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Hippos > Ortho > Flashcards

Ortho Flashcards

1
Q

What is the difference in onset of pain with a ligament tear vs meniscus tear?

A 
Ligament = sudden onset
Meniscal = gradual onset
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2
Q

Wounds in a recent ortho surgery is what until proven otherwise?

A

Deep space/joint infection

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3
Q

What are the minimum views needed for an x-ray of an injury?

A

Minimum two views at 90 degrees from each other

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4
Q

What is the most commonly missed fracture on x-rays?

A

The second one

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5
Q

What is the clinical significance of a: comminuted fx?

A

Harder to hold together

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6
Q

What is the clinical significance of a: fx in which a joint is involved?

A

Must be maintained in anatomic position otherwise increase risk of arthritis

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7
Q

What is the clinical significance of a: shifted fx?

A

Tore a lot of soft tissue-less stable

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8
Q

What is the clinical significance of an oblique/spiral fx?

A

More likely to shift/slide

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9
Q

What is the treatment for a buckle fracture?

A

Self limited-give something for comfort and protection

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10
Q

Does good position mean a stable fx?

A

No

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11
Q

What is the principle on whether to mold a cast in flexion or extension?

A

If the fx is reduced, want to antagonize movement of the fx, otherwise it will try to shift back to where it originally was

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12
Q

What are the four characteristics of a bad fx?

A
  • Shifted
  • Comminuted
  • joint involved
  • oblique/spiral fx
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13
Q

What is a colles fx?

A

extra articular fx of the distal radius, with distal fragment dorsally displaced

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14
Q

What a smith’s fx?

A

Extra articular fx of the distal radius, with the distal fragment displaced volarly

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15
Q

Which is more stable: a smith or colles fx? Why?

A

Colles is more stable since the flexors move the distal radius volarly with a smith’s fx

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16
Q

What is a Barton’s fx? Which is more unstable: a volar or dorsal displacement? Why?

A
  • An intra-articular fracture of the distal radius with dislocation of the radiocarpal joint.
  • Volar displacement less stable, since flexors pull on the bone more
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17
Q

What is a Chauffeur’s (Hutchinson’s) fx?

A

Fx of the distal radial styloid

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18
Q

In how many week should a scaphoid fx be apparent?

A

4 weeks, although can be sooner

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19
Q

How can you place the hand to better appreciate a scaphoid fx?

A

Wrist in ulnar deivation

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20
Q

Is a more proximal or distal fx to the scaphoid more concerning?

A

Proximal

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21
Q

What is the complication from a scapholunate dislocation?

A

Arthritis several years later

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22
Q

What discharge instructions should you give to someone who has a scapholunate dislocation?

A

Must not return to impact sport that caused it

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23
Q

What is the “terry thomas” sign?

A

Gap of over 3 mm in scaphoid and lunate in a scapholunate discloation

24
Q

What is the “spilled tea cup” sign?

A

Lunate dislocation

25
Q

What is the classic presentation of a lunate dislocation?

A

FOOSH injury with subsequent swelling over the volar aspect of the wrist

26
Q

What is the general management for a lunate dislocation?

A

Reduce and refer (to OR)

27
Q

What is a perilunate dislocation?

A

All of the carpal bones are displaced, except the lunate

28
Q

What is the line of bones that should connect in the wrist, starting distally, and ending in the radius? (4)

A

Metacarpal
Capitate
Lunate
Radius

29
Q

What is the general management of a perilunate dislocation?

A

Reduce and refer for probable operative management

30
Q

What are Gilula’s arcs?

A

Three arcs

  • Proximal aspect of the proximal carpals
  • Distal aspect of the proximal carpals
  • Proximal aspect of the distal carpals
31
Q

What is the most proximal carpal bone on the radial side of the hand? Ulnar?

A 
Radial = Scaphoid
Ulnar = lunate
32
Q

What is the bone that sits above and between the lunate and the scaphoid?

A

Capitate

33
Q

What is the bone just lateral to the scaphoid?

A

Trapezium

34
Q

What is the bone just medial to the lunate?

A

Triquetrum

35
Q

What is the distal carpal bone that sits just proximal to the 1st through 5th metacarpals?

A 
1 = Trapezium
2 = Trapezoid
3 = Capitate
4 = Hamate
5 = Pisiform/triquetrum
36
Q

What is the treatment for a triquetrum fx?

A

Splint and refer (usually heal well on their own in 6-8 weeks)

37
Q

What is the “piano key” sign?

A

Pushing down on the ulnar styloid when broken feels like a piano key

38
Q

How can you tell if you have a radial-ulna ligament tear?

A

Pronate and supinate while stabilizing the radial head and ulnar head respectively– if laxity, may have it

39
Q

What is the stress view for a scapholunate dislocation?

A

Make a fist

40
Q

What is the hamate view on x-ray?

A

X-ray shot parallel to the metacarpals hand when it is fully extended at the wrist

41
Q

What is the proper splint position for a hook of the hamate fx?

A

ulnar gutter with wrist extension, with flexion at the MCPs, but extension at the PIPs and DIPs.

42
Q

Why is a native hip dislocation an orthopedic emergency, while a prosthetic hip dislocation is not?

A

Risk of femoral head necrosis with native hip

43
Q

How many hours do you have to reduce a dislocated hip before avascular necrosis sets in?

A

6 hours

44
Q

What must always be visualized with a prosthetic joint on x-ray? Why?

A
  • The ends of the prosthesis with two views at 90 degrees

- Can have periprosthetic fractures

45
Q

What type of hip fracture is most likely to cause vascular disruption?

A

Subcapital

46
Q

What is the risk of bisphosphonates in terms of fractures?

A

Increased susceptibility 2/2 laying down irregular bone

47
Q

What is the presentation of IT band syndrome?

A
  • Lateral knee pain worse with walking/running

- Usually occurs in runners

48
Q

What is the pressure number to remember for diagnosing compartment syndrome? How are these used (2)?

A
  • within 30 mmHg of DBO

- Over 30 mmHG

49
Q

Which is more likely to have abnormalities in CRP, ESR, WBC: acute or chronic osteomyelitis?

A

Acute

50
Q

What is the difference between wet and dry gangrene?

A 
Wet = infectious
Dry = Ishemic
51
Q

Heliotrope rash + elevated CK + MSK pain = ?

A

Dermatomyositis

52
Q

What are the components of the CRAB mnemonic for multiple myeloma?

A
  • hyperCalcemia
  • Renal failure
  • Anemia
  • Bone lesions
53
Q

What are the four typical features of OA on plain films?

A
  • Joint space narrowing
  • Subchondral sclerosis
  • Osteophytes
  • Subchondral cysts
54
Q

What must always be high on the differential for a patient with RA that comes in with joint pain?

A

Septic arthritis (usually on immunosuppression)

55
Q

Which affects distal hand joints and which proximal: RA vs OA

A 
RA = proximal
OA = distal
56
Q

Which are positively birefringent and which are negative : gout vs pseudogout?

A 
Pseudogout = Positive
Gout = negative

Hippos (23 decks)

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