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MRCEM INTERMEDIATE > Trauma & Orthopaedics > Flashcards

Trauma & Orthopaedics Flashcards

1
Q

Salter Harris classification

1
2
3
4
5

A
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2
Q

Spinal cord tract locations and functions

A

Dorsal column (posterior) - fine touch

Spinothalamic (anterolateral) - pain and temp

Corticospinal (lateral) - movement

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3
Q

Supraspinatus action + test

A

Initiation of abduction of arm to 15 degrees at glenohumeral joint

Empty can test

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4
Q

Infraspinatus action + test

A

Lateral rotation of arm at glenohumeral joint

Adduct, 90 degrees and attempt lateral rotation against resistance

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5
Q

Teres minor test

A

Lateral rotation of arm at glenohumeral joint

Horn blowers

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6
Q

A galeazzi fracture is?

A

Distal 1/3 radial shaft fracture with an associated distal radioulnar joint (DRUJ) injury.

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7
Q

Colles fracture

A

distal radius points backward

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8
Q

Smith fractures

A

distal radius points forwards

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9
Q

McLaughlin lesion

A

Reverse H-S defect

Impaction fracture of anteromedial aspect of the humeral head following posterior dislocation of the humerus.

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10
Q

Anterior shoulder dislocation on XR

A

Where the humeral head is displaced medially and overlies the glenoid, the dislocation is anterior.

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11
Q

Posterior shoulder dislocation on XR

A

Light bulb sign, symmetrical appearance of the humeral head

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12
Q

Monteggia fracture

A

A Monteggia fracture is defined as a proximal 1/3 ulna fracture with an associated radial head dislocation.

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13
Q

Anatomical landmarks for pericardiocentisis

A

1-2cm inferior and left of the xiphochondral junction at a 45 degree angle towards the left scapula

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14
Q

Early severe complication of rib #

A

Lung contusion

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15
Q

Treatment for surgical emphysema

A

Give high flow O2 (gets rid of nitrogen)

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16
Q

Commonest hip dislocation is?

A

Posterior

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17
Q

Common complication of a posterior hip dislocation

A

Sciatic nerve compression

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18
Q

What type of pressure is a barton’s #

A

Crush #

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19
Q

Smiths vs colles management

A

Colles -> maipulate and cast

Smiths -> usually needs surgical management

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20
Q

Mallet finger cause

A

Rupture of the extensor tendon attachment at the base of the phalynx.

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21
Q

Deformity linked to metacarpal #

A

Rotated finger

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22
Q

Radial nerve injury

common location

neurologu

A

mid shaft humerus

Loss of supination
Extensors
Dorsum sensation of hand

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23
Q

Bankart lesion

A

Fracture of the glenoid labrum

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24
Q

How to recognise a posterior shoulder dislocation

A

Light bulb sign

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25
Q

Where does the perineus brevis attach

A

5th metatarsal

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26
Q

Plantar ecchymosis =

A

Mid foot # (lisfrank)

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27
Q

Calcaneal # often linked to

A

Contralateral calcaneal #
Tibial plateu #
NOF #
Compression spinal #

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28
Q

How to recognise a calcaneal #

A

Reduction in this angle

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29
Q

Rotational injury of the knee, most likely injury

A

Triad
Medial meniscus
Medial collateral
Ant. cruciate

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30
Q

Maisonneuve #

A

The Maisonneuve fracture is a spiral fracture of the proximal third of the fibula associated with a tear of the distal tibiofibular syndesmosis and the interosseous membrane. There is an associated fracture of the medial malleolus or rupture of the deep deltoid ligament of the ankle. This type of injury can be difficult to detect.[1][2]

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31
Q

Management of tetanus prone wound

A
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32
Q

When to give FFP in trauma

A

INR >1.5

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33
Q

When to give which blood products in bleeding trauma pt depending on blood results

A
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34
Q

Bennet #

A

The Bennett fracture is the most common fracture involving the base of the thumb. This fracture refers to an intraarticular fracture that separates the palmar ulnar aspect of the first metacarpal base from the remaining first metacarpal.

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35
Q

XR signs to diagnose SUFE

A

Trethowan sign

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36
Q

Severs disease

A

What is Sever’s disease? Sever’s disease is the most common cause of heel pain in growing children, especially those who play sports or exercise regularly. Also known as calcaneal apophysitis, Sever’s disease occurs when the growth plate in the back of the heel becomes inflamed and painful.

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37
Q

Garden classification of intracapsular hip fractures

A
38
Q

Conservative management for achilles tendon rupture

A

Equinus cast, crutches, immobilisation and pain relief for 6 weeks and then rehab

39
Q

Burns fluid resuscitation, UO aim

Adults

Children

A

0.5ml/kg/hr

1ml/kg/hr IF < 30 KG

40
Q

Weight used to traction limbs in trauma

A

10% of body weight

41
Q

De Quervain’s tenosynovitis is

A

tenosynovitis of the sheath containing the extensor pollicis brevis and abductor pollicis longus tendons.

42
Q

Where is the pain typically in De Quervain’s tenosynovitis

A

Radial side of the wrist

43
Q

Finkelstein’s test

A

The Finkelstein test is used in the diagnosis of De Quervain’s syndrome.

involves moving the wrist into flexion and ulnar deviation, with the thumb flexed across the palm of the hand:

44
Q

Febuxostat (Uloric)

A

an alternative to allopurinol used in the management of chronic gout

45
Q

Damage to the Ulnar nerve at elbow (vs wrist)

A

Elbow:
Hand held in abduction
Hypothenar eminence wasting
Froments sign - patient will flex thumb at IPJ when asked to hold piece of paper

Wrist:
Ulnar claw
Hypothenar eminence wasting
Froments sign - patient will flex thumb at IPJ when asked to hold piece of paper

45
Q

Blunt abdominal trauma, most common organs damaged

A

Spleen (40-55%)
Liver (35-45%)
Small bowel (5-10%)

46
Q

Common spinal injury in elderly patients with neck extension

A

Central cord

It is characterised by disproportionately greater motor loss in the upper extremities than lower extremities. There is generally variable sensory loss below the level of injury with associated bladder dysfunction and urinary retention.

47
Q

Jones fracture

A

A Jones fracture is a fracture of the proximal diaphysis of the 5th metatarsal, distal to the tuberosity, without joint involvement.

48
Q

Pivot shift test

A

The patient lies on one side of their body. The knee is extended and internally rotated and stress applied to the lateral side of the knee, while the knee is being flexed. Subluxation felt at 30 degrees flexion indicates a positive test.

49
Q

Most commonly associated mechanism of injury for posterior cruciate ligament

A

Direct blow to proximal tibia with flexed knee (dashboard injury)

50
Q

Most commonly associated mechanism of injury for anterior cruciate ligament

A

Non-contact pivoting injury causing forced flexion of hyperextension

51
Q

Most commonly associated mechanism of injury for medial collateral ligament

A

Direct blow to lateral knee causing excessive valgus stress

52
Q

Most commonly associated mechanism of injury for lateral collateral ligament

A

Direct blow to medial knee causing excessive varus stress

53
Q

Which of the burn zones represents the point of maximal damage?

A

Zone of coagulation

54
Q

‘Terry Thomas sign’

A

an increased gap >3 mm between the scaphoid and lunate, which indicates scapholunate dissociation

55
Q

Five pre-existing conditions are highlighted as posing a twofold risk for trauma mortality

A

Cirrhosis
Coagulopathy
Chronic obstructive pulmonary disease
Ischaemic heart disease
Diabetes mellitus

56
Q

Nerve damage which can be associated with peri-lunate dislocation?

A

Median

57
Q

Differentiate between

Superficial partial-thickness burns

Deep partial-thickness burns

A

Deep partial thickness don’t blanch to pressure, drier, less painful, red / mottled rather than homogeneously pink

58
Q

Which muscle should be primarily focused on during his rehabilitation to prevent recurrent dislocation of the patella?

A

Vastus medialis

59
Q

ANKLE radiographs are only required if there is pain in the malleolar area and any one of the following:

A

Bone tenderness over the distal 6 cm of the posterior edge or tip of the lateral malleolus
Bone tenderness over the distal 6 cm of the posterior edge or tip of the medial malleolus
Inability to weight bear immediately and in the Emergency Department

60
Q

The following patients are excluded from the Ottawa rules:

A

Pregnant women
Head injury patients with diminished ability to follow test
Intoxicated patients with diminished ability to follow test
Children under 6

61
Q

FOOT radiographs are only required if there is pain in the midfoot area and any one of the following:

A

Bone tenderness at the base of the fifth metatarsal
Bone tenderness at the navicular bone
Inability to weight bear immediately and in the Emergency Department

62
Q

The Weber system is a simple method used to describe lateral malleolar fractures:

Type A
B
C

A

Type A – fracture below the level of the syndesmosis
Type B – fracture at the level of the syndesmosis
Type C – fracture above the level of the syndesmosis

63
Q

Spinal cord damage at what level causes flaccid bladder

and what causes it

A

Below T12

Parasympathetic innervation no longer works so even when the bladder wall is stretched it doesn’t empty

64
Q

Lisfranc fracture is

A

fracture-dislocation involving the articulation of the tarsus with the metatarsal bases.

65
Q

A Galeazzi fracture is

A

a fracture of the distal radius in association with a dislocation of the distal radioulnar joint.

66
Q

A Jones fracture is

A

an extra-articular fracture of the base of the fifth metatarsal bone.

67
Q

Tillaux fracture

A

is a Salter-Harris type III fracture extending through the lateral aspect of the left tibial epiphysis.

68
Q

Segond fracture

A

an avulsion fracture of the knee that involves the lateral aspect of the tibial plateau

69
Q

Jefferson fracture

A

eponymous name given to a burst fracture of C1

70
Q

fluid resuscitation for all patients with major burns

how much given over 1st 8 hrs

Then the next 16

A

1/2

then the next 1/2

71
Q

Schatzker classification system

A

For tibial plateau #s

72
Q

‘Terry Thomas sign’

A

an increased gap >3 mm between the scaphoid and lunate

73
Q

An X-ray of the knee is only required for patients with knee injuries if any of the following are present:

A

Age >55 years
Isolated tenderness of the patella
Tenderness of the head of the fibula
Inability to flex knee to 90 degrees
Inability to weight bear both immediately and in the Emergency Department for 4 steps.

74
Q

Open book pelvic fractures occur as a result of

A

anteroposterior (AP) compression injury to the pelvis

75
Q

Intertrochanteric fractures can be classified using…

(2)

A

Kyle classification (‘Part classification’)

or

Boyd and Griffin

76
Q

Which complication is most likely to occur if scapoid lunate dislocation is not treated

A

SLAC wrist - scapholunate advanced collapse

77
Q

Burns surface area %s in children vs adults (differences)

A

Head - 18%
Leg - 13.5%

78
Q

Segond fractures are very frequently (~75% of cases) associated with disruption of the

A

ACL

79
Q

When is the dose of tetanus immunoglobulin doubled

A

4 hours have passed since the injury or the wound is heavily contaminated

80
Q
A

Anterior tear drop # of C6

81
Q

Cooper’s sign

A

Patient complains of joint line pain in the affected knee when turning over at night and changing the position of their legs.

Sign of meniscal tear

82
Q

description

Toddler’s fracture also known as …

A

Childhood accidental spiral tibial (CAST) fracture

Spiral fracture of the distal third of the right tibia

83
Q
A

Hangman #

This X-ray shows a fracture of the pars interarticularis of C2 and disruption of the C2/C3 junction

84
Q

The triangular fibrocartilage complex (TFCC) is …

A

The triangular fibrocartilage complex (TFCC) is a load-bearing structure between the lunate, triquetrum, and ulnar head. The function of the TFCC is to act as a stabilizer for the ulnar aspect of the wrist. The TFCC is at risk for either acute or chronic degenerative injury.

85
Q
A

Galeazzi fracture

86
Q
A

Monteggia fracture

87
Q
A

Bennet’s fracture

88
Q
A

Jones’ fracture

89
Q
A

MRCEM INTERMEDIATE (18 decks)

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