Orthopedics Ii Final

Front 1

cervical DJD normally occurs here first

Back 1

C5-C6 then C6-C7

Front 2

cervical DJD occurs earlier in women or men?

Back 2

men

Front 3

increased pain associated with cervical DJD with flexion if anterior anatomy is involved may involve_______

Back 3

herniation, disc damage

Front 4

increased pain associated with cervical DJD with extension if posterior anatomy is involved may involve_________

Back 4

facets, IVF encroachment

Front 5

cervical DJD signs are the worst at ___

Back 5

C3-C4

Front 6

T or F - cervical facet syndrome is normally localized but may radiate pain to the shoulders neck and head

Back 6

true

Front 7

a normal neutral, flexion and extension cervical x-ray should show less than ___mm of translation and less than ___degrees of angular displacement of one body on the next

Back 7

less than 3.5 mm
less than 11 degrees

Front 8

approximately ___ % of patients with a radiculopathy have shoulder pain

Back 8

70%

Front 9

most common nerve root levels for cervical radiculopathy

Back 9

C7 (60%)
C6 (25%)

Front 10

nerve root level(s) of suprascapular pain resulting from a radiculopathy

Back 10

C5 or C6 nerve roots

Front 11

nerve root level(s) associated with a radiculopathy resulting in interscapular pain

Back 11

C7 or C8 nerve roots

Front 12

nerve root level(s) associated with a radiculopathy resulting in scapular pain

Back 12

C8

Front 13

T or F - a radiculopathy of the cervical spine is likely to be exacerbated by the shoulder abducted and hand behind the head (Bakody's sign)

Back 13

False
Bakody's sign likely to relieve symptoms

Front 14

a patient treated for a radiculopathy should show signs of improvement within __ weeks

Back 14

6 weeks

Front 15

who might have been the first to describe TMJ syndrome?

Back 15

Hippocrates

Front 16

When evaluating a muscle strain/sprain, what should always be ruled out?

Back 16

Hemarthrosis
Fracture
Radiculopathy

Front 17

Normal jaw opening is ___ mm minimum

Back 17

40 mm min (3 finger tips)

Front 18

Protrusive and lateral mandibular movement is normally ____ cm

Back 18

1 cm

Front 19

Are x-rays ususally useful diagnosing TMJ

Back 19

No
MRI might show disc position however

Front 20

What 4 conditons must be differentiated between when diagnosing TMJ?

Back 20

Headache
Temporal / Giant cell arteritis
Trigeminal neuralgia
Dental infections, parotiditis

Front 21

2 synonyms for TOS

Back 21

scalenus anticus syndrome
cervical rib syndrome

Front 22

T or F
TOS is often underdiagnosed.

Back 22

False
it's overdiagnosed

Front 23

What nerve root level is normally associated with TOS?

Back 23

C8-T1

Front 24

TOS more prevalent in men or women?
Neurological type?
Venous Type?
Arterial Type?

Back 24

Neuro - Females (20-50 years)
Venous - Males (20-35 years)
Arterial - Same (yng adlt->50 years)

Front 25

% population with cervical rib

Back 25

10%
(only 1% are symptomatic)

Front 26

Can a TP cause TOS?

Back 26

Yes
an elongated C7 TP

Front 27

Name 3 muscles commonly associated with TOS

Back 27

subclavian
pec minor
scalenes

Front 28

Is TOS pain normally down the medial or lateral aspect of the arm

Back 28

medial aspect

Front 29

Which type of TOS is by far the most common?

Back 29

Neurological

Front 30

Headaches associated with TOS are normally where?

Back 30

Occipital region

Front 31

A condition associated with TOS consisting of hand coldness, intolerance to cold, and color change.

Back 31

Raynaud phenomenom

Front 32

Swelling of the arm is associated with which type of TOS?

Back 32

Venous

Front 33

Pain, pallor, coldness and parasthesias normally in young adults is what type of TOS?

Back 33

Arterial

Front 34

Name 3 tests for vascular TOS

Back 34

Roos
Adsons
Wrights
(though aren't very reliable)

Front 35

What grade of rotator cuff strain presents ecchymosis, arm drop sign?

Back 35

Grade 3 (severe)

Front 36

T or F
A grade 2 (moderate) rotator cuff strain presents a marked loss of strength and takes 2 weeks to 1 year to heel.

Back 36

True

Front 37

Name 3 tests for rotator cuff injury

Back 37

Codmans
Apleys
Suprispinatus stress test (empty can)

Front 38

Shoulder impingement is irritation or pinching of the ____ or ____ tendons as they pass b/t the ____ arch and the ____

Back 38

biceps brachii or rot cuff tendons passing b/t the coracoacromial arch and greater tuberosity

Front 39

Which stage(s) of shoulder impingement is reversible by conservative treatment?

Back 39

STAGE 1
Stage 2 and 3 are irreversible

Front 40

4 types of shoulder impingement

Back 40

Anterosuperior
Posterosuperior
Subcoracoid
Spinoglenoid

Front 41

This type of shoulder impingement is a primary mechanical impingement

Back 41

Anterosuperior

Front 42

This type of shoulder impingement involves the suprascapular nerve

Back 42

Spinoglenoid

Front 43

This type of shoulder impingement is an internal impingement

Back 43

Posterior superior

Front 44

T or F
Subcoracoid type of shoulder impingement is very rare

Back 44

True

Front 45

Type of shoulder impingement involving forward elevation (flexion) and abduction
i.e. throwing, swimming

Back 45

Anterosuperior

Front 46

Type of shoulder impingement could result in atrophy of the infraspinatus from repeated ballistic overhead activities

Back 46

Spinoglenoid

Front 47

Type of shoulder impingement results in posterior shoulder pain resulting from repeated overhead abduction-external rotation

Back 47

Internal

Front 48

3 types of Glenohumeral instability

Back 48

Traumatic
Atraumatic dislocation
Acquired

Front 49

T or F
Traumatic type glenohumeral instability is more common in elderly than young

Back 49

False
More common in young

Front 50

T or F
Glenohumeral instability is a common cause for poor response to conservative treatment

Back 50

True
in biceps tendinopathy, rot cuff inj, impingement, and subacrom bursitis

Front 51

Calcific tendinopathy commonly occurs in what muscles of the shoulder?

Back 51

supraspinatus
infraspinatus (occasionally)

Front 52

4 phases of calcifying tendinopathy

Back 52

Formative
Resting
Resorptive
Postcalcific

Front 53

2 causes of the loss of ROM in Frozen shoulder

Back 53

adhesive capsulitis
soft tissue contracture around the GH joint

Front 54

4 stages of Frozen shoulder

Back 54

Pre-adhesive
Acute adhesive synovitis
Maturation
Chronic

Front 55

Is Frozen shoulder more common in laborer or sedentary people?

Back 55

Sedentary people
women > men

Front 56

MCL or LCL more common elbow sprain?

Back 56

MCL

Front 57

Panner's disease is synonymus with

Back 57

Elbow Osteochondritis

Front 58

Most common body part affected by osteochondritis

Back 58

1. knee (most common)
2. ankle
3. elbow

Front 59

Elbow osteochondritis is commonly associated with VARUS or VALGUS stress?

Back 59

Valgus
i.e. throwing

Front 60

Tennis elbow or Carpenter's elbow is synonymus with

Back 60

Lateral epicondylitis

Front 61

Most common overuse injury of the elbow

Back 61

Lateral epicondylitis

Front 62

T or F
Inflammation is a key factor in diagnosing lateral epicondylitis

Back 62

False
no signs of inflammation

Front 63

pitted nails may indicate

Back 63

psoriasis or alopecia areata

Front 64

ulnar deviation of fingers and wrist
Haygarth's and Bouchard's nodes often present

Back 64

Seal fin deformity

Front 65

associated with severe/chronic ulnar neuropathy where the interossei muscles of the hand atrophy

Back 65

Skeleton hand

Front 66

associated with metacarpal fracture - rotational displacement

Back 66

Skewed finger/hand

Front 67

nails become thin and concave dorsally

Back 67

Spoon nails

Front 68

finger deformity where proximal interphalangeal joint is hyperextended and distal joint is flexed

Back 68

Swan neck deformity

Front 69

fusiform swelling in the flexor digitorum superficicalis tendon, snapping initially then locking

Back 69

Trigger finger/thumb

Front 70

ischemic contracture of anterior forearm muscles with varying degree of neurological deficits

Back 70

Volkman's ischemic contracture

Front 71

associated with severe/chronic radial neuropathy usually with lesion at elbow

Back 71

Wrist drop deformity
(Drop hand)

Front 72

spider fingers

Back 72

arachnodactyly

Front 73

congenital anomaly - extra toes / fingers

Back 73

polydactyly

Front 74

congenital anomaly - fusion or webbing of the toes / fingers

Back 74

syndactyly

Front 75

most common compressive neuropathy

Back 75

carpal tunnel syndrome

Front 76

CTS is often accompanied by

Back 76

wrist flexor tendonopathy

Front 77

T or F
In CTS, numbness is usually over the palm and ant wrist

Back 77

False
thumb, index, and middle finger
(if palm is numb, the lesion is likely near the elbow or brachial plexus)

Front 78

BEST test for CTS

Back 78

Phalen's compression test

Front 79

tenosynovitis of the abductor pollicus longus and extensor pollicus brevis at snuff box

Back 79

de Quervain's tenosynovitis

Front 80

washer woman's strain
blackberry thumb

Back 80

de Quervain's tenosynovitis

Front 81

test for de Quervain's

Back 81

Finkelstein's

Front 82

a ganglion cyst of the distal interphalangeal joint is aka

Back 82

mucous cyst

Front 83

T or F
Ganglion cysts are connected to the skin.

Back 83

False
must differentiate b/t a ganglion and a skin tumor or sebaceous cyst

Front 84

Which is soft and large?
Arthrosynovial cyst or Tenosynovial cyst

Back 84

Arthrosynovial

Front 85

a possibly beneficial test for a Ganglion cyst

Back 85

Allen's

Front 86

In a Slipped Capital Femoral Epiphysis, which direction is the femoral epiphysis displaced?

Back 86

posterior and inferior
due to a weakness in the epiphyseal growth plate

Front 87

aka - adolescent coxa vara

Back 87

slipped capital femoral epiphysis

Front 88

mild limp or awkward gait with the affected foot turned out, and a externally rotated and adducted thigh
Possible pos. Trendelenburg

Back 88

Slipped Capital Femoral Epiphysis

Front 89

Pediatric condition involving avascular necrosis of the femoral capital epiphysis ossification center resulting in deformity of the femoral head and degenerative arthropathy

Back 89

Legg-Calve-Perthes (LCP)

Front 90

T or F
Legg-Calve-Perthes will present a negative Fabere's

Back 90

False
+ Fabere
+ Thomas
+Trendelenburg
+Grinding w/circumduction
+ Anvil

Front 91

Ant or sup displacement/dislocation of the femoral head from the acetabulum in young children

Back 91

Congenital Hip Dislocation

Front 92

aka neonatal hip displasia

Back 92

congenital hip dislocation

Front 93

What during the 1st trimester may cause congenital hip dislocation of the baby?

Back 93

maternal hyperthyroidism

Front 94

T or F
In congenital hip dislocation, the gluteal fold would be higher on the dislocated side.

Back 94

True

Front 95

Tests for Congenital Hip Dislocation

Back 95

+ Trendelenburg (in older children)
+ Ortolani's Click
+ Alli's sign
+ Barlow's

Front 96

most common knee sprain

Back 96

MCL

Front 97

most common severe knee sprain / rupture

Back 97

ACL

Front 98

what is affected in the Unhappy Triad

Back 98

ACL, MCL, medial meniscus

Front 99

what is affected in the New Unhappy Triad

Back 99

ACL, MCL, lateral meniscus

Front 100

MCL or LCL?
valgus / abduction force injury

Back 100

MCl

Front 101

MCL or LCL?
varus / adduction force injury

Back 101

LCL

Front 102

ACL or PCL?
post to ant force injury

Back 102

ACL

Front 103

ACL or PCL?
ant to post force injury

Back 103

PCL

Front 104

Which ligament is most commonly vulnerable with all of the directional knee injuries?

Back 104

ACL

Front 105

Most meniscus tears are Medial or Lateral?

Back 105

Medial

Front 106

Which meniscus is "C" shaped?

Back 106

Medial
Lateral is "O" shaped

Front 107

T or F
The menisci are not vital to knee function.

Back 107

False
this was once thought, but now we know they distribute the load

Front 108

Which compresses the lateral meniscus and tractions the medial meniscus?
Valgus or Varus stress

Back 108

Valgus
(opposite for Varus)

Front 109

2 types of meniscal tears

Back 109

Traumatic
Degenerative

Front 110

What is considered a "red flag" if suspecting a traumatic meniscal tear?

Back 110

pain is localized at joint line
knee locking and catching

Front 111

Tests for meniscal tear

Back 111

Apley's prone compression/grind
Bounce home test
Steinman's
etc.

Front 112

Clarke's test

Back 112

Chondromalacia Patella

Front 113

avascular necrosis of subchondral bone and overlying articular cartilage that may lead to fragmentation or fracture

Back 113

Osteochondritits Dessicans

Front 114

2 forms of osteochondritis dessicans

Back 114

juvenile
traumatic

Front 115

most common site of osteochondritis dessicans

Back 115

knee

Front 116

Test for osteochondritis dessicans

Back 116

Wilson's

Front 117

traction apophysitis of tibial tubercle

Back 117

Osgood Schlatter's

Front 118

Is Osgood Schlatter's synonymous with osteochondritis?

Back 118

No
often incorrectly defined

Front 119

Can Osgood Schlatter's be bilateral?

Back 119

Yes

Front 120

Fibromyalgia has been linked to low levels of ___

Back 120

serotonin

Front 121

Fibromyalgia has been linked to a 4-fold increase in ____

Back 121

nerve growth factor

Front 122

A typical patient with fibromyalgia has seen ___ physicians and had it for ___ years before being properly diagnosed

Back 122

15 docs
5 years

Front 123

how many tender points must be present to indicate fibromyalgia?

Back 123

11 of 18 (bilateral)

Front 124

Name the 9 locations of the indicative tender points of fibromyalgia

Back 124

1. Occiput
2. Cervical (C5-7 art pills)
3. 2nd rib
4. Lat epicondyle
5. Knee (medial)
6. Trap
7. Supraspinatus
8. Gluteal region (sup-lat)
9. Greater trochanter

Front 125

Must differentiate fibromyalgia from ___

Back 125

myofascial pain syndrome

Front 126

progressive degeneration, loss of articular cartilage and joint margin changes of diarthrodial joints

Back 126

Osteoarthrosis

Front 127

DJD synonymous with ___

Back 127

osteoarthosis/itis

Front 128

T or F
PIP, DIP and cervical spine often affected by osteoarthrosis

Back 128

True

Front 129

T or F
Primary osteoarthosis is due to metabolic disturbances.

Back 129

False
Secondary
(Primary is due to wear and tear)

Front 130

Where are men and women more likely to develop osteoarthrosis?

Back 130

men = hip
women = hand

Front 131

Heberden's nodes

Back 131

Osteoarthrosis

Front 132

Bouchard's nodes

Back 132

RA

Front 133

Seal fin deformity
Swan neck deformity
Boutenniere deformity
Bouchard's nodes

Back 133

RA

Front 134

chronic autoimmune inflammatory disease resulting in symmetrical joint pain and swelling and destruction of the joints

Back 134

RA

Front 135

RA begins with which joints?

Back 135

PIP and MCP

Front 136

What is the key finding of RA?

Back 136

symmetry

Front 137

Rheumatoid nodules are most commonly found where?

Back 137

distal to the olecranon

Front 138

T or F
RA never affects the DIP

Back 138

True

Front 139

What syndrome occurs as result of RA that may develop due to atrophy of lacrimal glands?

Back 139

Sjogren's syndrome

Front 140

What are the Cardinal signs of acute inflammation?

Back 140

SHARP
Swelling
Heat
A loss of function
Redness
Pain

Front 141

3 phases of soft tissue healing

Back 141

I - Acute inflammation
II - Post acute repair/proliferation
III - Remodeling

Front 142

How long does each phase of soft tissue healing last?

Back 142

I - 1-2 days, up to 5
II - 48 hours to 6 weeks
III - 3 weeks to 12 months

Front 143

Which phase of soft tissue healing involves granulation and epithelialization

Back 143

Phase II

Front 144

T or F
Scar tissue is stronger than original tissue

Back 144

False
only 80%

Front 145

T or F
Corticosteroids slow healing.

Back 145

True

Front 146

2 types of strokes

Back 146

ischemic
intracerebral hemmorrhage (ICH)

Front 147

focal brain ischemia causing sudden onset of transient neurological deficits

Back 147

Transient ischemic attack (TIA)

Front 148

mini-stroke

Back 148

TIA

Front 149

insufficient blood supply to the brain due to disruption in blood flow supplied by the carotid or vertebral artery

Back 149

Vertebrobasilar Ischemia (VBI)

Front 150

"beauty parlor stroke"

Back 150

VBI

Front 151

odds of VBI from manipulation

Back 151

1 in 5.85 million

Front 152

Hoffman's test

Back 152

flicking finger

Front 153

Brudzinski's test

Back 153

meningitis

Front 154

Babinski

Back 154

UMN lesion (pyramidal)

Front 155

Mill's test

Back 155

lat epicondylitis

Front 156

Cozen's test

Back 156

lat epicondylitis

Front 157

Golfer's elbow

Back 157

med epicondylitis

Front 158

hypertrophy of synovial tissue and infiltration of white cells
(destructive)

Back 158

pannus
common in RA

Front 159

Due to pannus, there may be instability at what spinal level seen in RA

Back 159

C1-C2

Front 160

___% of pop has fibromyalgia

Back 160

2 %

Front 161

fibromyalgia was once called ___

Back 161

rheumatism

Front 162

Fibromyalgia presents pain with ___ lbs. of force applied to tender points

Back 162

8.8 lbs.