Brainscape's Knowledge GenomeTM

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


See full index

Pastana > Orthopedics > Flashcards

Orthopedics Flashcards

1
Q

Developmental dysplasia of hip

A
  1. familial
  2. uneven gluteal folds
  3. p/e shows easy dislocation (click and snap0
  4. sonogram diagnostic
  5. tx = abduction splinting 6 months
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Hip pathology

A

hip pain or knee pain

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

Legg-Perthes disease

A
  1. = Avascular necrosis of the capital femoral epiphysis
  2. starts at age six- slow development limping, less hip motion, pain
  3. antalgic gait, guarded hip motion
  4. dx = Ap/lat hip x rays
  5. tx = contain femoral head w/ casting + crutches
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

slipped capital femoral epiphysis

A

ORTHO EMERGENCY! 13 y/o boys, groin/knee pain, sole of affected food points to other food, limited hip motion, no internal rotation, dx w/ x-ray, tx w/ pins

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

Septic hip

A

Toddlers w/ febrile illness, won’t move hip, hold hip flexed (slgith abduct/external rotate), sed rate up, dx = aspirate hip + open drainage

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

Acute hematogenous osteomyelitis

A

little kids w/ fever, local sever pain in a bone, nothing on x-rays, do bone scan + abx

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

Genu varum

A

Bow legs (normal up to age 3, no tx), persistent beyond age 3 = Blount disease (do surgery, growth plate messed up)

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

Genu valgus

A

Knock knee normal aages 4-8

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

Osgood-Schlatter

A

Osteochondrosis of tibial tubercle, teenagers w/ persistent pain over tubercle, worse w/ quad contraction, no knee swelling, keep knee in cylinder cast 4-6 wks

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

Club Foot (talipes equinovarus)

A

Both feet inward, plantar flexion of ankle, inverted food, adduction forefoot, internal rotated tibia. Casts in neonatal period correct 1/2, others need surgery between 8 mo-2 years

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

Scoliosis

A

Adolescent girls, thoracic spine curves right- bend forward (hump?), deformity progresses till skeletal maturity, can decrease pulm function, braces/surgery

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

Remodeling

A

Happens A LOT in kid’s fractures, so high degrees angulation ok! Also kids heal faster. Only bad for supracondylar fractures of humerus + growth plate

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

Supracondylar humerus fracture

A

hyperextend elbow in child who falls on hand. Vasc/nerve injuries, Volkmann contracture possible- monitor closely. Tx w/ cast or traction

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

Growth plate fractures

A

Closed reduction if later displacement of epiphyses/growth plate, but in one piece. If two pieces, open reduction + internal fixation (otherwise uneven growth!)

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

primary malignant bone tumors (KIDS)

A

persistent low grade pain, x-ray = adjacent soft tissue invasion, sunburst pattern, periosteal onion skinning.

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

osteogenic sarcoma

A

most common primary malig bone tumor, ages 10-25, around knee (lower femur/upper tibia), sunburst

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

Ewing sarcoma

A

2nd most common, grows in diaphyses of long bones, onion skinning

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

adult malig bone tumors

A

METAStATIC (breast, prostate). Localized pain, bone scan more sensitive (follow up with x-ray), sometimes lytic lesions appear w/ pathologic fracture

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

multiple myeloma

A

old men, fatigue, anemia, localized pain at several bone places, x-ray shows punched out lytic lesions. Bence- jones proteins in urine, abnormal IG in blood 9immunoelectrophoresis). Chemo + Thalidomide

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

Soft tissue sarcomas

A

relentless growth of soft tissue mass anywhere, firm/fixed to surroundings, mets to lungs but not lymph nodes. MRI for dx + incisional biopsy by expert

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

X-ray for fractures

A

2 views at 90 degrees to each other, always include joints above and below. Take x-rays of other bones in line of force!

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

Closed reduction

A

for broken bones not badly displaced or angulated, external manipulation + a cast

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

Open reduction

A

sever displacement/angulation or not easily aligned

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

Clavicular fractures

A

Between middle and distal third, give figure-of-eight device for 4-6 weeks

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

anterior dislocation of shoulder

A

most common, hold arm close but rotate outward 9ready to shake hands0, may be deltoid numbness from axillary nerve stretch.

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

posterior shoulder dislocation

A

rare, occurs after massive uncoordinated muscle contractures (seizure/electric burn), arm held close to body, internal rotation, need scapular or axillary view to see it

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

Colles fracture

A

Fall on outstretched hand, old ladies, wrist looks like dinner fork, dorsal dispalce/angulated distal radius fracture. Closed reduction + long arm cast

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

Monteggia fracture

A

direct blow to ulna (PROTECT YOURSELF FROM THE NIGHTSTICK!), diaphysial fracture of proximal ulna + anterior dislocation of radial head

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

Galeazzi fracture

A

mirror of monteneggia, distal 1/3 of radius gets the blow, dorsal dislcation of dsital RU joint. Open reduction/internal fixation

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

Schapoid fracture

A

Young adult, outstretched hand, wrist pain, tenderness over SNUFF BOX. undisplaced = neg xray, thumb spica, xray 3 weeks later. if xray shows dispalced/angulated, ORIF. Scaphoid =>nonuion

31
Q

Metacarpal neck fractures

A

Fourth, fifth or both. Closed fist hits hard surface, hadn swollen, tender. xray dx. tx dep on angulation/displacement/rotary. Closed reduction +ulnar gutter spint for mild, Kirschner wire/plat for bad

32
Q

Hip fractures

A

Old ppl fall down, hip hurts, class position = shortened affected leg, externally rotated. Tx dep on location

33
Q

Femoral neck fractures

A

Compromise tenous supply to femoral head. Fast heal/early mobilize w/ femoral head prosthesis

34
Q

Intertrochanteric fractures

A

Less likely to cause avasc necrosis, tx = OR and pin, immobilization can => DVT/PE, so anticoag

35
Q

Femoral shaft fractures

A

tx= intramedullary rod fixation. Bilat/comminuted => shock, do external fixation. Open frac = ortho emergency- or clean/closure. Multiple frac => fat embolism!

36
Q

Knee injuries

A

Swelling of knee = poor mam’s MRI

37
Q

Collateral ligament injuries

A

Knee hit sideways. Medial blows mess up lateral, vice versa. Swollen knee + local pain, and 30 deg flexion with passive abd or add makes pain. Abduction for medail (valgus), adduction for lateral (varus). Tx = hinged cast, several ligaments needs surgical repair

38
Q

ACL injury

A

more common than PCL. Severe knee swelling + pain. Anterior drawer sign (at 90 deg), or knee at 20, grab thigh and pull leg with other (Lachman test).

39
Q

PCL

A

opposite findings of ACL. MRI dx. Sednetary pts with immboiliz/rehab. Athletes need arthroscopic reconstruction

40
Q

Meniscal tears

A

Dx w/ MRI. Protractd pain/swelling, catch/lock + click. Arthroscopic repair to save meniscus. Compete meniscectomy => late degen arthritis

41
Q

Tibial stress fractures

A

young men doing forced marches. Tenderness at specific point, normal x ray initially. tx w/ cast, xray in 2 weeks. or crutches

42
Q

Tib/fib fracture

A

Pedestrian hit by car. P/e w/ angulation, dx w/ xray. Cast for easy reducable, intramed nailing if not alignable. Lower leg => compt sndrome common. Pain? remove cast!

43
Q

Ruptured achilles

A

Out of shape middle aged men playing tennis. Hear a lout pop, cluch and fall. Lim plantarflexion, pain/swelling/limping, feel a gap in tendon, cast in equinus position or surgery for faster cure

44
Q

Ankle fracture

A

Fall on everted or inverted foot. Both malleoli break. Ap, laterla, mortise xrays dx. ORIF if fragments displaced

45
Q

Compt syndrome

A

Forearm or lower leg. Prolonged ischemia then reperfusion, crush or trauma => syndrome. Pain, limited use of extremity, tight/tender to palpation. Excrutiating pain with passive extension, maybe normal pulses. TX = emergency fasciotomy

46
Q

Pain under cast?

A

REMOVE THE CAST!

47
Q

Open fracture

A

Cleanin OR, suitable reduction within 6 hours

48
Q

Posterior hip dislcoation

A

Femur driven back (head/on car collision, knees hit dashboard0. Hip pain, leg shortened, adducted, INTERNALLy rotated (opp). Emergency reduction to avoid avasc necrosis

49
Q

Gas gangrene

A

Deep penetrating dirty wounds, in 3 days pt sick, toxic, moribund. Affected site tender, swollen, discolered, gas crepitus. Tx = IV penicillin, debridement, hyperbaric o2

50
Q

Radial Nerve

A

injured in oblique frac to distal 2/3 of humerus. No dorsiflex but regained w/ reduction, then cast/sling! But if nerve paralysis, entrapped nerve, surgery required

51
Q

Popliteal artery injuries

A

Occur w/ posterior disloc of knee. Look at pulses, doppler, arteriogram. Reduce fast to save vasculature, otherwise fasciotomy

52
Q

Second hidden fracture

A

Direction of force may produce a second frac. Fall from a height might break spine (along w/ obv leg). Head on MVC might mess up femurs, facial fractures could indicate C-spine issue

53
Q

Carpal tunnel

A

women doing repetitive hand work. Numb/tingly hands esp at night, on radial 3.5 fingers. Reproduce sx by hanging hand limp or tappig median nerve. clin dx but xray good to rule out. tx = splint + antiinflamm. If need surgery, do EMG

54
Q

Trigger finger

A

Favors women. Wake up w/ acutely flexed finger, snaps when they pull it. Steroid injection, surgery as last resort

55
Q

De Quervain tenosynovitis

A

Young mothers form carrying baby, wrist flexion/thumb extension. pain on radial side + first dorsal compt. Reproduce sx if hold thumb inside fist and force ulnar deviation. Splint, antiinflamm, steroid injection. Rare surgery

56
Q

Dupuytren contracture

A

Older Norwegian men. Palm contracture, feel palmar fascia nodules. Tx = surgery if can’t place hand flat

57
Q

Felon

A

Abscess in fingertip pulp- from neglected penetrating injury. Throbbing pain + fever. Urgent surgical drainage to avoid tissue necrosis

58
Q

Gamekeeper thumb

A

Ulnar collateral ligament injury from forced thumb extension (skiing injury). P/e shows laxity at thumb-MCp joint, can lead to arthritis. CAST IT

59
Q

Jersey finger

A

Injury to flexor tendon, forcefully extended (grab a running person’s jersey). Can’t flex. SPLINT IT

60
Q

Mallet finger

A

Opposite of jersey. Extended finger forcefully flexed, extender tendon ruptures. SPLINT

61
Q

Traumatic digit amputation

A

clean with saline, rap in gause, place in bag w/ ice Reattach w/ surgery. Dont’ freeze or put in alcohol

62
Q

Lumbar disk herniation

A

L4-5 or L5-S1, age 45-6, severa months of vague aching pain, then sudden neurogenic pain w/ forced movement, very severe, shoots down leg. Exac by cough, sneeze, poop. No ambulation, hold leg flexed. Straight leg-raising => PAIN, MRI dx. Bed rest 3 weeks, pain control w/ nerve blocks. Surgery if progressive muscle weakess, emergency if cauda equina sydrome ()

63
Q

Cauda Equina syndrome

A

distended bladder, flaccid rectum, perineal saddle anesthesia, emergency decompression

64
Q

Ankylosing spondylitis

A

Young men in 30s/40s, back pain + mroning stiffness, worse at rest, improves w/ activity. Progressive sx => xray with bamboo spine. Antiinflamm + PT, many pt have HLA B-27 antigen, w/ uveitis and IBD

65
Q

Metastatic malignancy

A

Suspect in oldies w/ progressive back pain worse at night unrelieved by rest/position change. Weight loss. X-ray shows lesions if advanced (from breast cancer in pedicles or blastic mets from prostate). Early mets on bone scan. MRI is best dx (but $$)

66
Q

Diabetic ulcers

A

INdolent, at pressure pts (heel, metatarsal head, toe tips). Neuropathy, don’t health b/c microvasc disease. Can heal w/ good diabetic control, clean, elevated leg. But often get worse and => amputation

67
Q

Ulcers from aterial insufficiency

A

Tip of toes, look dirty, pale base w/ not granu tissue. Pt also has other sx- absent pulses, trophic changes, claudication, rest pain. W/u w/ doppler studies for pressure gradient (if not +, no surgry). Then arteriogram, surgical revasc

68
Q

Venous stasis ulcers

A

In chronically edematous, indurated, hyperpig skin about medial malleolus. Painless, granulating bed. Varicose veins + cellulitis. Tx w/ physical support to keep vains empty (support stockings, etc). Surgery maybe (vein stripping, ulcer grafting)

69
Q

Chronic foot ulcers

A

look for diabetes and arteriosclerotic occlusive disease (both can coexist)

70
Q

Marjolin ulcer

A

Squam cell carcinoma of skin in chronic leg ulcer. Many years of healing/breaking down (untx third degree burns or chronic draining sinuses after osteomyelitis). Dirty, deper ulcer w/ heaped growth. Biopsy, wide local excision, skin graft

71
Q

Plantar fascitis

A

Older, overweight patients w/ diabling sharp heel pain when foot hits ground, worse in mornings. Xray shows bony spur at pain location, exquis tenderness. But spur is not issue. Spontaneous resolution in 12-18 mo.

72
Q

Morton neuroma

A

Inflamm of digital nerve @ between toe 3 and 4, palpable/very tender. Don’t wear high heels or cowboy boots. Tx analgesics + sensible shoes, or surgical excision

73
Q

Gout

A

Typical swelling, redness, exquiste sudden pain @ first Metatarsal-Phalangeal joint. Middle age fat men w/ high serum uric acid. See crystal sin joint fluid. Tx acute w/ indomethacin + colchicine. Allopurinol + porbenicid for chronic

Pastana (12 decks)

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