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ABOS > Miller's > Flashcards

Miller's Flashcards

1
Q

Pinch strength after CTR returns

A

6 wks

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2
Q

Grip strenght returns after CTR when?

A

3 mos

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3
Q

difference btw AIN syndrome/pronator syndrome

A

AIN is motor only usually presents as Parsonage-Turner Syndrome
Pronator syndrome is due to compression

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4
Q

Mannerfelt lesion

A

FPL rupture in RA

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5
Q

Diagnostic finding on electrodx study for cubital tunnel syndrome

A

<50m/sec conduction

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6
Q

only time to transpose unlar n

A

subluxing/unstable nerve

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7
Q

Guyon Canal zones and assoc most common pathology

A

1- motor/sensory, ganglio
2- motor, hook of hamate fx
3- sensory, ulnar a thrombosis

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8
Q

Surgery for concomitant CTS and guyon canal syndrome

A

release transverse carpal ligament

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9
Q

Difference btw PIN and Radial tunnel syndrome

A

PIN is motor deficit ONLY

Radial tunnel -> a pain syndrome without motor/sensory deficits

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10
Q

Treatment for PIN and radial tunnel

A

at least 12 most nonop b4 decompression

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11
Q

Adson test

A

diminished radial artery pulse with inhalation -> consistent with subclavian vessel compression

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12
Q

Timing and management of pre-ganglioninc injury

A

not repairable

reconstruct at 3 mos

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13
Q

upper brachial plexus injury in obstetrics management

A

surgery if no biceps contraction by 6 mos

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14
Q

Radial nerve is out

What are the transfers to restore function

A

Wrist extension: Pronator teres -> ECRB (most consistent in testing)

Finger extension: FCR/FCU/FDS -> EDC
- FCR => EDC is most common

Tumb Ext: PL -> EPL

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15
Q

Elderly with severe long standing CTS and poor opposition

A

Camitz - palmaris longus transfer

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16
Q

Transfer for loss of adduction of thumb from ulnar n issue

A

ECRB to adductor pollicis

FDS-> adductor

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17
Q

Congenital abscence of thenar muscles

reconstruction?

A

Huber: ADM to thumb proximal phalanx

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18
Q

2-octylcyanoacrylate

A

dermabond

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19
Q

Dorsal distal phalanx flap coverage

A

digital island

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20
Q

Dorsal thumb skin coverage

A

FDMA kite flap

- comes from dorsal IF

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21
Q

Volar distal phalanx skin coverage if not doing secondary intention

A

Cross finger in adult

thenar flap in kids (maybe)

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22
Q

dorsal hand flap coverage

A

groin or abdomen flap

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23
Q

Dominante arch/artery of hand

% of people with complete arch in hand

A

Ulnar/superficial

80%

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24
Q

digital brachial index that is abnormal

A

< 0.7

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25
Q

hypothenar hammer syndreome

  • when DBI > .7
  • when DBI < .7
A

> –> sympathectomy

< – reconstruct

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26
Q

level wheren embolic disease occurs in the hand

A

PIP level

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27
Q

Diff btw Raynaud Disease and Phenomenon

A

Phenom is assoc with an undelrying disease thus treat the systemic disease

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28
Q

order of replant in hand

A

BEFNAV

bone, extensor, flexor, nerve, a/v

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29
Q

abx to treat infection from leech

A

ceftriaxone or cipro

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30
Q

> 50% extensor tendon injury

A

repair and protect mobilization

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31
Q

Zone 4 exten tendon injury > 50%

- how to manage

A

repair

place in Yoke splint (relative motion splint)

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32
Q

EPL rupture after nondisplaced DR fx

- how to treat

A

EIP transfer to EPL

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33
Q

Intrinsic tightness that doesn’t respond to therapy stretching

A

surgical release of the lateral bands

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34
Q

gap in tendon repair at risk for rerupture

A

> 3mm

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35
Q

minimal strands in core repair for flexor tendon repair

A

at least 4 core sutures

more is stronger

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36
Q

benefits of epitendinouse suture in flexor tendon repair

A

smooths surface
increase strength by 10-50%
decreases gap formation

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37
Q

where to flexor tendon repairs usually fail if they do

A

at the knots

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38
Q

timing of repair of flexor tendon avulsions

A

Type 1 -> within 1 wk b’c blood supply disrupted

Type 2,3 -> up to 6 wks

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39
Q

partial flexor tendon injury

A

< 25%-> trim
25-50% -> epi repair
>50% -> core and epitenon repair
All with protected mobilization

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40
Q

treatment for lumbrical plus finger

A

release lumbrical

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41
Q

pronator’s space

A

potential space just superficial to pronator quadratus

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42
Q

bug causing hand celluliti s

A

Group A betahemolytic strep

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43
Q

most common bug of necrotizing fasciitis

A

Group A beta-hemolytic strep

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44
Q

most important variable in high pressure injection finger injury

A

material injected

  • paint is worse (oil specifically)
    others: > 10 hrs on presentation, > 7k psi
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45
Q

pathologic tissue in medial epicondylitis

A

at junction of FCR/PT

46
Q

aspect of SC joint that provides most stability

A

posterior and costoclavicular

47
Q

medial to lateral footprint of rotator cuff insertion

A

~12mm

48
Q

Beighton’s number considered to be hyperlax

A

> 6

49
Q

impingement test vs sign

A

sign is no pain with impingement test after lidocaine injection

50
Q

XR view for bony bankart

A

West point

51
Q

view for hillsachs

A

stryker notch

internal rotation AP

52
Q

ALPSA

A

Anterior labral periosteal sleeve avulsion

- may require an open procedure to completely address it

53
Q

GLAD

A

Glenoid labrum articular disruption

54
Q

HAGL is addressed via

A

subscap approach, open when open

when posterior -> scope it

55
Q

indications for surgery in first time anterior shoulder dislocators

A

< 22 yo
contact athlete
bony bankart

56
Q

open bankart with capsulorahy over scope benefits

A

lower recurrence

57
Q

number of anchors needed in bankart repair

A

at least 3

58
Q

number of anchors needed in bankart repair

A

at least 3

59
Q

closing down rotator interval can be done for

A

MDI or inferior subluxation of HH

60
Q

Best way to get into subacramial space with injection

A

lateral

61
Q

Bear hug test

A

for subscap tear, good test

62
Q

critical shoulder angle > 35-38 is assoc with

A

increase risk of rotator cuff tear

63
Q

Mini open vs arthroscopic cuff repair

A

equivalent outcomes with less pain, better visualization and less risk

64
Q

Deadmans angle

A

45 degrees for anchors in RCR

65
Q

Barbotage procedure

A

guided aspiration of calcific tendinopathy

66
Q

Age cut off for labral repair

A

< 35 should repair
> 35 tenodesis vs tenolysis

IF RED FLAG -> don’t repair, tenodes (workers comp)

67
Q

Surgical treatment for labral tear in over head throwing athlete

A

repair

68
Q

Max amount of distal clavicle that can be resected

A

1 cm

69
Q

SC joint injury in someone around 18 where is the injury really?

A

physis b’c it closes so late

70
Q

Treatment for latissimus avulsion

A

nonop: rest, PT, return to sport

71
Q

Essential lesion of frozen shoulder

A

coracohumeral ligament and rotator interval contracture -> loss of ext rotation

72
Q

Roos (East) test

A

Elevation of arm above head causes thoracic outlet syndrome sx’s

73
Q

Failed nonop of medial scapular winging

A

Split pec major transfer

74
Q

Fix for lateral winging

A

Eden Lange Transfer

- transfer levator scapulae and rhomboids

75
Q

Joint where it is reasonable to scope and debride with OA

A

Shoulder

Elbow

76
Q

Peg vs keel glenoid component difference

A

Peg has lower loosening

77
Q

most common complication in TSA

A

glenoid loosening

78
Q

most likely cause of humeral loosening in TSA

A

infection

79
Q

preventing of scapular notching in rTSA

A

lateralize

place glenoid inferior with tilt facing down

80
Q

What is Cultibacterium Acnes

A

Sames as proprionobacterium

81
Q

Consider these tricks for trigger release in RA pt

A

More extensive tenosynovectomy
release pulley on radial side
consider FDS slip excision

82
Q

number of people that respond to trigger finger injection

- what pt is it less effective in

A

60%

- diabetics

83
Q

EMG findings with nerve injury

insertional activity/spontaneous activity minimal activity

A

neuropraxia - normal/silent/none

axonotmesis/neurotmesis - increased/fibrillations and positive sharp waves

84
Q

Z plasty cuts and respective lengths gained

A

60 degree -> 75% increase
45 -> 50% increase
30 -> 25 % increase

85
Q

Most common intra-articularsoft tissue injury of the wrist

A

TFCC

86
Q

Most predictive of loss of reduction of DR fx treated nonop

A

age > 60 yo

87
Q

Outcomes for Distal Radius fx op vs nonop in pts > 65 yo

A

Overall no difference except for . . .

Op pts with > grip strength and better xrays

88
Q

Assoc injury with the below MOA:

  • wrist ext + radial deviation
  • wrist ext + ulnar deviation
A

radial -> scaphoid injury

ulnar -> TFCC

89
Q

complication of hammate hook excise

A

ulnar n injury

15% grip strength b’c pulley for 4/5 FDP disrupted

90
Q

fite bite management

A

gotta take to OR to washout the joint

91
Q

2 most important thumb ligaments

A

Volar oblique -> fx frag that remains stable in bennet fx

dorsoradial -> primary restraint to dorsal dislocation od CMC of thumb

92
Q

Treatment for chronic Gamekeep with arthritis

A

fusion

93
Q

DRUJ dislocation

  • dorsal
  • palmar
A

splint

  • dorsal -> supination
  • palmar -> pronation
94
Q

how to assess for ulnar impaction on xray

A

True PA xray (0 degree PA)

- any rotation causes movement of ulna

95
Q

Max in Wafer procedure

A

4mm more will inur radioscaphocapitate (i thin kthat’s what he said)
if more needed ->< ulnar shortening

96
Q

primary complication of

  • DIP fusion
  • DIP arhtroplasty
A

fusion
- K wire -> infection
- screw -> gotta listen to the lecrure wasn’t on slide
Arthroplasty -> extensor lag

97
Q

best prosthetic for PIP joint replacement

A

constrained silicone

- good stability

98
Q

inability to extent SF in FA

A

tendon rupture b’c ulna tends to sublux dorsal (caput ulnar syndrome)

99
Q

most sensitive test for detecting early RA disease

A

MRI with contrast of the joint

100
Q

1 compication with wrist replacement in RA

A

distal component loosening

101
Q

When to perform complete radiocarpal arthrodesis for SLAC

A

when the lunate facet is arthritic

102
Q

Preiser Disease

A

Scaphoid AVN

103
Q

causes MCP joint flexion in dupuytren’s

spiral lig causes

A

pretendinous cord

displaces N/v structure

104
Q

When to operate on duputrey

A

any PIPj contracture

MCP contractur e> 30

105
Q

Which fascial structure is never involved in Dupuytren’s

A

Cleland’s

106
Q

gold standard for motor nerve reconstruction

A

autograft

107
Q

Hemangioma of skin in kid

- nautral history

A

70% regress by 7 yo

90% regress by age 9

108
Q

Lat Epicondylitis

  • main tendon involved
  • other tendon involved 50% of the time
A

ECRB

anterior edge of EDC 50% of the time

109
Q

most common cause of elbow arthritis

A

RA

110
Q

When is ligament repair weakest?
When does repair ligament near full strength?
% of strength return compared to original tendon ?

A

weakest 7-10d
Nears full strength 21-28d
usually 2/3 of original strength

111
Q

Sequence of functiona loss from nerve injury

- recovery sequence?

A

motor -> proprioception -> touch -> temp -> pain -> sympathetics

*MP Touched Toots PartS
recovery occurs reverse

ABOS (14 decks)

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