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Residency PIMP Questions (my edits)
Terms in this set (169)
Function of Extensor Hallucis Capsulitis
"Student nerve"; Medial to EHL; Moves capsule out of the way when EHL dorsiflexes Hallux, avoiding impingement of capsule
What does AO stand for?
Association of Osteosynthesis
-Arbeitsgemeinschaft für Osteosynthesefragen
What are the 4 AO/ASIF goals?
1) anatomic reduction
2) preserve blood supply/atraumatic
3) early active mobilization
4) stable internal fix
What's the difference b/w cortical and cancellous screws?
-small pitch for
-large pitch for less-dense bone
What's a canulated screw?
hole through it
What's the shank part of the screw?
What does ASIF stand for?
Association for the Study of Internal Fixation
What's the Blix curve?
Tendon too long, less functioning
Tendon too short, less functioning as well.
We need it juuuuust right
What to avoid when doing 1st mpj incision
Medial neurovascular bundle(dorsal digital artery+nerve) + EHL tendon
Test done to determine ruptured achilles. Squeeze calf, positive if foot doesn't plantarflex.
ID for Rearfoot Cavus
High Calcaneal inclination angle(>22), posterior fibula(due to external rotation)
Types of Bone Healing
Primary vs Secondary. Secondary more common-Soft callus, hard callus(woven bone)
Insertion of Tibialis Anterior
Medial Cuneiform and first metatarsal
5th Metatarsal fractrue
Avulsion- fracture at styloid process; Jones- Fracture at Metaphyseal region of shaft.
What is Vicryl
Absorbable suture; polyglycolic acid; coated and braided.
What is Prolene
Non-absorbable suture; Polypropelene
Is STATT tendon transfer done anterior or posterior to cruciate ligament?
TaloCalcaneal angle: Lateral: 25-45(normal), >45-valgus, <25- varus; AP: 15-30(normal) >30 valgus
Systemic Inflammatory Response System: 2 or more criteria= SIRS
Body Temperature >100.4 or <96.8
Heart Rate >90bpm
Tachypenia(high respiratory rate) >20breaths per min
WBC count <4000 or >12000
Hyperglycemia >6.66 mmol in non-diabetics
What structure is not affected in Necrotizing fasciitis that is in gas gangrene
Used to assess Fibular Shortening. Fibula has small "spur" at proximal extent and the curve of this is continuous with the tibial plafond. If it is not continuous, there is shortening of fibula.
Radiographic Angles to assess intracalcaneal fractures
Gissane's angle(Critical Angle). Normal value is 95-105. Increases in fracture. Bohlers Angle. Normal value is 20-40. Increases in fracture.
Bacteria most common in human bites
Eikenella or Staph
Posterior tibial fracture % for surgery
What is the The deformity where there is a unilateral clubfoot and one that is Calcaneal Valgus
Fibula line and angle used to determine shortening after fracture
Shenton's line. Talocrural angle(normal is 83)
Pin point bleeding when going below cartilage, indicating good blood flow
improved ankle dorsiflexion with knee flexed = gastrocnemius tightness
equivalent ankle dorsiflexion with knee flexion and extension= achilles tightness
Gout vs Pseudogout
Gout= Uric Acid level(normal is under 7mg/dL); Usually underproducer; Acute treatment with Colchicine;Indomethacin. Chronic treat with Allopurinol; probenecid; Diagnose with monosodium urate crystals
small bony fragment seen in the Lisfranc space (between the base of the 1st and 2nd metatarsal) associated with avulsion of Lisfranc's ligament (at the base of the 2nd metatarsal).
PET SCAN OSTEO
Good for Chronic Osteomyelitis. 100%sensitivity 88% specificity.
Early signs of Osteomyelitis on Radiographs
Demineralization and Radiolucency; Necrotic bone fragments and Sequestra(piece of dead bone within a diseased bone)
What's the shaft of the screw?
-doesn't include threads and the minor diameter
What's a glide hole?
The overdrill (proximal)
What's a thread hole?
The underdrill (distal)
burying the head of the screw
What 2 donor sites can stem cells be harvested?
What's BMP used for in surgery?
Bone Morphogenetic Proteins
- BMP 2 & 7
-play role in bone formation
What's paprika sign?
Debride away OM until punctate bleeding (red speckles) occurs
When does the inflammatory wound healing phase occur?
When does the proliferative wound healing phase occur?
week 2 to week 3
When does the remodeling wound healing phase occur?
week 3 to year 2
On average, how thick is the 1st met / medial cuneiform?
Who's the badass who accidentally found a surgical treatment for flatfoot?
-lead to the Evans Osteotomy
In what plain does an Evans osteotomy correct?
-Frontal: corrects Achilles
-Sagittal: PL, plantar fascia
What angles indicate a tailor's bunion?
lateral deviation angle >5
IM angle >8
What test determines equinus?
Silfverskiold (silver-scold) test
How's the Silfverskiold test performed?
Used to test AJ dorsiflexion (equinus) by comparing ROM of joint with and without knee flexed.
If the AJ can be dorsiflexed with knee bent to 90 degrees but can't be dorsiflexed with the leg extended, then pt has gastroc contracture.
What surgeries would be used to treat gastroc equinus?
Vulpius - superficial gastrocnemius-soleus recession includes an intramuscular lengthening of the soleus muscle
What's the classing system for achilles tendon rupture?
Kwanda I, II, III, IV
What's the classing system for navicular fracture?
I, II, III (III A, B, C)
I: nav tuberosity fx
II: nav dorsal lip fx
III: nav body fx
IIIA: transverse fx
IIIB: trnasverse displaced fx
What's the word for multi fractures in one bone?
What are two tests you could use for lateral ankle instability (with someone who gets inversion sprains a lot)?
Anterior drawer test
Talar tilt test
With ankle instability, how far should the foot deviate in the ant. drawer test? How
Open Fx antibiotics
Used for matrixectomy
Names of surgical matrixectomies
Purpose of alcohol flush
Matrixectomy contraindicated with infection?
Distance of displacement necessitating ORIF
Why do you denude & fenestrate or fishscale?
Lag technique: 3 ways to achieve?
Screw insertion steps
Underdrill size for 3.0 screw
What are the types for plates for fixation?
What's the sequential release for hammertoes?
De-rotational arthroplasty incision direction
types of hammertoes
causes of hammertoes
first person to describe arthroplasty
Ddx for 2nd MTPJ pain
white post-op toe
Angles associated with bunions
Names of bunion procedures
Surgical and non-surgical causes of hallux varus
1st MTPJ fusion: types of fixation
1st MTPJ fusion: angles/position of fixation
1st MTPJ fusion: most common complications
5th met: types of bunionettes
5th met: vascular supply of shaft vs. base
5th met: nutcracker fracture
Midfoot fusions: depth of 1st MCJ
Midfoot fusions: lisfranc fixation
Midfoot fusions: relationship of 2nd met base to intermediate cuneiform
Midfoot fusions: relationship of 4th met base to cuboid
Calcaneus: important during surgical restoration
Calcaneus: Mondour's sign
Calcaneus: will foot varus or valgus after calc fx?
"Thou shall not varus."
Calcaneus: stable fragment
Talus: Hawkin's sign
Talus: tx of osteochondraldefects (talar dome lesion)
Talus: blood supply and AVN with fx
Achilles: where to make incisions and why
Achilles: Toyger's angle
Achilles: complications of surgical vs non-surgical repair
Achilles: rupture rates
Achilles: Hoke hemisection
Achilles: repair if there's a large gap
Ankle sprain: ligament anatomy and test for rupture
Ankle sprain: locations to palpate for acute sprain
Ankle sprain: Ottawa rules
Ankle sprain: plate or interfragment screw first
Ankle sprain: start medial or lateral
Ankle sprain: role of fibula
Ankle sprain: Vassal's rule
Ankle sprain: Syndesmotic ruptures
Ankle sprain: types of fx
Ankle sprain: how to evaluate
Ankle sprain: overlap of tibia and fibula on AP & mortise view
Ankle sprain: associated fx and eponyms
Arthroscopy: protal locations
Arthroscopy: Basset's ligament
Arthroscopy: Benefits of arthroscopy vs open surgery
Coalitions: most common in foot
Coalitions vs bar
Coalitions: radiographic signs
Coalitions: How to prevent re-union of navicular-cuneiform coalition resection
Flatfoot: single heel raise
Meanwell uses a single-sided heel raise for classification. Patients in
of PTTD are unable to balance on one foot and raise their bodies on that foot. At this point, he also finds that patients feel tenderness and the beginnings of structural deformity in that area, as well as possible bony prominences on the medial side as the foot starts to lose its normal or proper shape
center of rotation of angulation
Flatfoot: plane of deformity
Flatfoot: procedures of flexible vs rigid
Flatfoot: evans planes of correction
Creates a significant sagittal plane correction. Once thought of as just a transverse plane correction, the Evans creates powerful realignment in three planes.
Flatfoot: distance from CC to make osteotomy
Flatfoot: types of fixation
Flatfoot: gastroc recession types
Flatfoot: Order of reduction and fixation for triple arthrodesis. Joint responsible for the most motion
Cavus: Coleman block
Cavus: Order of muscle atrophy in CMT
Cavus: Types of equinus
Cavus: procedures for flexible
Cavus: procedures for rigid
Cavus: procedures for rearfoot
Cavus: procedures for forefoot
External fixation: Delta frame
External fixation: safe zones
External fixation: pin care
External fixation: types of external fixation
Osteomyelitis: IV vs oral
Charcot: skin temperature
Charcot: Gold standard treatment
Congenital: planes of talipes equinovarus
Congenital: order of casting correction
Congenital: Ponsetti technique
Congenital vertical talus (rigid?)
Congenital calcaneal valgus (rigid?)
Non-invasive Vascular Studies (NIVS): TcPO2, pressure required to heal wounds
Non-invasive Vascular Studies (NIVS):
-blunting or dichrotic notch
Non-invasive Vascular Studies (NIVS): significant segmental pressure drop
Non-invasive Vascular Studies (NIVS): ABI normal values
Puncture wound classification
Puncture wound organisms
Effects of a PT block on vessels
Jones compression vs cast
Fx blisters role in surgical timing
Process of wound healing
Process of bone healing
Local nerve blocks
Max dose of xylocaine
Max dose of bupivicaine
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