Orthopedics

Question 1

what is medial epicondylitis

Answer 1

(golfers elbow)
tendinopathy of the common flexor tendon

Question 2

what is lateral epicondylitis

Answer 2

(tennis elbow)
tendinopathy of the supinator (extensor carpi radiatis brevis)

Question 3

What is the common mechanism for AC joint spain/separation

Answer 3

fall onto superior aspect of shoulder with arm adducted

Question 4

What is the management for AC separation

Answer 4

Type 1-2: non-operative, sling 2 week, PT, resolves 6 weeks
Type 3-6: conssult ortho posssible surgery

Question 5

What is the mechanism of action for a biceps tendinopathy

Answer 5

repeated elbow flexion with forearm in sup or pronation

Question 6

What is the management of clavicle fractures

Answer 6

Group 1 - middle 1/3 - if displaced or overlap >2cm refer and consider surgery
Group 2 - distal 1/3 - refer to ortho, consider surgery, highest risk non-union
Group 3 - medial 1/3 - conservative

Question 7

Signs of posterior sternoclavicular dislocation

Answer 7

Difficulty breathing
Asymmetric pulses
Assymetric clavicle prominences

Question 8

What are ottawa foot and ankle rules

Answer 8

Ankle XR if:
Pain in malleolar zone and any of the following:
- bone tenderness on posterior 6 cm of lateral malleolus
- bone tenderness of posterior 6 cm of medial malleolus
- Inability to weight bear immediately and in ER

Foot XR if:
Pain in midfoot and any of the following:
- bone tenderness base of 5th metatarsal
- bone tenderness navicular bone
- Inability to weight bear immediately and in ER

Question 9

What ligaments are involved in a lateral ankle sprain

Answer 9

anterior talofibular and calcaneofibular

Question 10

What test to do in a high ankle sprain

Answer 10

Attempt to separate distal tub and fib by 1) squeezing lower leg mid calf 2) having patients crosss their legs with injured leg resting at mid calf 3) externally rotate the ankle with the foot dorsiflexed

Question 11

What are the Canada C-spine rules

Answer 11

XR if:
>65
Dangerous mechanism
Parasthesia in extremities

Question 12

Jersey finger injury site and management

Answer 12

Flexoe digitorum profundus tendopn injury
Refer to ortho, prognosis worsens with delay

Question 13

What areas does the ulnar nerve supply?

Answer 13

Hypothenar eminence , deep motor to hypothenar muscle, adductor pollicis, flexor policis brevis

Question 14

Motor weakness, exam and reflex for L4

Answer 14

Exension of quad
Squat and rise
Knee

Question 15

Motor weakness, exam and reflex for L5

Answer 15

Dorsiflexion and great toe
Heel walk
N/A

Question 16

Motor weakness, exam and reflex for S1

Answer 16

Plantar flexion of great toe and foot, gluteus maximus
Toe walk
Ankle

Question 17

What are the backpain patterns?

Answer 17

1: Discogenic: back pain dominant, worse with flexion, constant or intermittent, neuro normal
2: Facet joint: back pain dominant, worse with extension, never worsened with flexion
3: Compressed nerve: leg dominant, sciatica, constant, straight leg positive, possble changes L4-S1
4: Spinal stenosis: leg dominant, worse with walking, bilateral