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93 Cards in this Set
- Front
- Back
what are ligament injuries called?
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sprains
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what degree sprain would be detectable joint laxity with localized pain and tenderness
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2nd degree
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which test would you perform to determine the full extent of a sprain injury
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MRI
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the tearing of a muscle-tendon unit
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A strain (also termed tendonitis)
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what causes strains?
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strains may be caused by prolonged overuse or by a single episode of over activity
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define dislocation and sublaxation
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In a dislocation the normally apposing joint surfaces are completely displaced,
while in a subluxation those surfaces are partially displaced |
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what is a greenstick fracture
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an incomplete break where one side of the bone is broken and the other side is bent
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what do you call a Fx in which the bone is broken in several places
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a comminuted fracture
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in this fracture, there is failure of the bone to complete the healing process
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nonunion fracture
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in this fracture, a ligament or tendon tears away (avulse) a small piece of a bone
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avulsion fracture
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how do you treat open fractures?
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debrided, irrigated and parenteral antibiotics administered in the OR within 6 hours of injury
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which fracture heals more quickly, metaphyseal or diaphyseal fractures?
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metaphyseal fx heals more rapidly because there is more blood supply in this area
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which fractures usually have a transverse pattern
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Stress and pathologic fractures
Ex- "night stick" fx involving the ulna |
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These fractures have a tendency to displace after reduction and immobilization;
typically require ORIF |
Spiral or oblique fractures
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these fractures have the potential to cause growth disturbance of the involved bone
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Salter-Harris/growth plate fractures
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what are the stages of fracture healing
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hematoma formation
inflammatory phase reparative phase remodeling phase |
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how do you treat AC separation?
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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 |
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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
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Hill-Sachs Lesion
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what is the most common mechanism of injury for a proximal humerous fracture?
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FOOSH- fall on an outstretched hand
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what is a Monteggia Fracture
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Monteggia Fracture
Usually a fx of the mid or proximal ulna with anterior dislocation of the radial head |
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what is a Galeazzi Fracture?
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involves a radial shaft fracture with associated dislocation of the distal radioulnar joint (DRUJ), which disrupts the forearm axis joint
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this fracture is assoc. with sports requiring a throwing motion
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"little leaguer's elbow"- a fracture involving the medial epicondyle of the humerous
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what is the MC fx about the wrist
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Colles Fracture- Extra-articular fx with volar angulation and dorsal tilt
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this fracture is the reverse Colles fx:
Fracture of the distal radius with anterior palmar displacement |
Smith’s fx
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a fracture of the radial styloid is called?
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Chauffer's Fracture (Hutchinson's fx)
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MC fx’d carpal bone
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Scaphoid
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why is there great risk of vascular necrosis of the scaphoid?
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because the proximal scaphoid has no direct blood supply
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how do you treat snuffbox tenderness
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treat as if it was a scaphoid fracture bcoz XR may not show fx for upto 4 wks
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this fracture most frequently occurs at the 5th metacarpal as a result of a direct blow delivered to the hand or by the hand
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Boxer’s fx
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A comminuted Fx of the first metacarpal
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Rolando's fracture; Treatment by external fixation
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what is a Jones fracture
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a fracture of the fifth metatarsal of the foot
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what is the MC injury to the knee requiring surgery
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Meniscal tear of the knee
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what is a varus deformity
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a term for the inward angulation of a joint
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what is a valgus deformity
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the outward angulation of the distal segment of a bone
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what type of force could injure the MCL
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Valgus force
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this ligament is most likely injured by twisting of knee while foot is firmly planted on ground
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ACL
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Caused by hyperextension of knee or direct blow to anterior aspect of flexed knee (Dashboard)
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PCL sprain
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What is the Unhappy Triad?
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1. ACL tear
2. MCL tear 3. Medial meniscus tear usually due to a lateral blow to the knee with the foot fixed |
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name the tarsals of the foot
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7 tarsals:
Talus Calcaneus Navicular Medial Cuneiform Intermediate Cuneiform Lateral Cuneiform |
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Bones of the foot
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Bones of the foot:
7 tarsals Talus Calcaneus Navicular Medial Cuneiform Intermediate Cuneiform Lateral Cuneiform 5 metatarsals “rays of the foot” 14 phalanges |
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the #1 most common foot problem
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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
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contributing factors of Plantar Fascitis
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flat feet
high arches (supinated feet) increasing age sudden weight increase sudden increase in activity level running in sand |
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the most common deformity of the foot;
Results in excessive valgus angulation of the big toe |
Hallus Valgus
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what other test should be done on a pt with a calcaneous fracture
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CT Scan of calcaneus and lumbar spine XRay
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what are the Ottawa ankle rules
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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 |
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what is the MC ankle ligament sprained
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Anterior talofibular ligament; usually due to inversion injury
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this is a fracture of the proximal fibula with syndesmosis rupture and associated medial malleolus fracture or deltoid ligament rupture
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Maisonneuve Fx
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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
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what is a + Thompson test
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squeeze calf, foot should plantarflex, if no plantarflexion then achilles tendon is out
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what are femoral head fractures usually associated with?
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hip dislocations
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the Hill-Sachs lesion can be caused by which maneuver
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The Mitch maneuver to repair a shoulder dislocation
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This injury is an anterior capsular injury assoc with a tear of the glenoid labrum off the anterior glenoid rim
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Bankhart Lesion
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paralysis of this muscle causes the "winging" of the scapula
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serratus anterior
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describe the brachial plexus
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C5-T1
Musculocutaneous nerve Axillary Radial Median Ulnar |
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Injury to these nerves can cause Erb's Palsy or "waiter's tip"
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C5, C6 and sometimes C7 nerves are involved
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Klumpke's Palsy (claw hand)involves these nerves
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C8 and T1
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which nerve is assoc with your funny bone
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Ulnar nerve
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If you have a Fx of the surgical neck of the humerous, which nerve can be injured
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Axillary nerve (C5-C6)
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A Fat Pad sign is most commonly assoc. with this fracture
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A radial head or neck fracture
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what is Myositis ossificans
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muscle that becomes bone (horseback riders)
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what is Bennet's Fx
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Fracture of the proximal 1st metacarpal
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Barton's Fracture
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A dislocation of the distal radial joint
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when do you often see a ulnar styloid Fx
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with a Colle's Fx
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what is Game Keeper’s Thumb, Skier’s Thumb
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Injury to the ulnar collateral ligament of the MCP joint of the thumb
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MC place for a clavicular Fx
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at the junction of the middle and distal part
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the two ligaments surrounding the snuff box
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longus and brevis
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some symptoms you may see with a meniscal tear injury
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locking
catching episodes giving way episodes pain with squatting Swelling |
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what do you suspect if a patient cannot actively extend knee
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patellar tendon rupture
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what is a lisfranc injury
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dorsal dislocation of the 2nd metatarsal
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this is a transverse fracture of the 5th metatarsal at the junction of the diaphysis and metaphysis
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Jones Fx
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A Pseudo Jones Fx?
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a fracture of the proximal part of the 5th metatarsal
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Stress fracture usually of the middle of the shaft of the 3rd metatarsal (or 4th)
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March Fracture
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where do most sprains tend to occur?
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shoulder, the elbow, the knee and the ankle
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4 things to describe a fracture
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open or closed
site fracture pattern degree of displacement |
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what injury can be caused by external rotation & abduction force on humerus
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shoulder dislocation
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how do you treat a midshaft humerous fracture
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Coaptation splint:
Carefully molded plaster slab placed around medial & lateral aspects of arm, extending from axilla around elbow & over deltoid & acromion x 2 wks |
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how does a Boutonniere deformity present?
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with a flexed PIP joint (hand)& hyperextended DIP joint
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how does a Mallot finger present?
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with a flexion at the DIP joint & extension or hyperextension at the PIP joint
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what is the most classic finding in de Quervain tenosynovitis
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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
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what is Saturday night palsy?
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when the hand is pronated, the wrist and hand will drop
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which dermatome ennervates the middle and index fingers
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C7
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which dermatome ennervates the ring and pinky
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C8
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which dermatome ennervates the thumb
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C6
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With this syndrome, patients develop popping with knee extension
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Discoid Meniscus (Popping Knee Syndrome)
Congenitally round (discoid) lateral meniscus that does not acquire its normal semilunar shape |
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what condition may you have if you have a:
+ Lachman + Anterior drawer |
ACL tear
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what condition may you have if you have a + Tibia sag test
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PCL tear
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what disease is caused by overuse of the tendon attached to the tibial tuberosity; usually assoc. with adolescents and sports
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Osgood-Schlatters Disease
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what is the most common mass in the popliteal fossa called that results from fluid distension of the gastrocnemio-semimembranosus bursa
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Baker's cyst, also termed popliteal cyst
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What is Virchow triad?
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Risk factors for DVT:
venous stasis hypercoagulability vessel intimal injury |
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what is Homan’s sign?
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A sign of DVT;
presents with discomfort in the calf muscles on forced dorsiflexion of the foot with the knee straight |
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what test is used to rule out DVT, but not to confirm the diagnosis of DVT?
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The D-Dimer assays
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What study is best to confirm DVT?
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duplex ultrasonography
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what joint is responsible for a Hammer toe deformity?
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flexion deformity of the PIP joint
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