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ortho > ortho1_n > Flashcards

ortho1_n Flashcards

1
Q

if positive obrien and crank test with pain and popping, what next step?

A

arthrogram MRI

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2
Q

What were the conclusions of Beacher et al. (2016) study in the SEER database regarding BMP in spine surgery?

A

BMP not a/w cancer

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3
Q

If patient under 10 with curve over 20 degrees what get?

A

MRI

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4
Q

where is the incision for the hamstring graft in acl reconstruction?

A

level of tibial tubercle, 6cm below medial joint line

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5
Q

what is a bony bridge between the proximal radius and ulna known as?

A

radioulnar synostosis

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6
Q

what can you do to a knee effusion prior to closed reduction for proximal tibial physeal fracture?(2)

A

aspiration and inject anesthetic

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7
Q

RVAD > 20 degrees, phase 2 rib-vertebra relationship and cobb angle over 30 predicts what?

A

progression of IS

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8
Q

what are components of neuro exam?(3)

A

sensory, motor, reflexes

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9
Q

what covers the iliacus muscle?

A

iliopectineal fascia

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10
Q

what vessels should be ligated medially when entering the deep inguinal ring in the ilioinguinal approach?

A

inferior epigastric artery/vein

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11
Q

what can happen to nondystrophic scoliosis in NF that in terms of change?

A

can transform to the dystrophic type

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12
Q

what get if someone has asymmetric abdominal reflex?

A

MRI

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13
Q

what sciolemeter measurement used for scoliosis detection?

A

7 degrees

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14
Q

how many windows does the ilioinguinal approach create?

A

3

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15
Q

which lumbar curve sizes progress over time?

A

over 40 degrees

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16
Q

when do the radius and ulna split from one another?

A

7 weeks in utero

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17
Q

Obesity, poor cardio, failure to comply with treatment all predictors of what for TOS?

A

failure of nonop management

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18
Q

what does skin look like in third degree frost bite?

A

grayish blue

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19
Q

what size OCD do you do fixation for?

A

> 2cm in size

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20
Q

how treat flexion instability in TKA?

A

revision to posterior stabilized design

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21
Q

160 degrees of scaptation, axial load and internal/external rotation is what shoulder test?

A

crank test

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22
Q

how good does your reduction have to be in midshaft BB forearm fx in a kid with less than 2 year growth remaining?

A

anatomic

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23
Q

posterior capsule tightiness in pitcher predisposes to what tear in the shoulder?

A

type II SLAP tear

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24
Q

what muscle do you strip off the ilium in the ilioinguinal approach to the acetabulum?

A

iliacus

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25
Q

how does exercise induced compartment usually resolve?

A

rest

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26
Q

tibia vara, procurvatum, and internal torsion are a/w what condition in kids?

A

blount’s

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27
Q

how are vertebrae shaped in dystrophic NF scoliosis?(2)

A

wedged/scalloped

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28
Q

what part of the patella does the mpfl insert?

A

proximal

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29
Q

what part of the TFCC is avascular?

A

central

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30
Q

Where in the foot does OCD occur most often?

A

talus

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31
Q

What kind of supplementation in the knee do AAOS not support

A

viscosupplementation with hyaluronic acid

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32
Q

In the knee where do most OCD occur?

A

posterolateral aspect of medial femoral condyle

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33
Q

how long cast stay on for proximal tibial physeal fractures? (range)

A

4 to 6 weeks

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34
Q

what thoracic curve direction more common for juvenile scoly?

A

right

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35
Q

why triangular block made for patella in harvest for acl?

A

avoid fracture

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36
Q

what is the first step in imaging for TOS?

A

radiographs of c spine and the chest

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37
Q

how much can flex neck for the cookie test and still be vaid?

A

45 degrees

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38
Q

which acetabulum quadrant is safe zone?

A

the posterosuperior one

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39
Q

…., PT, and NSAIDs used to treat painful os trigonum

A

immobilization

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40
Q

NSAIDs, self management, weight loss, and activity modification recommended by what body for initial management of TKA?

A

AAOS

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41
Q

how can compartment syndrome affect the kidneys?

A

acute renal failure

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42
Q

what is normal thoracic kyphosis?(range)

A

20-45 degrees

OB

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43
Q

what inserts superior the gracilis or semitendinouss?

A

gracilis

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44
Q

how would you treat a congenital radial head dislocation that gets painful with restricted range of motion of the elbow?

A

radial head resection

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45
Q

how is antigravity muscle function assessed in a kid in the upper extremity?

A

hand to mouth

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46
Q

what structure lies superficially anteriorly to the MPFL and inserts on the anterior third?

A

VMO(vastus medialis obliquus)

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47
Q

why get EMG/nerve conduction study when assessing for lumbar stenosis?

A

looking for peripheral neuropathy

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48
Q

what is most important aspect of PIPJ stability after injury?

A

percentage of middle phalanx articular surface fractured

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49
Q

what angle does scoly measurement of 7 degrees supposed to correspond to?

A

20 degrees

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50
Q

what is it called when UCL of the thumb incarcerated superficial to the underlying adductor aponeurosis?

A

stener lesion

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51
Q

What joint is the most common site of OCD?

A

knee

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52
Q

what abdominal structure can be located in the femoral canal in some people?

A

a hernia

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53
Q

What is scoly 3-10?

A

juvenile scoly

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54
Q

what is the space between the pubic symphysis and the bladder known as?

A

cave of retzius

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55
Q

why get ABI when working up lumbar stenosis?

A

looking for vascular claudication

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56
Q

This angle measures inclination of weight bearing zone of acetabulum?

A

tonnis angle

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57
Q

what is the width of the mpfl?

A

12mm

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58
Q

what do you want to avoid in a hinge prosthesis for TKA concerning the patella position?

A

patella baja

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59
Q

when fail cookie test lead to referral?

A

3 months

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60
Q

what does satisfactory result of lisfranc injury result from?

A

accuracy of reduction

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61
Q

What do obrien and crank test assess?

A

labral injuries in the shoulder

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62
Q

This is the name for pathologic lesion affecting articular cartilage and subchondral bone with variable manifestations?

A

osteochondritis dissecans

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63
Q

how does the forearm start out in utero?

A

single cartilaginous anlage

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64
Q

what approach use for a k line negative OPLL?

A

anterior approach

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65
Q

10 degree angulation and 1cm bayonet apposition acceptable for midshaft radius/ulna fx in what age group?

A

female >8, male >10 with over 2 year growth remaining

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66
Q

how deep does third degree frost bite go?

A

down to the subQ level

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67
Q

what is most common level of disc herniation?

A

L5-S1

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68
Q

what imaging modality can be used for tissue perfusion in frostbite?

A

technetium 99m bone scan

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69
Q

What might be persistent gap between the tibial tuberlce and the metaphysis indicate?

A

interposed periosteum

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70
Q

when micro surgery for BPP agewise?

A

best around 6 months

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71
Q

Anastamosis bw the obturator vessels and the inferior epigastric vessels is what?

A

corona mortis

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72
Q

signs of pelvic discontinuity: 1) fx through ilioischial line, 2) medial migration of inferior hemipelvis 3) ***

A

asymmetry of the obturator ring

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73
Q

why apply mold above the patella for tibial tubercle fracture?

A

minimize pull of the quadriceps

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74
Q

how often radioulnar synostosis bilateral?

A

60%

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75
Q

which half of acetabulum is danger zone for THA?

A

anterior half

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76
Q

Rim avulsion is what hohl and moore type?

A

3

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77
Q

condyle fracture extending to the contralateral tibial side of tibial spine is what Hohl and moore type?

A

2

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78
Q

what approach used to treat a k line positive OPLL?

A

posterior approch

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79
Q

how stabilize unstable proximal tibial physeal fracture?

A

crossing percutaneous smooth pins

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80
Q

how do you get a tunnel view of the knee?

A

flex it 30-50 degrees

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81
Q

if tibial stress fracture is seen in the posterior cortex how can it be treated?

A

nonoperatively with nonweightbearing

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82
Q

What zone of the physis closest to the epiphysis?

A

reserve(germinal) zone

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83
Q

what do to cast for proximal tibial physeal fracture after putting it on?

A

univalve or bivalve for swelling

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84
Q

this window in the ilioinguinal approach gives you access to the superior pubic ramus and the symphysis?

A

medial window

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85
Q

Do you want to release syndactyly early or what for the bones to form?

A

early

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86
Q

why extend the elbows a little in the roos test?

A

eliminate ulnar nerve compression as factor

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87
Q

How is a TOS test considered positive?

A

symptoms reproducible

88
Q

What pain medication category recommended by AAOS for knee osteoarthritis?

A

NSAIDs

89
Q

what is stage III of nonop management for TOS?

A

muscle strengthening

90
Q

What is normal lumbar lordosis?

A

30-60 degrees

91
Q

if electrically positive TOS what advanced imaging should you get?(2)

A

CT or MRI

92
Q

when does adolescent blount’s disease present?

A

after 10 years

93
Q

How long do patients hold arms and close hands in and out in roos test?

A

3 min

94
Q

What is a type 4 hohl and moore?

A

rim depression

95
Q

which form of blount’s more likely to have distal femoral vara?

A

adolescent

96
Q

what does the middle window in the ilioinguinal approach give you access to?

A

quadrilateral plate

97
Q

what tissue layer covers the gracilis and semitendinosus?

A

sartorial fascia

98
Q

what good surgical option for treating thumb trapezometacarpal arthritis that has failed conservative management?

A

arthrodesis

99
Q

where is the physis defective in blount’s?

A

posteromedial proximal tibial physis

100
Q

what is a positive fovea sign in tfcc tear?

A

tenderness soft spot bw ulnar styloid and FCU tendon

101
Q

what is asymmetric abdominal reflex a/w in the spinal cord?

A

syrinx

102
Q

which occupation at risk for recurrent herniation after surgery for lumbar disc?

A

heavy lifting

103
Q

Elevating shoulder to 90, adducting 10-15 and then supinating and pronating the forearm and providing downward compression is what test?

A

o’brien

104
Q

the vas deferens and the testicular artery are in what structure?

A

spermatic cord

105
Q

what deficit in the forearm can shoulder abduction overcome?

A

decreased pronation

106
Q

what is a type I in the hohl moore classification?

A

coronal split

107
Q

what appearance on XR indicates worse prognosis for OCD?

A

sclerosis

108
Q

Besides leg, what else treat in stress fracture?(2)

A

vitamin D, bone mineral density check

109
Q

How figure out quadrants of acetabulum?

A

draw line from ASIS to the center of the acetabulum and then another line perpendicular to that

110
Q

what bone is the iliopectineal fascia attached to?

A

pubic bone

111
Q

Where in elbow does OCD occur most often?

A

capitellum

112
Q

what annular defect size is a/w a recurrent lumbar disc herniation after discectomy?

A

> 6mm

113
Q

Medial tibia pain occurs beginning of activity and improves, diffuse tenderness is what condition?

A

medial tibia stress syndrome

114
Q

what is the load at which the ligament breaks?

A

failure load

115
Q

what are the first changes to be seen in electrodiagnostic studies for TOS?

A

changes in EMG

116
Q

how often neural axis abnormality in JIS kid?

A

20-25%

117
Q

how much rib pencilling a/w progression of scoliosis?

A

> 3

118
Q

what type of chromosome duplication is a/w radioulnar synostosis?

A

sex chromosome

119
Q

In general, how treat a tibia stress fracture of the anterior cortex?

A

surgical fixation

120
Q

how much bone block do you want for acl surgery?

A

~25mm

121
Q

when curve magnitude get MRI of JIS (scoliosis) patient?

A

when curve over 20 degrees

122
Q

where in relation to the physis does the MPFL insert?

A

distal

123
Q

what is wilson test used to assess?

A

OCD of the knee

124
Q

the slope of the initial load deformation curve is what?

A

stiffness

125
Q

how much patellar tendon do you want for acl surgery?

A

~10mm

126
Q

what nerve watch out for during paramedian incision in knee for acl harvest?

A

saphenous

127
Q

how deep does fourth degree frostbite go?

A

down to muscle, tendon, bone

128
Q

which patient population gets recurrent disc herniation after lumbar discectomy?

A

younger

129
Q

the lateral window of the ilioinguinal approach is lateral to what structure?

A

iliopsoas

130
Q

where does the surgeon stand for getting access to the medial window in the ilioinguinal approach?

A

opposite side of the table

131
Q

What appearance on MRI indicates worse prognosis for OCD?

A

synovial fluid behind the lesion

132
Q

How many Lumbar disc herniations are surgical candidates?

A

less than 10%

133
Q

What kind of fixation want for host allograft junction in patellar tendon repair?

A

rigid

134
Q

what activity difficult for those with TFCC tear?

A

turning key

135
Q

In what position do you tension a graft used to treat patellar tendon disruption?

A

extension

136
Q

when do you consider doing harvest on contralateral hamstring or augment hamstring autograft with allograft?

A

if diameter < 8mm

137
Q

failure to achieve antigravity biceps function by what age would argue for surgical microexploration of the plexus?

A

3 to 4 months

138
Q

what is the k line in the cervical spine?

A

vertical line drawn on lateral image at midpoint of spinal canal @ C2 to C7

139
Q

The middle window in the ilioinguinal approach is between the iliopsoas and the ….

A

femoral artery and vein

140
Q

In younger patient, what correlated to success in nonop treatment for OCD? (ie knee OCD)

A

open distal femoral physes

141
Q

what view can help visualize a cervical rib?

A

apical lordotic view of the chest

142
Q

why get flex/ex films for working up lumbar stenosis?

A

see if there is lumbar spondylolisthesis

143
Q

arms elevated to the side, wrists dorsiflexed and head tilted away is what test?

A

upper limb tension test

144
Q

what makes o’brien’s test positive?

A

deep pain with resistance and forearm pronated

145
Q

what muscle has attachments to the medial head of the gastrocnemius in hamstring graft harvest for acl?

A

semitendinosus

146
Q

what type of fusion for dystrophic scoly a/w decreased pseudarthrosis?

A

anterior and posterior fusion

147
Q

signs of pelvic discontinuity: 1) ***, 2) medial migration of inferior hemipelvis 3) asymmetry of the obturator ring

A

fx through ilioischial line

148
Q

what part of the tendon do you harvest for patellar tendon in acl reconstruction?

A

central

149
Q

how many types in the king-moe classification?

A

5

150
Q

Using achilles tendon bone block allograft or whole extensor mechanism allograft used to treat disruption of what tendon after TKA?

A

disruption of patellar tendon

151
Q

if positive what does o’brien’s test show?

A

SLAP tear

152
Q

flexion instability and varus/valgus instability is known as what after TKA?

A

global instability

153
Q

which joints do kids with radioulnar synostosis compensate through?(2)

A

shoulder and wrist

154
Q

why get hip xr when assessing for lumbar stenosis?

A

see if there is hip OA

155
Q

what landmark is the mpfl insert just distal to on the femur?

A

adductor tubercle

156
Q

what is the MOI in traumatic TFCC tear?

A

fall on extended wrist with forearm pronation

157
Q

what is the underlying pathophysiology of frostbite?

A

lower tempature, blood more viscous leading to thrombosis of vessels

158
Q

which of the following is a/w point tenderness at the tibia, stress syndrome or stress fracture?

A

stress fx

159
Q

what is the normal tonnis angle?

A

<10 degrees

160
Q

Is glucosamine and chondroitin recommended by the AAOS?

A

no

161
Q

what is deformity in the spine more than 10 degrees known as?

A

scoliosis

162
Q

how many juvenile idiopathic scoly kids progress?

A

> 95%

163
Q

How often do symptoms related to lumbar disc herniations improve over time?

A

90%

164
Q

doing valgus stress in thumb extension tests what ligament (specifically)?

A

accessory ulnar collateral ligament

165
Q

when would you consider radial head resection age-wise for someone with a congenital dislocation if they are symptomatic?

A

adult

166
Q

how do you take tension off the femoral n when doing the ilioinguinal approach to the acteabulum?

A

flex the hip

167
Q

what is the top of the slope where it starts to change in the load deformation curve?

A

yield load

168
Q

when is the k line positive in the cervical spine?

A

OPLL does not extend past the k line

169
Q

why retract femoral sheath gingerly in ilioinguinal approach to the acetabulum?

A

prevent DVT

170
Q

how treat minimally displaced proximal tibial epiphyseal fracture?

A

long leg cast with some knee flexion

171
Q

why treat anterior cortex tibial stress fracture with surgery?

A

tension side so high risk of nonunion

172
Q

how does the forearm divide into the radius and ulna direction wise?

A

from distal to proximal

173
Q

which shoulder motion can pitchers have less of?

A

internal rotation

174
Q

what is toughness?

A

amount of energy absorbed from initial loading to failure

175
Q

when treat dystrophic scoliosis?

A

early fusion

176
Q

what type of contracture getin subacute compartment syndrome?

A

progressive flexion contracture

177
Q

which acetabular approach is used to treat both column injuries?

A

extended iliofemoral

178
Q

what kind of knee implant want for gross MCL incompetence?

A

hinged, rotating-platform construct

179
Q

what is the first goal in treating TOS nonop?

A

relieve pain and control progression of symptoms

180
Q

what layer does the medial patellofemoral ligament lie between?

A

between the medial retinaculum and the joint surface deeply

181
Q

which line is disrupted in a posterior column fracture?

A

ilioischial line

182
Q

when brace juvenile scoly?

A

when over 20 degrees

183
Q

what is recommended for working up neurogenic TOS to rule out distal nerve compression?

A

electrodiagnostic studies

184
Q

doing valgus stress in 30 degree of thumb flexion tests what ligament (specifically)?

A

proper ulnar collateral ligament

185
Q

which approach to the acetabulum allows access to the posterior column and posterior wall?

A

kocher-langenbeck

186
Q

what is the area under the load deformation curve equal to?

A

toughness

187
Q

what is the main medial soft tissue restraint in the knee

A

medial patellofemoral ligament

188
Q

what seperates first and second degree frostbite?

A

blistering, vesicle formation

189
Q

what is the time window for releasing compartment in CS?

A

4 to 6 hours

190
Q

what is considered rapid scoly progression?

A

more than 1 degree per month

191
Q

How do OCD in lateral femoral condyle and patella do?

A

poorer prognosis

192
Q

what is stage II of nonop management for TOS?

A

muscle balance for better posture

193
Q

besides PE maneuvers what else can you do to help diagnose TOS ?

A

scalene injection

194
Q

what can you do to reduce amputation overgrowth besides disarticulation?

A

capping distal end with autologous osteocartilaginous graft

195
Q

what vessel besides the obturator can the inferior epigastric vessels have an anastamosis with?

A

external iliac vessels

196
Q

Is the posterior cortex of the tibia tension side?

A

no, non-tension side

197
Q

what is a type 5 hohl and moore?

A

four part fracture

198
Q

What is scoliosis less than 3?

A

infantile

199
Q

when is the k line negative in the cervical spine?

A

when OPLL goes dorsal to the k line

200
Q

why gently adduct a leg with a valgus proximal tibial physeal fracture?

A

decrease risk of injury to the peroneal nerve

201
Q

what chest issue look for in total plexus lesions?

A

diaphragm for phrenic dysfunction

202
Q

What is the false positive rate for scoliometer measure over 7 degrees?

A

50 percent

203
Q

what is o’brien’s test also known as?

A

active compression test

204
Q

T/F: AAOS standards of professionalism include activities related to expert testimony, advertising practice, and relationship to industry

A

TRUE

205
Q

the layers of muscle in the ilioinguinal approach go from external oblique to internal oblique to ….

A

transversalis m

206
Q

how long is the mpfl?

A

58mm

207
Q

if electrically negative TOS what CT should you get?

A

you don’t get one

208
Q

what should you do to decrease risk of physeal injury when reducing proximal tibial physeal fractures?

A

apply traction

209
Q

what causes frostbite?

A

exposure to tempature low enough to cause crystal formation in tissue

210
Q

signs of pelvic discontinuity: 1) fx through ilioischial line, 2) *** 3) asymmetry of the obturator ring

A

medial migration of inferior hemipelvis

211
Q

what muscle do you divide 1cm proximal to the pubic symphysis in the ilioinguinal approach?

A

rectus abdominis

212
Q

How do wilson’s test?

A

pain when internal rotation of tibia and extension from 90 relieved by tibial external rotation

213
Q

what percentage of disc herniations are symptomatic?

A

4-6%

214
Q

what is yield load force a/w in terms of affect on soft tissue?

A

microdamage to ligament

215
Q

What were the conclusions of Carragee et al(2013) regarding use of BMP in lumbar arthrodesis? what dose a/w this increased risk? (2)

A

high dose (40mg) of BMP a/w increase incidence of cancer

216
Q

What is the 90 degree abduction external rotation test, stick up test, elevated arm stress test also known as?

A

roos test

217
Q

Hip dysplasia with femoral head uncovering a/w increased or decreased tonnis angle?

A

increased

ortho (6 decks)

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