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ortho_3_n Flashcards

1
Q

reasons for fat suppressing: *** recognize where edema distinct from fat or prove something fatty

A

make tissue easier to appreciate

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2
Q

what causes an AIIS avulsion?

A

eccentric contraction of the rectus femoris

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3
Q

how do you measure a true limb length discrepancy?

A

ASIS t the medial malleolus

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4
Q

which tendons get more irritated after a distal radius ORIF?

A

extensor tendon irritation

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5
Q

why patients with osteopetrosis get vision issues?

A

encroachment on optic and oculomotor nerves

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6
Q

what is the nerve innervationgo betweenfor extending approach to distal radius proximally?

A

median nradial nerve

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7
Q

The dorsomedial cutaneous nerve of the hallux consists of branches ofWhich of the following nerves?

A

Saphenous and superficial peroneal

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8
Q

Operative indications DR fx:* Secondary loss of reduction* Articular comminution, step-off, or gap* —* Loss of volar buttress with displacement* DRUJ incongruity* Open fractures* Associated carpal fractures* Associated neurovascular or tendon injury* An impaired contralateral extremity

A

metaphyseal comminution or bone loss

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9
Q

what mm comes off of your ischial tuberosity?

A

hamstring

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10
Q

Figures 1 and 2 are the anteroposterior and lateral plain radiographs of a 45-year-old woman who had severe bilateral leg pain for 6 months. Videos 1 and 2 are her sagittal and axial T2-weighted MRI scans. After attempting nonsurgical treatment including physical therapy and epidural injections, she continued to experience persistent pain. What is the most appropriate treatment?(2)

A

decompression and instrumented fusion

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11
Q

what happens to IM canals in osteopetrosis?

A

filled with bone, no distinction bw cortical and cancellous bone

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12
Q

What are the two surgical options for treating a lisfranc sprain?

A

ORIF or fusion of the 1st and 2nd TMTJ

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13
Q

what type of symptoms operate on someone with a meniscus tear?(3)

A

catching, locking, or giving way

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14
Q

Operative indications DR fx:* Secondary loss of reduction* Articular comminution, step-off, or gap* Metaphyseal comminution or bone loss* Loss of volar buttress with displacement* DRUJ incongruity* —* Associated carpal fractures* Associated neurovascular or tendon injury* An impaired contralateral extremity

A

open fractures

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15
Q

patellar tilt >20 can be indication for what procedure?

A

lateralr retinacular release

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16
Q

most sensitive imaging modality for patellar tendon rupture?

A

MRI

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17
Q

Compared with placebo, how do CS injections compare with placebo for lateral epicondylitis at 6 months in terms of pain and function?

A

no difference in pain and function

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18
Q

Indications for glenohumeral joint arthrodesis:Brachial plexus injury***Chronic infectionFailed GH joint arthroplastySevere refractory instabilityBony deficiency following tumor or bone resectionPainful flail shoulder

A

Paralysis or severe paresis of the RTC or deltoid

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19
Q

How can post stroke shoulder pain be treated if nonop measures fail?

A

Glenohumeral arthrodesis

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20
Q

What is an absolute contraindication to shoulder fusion?

A

Active infection

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21
Q

Operative indications DR fx:* Secondary loss of reduction* Articular comminution, step-off, or gap* Metaphyseal comminution or bone loss— DRUJ incongruity* Open fractures* Associated carpal fractures* Associated neurovascular or tendon injury* An impaired contralateral extremity

A

loss of volar buttress with displacement

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22
Q

how do grind test on the toe?

A

hold PP compressed against the met head and move it plantar and dorsal in mid arc of motion

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23
Q

what deformity in carpal bone position (scaphoid and lunate) does scapholunate dissocation lead to? 2

A

scaphoid flex palmar

lunate to dorsiflex

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24
Q

how many degrees of flexion keep elbow while reducing it for an elbow dislocation?

A

30 degrees

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25
Q

reasons for fat suppressing:make tissue easier to appreciate***or prove something fatty

A

recognize where edema distinct from fat

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26
Q

what does tgf-beta do in dupuytren dz?

A

transform normal fibroblasts into myofibroblasts

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27
Q

-3

A

scapular stabilizationproprioceptive re-educationrotator cuff co-contraction

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28
Q

what initial nonop management of tibial tubercle apophysitis before casting?(6)

A

NSAIDresticeactivity modificationstrapping/sleevequad stretching

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29
Q

how do ober test?

A

lateral, hip from flexion and abduction into extension and adduction

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30
Q

uses for posterior approach to elbow w/out olecranon osteotomy:ORIF distal humerusTJA***

A

excision of tumor

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31
Q

Causes of boutinerre:Traumatic lac of central slipDupeytrenAnterior dislocation of PIPJ***Burn

A

RA

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32
Q

what is the thomas test used to evaluate?

A

hip flexion contracture

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33
Q

is .5mm articular step an operative indication for a tibial plateau fracture?

A

no

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34
Q

what additional xr view want of knee for OCD lesion?

A

tunnel knotch view with knee bent 30-50 degree

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35
Q

contribution to the spiral cord:pretendinous bandspiral band***grayson ligament

A

lateral digital sheet

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36
Q

Causes of boutinerre:***DupeytrenAnterior dislocation of PIPJRABurn

A

Traumatic lac of central slip

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37
Q

How position shoulder if glenohumeral arthrodesis performed?

A

30 abduction, forward elevation and internal rotation

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38
Q

why sometimes hard to tell bw aseptic and septic prepatellar bursitis?

A

collection is extra-articular so the patient does not have the pain one has with septic arthritis

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39
Q

what is the mechanism of a turf toe injury?

A

hyperextension of the hallux MTPJ

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40
Q

what is the approach of henry?

A

anterior approach to radius

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41
Q

what first step in management?

A

eval using ATLS protocol

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42
Q

surgical indications for cervical disc herniation:
progressive pain unresponsive to***
severe radicular pain runs along matching distribution
myelopathy

(3)

A

meds, PT, epidural for 6 weeks

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43
Q

what structure at risk when exposing the proximal radius through anterior approach?

A

PIN

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44
Q

what is the difference between a high T and a low T distal humerus fracture?

A

high T transverse component proximal or at level of olecrnonlow T transverse just proximal to the trochlea

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45
Q

what gene messed up in osteopetrosis?

A

carbonic anhydrase II

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46
Q

what is osteitis pubis?

A

inflammation of the pubic symphysis caused by repetitive trauma

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47
Q

what collagen ratio is increased in dupuytren?

A

increase in ratio of type III to type I collagen

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48
Q

disruption of the alignment of the lateral base of the 3rd MT with the lateral aspect of the the lateral cuneiform on the oblique view of the foot?

A

Lisfranc injury

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49
Q

how does the thumb look like in holt oram?

A

stiff hypoplastic joined to index finger by complete simple syndactyly

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50
Q

what tendon envelopes hallux sesamoid?

A

FHB

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51
Q

this is association between congenital heart disease and radial longitudinal deficiency?

A

holt oram syndrome

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52
Q

in general how are tibial plateau fx with medial and lateral condyle involvement treated?

A

operatively

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53
Q

rugger jersey spine, marble bone, erlenmeyer flask deformity of proximal humerus and distal femur a/w what disease?

A

osteopetrosis

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54
Q

what anatomic structure might cause projections of the CMCJ to appear oblique when getting xr of the hand?

A

transverse metacarpal arch

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55
Q

what serum ion level is a poor prognostic factor for metal on metal total hip?

A

> 7ppb

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56
Q

how are type I collagen levels affected by degeneration of intervertebral discs?

A

increase

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57
Q

besides thumb problem and radial deficiency how else arm affected in holt oram?

A

proximal radial synostosis

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58
Q

what are the three stages of dupuytren?

A

proliferative, involutional, residual

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59
Q

how operatively fix stable ocd lesion?

A

drilling

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60
Q

what is another word for “pins and needles” sensation?

A

paresthesias

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61
Q

Indications for glenohumeral joint arthrodesis:***Paralysis or severe paresis of the deltoid and rotator cuffChronic infectionFailed GH joint arthroplastySevere refractory instabilityBony deficiency following tumor or bone resectionPainful flail shoulder

A

Brachial plexus injury

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62
Q

Indications for glenohumeral joint arthrodesis:Brachial plexus injuryParalysis or severe paresis of the deltoid and rotator cuffChronic infection***Severe refractory instabilityBony deficiency following tumor or bone resectionPainful flail shoulder

A

Failed GH joint arthroplasty

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63
Q

Following signs/treatment/complication profile indicate infection in what space:dorsal hand is swollen, warm and erythematousfinger extension is painful and usually difficulttreated with one or two dorsal longitiduinal incision (first index MC, between 4th and 5thMC)patients can get an extensor lag, tendon necrosis, scar formation

A

subaponeurotic space deep to the extensor tendons

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64
Q

uses for posterior approach to elbow w/out olecranon osteotomy:ORIF distal humerus***excision tumor

A

TJA

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65
Q

what causes ASIS avulsion? (mm involved)

A

forceful contraction of the tensor fascia latae and the sartorius

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66
Q

what produces more shear, open or close chain exercise?

A

open

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67
Q

what can interpose in MCPJ dislcoation blocking closed reduction?(2)

A

volar platesesamoids

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68
Q

Causes of boutinerre:Traumatic lac of central slipDupeytren***RABurn

A

Anterior dislocation of PIPJ

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69
Q

Operative indications DR fx:* Secondary loss of reduction* Articular comminution, step-off, or gap* Metaphyseal comminution or bone loss* Loss of volar buttress with displacement* DRUJ incongruity* Open fractures* Associated carpal fractures* —* An impaired contralateral extremity

A

associated nv or tendon injury

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70
Q

Compression from tight cast, wrist watch or bracelet can cause what compressive neuropathy?

A

wartenberg syndrome (superificial sensory br of the radial nerve)

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71
Q

tibial tubercle-trochlear groove (TT-TG) distance *** is highly associated with patellar instability secondary to rotational malalignmen

A

> 20mm

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72
Q

how treat thumb ucl injury with MCPJ arthrosis?

A

arthrodesis

73
Q

what step do first for cervical facet fx/dx in a obtunded patient?

A

MRI

74
Q

what test is it and what indicate?

A

hawkin+impingement

75
Q

what makes a positive thomas test?

A

contralateral hip lifting off the table when fully flex one hip with patient supine

76
Q

How treat lisfranc sprains in general?

A

Surgery

77
Q

what do you divide when trying to reduce MCPJ dislocation?

A

A1 pulley

78
Q

flexing the knee to 90, stabilizing the leg and then externally rotating the foot tests what structure?

A

the syndesmosis

79
Q

what test and what indicate?

A

speed testproblem w/biceps tendon

80
Q

how is trochlear dysplasia of femur defined?

A

sulcus angle >145 degree

81
Q

what makes a positive ober test?

A

pain, tightness, clicking over IT band

82
Q

In an elderly woman, what factor is most associated with risk of future spinal fragility fracture?

A

prior thoracic insufficiency fracture

83
Q

contribution to the spiral cord:pretendinous band***lateral digital sheetgrayson ligament

A

spiral band

84
Q 
Operative indications DR fx: 
Open fractures
Articular comminution, step-off, or gap
Metaphyseal comminution or bone loss
Loss of volar buttress with displacement
 ---
Secondary loss of reduction
Associated carpal fractures
Associated neurovascular or tendon injury
An impaired contralateral extremity
A

DRUJ incongruity

85
Q

most important factor for outcome after patellar tendon rupture?

A

timing of repair

86
Q

surgical indications for cervical disc herniation:***pain unresponsive to meds, PT, epidural for 6 weekssevere radicular painruns along matching distributionmyelopathy

A

progressive

87
Q

what type of ocd do you operate on?(2)

A

detached/unstable

88
Q

what can you do to distinguish bw septic and aseptic prepatellar bursitis?

A

aspiration with gram stain/culture

89
Q

Operative indications DR fx:* —* Articular comminution, step-off, or gap* Metaphyseal comminution or bone loss* Loss of volar buttress with displacement* DRUJ incongruity* Open fractures* Associated carpal fractures* Associated neurovascular or tendon injury* An impaired contralateral extremity

A

secondary loss of reduction

90
Q

Operative indications DR fx:* Secondary loss of reduction* Articular comminution, step-off, or gap* Metaphyseal comminution or bone loss* Loss of volar buttress with displacement* DRUJ incongruity* Open fractures* —* Associated neurovascular or tendon injury* An impaired contralateral extremity

A

associated carpal fractures

91
Q

Operative indications DR fx:

  • Secondary loss of reduction
  • Articular comminution, step-off, or gap
  • Metaphyseal comminution or bone loss
  • Loss of volar buttress with displacement
  • DRUJ incongruity
  • Open fractures
  • Associated carpal fractures
  • Associated neurovascular or tendon injury
A

impaired contralateral extremity

92
Q

what vascular zone think of fixing a meniscus?

A

red-red

93
Q

what mm attach to superior edge of pubic symphysis?(2)

A

pectineusrectus abdominis

94
Q

Old pts with OCD knee how treat?

A

arthroplasty

95
Q

which tendon crosses the front of the elbow just medial to the BR?

A

biceps

96
Q

First dorsal interosseous contraction a/w what nerve in the hand?

A

deep motor br of the ulnar nerve

97
Q

for boys what age group does osgood schallter show up?

A

15-Dec

98
Q

what is at risk with volar approach to reduce MCPj dislocation?

A

nv structures

99
Q

Classification useful for1) true fracture-dislocations 2) fracture patterns that do not fit into the Schatzker classification (10% of all tibial plateau fractures)3) fractures associated with knee instability

A

Hohl and Moore

100
Q

what hip motion causes asis avulsion?

A

extension

101
Q

reasons for fat suppressing:make tissue easier to appreciaterecognize where edema distinct from fat***

A

or prove something fatty

102
Q

what is the difference in the insertion of the direct and indirect head of the rectus femoris?

A

direct - AIISindirect - superior acetabular ridge

103
Q

what is the proximal muscle plane for anterior approach to the radius?

A

BR and pronator teres

104
Q

Pelvic fractures in children differ from those in adults because children with pelvic fractures are more likely to be treated how?

A

nonsurgically

105
Q

what imaging get first for OCD lesion?

A

XR

106
Q

what symptom indicates instability of OCD lesion of the knee?

A

mechanical symptoms

107
Q

Operative indications DR fx:* Secondary loss of reduction* —* Metaphyseal comminution or bone loss* Loss of volar buttress with displacement* DRUJ incongruity* Open fractures* Associated carpal fractures* Associated neurovascular or tendon injury* An impaired contralateral extremity

A

articular comminution, step off or gap

108
Q

why get MRI for cervical facet fx/dx?

A

look for disc herniation –> would do anterior approach

109
Q

contribution to the spiral cord:pretendinous bandspiral bandlateral digital sheet***

A

grayson ligament

110
Q

what’s the name of this test: manual distraction of the hip prosthesis used to assess limb tension during THA?

A

shuck test

111
Q

what age group think of operating on with a meniscus tear?

A

younger

112
Q

what condition is AIN syndrome a/w?

A

parsonage turner syndrome

113
Q

surgical indications for cervical disc herniation: progressive painunresponsive to meds, PT, epidural for 6 weeks, severe radicular pain, ***, myelopathy

A

runs along matching distribution of abnormality

114
Q

surgical indications for cervical disc herniation:progressivepain unresponsive to meds, PT, epidural for 6 weeks***runs along matching distributionmyelopathy

A

severe radicular pain

115
Q

Causes of boutinerre:Traumatic lac of central slip***Anterior dislocation of PIPJRABurn

A

Dupeytren

116
Q

how can the shoulder be affected in holt oram?

A

GH joint hypoplasia

117
Q

what is a gantzer muscle?

A

accessory FPL head

118
Q

how “malignant” osteopetrosis inherited?

A

AR

119
Q

Indications for glenohumeral joint arthrodesis:Brachial plexus injuryParalysis or severe paresis of the deltoid and rotator cuff***Failed GH joint arthroplastySevere refractory instabilityBony deficiency following tumor or bone resectionPainful flail shoulder

A

Chronic infection

120
Q

how treat 40 y/o male with recent onset great toe pain w/mild arthritic changes?

A

carbon fiber insert with morton extension

121
Q

coleman blocks used to assess for what type of limb length discrepancy?

A

apparent limb length discrepancy

122
Q

in what direction does the tibial tubercle move if doing osteotomy for patellar instability?(2)

A

anterior and medial

123
Q

what operation can you do for refractory osgood schlatter dz?

A

ossicle excision

124
Q

what is the goal of scoping an OCD that has failed nonop?

A

see if it moves w/probe

125
Q

what does lack of limb flexion to 90 and recoil indicate in the drop kick test?

A

lengthening

126
Q

what’s here?

A

compression sided femoral neck stress fx

127
Q

how treat 63 yF with arthritic changes to the big toe but pain with dorsiflexion only?

A

cheilectomy

128
Q

what test do for IT band tightness?

A

ober test

129
Q

what’s the most common pattern for patellar tendon rupture in terms of location?

A

avulsion with or without bone from theproximal insertion/inferior pole of patella

130
Q

A child of short stature with cauliflower ears, hitchhikers’ thumb, and kyphoscoliosis typically has a defect in what gene?

A

DTDST

131
Q

how does heart disease and radial longitudinal deficiency correlate in holt oram?

A

they dont

132
Q

how do you measure an apparent limb length discrepancy?

A

umbilicus to the medial malleolus

133
Q

Arthroscopic remplissage of the shoulder is most indicated for patients with what bony deficit and how much?

A

large >25% humeral head deficiency

134
Q

how mild ostepetrosis inherited?

A

AD

135
Q

surgical indications for cervical disc herniation:
progressivepain unresponsive to meds, PT, epidural for 6 weeks
severe radicular painruns along matching distribution
***

A

myelopathy

136
Q

Indications for glenohumeral joint arthrodesis:
Brachial plexus injury
Paralysis or severe paresis of the deltoid and rotator cuff
Chronic infection
Failed GH joint arthroplasty
***
Bony deficiency following tumor or bone resection
Painful flail shoulder

A

Severe refractory instability

137
Q

uses for posterior approach to elbow w/out olecranon osteotomy:***TJAexcision tumor

A

ORIF distal humerus

138
Q

why patients with osteopetrosis get anemic?

A

bc IM canal fills with bone

139
Q

What is the romberg test?

A

Ask the patient to stand with their feet together (touching each other). Then ask the patient to close their eyes.Remain close at hand in case the patient begins to sway or fall.

140
Q

-3

A

painfluid fluid mass on MRIcobalt ion levels

141
Q

what is it?

A

osteitis pubis

142
Q

how treat 57year old female with positive grind test and pain in mid arc of motion of the great toe?

A

1st MTP fusion

143
Q

Indications for glenohumeral joint arthrodesis:Brachial plexus injuryParalysis or severe paresis of the deltoid and rotator cuffChronic infectionFailed GH joint arthroplastySevere refractory instabilityBony deficiency following tumor or bone resection***

A

Painful flail shoulder

144
Q 
contribution to the spiral cord:
***
spiral band
lateral digital sheet
grayson ligament
A

pretendinous band

145
Q

how effective is CS injection compared to placebo for lateral epicondylitis at 6 months?

A

no difference

146
Q

Indications for glenohumeral joint arthrodesis:Brachial plexus injuryParalysis or severe paresis of the deltoid and rotator cuffChronic infectionFailed GH joint arthroplastySevere refractory instability***Painful flail shoulder

A

Bony deficiency following tumor or bone resection

147
Q

A 16-year-old female swimmer had bilateral shoulder pain for 3 months that limited her ability to complete workouts. Her shoulder range of motion was symmetric. Rotator cuff and deltoid strength findings were normal. Her Hawkins impingement sign and speed test results were positive on both shoulders. Radiograph and MRI scan findings were normal. Which intervention is the next step in evaluation and treatment?

A

therapy

148
Q 
Causes of boutinerre:
Traumatic lac of central slip
Dupeytren
Anterior dislocation of PIPJ
RA
***
A

Burn

149
Q

what physical exam maneuverdo for piriformis muscle syndrome?

A

FADIR

OB

150
Q

First line rx for piriformis muscle syndrome?(5)

A

rest, NSAIDS, muscle relaxants, PT, steroid injections

151
Q

what is the most common variant for course of the sciatic n?

A

splitting proximal to the piriformiswith one branch passing anterior to and one branch passing through the piriformis

152
Q

what constitutes a + ober test?

A

limited hip adduction when the hip is held in extension

153
Q

Decreased IR with flexion abduction and IR, sign of what type of impingement?

A

CAM

154
Q

This XR view is used to assess anterior coverage of the acetabulum?

A

false profile view

155
Q

what angle is the pelvis to the film for a false profile view?

A

65 degrees

156
Q

what eponym for xr deformity you see w/cam impingement?

A

pistol grip

157
Q

what does crossover sign for hip indicate?

A

acetabular retroversion seen in pincer type impingement

158
Q

what is this measuring?

A

head neck offset ratio

159
Q

this is the best imaging modality to evaluate articular cartilge, labral degeneration/tears?

A

MRI

160
Q

when consider surgery for FAI?(2)

A

patient symptomatic w/mechanical symtpoms

161
Q

how treat FAI w/age >60 and end stage hip degeneration?

A

total hip

162
Q

in what patient do PAO for FAI? (ie what type of abnormality)

A

structural deformity of acetabulum w/poor coverage of femoral head

163
Q

what is the primary viewing portal for a hip scope?

A

anterolateral

164
Q

what do you do before pumping joint with saline in hip scope?

A

apply in-line traction

165
Q

what is the distal anterolateral hip portal used for?

A

access peripheral compartment in region of femoral neck

166
Q

what n at risk w/anterolateral portal in hip scope?

A

superior gluteal n

167
Q

what motion helps place anterior hip portal?

A

flexion and internal rotation

168
Q

what motion puts sciatic n at risk during PL hip portal placement?

A

ER

169
Q

what n placed at risk w/anterior hip portal?

A

LFCN

170
Q

where is the most common site of rupture along the muscle for a hamstring?

A

myotendinous structure

171
Q

which hamstring mm is more lateral?

A

semimembranosus

172
Q

what’s usually the cause of quad contusion?

A

direct trauma

173
Q

what motion is limited after a quad contusion?

A

active knee flexion

174
Q

what can you see on xr for eval of chronic injury to the quad tendon?

A

myositis ossificans

175
Q

After sustaining a muscle contusion injury, prolonged immobilization leads to what histologically?

A

more granulation tissue

176
Q

A 14-year-old girl reports a 3-week history of anterior thigh pain and a palpable mass after sustaining a soccer-related injury. Examination reveals a tender, firm mass in the midportion of the rectus femoris. Besides pseudotumor what can it be?

A

partial rupture of the rectus femoris

177
Q

what is exertional compartment syndrome?

A

condition where there is reversible ischemia within a muscular compartment

178
Q

what is most common exercise induced leg syndrome?

A

medial tibial stress syndrome

ortho (6 decks)

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