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. 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
Dislocated patella
Patella Fx Treatment: Open fx
Physical Exam findings suspect of Hip Fracture
2. The _______ of the upper extremity is most likely to develop compartment syndrome - Tibia (Anterior - Posterior - Medial)
Stimpson maneuver
Forearm (flexor - extensor - mobile wad)
Treatment of ALL knee ligament injuries
Uncomplicated ankle fracture treatment
3. Noncontact injury - decelleration - hyperextension - or marked internal rotation of the tibia on the femur - 'Pop' -> swelling within hours
ACL injury
Fibula (Anterior - Lateral - superficial posterior - deep posterior)
Surgical management of dislocated patella
Stimpson maneuver
4. 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
Treatment of ALL knee ligament injuries
Patella Fx Treatment: Severely comminuted
Clinical History suspect of Hip Fracture
Non-displaced metatarsal shaft fractures
5. Widening of Pubic Symphysis - Disruption of SI Joint - Sacral ligament injuries
LCL PE findings
Calcaneal fractures
Achilles tendon rupture
AP Compression Pelvic Fracture Xray Findings
6. Lachmans Test (84% sensitivity) - Anterior Drawer Test (62% sensitivity) - Pivot shift Test
Uncomplicated ankle fracture treatment
ACL PE maneuvers
Lachmans Test
ACL injury
7. Varus deformity w/ flexion - Laxity >1cm w/o endpoint: complete rupture - Laxity <1cm w/ endpont: incomplete/partial tear - no laxity but pain: ligament strain
Patella Fx treatment: Nondisplaced & intact extensors
Vertical Shear Pelvic Fracture
Tibial fracture
LCL PE findings
8. Occurs from a twisting injury to extended knee - Women > men - Lateral displacement common - Tearing of medial knee joint capsule occurs
Vertical Shear Pelvic Fracture
Physical Exam findings suspect of Hip Fracture
Calcaneal fracture treatment
Dislocated patella
9. 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
Posterior hip dislocation treatment
Displaced femoral neck fractures
Clinical History suspect of Hip Fracture
10. MOI: high energy trauma (MVC - direct blows) - PE findings: shortening of leg - deformity - swelling - pain - hemorrhage
Femoral Neck Fractures
Femoral shaft fracture
Achilles tendon rupture
Lisfranc ligament injury PE findings
11. 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
Pilon fractures
Achilles tendon rupture
Jones Fracture
Pivot Shift Test
12. PE: Thompson test - Tx: in ED - short leg cast in slight plantar flexion. Heals well w/ conservative tx or surgery
Lateral Compression Pelvic Fracture
Lachmans Test
Calcaneal fractures
Achilles tendon rupture
13. 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
Achilles tendon rupture
Pilon fractures
Displaced femoral neck fractures
Jones Fracture
14. Most common tarsal bone fx - 2 categories: Intra-Articular Fx - Extra-Articular Fx - Associated injuries are common
Femoral shaft fracture
Causes of Compartment Syndrome
Calcaneal fractures
MCL PE findings
15. Immediate reduction of a fracture / dislocation is needed if __________ suspected
Ottowa Ankle Rules
Patella Fx treatment: Displaced >3mm &/or disrupted extensors
Vascular compromise (dusky foot - absent pulse)
Vertical Shear Pelvic Fracture
16. 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
Patella Fx Treatment: Open fx
Lachmans Test
Patella Fx Treatment: Severely comminuted
17. Ortho referral - NSAIDs and partial weightbearing - Difinintive Dx by MRI & arthroscopy
Uncomplicated ankle fracture treatment
AP Compression Pelvic Fracture Xray Findings
Clinical History suspect of Hip Fracture
Meniscal Tear Treatment
18. Occurs with fall / jump from a height - 5% of injuries
Forearm (flexor - extensor - mobile wad)
Vertical Shear Pelvic Fracture
Uncomplicated ankle fracture treatment
Quadriceps tendon rupture
19. Knee immobilizer & RICE -> referral for ORIF
Patella Fx Treatment: Severely comminuted
Meniscal Tear
Patella Fx treatment: Displaced >3mm &/or disrupted extensors
Lisfranc ligament injury PE findings
20. Pain elicited by torsion of the midfoot - Injuries about the tarsometatarsal joint - with pain on passive dorsi/plantar flexion of foot - Bony displacement > 1mm between bases of 1st-2nd metatarsal
Lisfranc ligament injury PE findings
Quadriceps tendon rupture
Immediate Ortho consults
Nondisplaced Phalangeal fractures
21. Presentation: fibula may be fx at head -> 6 cm above ankle joint - Tx: Reduce / stabalize fractured medial malleolus - secure fibula to distal tibia
Maisoneuve fractures
Pilon fractures
Patella fracture presentation
MCL PE findings
22. 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
Posterior hip dislocation
LCL PE findings
ACL PE maneuvers
Lachmans Test
23. Transverse fx is most common - displacement & disrupted extensor mechanism likely
Patella fracture
Fibula (Anterior - Lateral - superficial posterior - deep posterior)
Displaced femoral neck fractures
Pivot Shift Test
24. SI crush injury may occur - Fracture and horizontal counterclockwise rotation of pelvis on the coronal plane - Ligament injuries may occur
Patella Fx treatment: Displaced >3mm &/or disrupted extensors
ACL PE maneuvers
MRI
Lateral Compression Pelvic Fracture Xray Findings
25. 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
Patella Fx treatment: Displaced >3mm &/or disrupted extensors
Compartment Syndrome
MCL PE findings
Pain - Parasthesia - Pallor - Pulselessness - Poikilothermia
26. 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
Pain - Parasthesia - Pallor - Pulselessness - Poikilothermia
Tibial fracture complications
Complications of Pelvic Fractures
2nd Metatarsal / Lisfranc ligament injury
27. Common in older adults - Women > Men - Usually secondary to osteoporosis - Fall is usually the cause
Vertical Shear Pelvic Fracture Xray Findings
AP Compression Pelvic Fracture Xray Findings
Femoral Neck Fractures
Patella Fx treatment: Nondisplaced & intact extensors
28. 'Open book fracture' - 25% of injuries - Head on MVC
AP Compression Pelvic Fracture
Patella fracture presentation
Lateral Compression Pelvic Fracture
Meniscal Tear Treatment
29. Open fractures - Fracture dislocations - Dislocations - Bimalleolar / Trimalleolar fractures - Unstable unimalleolar fractures - Mausonneuve fractures
Quadriceps tendon rupture
Meniscal Tear Treatment
Immediate Ortho consults
Lateral Compression Pelvic Fracture
30. Most sensitive imaging of occult hip fx
Lisfranc ligament injury PE findings
Treatment of ALL knee ligament injuries
Vascular compromise (dusky foot - absent pulse)
MRI
31. 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
Ottawa Knee Rules
Compartment Syndrome
AP Compression Pelvic Fracture
Maisonneuve fractures
32. Surgical debridement - suturing of quadriceps and patellar tendons
Patella Fx Treatment: Severely comminuted
Femoral shaft fracture
Immediate Ortho consults
Dislocated patella
33. Orthopedic (Tibial / Forearm Fx) - Vascular (Ischemic-reperfusion injury - hemorrhage) - Iatrogenic (Vascular puncture in anticoagulated patients - IV/intra-arterial drug injection - constrictive casts) - Soft Tissue Injury (Prolonged limb compressio
Causes of Compartment Syndrome
Achilles tendon rupture
Physical Exam findings suspect of Hip Fracture
Dislocated patella
34. Forceful contraction of ____ - Falling on flexed knee - Patients over 40 years
Reduction of dislocated patella
Anterior Drawer Test
Patella Fx Treatment: Severely comminuted
Quadriceps tendon rupture
35. Recurrent lateral dislocation (15% of cases) - Superior - horizontal - intercondylar disolcations - Irreducible dislocations
ACL PE maneuvers
Meniscal Tear
Surgical management of dislocated patella
Reduction of dislocated patella
36. Valgus deformity w/ flexion - Laxity >1cm w/o endpoint: complete rupture - Laxity <1cm w/ endpont: incomplete/partial tear - no laxity but pain: ligament strain
Achilles tendon rupture
Meniscal Tear PE Maneuvers
ACL PE maneuvers
MCL PE findings
37. The ______ level of the lower extremity is most likely to develop compartment syndrome
Fibula (Anterior - Lateral - superficial posterior - deep posterior)
Quadriceps tendon rupture
Surgical management of dislocated patella
Causes of Compartment Syndrome
38. W/o fracture-> closed reduction under procedural/GA sedation -> within 6 HOURS - Stimpson Maneuver
Posterior hip dislocation treatment
Clinical History suspect of Hip Fracture
Achilles tendon rupture
Achilles tendon rupture
39. Most common fracture of foot - MOA: stubbing mechanism - crush injury - Dx: Xrays - Tx: Buddy taping - hard soled shoes
Pain - Parasthesia - Pallor - Pulselessness - Poikilothermia
Nondisplaced Phalangeal fractures
Calcaneal fractures
Maisoneuve fractures
40. 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
Nondisplaced Phalangeal fractures
Meniscal Tear
Femoral shaft fracture
Immediate Ortho consults
41. Irrigation & antibiotics in ED - I&D in OR
Patella Fx Treatment: Open fx
Nondisplaced Phalangeal fractures
MRI
Physical Exam findings suspect of Hip Fracture
42. Patient may be ambulatory - Physical exam findings: may be subtle - Xray findings: Normal Shenton's line - Treatment: Internal fixation
Pain - Parasthesia - Pallor - Pulselessness - Poikilothermia
Maisoneuve fractures
Non-displaced femoral neck fractures
Complications of Pelvic Fractures
43. 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
Forearm (flexor - extensor - mobile wad)
Patella fracture
Non-displaced metatarsal shaft fractures
Achilles tendon rupture
44. Immobilization by cast / surgery - Goal is to restore anatomical relationship of ____ - maintain reduction during healing - mobilize ankle early - Most ___ fx require ORIF
Uncomplicated ankle fracture treatment
Meniscal Tear PE Maneuvers
Vertical Shear Pelvic Fracture
Forearm (flexor - extensor - mobile wad)
45. Most common mechanism of pelvic fracture (50%) - occurs when pedestrians are broad-sided by car
Lateral Compression Pelvic Fracture
Causes of Compartment Syndrome
Patella Fx Treatment: Open fx
Surgical management of dislocated patella
46. 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 -
Tibial fracture
Patella Fx treatment: Nondisplaced & intact extensors
Pilon fractures
Dislocated patella
47. 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)
Causes of Compartment Syndrome
Tibial fracture
Displaced femoral neck fractures
MCL PE findings
48. 5 P's of Compartment Syndrome
Patella fracture presentation
Fibula (Anterior - Lateral - superficial posterior - deep posterior)
Pain - Parasthesia - Pallor - Pulselessness - Poikilothermia
Vascular compromise (dusky foot - absent pulse)
49. 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
Patella Fx treatment: Displaced >3mm &/or disrupted extensors
MCL PE findings
Complications of Pelvic Fractures
Lateral Compression Pelvic Fracture
50. Treatment for posterior hip dislocation - downward traction placed on femur at the knee -> uther hand applies external and internal rotation
Maisoneuve fractures
Pivot Shift Test
Stimpson maneuver
Reduction of dislocated patella