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Year 6 > Ortho > Flashcards

Ortho Flashcards

1
Q

Tx of open fracture

A

IV ABx, photography and sterile gauze
In surgery- debride, washout, external fixation

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2
Q

Tender snuffbox but no fracture on X ray

A

Plaster for 10 days
Repeat x ray

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3
Q

Smith vs colles

A

Smith- volar displacement
Colles- dorsal displacement

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4
Q

Complications of colles fracture

A

Median nerve injury
Complex regional pain syndrome
EPL reputure

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5
Q

Colles Sx

A

Dorsal displaced
usual 1 inch from radio-carpal joint
Dinner fork abnormality

Doesn’t matter if ulnar is broken too

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6
Q

Test for De Quervain’s tenosynovitis

A

Finkelstein test

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7
Q

Sx and Tx for De Quervain’s tenosynovitis

A

Tenderness over the radial styloid process
Abduction of the thumb against resistance is painful

Analgesia
Steroid injection

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8
Q

Monteggia and Galleazzi fracture

A

M- proximal ulnar shaft fracture, radial head dislocation (proximal end)
G- distal radial fracture and dislocation of RU joint

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9
Q

Bicep tendon rupture Sx

A

Distal reverse popeye
Proximal- Popeye
Hook test +

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10
Q

Gartland scoring

A

Supracondylar fracture
1- non displaced
2- angulated, post inf intact
3- displaced not in tact

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11
Q

Mx of supracondylar fractures

A

Displaced- fix with wires
Not displaced- flex as much, collar and cuff 3 wks

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12
Q

Mx of fractures

A

Resus
Reduction- local
Restriction
Rehabilitate

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13
Q

Length of time of cast for scaphoid, colles and smith fx

A

6 weeks

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14
Q

Sx of compartment syndrome

A

Pain
Usually few hours after fracture- CRPS is days/weeks
Pain on passive muscle stretching
Warm, erythematous, swollen limb

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15
Q

Tx of compartment syndrome

A

Fasciotomy

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16
Q

Causes of malunion

A

Ischaemia
Infection
Disease
Tissue in-between

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17
Q

Salter Harris classification

A

1-straight
2- above
3- lower
4-through
5-crush

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18
Q

Sx of NOF fracture

A

External rotation and shortening

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19
Q

Garden classification

A

1- incomplete
2- complete- undisplaced
3- partial displaced
4- complete

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20
Q

Tx of NOF fracture

A

Intracapsular- 1,2- ORIF, cancellous screws
3,4- total, hemi if less mobile
Extracapsular- ORIF- DHS

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21
Q

Sx of hip dislocation

A

Posteriori- shortened, internal
Anterior- external and abducted

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22
Q

Fat embolism sx

A

Usually after fracture of long bones

Resp- sinus achy, hypoxia 72 hours, neuro- retinal haemorrhages, confusion, petechiae

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23
Q

What SE can bisphosphonates cause

A

oesophagitis
Osteonecrosis of the jaw
Increased risk of atypical stress fractures of the proximal femoral shaft in patients taking alendronate

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24
Q

Sx and causes of shoulder dislocation

A

Anterior- trauma
Bulge in infraclavicular fossa
Hills Sachs lesion- cortical depression of posterolateral humeral head
Bankark- labrum tear
Posterior- epileptics

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25
Q

Tx of shoulder dislocation

A

Reduction under sedation
Hippocratic or Kocher
Sling 3-4 wks

Recurrent
TUBS- bankark- surgery

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26
Q

Impingement Sx

A

Painful arc -60-120
Tender shoulder on palpation

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27
Q

Frozen shoulder sx

A

Poor external rotation <30 and abduction <90

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28
Q

Rotator cuff tear sx

A

Partial- painful arc -can be <60
Complete- inability to abduct, can active after passive to 90
Drop arm sign

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29
Q

Weber classification and Tx

A

A- below - boot
B- on- boot 6wks
C- above- reduction and fixation

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30
Q

Ottawa rules

A

Malleolar pain and tender 6cm distal posterior tib/fib or inability to weight bare

Bony tenderness on fifth metatarsal or navicular

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31
Q

Achilles rupture sx

A

Simmonds triad
Greater dorsiflexion
Calf squeeze
Gap of tendon

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32
Q

Ix of achilles rupture

A

Ultrasound

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33
Q

Spinal stenosis Sx

A

UMN lesions
Relief sitting forward, going up hill
Radiates to calves

34
Q

Cauda equina sx

A

LMN
Red-Bilateral sciatica, perianal parasthesia, urinary, bowel

35
Q

Ix and Tx of caudal equina

A

MRI and spinal decompression

36
Q

Dermatomes of leg

A

L1- groin
L2- ant thigh
L3- knee
L4- medial
L5- lateral
S1- little toe and heel
S3- bum

37
Q

Myotomes of leg

A

Hip flexion- L1,2
Knee extension-L3, L4
Ankle dorsiflexion-L4
Big toe - L5
Plantae- S1

38
Q

Reflexes and roots in leg

A

L3, L4- kick the door- knee
S1,S2- buckle my shoe- foot plantar

39
Q

Myotomes Upper limb

A

Shoulder abduction- C5
Elbow flexion- C5,6
Elbow, wrist and finger- extension- C7
Wrist and finger flexion- C8
Finger abduction- T1

40
Q

Malignancies that can cause bone mets

A

BLT with proper Ketchup
Breast, lung, thyroid, prostate, kidney

41
Q

Treatment of Acromioclavicular damage

A

I-II- conservative with sling and rest
IV-VI- surgical

42
Q

Mx of carpal tunnel

A

Splinting +/- steroids- 6 weeks
Severe- surgical decompression

43
Q

Tx of achilles tendinitis

A

Rest NSAIDs 7 days
Then Physio after

44
Q

If rib fracture not managed by IV analgesia

A

Nerve block

45
Q

Fracture most at risk of causing radial nerve damage

A

Humeral shaft

46
Q

Red flags of back pain

A

Thoracic back pain
>50
Unexplained Wt loss
Local tenderness
Focal neurology

47
Q

Median nerve damage in colles vs radial head

A

Colles- loss of sensation and weak thumb

Radial head- more proximal
Inability to pronate, weak wrist flexion, ulnar deviate,

48
Q

First line for back pain

A

NSAIDs

49
Q

Most common part of bones affected by osteomyelitis in children

A

Metaohysis

50
Q

Imaging of ostemyeltiits

A

MRI

51
Q

Tx of osteomyelitis

A

Fluclox 6 weeks

52
Q

Most common cause of discitis

A

Staph aureus

53
Q

Ix if thinking of OP veterbral fracture

A

X ray of spine

54
Q

Ganglion presentation

A

Cyst usually on dorsal aspect of wrist
Firm well circumscribed, transilluminates

55
Q

Mx of ganglion

A

Reassurance
Should disappear after several months
Can surgically remove if not going

56
Q

Causes of Raynauds

A

Vibrating tools
Scleroderma
RhA
SLE

57
Q

Medication making you more prone to achilles tendon rupture

A

Ciprofloxacin

58
Q

Analgesia of hip fracture

A

Iliofascial nerve block
With LA
Reduced opioid effects in elderly

59
Q

When can you commence bisphosphonate without DEXA scan

A

> 75 with fragility fracture

60
Q

Olecranon bursitis sx

A

Swelling over posterior aspect of elbow
Pain, erythema

61
Q

Nerve most likely damaged in knee arthroplasty

A

Common perineal nerve

62
Q

Spondylolisthesis vs spondylosis

A

Sponylothesis- move forward from stress fracture

Spondylosis- fracture of pars interarticularis

63
Q

Differentiating spinal root lesion vs peripheral lesion in hand/arm

A

Ulnar/radius/median- supply sensory only to hand
If forearm- root lesion

64
Q

Adhesive captulitis sx

A

Pain on coracoid palpation and impairment of external rotation
DM, thyroid, female

65
Q

Coronoid process

A

Alternate side to olecranon in radius

66
Q

Fracture of radial head sx

A

Fracture of the radial head is common in young adults.

FOOSH

Local tenderness over the head of the radius

Impaired movements at the elbow, and a sharp pain at the lateral side of the elbow at the extremes of rotation (pronation and supination).

67
Q

Differentiating L5 vs S1 vs Sciatic nerve damage

A

Most cause pain all down leg

L5- weak hip abduction, foot drop
Positive straight leg test
Sensory loss- big toes and dorsum

Scaitic- loss of ankle reflex
Loss of knee flexion
Anterior thigh sensation

S1- little toe
Ankle reflex

68
Q

Straight leg test

A

Positive- pain
Nerve compression

69
Q

Acetabulum labrum tear

A

After trauma in younger adults

hip/groin pain
snapping sensation around hip
there may occasionally be the sensation of locking

70
Q

Rf for avascular necrosis

A

long-term steroid use
chemotherapy
alcohol excess
trauma

71
Q

Tear of ligaments vs meniscus

A

Meniscus- pain on palpation of joint line
Slower swelling

Ligamanet- rapid

72
Q

Fractures most commonly associated with compartment syndrome

A

Tibial and supraconylar

73
Q

Fragility fracture prescription

A

Alendronate

Ca and Vit D correcte first
Only prescribed if low or diet inadequate

74
Q

Avascular necrosis on X ray

A

Smaller femoral head

75
Q

Epidural abscess Ix

A

MRI whole spine

76
Q

Fracture when pucnhing

A

Fracture of fifth metacarpal

77
Q

Communated fracture imaging for surgery

A

CT

78
Q

Stress fracture metatarsal

A

2nd meta
Repeated strain
Better on rest

79
Q

Best x ray for cervical fracture

A

Lateral

80
Q

FDP vs FDS

A

FDP flexes DIP joint
FDS flexes PIP joint

81
Q

If cut finger what are you most likely to damage

A

Digital nerve

Year 6 (28 decks)

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