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NSGY and Ortho Flashcards

1
Q

neurapraxia

A

no axonal injury; temporary loss of function

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2
Q

axonotmesis

A

disrupt axon, not sheath; will improve

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3
Q

neurotmesis

A

disrupt axon and sheath; might need OR

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4
Q

growth of nerve

A

1mm/day

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5
Q

salutatory conduction

A

nodes of ranvier in nerve

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6
Q

regulation of ADH

A

hyperosmolar serum causes supraoptic nucleus of hypothalamus to release in posterior pitutary gland

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7
Q

when to operate on subdural vs epidural

A

subdural 1cm
epidural 0.5 cm

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8
Q

MC intracerebral hematoma

A

temporal lobe ; drain only if focal deficits

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9
Q

Cushings triad

A
  1. HTN
  2. brady
  3. low RR
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10
Q

spinal shock level

A

above T6

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11
Q

anterior spinal cord syndrome

A

injury to anterior spinal artery

(vert body burst fx, aortic problem, ruptured disc)

b/l loss MOTOR, PAIN, TEMPERATURE below lesion
proprioception and light touch are FINE.

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12
Q

Borwn Sequard syndrome

A

hemisection

(penetrating injury)

loss of IPSILATERAL MOTOR and CONTRALATERAL PAIN/TEMP below lesion

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13
Q

central cord syndrome

A

(hyperextension of spine, old people with sponylosis)

*MC MC MC spinal cord injury**

b/l loss ofUPPER EXTREMITY MOTOR, PAIN, TEMPERATURE

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14
Q

cauda equina

A

LOWER EXTREMITY pain and weakness due to compression of lumbar nerve roots, loss rectal tone, perineal saddle asnethesia, distended bladder
mgmt: decompression emergently.

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15
Q

spinothalamic

A

pain temp DORSAL

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16
Q

corticospinal/rubrospinal tract

A

motor VENTRAL

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17
Q

dorsal vs ventral nerve roots

A

dorsal: AFFERENT
ventral: MOTOR

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18
Q

MC brain tumor

A

glioma (esp glioma multiforme)

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19
Q

meninigioma mgmt

A

resect

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20
Q

MC met to brain

A

lung

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21
Q

MC children brain tumor

A

medulloblastoma

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22
Q

MC metastatic brain tumor in children

A

neuroblastoma

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23
Q

acoustic neuroma origin

A

8th CN at cerebellopontine angle (vetigo, hearing loss)

mgmt; resect

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24
Q

MC spinal tumor

A

neurofibroma

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25
Q

intradural tumor vs extradural malignant potential

A

extradural is most likely malignant

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26
Q

paraganglionoma

A

check for metanpehrines

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27
Q

intraventricular hemorrhage = subependymal

A

premies rupture GERMINAL MATRIX

mgmt: drain

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28
Q

myelomeninigocele

A

neural cord defect esp LUMBAR
spinal cord and nerve roots herniate through!

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29
Q

wernicke’s location

A

temporal; left; speech comprehension

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30
Q

brocas location

A

posterior frontal; speech motor

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31
Q

brain abscess drainage indication

A

2.5cm (otherwise just ABx)

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32
Q

Causalgia

A

reflex sympathetic dystrophy…

cosntant burning pain if you touch the area (cold cyanotic, moist)
mgmt: sympathetctomy

33
Q

salter harris fx I-V

A

I: epiphysiolysis of growth plate (no fx)
II: metaphys fx
III: growth plate and epiphysis fx
IV: fx crosses epiphysis, growth palte and metaphysis
V: crush of growth plate witout fx (growth plate closes prematurely)

34
Q

salter harris fx mgmt

A

I and II: CRIF
III-V; growth plate affected so need ORIF

35
Q

JOnes fx

A

5th metatarsal fz (ass’d nonunion)

36
Q

fx ass’d compartment synd

A

supracondylar humerus (ant interosseous aa), tibia (ata), calcaneus (idk)

37
Q

fx ass’d avascular necrosis

A

scaphoid, femoral neck, talus, hip dislocation

38
Q

obturator nerve
super gluteal n
inf gluteal n
fem nerve

A

obturator nerve: hip adduction
super gluteal n: hip abduction
inf gluteal n: hip extension
fem nerve: knee extension

39
Q

L3-S1 function

A

L3: hip flexion
L4: knee extension(patellar)
L5: dorsiflexion, sensation to big toe
S1: platarflex (Achilles), sensation lateral foot

40
Q

ulnar nerve function

A

intrinsic motor, finger abduction, wrist flexion, sensory to pinky

injury = CLAW HAND DEFORMITY

41
Q

median nerve function

A

thumb apposition, OK, finger flexors, sensory to all but pinky

42
Q

radial nerve

A

wrist extension, finger extension, triceps, sensory back of fingers

43
Q

axillary nerve

A

motor to deltoid

44
Q

shoulder dislocation risks ant vs post

A

ANTERIOR: axillary NERVE (CRIF)
POSTERIOR (electrocution): axillary ARTERY (CRIF)

45
Q

monteggia fx

A

FOOSH. proximal ulnar and radial head dislocation

mgmt: ORIF

46
Q

Colles fx

A

FOOSH. distal radius

mgmt: CRIF

47
Q

nursemaids elbow

A

sublux of radius at elbow from pulling on extended pronated arm

mgmt: CRIF

48
Q

metacarpal fx

A

4th adn 5th from punching

mgt: ulnar gutter splint CRIF, +/- K wires

49
Q

Volkmanns contracture

A

anterior interosseous artery injury from supracondylar humerus fx causing reperfusion injury after CRIF… forear compartment

50
Q

dupuytrens contracture

A

palma fascia of hand proliferates mostly 4th and 5th digits (can’t extend)

mgmt: NSAIDs, steroids, excise fascia

51
Q

carpal tunnel syndrome

A

median nere compression by transverse carpel ligament

mgmt: splint, NSAIDs, steroids, transverse carpal ligament release

52
Q

trigger finger

A

tenosynovities of flexor tendon at MCP joint

mgmt: splint, tendon sheath steroid injection vs release MCP joint

53
Q

suppurative tenosynovitis mgmt

A

midaxial longitudinal I&D

54
Q

posterior hip dislocation injury

A

SCIATIC NERVE injury; presents internally rotated with adduction

mgmt: CRIF

55
Q

anterior hip dislocation injury

A

FEMORAL ARTEYR injury; externally rotated with abduction

mgmt: CRIF

56
Q

lateral knee injury will affect what

A

ACL, PCL, MEDIAL MENISCUS

57
Q

ACL injury dx

A

anterior drawer test

58
Q

foot eversion injury to? after compartment fasciotomy

A

superficial peroneal nerve

59
Q

foot drop injuyr to?

A

comon peronal nerve (after fibula head fraction / lithotomy / crossed legs)

60
Q

compartment lower leg contents

A

anterior: anterior tibial aa, deep peroneal NERVE
lateral: superficial peroneal NERVE
deep posterior: posterior tibial aa, peroneal aa, tibial NERVE
superficial posterior: sural NERVE

61
Q

SCFE

A

AVN to femoral head, painful hip
XR: widening of epiphyseal plate
mgmt: EMERGENT Surgical pinning of femoral head

62
Q

Legg Calve Perthes disease

A

AVN to femoral head (younger kids) hypercoagulable maybe
painful hip
XR; flat head
mgmt: limit ROM it will be OK

63
Q

genu varum vs valgus

A

varum: younger. BOW legs; ass’d BLOUNT disease (medial tibial plate abnormality)
valgus: KNOCK KNEE. slightly older 4-8 YO

64
Q

talipes equinovarus (clubfoot)

A

serial casting

65
Q

MC bone tumor

A

met (breast lytic > prostate blastic)

66
Q

mgmt bone tumor

67
Q

MC primary malignant bone tumor

A

multiple myeloma

68
Q

dx multiple myelmoa

A

XR: lytic lesion, Bence JOnes protein in urine, Igg on blood smear

69
Q

mgmt multiple myeloma

A

chemotherapy

70
Q

osteogenic sarcoma

A

10-25 YO
XR: codmans triangle = periosteal reaction (sunburst)

71
Q

mgmt osteogenic sarcoma

A

doxorubicin neoadjuvant then resect and radiate

72
Q

ewings sarcoma

A

less common.
5-15 YO (younger) diaphysis o long bones
XR: onion skinning

73
Q

MCtumor in general

A

osteochondroma (can curette and bone graft if tsymptomatic)

74
Q

giant cell tumor mgmt

A

total resection +/- radiation

75
Q

both bone

A

CRIF kid
ORIF adult

76
Q

developmental hip dysplasia

A

gluteal asymm folds
dx: US (XR not calcified)
tx: pavlik harness x 6 mos

77
Q

osgood schlatter

A

tibial tubercle apophysitis (osteochondrosis)
from traction injury to quads … tibial tubercle pain

conservative

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