Term
| Which bone is most often fractured at birth? |
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Definition
|
|
Term
| What is the most common type of shoulder dislocation? |
|
Definition
|
|
Term
| What nerve is injured in a glenohumeral dislocation? |
|
Definition
| Axillary nerve if @ neck of humerus |
|
|
Term
| What is the most reliable method of diagnosing a posterior shoulder dislocation? |
|
Definition
| Posterior apprehension test |
|
|
Term
| In a humeral shaft fracture, what nerve is most commonly injured? |
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Definition
|
|
Term
| What humerus position puts the shoulder in greatest risk of dislocating anteriorly? |
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Definition
| Abduction and external rotation |
|
|
Term
| Shoulder separations mainly happen at what joint? |
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Definition
|
|
Term
| Shoulder dislocations mainly happen at what joint? |
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Definition
|
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Term
| What is the best way to position a patient’s arm to palpate the subacromial bursa? |
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Definition
|
|
Term
| What muscle is most frequently absent due to a congenital anomaly? |
|
Definition
| Pectoralis major (Poland’s syndrome). |
|
|
Term
| What is the portion of the bicep that is most commonly torn from its bony attachment? |
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Definition
|
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Term
| Winging of the scapula signifies weakness of what muscle? |
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Definition
|
|
Term
| What nerve innervates the muscle that causes winging of the scapula? |
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Definition
|
|
Term
| A positive drop arm test is suggestive of what condition? |
|
Definition
| Tear of the supraspinatus muscle |
|
|
Term
| A patient cannot actively abduct her shoulder due to pain and weakness. What injury does this suggest? |
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Definition
| Supraspinatus muscle injury and medial Deltoid |
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Term
| A patient presents with a complaint of pain at the site of the deltoid insertion with radiation to the back of her arm (C5 distribution). On examination, there is increased pain with active abduction from 70deg to 120deg. X-rays reveal calcification at the tendinous insertion of the greater tuberosity. What is the most likely diagnosis? |
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Definition
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Term
| What is the likely diagnosis in a patient with significantly restricted range of motion at the shoulder joint 4 weeks after a painful shoulder injury? |
|
Definition
Adhesive capsulitis??? or Compartment Syndrome
???? |
|
|
Term
| What is “nursemaid’s elbow”? |
|
Definition
|
|
Term
| What is the significance of a fatpad sign seen on a lateral x-ray of the elbow following an injury? |
|
Definition
| Signifies occult fracture to radial head |
|
|
Term
| What is the most common site of bursitis? |
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Definition
|
|
Term
| What is the usual mechanism of injury in a supracondylar distal humerus fracture? |
|
Definition
| Supracondylar fracture with posterior elbow dislocation |
|
|
Term
| What artery is commonly injured with a supracondylar distal humerus fracture? |
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Definition
|
|
Term
| What nerve is commonly injured with a supracondylar fracture? |
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Definition
|
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Term
| Why is a displaced supracondylar fracture of the distal humerus in a child considered an emergency? |
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Definition
| Can cause Volkmann’s Ischemic contracture |
|
|
Term
| What nerve injury is associated with a medial epicondyle fracture? |
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Definition
|
|
Term
| What is the most commonly missed fracture in the elbow joint? |
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Definition
|
|
Term
| Which epicondyle is involved in tennis elbow? |
|
Definition
|
|
Term
| Which epicondyle is involved in golfer’s elbow? |
|
Definition
|
|
Term
| Which bone articulates with the humerus in the olecranon fossa? |
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Definition
|
|
Term
| What are the 3 bony articulations of the elbow? |
|
Definition
| Humeroulnar articulation, Humeroradial articulation, and Proximal radioulnar articulation |
|
|
Term
| Where can the ulnar nerve be best palpated at the elbow joint? |
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Definition
| Between the medial epicondule and the olcranon fossa |
|
|
Term
| What are the 4 motions that occur at the elbow joint? |
|
Definition
| Flexion, extension, pronation, supination |
|
|
Term
| What tendons are involved in deQuervain tenosynovitis? |
|
Definition
| Extensor pollicis brevis and abductor pollicis longus |
|
|
Term
| What is Finkelstein test? |
|
Definition
| Test for DeQuervain’s, thumb flexed and ulnar deviation |
|
|
Term
| What is the most common type of peripheral nerve compression? |
|
Definition
| Median nerve compression via carpal tunnel syndrome |
|
|
Term
| Which fingers are potentially affected by carpal tunnel syndrome? |
|
Definition
| 1st to 3rd and half of 4th |
|
|
Term
| Describe Tinel and Phalen tests? |
|
Definition
Tinel- tap on the median nerve this should worsen the tingling
Phalen- pushing on the back of your hands for one minute (fingers facing the floor) its positive if you have tingling |
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|
Term
| What injury is referred to as Gamekeeper’s thumb? |
|
Definition
| Injury to the ulnar collateral ligament of the thumb MCP joint, causing instability |
|
|
Term
| What is the most commonly fractured carpal bone? |
|
Definition
|
|
Term
| What is Kienbock disease? |
|
Definition
| AVN/ blood supply to the lunate bone is interrupted, with collapse of lunate bone secondary to fx. |
|
|
Term
| How is a scaphoid (navicular) fracture diagnosed? |
|
Definition
|
|
Term
| What is the most feared complication of a scaphoid fracture? |
|
Definition
|
|
Term
| What is boutonniere deformity and how does the injured finger appear? |
|
Definition
| Flexion deformity of PIP joint, the central band of extensor expansion detached/severed |
|
|
Term
| How is boutonniere deformity initially treated? |
|
Definition
| Closed: splinting MCP and PIP in hyperextension for 6 weeks. Open: suture repair (figure 8 suture) |
|
|
Term
| Describe Dupuytren contracture |
|
Definition
| Is a localized thickening of the palmar fascia, most frequently affecting the 4th and 5th metacarpals. It can lead to hand contracture, deformity and decreased function |
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|
Term
| Describe Galeazzi fracture/dislocation |
|
Definition
| adial shaft fracture, with dislocation of DRUJ |
|
|
Term
| Describe Monteggia fracture |
|
Definition
| fracture of the proximal 3rd of the ulna with dislocation of the head of the radius |
|
|
Term
| What is a Colles fracture? |
|
Definition
| Dorsally displaced fracture of the distal radius with approximately 15 degrees of dorsal angulation “silver fork deformity”: MOI fall on extended wrist |
|
|
Term
| What is a Smith fracture? |
|
Definition
| “Reverse Colles”, is a transverse fracture of the distal radius with volar angulation: MOI fall on flexed wrist. |
|
|
Term
| Active adduction of the thumb tests which nerve? |
|
Definition
|
|
Term
| What nerve provides sensations to both the dorsum and the volar aspects of the hand? |
|
Definition
Radial (Mainly dorsal region for first 3 and half of 4, including lateral most part of the thenar eminence and ulnar for half of 4 and 5.
Median primarily volar aspect. |
|
|
Term
| In the wrist, which bone is dislocated most often? |
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Definition
|
|
Term
| In a boxer fracture, how much angulation of the fifth metacarpal neck is acceptable? |
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Definition
|
|
Term
| What ligament in the hand is commonly injured in a fall while skiing? |
|
Definition
| Ulnar collateral ligament |
|
|
Term
| Why is it important to obtain a radiograph studies after an acute dislocation? |
|
Definition
| To r/o other injuries such as ligament avulsion, articular fxs, or other signs that may indicate gross joint instability. |
|
|
Term
| Atrophy of the thenar eminence of the palm may indicate entrapment of what nerve? |
|
Definition
|
|
Term
| Atrophy of the hypothenar eminence of the palm may indicate entrapment of what nerve? |
|
Definition
|
|
Term
| What structure does the ulnar nerve and artery pass through at the wrist? |
|
Definition
| tunnel of Guyon (btw pisiform and hook of Hamate), |
|
|
Term
| A patent presents with an injury to his second finger after forced flexion. He reports an inability to actively extend the tip of his finger (but it can be passively extended). What is the likely injury? |
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Definition
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|
Term
| A patient presents with a small, soft bump on the dorsum of his wrist. The mass has a jelly-like consistency and is not significantly point tender. What is the likely diagnosis? |
|
Definition
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|
Term
| A patient presents with a snapping sensation in the wrist and a click. The X-ray of the patient’s hand reveals a 3 mm space between the scaphoid and the lunate. What is your diagnosis? |
|
Definition
|
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Term
| What must be checked in a patient with Down Syndrome before medical clearance can be given for participation in sports? |
|
Definition
|
|
Term
| What is the common name for a C1 burst fracture from vertical compression? |
|
Definition
| Jefferson’s Burst Fracture C1 |
|
|
Term
| Where is the most common site of cervical disk herniation? |
|
Definition
|
|
Term
| Of the cervical, thoracic, and lumbar intervertebral disks, which has the lowest rate of herniation? |
|
Definition
|
|
Term
| Fifty percent of cervical rotation takes place between what two cervical vertebrae? |
|
Definition
|
|
Term
|
Definition
| A defect in the pars interarticularis |
|
|
Term
| Define spondylolisthesis? |
|
Definition
| Forward movement of one vertebral body on the vertebra below. |
|
|
Term
| What condition in a middle-aged man with profound limitation in spinal mobility must be ruled out? |
|
Definition
|
|
Term
| Injury to what cervical area results in Horner’s syndrome? |
|
Definition
|
|
Term
| At what level does spinal stenosis mostly occur? |
|
Definition
|
|
Term
| In a patient with spinal stenosis, does walking lead to worsening or improving leg pain? |
|
Definition
|
|
Term
| What is the most common site for lumbar disk herniations? |
|
Definition
|
|
Term
| A patient in a MVA sustains a hyperextension injury to the neck. Plain films reveal a C2 bilateral facet fracture through the pedicles. What is the common name for this type of fracture? |
|
Definition
|
|
Term
| A patient has difficulty squatting and standing due to weakness. What is the most likely spinal pathology? |
|
Definition
|
|
Term
| A patient with back pain complains of incontinence. On examination, loss of anal reflex and decreased sphincter tone is noted. What is your diagnosis? |
|
Definition
|
|
Term
| A patient has an avulsion fracture of the spinous process of C7 with a history of a hyperflexion mechanism. What is your diagnosis? |
|
Definition
|
|
Term
| A patient suffers a bilateral interfacetal dislocation as a result of excessive flexion. What is your concern? |
|
Definition
| Ligament disruption makes spine unstable |
|
|
Term
| While providing medical coverage at a soccer game, a player goes down complaining of neck pain after a hard collision with another player and the ground. She does not lose consciousness, has full sensation and motor function in her extremities, but has significant point tenderness directly over her cervical vertebrae. How should you remove this player from the field? |
|
Definition
| Stabilize the neck with a neck brace and remove the patient on a flat board or stretcher. |
|
|
Term
| What is the most commonly fx’d bone of the lower leg? |
|
Definition
|
|
Term
| What are the four compartments of the leg? |
|
Definition
| Anterior, Superficial-Posterior, Deep Posterior, Lateral |
|
|
Term
| What is the most common site of compartment syndrome? |
|
Definition
|
|
Term
| Differentiate between an avulsion fx of the tibial tubercle and Osgood-Schlatter disease? |
|
Definition
| Osgood-Schlatter- overuse injury, worsens with running, jumping, and kneeling. Self resolves with RICE, an avulsion fracture patient has ACUTE inability to ambulate. |
|
|
Term
| Which is the most sensitive test when examining for ACL tear, the Lachman or the anterior drawer test? |
|
Definition
|
|
Term
| What nerve is most commonly injured in a distal femoral fx? |
|
Definition
|
|
Term
| Which of the following demonstrates a more dramatic appearing knee effusion, a torn meniscus or a torn cruciate ligament? |
|
Definition
| Torn Cruciate (especially the ACL) due to increased vascularity. |
|
|
Term
| The anterior and posterior cruciate ligaments are named according to their attachments to the tibia or the femur? |
|
Definition
|
|
Term
| Which meniscus (medial or lateral) is injured more frequently and why? |
|
Definition
| Medial due to a more firm fixation to the tibia, joint capsule, and MCL |
|
|
Term
| Do patellar dislocations result in the patella going medially or laterally from its normal position? |
|
Definition
|
|
Term
| Do patellar dislocations occur more in males or females? |
|
Definition
|
|
Term
| A patient presents with a large area of swelling localized to the front of the knee, between the patella and the skin after a fall directly on her patella. What is the most likely diagnosis? |
|
Definition
|
|
Term
| A 40 year old female runner complains of diffuse, aching anterior knee pain that is worsened when she walks up or down stairs or when she squats. There has been no acute trauma, but she has been increasing her running mileage. No effusion is present. What is the most likely diagnosis? |
|
Definition
| Patellar Femoral Syndrome (Runner's Knee) |
|
|
Term
| A patient comes in complaining of anterior knee pain s/p fall, you suspect a patellar fx- what x-ray view must not be excluded to confirm your diagnosis? |
|
Definition
| Standing radiographs including patellar or “sunrise views” and also include the uninvolved knee for comparison |
|
|
Term
| What is the most common type of ankle injury? |
|
Definition
|
|
Term
| Where are the most common sites of stress fxs in the foot? |
|
Definition
|
|
Term
| What is the most helpful P.E. test for determining if an anterior talofibular ligament injury has occurred? |
|
Definition
|
|
Term
| What are the signs and symptoms of compartment syndrome involving the anterior compartment of the leg? |
|
Definition
-Pain on active and passive dorsiflexion and plantarflexion of the foot
-Hypesthesia/Paresthesia of the first web space of the foot
-Foot drop |
|
|
Term
| What metatarsal fx is associated with a disrupted tarsal-metatarsal joint? |
|
Definition
| Lisfrance Joint Fracture, |
|
|
Term
| What fracture is frequently missed when a patient is complaining of an ankle injury |
|
Definition
| Fx of 5th metatarsal base caused by plantarflexion and inversion. Xrays of ankle may not include the 5th metatarsal base |
|
|
Term
| Achilles tendon ruptures occur most commonly in which population? |
|
Definition
|
|
Term
| A stress fx of the 2nd and 3rd metatarsal is suspected but not detected on initial x-ray. How many days after the initial examination should a second x-ray be ordered? |
|
Definition
|
|
Term
| What is the most commonly fx’d tarsal bone? |
|
Definition
|
|
Term
| What is the mechanism of injury for the most commonly fx’d tarsal bone? |
|
Definition
|
|
Term
| What guidelines are often used to determine if a patient who has suffered an ankle injury needs x-rays? |
|
Definition
Ottawa Ankle Rules
–pain in malleolar zone and any of these findings:
- bone tenderness at posterior edge or tip of lateral or medial malleolus
- inability to bear weight both immediately and in the emergency department |
|
|
Term
| What is another name for the tarsal-metatarsal joint? |
|
Definition
|
|
Term
| A fx of the base of the 2nd metatarsal should raise suspicions for what? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| The mortise view of the ankle is important in the diagnosis of what? |
|
Definition
| Medial (deltoid) ligament disruption of the ankle |
|
|
Term
| What is the common presentation of a Charcot joint on x-ray? |
|
Definition
|
|
Term
| What is the most common cause of Charcot joint? |
|
Definition
| Diabetic peripheral neuropathy |
|
|
Term
| What nerve is located in the tarsal tunnel? |
|
Definition
|
|
Term
| What ligament is commonly injured after an inversion ankle sprain? |
|
Definition
| Anterior Talofibular Ligament |
|
|
Term
| What joint is commonly affected with gout? |
|
Definition
|
|
Term
| What joint is commonly affected with psuedogout? |
|
Definition
|
|
Term
| Describe the signs and symptoms of tarsal tunnel syndrome. |
|
Definition
| Pain worsens during sleep, walking or dorsiflexion. Medial malleolus pain that may radiate to medial side of the calf mm, paraesthesia is usually present, and decreased pain with rest. |
|
|
Term
| What ankle motion leads to injury of the deltoid ligaments? |
|
Definition
|
|
Term
| Extreme pain on the undersurface of the foot from the calcaneus anteriorly that is often worse with the first few steps of the day or after prolonged standing is caused by? |
|
Definition
|
|
Term
| What is the common name for a laterally deviated first toe or hallux valgus? |
|
Definition
|
|
Term
| What are the characteristics of a pes planus foot? |
|
Definition
| Fallen arch seen in obese patients, specifically medial longitudinal arch with associated excessive foot pronation. |
|
|
Term
| A 20 yr old female complains of pain and clicking sound located at the posterior lateral malleolus. A fullness beneath the lateral malleolus is found. What is the most likely diagnosis? |
|
Definition
| Peroneal tendon subluxation with associated tenosynovitis |
|
|
Term
| Which wrist bone is concerning when a wrist fracture is involved and why? |
|
Definition
Navicular (scaphoid)
Avascular necrosis risk, the navicular/scaphojd is highly vascularized and if doesn’t heal properly may result in nonunion due to decreased vascularity. |
|
|
Term
| What joints are Heberden’s nodes found? |
|
Definition
|
|
Term
| What joints are Bouchard’s nodes found? |
|
Definition
|
|
Term
| Anatomically, on physical exam where is the sciatic nerve palpated? |
|
Definition
| In the sciatic notch. Find it btw the greater trochanter of the femur and the iscial tuberosity. |
|
|
Term
| List the movements tested for back range of motion. |
|
Definition
Flexion
Extension
Lateral flexion (R &L)
Rotation (R&L) |
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|
