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Intro to orthopedics
Question | Answer |
---|---|
what is orthopedics? | a branch of medicine that deals w/ the prevention & Rx of bone diseases and surrounding tissue |
what are the common complaints patients come with? | pain, stiffness, swelling, redness, weakness, deformity, locking |
what does SOCRATES stand for? | a way to remember what to ask the patient about his pain. S: site, O: onset, C: character, R: radiography, A: associated symptoms, T: time, E: exacerbation and relief, S: severity |
what is mechanical pain? | a pain that comes with movement. it is the most important type of pain |
what is inflammatory pain? | a pain that is associated w/ inflammation |
what is sudden onset pain and what are its causes? | a pain that appears suddenly, indicates trauma or infection |
what is gradual onset pain and what are its causes? | a pain that appears gradually, indicates inflammation |
what is migratory joint pain? | a pain that starts in one joint then migrates to another and disappears from the first (ex: as in rhematic fever) |
what is radiating pain? | a pain that starts in one place and spreads into a broader area within the same dermatome |
match the site of pathology and its associated radiating pain a. cervical spine b. thoracic spine c. lumbar spine | a. shoulder and arm b. chest c. buttocks, knees, legs |
what is referred pain? | a pain that is felt in an area different from the original site of pain |
match the site of pathology and its associated referring pain a. shoulder b. elbow c. hip d. knee | a. lateral aspect of the arm b. forearm c. ant thigh and knee d. calf and thigh |
what is stiffness? | restricted joint motion |
what does localized stiffness indicate? | trauma or surgery |
what does generalized stiffness indicate? | systemic disease (ex: RA) |
redness is a character for? | inflammation, seen in: infection, crystal deposition arthritis (GOUT/ pseudogout), trauma |
what does diffuse swelling indicate? | edema |
what does localized swelling indicate? | joint swelling, bursitis |
what does immediate swelling after trauma indicate? | hemarthrosis (ie. injury of vascularized structure, ex: bone or ACL) |
what does reactive effusion swelling indicate? | trauma of non vascularized structure, ex: cartilage, meniscus |
what are the causes of weakness? | pain, nerve problem, muscle problem, cut of tendon |
what does bilateral muscle weakness indicate? | systemic disease, ex: hereditary myopathies, neuropathies |
what is Gower's sign? | weakness of quadriceps and gluteus muscles characteristic for bilateral muscle weakness seen in DMD patients |
what does unilateral muscle weakness indicate? | nerve injury, ex: wrist drop indicates radial nerve injury, foot drop indicates peroneal nerve injury |
what is locking? | inability to complete full range of motion due to mechanical block in the joint |
what is deformity? | deviation from normal |
what is genu varus? | medial deviation |
what is genu valgus? | lateral deviation |
what is genu recurvatum? | ant deviation |
what is genu procurvatum? | post deviation |
what are two types of rotational deviation? | external and internal |
what are equipment used by orthopedics? | tape measures, goniometer, tendon hammer, a pen, coin, or key for hand function |
what system is recommended in physical exam? | look, feel, move |
what does a bruising indicate? | trauma or coagulation defect |
what are the indications of muscle wasting? | disuse or nerve problem |
what does a deformity indicate? | congenital anomaly, skeletal dysplasia, or previous injury |
what is the wavelength of most x-rays? | 0.01-10nm |
what are the steps in reading a radiographic film? | 1. patient profile 2. x-ray details: part, side, view 3. describe pathology: site, shape, displacement |
how to describe fracture site? | a. diaphyseal b. metaphyseal c. intra-articular (ie. epiphyseal) d. combination |
how to describe the shape of a fracture? | 1. simple: a. transverse b. oblique c. spiral 2. comminuted: a. complex b. butterfly c. segmental |
how to describe a fracture displacement? | a. anglulations b. translation c. rotation |
how to describe a bony lesion on x-ray? | a. patient history b. tumor location c. margins/ zone of translation d. periosteal reaction e. matrix f. presence of soft tissue component g. size and no of lesions |
what are the most important characters for determining aggressiveness? | margins/ zone of translation and periosteal reaction |