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Questions Flashcards

1
Q

Dorsal Thompson approach to forearm is between

A

EDC and ECRB

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2
Q

Nerve with deep palmar arch

A

Deep motor ulnar

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3
Q

Supracondylar process is

A

A normal distal humerus variation, looks like osteochondroma

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4
Q

Nerve in plantar fasciitis is

A

Lateral calcaneal

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5
Q

A fabella is normally located

A

In the lateral head of gastroc around knee

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6
Q

Pacinian corpuscles sense

A

Pressure (high frequency, quick adaptation)

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7
Q

Froment’s sign

A

Weak adductor pollicis (ulnar) leads to flexion at thumb IPJ during pinch

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8
Q

Artery of adamkiewitz arises from

A

Left posterior intercostal artery between T8-12

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9
Q

Rhomboid innervation

A

C5 and dorsal scapular nerve

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10
Q

Median nerve goes ____ the pronator teres

A

Through the belly of

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11
Q

Interval for anterior approach to SCH fx

A

Between pronator teres and brachialis

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12
Q

Parona’s space

A

Distal forearm potential space, horseshoe abscess communication space

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13
Q

Define stieda fracture

A

Avulsion of MCL off femur

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14
Q

The small saphenous vein is ____ to the sural nerve at mid calf

A

Medial

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15
Q

Ligament that limits hip IR

A

Ischiofemoral

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16
Q

Posteromedial bundle of PCL resists

A

Hyperextension

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17
Q

Last muscle innervated by ulnar nerve

A

First dorsal interossei

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18
Q

Innervation of EDM

A

Radial

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19
Q

Synthetic nerve conduits treat gaps up to ____

A

3cm

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20
Q

Abx for early mycobacterium marinum infection

A

Clarithromycin

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21
Q

Impulse conduction implicated in neuropathic pain

A

Ephaptic

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22
Q

Treatment of trigger finger in rheumatoid

A

Tenosynovectomy (not A1 pulley release!)

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23
Q

Congenital clasped thumb is caused by

A

Hypoplastic extensor pollicis brevis

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24
Q

Most common finger deformity in psoriasis

A

PIPJ flexion and MCPJ extension contractures

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25
Q

Spiral cord displaces the bundle ___, ___, and ___.

A

Proximally, volarly and towards midline.

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26
Q

Bacteria symbiotic with leeches

A

Aeromonas hydrophila

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27
Q

Timing of upper extremity embryogenesis

A

4-8 weeks

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28
Q

Volkmann ischemic contracture affects which muscle bellies

A

Deep finger flexors: FPL and FDP

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29
Q

Vitamin that reverses effect of steroids on wound healing

A

A

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30
Q

The cell involved in dupuytren’s is

A

Myofibroblast

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31
Q

For clenched fist reconstruction, when is superficialis to profundus transfer indicated?

A

When there is no volitional control (otherwise do fractional lengthening)

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32
Q

How to block xanthine production after reperfusion

A

Allopurinol (generation of xanthines causes ischemic damage)

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33
Q

Radially deviated hands with normal thumbs in a baby is

A

TAR syndrome (thrombocytopenia absent radii)

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34
Q

What is imaging and initial treatment for severe frostbite?

A

Technetium-99 bone scan and IV tPA administration if no blood flow

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35
Q

What blocks reduction of thumb MCPJ dislocation

A

Adductor pollicis and FPB

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36
Q

Dwarf w normal facies and abnormal joints is

A

Pseudoachondroplasia (COMP)

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37
Q

Radiating a poly accomplishes:

A

Increased cross linking and overall improved wear resistance

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38
Q

Frataxin mutation

A

Friedreich’s ataxia: CNS disorder, cavovarus feet, scoliosis, cardiomyopathy

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39
Q

Most common proteoglycan in tendons

A

Decorin

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40
Q

t(2,13)

A

Alveolar rhabdomyosarcoma (PAX3-FKHR)

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41
Q

Cellular mechanism of BMP activity

A

Bind serine/threonine receptors, which cause phosphorylation of SMADs

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42
Q

MOA of argatroban

A

Direct thrombin inhibitor (blocks fibrinogen to fibrin conversion)

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43
Q

Popliteal artery is ____ to the PCL

A

Posterolateral

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44
Q

Define/explain wartenburg sign

A

Abduction of small finger due to ulnar nerve denervation

Unopposed pull of EDM (radial n)

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45
Q

PITX1-TBX4

A

An intergenic SNP related to clubfoot formation

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46
Q

Missense mutation in GNAS causes

A

Fibrous dysplasia (mon/polyostotic)

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47
Q

Pseudarthrosis of the tibia is associated with

A

NF-1

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48
Q

Spring ligament connects the

A

Calc and navicular

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49
Q

CD1a stain is specific for

A

Langerhans cell histiocytosis

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50
Q

Best approach for scaphoid humpback fixation is

A

Volar

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51
Q

Treatment for blounts in kids

A

Proximal tibia osteotomy

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52
Q

Mets that are resistant to radiation include

A

Renal and thyroid

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53
Q

Nuclear beta-catenin stain is specific for

A

Desmoid tumor

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54
Q

Lisfranc ligament is AKA

A

Oblique interosseous ligament

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55
Q

Most common glenoid wear pattern in OA

A

Posterior

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56
Q

At what degree of glenoid retroversion should graft be used in TSA

A

> 15 degrees

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57
Q

Order of ligament tears in elbow dislocation

A

LUCL, posterior band of MCL, anterior band of MCL

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58
Q

What is bunnell test

A

Intrinsic tightness test: decreased PIP flexion with MCP extended

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59
Q

Name of osseous ridge separating ACL bundles at attachment on femur

A

Bifurcate ridge

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60
Q

Most common site of PIN compression

A

Arcade of Frohse (fibrous edge of supinator)

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61
Q

Corticosteroids inhibit ____ and prevent formation of _____

A

Phospholipase A2 and arachidonic acid

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62
Q

MRSA is resistant to abx by what mechanism

A

Mutation in the mecA gene that alters pcn-binding protein

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63
Q

Osteoclasts resorb bone using what 3 enzymes

A

Carbonic anhydrase, MMP, and cathepsin K

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64
Q

What percentage of cartilage is chondrocytes

A

2%

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65
Q

wnt protein binds to

A

LRP5/6 receptor to stimulate beta-catenin translocation to differentiate osteoblasts

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66
Q

Thin eyebrows, juvenile cataracts, abnormal teeth, growth restriction

A

Rothmund-Thomson syndrome (increased risk of osteosarc)

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67
Q

Gene mutation leads to OA

A

type IX collagen

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68
Q

Master switches of osteoblast differentiation

A

runx2 and Osx

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69
Q

Biggest risk factor for PE in TKA is

A

Diabetes. Also bilateral TKA and BMI >30

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70
Q

Soft tissue cancer causing skin ulcerations

A

Dematofibrosarcoma protuberans

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71
Q

Most common soft tissue tumor in hand

A

Epithelioid sarcoma

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72
Q

t(12,22)

A

Clear cell sarcoma

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73
Q

CD99+

A

Ewing’s

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74
Q

USP6 gene mutation

A

Leads to ABC formation (ubiquitin specific protease)

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75
Q

Treatment for chondroblastoma

A

Curettage, augment, grafting

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76
Q

Lobulated tumor in hand/foot bones or proximal tibia, stellate cells on path

A

Chondromyxoid fibroma

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77
Q

Acral mets are most commonly from which primary solid organ tumor

A

Lung cancer

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78
Q

Atypical thoracic scoliosis bends to the

A

LEFT

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79
Q

Abnormal lab in Duchenne’s

A

Serum CPK

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80
Q

Anterolateral elbow scope portal risks injury to

A

Radial nerve

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81
Q

SBRN gets compressed in the interval between

A

Brachioradialis and ECRL

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82
Q

Most consistently proposed transfer for radial nerve palsy

A

Pronator teres to ECRB

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83
Q

Ligaments detached w labrum in bankart

A

MGHL and IGHL

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84
Q

Directional instability caused by isolated coronoid fx is

A

Varus posteromedial

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85
Q

Chronic swan neck is due to attenuation of

A

Spiral oblique retinacular ligament

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86
Q

The most common complication after talar neck fx

A

Posttraumatic OA! AVN is next

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87
Q

Most common coronoid fx pattern in terrible triad

A

Tip fx (2-3mm)

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88
Q

Reliable systemic inflammatory marker after polytrauma

A

IL-6

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89
Q

Chronic CN XI injury treated with

A

Levator/rhomboid transfer

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90
Q

Define zones of guyon’s canal

A
  1. Proximal to bifurcation
  2. Surrounds deep motor branch
  3. Surrounds superficial sensory branch
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91
Q

Nonunions of scaphoid waist can be treated w

A

Corticocancellous graft

92
Q

Nonunions of scaphoid proximal pole treated w

A

Vascularized bone graft off 1,2 intercompartmental supraretinacular artery

93
Q

When should radial n palsy after humerus fx be explored

A

6 months

94
Q

Corrosion resistance is provided by

A

Adherent oxide layer (chromium oxide in steel and cobalt, titanium oxide in titanium)

95
Q

Artery for patellar cartilage

A

Superior genicular

96
Q

Artery for ACL

A

Middle genicular

97
Q

Artery for menisci

A

Inferior genicular (medial and lateral) … Except horns, which are middle genicular artery

98
Q

Energy expenditure in unilateral AKA

A

65% above baseline

99
Q

MOA of linezolid

A

Binds 70S ribosomal subunit

100
Q

Collagen type in tendon and menisci

A

Type I

101
Q

Primary drawback of bioabsorbable polymers

A

Foreign body reaction (cost offset by no need for implant removal later)

102
Q

Primary restraint to valgus stress

A

Superficial MCL

103
Q

Appropriate anterolateral ankle portal placement is

A

4mm lateral to peroneus tertius

104
Q

Most commonly injured nerve during anterolateral approach to hip

A

Femoral nerve

105
Q

Most common direction of scapular winging

A

Medial (long thoracic nerve predisposed to viral neuritis)

106
Q

Brachialis is innervated by

A

Musculocutaneous AND radial nerves

107
Q

Sensation to lateral heel pad provided by

A

Lateral calcaneal nerve (branch off sural)

Plantar fasciitis!!

108
Q

Radial artery contributes to which palmar arch

A

Deep (which is distal)

109
Q

Most common birth plexus palsy (name and structure injured)

A

Erb’s palsy, upper trunk

110
Q

Most common complication after pelvic or acetabular trauma

A

DVT

111
Q

Strongest component of scapholunate ligament

A

Dorsal

112
Q

Approach to PCL insertion on tibia

A

Medial between gastroc head and semimembranosus (same as baker cyst location)

113
Q

LABC is a terminal branch of

A

Musculocutaneous nerve

114
Q

For lateral approach to hip, safe medius dissection is __ to protect the ___

A

4cm above GT, SGN

115
Q

Sensation over dorsal medial great toe provided by

A

SPN (medial branch)

116
Q

Teres major is innervated by

A

Lower subscap nerve

117
Q

Teres minor innervated by

A

Axillary nerve

118
Q

Sensation over dorsal medial great toe provided by

A

SPN (medial branch)

119
Q

Piriformis start in kids injures what vessel

A

Ascending/cervical branch of medial fem circumflex

120
Q

Deep and superficial heads of the FPB innervated by

A

Ulnar (deep) and median (superficial)

121
Q

Intermuscular interval in anterolateral hip approach

A

Gluteus medius and TFL (both innervated by SGN)

122
Q

What muscle/nerve still functions with lesion at Erb’s point (where upper trunk forms from C5-6)

A

Rhomboids/dorsal scapular

123
Q

Origin of elbow MCL

A

Anteroinferior undersurface of medial epicondyle

124
Q

Bifurcate ligament of foot connects the

A

Anterior process of calc to navicular and cuboid

125
Q

Blood supply to lateral 2/3 of talus is from artery of the tarsal ___

A

Canal

126
Q

Mechanism of chemo resistance in chondrosarcoma

A

Expression of p-glycoprotein which effluxes hydrophobic agents

127
Q

Latissimus Dorsi inserts between the ___ and ___ on the humerus

A

Pec major and teres major

128
Q

What are the 3 thenar muscles

A

ABductor pollicis brevis, FPB, and opponens pollicis

129
Q

Is flexor tendon blood supply richer dorsal or volar?

A

Dorsal

130
Q

Ogilvie syndrome

A

Colonic pseudo-obstruction (ileus but with normal BM), occurs post-op

131
Q

Most common complication after HTO is

A

Patellar baja

132
Q

Patellar component in TKA should always be ____ized

A

Medialized

133
Q

Factors affected by warfarin

A

II, VII, IX, X

134
Q

Innervation of Pronator teres

A

Median

135
Q

Type X collagen mutation

A

Schmidt metaphyseal chondrodysplasia

136
Q

Initial treatment of a patient with Mets and high Ca

A

Hydration with NS (hypercalcemia of malignancy)

137
Q

Material most susceptible to crevice/pitting corrosion

A

Stainless steel

138
Q

Type 1 error is defined as

A

Falsely rejecting the null hypothesis (alpha error)

139
Q

Ligament(s) torn if >5mm AP displacement between C1-2; if >10mm?

A

Transverse only; transverse AND alar

140
Q

Limbus fx and treatment

A

Apophyseal spine fx; wide laminectomy

141
Q

Treatment of scoliosis in NF1

A

Front/back fusion (always get MRI to r/o lesions on nerve roots)

142
Q

Treatment for any SH IV fx of the distal tibia

A

ORIF w screws parallel to physis

143
Q

Inheritance of cleidocranial dysostosis

A

Autosomal dominant

144
Q

Where is sustentaculum and what passes below it

A

Medial calc; FHL

145
Q

Plantar heel spurs are located within the

A

FDB origin

146
Q

Triangular interval contains

A

Radial nerve and profunda brachii artery

147
Q

Interval for Posterolateral ankle approach

A

PB and FHL

148
Q

Injury to which hypogastric plexus causes retrograde ejaculation?

A

Superior

149
Q

Recurrent laryngeal nerves are branches of the

A

Vagus nerves

150
Q

Atraumatic apnea, bradycardia and hypotension

A

Bezold-Jarisch reflex

151
Q

Most radial volar extrinsic ligament of wrist

A

Radioscaphocapitate

152
Q

Management of Vaughan Jackson syndrome

A

Ulnar head resection and EIP to EDC transfer

153
Q

Pedicle of groin flap

A

Superficial circumflex iliac artery

154
Q

Greater occipital nerve exits at what level

A

C1-2 (is medial branch of C2 dorsal ramus)

155
Q

Nerve running w brachial artery in arm

A

Median nerve

156
Q

MIC-2+

A

Ewing’s (neuroectodermal)

157
Q

Treatment of symptomatic McCune-Albright lesions

A

Bisphosphonates

158
Q

Small cortical lesion at Posteromedial femur

A

Periosteal desmoid lesion (tug lesion from gastroc), NOT a tumor

159
Q

An osteoid osteoma of the femoral neck is actually a

A

Synovial herniation pit (associated w FAI)

160
Q

Most common complication after distal biceps repair

A

LABC neurapraxia

161
Q

Most distal muscle innervated by PIN

A

EIP

162
Q

Septic arthritis after ACL recon is most commonly what bacteria

A

Staph epi

163
Q

Painless loss of elbow extension and a dislocated radial head is probably

A

Congenital!

164
Q

Chondral injury to acetabulum occurs in FAI in what location

A

Posteroinferior

165
Q

Glycoprotein that binds calcium in bone

A

Osteonectin

166
Q

Function of PTHrP

A

Slows maturation of chondrocytes in physis

167
Q

The best nerve conduits for digital nerve graft are composed of

A

Collagen

168
Q

Treatment of Kienbock’s in adolescence

A

Temporary STT pinning

169
Q

Treatment of trigger finger in kids consists of

A

A1 pulley release AND FDS resection (one or multiple slips)

170
Q

Which BMP is not osteoinductive

A

BMP-3

171
Q

Function of vitronectin

A

Adherence of osteoclasts to bone

172
Q

Osteocytes communicate via

A

Cannaliculi in lacunar network

173
Q

Bending and torsional rigidity are proportional to what power

A

Radius to the 4th

174
Q

Plate bending rigidity proportional to

A

Thickness to the 3rd power

175
Q

Classic abnormality in renal osteodystrophy

A

Phosphate retention (everything else follows this)

176
Q

Floor and roof of cubital tunnel

A

Osborne’s ligament and MCL

177
Q

PCL should be tensioned at what position

A

90 deg flexion

178
Q

BMP to use in open tibial fractures

A

BMP-2

179
Q

Which lumbricals are unipennate, and where do they originate/insert

A

1st and 2nd; originate in RADIAL side of FDP and insert on RADIAL sagittal bands

180
Q

Cause of cubitus varus after SCH fx

A

Malreduction!

181
Q

Two syndromes caused by COMP mutations

A

Pseudoachondroplasia and multiple epiphyseal dysplasia

182
Q

Best surgical option for cavus foot in CMT

A

PT transfer to dorsum of foot

183
Q

Common wear pattern in PCL deficient knee

A

Medial and patellofemoral compartments

184
Q

Odontoid ossification centers fuse at what ages

A

6 and 12 years

185
Q

Epiphyseal lesion in a 20-30 year old with clear cytoplasm

A

Clear cell chondrosarcoma

186
Q

Smallest lumbar peduncle diameter

A

L1

187
Q

Malignancy type and risk in MHE

A

Chondrosarcoma, 10%

188
Q

Resection of both hallucal sesamoids leads to

A

Cockup toe (loss of moment arm for FHB)

189
Q

Quads are active during which phase of gait

A

Stance

190
Q

What % of Brachial plexus birth palsies w Horner’s syndrome recover

A
191
Q

For TKA w valgus deformity, when should LCL, popliteus or IT band be released?

A 
LCL = tight in both
Pop = tight in flexion
IT = tight in extension
192
Q

Prognosis in central cord syndrome

A

Recovery in bowel/bladder and LE function, poor recovery in UE

193
Q

Most common variation of Hoffa fx

A

Coronal fx of LATERAL femoral condyle

194
Q

Interval for medial approach to hip and NV structure at risk

A

Between adductor longus and gracilis; medial femoral circumflex artery

195
Q

Imaging modality to confirm snapping hip

A

Ultrasound

196
Q

Scarf osteotomy is a

A

Proximal 1st MT osteotomy

197
Q

“Internal impingement” is specifically impingement of what

A

Posterior rotator cuff on the posterior/superior labrum

198
Q

First line treatment for EOG

A

Observation. Is self-limited process.

199
Q

Treatment of fixed MCPJ deformities in RA

A

MCPJ arthroplasties

200
Q

The Keller procedure is indicated for

A

Severe 1st MTPJ degeneration in low demand elderly patients (resection arthroplasty)

201
Q

Calcific tendinitis of shoulder most commonly affects the

A

Supraspinatus

202
Q

Borders of rotator interval

A

Coracoid base (medial), Supraspinatus (superior), subscap (inferior)

203
Q

Contents of rotator interval

A

Biceps tendon, SGHL, coracohumeral ligament

204
Q

Anterolateral tibial bowing is associated w

A

Pseudarthrosis of the tibia

205
Q

Anteromedial tibial bowing is associated w

A

Fibular hemimelia (hAMimelia = anteromedial)

206
Q

BMP used in open tibial nonunions

A

BMP-7

207
Q

Synostosis more common with what approach to proximal BBFA

A

One-incision approach

208
Q

Ilioinguinal nerve passes through which inguinal ring

A

Superficial ONLY

209
Q

Direction of tib-fib instability after syndesmotic injury

A

A to P

210
Q

MOA of indomethicin

A

IGF-1 inhibitor (NSAID but not a COX inhibitor)

211
Q

Direction of displaced odontoid fx most at risk for nonunion

A

Posterior (type II)

212
Q

Structure that blocks DRUJ reduction in Galeazzi fx

A

ECU tendon

213
Q

Strongest predictor of deep infection in TSA

A

Male gender

214
Q

Use of triceps-reflecting approach for TEA leads to

A

Weakness w elbow extension

215
Q

Location of femoral osteotomy in THA for severe high hip center deformity

A

Subtrochanteric (troch osteotomies prone to nonunion)

216
Q

Osteotomy for young person w varus knee OA

A

Proximal tibia

217
Q

Compared to other bearings, revision rate in ceramic-on-ceramic THA is

A

Lower

218
Q

Structure that limits distal extent of anterior hip approach

A

Femoral nerve

219
Q

Higher levels of cobalt compared to chromium after MoM THA are likely related to

A

Trunnionosis

220
Q

Body CT for work up of primary bone sarcoma includes which areas

A

Chest ONLY. (Rarely metastasize to visceral organs)

221
Q

After a tear, describe changes in collagen in ligament at 1 year

A

Increased number of fibers, decreased mass/diameter of fibers, and decreased crosslinks

222
Q

Process that converts UHMWPE to amorphous state

A

Remelting (NOT annealing… Annealing preserves crystallinity)

223
Q

Which nerve root contributes to both sciatic and femoral nerves

A

L4

224
Q

Which nerve root contributes to both obturator and femoral nerves

A

L3

225
Q

Primary effect of hip labral repair is improvement in

A

Lubrication

226
Q

Ethnic group with high prevalence of spondylolysis

A

Native Americans

227
Q

Proximal femoral epiphyseal secondary ossification center appears at what age

A

4-7 months (delayed in DDH)

OITE Prep (13 decks)

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