外科：骨科

60 flashcards · Other · by Wanying Koh

1. most common dislocation second most common dislocation

   1) shoulder dislocation (50%) 2) elbow dislocation

2. most common shoulder dislocation direction

   anterior dislocation (95%)

3. which nerve is injured during anterior shoulder dislocation?

   axillary n.

4. Structures providing shoulder joint stability 1) lig. 2) lig. 3) m.

   1) glenohumeral lig. (sup. med. inf.) 2) glenoid labrum (glenoid lig.) 3) rotator cuff (supraspinatus, infraspinatus, subscapularis, teres minor)

5. What does light bulb sign indicate?

   Post. shoulder dislocation

6. unable to elevate shoulder indicates?

   Acromioclavicular joint injury

7. ulnar n. innervates what hand m.

   1) OAF digiti minimi (hypothenar m.) 2) interossei m. (DAB PAD) 3) lumbricalis 3/4 4) ADductor pollicis 5) palmaris brevis

8. median n. innervates what hand m.

   1) OAF pollicis brevis (thenar m.) 2) lumbricalis 1/2

9. most commonly ruptured rotator cuff muscle

   supraspinatus

10. most common elbow dislocation direction

    posterolateral direction

11. most common upper limb fracture

    distal radius fracture

12. Carpal tunnel 包含 1) nerve 2) muscle tendons x3 3) muscle tendon (transverse carpal lig. & trapezius 內）

    1) median n. 2) flexor digitorum superficialis tendon flexor digitorum profundus tendon flexor pollicis longus 3) flexor carpi radialis tendon

13. Ankle joint 最易受傷 in what position

    Supination + external rotation

14. Maisonneuve fracture 1) fracture of which bone (proximal or distal)? 2) mechanism of injury?

    1) proximal fibula 2) external injury --> spiral fracture

15. Blood supply of ACL/PCL

    popliteal a. -> middle genicular a.

16. Meniscus made up of what collagen?

    Mostly collagen type I, some type II

17. Avascular necrosis 好發於？

    Femoral head, scaphoid

18. TKA procedure 切/保留？ 1）ACL 2）PCL 3）Patellar lig 4）MCL/PCL

    1) 切 2）切/保留 3）保留 4）切/保留 depending on whether need to release tension

19. In-toeing gait (內八）包含什麼動作

    femoral anteversion (hyperanterversion of hip) medial tibial torsion metatarsal adductus

20. Direction of most common dislocation: 1) shoulder 2) elbow 3) hip 4) knee

    1) ant 2) post 3) post 4) ant

21. fractures 應該用哪一種影像工具看？ 1) CT 2) XRAY 3) MRI

    1）CT - 判斷骨折型態 2）MRI - 評估血流及軟組織受傷

22. Osteochondritis dissecans 發生於哪些關節

    elbow, knee, ankle shoulder 沒有

23. Leg muscles of 1) superficial post. compartment 2) deep post. compartment

    1) Gastronemius, soleus, plantaris 2) flexor digitorum longus, flexor hallucis longus, tibialis post.

24. Nerves innervating 1) dorsiflexion 2) plantarflexion

    1) deep peroneal n. 2) tibial n.

25. Knee dislocation damages what artery?

    popliteal a.

26. Homan's sign 1) Define 2) indicative of ?

    1) pain during dorsiflexion of foot, at knee extension 2) indicative of DVT

27. 易發生 hip joint posterior dislocation 的動作？

    【記得復健 FAIR 要避免】 internal rotation (內旋 ADduction （內展 hip flexion (ant. dislocation 則 opposite)

28. pelvic outlet view vs pelvic inlet view 個別看什麼

    outlet: pubic symphysis inlet: hemipelvis （半側骨盆）

29. 1) Diagnosis? 2) Characteristics?

    1) Osteonecrosis of femoral head 2) joint space narrowing, subchondral cyst (at right)

30. Risk factors of osteonecrosis of femoral head

    male steroid use alcohol autoimmune disease (e.g. RA, SLE) virus infection trauma (femoral neck fracture, intertrochanteric fracture)

31. most common clavicle fracture location at: medial / middle / lateral third? (proximal / midshaft / distal)

    middle third (midshaft) thinnest no ligamentous attachements

32. which has higher nonunion rate? distal / midshaft clavicle fracture

    distal

33. Neer's sign 1）是測什麼？ 2）怎麼做？

    1) impingement syndrome - compression of rotator cuff tendon 2）dr stabilizes scapula to prevent protraction. patient forward flexion and elevation of arm above head 會覺得痛

34. supracondylar fracture 1) most commonly injured nerve 2) most commonly injured a.

    1) ant. interosseous n. (br. of median n.) 2) brachial a.

35. positive fat pad sign indicative of what fractures in 1) adults 2) children

    1) radial head fracture, proximal ulnar fracture 2) supracondylar fracture

36. Olecranon fractures cause loss of: extension or flexion?

    extension

37. Olecranon fractures most common complication

    elbow stiffness (~50% of patients)

38. Diagnosis?

    Avascular necrosis of scaphoid bone

39. Congenital radioulnar synostosis: 無法 pronation / supination?

    無法 supination

40. Developmental dysplasia of hip PE 1) Barlow test 怎麼做 2) Ortolani test 怎麼做

    1) push Back femur + adduction -> 是否會 hip dislocation 2) "O" shape, ABduction -> dislocated hip 是否會 hip reduction 復原

41. cubitus varus deformity most commonly caused by ?

    supracondylar fracture (due to post-fracture non-union)

42. cartilage mostly made up of type 2 collagen

43. most common lower limb stress fracture (which bone)

    tibia

44. metatarsal stress fracture mostly occurs at which toe(s)

    second and third toe metatarsals

45. 1) Fat embolism syndrome triad 2) Occurs in which patients

    1a) conscious disturbance w lucid interval 1b) petechiae 1c) respiratory distress 2) after pelvis / long bone fracture

46. gout vs pseudogout bifringence (+) or (-)?

    gout: (-) pseudogout: (+) weakly

47. muscles can tolerate ischemia for how long?

    8hrs

48. carcinoma metastasis to bone 1) via what route? 2) usually to what kinds of bone?

    1) hematogenous route 2) long bones e.g. tibia, humerus, femur

49. Dx by serum markers or imaging: plasmacytoma fibrous dysplasia osteosarcoma Ewing's sarcoma

    plasmacytoma: serum monoclonal AB fibrous dysplasia: Dx by imaging osteosarcoma: serum ALKP Ewing's sarcoma: serum LDH

50. double lumen sign dx

    fracture dislocation 看到2 spinal canal

51. dashboard injury which lig injured

    PCL rupture

52. proximal radius injury most common n. injury

    post interosseous n.

53. bone meta tx

    non-invasive 為主 止痛，RT OP only if spinal instability, neuro s/s, failure of conservative tx

54. post interosseous nerve injury (PION syndrome) 不會影響到哪些muscle

    supinator ECRL ECRB brachialis sensory

55. most common tarsal fracture

    calcaneus

56. knee hemarthosis + 還能走動 which part injury

    ACL patellar tendon / quadriceps tendon rupture --> 劇烈疼痛，無法伸直，無法走動

57. used to test for

    cubital tunnel syndrome - ulnar n. injury adductor pollicis function

58. adolescent idiopathic scoliosis most common which direction

    90% convex to the right @thorax

59. Most pelvic fractures are stable or unstable

    stable and occur with a low-energy mechanism of injury ---- such pts may have compartment syndrome of abdomen or pelvis . NOT leg

60. druj arthritis tx

    Darrach procedure - 切 ulnar head (used in elderly) hemi-resection arthoplasty - 切 ulnar head Sauve-Kapandji procedure - 融合 radioulnar joint + 人工關節固定 ulnar neck ---- adam procedure - reconstruction of ligament for druj mobility - NOT used in arthritis - doesnt correct pain