Ortho/Trauma

Question 1

What are the criteria for OR thoracotomy after placing a chest tube?

Answer 1

Initial output > 20 mL/kg
Output > 200 mL/hr for 3 hours
Persistent output > 7 mL/kg/hr
Or persistent hypotension

Question 2

What are the different types of blast injury?

Answer 2

Primary - sound wave (ex: TM rupture)
Secondary - shrapnel/debris
Tertiary - moving objects or people falling into objects

Question 3

What are the arthrocentesis findings in septic arthritis?

Answer 3

> 50,000 WBCs

> 50% neutrophils

Question 4

What are the measurements seen in compartment syndrome?

Answer 4

Delta pressure (DBP - compartment) < 30 mmHg
Absolute compartment pressure > 30-40 mmHg

Question 5

How can you test the sensory and motor function of the nerves of the hand?

Answer 5

Median: “ok” sign, sensation at tip of index finger
Ulnar: 5th finger abduction, sensation over 5th finger
Radial: wrist/finger extension (thumbs up), sensation of the thumb-index web space

Question 6

What are the artery and nerve most often injured in anterior knee dislocation?

Answer 6

Popliteal artery
Peroneal nerve (sensation of medial dorsum of foot, dorsiflexion at the ankle)

Question 7

Define Monteggia and Galeazzi fractures.

Answer 7

Monteggia - proximal ulnar fracture and radial head dislocation
Galeazzi - mid- to distal radial fracture and distal radioulnar joint dislocation

Question 8

When does a patellar fracture require immediate orthopedics evaluation?

Answer 8

If the patient cannot extend the leg at the knee

Question 9

What ligament is affected in skier’s thumb (gamekeeper’s thumb)?

Answer 9

Ulnar collateral ligament

Presents with 1st MCP tenderness and weak pincer grasp

Question 10

What are the two physical exam signs that suggest RP bleed?

Answer 10

Cullen’s sign - periumbilical ecchymosis

Grey-Turner sign - flank ecchymosis

Question 11

What is Sever disease?

Answer 11

Calcaneal apophysitis - inflammation of the calcaneal growth plate, seen in adolescent and typically bilateral

Question 12

What is the sensory and motor function of the following nerves: L4, L5, S1?

Answer 12

L4 - medial thigh and foot sensation
L5 - lateral leg sensation, dorsiflexion
S1 - posterior leg sensation, plantarflexion

Question 13

What nerves are associated with the following reflexes?
Biceps
Brachioradialis
Triceps
Patella
Achilles

Answer 13

Biceps - C5/6
Brachioradialis - C6
Triceps - C7
Patella - L4
Achilles - S1