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Sugery - AS PACES > Ortho > Flashcards

Ortho Flashcards

1
Q

Cause of true leg length shortening

A 
Fractured NOF 
Hip dislocation 
Growth disturbance of tibia/fibula e.g osteomyelitis or fracture 
Surgery e.g. Total hip replacement 
SUFE 
Perthes
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2
Q

Cause of apparent shortening of leg

A

Scoliosis of the spine

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3
Q

Feature of OA in hip

A

Pain
Stiffnes
Trendelenburg gait or positive trendenlburg test
Decreased range of motion - especially internal rotation
Fixed flexion deformity

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4
Q

Definition of osteoarthritis

A

Degenerative joint disorder in which there is progressive loss of hyaline cartilage and new bone formation at the joint surface and its margin

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5
Q

Risk of posterior approach - hip athroplasty

A

Higher dislocation rates than anterolateral

Injury to sciatic nerve - foot drop

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6
Q

Complication of anterolateral approach - hip athroplasty

A

Injury to superior gluteal nerve - trendenlburg gait

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7
Q

Complications of hip athroplasty

A 
Immediate: nerve injury, fracture, cement reaction 
Early: DVT, deep infection, dislocation 
Late: 
- loosening - septic or aseptic 
- leg length discrepancy 
- metalosis 
- need for revision
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8
Q

Knee locking differential

A

Meniscal tear
Crucible ligament injury
Osteochondritis dissecans: adolescents
Loose body

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9
Q

Surgical management of ACL repair

A

Autograft repair - classically using semitendonous and gracillis

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10
Q

Aietology of hallux valgus

A

Familial tendency
Increased enclosed and pointed shoes
Associated with rheumatoid athritis

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11
Q

Surgical management of hallux valgus

A

Bunionectomy
1st metatarsal reallimgement surgery
Excision athroplasty

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12
Q

Definition of Charcot joints

A

Progressive destructive joint athropathy secondary to disturbance of the sensory innervation to the joint. It results in a painless deformed joint resulting from repatitive minor trauma

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13
Q

Cause of Charcot joints

A

Peripheral: DM, peripheral never Injury, leprosy
Central: syringomyelia, tabes dorsalis

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14
Q

Definition of a bakers cyst

A

Posterior herniation of knee joint capsule

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15
Q

Cause of winging of the scapula

A

Long thoracic nerve damage
Upper brachial plexus injury
Muscular dystrophy

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16
Q

Froment test

A

Flexion of thumb at IPJ - weak adductor policis

Indicates ulnar nerve lesion

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17
Q

Contents of the carpal tunnel

A

4 tendon of FDS
4 tendon of FDP
1 tendon of flexor palmaris longus
Median nerve

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18
Q

Muscle in hands innervates by median nerve

A

Lateral two lumbricals
Oppens pollicis
Abductor pollicis brevis
Flexor pollicis brevis

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19
Q

Cause of carpal tunnel syndrome

A 
Idiopathic - commonest 
Water: pregnancy, hypothyroidism 
Radial fracture 
Inflammation: RA, gout
Soft tissue swelling: lipomas, acromegaly,Amyloidosis 
Toxic: diabetes melitus, EtOH
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20
Q

Cause of a positive trendelenburg test

A

Abductor wasting secondary to chronic pain
Superior gluteal nerve injury
Structural - developmental dysplasia of the hip

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21
Q

Cause of an ulnar palsy

A 
Anatomical compression 
- cubital tunnel syndrome at elbow 
- guyons canal syndrome at wrist 
Trauma 
- supracondylar fracture of the humerus 
- elbow dislocation
22
Q

Ulnar pardox

A

Proximal lesion lead to paralysis of ulnar half of FDP which leads to less wasting

23
Q

Feature of ulnar nerve palsy

A

Partial claw hand - little and ring fingers
Weak abduction and adduction of fingers
Weak flexion of DIPJ in little and ring finger
Wasting: hypothenar emminance, dorsal interossei

24
Q

Indication for surgical management of lumbar disc herniation

A

Progressive neurological defecit
Severe incapacitating pain
Failing of non surgical management

25
Q

Risk factors for OA

A

Age
Obesity
Joint abnormality
Physical/manual occupation

26
Q

Definition of athrodesis

A

Artificial induction of joint ossification between two bones by surgery

27
Q

Risk factor for septic athritis

A

Joint diesease
Chronic renal failure
Immunosprresion e.g DM
prosthetic joints

28
Q

Comlications of septic athritis

A

Sepsis
Osteomyelitis
Athritis
Ankylosis - fusion

29
Q

Risk factors for osteoporosis

A 
SHATTERED 
Steroids 
Hyperthyroid, Hyperparathyroidism, HIV 
Alcohol and cigarettes 
Thin - BMI
30
Q

Indication for a DEXA scan

A

Low trauma fracture
Women > 65 with one or more risk factor
Before giving long term steroids
Parathyroid disorders, myeloma, HIV

31
Q

Intepretation of T scores produced from a DEXA scan

A

T>1 = normal
T: 1-2.5 = osteopenia
T:

32
Q

Osteoporotic fractures

A

Vertebral collapse
neck of femur
Neck of humerus
Colles

33
Q

Definition of a sublaxation

A

Normal anatomy of the joint is disrupted but there remain some contact between the articualar surfaces of the joint

34
Q

Definition of dislocation

A

Complete disruption of the joint with no contact between joint surfaces

35
Q

Clincal sign of a fracture

A 
Pain 
Swelling 
Crepitus 
Deformity 
Adjacent structural injury: nerves ligaments, vessel, tendon
36
Q

Complication of fractures

A 
Immediate 
- neurovascular complications 
- visceral damage 
Early
- compartment syndrome 
- infection 
- fat embolism 
Late 
- problems with union 
- Avascular necrosis 
- growth disturbances 
- post traumatic OA 
- complex regional pain syndrome
- myosotis ossificans
- reflex sympathetic dystrophy
37
Q

Complication of a Colles fracture

A 
Median nerve injury 
Frozen shoulder/adhesive capuslitis
Tendon rupture - EPL 
Carpal tunnel syndrome 
Mal/non-Union 
Complex regional pain syndrome
38
Q

What is a dinner fork deformity

A

Dorsally displaced and angulated with shortening of the radius

39
Q

Smiths fracture

A

Fracture of the distal radius with volar displacement and angulation of the distal fragment

40
Q

Barron’s fracture

A

Oblique intra-articular fracture involving the dorsal aspect of the distal radius and dislocation of the radio-ulnar joint

41
Q

Monteggia fracture

A

Fracture of the proximal 1/3 of the ulna shaft with anterior dislocation of the radial head of the capiteleum

42
Q

Galleazi fracture

A

Fracture of radial shaft between mid and distal 1/3

43
Q

Bankart lesions

A

Damage to anteroinferior glenoid labrum following shoulder dislocation

44
Q

Hill-Sachs lesion

A

Cortical depression in the posterolateral part of the humeral head following impaction against the glenoid rim during anterior dislocation

45
Q

Complication of shoulder dislocations

A 
Recurrent dislocation 
Axillary nerve damage 
Brachial plexus injury 
Axillary artery damage 
Associated fracture
46
Q

Muscles of the rotator cuff and test

A
  1. Supraspinatus - jobes test
  2. Infraspinatus - external rotation
  3. Subscapularis - gerber lift of test
  4. Teres minor - external rotation
47
Q

Impingement syndrome

A

Entrapment of supraspinatus tendon and subacromial bursa between acromion and greater tuberosity of the humerus

48
Q

Unhappy triad of O’donoghue

A

ACL
MCL
Medial meniscus

49
Q

Spinal fractures

A
  1. Anterior wedge # - loss of vetebral body
  2. Burst # - axial compression of spine (unstable)
  3. Chance # - transverse # across L2/3
  4. L2# - unstable
  5. Jefferson #
50
Q

Definition of Dupuytrens contracture

A

Progressive, painless, fibrotic thickening of palmar fascia

Sugery - AS PACES (7 decks)

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