Intro to Orthopedics Lecture Powerpoint

Question 1

Osteoarthritis differs from rheumatoid arthritis in that it commonly affects this joint, while it is spared in rheumatoid arthritis

Answer 1

DIPs

Question 2

X ray findings consistent with osteoarthritis (3)

Answer 2

• Narrowing of joint space (RA has preserved joint space)
• subchondral sclerosis
• osteophytes

Question 3

Orthopedics definition

Answer 3

Branch of medicine concerned with acute, chronic, traumatic, and overuse injuries and other disorders of the musculoskeletal system

Question 4

Articulation definition

Answer 4

Joint or junction between any 2 bones or cartilages

Question 5

Genu varum vs genu valgum

Answer 5

Varum is outward bowing knees (collapsing of the joint space medially and gapping of it laterally either traumatic or degenerative) then test with valgus stress test to see if repairable with bracing or LCL integrity test via varus stress testing, valgum is inward bowing of the knees (loss of joint space laterally and expansion medially) that can be tested with varus stress test to see if repairable with bracing or MCL integrity test via valgum stress testing

Question 6

Epiphyseal plate (physis) definition

Answer 6

Growth plate, open in children allowing them to grow, sealed off in adults

Question 7

3 compartments of the knee

Answer 7

• medial
• lateral
• patellofemoral compartment (front of knee space between patella and femur)

Osteoarthritis can occur in any of these 3

Question 8

Sprain vs strain

Answer 8

Stretching or tearing of the ligaments supporting an articulation (includes capsules ligaments are located within as well), vs stretching or tearing of a musculotendinous unit

Question 9

Tendonitis definition

Answer 9

Inflammation/irritation of a tendon most commonly due to overuse

Question 10

Tendinosis (chronic tendonitis) definition

Answer 10

Degenerative condition affecting the tendon, commonly associated with micro tears that can be seen only on MRI (not x ray)

Question 11

Shoulder dislocation vs shoulder separation

Answer 11

Dislocation refers to glenohumeral joint (humerous head in the glenoid fossa pops out most often anterior), vs separation refers to acromial clavicular joint (clavicle not aligned with acromion, clavicle pops up creating characteristic bony step off)

Question 12

Osteoarthritis/degenerative joint disease

Answer 12

Mechanical wearing of articular surfaces with loss of articular cartilage collapsing of joint space and new bone growth (osteophytes) and hardening (sclerosis) of bone, either primary (unknown cause) or secondary (to injury)

Question 13

Angulation of fracture

Answer 13

Condition where fracture fragments are not anatomically aligned, fracture fragments are at an angle to one another in comparison to anatomical alignment, described by direction that apex is pointing relative to long axis of bone in anatomical position (ex - volar angulation in a colles fracture)

Question 14

Displacement/translation of fractures

Answer 14

When fracture fragments/dislocations are not axially aligned, describe direction of placement based on DISTAL fragment relative to proximal (ex - dorsal displacement in a colles fracture)

Question 15

Rotation of fractures

Answer 15

Condition in which fracture fragments are rotated relative to each other, described according to the direction in which the distal fragment is rotated relative to proximal portion, very important in the digits

Question 16

Reduce/reduction

Answer 16

To restore a fracture or dislocation to correct positioning/alignment, either closed (manipulation of joints thru skin) or open (surgical procedure)

Question 17

External fixation/fixator or “ex-fix” definition

Answer 17

External device that has pins entering the skin into the bone proximal and distal to the fracture site with metal bars connecting to adjust the length and tension in order to realign properly in the process of reducing a bone

Question 18

ORIF definition

Answer 18

Open reduction, internal fixation, involves making incision thru skin, identifying fracture and placing it into proper alignment, and placing a fixator device (plates, screws, rods, etc)

Question 19

Volar vs dorsum of wrist

Answer 19

Volar is the anterior surface in anatomical position and dorsum is the posterior surface

Question 20

If the distal fragment of a bone moves medial relative to the proximal fragment, we call it ___ displacement

Answer 20

medial displacement

Question 21

What should be rechecked following any and all orthopedic procedures and treatments?

Answer 21

Neurovascular status - you don’t want to be the cause of why they lose a limb!

Question 22

Splint definition

Answer 22

External fixation to support body parts or structures, noncircumferential as it immobilizes but allows for swelling** and easy removal, want to put on a splint in the acute stage of an injury

Question 23

Cast definition

Answer 23

Form for a body part in a stiff mold made of bandage and hardening material (plaster more flexible and fiberglass less flexible but more supportive), circumferential for fixation of extremity, do not want to put on in presence of any swelling for fear of compartment syndrome or shrinkage resulting in loose cast, used in the long term

Question 24

3 layers of splinting and casting materials

Answer 24

1) stockinette (cotton, tubular, sock like material)
2) undercast padding (cotton or gore-tex [skip the 1st step in this case - can get wet])
3) Casting tape/splint material

Question 25

Position of function

Answer 25

Positioning for most splints/casts as it preserves normal lay of extremity and provides least tension on fracture fragments (body going limp)

Question 26

Position of rehabilitation

Answer 26

Positioning for some casts/splints as it maintains reduction while preserving functional balances and preventing contractures/adhesions

Question 27

Where should adequate cotton padding be used especially in a cast?
How do we smooth over plaster/fiberglass?
What temp water is used?

Answer 27

• at bony prominances and edges of cast
• Gloved palm, no fingers
• Cool to room temp, not hot, the resin activation is already warm