Orthopaedic Examination Flashcards
What is the technical name for Leriche’s syndrome?
Aortoiliac occlusive disease
What is Leriche’s syndrome?
A form of peripheral artery disease involving the blockage of the abdominal aorta as it transitions into the common iliac arteries.
What triad of symptoms in the lower half of the body do you get in Leriche’s syndrome?
Claudication in the buttocks (and thighs)
Absent or decreased femoral pulses
Erectile dysfunction
In history and examination of MSK you can boil it down to 3 broad terms of what yours looking for.
What are they?
Looks wrong
Feels wrong
Moves wrong
What are the three broad GALS screening questions?
Do you have any pain or stiffness in your muscles, joints or back?
Can you dress yourself completely without any difficulty?
Can you walk up and down stairs without any difficulty?
In MSK history it is good to ask the patient to take you through a typical day.
Give some general examples of points that are good to touch on
Wake at normal time or woken by pain?
-How are they first thing
Dressing? Cut own toenails?
Get into and out of bath?
Walking distance on the flat
Driving
DOES OWN SHOPPING
Work hobbies -> does it get in the way
Give some read flag symptoms of pain that should never go uninvestigated.
Severe and worsening pain
Night pain during sleep
Non-mechanical pain
Apart from pain give some other red flag symptoms
what gets you worried when you take a history?
General malaise, febrile, rigors
Unexplained weight loss, anorexia, night sweats
Past history of malignant disease
Give some common allergens hospitals will be concerned with
- Penicillin
- Iodine
- General anaesthetic (?morphine)
- blood transfusion
- Elastoplast
- Metal sensitivity (nickel, cobalt in ortho)
- LATEX
What medications should you be thinking about in a drug history in general?
(keep it basic)
Paracetamol Oral contraceptive Aspirin/ warfarin/ clopidogrel NSAIDS Steroid
If you have 2 legs and the patient is complaining about one, which leg do you examine first and why?
Normal leg first
-Can then compare the abnormal leg
How do you communicate the affected finger during a clinical handover?
(how do you describe the different fingers of the hand?)
Thumb Index Middle Ring Small/ pinkie
How are the joint degrees taken?
What is 0 degrees in termf of joints?
Anatomical position = 0 degrees for all joints
i.e. en extended elbow = 0 degrees NOT 180
What do we mean by varus and valgus?
(explain the concept)
How do you remeber the differences?
The terms valgus and varus refer to angulation (or bowing) within the shaft of a bone or at a joint.
It is determined by the distal part being more medial or lateral than it should be. Whenever the distal part is more lateral, it is called valgus. Whenever the distal part is more medial, it is called varus. Therefore, when the apex of a joint points medially, the deformity, if any, would be called valgus, as the distal part points laterally.
It is important to bear in mind that the most proximal part of a bone or joint is the reference point and that varus and valgus angles are relative to the angle in a normal situation, which need not be zero.
L for lateral in vaLgus
What is another name for corneal arcus?
arcus senilis
