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MRCS > Trauma & Orthopaedics > Flashcards

Trauma & Orthopaedics Flashcards

1
Q

What is the normal range of extension/flexion of the tibiofemoral joint in the knee (in degrees) ?

A

-5 extension 150 flexion

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2
Q

What is the “screw home” mechanism of the tibiofemoral joint?

A

The Tibia can externally rotate 5 degrees when the knee is fully extended, allowing the knee to lock when standing.

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3
Q

What is O’Donahue’s triad (unhappy triad)?

A

Tear of the ACL, MCL and medial meniscus.

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4
Q

List the 5 blood supplies to the knee joint?

A

1- Five geniculate branches of the popliteal artery
2- The descending geniculate branch of the femoral artery
3- The descending branch of the lateral circumflex femoral artery
4- Two recurrent branches of the anterior tibial artery
5- The circumflex fibulae branch of the posterior tibial artery

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5
Q

List 3 surgical managements of osteoarthritis of the knee?

A

1- re-alignment osteotomy
2- Unicompartmental knee replacement (UKR)
3- Total Knee Replacement (TKR)

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6
Q

Which ligament is always sacrificed in TKR ?

A

ACL

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7
Q

List 4 radio graphic views of the knee to assess for Osteoarthritis?

A

1- Weight-bearing AP
2- Lateral
3- Skyline
4- Schuss/Rosenberg

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8
Q

What does Schuss/Rosenberg radiographic view assess for in the knee?

A

Lateral compartment arthritis

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9
Q

What are the benefits of Unicompartmental knee replacement (UKR) compared to TKR.

A
  • Preserves non-arthritic bone on the other compartment + ACL
  • Reduced surgical complications e.g infection
  • Better function than TKR e.g climbing stairs
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10
Q

List 4 causes of knee locking

A

1- Meniscal tears
2- ACL rupture
3- Loose bodies
4- Tibiofemoral dislocation

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11
Q

Why is tibiofemoral dislocation an orthopaedic emergency ?

A

10% have popliteal artery injury

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12
Q

What is the most common operative management of Meniscal tears?

A

Arthroscopic Meniscectomy

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13
Q

A footballer had his studs in the ground when he twisted on his right leg. He heard a “pop” and noticed immediate swelling of his knee.

What is the most likely injury?

A

ACL tear

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14
Q

What is the imaging modality of choice to assess for ACL tears ?

A

MRI

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15
Q

List 3 special tests that are positive in ACL tears?

A

1- Lachman’s (most sensitive)
2- Anterior draw
3- Pivot shift

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16
Q

List 3 causes of anterior knee pain in adolescents ?

A

1- Osgood-Schlatter
2- Patellar instability
3- Chondromalacia patella

17
Q

List 5 causes of anterior knee pain in adults ?

A 
1- Patellar/quadriceps tendinitis 
2- Bursitis 
3- Patellofemoral joint (PFJ) arthritis 
4- Fat pad impingement 
5- iliotibial band syndrome
18
Q

Name the sign seen in patellar instability where the patella lateralises excessively on extension then pops back into the groove during flexion.

A

“J sign”

19
Q

Which condition occurs in young women who present with anterior knee pain and sensation of the knee giving way on descending stairs?

A

Chondromalacia Patellae

20
Q

Which condition occurs more commonly in plumbers/decorators and is associated with anterior knee pain and swelling with preserved ROM.

A

Prepatellar Bursitis

  • common in occupations with excessive kneeling
21
Q

what is “popeye sign” and what does it indicate ?

A

A bicep bulge in the distal aspect of the upper arm.

Indicates Long Head of Biceps (LHB) rupture.

22
Q

List the 4 rotator cuff muscles ?

A

1- Supraspinatus
2- Infraspinatus
3- Teres minor
4- subscapularis

23
Q

List the 3 radiographic views used to x-ray the shoulder?

A

1- AP shoulder
2- GHJ view
3- Axial

24
Q

Which imaging modality is used to diagnose subacromial bursitis, shoulder Impingement, ACJ synovitis and rotator cuff tears ?

A

USS

25
Q

Which imaging modality is used to diagnose shoulder instability and Labral tears ?

A

MRI

26
Q

What is the mainstay of management for subacromial impingement ?

A

Steroid injection into subacromial bursa

Physiotherapy

27
Q

Which rotator cuff muscle is affected in subacromial impingement ?

A

Supraspinatus

28
Q

Which special test is +ve in subacromial impingement ?

A

Painful arc

29
Q

Which condition presents with sudden onset severe pain in the shoulder with eventual reduction in ROM and pain at night ?

A

Calcific tendinitis

30
Q

Which special test is +ve in Supraspinatus tear?

A

Jobe’s test (empty can test)

31
Q

Which 2 special tests are +ve in subacromial impingement?

A

1- Neer’s test

2- Hawkins test

32
Q

Which 2 tests are +ve in subscapularis tear?

A

1- Belly-press test

2- Lift off test

33
Q

Which special test is +ve in infraspinatus or teres minor tear ?

A

Resisted external rotation test

MRCS (1 decks)

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