Spine/Hand Flashcards
spinal cord injury location with highest rate of recovery
- lowest chance change of recovery?
conus
lowest -> complete thoracic
Re: sagittal alignment
- how far should C7 plumb line be from back of sacrum?
4-5 cm
% people that improve nonop for C spine HNP
% who get long term benefit from cervical NRB
% of those with lumbar HNP that resolve with nonop
75%
70%
90%
where does sympathetic chain end?
T6/7
nerve root for FHL
S2
TLICS value that indicates surgery
> 4 (5 and up)
Sternoclydomastoid innervation
CN 11 (spinal accesory) - along with trap
most common PE in cervical myelopathy
hoffman
Torg ratio
diameter of spinal canal vs diameter of vertebral body
< 0.8 = severe stenosis
most mobile segment of lumbar spine
L4/5
1st radiographic finding in pediatric diskitis
loss of normal lordosis
incidentals on MRI of L spine
30% -> HNP
80% -> bulding disc
90% -> DDD
Spinal cord monitoring questions
- significant SEP change
- appropriate MAP
Decrease 75% amplitude on SEP is concerning
MAP > 90
What does burst activity indicate in mechanical electromyography?
- sustained train?
burst = contacting nerve root (not bad)
sustained train = significant root traction
this prevents dorsal subluxation of lateral bands
transverse retinacular ligament
where do lumbricals originate from
FDS
1/2-> innervated by median n
3/4 -> innervated by ulnar n
distribution of pressure btw distal radius and ulna
- ulnar neutral
- ulnar postitive +2.5
- ulnar neg - 2.5
neutral - 80/20
+2.5-> 60/40
-2.5-> 95/5
structure that anchors the volar plate
order of release for flexion contracture
checkrein ligaments
checkrein-> volar plate-> proper collateral> extensor tendon tenolysis
The only nerve in an extensor wrist compartment
PIN
4th
Which tendon is usually pathological in trigger finger?
FDP
Tendon typically used for opponnens plasty
EIP
Cotton Loder position
- position?
- significance?
extreme flexion and ulnar deviation to hold DR reduction
can lead to carpal tunnel syndrome
Factor most assoc with loss of reduction nonop Distal Radius
Pt factor assoc with worse outcomes re: DR fx
loss of reduction -> older ppl
Depression
pressure injection material with highest likelihood of amputation
organic solvents
- ***Time from injury of Jersey finger when you need to do 2 stage revision
> 3mos
- b’c the pulleys scar down
Dorsal DIP dislocation blocks to reduction
- closed
- open
closed-> volar plate
open -> FDP
fix for lumbrical plus finger
release the lumbrical
Duration of immbolization for scaphoid fx
distal- 3 mos
waist- 4 mos
proximal- 5mos
Benefits of fixing non-displaced scaphoid
cost difference?
decrease time to union
earlier return to sport/work
no difference in cost
Abx’s for infection from Leeches
Cipro
Bactrim 2nd liner
“Those leeches were Cipro’n on some Blood/Bactrim”
most important fingers when it comes to salvage in amps
Thumb and MF
least so -> IF
Most sensitive carpal tunnel clinical exam test
Durkans (compression to CT)
Most important factor in nerve recovery after repair
Age (older is worse)
What is the Leash of Henry
radial recurrent arteries
Arcade of Frohse
supinator arch
Most common location of PIN compression
Arcade of Frohse
when does grip return after CTR
returns to proep level around 3 mos
120% by 6 mos
