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Ortho- World Flashcards

1
Q

What is colles Fracture

A

It is a distal Radial Fracture

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2
Q

What does A colles Fracture look like ?

A

A dinner fork

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3
Q

What migh a Colles fracture affect ?

A

Median nerve ( sensantion to lateral 3 and 1/2 digits and motor inervation of thenar muscles )

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4
Q

What are thenar muscles ?

A

Thenar muscles are muscles like abductor policis longus and Opponens policis, responsible for thumb movement

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5
Q

CF of scaphoid fracture

A

Fall over the wrist
Pain at the radial wrist prosimal to the base of the thumb
Pain at the anatomic snuff box

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6
Q

Do scaphoid fractures show on Xray ?

A

No, non-displaced scaphoid fractures dont

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7
Q

CF of scaphoid fracture

A

Fall over the wrist
Pain at the radial wrist prosimal to the base of the thumb
Pain at the anatomic snuff box

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8
Q

What is the anatomic snuff box

A

Shallow depression at the base of the thumb bounded medially by extensor policis longus, Laterally by abductor policis longus and extensor policis brevis.

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9
Q

What is the MC risk in Scaphoid fractures ?

A

Osteonecrosis

because the blood supply to the scaphoid bone is proximal to distal

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10
Q

What is a Torus fracture or buckle fracture ?

A

it is a type of incomplete fracture
affecting one side of the cortex where the bone buckle out and form a bulge.

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11
Q

What are the muscles of the Rotator Cuff

A

Supraspinatus, infraspinatus, teres minor and Subscapularis

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12
Q

Where do the Rotator cuff muscles insert ?

A

On the Humerus

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13
Q

Thus what are the movements the Rotator Cuff help with ?

A

external anf internal rotation of shoulder
Abduction of arm

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14
Q

Origina and insertion of Supraspinatous muscle ?

A

Origin: supraspinous fossa
Insertion: Greater tuberosity of humerus

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15
Q

Action of Supraspinatous

A

Abduction of humerus

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16
Q

Origin and insertion of infraspinatous

A

Origin: infraspinous fossa
Insertion: greater tuberosity ( middle facet)

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17
Q

Action of Infraspinatous ?

A

External rotation

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18
Q

Origin of Teres minor and insertion ?

A

Origin: Under neath the infraspinatous
Insertion: inferior facet of greater tuberosity

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19
Q

Action of Teres minor ?

A

External rotation of humerus

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20
Q

Origin and Insertion of Subscapularis muscle

A

Origin: subscapular fossa ( anterior part of scapula)
Inserts on lesser tuberosity of humerus

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21
Q

Action of subscapularis muscle ?

A

Internal rotation

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22
Q

CF of Rotator Cuff tear ?

A

Weakness of arm and limited abduction

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23
Q

In case of an anterior humeral dislocation which nerve do you affect ?

A

The axillary nerve

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24
Q

Difference between location of osteosarcoma and Ewing sarcoma ?

A

Osteosarcoma: metaphysis of long bones
Ewing sarcoma: at diaphysis of lone bones

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25
What is the manifestation of Axilary nerve injury ?
Decreased sensation over the lateral shoulder Impaired abduction and external rotation of the arm
26
Difference between Osteosarcoma and Ewing sarcoma on Imaging
Osteosarcoma: Sunburst lytic lesion ( concentric layers) with codman triangle Ewing sarcoma: Moth eaten appearance, onion skining, lytic lesion.
27
Difference between Osteosarcoma and Ewing Sracoma in lab tests
Osteosarcoma: High ALP (lytic lesions) Ewing Sracoma: High ESR
28
What happens in lateral epicondylitis ?
Repeated extension of the wrist pust force on extensor muscles like ( extensor carpi radialis brevis and extensor digitorum communis)
29
What structres are at risk in case of a suprachondylar fracture of the humerus ?
The anteriorly displaced proximal humerus migh compress the brachial artery and median nerve.
30
What is Radial Subluxation
pulling on a childs forarm or wrist causes displacement of the radius through the ligament | Also known as Nurse maids elbow
31
What does the Achilles tendon attach together ?
The gastrocnemius muscle to the posterior part of the calcaneus bone.
32
CF of Achilles Tendinopathy ?
Swelling, erythema, and pain at the posterior heel, (2-6 cm proximal to tendon insertion).
33
Management of Achilles tendinopathy if NSAIDs fail ?
for chronic pain: eccentric resistance exercise
34
What drug increases the risk of Achilles tendinopathy ?
Fluroquinolones
35
How to asses for Achilles Tendon Rupture ?
Squeeze on Soleus/ Gastrocnemius muscle, if that doesnt elicit movement of the foot, means there is a rupture.
36
What type of injury causes Medical Collateral Ligament tear ?
lateral knee injury
37
Patellofemoral Pain syndrome ?
Pain in the anterior knee. Due to weak Quadriceps muscles.
38
What is the RF of Osteonecrosis ?
Alcoholism, due to fat embolism
39
What are the Radiologic findings of femoral Osteonecrosis on Xray ?
Flattening of bone head and sclerosis
40
Difference between a complete rotator cuff tear or tendinopathy
Complete tear involves weakess Tendinopathy involves pain
41
Patellar dislocation
Lateral dislocation ( deformity seen) because quads exert lateral force on the patella Asc with medial collateral ligament tear
42
Posteriorly dislocated hip
Presents with typical dashboard force Shortened, internally rotated and adducted Limb. Needs emergency closed reduction
43
What is leg calves perthes disease ?
Idiopathic avascular necrosis of the femoral head
44
CF of leg Calves Perthes disease
Hip pain on weight bearing insidous onset Pain on internal rotation and abduction causing limp
45
Difference between Leg Calves perthes disease and Slipped capital femoral head
Leg Calves: Insidous, mismatch between epiphyseal growth and blood supply, 4-10 years, Limp Slipped capital: Acute on chronic, problem with epiphyseal ossification, 10-16 years, limp
46
Osteoid Osteoma
is a benign bone tumor
47
CF of compartment Syndrome ?
Pain out of proportion to injury Swelling and tenderness Pain not responding to narcotics Early parasthesia
48
What confirms acute compartment syndrome ?
Needle manometry
49
CF of Osteod Osteoma
thigh (proximal) pain, worse in the evening. Relieved by NSAID. Not related to exercise
50
Management of Compartment Syndrome ?
Urgent Fasciotomy
51
Post-traumatic Neuroma
Collection of tangeled unmyelinated Nerves, after limb amputation. With low depolarization threshold. Which causes pain with usually unpainful stimuli (like prosthesis fitting over a stump).
52
How to confirm Post-Traumatic Neuroma ?
Relief of pain with local anasthetic injection
53
What is a toddlers fracture ?
It is a spiral, distal tibia fracture MC in toddlers of walking age
54
CF of toddlers fractures ?
Pain, swelling at distal tibia Pain elicited on dorsiflexion of the ankle or when moving knee and ankle in opposite direction. ( Spiral Fracture)
55
What is Spinal stenosis ?
It is stenosis of the spinal canal due to 1. Ligamentum flavum thickening 2. Osteophyte formation 3. Bulging of intervertebral disk
56
CF of Spinal stenosis ?
Lower back pain radiating to the thighs Pain is postural Improves with walking with a cane (leaning forward) shopping cart sign or when the back is flexed.
57
What is a green stick fracture ? and who is it most commonly present in ?
It is a fracture that does not extended throught the whole coretex. MC in young children, falling on an outstreched hand.
58
Do you expect long term Complications in greenstick fractures ?
NO
59
What is Vertebral Compression fractures
Fracture of the vertebra due to decreased bone density ( osteoporosis and Ostemalacia). Common in men > 65 and post menopausal women.
60
CF of compression vertebral Fracture ?
Acute/ chronic low back pain if acute after heavy lifiting or pulling No neurologic deficit Pain increases with movement and remains at rest Focal tenderness over the vertebra
61
What is the pes ansirinus ?
a fluid filled sac ( Bursa) underneath tendons of 3 muscles ( Sartorius, Gracilis, Semi-tendinous) inserting over the tibia ( on the medial surface)
62
Pes anserinus bursitis
is pain over the medial aspect of the tibia, due to friction over the tendons of the pes anserinus muscles
63
What is ruptured in case the patella rides high ?
Patellar ligament tear
64
What is ruptured if the patella rides low ?
Quadriceps tendon tear
65
Difference between ACL and Quadriceps tendon tear ?
With Quadriceps tendon tear the patient is unable to fully extend the knee.
66
What is Paget disease ?
Bone disease, in which there is osteoclast dysfunction
67
What are the three stages of Paget disease ?
1. Increased osteoclast activity, bone resorption 2. Mixed phase of increased osteoclast and osteoblast 3. Increased bone formation and sclerotis bones
68
CF of paget disease
Bone deformity ( bowing of bones) , fractures and pain Nerve entrapment ( increased hat size) causing hearing loss
69
Difference between Adhesive capsulitis and Rotator cuff tendinopathy
Adhesive capsulitis: Active and passive movement is affected RC tendinopathy: Passive movement is intact
70
CF of Plantar Fascitis
Pain elicited with dorsiflexion of the toes and after prolonged rest Atheletes doing high impact exercises
71
RF of plantar fascitis
Obesity Walking bear foot High arched feet
72
Deformities seen in case of Breech Presentation
Developmental Dysplasia of the hips Congenital muscular Torticollis Club feet Metatarsus adductus
73
What is congenital Muscular Toricollis
is a positional deformity, with prefrance to tilt the head to one side more than the other
74
CF of Congenital Muscular Tortocollis
Plagiocephaly ( flattening on the side where the infant sleeps) Anterior displace ipsilateral ear Sternoceleido mastoid muscle mass ( thickening) Limited range of motion of the neck tilting of the head to the affected side and chin pointed upwards towards the other side
75
What is Metatarsus Adductus ?
It is a congenital foot deformity that involves medial positioning of the metatarsus and neurtal position of the hindfoot. MC foot congenital deformity Corrects spontaneously
76
Diff. between Metatarsus adductus and club foot
Club foot has medial deviation of both metatarsus and hindfoot
77
Diff between compression fracture and lumbosacral strain
Compression fracture: vertebral tenderness Lumbosacral strain: paravertebral tenderness
78
CF Menisceal tear ?
twisting injury localized pain locking of knee ( unable to fuly extend the knee).
79
Complex regional pain syndrome
Severe, debilitating pain of the extremities with associated sensory, motor, and/or autonomic changes. Typically associated with a specific precipitating trauma and restricted to a specific nerve territory.
79

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