MSK elective surgery and general trauma formative Flashcards

1
Q

Name a tendon which needs surgical repair

A

Patellar tendon- need it to function

achilles, rotator cuff, long head of biceps, distal biceps can be managed conservatively

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2
Q

Do upper or lower limb fractures heal quicker?

A

Upper limb - better blood supply

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3
Q

Name a bone which is very slow to heal

A

Tibia

Fractures typically take 16 weeks, can take up to a year!

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4
Q

Nerve damaged in humeral shaft fracture?

A

Radial

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5
Q

Nerve damaged in colles (distal radial) fracture?

A

Median nerve

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6
Q

Nerve damaged in anterior dislocation of shoulder?

A

Axillary nerve

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7
Q

Cardinal sign of compartment syndrome?

A

Increased pain on passive stretching of the involved muscle

  • the limb will be tensely swollen and the muscle is usually tender to touch
  • Loss of pulses is a feature of end stage ischemia and the diagnosis has been made too late
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8
Q

Volkmanns contracture

A
  • Can occur following compartment syndrome

- fibrotic contracture

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9
Q

A complete transection of a nerve requiring surgical repair for any chance of recovery of function

A

Neurotmesis

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10
Q

A temporary conduction defect from compression or stretch and will resolve over time with full recovery

A

Neurapraxia

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11
Q

Nerve injury sustained due to compression or stretch from a higher degree of force with death of the long nerve cell axons distal to the point of injury die

A

Axonotmesis

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12
Q

GCS that implies loss of airway control?

A
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13
Q

Can be associated with hypertrophic non-union when the fracture is not properly stabilised

A

2ndry bone healing

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14
Q

Involves an inflammatory response and laying down of immature bone

A

2ndry bone healing

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15
Q

Occurs in anatomically reduced fractures fixed rigidly with plates and screws

A

Primary bone healing

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16
Q

Occurs with a fracture gap of less than 1mm

A

Primary bone healing

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17
Q

Blow to the lateral aspect of the knee (“Bumper injury”) can result in damage to which nerve?

A

Common peroneal

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18
Q

Posterior dislocation of the hip could damage which nerve?

A

Sciatic

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19
Q

Salter Harris intra-articular fractures?

A

III and IV

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20
Q

Most common salter harris fracture?

A

II

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21
Q

Which type of salter harris cannot be diagnosed on x-ray?

A

Type V

These are compression injuries (with subsequent growth arrest)

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22
Q

Occur due to torsional forces acting on the bone. These fractures are most unstable to rotational forces but can also angulate

A

Spiral fracture

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23
Q

Occur when bone is exposed to a shearing force (e/g/ fall from height, deceleration). There is a risk of shortening and angulation with these fractures as they’re inheritently unstable

A

Oblique fracture

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24
Q

Occur when a pure bending force is applied to a bone. The cortex on one side fails in compression and the cortex on the other side fails in tension

A

Transverse fracture

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25
Q

Tendons that need managed surgically?

A

Patellar
Hip adductor
Quadriceps

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26
Q

Good for end stage ankle arthritis

A

Arthrodesis

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27
Q

Good for end stage wrist arthritis

A

Arthrodesis

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28
Q

Good for hallux rigidus (OA of the first MTP)

A

Arthrodesis

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29
Q

Artery to watch out for in shoulder dislocation?

A

Axillary artery

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30
Q

Artery to watch out for in knee dislocation?

A

Popliteal artery

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31
Q

Artery to watch out for in paediatric supracondylar fracture?

A

Brachial artery

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32
Q

Maximum GCS

A

15

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33
Q

Minimum GCS

A

3

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34
Q

Treatment for mallet finger

A

Mallet splint holding the DIPJ extended

-worn for a minimum of four weeks

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35
Q

Avascular necrosis can occur in which part of scaphoid?

A

Proximal pole (as blood supply comes distally from a branch of the radial artery)

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36
Q

Treatment for displaced scaphoid fracture?

A

Special compression screw sunk into the bone to avoid non-union

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37
Q

Mortality from hip fracture?

A

10% at 1 month
20% at 4 months
30% at 1 year

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38
Q

Criteria to clinically clear a C-spine

A

No history of loss of consciousness, GCS 15 with no alcohol intoxication
No significant distracting injury (such as head injury, chest trauma or other fractures including more distal spinal fractures)
No neurological symptoms in the upper or lower limbs
No midline tenderness on palpation of the c-spine,
No pain on gentle active neck movement (ask the patient to gently flexed forward, then rotate to each side)

39
Q

Name a tendon which needs surgical repair

A

Patellar tendon- need it to function

achilles, rotator cuff, long head of biceps, distal biceps can be managed conservatively

40
Q

Do upper or lower limb fractures heal quicker?

A

Upper limb - better blood supply

41
Q

Name a bone which is very slow to heal

A

Tibia

Fractures typically take 16 weeks, can take up to a year!

42
Q

Nerve damaged in humeral shaft fracture?

A

Radial

43
Q

Nerve damaged in colles (distal radial) fracture?

A

Median nerve

44
Q

Nerve damaged in anterior dislocation of shoulder?

A

Axillary nerve

45
Q

Cardinal sign of compartment syndrome?

A

Increased pain on passive stretching of the involved muscle

  • the limb will be tensely swollen and the muscle is usually tender to touch
  • Loss of pulses is a feature of end stage ischemia and the diagnosis has been made too late
46
Q

Volkmanns contracture

A
  • Can occur following compartment syndrome

- fibrotic contracture

47
Q

A complete transection of a nerve requiring surgical repair for any chance of recovery of function

A

Neurotmesis

48
Q

A temporary conduction defect from compression or stretch and will resolve over time with full recovery

A

Neurapraxia

49
Q

Nerve injury sustained due to compression or stretch from a higher degree of force with death of the long nerve cell axons distal to the point of injury die

A

Axonotmesis

50
Q

GCS that implies loss of airway control?

A
51
Q

Can be associated with hypertrophic non-union when the fracture is not properly stabilised

A

2ndry bone healing

52
Q

Involves an inflammatory response and laying down of immature bone

A

2ndry bone healing

53
Q

Occurs in anatomically reduced fractures fixed rigidly with plates and screws

A

Primary bone healing

54
Q

Occurs with a fracture gap of less than 1mm

A

Primary bone healing

55
Q

Blow to the lateral aspect of the knee (“Bumper injury”) can result in damage to which nerve?

A

Common peroneal

56
Q

Posterior dislocation of the hip could damage which nerve?

A

Sciatic

57
Q

Salter Harris intra-articular fractures?

A

III and IV

58
Q

Most common salter harris fracture?

A

II

59
Q

Which type of salter harris cannot be diagnosed on x-ray?

A

Type V

These are compression injuries (with subsequent growth arrest)

60
Q

Occur due to torsional forces acting on the bone. These fractures are most unstable to rotational forces but can also angulate

A

Spiral fracture

61
Q

Occur when bone is exposed to a shearing force (e/g/ fall from height, deceleration). There is a risk of shortening and angulation with these fractures as they’re inheritently unstable

A

Oblique fracture

62
Q

Occur when a pure bending force is applied to a bone. The cortex on one side fails in compression and the cortex on the other side fails in tension

A

Transverse fracture

63
Q

Tendons that need managed surgically?

A

Patellar
Hip adductor
Quadriceps

64
Q

Good for end stage ankle arthritis

A

Arthrodesis

65
Q

Good for end stage wrist arthritis

A

Arthrodesis

66
Q

Good for hallux rigidus (OA of the first MTP)

A

Arthrodesis

67
Q

Artery to watch out for in shoulder dislocation?

A

Axillary artery

68
Q

Artery to watch out for in knee dislocation?

A

Popliteal artery

69
Q

Artery to watch out for in paediatric supracondylar fracture?

A

Brachial artery

70
Q

Maximum GCS

A

15

71
Q

Minimum GCS

A

3

72
Q

Treatment for mallet finger

A

Mallet splint holding the DIPJ extended

-worn for a minimum of four weeks

73
Q

Avascular necrosis can occur in which part of scaphoid?

A

Proximal pole (as blood supply comes distally from a branch of the radial artery)

74
Q

Treatment for displaced scaphoid fracture?

A

Special compression screw sunk into the bone to avoid non-union

75
Q

Mortality from hip fracture?

A

10% at 1 month
20% at 4 months
30% at 1 year

76
Q

Criteria to clinically clear a C-spine

A

No history of loss of consciousness, GCS 15 with no alcohol intoxication
No significant distracting injury (such as head injury, chest trauma or other fractures including more distal spinal fractures)
No neurological symptoms in the upper or lower limbs
No midline tenderness on palpation of the c-spine,
No pain on gentle active neck movement (ask the patient to gently flexed forward, then rotate to each side)

77
Q

Criteria to clinically clear a C-spine

A

No history of loss of consciousness, GCS 15 with no alcohol intoxication
No significant distracting injury (such as head injury, chest trauma or other fractures including more distal spinal fractures)
No neurological symptoms in the upper or lower limbs
No midline tenderness on palpation of the c-spine,
No pain on gentle active neck movement (ask the patient to gently flexed forward, then rotate to each side)

78
Q

Deformity in which plane is not well tolerated and requires manipulation and possible fixation?

A

Rotational deformity

79
Q

Most common site for proximal humerus fracture?

A

Surgical neck of the humerus

80
Q

Osgood Schlatters

A

Inflammation of the tibial tubercle

81
Q

Sinding Larsen Johanssen disease

A

Inflammation of the inferior pole of the patella

82
Q

Risk factors for patello-femoral dysfunction

A

The aetiology is unclear and may be due to muscle imbalance, ligamentous laxity and subtle skeletal predisposition (genu valgum, wide hips, femoral neck anteversion)

83
Q

Talipes equinovarus (club foot) is more common in which gender?

A
  • Boys
  • around 50% of cases are bilateral
  • may be genetic link with positive family history
  • low amniotic fluid
  • breech presentation
84
Q

Often the first sign of Perthes?

A

Loss of internal rotation
-common in very active boys of short stature haha

  • loss of internal rotation
  • then loss of abduction
  • then positive trendelenberg test
85
Q

Patients with SUFE, proportion that are bilateral?

A

1/3

86
Q

Loss of primitive reflexes

A

1-6 months

87
Q

Head control

A

2 months

88
Q

Speaking a few words

A

9-12 months

89
Q

Eats with fingers, uses spoon

A

14 months

90
Q

Stacks four blocks

A

18 months

91
Q

Understands 200 words, learns around 10 words a day

A

18-20 months

92
Q

Potty trained

A

2-3 years

93
Q

Approx how many patients with a dislocated patellar will dislocate it again in the future?

A

20%