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ortho > ortho_4_n > Flashcards

ortho_4_n Flashcards

1
Q

what’s required if LOC >5min for someone w/concussion?<img></img><img></img>

A

CT scan

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2
Q

what genetic disorder a/w small or absent patellae?

A

nail patella syndrome

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3
Q

what test is this:axially loading the tibiofemoral joint at 90° of knee flexion. Pain with compression and external rotation (medial meniscus) or internal rotation (lateral meniscus) is considered positive. ?

A

apley test

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4
Q

and the xr shows a lesion in the proximal femur…

A

proximal femur replacement

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5
Q

most common organ injured in the abdomen as a result of blunt trauma?

A

spleen

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6
Q

common MOI of athletic neck injuries?(2)

A

axial load and flexion

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7
Q

what is the torg pavlo ratio?

A

canal/vertebral body width

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8
Q

what letter and structure?

A

C, the FHL

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9
Q

between what two ossification centers is os acromiale usually?

A

between the meso and meta acromion

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10
Q

symptoms of concussion: ***, unsteadiness, confusion, LOC, change in personality/memory

A

headache

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11
Q

what type of prosthesis do for someone’s knee in the revision setting with multiplanar instability and a deficient extensor mechanism?

A

hinged knee

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12
Q

what is the normal torg-pavlo ratio?

A

1

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13
Q

what can be seen with MRI in someone with tibial stress fracture?

A

marrow edema

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14
Q

what usually causes popliteal artery entrapment?

A

anatomic abnormality

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15
Q

what provocative PE test for tibial stress syndrome?

A

pain w/resisted plantar flexion

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16
Q

what is the difference bw whelan III vs IV whelan popliteal artery entrapment?

A

medial head of gastrocnemius surrounding artery vs popliteus

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17
Q

what can patients complain of w/popliteal artery entrapment?

A

numbness/paresthesias

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18
Q

Indication for UKA:patients older than 60 with relatively low activity demands. Additionally, the patients should weigh less than 82 kg, have minimal pain at rest, have motion ***, and have minimal flexion and angular deformities.

A

> 90 degree

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19
Q

what blood supply supplies the inner 2/3 of bone?

A

nutrient artery system

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20
Q

stress fx to the first rib show up in what part of the bone (near what structure)?

A

groove for the subclavian artery

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21
Q

what’s bw the pia mater and the arachnoid mater?

A

subarachnoid space

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22
Q

where does tibial stress syndrome occur most often?

A

posteromedial tibia

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23
Q

when is risk of splenic rupture highest after infectious mono?

A

3 weeks after the onset of symptoms

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24
Q

what is kehr sign?

A

pain tip of shoulder due to irritation of peritoneal cavity

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25
Q

what is the direction of flow of arterial blood through mature bone?

A

inside out

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26
Q

symptoms of concussion: headache, unsteadiness, confusion, LOC, change in ***

A

personality/memory

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27
Q

what PE can you see with popliteal artery entrapment?(2)

A

limb swellingdiminished pulse w/active foot plantar flexion or passive dorsiflexion

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28
Q

how an you treat os acromiale with persistent symptoms?

A

open reduction internal fixation

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29
Q

Indication for UKA: patients older than 60 with relatively low activity demands. Additionally, the patients should weigh ***, have minimal pain at rest, have motion >90 degress, and have minimal flexion and angular deformities.

A

less than 82kg

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30
Q

what testing used to confirm diagnosis of popliteal artery entrapment?

A

arteriogram

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31
Q

most common symptoms of concussin?(2)

A

headache and dizziness

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32
Q

Indication for UKA:patients older than 60 with relatively low activity demands. Additionally, the patients should weigh less than 82 kg, have minimal pain at rest, have motion >90 degress, and have minimal *** deformities.

A

flexion and angular

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33
Q

what do phase 1 and 2 look like for tibial stress syndrome?

A

normal

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34
Q

what type of force a/w visceral injury?

A

deceleration

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35
Q

symptoms of concussion: headache, unsteadiness, confusion, ***, change in personality/memory

A

LOC

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36
Q

what’s the difference bw grade I and II concussion?

A

symptoms < or > 15min

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37
Q

how long wait until RTP after getting infectious mono?

A

3 week after symptom resolution

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38
Q

Indication for UKA:patients older than 60 with relatively ***Additionally, the patients should weigh less than 82 kg, have minimal pain at rest, have motion >90 degress, and have minimal flexion and angular deformities.

A

low activity demands

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39
Q

what blood supply to bone is higher pressure?

A

nutrient artery system

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40
Q

what’s difference bw grade IIIa and b concussion

A

LOC sec vs min

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41
Q

what stays on when athlete has suspected neck injury while you are making sure the airway is ok?(2)

A

helmet and pads

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42
Q

Indication for UKA:patients older than 60 with relatively low activity demands. Additionally, the patients should weigh less than 82 kg, have *** at rest, have motion >90 degress, and have minimal flexion and angular deformities.

A

minimal pain

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43
Q

what supplies majority of blood supply to the humeral head/

A

posterior humeral circumflex artery

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44
Q

symptoms of concussion: headache, ***, confusion, LOC, change in personality/memory

A

unsteadiness

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45
Q

Condition caused by decreased blood flow distal to the popliteal fossa and ss consistent with compartment syndrome?

A

popliteal artery entrapment

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46
Q

Indication for UKA:[age] with relatively low activity demands. Additionally, the patients should weigh less than 82 kg, have minimal pain at rest, have motion >90 degress, and have minimal flexion and angular deformities.

A

patients older than 60

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47
Q

what is normal cervical canal diameter?

A

~17mm

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48
Q

what can happen if nonop a anterior tibial stress fx over time?

A

fx propogation

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49
Q

how much time does graduated retrun to play for concussion take?

A

7 days

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50
Q

when does second impact syndrome occur?

A

second minor blow before symptoms resolve

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51
Q

what is spear tackler’s spine?

A

developmental narrowing(stenosis) of ther cervical canal caused by repetitive microtrauma

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52
Q

what is considered a massive rotator cuff tear in terms of size?

A

over 5cm

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53
Q

which shoulder usually affected by cuff tear arthropathY?

A

dominant shoulder

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54
Q

what classification system used for cuff tear arthropathy?

A

seebauer

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55
Q

what are the two aspects that determine the seebauer classification for cuff tear arthropathy?

A

centralization of the humeral headstability of position of the humeral head

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56
Q

If doing arthroscopic debridement for cuff tear arthropathy, what structure should be maintained?

A

CA arch

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57
Q

besides functioning deltoid, what else needed before considering rTSA?

A

adequate glenoid bone stock

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58
Q

what would be the treatment of choice for salvage of cuff tear arthropathy w/pts with history of osteomyelitis, chronic infections,multiple previous operations or poor soft tissue envelope?

A

resection arthroplasty

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59
Q

what treatment is contraindicated for cuff tear arthropathy due to glenoid failure from the rocking horse phenomenon?

A

TSA

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60
Q

why would someone have subacromial effusion after rotator cuff tear?

A

synovial fluid escape

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61
Q

what does SAPHO syndrome stand for?

A

synovitis–acne–pustulosis–hyperostosis–osteomyelitis

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62
Q

what social factor a/w pustular psoriasis?

A

smoking

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63
Q

RA with splenomegaly and leukopenia is what?

A

felty syndrome

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64
Q

what is acute onset RA with fever, rash and splenomegaly?

A

still’s disease

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65
Q

arithmetic methodThe growth remaining methodThe Moseley straight-line methodThe Paley multiplier techniqueall used to measure what?

A

LLD at maturity

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66
Q

this isOvergrowth syndrome with both increased length and limb girth?

A

hemihypertrophy

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67
Q

what type of person gets a T score on the DEXA versus a Z score?

A

postmenopausal

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68
Q

A patient undergoing joint arthroplasty is put on a drug that competitively inhibits the activation of an enzyme that breaks down Factor Ia. The drug is?

A

tranexemic acid

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69
Q

Factor Ia is also known as what?

A

fibrin

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70
Q

***is an antifibrinolytic that prevents the activation of plasmin from the inactive zymogen plasminogen.

A

Tranexamic acid (TXA)

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71
Q

In X-linked hypophosphatemic rickets, the gene defect may be found in which of the following?

A

PHEX

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72
Q

Patients older than age 65 are at increased risk for adverse gastrointestinal effects when placed on nonsteroidal anti-inflammatory drugs, and they should be placed on a *** prophylaxisat thesame time

A

proton pump inhibitor

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73
Q

Corticosteroids inhibit the formation of effectors of the inflammatory pathway via inhibition of

A

phospholipase A2

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74
Q

what can continuous infusion of local anesthetics for pain control lead to?

A

chondrolysis

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75
Q

this class of medication acts byreducehyper-excitability of voltage dependent Ca2+ channelsin activated neurons.?

A

GABA agents

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76
Q

what receptor does tramadol work on?, what affect does it have

A

mu opioid reeceptor agonist

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77
Q

What is the most appropriate delivery route for pain medication to a morbidly obese post-operative patient to ensure a therapeutic plasma concentration?

A

IV PCA based on ideal body weight

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78
Q

what do isoflurane, sevoflurane, desflurane and nitrous oxide have in common?

A

all inhalational anesthetics

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79
Q

what’s common to rocuronium, vecuronium, atracurium, cisatracuriumand pancuronium?

A

non depolarizing neuromuscular blocking agents

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80
Q

What tumor involvesinvolves perichondral node of ranvier and bony excrescence from physeal plate?

A

osteochondroma

81
Q

where is periosteal chondroma most commonly found?

A

proximal humerus

OB

82
Q

lobules of hyaline cartilageperipheral encasement by bonecentral necrosis with calcificationoften times incidental finding?

A

enchondroma

83
Q

popcorn calcificationrings and arcsa/w what malignancy?

A

chondrosarcoma

84
Q

what is enostosis?

A

bone island seen with osteoma

85
Q

what’s on differential for osteopoikilosis?

A

mets

86
Q

how differentiate mets and osteopoikilosis?

A

bone scan

87
Q

what best imaging modality to see a medullary osteoid osteoma?

A

MRI

88
Q

early finding of LCPD on xr of the pelvis?

A

medial joint space widening

89
Q

how treat children < 8 years of age (bone age <6 years) withlateral pillar A involvement in LCPD?

A

nonop with activity mod and limit wb

90
Q

what phase ofMRI good for seeing the anatomy?

A

T1

91
Q

what mm superior to the soleus on the back of the tibia?

A

popliteus

92
Q

Atypical ABC should raise suspicion of what diagnosis?

A

telangiectatic osteosarcoma

93
Q

what benign bone forming lesions often also treated by ENT doctors?

A

osteoma

94
Q

long-standing chronic lymphedema can lead to the formation of this type of cancer? what is it known as?

A

angiosarcoma (steward treves)

95
Q

hard white dense boneareas of dedifferentiation soft and fleshyencapsulated by thin adventitial tissuecan have a cartilage capfibroblastic low grade“school of fish” patternno osteoblastic rimmingstain with MDM2 stain, amplification

A

parosteal osteosarcoma

96
Q

malignant tumorbag of blood with cancer in it?

A

telangiectatic osteosarcoma

97
Q

Young kid met bone cancer, what could it be?

A

neuroblastoma

98
Q

lower abdominal pain and inguinal pain at extremes of exertion,tenderness toadductor longus,tenderness toadductor longus all symptoms of what?

A

athletic pubalgia

99
Q

what position of forefoot leads to MT overlap on the AP foot XR?

A

forefoot pronation

100
Q

what calcaneal pitch value (greater than what) can be seen in someone with cavovarus foot?

A

> 30

101
Q

what is dorsally dislocated on the talus in CVT?

A

navicular

102
Q

In CVT, how do theperoneal longus and posterior tibilais act on the ankle?

A

as dorsiflexors

103
Q

what type of coalition is more common?

A

calcaneonavicular

104
Q

synchondrosis involves what tissue type?

A

cartilage

105
Q

consider this treatment if coalition involves >50 % of the joint surface of a talocalcaneal coalition?

A

subtalar arthrodesis

106
Q

what medication class may be helfpul in reducing fracturs in kids with CP who have low BMD?

A

bisphosphonates

107
Q

what is the most reliable predictor for ability to walk in a kid with cerebral palsy?

A

independentsitting by age 2

108
Q

Velocity-dependent increased muscle tone and hyperreflexia with slow, restricted movement due to simultaneous contraction of agonist and antagonist muscles is a feature of what type of CP?

A

spastic

109
Q

slow, writhing, involuntary movements is a feature of what type of CP?

A

athetoid

110
Q

Walks with assistive devices is what GMFCS level of CP?

A

III

111
Q

Severely limited walking ability, primary mobility is wheelchair is what CP level?

A

IV

112
Q

Most common finding in MRI brain of someone with cerebral palsy?

A

periventricular leukomalacia

113
Q

what enzyme doesPyridostigmine block?

A

acetylcholinesterase

114
Q

can someone with calcaneonavicular coalition have TN beaking?

A

yes

115
Q

how is CMT inherited most commonly?

A

autosomal dominant

116
Q

what is the most common foot deformity in CP?

A

equinus

117
Q

what happens to the knee at heel contact in a kid with CP?

A

hyperextension

118
Q

what does equivalent ankle dorsiflexion with knee flexion and extension indicate?

A

achilles tightness

119
Q

how treat painful hallux valgus in someone with CP?

A

first MTPJ arthrodesis

120
Q

what procedure do in someone with hallux valgus and associated valgus interphalangeus in CP?

A

proximal phalanx (akin) osteotomy

121
Q

This isextra-articularsubtalararthrodesis via a lateral approach using ICBG used in CP?

A

grice procedure

122
Q

what autoimmune dz a/w destruction of acetylcholien receptor?

A

myasthenia gravis

123
Q

what type of foot deformity in CP consider a split tibialis anterior tendon transfer for?

A

flexible equinovarus

124
Q

Rigid deformities in CP foot usually require what generally?

A

bony reconstructions procedures

125
Q

how is the lower back aligned in someone with achondroplasia?

A

excessive lordosis

126
Q

COL1A2 a/w what problem in kids?

A

Osteogenesis imperfecta

127
Q

what is defective in cleidocranial dysplasia (gene and inheritance)?

A

AD defet in RUNX2

128
Q

Besides MRI, what other screening study should be done for someone with achondroplasia to assess apnea?

A

sleep study

129
Q

how is diastrophic dysplais inhertied?

A

AR

130
Q

what elbow motion increases symptoms related to cubital tunnels yndrome?

A

flexion

131
Q

which one is more mild OI, autosomal recessive or dominant?

A

dominant

132
Q

hereditary condition from decrease in normal type I collagen?

A

osteogenesis imperfecta

133
Q

what doCOL1A1andCOL1A2 cause in osteogenesis imperfecta?

A

abnormal collagen cross-linking via a glycine substitution

134
Q

what type of radial head dx someone with OI get?

A

anterolateral

135
Q

In the context of elbow instability, optimal treatment of a comminuted radial head fracture with greater than three fragments is with a ***

A

radial head replacement

136
Q

What% of humeral growth occurs at the proximal physis?

A

80%

137
Q

what part of the TFCC is more vascularized?

A

periphery

138
Q

where do the dorsal and volar radioulnar ligaments originate?

A

sigmoid notch of the radius

139
Q

where is somone tender if they have a positive fovea sign in TFCC injury?

A

tenderness in the soft spot between theulnar styloid and flexor carpi ulnaris tendon,

140
Q

what modality is most accurate for diagnosing TFCC injury?

A

arthroscopy

141
Q

what finger gets seymour fx more often?

A

MF

142
Q

in context of seymour fxextensor tendoninserts into the ***of the distal phalanxflexor tendon insertsintometaphysisof the distal phalanx

A

epiphysis

143
Q

in context of seymour fxextensor tendoninserts into theepiphysisof the distal phalanxflexor tendon insertsinto ***of the distal phalanx

A

metaphysis

144
Q

why operate on seymour fx (aka this is what can cause widened appearance of the physis)?

A

interposed tissue

145
Q

In a seymour fx does thefracture line traverse outside of the physis?

A

no

146
Q

what direction mcpj dislocation usually?

A

dorsal

147
Q

these are the primary stabilizers of the MCPj?

A

proper collateral ligaments

148
Q

mcpj collateral ligaments are tight in what position?

A

flexion

149
Q

interposition of volar plateand/or sesamoids makes a MCPJ dislocation what?

A

complex

150
Q

this is whenmetacarpal head buttonholes into palm (volarly)?

A

kaplan lesion

151
Q

where does the FHL insert?

A

first phalanx of the great toe

152
Q

What is the antibiotic of choice for gonococcal septic arthritis of the knee?

A

ceftriaxone

153
Q

To cover both gonorrhea and chlamydia what abx add to ceftriaxone?

A

doxycycline

154
Q

How much shortening of clavicle fx a/w poor outcomes?

A

2cm

155
Q

1-beta = ?

A

power

156
Q

stata command for indepdent samples power analysis?

A

power twomeans mean1 mean2, sd(??) power(.8)

157
Q

command added to power analysis in stata for specifying ratio of participants?

A

nratio(#)

158
Q

Treatment for phalanx dislocation:treatment is ***(2) unless volar plate entrapment blocks reduction or a concomitant fracture renders the joint unstable

A

closed reduction and splinting

159
Q

Treatment for phalanx dislocation:treatment is closed reduction and splinting unless *** entrapment blocks reduction or a concomitant fracture renders the joint unstable

A

volar plate

160
Q

which collateral ligament of the phalanx inserts on the volar plate?

A

accessory

161
Q

two types of collateral ligaments of the phalanxes(2)?

A

proper and accessory

162
Q

what acts as a restraint against hyperextension of the phalanxes?

A

volar plate

163
Q

where does the central slip insert?

A

dorsal base of the middle phalanx

164
Q

PIPJ fx/dx what modality treat if >40% of the joint is involved?

A

operatively

165
Q

what structure have to resect to get to volar plate in PIPJ fx/dx?(3)

A

proximal portion of C2 pulleyentire A3 pulleydistal C1 pulley

166
Q

what treatment option can do forhighly comminuted “pilon” fracture-dislocations of the PIPJ?

A

dynamic distraction ex fix

167
Q

This patient should be taken for a laparotomy. When a patient has a gunshot wound to the pelvis and the bullet path crosses the midline, a *** is indicated.However,if the patient has peritoneal signs, he should have a laparotomy because he or she likely has a perforated viscous

A

sigmoidoscopy

168
Q

This patient should be taken for a laparotomy. When a patient has a gunshot wound to the pelvis and the bullet path crosses the midline, a sigmoidoscopyis indicated.However,if the patient has peritoneal signs, he should have a *** because he or she likely has a perforated viscous

A

laparatomy

169
Q

An EMG/NCS can be done after *** to assess for nerve return but will not help at this time.

A

3 weeks

170
Q

A 68-year-old woman fell and sustained a displaced femoral neck fracture. She is a community ambulator and enjoys playing tennis weekly. Which treatment will provide her with the best hip function?

A

total hip arthroplasty

171
Q

In children and adolescents, the piriformis fossa is close to the ascending branch of the *** and the lateral epiphyseal vessels,

A

medial femoral circumflex

172
Q

In children and adolescents, the piriformis fossa is close to the ascending branch of the medial femoral circumflex artery and the ***

A

lateral epiphyseal vessels,

173
Q

this is partial intra-artciular fx of the base of the thumb?

A

bennet fx

174
Q

this is a complete intra-articular fx of the base of the thumb?

A

rolando

OB

175
Q

what inn the adductor pollicis?

A

ulnar n

176
Q

this ligament spans the trapezium to the volar edge of 1st MC?

A

volar beak ligament

177
Q

how get roberts view of thumb?

A

arm in full pronation with dorsum of thumb on the cassette

178
Q

Rolando fracture with >1mm displacement and major soft tissue injuryseverely comminuted fractures with major soft tissue injury or impacted articular fragmentsBennett, Rolando, or severely comminuted fractures with fragments too small for ORIFtreat how?(2)

A

distraction and ex fix

179
Q

what ligament disrupted in dorsal thumb cmc dx? what just peeled?

A

dorsoradial ligament(anterior oblique is peeled)

180
Q

this ligament resists valgus load with the thumb in flexin?

A

proper collateral ligament

181
Q

this ligament resists valgus load with the thumb in extension?

A

accessory collateral

182
Q

how treat chronic thumb collateral ligament injury? (2)

A

reconstruction or adductor advancement

183
Q

what will happen to stener lesion if no surgery?

A

won’t heal

184
Q

Unopposed pull of the flexor digitorum profundus leads to what deformity?

A

clawing

185
Q

when do surgery for hand mucous cyst?

A

if causing pain

186
Q

when do wafer procedure for a TFCC tear(ie what anatomic factor exists)?

A

if positive ulnar variance

187
Q

most common site of fracture from a metastatic bone lesion?

A

proximal femur

188
Q

what part of the spine most common sites of metastatic bone disease?

A

thoracic spine

189
Q

what cell type is increased in metastatic bone disease and cause for osteolysis?

A

osteoclasts

190
Q

what xr view good for looking at the metacarpal head?

A

brewerton view

191
Q

how get brewerton view? (how finger flexed, hand positioned, what about xr tube position)

A

MP flexed 65
dorsum of the hand on the platetube
angled 15 degree ulnar to radial

192
Q

most common complication of articular metacarpal head fractures?

A

stiffness

193
Q

Most important cord in dupuytren disease?

A

spiral

194
Q

what type of finger contracture caused by the spiral cord?

A

PIPJ

195
Q

pretendinous bandspiral bandlateral digital sheetGrayson’s ligamentare components of what?

A

spiral cord

196
Q

what causes MCPJ contracture in dupuytren?

A

central cord

197
Q

this causes DIPJ contracture in dupuytren disease?

A

retrovascular cord

198
Q

what type of contracture does the natatory cause in dupuytren?

A

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