minor adult disorders

Question 1

tennis elbow is inflammation of the common origin of the flexors/extensors ?

Answer 1

extensors

Question 2

If a steroid injection is given for enthesopathy, why must care be taken?

Answer 2

to prevent steroid leaking into the subcut fat or ski because this will exacerbate pain and leave an unsightly dimple

Question 3

if surgery is undergone for enthesopathy what does it involve

Answer 3

scraping the origin of the muscle from the bone and letting it slide distally thus decompressing the area

Question 4

what is it called if a nerve is compressed or stretched

Answer 4

neuropraxia

Question 5

what will continued pressure on a nerve lead to? is this permanent?

Answer 5

atrophy

usually permanent

Question 6

are neuropraxias usually intrinsic or extrinsic

Answer 6

intrinsic

Question 7

name the most common site at risk from extrinsic neuropraxia

Answer 7

common peroneal nerve as it wraps around the head of the fibula

Question 8

common sites at risk from intrinsic nerve entrapment

Answer 8

median nerve at wrist
ulnar nerve ar the elbow and wrist
posterior tibial nerve at the ankle

Question 9

what is diagnostic of nerve entrapment?

Answer 9

weakness and real sensory loss

Question 10

what is tenosynovitis

Answer 10

inflammation of tendons and their associated synovial sheaths

Question 11

what is tenosynovitis often associated with

Answer 11

Rheumatoid arthritis

Question 12

what is tenosynovitis usually precipitated by?

Answer 12

unusual levels of activity / overuse

Question 13

what is a bursa

Answer 13

a small sac of fibrous tissue lined with synovial membrane and filled with fluid

Question 14

most common sites of bursitis

Answer 14

knee and elbow

greater trochanter

Question 15

infected bursae should be ?

Answer 15

incised and drained as this usually leads to spontaneous recovery through scarring and fibrosis

Question 16

what may a very painful spasmodic flat foot be associated with?
what might examination reveal?
does it need intervention?

Answer 16

infection or chronic inflammatory disease

examination may reveal painful and tender swelling over the insertion of the tibialis posterior

yes, early intervention, as it may indicate acute or impending degenerative rupture

Question 17

if painful flat feet is a persistent problem which joint may be fused to help the condition?

Answer 17

subtalar joint

shouldn’t be undertaken lightly as it disturbs foot and ankle function profoundly

Question 18

what is hallux valgus

Answer 18

turning away of the pahalnges of the big toe from the midline

Question 19

what is hallux rigidus

Answer 19

OA of the MTP joint

Question 20

conservative mx of hallux rigidus in adolescents

Answer 20

metatarsal bar (to provide a rocker at the front of the foot so that the toe doesn’t need to bend during walking)

Question 21

what do the terms claw foot and claw toes imply

Answer 21

wasted muscles making the bones and toe nails appear more prominent

Question 22

on examination of claw foot, what may it imply if the patient has weak or denervated small muscles of the feet?

Answer 22

underlying minor spinal abnormality such as spina bifida occulta

Question 23

what are hammer toes secondary to

Answer 23

disruption of MTP joints

Question 24

what is often all thats required for hammer toes?

if surgery was undergone what would be done?

Answer 24

soft comfortable shoes

surgery would involve fusion of the interphalangeal joints in a straight position

Question 25

what is a Mortons neuroma

Answer 25

cutaneous nerves to the toes becoming trapped or irritated between the metatarsal heads

Question 26

What may a morton’s neuroma be secondary to

Answer 26

metatarsal head prolapse

Question 27

type of pain in Mortons neuroma

Answer 27

dull and throbbing often with sharp exacerbations accompanied by tingling

Question 28

what classically reproduces the symptoms of Mortons neuroma

Answer 28

sideways compression of the foot, producing a palpable click

Question 29

is recurrence common with neuromas

Answer 29

yes

Question 30

what is a serious consequence of an ingrown toenail

Answer 30

blood borne infection which can be serious if the patient has prosthetic joints or prosthetic heart valves

Question 31

what is the surest way of relieving the problem of an ingrown toenail

Answer 31

removal of the nail bed using phenol after removing the nail

Question 32

where does the plantar fascia run from/to

Answer 32

os calcis to each toe base

Question 33

characteristic complaint of plantar fasciitis

Answer 33

soreness of the instep worse on rising or after sitting for prolonged period

Question 34

what are symptoms of plantar fasciitis minimally relieved by

Answer 34

walking

but then persist as a debilitating ache, often exacerbated by change of direction or waking on rough surface

Question 35

most cases of plantar fasciitis will settle on their own - true or false?

Answer 35

true

Question 36

what can be done for plantar fasciitis if there is a marked tender point

Answer 36

local injection of steroid and long acting local anaesthetic

Question 37

pain around the tendo-achilles where it inserts into the os calcis is seen in 2 groups of people - who?

Answer 37

young athletes

middle aged men

Question 38

what part of the tendo achilles has a poor bloody supply

Answer 38

lower part

Question 39

if the achilles tendon ruptures how can healing be encouraged?

Answer 39

if the ankle is kept in an equinus plaster for a minimum of EIGHT WEEKS

Question 40

following achilles rupture what will help prevent re-rupture

Answer 40

wearing a felt raise inside the heel of the shoe for as long as possible

Question 41

what is tenderness under active shoulder movement with a painful arc suggestive of?

Answer 41

supraspinatous inflammation or subacromial bursitis

Question 42

why are repetitive injections not advised in rotator cuff tears

Answer 42

can cause further degeneration of the rotator cuff

Question 43

2 possible aetiologies of frozen shoulder

Answer 43

epileptic fit

electric shock

Question 44

what is “frozen shoulder”

Answer 44

a condition in which there is little or no glenohumeral movement. cause is often obscure and they eventually recover in 18m to 2 years