Stephas Flashcards
Hip rx questions to ask
Have you fallen in the past year
Do you feel unsteady when walking and or standing
Do you worry about falling
Ask these questions for 65 year old and up
Scaphoid fx at risk for what
AVn
Complications due to retrograde blood flow
Other bones associated with this is femoral neck, scaphoid, lunate
Game keeper thumb
Fx at ulnar collateral ligament MPJ of thumb
Pt will have pain and swelling with laxity at UCL ligament
Mallet finger
D/t pain when smashing finger
Splint for 6-8 walks be careful when removing splint
Green stick fx
3rd most common fx for kids
FOOSH mOA
Check joint above and below
Think abuse in less than 1 year old
AC joint seperation
Occurs from forceful fall on shoulder
Will have a bump on joint
Tx: ice, rest, nsaids
AC joint seperation grading
1-3 non operable, 4-6 operable
Starts from simple dislocation to worse and worse
Tibia shaft fx
Occurs from high impact injury like parachuting so think of joints above and below
Complications can occur such as compartment sx, and avn, 3 compartments in thigh and 4 in lower leg pain swelling and paresthesias will occur
Weber classification
A- below syndesonosis - nwb 4 - 6 wk boot
b- level of syndesonosis
c- above levle syndesnosis surgery requiered
Lisfranc injury
Injury of mid foot fracture
Get weight bearing xr and ct if sus still
Trochanter bursitis
Pain at brusa in hip hot joint “snapping hip syndrome”
Piriformis injury syndrome
Tightening shortening hypertrophy of muscle can cause low back pain
Hip dislocation
Rare occurrence and considered medical emergency
Tri joint complex name
Zygapophyseal facet joint
Cauda equine syndrome
Sx: saddle anesthesia, lose of control of urine or bowel syndrome, foot drop, neurological symptoms, unexpected rectal laxity
Order: MRI, call neurosurgery
Caused: my massive midline disc herniation and compression of the cord
Sx: BL weakness adn numbness
Lower back pain is described as
Somatic dysfunction of lumbar spine
Moa: lifting, falling which indices muscle spasm
Three categories: mechanical, inflammatory, infectious
RED FLAGS FOR BACK PAIN
UNDER 20 OVER 50 Fevers, chills, UTI Significant trauma, Unrelenting pain at night and at rest Weight loss Loss of bowel, urine control Motor weakness Hx ca, hx osteoporosis Pain worse when supine
Sciatica risk factors
Age Obese Occupation Prolonged sitting DM
Ankylosis spondylitis
A form os inflammatory arthritis
Primary cause inflammation joint between vertebra spine and joint
Occurs in early adult males
Schober test
Can impact, eyes, liver colon, skin and heart
Spondylolysis
Scottie dog in XR
BL or Uni
Stable defect in PARS of vertabre
Spondylisthesis
Fed displacement,ent of vertebrae
Xr: decapitaed dog
To: rest ice, flexion is best for these ppl
Medication used in back pain
Tylenol
Nsaids
Trauma doll
TCA
Polymialgia rheumatia
Men above 65
With sever pain bL
Tx: prednisone
L4-L5 herniation
@l5 cause hip and lateral thigh pain hard to Doris flex and flex great tie
L5-s1
Causes back pain to the butt and posterior thigh and little toe hard to walk on ropes and plantar flex foot.
When do you order mri of back?
When pain is been going on for 6-12 week
When is surgery applicable for back pain?
When there is an anatomical lesion consistent with pain distribution
Spinal stenosis
Narrowing of spinal canal
To: conservative
What do you order if you think ca?
CRP, esr, CBC, psa
What imaging do you order if you think back fx?
Xr, ct, mri
What do you order if you suspect infection?
CRP, esr, CBC, UA
Clavicle fx characteristics
FOOSH mid shaft non displace ok no surg
Sever displacement non union open fx u know surgery
Jones fx
This is rx to the 5th metatarsal @metaphysis and diaphysis place pt on nwb for 6-8 wks
Call ortho zone 2 requires surgery
Boxers fx
Fracture to 4th and 5th Mc neck place in velar splint 3-4 wks more than 30 degrees angle call ortho
Collies fx
Call ortho
Carpal tunnel sx
Compression of medial nerve Pt with nocturnal pain and bunmbess to the thumb 4th finger and hand of ring finger \+ tinnels and phablets Happens more with PREGO and DM Tx: splint, injections, NSAIDS
Ganglyon cyst
Benign synovial cyst splint 2-3 weeks reassure aspirate
