Musculoskeletal Flashcards
Rotator cuff muscles
S- supraspinatus
I- infraspinatus
T- teres minor
S- subscapularis
SALTER
Epiphyseal fractures S-strait A-above or away from joint L- lower T- through R- rammed
Gout
Increased risk with thiazides and etoh consumption. Test of choice is inspiration of joint fluid.
Gout crystals
Negative bifringent crystals
What medication works well for anticoag in ortho surgery?
Low molecular weight heparin
Slipped capital femoral epiphysis (SCFE )
Ortho emergency, chubby teenager limping and can’t internally rotate with possible referred pain to knee or thigh
HLA-B27
Ankylosing spondylitis
To avoid what nerve do you give injections in the upper outer buttock
Sciatic
Rhomboid positive bifringent calcium pyrophosphate crystals
Pseudo gout
Fusion of the vertebrae, is joint involvement, am lower back pain better with exercise, seronegative, hLAB27
Ankylosing spondylitis
If you suspect ankylosing spondylitis what should you rule out first?
Chrones or ulcerative colitis…. 10-20% mimic AS
Increased age, obesity, decreased joint spaces on X-ray weight bearing joints, crepe dis on exam is?
Osteoarthritis
Monoarticular swelling and pain, fever, adult, with WBC over 50,000 think?
Septic arthitis and aspirated fluid. Could be gout could be ghonococcal disease.
ANA positive, rash on face, arthritic pain, oral ulcers, protein urea, painful discoid rash on fingers, what is the treatment?
SLE, treatment is methotrexate, NSAIDs, steroids.
First line of treatment for gout.
High dose NSAIDs
Inhibits formation of uric acid and therefore decreases it in the serum and ruin. Also decreases the size of tophi. Don’t use in acute attacks.
Allopurinol.
This med has no effect on uric acid levels and is given in acute attacks.
Colchicine
Prolonged ischemia followed by reperfusion, mc found in forearm or lower leg, pain with passive extension.
Compartment syndrome
Dx for adult with Monoarticular arthritis?
Arthrocentesis
What is the first line treatment for patients with symptomatic rheumatic arthritis?
DMARDS, methotrexate
Atlas
C1
Axis
C2, Odontoid process can break off after hyperextension and cause bony fragments that injure spinal cord.
MC fx of the wrist. Fx to the distal radius with DORSAL displacement, dinner fork deformity.
Colles fx, splint x 6 wks
Fx of distal radius with volar displacement.
Smith fx
Radial styloid fx, chauffeur fx.
Hutchensons fx, thumb spica or sugar tong splint
Origin of phrenic nerve
C3-c5. Injury below and the diaphragm works.
Which nerve
Is involved in carpal tunnel?
Median
A malignant bone tumor that produces osteoid and bone, sunburst appearance on X-ray, periosteal elevation that forms an angle with bone cortex
Osteosarcoma.
Excessive bone resorption replaced by soft matrix (osteoid), X-ray shows enlarged translucent bone, patient is usually over 40, bone fx, hearing loss, increased alk phos,
Padgets disease
Central cord syndrome
Hyperextension of neck and patient only has upper extremity deficits, lower extremities normal
All function lost except positional and vibratory
Anterior cord syndrome
Loss of only positional and vibratory sense, rare
Posterior cord syndrome
Non inflammatory joint dz with loss of articular cartilage, osteophytes, deep aching joint pain worse with use, relieved with rest. Obesity and increased age are risk factors.
Osteoarthritis
Autoimmune dz, joint pain in am, sx greater than 30 min, bony erosions on X-ray, joint pain, swelling, low grade fever, malaise, vasculitis, rheumatic nodules, scleritis, anemia.
Rheumatoid arthritis
Stress reaction of the insertion of the patellar tendon to the tibial tubercle.
Osgood schlater disease. Tx is stop offending activity.
A vascular necrosis of the femoral head. Limping patient with mild intermittent pain that may refer to thigh or knee. Normal née exam.
Legg calve perthes disease.
Nerve injured with foot drop
Deep peronial
Nerve injured with clawing of the toes
Tibial nerve
Young middle aged woman with rash on face, hair loss, fatigue, apples on fingers that are tender, and increased protein in urine?
SLE
Pos ANA
RA, SLE, scleroderma, polymyositis, dermatomyosis
Anti-ds DNA
SLE
RF
RA
Anti-Sm (ith)
SLE
Anti-ro, Anti-La
Sjogrens
Anti-SCL 70
Scleroderma