Miscellaneous And Pediatric Orthopedics

Front 1

osteochondritis dissecans

Back 1

--portion of subchondral bone undergoes avascular necrosis
-it can partially or completely separate from the adjacent bone and extrude from that joint

Front 2

occurrence of osteochondritis dissecans

Back 2

-most commonly seen in knee, but can be seen in elbow esp with little league
-usually adolescent males
-cause unknown but may be due to repetitive traumatic compression

Front 3

how does osteochondritis dissecans present?

Back 3

-dull, aching pain with stiffness and occasional episodes of locking

Front 4

PE for osteochondritis dissecans will reveal?

Back 4

-limited ROM, local tenderness, joint effusion

Front 5

tx for osteochondritis dissecans

Back 5

-rest, possibly sling if elbow
-surgery to remove any loose bodies
-prognosis good if pt is young

Front 6

joint swelling is __________until proven otherwise

Back 6

sepsis

Front 7

septic arthritis presentation

Back 7

-bone pain, fever, malaise
-bone aspirate will yield pus

Front 8

pathogens most associated with septic arthritis are ?

Back 8

-H. flu, group Bstrep and staph

Front 9

when might pseudomonas lead to osteomyelitis?

Back 9

puncture wounds

Front 10

what do you call the thick, vascular, osteogenic portion of growing bone?

Back 10

periosteum

Front 11

what factors determine the remodeling capacity?

Back 11

-number of years of growth remaining
-proximity to physis
-magnitude of angular deformity
-plane of angulation

Front 12

Salter Harris Type I

Back 12

-transverse fracture through the entire growth plate
-presents with localized swelling/tenderness
-X-Ray appears negative
-prognosis excellent

Front 13

Salter Harris Type II

Back 13

-fracture line passes through a portion of the growth plate and exits through the metaphysis

Front 14

Salter Harris Type II associated with growth arrest where?

Back 14

-50% of pts with distal femur
-rarely cause growth arrest in distal radius

Front 15

Salter Harris Type III

Back 15

-fracture line passes though physis and extends to articular surface
-prognosis for growth is guarded
-must restore congruity of the articular surface

Front 16

Salter Harris Type IV

Back 16

-fracture line crosses all zones of the physis vertically
-high risk of growth arrest even though only a small portion of physis is affected
-requires anatomic reduction to restore the articular surface

Front 17

Salter Harris Type V

Back 17

-injury results from crushing force applied to the growth plate(axial load)

Front 18

what is the most commonly fractured bone in kids and how long does it take to heal?

Back 18

-clavicle
-takes a year to 18months to heal on its own

Front 19

which fractures tend to occur at birth?

Back 19

-humeral shaft fractures

Front 20

what do you call the thick, vascular, osteogenic portion of growing bone?

Back 20

periosteum

Front 21

what factors determine the remodeling capacity?

Back 21

-number of years of growth remaining
-proximity to physis
-magnitude of angular deformity
-plane of angulation

Front 22

Salter Harris Type I

Back 22

-transverse fracture through the entire growth plate
-presents with localized swelling/tenderness
-X-Ray appears negative
-prognosis excellent

Front 23

Salter Harris Type II

Back 23

-fracture line passes through a portion of the growth plate and exits through the metaphysis

Front 24

Salter Harris Type II associated with growth arrest where?

Back 24

-50% of pts with distal femur
-rarely cause growth arrest in distal radius

Front 25

Salter Harris Type III

Back 25

-fracture line passes though physis and extends to articular surface
-prognosis for growth is guarded
-must restore congruity of the articular surface

Front 26

Salter Harris Type IV

Back 26

-fracture line crosses all zones of the physis vertically
-high risk of growth arrest even though only a small portion of physis is affected
-requires anatomic reduction to restore the articular surface

Front 27

Salter Harris Type V

Back 27

-injury results from crushing force applied to the growth plate(axial load)

Front 28

what is the most commonly fractured bone in kids and how long does it take to heal?

Back 28

-clavicle
-takes a year to 18months to heal on its own

Front 29

which fractures tend to occur at birth?

Back 29

-humeral shaft fractures

Front 30

what do you call the thick, vascular, osteogenic portion of growing bone?

Back 30

periosteum

Front 31

what factors determine the remodeling capacity?

Back 31

-number of years of growth remaining
-proximity to physis
-magnitude of angular deformity
-plane of angulation

Front 32

Salter Harris Type I

Back 32

-transverse fracture through the entire growth plate
-presents with localized swelling/tenderness
-X-Ray appears negative
-prognosis excellent

Front 33

Salter Harris Type II

Back 33

-fracture line passes through a portion of the growth plate and exits through the metaphysis

Front 34

Salter Harris Type II associated with growth arrest where?

Back 34

-50% of pts with distal femur
-rarely cause growth arrest in distal radius

Front 35

Salter Harris Type III

Back 35

-fracture line passes though physis and extends to articular surface
-prognosis for growth is guarded
-must restore congruity of the articular surface

Front 36

Salter Harris Type IV

Back 36

-fracture line crosses all zones of the physis vertically
-high risk of growth arrest even though only a small portion of physis is affected
-requires anatomic reduction to restore the articular surface

Front 37

Salter Harris Type V

Back 37

-injury results from crushing force applied to the growth plate(axial load)

Front 38

what is the most commonly fractured bone in kids and how long does it take to heal?

Back 38

-clavicle
-takes a year to 18months to heal on its own

Front 39

which fractures tend to occur at birth?

Back 39

-humeral shaft fractures

Front 40

what is the most common elbow fracture and how does it occur?

Back 40

-supracondylar humerus fractures
-hyperextension

Front 41

which type of fracture is common around age 10 and is due to valgus stress with a fall on the extended elbow?

Back 41

-radial neck fracture
-radial neck is within the joint capsule and causes stiffness

Front 42

what do you call a fracture of the radius and a dislocation of the radial head?

Back 42

monteggia

Front 43

what do you call a fracture of the radius and a dislocation of the distal radioulnar joint?

Back 43

galeazzi

Front 44

what fractures need to be fixated under anesthesia?

Back 44

-distal femur , because fractures of the distal femur growth plate are very likely not to grow afterwards
-after kid is >30lbs, cast is insufficient

Front 45

children under age 3 who limp probably have _______

Back 45

DDH

Front 46

children ages 3-6 who limp probably have________

Back 46

septic arthritis

Front 47

what condition has a positive trendelenberg sign?

Back 47

Legg-Calve-Perthes dz (common in ages 6-10)

Front 48

what is the most common adolescent hip disorder?

Back 48

SCFE (slipped capital femoral epiphysis)

Front 49

what is the association of the degree of curvature in scoliosis with tx?

Back 49

-<20degrees::observe
-20-40degrees::bracing
->40degrees::surgery

Front 50

what is the definitive test for nerve pain?

Back 50

-straight leg raise
-pain in sciatic distribution is reproduced between 30-70 degrees passive flexion of the straight leg is positive finding

Front 51

when would a bone scan be indicated with low back pain?

Back 51

-if tumor , infection, or occult fracture is suspected

Front 52

what is the imaging test of choice for low back pain?

Back 52

MRI with contrast

Front 53

what is the official name for degenerative disc disease?

Back 53

HNP::herniated nucleus pulposus

Front 54

why are most herniations lateral rather than central?

Back 54

-the presence of the posterior longitudinal ligament and the ligamentum flavum

Front 55

upper motor neuron lesions present with?

Back 55

-spasticity,hyper-reflexivity, and pathologic reflexes

Front 56

lower motor neuron lesions present with?

Back 56

-flaccidity, hyporeflexivity, and no pathologic reflexes

Front 57

what is a subluxation of one vertebral body over another?

Back 57

spondylolisthesis

Front 58

spinal stenosis

Back 58

-hypertrophy of spinal architecture resulting in compression of thecal sac or nerve roots
-leads to chronic problems like arthritis, scoliosis, and hypermobility

Front 59

spondylosis/spondylolisthesis are due to _____________

Back 59

-repetitive hyperextension of the spine

Front 60

osgood shlatter disease is caused by ?

Back 60

-repetitive trauma to the tibial tuberosity
-commonly seen in children who do cutting and jumping sports

Front 61

osgood shlatter disease PE, Xray, and tx

Back 61

-PE will show tenderness and swelling over tibial tuberosity
-Xray will show fragmentation and irregular ossification at the tibial tubercle
-tx is rest, stretching,and icing

Front 62

patellar tendonitis presentation, occurrence, an tx

Back 62

-presents with pain at the inferior pole of the patella
-commonly seen in jumping sports
-tx is stretching,ice, US and E-stim, chopat strap

Front 63

shin splints

Back 63

-pain after exercise over an area of the medial tibia 3-4 inches long

Front 64

when so you suspect a stress fracture rather than a shin splint?

Back 64

-if pain is in smaller area and is on the lateral tibia

Front 65

rotator cuff tendonitis

Back 65

-pts under 30 tend to have pain without a tear
-they will have pain with overhead activities
-they will have a positive empty can test

Front 66

DeQuervain's tenosynovitis::
1. location of pain
2. test

Back 66

1. over the snuff box
2. Finkelstein's

Front 67

what are the prerequisites for bone healing?

Back 67

-adequate blood supply and adequate mechanical stability

Front 68

what are the three stages of fracture healing?

Back 68

-inflammation, repair, and remodeling

Front 69

avascular necrosis is a common side occurrence in ___and ______

Back 69

posterior hip dislocation and femoral neck fracture

Front 70

hip pain can be referred to the _

Back 70

knee

Front 71

acute posterior dislocation of the shoulder is common in ___________pts

Back 71

seizure