Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Surgery > Ortho > Flashcards

Ortho Flashcards

0
Q

Leg-Calve-Perthes Disease

A

Aka avascukar necrosis of capital femoral epiphysis
Age 6
Features: insidious, limping, decreased hip motion, hip/knee pain, antalgic gait, guarded passive motion of hip.
Dx: AP and lateral hip X-rays.
Tx: cast and crutches to keep acetabulum in femoral head.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
1
Q

Developmental dysphasia of hip

A

Feature: uneven gluteal folds, hip easily dislocated posteriorly with jerk and click, snaps to return.
Dx: US
Tx: abduction splinting with pavlik harness 6 months.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Slipped capital femoral epiphysis

A 
Ortho emergency
Chubby boy, age 13.
Features: groin or knee pain, limping, sole of foot on affected side points toward other foot, limited hip motion, thigh externally rotates as hip is flexed
Dx: X-ray
Tx: pin femoral head in place
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Septic hip

A

Ortho emergency
Toddler who had febrile illness, won’t move hip.
Features: hold leg with hip flexed, slight abduction and external rotation, refuse to let you move it.
Dx: ⬆️ ESR, aspiration of hip.
Tx: drain if find pus.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Acute hematogenous osteomyelitis

A

Little kids, had febrile illness.
Features: severe localized pain in bone.
Dx: MRI
Tx: abx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Genu varum

A

Aka bow legged
Normal until age 3
Persists past 3yr usually Blount disease = disturbance of medial proximal tibial growth plate
Tx: surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Genu valgus

A

Aka knock-knee
Normal between 4-8
No tx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Osgood-Schlatter disease

A

Aka osteochondrosis of tibial tubercle
Teens with persistent pain over tibial tubercle, aggravated by contraction of quads.
Features: localized pain over tibial tubercle, no knee swelling
Tx: RICE, if not better then extension or cylinder cast 4-6wk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Club foot

A

Aka talipes equinovarus
At birth
Features: feet turned inward, plantar flexion of ankle, inversion of foot, addiction of forefoot, internal rotation of tibia.
Tx: serial casting, Achilles tenotomy, long term braces, surgery btw 9-12 months.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Scoliosis

A

Adolescent girls
Thoracic spine turned to right. Progresses until skeletal maturity.
Dx: bend forward, see hump on right thorax.
Tx: bracing, if severe then surgery.
Can cause ⬇️ pulmonary function.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Issues with bone remodeling in kids

A

Areas: suprachondylar fractures of humerus, fractures of growth plate.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Suprachondylar fractures of humerus

A

Cause: hyperextension of elbow in kid who falls on hand with arm extended
Can injure vasculature and nerves ➡️ Volkmann contracture
Tx: casting or traction
Watch out for problems with nerves/vasculature, compartment syndrome.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Growth plate fracture

A

Tx: if epiphysis and growth plate laterally deviated but in one piece = closed reduction.
Two pieces = open reduction for alignment and internal fixation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Osteogenic sarcoma

A

Most common primary bone malignancy.
Ages 10-25, persistent low grade pain
Around knee ( lower femur or upper tibia)
Dx: sunburst on X-ray

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Ewing sarcoma

A

Second most common primary bone malignancy
Ages 5-15
Grows in diaphysis of long bones
Dx: onion-skinning on X-ray

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Malignant bone tumors adults

A

Women = breast metastasis, lytic, present with pathological fracture
Men = prostate metastasis, blastic.
Feature: localized pain
Dx: X-ray, CT, MRI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Multiple myeloma

A

Old men with fatigue, anemia, localized pain at specific places along multiple bones.
Dx: X-ray with punched out lytic lesions, bence-jones protein in urine, abnormal Ig in blood on immunoelectrophoresis.
Tx: chemotherapy, thalidomide if fails.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Soft tissue sarcomas

A 
Relentless growth of soft tissue mass.
Firm, fixed to surroundings.
Metastasize to lung, not to lymph nodes.
Dx: MRI, incisional biopsy.
Tx: wide local excision, radiation, chemotherapy.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Closed reduction

Open reduction

A

Closed = immobilized in cast

Open with internal fixation = surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Clavicular fractures

A

At junction of middle and distal thirds

Tx: sling, surgery for cosmetic reasons.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Anterior dislocation of shoulder

A

Most common shoulder dislocation
Feature: hold arm close to body, rotated outward, numbness over small area of deltoid (stretched axillary nerve).
Dx: AP and lateral X-rays.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Posterior dislocation of shoulder

A

Rare, after massive uncoordinated muscle contractions (epileptic seizure or electrical burn)
Feature: held close to body, internally rotated.
Dx: axillary or scapular lateral X-rays.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Colles fracture

A

From fall on outstretched hand
Old osteoporotic women
Deformed, painful wrist, looks like dinner fork.
Dorsally displaced, dorsally angular fracture of distal radius.
Tx: closed reduction, long arm cast

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Monteggia fracture

A

Cause: direct blow to ulna (raised protective arm)
Diaphyseal fracture of proximal ulna, anterior dislocation of radial head.
Tx: open reduction with internal fixation, closed reduction of dislocation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Galeazzi fracture

A

Cause: direct blow to distal third of radius causing fracture and dorsal dislocation of distal radioulnar joint.
Tx: open reduction with internal fixation, closed reduction of dislocation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Fracture of scaphoid

A

Young adult who falls on outstretched hand
Feature: wrist pain, localized tenderness over an atomic snuff box.
Dx: clinical, X-ray.
Tx: thumb spica cast if undisplaced.
Displaced and angulated = open reduction and internal fixation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Metacarpal neck fracture

A 
Usually 4th, 5th, or both.
Closed fist hits hard surface.
Feature: hand swollen and tender.
Tx: mild = closed reduction and ulnar gutter splint.
Bad = kirschner wire or plate fixation.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Hip fractures

A

Elderly who fall
Features: hip hurts, affected leg is shorter and externally rotated.
Dx: X-ray

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Femoral neck fracture

A

Displaced = compromise blood to femoral head.

Tx: femoral head replaced with prosthesis.

29
Q

Intertrochanteric fractures

A

Less likely to cause avascular necrosis than femoral neck fracture.
Tx: open reduction with internal fixation. Post-op anticoagulation.
Risk of DVT, PE.

30
Q

Femoral shaft fracture

A

Tx: intermedullary rod fixation.
Open = ortho emergency, ORA cleaning and closure within 6 hr.
Can cause fat emboli.

31
Q

Collateral ligament injuries

A

Cause: sideways blow to knee, sports
Features: swollen knee, localized pain by direct palpation, pain with passive abduction or adduction when knee flexed at 30 degrees.
Abduction shows medial injuries, adduction shows lateral injuries.
Dx: MRI
Tx: only 1 affected = hinged cast.
More than 1 affected = surgery.

32
Q

Anterior cruciate ligament injury

A

Features: severe swelling and pain of knee, positive anterior drawer test, pain when knee flexed at 20 degrees by grasping thigh and pulling leg with other hand (Lachman test).
Dx: MRI
Tx: immobilization and rehab, or surgery for athletes.
Opposite signs for PCL injury.

33
Q

Meniscal tears

A

Features: protracted pain and swelling in knee, knee catches and locks with click to release.
Dx: MRI
Tx: open repair.
Complete meniscectomy ➡️ degenerative arthritis

34
Q

Terrible triad

A

Medial meniscal tear, medial collateral tear, anterior cruciate tear

35
Q

Tibial stress fracture

A

Young men on long marches
Features: tenderness to palpation over specific part of bone, normal X-ray.
Tx: cast, repeat X-ray in 2 weeks, crutches.

36
Q

Leg fractures of tibia and fibula

A

Pedestrian hit by car.
Dx: angulation, X-ray.
Tx: casting, intramedullary nailing.
Be ware of compartment syndrome

37
Q

Rupture of Achilles’ tendon

A

Out of shape middle aged men under severe stress (tennis).
They plant foot, change direction, hear pop like a gunshot, fall clutching ankle.
Features: limited plantar flexion, pain, swelling, limping.
Dx: gap on tendon palpation.
Tx: casting in equinus position for months, surgery

38
Q

Ankle fracture

A

Falling on inverted or exerted foot.
Features: both malleoli break.
Dx: AP, lateral, and mortise X-rays
Tx: open reduction and internal fixation.

39
Q

Compartment syndrome

A

Mostly in forearm or lower leg.
Causes: prolonged ischemia with repercussion, crushing injury, trauma, closed reduction of lower leg.
Features: excruciating pain with passive extension, limited use of extremity.
Tx: fasciotomy

40
Q

Posterior dislocation of hip

A

Cause: femur driven backward, head in collision.
Features: hip pain, leg shortened, addicted, internally rotated.
Tx: emergency reduction to prevent avascular necrosis.

41
Q

Gas gangrene

A

Cause: deep penetrating, dirty wounds.
Features: 3 days later extremely sick, toxic, moribund. Site is tender, swollen, discolored, gas crepitation.
Tx: IV penicillin, debridement, hyperbaric oxygen

42
Q

Radial nerve injury

A

Cause: oblique fracture of middle to distal third of humerus.
Surgery if reduction does not relieve nerve involvement.

43
Q

Popliteal artery injury

A

Cause: posterior dislocation of knee
Dx: integrity of pulses, Doppler, CT angio.
Tx: reduction.
Delayed restoration of flow requires fasciotomy.

44
Q

Falls from height

A

Fractures of foot or leg

Fractures of lumbar or thoracic spine

45
Q

Head on collision

A

Facial, head, torso injury

Femoral or pelvic injury

46
Q

Facial fracture or closed head injury

A

Look at cervical spine as well

47
Q

Carpal tunnel syndrome

A

Women doing repetitive hand work.
Features: numbness and tingling in hands, particularly at night, along median nerve (radial 3 1/2 fingers).
Dx: reproduced by hanging hands limply a few minutes or tapping median nerve in carpal tunnel, X-ray
Tx: splints, anti-inflammatory agents, electromyography then surgery

48
Q

Trigger finger

A

Women
Features: wake up with flexed finger, can’t extend it unless pull on it causing snap.
Tx: steroid injection, surgery as last resort

49
Q

De Quervain tenosynovitis

A

Young mothers carrying kids, force hand into wrist flexion and thumb extension.
Features: pain along radial side wrist and first dorsal compartment.
Dx: reproduced by holding thumb inside closed fist then forcing ulnar deviation of wrist.
Tx: splint, anti-inflammatory agents, steroid injection***

50
Q

Dupuytren contracture

A

Older men, Norwegian ancestry
Contracture of palm and palmar fascial nodules felt.
Tx: surgery if hand can’t lay flat on table

51
Q

Felon

A

Abscess in pulp of fingertip from neglected penetrating injury
Features: throbbing pain, abscess features (fever).
Can cause tissue necrosis.
Tx: surgical drainage.

52
Q

Gamekeeper thumb

A

Injury of ulnar collateral ligament by forced hyperextension of thumb.
Skiing injury.
Features: collateral laxity at thumb metacarpophalangeal joint.
Can lead to arthritis if untreated.
Tx: casting.

53
Q

Jersey finger

A

Injury to flexor tendon when finger forcefully extended ( grabbing jersey).
Dx: making fist, distal phalanx doesn’t flex with others
Tx: splinting

54
Q

Mallet finger

A

Extended finger is forcefully flexed. Volleyball.
Extensor tendon is ruptured.
Dx: tip of finger remains flexed when others are extended.
Tx: splinting.

56
Q

Lumbar disc herniation

A

At L4-L5 or L5-S1.
Age 45-46
Features: months of vague aching pain then sudden severe pain that shoots down leg, exacerbated by coughing/sneezing/defecating, cannot walk, hold leg flexed.
Dx: straight leg test positive, MRI
Tx: pain control via nerve blocks, surgery if progressing neuro deficits, emergency if get cauda equina syndrome.

57
Q

Cauda Equina Syndrome

A

Distended bladder, flaccid rectal sphincter, perineal saddle anesthesia.
Tx: immediate decompression.

58
Q

Ankylosing spondylitis

A

Young men in 30’s and 40’s.
Many have HKA- B27 antigen, associated with uveitis and IBD.
Features: chronic back pain, morning stiffness, worse at rest, improves with activity, progressive.
Dx: bamboo spine on X-ray.
Tx: anti-inflammatory agents, PT.

59
Q

Metastatic malignancy of back

A

Elderly with progressive back pain, worse at night, not relieved by rest or positional changes, weight loss.
Dx: X-ray shows lesions (lytic breast cancer at pedicles, blastic from prostate), MRI

60
Q

Traumatically amputated digits

A

Tx: surgically reattach.

Clean with saline, wrap in moist gauze, keep on ice.

61
Q

Lumbar Disk Herniation

A

usually L4-L5 or L5-S1
peak age 45-46
Features: months of vague aching pain, sudden onset neurogenic pain from a forced movement, pain shoots down leg, exacerbated by coughing, sneezing, defecating. Can’t walk, hold leg flexed.
Dx: straight leg test +, MRI
Tx: bed rest for 3 wks, pain control via nerve blocks, surgery if progressive neuro deficits or cauda equina syndrome.

62
Q

Cauda Equina Syndrome

A

distended bladder, flaccid rectal sphincter, perineal saddle anesthesia
Tx: surgical decompression

63
Q

Ankylosing Spondylitis

A

young men in 30’s or early 40’s
Features: complain of chronic back pain and morning stiffness, worse at rest, improves with activity, progressive.
Dx: ‘bamboo spine’ on x-ray
Tx: antiinflammatory agents, PT
HLA B-37 antigen associated with uveitis and IBD.

64
Q

Back pain from Metastatic Malignancy

A

Features: elderly with progressive back pain, worse at night, unrelieved by rest or positional changes, weight loss.
Dx: lytic breast cancer in pedicles, blastic prostate cancer on MRI

65
Q

Diabetic Ulcers

A

At pressure points (heel, metatarsal head, tip of toes) from neuropathy. Don’t heal because of microvascular disease.
Tx: keep clean and elevated, amputation.

66
Q

Arterial Insufficiency Ulcers

A

at tip of toes
Features: look dirty, pale base without granulation, features of arteriosclerotic occlusive disease (absent pulses, trophic changes, claudication or rest pain).
Dx: Doppler, CT angio, MRI angio, arteriograms.
Tx: surgical revascularization, angioplasty, stents

67
Q

Venous Stasis Ulcers

A

in chronically edematous, indurated, hyperpigmente sin above medial malleolus.
Features; painless ulcer with granulating bed, varicose veins, frequent bouts of cellulitis.
Dx: duplex scan
Tx: support stockings, ace bandages, unna boot, vein stripping, grafting, endovascular ablation, radiofrequency ablation

68
Q

Marjolin Ulcer

A

squamous cell carcinoma of skin in a chronic leg ulcer.
Features: dirty looking, deep ulcer with heaped up tissue growth around edges.
Dx: biopsy
Tx: wide local excision, skin grafting.

69
Q

Plantar Fasciitis

A

older, overweight patients with disabling, sharp heel pain when foot strikes ground, worse in morning.
Dx: x-ray shows bony spur at location of pain, tenderness to palpation over spur
Tx: spontaneous in 12-18 months, treat symptoms, remove spur.

70
Q

Morton Neuroma

A

inflammation of common digital nerve at third interspace btw 3rd and 4th toes.
Features: palpably tender spot, from high heels that are pointed.
Tx: analgesics, sensible shoes, surgical excision

71
Q

Gout

A

Features: swelling, redness, exquisite pain suddenly at first emtatarsal phalangeal joint in middle age obese man, high serum uric acid.
Dx: uric acid crystals in joint fluid.
Tx: indomethacin and colchicine if acute. chronic = allopurinol and probenicid.

Surgery (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions