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Medicine > Ortho > Flashcards

Ortho Flashcards

1
Q

What is at risk in shoulder dislocation?

A

Axillary nerve and axillary artery

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2
Q 
Common direction of dislocation:
Shoulder
Elbow
Hip
Knee
A

Shoulder: a
Elbow: p
Hip: p
Knee: either

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3
Q

What is at risk in elbow dislocation?

A

Brachial artery, median nerve, ulnar nerve

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4
Q

What is at risk in hip dislocation?

A

Sciatic nerve and blood supply to femoral head

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5
Q

What is at risk in knee dislocation?

A

popliteal artery and vein, ACL, PCL, peroneal nerve (esp with posterior)

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6
Q

Which dislocations need immediate relocation?

A

Knee (don’t wait for x-ray)

Hip

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7
Q

Where do the knee menisci lie?

A

Between femoral and tibial surfaces

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8
Q

Which meniscus more commonly torn?

A

Medial

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9
Q

How is the meniscus usually torn?

A

Traumatic (knee flexed and twisting/ maybe in association with previous ligamentous injury as knee chronically unstable)
Degenerative (oldies with abnormal cartilage)

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10
Q

How is a meniscal cyst formed?

A

synovial fluid pumped into the meniscal tear, valve effect stops them returning

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11
Q

General mx principle for meniscal tear

A

more peripheral = more amenable to healing

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12
Q

How does meniscal tear present?

A

Locked knee
Effusion (large suggests v peripheral)
Joint line tenderness
McMurray’s (but not v reliable)

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13
Q

Mx of meniscal tear

A

RICE and early physio

may need surgery (but removal of significant portions leads to OA changes)

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14
Q

Classic hx for chronic ACL injury

A

Can run in straight line but can’t turn

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15
Q

Effusion biggest in ACL or meniscal tear?

A

ACL: huge effusion in minutes/ hours
meniscal: develops over 24h

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16
Q

how is ACL usually injured?

A

Twisting or valgus strain when knee extended or slightly flexed

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17
Q

How do PCL tears usually occur?

A

Rare - dashboard injuries, goalkeeper, knee forcibly hyperextended

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18
Q

Which collateral ligament commonly injured with ACL?

A

MCL

19
Q

How to differentiate from ACL and MCL tears, based on hx?

A

Both cases something pops - but no effusion if MCL

20
Q

Causes of patellar dislocation

A

More commonly in young women with ligamentous laxity/ recurrent dislocations from minor injury

Traumatic: side impact on slightly flexed knee

(V painful, usually reduced before transport)

21
Q

What causes patellofemmoral pain syndrome?

A

Provoked by stairs, squatting, or sitting with flexed knees for long time.

Over half are bilateral (but maybe one side worse)

Diagnosis of exclusion

22
Q

Knee pain you came across in GP

A

Osgood-Schlatters

Pain and swelling below knee cap

23
Q

Ottawa ankle rules

A

xray if:
can’t weight bear after injury and in ED
pain on posterior edge of either malleolus
base of 5th metatarsal pain

24
Q

Examples of pathological fractures

A 
Osteoporotic
Malignancy
Mets
Metabolic disorders
Stress fractures
25
Q

Comminuted fracture

A

more than 1 bone fragment

26
Q

Compound fracture

A

open fracture

27
Q

Impacted fracture

A

affects cancellous bone

28
Q

greenstick fracture

A

partial crack on convex side, bend on concave side

29
Q

Buckle fracture

A

impaction injury in children where cortex is buckled but not disrupted

30
Q

Dislocated vs subluxed

A

Subluxed: partial loss of contact of the joint surfaces

31
Q

What 7 As does an open fracture require?

A 
Analgesia
Antibiotics
Anti-tetanus
Antiseptic dressing
A splint
A photograph
An op
32
Q

Immediate complications of fractures

A

Systemic: hypovolaemic shock

Local: injury to major vessels, muscles/ tendons, joints, viscera

33
Q

Early complications of fractures

A

Systemic: hypovolaemic shock, ARDS, fat embolus, DVT, crush syndrome, sepsis (open)

Local: infection, compartment sx

34
Q

Late complications of fractures

A

Problems with union, avascular necrosis, shortening, OA…

35
Q

Complications of compartment sx

A

muscle necrosis, nerve damage, contractures, myoglobinuria

36
Q

Cardinal signs of arthritic joint

A

pain, stiffness, functional limitation

37
Q

Cardinal features of OA on x-ray

A

Loss of joint space
Osteophytes
Subchondral cysts
Subchondral sclerosis

38
Q

Pain when IT band adducted - in hill walkers/ runners

A

Greater trochanteric bursitis

seen on imaging

39
Q

What is fractured in hip #?

A

Proximal femur

40
Q

Which hip fractures are at risk of avascular necrosis?

A

Intracapsular

41
Q

In a hip fracture, how may the leg present?

What is elicited o/e?

A

Shortened leg, adducted and externally rotated
aggravated by flexion and rotation of leg
may only have referred knee pain

42
Q

What line do you look for in hip x-rays?

A

Shenton’s line - disrupted in fractures

43
Q

Commonest OA pattern in knees

A

varus

Medicine (30 decks)

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