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OCS prep (TQ) > Misc Trivia 2 > Flashcards

Misc Trivia 2 Flashcards

1
Q

What portion of the scaphoid is most susceptible to avascular necrosis/non-union after fracture?

A
  • proximal pole
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2
Q

How many stages are there for posterior tib tendon dysfunction?

A
  • 4
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3
Q

The following is most consistent with which stage of PTTD:

Posterior tibial tendon intact and inflamed, no deformity, mild swelling

A
  • Stage I
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4
Q

The following is most consistent with which stage of PTTD:

Posterior tibial tendon dysfunctional, acquired pes planus but passively correctable, commonly unable to perform a heel raise

A
  • Stage II
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5
Q

The following is most consistent with which stage of PTTD:

Degenerative changes in the subtalar joint and the deformity is fixed

A
  • Stage III

- starting to see arthritis

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6
Q

The following is most consistent with which stage of PTTD:

Valgus tilt of talus leading to lateral tibiotalar degeneration

A
  • Stage IV
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7
Q

What’s the difference between a neurotmesis, axonotmesis, and neuropraxia?

A
  • neuropraxia: local myelin damage; usually due to compression
  • axonotmesis: axon damage, but epineurium is intact. Allows for Wallerian regeneration; the nerve can regrow in it’s tube.
  • neurotmesis: complete disruption of both the axon and the epineurium; most severe
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8
Q

What is 2nd rib syndrome? What is it also known as?

A
  • Tietze syndrome
  • inflammatory disorder of the cartilage, typically at the costochondral junction of the upper ribs at the sternum. Causes pain with coughing, sneezing, strenuous activity. Can cause pain in the neck/shoulder sometimes.
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9
Q

What is Scheuermann’s disease?

A
  • pediatric condition
  • usually occurs in teenagers, with the vertebrae growing unevenly in the sagittal plane (usually more posteriorly), resulting in increased thoracic kyphosis
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10
Q

What does the sural nerve supply? What is a helpful characteristic for differential dx to see if it’s involved?

A
  • pure sensory nerve

- supplies the posterolateral sensation to the distal third of the leg, and the lateral ankle, heel, and foot

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11
Q

A foot deformity that looks like a “rocker” foot (inverted arch) is characteristic of what deformity?

A
  • Charcot foot
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12
Q

What pediatric condition is characterized by ischemic damage of the navicular?

What ages are usually impacted?

A
  • Kohler’s disease
  • 6-9yo
  • usually self-resolving
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13
Q

Which two muscles are innervated by the posterior branch of the obturator n?

A
  • adductor brevis
  • adductor magnus
  • other adductors innervated by the anterior branch
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14
Q

What is the CPR for success with C-spine traction?

5

A
  • patient reported periperalization with lower cervical spine (C4-7) mobility testing
  • positive shoulder abduction test,
  • age > 55,
  • positive upper limb tension test A,
  • positive neck distraction test
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15
Q

What is the CPR for hip mobs for knee OA? (5)

A
  1. Hip or groin pain or parasthesias
  2. Ipsilateral anterior thigh pain
  3. Passive knee flexion < 122 deg
  4. Passive hip internal rotation < 17 deg
  5. Pain with hip distraction
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16
Q

What is occurring with a “dead arm” with pitchers?

A
  • a sudden, sharp, paralyzing pain when teh shoulder is moved into ER with elevation
  • thought to be associated with anterior instability, causing a subluxation and subsequent transient traction injury to the brachial plexus
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17
Q

An entrapment of the superficial branch of the radial nerve is called what? What does it look like?

A
  • Wartenberg’s syndrome

- sensory deficits ONLY

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18
Q

Kiloh-Nevin syndrome is also known as…?

A
  • anterior interosseous nerve syndrome (AINS). Motor deficits of the AIN of the median nerve
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19
Q

What is the Slocum test? What does it look at?

A
  • modification of the anterior drawer to look at anteromedial vs anterolateral rotary instability
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20
Q

During a Dial test, when there is >10* of tibial ER difference at 30* of knee flexion, but not at 90*, this is indicative of instability in what structure? What about the opposite?

A
  • Posterolateral corner (PLC)
  • when there’s >10* at 90*, it’s more indicative of a PCL injury that’s isolated.

Often it’s combined, so you’ll see the difference at both ranges of flexion. ACL tear will also contribute to ER laxity (up to 7*)

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21
Q

Research supports which specific interventions for “multimodal” treatment of cervical radiculopathy?

A
  • intermittent traction
  • manual therapy
  • deep neck flexor therex
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22
Q

What is the CPR for short term outcome success with cervical radiculopathy and multimodal treatment? (4)

A
  • age < 54
  • dominant arm not affected
  • looking down does not worsen symptoms
  • multimodal treatment of traction, manual therapy, and deep neck flexor therex
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23
Q

What are the types of validity? (4, in general…there are more)

A
  • construct validity: Does the test measure what it’s supposed to measure?
  • content validity: Is the test representative of what aims to measure?
  • face validity: Does the test appear to measure what it says it will measure?
  • criterion validity: Do the results correspond to a different test of the same thing?
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24
Q

What are the Ottawa knee rules? (5)

A

Get imaging if any of the following are present:

▪ Age greater than 55
▪ TTP over patella
▪ TTP fibular head
▪ Inability to flex greater than 90 degrees
▪ Unable to WB immediately or in ED for 4 steps

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25
Q

What is the classification grading for arthrofibrosis following knee surgery?

A

▪ I - less than or equal to 10 degrees extension loss, normal flexion
▪ II - greater than or equal to 10 degrees of extension, normal flexion
▪ III - greater than 10 degrees of extension loss, greater than 25 degrees of flexion loss without shortening of patellar tendon
▪ IV –greater than 10 degrees of extension loss, greater than 30 degrees of flexion loss with patellar tendon contracture

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26
Q

A Segond fx is common with what type of injury?

A
  • ACL injury

- Segond fx is a lateral tibial plateau avulsion fx

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27
Q

What is transverse myelitis?

A
  • inflammation in the spinal cord

- presents like a variable cord injury

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28
Q

A neuritis involving the brachial plexus is named what syndrome?

What nerves does it usually affect?

A
  • Parsonage Turner syndrome or neuralgic amyotrophy

- usually axillary, suprascapular, long thoracic, and upper trunk of the brachial plexus

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29
Q

What does the “terrible triad” of the elbow consist of?

A

Combination of:

  • elbow dislocation
  • coranoid fx
  • radial head fx

Requires surgical fixation to restore stability, often with poorer outcomes

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30
Q

Lumbar thrust manips were found to have what effects on each of the following muscles:

  • TrA
  • internal obliques
  • multifidus
A
  • had transient effects on the thickness of all muscles
  • only multifidus seemed to have improved contractile quality that endured following the manips
  • another study looked at the TrA specifically, and didn’t find any effect
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31
Q

T or F;

Cauda equina syndrome can result in either/both urinary incontinence or retention.

A
  • T. Weird. Just incontinence for bowel movements though. Still a lower motor neuron issue.
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32
Q

What’s the difference between a suprascapular nerve entrapment at the suprascapular vs spinoglenoid notch?

A
  • the suprascapular notch is superior to the spinoglenoid notch.
  • If spinoglenoid entrapment, then the supraspinatus will be spared, but will see infraspinatus atrophy
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33
Q

What is a “fat pad sign” indicative of on xray of the elbow?

What does it look like?

A
  • fracture

- effusion lifts the anterior fat pad, so that there looks like there’s a billowing sail

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34
Q

What’s the scaphoid shift test used for?

A
  • examines dynamic stability of the scaphoid and assesses symptom reproduction
  • essentially looking at scapholunate laxity/instability
  • more sensitive than specific
35
Q

What position should the ankle be in for an anterior drawer test?

A
  • ~20* plantar flexion
36
Q

An axillary nerve injury/palsy will impact which movements? Why?

A
  • external rotation and overhead

- deltoid and teres minor innervation

37
Q

What is the “optimal” time limit vs the “likely permanent damage” time limit to receive surgical intervention for something like cauda equina?

A
  • optimal: w/in 48 hrs

- to avoid permanent damage: w/in 72 hrs

38
Q

What are the 3 grades of ligamentous sprain?

A
  • Grade 1: Mild. Minimal to no swelling/pain/disability.
    Minor tearing/injury to ligament. No instability in weight bearing.
  • Grade 2: Moderate. Mild-moderate swelling/pain/disability. Partially torn ligament. May be some moderate instability in weight bearing. Knee can buckle/give out.
  • Grade 3: Severe. More significant swelling/pain/disability. Fully torn/separated ligament with instability at the joint.
39
Q

What are the Ottawa ankle rules?

A

X ray required if:

Pain in the malleolar zone AND:

  • TTP on the POSTERIOR edge or tip of either malleolus
  • unable to bear weight

Pain in midfoot zone AND:

  • TTP at navicular or base of 5th met
  • unable to bear weight
40
Q

What is the testing cluster for subacromial impingement? (3)

A
  • Hawkin’s-Kennedy
  • painful arc
  • infraspinatus weakness
41
Q

What is the testing cluster for anterior instability of the shoulder?

A
  • apprehension test
  • relocation test
  • anterior drawer test
42
Q

There are two clusters for RC pathology…what are they? (3 for both)

A
  • painful arc
  • drop arm
  • infraspinatus MMT
  • age >65
  • nighttime pain
  • external rotation weakness
43
Q

What is the Foot Lift Test for balance? What condition has it been studied in? What are the cutoffs?

A
  • stand on one leg for 30 seconds. Count the number of times a portion of the foot lifts up to maintain balance (“wobbles”).
  • Studied for CAI
  • > /= 3 wobbles (points) associated w/ CAI
44
Q

What is the Time in Balance Test? What condition has it been studied in? What are the cutoffs?

A
  • 3 trials of 60 seconds each in EO and EC in SLS
  • studied for CAI
  • <26” associated w/ CAI
45
Q

Is it important to train the unaffected LE with CAI?

A
  • yes; currently thought of as having a strong sensorimotor contribution. Thus training the strong side can still drive central improvements.
46
Q

How long does Sever’s disease usually last? What is recommended intervention?

A
  • usually resolves in 2-4 weeks with relative rest.

- stretching exercises and use of heel cups (increased cushioning) are recommended

47
Q

How long does it usually take to recover from plantar fasciopathy?

Can people expect a complete resolution of symptoms?

A
  • 10 months is the natural course for most adults

- 80% of people experience significant symptom relief, but complete resolution is elusive to many

48
Q

What are the current theories for structural causes of medial tibial stress syndrome?

A
  • periosteal remodeling to reinforce the tibia where it bears the greatest stress
  • inflammation of the periosteum due to excessive traction
  • of note, they do not currently see this is a primary sensorimotor or muscle imbalance issue
49
Q

Relative rest for a medial tibial stress syndrome is recommended for how long?

A
  • can be up to 4 months
50
Q

What are two key risk factors for developing medial tibial stress syndrome?

A
  • higher BMI

- navicular drop (increased pronation)

51
Q

Is decreased DF ROM a risk factor for developing medial tibial stress syndrome?

A
  • hasn’t been established as a risk factor
52
Q

Is stretching expected to be an effective preventative measure for medial tibial stress syndrome?

A
  • no; since limited DF doesn’t seem to be a risk factor
53
Q

What are two primary differential dxs for a medial tibial stress syndrome?

A
  • stress fracture

- posterior compartment syndrome

54
Q

What are differentiating characteristics between a medial tibial stress syndrome and a stress fracture or a posterior compartment syndrome?

A
  • a stress fracture would be expected to have a focal point of TTP
  • Posterior compartment syndrome will likely be aggravated by activity, but will be alleviated more fully with rest. MTSS when severe can remain aggravated after exercise for hours/days.
  • Posterior compartment syndrome also may have some paresthesias associated with it.
55
Q

What type of research design is most appropriate for trying to identify:

  • best treatment
  • prevention
  • diagnosis
  • prognosis
  • causation
A
  • treatment: RCT
  • prevention: RCT or prospective cohort study
  • diagnosis: RCT or cohort study
  • prognosis: cohort study or case control
  • causation: cohort study
56
Q

After a total shoulder arthroplasty, which muscle is most at risk for damage during early phase recovery?

What limitations are typically in place? For how long?

A
  • subscapularis; typically released to conduct the surgery. Will have ER limitations to avoid damage. Typically 30-45* for the first 6 weeks.
57
Q

What may be a reason for limited AROM compared to PROM following a complex shoulder fx surgery?

A
  • greater tuberosity migration

- i.e., don’t assume muscular issue

58
Q

What are the types of SLAP lesions?

A
  • Type I: partial tear and degeneration, but labrum is not completely separated from the glenoid. Treated with debridement.
  • Type IIa: complete detachment, anteriorly (does not go past biceps tendon midpoint)
  • Type IIb: complete detachment, posteriorly (does not go past biceps tendon midpoint)
  • Type IIc: complete detachment, with tear going past the biceps tendon midpoint. Combination anterior and posterior. All Type IIs are typically treated with anchors.
  • Type III: Bucket handle tear. Torn labrum hangs in the joint. Treated with debridement/anchors
  • Type IV: Tear involves the biceps tendon
59
Q

What type of SLAP tear is most commonly diagnosed?

A
  • Type II
60
Q

Is oral contraceptive use a risk factor for DVT?

A
  • yes
61
Q

What is the cut-off score for the Well’s criteria that would indicate that an ultrasound should be conducted?

A
  • 3 or greater
62
Q

Would contralateral or ipsilateral flexion be expected with a pneumothorax?

A
  • neither. Look for general changes with chest expansion w/ inspiration, RR, HR, etc
63
Q

Is a negative ultrasound sufficient to rule out DVT?

A
  • not really. Currently there’s mixed evidence for the sensitivity, although Doppler seems pretty high (upper 90’s).
  • thought to be good practice to also do a D-dimer
64
Q

What should be high in the differential for any cyclist who has c/o buttock pain?

A
  • pudendal nerve entrapment. Common in cyclists
65
Q

When is it currently recommended to remove WB/ROM restrictions s/p Achilles tendon repair?

A
  • ~7 weeks; better pt satisfaction and quicker return to work
66
Q

What is the CPR for spinal stenosis?

A
  • bilateral symptoms
  • Leg pain > back pain
  • pain during standing/walking
  • relief with sitting
  • age > 48
67
Q

What is the SNOOPx4 acronym for red flags for cervicogenic headache screening?

A
  • Systemic symptoms
  • Neurologic signs
  • Onset(abrupt)
  • Older (giant cell arteritis)
  • Previous headache history pattern change
  • Postural/positional (decreases with decreased intracranial pressure)
  • Precipitated by Valsalva
  • Papilledema
68
Q

What do AMBRI and TUBS stand for?

A
  • Atraumatic, multidirectional, bilateral (frequently), rehabilitation (often responds to), inferior capsule shift (best alternative to non-op)
  • Traumatic, unidirectional, Bankart lesion, Surgical repair
69
Q

What is the CPR for MCL injury? (4)

A
  • Trauma by external force to leg
  • rotational trauma
  • pain with valgus stress test at 30 degrees
  • laxity with valgus stress test at 30 degrees.
70
Q

What are the types for Kibler’s classification of scapular dysfunction?

A
  • bottom to the top
  • Type 1 - inferior angle
  • Type 2 - medial border
  • Type 3 - superior dysfunction
71
Q

Is hip abductor strength better preserved with an anterior or posterior approach for THA?

A
  • posterior approach
72
Q

Does lumbar manipulation technique/direction matter for low back pain?

A
  • no. Even with a directional hypomobility
73
Q

What SIJ dysfunction cluster test has the highest sensitivity?

A
  • thigh thrust
74
Q

What is the prioritization for impairment categories for the movement control category of the TBC for LBP?

A
  • neural mobility impairment
  • joint and soft tissue impairment
  • motor control impairment
  • muscle endurance impairment
75
Q

What are the Canadian C-spine rules?

A

High risk factors

  • age 65 or higher
  • dangerous mechanism
  • paresthesias in extremities

Absence of low risk factors allowing c-spine ROM

  • simple rear-end MVA
  • sitting in the ED
  • ambulatory at any time
  • delayed onset of neck pain
  • absence of midline c-spine tenderness

Unable to actively rotate 45* to R and L

76
Q

What are considered dangerous mechanisms in the Canadian C-spine rules?

A
  • fall from 3 feet or greater
  • axial load to the head
  • MVC high speed (>100kph), rollover, ejection
  • bicycle accident
  • motorized recreational vehicles
77
Q

What is Rent’s sign? What does it look for?

A

Looking for RC pathology. Bring pt’s shoulder into extension and passively ER/IR. Other hand palpating at acromion. Looking for palpable GT or sulcus; indicative of full-thickness tear.

78
Q

Paresthesias, numbness, or upper extremity pains associated with or without headaches and upper back stiffness characterize which diagnosis?

A
  • T4 syndrome
79
Q

What is the characteristic paresthesia pattern for a T4 syndrome?

A
  • stocking glove
80
Q

What is the standard presentation for T4 syndrome?

A
  • Paresthesias
  • numbness
  • upper extremity pains associated with or without headaches
  • upper back stiffness
81
Q

A ruptured spleen can refer pain to which shoulder?

A
  • L
82
Q

Which of the following are less likely to refer to the shoulder or neck?

  • stomach
  • lung
  • diaphragm
  • gall bladder
  • liver
  • pancreas
  • spleen
  • heart
A
  • stomach and pancreas
  • liver and gallbladder are more likely on the R
  • spleen more likely on the L
83
Q

What are the Start Back Tool categories? How is it scored?

A
  • Low, medium risk, and high risk for poor outcome.
  • overall score of 3 or less is Low risk
  • If score is 4 or greater, then look at the subscale score for Q5-9. If that score is 3 or less, then they are Medium risk
  • if the subscore is 4 or more, then they are High risk

Overall, the tool is quick; just 9 questions.

OCS prep (TQ) (25 decks)

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