Orthopedics 1

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HuskerDevil
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94424
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Orthopedics 1
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2011-07-18 15:07:26
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DPAP2012 Orthopedics
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Orthopedics flashcards made by previous students
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  1. Apply inferior traction with arm at side. Positive for AC joint instability if there is a gap between humeral head and acromion
    Sulcus sign
  2. Arm at 90 deg forward flexion, passive IR Pain is positive for impingement/RC tendonitis
    Hawkins
  3. start with arm at 90 deg forward flex and pronation, hold scap and passively forward flex to overhead. Pain is pos. for supraspinatus impingement.
    Neer's
  4. Have patient horizontally ADD arm. Pain is positive for AC injury
    Cross over test
  5. IR with hand on back. If pt cannot lift hand off back pos for weakness/tear of subscapularis
    Lift-off test
  6. With pt supine and arm at side with elbow flexed to 90, place your finger on biceps tendon. Externally Rotate. Pos for biceps tendonitis if pain or feel tendon slip out of groove
    Yergason's test
  7. Pt arm starts in forward flexion and supination, resist this motion, pain is pos for biceps tendonitis
    Speed's
  8. Shoulder AB to 90, elbow flexed to 90. Apply pressure behind humeral head and ER shoulder. Pos for anterior instability if pain.
    Apprehension test
  9. Tapping on volar aspect of wrist over carpal tunnel will reproduce pain/paresthesias in median nerve distribution. Pos for carpal tunnel syndrome.
    Tinnel's
  10. Place dorsum of hands together for 1 min. Pos for carpal tunnel syndrome if pain/paresthesias in median nerve distribution.
    Phalen's
  11. radial head fx in adults, supracondylar fx in kids
    Posterior fat pad sign
  12. usually normal, sail sign
    Anterior fat pad sign
  13. Test for disc herniation. Pt lies supine and leg is elevated. Pos is radicular pain below the knee.
    Straight leg raise test
  14. Essentially place foot of affected leg on pt's unaffected knee (Flexion, Abduction, ext. rotation). Hold opposite ASIS and apply downward pressure to affected knee. Pain is pos for problem with SI joint.
    FABER test
  15. Test for lumbar nerve root irritation. Pt sitting, passively extend affected leg. Pain is pos test (patient will put hands on table and arch backward)
    Flip test
  16. Gold standard for ACL tear. Knee flexed 15 deg. stabilize femur with one hand and tibia with other. Move tibia forward. Pos for ACL tear if movement and soft end point
    Lachman
  17. Knee flexed 90 deg. stabilize foot on table, pull tibia forward. Laxity can indicate ACL injury
    Anterior drawer
  18. Test for ACL dysfunction-Apply valgus stress, IR force and extend the knee. Maintain valgus stress and IR, and flex knee to 30 deg. ACL deficient knee will anterolaterally sublux on distal femur.
    Pivot shift
  19. For chronic PCL tear. Flex knee to 90 deg, stabilize heel on table. Tibia will droop at knee joint.
    Sag sign
  20. Knee flexed to 90 deg, stabilize foot on table. Move tibia posterior. Laxity can indicate PCL injury
    Posterior drawer
  21. Test for LCL injury, apply stress to medial knee while stabilizing lower leg.
    Varus stress
  22. Test for MCL injury, apply stress to lateral knee while stabilizing lower leg
    Valgus stress
  23. Test for meniscus injury. One hand on joint line and the other on the sole of the foot. Flex knee to 90 deg. IR/ER and extend the knee. Palpable or audible click
    McMurray
  24. Test for meniscal tears. Pt in prone position, flex knee to 90 deg, apply load through foot and IR/ER rotate. Pain is pos test.
    Apley grind test
  25. Cup hand around superior patella. Have pt contract quads while applying pressure. Pain is pos sign for patellar injury.
    Patella grind
  26. Draw line from ASIS to tibial tubercle. Draw straight line from tibial tubercle up. Measure angle. Females less than 17, males less than 14 is normal.
    Q angle
  27. Pt lying on side. Hold hips in neutral and cradle affected leg. Bring pt into hip flexion then adduction and extension. Let leg drop, if leg stays elevated positive for IT band tightness.
    Ober test
  28. put foot into 10 deg plantar flexion, stabilized tibia, other hand on heel and move ankle mortis forward on tibia. Pain and laxity pos for lateral ankle sprain. Tests ATF.
    Anterior drawer (ankle)
  29. Dorsiflex foot to 10 deg. Hold heel and invert talus/calcaneous on tibia while supporting tibia with other hand. Pain and laxity pos for lateral ankle sprain (CF).
    Talar tilt
  30. evert talus/calcaneus on tibia while supporting tibia with other hand. Pain and laxity pos for medial ankle sprain (deltoid lig.)
    Valgus stress (ankle)
  31. With both hands press tibia and fibula together. Pain indicates injury to syndesmosis.
    Squeeze test
  32. Pt in prone position, squeeze calf. Lack of plantar flexion indicative of Achilles tendon rupture.
    Thompson's test
  33. Fusiform swelling of fingers, significant tenderness along the course of the tendon, marked pain on passive extension, flexed finger at rest. Positive for septic tenosynovitis.
    Kanavel sign
  34. Cervical disc degeneration
    Spondylosis
  35. cervical sprain
    Whiplash
  36. C1 burst fx
    Jefferson fx
  37. C2 fx/dislocation from hyperextension and distraction
    hangman's fx
  38. C7 spinous process fx
    Clay shoveler's fx
  39. An injury to the glenoid labrum that can be described as Superior Labrum Anterior to Posterior.
    SLAP lesion
  40. 95% of all shoulder dislocations
    Anterior shoulder dislocation
  41. cortical depression in the head of the humerus bone.from forceful impaction of the humeral head against the anteroinferior glenoid rim when the shoulder is dislocated anteriorly.
    Hill Sachs
  42. An avulsion of the anteroinferior glenoid labrum at its attachment to IGHL complex.
    Bankhart lesion
  43. Dislocation caused by an anterior force, seizure, or electric shock, and is fairly uncommon
    Posterior shoulder dislocation
  44. This injury can damage the radial nerve.
    Humeral shaft fracture
  45. Medial epicondylitis
    golfer's elbow
  46. Lateral epicondylitis
    Tennis elbow
  47. dislocation of the elbow joint caused by a sudden pull on the extended pronated arm. The head of the radius slips out of the annular ligament
    Nurse maid's elbow
  48. 90% of elbow dislocations are in this direction
    Posterior
  49. Most common elbow fracture in kids
    Supracondylar
  50. Ulnar shaft fracture with proximal radius dislocation.
    Monteggia fracture
  51. Radial fracture with distal ulna dislocation
    Galeazzi fracture
  52. Isolated ulna fracture caused by direct blow to the forearm
    Night stick fracture
  53. 90% of distal radial fractures. Usually from a FOOSH. Dorsal angulation of distal fragment
    Colles fracture
  54. Distal radial fracture from a fall on the back of the hand. Causes a volar angulation of the distal fragment.
    Smith fracture
  55. Most common carpal fracture, at an increased risk for avascular necrosis
    scaphoid fracture
  56. fracture of the distal 5th metacarpal
    Boxer's or Brawler's fracture
  57. Forced flexion of the finger from an axial load, causing rupture of extensor digitorum to DIP.
    Mallet finger
  58. Thickened palmar fascia forms nodules over the flexor tendons causing a flexion contracture. Most common at ring and pinky finger.
    Dupuytren's contracture
  59. occurs when the motion of the tendon that opens and closes the finger is limited, causing the finger to lock or catch
    trigger finger
  60. Caused by abduction stress at the thumb. UCL injury
    Skier's thumb (gamekeeper's thumb)
  61. bony growths on the terminal (DIP). interphalangeal joints of the fingers
    Heberden's nodes
  62. hard, bony outgrowths or gelatinous cysts on the proximal interphalangeal joints
    Bouchard's nodes
  63. flexion of DIP and hyperextension of PIP
    swan neck deformity
  64. Loss of central slip insertion on proximal dorsal middle phalanx. Flexion fo PIP and hyperextension of DIP.
    boutonnieres deformity
  65. Seen on oblique view, a defect in the pars interarticularis puts a collar on the scotty dog.
    Spondylolysis
  66. MVA injury where the lap belt immobilizes pelvis and the thorax is forcefully flexed forward. seen on AP as a crack through the owl's eyes (pedicles), or an open beak (cracked spinous process)
    Chance fracture
  67. Collapse of anterior vertebral body with intact posterior wall from hyperflexion or osteoporosis
    wedge fracture
  68. vertebral slipping
    Spondylolisthesis
  69. lateral curvature of the spine
    Scoliosis
  70. classification system used for grading hip fractures
    Garden type
  71. 90% of hip fractures are in this direction
    Posterior
  72. Occurs at the origin og the sartorius, and is caused by knee flexion and hip hyper-extension.
    ASIS avulsion fracture
  73. Occurs at the origin of the hamstring, and is caused by vigorous hip flexion with knee extension.
    Ischial tuberosity avulsion fracture
  74. Occurs in obese adolescent boys. Will cause a limp and hip, thigh or knee pain, loss of IR, flexion and abduction
    Slipped capital femoral epiphysis
  75. avulsion fragment of the lateral tibial plateau associated with ACL or meniscus tear
    Segond fracture
  76. Gastrocnemius tendon sesamoid
    Fabella
  77. Proximal 1/3 fibula fracture associated with medial ankle fracture.
    Maisonneuve fracture
  78. Tibial tubercle apophysitis common in adolescents
    Osgood Schlatter's
  79. Holds tibia and fibula together
    Syndesmosis
  80. indications for getting imaging after ankle injury
    Ottawa rules
  81. 85% of all ankle sprains are in this direction, and are from a plantar flexion inversion injury.
    Lateral
  82. Fracture of proximal 5th metatarsal, from an inversion injury
    Jones fracture
  83. most common fracture of the ankle
    distal fibula fracture
  84. Usually seen in deconditioned athletes, and is caused by quick plantar flexion
    Achilles injury
  85. AKA shin splints
    medial tibial stress syndrome
  86. Calcaneal apophysis, very common in 7-15 year olds
    Sever’s disease
  87. pain on plantar aspect of calcaneus, will result in but are not caused by heel spurs
    Plantar fasciitis
  88. disruption of tarsometatarsal joint
    Lisfranc fracture
  89. Perineural fibrosis of digital nerve between 3rd and 4th web space, caused by walking on hard surfaces or wearing tight shoes.
    Morton's neuroma
  90. Urate crystals in 1st MTP joint
    Gout
  91. flat foot
    Pes planus
  92. first mtp joint sprain from excessive force of dorsiflexion or plantarflexion
    turf toe
  93. Childhood fracture in which the physis is widened. Growth disturbances are uncommon.
    Salter Harris I
  94. Childhood fracture that involves the metaphysis as well as the physis. Rarely results in functional deficits. The most common type.
    Salter Harris II
  95. Childhood fracture that involves both the epiphysis as well as the physis. There is damage to the growth plate but prognosis is relatively favorable.
    Salter Harris III
  96. Child hood fracture that involves the epiphysis, physis, and metaphysis. Can result in chronic disability.
    Salter Harris IV
  97. Childhood fracture that is a compression of the physis caused by an axial load. Poor functional prognosis.
    Salter Harris V
  98. As seen on a lateral radiograph of the cervical spine a widened predental space (greater than 2.5 mm)idicates what type of injury.
    Transverse ligament injury or laxity.
  99. Can occur from a blow to the top of the head and affects C1.
    Jefferson fx
  100. Tip of the dens, usually stable
    Type I odontoid fracture
  101. Base of the dens, most common
    Type II odontoid fracture
  102. Through C2 body, unstable
    Type III odontoid fracture
  103. Commonly occur at proximal 2/3 and distal 1/3 of the involved bone.
    Clavicle fx
  104. When the humeral head slightly overlaps the glenoid in a normal AP radiograph.
    Crescent sign
  105. AP view of the shoulder shows the humeral head to lie medial to the glenoid and inferior to the coracoid
    Anterior shoulder dislocation
  106. On an AP radiograph the humeral head is lateral to the glenoid so that there is no overlap.
    Posterior shoulder dislocation
  107. These are the three cardinal signs for what; joint space narrowing, bony overgrowth at edge of joint, sclerosis along articular surface
    Osteoarthritis
  108. A focal area of avascular necrosis
    Osteochondritis desiccans
  109. Most common site of osteochondritis desiccans
    Knee
  110. Loose body in a joint
    Joint mouse
  111. Avascular necrosis of the lunate
    Kienböck’s disease
  112. Oblique fracture through the base of the radial styloid
    Chauffeur's fracture
  113. Buckle fracture with intact periosteum, common in children
    Torus fracture
  114. Fracture of the thumb metacarpal base from an axial blow or adduction stress to thumb
    Bennet's fracture
  115. Comminuted Bennet's fracture
    Rolando fracture
  116. This part of a carpal bone can get fractured from a direct impact of a racquet, baseball, golf club.
    Hook of the Hamate
  117. Forceful extension of the DIP, patient now unable to flex DIP due to FDP avulsion.
    Jersey finger
  118. Acetaminophen (Tylenol)
    Efficacy comparable to aspirin, first line therapy for osteoarthritis. No good antiinflammatory action
  119. Aspirin
    First NSAID, Irreversible platelet effects
  120. Ibuprofen (Motrin, rufen, Nuprin, Advil)
    NSAID-200 mg superior to 650 mg aspirin. Better antiinflammatory than acetaminophen.
  121. Naproxen(Naprosyn)naproxen Na (Anaprox, Aleve)
    NSAID-275 mg Na salt comparable to 650 mg aspirin with slower onset and longer duration
  122. Ketorolac (Toradol)
    NSAID 30-60 mg is comparable to 6-12 mg morphine
  123. Celecoxib (Celebrex)
    Selective COX-2 inhibitor-use sparingly if at all, short term reduction of GI toxicity
  124. Diclofenac patch (Flector)
    Topical NSAID strains, sprains, contusions
  125. Diclofenac gel (Voltaren)
    Topical NSAID approved for osteoarthritis
  126. Tramadol
    Opioid-adjust for renal function, not a controlled substance
  127. Meperidine (Demerol/demonal)
    Opioid-not recommended. Metabolite causes CNS toxicity, accumulates due to long half-life.
  128. Nalbuphine
    Kappa-opioid not recommended
  129. Butorphanol
    Kappa-opioid not recommended
  130. Dexacine
    Kappa-opioid not recommended
  131. Buprenorphine
    Kappa-opioid not recommended
  132. Pentazocine
    Kappa-opioid not recommended
  133. Propoxyphene (Darvocet/darvocrap)
    Opioid-not recommended, efficacy in trials no more than that of 650 mg ASA or APAP. Metabolite accumulation may cause seizures.
  134. Used for neuromuscular conditions. Little evidence for use in musculoskeletal conditions
    Antispastic
  135. Used for musculoskeletal spasms related to injury. Evidence supports SHORT TERM use
    Antispasmodic
  136. Cyclobenzaprine (Flexeril)
    tricyclic antidepressant used clinically as a muscle relaxant/antispasmodic
  137. Methocarbamol (Robaxin)
    muscle relaxant/antispasmodic
  138. Tizanidine (Zanaflex)
    muscle relaxant/antispasmodic
  139. Carisoprodol (soma)
    Muscle relaxant
  140. Chlorzoxazone (Parafon forte)
    muscle relaxant/antispasmodic
  141. Tizanidine (Zanaflex)
    muscle relaxant/antispasmodic
  142. Pregabalin (Lyrica)
    indicated for fibromyalgia
  143. Gabapentin (Neurontin)
    indicated for fibromyalgia
  144. Seldom warranted for back pain
    Opioids in general
  145. Amitriptyline
    Tricyclic antidepressant-low doses indicated for treatment of back pain.
  146. duloxetine (Cymbalta)
    SNRI-Used for treatment of subacute and chronic musculoskeletal pain
  147. venlafaxine (Effexor)
    SNRI-Used for treatment of subacute and chronic musculoskeletal pain
  148. Neck flexion
    C1-2
  149. Neck lateral bending
    C3
  150. Shoulder shrug
    C4
  151. Shoulder abduction/elbow flexion
    C5-6
  152. Wrist extension
    C6
  153. Elbow extension
    C7-8
  154. Finger flexion
    C8
  155. Finger abduction
    C8-T1
  156. Sensory-upper neck
    C2
  157. Sensory-lower neck
    C3
  158. Sensory-tip of shoulder
    C4
  159. Sensory-thumb
    C6
  160. Sensory-lateral arm
    C5
  161. Sensory-middle finger
    C7
  162. Sensory-little finger
    C8
  163. DTR-biceps
    C5-6
  164. DTR-brachioradialis
    C5-6
  165. DTR-triceps
    C7-8
  166. Brachial plexus
    C5, C6, C7, C8, T1
  167. Hip flexion
    L1
  168. Hip adduction
    L2
  169. Knee extension
    L3
  170. Ankle dorsiflexion
    L4
  171. Hallices longus extension
    L5
  172. Hallices longus flexion
    S1
  173. Sensory-upper outer thigh
    L1
  174. Sensory-mid anterior thigh
    L2
  175. Sensory-below patella
    L3
  176. Sensory-medial ankle
    L4
  177. Sensory-first web space foot
    L5
  178. Sensory-lateral ankle
    S1
  179. DTR-knee
    L2-4
  180. DTR-ankle
    S1
  181. Hand grip
    C8
  182. Sensory-first dorsal web space hand
    Radial nerve
  183. Sensory-palmar middle pad
    Median nerve
  184. Sensory-palmar small pad
    Ulnar nerve
  185. Sensory-groin
    L1
  186. Sensory-upper thigh
    L2
  187. Sensory-outer thigh at knee
    L3
  188. Sensory-lateral ankle
    S1
  189. Sensory-buttock
    L2-3
  190. Sensory-perianal
    L4
  191. Grade 0 DTR
    Absent
  192. Grade 1 DTR
    Diminished
  193. Grade 2 DTR
    Average
  194. Grade 3 DTR
    Exaggerated
  195. Grade 4 DTR
    Clonus
  196. Strength testing 0/5
    Absent
  197. Strength testing 1/5
    trace movement/fasciculation
  198. Strength testing 2/5
    Full range of motion without gravity
  199. Strength testing 3/5
    Full range of motion against gravity but not resistance
  200. Strengths testing 4/5
    Full range of motion against gravity and mild resistance
  201. Strength testing 5/5
    Full range of motion against full resistance
  202. Hand-CMC flexion
    0-15
  203. Hand-CMC extension
    0-30
  204. Hand-MCP
    0-90
  205. Hand-PIP
    0-100
  206. Hand-DIP
    0-70
  207. Elbow flexion
    0-150
  208. Elbow pronation/supination
    0-80
  209. Wrist-dorsiflexion
    0-60
  210. Wrist-palmar flexion
    0-70
  211. Wrist-ulnar deviation
    0-30
  212. Wrist-radial deviation
    0-20
  213. Shoulder flexion
    0-150
  214. Shoulder extension
    0-40
  215. Shoulder abduction
    0-150
  216. Shoulder adduction
    0-30
  217. Shoulder external rotation
    0-90
  218. Shoulder internal rotation
    0-40
  219. Hip flexion
    0-100
  220. Hip extension
    0-30
  221. Hip abduction
    0-40
  222. Hip adduction
    0-20
  223. Hip internal rotation
    0-40
  224. Hip external rotation
    0-50
  225. Knee
    0-150
  226. Ankle dorsiflexion
    0-20
  227. Ankle plantarflexion
    0-40
  228. Ankle inversion
    0-30
  229. Ankle eversion
    0-20
  230. Cervical spine flexion
    0-45
  231. Cervical spine extension
    0-45
  232. Cervical spine lateral flexion
    0-45
  233. Cervical spine rotation
    0-80
  234. Thoracolumbar spine flexion
    0-90
  235. Thoracolumbar spine extension
    0-30
  236. Thoracolumbar spine lateral flexion
    0-30
  237. Thoracolumbar spine rotation
    0-30
  238. Diflunisal
    Dolobid
  239. Celecoxib
    Celebrex
  240. Diclofenac
    Voltaren
  241. Ibuprofen
    Motrin, Advil
  242. Ketorolac
    Toradol
  243. Meloxicam
    Mobic
  244. Naproxen
    Naprosyn
  245. Naproxen Sodium
    Anaprox, Aleve
  246. Oxaprozin
    Daypro
  247. Piroxicam
    Feldene
  248. Sulindac
    Clinoril
  249. Carisoprodol
    Soma
  250. Chlorzoxazone
    Parafon Forte
  251. Cyclobenzaprine
    Flexeril
  252. Dantrolene
    Dantrium
  253. Metaxalone
    Skelaxin
  254. Methocarbamol
    Robaxin
  255. Orphenadrine
    Norflex
  256. Tizanidine
    Zanaflex

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