Musculo- Upper extremites + Spine Flashcards
1
Q
What nerve 1st dorsal web space
A
Radial
2
Q
What nerve Volar pad of small finger
volar and dorsal surface of hand
A
Ulnar
3
Q
What nerve Volar pad of index finger
A
Median
4
Q
What nerve does thumb extension
A
Radial
5
Q
What nerve thumb opposition
A
Median
6
Q
What nerve criss-cross fingers
A
Ulnar
7
Q
What nerve Medial calf
A
L3-L4
8
Q
What nerve outside of the calf
A
Supra peroneal L4-5
9
Q
What nerve top of foot
A
Deep Peroneal L4-L5
10
Q
What nerve calf region
A
Sural S1-S2
11
Q
What nerve plantar foot
A
Tibial nerve
12
Q
What nerve dorsiflexion
A
Deep peroneal
13
Q
What nerve Plantar flexion
A
Tibial N
14
Q
What nerve Inversion
A
Tibial N
15
Q
What nerve Eversion
A
Superficial perineal
16
Q
What type of salter-Harris affects only the physis
A
AKA the growth plate
Type 1
17
Q
What type of salter-Harris: Physis + Metaphysis
A
Type 2 - most common
growth plate plus superior
18
Q
What type of salter-Harris: Physis + Epiphysis
A
Type 3
Growth plate plus inferior
19
Q
What type of salter-Harris: Physis + Metaphysis + Epiphysis
A
Type 4
Through top portion, growth plate and below
20
Q
What type of salter-Harris: crush to Physis
A
Type 5
21
Q
What tendon is involved in Rotator cuff impinement syndrome
A
Supraspinatus tendon entrapment
22
Q
What physical exam sign are postitive in impinement syndrome
A
Painful arc * Night pain* Hawkins kennedy test Neer test Empty can test
23
Q
What are the mucles involved in Rotator Cuff tear
A
SITS supraspinatus - external rotation infraspinatus - external rotation Teres minor - exxternal rotation Subscapularis - internal rotation
24
Q
What motion/physical exam will be decreased in Rotor cuff tears
A
abduction
external rotation
Drop arm test +
25
Grading for AC joint injury
```
Grade 1. Stretched
Grade 2. Torn 0-100 degrees lift
Grade 3 >100 degree lift
Acromioclavicular joint injury + Coracoclavicular ligament tear
3- will need surgery
```
26
What joint is affected in dislocation
Glenohumeral joint
27
Hill-sachs lesion
Humeral head fraction/indentation
28
Bankart lesion
Glenoid larum Tear
| need an MRI to see this
29
What would be buzz words for a posterior shoulder dislocation
Seizure
lightening strike
Electroconvulsive therapy
30
What nerve can become intraped in Shoulder dislocation
Axillary nerve
31
What do you need to do after closed reductions
Re-xray always! and redo physical exam
32
key terms for this diagnosis-
history of DM, Autoimmune thyroid disease
Slow onset of diffuse pain across shoulder for 6 months
Stiffness for 6 months
then increase ROM 2 years
Adhesive capsulitis
| thickening of the joint capsule
33
Most common site for Clavicle fracture
middle 1/3
34
Key terms for this diangosis
Postitive Adsons
Roos test
Thoracic outlet syndrome
35
what physical exam
hold arm up and feel pulse
turn head and take a deep breath and hold it
Adsons
the pulse will drop
+Thoracic outlet syndrome
36
what physical exam
both arms up like a field goal
open and close both fists 1-3mins
Roos test
reproduce symptoms - numbness, tingling
+ Thoracic outlet syndrome
37
Nerve injured with
| Humerus fracture
Radial Nerve
- dropped hand
- cant do thumb extension
- numb inside arm
38
Supracondylar Humerus Fracture - most common in whom ?
KIDS!
distal humerus
above the elebow
39
What nerve can get damaged in Supracondylar Humerus Fracture
Brachial artery injury
40
What is a complication of Supracondylar Humerus Fracture
Volkmann contracture
| -type of compartment syndrome
41
Sail sign
Anterior fat pad sign
42
What splint for Radial head fracture
Long arm posterior molded splint
| LAPMS
43
key terms for this diangosis-
numbness of ring and small fingers
+ tinels
+ Froment sign
Cubital Tunnel Syndrome
44
Froment sign
```
Flexion at the thumb IPJ
have them put paper inbetween and flex
+ the paper will slip out
+ = Cubital Tunnel Syndrome
the ulnar nerve
```
45
Cubital Tunnel Syndrome
| involves what nerve
ulnar nerve
46
Key terms- Inflamed or nonflammed elbow
| red and painful
Olecranon Brusitis
- elbow trauma
- infection
- gout
47
Key terms- pain will hand grib and wrist extension
Lateral Epicondylitis
| "tennis elbow"
48
Key terms- pain with wrist flexion
Medial Epicondylitis
| " Golfers elbow"
49
Subluxation of non-ossified radial head
Nursemaid elbow
| -From incomplete developed annular ligament
50
What type of fracture -
| Fracture of posterior ulna and radial head dislocation
Monteggia fracture
51
What type of fracture -
Fracture of distal radius & dislocation of ulnar head
"distal radio-ulnar joint"
Galezzi fracture
52
What type of fracture -
Fracture of radial head
dislocation of the distal radial ulnar joint & tear of the interosseous membrane
Essex-Loresti
53
THINK pneumonic for forearm fractures
| GRUM
GRUM
| Galeasszi -> Radius fracture ulnar dislocated
54
key terms- Compartment of extensor pollicuis brevis & Abducctor pollicis longus
pain over radial styloid
DeQuervain Tenosynovitis
55
Finkelstein
Thumb in fist & ulnar deviate
| + = DeQuervain Tenosynovitis
56
Treatment DeQuervain Tenosynovitis
Thumb spica splint
57
Key terms- pain/numbness first 3 fingers &
| half of ring finger
Carpal tunnel syndrome
| median nerve entrapment
58
Treatment for Carpal Tunnel
Volar splint
| atrophy- > surgery
59
Dinner Fork deformity
Colles Fracture
60
key terms- dorasal angulated
fracture of radius
+/- unlar styloid
Colles Fracture
61
key terms- radial wrist pain, snuff box tenderness
Scaphoid fracture
| risk of - AVN
62
Most common wrist bone fracture
Scaphoid fracture
63
Key terms- Diastatsis >3MM
| of scaphoid and lunate bone
Scapholunate Dislocation
aka a wrist sprain but usually
-> surgery!
64
Key terms- Volar dislocation of the lunate
| * tea cup is pouring out
Lunate Dislocation
| -> Surgery !
65
Key terms- Dorsal dislocation of the distal carpal row with near-normal alignment of the lunate with the radius
Perilunate Dislocation
| -> Surgery !
66
key terms- flexion of the palmar fascia with painless cords/nodules of the ring & small finger
ETOH use, DM risk factors
Dupuytren contracture
67
Treatment Dupuytren contracture
Collagenase injection
PT
surgery
68
key terms- sprain of the ulnar collateral ligament
| from forced abduction
gamekeepers thumb
69
key terms- Extrapment of finger flexor tendon at A1, clicking or locking
history of DM, RA
Trigger finger
70
What is the most common finger to have Trigger Finger
Ring finger
71
Treatment for Trigger Finger
splint
72
Key terms- hyperextension of PIP, flexion of DIP
Swan neck
| --> RA *
73
Key terms - flexion of PIP
| extension of DIP
Boutonniere
| -->. RA *
74
Key terms- extensor tendon avulsion of the distal phalanx
| hyperflexion of DIP
Mallet finger
75
key terms- puncture would to volar pad
Felon
| complicaiton- osteomylitis
76
Treatment for Felon
I & D
| from puncture wound that became and abcess
77
Complication of Felon
Flexor Tenosynovitis
78
Kanavel's four signs
Flexor Tenosynovitis
1. wounded finger is flexed
2. tender to touch over tendon
3. pain will passive extension
4. fusiform swelling of finger
79
Treatment Flexor Tenosynovitis
ORTHO ASAP
| admit and start abx
80
Organism & Treatment Dog bite wound
Pasteurella
-> Amoxicillin-clavulanic acid
augmentin
81
Organism & Treatment Cat bite wound
Pasteurella
-> Amoxicillin-clavulanic acid
augmentin
82
Organism & Treatment Human bite wound
Staph, strep, Eikenella
-> Ampicillin- Sulbactam
uynsam
83
Organism & Treatment Cat Stratch
Bartonella
| rifampin or ciprofloxacin
84
Jefferson Fracture
where ?
what type of injury?
Brust fracture of C1
85
Hangmans
where ?
what type of injury?
C2 par interarticularis
subluxation
spondylolisthesis
86
key terms- 40-50 years old
neck pain, numbess/tingling
+ spurling test
Cervical spondylosis
| chronic degerative disc disease
87
spurling test
neck extension
lateral bending
and axial loading
= pain
88
Red flags with back pain
```
Pain for > 1 month
Constant night pain
lower extremity weakness
Bowel or bladder dysfunciton
Fever, chills
Age >50years
Cancer history
weight loss
```
89
Most common location for Disc herniation
****L5- S1
L4-L5
annulus pushing out and pinches nerves
90
key terms- one leg has numbess/tingling
| + Straight leg raise
Disc herniation
91
What nerve- Patella reflex
L3-L4
92
What nerve-Achilles reflex
L5-S1
93
What nerve-Dorsiflexion
L3-L4
94
What nerve- Big toe extension
L4-L5
95
What nerve- Plantar flexion
L5-S1
96
What nerve- medial malleolus
L3-L4
97
What nerve- 1st dorsal web space
L4-L5
98
What nerve- Lateral foot
L5-S1
99
key terms for this diagnosis-
Low back pain, pain/numbness bilateral
leg weakness, incontience, flaccid penis
Cauda Equina
100
key terms- back pain that radiates to the butt or thigh
pain gets worse when standing and walking
gets better when sitting
Lumbar spinal Stenosis
| straight leg is usually negative
101
most common location for Spondylolysis
fracture of pars Interarticularis L5
102
Xray- scotty dog
Spondylolysis
103
Anterior slipping of veretral segment in lumbar spine
Spondylolistesis
104
To be consider Scoliosis has to be how many degrees?
| what side curveature most common?
> 10 degree curvature
| Right side curvature
105
Cobb angle
used to measure degree of curvature in Scoliosis on standing xray
106
Treatment Scoliosis
< 25 degrees - xray every 6 months just watch
>25 brace
>45-50 surgery
107
What are the 3 types of Kyphosis
1. postural - nothing wrong with spine
2. Scheuermann disease
- > irreguar & wedge shaped vertebra
3. Senile - decrease muscle tone, disc degeneration
108
Scheuermann disease
Kyphosis
genetic ?
irregualr and wedge shaped vertebra
sagittal curvature of the spine
109
Inflammatory arthropathy of veretbral column & sacroiliac joints
Ankylosing Spondylitis
110
Key terms- seronegativity, HLA-B27, young, uveitis, carditis, back pain starts low and moves up, lordosis, kyphosis
Ankylosing Spondylitis
| seronegativity means RF-
111
Treatment for Ankylosing Spondylitis
1. NSAIDS
2. Sulfasalazine
3. TNF inhibitors-Infliximab
