Ortho Flashcards
Define avascular necrosis. What are the common risk factors
bone + bony tissue injury leads to cell death of bone + marrow = bone + joint destruction
risk factors
less than 50
glucocorticoid use - dose dependent
alcohol use
SLE
describe primary and secondary bone healing
primary - lamellar bone can be directly formed in the small (<1 mm) fracture gap
secondary bone healing
- initial bridging of the fracture gap formed with CT or cartilage = fibrocartilage callus
- conversion into woven bone (bony callus) by endocondral ossification
- months: woven bone remodeled into lamellar bone
describe volkmann contracture
permanent shortening of the forearm muscles
- claw-like deformity of the fingers + hand
- atrophy of the flexors of the hand + fingers when casts are too tight or blood vessels/nerves have been damaged
what are the roles of articular cartilage. how is it conditioned?
specialized hyaline cartilage
- shock absorption, reduces friction, uniform distribution of force across joint
moderate mechanical loads can cause hypertrophy + increase synthesis
describe capcipenia and phosphoric rickets
rickets: impaired bone mineralization on when growth plates are still open
capcipenia: decreased calcium = increased PTH = decreased phosphate = impaired bone mineralization
phosphopenic: decreased phosphate = impaired bone mineralization
What are the diagnostic characteristics that help differentiate between a benign and a malignant bone tumor?
benign: well-circumcribed, reactive (sclerotic) margins, context intact/expanded, NO soft tissue extension
malignant: ill-defined margins, moth-eaten/patchy, cortex eroded, soft tissue mass
Describe resuscitation. What’s the ABCDE approach?
ABCDE - advanced life support
- Airway maintenance
- Breathing + ventilation
- Circulation + hemorrhage control
- Disability: motor/sensory, reflex, tone
- ExposureL bruising, tenderness
Large bore IVs
Crystalloid bolus
Early blood PRN
Monitor: BP, urinary output, base/deficit/lactate
What’s a FAST-POCUS?
focused assessment with sonography for trauma
- thorocoabdominal POCUS used in trauma pts used to detect free fluid within the peritoneal, pericardial, pleural cavities
What are the sulcus and the apprehension/relocation tests? What are they used to evaluate?
tests glenohumeral instability
sulcus: arm neutral + pulled down at wrist
- positive: visible sulcus in infracromial area
apprehension/relocation test: table supine, arm bent 90, look at max external rotation
- positive: if pt reactive
What does the cross-over adduction test for?
AC joint injury
Describe the Neer test. what does it test for?
tests for impingement syndrome (shoulder)
Describe the Hawking-Kennedy test. What does it test for?`
impingement syndrome (shoulder)
What is the positive drop arm test and what does it test for?
rotator cuff injury
- hold pt arm upright, and then let go
What does the cozen test indicate?
Tennis elbow
lateral epicondylitis
What does the provocation maneuver test for?
golfers elbow
medial epicondylitis
What does the froment sign indicate?
cubital tunnel syndrome
What is the phalen set and what does it indicate?
carpal tunnel
What is the tinel sign and what does it indicate?
carpal tunnel
What does the finkelstein test indicate?
deQuervian’s tendonitis
what does the balloon test indicate?
knee joint effusion
Describe the McMurray test. What does it test for?
meniscus tear
- external rotation: medial tear
- internal rotation: lateral tear
Describe the talar tilt test. What does it indicate?
lateral ankle sprain
what is the external rotation test and what does it indicate?
medial ankle sprain
What does the cross leg test indicate?
high ankle sprain
