Brainscape's Knowledge GenomeTM

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


See full index

Ortho > Upper Extremity > Flashcards

Upper Extremity Flashcards

1
Q

How many extensor zones are there in the hand? Draw them

A

8 zones

Zone 3 over PIP
Zone 5 over MCP
Zone 7 over carparl
Zone 8 radius/ulna with carpals

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

How many extensor zones does the thumb have? Draw them or describe key locations

A

5

Zone T1 IP jt
zone T3 MCP joint
T5 CMC joint

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

Which extensor zone injuries should not be repaired in the ED?

A

7 and 8
zone 5 if bite wound
zone 3 if joint capsule penetrated

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

Describe Elson’s test for central slip injury

A
  1. Place hand over table ende with PIP joint on edge.
  2. Ask pt to extend PIP jt. If central slip is intact they will extend the joint at the DIP joint will be loose (b/c lateral bands have not been recruited)
  3. If the central slip is injured, they may still extend the PIP joint but the DIP joint will be stiff and hyperextended due to lateral band recruitment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

4 cardinal signs of tenosynovitis:

A
  1. Tenderness along tendon sheath
  2. Fusiform swelling
  3. Pain with passive extension
  4. Flexed posture of finger
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Which carpal bones are at increased risk for AVN and why?

A
  • Scaphoid, capitate, lunate
    • Because they receive blood supply from single distal artery.
      (most carpal bones receive distal to proximal blood supply)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the normal features of a wrist PA?

A
  • Radial length: 9-12mm
  • Radial inclination: 15-25 degrees
    Volar tilt 10-25 degrees
    • Distance between carpal bones: 1mm
    • 3 smooth lines drawn along carpal articular surfaces: carpal, or Gulia’s arcs.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the normal features of a wrist lateral?

A
  • Volar tilt: 10-25 degrees
    • Long axis of radius, lunate, capitate, 3rd metacarpal should appear as straight line with 10 degrees
    • Scapholunate angle: 30-60 degrees
    • Capitolunate angle: 0-30 degrees
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Describe the stages of carpal bone instability and their associated radiographic findings:

A

· Stage I: Scapholunate dissociation
o PA: widening >2mm scapholunate space “Terry Thomas sign”
o If scaphoid is subluxed/rotated, will also see cortex of distal pole end on as “signet ring sign”
o Stress views if clinically concerned with normal XR à clenched fist in ulner deviation, gap >3mm is suggestive of disruption.

  • Stage II: Perilunate dislocation
    o Lateral: lunate remains articulated to distal radius, capitate dorsally dislocated
    o PA: overlap of distal & proximal carpal rows
    o Associated #’s: scaphoid mc, radial styloid, capitate
  • Stage III: associated triquetral dislocation
    o Radiographically as stage II
    o PA: Triquetral dislocation seen as overlap of tiquetrum on lunate or hamate
  • Stage IV: Lunate dislocation
    o PA: triangular appearance of lunate (by rotaion in volar direction) “piece of pie sign”
    Lateral: lunate volarly displaced “spilled tea cup sign” with dorsal displacement capitate, and lunate no longer articulating with distal radius
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

List 4 criteria for reduction of colle’s type fracture:

A
  • > 20 degrees angulation
    • Intra-articular involvement
    • Marked comminution
    • > 1cm shortening
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is an acceptable post reduction?

A
  • Neutral or volar tilt
    • Radial inclination >11 degrees
    • Radial height >11mm
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

List causes of carpel tunnel syndrome.

A
  • Distal radius fracture
    • Repetitive strain
    • RA
    • Hypothyroidism
    • DM
    • Renal failure
    • Amyloid
    • Acromegaly
    • Collagen vascular disease
    • Pregnancy
    • Menopause
    • Obesity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

List four important ligamentous structures of the elbow.

A
  • Annular ligament
  • Radial collateral ligament
  • Ulnar collateral ligament
    Anterior capsule
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Which nerve is most at risk by humeral shaft fractures?

A
  • Radial (20%) à closely associated with the humerus

Most are neuropraxia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

List 7 indications for ORIF for humeral shaft fractures.

A
  • Open fractures
  • Multiple injuries precluding mobilization
  • Bilateral fractures
  • Poor reduction
  • Poor patient compliance
  • Failure of closed treatment
  • Pathologic fractures
    Radial nerve palsy developing after manipulation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What suggests Septic olecranon bursitis?

A
  • Rapid onset
  • Hot red tender bursa
  • Limited flexion
  • Fever
  • Adenopathy
    Wounds or abrasions
17
Q

If septic bursitis is suspected what is the diagnostic test?

A
  • Aspiration (Cell count, gram stain, and culture)

- Traumatic / non septic = leuk count

18
Q

What is the treatment of septic olecranon bursitis?

A
  • Aspiration
  • Antibiotics
  • I and D (if resistant to aspiration and ABx) controversial as it is associated with recurrence of bursitis
19
Q

List indications for immediate and urgent orthopedic referral for operative management of clavicle fractures.

A 
Immediate
- Open fractures
- Associated neurovascular injuries
- Skin tenting
Interpositioning of soft tissues

Urgent

  • Type II lateral fractures (30% nonunion)
  • Severely comminuted or displaced middle third with >20mm shortening (20% malunion)
  • Medial third >2cm overlap
20
Q

How long are clavicle fractures immobilized?

A
  • Children: 2 – 4 weeks
    • Adolescents and adults: 4 – 8 weeks
    • Full non-painful ROM and absence of pain are good indicators of healing
21
Q

What are the three types of clavicle fractures.

A 
Medial third (5%)
Assoc with PTX and pulm injury

Middle third (80%)

Lateral third (15%)
- Type I: Lateral to CC ligaments, stable
- Type II: Medial to CC ligaments, 30% malunion
Type III: Articular surface

22
Q

What injuries are associated with scapulothoracic dissociation?

A
  • Severe soft tissue injury
    • Brachial plexus injury
      Subclavian artery disruption
23
Q

List indications for involvement of an orthopedic surgeon in proximal humerus fractures.

A
  • ≥ Neer 2 part displaced fractures (>1cm and >45 degrees)

Fracture dislocations à closed reduction often not successful

24
Q

Which of anterior or posterior sternoclavicular dislocations is more concerning?

A

Posterior – 30% associated mediastinal injuries and airway compromise. May present with hoarseness, dysphagia, dyspnea, weakness or parasthesia of contralateral upper extremity

Ortho (7 decks)

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