SUBJECTS
|
BROWSE
|
CAREER CENTER
|
POPULAR
|
JOIN
|
LOGIN
Business Skills
|
Soft Skills
|
Basic Literacy
|
Certifications
About
|
Help
|
Privacy
|
Terms
|
Email
Search
Test your basic knowledge |
Emergency Medicine: Lower Extremity
Start Test
Study First
Subjects
:
health-sciences
,
emergency-medicine
Instructions:
Answer 50 questions in 15 minutes.
If you are not ready to take this test, you can
study here
.
Match each statement with the correct term.
Don't refresh. All questions and answers are randomly picked and ordered every time you load a test.
This is a study tool. The 3 wrong answers for each question are randomly chosen from answers to other questions. So, you might find at times the answers obvious, but you will see it re-enforces your understanding as you take the test each time.
1. Ortho referral - NSAIDs and partial weightbearing - Difinintive Dx by MRI & arthroscopy
Fibula (Anterior - Lateral - superficial posterior - deep posterior)
Lateral Compression Pelvic Fracture Xray Findings
Lachmans Test
Meniscal Tear Treatment
2. Occurs with fall / jump from a height - 5% of injuries
Vertical Shear Pelvic Fracture
Surgical management of dislocated patella
Patella fracture presentation
Pivot Shift Test
3. MOA: Acute direct blow or twisting force - Dx: Typically seen in oblique or lateral foot films - Tx: Posterior splint or Orthopedic shoe/boot
Non-displaced metatarsal shaft fractures
Quadriceps tendon rupture
Vertical Shear Pelvic Fracture
Maisoneuve fractures
4. Retroperitoneal bleeding (can hold 4 L) - Sciatic nerve injury - Urogynecologic injury - Rectal injury - Ruptured diaphragm - Nerve root injury - Long term effects - Chronic pain - sexual dysfunction
Complications of Pelvic Fractures
Non-displaced femoral neck fractures
Vertical Shear Pelvic Fracture
Nondisplaced Phalangeal fractures
5. Irrigation & antibiotics in ED - I&D in OR
Uncomplicated ankle fracture treatment
Calcaneal fracture treatment
Patella Fx Treatment: Open fx
Causes of Compartment Syndrome
6. 5 P's of Compartment Syndrome
Vertical Shear Pelvic Fracture
Forearm (flexor - extensor - mobile wad)
ACL PE maneuvers
Pain - Parasthesia - Pallor - Pulselessness - Poikilothermia
7. Noncontact injury - decelleration - hyperextension - or marked internal rotation of the tibia on the femur - 'Pop' -> swelling within hours
Compartment Syndrome
Tibial fracture complications
ACL injury
Fibula (Anterior - Lateral - superficial posterior - deep posterior)
8. Potential complications: overal prognosis very good - potential for limb shortening -> limp - arthritis - delayed/non-union - pain w/ ortho hardware - Treatment: initial traction splint - intermedullary nailing - ex-fix
Quadriceps tendon rupture
Femoral shaft fracture
Causes of Compartment Syndrome
Complications of Pelvic Fractures
9. Knee in 30 degrees flexion - Stabalize femur above knee - anterior force applied behind tibia @ tubercle level -> attempt to displace tibia anteriorly - >5mm movement = ligament tear
Pivot Shift Test
Achilles tendon rupture
Lachmans Test
Physical Exam findings suspect of Hip Fracture
10. PE: Thompson test - Tx: in ED - short leg cast in slight plantar flexion. Heals well w/ conservative tx or surgery
Meniscal Tear PE Maneuvers
Achilles tendon rupture
Stimpson maneuver
Vertical Shear Pelvic Fracture
11. Treatment for posterior hip dislocation - downward traction placed on femur at the knee -> uther hand applies external and internal rotation
Calcaneal fractures
Clinical History suspect of Hip Fracture
Stimpson maneuver
Tibial fracture complications
12. May be ambulatory - focal patellar tenderness - swelling - effusion - potential for poplitieal artery injury - check distal pulses
Compartment Syndrome
Meniscal Tear PE Maneuvers
Patella fracture presentation
Fibula (Anterior - Lateral - superficial posterior - deep posterior)
13. Surgical debridement - suturing of quadriceps and patellar tendons
Patella Fx Treatment: Severely comminuted
Reduction of dislocated patella
MCL PE findings
Posterior hip dislocation
14. Recurrent lateral dislocation (15% of cases) - Superior - horizontal - intercondylar disolcations - Irreducible dislocations
Surgical management of dislocated patella
Ottowa Ankle Rules
Physical Exam findings suspect of Hip Fracture
Non-displaced femoral neck fractures
15. Strain: knee immobilizer - ROM exercises - ice/elevation - NSAIDS - ambulation ASAP - f/you w/ ortho/PCP <1 week - Rupture: Same above - functional bracing - immediate ortho consult for difinitive surgery
ACL PE maneuvers
Physical Exam findings suspect of Hip Fracture
Treatment of ALL knee ligament injuries
Femoral shaft fracture
16. Patients typically unable to bear weight - Physical exam findings: external rotation - abduction - and shortening - Xray findings: disruption of Shenton's line + 'it don't look right' - Treatment: emergency surgery (fixation)
Displaced femoral neck fractures
Patella Fx Treatment: Open fx
Tibial fracture
MRI
17. Intra-Articular: immobilization w/ well padded posterior splint - strict elevation - non-weightbearing - analgesia - ortho f/you - Extra-Articular: Immobilization - analgesia - ortho f/you
Vertical Shear Pelvic Fracture Xray Findings
Calcaneal fracture treatment
Immediate Ortho consults
Treatment of ALL knee ligament injuries
18. Immobilization by cast / surgery - Goal is to restore anatomical relationship of ____ - maintain reduction during healing - mobilize ankle early - Most ___ fx require ORIF
Nondisplaced Phalangeal fractures
Pilon fractures
Uncomplicated ankle fracture treatment
Patella Fx treatment: Nondisplaced & intact extensors
19. I&D - splint -> Xrays - Tetanus shot - parenteral Atbx - Cefazolin for open Fx - Measure pressures if Compartment suspected
Femoral shaft fracture
Jones Fracture
Tibial fracture
Calcaneal fracture treatment
20. Varus deformity w/ flexion - Laxity >1cm w/o endpoint: complete rupture - Laxity <1cm w/ endpont: incomplete/partial tear - no laxity but pain: ligament strain
Pilon fractures
LCL PE findings
Surgical management of dislocated patella
Meniscal Tear
21. Early detection w/ high index of suspicion - Initially complain of severe pain - poorly controlled w/ analgesics - Pain starts few hours after injury - Swollen - firm - tender to squeeze by examiner
Compartment Syndrome
Reduction of dislocated patella
Ottawa Knee Rules
AP Compression Pelvic Fracture Xray Findings
22. Shortening / rotation of lower extremities - Lacerations - bruising - tenderness - crepitence @ site - Instability of extremities - Limited ROM - Pain w/ motion - Significant pain w/ weight bearing - even if Xrays show no fx (Suspect for femoral neck
Quadriceps tendon rupture
Pivot Shift Test
Physical Exam findings suspect of Hip Fracture
Tibial fracture
23. Occurs from a twisting injury to extended knee - Women > men - Lateral displacement common - Tearing of medial knee joint capsule occurs
Dislocated patella
MCL PE findings
Physical Exam findings suspect of Hip Fracture
Immediate Ortho consults
24. MOA: vertical or mediolateral forces exerted on base 5th metatarsal while heal is raised and foot plantar flexed - Or significant adduction force applied to forefoot - while ankle is plantarflexed - Sudden change in direction w/ heel off ground in sp
Non-displaced femoral neck fractures
Pivot Shift Test
ACL injury
Jones Fracture
25. Forceful contraction of ____ - Falling on flexed knee - Patients over 40 years
Achilles tendon rupture
Quadriceps tendon rupture
ACL PE maneuvers
Posterior hip dislocation
26. Widening of Pubic Symphysis - Disruption of SI Joint - Sacral ligament injuries
Ottawa Knee Rules
Non-displaced metatarsal shaft fractures
AP Compression Pelvic Fracture Xray Findings
Surgical management of dislocated patella
27. Painful to patient - Patient supine - hip internally rotated 45 degrees - force applied to fibular head - internally rotate ankle and knee - valgus force to knee - flex knee. - If anterior subluxation occurs = ligament tear
Clinical History suspect of Hip Fracture
Pivot Shift Test
Reduction of dislocated patella
AP Compression Pelvic Fracture
28. Open fractures - Fracture dislocations - Dislocations - Bimalleolar / Trimalleolar fractures - Unstable unimalleolar fractures - Mausonneuve fractures
Femoral Neck Fractures
Vascular compromise (dusky foot - absent pulse)
Posterior hip dislocation treatment
Immediate Ortho consults
29. Radiographs required if pain in malleolar zone plus:- Tenderness at base of 5th metatarsal - posterior medial / lateral malleolus - navicular - can NOT take 4 steps immediately and in ED
Ottowa Ankle Rules
Vertical Shear Pelvic Fracture
LCL PE findings
Posterior hip dislocation treatment
30. French for 'pestle' - May be accompanied by compartment syndrome or vertebral body fx (L1) - MOA: grinding of the talus into the distal tibia - Presentation: high energy mechanism -> ST damage and extensive bone fragmentation - Tx: Reduction of fx -
Posterior hip dislocation treatment
Non-displaced metatarsal shaft fractures
Pilon fractures
Patella fracture
31. Forceful contraction of ____ - Falling on flexed knee - Patients under 40 years w/ hx of tendinitis or past steroid injections
Reduction of dislocated patella
Patellar tendon rupture
Maisoneuve fractures
Ottowa Ankle Rules
32. Most common tarsal bone fx - 2 categories: Intra-Articular Fx - Extra-Articular Fx - Associated injuries are common
Femoral shaft fracture
Calcaneal fractures
Lachmans Test
Nondisplaced Phalangeal fractures
33. Ligament runs between lateral base of medial cuneiform and medial base of 2nd metatarsal - Ranges from sprains -> fracture-dislocations - Concurrent fx of hind - forefoot - 2nd metatarsal
MCL PE findings
2nd Metatarsal / Lisfranc ligament injury
Forearm (flexor - extensor - mobile wad)
Anterior Drawer Test
34. The _______ of the upper extremity is most likely to develop compartment syndrome - Tibia (Anterior - Posterior - Medial)
Immediate Ortho consults
Patella Fx Treatment: Severely comminuted
Forearm (flexor - extensor - mobile wad)
Fibula (Anterior - Lateral - superficial posterior - deep posterior)
35. Atrophy of quads / joint line tenderness - McMurray Test (50% positive) - Grind Test (50% positive)
Patella fracture
Meniscal Tear PE Maneuvers
Lisfranc ligament injury PE findings
Achilles tendon rupture
36. Hip flexed @ 45 degrees - knee flexed @ 90 degrees - Both hands @ tibia tubercle level -> anterior displacement foce applied - >6 mm movement = ligament tear
Anterior Drawer Test
ACL injury
Complications of Pelvic Fractures
Jones Fracture
37. Occurs w/ cutting - squatting - or twisting maneuvers - Can occur independent or w/ ligament injury - Medial > Lateral frequency - 'Locking - popping - clicking - snapping' sensations - joint instability
Ottowa Ankle Rules
Meniscal Tear
Stimpson maneuver
Physical Exam findings suspect of Hip Fracture
38. Xray if one is present: - Patient age >55 years - tenderness @ head of fibula - isolated patellar tenderness - Inability to flex knee to 90 degrees - Inability to transfer weight for four steps both immediately after injury and in the ED
Clinical History suspect of Hip Fracture
Ottawa Knee Rules
Forearm (flexor - extensor - mobile wad)
Lateral Compression Pelvic Fracture
39. Most common mechanism of pelvic fracture (50%) - occurs when pedestrians are broad-sided by car
LCL PE findings
Lateral Compression Pelvic Fracture
Tibial fracture complications
MRI
40. Common in older adults - Women > Men - Usually secondary to osteoporosis - Fall is usually the cause
Femoral Neck Fractures
Patella fracture presentation
AP Compression Pelvic Fracture
Patella Fx Treatment: Severely comminuted
41. W/o fracture-> closed reduction under procedural/GA sedation -> within 6 HOURS - Stimpson Maneuver
Fibula (Anterior - Lateral - superficial posterior - deep posterior)
Posterior hip dislocation
Posterior hip dislocation treatment
Reduction of dislocated patella
42. Most common hip disolcation (90%) - Cause is secondary to force applied to a flexed knee - directed posteriorly - Common in MVC injuries
Tibial fracture
ACL injury
Vertical Shear Pelvic Fracture
Posterior hip dislocation
43. Lachmans Test (84% sensitivity) - Anterior Drawer Test (62% sensitivity) - Pivot shift Test
Patella fracture
Lateral Compression Pelvic Fracture
Meniscal Tear PE Maneuvers
ACL PE maneuvers
44. Hx of recent fall or MVC - Prolonged steroid use - Hx cancer - CKD - Metabolic disorders -> Pathalogic Fx - Pain @ site of injury - Pain @ knee - groin - other injured sites
Clinical History suspect of Hip Fracture
Achilles tendon rupture
Causes of Compartment Syndrome
AP Compression Pelvic Fracture Xray Findings
45. Transverse fx is most common - displacement & disrupted extensor mechanism likely
Stimpson maneuver
Patella Fx Treatment: Open fx
Patella fracture
Fibula (Anterior - Lateral - superficial posterior - deep posterior)
46. SI crush injury may occur - Fracture and horizontal counterclockwise rotation of pelvis on the coronal plane - Ligament injuries may occur
Femoral shaft fracture
Treatment of ALL knee ligament injuries
Lachmans Test
Lateral Compression Pelvic Fracture Xray Findings
47. 'Open book fracture' - 25% of injuries - Head on MVC
Calcaneal fractures
AP Compression Pelvic Fracture
Patella fracture
Pain - Parasthesia - Pallor - Pulselessness - Poikilothermia
48. Most sensitive imaging of occult hip fx
Vertical Shear Pelvic Fracture Xray Findings
Femoral Neck Fractures
MRI
Tibial fracture
49. MOA: eccenric force applied to dorsiflexed foot - Presentation: 30-50 yr old weekend warrior - sudden severe pain - can't run - stand on toes - swollen calf - palpable gap 2-6 cm from calcaneus - Fluoroquinolones & Corticosteroids increase risk
Patella fracture presentation
Achilles tendon rupture
Meniscal Tear PE Maneuvers
Compartment Syndrome
50. Patient may be ambulatory - Physical exam findings: may be subtle - Xray findings: Normal Shenton's line - Treatment: Internal fixation
Complications of Pelvic Fractures
Non-displaced femoral neck fractures
Patella fracture presentation
ACL injury