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emergency med final > upper extremity ortho > Flashcards

upper extremity ortho Flashcards

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Royal College: Emergency Medicine flashcards
1
Q

patients with a clavicle fracture will have more pain in what position

A
  • lying flat
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2
Q

tx of non-displaced or pediatric clavicle fracture

A
  • 8-12 weeks
  • figure 8 or sling
  • muscle relaxant beneficial
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3
Q

surgery option for clavicle fracture

A
  • ORIF
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4
Q

MOI of scapula fracture

A
  • high energy injury
  • typically associated with other trauma
    • evaluate UE, torso, spine
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5
Q

tx for scapula fracture

A
  • 6 months -1 year
  • conservative
    • sling/shoulder immobilizer
    • surgery rarely indicated
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6
Q

MOI for proximal humerus fracture

A
  • young: high energy trauma
  • elderly: simple fall
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7
Q

Neer classification used for

A

proximal humerus fracture

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8
Q

What specific neurovascular function must you evaluate for in a humerus fracture

A
  • radial nerve
    • wrist drop
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9
Q

if patient has a humerus fracture, r/o pathologic fx caused by

A
  • unicameral bone cyst
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10
Q

why would you promote early motion in patient with humeral shaft fracture

A
  • prevent frozen shoulder
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11
Q

Glenohumeral dislocations most often occur

A
  • anteriorly
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12
Q

physical exam tests for Glenohumeral dislocations

A
  • sulcus sign
  • apprehension and relocation test
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13
Q

what view is best for posterior Glenohumeral dislocations

A
  • axillary view
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14
Q

if you reduce Glenohumeral dislocation and ROM does not return, be suspicious for

A
  • axillary nerve injury
  • rotator cuff tear
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15
Q

tx for Glenohumeral dislocations

A
  • reduction
  • shoulder immobilizer: sling and swathe 2-4 weeks (short duration)
    • limit frozen shoulder
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16
Q

what is a Bankart lesion

A
  • detachment of anterior inferior labrum from glenoid rim
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17
Q

what is a Hills Sachs lesions

A
  • cortical depression of the posterolateral humeral head when humeral head is impacted by anterior rim of glenoid
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18
Q

if patient with an anterior glenohumeral dislocation has decreased sensation to the lateral aspect of the shoulder (mid deltoid) and decreased deltoid function (abduction) be suspicious of

A

axillary nerve damage

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19
Q

supracondylar fracture

A

fracture of the distal humerus just above the epicondyles

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20
Q

what special neurovascular exam should you do with supracondylar fracture

A
  • anterior interosseos nerve coming off medial nerve
  • okay sign
21
Q

when looking at radiograph images for suspected supracondylar fracture, what are you looking for

A
  • anterior humeral line must intersect the capitellum
22
Q

distinguish between subluxation vs dislocation

A
  • Dislocation (a complete disruption of the joint) and subluxation (a partial dislocation followed by relocation)
23
Q

nursemaids elbow. description and cause

A
  • dislocation of radial head
    • common cause: sudden pull of pronated arm in 1-4 y.o
24
Q

what must you remember to get when ordering imaging for forearm fractures

A
  • include elbow to r/o dislocation or fracture
25
Q

what is a Monteggia fracture

A
  • ulnar (or radial and ulnar) shaft fracture with dislocation of radial head
26
Q

Nightstick fracture

A
  • isolated ulnar shaft fracture
    • nighstick (defensive)
27
Q

biggest risk of elbow and forearm fractures

A
  • compartment syndrome
    • Pain, pallor, paresthesias, pulselessness, paralysis
28
Q

a complication of elbow and forearm fractures is volkmann’s ischemic contracture which is

A
  • flexor shortening
  • brachial artery obstruction
29
Q

For a wrist fracture, evaluate neurovascular function via

A
  • thumbs up : radial
  • okay sign: medial
  • scissors: ulnar
30
Q

MOA of Colles fracture

A
  • dorsal displacement causes wrist fx
  • dinner form deformity
31
Q

MOA of smiths fx

A
  • volar displacement causing wrist fx
32
Q

cast smiths fx in what position

A
  • supination
  • extension
33
Q

tx for wrist fracture

A
  • +/- reduction
  • splint
  • casting 4-6 weeks
  • ? surgery
34
Q

What is a Galeazzi fracture

A
  • distal radius fx with disruption of distal radioulnar joint (DRUJ)
35
Q

how is scaphoid fx diagnosed

A
  • clinical dx
    • TTP over anatomic snuffbox
    • radiographs may be negative. repeat x-rays in 2 weeks to detect delayed findings
36
Q

border of scaphoid fx

A
  • lateral border
    • extensor pollicis brevis
    • abductor pollicis longus
  • medial
    • extensor pollicis longus
37
Q

tx of scaphoid fx

A
  • thumb spica
  • surgery required for displaced fractures
38
Q

which aspect of scaphoid is at highest risk for avascular necrosis if fractured

A
  • proximal aspect of scaphoid
39
Q

what type of PIP dislocation is most common

A

dorsal dislocation

40
Q

What is jersey finger

A
  • Flexor tendon rupture
  • inability to flex DIP joint
  • ring finger most common
41
Q

tx of jersey finger

A
  • surgical
    • direct tendon repair/reinsertion
    • repair in 10-14 days to prevent tendon shortening
42
Q

what is a Mallet finger

A
  • rupture of extensor tendon
    • inability to extend DIP
43
Q

tx of Mallet finger

A
  • STAT extension splint 6-8 weeks
  • surgery with large fx fragment or subluxation at joint
44
Q

boutonniere deformity

A
  • flexion of PIP joint
  • hyperextension at DIP
  • ruptured central slip extensor tendon
45
Q

swan neck deformity

A
  • hyperextension of PIP joint
  • flexion of DIP joint
  • volar plate attenuation of PIP joint
46
Q

boxer’s fracture

A
  • fx to neck of 5th metacarpal
47
Q

degrees of angulation allowed before surgery required for metacarpal fractures

A
  • 10, 20, 30, 30
    • ex: boxers fracture can have up to 30 degrees of angulation
48
Q

what is a Bennett’s fracture

A
  • fracture to the base of 1st metacarpal
49
Q

what is a game keepers thumb (skier’s thumb)

A
  • injury to the MCP joint resulting in a ulnar collateral ligament tear and instability of MCP joint

emergency med final (4 decks)

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