ortho Flashcards
(99 cards)
1
Q
this is the most common cause of a painful limp in TODDLERS
A
transient synovitis
2
Q
this is idiopathic avascular necrosis of the femoral head
A
Legg-Calve- Perthes disease
3
Q
Legg - Calve - Perthes disease pain occurs on internal or external rotation?
A
Internal
4
Q
what is the hallmark sign on radiograph of legg calve perches disease?
A
Crescent sign
” AP and frog leg lateral radiograph show an increased density int he affected femoral head or a crescentic subchondral fracture int he femoral head”
5
Q
what is the management for legg calve parties disease?
A
physical therapy and restriction of excursive
6
Q
the typical patient for this is an OBESE ADOLESCENT BOY
A
slipped capital femoral epiphysis
7
Q
endocrine disorder related to SCFE
A
obese adolescent boy
8
Q
true or false a klein line crosses the epiphysis in a SCFE?
A
false, it does NOT cross the epiphysis at all
9
Q
name 4 complications of SCFE
A
- avascular necrosis of the femoral head
- chondrolysis
- Limb length discrepancy
- Osteoarthritis
10
Q
this is an infection of the bone
A
osteomyelitis
11
Q
pathogen for osteomyelitis w/ sickle cell?
A
salmonella
12
Q
what are the lab studies for osteomyelitis?
A
elevated WBC
13
Q
MRI/BONE SCAN/ PLAIN RADIOGRAPH to diagnose osteomyelitis?
A
MRI/BONESCAN
- not plain radiograph because it is not a good initial study
14
Q
what 2 things may cause chronic osteomyelitis
A
sequestrum and involucrum
15
Q
metatarsus adductes causes ?
A
intoning of the foot
16
Q
how can you distinguish clubfoot w/ intoe?
A
clubfoot cannot dorsiflex
17
Q
what is the management of a intoefoot that can overcorrect?
A
observation
18
Q
what is the management of intoe foot that cannot over correct but is flexible?
A
stretching excersizes
19
Q
what is the management of stiff foot that cannot be straightened?
A
refer to pediatric orthopedic specialist
20
Q
talipes equinovarus AKA?
A
club foot
21
Q
management of club foot?
A
casting and then surgical correction
22
Q
this form of intoe is caused by utero position?
A
internal tibial torsion
23
Q
what is the management for internal tibial torsion?
A
observation only
24
Q
what is the difference in incidence age of internal tibial torsion and femoral ante version?
A
femoral anteversion >2 years
internal tibial torsion
25
if a child prefers to sit in a W position vs. a cross legged position what may he have?
femoral anteversion
26
clinical presentation of calcaneovalgus foot
foot is excessively dorsiflexed
27
ghetto walk of african american boys? Lateral thrust with gait?
Blount's disease
28
etiology of blunts disease?
overload injury to the medial tibial growth plate causing inhibited growth only on the medial side
29
when should blounts disease be considered in a child ?
anyone with leg bowing after 2 years old
30
this is inflammation or micro fracture of the tibial tuberosity caused by overuse injury?
osgood shatter disease
31
true or false, radiographs diagnose osgood shatter disease?
FALSE - too small to be seen
32
lateral position of the patella causing knee pain in girls
patellofemoral syndrome ( patellar chondromalacia)
33
what is the timing of growing pains?
bilateral leg pain occurring in LATE AFTERNOON OR EVENING ( DONT INTERFERE W/ PLAY )
34
open vs closed fracture?
closed- skin intact
| open - skin broken (need antibiotics)
35
A. nondisplaced
B. displaced
C. Angulated
D. Overriding
fracture ends that are shifted
B. Displaced
36
A. nondisplaced
B. displaced
C. Angulated
D. Overriding
Fracture ends that are well approximated
A. Non displaced
37
A. nondisplaced
B. displaced
C. Angulated
D. Overriding
fracture ends that override w/out cortical contact
D. Override
38
a. torus
b. greenstick
c. transverse
d. oblique
e. spiral
f. comminuted
Occur w/ twisting injuries common in child abuse
E. Spiral
39
a. torus
b. greenstick
c. transverse
d. oblique
e. spiral
f. comminuted
horizontal fracture
c. transverse
40
a. torus
b. greenstick
c. transverse
d. oblique
e. spiral
f. comminuted
buckle fracture occurring under a compressive force in the metaphysis?
a. torus
41
a. torus
b. greenstick
c. transverse
d. oblique
e. spiral
f. comminuted
incomplete fracture where one side side of cortex is fractured and the other side is intact causing angulation. may require fracturing the other side to minimize angulation
b. greenstick
42
a. torus
b. greenstick
c. transverse
d. oblique
e. spiral
f. comminuted
type of fracture w/ many pieces?
f. comminuted
43
a. torus
b. greenstick
c. transverse
d. oblique
e. spiral
f. comminuted
diagonal fracture across a bone
oblique
44
the salter harris classification system describes what?
fractures involving the growth plate
45
bone growth is affected in all grade ____ -_____ fractures?
```
grade IV (through and through)
grade V ( Crush )
```
46
SALTR stands for?
SAME, ABOVE, LOW, THROUGH, cRUSH
47
FOOSH fracture?
supracondlar
48
why is supracondylar fracture an orthopedic emergency?
when it is DISPLACED or ANGULATED because risk of neuromuscular injury and compartment syndrome
49
how can you detect neuromuscular injury and compartment syndrome in Supracondylar fracture?
assess pulse, sensation and movement of fingers + passive extension
50
posterior fat gap sign shows what?
supracondylar fraacture
51
what do you never do in a supracondylar fracture?
never passively move the arm
52
this is a fracture to the distal radius
Colles fracture
53
fracture to the proximal ulna w/ dislocation of the radial head
monteggia fracture
54
fracture of the radius w/ distal radioulnar joint dislocation
galeazzi fracture
55
this is a ' tollders fracture' which occurs after a very mild or no identified trauma
spiral fracture of the tibia
56
upper brachial plexus injury involving c5 and c6 roots
erb's palsy
57
erbs palsy position?
waiters tip
| extended pronated and flexed fingers
58
involves c7 and c6 nerve roots?
klumpke palsys
59
klumpke palsy position?
claw hand, decreased ability to extend elbow and flex wrist
60
what may be present in klumpke's palsy?
horners syndrome (ptosis, miosis and anhydrosis)
61
this is a subluxation of the radial head that occurs when pulling the toddler upward?
nursemaid's elbow
62
what is the most common shoulder dislocation?
anterior
63
true or false, recurrence is common with anterior shoulder dislocation?
true
64
defined as tilting of the head to one side?
torticollis
65
management of cervical torticollis?
stretching excersizes, if not helmet therapy by 4-6 months of age
66
what are complications of torticollis?
skull deformity and facial asymmtery (plagiocephaly)
67
altantoaxial instability is seen most w/ what anomaly?
down syndrome
68
if there is severe instability in the AA joint what is management?
c1 and c2 fusion
69
this is a failure of normal vertebral segmentation that results in relative fusion of the involved vertebrae?
klippel feil syndrome
70
klippel fiel syndrome is also related to what?
torticollis, genitourinary, hearing loss and sprengels deformity ?
71
what is sprengels deformity?
abnormality of the scapula where scapula is rotated laterally leading to shoulder asymmetry and diminished shoulder motion
72
how is the cobb angle measured?
line along the most angulated vertebra on either end of the curve
73
when does progression of scoliosis occur?
only during growth or if spinal curvature is greater than 50 %
74
so if a woman has had her period for 6 months and has scoliosis does it need to be managed?
no because all growth in females ceases between 6 months of menarche
75
this degree of scoliosis only requires observation
10-20 degrees
76
this degree of scoliosis requires bracing?
20-40 degrees
77
this degree of scoliosis requires surgery if still growing?
>40
78
what degree of scoliosis causes respiratory and CV compromise?
>60
79
backpain, urinary incontinence, and palpable step off in the limbo sacral area are a result of?
spondylolithesis
80
how can you distinguish between ankylosing spondylitis and spondylolithesis?
spondylolithesis will have a neurologic component
81
this is a infection caused by staph aureus of the intervertebral disk?
diskitis
82
what is treatment of a herniated disk in an adolescent?
bed rest unless abnormal neurologic examination
83
flat acetabulum and breech position cause?
developmental dysplasia of the hip
84
this maneuver attempts to dislocate a hip by pushing posterior and laterally?
barlow maneuver
85
this maneuver attempts to reduce a hip by pushing upward and medial
ortolani maneuver
86
how can you diagnose DDH in older infants?
assymmetric buttock folds
87
what is used to diagnose DDH in infants 4-6 months of age?
ULTRASOUND
88
if someone greater than 6 months is suspected of DDH, what do you order?
AP RADIOGRAPH
89
this holds the head of the femur against the acetabulum to stimulation formation of the normal cup shape of the acetabulum used in ages 2-3 months if dx by 6 months?
pavlik harness
90
if diagnosis is made beyond 6 weeks of age what is indicated in DDH?
surgery
91
what is most commonly affected in younger children w/ septic arthritis?
the hip
92
what is most commonly affected in older children w/ septic arthritis?
the knee
93
how is the hip held in septic arthritis?
flexion/abduction and external rotation
94
how are lab studies in septic arthritis?
elevated white blood cell count, elevated ESR and elevated CRP
95
what is the best imaging used for septic arthritis?
ultrasound
96
what should you do before ultrasound for septic arthritis?
synovial fluid aspiration
97
what is the management for septic arthritis?
1. surgical decompression
| 2. empiric antibiotics covering gram positive organisms
98
what usually processed transient synovitis?
URI and Diarrhea
99
what is the treatment for transient synovitis?
nsaids, bed rest and observation
