Orthopedics

Question 1

Osteoblasts \_\_\_ (build/destroy) bone;
osteoclasts \_\_\_ (build/destroy) bone

Answer 1

osteoblasts build; osteoclasts destroy

Question 2

L3L4 disc= __ root compression; injury: ____

Answer 2

L4; L4 think 4 quadriceps, weak knee jerk

Question 3

L4L5 disc= ___ root compression; injury: ___

Answer 3

L5; lift 5 toes, dorsiflexion; may see big toe hyperesthesia

Question 4

L5S1 disc= ___ root compression; injury: ___

Answer 4

S1; stand on tiptoes, plantar flexion, weak ankle jerk, change in sensation to lateral foot/calf

Question 5

Biceps reflex: ___
Triceps reflex: ___
anal wink: ___

Answer 5

Biceps reflex: C5/6
Triceps reflex: C7
Anal wink= S2-S4

Question 6

Ulnar nerve: Motor function: ___, ___, ____

Sensation to: ___, ____, ____

Answer 6

intrinsic musculature of hand, finger abduction (for ‘U’ shape); wrist flexion;
Sensation to pinkie, ring fingers, back of hand

Question 7

Median nerve: Motor function: ____

Sensation to: _____________

Answer 7

thumb apposition; sensation to most of palm, 1st 2 1/2 fingers (carpal tunnel)

Question 8

Radial nerve: Motor function: ___, ___, ___

Sensation to: _________

Answer 8

no motor in hand; wrist extension, finger extension;

sensation to back of lateral hand

Question 9

Femur fx: early ORIF allows ____, _____, ____

Answer 9

early mobilization, decr fat embolization, decr complications

Question 10

Pediatric femur fx, Rx: _________

Answer 10

closed reduction, not ORIF (avoid interference with epiphyseal growth plate)

Question 11

Salter Harris fx III, IV, and V are ____ and generally need ___

Answer 11

intra-articular and generally need open procedure

Question 12

Hip dislocation: ___% are posterior which present with ________________

Answer 12

90%; internal rotation, flexed, adducted thigh

Question 13

Hip dislocation has risk of ______ and ______

Answer 13

sciatic nerve injury, AVN of femoral head

Question 14

_______ : frog leg, (external rotation, abduction)

Answer 14

anterior hip dislocation

Question 15

_______ fx: shorted limb, ext rotation, risk of non-union, AVN

Answer 15

femoral neck fx

Question 16

Terrible triad of O’donaghue

Answer 16

lateral blow to knee-> injury to ACL, MCL, medial meniscus

Question 17

Posterior knee dislocation: _____ injury common, texts say need to __________

Answer 17

popliteal injury common, texts say arteriogram all

Question 18

Fxs prone to compartment syndrome….. x 3

Answer 18

Calcaneous fx, also tibia fx, supracondylar humerus fx

Question 19

Shoulder Dislocation: __% are _______ (anterior/posterior) risk _______ nerve injury

Answer 19

90% are anterior; risk axillary nerve injury

Question 20

Posterior shoulder dislocation associated with ____ and ____

Answer 20

seizures, electrocution

Question 21

Humerus fx: may see this nerve injury ____ and these motor and sensory deficits: _____ and ___

Answer 21

radial nerve injury; weak wrist extension, sensation lateral dorsal ahnd

Question 22

Volkmann’s contracture: ________ fx -> compromised ___ artery….
Path? Rx?

Answer 22

supracondylar humerus fx -> compromised anterior interosseous artery;
Deep forearm flexor compartment syndrome, need fasciotomy. Pain in forearm w extension. Median nerve.

Question 23

Dupuytren’s contracture of palmar fascia:

Rx with ___, _____, may need ____

Answer 23

Rx w steriods, physical therapy; may need fasciotomy

Question 24

Navicular fx: what is it? what is rx?

Answer 24

tender snuffbox; even with negative XR, requires cast up to elbow

Question 25

Monteggia fx: what is it? what is rx?

Answer 25

proximal ulnar fx w radial head dislocation. ORIF.

Question 26

Bone mets rx? % symptomatic?

Answer 26

Can fixate, XRT for pain relief, only 65% symptomatic

Question 27

Ewing’s Sarcoma: Path? Rx? Average survival?

Answer 27

‘onion layering’, pseudorosettes on path. Rx is XRT; avg survival is 2 years