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Clinical Medicine LAB - Professor Sample > MS II > Flashcards

MS II Flashcards

1
Q

Anterior dislocation occurs with ?

A

external rotation and abduction

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2
Q

Humeral head lies inferiorly and medial to the glenoid ( and anterior ) for what ?

A

Anterior dislocation dislocation fo shoulder

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3
Q

What is most common shoulder dislocation ?

A

anterior

  • *this does not alway happen but we see this when patients have had dislocations in the past
  • *
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4
Q

Hill-Sachs deformity (more common according to sample) ?

A

Indentation on the posterosuperior portion of the humeral head

** “on top of the hill”
when it goes down and inferior it strikes the glenoid process **

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5
Q

Bankart deformity ?

A

Bony irregularity or fragment of the glenoid

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6
Q

What is the bets view for shoulder dislocation ?

A

✪ Best view- transscapular view (“Y” view)

scapula and the humeral head should be in the center of the Y or when the glenoid process, acromiun process ( know the three parts of the Y)

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7
Q

AC separation grades ?

A

1 - strain

2 - tear

3- dislocation ( complete separation of the clavicle from the acroimun process)

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8
Q

AC separation ?

A

when someone falls onto a shoulder it is a high impact injury (fall down hard) ATV or dirt bike accident

cartilage and ligament that attack clavicle to acronym and when you tear them then you get separation and cause the clavicle to lie superiorly to the acromium process

weight bearing films ( it pulls down on the humeral head and acromium process and makes the dislocation look more obvious ( weight bearings films are the Gold standard!)

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9
Q

Elbows we want to remember to look for ?

A

fat pads

sometimes we dont see the fractures so we look for these fat pad signs

fat pad by the posterior part of the distal humorous

fracture causes bleeding in the joint pushes the fat pad out of the joint and we can see it in the fat pad (“ blown out cell”)

xray with no obvious fracture but we see a fat pad sign then we are going to treat it like a fracture and splint it and everything etc .

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10
Q

Elbow: fat pad sign normal location ?

A

Normally posterior fat pad is tucked into the olecranon bursa

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11
Q

Elbow: fat pad sign occurs cause the fat pad is displaced by ?

A

bleeding fracture

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12
Q

what is the “sail sign” ?

A

bowed anterior fat pad

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13
Q

By your elbow the ulna is ___ and the radius is _____

A

big

small

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14
Q

Bennett fracture occurs in the ?

A

hand

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15
Q

Bennett fracture occurs where?

A

Base of the thumb into the carpometacarpal joint.

**fracture at the base of the thumb at the carpal and metacarpal joint - almost always needs surgery cause it goes into the intraacular joint **

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16
Q

Bennett fracture almost always requires ?

A

surgical fixation

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17
Q

Comminuted bennett fracture ?

A

Rolando fx.

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18
Q

Mallet Finger is in the ?

A

hand

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19
Q

Mallet Finger is a ________ injury at the base of the _____ phalanx

A

Avulsion

distal

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20
Q

Mallet Finger is a ______ tendon injury

A

extensor

** the extensor tendon is snapped ( jams finger really hard) cant straighten it out ( when it snapped it takes a chunk of bone off the distal phalanx) evulsion injury which sometime fluxation

you need to separate the joints when examine the fingers ( **

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21
Q

Jersey finger is a _______ tendon injury

A

flexor

** they can keep it in extension but the cannot flex it **

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22
Q

Gamekeeper’s thumb is an ________ on the _____ aspect of the ______ MCP joint

A

Avulsion

ulnar

1st

***when people used t filed dress a rabbit and peeling the skin back forcefully and get there thumb caught ans snap there thumb back

it creates an injury at the base of the thumb ( it is in evulsionn injury cause the tendon is pulling part of the bone)

aka Skiers thumb**

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23
Q

Boxer’s fracture caused by ?

A

punching mechanism

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24
Q

Boxer’s fracture is of the ?

A

4th or 5th metacarpals

  • *typically 5th metacarpal distal portion and usually the next ( maybe the 4th )
  • *

**look for sissoring of the fingers when the make a fist the pinky moved inward and gets stuck under the ring finger **

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25
Q

Boxer’s fracture can sometimes involve the ?

A

Sometimes 2nd and 3rd are included in the diagnosis.

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26
Q

Hand bones ?

A

Trapezium

Trapezoid

Capitate

hamate

triquetrum

lunate

scaphoid

pisiform

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27
Q

Lunate/Perilunate Dislocation occurs when?

A

ligaments between the lunate and the capitate are disrupted

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28
Q

Lunate/Perilunate Dislocation best view ?

A

lateral view

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29
Q

Lunate/Perilunate Dislocation different in the way the bone is ?

A

situated

perilunate - complete dislocation of the capitate off the lunate

lunate - looks like a spilled tea cup

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30
Q

Scaphoid Fracture tx?

A

clinically

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31
Q

Scaphoid Fracture is frequently missed on ?

A

XR

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32
Q

Scaphoid Fracture: cast wrist and repeat XR in __ wk?

A

1

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33
Q

Scaphoid Fracture has a high risk of ?

A

avascular necrosis

**avascular necrosis and loss of function of the rest ( cause blood supply goes distally and the comes back proximally ) **

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34
Q

Triquetral Fracture best seen on a ?

A

lateral view XR

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35
Q

Triquetral Fracture is a?

A

Small chip off of the dorsum of the wrist

36
Q

What is the most common fracture of the forearm ?

A

Colles Fracture

37
Q

What is a Colles Fracture ?

A

Fracture of the distal radius +/- ulna with dorsal displacement

**dinner fork deformity , dorsally displaced **

** C and D are next to each other in the alphabet ( collet dorsal)**

38
Q

What fracture of the forearm is less common?

A

Smith Fracture

39
Q

Smith Fracture is a ?

A

Fx of the distal radius +/- ulna with volar displacement

40
Q

Monteggia Fracture is a fx. of the ____ with ________ radius disolcation

A

ulna

proximal

big bone breaks and the little bone becomes displace

** the ulna breaks and the radial head displaces

if someone has knee pain look at ankle and hip **

41
Q

What can be missed if the elbow is not examined ?

A

Monteggia Fracture

42
Q

Galeazzi Fracture is a fx. of the ______ with ______ ulna displacement ?

A

radius

distal

Ulna its little at the wristband is displaced here ,you can have breaks w/o the displacement b

43
Q

Neck facts ?

A

vertebral prominences

can see the space when the spine is and if the space is smaller then it could be something wrong with the disc

normal lordosis - straightening of lordosis can be from spasms in the neck on both sides causes the neck to be lordotic

44
Q

Lateral C-spine XR?

A

line along the anterior and posterior part of the verterbrae and down the middle

the lines should line up nicely in the lateral view and the lines should not be squiggly

45
Q

Jefferson fracture involves the ?

A

C-spine

46
Q

Jefferson fracture is a split of the bony ring of ?

A

C1

**breaking one side of a ring bone the other side breaks as well

secondary to a blow to the top of the head

someone who is ina car accident and hits the windshield or falls and hits top of head and they can shatter the C1

lateral displacement of the lateral masses ( the right pic the right mass is more displaced) you know it is broken when you see lateral displacement **

47
Q

Jefferson fracture is usually a ________ to the top of the head?

A

2/2 blow

48
Q

Jefferson fracture view ?

A

Odontoid view

49
Q

Jefferson fx. make sure to order a ?

A

Order CT scan

50
Q

Clay-shoveler fracture is of the __ or __ spinous processes?

A

C6

C7

51
Q

Clay-shoveler fracture is a ________ injury ?

A

Avulsion

**staining to pull shover out of clay and snap neck back

vertebral process fracture ( not dangerous cause does not involve the cord or disc) it is essential an evulsion fracture **

52
Q

Hangman fracture caused by ?

A

hyperextension and distraction

(ie; hitting head on dashboard)

**hyperextended and backwards ,hitting head on dashboard **

53
Q

Hangman fracture is a fx of ?

A

the posterior elements of C2

54
Q

Hangman fracture can also involve ?

A

+/- displacement of C2 body anterior to C3

55
Q

Spondylolysis - just the fracture with no _________

Spondylolisthesis ?

A

slipping

this one moves

**allows slipping forward and backward it is pretty common

when a disc squishes and the caused the disc to bulge and then this cause inflammation and hits a nerve - rediculoapathy (herinated disc)

leg pain - from my but down to my left **

56
Q

Spondylolysis/Spondylolisthesis views ?

A

oblique view for this

a scotty dog leg connected to a scotty dogs back

57
Q

Knee views ?

A

sunrise view or tunnel view or merchant view on the right - great view of patellar fracture ( if you suspect tendon rupture then you need to get this sunrise view)

AP and lateral view for just normal knee exam

weight bearing views good for arthritis or narrowing of the joint space - helpful cause it can show you a degree of narrowing in a real life situation instead of them lying down and comparing one knee to the other

58
Q

Osgood-Schlatter is from ? and causes a ?

A

Patellar tendon pulling on the tibial tubercle

bump

59
Q

Osgood-Schlatter own notes ?

A

younger athletes

tibial tubercle is not sealed to the tibia - really active kids get swelling of areas and causes inflammation and pain on the tibial tubercle and the get a bump there

over time may heal and ossify and get a permanent bump

60
Q

Tibial plateau fracture best view ?

A

Best seen on lateral but may be difficult to find

**best seen on lateral view and it is difficultt to find *( they are inside the joint) patients do not want to bear weight
this is a surgical knee **

61
Q

Tibial plateau fracture imaging to better at distinguishing extent ?

A

CT

MRI

** if they cant bear weight do a CT scan **

62
Q

Patellar tendon rupture appears as a __________________ on films ?

A

“high riding patella”

**typically cannot flex **

63
Q

Patellar tendon rupture results in ?

A

Unopposed traction on the patella

** the unopposed traction on the patella will cause the patella to get pulled up by the quadriceps tendon **

64
Q

patella fracture can be missed on a AP view but not so much on a _______ view ?

A

sunrise

65
Q

Pronation is ?

A

inversion

66
Q

Supination is ?

A

eversion

67
Q

Ankle XR viewing ?

A

important to look at the clear space

clear space on the right pic is from ligamentous fracture and it is unstable and a surgical ankle

the spaces should be less the 5 mm in width indicating a disruption of the ankle mortise

68
Q

Malleolar Fracture is usually an ________ injury from ________ or inversion of the ankle

A

avulsion

eversion

“rolling the ankle” injury

**portion of the lateral malleolus the ligament pulled on the end of bone and pulled it off - evulsion injury

this is the most common **

69
Q

Maissoneuve Fracture ?

A

proximal fibula fracture

you can have a distal fracture which causes a proximal fracture ( pic on right is the proximal portion - oblique )

if anke is hurt then look at knee and toes ( check neurovascular relfex, cap refill etc of the toes)

70
Q

Pilon fracture any fracture of the ______ ______ that involves that articular surfaces of the ______ plafond

A

distal tibial

tibial

**ankle fracture of the distal tibia that involve the plafond which is just the articular surface

pilon means the fracture is communicating with ta articular surface **

71
Q

Lisfranc fx ?

A

Medial border of the 2nd metatarsal should align with the medial border of the 2nd cuneiform

72
Q

Lisfranc own notes ?

A

a ligamentous disruption with the ligaments int he foot and when they get tore you can have displacement in different ways

know that if you have a widening of the metatarsal it will signify you have a ligamentous disruptions and a lisfranc

jump from a high surface and land on feet and split ligaments - pain will just not go away its for months and months

standing view you can see

73
Q

Torus fracture aka ?

A

“buckle” fracture

74
Q

Torus fracture is from ?

A

Force causes bowing of the pliable bone

75
Q

Torus fracture ?

A

force that cause pliable bone to bow

not unilateral force causing bending it is more falling forward and landing on hands etc and cause compression of hand bones and the y can buckle

lateral view you can deff see the buckling

76
Q

Pediatric fractures ?

A

Torus fracture

Greenstick fractures

Salter-Harris

77
Q

Greenstick fractures is ?

A

Bowing on one side with an incomplete fracture on the other side

**pliable bone that breaks on one side and bends on the other **

78
Q

Salter-Harris is a fracture of ?

A

Epiphyseal plate

79
Q

Salter-Harris: what are radiopaque ?

A

Epiphysis

metaphysis

80
Q

Salter-Harris: what is radiolucent ?

A

Cartilaginous growth plate

81
Q

A 12 year old presents to the family practice c/o right knee pain. He is active and plays many sports. On PE, there is a tender raised area near the right tibial tubercle. What is the best diagnostic test to order?

A

get a xray of knee

osgood slaughter

see the what being pulled away from the tubercle

best seen on lateral view will not see it that much on AP

82
Q

A 42 year old female presents with neck pain after being falling and striking her forehead against a coffee table. PE shows midline tenderness of the cervical spine. Which cervical spine view will give you the best diagnostic information?

A

dashboard on she has some extraction and hyper extension and at risk for hang man so the best view is lateral and we will see anterior displacement of C2 from C3

83
Q

A 17 year old presents with right shoulder pain after falling off of an ATV…while it was moving. PE reveals tenderness along the clavicle and AC joint. What test would you order?

A

best initial test is xray of shoulder ( AP and lateral views of shoulder )

this is same pic as last slide but this is weight bearing

this is just called AC separation

84
Q

A 60 year old female FOOSH after slipping on black ice in the parking lot. Now c/o right wrist pain. She has no NV deficit.

A

fell on outstretched hand

colles

we see fracture of the distal radius that is comminuted with distal displacement of the hand

85
Q

A 2 year old is brought in by mother with concerns that the patient will not move her left arm and keeps crying. States that it began after she picked her up out of the bath tub by her arms. PE seems to reveal pain at the elbow. What next?

A

nurse maids elbow

hypersupinate and the flex wth pressure on the radial head and it should pop back into place ( you can try reduction before xray)

dislocate or sublux the radial head ( slips out of the pocket easily)

if the fall or have built trauma then get an xray but if there is a good history and you know it is nuse maids elbow then you dont need xray

86
Q

Salter Harris own notes ?

A

fracture of epiphyseal plate and classify them by how the look

above - above the epiphyseal plate

5 types - be careful cause it works when looking at a bone in front of you like tibia, but the wrist when you are talking about above it actually looks below

low goes through the epiphysis and the plate

Clinical Medicine LAB - Professor Sample (36 decks)

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