Ortho Questions Flashcards
90% of clinical cases result from prolapses at L4/5 and L5-S1 levels.
T or F
True = L5-S1 most common
Loss of the knee jerk is a good sign of L5-S1 disc prolapse.
false
What is the knee jerk myotome?
L4/5
Bladder dysfunction and paraplegia may result from disc prolapse and L5-S1?
true
Symptoms and signs of Disc prolapse will settle with conservative treatment in greater than 70% of cases.
true
Concerning the management of a compound tibial fracture:
Primary suture should not normally be carried out if the wound is more than 8 hours old.
true
Concerning the management of a compound tibial fracture:
Appropriate anti-tetanus prophylaxis should be prescribed.
true
tibial fracture: Ampicillin is the best choice of antibiotic to prevent infection.
false
flucloxacillin
IV 2 g every six hours
if concerned about MRSA add vancomycin
1000 to 2000 mg 12-hourly
External fixation of the fracture allows good access for continued wound management.
true
Concerning lateral dislocation of the patella:
it occurs more often in females true or false
true
Concerning lateral dislocation of the patella: It is frequently bilateral.
true
Concerning lateral dislocation of the patella: Fractures do not occur with this injury.
false (can fracture the patella)
Concerning lateral dislocation of the patella: Fractures do not occur with this injury.
false (can fracture the patella)
Concerning lateral dislocation of the patella: In the acute stage would be associated with a haemarthrosis.
true
Concerning osteoarthritis of the hip: Pyrophosphate crystals are always present in the synovium.
False
what are pyrophosphate crystals in synovium a sign of ?
Pseudogout (or “false gout”) is a form of arthritis that results from deposits of calcium pyrophosphate crystals (its medical term is calcium pyrophosphate dihydrate crystal deposition disease, or CPPD). It commonly affects the knees and wrists.
Concerning osteoarthritis of the hip: Subchondral cysts are a typical radiological feature.
true
Concerning osteoarthritis of the hip: It may occur as early as the third decade, after congenital dislocation of the hip.
true
The typical patient has an abduction and internal rotation contracture of the
hip.
false - external rotation and adduction
Patient with carpal tunnel:
Wasting of the hypothenar eminence may occur
false
Median Nerve Motor Innervation:
Flexor Carpi Radialis
Flexor Digitorium Superficialis + lateral half FDP
Palmaris Longus
Pronator Teres
(supplies all in anterior forearm except FCU + Medial half of FDP)
Thenar eminence: LOAF muscles
Hypothenar muscles
Muscles of the 5th finger (opponens digiti minimi, Abductor digiti minimi and flexor digiti minimi)
which nerve innervates hypothenar muscles
Ulnar nerve
considering patient with carpal tunnel: Abnormal sensation around the fingernail of the middle finger. true or false
true
Injury to Median Nerve will cause:
Sensation abnormalities of lateral 3.5 fingers (thumb) on palmar and dorsal distal half of 3.5 fingers)
Weak OKAY sign: Due to weakness of the thenar eminence + lateral two lumbricals and loss of FDS + FDP to index finger)
considering patient with carpal tunnel: weakness of thumb abduction true or false
true
considering patient with carpal tunnel: A positive phalens test true or false
true
Concerning slipped upper femoral epiphysis: There may be a history of knee pain
true (referred knee pain with painful limp )
Concerning slipped upper femoral epiphysis: Often associated with shortening and loss of internal rotation of the affected limb.
true (restricted movement internal rotation) and often holding in passive external rotation
Concerning slipped upper femoral epiphysis: Tend to occur in adolescent males with a tendency to hypogonadism and obesity.
true
Concerning slipped upper femoral epiphysis: more common in males or females?
males
Concerning slipped upper femoral epiphysis: Often associated with loss of flexion of the ipsilateral knee.
false (can get knee PAIN but not restricted movement)
Which of the following nerve and muscle combinations are true?
Median Nerve = pronator teres and FCR
true
Which of the following nerve and muscle combinations are true?
Radial nerve - triceps and wrist extensors.
true
Which of the following nerve and muscle combinations are true?
Median nerve - pronator terres and flexor carpi radialis.
true
Which of the following nerve and muscle combinations are true?
Common peroneal nerve - tibialis anterior and peroneus brevis.
true
Which of the following nerve and muscle combinations are true?Ulnar nerve - flexor carpi ulnaris and adductor pollicis.
What does ulnar nerve innervate?
true
FCU
Palmaris brevis
Almost all of hand:
medial half of FDP, adductor pollis, interossei muscles, hypothenar eminence (muscles associated with the little finger) as well as medial two lumbricals
Hypothenar muscles (a group of muscles associated with the little finger)
Medial two lumbricals (3 and 4th)
Adductor pollicis
Palmar and dorsal interossei of the hand
Palmaris brevis
Dorsal and palmar interossei
3rd and 4th lumbricals
Adductor pollucis brevis
Palmaris brevis
Opponens digiti minimi
Flexor digiti minimi
abductor digiti minimi
Flexor Carpi ulnaris
Medial half of the FDP
Axillary Nerve motor innervation
Teres minor and deltoid
A 50 year old male develops acute agitation and decreased oxygen saturation following a femoral shaft fracture. Which of the following are true: A blood transfusion is likely to help.
false (decrease in oxygen sats indicates not blood loss alone - potentially PE due to decrease air entrey)
A 50 year old male develops acute agitation and decreased oxygen saturation following a femoral shaft fracture. Which of the following are true: Pain relief in the form of Opioids is required to control the agitation.
false - Analgesic required, not necessarily opiods
A 50 year old male develops acute agitation and decreased oxygen saturation following a femoral shaft fracture.
Is high flow oxygen treatment harmful?
False - it is INDICATED
A 50 year old male develops acute agitation and decreased oxygen saturation following a femoral shaft fracture.
Infection should be considered the most likely cause.
false –> Probably PE
Concerning spinal osteomyelitis in adults:
Bacteriological diagnosis can be obtained by needle aspiration of the disc space.
false
Concerning spinal osteomyelitis in adults:Between 40% and 50% of cases have had urinary infection or instrumentation.
true
Concerning spinal osteomyelitis in adults:
The radiological appearances cannot be distinguished from tuberculosis.
false
Changes of disc space loss and vertebral erosion are apparent before symptoms arise.
The correct answer is ‘False’.
Changes are late
Vetebral levels:
C3
hyoid bone
c4
bifurcation of common carotid + thyroid cartilage
L2
renal veins
L3
umbilicus
L4
iliac crest
S1
Sacral promontory
T12
Aortic hiatus of the diaphragm
