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Ortho- UWorld > Ortho- World > Flashcards

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
Q

What is the manifestation of Axilary nerve injury ?

A

Decreased sensation over the lateral shoulder
Impaired abduction and external rotation of the arm

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26
Q

Difference between Osteosarcoma and Ewing sarcoma on Imaging

A

Osteosarcoma: Sunburst lytic lesion ( concentric layers) with codman triangle

Ewing sarcoma: Moth eaten appearance, onion skining, lytic lesion.

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27
Q

Difference between Osteosarcoma and Ewing Sracoma in lab tests

A

Osteosarcoma: High ALP (lytic lesions)

Ewing Sracoma: High ESR

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28
Q

What happens in lateral epicondylitis ?

A

Repeated extension of the wrist pust force on extensor muscles like ( extensor carpi radialis brevis and extensor digitorum communis)

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29
Q

What structres are at risk in case of a suprachondylar fracture of the humerus ?

A

The anteriorly displaced proximal humerus migh compress the brachial artery and median nerve.

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30
Q

What is Radial Subluxation

A

pulling on a childs forarm or wrist causes displacement of the radius through the ligament

Also known as Nurse maids elbow

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31
Q

What does the Achilles tendon attach together ?

A

The gastrocnemius muscle to the posterior part of the calcaneus bone.

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32
Q

CF of Achilles Tendinopathy ?

A

Swelling, erythema, and pain at the posterior heel, (2-6 cm proximal to tendon insertion).

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33
Q

Management of Achilles tendinopathy if NSAIDs fail ?

A

for chronic pain: eccentric resistance exercise

34
Q

What drug increases the risk of Achilles tendinopathy ?

A

Fluroquinolones

35
Q

How to asses for Achilles Tendon Rupture ?

A

Squeeze on Soleus/ Gastrocnemius muscle, if that doesnt elicit movement of the foot, means there is a rupture.

36
Q

What type of injury causes Medical Collateral Ligament tear ?

A

lateral knee injury

37
Q

Patellofemoral Pain syndrome ?

A

Pain in the anterior knee.
Due to weak Quadriceps muscles.

38
Q

What is the RF of Osteonecrosis ?

A

Alcoholism, due to fat embolism

39
Q

What are the Radiologic findings of femoral Osteonecrosis on Xray ?

A

Flattening of bone head and sclerosis

40
Q

Difference between a complete rotator cuff tear or tendinopathy

A

Complete tear involves weakess
Tendinopathy involves pain

41
Q

Patellar dislocation

A

Lateral dislocation ( deformity seen) because quads exert lateral force on the patella
Asc with medial collateral ligament tear

42
Q

Posteriorly dislocated hip

A

Presents with typical dashboard force

Shortened, internally rotated and adducted Limb.

Needs emergency closed reduction

43
Q

What is leg calves perthes disease ?

A

Idiopathic avascular necrosis of the femoral head

44
Q

CF of leg Calves Perthes disease

A

Hip pain on weight bearing
insidous onset
Pain on internal rotation and abduction causing limp

45
Q

Difference between Leg Calves perthes disease and Slipped capital femoral head

A

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
Q

Osteoid Osteoma

A

is a benign bone tumor

47
Q

CF of compartment Syndrome ?

A

Pain out of proportion to injury
Swelling and tenderness
Pain not responding to narcotics
Early parasthesia

48
Q

What confirms acute compartment syndrome ?

A

Needle manometry

49
Q

CF of Osteod Osteoma

A

thigh (proximal) pain, worse in the evening. Relieved by NSAID.
Not related to exercise

50
Q

Management of Compartment Syndrome ?

A

Urgent Fasciotomy

51
Q

Post-traumatic Neuroma

A

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
Q

How to confirm Post-Traumatic Neuroma ?

A

Relief of pain with local anasthetic injection

53
Q

What is a toddlers fracture ?

A

It is a spiral, distal tibia fracture
MC in toddlers of walking age

54
Q

CF of toddlers fractures ?

A

Pain, swelling at distal tibia
Pain elicited on dorsiflexion of the ankle
or when moving knee and ankle in opposite direction. ( Spiral Fracture)

55
Q

What is Spinal stenosis ?

A

It is stenosis of the spinal canal due to
1. Ligamentum flavum thickening
2. Osteophyte formation
3. Bulging of intervertebral disk

56
Q

CF of Spinal stenosis ?

A

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
Q

What is a green stick fracture ? and who is it most commonly present in ?

A

It is a fracture that does not extended throught the whole coretex.
MC in young children, falling on an outstreched hand.

58
Q

Do you expect long term Complications in greenstick fractures ?

A

NO

59
Q

What is Vertebral Compression fractures

A

Fracture of the vertebra due to decreased bone density ( osteoporosis and Ostemalacia).
Common in men > 65 and post menopausal women.

60
Q

CF of compression vertebral Fracture ?

A

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
Q

What is the pes ansirinus ?

A

a fluid filled sac ( Bursa) underneath tendons of 3 muscles ( Sartorius, Gracilis, Semi-tendinous) inserting over the tibia ( on the medial surface)

62
Q

Pes anserinus bursitis

A

is pain over the medial aspect of the tibia, due to friction over the tendons of the pes anserinus muscles

63
Q

What is ruptured in case the patella rides high ?

A

Patellar ligament tear

64
Q

What is ruptured if the patella rides low ?

A

Quadriceps tendon tear

65
Q

Difference between ACL and Quadriceps tendon tear ?

A

With Quadriceps tendon tear the patient is unable to fully extend the knee.

66
Q

What is Paget disease ?

A

Bone disease, in which there is osteoclast dysfunction

67
Q

What are the three stages of Paget disease ?

A
  1. Increased osteoclast activity, bone resorption
  2. Mixed phase of increased osteoclast and osteoblast
  3. Increased bone formation and sclerotis bones
68
Q

CF of paget disease

A

Bone deformity ( bowing of bones) , fractures and pain
Nerve entrapment ( increased hat size) causing hearing loss

69
Q

Difference between Adhesive capsulitis and Rotator cuff tendinopathy

A

Adhesive capsulitis: Active and passive movement is affected

RC tendinopathy: Passive movement is intact

70
Q

CF of Plantar Fascitis

A

Pain elicited with dorsiflexion of the toes and after prolonged rest
Atheletes doing high impact exercises

71
Q

RF of plantar fascitis

A

Obesity
Walking bear foot
High arched feet

72
Q

Deformities seen in case of Breech Presentation

A

Developmental Dysplasia of the hips
Congenital muscular Torticollis
Club feet
Metatarsus adductus

73
Q

What is congenital Muscular Toricollis

A

is a positional deformity, with prefrance to tilt the head to one side more than the other

74
Q

CF of Congenital Muscular Tortocollis

A

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
Q

What is Metatarsus Adductus ?

A

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
Q

Diff. between Metatarsus adductus and club foot

A

Club foot has medial deviation of both metatarsus and hindfoot

77
Q

Diff between compression fracture and lumbosacral strain

A

Compression fracture: vertebral tenderness
Lumbosacral strain: paravertebral tenderness

78
Q

CF Menisceal tear ?

A

twisting injury
localized pain
locking of knee ( unable to fuly extend the knee).

79
Q

Complex regional pain syndrome

A

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
Q
A

Ortho- UWorld (2 decks)

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