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NPLEX 2 > Orthopedic > Flashcards

Orthopedic Flashcards

1
Q

Name the Salter-Harris fracture:

1) Halfway through the growth plate
2) Straight through the growth plate
3) Breaks the epiphyseal plate in half
4) Crush injury - crushing the growth plate
5) Breaks halfway through the growth plate into the epiphysis and metaphysis

A

1) Type II (M)
2) Type I
3) Type III (E)
4) Type V
5) Type IV (ME)

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2
Q

Name the cervical spine fracture:

1) Result of flexion injury in the lower cervical spine in which the spinous process is broken or fractured.
2) Occurs frequently in a motor vehicle accident or in hangings. It is a bilateral pedicle fracture with anterior displacement of C2.
3) Caused by heavy object falling directly on head or hitting head while diving. Consists of at least two fractures of C1.

A

1) Clay Shoveler’s
2) Hangman’s
3) Jefferson’s

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3
Q

Name the thoracolumbar spine fracture:

1) Horizontal fracture of a vertebra, usually result of a motor vehicle accident where the seat belt immobilizes the pelvis but the upper body is thrust forward.
2) Horizontal fracture of a vertebra, usually result of a motor vehicle accident where the seat belt immobilizes the pelvis but the upper body is thrust forward.
3) Defect in the pars interarticularis, appears as a collar on the “Scottie dog”. Best seen on oblique view.
4) Bilateral pars interarticularis defect.

A

1) Chance
2) Burst/Compression
3) Spondylolysis
4) Spondylotisthesis

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4
Q

Name the wrist fracture:
1)Distal radial fracture posteriorly displaced.

2)Distal radial fracture anteriorly displaced.

3)Most common fractured carpal bone, may give rise to avascular necrosis.
Pain in the anatomical snuffbox!

A

1) Colles’
2) Smith’s
3) Scaphoid

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5
Q

Name the hand fracture:
1) Fracture of the base of the proximal phalanx of the thumb.

2) Fracture through the base of the first (thumb) metacarpal
3) Fracture of the 5th metacarpal.
4) Fracture of the 3rd metacarpal.

A

1) Gamekeeper’s Thumb or Skier’s Thumb
2) Bennett’s Fracture
3) Boxer’s Fracture
4) Bar room/Brawler’s Fracture

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6
Q

Name the Pelvis fracture:

1) Fracture through ischiopubic rami on one side and fracture of SI joint on the other side.
2) Fracture through the ischiopubic rami and SI joint on the same side.
3) A small piece of bone is separated from the origin or insertion site of a tendon.

A

1) Bucket Handle Fracture
2) Malgaine Fracture:
3) Avulsion Fracture

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7
Q

Name the Elbow fracture:

1) difficult to see, but look for anterior and posterior fat pad signs.
2) Caused by receiving a blow when protecting onself, dislocation of radial head and fracture of the ulna.
3) Caused by falling on outstretched hand and dislocating the distal radio-ulnar joint and fracturing the distal radius.

A

1) Radial Head fracture
2) Monteggia Fracture-dislocation (night-stick)
3) Galeazzi Fracture-dislocationElbow

Mnemnonic:
Policeman Radii Galeazzi tried to hit thief Ulna Monteggia for stealing his bike. Ulna Monteggia blocked the blow to his forarm and tripped Policeman Radii Galezzi who fell on his outstretched hand.

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8
Q

Name the Upper Limb injuries:

1) Diagnosed with X-ray taken with patient holding weights, 3 grades.
2) occurs most frequently in the middle third of the bone.

A

1) AC Joint Separation

2) Clavicular fracture

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9
Q

Indications for a bone scan - radiographic tracer Tcn99m phosphate or gallium 67 citrate

A

Osteomyelitis
Bony neoplasm/METS
Occult vertebral fracture

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10
Q

What are the disadvantages of bone scan?

A

False pos in older people w/ OA

False neg with diffuse bony METS and mult myeloma

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11
Q

What are the disadvantages of bone scan?

A

False pos in older people w/ OA

False neg with diffuse bony METS and mult myeloma

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12
Q

What is the MC muscular dystrophy in children? MC in adults?

A

Duchenne’s

Myotonic

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13
Q

What are SSX of Duchenne’s MD?

A

Muscle replaced by fat/pseudo-hypertorphy of calves.

Gower’s sign +

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14
Q

What test is used to diagnose Myasthenia gravis?

A

Tensilon test

Antibodies to ACH receptors

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15
Q

What test is used to diagnose Myasthenia gravis?

A

Tensilon test

Antibodies to ACH receptors

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16
Q

MC benign bone tumor

A

Osteochondroma - risk of chondrosarcoma w/ multiple lesions

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17
Q

Osteitis deformans or Paget’s dz presents with what SSX?

A

Lytic mixed with sclerotic areas - esp skull, bowing femur/tibia, OA, pathological fracture

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18
Q

Term: Demineralization of bone

A

Osteomalacia

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19
Q

What is the MC primary malignant bone tumor (age)? What is the second MC primary malignant bone tumor (age)? What is the more common bone tumor in the young?

A

Chondrosarcoma (middle age)
Osteosarcoma (elderly)
Ewing’s sarcoma

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20
Q

With unilateral joint inflammation, what two conditions are high on your DDX?

A

Gouty and infectious arthritis

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21
Q

Which arthritis conditions are HLA B27+?

A

Psoriatic, Enteropathogenic, and Reactive arthritis

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22
Q

What are some ominous signs of bone/musculoskeletal pain?

A 
Pt > 50 yo
Hx of CA
Trauma 
Systemic symptoms of inflammation
Not better lying down/rest
Osteoporosis 
Neurological ssx (bowel/bladder incontinence) 
Referred pain
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23
Q

What is mandatory in a febrile pt with joint effusion?

A

Arthrocentesis

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24
Q

What is the work-up for suspected RA?

A

RF and ANA antibody

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25
Q

What does Adam’s sign detect?

A

Scoliosis

Have patient bend forward

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26
Q

What does Adson’s test detect?

A

TOS

Taking radial pulse and lifting arm to see if pulse is still detected

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27
Q

What does Braggard’s test detect?

A

Sciatica

During SLR - flex foot

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28
Q

What does Betcherew’s test detect?

A

Sciatica

Extending knees while seated

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29
Q

What does East or Roos’ test detect?

A

TOS

Hands up, open/close hands for 3 min

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30
Q

What are two test for Malingering?

A

Hoover’s and Burn’s Bench tests

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31
Q

What does Kemp’s test detect?

A

Disc Herniation

Rotate, extend flex, push on lumbar SP

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32
Q

What does Kernig’s test detect?

A

Meningitis

Flex knee then extend

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33
Q

What does SLR test detect?

A

Disc herniation or sciatica

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34
Q

What does Linder’s test detect?

A

Sciatica

Supine, flex neck

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35
Q

What does Milgram’s test detect?

A

Disc herniation

Supine, raise extended legs for 30 sec

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36
Q

What does Minor’s sign detect?

A

Sciatica

Sit then stand and put one hand on back

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37
Q

What does Shoulder depression test detect?

A

Brachial plexus lesion

Apply pressure down on shoulder, flex the head

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38
Q

What does Soto-Hall’s test detect?

A

Disc herniation

SLR + flex head

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39
Q

What does valsalva detect?

A

space occ lesion

bear down

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40
Q

What does Wright’s test detect?

A

TOS

Palpate both radial pulses, raise arm

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41
Q

What does Apley’s scratch test detect?

A

Rot cuff tear, tendonitis

Touch fingertips to middle of back

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42
Q

What does drop arm test detect?

A

Rot cuff tear

abduct both arms to 180, adduct

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43
Q

What does Glenohumoral apprehension test detect?

A

Disloc shoulder

Cross painful arm, push elbow toward painful shoulder

44
Q

What does Impingement test detect?

A

Shoulder lesion

Abduct arm, rotate medially + passively elevate it

45
Q

What does Lippman’s scratch test detect?

A

Bicip tendonitis

Palpate bicipital groove

46
Q

What does speed’s test detect?

A

Bicip tendonitis

Resisted shoulder flexion

47
Q

What does Yergason’s test detect?

A

Bicip tendonitis

Flex elbow, resist supination/lat rot

48
Q

What does Cozen’s test detect?

A

Lat epicondylitis/ext tendonitis (tennis elbow)

Resist wrist extension in prontated/flexed arm

49
Q

What does Finkelstein’s test detect?

A

De quervain’s

Hold thumb in hand and ulnar deviate

50
Q

What does Mill’s test detect?

A

Lat epicondylitis/ext tendonitis (tennis elbow))

Palpate lateral epicondyle

51
Q

What does Phalen’s test detect?

A

Carpal tunnel

Backwards prayer

52
Q

What does Retinacular’s test detect?

A

Tight retinacular lig or capsule
Hold PIP, flex DIP - Fled Pip, fled DIP

Likely to be a distractor

53
Q

What does Tinel’s sign detect?

A

Carpal tunnel

Tap on median n

54
Q

What does valgus/varus stress test detect?

A

Med/lat collateral lig instability
Valgus = Medial (6 letters each)
Varus = Lateral

55
Q

What does Ely’s test detect?

A

Tight rec fem, lumbar lesion, contracture of TFL, osseus hip lesion
Prone, flex knee to butt

56
Q

What does Gaenslen’s test detect?

A

SI lesion, hip path, likely L4 lesion

Supine, one leg off table, bring other knee to chest

57
Q

What does Hibb’s test detect?

A

Spondylolisthesis, facet syndrome, SI lig sprains

Prone, flex knee, move leg laterally

58
Q

What does Nachla’s test detect?

A

Tight rect fem, upper lumbar lesion

Prone knee bending

59
Q

What does Ober’s test detect?

A

Contracture of TFL

Lateral decubitus, affected leg up, flex knee, raise leg, let if fall

60
Q

What does Ortolani click test detect?

A

Congenital hip dislocation

61
Q

What does Patrick Faber’s test detect?

A

Hip arthritis, bursitis, leg sprain

Cross legs

62
Q

What does Pelvic rock test detect?

A

SI lesion

Rock the pelvis

63
Q

What does telescoping test detect?

A

Congenital hip dislocation

Move legs like you’re adjusting a telescope

64
Q

What does Thomas’ test detect?

A

Tight hip flexor

Bring knee to chest while supine

65
Q

What does Trendelenburg test detect?

A

Gluteus medius weakness

Stand, flex one knee

66
Q

What does Yeoman’s test detect?

A

SI joint dysfunction

Prone, extend hip with knee extended/flexed

67
Q

What does Yeoman’s test detect?

A

SI joint dysfunction

Prone, extend hip with knee extended/flexed

68
Q

What does Anterior/Posterior drawer test detect?

A

ACL/PCL Tear

Sit on foot, pull push flexed eg

69
Q

What does Apley’s compression/distraction test detect?

A

Med/Lat Meniscus tear
Compression = meniscus
Distraction = ligament
Push ankle while knee is flexed in prone

70
Q

What does Apprehension test detect?

A

Patellar dislocation

Press patella laterally

71
Q

What does Bounce home’s test detect?

A

Torn meniscus

Passively extend knee “bounce home”

72
Q

What does Lachman’s test detect?

A

ACL injury

Move tibia toward femur

73
Q

What does McMurray test detect?

A

Meniscus fragment in joint

Flex patient hip/knee, internally/externally rotate the knee

74
Q

What does Patellar femoral grinding test detect?

A

Chondromalacia patella
Press on patella while patient contracts quad
Younger/growing pts

75
Q

What does reduction click detect?

A

Menisci fragment in joint (same as McMurray)

76
Q

What does valgus/varus stress test detect?

A

MCL/LCL sprians
Valgus = Medial
Varus = Lateral

77
Q

What does ballot and bulge tests detect?

A

Bulge - minor effusion
milk medial side of patella, then stroke lateral side

Ballot - major effusion

78
Q

What does anterior/posterior drawer test detect?

A

Med/Lat Talofibular lig lesion

Excess motion on side the ankle turns away from

79
Q

What does Forefoot adduction test detect?

A

Structural foot detect (INFANTS only)

Excessive forefoot adduction, try to bring foor to neutral position

80
Q

What does Dorsiflexion test detect?

A

Gastrocnemius/soleus hypertonicity

Dorsiflex ankle

81
Q

What does Forefoot squeeze test detect?

A

Stress fracture or neuroma

Squeeze metatarsal bones together

82
Q

What does Homan’s sign detect?

A

DVT

Dorsiflex pt foot

83
Q

What does talor tilt test detect?

A

Torn calcaneofibular ligament

Talus is tilted from side to sdie

84
Q

What does test for rigid or supple flat feet detect?

A

Obs in 3 pos: stand, sit, standing on toes
Rigid: no arch present
Supple: arch present while standing

85
Q

What does Thompson’s test detect?

A

Ruptured achilles tendon

Squeeze gastroc toward midline

86
Q

What does Tibial torsion test detect?

A

Measures angles between malleoli

Toe-in or toe-out torsion

87
Q

Alpha stim indications and contraindications?

A

Chronic pain, cranial for depression/insomnia/addiction

CI: pacemaker, CA lesion, uterus

88
Q

Electroacupuncture indications and contraindications?

A

Pain

CI: pacemaker, arrhythmia, seizures, anxiety attacks

89
Q

TENS indications and contraindications?

A

Pain, ST use

CI: eyes, fractures, metallic implants, uterus

90
Q

Sine wave indications and contraindications?

A

LMN lesions, spasm, other nerve problems

Constitutional hydrotherapy tx

91
Q

Interferential indications and contraindications?

A

Deep/large joint problems, muscles spasms

92
Q

Infrared phototherapy indications and contraindications?

A

Arthritis, infection, spasm, inc circulation

CI: CA

93
Q

Iontophoresis indications and contraindications?

A

Calcium - adhesive capsulitis
CuSo4 - fungal infx
MgSo4 - bursitis, edema, OA, RA, spasms

94
Q

Low voltage galvanism indications and contraindications?

A

Denervated muscle, LMN lesion, decreased motion, pain

95
Q

High voltage galvanism indications and contraindications?

A

Pain (neuralgia, sciatica strain/sprain)

96
Q

Phonophoresis indications and contraindications?

A

Inflammation (anti-inflammatory substances)

97
Q

Therapeutic ultrasound indications and contraindications?

A

Micromassage, adhesions, chronic inflammation

Penetrates deeply, does not affect adipose

98
Q

Diathermy indications and contraindications?

A

Inflammation/infections
(Bursitis, tendinitis, bronchitis, prostatitis)
CI: Long-term use, areas of low vascularity

99
Q

Ultraviolet phototherapy indications and contraindications?

A

Psoriasis or other skin issues

CI: Eye, genitals, sunburns, CA

100
Q

Colon irrigation indications and contraindications?

A

Constipation, detox

CI: Active UC, diverticulitis, children

101
Q

Hyperthermia baths indications and contraindications?

A

Immune booster, inc circulation

102
Q

Contrast hydrotherapy indications and contraindications?

A

Immune, inflam, infection, arthritis

Very safe, good for many conditions

103
Q

Constitutional hydrotherapy indications and contraindications?

A

Immune boost, nourishing, healing

104
Q

External cold application indications and contraindications?

A

Acute inflammation

105
Q

External heat application indications and contraindications?

A

Chronic inflammation

106
Q

Osseous manipulations indications and contraindications?

A

Specific body part has pain or fixation

CI: CA, fracture, osteoporosis

NPLEX 2 (22 decks)

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