MSK Flashcards
What are risk factors for developing septic arthritis?
Intra-articular injections
RA
DM
Immunosuppression
Penetrating injury
Infections elsewhere e.g. gonococcal
What is the most common organism in septic arthritis?
Staph aureus
What organism should be considered if septic arthritis in a prosthetic valve?
Staph epidermis
What are the rotator cuff muscles?
Supraspinatus
Infraspinatus
Teres minor
Subscapularis
Where does the supraspinatus attach to the humerus?
Greater tubercle
What muscle takes over abduction of the arm after supraspinatus initiates movement (first 10-15 degrees)?
Deltoid
What two muscles are innervated by the accessory nerve?
Teres minor
Deltoid
What two methods are used to image the supraspinatus and assess for tears?
MRI and US
What airway manoeuvre is used if C spine is unstable?
Jaw thrust.
Head tilt chin lift cannot be performed
When can a nasopharyngeal airway not be used?
Possibility of basal skull fracture
Which images are requested in a trauma series?
AP CXR
AP pelvic X-ray
Lateral cervical X-ray
What test is performed to test the integrity of the anterior cruciate ligament?
Lachman’s/Anterior draw test
How do you test the collateral ligaments of the knee?
Flexion of knee to 20 degrees to loosen the ligaments
One hand on the ankle and the other stabilises the femur
The knee joint is then stressed in abduction to test the medial collateral ligament
If the knee ‘opens up’, it signifies that the ligament has completely torn
Which structures make up the ‘unhappy triad’?
Anterior cruciate ligament
Medial collateral ligament
Meniscal tear (tightly adheres to medial collateral ligament)
What test is positive in a meniscal tear?
McMurray’s
What imaging is used to assess damage to the medial meniscus?
MRI
Where can an autograft be taken from to reconstruct the ACL?
Patella tendon
Hamstring tendon
Quadriceps tendon.
What system is used to classify intracapsular femoral neck fractures?
Garden
Name two arterial supplies to the head of the femur.
Intramedullary vessels
Cervical vessels in the joint capsule retinaculum
Artery of the ligament teres
What procedure if performed if there is an undisplayed intracapsular fracture?
Internal fixation with nails/screws
Which bone is fractured in Colles’?
Distal radius (distal metaphysis part) with dorsal displacement and angulation.
A Smith’s fracture is volar displacement and angulation
What deformity is seen in a Colles’ fracture?
“Dinner fork” deformity
What pain block is used in Colles’?
Bier’s block
Local anaesthetic is injected intravenously
What is an operative procedure for a fracture?
Open reduction and internal/external fixation.
How long does Colles’ take to heal?
6-8 weeks
What system is used to classify open fractures?
Gustilo and Anderson
How do you manage an open fracture?
Fluid resuscitation
Analgesia
Assessment of neuromuscular and soft tissue damage
Photograph wound
Sterile cover
Broad spectrum abs
Tetanus prophylaxis
Surgical debridement
Surgical fracture stabilisation
Wound closure
What are complications of an open fracture?
Compartment syndrome
Wound infection
Tetanus infection
Osteomyelitis
Nerve damage
Vascular damage
Sepsis
Malunion/non-union
DVT
Death
What is the termination of the spinal cord known as?
Conus medullaris
Where does spinal cord end in newborns?
L4-L5
What are possible causes of caudal equine?
Fracture
Haematoma
Abscess
Tumour
Disc prolapsed
What are the complications of cauda equine?
Paralysis
Sensory abnormalities
Bladder dysfunction
Bowel dysfunction
Sexual dysfunction
Are males or females more at risk of OA?
Females
What is found on examination in OA?
Tenderness
Derangement
Swelling
Decreased ROM
Pain on movement
Crepitus
Instability
What are the X-ray changes in OA?
L oss of joint space
O steophytes
S ubchondral cysts
S ubchondral sclerosis
