Musculoskeletal Flashcards
Duputryen’s causes
Alcohol
Family history
Diabetes
Epileptic drugs (phenytoin)
JIA/Still’s disease
Still’s = systemic JIA = salmon pink rash
Type of inflammatory arthritis
Salmon pink rash on trunk, arms and legs
Tx: same for rheumatoid
Recovery after knee replacement vs hip
ERAS
Knee: Bend knee after 2-3 days, approx 10 days in hospital
Hip: mobilise and stand as early as possible, even next day
Damage to what vessels during knee replacement
SFA
Popliteal
What is ERAS
is a multimodal, multidisciplinary approach to the care of the surgical patient
minimally invasive approaches instead of large incisions
management of fluids to seek balance rather than large volumes of intravenous fluids
avoidance of or early removal of drains and tubes, early mobilization
and serving of drinks and food the day of the operation
Haemoarthrosis
Primary spontaneous (coagulopathy e.g. Haemophilia, no major trauma necessarily)
Secondary (trauma)
ACL classically
Hallux valgus causes and treatment
Familial
Bad shoes
Assoc with RA
Management
Non surgical: appropriate footwear, physio, splints
Surgery: Bunionectomy, excision arthroplasty
Hammer/claw/mallet toe causes
Imbalance between intrinsic and extrinsic toe muscles
Commoner in females, elderly
Weber classification of ankle injuries
Fibula; determines stability
A: below syndesmosis
B: above syndesmosis
C: highest above syndesmosis
What is a charcot joint?
Progressive, destructive joint arthropathy secondary to peripheral neuropathy
Phases of gait
4 phases:
Heel strike
Stance phase
Toe-off
Swing phase
Baker’s cyst
Posterior herniation of knee joint capsule
Associated with degenerative knee disease
Ix for popliteal aneurysm
Duplex scan
Shoulder dislocation and complications
Anterior (most common)
Posterior (seizure/electrocution)
Axillary nerve damage
Carpal tunnel syndrome on examination? What will they complain of?
Wasting of thenar eminence
Scar over flexor retinaculum
Parasthesia/anaesthesia in thumb, index, middle fingers
Worse at night or repetitive actions
Causes of carpal tunnel syndrome?
Idiopathic RA Pregnancy DM Acromegaly
What runs through carpal tunnel?
The tendon of flexor pollicis longus
Four tendons of flexor digitorum profundus
Four tendons of flexor digitorum superficialis
Median nerve
Ulnar palsy on examination? How can you test for it?
Hypothenar eminence wasting
Ulnar claw
Loss of sensation in ulnar distribution
Examine the hand
Examine the brachial plexus/neck
Blood supply to the femoral head
Lateral circumflex arteries giving rise to retinacular vessels
Intramedullary vessels
Artery of ligamentum teres
Nerve supply to: Supraspinatus Infraspinatus Teres minor Subscapularis Deltoid
Supraspinatus & Infraspinatus - suprascapular nerve
Deltoid & Teres Minor - axillary nerve
Subscapularis - subscapular nerve
Fracture management
Resuscitation (ATLS guidelines)
Reduction (closed or open)
Restriction (non-rigid, plaster, ex-fix or int-fix)
Rehabilitation (physio, OT)
Mortality of hip replacement
30% at 1 year
Cauda equina red flags
Saddle anaesthesia
Loss of anal tone
Bladder/bowel incontinence
Leg pain
Klumpke’s paralysis? Erb’s palsy?
KP: C8/T1 of brachial plexus
Erbs: C5/C6 of brachial plexus
