misc ortho Flashcards
worsens with use/am stiffness
OA
improves with use/am stiffness after an hour
RA
neg ANA, neg RF, recurrent high fever, hepatosplenomegaly, salmon rash in pm, koebner
stills d/s(systemic JRA)
+ ANA, - RF, no systemic symptoms, uveitis common
pauciarticular JRA-most common; can lead to blindness, do slit lamp
what is sensitive and specific in lupus
+ANA highly sensitive
antibodies to double stranded DNA and smith antigen is highly specific
procainamide, hydralazine, INH, methyldopa, quinidine, chlorpromazine
can cause lupus like syndrome
osteopenia on a DEXA
1-2.5; 2.5 is osteoporosis
distribution of sciatic nerve
buttock , post thigh, posterolateral aspect of leg around lateral malleolus to lateral dorsum of foot and entire sole
Motor/Reflex/sensory of L4
Motor: foot dorsiflexion(tibialis anterior)
reflex: patellar
sensory: medial aspect of lower leg
Motor/Reflex/sensory of L5
Motor: big toe dorsiflexion(extensor hallucis longus); foot eversion(peroneus muscles)
reflex: none
sensory: dorsum of the foot and lateral aspect of lower leg
Motor/Reflex/sensory of S1
Motor: plantar flexion(gastrocnemius/soleus), hip extension(gluteus maximus)
reflex: achilles
sensory: plantar and lateral aspects of the foot
motor and sensory deficit for radial nerve
motor: wrist extension
sensory: dorsal forearm and hand(1st 3 fingers)
motor and sensory deficit for median nerve
motor: forearm pronation, thumb opposition
sensory: palmar surface(1st 3 fingers) [cannot close]
motor and sensory deficit for ulnar nerve
motor: finger ABDUCTION
sensory: palmar and dorsal surface (last 2 fingers)[cannot open]
motor and sensory deficit for axillary nerve
motor: arm ABDUCTION
sensory: decreased sensation over the deltoid
motor and sensory deficit for peroneal nerve
motor: dorsiflexion, eversion
sensory: dorsal foot and lateral leg
What nerve is affected?
humeral fracture; prolonged compression at level of humerus
radial
What nerve is affected?
wrist drop
radial
What nerve is affected?
elbow dislocation
ulnar
What nerve is affected?
anterior shoulder dislocation
axillary
What nerve is affected?
weak wrist flexion and flat, thenar eminence
median
What nerve is affected?
cannot open
and cannot close hand
cannot open: ulnar
cannot close: median
overweight males with knee pain?
Anterior knee pain in a 13 year old soccer player. What is the most likely diagnosis?
If you can only choose one physical exam test to test for an ACL injury which should you choose?
Which fifth metatarsal fracture has a high rate of nonunion?
overweight males with knee pain? Slipped capitol femoral epiphysis
Anterior knee pain in a 13 year old soccer player. What is the most likely diagnosis? Osgood Schlatter
If you can only choose one physical exam test to test for an ACL injury which should you choose? Lachman
Which fifth metatarsal fracture has a high rate of nonunion? Jones fracture
The shopping cart sign is a symptom of what disorder?
Numbness of the posterior calf may indicate a dysfunction of which nerve root?
Decreased strength of great toe dorsiflexion may indicate a dysfunction of which nerve root?
Saddle anesthesia should make you think of what diagnosis?
The term bamboo spine should make you think of what diagnosis?
What is the minimum you should wait to order imaging on a patient with generalized low back pain and no significant history?
The shopping cart sign is a symptom of what disorder? Spinal stenosis
Numbness of the posterior calf may indicate a dysfunction of which nerve root? S1
Decreased strength of great toe dorsiflexion may indicate a dysfunction of which nerve root? L5
Saddle anesthesia should make you think of what diagnosis? Cauda equina syndrome
The term bamboo spine should make you think of what diagnosis? Ankylosing spondylitis
What is the minimum you should wait to order imaging on a patient with generalized low back pain and no significant history? 4 weeks
X-ray shows a silver fork deformity
Pain with palpation over the anatomical snuffbox
Lateral Epicondylitis
Medial Epicondylitis
A fracture of the neck of the 4th and often 5th metacarpal
Name the four rotator cuff muscles
X-ray shows a silver fork deformity= Colles fracture
Pain with palpation over the anatomical snuffbox = scaphoid fracture
Lateral Epicondylitis = Tennis Elbow
Medial Epicondylitis = Golfers Elbow
A fracture of the neck of the 4th and often 5th metacarpal = Boxer’s fracture
Name the four rotator cuff muscles
Supraspinatus
Infraspinatus
Teres minor
Subscapularis
Describe Tinel’s sign =
Describe Phalen’s sign
What do Neer and Hawkins asses
Which fingers are affected in carpal tunnel
What does the crossover test evaluate
What is the most commonly injured rotator cuff muscles
What does a fat pad sign indicate?
Describe Tinel’s sign = Tapping
Describe Phalen’s sign = Wrist flexion
What do Neer and Hawkins asses – Rotator cuff impingement
Which fingers are affected in carpal tunnel – all but the pinky
What does the crossover test evaluate – AC joint
What is the most commonly injured rotator cuff muscles – Supraspinatus
What does a fat pad sign indicate? – occult elbow fracture
which hip dislocation?
shortened, IR leg
posterior
which hip dislocation?
lengthened, ER leg
anterior
shortened, ER leg
hip fracture
