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Ortho > Ortho Intro > Flashcards

Ortho Intro Flashcards

1
Q

Dermatomes: dorsal arm, 2nd and 3rd digits

A

C7

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2
Q

dermatomes: lateral arm, thumb

A

C6

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3
Q

dermatomes: medial arm, 4th and 5th digits

A

C8

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4
Q

dermatomes: nipple line

A

T4

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5
Q

dermatomes: clavicle, deltoid, lateral arm

A

C5

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6
Q

dermatomes: anterior/medial arm

A

T1

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7
Q

dermatomes: umbilical line

A

T10

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8
Q

dermatomes: groin

A

T12

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9
Q

dermatomes: upper medial thighs and FUPA area

A

L1

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10
Q

dermatomes: SI line, spiraling to lateral thigh, lateral knee, anterior shin, dorsal foot, and sole of foot

A

L5

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11
Q

dermatomes: SI line, spiraling to anterior thigh, anterior knee, medial ankle, great toe

A

L4

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12
Q

dermatomes (pick 2): anterior thigh and medial thigh

A

L2 and L3

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13
Q

dermatomes: posterior/lateral thigh/calf, lateral ankle

A

S1

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14
Q

dermatomes: posterior/medial thigh, genitalia, perineum

A

S2

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15
Q

dermatomes: genitalia and perineum

A

S3

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16
Q

dermatomes: perineum only

A

S4

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17
Q

Your patient complains of right ankle pain after a fall. You establish that it occurred as a result of twisting it stepping off a curb. You’ve noticed that the ankle looks bruised and swollen. Describe your physical exam. (basics)

A

1) Palpate the LEFT ankle first to establish baseline. Then the right ankle.
2) Request active ROM in left and then right ankles to compare
3) PROM in left, then right if there is a discrepancy in range on #2.
4) continue with neuro, special tests, and imaging.

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18
Q

Besides the typical PQRST questions, what additional questions will you specifically be asking for an MS history?

A

handedness and typical daily activity/work/athlete, etc.

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19
Q

MS pain is described as a burning stinging pressure. What’s the most likely cause?

A

sympathetic nerve

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20
Q

MS pain described as sharp, severe, and intolerable

A

fx

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21
Q

MS pain is bright and lightning-like

A

nerve

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22
Q

MS pain is shooting

A

nerve root

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23
Q

MS pain is cramping, dull, and aching

A

muscle

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24
Q

MS pain is deep, nagging, and well localized

A

bone

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25
Q

MS pain is throbbing, diffuse, and cramping

A

vascular

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26
Q

What time of day would you expect the pain/stiffness from chronic inflammation and edema to be the worst?

A

AM

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27
Q

What type of MS pain typically gets worse throughout the day?

A

joint pain/swelling

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28
Q

What types of MS pain are typically worse in the evening?

A

peripheral nerve entrapments, thoracic outlet syndrome

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29
Q

For a “tumor” diagnosis, how would you expect your patient to describe their MS pain?

A

deep, nagging pain at night that is unrelenting regardless of position

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30
Q

What type of MS pain is most affected by activity levels and posture?

A

chronic pain

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31
Q

bow-legged

A

Genu Varum

32
Q

knock-kneed

A

Genu Valgum

33
Q

What PE findings are most often missed (typically b/c patient was not undressed fully)

A

muscle atrophy and asymmetry

34
Q

What structures are included in the MS exam of the “shoulder”? (8)

A

1) sternoclavicular joint
2) clavicle
3) AC joint
4) coracoid process
5) biceps tendon
6) spine of scapula
7) infra/supraspinatus
8) inferior angle of scapula

35
Q

When describing a normal “end feel”, elbow flexion would be ___________

A

soft

36
Q

When describing a normal “end feel”, knee extension would be _________

A

hard

37
Q

When describing a normal “end feel”, head rotation would be ___________

A

firm

38
Q

When describing a normal “end feel”, forearm supination would be __________

A

firm

39
Q

When describing a normal “end feel”, knee flexion would be _______

A

soft

40
Q

When describing a normal “end feel”, elbow extension would be _________

A

hard

41
Q

What a patient prevents you from reaching FROM on exam due to pain, how do you describe that “end feel”?

A

empty

42
Q

If you were EXTENDING the knee, and it felt soft, what would you consider? (abnormal finding)

A

edema, synovitis

43
Q

If you were extending the knee and it felt firm, what would you consider? (abnormal)

A

muscle spasm

44
Q

If you were flexing the elbow, but you felt a hard endpoint, what would you consider? (abnormal)

A

a fracture or loose body

45
Q

You test elbow flexion and find the strength to be 5/5, but the patient complains of pain. What is the likely anatomy that is affected?

A

muscle or tendon

46
Q

You test elbow flexion and find the strength to be 3/5, and the patient complains of pain. What is the likely anatomy that is affected?

A

Fx or bone lesion

47
Q

You test elbow flexion and find strength is 2/5, but there is no pain. What is the likely anatomy that is affected?

A

Nerve problem, muscle rupture (or poor pt effort)

48
Q

_____ is a group of muscles supplied by a single nerve root

A

myotome

49
Q

decreased biceps reflex

A

C5

50
Q

decreased triceps reflex

A

C7

51
Q

decreased patella reflex

A

L4

52
Q

decreased Achilles reflex

A

S1

53
Q

weak foot inversion

A

L4

54
Q

weak dorsiflexion of great toe

A

L5

55
Q

weak elbow flexion

A

C5

56
Q

weak foot eversion

A

S1

57
Q

No sensation over the knee

A

L4

58
Q

No sensation lateral ankle

A

S1

59
Q

No sensation lateral calf

A

L5

60
Q

No sensation of deltoid

A

C5

61
Q

No sensation of pinky finger

A

C8

62
Q

No sensation of middle finger

A

C7

63
Q

No sensation of thumb

A

C6

64
Q

Absent deep tendon reflexes are graded at a _____, normal DTR is a _______, and clonus is a ______

A

1) Absent=0
2) Normal = 2+
3) Clonus = 4+

65
Q

No contraction on strength exam is graded a ________, movement against gravity only is _________ and normal is __________

A

1) None = 0
2) Gravity = 3
3) Normal = 5

66
Q

Rheum/Ortho review: ANA could indicate what?

A

SLE, sclera, sjogrens, RA

67
Q

Rheum/Ortho review: RF could indicate what?

A

RA, SLE

68
Q

Rheum/Ortho review: HLA-B27 could indicate what?

A

ankylosing spondylitis, Reiter’s syndrome, psoriatic arthritis

69
Q

What imaging is typically the first step for ortho complaints?

A

plain film

70
Q

What must you ALWAYS remember to do when ordering plain film to dx an ortho problem?

A

get orthagonal views

71
Q

What type of imaging is best for soft tissue?

A

MRI

72
Q

what are CT’s best for?

A

bone and blood (trauma)

73
Q

What type of imaging shows fat as bright and water as dark?

A

T1 imaging on MRI

74
Q

You want to see the ligaments and tendons on MRI, would you order T1 or T2?

A

TRICKSTER: doesn’t matter, they are dark on both. (if any area appears bright, that means pathology)

75
Q

This type of imaging marks bone turnover

A

radionucleotide bone scan

76
Q

When would you use contrast dye to help you diagnose an ortho problem?

A

1) intravascular (artery, vein)
2) arthrography (into joint)
3) myelography (into spinal cord, nerve root)

Ortho (10 decks)

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