Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Clin med sem 2 > Ortho- lower extremity > Flashcards

Ortho- lower extremity Flashcards

1
Q

Anterior Cruciate Ligament Injury- pathophysiology

A

ACL connects posterior aspect of femoral condyle to anterior aspect of tibia
- controls anterior tibia on femur and rotational stability

Bones twist in opposite directions under full body weight

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Anterior Cruciate Ligament Injury- cause

A

Non-contact deceleration -> valgus twisting
Hyperextension
Marked internal rotation
Pure deceleration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Anterior Cruciate Ligament Injury- epidemiology

A

F>M

Common - soccer, basketball, football, skiing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Anterior Cruciate Ligament Injury- S/S & PE

A

S/S:

  • pop
  • immediate effusion
  • Difficulty/Can’t weight bear
  • Unstable

Exam:

  • Lachmans
  • anterior drawer
  • Lever sigh
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Anterior Cruciate Ligament Injury- diagnosis

A

MRI w/ out contrast

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Anterior Cruciate Ligament Injury- labs & imaging

A

Xray - NOT diagnostic - will show effusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Anterior Cruciate Ligament Injury- treatment

A

Young/active + complete tear - surgery

  • autograft - own patellar or hamstring tendon
  • allograph - cadaver

Older/sedentary OR partial tear - conservative

  • PT to strengthen hamstrings
  • bracing

Bracing? - debated - remain weight bearing if possible!!

  • to protect other structures - inc risk of 2nd meniscus injury
  • acute - knee immobilizer and crutches
  • Subacute/chronic - hinged brace

Rice
Pain control
Refer Orther

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Posterior Cruciate Ligament Injury- pathophysiology

A

PCL - strongest ligament in knee

Sprains or partial tears more common

Associated w/ injuries - ACL and MCL tears

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Posterior Cruciate Ligament Injury- cause

A

Blow to knee while flexed

  • striking knee against dashboard
  • falling on a bent knee
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Posterior Cruciate Ligament Injury- S/S & PE

A

S/S:

  • swelling IMMEDIATE and PROFOUND
  • Severe pain
  • Limited ROM
  • instable - unable to move
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Posterior Cruciate Ligament Injury- diagnosis

A

Sag sign - tibia posteriorly set off
Posterior draw test - positive
MRI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Posterior Cruciate Ligament Injury- treatment

A

Refer Ortho
RICE, pain control, immobilization w/ crutches
Isolated PCL tear - treated non-op w/ PT
W/ other injuries - surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Medial Collateral Ligament injury- pathophysiology

A

Most commonly injured

w/ ACL

Extra-articular - joint effusion LESS COMMON

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Medial Collateral Ligament injury- cause

A

Valgus stress on partially flexed knee

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Medial Collateral Ligament injury- S/S & PE

A

S/S:

  • Focal pain over ligament
  • Minor swelling
  • Limited ROM - improves w/in 2w
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Medial Collateral Ligament injury- diagnosis

A

Valgus stress exam

MRI - doesn’t need to happen acutely

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Medial Collateral Ligament injury- treatment

A 
Graduated weight bearing
Bracing
- minor -hinged
- sever -immobilizer
PT
6-8 weeks of healing
Isolated - Rarely need surgery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Meniscus injuries- pathophysiology

A

“Shock absorbers”
Very common injury
Acutely or degeneration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Meniscus injuries- cause

A

Internal rotation of femur on tibia w/ flexion knee
- posterior meniscus b/t femur and tibia

Sudden extension - external rotation
- lateral meniscus

Partial or complete tear
Posterior or anterior horn tear
Longitudinal or bucket handle tear

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Meniscus injuries- S/S & PE

A 
S/S: 
- catching, locking, clicking
- Painful walking and squatting
- Mild to mod joint swelling 
- JOINT LINE TENDERNESS
- lock in extension - piece of menis obstructing joint
Exam - McMurray
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Meniscus injuries- diagnosis

A

MRI w/ out contrast

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Meniscus injuries- labs & imaging

A

Xray - nl, but may show joint space narrowing or effusion

- more helpful if hx or OA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Meniscus injuries- treatment

A

“Degenerative tears - PT

Acute tears - arthroscopic meniscus repair or debridement “

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Knee Dislocation- pathophysiology

A

Dislocation of tibiofemoral joint of knee
ORTHO EMERGENCY
Many present already reduced!

To dislocate - at least 3, if not 4, major knee ligaments are torn

Anterior - most common
Posterior, lateral, medial

Popliteal artery - partial or complete disruption in 40%
Peroneal nerve - 23% injured

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Knee Dislocation- cause

A

Multi-trauma

High-energy trauma

  • Hyperextension - anterior dislocation
  • anterior blow - posterior desolation: dashboard
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Knee Dislocation- S/S & PE

A

Gross deformity - if not reduced
LARGE effusion
SIGNIFCANT pain- can’t weight bear

MUST EVAL FOR NEUROVASC

  • palpable distal pulses - DOES NOT exclude vascular injury
  • MUST DO ABI
  • assess sensation and strength
ABI
- Systolic BP in LE - ankle
- Systolic BP in UP - brachial 
- >.9 - monitor w/ serial exams
-
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Knee Dislocation- labs & imaging

A

Xray - AP and lateral
- obtain even if reduced - tibial plateu fracture

CT arteriogram - GOLD
Arterial duplex US
- both eval popliteal artery
- not always indicated -> if ABI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Knee Dislocation- treatment

A

IV pain control
Reduce - even if has vascular injury
- then reassess
Post reduction xray
Splint - long leg w/ 20–30-degree flexion
Admit for pain control - serial exams w/ortho consult

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Knee Dislocation- prognosis

A

Require MRI after swelling reduced - will likely need surgery

Complications are frequent

Rarely go back to pre-injury state

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Knee Dislocation- complications

A

Complications - limb ischemia, permanent nerve damage, compartment syndrome, arthrofibrosis (most common)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Knee Bursitis- pathophysiology

A

Bursa becomes irritated - produced too much fluid
-> swelling and puts pressure on adjacent parts

Pre-patellar - most common
- Housemaid’s knee

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Knee Bursitis- S/S & PE

A

S/S:

  • swelling and tenderness over bursa
  • become infected -> erythema, warmth
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Knee Bursitis- diagnosis

A

Clinical

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Knee Bursitis- treatment

A

NSAIDs
RICE
No pressure over patella
Refractory - prepatellar bursa injections - corticosteroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Knee Osteoarthritis- pathophysiology

A

3x more common than hip
Chronic progressive knee pain
- medial more affected

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Knee Osteoarthritis- epidemiology

A

> 65

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Knee Osteoarthritis- S/S & PE

A

S/S:

  • Morning stiffness <30min
  • Crepitus
  • Mild effusion
  • Pain relieved w/ rest
  • Severe - Genu Valgum or Genu Varum
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Knee Osteoarthritis- diagnosis

A

Xray - joint space narrowing, osteophytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Knee Osteoarthritis- treatment

A

Conservative - weight loss, graded exercise
APAP and NSAIDs
Intra-articular Corticosteroid - short term relief
- doesn’t improve quality of life -> greater cartilage loss
Synvisc - intra-articular viscosupplementionation
- mixed date
Platetet-Rich plasma injections - mixed

Total or partial knee replacement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Patella Subluxation & Dislocation- pathophysiology

A

Very common

Medial or lateral - more common

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Patella Subluxation & Dislocation- cause

A

Direct blow to side of knee

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Patella Subluxation & Dislocation- S/S & PE

A

Pain, swelling, deformity

Limited ROM - locked in extension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Patella Subluxation & Dislocation- diagnosis

A

Xray - sunrise view

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Patella Subluxation & Dislocation- treatment

A 
Reduction - apply pressure while extending knee
Immobilization short-term
PT - quad strengthening
1st time - no surgery
Recurrent - surgery
45
Q

Patella Fracture- cause

A

Direct patellar impact

  • dashboards
  • fall onto flexed knee
46
Q

Patella Fracture- S/S & PE

A

Significant swelling

Focal pain - will bruise

47
Q

Patella Fracture- diagnosis

A

Xray - AP, Later, SUNRISE VIEW

  • multiple fracture types
  • important to examine and document - intact extensor mechanism
48
Q

Patella Fracture- treatment

A

Refer Ortho
RICE
Pain Control
No surgery - extensor mechanism intact, nondisplaced fx, vertical fracture
- Extension bracing WITH WEIGHT BEARING
Surgery - extensormechanism failur, open fx, displaced fx, comminuted fx
- ORIF

49
Q

Patella Fracture- Bipartite Patella

A

Bipartite Patella

  • patella composed of 2 bones, seen bilaterally
  • If separate while bending knee - pos for bipartite
50
Q

Patellar Tendon Rupture- pathophysiology

A

Not common

51
Q

Patellar Tendon Rupture- cause

A

Sudden quadriceps contraction with knee in a flexed position
- jumping

52
Q

Patellar Tendon Rupture- S/S & PE

A

Pain, swelling

ELEVATION OF PATELLA

53
Q

Patellar Tendon Rupture- diagnosis

A

Xray - patella displacement

MRI

54
Q

Patellar Tendon Rupture- treatment

A

Refer Ortho
Complete tear - surgery
Partial - splint and watch

55
Q

Chondromalacia/Patellofemoral syndrome- pathophysiology

A

Runnes Knee

Damage to undersurface cartilage of patella - sec to poor patellar tracking

Risk for lateral patella subluxation

56
Q

Chondromalacia/Patellofemoral syndrome- epidemiology

A

W>M

adolescents/YA

57
Q

Chondromalacia/Patellofemoral syndrome- S/S & PE

A 
Chronic, anterior knee pain
- inc when going upstairs and/or squatting
No effusion
Grand test
Apprehension test

This causes knee to be unstable - will come in because of dislocation

58
Q

Chondromalacia/Patellofemoral syndrome- diagnosis

A

Xray - AP, lateral, SUNRISE (bilateral)
- Patella alta/baja or lateral patella tilt

MRI - cartilage damage

59
Q

Chondromalacia/Patellofemoral syndrome- treatment

A

NO surgery - 1st line

  • NSAIDs
  • PT

Surgery - persistent/progressive

  • PT failed after 1y
  • Arthroscopic debridement
  • Patellar realignment surgery
60
Q

Tibial Plateau fracture- pathophysiology

A

Fracture of proximal tibia - intra-articular

61
Q

Tibial Plateau fracture- cause

A

Higher energy injury
- other ST injuries

Valgus or vaus twist with axial loading
Trauma

62
Q

Tibial Plateau fracture- S/S & PE

A

Severe pain

Swelling

63
Q

Tibial Plateau fracture- diagnosis

A

Xray - eval proximal and distal tibia
- can miss this fracture

CT - if high suspicion

64
Q

Tibial Plateau fracture- treatment

A

Pain control
Consult ortho

No surgery - no to min displacement
- hing brace, crutches
Surgery - displaced, comminuted, open
- ORIF

65
Q

Tibial Plateau fracture- prognosis

A

Complications

  • Peroneal nerve injury - foot drop?
  • MRI for ST injury - ACL and meniscal tear
  • Compartment syndrome
66
Q

Tibial Shaft fracture- pathophysiology

A

Common

67
Q

Tibial Shaft fracture- cause

A

Torsional injury

Direct blow

68
Q

Tibial Shaft fracture- diagnosis

A

Xray

69
Q

Tibial Shaft fracture- treatment

A

No surgery - no to min displacement
- hing brace, crutches -> watlking cast
Surgery - displaced, comminuted, open
- splint w/ crutches -> ORIF

70
Q

Fibula Shaft Fracture- pathophysiology

A

Fibula - no weight bearing bone

71
Q

Fibula Shaft Fracture- diagnosis

A

Xray - visualize entire bone

72
Q

Fibula Shaft Fracture- treatment

A

Splint -> cast

Weight bear just fine

73
Q

Ankle Sprain- pathophysiology

A

Most common reason to miss athletics

Inversion - most common

High ankle sprain - <10%
- syndesmosis injury - tibiofibular and interosseous ligaments

Low ankle sprain - >90%

  • anterior talofibular ligament (ATFL)
  • Calcaneofibular ligament (CFL)
74
Q

Ankle Sprain- S/S & PE

A

Anterior draw

Talar tilt

75
Q

Ankle Sprain- diagnosis

A 
Should you xray? - way over ordered
Ottawa Ankle rules: 
- inablitiy to bear weight
- medial, lateral malleolus point, bony tenderness
- 5MT base tenderness
- Navicular tenderness

MRI - ligamentous injury

76
Q

Ankle Sprain- treatment

A

RICE
Immobilization - w/ weight bearing
Early ROM and reture - 2w low, several w high
Surgery - complete or recurrent sprain/instability

77
Q

Malleoli Fracture- pathophysiology

A

Distal tibia fracture
- can be inconjunction w/ fibula

Bimalleolar - medial and lateral

Trimalleolar - medial, lateral, posterior

78
Q

Malleoli Fracture- treatment

A

Isolated <3mm displacement - ortho refer, walking boot 6-8w

Displaced, comminuted, open - surgery

79
Q

Achilles Tendon Rupture- pathophysiology

A

Largest tendon in body

80
Q

Achilles Tendon Rupture- cause

A

Trauma
Abrupt
Weekend warrior

81
Q

Achilles Tendon Rupture- epidemiology

A

M

30-40

82
Q

Achilles Tendon Rupture- S/S & PE

A

Felt like shot in the foot, big pop

Thompson test
Achilles - feels soft

83
Q

Achilles Tendon Rupture- diagnosis

A

Xray - eval for bony injury

MRI - TOC

84
Q

Achilles Tendon Rupture- treatment

A

Refer ortho
Surgery - sooner the better
Splint, crutches, pain meds
- may need hosp to control pain

85
Q

Phalangeal Fractures- pathophysiology

A

very common

86
Q

Phalangeal Fractures- treatment

A

Rarely surgery

Buddy tape + hard soled shoe

87
Q

5th Metatarsal Fracture- pathophysiology

A

Very common

Dancer’s fracture

88
Q

5th Metatarsal Fracture- cause

A

Forced inversion during plantar flexion

89
Q

5th Metatarsal Fracture- treatment

A 
Stress fracture - distal 
- no weigth bearing 
Jones - middle
- no weight bearing
Avulsion (Pseudo Jones) 
- weight bearing ok

No surgery - stiff soled shoe
- 1-4
Surgery - open fractures, displacement of 1st or multiple fractures

90
Q

Plantar Fasciitis- pathophysiology

A

Inflammation of aponeurosis at origin on the calcaneus

- chronic overuse -> microtears

91
Q

Plantar Fasciitis- epidemiology

A

Obesity
Dec dorsiflexion in a non-athletic population
Weight bearing endurance activity

92
Q

Plantar Fasciitis- S/S & PE

A

Sharp heel pain

  • stepping out of bed - worse at end of day
  • bilateral
93
Q

Plantar Fasciitis- diagnosis

A

Clinical

  • pinpoint tenderness
  • dorsiflexion of toes - foot inc tenderness w/ palpation
94
Q

Plantar Fasciitis- treatment

A

Stretching
NSAIDs
arch support

95
Q

Hammer Toe- pathophysiology

A

Flexion deformity of PIP w/ extension of DIP

96
Q

Hammer Toe- cause

A

High heals

97
Q

Hammer Toe- diagnosis

A

Clinical

98
Q

Hammer Toe- treatment

A

No surgery - wide shoes, padding/splinting

Refer Podiatry

99
Q

Corns and Calluses- pathophysiology

A

Toughened area of skin - relatively thick and hard due to repeated friction, pressure, other irritation

100
Q

Corns and Calluses- S/S & PE

A

Corn - painful, small, hard center

Callus - larger, non-painful

101
Q

Corns and Calluses- treatment

A

File

Padding

102
Q

Bunions- pathophysiology

A

Hallux valgus

Pressure on lateral MCP joint - causes metatarsal head displaced medially -> bone deformity

103
Q

Bunions- epidemiology

A

Genetic

104
Q

Bunions- S/S & PE

A

Slow onset

Can be painful

105
Q

Bunions- treatment

A

Wide shoe
Pain control
Refer podiatry - surgery?

106
Q

Ingrown Toenail- pathophysiology

A

Nail grows - cutting into one or both sides of paronychium or nail bed

107
Q

Ingrown Toenail- S/S & PE

A

Painful

Infected?

108
Q

Ingrown Toenail- treatment

A

Warm water soaks
Abx ointment
well-fitting shoes
Nail lifting or removal

Clin med sem 2 (30 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions