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JL Musculoskeletal > Week 6 > Flashcards

Week 6 Flashcards

1
Q

What are soft tissue injuries well demonstrated by?

A

MRI and US

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2
Q

What can image tendons really well?

A

US

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3
Q

Name three typical sites of impacted fractures of the lower lib?

A
  1. Femoral neck
  2. Tibial plateau
  3. Calcaneus
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4
Q

What energy status are pelvic ring fractures in young people?

A

High energy

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5
Q

What two methods are pelvic ring fractures typically due to?

A

RTA and fall from height

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6
Q

What is the primary imaging technique in all polytrauma patients?

A

CT

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7
Q

What energy status are pelvic ring fractures in elderly patients with osteoporosis?

A

Low energy

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8
Q

What is the imaging of choice for low energy pelvic ring fractures?

A

MRI

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9
Q

Give two features of a typical hip dislocation?

A
  1. Posterior

2. With acetabular rim fracture

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10
Q

What is the most useful fracture classification?

A

Intra versus extracapsular

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11
Q

What type of proximal femoral fracture interferes with blood supply to femoral head, is prone to femoral head AVN or non-union and is treated by hemiarthroplasty, unless undisplaced or young patient where reduction may be tried?

A

Intra-capsular

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12
Q

How are extra-capsular fractures of proximal femor treated?

A

By internal fixation using DHS

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13
Q

What two things are at risk with a femoral shaft fracture?

A

Blood loss

Fat embolus

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14
Q

What is a specific sign of an intra-articular fracture of knee?

A

Lipohaemarthrosis collecting in suprapatellar recess

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15
Q

What parts of extensor mechanism injury can be easily clarifeid by US?

A

quadriceps and patellar tendon tears

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16
Q

What can excessive inversion or eversion of the ankle cause?

A

Talar dome margin fracture

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17
Q

What does calcaneal fracture usually follow?

A

Axial compression - fall from height

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18
Q

In adolescents what does the 5th metatarsal have at its base?

A

Longitudinal accessory ossification centre

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19
Q

What is the os trigonum?

A

An accessory ossification centre commonly seen posterior to talus

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20
Q

Name three things which predispose to tendon rupture?

A

Diabetes, RA and steroid use

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21
Q

Name the three forms of blood supply to femoral head?

A
  1. Intramedullary artery of shaft of femur
  2. Medial and lateral circumflex branches of profunda femoris
  3. Artery of ligamentum teres
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22
Q

Give two signs of a proximal femoral fracture?

A
  1. Shortening

2. External rotation

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23
Q

Give three steps in secondary bone healing

A
  1. Fracture gap fills with granulation tissue
  2. Then cartilage (soft callus)
  3. Then bone (enchondral ossification, hard callus)
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24
Q

If a high energy fracture - what should be done first?

A

Resuscitation - ABCD

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25
Q

What type of fracture happens with bending force?

26
Q

What type of fracture happens with axial loading?

27
Q

How should open fractures be managed?

A

Antiseptic cover, tetanus, early debridement and operative stabilisation

28
Q

For femoral shaft fracture - what alagesia should be used and what splintage?

A

Femoral nerve block

Thomas splint

29
Q

What is the term for intra=articular distal tibial fractures?

A

Pilon fractures

30
Q

In humeral shaft fractures what nerve is risked?

A

Radial nerve in spiral groove

31
Q

If the radius is fractured in isolation, suspect a dislocation of DRUJ - otherwise knwon as?

32
Q

If the ulna is fractured in isolation, suspect a dislocation of the radial head - otherwise known as?

A

Monteggia fracture

33
Q

Name four complications of colles fracture?

A
  1. Median nerve compression
  2. EPL rupture
  3. CRPS
  4. Loss of grip strenght
34
Q

What fracture results from a fall onto back of hand?

A

Smiths - extra-articular, volar displacement and angulation

35
Q

Give two features of first degree nerve injury - neurapraxia?

A
  1. Temporary conduction block/demyelination

2. Should resolve within 28 days

36
Q

Give three features of 2nd degree nerve block - axonotmesis?

A
  1. Nerve cell axon dies distally from point of injury = wallerian degeneration
  2. Structure of nerve (endoneurial tubes) intact
  3. Regenerates at 1mm per day
37
Q

Give two features of 3rd degree nerve injury - neurotmesis?

A
  1. Nerve transected

2. No recovery without surgery

38
Q

In childrens fractures what immobilisation do diaphyseal fractures need?

A

Above and below joint

39
Q

In childrens fractures what immobilisation do metaphyseal fractures need?

A

Just the adjacent joint

40
Q

What can be a cause of decreased conscious level and how can it be treated?

A

Hypoglycaemia - give dextrose orally or IV, IM glucagon

41
Q

What is the term for angulation of the first MT towards the midline (varus) increasing the distance between 1st and 2nd MTs?

A

Primus varus

42
Q

What is the condition where there is lateral angulation (valgus) of the great toe?

A

Hallux valgus

43
Q

What is hallux valgus often associated with?

44
Q

What is hallux rigidis?

A

OA of the first MTPJ

45
Q

What is lesser metatarsalgia and what does it feel like?

A

Painful lesser MT heads (2-5) - feels like walking on marbles

46
Q

What is a swelling of one of the intermetatarsal nerves where the patient describes shooting/burning pain or numbness?

A

Morton’s neuroma

47
Q

What is the term for flattening of the medial arch and what does it suggest?

A

Pes planus

Suggests RA/ tib post dysfunction

48
Q

What is pes cavus?

A

Increased height of medial arch - think neurological condition

49
Q

Name a medial ligament of the foot and ankle?

50
Q

Name a lateral ligament of the foot and ankle?

A

Talofibular

51
Q

What is tendo-achilles made up from and what does it do?

A

Plantar-flexes foot

Tendinous extension of gastrocnemius and soleus

52
Q

What is the term for inflammation of the sheath covering two tendons of the wrist (1st dorsal compartment)?

A

De Quervains tenosynovitis

53
Q

What two tendons are involved in De Quervains tenosynovitis

A

ABductor pollicis longus

Extensor pollicis brevis

54
Q

How could a shoulder be anteriorly dislocated?

A

Fall with shoulder in external rotation

55
Q

What assessment needs to be done on an anterior shoulder dislocation?

A

Regimental badge area sensory assessment for axillary nerve

56
Q

How can a shoulder be posteriorly dislocated?

A

Fall with shoulder in internal rotation

57
Q

For a posterior shoulder dislocation what sign is seen on x-ray?

A

Light bulb sign

58
Q

What is the mechanism of interphalangeal joint dislocation?

A

Hyperextension injury, direct axial blow - ball sports

59
Q

What way does the patella always dislocate?

60
Q

Name two things which increase the Q angle making patella dislocations more common?

A
  1. Genu valgum

2. Increased femoral neck anteversion

61
Q

What does lateral collateral ligament injury and peroneal nerve injury suggest?

A

Dislocation of knee

JL Musculoskeletal (35 decks)

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