Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Finals HH > Orthopeadics > Flashcards

Orthopeadics Flashcards

1
Q

What causes a transverse fracture?

A

From pure bending force

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

What causes an oblique fracture?

A

Shear force (fall from height)

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

What causes a spiral fracture?

A

Torsional forces

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

What is a comminuted fracture?

A

Fracture with 3+ fragments
Due to high energy trauma or poor bone quality

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

What is a segmental fracture?

A

Bone fracture sin two separate places

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

What is the order of fracture healing?

A

Fracture healing order:
1. Haematoma
2. Inflammation
3. Soft callus
4. Hard callus
5. Remodelling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the px and mx of compartment syndrome?

A

Px – severe pain, tensely swollen, loss of distal pulse and numbness

Mx - emergency fasciotomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

When do fat embolisms occur?

A

After long bone fractures where fat globules are released into circulation
-> Systemic inflammatory response 24-72hrs after fracture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Px of fat embolism?

A

Respiratory distress, petechial rash, cerebral involvement, jaundice, thrombocytopenia, fever

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

What is a Colle’s fracture?

A
  • FOOSH -> transverse fracture of distal radius with dorsal angulation
  • Displacement posteriorly (upwards) causing a “dinner fork deformity”
  • Extra-articular
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is a smith fracture?

A
  • Falling onto back of outstretched wrist -> transverse fracture of distal radius with volar angulation
  • Reverse Colle’s fracture
  • Extra-articular
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the risk of a scaphoid fracture?

A

Only one blood supply so fracture can result in avascular necrosis & non-union

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is a Monteggia fracture-dislocation?

A

Ulna fracture + dislocation of radial head at elbow
Age 4-10 years commonly

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

What is a Galeazzi fracture-dislocation?

A

Radius fracture + dislocation of radioulnar joint

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

What nerve is at risk if a humeral shaft fracture?

A

Radial nerve risk

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

What nerve is at risk in a proximal humerus fracture?

A

Axillary nerve risk

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

Is an intertrochanteric hip fracture intra- or extra- capsular?

A

Extracapsular

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

Is a subcapital hip fracture intra- or extra- capsular?

A

Intracapsular

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

Is a subtrochanteric hip fracture intra- or extra- capsular?

A

Extracapsular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is osteochondritis dissecans?

A

Inflammation of bone and cartilage which occurs in young adults due to increased physical activity and body weight

o Recurrent impact trauma -> bleeding + oedema in bone -> capillary compression -> bone necrosis -> bone fragmentation

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

Px & Mx of osteochondritis dissecans?

A

Px - Poorly localised pain, effusion, locking

Mx - Pinning or removal of unstable fragments

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

Who does osteoporosis affect?

A

Occurs – post-menopause, old age, steroid/alcohol use, malnutrition

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

What is used to Dx osteoporosis?

A

DEXA scan

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

T-scores of osteoporosis?

A

More than -1 Normal

-1 to -2.5 Osteopenia

Less than -2.5 Osteoporosis

Less than -2.5 plus a fracture Severe Osteoporosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Mx of osteoporosis?

A

Calcium + Vitamin D

Bisphosphonates - Alendronate, Zoledronic acid

Others:
- Denosumab - blocks osteoclasts
- Strontium ranelate - stimulates osteoblasts, blocks osteoclasts
- Raloxifene (secondary prevention only)
- HRT (if early menopause)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Mx of osteoporosis?

A

Calcium + Vitamin D

Bisphosphonates - Alendronate, Zoledronic acid

Others:
- Denosumab - blocks osteoclasts
- Strontium ranelate - stimulates osteoblasts, blocks osteoclasts
- Raloxifene (secondary prevention only)
- HRT (if early menopause)Wha

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is osteomalacia?

A

Abnormal softening of bone due to deficient mineralisation
o Due to insufficient calcium absorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Px of osteomalacia?

A

Bone pain, soft bone deformities, fractures, hypocalcaemia signs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Biochemistry markers seen in osteomalacia?

A

Low calcium
Low serum phosphate
High serum ALP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Mx of osteomalacia?

A

Vitamin D + calcium + phosphate supplementation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is Paget’s disease?

A

Thickened, brittle and mishappen bones due to osteoclasts / osteoblasts speeding up

Px - constant dull bone pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Mx of paget’s disease?

A

Bisphosphonates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What is impingement syndrome?

A

Compression of rotator cuff muscles in subacromial space -> thinning / tearing of tendons

Causes:
Injury or overuse causing thicker & swollen tendon (swimmer’s shoulder)
Abnormal acromion – curved bony growth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Px of impingement syndrome?

A

Painful arc between 60-120° of abduction, radiates to deltoid & upper arm

Hawkins-Kennedy test (internally rotating flexed shoulder) recreates pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Px of adhesive capsulitis?

A

Progressive pain & stiffness of shoulder. Pain becomes negligible when shoulder is fully stiff.

Resolves in 18-24mo where the shoulder ‘thaws’ out

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Mx of adhesive capsulitis?

A

Physio, NSAIDs, corticosteroid injection, manipulation under anaesthesia (teras capsule)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What is the Px of acute calcific tendonitis?

A

Acute, severe shoulder pain due to calcium deposits in the supraspinatus tendon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Where / when is the pain with lateral epicondylitis?

A

Extensor region (outside of elbow)
Pain on wrist extension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Where / when is the pain with medial epicondylitis?

A

Flexion region (inside of elbow)
Pain on wrist flexion, tingling in digits

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Mx of epicondylitis?

A

Resolves with rest, physio, NSAIDs in meantime

Steroid injections in lateral (risk to ulnar nerve in medial)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Ix & Mx of olecranon bursitis?

A

Ix – Aspirate -> microscopy + culture

Mx:
- Non-infectious -> RICE + analgesia
- Infection -> antibiotics (flucloxacillin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What is dupuytren’s contracture?

A

Contractures at MCP and PIP joint

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What is trigger finger?

A
  1. Tendonitis of flexor tendon
  2. Nodular enlargement
  3. Catches on tendon sheath
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What is the px of trigger finger?

A

F>M, >40yrs
* Middle & ring finger
* ‘Clicking’ sensation
* Pain at base
* Worse in morning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

What is a ganglion cyst?

A

Fluid filled swelling near a joint or tendon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Red flag back pain px?

A

Pain – constant, severe, worse at night, lasting >6 weeks

Worse on coughing – herniated disc

Systemic upset – fever, night sweats, weight loss, fatigue, malaise

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

What is scoliosis?

A

Lateral curvature of spine
Can be congenital, idiopathic or due to tumour, infection
- If painful -> urgent MRI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

What is kyphosis?

A

Abnormal rounding of upper back

Can be due to osteoporosis compression fractures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

What is cervical spondylosis?

A

Degenerative changes in cervical spine
+/- radiculopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

What are the spine levels?

A

Cervical 7
Thoracic 12
Lumbar 5
Sacrum 5
Coccyx 4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

What is spondylolysis?

A

Stress fracture in the pars interarticularis

52
Q

What is spondylolisthesis?

A

Slippage of one vertebra over another (L4-S1)

53
Q

Who suffers from spondylolysis?

A

Younger patients with sport

54
Q

Who is at rx of spondylolisthesis?

A

> 50, F>M

Spondylolysis in adolescence

55
Q

What are common causes of radiculopathy?

A

Nerve root entrapment due to:
- A herniated disc (bulged, slipped or ruptured)
- Osteophyte formation (OA), spinal stenosis, bone spurs

56
Q

Mx of acute disc tear?

A

Analgesia + NSAIDs + physio [pain settles after 2-3 mo]

57
Q

What is sciatica?

A

Shooting, burning pain from buttocks radiating down the back of the thigh to below the knee or feet [L4-S3]

58
Q

Px of L3/4 prolapse?

A

L4 root entrapment

Pain down to medial ankle (L4)

59
Q

Px of L4/5 prolapse?

A

L5 root entrapment

Pain down dorsum of foot

60
Q

Px of L5/S1 prolapse?

A

S1 root entrapment

Pain to sole of foot

61
Q

Mx of sciatica?

A

Analgesia, physiotherapy [90% recover <3mo]

  • Neuropathic pain drugs (gabapentin)
  • If severe – surgery (discectomy)
62
Q

What is cauda equina?

A

Emergency

Large disc prolapses compressing lumbar nerve roots (L2-L5)

62
Q

What is cauda equina?

A

Emergency

Large disc prolapses compressing lumbar nerve roots (L2-L5)

63
Q

Px of cauda equina?

A

Px:
- Bilateral leg pain
- Saddle anaesthesia (numbness around sitting area)
- Altered bladder / bowel function

64
Q

Ix & Mx of cauda equina?

A

Ix – PR exam, urgent MRI (call ortho on-call)

Mx – urgent discectomy (untreated -> permanent nerve damage)

65
Q

Px of spinal stenosis?

A

Lumbar pain which is relieved sitting forward (flexion)

66
Q

Ix & Mx of spinal stenosis?

A

Ix - MRI

Mx - Analgesia + physiotherapy [surgery if severe]

67
Q

4 features of osteoarthritis?

A

L - Loss of joint space
O - Osteophytes
S - subchondral sclerosis
S - subchondral cysts

68
Q

Mx for hip osteoarthritis?

A
  1. Topical analgesia
  2. Injections
  3. THA / THR
69
Q

Rx for avascular necrosis?

A

M>F
35-50
Rx – alcohol, steroids, injury

70
Q

Px of hip avascular necrosis?

A

Insidious dull ache, throbbing pain in groin

71
Q

What is avascular necrosis of the hip?

A

Blood supply lost to femoral head -> collapse

72
Q

Px of trochanteric bursitis?

A

Sharp pain at hip point with ache spreads across thigh
- Worse at night

73
Q

What is FAI?

A

Femoracetabular impingement syndrome (FAI)

Extra bone at hip joint
- Pincer = above
- Cam = below

74
Q

Px & Mx of FAI?

A

Px - Groin pain on flexion / extension -> OA

Mx - Osteotomy (remove bone)

75
Q

What is and the steps of ITOH?

A

Idiopathic transient necrosis of the hip (ITOH)

  1. Local hyperaemia
  2. Marrow oedema
  3. ^Pressure
  4. Osteoporosis + osteolysis
76
Q

Who is at rx of ITOH?

A

Female in third trimester

77
Q

Px & Mx of ITOH?

A

Sudden progressive onset of pain -> worse walking

Resolves in 6-9months
- Avoid stress fracture

78
Q

What is perthe’s disease?

A

Femoral head disease involving necrosis, collapse, repair & remodelling

79
Q

Who is at rx of perthes disease?

A

M>F [5:1]
4-9yo

80
Q

Px & Mx of perthes disease

A

Px:
- Pain
- Loss of internal rotation / abduction

Mx:
- Self-limiting
- Keep hip in socket and rest

81
Q

Who is at rx of SUFE?

A

Fat, pre-pubescent teenage boys

82
Q

What is SUFE?

A

Growth plate in hip can’t hold weight, so slips

83
Q

Px & Mx of SUFE?

A

Px:
- Pain in hip
- Radiates to knee

Mx:
Urgent surgery to pin femoral head

84
Q

Are medial or lateral meniscus tears more common?

A

Medial tears > lateral tear [10:1]

85
Q

Mechanism of action of meniscal tears?

A

MOA – twisting, getting up from squatting

86
Q

Px of meniscal tears?

A

Pain, effusion, locking, joint line tenderness

87
Q

Ix for meniscal tear?

A

Steinman test

88
Q

Mx for meniscal tears?

A

rest + physio

Locked knee = urgent arthroscopic surgery

> 3mo symptoms = consider surgery

Degenerative tear (elderly) = no surgery

89
Q

Grades of ligament injuries?

A

Grade 1 = Sprain
Grade 2 = Partial tear
Grade 3 = Complete tear

90
Q

MOA / px of ACL tear?

A

Twisting, ‘pop’ heard

anterior drawer test + lachman test

91
Q

MOA / px of PCL tear?

A

Hyperextension / car crash

92
Q

MOA / px of MCL tear?

A

Pain on valgus stress

93
Q

MOA / px of LCLtear?

A

Pain on varus stress (uncommon)

94
Q

ACL tear mx?

A

Physio, 40% have reconstruction

95
Q

Knee dislocation mx?

A

Emergency reduction (<6 hour window)

+

Check neurovascular status before and after reduction

96
Q

What way does a patella dislocate?

A

Laterally

97
Q

Rx for extensor mechanism rupture?

A

Steroids, tendonitis, CKD, ciprofloxacin, DM

98
Q

Age and what tendon ruptures in extensor tendon rupture?

A

<40 – patellar tendon ruptures

> 40 – quadriceps tendon rupture

99
Q

Px of extensor mechanism rupture?

A

Palpable gap
Can’t straight leg raise

100
Q

What is tibialis posterior dysfunction and who is at rx?

A

Acquired flat foot in adults as inflamed tibialis posterior tendon can’t support arch of foot

Obese, middle-aged female

101
Q

Px and Ix for plantar fascitiis?

A

Px – Pain with walking at plantar aspect of heal

Ix – Tinnel’s test +ve for Baxter’s nerve

102
Q

What is hallux valgus?

A

Bunions

Medial deviation of the 1st metatarsal

Pain due to joint incongruence & widened foot

103
Q

What is Morton’s neuroma?

A

Degenerative fibrosis of digital nerve

Forefoot pain, burning and tingling in toes (high heels)

o “small stone under foot” [between 3rd/4rth toes]

104
Q

MOA & Px of achille’s rupture?

A

MOA - ‘lunging at squash’ in weak tendon

Px – sudden pain, palpable gap, can’t weight bear

105
Q

Ix for achille’s rupture?

A

Ix – Simmonds test – squeezing the calf -> no plantarflexion

106
Q

What are the ottawa rules for an ankle sprain?

A

X-ray required if pain in malleolar zone +:
- Bone tenderness at lateral malleolar zone
- Bony tenderness at medial malleolar one
- Inability to weight bear

107
Q

MOA for lateral and medial ankle tear?

A

Inversion -> lateral tear [calcaneofibular]

Eversion -> medial tear [deltoid ligament]

108
Q

What is pes cavus?

A

Abnormal high arched foot (+toe clawing) – can be neuromuscular or idiopathic

109
Q

What is pes planus?

A

low arched foot (flat foot) – can be developmental or acquired

110
Q

What is hallux rigidus?

A

OA of the first MTPJ

111
Q

What are claw & hammer toes?

A

Imbalance between flexors and tendons

112
Q

Mx of shoulder dislocation?

A

Reduction and immobilisation in a broad arm sling for 2 weeks

Check for axillary nerve damage

113
Q

What does Jobe’s test tell us?

A

Tests the supraspinatus - loss of abduction >90 degrees

114
Q

Mx of rotator cuff tear?

A

Within 2 weeks - conservative (physio, NSAIDs, steroid injection)

> 2 weeks or failed conservative mx:
- Tendon repair
- Acromial decompression

115
Q

Nerve injury in supracondylar fracture?

A

Most common - Anterior interososseus nerve (branch of median)
2nd most common - Radial nerve

116
Q

Radial nerve palsy px?

A

Wrist drop - unable to extend wrist

117
Q

Mx of Gartland type 1 or minimally displaced type 2 fracture? (elbow)

A

Conservatively with an above elbow cast in 90o flexion

118
Q

Mx of elbow fracture with compromise or displacement?

A

Closed reduction and K wire placement (removed after 4w)

119
Q

Garden classification of hip fracture?

A

1 - incomplete, un-displaced
2 - complete, un-displaced
3 - complete, incompletely displaced
4 - complete, completely displaced

120
Q

Ix for developmental dysplasia of hip?

A
  1. US
  2. If baby >4.5m -> x-ray
121
Q

Mx of developmental dysplasia of hip?

A

<4-6 months: Pavlik harness
6-18 months or failure of Pavlick harness: closed reduction and hip spica casting
>18months: open reduction and hip spica casting
>2 years: open reduction femoral/pelvic osteotomy

122
Q

Mx of Perthe’s disease?

A

<8 y/o: NSAIDS for pain, physiotherapy to restore range of motion
>8y/o: femoral/pelvic osteotomy

123
Q

Ix & Mx of SUFE?

A

Ix - AP and lateral frog leg x rays

Mx - Internal fixation using a single cannulated screw

124
Q

Medial sensation down leg to foot?

A

Saphenous nerve

Finals HH (21 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions