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MSK > Spine and UL > Flashcards

Spine and UL Flashcards

1
Q

Symptoms of mechanical back pain

A

Recurrent relapsing and remitting back pain
No neuro symptoms
Worse on movement, relieved by rest

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2
Q

Causes of mechanical back pain

A 
Obesity
Poor posture/lifting technique
Depression
Lack of physical activity
Disc prolapse
Degenerative OA
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3
Q

Treatment of mechanical back pain

A

Analgesia
Physio
Surgery (single level)

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4
Q

Symptoms of disc tear

A

After lifting heavy object

Severe pain, worse on coughing

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5
Q

Treatment of disc tear

A

Analgesia
Physio
2-3 months

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6
Q

Sciatica

A

NP herinates and presses on SC = pain, altered sensation , reduced reflexes
Burning/tingling pain to buttock and thigh

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7
Q

Lateral vs. Central prolapse

A

Lateral: upper nerve root
Central: lower nerve root or cauda equina

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8
Q

Treatment of disc prolapse/sciatica

A

Analgesia, physio
Gabapentin
Discectomy

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9
Q

Spinal stenosis

A

Cauda equina has less space due to bulging disc/ligamentum flavum/osteophytes

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10
Q

Symptoms of spinal stenosis

A

Over 60 years

Claudication - worse downhill, variable, burning pain, pedal pulses preserved

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11
Q

Treatment of spinal stenosis

A

Weight loss, analgesia, physio

Decompression

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12
Q

Cauda equina syndrome

A

Central disc prolapse affecting sacral nerve roots S4-5 (urination and defecation) = surgical emergency
Bilateral leg pain, paraesthesiae/numbness, saddle anaesthesia, urinary retention/incontinence, faecal incontinence/constipation

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13
Q

Investigations and treatment of cauda equina syndrome

A

PR exam
Urgent MRI
Urgent discectomy

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14
Q

Red flags

A

Less than 20 years or over 60 years
Constant severe pain, worse at night
Systemic upset (fever, night sweats, weight loss, fatigue)

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15
Q

Symptoms of osteoporotic crush fractures

A

Spontaneous fracture of vertebral body
Acute pain, kyphosis
Conservative or balloon vertebroplasty

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16
Q

Cervical spondylosis

A

Degeneration of IVD, OA of facet joints
Slow onset pain and stiffness, radiates to occiput and shoulders
Physio, analgesia, shaving, decompression

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17
Q

Cervical spine instability seen in:

A 
Down syndrome (C1/2)
RA
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18
Q

Impingement syndrome

A

Painful arc 60-120
Tendonitis, bursitis, ACJ OA, hooked acromion, RC tear
Pain to deltoid and upper arm

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19
Q

Treatment of impingement syndrome

A

NSAIDs, analgesia, physio, subacromial steroid, decompression

20
Q

Adhesive capsulitis

A

Frozen shoulder - capsule and glenohumeral ligments stiff and contracted
Progressive pain and stiffness (pain first then stiffness)
Age 40-60, resolves 18-24 months
Loss of ER
Physio, analgesia, NSAIDs, anaesthetic

21
Q

Aetiology of adhesive capsulitis

A

Injury, surgery
Diabetes
Hypercholesterolaemia
Dupuytren’s

22
Q

Acute calcific tendonitis

A

Acute onset severe shoulder pain due to Ca deposition in supraspinatus
Seen on xray proximal to greater tuberosity
Subacromial steroid and LA, Ca resorbs with time

23
Q

Treatment of instability

A

Physio

Surgery (Bankart - reattaches labrum)

24
Q

Biceps tendonitis

A

Inflammation of long head of biceps = anterior shoulder pain
Pain on resisted contraction
Popeye deformity if ruptures
Surgicla division, reattachment

25
Q

SLAP lesions

A

Tear in labrum where long head of biceps attaches

Tentomy/resection/repair

26
Q

What passes through carpal tunnel

A

9 flexor tendons (FDS + FDP + FPL)

Median nerve

27
Q

Causes of CTS

A

RA, fluid retention (pregnancy, CKD, hypothyroid), Colles fracture

28
Q

Symptoms of CTS

A

Pain and tingling in lateral 3.5 digits, worse at night
Loss of sensation, weakness of thumb
Thenar muscle wasting

29
Q

Tinel’s test

A

Percuss over median nerve

30
Q

Phalen’s test

A

Hold wrist hyperflexed

31
Q

Treatment of CTS

A

splints

decompression surgery

32
Q

Cubital tunnel syndrome

A

Compression of ulnar nerve at medial epicondyle
Paraesthesia medial 1.5 digits
Due to osbornes fascia or tightness of intermuscular septum as nerve passes between FCU
positive fromonts test

33
Q

Triceps inserts onto

A

Olecranon process = extends elbow

34
Q

What flexes elbow?

A

Brachialis and biceps

35
Q

What performs supination and pronation?

A

Biceps and supinator

Pronator teres and pronator quadratus

36
Q

Common extensor origin

A

Lateral epicondyle

Tennis elbow

37
Q

Common flexor origin

A

Medial epicondyle

Golfer’s elbow

38
Q

Dupuytren’s

A

Proliferative CT disorder where palmar fascia undergoes hyperplasia to form nodules and cords
Type III collagen produced instead of type I
Myofibroblasts cause contracture
Males, FH, alcoholic cirrhosis, diabetes

39
Q

Peyronie’s disease

A

Accopmanies dupuytren’s

Fibromatosis affecting penis

40
Q

Ledderhose disease

A

Accompanies dupuytren’s

Fibromatosis affecting feet

41
Q

Up to how many degrees contracture can be tolerated at MCP in dupuytrens?

A

30 degrees

Fasciectomy or fasciotomy

42
Q

Trigger finger

A

Flexor tendonitis = nodular enlargement
A1 pulley
Clicking, catches, pain
Steroid, surgery

43
Q

Ganglion cyst

A

Mucinous filled cysts adjacent to tendon or synovial joint
Hand and wrist, knee (Baker’s)
Localised pain, irritation, cosmesis
Firm, smooth, rubbery, translumiante

44
Q

Giant cell tumour of tendon sheath

A

Palmar surface of PIP of index and middle fingers
Can erode into bone
Multinucleate giant cells and haemosiderin
Excision

45
Q

Features of OA

A

Bouchards and Heberdens nodes

Squaring of thumb

46
Q

Features of RA

A

Ulnar deviation
Z shaped thumb
Swan neck
Boutonnieres

MSK (10 decks)

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