Brainscape's Knowledge GenomeTM

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


See full index

Year 5 > Orthopedics > Flashcards

Orthopedics Flashcards

1
Q

What is the classification system for growth plate fractures in children?

A

Salter-Harris System
I - fracture through physis only
II - fracture through physis and metaphysis
III - fracture through physis and epiphysis
IV - fracture through physis, metaphysis and epiphysis
V - crush injury involving the physis

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

What is osteogenesis imperfecta

A

Failure of maturation of collagen in all connective tissues, leads to defective osteoid formation

This can lead to pathological fractures in children

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

What is the common age of presentation of perthes’ disease?

A

Between 4-10 years

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

Pathophysiology of perthes disease

A

Rapid growth leads to avascular necrosis of femoral head (femoral epiphysis)
Interruption of blood supply results in necrosis, removal of necrotic tissue and replacement with new bone
During this process of replacement (which can last several years), there is an initial softer bone. It is during this state that the head of the femur is more likely to collapse into a flatter position

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

Symptoms of Perthes diabetes

A

Hip pain
Limp
Stiffness and reduced range of movement in hip

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

Management of perthes’ disease

A

Observation - in young children who show few changes in femoral head in initial X-rays (repeat x-rays over term to make sure regrowth is on track)

Casting and bracing - if range of motion becomes limited or if x-rays suggest that a deformity is developing, this may be used to keep the head in the acetabulum while reformation occurs

Conservative - physio, NSAIDs, avoid high impact running/jumping

Surgery - if child is >6 years of age at diagnosis may be considered to realign the joint

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

What is slipped upper femoral epiphysis (SUFE)

A

Where the is displacement of the femoral neck anterio-laterally and superiorly

Classically seen in obese teenagers

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

Clinical features of SUFE

A

Hip pain, thigh pain or knee pain

Loss of internal rotation of the leg in flexion

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

Investigations for SUFE

A

Bilateral hip X-ray - as bilateral slip occurs in 20% of cases

AP and frog-leg views

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

Management of SUFE

A

Internal fixation of hip - using single cannulated screw in epiphysis

May consider prophylaxis management of other hip

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

What is compartment syndrome?

A

Complication that may occur following fractures or surgery

Characterised by raised pressure within closed anatomical space - this can lead to decreased tissue perfusion resulting in necrosis

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

What are the two main fractures compartment syndrome is more common in?

A

Supracondylar humerus fractures

Tibial shaft fractures

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

Features of Compartment Syndrome

A

Pain - especially on passive movement
Excessive use of breakthrough analgesia
Parasthesisa
Pallor

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

What Intracompartmental pressure is diagnostic for compartment syndrome?

A

> 40mmHg

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

Management of compartment syndrome

A

Remove cast (if present)
Prompt fasciotomies
Aggressive IV fluids - as myoglobinuria may occurs following fasciotomy and result in renal failure

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

What is the most common infection organism in osteomyelitis?

A

Staph aureus

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

What is the most common infective organism in osteomyelitis in patients with sickle cell disease

A

Salmonella

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

Patients at risk for osteomyelitis

A

Diabetics
Sickle cell anaemia patients
IVDUs
Immunosuppresed patients

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

Management of osteomyelitis

A

Flucloxacillin - 6 weeks

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

Red flags for back pain

A 
<20 years, >50 years
Hx of previous malignancy 
Night pain 
Trauma 
Bowel/bladder incontinence 
Saddle anaesthesia 
Weight loss, fever
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

When would you offer MRI to patients with back pain

A

If suspecting: malignancy, infection, fracture, cauda enqina or Ankylosing spondylitis

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

What is the management for simple back pain

A

Encourage activity as limited
NSAIDs 1st line for pain relief
Physio

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

What is lumbar spinal stenosis?

A

Condition where the central spinal canal is narrowed by degenerative changes

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

Clinical signs of lumbar spinal stenosis

A 
Gradual onset back pain 
Neuropathic leg pain (with or without back pain)
Neurogenic claudication 
Pain resolves when sitting 
Easier to walk uphill than downhill
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Management of suspected lumbar spinal stenosis

A

Simple analgesia

Referral for consideration of laminectomy if not improving

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

Signs of a prolapsed disc

A

Leg pain worse than back pain
Pain worse when sitting
Clear dermatomal distribution dependant on which nerve root is compressed

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

Difference between femoral and sciatic nerve stretch test and what they mean

A

Femoral (mackiewicz) - patient lies on front, knee passively flexed to thigh, and hip is passively extended. If anterior thigh pain test is positive (this suggests either L3 or L4 root compression)

Sciatic (Lazarevics) - straight leg raise test, when raising the leg to 30 to 70 degrees, pain occurs and radiates down the leg to below the knee (suggests either L5 or S1 compression)

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

What is discitis?

A

Infection of the intervertebral disc space

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

Features of discitis

A

Back pain
Systemically unwell - fever, rigor, sepsis
Neurological features - if epidural abscess develops secondary

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

Why would you do an ECHO on a patient presenting with discitis?

A

To assess for endocarditis - which can be a common cause of discitis

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

What is de Quervain’s tenosynovitis

Who is it most common in?

A

Inflammation of the sheath containing the extensor pollicis brevis and abductor pollicis longus

Typically affects females aged 30-50 years old

32
Q

Features of tenosynovitis

A

Pain on radial side of wrist
Tenderness over radial styloid process
Abduction of thumb against resistance is painful

33
Q

Test used to diagnose de Quervain’s tenosynovitis

A

Finkelstein’s test - thumb in closed fist, tilt hand down (ulnar deviation), pain felt over the radius is positive indicator of de Quervain’s

34
Q

When would you have surgery for Dupuytren contracture?

A

When the metacarpophalyngeal joints cannot be straightened and thus hand cannot be placed flat on a table

35
Q

Features of carpal tunnel syndrome

A

Pain/paresthesia in thumb, index and middle finger

Patients classically shake hand at night to obtain relief

36
Q

What are the two examination signs associated with carpal tunnel syndrome?

A

Tinel’s sign - tapping the carpal tunnel causes paresthesia

Phalen’s sign - flexion of the wrist causes symptoms

37
Q

Management of carpal tunnel syndrome

A

Corticosteroid injection
Wrist splints
Surgical decompression - division of flexor retinaculum

38
Q

What are the most common fractures associated with a fall onto an outstretched hand?

A

Scaphoid fracture

Distal radial fractures

39
Q

Blood supply to scaphoid bone

A

Dorsal carpal branch of radial artery

40
Q

Clinical features of scaphoid fracture

A 
Pain along radial aspect of wrist (base of thumb)
Tenderness over anatomical snuffbox 
Loss of grip/pinch strength 
Pain on ulnar deviation 
Wrist joint effusion
41
Q

Management of scaphoid fractures

A

Emergency - immobile in future splint or standard below elbow backslab
If undisplaced - cast for 6-8 weeks
If displaced - surgical fixation

42
Q

What is the main complication of a scaphoid fracture

A

Avascular necrosis to scaphoid due to retrograde blood supply

43
Q

What is the most common type of shoulder dislocation?

A

Glenohumeral dislocation (anterior shoulder dislocation - where the dislocated humeral head lies in a sub coracoid position)

44
Q

How does an anterior shoulder dislocation usually present

A

Externally rotated and abducted

45
Q

What is impingement syndrome?

A

Subacromial impingement

Painful abduction of shoulder - pain between 90-120 degrees

46
Q

How many degrees would pain be elicited in a rotator cuff tear injury

A

Pain usually in first 60 degrees of abduction

47
Q

Rotator cuff muscles special tests

A

Supraspinatus- empty can test
Infraspinatus - external rotation against resistance
Teres minor - horn blowers test
Subscapularis- gerbers lift off test

48
Q

What group of patients is adhesive capsulitis (frozen shoulder) more common?

A

Diabetics

49
Q

Types of hip dislocation, presentation and which is more common?

A

Posterior (90%) - shortened, adducted and internally rotated

Anterior - abducted, externally rotated, no leg shortening

50
Q

Management of hip dislocation

A

Analgesia

Reduction under anaesthetic within 4 hours - to reduce risk of avascular necrosis to the femoral head

51
Q

Features of hip fracture

A

Shortened
Externally rotated
Painful

52
Q

What is the difference between Intracapsular and extracapsular hip fractures?

A

Intracapsular - from edge of femoral head to insertion into acetabulum

Extracapsular - can either be Trochanteric (between greater and lesser trochanter) OR sub trochanteric (below lesser trochanter)

53
Q

Classification of hip fractures

A 
Garden classification:
I - stable 
II - complete but undisplaced
III - displaced, usually rotated and angulated 
IV - complete boney disruption
54
Q

Management of Intracapsular hip fracture

A

Undisplaced - internal fixation
Displaced (<70 years and fit) - reduction and internal fixation surgery
Displaced ( >70 but independent and mobile) - total hip replacement
Displaced (>70 but not independently mobile) - hemiarthroplasty

55
Q

Management of extracapsular hip fracture

A

Depends on location:
Trochanteric - dynamic hip screw
Subtrochanteric - intramedullary nail

56
Q

Difference between a high and low ankle sprain in location and mechanism of injury

A

Low ankle - involves lateral collateral ligaments
- mechanism is usually via inversion

High ankle - involves the syndesmosis (fibrous ligament holding tibia and fibula together)
- mechanism is usually via external rotation

57
Q

How would you differentiate between a high and low ankle sprain?

A

Low - able to weight bear usually
High - weight bearing painful, pain elicited when tibua and fibular squeezed together at level of mid calf (Hopkins squeeze test)

58
Q

Classification of ankle fractures

A

Danis Weber classification
A - below syndesmosis (low ankle fracture), stable
B - may extend to involve syndesmosis
C - above syndesmosis

59
Q

Management of ankle fractures

A

Stable (type A) - CAM boot for 6 weeks

Unstable (type C) - surgical repair

60
Q

How does an Achilles’ tendon rupture usually present?

A

Audible pop in the ankle while playing sport or running
Significant pain in calf or ankle
Inability to walk

61
Q

How would a calf squeeze help to diagnose Achilles’ tendon rupture?

A

Normally the calf would plantar flex on squeezing

In Achilles’ tendon rupture - the foot will stay in neutral position

62
Q

Imaging choice for diagnosis of Achilles’ tendon rupture

A

USS

63
Q

What is plantar fasciitis and how does it usually present

A

Heel pain in adults
Inflammation of plantar fascia on the bottom of the foot
Presents in patients who have recently started doing more walking/running
Pain elicited when squeezing medial calcaneal tuberosity (heel)

64
Q

Management of plantar fasciitis

A

Rest foot

Wear shoes with good arch support and cushioned heels

65
Q

What is Morton’s neuroma

A

Benign neuroma affecting the plantar nerve - most commonly in the 3rd inter-metatarsophalangeal space

66
Q

How does Morton’s neuroma present

A

Forefoot pain

Pain worse on walking - patients may feel they have a pebble in shoe

67
Q

Management of Morton’s neuroma

A

Metatarsal pad

68
Q

What is Charcot joint

A

Neuropathic joint - commonly in foot
Commonly occurs in neuropathy e.g diabetics, alcoholics
Presents with neuropathic pain and loss of sensation
Foot appears swollen and disfigured

69
Q

Common Reflexes and spinal cord levels they arise from

A 
Biceps - C5/C6
Brachioradialis - C5/C6
Triceps - C7/C8
Knee - L3/L4
Ankle - S1/S2
70
Q

Which nerve is most commonly injured during a shoulder dislocation?

A

Axillary nerve

71
Q

What is the usual mechanism of injury for a meniscal tear

A

Twisting injury

Typically twisting around a flexed knee

72
Q

Examination finding on anterior and posterior cruciate ligament rupture

A

Anterior cruciate - positive anterior drawer test

Posterior cruciate - positive posterior drawer test

73
Q

Difference between medial and lateral epicondylitis

A

Medial (golfers) - tenderness over medial epicondyle and medial wrist pain on resisted wrist pronation

Lateral (tennis) - tenderness over lateral epicondyle and elbow pain on resisted wrist extension

74
Q

Difference between the two types of Barton fracture: colles and smiths fracture

A

Both fractures of radial bone
Colles - wrist extended on impact, dorsal displacement and angulation
Smiths - wrist flexed on impact, reverse colles

75
Q

What is the line that is lost on an-X-ray of a hip fracture?

A

Shenten’s line

Year 5 (17 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions