Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

FRCEM SBA > Trauma and Orthopaedics > Flashcards

Trauma and Orthopaedics Flashcards

1
Q

What is Mallet finger?

A

Rupture of extensor tendon at DIPJ

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is gamekeepers thumb?

A

Hyperabduction of thumb - ruptures ulnar collateral ligament. Unstable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is Karnavels signs (4) and what do they show (1)?

A
  1. Tenderness over flexor tendon
  2. Symmetrical swelling of finger
  3. Finger held in flexion
  4. Extreme pain on passive extension

Pyogenic flexor tenosynovitis
Flexor sheath infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is a clue towards lunate dislocation?

A

Median nerve parasthesia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is Bartons/reverse Bartons #?

A

Intra-articular # involving only dorsal or volar portion of distal radius.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is triangular fibrocartilage complex injury? (TFCC)

A

Distal end of ulnar, often thought to be simple sprain but doesn’t heal. Needs MRI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is de Quervains Tenosynovitis?

A

Inflammation of sheath of abductor pollicis longus and extensor pollicis brevis. Pain/swelling lateral aspect of radial styloid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is Finkelsteins test?

A

Clench thumn in fist and move ulnar-ward.
Positive test - de Quervains tenosynovitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is a Galeazzi # dislocation?

A

Middle/distal radius # and dislocation of distal radio-ulnar joint

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is a Monteggia # dislocation?

A

ulnar and dislocation of radial head

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What can be damaged in both supracondylar #s and dislocated elbows? (2)

A
  1. Brachial artery
  2. Median/ulnar/radial artery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is tennis elbow?

A

Lateral epicondylitis
Repetitive stress of extensors on lateral condyle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is golfers elbow?
What can it lead to?

A
  1. Medial epicondylitis
    Repetitive stress of flexors on medial condyle
  2. Reduced grip strength secondary to ulnar neuritis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Describe the 3 grades of AC disruption

A
  1. Minimal
  2. Obvious subluxation but still some opposition
  3. Complete disruption
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What part of the pelvis usually #s in hip dislocation?

A

Acetabulum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What nerve can be damaged in a hip dislocation and how do we test for it?

A
  1. Sciatic
  2. Dorseflexion foot and sensation below knee
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

In a # coccyx what should be done to check for further injury?

A

PR to check for rectal tear

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are Shentons Lines?
What does their disruption mean?

A
  1. Imaginary line from inferior border of superior pubic symphysis and along inferiomedial border of NOF
  2. NOF#
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the Garden criteria? (4)

A
  1. # line not though both cortex
  2. # line through both cortex
  3. Mild displacement
  4. Displaced
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What does NICE recommend as first line imaging for NOF# if can occur < 24 hours

A

MRI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are the Ottawa knee rules? (4)

A

1 of the following:
1. Isolated patellar tenderness
2. Unable to flex to 90 degrees
3. Bony tenderness over fibula head
4. Unable to WB at time of injury and now

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are postero-lateral corner injuries?

A

Group of ligaments/tendons/muscles which when damaged can lead to a chronically unstable knee joint

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are anterior cruciate ligament injuries associated with? (2)

A
  1. ‘pop’
  2. medial collateral ligament or medial meniscus injury
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are the 3 grades of collateral ligament injury?

A
  1. Tenderness but no laxity
  2. laxity but definitive end point
  3. Major laxity and not end point - needs POP
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is a Maisonneuve #?

A

Transmitted forces from ankle injury leads to proximal fibula #

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is the test called for Achilles tendon rupture?

A

Simmonds/Thomas test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is the managment of a Achilles tendon rupture?

A

Equinus cast

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What are the Ottawa ankle rules?

A
  1. Unable to WB immediately after and now
  2. Tenderness of posterior medial or lateral malleolus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Describe the Weber ankle classification

A

A - below syndesmosis and stable
B - at the level, can be either
C - above the level of syndesmosis and unstable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is Bohlers angle and what value should it be?

A

For assesssing calcaneal #s
35-40 degrees

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

How to we check for a Lisfranc injury?

A

Ensure medial side of second metatarsal aligns with medial side of medial cuneiform

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What is Jones #?

A

Transverse # just distal to inter MT joint - prone for non-union

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What is Perthes disease?

A

Aseptic necrosis of the upper femoral epiphysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Who does Perthes disease affect most commonly? (2)

A
  1. M>F
  2. 3-10 years
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What will an XR of Perthes disease show?

A

Increase bone density
Fragmentation/flattening of upper femoral epiphysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What might an US show in a child with transient synovitis?

A

Effusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Who tends to get SUFEs? (4)

A
  1. M:F = 3:1
  2. 10-16yrs
  3. Fat/hypogonadism
  4. Tall/skinny with rapid growth
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

How do patients with SUFE present?

A

Gradual limp
Often hx trauma
Legs maybe abducted and short/externally rotate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What type of XR is required for SUFE and what is the eponymous sign?

A
  1. Frogs leg
  2. Trethowans sign
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Describe the Salter Harris classifcation

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Which Salter Harris fractures are at most risk of premature growth plate fusion?

A
  1. I/II low risk
  2. III - moderate
  3. IV/V - high risk
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What is the the order of the elbow ossification?

A

Capitellum
Radial head
Internal (med) epicondyle
Trochlea
Olecranon
External (lat) epicondyle

1yr - 11 yrs

43
Q

What is Toddlers #

A

Minor trauma 1-4 years leading to a spiral undisplaced # of the distal tibia.
XR may be normal, if suspected POP and clinic review in 10 days

44
Q

Which #s are suspicious of NAI? (4)

A
  1. Rib/spinal #s
  2. Long bone < 3years
  3. Epiphyseal seperation + metaphyseal ‘chip’ knees/wrist/ankles - shaking
  4. Multiple #s of different ages
45
Q

What are the indications for immediate CTH in children? (8)

A
  1. ? NAI
  2. Seizure
  3. GCS <14 at presentation
  4. GCS <15 at 2 hours
  5. ? skull # / tense fontanelle
  6. Basal skull # signs
  7. Focal neurological deficit
  8. Bruising/swelling >5cm in <1years
46
Q

What are the risk factors that may require observation in paeds head injurys? (5)

A
  1. LOC >5mins
  2. Amnesia > 5 mins
  3. Abnormal drowsiness
  4. 3 or more vomits
  5. Dangerous MOI
47
Q

If a child has one risk factor following head injury what should be their management?

A

4 hours observation

48
Q

If a child has more than one risk factor following head injury what should be done?

A

CTH < 1hour

49
Q

What are the indications for CT neck over XR neck in kids? (7)

A
  1. GCS <15
  2. I+V
  3. Needs rapid definitive diagnosis i.e. theatre
  4. Polytrauma requiring other body parts CT
  5. Peripheral neuro signs
  6. Parasthesia upper/lower limbs
  7. XR normal but ongoing concerns
50
Q

What is the primary modality for chest imaging in paediatric trauma?

A

XR

51
Q

What 2 circumstances require CT chest in paeds trauma?

A
  1. Penetrating trauma
  2. Severe blunt trauma
52
Q

What is the imaging recommended for high suspicion of spinal injury in children?

A

XR and MRI
(CT if unable to perform MRI)

53
Q

What are 6 risk factors for needing CT abdomen in paeds trauma?

A
  1. Abdominal wall bruising
  2. Lap belt injury
  3. Abdominal tenderness
  4. Abdominal distension
  5. Persistent hypovolaemia
  6. PR or NG blood
54
Q

What is the imaging of choice for paeds pelvic injuries?

A

CT
Pelvic XR as primary survey not recommended

55
Q

What are the increased risk factors needing imagine in the Canadian c-spine rules? (3)

A
  1. Over 65years
  2. Dangerous MOI
  3. Parasthesia in the extremities
56
Q

What constitutes a dangerous MOI in the Canadian C-spine rules? (5)

A
  1. Fall over 3 foot or 5 stairs
  2. Axial load to head
  3. High speed MVC (>100kmph)/rollover/ejection
  4. Motorised recreational vehicles
  5. Bicycle collision
57
Q

What are the low risk factors in the Canadian C-Spine rules? (5)

A
  1. Simple rear end shunt
  2. Sitting position in ED
  3. Walking at any point
  4. Delayed onset neck pain
  5. Absence of midline tenderness
58
Q

How many low risk factors do you need to avoid imaging in the Canadian C-spine rules?

A

1

59
Q

What is the final step in the Canadian C-Spine rules?

A

Can they rotate their neck 45 degrees left to right

60
Q

What are the indications for immediate CTH in adults? (7)

A
  1. GCS <13
  2. GCS <15 after 2 hours
  3. Open/suspected skull #
  4. Signs basal skill #
  5. Seizure
  6. Focal neurology
  7. More than 1 vomit
61
Q

Within what period should patients on anticoagulation have a CTH according to NICE?

A

8 hours

62
Q

If an adult patient has no indication for CTH immediately and is not on anticoagulation, what is the next question to be asked?

A

Any LOC or amnesia - if no then no imaging
If yes move onto risk factors

63
Q

What are the risk factors used to determine whether a patient needs a CTH within 8 hours who have had a LOC or amnesia? (4)

A
  1. Over 65years
  2. Hx bleeding/clotting disorder
  3. Dangerous MOI
  4. > 30mins retrograde amnesia (events before injury)
64
Q

What is Chance #? (2)

A

Spinal # through body + pedicle + posterior elements of vertabrae - 3 column
Usually thoracolumbar

65
Q

How are Chance #s normally caused?

A

Hyperflexion
Classically lap seat belt
3 column injury

66
Q

What does a Chance # look like on XR?

A

2 spinous processed excessively apart

67
Q

How is a tear drop # caused?

A

Severe flexion and compressive forces i.e diving

68
Q

What is a tear drop # ?

A

anteroinferior lip of vertebrae

69
Q

What other structures are damaged in a tear drop #? (3)

A

1, Posterior ligamentous injury/rupture
2. Can lead to subluxation and retropulsion and cord damage
3. Anterior cord syndrome common

70
Q

What mechanism causes odontoid peg #s? (2)

A

Either hyperextension or hyperflexion

71
Q

In which 2 types of injury are odontoid peg #s typically seen?

A
  1. Low energy falls in elderly
  2. High impact in young
72
Q

What are the 3 types of odontoid peg #?

A

1 - tip of odontoid process avulsed
2 - base of process # secondary to extensive extension
3 - # though body of C2

73
Q

Which odontoid #s are not stable?

A

II

74
Q

What mechanism causes most spinal #s?

A

Flexion/rotation

75
Q

What is a clay shovellers #

A

Avulsion C6/7 from spinous process

76
Q

What mechanism causes a Hangmans #

A

Hyperextension through C2 pedicles

77
Q

What is a Hangmans #?

A

though both pedicles of C2

78
Q

What does a Hangmans # normally show on XR?

A

C2 moves forward over C3

79
Q

What is a Jeffersons #?

A

Burst # of Atlas
Anterior and posterior arches of C1

80
Q

What can Jeffersons # lead to? (4)

A

Vascular damage leading to:
1. Horners syndrome (proptosis/miosis/anhidrosis)
2. Ataxia
3. Lateral medullary sydrome

Commonly no neurology

81
Q

In which group is SCIWORA more common?

A

Children (around 30%)

82
Q

Describe the 3 columns in the 3 column spinal theory

A

Anterior column - anterior longitudinal ligmaent, anterior 1/2 of vertebral body
Middle column - posterior ligament, posterior half of vertebral body
Posterior column - everything posterior to vertebral ligament - neural arch, facet joints etc.

83
Q

Which column is the most important for the spines stability?

A

Middle
Posterior also unstable

84
Q

How much prevertebral swelling should you see above C4?

A

< 1/3 adjacent vertebral body or <7mm

85
Q

How much prevertebral swelling should you see C4 or below?

A

No larger than the width of one whole vertebral body or <22 mm

86
Q

Give 3 clinical features of an orbital blow out #

A

If inferior rectus involved

  1. Unable to look up
  2. Diplopia
87
Q

What can happen as a consquence of an orbital blow out
#?

A
  1. Inferior rectus can become trapped leading to ischaemia and diplopia
88
Q

What sign maybe on facial XR to suggest orbital blow out #?

A

Tear drop sign

89
Q

What is a sign that a nasal # has lead to nasoethmoidal #?

A

CSF in rhinorrhoea

90
Q

What can occur following a zygomatic arch #?

A

Temporalis muscle can become trapped leading to trismus

91
Q

What can ZMC #s lead to?

A

Infra-orbital nerve damage
- Lower eyelid
- lateral nose
- upper lip

92
Q

What does damage to infra-orbital nerve lead to and what can cause it?

A

Numb cheek and upper lip
ZMC #s

93
Q

What are the risk factors than mandate a CTH in patients who have had a LOC/amnesia? (4)

A
  1. Over 65 year
  2. Any bleeding or clotting disorder
  3. Dangerous MOI
  4. More than 30 mins retrograde amnesia (before event)

Within 8 hours

94
Q

What nerve causes meralgia paresthesia?

A

Lateral cutaneous nerve

95
Q

What nerve is involved in tarsal tunnel syndrome?

A

Tibial nerve

96
Q

Where does the compression occur in tarsal tunnels syndrome?

A

As the tibial nerve passes through tarsal tunnel (flexor retinaculum provides roof) - posterior to medial malleolus

97
Q

What are the symptoms of tarsal tunnel syndrome?

A

Pain radiating from ankle to foot/toes

98
Q

Describe the 3 neck zones in terms of trauma?

A
  1. Region bounded by the clavicles/sternum and up to cricoid cartilage
  2. Between cricoid cartilage and angle of mandible
  3. Superior to the angle of the mandible
99
Q

What ages do you expect the ossification centres to have fused by?

A

Capitellum - 1 yr
Radial head - 3 years
Internal condyle - 5 years
Trochlea - 7 years
Olecranon - 9 years
Lateral epidondyle - 11 years

100
Q

What are the 4 compartments of the lower limb?

A
  1. Lateral
  2. Anterior
  3. Deep posterior
  4. Superficial posterior
101
Q

What is Trethowans sign?

A
102
Q

What percentage of SUFEs are bilateral?

A

20%

103
Q

Above what spinal level would you see neurogenic shock in the context of cord injury?

A

T6

FRCEM SBA (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions