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93 Cards in this Set

  • Front
  • Back
what are ligament injuries called?
sprains
what degree sprain would be detectable joint laxity with localized pain and tenderness
2nd degree
which test would you perform to determine the full extent of a sprain injury
MRI
the tearing of a muscle-tendon unit
A strain (also termed tendonitis)
what causes strains?
strains may be caused by prolonged overuse or by a single episode of over activity
define dislocation and sublaxation
In a dislocation the normally apposing joint surfaces are completely displaced,
while in a subluxation those surfaces are partially displaced
what is a greenstick fracture
an incomplete break where one side of the bone is broken and the other side is bent
what do you call a Fx in which the bone is broken in several places
a comminuted fracture
in this fracture, there is failure of the bone to complete the healing process
nonunion fracture
in this fracture, a ligament or tendon tears away (avulse) a small piece of a bone
avulsion fracture
how do you treat open fractures?
debrided, irrigated and parenteral antibiotics administered in the OR within 6 hours of injury
which fracture heals more quickly, metaphyseal or diaphyseal fractures?
metaphyseal fx heals more rapidly because there is more blood supply in this area
which fractures usually have a transverse pattern
Stress and pathologic fractures
Ex- "night stick" fx involving the ulna
These fractures have a tendency to displace after reduction and immobilization;
typically require ORIF
Spiral or oblique fractures
these fractures have the potential to cause growth disturbance of the involved bone
Salter-Harris/growth plate fractures
what are the stages of fracture healing
hematoma formation
inflammatory phase
reparative phase
remodeling phase
how do you treat AC separation?
Grade I-II: sling, ice x 2 wks then ROM
Grade III: sling, ice x several wks until pain subsides, then ROM & strengthening vs. surgical repair
Compression fracture of the articular surface of the humeral head, created by the sharp edge of the anterior glenoid as the humeral head dislocates over it
Hill-Sachs Lesion
what is the most common mechanism of injury for a proximal humerous fracture?
FOOSH- fall on an outstretched hand
what is a Monteggia Fracture
Monteggia Fracture
Usually a fx of the mid or proximal ulna with anterior dislocation of the radial head
what is a Galeazzi Fracture?
involves a radial shaft fracture with associated dislocation of the distal radioulnar joint (DRUJ), which disrupts the forearm axis joint
this fracture is assoc. with sports requiring a throwing motion
"little leaguer's elbow"- a fracture involving the medial epicondyle of the humerous
what is the MC fx about the wrist
Colles Fracture- Extra-articular fx with volar angulation and dorsal tilt
this fracture is the reverse Colles fx:
Fracture of the distal radius with anterior palmar displacement
Smith’s fx
a fracture of the radial styloid is called?
Chauffer's Fracture (Hutchinson's fx)
MC fx’d carpal bone
Scaphoid
why is there great risk of vascular necrosis of the scaphoid?
because the proximal scaphoid has no direct blood supply
how do you treat snuffbox tenderness
treat as if it was a scaphoid fracture bcoz XR may not show fx for upto 4 wks
this fracture most frequently occurs at the 5th metacarpal as a result of a direct blow delivered to the hand or by the hand
Boxer’s fx
A comminuted Fx of the first metacarpal
Rolando's fracture; Treatment by external fixation
what is a Jones fracture
a fracture of the fifth metatarsal of the foot
what is the MC injury to the knee requiring surgery
Meniscal tear of the knee
what is a varus deformity
a term for the inward angulation of a joint
what is a valgus deformity
the outward angulation of the distal segment of a bone
what type of force could injure the MCL
Valgus force
this ligament is most likely injured by twisting of knee while foot is firmly planted on ground
ACL
Caused by hyperextension of knee or direct blow to anterior aspect of flexed knee (Dashboard)
PCL sprain
What is the Unhappy Triad?
1. ACL tear
2. MCL tear
3. Medial meniscus tear

usually due to a lateral blow to the knee with the foot fixed
name the tarsals of the foot
7 tarsals:

Talus
Calcaneus
Navicular
Medial Cuneiform
Intermediate Cuneiform
Lateral Cuneiform
Bones of the foot
Bones of the foot:
7 tarsals
Talus
Calcaneus
Navicular
Medial Cuneiform
Intermediate Cuneiform
Lateral Cuneiform
5 metatarsals
“rays of the foot”
14 phalanges
the #1 most common foot problem
Plantar fasciitis;inflammation due to repeated overstretching of the plantar fascia ligament (fat pad of the foot); Pain is most severe in the morning and stepping down onto foot, decreases as day goes on
contributing factors of Plantar Fascitis
flat feet
high arches (supinated feet)
increasing age
sudden weight increase
sudden increase in activity level
running in sand
the most common deformity of the foot;
Results in excessive valgus angulation of the big toe
Hallus Valgus
what other test should be done on a pt with a calcaneous fracture
CT Scan of calcaneus and lumbar spine XRay
what are the Ottawa ankle rules
IF:
<55 y/o
able to walk 4 steps
No tenderness over the posterior edge (distal 6 cm) or tip of either malleolus
No tenderness at base of 5th metatarsal or navicular

Then: No XRay needed
what is the MC ankle ligament sprained
Anterior talofibular ligament; usually due to inversion injury
this is a fracture of the proximal fibula with syndesmosis rupture and associated medial malleolus fracture or deltoid ligament rupture
Maisonneuve Fx
what are these symptoms assoc. with?:

C/O acute pain in lower calf & difficulty ambulating
+/- palpable defect or mass in post. calf
+ Thompson test
Achilles tendon rupture
what is a + Thompson test
squeeze calf, foot should plantarflex, if no plantarflexion then achilles tendon is out
what are femoral head fractures usually associated with?
hip dislocations
the Hill-Sachs lesion can be caused by which maneuver
The Mitch maneuver to repair a shoulder dislocation
This injury is an anterior capsular injury assoc with a tear of the glenoid labrum off the anterior glenoid rim
Bankhart Lesion
paralysis of this muscle causes the "winging" of the scapula
serratus anterior
describe the brachial plexus
C5-T1

Musculocutaneous nerve
Axillary
Radial
Median
Ulnar
Injury to these nerves can cause Erb's Palsy or "waiter's tip"
C5, C6 and sometimes C7 nerves are involved
Klumpke's Palsy (claw hand)involves these nerves
C8 and T1
which nerve is assoc with your funny bone
Ulnar nerve
If you have a Fx of the surgical neck of the humerous, which nerve can be injured
Axillary nerve (C5-C6)
A Fat Pad sign is most commonly assoc. with this fracture
A radial head or neck fracture
what is Myositis ossificans
muscle that becomes bone (horseback riders)
what is Bennet's Fx
Fracture of the proximal 1st metacarpal
Barton's Fracture
A dislocation of the distal radial joint
when do you often see a ulnar styloid Fx
with a Colle's Fx
what is Game Keeper’s Thumb, Skier’s Thumb
Injury to the ulnar collateral ligament of the MCP joint of the thumb
MC place for a clavicular Fx
at the junction of the middle and distal part
the two ligaments surrounding the snuff box
longus and brevis
some symptoms you may see with a meniscal tear injury
locking
catching episodes
giving way episodes
pain with squatting
Swelling
what do you suspect if a patient cannot actively extend knee
patellar tendon rupture
what is a lisfranc injury
dorsal dislocation of the 2nd metatarsal
this is a transverse fracture of the 5th metatarsal at the junction of the diaphysis and metaphysis
Jones Fx
A Pseudo Jones Fx?
a fracture of the proximal part of the 5th metatarsal
Stress fracture usually of the middle of the shaft of the 3rd metatarsal (or 4th)
March Fracture
where do most sprains tend to occur?
shoulder, the elbow, the knee and the ankle
4 things to describe a fracture
open or closed
site
fracture pattern
degree of displacement
what injury can be caused by external rotation & abduction force on humerus
shoulder dislocation
how do you treat a midshaft humerous fracture
Coaptation splint:

Carefully molded plaster slab placed around medial & lateral aspects of arm, extending from axilla around elbow & over deltoid & acromion x 2 wks
how does a Boutonniere deformity present?
with a flexed PIP joint (hand)& hyperextended DIP joint
how does a Mallot finger present?
with a flexion at the DIP joint & extension or hyperextension at the PIP joint
what is the most classic finding in de Quervain tenosynovitis
a positive Finkelstein test, which is when the pt makes a fist with the thumb inside the fingers; pain is usuallly in the radial side of the wrist
what is Saturday night palsy?
when the hand is pronated, the wrist and hand will drop
which dermatome ennervates the middle and index fingers
C7
which dermatome ennervates the ring and pinky
C8
which dermatome ennervates the thumb
C6
With this syndrome, patients develop popping with knee extension
Discoid Meniscus (Popping Knee Syndrome)
Congenitally round (discoid) lateral meniscus that does not acquire its normal semilunar shape
what condition may you have if you have a:

+ Lachman
+ Anterior drawer
ACL tear
what condition may you have if you have a + Tibia sag test
PCL tear
what disease is caused by overuse of the tendon attached to the tibial tuberosity; usually assoc. with adolescents and sports
Osgood-Schlatters Disease
what is the most common mass in the popliteal fossa called that results from fluid distension of the gastrocnemio-semimembranosus bursa
Baker's cyst, also termed popliteal cyst
What is Virchow triad?
Risk factors for DVT:

venous stasis
hypercoagulability
vessel intimal injury
what is Homan’s sign?
A sign of DVT;
presents with discomfort in the calf muscles on forced dorsiflexion of the foot with the knee straight
what test is used to rule out DVT, but not to confirm the diagnosis of DVT?
The D-Dimer assays
What study is best to confirm DVT?
duplex ultrasonography
what joint is responsible for a Hammer toe deformity?
flexion deformity of the PIP joint