Orthopedics Absite Flashcards

Front 1

what structure is injured in anterior shoulder dislocation?

Back 1

AXILLARY NERVE injured in anterior shoulder dislocation

Front 2

Bone mets:
-_% symptomatic
-Tx is _

Back 2

Bone mets:
-65% symptomatic
-can fixate, XRT for pain relief

Front 3

what 3 fractures are most prone to compartment syndrome?

Back 3

calcaneus fracture:
-prone to compartment syndrome
(also happens with tibia fracture, supracondylar humerus fracture)

Front 4

Ewing's sarcoma:
Xray finding = _
-Tx: _
-Ave survival = _ yrs

Back 4

Ewing's sarcoma:
-"onion layering"
-pseudorosettes on path
-Tx: XRT
-Ave survival = 2 yrs

Front 5

What cancer?
-"onion layering"
-pseudorosettes on path

Back 5

Ewing's sarcoma:
-"onion layering"
-pseudorosettes on path
-Tx: XRT
-Ave survival = 2 yrs

Front 6

femur fracture - when to time ORIF

Back 6

Femur fracture:
early ORIF allows early mobilization, decreased fat embolization, decreased complications

Front 7

femur fracture - how is management different in children

Back 7

Pediatric femur fracture -
closed reduction, not ORIF, to avoid damage to epiphyseal growth plate

Front 8

Hip dislocation:
_% are in the __ direction, which presents c/ __

Back 8

Hip dislocation:
-90% posterior - present c/ internal rotation, flexed, adducted thigh
-risk of sciatic nerve injury, AVN of femoral head
-Anterior hip dislocation -> frog leg (external rotation, adduction)

Front 9

Hip dislocation in the __ direction causes "frog leg" (external rotation, adduction)

Back 9

Hip dislocation:
-90% posterior - present c/ internal rotation, flexed, adducted thigh
-risk of sciatic nerve injury, AVN of femoral head
-Anterior hip dislocation -> frog leg (external rotation, adduction)

Front 10

nerve injury classically seen c/ spiral humerus fracture, supra- and intra-condylar fractures
-inability to extend wrist and MCP joints

Back 10

RADIAL nerve injury 2/2 spiral humerus fracture, supra- and intra-condylar fracture ->
inability to extend wrist and MCP joints

Front 11

Humerus fracture:
-may see injury to the __ nerve =>
weak wrist extension

Back 11

Humerus fracture:
-may see radial nerve injury =>
weak wrist extension, sensation to lateral-dorsal hand

Front 12

Monteggia fracture =
fracture to the proximal _ c/ dislocation of the __
Tx = _

Back 12

Monteggia fracture =
proximal ulnar fracture c/ radial head dislocation
Tx = ORIF

Front 13

patient presents with tender snuffbox +/- x-ray abnormality
-the __ bone is likely fractured
-Tx = _

Back 13

Navicular fracture:
-tender snuffbox; even with (-) xray
-requires cast to elbow

Front 14

what cancer? Sunburst pattern on x-ray

Back 14

Osteogenic sarcoma:
-Sunburst pattern on xray

Front 15

__ nerve =>sensation to pinkie, ring fingers, back of hand

Back 15

ulnar nerve:
-intrinsic musculature of the hand, finger abduction (into a "u")
-wrist flexion
-sensation to pinkie + ring fingers, back of hand

Front 16

_ nerve => instrinsic musculature of the hand

Back 16

ulnar nerve:
-intrinsic musculature of the hand, finger abduction (into a "u")
-wrist flexion
-sensation to pinkie + ring fingers, back of hand

Front 17

_ nerve => thumb apposition

Back 17

Median nerve
-thumb apposition
-sensation to most of palm, 1st 2.5 fingers

Front 18

_ nerve => wrist extension, finger extension

Back 18

Radial nerve:
-no motor function in hand
-wrist extension, finger extension
-sensation to back of lateral hand

Front 19

nerve injury seen after trauma to fibular head or 2/2 compression of lateral aspect of knee joint ->
foot drop/ diminished dorsiflexion of ankle

Back 19

trauma to fibular head or compression of lateral aspect of knee joint ->
PERONEAL NERVE injury ->
foot drop/ diminished dorsiflexion of ankle

Peroneal nerve lies lateral below knee, wraps around head of fibula

Front 20

patient s/p 12-hour APR c/o foot drop.
-suspect _

Back 20

Peroneal nerve injury 2/2 prolonged lithotomy position
-Peroneal nerve injured where it wraps around leg @ level of fibula

Front 21

If patient has posterior knee dislocation, workup must include ...

Back 21

posterior knee dislocation => do an arteriogram to r/o popliteal injury

Front 22

what 3 Salter-Harris types of fractures need open procedure?

Back 22

Salter-Harris fracture = involves the epiphyseal plate or growth plate of a bone. 15% of pediatric long bone fractures
-III, IV, V are intra-articular, generally need open procedure

I - S = Same (or Straight across). Fx of growth plate (physis) cartilage
II - A = Above above the physis.
III - L = Lower than the physis = in the epiphysis.
IV - T = Through the metaphysis, physis, and epiphysis.
V - R = Rammed (crushed physis)

Front 23

posterior dislocation of the hip is most likely to injure what anatomic structure

Back 23

SCIATIC NERVE injured by posterior dislocation of the hip

Front 24

patient c/ hx of fall onto outstretched hand c/o tenderness proximal to thumb in "snuffbox" area
-the __ bone is likely fractured
-Tx = _

Back 24

Scaphoid fracture:
-fall on outstretched hand -> snuffbox tenderness
-hard to see on xray
-risk for AVN => cast to elbow, f/u xray in 2 wks

Front 25

patient presents after trauma c/ shoulder pain, holding arm slightly abducted, unable to lower it
-C/w anterior or posterior dislocation?
-Tx = _

Back 25

90% of shoulder dislocations are ANTERIOR
-risk of AXILLARY nerve injury -> holding arm slightly abducted, unable to lower it
-Tx: reduce dislocation

Front 26

shoulder dislocation
-90% are the __ direction (=> risk to the __ nerve)

Back 26

shoulder dislocation:
-90% anterior (risk of axillary nerve injury)
-posterior dislocation seen c/ seizures, electrocution

Front 27

what orthopedic injury if often seen c/ seizures, electrocution

Back 27

shoulder dislocation:
-posterior dislocation seen c/ seizures, electrocution
-90% anterior (risk of axillary nerve injury)

Front 28

compression of the L_-L_ disk causes weak leg jerk (quadriceps)

Back 28

compression of the L3-L4 disk (L4 root) causes weak leg jerk (quadriceps)

Front 29

compression of the L_-L_ disk causes hyperesthesia of the big toe and/or inability to dorsiflex the foot/toes

Back 29

compression of the L4-L5 disk (L5 root) causes hyperesthesia of the big toe and/or inability to dorsiflex the foot/toes

Front 30

compression of the _ spinal nerve root causes weak ankle jerk, difficulty standing on tiptoe, and/or change in sensation to lateral foot/calf

Back 30

compression of the L5 diskL5-S1 disk (S1 root) causes weak ankle jerk, difficulty standing on tiptoe, and/or change in sensation to lateral foot/calf

Front 31

muscle reflex associated with C5/6 = _

Back 31

muscle reflex associated with C5/6 = BICEPS

Front 32

muscle reflex associated with C7 = _

Back 32

muscle reflex associated with C7 = TRICEPS

Front 33

reflex associated with S2-4 = _

Back 33

reflex associated with S2-4 = anal wink

Front 34

Patient s/p reduction of supracondylar humeral fx earlier that day c/o worsening forearm pain, swelling
-Suspect _
-Net step = _

Back 34

Compartment syndrome (Volmann's contracture in this case) occurs 4-6 hrs after reduction of fracture
-ANTERIOR INTEROSSEOUS ARTERY
-Needs forearm fasciotomies to volar and dorsal compartments

Front 35

___ injury causes the "Terrible triad of O'Donaghue" (injury to ACL, MCL, and meniscus)

Back 35

"Terrible triad of O'Donaghue": lateral blow to knee => injury to ACL, MCL, medial meniscus

Front 36

Volkmann's contracture:
-___ type fracture compromises the __ artery -> compartment syndrome in the __ compartment, affects the __ nerve

Back 36

Volkmann's contracture:
-supracondylar humerus fx => compromised anterior interosseous artery =>
deep forearm flexor compartment syndrome, need fasciotomy
-pain in forearm c/ extension
-median nerve

Front 37

What is the treatment of a fracture through the obturator ring with slight displacement of the ischial ramus.

Back 37

The treatment for non displaced ischial rami fracture is non-weight bearing for 2 weeks. (external fixation is used in displaced pelvic and long bone fractures; DCP plate is for open book pelvic fracture)