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Acute Care > Ortho OSCE > Flashcards

Ortho OSCE Flashcards

1
Q

Complications of cervical traction

A
  • bleeding from temporal artery
  • pressure sore on scalp
  • sepsis
  • worsening neurological status
  • cranial nerve 6 palsy
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2
Q

Nexus criteria to X-ray C-spine

A
  • midline cervical tenderness
  • focal neurologic deficits
  • altered level of consciousness
  • evidence of intoxication
  • painful distracting injury
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3
Q

What does a unifacet dislocation look like on X-ray

A
  • anterior displacement of vertebral body <25%
  • bow-tie sign on lateral view
  • rotation and misalignment of spinous processes on AP view
  • widening of interspinous space
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4
Q

How does a unifacet dislocation occur?

A
  • flexion/distraction with rotation
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5
Q

How does a Weber A happen?

A

Inversion and adduction

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6
Q

How does a Weber B happen?

A

Eversion, abduction and external rotation

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7
Q

How does a Weber C happen?

A

Abduction and external rotation

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8
Q

X-ray findings of Colles fracture

A
  • extra-articular
  • proximal to radioulnar joint
  • dorsal angulation of the distal fracture fragment
  • impaction and shortening of radius
  • associated ulnar styloid fracture present in 50%
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9
Q

How to reduce a colles fracture

A
  • disimpact
  • hyperdorsiflex
  • push down to reduce
  • flex wrist
  • ulnar deviation
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10
Q

Definition of sciatica

A

Pain in one side of the buttock which shoots down the length of the leg

  • worse when sitting
  • burning/tingling associated with weakness/numbness
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11
Q

Causes of sciatica

A
  • lumbar disc herniation
  • degenerative disc disease
  • spondylolisthesis
  • lumbar spinal stenosis
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12
Q

Treatment of sciatica

A
  • rest
  • analgesia and NSAIDS
  • spinal decompression of a compressed nerve root that doesn’t improve with rest
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13
Q

Causes of cauda equina

A
  • ruptured disc in lumbar area
  • spinal stenosis
  • spinal lesion or malignant tumour
  • complication of lumbar injury
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14
Q

Signs and symptoms of cauda equina

A
  • severe back pain
  • numbness and weakness in one or both legs
  • saddle anaesthesia
  • bladder or bowel dysfunction
  • sexual dysfunction
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15
Q

3 ways infection can get to bone

A
  • bacteriaemic seeding
  • direct inoculation
  • contiguous spread
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16
Q

Differential for swollen knee

A
  • gout
  • pseudogout
  • cellulitis
  • bursitis
  • prepatellar bursitis
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17
Q

Complications of septic arthritis

A
  • chondrolysis
  • stiffness
  • AVN in the hip joint
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18
Q

X-ray features of osteoarthritis

A
  • narrowed joint space
  • cystic changes
  • sclerosis
  • osteophytes
  • no osteopenia
19
Q

Common elbow conditions

A
  • tennis elbow (lateral)
  • golfer’s elbow (medial)
  • biceps tendonitis
  • triceps tendonitis
  • olecranon bursitis
  • posterior olecranon impingement
  • arthritis
20
Q

Treatment of calcific tendonitis

A
  • cortisone injection into painful area
  • ultrasound guided aspiration
  • surgical removal
21
Q

Investigations for septic arthritis

A
  • FBC
  • ESR
  • Blood culture
22
Q

What is compartment syndrome

A

When the tissue pressure within a closed muscle compartment exceeds the perfusion pressure and results in muscle and nerve ischaemia (increased contents or increased extrinsic pressure)

23
Q

What do patients with compartment syndrome complain of?

A
  • pain out of proportion to injury
  • pain on passive stretch
  • parasthesia
24
Q

Examination of compartment syndrom

A
  • woody, hard compartment
  • altered sensation
  • muscle weakness
  • pain on passive stretch
  • pulses preserved until very late
25
Q

Treatment of compartment syndrome

A
  • immediate removal/splitting of POP

- if failure to remove in 15 mins, do open fasciotomy and delayed closure

26
Q

Compartments of leg

A
  • anterior
  • lateral
  • superficial posterior
  • deep posterior
  • tibialis posterior
27
Q

What is a Volkmann contracture?

A
  • muscle and nerves undergo ischemic necrosis and contract in compartment syndrome
28
Q

Possible sites of compartment sydrome

A
  • lower leg
  • forearm
  • wrist
  • hand
29
Q

How does an anterior shoulder dislocation occur?

A
  • abduction, external rotation
30
Q

Examination signs in anterior shoulder dislocation

A
  • flattened/ hollow contour of shoulder
  • patient supporting arm
  • anterior fullness below the coracoid process
  • painful limitation of all shoulder movements
31
Q

X-Ray views for anterior shoulder dislocation

A
  • AP view
  • lateral ciew
  • modified axillary view
32
Q

Treatment of anterior shoulder dislocation

A 
Analgesia/ anaesthesia
- Kocher manouver
- Hippocratic method
- Modified Milch
Sling and analgesia 
Re-X-ray
33
Q

Complications of anterior shoulder dislocation

A
  • recurrent disolcation
  • Bankart lesion
  • Hill-Sachs lesion
  • axillary nerve damage
34
Q

DD for shoulder problems

A
  • traumatic anterior dislocations
  • atraumatic dislocation
  • rotator cuff syndrome
  • biceps tendinitis
  • calcific tendinitis
  • rotator cuff tear
  • ACJ arthritis
  • frozen shoulder
  • glenohumeral arthritis
35
Q

Deposits in calcific tendonitis

A

Calcium phosphate

36
Q

Causes of hip pain/problems

A
  • osteoarthritis
  • septic arthritis
  • AVN
  • trochanteric bursitis
  • snapping hip
  • inflammatory arthritis
  • synovial chrondromatosis/ osteochondromatosis
37
Q

Management of OA

A
  • lose weight and modifty lifestyle
  • initial alangesia and anti-inflammatories
  • steroid injections
  • then surgery (joint debridement/ osteotomy/ arthroplasty/arthrodesis/decompression)
38
Q

When do you decide to operate in OA

A
  • relief of uncontrollable pain
  • symptoms interfere with ADLs
  • risk of surgery outweighed by consequences of arthritis
  • early surgery is easier
39
Q

Aims of closed traction-reduction of cervical spine

A
  • cervical spine re-alignment
  • spinal cord decompression
  • neurological outcome optimisation
40
Q

Pre-requisites for Cohn’s callipers

A
  • patient alert and co-operative

- neurological and physiological monitoring

41
Q

Contraindications to Cohn’s callipers

A
  • skull fracture (relative)
  • severe soft tissue degloving
  • unconscious/unco-operative patient
42
Q

Endpoints of Cohn’s traction

A
  • reduction
  • failure of reduction
  • worsening of neurological status
  • radiographic features of over-distraciton
43
Q

Gustilo-Anderson classification of open fractures

A 
1 = wounds less than 1cm, minimal contamination
2= wounds 1-10cm, moderate comminution and contamination
3a = minimal periosteal stripping, ST coverage required
3b = significant periosteal stripping at fracture site, ST coverage required
3c = repairable vascular injury
44
Q

Medial ankle ligament

A

Deltoid ligament

Acute Care (2 decks)

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