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ortho > ortho_2_n > Flashcards

ortho_2_n Flashcards

1
Q

what is the most severe consequence of amniotic band syndrome?

A

amputation

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2
Q

How aspirate the elbow:palpate lateral epicondyle***palpate olecranonin the middle soft spot for injectiongo perpendicular to the skin when placing the needle

A

palpate radial head

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3
Q

These are the uses for the anterior approach to the hip:***synovial biopsyfusionTHAhemiarthroplastyexcision of tumorupper pelvic osteotomy

A

ORIF hip dislocation with the head anterosuperior

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4
Q

what is normal flexion/extension for the hip?

A

120-140 degrees

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5
Q

what may be a potential option for younger patients with lateral compartment OA of the knee who are not good candidates for arthroplasty and have lateral condyle hypoplasia?

A

distal femoral osteotomy

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6
Q

How aspirate the elbow:***palpate radial headpalpate olecranonin the middle soft spot for injectiongo perpendicular to the skin when placing the needle

A

palpate lateral epicondyle

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7
Q

if someone has dorr c femur, old, osteoporotic and >75, what type of fixation can pursue?

A

cemented

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8
Q

More than 90% of GCT and chondroblastoma a/w what genetic defect?

A

Histone H3.3 mutation

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9
Q

MSIS criteria(need 4):1) elevated esr(30) or crp(10)2) elevated synovial wbc(1,1k knee/3k hip)3) elevated synovial pmn(64 knee/80%hip)4) purulence5) pathogen isolation 1 culture6) ***

A

> 5 PMN per hpf frozen section

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10
Q

MSIS criteria(need 4):1) ***2) elevated synovial wbc(1,1k knee/3k hip)3) elevated synovial pmn(64 knee/80%hip)4) purulence5) pathogen isolation 1 culture6) >5 PMN per hpf frozen section

A

elevated esr(30) or crp(10)

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11
Q

These are the uses for the anterior approach to the hip:ORIF hip dislocation with the head anterosuperiorsynovial biopsyfusionTHAhemiarthroplasty***upper pelvic osteotomy

A

excision of tumor

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12
Q

which metacarpal do the lunate and capitate line up with?

A

3rd

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13
Q

These are the uses for the anterior approach to the hip:ORIF hip dislocation with the head anterosuperior***fusionTHAhemiarthroplastyexcision of tumorupper pelvic osteotomy

A

synovial biopsy

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14
Q

what femoral condyle does the PCL attach?

A

medial

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15
Q

contracture of what tissue is the initial deformity at the anterior elbow in CP?

A

muscle

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16
Q

Neuro ddx for hip pain:***spinal stenosisneuropathymeralgia parestheticaCRPS

A

lumbar radiculopathy

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17
Q

how is the torso oriented in a trendelenburg gait?

A

leaned over the affected side

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18
Q

Hip DJD ddx:OA***osteonecrosisdysplasiatraumasepsis

A

inflammatory arthritis

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19
Q

what is thought to cause amniotic band syndrome?

A

amniotic disruption with release of bands

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20
Q

how can release a proximal ring that is proximal and severe but which can lead to 6-10% chance of abortion?

A

fetoscopic release

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21
Q

How treat zone 1 fifth MT fx(2)?

A

wbat in a hard soled shoe or boot

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22
Q

MSIS criteria(need 4):1) elevated esr(30) or crp(10)2) elevated synovial wbc(1,1k knee/3k hip)3) ***4) purulence5) pathogen isolation 1 culture6) >5 PMN per hpf frozen section

A

elevated synovial pmn(64 knee/80%hip)

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23
Q

why would you wait to do a THA after giving a CS injection?

A

decrease chance of infection

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24
Q

6 yr old R thigh pain, limp, very active, smaller kid, + log roll, < IR and abduction, + ischial spine sign, what is the diagnosis?

A

legg calve perthes

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25
Q

what type of abnormal gait gets better when walking faster?

A

trendelenburg

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26
Q

what do you have to protect while placing guidewire for PCL tibial tunnel?

A

neurovascular structures

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27
Q

after elbow release in CP, what position splint extremity?

A

in extension

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28
Q

what imaging can you get beforehand when planning THA in someone with prior acetabular fx fixation?

A

CT

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29
Q

What rehabilitation strategy should you use following repair of tendon to bone?

A

protective immobilization of tendon to bone injury

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30
Q

The deep internervous plan for the anterior approach to the hip:rectus femoris(femoral n)***

A

gluteus medius (superior gluteal n)

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31
Q

The superifical internervous plane for the anterior approach to the hip:***tensor fascia latae(superior gluteal n)

A

sartorius(femoral n)

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32
Q 
The deep internervous plan for the anterior approach to the hip:
***
gluteus medius (superior gluteal n)
A

rectus femoris(femoral n)

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33
Q

besides AL and medial portal, what else might need in PCL reconstruction?

A

posteromedial portal

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34
Q

These are the uses for the anterior approach to the hip:ORIF hip dislocation with the head anterosuperiorsynovial biopsy***THAhemiarthroplastyexcision of tumorupper pelvic osteotomy

A

fusion

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35
Q

Neuro ddx for hip pain:lumbar radiculopathyspinal stenosis***meralgia parestheticaCRPS

A

neuropathy

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36
Q

what can trendelenburg gait indicate in terms of muscle deficiency?

A

abductor deficiency

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37
Q

besides latarjet and iliac crest grafting, what other bone can you use for allograft in addressing recurrent anterior shoulder instability with >20% glenoid bone loss?

A

tibia

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38
Q

MSIS criteria(need 4):

1) elevated esr(30) or crp(10)
2) ***
3) elevated synovial pmn(64 knee/80%hip)
4) purulence
5) pathogen isolation 1 culture
6) >5 PMN per hpf frozen section

A

elevated synovial wbc(1,1k knee/3k hip)

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39
Q

what is normal abduction of the hip?

A

60-80

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40
Q

older low demand patient who are thin and have unicompartmental dz candidates for what knee procedure?

A

uka

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41
Q

what condition is PAX3-MAML3 a/w?

A

sinonasal sarcoma

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42
Q

Neuro ddx for hip pain:lumbar radiculopathyspinal stenosisneuropathy***CRPS

A

meralgia paresthetica

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43
Q

How aspirate the elbow:palpate lateral epicondylepalpate radial headpalpate olecranon***go perpendicular to the skin when placing the needle

A

in the middle soft spot for injection

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44
Q

what area of femoral malunion has a greater magnitude on knee joint deformity?

A

more distal

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45
Q

does all the hardware have to come out when doing a THA in someone with a past procedure?

A

no, just take out what you need

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46
Q

What do the lunate and capitate line up on the AP of the hand?

A

3rd metacarpal

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47
Q

how treat nondisplaced both bone forearm fractures?

how arm/elbow positioned?

A

well molded long arm cast in neutral rotation, elbow flexed to 90

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48
Q

These are the uses for the anterior approach to the hip:ORIF hip dislocation with the head anterosuperiorsynovial biopsyfusionTHA***excision of tumorupper pelvic osteotomy

A

hemiarthroplasty

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49
Q

These are the uses for the anterior approach to the hip:ORIF hip dislocation with the head anterosuperiorsynovial biopsyfusion***hemiarthroplastyexcision of tumorupper pelvic osteotomy

A

THA

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50
Q

patient with inflammatory arthritis, acl deficiency, varus/valgus deformity, decreased rom, and tricompartental arthritis shouldn’t get what procedure for knee pain?

A

uka

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51
Q

what is the predominant deformity at the elbow in CP?

A

flexion contracture

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52
Q

how treat patient when can’t abduct thumb after a carpal tunnel release?

A

urgent exploration and repair of median nerve

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53
Q

how far below the joint line does the PCL attach to the tibia?

A

1-1.5cm

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54
Q

how many legs do you need to see on xr to see the LLD?

A

both

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55
Q

How treat K line negative OPLL?

A

cervical corpectomy and anterior fusion

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56
Q

Steps for shoulder injection:1) mark PL corner of the acromion2) ***3) go inferior and medial to the PL corner about 2 finger breadth4) insert needle aiming for the coracoid

A

mark the coracoid

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57
Q

Nonunion and *** are complications of having a midfoot dislocation?

A

posttraumatic arthritis

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58
Q

what type of shoulder dx/glenoid not do latarjet for?

A

first time dislocator with minimal glenoid bone loss

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59
Q

what is the most common msk area to be injured with golf?

A

lower back

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60
Q

how much can biceps, brachialis, and BR lengthening increase elbow extension in CP kid?

A

40 degrees

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61
Q

kyphosis above what degree mark is a/w poor outcome in someone who undergoes cervical laminoplasty?

A

13 degrees

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62
Q

what type of bearing doesn’t tolerate malposition well and can cause squeaking after THA?

A

ceramic on ceramic

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63
Q

what is meant by the MPFL being isometric?

A

doesn’t change length

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64
Q

Hip DJD ddx:OAinflammatory arthritis***dysplasiatraumasepsis

A

osteonecrosis

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65
Q

how can a nerve be negatively affected by constriction ring?

A

peripheral nerve palsy

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66
Q

what degree of spastic deformity is musculocutaneous neurectomy used for in elbow contracture in CP?

A

<30 degrees

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67
Q

what side dips in trendelenburg gait?

A

contralateral hip dips

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68
Q

What bone can break if a golf club hits the ground when swinging?

A

hook of the hamate

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69
Q

what type of fracture can you see with hip resurfacing?

A

femoral neck

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70
Q

laminectomy, laminotomy, and foraminotomy are examples of what kind of spinal procedure?

A

decompression

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71
Q

If someone has ipsilateral hip and knee OA, what address first?

A

hip first then knee

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72
Q

rigid flatfoot can be causes by what problem in the adolescent?

A

coalition

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73
Q

what is the dorr classification useful for, or what attempt to do?

A

guide indications for cemented versus uncemented femoral component fixation

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74
Q

MSIS criteria(need 4):1) elevated esr(30) or crp(10)2) elevated synovial wbc(1,1k knee/3k hip)3) elevated synovial pmn(64 knee/80%hip)4) ***5) pathogen isolation 1 culture6) >5 PMN per hpf frozen section

A

purulence

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75
Q

In uncemented THA, how does acetabular component stay in?

A

press fit allowing bone ingrowth/ongrowth

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76
Q

what is the effect of distance of femoral malunion on joint deformity?

A

further deformity away is, less joint deformity

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77
Q

What is the standard of treatment for hip DJD refractory to nonop management?

A

THA

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78
Q

Coracoid transfer to the anteroinferior glenoid rim is what procedure?

A

latarjet

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79
Q

what postoperative complication are those who have THA for avn at risk for?

A

dislocation

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80
Q

in longstanding flexion contracture of the elbow in CP, what may you need to release in the elbow besides muscle?

A

joint capsule

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81
Q

what test can get to determine what tendons to lengthen in elbow contracture in CP?

A

dynamic EMG

82
Q

These are the landmarks for the anterior approach to the hip?(2)

A

ASISiliac crest

83
Q

where doe the meniscofemoral ligaments originate?

A

posterior horn of lateral meniscus

84
Q

T/F: lower volume hospitals have higher rates of PJI?

A

false (Namba et al. JBJS 2013)

85
Q

for both bone forearm fractures, in general what is the ratio of open injuries to closed compared to other anatomic areas?

A

higher open to closed ratio

86
Q

what is the risk of a patella dx after the second dx?

A

> 50%

87
Q

What does desiccate mean?

A

remove moisture from something

88
Q

Hip DJD ddx:OAinflammatory arthritisosteonecrosisdysplasiatrauma***

A

sepsis

89
Q

condition caused by perinatal brain injury leading to irreversible, static injury?

A

cerebral palsy

90
Q

13 y/o w/knee pain and limp, plays football, knee exam normal, hip extended, externally rotated, infantile genitalia what they got?

A

SCFE

91
Q

The superifical internervous plane for the anterior approach to the hip:sartorius(femoral n)***

A

tensor fascia latae(superior gluteal n)

92
Q

*** and postratumatic arthritis are complications of having a midfoot dislocation?

A

Nonunion

93
Q

if someone has tinnitus, and possible new heart problem after a total hip, what type of toxicity may be going on?

A

cobalt toxicity

94
Q

which facet of the patella is bigger?

A

lateral

95
Q

posterolateral ankle pain with resisted eversion of the foot is what problem?

A

peroneal tendinopathy

96
Q

how do you treat displaced both bone forearm fractures?

A

ORIF

97
Q

what can you see sometimes on tibia in someone with pcl tear on XR?

A

avulsion fx

98
Q

this disorder is a/w avn of the femoral head and involves bubbles forming in body when going from high to low pressure environment?

A

caisson disease

99
Q

if treating both bone forearm fracture nonoperatively, what do you have to do after patient discharged?

A

frequent follow up

100
Q

what does an ischial spine sign mean on AP pelvis in a kid?

A

hip stiff so the hemipelvis is rotating to try to compensate

101
Q

why is stem polished in cemented tha?

A

prevent motion at the cement bone interface

102
Q

what is normal IR/ER of the hip?

A

60-90

103
Q

if someone has PCL tear with hyperextension, what other things look out for?

A

combined ligamentous injuries

104
Q

if someone has previous fixation in the proximal femur, what should you do first before taking it out when converting to THA?

A

dislocate to prevent iatrogenic fracture if you take out implant first

105
Q

MSIS major criteria for prosthetic joint infection(need 1):1) sinus tract to prosthesis2) ***

A

pathogen isolated by culture from 2 separate samples from joint

106
Q

MSIS criteria(need 4):1) elevated esr(30) or crp(10)2) elevated synovial wbc(1,1k knee/3k hip)3) elevated synovial pmn(64 knee/80%hip)4) purulence5) ***6) >5 PMN per hpf frozen section

A

pathogen isolation 1 culture

107
Q

what is a more important aspect of doing a THA related to the implants that prevents further risk of dislocation ahead of capsular repair?

A

component position

108
Q

bmi over what increases risk of PJI in TKA/

A

> = 35

109
Q

Other ddx of hip pain:vascular claudicationmetastatic disease***

A

infection

110
Q

MSIS major criteria for prosthetic joint infection(need1):1) ***2) pathogen isolated by culture from 2 separate samples from joint

A

sinus tract to prosthesis

111
Q

besides release what else can do to muscle contracture surgically causing hyperflexion in CP?

A

muscle denervation

112
Q

if no subtalar arthritis, how treat a coalition?

A

resection

113
Q

flicking nail of middle finger with ipsilateral thumb/index finger contraction is what test?

A

hoffman

114
Q

How aspirate the elbow:palpate lateral epicondylepalpate radial head***in the middle soft spot for injectiongo perpendicular to the skin when placing the needle

A

palpate olecranon

115
Q

Other ddx of hip pain:vascular claudication***infection

A

metastatic disease

116
Q

which of the following chemo agents can be used for ewing sarcoma? doxorubicin, cyclophosphamide, methotrexate, etoposide?

A

everything except methotrexate

117
Q

what is the prognosis for nerve injuries in the forearm?

A

rarely recover

118
Q

most common presentation of nonaccidental trauma in kid?

A

skin lesions

119
Q

What are the two goals for fixing a both bone forearm fracture?

A

restore length and alignment

120
Q

Steps for shoulder injection:1) mark PL corner of the acromion2) mark the coracoid3) ***4) insert needle aiming for the coracoid

A

go inferior and medial to the PL corner about 2 finger breadth

121
Q

what cell type makes up the initial response to an injury or infection?

A

neutrophil

122
Q

this knee procedure is effective for offloading the medial compartment of the knee in younger patients as alternative to arthroplasty and also useful adjunct in those undergoing cartilage preservation procedures?

A

high tibial osteotomy

123
Q

where doe the meniscofemoral ligaments insert?

A

posterolateral medial femoral condyle

124
Q

Other ddx of hip pain:***metastatic diseaseinfection

A

vascular claudication

125
Q

what force apply to the tibia when applying fixation to graft for PCL reconstruction?

A

anterior tibial force

126
Q

what is acrosyndactyly?

A

fusion of the digits distally

127
Q

what is critical to evaluate in both bone forearm injuries preoperatively, intraoperatively and postoperatively?(2)

A

radioulnar jointradiocapitellar joint

128
Q

How is someone positioned for the anterior approach to the hip?

A

supine with a sandbag

129
Q

lateral forefoot post should be combined with what whenn placing orthotic for cavovarus foot?

A

1st MT head recess

130
Q

which pCL bundle taut in extension?

A

PM

131
Q

what can happen to skin in the AC fossa during flexion contracture of the elbow in CP?

A

skin breakdown

132
Q

why are people with avn at higher risk of dislocation if treated with THA?

A

capsule is looser since avn a more acute process than primary OA

133
Q

how surgically treat constriction ring?

A

excision of the ring with a z plasty or w plasty

134
Q

Anatomic ddx of hip pain:intrapelvicintrabdominal***SI joint pain

A

tumor

135
Q

small epiphyseal lesion in a kid is most often what?

A

chondroblastoma

136
Q

How can the hip be oriented in septic arthritis?

A

flexed, abducted, and externally rotated

137
Q

what degree of contracture do a full elbow release in CP?(functional)

A

> 40 degrees in functional extremtiy

138
Q

T cells recognize _____

A

antigens

139
Q

Steps for shoulder injection:1) mark PL corner of the acromion2) mark the coracoid3) go inferior and medial to the PL corner about 2 finger breadth4) ***

A

insert needle aiming for the coracoid

140
Q

Neuro ddx for hip pain:lumbar radiculopathy***neuropathymeralgia parestheticaCRPS

A

spinal stenosis

141
Q

This classification is based on the ratio of the inner canal diameter at midportion of lesser trochanter divided by diameter 10 cm distal?

A

dorr classification

142
Q

what may elevated in the urine of those with osteoid osteoma?

A

prostaglandind/cyclin

143
Q

C sign indicates coalition between what bones?

A

talus and calcaneus

144
Q

How do you treat path fx with enchondroma of the hand?

A

let the fracture heal, then go back take sample send to path, curettage, and let know from hand and graft

145
Q

what lab work up do you get in THA w/hx of acetabular fx?

A

ESR/CRP

146
Q

where deos the AL bundle of the PCL attach relative to the PM bundle on the tibia (in the medial lateral direction)?

A

lateral

147
Q

why use a constrained liner for a revision total hip arthroplasty in terms of muscle support?

A

abductor muscle deficiency

148
Q

Anatomic ddx of hip pain:***intrabdominaltumorSI joint pain

A

intrapelvic

149
Q

When does the patella engage with (how much flexion)?

A

20-30 degree

150
Q

These are the uses for the anterior approach to the hip:ORIF hip dislocation with the head anterosuperiorsynovial biopsyfusionTHAhemiarthroplastyexcision of tumor***

A

upper pelvic osteotomy

151
Q

what does ALVAL stand for?

A

aseptic lymphocyte-dominant vasculitis-associated lesion

152
Q

partial removal of the lamina?

A

laminotomy

153
Q

How aspirate the elbow: palpate lateral epicondyle palpate radial head palpate olecranon in the middle soft spot for injection ***

A

go perpendicular to the skin when placing the needle

154
Q

What motion at the hip can you do to help find the sartorius in the anterior approach to the hip?

A

externally rotate the leg

155
Q

T/F osteonecrosis decreases the chance of getting an infected total knee?

A

FALSE

156
Q

how are proximal structures affected in constriction band syndrome?

A

they aren’t

157
Q

how treat chondroblastoma in a kid(2)?

A

curretage and grafting

158
Q

Dendritic cells present antigens to T cells via ____

A

MHC class II receptors

159
Q

what do you keep eye out for in both bone forearm fracture and swelling in the forearm?

A

compartment syndrome

160
Q

Anatomic ddx of hip pain:intrapelvic***tumorSI joint pain

A

intrabdominal

161
Q

what is a type 3 constriction ring classifed by?

A

tips of fingers joined

162
Q

what part of the radius is important for supination and pronation?

A

radial bow

163
Q

most important question to ask someone who suffered a patella dx?

A

is it the first time

164
Q

complete removal of lamina?

A

laminectomy

165
Q

how many hands needed to examine a hip?

A

2

166
Q

what lab value normalizes first esr or crp?

A

crp

167
Q

what can fracture and shortening of one forearm bone lead to in the other?

A

dislocation

168
Q

Tenderness over the origin of the ECRB and pain with resisted middle finger extension are signs of what condition?

A

lateral epicondylitis

169
Q

why is an MRI useful in assessing early AVN of the femoral head?

A

assess what % involved

170
Q

when templating, what landmark does the acetabular cup sit next to medially?

A

the teardrop

171
Q

how treat skin protuberance in amniotic band syndrome?

A

excision, resurfacing with full thickness skin graft

172
Q

what issue with bone growth would argue for ulnar nerve release for surgery for elbow contracture?

A

heterotopic ossification

173
Q

how treat a zone 3 fifth MT fx?

A

nwb 6-8 weeks in a cast

174
Q

what about dial test would indicate combined PCL and PLC injury?

A

asymmetry in ER at 30 and 90 of flexion

175
Q

Hip DJD ddx:***inflammatory arthritisosteonecrosisdysplasiatraumasepsis

A

OA

176
Q

if can’t reduce subtalar dislocation, what do?

A

urgent open reduction and possible subtalar pinning

177
Q

what degree of contracture do a full elbow release in CP?(nonfunctional)

A

> 100 degrees

178
Q

culture every ** and biopsy every **

A

tumor, infection

179
Q

this treatment has been reserved for patients with spinal stenosis along with spondylolisthesis or scoliosis?

A

decompression and fusion

180
Q

what is good way to test upper extremity nerves in a both bone forearm fracture?

A

two point discrimination

181
Q

terminal abscence or amputation, localized swelling with digital edema distal to constriction a/w what condition?

A

amniotic band syndrome

182
Q

how can the physis of the femoral head look like on xr of a SCFE?

A

widened

183
Q

what nerve exits between the biceps and brachialis?

A

lateral antebrachial cutaneous nerve

184
Q 
Hip DJD ddx:
OA
***
trauma
sepsis
inflammatory arthritis
osteonecrosis
A

dysplasia

185
Q

this is the primary dynamic restraint in the ankle?

A

peroneal tendon

186
Q

what is a synchondrosis?

A

almost immovable joint bw two bones bound by layer of cartilage

187
Q

what is the most common primary malignant tumor in the pediatric population?

A

osteosarcoma

188
Q

What does fulgurate mean?

A

destroy by electricity

189
Q

How many degrees is physiologic genu valgum? (range)

A

5-7 degrees

190
Q

Where does current flow for unipolar cautery?

A

through the patient to the pad

191
Q

Anatomic ddx of hip pain:intrapelvicintrabdominaltumor***

A

SI joint pain

192
Q

positive tinel at posterolateral ankle is what nerve?

A

sural

193
Q

what is usually in the hx of a PCL tear?

A

direct blow to the anterior lower leg

194
Q

what cell type plays a role in integrating the innate and adaptive immune responses?

A

dendritic cells

195
Q

what is a conservative amount of time to wait to do a THA after a CS injection?

A

6 months

196
Q

Neuro ddx for hip pain:lumbar radiculopathyspinal stenosisneuropathymeralgia paresthetica***

A

CRPS

197
Q

what should the radial head align with on views of the elbow?

A

capitellum

198
Q

Hip DJD ddx:OAinflammatory arthritisosteonecrosisdysplasia***sepsis

A

trauma

199
Q

for tendon to bone injuries, like rotator cuff tear, which is the primary healing response?

A

formation of a fibrovascular scar

200
Q

7 y/o with fever and thigh pain, temp of 39 C and NWB, what have to have suspicion for?

A

septic arthritis

201
Q

Steps for shoulder injection:1) ***2) mark the coracoid3) go inferior and medial to the PL corner about 2 finger breadth4) insert needle aiming for the coracoid

A

mark PL corner of acromion

ortho (6 decks)

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