Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Year 4 > Orthopaedics > Flashcards

Orthopaedics Flashcards

1
Q

Name the three bones that make up the acetabulum

A

Ischium
Ilium
Pubis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Describe the classification of hip fractures, and which type causes risk of AVN

A

Intracapsular (proximal to the trochanters)

Extracapsular (intra-trochanteric or subtrochanteric)

DISPLACED INTRAcapsular fracture = risk of AVN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the presenting features of a NOF #

A

Pain - groin, thigh, referred to knee

Leg length shortened and externally rotated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Describe the main blood supply to the head of femur

A

Retrograde

From medial circumflex femoral artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the mortality of hip fractures at 1 year?

A

30%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What investigations should be carried out for a hip #

A 
X-ray (AP and lateral views)
Bloods: FBC, U&E, coag, G&S, CK (if long lie)
Urine dip (cause of fall)
CXR
ECG
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Describe the management of NOF#

A 
A-E
Analgesia (opioids, or regional -> fascia-iliaca block)
Definitive management -> surgical:
Total hip arthroplasty
Hemiarthroplasty
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Describe the risk factors for osteoporosis (overlap with RFx for hip #!)

A 
S - steroids
H - hyperthyroid, hyperparathyroid
A - age increasing
T - low testosterone
T - thin (less weight-bearing)
E - early menopause
R - renal/liver failure
E - erosive/inflammatory bone disease
D - diet (low vitamin D/Ca)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Describe the bones that make up the pelvic ring

A

Sacrum
+
Ilium, ischium, pubis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the polo-mint rule

A

In Pelvic ring fractures, always look for a second fracture site

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Describe the management of pelvic #

A

Stabilisation -> prevent blood loss
Pelvic binder initially will hold the pelvis in place until definite stabilisation -> for attempted clot formation
Fractures fixed definitively with plates/bolts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the complications of pelvic #

A 
Risk of damage to pelvis structures:
		○ Bowel
		○ Bladder
		○ Genitals
		○ Nerves 
Urological injury
Venous thromboembolism
Long-standing pelvic pain
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what is the rule when diagnosing patella tendon rupture?

A

if the patellar tendon is longer than the length of the patella +/- 20%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Describe the function of supraspinatus

A

Helps adduct the first 15 degrees, then deltoid aids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Describe the function of infraspinatus

A

External rotation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Describe the function of subscapularis

A

Internal rotation and adduction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Describe the function of teres minor

A

External rotation at shoulder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Why are knee dislocations emergencies?

A

Risk of damage to popliteal artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Describe the management of femoral fractures

A

The longest bone in the body therefore can bleed a lot and cause hypovolaemic shock

Reduce and splint
	• Thomas-type splint -> fixed traction
	• Reduces fracture movement
	• Reduces bleeding
	• Reduces risk of damage to nerves/vessels
	• Improves pain
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Describe the parts of a long bone

A

Epiphysis
Growth plate
Metaphysis
Diaphysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Describe Bohler’s angle

A

draw two lines tangent to the calcaneous, should be 20-40o

To assess for normality of the ankle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Describe a stable vs unstable ankle fracture

A

Stable fractures = have damage to only one side of the joint e.g. medial or lateral
○ Therefore no disruption to the ankle joint mortice and the risk of degenerate change in the future is low

Unstable fractures = damage to both medial and lateral sides
○ May be disruption of the ankle joint mortice and risk of degenerative change in the future is high
○ These fractures require to be stabilised, usually with internal fixation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Describe the bones of the hindfoot, midfoot and forefoot

A

Hindfoot = talus + calcaneus

Midfoot = Navicular, cuboid, cuneiforms

Forefoot = metatarsals and phalanges

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is a Lisfranc fracture

A

Dislocation of the midfoot between the tarsal bones (navicular, cuboid and cuneforms) and the base of the metatarsals

Commonly missed!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
List the components to describe an x-ray
SOC-F-DAP ``` Patient details, this is an X-ray of SITE and which side Open or closed Fragmented? Direction - transverse/oblique/spiral? Articular involvement? Position (displaced/undisplaced) ```
26
Describe the radiographic findings of OA
LOSS Loss of joint space Osteophytes Subchondral cysts Subchondral sclerosis
27
What is a colle's fracture
Transverse distal radius fracture, caused by FOOSH, with dorsal displacement
28
What is a Smith's fracture?
Transverse distal radius fracture, caused by falling onto flexed hand, with volar displacement (opposite of Colles)
29
Describe a Galeazzi and Monteggia #
GRIMUS! Galeazzi - (radial inferior) i.e. radial # with displaced dislocated radio-ulnar joint Monteggia - (ulna superior) i.e. ulnar fracture with dislocated head of radius (at elbow e.g. proximal/superior)
30
What is the most dangerous infective agent of an open fracture?
Clostridium perfringes -> causes gas gangrene/renal failure
31
Describe the gardner classification of NOF#
Grade 1 = incomplete # Grade 2 = complete # without displacement Grade 3 = complete # with partial displacement Grade 4 = complete # with full displacement
32
What examination findings may you get on examination of an OA hip
``` Pain (buttock, groin, referred to thigh) Antalgic gait/trendelenberg Tenderness over hip reduced ROM (esp. internal rotation) Positive thomas' test ```
33
What are the x-ray findings of OA?
``` LOSS loss of joint space osteophytes subchondral cysts subchondral sclerosis ```
34
What are the x-ray findings of RA?
``` SPADES Soft tissue swelling periarticular erosions absent osteophytes deformity erosion subluxation ```
35
Describe the management of OA
Non-op: Education, weight loss, walking aids, analgesia, non-weight bearing exercise Operative: THR
36
List the risk factors for avascular necrosis
Traumatic: Fractures, dislocations, SUFE Non-traumatic: Alcohol, steroids, bone malignancy, connective tissue disorders
37
What is SUFE
Slipped upper femoral epiphysis = fracture through the capital femoral growth plate and the epiphysis slips posteriorly and inferiorly common in 10-16yr olds during rapid growth RFX: Male, obesity
38
What are the radiographic features of SUFE?
Steel sign = a shadow behind the superior femoral neck Shenton's line disrupted Line of Klein - fails to intersect the superior femoral epiphysis
39
What is DDH?
Developmental dysplasia of the hip = abnormal hip development resulting in shallow under-developed acetabulum, and possible subluxation/dislocation
40
What are the RFx for DDH and what are its tests
Female, first born, breech position, FHx Test with Barlow's and Ortolani tests
41
Describe the principles of fracture management
Resuscitation (A-E) Reduction Restriction Rehabilitation
42
Describe the Gardner classification of intracapsular hip fractures
Stage I: Incomplete fracture of the neck (so-called abducted or impacted) Stage II : Complete without displacement Stage III: Complete with partial displacement. Fragments are still connected by posterior retinacular attachment and there is malalignment of the femoral trabeculae Stage IV : This is a complete femoral neck fracture with full displacement, the proximal fragment is free and lies correctly in the acetabulum so that the trabeculae appear normally aligned.
43
Describe the benefits and cons of hemiarthroplasty vs THR
Hemi benefits: Shorter operation Lower risk of post-op dislocation (as the replaced head is larger than the head put in during a THR) Hemi cons: Long term pain Worse mobility
44
Define staging and grading
Staging - working out how far a tumour has spread (e.g. pan-CT plus CT/MRI of organs involved) Grading - usually from a biopsy sample, to assess how well differentiated/the cell types/how aggressive a cancer is. Predicts cancer behaviour and patient prognosis.
45
What cancers commonly metastasise to bone?
think of 5 paired organs!! - thyroid - lung - breast - renal - prostate
46
What boney sites do cancers commonly metastasise to?
Vertebrae | Proximal metaphyses
47
Describe the difference between T1 and T2 weighted MRI scans
T1 - fat is bright | T2 - fat and water is bright
48
What nerve root is likely to be affected by a L4/5 disc paracentral herniation?
The transiting L5 nerve root
49
What nerve root is likely to be affected by a L4/5 disc foraminal (lateral) herniation?
The exiting L4 nerve root
50
In layman's terms describe osteoporosis, Paget's disease and Rickets/Osteomalacia
Osteoporosis = not enough bone (but normal quality) Paget's disease = XS bone (but normal quality) Osteomalacia = normal quantity of bone but defective mineralisation (after skeletal maturity) Ricket's = normal quantity of bone but defective mineralisation (before skeletal maturity)
51
What is the role of OGP (osteoprotegerin)
OPG is released from OB Prevents XS bone resorption as it binds to RANK-L (also released from OB) and stops RANK-L converting pre-OC into OC, therefore limiting the formation of mature OC's
52
What are the most common # in osteoporotic patients?
Hip, femur, spine and radial
53
Describe DEXA scans and the T/Z score result
DEXA = dual energy x-ray absorptiometry T-score = The score is made from comparing your result to a ~30yr old young healthy adult (so not age matched!) Z-score = The score you get is by comparing your result to an age matched healthy control (e.g. if you are 45 then your score is compared to a 45yr old)
54
Describe the standard deviations generated from DEXA scan
SD's use the T-score (not aged matched) 0 to -1.5 = normal -1.5 to -2.5 = osteopenia < -2.5 = osteoporosis < -2.5 with # = 'defined' OP
55
Describe the role of calcitonin
Opposes the action of PTH - Reduces OC activity (less bone resorption and less Ca released into bloodstream) - Reduces Ca absorption at the DCT
56
Describe the two main forms of rickets/osteomalacia:
Vitamin-D dependent and vit-D independent Dependent causes: - reduced sun exposure - reduced dietary intake - reduced intestinal absorption (e.g. IBD) Independent causes: - kidneys not working (i.e. there is enough vit D in the body but it cannot be absorbed)
57
Define Paget's, it's phases and the bony sites commonly affected
Bone remodelling due to increased OC activity 3 phases: lytic/mixed/sclerotic Bones affected: skull, spine, pelvis, femur
58
What are the S/Sx of Paget's
Joint/bone pain Deformity Isolated raised ALP Headaches/deafness (due to entrapment of CN in growing skull) Loss of visual fields (bony growth at optic chiasm) Can cause high output cardiac failure
59
What are the typical X-ray features of Paget's
Mixture of lytic and sclerotic disorganised bone (Due to accelerated OC resorption of bone, followed by disordered and XS formation) Acetabular protrusion can occur 2o to Paget's
60
What is the blood supply of the scaphoid?
Branch of radial artery (enters distally and travels proximally)
61
Name the 3 anatomical parts of the scaphoid bone
Distal pole Waist Proximal pole
62
What makes up the borders of the anatomical snuffbox?
EPL (ulnar side) | EPB + APL (radial side)
63
What are the important contents of the anatomical snuffbox?
Radial artery Radial nerve Cephalic vein
64
Describe risk factors for carpal tunnel syndrome
``` Previous wrist trauma OCP Pregnancy RA Cardiac failure Hypothyroidism ```
65
What is the management for carpal tunnel syndrome
1. Splintage and rest 2. Steroid injection 3. Surgical release
66
Describe the management of a hip fracture based on its location
The management of the fracture depends on its location. Intracapsular fractures: - Replacement arthroplasty (hemiarthroplasty or total hip replacement) for patients with a displaced intracapsular fracture. - Total hip replacements for patients with a displaced intracapsular fracture who: - > Are able to walk independently out of doors with no more than the use of a stick; and - > Are not cognitively impaired; and - > Are medically fit for anaesthesia and the operation. Extracapsular fractures: - Extramedullary implants e.g. a sliding (dynamic) hip screw for trochanteric fractures above and including the lesser trochanter - Intramedullary e.g. pin and plate or extramedullary internal fixation for subtrochanteric fractures
67
What is Froment's sign?
Ulnar nerve weakness results in inability to hold paper between thumb and index finger/terminal phalanx has to compensate by flexing to hold on to the paper
68
Damage to which nerve is associated with claw hand?
Ulnar
69
What nerve roots make up the ulnar nerve
C8 & T1
70
What nerve roots make up the median nerve
C5, 6, 7, 8, T1
71
What nerve roots make up the radial nerve
C5, 6, 7, 8, T1
72
How is the motor function of the median nerve tested?
Thumb abduction
73
How is the motor function of the radial nerve tested?
Wrist extension
74
How is the motor function of the ulnar nerve tested?
Finger spread and don't let them be pushed together!
75
What are the 3 principles of # management?
Resus Reduce Retain
76
Name and describe 3 tests for impingement syndrome
1) Painful arc test (painful abduction between 60-120) 2) Neer impingement test (pain on forward flexion >90) 3) Hawkins Kennedy test (pain when forward flex to 90 and then internally rotate)

Year 4 (28 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions