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F1 and Stage 5 > MSK conditions: Fractures, Anatomy > Flashcards

MSK conditions: Fractures, Anatomy Flashcards

1
Q

What muscles does the radial N innervate

A
  1. Triceps
  2. all EXTENSOR forearm muscles (eg brachioradialis, supinator, extensor policis longus, brevis)
  3. An industry (tiny muscle in olecranon fossa)
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2
Q

What muscles does the median N innervate

A
  1. Most FLEXOR forearm muscles
    (Except flexor carpi ulnaris)
  2. med-LOAF hand muscles:
    - 2 lumbricals on radial side
    - opponens pollicis
    - abductor pollicis brevis
    - flexor pollicis brevis
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3
Q

What muscles does the ulnar N innervate

A
  1. Most hand muscles
    (Except med LOAF)
  2. Flexor carpi ulnaris
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4
Q

What N is affected in an anterior shoulder dislocation

What are the motor/ sensory effects of this

A

Shoulder dislocated = axillary N

MOTOR
Deltoid cannot abduct arm
Teres minor cannot externally rotate arm

SENSORY
Deficit over Sergeants patch

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5
Q

What N is affected in a mid-shaft humerus fracture

What are the motor/ sensory effects of this

A

mid-shaft humerus fracture = radial nerve

MOTOR
Wrist drop
Can’t extend wrist/ fingers

SENSORY
Deficit over radial part of dorsum of hand

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6
Q

Thigh innervation

  • anterior
  • medial
  • posterior
A

Thigh

Anterior = femoral N
Medial = obturator N
Posterior = tibial N
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7
Q

Leg innervation

Anterior
Lateral
Posterior

A

Leg

Anterior = deep branch of common fibular N
Posterior = tibial N
Lateral = superficial branch of common fibular N
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8
Q

What N is affected with these symptoms:

Weak knee extension
Loss of patella reflex
Numb thigh

A

Femoral N

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9
Q

What N is affected with these symptoms:

Weak ankle dorsiflexion
Numb calf/ foot

A

Peroneal N aka fibula N (branch of sciatic N)

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10
Q

What N is affected with these symptoms:

Weak knee flexion
Pain/ numbness from glutes to ankle

A

Sciatic N

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11
Q

What N is affected with these symptoms:

Cannot adduct hips
Numbness on medial thigh

A

Obturator N

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12
Q

What N is affected in a hip dislocation

A

Sciatic N

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13
Q

What N is affected in a knee dislocation (neck of fibula)

A

Peroneal/fibula N

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14
Q

Management for the following:

NOF fracture
Intra-capsular + not displaced
Good pre-morbid status

A

Internal fixation

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15
Q

Management for the following:

NOF fracture
Intra-capsular + not displaced
Poor pre-morbid status

A

Hemiarthroplasty

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16
Q

Management for the following:

NOF fracture
Intra-capsular + displaced
Good pre-morbid status, Age <70

A

Internal fixation

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17
Q

Management for the following:

NOF fracture
Intra-capsular + displaced
Good pre-morbid status, Age >70

A

Total hip replacement

18
Q

Management for the following:

NOF fracture
Intra-capsular + displaced
Poor pre-morbid status

A

Hemiarthroplasty

19
Q

Management for the following:

NOF fracture
Extra-capsular
Non-special type

A

Dynamic hip screw

20
Q

Management for the following:

NOF fracture
Extra-capsular
Reverse oblique/ transverse/ sub-trochanteric

A

Intramedullary nail

21
Q

Immediate fracture complications

A
  • Bleeding, shock

* Neurovascular, visceral damage

22
Q

Early fracture complications

A
  • Infection
  • Fat embolism (ARDS)
  • Rhabdomyolysis
23
Q

Late fracture complications

A
  • Delayed/ mal-union
  • Avascular necrosis
  • Complex regional pain syndrome
  • Myositis ossificans
  • Joint stiffness
  • Growth disturbance
24
Q

Describe Salter Harris fractures type 1-5

A

Salter Harris = fracture involving growth plate in children

  1. Straight across = physis
  2. Above = physis + metapiphysis
  3. Lower = physis + epiphysis
  4. Through everything
  5. Rammed (crushed)
25
Q

Describe Gardens fractures type 1-4

A

Gardens = intra-capsular NOF fractures

  1. Incomplete
  2. Complete, NOT displaced
  3. Complete, displaced slightly
  4. Complete, completely not in line
26
Q

Which types of fractures are at greatest risk of compartment syndrome

A
  • Humerus supracondylar fractures

- Tibial shaft fractures

27
Q

Signs/symptoms of compartment syndrome

A
  • Pain on active and passive movement
  • Parasthesia
  • +/- Pallor
  • +/- Pulse: arterial pulse may be present as necrosis is due to microvascular compromise
  • +/- Paralysis
28
Q

How to differentiate compartment syndrome vs acute limb ischaemia

A

Compartment syndrome: limb is warm and red

Acute limb ischaemia: limb is cold and pale

29
Q

How might compartment syndrome lead to an AKI

A
  1. Compartment syndrome
  2. Muscle death and Rhabdomyolysis
  3. Myoglobin accumulates in renal tubules
  4. AKI

(thus give fluids as part of compartment syndrome treatment)

30
Q

Signs of rhabdomyolysis

A
  1. Muscle pain/ weakness
  2. Dark red/brown urine
  3. Decreased urine output
31
Q

Which fractures are at greatest risk of avascular necrosis

A
  1. NOF (intra-capsular)
  2. Scaphoid
  3. Talus (in foot)
32
Q

What causes a proximal humerus fracture?

Signs of proximal humerus fracture

A

FOOSH injury

Swollen elbow held semi-flexed

33
Q

What is a Galeazzi fracture?

What causes this?

A

Fracture of Distal radius +
Dislocation of Distal radio-ulnar joint

Due to FOOSH injury

34
Q

What is a Monteggia fracture?

What causes this?

A

Fracture of Ulnar shaft +
Dislocation of Radial head

Due to direct blow

35
Q

Signs of a fat embolus on

  • observations
  • skin
  • eyes
A
  • observations: low sats
  • skin: non-blanching rash over torso
  • eyes: retinal haemorrhage, intra-arterial fat globules on fundoscopy
36
Q

Describe A to C of Weber’s classification of fibula fractures

A

A: below level of syndemosis
B: at level of syndemosis
C: above level of syndemosis

37
Q

Management of Weber A Fibula fracture

A

Walking boot, below-knee cast

Can weight bear

38
Q

Management of Weber B Fibula fracture

A

Walking boot, below-knee cast
Avoid weight bearing

(ORIF if talar shift involved)

39
Q

Management of Weber C Fibula fracture

A

ORIF

40
Q

Management of Maisonneubre Fibula fracture

A

ORIF

F1 and Stage 5 (29 decks)

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