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17
Q

What is a type 4 fracture in children?

A

Fracture that transects the metaphysis

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18
Q

What is a type 5 fracture in children?

A

Crushing injury to the metaphysis, stopping bone growth

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19
Q

What is the blood supply to bones? venous drainage?

A

Periosteal arteries and epiphyseal veins

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20
Q

True or false: the periosteum is richly innervated

A

True

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21
Q

How are calluses oriented to the bone fracture?

A

Follows periosteum

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22
Q

What is the role of the synovial fluid in joint space fractures?

A

may prevent healing

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23
Q

True or false: cartilaginous lining heals poorly

A

True

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24
Q

What is a major issue with join space fractures?

A

Causes misalignment, that may produce issues with weight bearing

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25
Q

What are the two most commonly dislocated joints?

A

Shoulder and fingers

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26
Q

What three joints that are devastating if dislocated?

A

Knee
Elbow
Hip

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27
Q

What is the function of the scapula, per Benzoni?

A

Protect the thorax

28
Q

What is the treatment for a fractured scapula?

A

Sling–muscles stabilize the area well

29
Q

Which is more common: anterior or posterior dislocation of the shoulder?

A

Anterior

30
Q

How do shoulder dislocation usually occur?

A

Force applied to an upraised arm

31
Q

What is the nerve that may be injured with a shoulder dislocation?

A

Axillary

32
Q

Where is the axillary nerve commonly injured?

A

Surgical neck of the humerus or anterior dislocation

33
Q

What is the presentation of an axillary nerve injury? (muscle findings, sensation deficits)

A
  • Flattened deltoid
  • Loss of arm abduction
  • Loss of sensation over deltoid and lateral arm
34
Q

What are the spinal levels of the axillary nerve?

A

C5-C6

35
Q

What are the spinal levels of the musculocutaneous nerve?

A

C5-C7

36
Q

What are the findings of a musculocutaneous nerve injury?

A
  • Loss of forearm flexion and supination

- Loss of of sensation over the lateral forearm

37
Q

Draw the brachial plexus.

A

https://www.youtube.com/watch?v=gTas7ijp0YE&index=2&list=WL

38
Q

How is the arm held with a posterior shoulder dislocation?

A

Forced internal rotation

39
Q

When should posterior shoulder dislocations always be checked for?

A

Post sz

40
Q

What is a major consequence of an inferior shoulder dislocation?

A

Brachial plexus injury

41
Q

How is an arm held with a posterior shoulder dislocation?

A

Luxatio erecta–arm held away from their side

42
Q

How, generally, do inferior shoulder dislocations occur?

A

Force applied downward

43
Q

What is the most common mechanism of shoulder fractures?

A

Falling on an outstretched arm

44
Q

What is the most common type of shoulder fracture?

A

Surgical neck fracture

45
Q

What is the treatment for shoulder fractures?

A

Sling with early mobilization

46
Q

When are shoulder replacements not needed?

A

If articular surface is intact

47
Q

What is the mechanism that causes a spiral fracture?

A

Twisting of the arm (or leg)

48
Q

Where does the radial nerve run in the proximal arm?

A

Encircles the humerus from internal to external (counterclockwise)

49
Q

Wrist drop indicates what nerve is damaged?

A

radial

50
Q

What area of the distal humerus is usually injured when FOOSH happens?

A

humeral condyles

51
Q

What nerves run in the antecubital region from lateral to medial?

A

Radial

Median

52
Q

What nerve runs just posterior to the medial epicondyle of the humerus?

A

Ulnar

53
Q

What is the treatment for a distal humeral fracture?

A

Stabilize with padded posterior splint, and sling

surgery

54
Q

What is the usual mechanism for elbow dislocation?

A

FOOSH!

55
Q

Why do the radius and ulna usually disarticulate together?

A

Interosseous membrane holds them together

56
Q

What is the treatment for an elbow dislocation?

A
  • Reduce immediately

- Tight elbow flexion and sling

57
Q

What is the correct order for reducing a dislocated elbow: axially then posterior, or posteriorly then axially?

A

posteriorly, and then axillary

58
Q

What is characteristic about the physical exam with elbow fractures?

A

Severe pain with RROM

59
Q

What is the treatment for an elbow fracture?

A

Padded posterior splint and sling, with a referral to surgeon

60
Q

What is the “sail sign” associated with elbow fractures?

A

Fat pad that appears on the posterior aspect of the elbow with fractures

61
Q

What is a Nursemaid’s elbow?

A

Pulling the proximal radius through the annular ligament

62
Q

What is the typical presentation of a nursemaid’s elbow?

A

Kid refusing to move the arm, with forearm internally rotated, and a 120 degree angulation of the elbow

63
Q

What is the treatment for a nursemaid’s elbow?

A

Reduce immediately

64
Q

What is a pilon fracture?

A

a type of break that occurs at the bottom of the tibia and involves the weight-bearing surface of the ankle joint. With this type of injury, the other bone in the lower leg, the fibula, is frequently broken as well. A pilon fracture typically occurs as the result of a high-energy event, such as a car collision or fall from height.

65
Q

What type of load produces a pilon fracture?

A

Axial load

66
Q

What type of load produces a transverse fx?

A

transverse load

Specialty Medicine (36 decks)

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