Orthopaedics 2 Flashcards
Erb’s palsy, which nerves?
C5-C6
Humeral neck fracture may damage which nerve?
Axillary
Medial epicondyle fracture damages which nerve?
Ulnar
Motor component of femoral nerve
Knee extension, thigh flexion
What is the unhappy triad?
damage to the:
- anterior cruciate ligament
- medial collateral ligament
- meniscus
Twisting injury is most likely to damage the…
anterior cruciate ligament
Dashboard injury is most likely to damage the…
posterior cruciate ligament
Skiing injusries are most likely to tear what in the knee
medial collateral ligament
Motor component of the femoral nerve
knee extension, thigh flexion
Motor component of the obturator nerve
thigh adduction
What areas does the lateral cutaneous nerve of the thigh supply?
Later and posterior surface of the thigh
What areas does the femoral nerve supply sensation to?
anterior and medial aspect of the thigh
lower leg
Motor component of the tibial nerve
plantarflexion and inversion of the foot
Sensory innervation from tibial nerve?
Sole of foot
Posterior knee dislocation may damage which nerve
tibial nerve
anterior hip dislocation may damage which nerve?
obturator nerve
hip and pelvic fractures or stab wounds may damage which nerve?
femoral nerve
Motor innervation of the superior gluteal nerve?
hip abduction
Positive trendelenburg sign shows injury to which nerve?
superior gluteal nerve
Motor component of the common peroneal nerve
dorsiflexion and eversion of the foot
Injury to which nerve causes foot drop?
Common Peroneal Nerve
Injury to which nerve causes wrist drop?
Radial nerve
A winged scapula is a result of damage to the…
Long thoracic nerve
Fractured neck of humerus damages the…
Axillary nerve
Claw hand following medial epicondyle fracuter?
Ulnar nerve
Hip extension and lateral rotation.. which nerve?
Inferior gluteal nerve
Claw hand and hyperextended wrist occur as a result to injury of…
Lower trunk of brachial plexus: C8-T1
What nerve may be damaged during a masectomy
long thoracic nerve
If frax score is >10% what do you do?
Arrange a DEXA scan
Short externally rotated hip indicates
hip fracture
Internally rotated thigh indicates
Hip dislocation
What test is positive if there is a meniscal tear?
Thessaly’s test
Classic sign of a hip fracture
short externally rotated leg
Management of displaced hip fracture in young and fit
reduction and internal fixation
management of displaced hip fracture in older/reduced mobility
hemiarthroplasty or total hip replacement
management of extracapsular hip fracture
dynamic hip screw
How would you get colle’s fracture?
Falling onto outstretched hand
What is colle’s fracture?
transverse fracture of the radius
What kind of fracture would you get if you fell backwards onto outstretched hands?
Smith’s fracture
If you punch someone with a bent thumb what fracture do you get?
Benett’s fracture
1st line treatment for lower back pain
NSAIDs
Advice for lower back pain
exercise, self management
Who should be assessed for risk of fragility fracture?
Women > 65
Men > 75
risk factors for achiles tendonitis
quinolone use (e.g. ciprofloxacin) hypercholeserolaemi
How to diagnose achiles tendon rupture
simmond’s triad
what is in simmond’s triad of tests
calf squeeze
angle of detonation
gap
investigation of avascular necrosis of the hip
MRI
Describe the typical presentation in syringomyelia
Patient with loss of pain and temp sensation on the neck and arms
Which tracts are affected in syringomyelia?
spinothalamic
What does the hand look like in COlle’s fracture?
Dinner fork deformity
How is spinal stenosis diagnosed?
MRI
lower back pain which is worse on walking?
Spinal stenosis
Weakness in knee extension, loss of the patella reflex, numbness of the thigh?
Damaged femoral nerve
Weakness in knee flexion and foot movements, pain and numbness from gluteal region to ankle
sciatic nerve damage
Weakness in hip adduction, numbness over the medial thigh
obturator nerve damage
What muscle wastes in carpal tunnel
thenar eminence
Extracapsular hip fracture treatment
dynamic hip screw
old age, reduced mobility, displaced intracapsular fracture
hemiarthoplasty
most common cuase of osteomelitis
staph aureus
teenage girl with pain walking up and down stairs
chondromalacia patellae
sporty teen with tenderness over the tibial tubercle
osgood-schlatter disease
Which nerve may be damaged in posterior hip dislocatino?
Sciatic nerve
Where does the common peroneal nerve branch from?
Sciatic nerve
What movement is especially impaired in frozen shoulder/adhesive capsulitis?
External rotation
Most common fractures causing comparntment syndrome>?
supracondylar fractures and tibial shaft injuries
comparntment syndrom X ray finding
nothing
treatment of compartment syndrome
fasciotomy
who is not suitable for total hip replacements?
patients with decreased mobility
Describe Monteggia’s fracture
fractured ulna
dislocation of proximal radioulnar joint
describe geleazzi’s fracture
radial fracture with distal radioulnar joint dislocattion
Red flags for lower back pain
- Middle of spine
- previous cancer
- <20, >50 years
- pain at night
- history of trauma
- systemically unwell
most common site of osteomyelitis in children
metaphysis
most common site of osteomyelitis in adults
epiphysis
treatment of osteomyelitis
6 weeks flucloxacillin
Describe Garden classification of NOF fractures
- Partial fracture
- Full fracture, no displacement
- Full fracture, some displacement
- Full fracture, fully displaced
Gradual swelling of the knee after injury indicates…
meniscal injury
Rapid joint swelling of the knee after injury indicates…
anterior/posterior cruciate ligament
X ray sign of supraspinatus tendonitis
calcification of supraspinatus tendon (small dot next to humeral head)
classic symptom of supraspinatus tendonitis
painful arc
what innervates the triceps (nerve and root)
radial, C7
What is exacerbated by walking on tiptoes?
plantar fasciitis
where is plantar fasciitis most painful?
Medial calcaneal tuberosity
What nerve may be damaged in anterior shoulder dislocatioun?
Axillary
Initial sign of compartment syndromeq
pain on passive stretching
shortened and internally rotated leg following trauma indicates
posterior dislocation of the hip
analgesia for hip fracture
iliofascial nerve block
the median nerve passes through the
flexor retinaculum
which imaging is best for meniscal tears
MRI
imaging of choice for osteomyelitis
MRI
triad of fat embolism syndrome
hypoxaemia
neurological abnormalities
petichial rash
L5 radiculopathy gives
weakness of hip abduction
foot drop
What deformity may be seen on X-ray in someone with repeated anterior shoulder dislcations
Hill-Sachs deformity