Module 4 Flashcards
1
Q
L1: 21-29 mm
L2: 23-36 mm
A
interpediculate distance
2
Q
10-15 deg
A
lumbosacral disc angle
3
Q
<12 mm - definite stenosis
<15 mm - suggests stenosis
A
Eisenstein’s
4
Q
50-60 deg
A
lumbar lordosis
5
Q
Ferguson’s angle?
A
30-60 deg
6
Q
Horizontal line from center of L3 vertebral body - passing thorugh anterior 1/3 of sacral base
A
lumbar gravity line
7
Q
20-40 deg
A
thoracic kyphosis
8
Q
adult = 3 mm max
children = 5 mm max
A
atlantodental interspace
9
Q
Spinolaminar junction line should be…
A
smooth and unbroken
10
Q
Chamberlain’s line? what does it screen for?
A
hard palate –> foramen magnum
basilar impression = >7 mm
11
Q
McGregor’s line?
A
hard palate –> base of occipital bone
dens should not pass
> 8 mm - males
10 mm - females
12
Q
Retropharyngeal interspace?
What level? what’s the max?
A
C2
7 mm
13
Q
Retrotracheal interspace?
What level? what’s the max?
A
C6
20-22mm
14
Q
Teardrop distance
Max?
L&R difference max? What is the Waldenstrom’s sign?
A
11mm max
> 2mm
indicative joint effusion
15
Q
Diastasis of the pubic symphysis = __mm
A
7 mm
16
Q
Bohler’s angle?
A
30-40 deg
17
Q
Instability - FL-EX
Cervical spine? > ___ = unstable
Lumbar spine? > ___ = unstable
A
- 5 mm
4. 5 mm
18
Q
GH joint space?
A
4-5 mm
19
Q
AC joint space?
A
2-4 mm
20
Q
Grade I AC Sprain (Mild)
AC ligament is….
Other ligaments are….
Clavicle is….
A
mild sprain of AC
other ligaments are intact
clavicle not elevated
21
Q
Grade II AC Sprain (Moderate)
AC ligament is….
Clavicle is….
A
AC ligament and joint capsules are RUPTURED
clavicle is elevated but not above superior border of acromion
22
Q
Grade III AC Sprain (Severe sprain)
AC ligament is….
Other ligaments are….
Clavicle is….
A
AC and CC liga and joint capsules are ruptured
clavicle elevated above superior border of the acromion
23
Q
AH joint space?
A
7-11 mm
24
Q
CC joint space?
A
11-13 mm
25
If anterior humeral line is disrupted - what do you suspect?
supracondylar fracture
26
If radiocapitellar line is disrupted - what do you suspect?
radial head fx
27
What is CRITOL?
```
capitellum
radial head
internal/medial epicondyle
olecranon
lateral epicondyle
```
28
What is the acronym for Salter Harris Fx?
What is the most common Type?
```
S - slip
A - above
L - lower
TE - through everything
R - rammed
```
TYPE 2
29
Capitolunate sign?
> 30 deg capitolunate angle
30
Scapholunate angle?
30-60 deg
31
Radial inclination
Volar inclination
radial = 20-25 deg
volar = 0-22 deg
32
```
C
A
T
B
I
T
E
S
```
```
Congenital
Arthrides
Tumor
Blood
Infection
Trauma
Endocrine
Soft tissue
```
33
Jefferson's
C1 Burst
34
Hangman's fx
bilat pedicle fx of C2
35
Clay shoveler's fx
alvusion of SP (C6-C7)
36
Avulsion of ant-inf VB?
teardrop - hyper FL
37
Avulsion of post-inf VB?
teardrop - hyper FL
38
Dens fx = type II
at level transverse ligament
39
Chance fx
TL junction
40
MOI of EEE
Trough sign
vacant glenoid sign
Posterior shoulder dx
41
3 associated injuries with ant shoulder dx?
hill sach
bankart
flap
42
MC AC separation/injury
Type I (other ligaments okay - just AC lig sprain)
43
Madelung deformity - ulna or radius?
4 types?
When does it usually manifest? Presenting as?
radius
late childhood or adolescents - wrist pain (females with Turner's syndrome)
dysplastic
traumatic
genetic
idiopathic
44
Colles fx - ulna or radius
radius
45
Malgaigne fx
vertical fracture with bilateral SI dx and fx of pubic ramus
46
Most common type of intra-capsular hip fx. What are some complications?
subcapital
AVN
non/mal union
47
Most common type of extra-capsular hip fx. What's usually the cause of these fx?
subtrochanteric (more so the shaft - no more than 5 cm below the lesser trochanter)
patho (biphos use, etc)
48
Segond's
Other complications?
avulsion of lateral tib
ACL, meniscus
49
Pellegrini's steida
Is it a fracture or a post-traumatic observation....
MCL
Pellegrini-Stieda lesions are ossified post-traumatic lesions at (or near) the medial femoral collateral ligament adjacent to the margin of the medial femoral condyle. One presumed mechanism of injury is a Stieda fracture (avulsion injury of the medial collateral ligament at the medial femoral condyle). Calcification usually begins to form a few weeks after the initial injury.
Clinical presentation
Most patients are asymptomatic while a small proportion will have medial knee pain (Pellegrini-Stieda syndrome).
50
Osgood Schlatter's
tib tub
chronic fatigue injury due to repeated microtrauma at the patellar ligament insertion onto the tibial tuberosity, usually affecting boys between 10-15 years.
51
Maisonneuve's
spiral fx of proximal 1/3 fibula - disrupting syndesmosis and interosseous
52
Lisfranc's
lateral displacement of 2-4 MTs
53
Chauffeur's
radial styloid
54
Minimum Diagnostic Series
Lumbar Spine
PA or AP*
Lateral View*
Medial/Lateral oblique
55
Minimum Diagnostic Series
Thoracic Spine
AP*
| Lateral*
56
Minimum Diagnostic Series
Cervical Spine
```
APOM*
AP lower cervical*
Lateral cervical*
Medial/lateral oblique
FL/EX
Pillar view
```
57
Minimum Diagnostic Series
Shoulder
```
AP*
AP EX ROT*
AP baby arm (EX ROT + ABD)
Axillary
Y/lateral/transthoracic view
AC joint view (cephalad tube)
```
58
Minimum Diagnostic Series
Elbow
AP*
Lateral*
Medial/lateral oblique
Tangential/Jones
59
Minimum Diagnostic Series
Wrist
PA*
Medial oblique*
Lateral*
PA + U deviation
60
Minimum Diagnostic Series
Hand
PA*
Medial oblique*
Lateral*
Ball catcher
61
Minimum Diagnostic Series
Hip
Minimum Diagnostic Series
Hand
62
Minimum Diagnostic Series
Knee
```
AP*
Lateral*
Tunnel
Tangential
Medial/lateral obliques
```
63
Minimum Diagnostic Series
Ankle
AP*
Medial oblique*
Lateral*
64
Minimum Diagnostic Series
Foot
DP*
Medial oblique*
Lateral*
65
burst vs. compression fx
* Bursts are a type of compression fracture!
* MOI of burst fractures: axial compression
* Unlike compression fx, usually there are multiple fracture lines
* Risk for neuro deficit because of sharp bony margins
* Vertical VB fracture line with posterior displacement of George’s line
66
List some common complications
* OA
* AVN
* Instability
* Non/mal-union
* MO
* DDD, DJD
* Infection
* CRPS
* Compartment syndrome
* Post-traumatic myelomalacia
* NM bundle disruption and FBI
67
Canadian C-Spine Rules:
3 High RF
5 Low RF
If they have one of the low RFs - what would you proceed to do?
sixty-five
fast drive
sensory deprive
```
slow wreck
slow neck
sitting down
walkin' round
c-spine fine
```
proceed check bilateral active rotation (45 deg)
68
Canadian C-Spine Rules:
In lateral FL-EX study - how much is "instability"?
How much is "angular deformity"?
3.5mm horizontal translation
angular deformity
69
What do you do if you suspect a fx but it is unseen/occult?
CT
CT
CT
CT
70
Ottawa Knee Rules (5)
Ottawa Ankle Rules (2)
```
55+ y/o
isolated patella tenderness
isolated head of fib tenderness
cannot FL 90 deg
non-WBing
```
tenderness at lat/med malleolus (post edge and tip of mall - 6 cm above)
non-WBing
71
Patient comes in with new/recent fracture - what observations or checks do you make?
```
vitals + neuro
ST swelling
discolouration, temperature
mobility, motion
impaired fxn?
deformity (visible/palpation)
```
72
What is typical of a supracondylar process?
What structures are at risk?
What ligament can also run along it?
Adjust?
points towards the joint
median nerve
Struther's
sure
73
What is often associated with a olecranon foramen?
os supratrochleare dorsale
74
MC carpal coalition? Best view to see this?
lun-triq
PA wrist
75
Are Duverney fx stable?
Yeah
76
Are alvusion fx of the ASIS/AIIS stable?
yes
77
Are Malgaigne's fx stable?
nope
78
Two types of stress fractures in the hip? What populations?
fatigue - young people (or active older adults)
insufficiency - osteoporosis elders (refer to GP) - usually no activity related
79
Posterior hip dislocation - commonly asso w/ what?
MOI?
post rim fracture, fem shaft fx,
MC hip dx
blow to knee in hip FL
80
MOI for an anterior hip dx? list some complications
forced ABD + EX ROT
neurovascular bundle injury, non/mal union, AVN, MO
81
What line(s) are disrupted in a SCFE?
POM?
Klein's, iliofemoral line
advise not to WB, head to GP asap for further imaging and potential ortho Rx
82
Which fractures of the femur appear to be T or Y shaped?
femoral condylar fx
83
Most patellar fractures are....
MOI?
DDx
transverse (60%)
hyper-FL
DDx - bi/tripartite patella
84
tibial plateau/bumper fx
T or F: usually affects the medial plateau
T or F: 50% of these happen in older adults
POM?
F - lateral
T
immobilize, monitor (vitals/neuro) - suggest MRI for further imaging (ST and ligamentous structures)
85
What is a trampoline fx?
fracture of the prox tib metaphysis
86
T or F: FBI sign means it is likely an extra-articular fx
nope - intra
87
MOI for lateral mall fractures
most common type of fracture
_____ sign usually present
EX ROT + EV
oblique or spiral
mckenzie
88
Maisonneuve fracture
is the combination of a spiral fracture of the proximal fibula and unstable ankle injury which could manifest radiographically by widening of the ankle joint due to distal tibiofibular syndesmosis and/or deltoid ligament disruption, or fracture of the medial malleolus. It is caused by pronation external-rotation mechanism. It requires surgical fixation.
89
Lover's fracture
calcaneal compression - decreased bohler's angle
usually comminuted, asso with tendon rupture
90
Jone's fractures
T or F: base of 4th
T or F: usually a transverse fx
MOI?
T or F: High rate of non-union
F
T
T
MOI: forced IN and PF (avulsion of peroneals)
91
diabetics, horse back riders, MVA, bikers
forefoot gets trapped and midfoot is dx and fx
what kind of dislocation is this?
lisfranc
92
MC being subacromial
Bankart lesion
flap fracture
hill sach's
Anterior shoulder dx
93
Distal clavicle - post-traumatic osteolysis
Often found unilateral in which population? What if it's bilateral - what may that be indicative of?
weight lifters
RA, hyperparathyroidism (females)
94
Fx of proximal humerus
What 4 locations would you categorize it?
Which location is the most common for a humerus to fx?
anatomical neck
surgical neck - MC
greater tub
lesser tub
95
Parry's/Nightstick fx vs. Monteggia fx vs. Galeazzi fx
Parry - Ulna only
Monteggia - The Monteggia fracture is a fracture of the proximal third of the ulna with dislocation of the proximal head of the radius.
Galeazzi - aka reverse monteggia - fracture at distal radius w/ distal dx of radioulnar joint
96
Colles fx vs. smith's fx vs. chauffeur's fx
Colles fractures are very common extra-articular fractures of the distal radius that occur as the result of a fall onto an outstretched hand. They consist of a fracture of the distal radial metaphyseal region with dorsal angulation and impaction, but without the involvement of the articular surface. This article describes radiographic features to check for and possible complications. MOI = FOOSH + PRO + FL. Dinner fork deformity (common in osteoporosis females)
Smith fractures, also known as Goyrand fractures in the French literature 3, are fractures of the distal radius with associated volar angulation of the distal fracture fragment(s). Classically, these fractures are extra-articular transverse fractures and can be thought of as a reverse Colles fracture. MOI = fall on wrist in hyper FL or direct blow to back of wrist
Chauffeur fractures (also known as Hutchinson fractures or backfire fractures) are intra-articular fractures of the radial styloid process. The radial styloid is within the fracture fragment, although the fragment can vary markedly in size.
97
Scaphoid fractures
T or F: you can usually find radiographic findings immediately
T or F: rare in children
T or F: pain snuff box
T or F: high risk for AVN
F
T
T
T
98
Terry Thomas sign is for.....
scapholunate dx
99
Bennett fractures tend to be intra-articular or extra-articular?
intra-articular
100
Mallet finger: MOI?
| Gamekeeper's: MOI?
hyper EX - avulsion of the IPJ's volar plate
forced ABD in fall
101
T or F: both Jefferson's and Hangman's fx have no neuro signs
T
with burst (Jeff) - fragments usually displace outwards - sparing the spinal cord
102
How do you differentiate a FL and EX teardrop fracture?
FL = NEURO NEURO NEURO!
FL = post-inf fragment
EX = ant-inf fragment
103
5 signs of a tear drop fx
```
lower Cs comp. fx
ant/inf fragment seen
increased interspinous distance
mild rotary subluxation of facet
potential listhesis
```
104
DDx for dens fracture
os odontoideum
105
Clay shoveler tends to happen where?
Neuro symptoms - yes or nah?
C7-T1
Nah
differentiate from unfused apopphysis
