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Ortho PANCE
quick hits for ORTHO section
53
Other
Graduate
05/18/2012

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Cards

Term
AC injury
Definition
direct fall on shldr; +crossover test; ice, sling, NSAIDs
Term
Clavicle Fx
Definition
direct trauma, FOOSH in kids; pain over collarbone, most commonly the distal third; sling
Term
Rotator Cuff Ms
Definition
Supraspinatis, Infraspinatis, Teres Minor, Subscapularis
Term
Rotator Cuff Injury
Definition
ppl who work overhead; +Neer (arm forward flexion), +pain down the arm; MRI; rest, ice, NSAID, PT, surgery
Term
Biceps Tendonitis
Definition
pain in front of my shoulder, just did a lot of carrying; ext rotate arm, palpate over humoral head; rest, ice, NSAID sling
Term
Prox Humoral Head Fx
Definition
elderly female FOOSH; pain, bruising; sling, early ROM, surgery for displacement
Term
Humoral Head Fx Must check
Definition
axillary nerve and artery
Term
Shldr dislocation
Definition
fell on ext rotated and aBducted arm; fell downstairs reached for handrail; arm presents externally rotated; immediate reduction
Term
Shldr dislocation must check
Definition
axillary nerve and artery
Term
Posterior Shldr dislocation
Definition
seizure or electric shock
Term
Lateral Epicondylitis
Definition
repetitive supination and wrist extension; +point tender lat epicondyle; +pain with resisted wrist extension; rest, ice, NSAID
Term
Supracondylar Fx
Definition
child fell off monkey bars FOOSH or direct blow; +pain/edema distal humerus; +post fat pad
Term
Radial Head Fx
Definition
FOOSH, pain at lat elbow, +post fat pad
Term
Colles Fx
Definition
distal radius fx with DORSAL angulation; elderly FOOSH; pain in distal forearm
Term
Smith Fx
Definition
distal radius fx with VOLAR angulation; elderly FOOSH; pain in distal forearm
Term
Gamekeeper Thumb
Definition
thumb forced into radial deviation, "ski pole got caught"; + pain over the ulnar collateral lig (thumb web space)
Term
Scaphoid Fx
Definition
FOOSH; +snuffbox tenderness, +pain with ulnar deviation of wrist; need hi suspicion d/t hi avascular necrosis risk
Term
Boxer's Fx
Definition
punched something; 5th MC head; ulnar gutter splint; need open cleaning and IV antibx if hit tooth and broke skin
Term
de Quervain's Tenosynovitis
Definition
overuse of gripping/new mothers; +pain radial aspect wrist, +Finkelstein (thumb tuck and ulnar deviate); thumb splint
Term
Trigger Finger
Definition
painless nodule in flexor tendon; need to manually extend finger; steroid inject or surgery
Term
Carpal Tunnel Syn
Definition
median nerve compression, repetitive flexion; +Phalens, +Tinel tap; +/- thenar wasting; night splint, surgery
Term
Cervical Fx
Definition
MVA; posterior midline tender; commonly C4-6; get lateral xray
Term
Ankylosing Spondylitis
Definition
chronic inflamm, M>>F, "bamboo spine", 90% + HLA-B27, -RF; PT and NSAIDs
Term
Scoliosis
Definition
lateral curve of spine, usually pre-adol girls; <20 deg observe, 20-40 brace, >40 surgery
Term
Herniated Disc
Definition
usually d/t DDD; +SLR, pain in nerve distribution, MRI, ice/heat, NSAID, rest, after 6-12 wks consider surgery
Term
Cauda Equina Syn
Definition
sudden compression of nerve roots L2-S4; tumor/central herniation/abscess/hematoma; saddle anesthesia, bowel/bladder dysfunction, loss sphincter tone; MRI, emergency surgery
Term
Spinal Stenosis
Definition
>60yo, M>F, relief of pain sitting or leaning forward, "shopping cart sign", MRI, rest, PT, NSAID, wt loss, surgery if dec QoL
Term
Avascular necrosis
Definition
loss of blood supply to femoral head; trauma/etOH/steroids/antiretrovirals; dull ache in groin, dec ROM on int/ext rotation; xray neg, MRI gold, refer!
Term
Hip Fx
Definition
elderly fell; shortened leg; usually neck or intertrochanteric; xray, ORIF
Term
Hip Dislocation
Definition
hi impact trauma, 90% MVA; shortened leg, internally rotated; xray/CT to r/o fx of acetabulum
Term
Tib Plateau Fx
Definition
axial load injury, fall from hi place lands on feet; knee swell, can't bear wt; xray tibial depression; cast
Term
Patellar Fx
Definition
direct blow to knee; inability to actively extend knee; xray
Term
ACL tear
Definition
forceful rotation with planted foot; here 'pop', sudden huge swelling/hemarthrosis; +Lachman's; MRI; brace, ice, surgery
Term
Meniscal Injury
Definition
h/o twisting/slipping; triad: joint pain, overnight effusion, locking/clicking; +McMurray, +Apley; RICE, NSAID, scope
Term
Prepatellar Bursitis
Definition
Housemaid knee/carpeter/tiler; palpable, painless boggy swelling over patella; if red/painful think infection; NSAID, ice
Term
Ankle Sprain
Definition
inversion and plantar flexion; Ant TaloFib lig MC; 'pop' then swelling over hours; xray; RICE, NSAID
Term
Ankle Fx
Definition
instability swelling pain on bone; check for prox fibula injury; check for foot drop/peroneal n injury
Term
Achilles Rupture
Definition
weekend warrior; "jumped up and felt like someone shot me in the leg"; +Thompson, may see visible gap in heel
Term
Avulsion Fx
Definition
inversion of foot; bone piece pulled away; common 5th MT head; hard shoe, wt bearing as tolerated
Term
Stress Fx
Definition
military recruit/runner/ballet; repetitive stress on bone; xray negative, bone scan will show; no h/o trauma; no wt bearing 4-8 wks
Term
CN5
Definition
DTR: Biceps M: Deltoid/shldr aBduct S: clavicle, lateral upper limb (w/ 6,7)
Term
CN6
Definition
DTR: Brachioradialis M: wrist extension S: thumb pad
Term
CN7
Definition
DTR: Triceps M: wrist flex, finger extend S: middle finger pad
Term
CN8
Definition
M: Finger flex S: little finger pad, ring finger
Term
T1
Definition
M: finger aBduct
Term
T8,9,10
Definition
upper abd reflex
Term
T10, 11, 12
Definition
lower abd reflex
Term
L1, 2
Definition
cremasteric reflex S:ant and inner surface lower limb
Term
L2,3,4
Definition
DTR: Patellar S:ant and inner surface lower limb
Term
L4
Definition
DTR: part of patellar M: invert/dorsiflex foot S: medial foot
Term
L5
Definition
M: dorsiflex toes (great) S: dorsum foot
Term
S1
Definition
DTR: Achilles M: evert/plantar flex foot S: lateral foot and plantar foot
Term
S3,4,5
Definition
Anal wink reflex S: perineum
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