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Boards Part 3

Terms in this set (288)

Charcot marie tooth type 1 is known as the ____________ type of CMT
Demyelinating form
Charcot marie tooth 2 is known as the _____ type of CMT?
Neuronal
What is the clinical appearance of the legs of a patient with CMT?
inverted champagne
What muscle group is affected the most with CMT?
Peroneals
What is the most common type of inherited ataxia?
Friedrich's ataxia
what protein is deficient in Friedrich's ataxia?
Frataxin
What is Friedrich's Ataxia also known as?
Hereditary spinocerebellar ataxia
What is the causative agent responsible for the development of neurosyphillis
Treponema pallidum in the tertiary stage
What is the a yeast passed to humans via pigeons which can produce subacute menigitis?
Cryptococcus neoformans
What is an RNA virus that clinically starts as the flu but then will lead to minigitis and then flaccid paralysis?
Poliomyelitis
Valley Fever or Dessert Rheumatism transmitted via dust particles. Delayed hypersensitivity sequale leading to persistent arthralgia, pleuritic pain Erythema multiforma
Coccidiodomycosis
Associated with Bat and Starling guano. molds and dusts are inhaled benign pulmonary lymphadenopathy splenopathy and disseminated RES disease ensue
Histoplasmosis
What muscles int eh posterior calf are supplied by the tibial nerve?
tibialis posterior, flexor hallucis longus, flexor digitorum longus
What muscles are innervated by the medial plantar nerve?
Abductor hallucis, Flexor digitorum brevis, Flexor hallucis brevis, 1st lumbricale (LAFF)
Joggers foot is considered entrapment of...
medial plantar nerve
What is lemont's nerve?
intermediate dorsal cutaneous nerve
what nerve supplies the EDB?
Deep peroneal nerve
What is the sural nerve composed of?
medial sural cutaneous nerve and the sural communicating branch
Joplins neuroma is entrapment of the...
medial plantar digital proper nerve
What is the triad of multiple sclerosis?
scanning speech, intention tremor, nystagmus
What is Romberg's test?
Proprioception test basically to determine if there is a dorsal column lesion or cerebellar defect
Involves the lateral columns and anterior gray matter which are closely connected within the spinal cord. Involves voluntary motor system involving degeneration of the corticospinal tracts and the alpha motor neurons
Amyotrophic lateral sclerosis
What are examples of a nucleoside reverse transcriptase inhibitors?
Zidivudine, Stavudine, Didnosiine, Lamivudine
What is the mechanism of action of Zidivudine?
Nucleoside reverse transcriptase inhibition
What are the common adverse reactions associated with nucleoside reverse transcriptase inhibitors?
Peripheral neuropathy, fatal lactic acidosis, fat redistribution and hyperlipidemia
What is the mechanism of action of sanquanavir?
protease inhibitor
What is the drug of choice for HIV patients?
2 nucleoside reverse transcriptase inhibitors and a protease inhibitor or
2 nucleoside reverse transcriptase inhibitors with 1 non-nucleoside reverse transcriptase inhibitors
What is an example of a non-nucleoside transcriptase inhibitor?
Nevirapine and Delaviradine
What is the empiric drugs of choice for a mycoplasm tuberoculosis infection?
RIPE
Rifampin
Isonazid
Pyrazinamide
Ethambutol
What is beriberi
deficiency of B1 (Thiamine)
What type of nerve fiber is associateed with the lose of autonomic response and sensory aspects leading to orthostatic hypotension, resting tachycardia and distal anhydrosis in patients with peripheral neuropathy?
Small Unmyelinated C fibers
What type of nerve fibers when affected by peripheral neuropathy result in symptoms of burning, tingling, numbness, allodynia and deep lacinating pain?
Large myelinated axons
What is the adverse drug reaction of isoniazid?
fatal hepatitis and often peripheral neuropathy
What is the contraindications of rifampin use?
Any patient with liver problems
What are the indications of Rifampin?
Staph, MAC, H. Influ. menigitis in children,
Huntington's chorea has an abnormality associated with which Chromosome?
Chromosome 4
Chest pain with exterion, remits with rest, substernal, relieved by nitro and usually is < 20 minutes in duration
Stable angina
Positional chest pain that feels pleuritic, on exam there is a rub noticed on auscultation, on EK PR depression and sT elevation in all leads
Pericarditis
Tearing pain to the back, widened mediastinum on CXR, false lumen on CT
Aortic dissection
Pleuritic, sudden onset dyspnea, fever cough, sputum crackles and CXR infiltrates
Pneumonia
What is the initial treatment for NSTEMI patients?
MONA - morphine, oxygen, nitrate and aspirin
What is the classic triad of coronary artery disease
substernal chest pain, pain with exertion, pain relieved by rest or nitrates
Which anti-hyperlipidemia agent will lower triglycerides?
gemfibrozil
Which anti-hyperlipidemia agent will raise HDL more than any other but side effects include gout and glucose intolerance
Niacin
what is the best initial test for chest pain?
EKG
If you have a positive stress exam what would you order next for a cardiac patient?
angiography (cardiac cath)
When would you use calcium channel blockers for a patient with stable angina?
if the patient has: severe asthma, prinzmetal's variant angina or cocaine induced chest pain
What does Copidogrel, prasugrel, ticagrelor and cangrelor all inhibit
ADP receptor by binding to the P2Y12 segment of a platelet
How long do you defer non cardiac surgery for if the patient has had a coronary angioplasty?
12 months
What is the most common complication after an MI durign the initial 1-2 days?
arrhythmia
If a patient is having hypotension following MI what would be the appropriate treatment protocol?
Repeat BP, put patient in Trendelenberg and Fluids (250-500 ml NS over 30 minuts and repeat every 15-30 minutes)
What are the common physical exam findings of a MI?
S3 gallop, rales, JVD
an inflammatory process causing visible enlargement of the costochondral junction (occurs in a single rib 70% of the time) usually within costal cartilages of ribs 2-3 predominantly in rib 2
Tietze syndrome
What is the initial vasopressor of choice for septic, cardiogenic and hypovolemic shock with hypotension
norepinephrine
Initial agent of choice in cardiogenic shock with low cardiac output and without significant hypotension
dobutamine
What is the sound made due to closure of the atrioventricular valves?
S1
What is the wound due to closure of the semilunar valves?
S2
Sound made in the heart due to rapid ventricular filling
S3
Type of murmur that is heard loudest at the aortic area, mid-systolic murmur. May radiate to the carotids adn sometimes apex has a classic crescendo-decrescendo pitch
Aortic stenosis
Early diastolic murmur with decrescendo, blowing and high pitched usually at the aortic area
Aortic regurgitation
Heard loudest at the apex (Mitral area), mid0diastolic murmur with opening snap. Low pitch accentuated by exercise
Mitral stenosis
Heard loudest at the mitral area or sometimes the aortic area, holosystolic murmur, radiates to left axilla, high pitched, blowing murmur
Mitral regurgitation
loudest at left 2nd intercostal space below left clavicle, continuous machine murmur
Patent ductus arteriosus
If there is a long PR interval what would be the most likely pathologic process?
Wolff-Parkinson-White or Lown-Ganong-Levine Syndrome
Hallmark of infarction on EKG
Q wave
What are U waves on EKG associated with
electrolyte disturbances
Type of heart block, delay in transmission of the electrical impulse from the atria to the venticles, prolonged P-R interval
1st Degree Heart Block
Type of heart block where not all atrial impulses reach the ventricles, P-R interval progressively lengthens until a QRS complex is dropped and the cycle repeats
Wenckebach's 2nd degree heart block
Not all atrial impulses reach the ventricles, no delay or prolongation of the P-R interval (type of heart block)
Mobit'z (type II heart block)
Type of heart block where non of the atrial impulses reach the ventricles, atrium and ventricles beat independently at their own regular rates (atrial rate 60-100 bpm.
Third-degree heart block
A focus in the atrium that depolarizes, giving rise to a series of rapid beats at a regular rate between 150 and 250 beats per minute
paroxysmal atrial tachycardia
Rapid firing of an ectopic atrial focus "Sawtooth" pattern, only some beats pass to the AV node
Atrial flutter
multiple atrial foci depolarizing in a chaotic manner, a small number passes through the AV node
Atrial fibrillation
rapid, irrgular, disorganized ventricular rhythm, results in lack of cardiac output
Ventricular fibrillation
Reproduction of back pain when patient's leg is elevated less than 30 degrees and foot is dorsiflexed
Lasegues test
Type of muscular dsytrophy associated with no dystrophin, primarily affecting walking due to the extensive involvement of the pelvic muscles. Pseudohypertrophy is present with replacement of muscle with fat and classic sign is the Gower's sign
Duchenne muscular dystrophy
Heterogeneous autosomal muscular dystrophies that affect specific muscle groups specifically the proximal muscles of the trunk and lower limbs
Limb girdle muscular dystrophy
Autosomal dominant trait most commonly seen in adults that cause a myotonia of a muscle group. The disorder tends to increase in severity and appear at a younger age in subsequent generations
Myotonic dystrophy
What would a normal healthy individual be rated as their ASA classification?
Class 1
A patient with mild lung disease (controlled asthma) would have which ASA classification for general anesthesia?
Class II
Any patient with severe systemic disease (limits activity, may be a threat to life) would be considered which class according to the ASA classification system?
Class 3
Which ASA classification does a patient with COPD, ESRD and DM
Class 3
Which ASA class does a patient with an incapacitating systemic disease fall into?
Class 4
Which ASA class does a patient that is not expected to survive in the next 24 hours?
Class 5
Which ASA class is a patient that is brain dead?
Class 6
What is the most common pathogen responsible for surgical site infections
staph and strep
why would clindamycin be a good prophylaxis antibiotic for a patient that is undergoing an prosthetic implant like a TAR
Penetrates glycocalyx around prosthetic implants
which neurological tract is responsible for relaying sharp pain, temperature, crude touch and noxious stimuli?
spinothalamic tract
Which nerve fibers contribute to chronic burning pain?
C fibers
which nerve fibers contribute to sharp, short lived pain?
A delta fibers
how are amide local anesthetics metabolized?
by the liver
Which nerves are blocked with a mayo block?
saphenous nerve, deep peroneal nerve, medial plantar nerve and medial dorsal cutaneous nerve
Which induction agent produces undesirable psychological reactions manifested by vivid dreaming, extracorporeal experience and illusions?
ketamine
What is a complication of etomidate that largely is the reason it isn't more commonly used as an induction agent?
Adrenocortical suppression
Of the induction agents for general anesthesia which one provides hemodynamic stability?
Etomidate
What component of radiographic parameters will control contrast or gray scale?
Kelovoltage
If you increase KVp you will _____ exposure to the patient
decrease
What will control radiographic density?
milliamperage
In order to decrease radiographic exposure you will have to ___________ Kvp and ___________ mA
Increase, decrease
The _______________ occurs when an xray photon interacts with an outer shell electron
Compton effect
A method of limiting the area of an xray beam, which by law cannot exceed the film size
collimation
Occurs at lower kVp when an X-ray photon collides with a lower shell electron. The electron is ejected, and another higher shell electron fills its space, releasing energy.
Photoelectric effect
How thick should lead aprons, gloves or goggles be?
0.25 mm thick
of the anatomical structures that are encountered in a radiographs from the most dense object to the least dense object what are they in order?
cortex -> cancellous -> muscle -> nerve -> tendon -> ligament -> subQ -> fat -> air
where is the central ray aimed when taking a DP radiograph?
second metatarsocuneiform joint
Where is the central ray aimed when taking a MO view of the foot?
3rd metatarsocuneiform joint
when taking a lateral radiograph of a foot where is the central ray aimed?
cuboid
which radiographic view is used for posterior and middle STJ coalitions?
Harris beath
How would you do a Harris Beath radiograph?
patient stands on film with knees and ankles flexed 15 to 20 degrees, first take a scout lateral film and determine the declination angle of the posterior facet of STJ. Then take three views: one at the ankle determined by the lateral film, one 10 degrees above and one 10 degrees below
Where is the central ray aimed with a calcaneal axial view?
Posterior aspect of the calcaneus
Which radiographic view will be good for assessing the anterior facet of the STJ?
Isherwood view
Which views are included in the Isherwood radiographic views?
Medial oblique
Lateral oblique axial
Medial oblique axial
when taking a medial oblique radiographic view for Isherwood what is the central ray aimed between?
the lateral malleolus and the cuboid
How do you take a Medial oblique axial for isherwoods views?
foot adducted 30 degrees from image receptor
dorsiflex and invert the foot using a sling
How do you take a lateral oblique axial for isherwoods views?
foot abducted 30 degrees, dorsiflex and evert the foot. Central ray is aimed between the medial malleolus and the navicular tuberosity
This view provides a good view of the talar neck for fractures in this area
canale view
This view is the same as the DP view but the foot is plantarflexed and pronated
canale view
how many radiographs are taken with a broden view?
4
This is an accessory ossicle at the styloid process of the 5th metatarsal
os vesalianum
Where is the secondary ossification center located in the 1st Metatarsal
at the base
When do the sesamoids begin to ossify?
6 to 8 years
When does the secondary ossification center for the calcaneus form?
6 to 8 years
In an MRI _____ images are produced by measuring the time taken for the magnetic vector to return to its resting state
T1
In an MRI _________ images are produced by measuring the time needed for axial spin to return to its resting state
T2
What is the 1st phase of a bone scan called
blood flow phase
What is the 2nd phase of bone scan called?
blood pooling images
What is the 3rd phase of bone scan called?
delayed image taken 3-4 hours after injection
What does indium bind to?
cytoplasmic components of the WBC membrane
What is technectium used for
to determine bone metabolism
If the gallium scan is negative and the technectium scan is positive on a patient what would this indicate?
Osteoarthropathy
if the gallium scan is positive and the technetium scan is positive this would mean that the patient has
osteomyelitis
What is a young procedure to fix flexible pes planovalgus
TAL, rerouting the tibialis anterior tendon through a a slot in the navicular with leaving its insertion intact
Tibialis posterior tendon is reattached to beneath the navicular as well
What is the anderson and fowler osteotomy
plantar flexory wedge osteotomy in the medial cuneiform usually combined with evans calcaneal osteotomy
What is a cotton osteotomy
open wedge osteotomy in the medial cuneiform to produce plantarflexion of the medial column
This osteotomy is approached laterally with a transection osteotomy of the calcaneus with the posterior fragement displaced medially until it lays below the level of the sustentaculum tali
Koutsogiannis osteotomy
This osteotomy is an oblique calcaneal ostetomy displaced anteriorly, helps increase the calcaneal inclination angle
Gleich
What is a keck and kelly procedure
dorsal closing wedge calcaneal osteotomy just anterior to the achilles tendon
When evaluated an ankle A/P radiograph, measure the tibiofibular overlap from medial aspect of the fibula to the lateral border of the anterior tibial prominence 1 cm above the plafond. The amount of overlap should be greater than ___________ on the mortise view and ___________ on the AP view
1 mm on mortise view and 10 mm on AP
A value of ___________ of the tibiofibular clear space is indicative of a syndesmotic injury
5-6 mm
On an AP ankle view widening of the medial joint space greater than ____________ is indicative of a deltoid ligament injury
4 mm
What would be considered a positive anterior drawer sign for ATFL injury on a stress view?
> 6 mm or greater gap between the posterior lip of the tibia and the nearest part of the talar dome
A talar tilt greater than _____________ compared to the contralateral side indicates a rupture of the CFL?
> 5 degrees
What is a bosworth fracture?
lateral malleolar fracture with posterior displacement of proximal fibula
What is a dupuytren fracture
bimalleolar fracture
what is a pott fracture?
bimalleolar fracture
What is a cotton fracture?
Trimalleolar fracture
What is the mnemonic for a salter harris fracture?
I - Same
II - Above
III - Lower
IV - Through
V - Really bad
Reactive phase of host biologic response to implanted biomaterials characterized by Implant encapsulation, bone resorption and sclerosis
Tissue remodeling
The response of the body to implanted biomaterials characterized by inflammation, immunologic response, toxicity and sometimes carcinogenic response
Cellular response
In skin graft physiology this term is a force applied per cross sectional area
stress
In skin graft physiology this term is an increase in strain seen when skin is under constant stress
Creep
In skin physiology this term is a change in length divided by the original length of the given tissue to which a force is applied
Strain
In skin graft physiology this term is a decrease in stress when the skin is held in tension at a constant strain for a given time
Stress relaxation
Which types of soft tissue procedures can be used for a repair of irregular or long hypertrophic scars?
W-plasty, short wavy incision method and the geometric broken line closure
Hamartomas of the Iris that do not affect vision, also associated with neurofibromatosis type I
Lisch nodules
Also called Koenen tumor
Periungual fibroma
What are some classic signs of primary idiopathic dermatomyositis
heliotrope rash around eyelids
Gottron's sign
What is it called in dermatomyositis when there is pink to violaceous scaling typically over the knuckles, elbows and knees?
Gottrons sign
In Rheumatoid arthritis patients they will have flexion of the PIPJ of the finger with hyperextension of the DIPJ
Boutonniere deformity
In rheumatoid arthritis patients they will have this deformity with hyperextension of the PIPJ of the finger with flexion of the DIPJ
Swan neck deformity
What is still's disease?
Juvenile rheumatoid arthritis with associated systemic involvement like splenomegaly, generalized adenopathy
What is the tetrad of Reiter syndrome?
Arthritis, Arethritis, Conjunctivitis, Mucucutaneous lesions
Which inflammatory arthritis is associated with keratoderma blennorrhagica?
Reiter's syndrome
What are some hallmark radiographic signs of psoriatic arthritis?
pencil in cup deformity of the IP joints
Whittling of the distal tufts of the phalanges
What is the most common infectious species of nongonococcal septic arthritis
Staphylococcus aureus
In patients that are IV drug users, have neurtropenia, UTI's and post op's the most common cause of a septic arthritis would be this gram negative bacteria
hemophilus influenzae
Accounts for half of all septic arthritis in the otherwise healthy sexually active young adults
Neisseria gonorrhoeae
What is the pathogen that causes lyme disease?
Borrelia burgdorferi
What is the treatment for a patient that presents with migratory polyarthritis and tendonitis associated with erythema chronicum migrans?
Doxycycline (100 mg BID)
Tetracycline (250 mg QID)
Amoxicillin (500 mg TID) x 3 weeks
what are some radiographic hallmarks of gout?
rat bites, cloud sign, punched out lesions, martel sign
What does the joint aspirate look like for gout?
negatively birefringent yellow needle-shaped crystals
What is the shape of CPPD crystals on microscopy of the joint aspirate
rhomboid crystals
What are some associated signs and symptoms of SLE?
Joint pain in 90%
Fever
Butterfly rash
Fatigue, weight loss
Raynaud phenomenon
Vision problems
Proximal nail fold telangiectasis
A systemic disorder of the connective tissue characterized by induration, thickening, and tightening of the skin. Beginning int he hands, then face, and then other areas. There is also associated fibrotic degenerative change in various organs, especially the lungs, heart and GI
Scleroderma
What is associated with Scleroderma
CREST
Calcinosis
Raynaud phenomenon
Esophageal dysphagia
Sclerodactyly
Telangiectasia
What are the clinical signs of sjogren syndrome?
Keratoconjunctivitis sicca (dry eyes)
Xerostomia (Dry mouth)
dysphagia
What are the characteristics of stage 1 anesthesia?
amnesia/analgesia
What are the characteristics of stage 2 anesthesia?
Delirium/excitement
What are the characteristics of stage 3 anesthesia?
Surgical anesthesia
What are the characteristics of stage 4 anesthesia?
Overdose
Thiopental and methohexital is an example of this class or intravenous induction agent
barbiturates
This group of pharmacological agent works by depressing the reticular activating system which results in loss of consciousness. Their duration of action is determined by being highly lipid soluble
Barbiturates
What is the mechanism of action of aspirin?
irreversible inhibitor of platelet cyclooxygenase
what is the last muscle to undergo degeneration in CMT?
Triceps Surae
Genu varum is
bow legged
genu valgum is
knock kneed
How many degrees of plantarflexion is present at the ankle
20-40 degrees
How many degrees of dorsiflexion is present at the ankle joint with the stj in neutral
10-20 degrees
What is the axis of the STJ
42 degrees from transverse plane and 16 degrees from the sagittal plane
How many degrees is needed at the STJ for normal ambulation
12 degrees of inversion and eversion combined
How many degrees of motion is present at the 1st MPJ
45 degrees dorsiflexion
70-90 degrees plantarflexion
Femoral neck is the orientation of the femoral neck in relation to the femoral condyles at the level of the knee when the femur is viewed along the axis of the shaft. What is the normal range in adults?
8-14
What is the normal malleolar positional in adults?
18 to 23 degrees
How is tibial varum compensated in the STJ joint
pronation
What is the normal talocrural angle?
83 degrees
What is the normal talar neck angle?
10-20 degrees
What is the normal metatarsal declination angle?
21
What will happen to Bohler's angle and to gissane angle in a calcaneal fracture?
Bohler- decreases
Gissane- increases
What is the normal meary angle?
0 - straight line through the mid axis of the talus and mid axis of the 1st metatarsal
What will be the meary angle of a patient with a severe flatfoot?
> 15 degrees
What is the normal calcaneal inclination angle
20 degrees
What is the angle of hibbs
long axis of the 1st metatarsal and long axis of the calcaneus
What is the normal range for Kites angle?
normal range is 20 to 40 degrees
Will you have an increased or decreased talocalcaneal angle in a pronated foot type?
increased
What is closed kinetic chain pronation noted to be?
talar plantarflexion and adduction in the ankle joint with calcaneal eversion
Type of orthotic or shoe modification that can be used for lateral instability and frequent inversion sprains
lateral flare
An anteromedial extension made to the heel to provide additional support to the longitudinal arch and limit late midstance pronation
Thomas heel
A modification made to the heel of a shoe to round off the heel in a rockerbottom fashion, allows a more cushioned fluid motion through the heel contact phase of gait
SACH heel
Manifested by internal rotation and adduction of the entire limb with hip/knee/ankle in marked flexion. Seen with CP, familial spastic diplegia, paraplegia and hemiplegia
Spastic gait
Characterized by a marked instability during single limb stance with an alternating wide/narrow base during double support. During swing pahse, the limb will swing widely and cross the midline. Seen with MS, tabes dorsalis, diabetic polyneuropathy, friedreich ataxia
Ataxic gait
Stance phase of each step leads to a contralateral tilt of the pelvis with a deviation of the spine to the affected side. Seen with dislocated hip or weakness of the gluteus medius muscle
Trendelenburg gait
What has denis browne bars been used to treat?
metatarsus adductus, convex pes planovalgus and positional abnormalities of the leg
Used to treat forefoot to rearfoot abnormalities such as metatarsus adductus; recommended for use after serial casting of metatarsus adductus, but not for primary correction
Bebax shoes
Used for metatarsus adductus as an alternative to serial casting for metatarsus adductus
Wheaton Brace
Osteochondrosis of the medial portion of the proximal epiphyseal ossification center in the tibia causing bowing of the legs
Blount disease
Osteochondrosis of the navicular is called
Kohler's disease
When does legg-calve perthes disease present
3-12 years old
Osteochondrosis of the calcaneus
Sever disease
When does sever disease occur?
between the ages of 6 and 12 years old
Osteochondrosis involving the cuneiforms
Buschke disease
Osteochondrosis involving the 5th metatarsal base
Iselin disease
Osteochondrosis involving the fibular sesamoid
Treve disease
Osteochondrosis involving the tibia sesamoid
Renandier disease
Ostochondrosis involving the head of the 1st metatarsal
Assmann disease
Also known as allis sign. While the hips and knees are flexed a dislocated hip results in a lower knee position on the affected side. May be a false positive in b/l cases
Galeazzi sign
With the baby supine, hips and knees are flexed to 90 degrees. The hips are examined one at a time by grasping the baby's thigh with the middle finger over the greater trochanter and lifting and abducting the thigh while stabilizing the pelvis and opposite leg with the other hand. The test is positive when a palpable click is felt as the femoral head is made to enter the acetabulum
Ortolani sign
This method takes the talus and calcaneus being longitudinally bisected on a lateral and AP xray. The calcaneus is bisected ont he lateral film by using the CIA. The talocalcaneal angle of the A/P view is added to the talocalcaneal angle of the lateral view. IF the sum is less than 40 degrees, the foot is clubbed
Beatson and Pearson Assessment method
What are the complications of cast treatment for clubfoot?
metatarsus adductus
heel varus
pes planovalgus
Rocker bottom foot
What is a lichtblau calcaneal osteotomy?
anterior calcaneal osteotomy
Plantarflexory talonavicular wedge arthrodesis performed with a TAL. The tibialis anterior tendon is rerouted under the navicular and sutured into the spring ligament to further support the arch. Next a slip of the Achilles tendon, which is left attached to the calcaneus, is folded forward along the medial arch
Lowman
What is a hoke procedure
plantarly based wedge arthrodesis of the navicular and the intermediate cuneiforms
What is the young procedure described for pes planovalgus deformity?
Reroute the anterior tibial tendon through a keyhole in the navicular without detaching it from its insertion. Posterior tibial advanced under the navicular
Which suture material has low tissue reactivity, maintains most of its tensile strength in tissues and holds a know well; however it does not handle easily
Stainless steel
What kind of local anesthetic is Lidocaine?
Amide
what kind of local anesthetic is procaine?
Ester
How are ester local anesthetics broken down?
blood esterases
How is lidocaine broken down?
liver
What was the grice arthrodesis?
block of bone stuck into the sinus tarsi, reserved for patients that were not old enough for a regular STJ arthrodesis
What are two procedures that could elevate the medial column?
Cotton osteotomy and the hoke arthrodesis
What is a koutsogiannis?
medial slide calcaneal osteotomy
What is a silver in terms of calcaneal osteotomies?
lateral opening wedge with graft (posterior to the posterior facet)
A bone graft is inserted laterally in the sinus tarsi between the talus and calcaneus. This procedure is acceptable for children because it provides excellent stability without interfering with the growth of the tarsal bones
Grice and green extra-articular subtalar arthrodesis
T/f the long plantar ligament is transected from the calcaneous periosteum in a steindler stripping
true
What is a dwyer calcaneal osteotomy used for
cavus foot - lateral closing wedge or an open medial wedge
Dorsiflexory fusion of the 1st metatarsal-medial cuneiform joint. If the deformity is severe, then a naviculocuneiform joint fusin is added
McElvenny-Caldwell Procedure
What is the difference between a Cole osteotomy, Duvries osteotomy, and the JAHSS
Location of the dorsiflexory wedge
Cole: Naviculocuneiform joint and cuboid
Duvries: Midtarsal joint (Naviculotalus and the CC)
JAHSS: Lisfranc joint complex
What is the radiographic hallmark for a TC coalition?
C sign or halo sign
which coalition will induce pain at an earlier age between TC coaltions vs. CN bars
CN bars
What would be considered an abnormal metatarsus adductus angle?
>20 degrees
What would be a normal engel angle?
24 degrees
What is a Heyman, Herndon, and strong procedure
Release of all soft tissue structures at the lisfranc joint except lateral and plantar lateral ligaments
What is the lichtblau procedure for metatarsus adductus?
Sectioning of the hyperactive abductor hallucis
Closing wedge osteotomy of the 1st metatarsal and the 5th metatarsal base with oblique rotational osteotomies of the three central metatarsals; used to treat metatarsus adductus
Lepird
What is the Fowler procedure for metatarsus adductus?
Opening wedge osteotomy of the medial cuneiform with insertion of bone graft
For metatarsus adductus excision of the base of the central three metatarsals; osteotomy of 5th metatarsal; mobilization of 1st metatarsal cuneiform joint
Peabody-Muro
Partial joining of digits with proximal opening, usually due to IU environmental factors
Acrosyndactyly
Known as the amount of deformation or stretch that a tensile stress or load will produce
Elongation
Number of cycles a metal can undergo without breaking when placed under a given cyclic load
Fatigue life
Cyclic load that a metal can endure indefinitely
Fatigue limit
Production of corrosion resistance by a surface of reaction products. This lay is normally an oxide layer, which is impervious to gas and water
Passivation
What is virchows triad
Stasis, Blood vessel injury, hypercoagulability
Any toe pressure above this value will have a change at wound healing of a diabetic foot ulcer on a digit
>30 mmHg
Which two tests will test the competency of superficial veins of the leg?
Trendelenburg Maneuver
Perthes Test
What is the hallmark of lichenification?
scaling
Which anemia is associated with poikylocytosis and koilonychia?
Iron deficiency
Which anemia is associated with a sore tongue and paresthesias?
B12 deficiency
In Iron deficiency anemia what will the resulting lab values look like?
Iron Decreased
TIBC Increased
Ferritin decreased
What is closed kinetic chain pronation?
Talus: plantarflexion and adduction
Calcaneus: Eversion
What is the motion of the hip during the contact phase of gait?
extension
What happens at the knee during the contact phase of gait?
flexes
What is the motion of the leg during the contact phase of gait?
internal rotation
what is the position of the LMTJ and OMTJ at contact phase of gait
LMTJ: Supinated
OMTJ: Pronated
what is the position of the STJ during midstance?
pronated
what is the motion of the STJ during midstance?
supinating
What is closed kinetic chain supination of the subtalar joint?
Calcaneus: Inversion
Talus: Dorsiflexion and abduction
During midstance what is the motion of the OMTJ and LMTJ?
OMTJ fixed in pronated position
LMTJ is pronating
what does the leg do during the midstance phase of gait?
externally rotates
what does the knee do during the midstance phase of gait?
extends
during the gait cycle when is the OMTJ supinating?
propulsion
what happens at the hip during the propulsive phase of gait?
flexion
What does the leg do during the propulsive period of gait?
external rotation
what is the knee doing during the propulsive period of gait?
flexion
A triangle elevation of periosteum seen in osteogenic sarcom and other pathologic aggressive conditions
codman triangle
Most common source of metastatic bone tumors are
breast, lung, prostate, kidney and thyroid
bone tumor that has an oval or round radiolucent appearance and measures less than 2 cm in diameter surrounded by a zone of uniform bone sclerosis
osteoid osteoma
What is a benign bone forming lesin; it is technically a hamartoma
enostosis
Rapidly growing benign bone forming tumors; rarely becomes malignant occurs in the second and third decades of life
osteoblastoma
lesion in the leg are usually in the tibia and located in the distal anterior diaphysis of the cortex; it is an intracortical osteolytic lesion with a ground glass appearance
ossifying fibroma
THIS SET IS OFTEN IN FOLDERS WITH...