Msk

Front 1

Describe the blood supply to the femur

Back 1

"1. ligamentum teres
2. Medial circumflex artery
3. Lateral circumflex artery
(Femoral artery -> profunda feromis (deep femoral) -> lateral/medial circumflex arteries)"
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Front 2

Describe the bony anatomy of the femur

Back 2

"-head of femur
-neck of femur
-greater trochanter
-leser trochanter
-Shaft"
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Front 3

Describe the 3 areas of bone

Back 3

"-Epiphysis
-Metaphysis
-Diaphysis"
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Front 4

Describe the landmarks of an intracapsular hip fracture

Back 4

"below the femoral head -> base of femoral neck
(Fracture @ intertrochanteric line = extracapsular fracture )"
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Front 5

Describe the late changes of OA in the hip

Back 5

"-fixed flexion ( w/ Thomas's test )
-External rotation
-aDduction"

Front 6

What X-ray changes are seen in Osteoarthritis

Back 6

"(LOSS)
-Loss of joint space
-Osteophytes
-Subchondral sclerosis
-Subchondral cysts"

Front 7

What X-ray changes are seen with Rheumatoid arthritis

Back 7

"-Bony erosions
-Periarticular osteopenia
-Loss of joint space
-Pannus
-RA deformities (subluxation ect..)"

Front 8

Characteristics of hip dislocation

Back 8

"-Internal rotation
-Shortening of leg"

Front 9

Characteristic of hip fracture

Back 9

"-External rotation
-Shortening of leg"

Front 10

What does trendelenburg's test show

Back 10

Weak gluteal aBductors ( drooping on the unaffected side-i.e muscles are unable to hold the opposite side )

Front 11

If multiple lytic bony lesions on X-ray ...?

Back 11

"? bony metastasis
commonly from myeloma/lymphoma, prostate, breast, lung"

Front 12

Describe the nerve supply to the thigh

Back 12

"Anterior compartment - Femoral nerve (L2-4)

Posterior compartment - sciatic nerve (L4-S3) (exists from greater sciatic foramen)

Medial compartment - Obturator nerve (L2-L4) ( exits from obturator foramen)"

Front 13

What structures are located in the popliteal fossa

Back 13

"-Popliteal artery/vein

-Tibial nerve ( arises from sciatic nerve) - divides into the posterior tibial nerve & common peroneal nerve"

Front 14

Describe the nerve supply to the leg

Back 14

"Anterior compartment - Deep peroneal nerve (& 1st web space )

Lateral compartment - Superficial peroneal nerve

Posterior compartment - posterior tibial nerve"

Front 15

"What injury affects the common peroneal nerve

what does it result in?"

Back 15

"Tight cast

Foot drop"

Front 16

What is shenton's line ?

Back 16

"Helps to diagnose a neck of femur fracture

line drawn from inferior border of the superior pubic ramus --> medial border of the femur neck"

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Front 17

What is Trethowan's sign?

Back 17

"Helps to diagnose SUFE (slipped upper femoral epiphysis )

a straight line superior surface of the femoral neck should pass through the femoral head.

If it remains superior/does not touch the femoral head/epiphysis --> trethowan's positive"

Front 18

What is characteristic of a frozen shoulder (i.e adhesive capsulitis)

Back 18

no external rotation

Front 19

"What does Hawkin's test elicit ?

How do you perform Hawkin's test"

Back 19

"Pain- suggest shoulder impingement

-perform passive internal/external rotation of the shoulder"

Front 20

Characteristic of shoulder impingement

Back 20

"-Painful arc (60-120 degrees)
-Hawkin's positive
-Pain on internal rotation"

Front 21

How do you elicit an isolated movement of the subscapularis muscle?

Back 21

internal rotation

Front 22

"What is os acromiale ?What can it lead to ?"

Back 22

"Unfused area of acromion

Can lead to shoulder impingement"

Front 23

What are the contrainidications for joint INJ/aspiration ?

Back 23

Overlying cellulitis/Dermatitis

Artificial joint

Front 24

For marfan's , what is the

inheritance

Mutation?

S/S

Back 24

Mutation in fibrillin-1 gene

Autosomal Dominant

S/S:

-Tall + long limbs

-Lens dislocation

-Scoliosis

-Pectus excavatum

-Pes planus

-Aortic dissection

-Mitral regurgitation

-Berry aneurysms

Front 25

For Ehler's danlos. what is the

Defect ?

S/S

Back 25

Defect in Type I/IV collagen--> weak collagen!

S/S

-Blue sclera

-Hyperextensible skin

-Bruising

-Berry aneurysms

Front 26

For Osteogenesis imperfect , describe the

Inheritance

Defect

S/S

Back 26

Autosomal dominant

Defect in type I collagen

S/S

-Blue sclera

-Multiple #

-Hearing loss

Front 27

What is the sarcomere composed of ?

Back 27

(MHAIZ)

M line

H band - Thick filaments

A band - Thin + Thick filaments

I band - Thin filaments

Z line

Front 28

Is type I muscle fibre

Slow/Fast

Red/White ?

Back 28

Slow - Red

Front 29

Which type of muscle fibre has more mitochondrial/myoglobin ?

Type I or type II

Back 29

Type I

Front 30

What type of muscle fibre uses anaerobic respiration?

Back 30

Type II

Front 31

Describe endochondrial ossification

Back 31

Cartilage formation --> woven bone -> lamellar bone

For longitudinal bone growth

Front 32

Describe membranous ossification

Back 32

Woven bone -> lamellar bone

For Flat bone growth

Front 33

Woven bone is found in what?

Back 33

Fractures

Paget's disease

Front 34

What do osteoblasts do ?

Where do they originate from?

Back 34

Lay down & mineralize bone

From Stem cells in periosteum

Front 35

What do osteoclasts do ?

What are they derived from ?

Back 35

Dissolve bone

Macrophages

Front 36

What muscles are involved in shoulder aBduction ?

Back 36

Supraspinatous tendon

Deltoid

Serratus anterior

Front 37

What is the serratus anterior innervated by ?

Back 37

Long-thoracic nerve

Front 38

Name the rotator cuff muscles

Back 38

(SITS)

Supraspinatous

Infraspinatous

Teres minor

Subscapularis

Front 39

What rotator cuff muscles performs internal rotation ?

Back 39

Subscapularis

Front 40

What rotator cuff muscle initiates shoulder aBduction ?

Back 40

Supraspinatous

Front 41

Which rotator cuff muscle performs external rotation?

Back 41

Infraspinatous

Front 42

Name the bones of the hand

Back 42

(Some lovers Try Positions That They Can't Handle)

Scaphoid

Lunate

Triquetrum

Pisiform

Trapezium

Trapezoid

Capitate

Hamate

-Metacarpals

-Phalanges

Front 43

What do the palmar interossei muscles do ?

Back 43

(Palmars ADduct =PAD)

aDduction of fingers

Front 44

What muscles oppose the thumb ?

What nerve is it innervated by ?

Back 44

Opponens pollicis brevis

Ulnar nerve! (tested by Froment's test)

Front 45

What is froment's test ?

Back 45

Finger a piece of paper - if Ulnar nerve injury then the thumb will bend to keep a hold onto the paper

Front 46

How do you Rx DDH ?

Back 46

If < 6 months = splint

If 6-18 months = closed reduction

If > 18 months = Open reduction

Front 47

How do you Rx PERTHES

Back 47

Rest + cast to maintain aBduction

If > 1/2 femoral head = surgery

Front 48

What x-ray sign is seen in SUFE's

Back 48

Trethowan's line

Front 49

What limited hip movement is seen in SUFE's?

Back 49

reduced internal rotation

(Hip is externally rotated)

Front 50

What is Transient synovitis ?

Ix

Back 50

Diagnosis of exclusion!

Post URTI --> Arthritis

Ix: Normal WBC

Front 51

What does the popliteal fossa contain ?

Back 51

Popliteal artery & vein

tibial nerve ( Supplying the posterior leg)

Front 52

What is the happy triad ?

Back 52

Injury to

ACL

MCL

Medial menisci

Front 53

What is characteristic of a meniscal injury ?

Back 53

pain along joint line

clicking/locking knee

Inability to squat

Front 54

tenderness/swelling over patella + prolonged kneeling + pain worse w/ kneeling/walking ?

Back 54

Housemaid's knee (i.e Prepatellar bursitis )

Front 55

tenderness inferior to patella ?

Back 55

Osgood Schlatters

Front 56

Hx of Jumping + Gradual onset knee pain ?

Back 56

Patellar tendonitis

Front 57

How do you Rx Baker's cyst ?

Back 57

Physio + NSAIDS

(Aspiration, arthroscopy)

Front 58

Name the bones in the foot

Back 58

-Talus ( Ankle joint)

-calcaneous

-Cuboid

-Navicular

-Cuneiform (3x)

-Metatarsals

-Phalanges

Front 59

what is Hallux valgus ?

Rx?

Back 59

Lateral deviation of the big toe

Rx: Bunion pads, wedges b/w 1st and 2nd toe

Front 60

What is pes planus ?

Back 60

Flat feet

Front 61

What is Pes cavus ?

Back 61

high arched foot

Front 62

What is quinti varus

Back 62

Overriding 5th toe

Front 63

For a ruptured achilles tendon, describe risk factors

S/S

Rx

Back 63

Risk factors: Badminton , Obesity , trauma

S/S: inability to plantar/stand on toes , Pain @ achilles tendon

Ix:

Simmonds test

Rx: Cast in equinus position

Front 64

What is simmonds test

Back 64

Squeezing the gastrocnemius --> Plantar flexion normally

Front 65

For plantar fasciitis, describe

Risk factors

S/S

Rx

Back 65

Risk factors: Running , obesity

S/S: Pain @ heel of foot.

Rx; Steroids INJ

Front 66

What does the long thoracic nerve innervate ?

Injury ?

Back 66

serratus anterior

Winged scapula

Front 67

What does the thoracodorsal nerve innervate ?

Injury ?

Back 67

Latissimus dorsi

"Can't wipe bottom" -i.e shoulder extension

Front 68

What is the motor function of the musculocutaneous nerve ?

Back 68

Forearm flexor & supinator

Front 69

What is the motor function of the axillary nerve ?

Back 69

Deltoid

Front 70

What is the motor function of the radial nerve ?

Back 70

Extensors of arm

Front 71

what is the motor function of the median nerve?

Back 71

Pronation

Flexion of wrist/fingers (i.e lumbricals)

Thenar muscles

Front 72

What is the motor function of the ulnar nerve ?

Back 72

Intrinsic muscles of hand ( aBduction & aDuction)

Hypothenar muscles

Opponens pollicis brevis (thumb opposition)

Front 73

Improper use of crutches , what nerve injury ?

Back 73

Radial nerve

Front 74

# surgical neck of humarus - what nerve injury ?

Back 74

Axillary nerve

Front 75

Suprachondrylar # of humerus , what nerve injury ?

Why is it also important

Back 75

Median nerve

Damage vascular supply! - poor radial pulse!!

SURGICAL EMERGENCY

Front 76

Midshaft # of humerus , what nerve injury ?

Back 76

Radial nerve

Front 77

Shoulder dislocation - what nerve injury ?

Back 77

Axillary nerve

Front 78

Fibular neck #, what nerve injury ?

Back 78

Common fibular/peroneal nerve

Front 79

Colles # , , what nerve injury ?

Back 79

Median

Front 80

medial epichondylar fracture of humerus , what nerve injury ?

Back 80

ulnar nerve

Front 81

Honeymooner's palsy , what nerve injury ?

Back 81

Radial nerve

Front 82

Tight leg cast , what nerve injury ?

Back 82

Common fibular/peroneal nerve

Front 83

Obturator nerve

What compartment is it located in ?

Function?

Back 83

medial thigh

Hip adduction

Front 84

Femoral nerve

What compartment is it located in ?

Function?

Back 84

Anterior thigh

Hip flexion

knee extension

Front 85

Sciatic nerve

What compartment is it located in ?

Function?

Back 85

Posterior thigh

Hip extension

Knee flexion

Front 86

What does the sciatic nerve divide into ?

Back 86

Common peroneal/fibular -> superficial/deep fibular nerve

Tibial nerve

Front 87

Common peroneal nerve

What compartment is it located in ?

Function?

Back 87

Anterolateral leg

-Dorsiflexion of foot

- Eversion

Front 88

Damage to Common peroneal nerve results in what ?

Back 88

Foot drop

high stepping gait

Front 89

What does the tibial nerve innervate ?

Back 89

posterior leg

Front 90

Which nerve is purely sensory to the foot ?

Back 90

Sural nerve

Front 91

What is important to assess for given a history of a Fracture ?

Back 91

Neurovascular bundle

Compartment syndrome

Front 92

How would you manage a fracture ?

Back 92

( 6 A's)

Assessment

Analgesia

Alignment

Anti-septic

ABx

Anti-tetanus

Front 93

What is characteristic of compartment syndrome ?

Back 93

Pain on passive stretch

Front 94

What are the complications of a fracture ?

Back 94

Infection, hemorrhage

Compartment syndrome

neurovascular damage

Fat embolism

DVT/PE

Malunion/non union

Front 95

What is rhabdomyolysis ?

risk factors

Ix

Back 95

breakdown of muscle

Risk factor: Prolonged compression , crushed limbs/compartment syndrome

Ix: ↑ myoglobin/CK , Hyperkalemia

Front 96

What are the complications of rhabdomyolysis ?

Back 96

AKI

Hyperkalemia

Front 97

How do you Rx Compartment syndrome

Back 97

Fasciotomy

Front 98

when are tension band wires useful ?

Back 98

Fractures near ligaments ( since the ligaments can pull it away

Front 99

Fall on an outstretched hand in a kid , what fracture ?

Back 99

Supracondylar fracture (damage to median nerve- emergency due to risk of vascular damage!)

Medial epichondylar fracture

Front 100

Pain in the anatomical snuffbox, what fracture is likely ?

Back 100

Scaphoid #

Front 101

What X-ray finding is found in a hip fracture ?

Back 101

Shenton's line is loss

Front 102

How do you Rx a hip fracture that is

intracapsular

Extracapsular

Subtrochanteric (i.e shaft)

Back 102

Intracapsular --> Hemiarthroplasty

Extracapsular -> Dynamic hip screw

Subtrochanteric -> intramedullary screw

+early mobilization

Front 103

What are the complications of a hip fracture ?

Back 103

Hemorrhage, infection , DVT/PE

Fat embolism

malunion/nonunion

Avascular necrosis

Front 104

what is a lisfranc injury ?

Back 104

Midfoot injury resulting in metatarsal dislocation

Front 105

What is the DDx for shoulder pain ?

Back 105

Impingement - Supraspinatous tendonitis, bursitis , tendon rupture , Os acromiale

Calcific tendonitis

Adhesive capsulitis

Arthritis ect..

Front 106

What is characteristic of shoulder impingement ?

Back 106

Painful arc (10-120 degrees)

worse on internal rotation (i.e Hawkin's sign)

Front 107

What is characteristic of calcific tendonitis ?

Back 107

Painful arc + swelling worse on palpation

Front 108

What is characteristic of rotator cuff tear ?

Ix

Back 108

No active movements !

Ix: USS , MRI

Front 109

What is characteristic of adhesive capsulitis ?

progresion ?

Back 109

Freezing painful phase -> Frozen -> thawing

(months - years)

Limited passive movement + no external rotation

Front 110

How do you manage shoulder pain ?

how would you manage rotator cuff tear ?

Back 110

1. NSAIDS + Physio + analgesia

2. Steroid INJ

If rotator cuff tear > 1 cm -> surgery

Front 111

a shoulder is commonly dislocated in which direction ?

What structures may be damaged ?

Back 111

Anterior

Axillary artery + posterior circumflex artery