Orthopedics Run 2.0 Flashcards
What is Adhesive capsulitis and how does it present clinically?
A frozen shoulder
Impairs the ability to externally rotate.
Passive and active movement impaired.
Common in middle aged women, and with diabetes
What muscle movement do you test for
L2
L3
L4
L5
S1
L2: Hip flexors
L3: knee extensors
L4: ankle dorsiflexion
L5: Big toe dorsiflexion
S1: Ankle plantaflexion
What muscle movement do you do for
C5
C6
C7
C8
T1
C5: elbow flexors
C6: wrist extensors
C7: elbow extensors
C8: finger flexors
T1: little finger abduct
Long bones take _____ to heal
3 months minimum
The Ottawa Rules are?
-
Bony tenderness at medial and lateral malleolar
- from condyle to 6cm above
- Inability to weightbear immediately after the injury and now.
This determines whether an ankle injury should have an xray
A 75-year-old woman presented to her GP with shoulder pain and discomfort. She had a full shoulder examination performed, during which she was unable to abduct her shoulder when it was flat against her body while standing. She was, however, able to fully abduct the shoulder after the doctor passively abducted it during the first 20 degrees. Which muscle is most likely to have been affected?
Supraspinatis
It is needed for the first 20<span>o</span> degrees of shoulder abduction, after that deltoid takes over
What are the rotator cuff muscles and what supplies them?
- Supraspinatis: suprascapularis
- Infraspinatis: Suprascapularis
- Subscapularis: superior and inferior scapularis
- Teres Minor: axillary
How do you know you’ve ruptured your ACL
Treatment?
- Sports injury
- High twisting force of bent knee
- Typically presents with: loud crack, pain and RAPID joint swelling (haemoarthrosis)
- poorly healing
Will need intense PT or surgery
What are the stabilising ligament of the knee?
- ACL: prevents anterior disloc. of TIBIA
- PCL: prevents posterior disloc of TIBIA
- Medial Collateral: inh. medial movement, femur > tibia
- Lateral Collateral: inh. lateral movement, femur > fibula
How do you get a ruptured posterior cruciate ligament and what do you do to test for it?
- Hyperextension injury
- Paradoxical anterior draw test:
Features of a Menisceal knee tear?
- Knee locking
- delayed swelling
- ROtational injury
- recurrent episodes of pain and effusion
What is Perthes disease?
Degenerative Hip condition, causes pain in boys ~4-8yrs due to AVN of the femoral head.
- hip pain: develops progressively over a few weeks
- limp
- stiffness and reduced range of hip movement
- x-ray: early changes include widening of joint space, later changes include decreased femoral head size/flattening
What is SLE
- Systemic Lupus Erythematous is an autoimmune disease which presents in early adulthood. More common in women or caribbean descent.
- Antibody/antigen complexes deposited to tissue or attach to cells
The general, skin, MS, cardiovascular symptomatic presentation of SLE is?
General:
- Fever
- Fatigue
- mouth ulcers
- lymphadenopathy
Skin
- Malar rash
- discoid rash
- alopecia
- raynauds phenomena
MS:
- joint pain/arthralgia
- Non-erosive arthritis
CV:
- Pericarditis
- Myocarditis
What are the common respiratory, renal and psychiatric symptoms indicative of SLE
Respiratory:
- pleuritis
- fibrosing alveolitis
Renal:
- proteinurea
- glomerulonephritis
Psychiatric
- anxiety and depression
- seizures
- psychosis
what vertebral levels should be included to ensure a good lateral neck xray?
minimum C1-T1
Name this anatomy.
What is the intra articular joints of the spine called?
Facet Joints
What is the Thomas Test and what does it assess?
Checks for fixed flexion deformities at the hip
- with patient supine, and your hand under the lumbar spine, fully flex one hip.
- if contralateral hip lifts off table, there is likely a fixed flexion deformity
What is FABER vs FADIR?
FADIR test
- hip Flexed to 90 deg, ADducted and Internally Rotated
- positive test if patient has hip or groin pain
- can suggest possible labral tear or FAI
FABER test (aka Patrick’s test)
- hip Flexed to 90 deg, ABducted and Externally Rotated
- positive test if patient has hip or back pain or ROM is limited
- can suggest intra-articular hip lesions, iliopsoas pain, or sacroiliac disease (posteriorly located pain)
