1
Q
__ joint is the only bony attachment of the upper extremity to the axial skeletal
A
Sternoclavicular joint
2
Q
Coracoclavicular and acromioclavicular ligaments
A
2 ligaments that attach the clavicle to the scapula
3
Q
4 components of the rotator cuff
A
Supraspinatus
Infraspinatus
Teres minor
Subscapularis
4
Q
Coracoacromial arch
A
Ligament that creates a hood between the coroacoid and acromion process, problematic if humerus rides high and migrates superiorally and hits against it causing shoulder impingement syndrome
5
Q
Sulcus sign
A
Test for glenohumeral instability in the shoulder, when elbow is grasped and forced downward see depression form just below the acromion
6
Q
Apley’s scratch test
A
Quick assessment of shoulder range of motion by having patient reach behind them and scratch their back in a stereotypical manner
7
Q
Apprehension test shoulder
A
Test glenohumeral joint anterior instability by having arm abducting and externally rotated, then apply force posteriorly and watch for apprehension
8
Q
Load and shift test
A
Test for anterior and posterior glenohumeral joint instability, stabilize shoulder joint and apply anterior or posterior translation for laxity
9
Q
Speeds test
A
Resisted glenohumeral flexion while elbow is extended testing for pressure over biceps tendon, pain indicates biceps tendon pathology
10
Q
Shoulder impingement mechanism of action
A
- deltoids raise shoulder and are resisted by rotator cuff muscles
- if weak or torn will see humerus head roll unapposed superiorally hitting the nerves and vessels going under the coracoacromial arch
11
Q
Allens test for thoracic outlet syndrome/halstead maneuver/adson’s maneuer
A
Test for thoracic outlet syndrome where arm is abducted and externally rotated and then the pulse is monitored while the patient turns head away, positive is pulse weakening, halstead features neck extension and adson features inspiration
12
Q
Nursemaid elbow
A
Dislocation of head of the radius in children often seen by pulling children by the wrist, can be fixed easily with reduction
13
Q
Ulnar collateral ligament tear treatment (2)
A
- conservative, will never return to full performance
- ulnar collateral ligament replacement (tommy john procedure) often done in throwers who need that ability
14
Q
Medial and lateral epicondylitis tests
A
Resist wrist flexion or extension (medial or lateral respectively) and put pressure on tendon
15
Q
Colle’s fracture
A
Fracture that occurs in the distal radius or ulna often from FOOSH, see forward displacement of radius causing visible deformity, possibility of tearing tendons causing median nerve damage
16
Q
Tenosynovitis and management
A
Inflammation of the synovium surrounding a tendon, most often in the wrist and because of repetitive wrist accelerations and decelerations or repetitive overuse of wrist tendons and sheaths, see pain with use or associated with passive stretching, managed with ice and NSAIDS
17
Q
Wrist ganglion and management
A
Synovial cyst from herniation of joint capsule that generally appears after a wrist strain most often on the dorsum of the wrist and may be soft, rubbery, or hard, can be aspirated or removed
18
Q
Scaphoid fracture
A
Often caused by force on outstretched hand and often fails to heal due to poor blood supply, presents like a wrist sprain but sees severe pain in anatomical snuff box and pain with radial flexion
19
Q
Mallet finger and management
A
Caused by blow that contacts tip of finger avulsing extensor tendon at the DIP resulting in inability to extend distal end of finger, managed with splinting
20
Q
Boutonneire deformity and management
A
Swelling of PIP flexion and extension of DIP from inflammation in PIP joints occurring in rheumatoid arthritis, can also be traumatic in origin, managed with splinting
21
Q
Swan neck deformity and management
A
Hyperextension of PIP and flexion of DIP joints causing rheumatoid arthritis, managed with splinting
22
Q
Jersey finger and management
A
Rupture of flexor digitorum profundus tendon from insertion on distal phalanx resulting in DIP that cannot be flexed and finger remains extended, must be surgically repaired
23
Q
Dupuytren’s contracture
A
Nodule development on palmar aponeurosis limiting finger extension causing flexion deformity often 4th or 5th digit,
24
Q
Recall the bones of the wrist
A
Distal ulna and radius and 8 carpal bones scaphoid (navicular) lunate triquetrum, pistiform, hamate capitate, trapezoid, tapezium (so long to pinky, here comes the thumb)
25
3 muscles for wrist extension
Extensor carpi radialis longis, brevis, and ulnaris
26
2 muscles for wrist flexion
Flexor carpi radialis, flexor carpi ulnaris
27
Abduction and adduction of fingers is performed by...
....dorsal and palmar interossei muscles
28
Atrophy of thenar muscles indicates ___ nerve compression, hypothenar muscle atrophy indicates ___
median, ulnar
29
Smith's fracture
Fracture of distal radius with ventral displacement of hand, reverse of colles fracture
30
Where does dequervain's tenosynovitis occur?
Over the extensor and abductor tendons of the thumb as they cross the radial styloid
31
What 2 tendons form the anatomical snuff box?
Exensor pollocis longus and extensor pollocis brevis/abductor pollocis longus
32
Finkelstein's test
Grip thumb in wrist and then undergo ulnar deviation to test for dequarvian tenosynovitis
33
Kienbocks disease
Avascular necrosis of lunate bone of unknown etiology (perhaps disease state, perhaps fracture, etc), bone fragments can cause excruciating pain, after bone degenerates other carpal bones migrate within hand causing crippling, surgical options can result in loss of function via bone removal or fusing but helps alleviate pain
34
Trigger finger and management
Painless nodule in flexor tendon in palm near metacarpal head, too big to enter tendon sheath during extension of fingers from flexed position, has auditory pop when extended with effort, can be treated with steroid injections or surgery
35
Gamekeepers/skier's thumb
Injury to ulnar collateral ligament of the thumb resulting from hyperabduction of MCP joint, either torn or avulsed at insertion to the proximal phalynx of the thumb, can be due to fall or skiing injury
36
4 articulations of elbow and forearm
- Ulnohumoral
- radiocapitellar
- proximal radio-ulnar
- distal radioulnar at the wrist
37
Radial head sublaxation at the annular ligament (nursemaids elbow) peaks at what age?
2-3
38
Radial tunnel syndrome and management
Compression of the posterior interosseous nerve, usually occurring between 35-50 gradual onset overuse injury, often time managed OT but may need surgery
39
Middle finger test
Test for radial tunnel syndrome test where middle finger is extended against resistance resulting in pain if positive
40
Fracture of distal humerus
Rare in adults but has high morbidity and risk of neurovascular injury (progression to compartment syndrome), high probability of injuring the ulnar nerve, sees anterior or posterior fat pad sign
41
Rupture of distal biceps tendon and management
Uncommon less than 5% of biceps ruptures usually in men greater than 40 with pre-existing degenerative changes, sees shortened biceps muscle popeye sign and puckered skin from shortened tendon, can be complete or incomplete, requires operative repair in complete tears and non op if older, partial, etc, typically do not return to full strength and see radial nerve damage
42
Majority of rotation of the head occurs at the ___ junction
Atlanto-Axial joint (C1-C2) held in place by the transvere ligament but can be loose or lax in individuals with trisomy 21 (not the cervical vertebrae)
43
Assessment of posture
Ear hole should be in line with acromion process
44
Slump test
A way to test for fake back pain that is same as straight leg raise but sitting upright, should cause symptoms same as straight leg raise
45
Hoover test
A way to test for fake or "conversion" disorder that asks patient to do a straight leg raise in supine while feeling for downward pressure under opposite heel if genuinely trying to raise leg but cannot vs if exaggerating symptoms
46
C1 (lacks vertebral body and spinous process) is also known as the ___, C2 as the ___ which features the ___
Atlas, axis, dens/odontoid process
47
Anterior longitudinal ligament vs posterior longitudinal ligament vs ligamentum flavum vs interspinous ligaments vs nuchal ligament
Anterior is in the front of the vertebral body, posterior is on the back of the body but in front of the spinal cord (the floor of the spinal column), the ligamentum flavum connects the lamina of each adjacent vertebrae on the roof of the spinal column, interspinous connects the spinous processes off the back of that, while the nuchal connects the spinous processes to the rhomboid and trapezius muscles (ending at the 7th cervical vertebra)
48
Most prominant spinous process of the cervical vertebrae
C7
49
Stable spine injury
Only impacts the anterior column (anterior longitudinal ligament, anterior half of vertebral body, disc and annulus)
50
Unstable spine injury
Affects anterior and posterior column (posterior longitudinal ligament and all posterior aspects of vertebral body)
51
Discitis
Inflammation of vertebraldisc space usually a coinfection with vertebral osteomyelitis from infection spreading from other sites, presents with neck pain and stiffness, evaluated with MRI**, treated with antibiotics or support if viral and immobilized, limited course
52
Bilateral facet dislocation
Severe form of c spine sublaxation and ligamentous injury, very unstable, disruption of both anterior longitudinal lig and posterior, complete anterior dislocation of vertebral body and high risk for spinal cord injury, needs surgical management
53
Compression fractures
Common in osteoporosis*** as well as malinancy from axial force, one of the vertebral bodies collapses into another, type 1 (wedge fracture) is stable and heals on its own in 8-10 weeks with cervical collar, type iii less stable and need surgery, type IV and V poor prognosis
54
Flexion teardrop fracture
Most unstable and dangerous c spine injury, variant of burst compression fracture, common from diving head first, displacement of anterior inferior edge of vertebral body displacing posterior inferior corner frragments into spinal cord, acute and severe neurologic deficits, diagnosed via lateral c spine view, needs life support measures
55
Hangman's fracture
C2 fracture, traumatic spondylolisthesis, bilateral fracture of pars interarticularis, anterior displacement of vertebra, usually result of hyperextension and axial compression with MVA being most comon cause, usually neurologically intact but see pain, need rigid collar or surgery
56
Jefferson fracture
C1 burst fracture, diving and MVA cause, immobilization and skeletal traction help manage
57
4 articulations of the shoulder
- glenohumeral
- scapulothoracic
- acromioclavicular
- sternoclavicular
58
Rotator cuff strain, tentinitis/tendinosis, impingement definition
Disorder often resulting from repetitive use injury or anatomical predisposition, possible to present at any age, shoulder pain most often present when attempting to abduct the shoulder as well as inability to lay on affected shoulder, locking sensation occasionally, loss of ROM especially external rotation, most often due to supraspinatous muscle being pinched by decreased subacromial space as it is responsble for allowing that abduction, subacromial bursa attached to supraspinatous becomes inflamed and irritated
59
What is the most common muscle torn in rotator cuff injury?
Supraspinatous
60
Individuals with a torn rotator cuff, when asked to abduct their shoulder, will often do what?
Shrug their shoulders up and lean to one side in order to try to compensate for the weakness to elevate the shoulder
61
Calcific tendonitis definition
Degenerative changes often with advanced age of supraspinatous tendon, see gradual or acute onset of shoulder stiffness and severe pain, aggrivated by any motion of shoulder, active at night, pain radiates to deltoid and down arm, x rays display the calcium deposits
62
Calcific tendonitis treatment options (5)
- local steroid injection
- NSAIDS or analgesics/sedatives
- aspiration
- PT
- surgery
63
Biceps tenosynovitis definition
Repetitive strain injury seeing pain over anterolateral shoulder down anterior arm with limited ROM, tenderness over bicipital groove, positive yergsons or speeds test
64
Adhesive capsulitis (frozen shoulder) definition what are the two most common presenting symptoms?
Etiology unknown, usually follows period of inactivity or minor injury, insidious onset, usually in 5th decade, pain localized to rotator cuff and anterior arm and interferes with sleep, see pain and decreased range of motion***
65
Adhesive capsulitis diagnosis (2) and treatment (2)
- shoulder series x ray
- rule out posterior shoulder dislocation
- physical therapy do not wait!
- manipulation under anesthesia
66
Glenohumeral dislocations (anterior vs posterior) causes
Anterior most often fall on externally rotated abducted arm, posterior most often force against internally rotated arm such as seizure or convulsive disorders
67
Hill sachs lesion
Indentation of superolateral humeral head in recurrent anterior shoulder dislocations (chip of bone taken out of head oof humerus)
68
Bankart lesion
Tear of lesion or possibly bone most often in anterior in shoulder dislocations from glenoid fossa
69
Glenohumeral dislocations treatment options (3)
- primary manipulative reduction often with IV sedation
- open reduction in recurrent cases
- immobilization of shoulder
70
What type of clavicle fracture has higher likelihood of needing ORIF?
Distal end fractures (proximal portion sticks up distal portion held together by coracoclavicular ligament)
71
If a patient has shoulder pain not aggrivated by neeck or shoulder motion but has positive GI history, be concerned for....
...referred pain to top of shoulder via phrenic nerve (C345 innervate diaphragm) could be abdominal cause
72
Radial nerve pathway in the upper extremity
Exits the subclavicular region and travels posteriorally down the back of the humerus before wrapping around laterally and then anteriorally by the time it hits the elbow joint
73
When a normal person stands on one foot, the pelvis tilts ___ on the opposite side (the side on which the foot is held off the ground, in trendelenberg patients, the pelvis tilts ___ on the opposite side
upwards, downwards
74
Osteitis pubis
Idiopathic inflammatory diz involving the pubic symphysis and surrounding tissue, common in athletes but can also occur post pregnancy or pelvic surgery, usually insidious onset of pelvic pain in absence of systemic symptoms (ruling out osteomyelitis typically), tender over pubic symphysis
75
Adduction maneuver for osteitis pubis
Have patients lying supine squeeze flexed thighs together (adduction) into the examiners hand
76
Osteitis pubis treatment options (2)
- conservative treatment
| - steroid injection
77
Coccydynia definition
Pain in the coccyx, typically self limiting, usually related to direct trauma, can be reproduced with direct pressure on the coccyx, can see pain with sex or defecation
78
Coccydynia treatment options (3)
- analgesics
- wedge pillow
- heat or cold applications, imaging typically not used as kind of useless
79
Femoacetabular impingement (FAI) definition
Developmental abnormality that may be responsible for progression to arthritis, see groin pain, pain with turning twisting squatting and prolonged sitting
80
Trochanteric bursitis definition
Inflammation of the trochanteric bursa often caused by exaggerated movement of the gluteus medius tendon and the extensor fascia over the outer femur, repetitive flexing of the hip and direct pressure aggrivate, caused by gait disturbance usually***, typically presents as lateral hip pain over the outer thigh or difficulty with walking****
81
Legg calve perthes disease definition***
Ischemia with subsequent necrosis of femoral head, avascular necrosis of epiphysis, abnormal growth at physis, remodeling of bone, most often in 4-10 y/o males, can be bilateral, can lead to osteoarthritis later in life
82
Perthes disease signs and symptoms (4)***
- pain in the groin or thigh
- possible knee pain
- limp gait (parents will typically have noticed)
- limited abduction and internal rotation
83
Perthes disease diagnostic studies (1)***
-x rays
84
Perthes disease treatment options**** (5)
- NSAIDS
- crutches
- PT
- casting/bracing of progressive deformity
- surgery if not caught
85
Slipped capital femoral epiphysis (SCFE) definition***
Posterior inferior displacement of femoral epiphysis thru the growth plate, ost common in early teenage males 11-15 often obese, sometimes with endocrine disorders, gradual process but may be due to minor trauma
86
Slipped capital femoral epiphysis (SCFE) signs and symptoms (4)***
- hip or knee pain
- externally rotated leg at rest when comfortable
- limp or pain walking
- stiffness of hip
87
Slipped capital femoral epiphysis (SCFE) treatment options (2)***
- surgery
| - watch for it to happen on other side
88
Snapping hip syndrome
Snapping with flexion/extension of hip caused by tendon catching on bony prominance, x ray usually normal but usually need to rule out pathology, treated with reassurance
89
Gradual onset of swelling around knee after falling indicates ___ type injury, while immediate is more likely___
meniscal tear, ACL
90
Meniscal tears signs and symptoms (3)
- pain usually well localized
- pain with full flexion (inability to duck walk)
- may have knee locking (inability to fully extend knee)
91
Meniscal tear treatment options (3)
- compression, dressing, ice, elevation, crutches, ROM therapy
- aspirate if tense painful effusion only
- remove, debride, repair meniscus
92
Aspiration of fluid from knee joint analysis (3)***
- mostly blood indicative of ACL tear
- clear yellowish fluid without fat cells or significant blood is meniscal tear
- blood and globules of fat is intra-articular fracture of the bone
93
Baker's (popliteal) cyst definition and management***
Normal variant enlargement of semimembranous bursae in medial popliteal space, may be found incidentally, may cause pain/paresthesias if nerve impingement if very inflamed and large, typically imaged on ultrasound or MRI, does NOT need to be excised often unless significantly problematic, often erroneously referred to ortho, can consider aspiration, rarely removed, may recur, treat any underlying cause
94
ACL tear signs and symptoms (3)
- often audible pop after noncontact injury
- immediate effusion/hemearthrosis
- may be able to ambulate
95
Q angle
Angle from knee to ASIS compared to tibial tubercle, widened in females creating greater likelihood of knee pathology
96
Plica syndrome definition
Synovitis of the folds of the knee, most often medial and may be due to trauma, overuse, treated with rest, activity restriction
97
Osteonecrosis of the femoral condyle
Avascular necrosis of the femoral condyle possibly caused by steroid use, alcoholism, etc.
98
Prepatellar bursitis (housemaid's knee)
Pain anterior and inferior well localized to the patella, have to rule out septic cause before treating conservatively
99
Sports medicine definition
Umbrella for area of medicine related to physically active and sports population including many populations of physically active individuals across age groups
100
Cardinal signs of inflammation (4)
- rubor (erythema)
- tumor (swelling)
- calor (warmth)
- dolar (pain)
101
Little leager's elbow
Apophysitis of medial epicondyle due to repetitive microtrauma of overuse injury
102
Segond fracture
Avulsion fracture of the lateral tibial plateau highly associated with ACL tear, if seen on x ray should have high clinical suspicion
103
Spondylolysis characteristic finding on x ray
Scottie dog sign
104
Post concussion syndrome
Persistent symptoms following concussion that can last months to years, severity of initial injury not associated with how long symptoms last, if not fully recoverred can see repeat concussions, can lead to 2nd impact syndrome
105
Second impact syndrome
Rare incidence where a person has a repeat concussion before recovering from previous, brain swells rapidly leading to increased ICP, herniation, and death
106
Complex regional pain syndrome
Painful conditions characterized by continuing regional pain disproportionate in time or degree to the usual course of any known trauma or other lesion, regional, non specific to nerve territory or dermatome and has distal prominance, 2 subtypes, most commonly occurs in postmenopausal women, unknown etiology only sometimes has inciting event
107
CRPS (Complex regional pain syndrome) type I vs II
- More common, without an identifiable nerve lesion
- less common, associated with a nerve lesion and obvious nerve injury and follows specific nerve group****, causalgia, involves peripheral, central, and autonomic nervous systems
108
5 Characteristics of CRPS (Complex regional pain syndrome)****
- Pain (burning or aching out of proportion to stimulus)
- Sensory hyperesthesia*** (amplified reaction to normal pain stimulus) and allodynia*** (painful response to normally harmless/nonpainful stimulus)
- Vasomotor (cyanosis, asymmetric skin temp)
- Sudomotor/edema (red skin or hyperhydrosis)
- Motor/trophic (changes in hair/nail growth, ulcerations, decreased ROM)
109
Diagnostic criteria for Complex regional pain syndrome (4)
- Clinical
- continuing pain disproportionate to inciting event
- displays at least one of the 5 characteristics
- no other diagnosis better explains
110
Complex regional pain syndrome (CRPS) stages
1 - acute, hours to days, sees burning aching pain, hyperalgesia and allodynia
II - Dystrophic, 3-6 months sees pain radiate distally, edema, cyanosis, hyperhydrosis
III - atrophic, >6 month, pain on any movement, ulcers, bone loss
111
Complex regional pain syndrome (CRPS) treatment options (4)
- PT and OT 1st line***
- psychosocial and behavioral therapy
- interventional pain management such as nerve blocks
- NSAIDs, gabapentin, bisphosphonates, TCA's, opioids contraversial!!!
112
Complex regional pain syndrome (CRPS) prognosis
-very disabling, only 15-20% return to work, many improve with combo of drug and PT, best treated early <6 months****
113
Compartment syndrome definition
Elevation of interstitial pressure in closed or fixed osseous or fascial compartment resulting in compromised microvascular perfusion, tissue hypoxia, and potentially irreversible damage to the contents, most often in the extremities (lower leg anterior (anterior tibial artery) and deep posterior compartments (deep peroneal artery) are concern)
114
Compartment syndrome pathophysiology (2)
- Increased compartment content (fracture, hemorrhage, penetrating trauma, edema)
- reduced volume (constriction by cast, burn, positional)
115
Chronic exertional compartment syndrome
Compartment syndrome with result of exercise, pain with repetitive overloading and relieved with rest, seen often in long distance runners, males and females, occurs frequently and consistently at a certain time during exercise with same level of exertion and same level of corresponding pain, treated with fascial release
116
Signs and symptoms of compartment syndrome (6)
- pain out of proportion
- tightness of compartment
- pain with passive ROM
- muscle weakness
- paresthesias
- skin changes consistent with ischemia
117
Compartment syndrome diagnosis (2)***
- clinical suspicion
| - pressure monitor with stryker device >30mmHg or delta pressure <30 (diastolic - compartment)***
118
5 P's of compartment syndrome
```
Pain
Paresthesia
Paralysis
Pallor
Pulselessness
- polkiothermia (you found the extremely rare 6th P)
```
119
Preferred pain relief for compartment syndrome
- Fentanyl (doesn't vasoconstrict or vasodilate)
| - do not ice or elevate!
120
Compartment syndrome sequelae (3)
- Tissue damage
- amputation
- renal failure and or death
121
Osteomyelitis definition
Infection of the bone, either nonhematogenous (direct, adjacent spread) or hematogenous (seeds to bone)
122
Osteomyelitis risk factors (6)
- open fractures (multiple organisms involved)
- IV drug use
- sickle cell (most often salmonella)
- Peripheral vascular disease in diabetics
- joint prosthesis
- cellulitis or burns
123
Osteomyelitis signs and symptoms (6)
- dull pain with or without movement
- fever or rigors
- irritability, fatigue, gait changes, refusal to weight bear
- hip, vertebrae, and pelvis have fewer symptoms
- long bones hematologic spread most common in children
- vertebral most common in adults
124
Osteomyelitis diagnostic studies (4)
- Nonspecific labs (WBC, ESR)
- radiographs in >2 week long infection
- MRI in <2 weeks long infection
- Bone biopsy for culture (gold standard)****
125
Osteomyelitis treatment options (3)
- antibiotics IV and IM
- surgical debridement
- remove prosthesis and don't replace until sterility
126
Sprain
Stretch or tear of a ligament (stabilize joints connecting bone to bone so they are flexible but have an end point)
127
Strain
Injury of Musculotendinous unit, may impact muscle body or closer to attachment points, may impact function such as strength or range of motion
128
Grade 1-3 strain
1 - stretching (tenderness with active use and minimal strength loss)
2 - partial tear (clear weakness with resisted muscle and pain with passive stress)
3 - complete rupture (significant functional and strength deficits, ecchymosis, full thickness tear)
129
Grade 1-3 sprain
1 - stretching of ligament, good stability and no laxity
2 - partial tearing, slight laxity
3 - complete tear, no end point and severe laxity
130
In complete gamekeeper's thumb tears, 50% will have stener lesion (detached ligament stuck between tendons), this needs what for treatment?
Surgery
131
Complications of muscle injury
- hematoma
- recurrent injury
- myositis ossificans (calcification of tissue limiting motion of joints)
132
Volkmann ischemic contracture
Occurs when there is ischemia to the forearm, typically when there is increased pressure due to swelling such as compartment syndrome, prolonged ischemia injures nerves and muscles causing them to become stiff and shortened, muscles of forearm are severely injured leading to deformities of fingers, hands, wrists, can involve 2-3 fingers, all, or complete hand
133
Neuropraxia
Transient episode of motor paralysis often involving he median or ulnar nerve in 20% of elbow dislocations
134
Pediatric bones vs adult bones (4)
- higher water content and lower mineral so less brittle, more elastic
- physis is cartilaginous in children
- children do not get sprains, they break bones
- growth plates more vulnerable than bone or ligaments
135
Growing pains
-recurrent, self limiting extremity pains (most commonly lower extremities and have no correlation with growth spurts) often with no explanation benign and usually resolve with 1 -2 years, must rule out pathologic causes thru thorough H&P, can give NSAIDS/acetaminophen, if persistent pain or constitutional symptoms then further investigation
136
Accessory navicular
Extra bone or cartilage on navicular bone in foot, anatomic variant seen prominently in females and during adolescence, usually results in point tenderness right over the navicular, can often cause pain or swelling, diagnosed via x ray and treat with modifications, may see grow out of it, or refer if persistent pain
137
Calcaneal apophysitis (Sever's disease)
Inflammation of calcaneal physis (achilles tendon pulling away slightly at the growth plate) resulting in localized point tenderness on the retrocalcaneal area, often self resolving as matures, heel lifts, activity restriction, casting in severe cases can help, only refer if not improving
138
Osteogenesis imperfecta (brittle bone dz)
Connective tissue disorder, if not identified at birth due to trauma with delivery then can see excess or atypical fractures, short stature, scoliosis, blue sclera, increased laxity of ligaments and skin as well as easy bruisability
139
Osteogenesis imperfecta treatment options (3)
- bisphosphonate therapy
- fracture management
- PT/OT
140
Polydactyly
Accessory toes
141
Syndactyly
Common fusion of skin or bone either partial or complete at birth
142
Developmental dysplasia of the hip (DDH) definition
When the acetabulum does not fully cover the femoral head, increasing risk of dislocation, can be associated with ligamentous laxity detectable at birth, neonates asymptomatic but by walking age may see manifestations
143
Adverse outcomes of fracture healing in pediatrics (3)
- malunion
- physeal arrest
- neurovascular compromise
144
Supracondylar fractures of the humerus in kids should be splints as....
....as they lie (no reduction)
145
Genu valgum/varum treatment options (3)
- observation
- no braces or shoes, spontaneousy corrects most of time
- refer if severe
146
Intoeing and outtoing
-Foot turns in or out more than expected, if stumbling or falling can consider casting, but as long as no underlying pathology typically don't need to do anything (shoes and braces don't help)
147
Distal fibula makes up the ___ malleolus, distal tibia makes up the ___ malleolus
lateral, medial
148
High ankle sprain/syndesmosis injury
Injury of the interosseous ligament and associated ligaments between the tibia and fibula, most often mechanism of injury is dorsiflexion and external rotation, will see widening of the syndesmosis space on x ray
149
Achilles tendon rupture treatment options
- surgery internal or external fixation in complete tear
| - immobilization in plantarflexion for partial tear
150
Trimalleolar fracture
Affects the distal fibula, distal tibia, and posterior tibia, recommended to be treated by ORIF in many cases
151
Bimalleolar fracture
Affects both the tibia and fibula (medial and lateral malleolus), causes loss of ankle mortise
152
Lisfranc injury
Injury of the 2nd metatarsal which is already in a lisfranc position (wedged between talar bones) pops dorsally upon a sudden axial load send thru the plantar flexed foot upward
153
Jones fractures
Occurs distal to the tuberosity of the base of the 5th metatarsal (different from avulsion), due to poor blood flow requires long time for healing, can be casted or surgically repaired
154
Morton's neuroma definition and diagnosis (2)
- inflamed nerve due to chronic trauma and repeptitve stress or tight fitting shoes, sees pain and paresthesias in distribution of the nerve involved, lateral compression often elicits symptoms
- Injection of anesthetic and MRI
155
Callus vs corn
Callus is thickened skin that is not painful and has no central core, corn's central core extends deep into skin and presses on nerve endings resulting in increased sensitivity and pain unlike calluses,
Professional Development
flashcards
Decks in class (62)
# Cards
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Part 1122
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Part 2123
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Part 3120
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Part 4150
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Part 5124
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Part 6125
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Part 7148
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Part 8160
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Part 9198
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Part 10119
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Part 11131
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Part 12119
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Part 13126
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Part 14123
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Part 15133
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Part 16142
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Part 17124
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Part 18135
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Part 19127
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Part 20108
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Part 21160
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Part 22125
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Part 23145
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Part 24160
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Part 25170
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Part 26120
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Part 27130
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Part 28153
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Part 29124
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Part 30144
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Part 31181
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Part 32121
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Part 33165
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Part 34133
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Part 35116
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Part 36175
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Part 37170
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Part 38191
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Part 39222
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Part 40150
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Part 41124
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Part 42154
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Part 43183
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Part 44132
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Part 45103
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Part 46125
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Part 47165
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Part 48126
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Part 49114
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Part 50155
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Part 51151
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Part 52101
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Part 53128
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Part 54151
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Part 55130
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Part 56132
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Part 57149
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Part 58131
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Part 59151
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Part 60151
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Part 61136
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Part 62111
