Basics Of Clinical Orthopedics Quiz

Orthopedics is a branch of surgery that deals with conditions related to the musculoskeletal system. This system includes bones, muscles, joints, ligaments, tendons, and other connective tissues that provide support, movement, and stability to the body. Orthopedic surgeons specialize in diagnosing and treating a wide range of musculoskeletal conditions, such as fractures, arthritis, sports injuries, and congenital disorders. They may perform surgeries, prescribe medications, or recommend physical therapy to help patients regain function and alleviate pain. Therefore, the correct answer is musculoskeletal system.

The explanation for the given correct answer is that Open Reduction Internal Fixation (ORIF) is indeed a surgical procedure used to realign fractured bones by placing screws and plates. This procedure is commonly used in orthopedic surgery to stabilize and promote proper healing of fractures. Therefore, the statement "The Open Reduction Internal Fixation (ORIF) is a surgical procedure in which screws and plates are placed to realign a fractured bone" is true.

During the common outpatient procedure of "debridement," dead, damaged, or infected tissue is removed. This procedure is typically performed to promote healing and prevent infection by eliminating unhealthy tissue from a wound or surgical site. Debridement helps to stimulate the growth of new tissue and allows for better wound healing.

Prednisone is indeed a commonly used corticosteroid. Corticosteroids are synthetic drugs that mimic the effects of cortisol, a hormone naturally produced by the adrenal glands. Prednisone is prescribed to treat a wide range of conditions, such as allergies, asthma, autoimmune diseases, and inflammatory conditions. It works by suppressing the immune system and reducing inflammation in the body. Due to its effectiveness and versatility, prednisone is widely prescribed and considered a commonly used corticosteroid.

Shoulder impingement occurs when the tendons in the shoulder become pinched or compressed. This can happen due to repetitive overhead arm motions, such as throwing, swimming, or weightlifting. These activities can cause the tendons to rub against the bones in the shoulder joint, leading to inflammation and pain. Therefore, it is true that shoulder impingement is usually caused by repetitive, overhead arm motions.

The statement accurately defines subluxation as a partial or incomplete dislocation. This means that the joint has moved out of its normal position but not completely. This can cause pain, limited range of motion, and instability in the affected joint. Therefore, the correct answer is true.

An open fracture refers to a situation where a fractured bone is connected to an open wound in the skin. This means that the broken bone is exposed to the outside environment, increasing the risk of infection and complicating the healing process. It is important to treat open fractures promptly to prevent further damage and reduce the risk of infection.

Degenerative Disc Disease is the correct answer because it accurately describes the gradual or rapid deterioration of the chemical composition and physical properties of the disc. This condition typically occurs due to aging, wear and tear, or injury, leading to symptoms such as pain, stiffness, and reduced mobility. Bulging Disc and Disc Rupture refer to specific disc abnormalities, while Old Age is not a medical term used to describe disc deterioration.

Crepitus refers to the grating sound that occurs when two ends of a bone rub together. This can happen due to various reasons such as joint degeneration, injury, or diseases like arthritis. It is often accompanied by pain and can be a sign of underlying joint or bone issues.

The correct answer includes the bones of the lower extremity, which are the femur, tibia, and patella. The femur is the thigh bone, the tibia is the shin bone, and the patella is the kneecap. These bones are all located in the lower part of the body and play important roles in supporting body weight, facilitating movement, and protecting vital structures. The radius, on the other hand, is a bone in the forearm and is not part of the lower extremity.

The acromioclavicular joint connects the scapula (shoulder blade) to the distal (far end) clavicle (collarbone). This joint is important for shoulder movement and stability.

Phalen's test is a diagnostic test used to assess for carpal tunnel syndrome. It involves flexing the wrist for a prolonged period of time, which can compress the median nerve. If the test reproduces the symptoms of carpal tunnel syndrome, such as numbness or tingling in the hand, it is considered positive and indicative of the condition. Therefore, the statement "Phalen's test is a test for carpal tunnel syndrome" is true.

Phalen's test is used to diagnose carpal tunnel syndrome. When a patient flexes their wrists and pushes the backs of the hands together for a prolonged time, it can cause compression of the median nerve in the carpal tunnel. This can result in symptoms such as numbness, tingling, and pain in the hand and fingers. Performing Phalen's test helps to assess for the presence of these symptoms and confirm the diagnosis of carpal tunnel syndrome.

Vertebral osteomyelitis refers to an infection that affects the vertebral body in the spine. This condition involves the inflammation and infection of the bone, which can lead to severe pain and damage to the spine. It is not related to traumatic injury, disc bulging, or inflammation of the sacroiliac joint.

DEXA scan is used to diagnose osteoporosis. DEXA stands for Dual-energy X-ray absorptiometry, which is a special type of X-ray that measures bone mineral density. It can detect low bone density, which is a characteristic of osteoporosis. CT scan and ultrasound are imaging techniques that may be used to evaluate bone health, but they are not specifically used for diagnosing osteoporosis. ORIF stands for Open Reduction and Internal Fixation, which is a surgical procedure used to treat bone fractures, not diagnose osteoporosis.

An arthroscope is a medical instrument that is used to perform minor surgeries. It is a small, tube-like device with a camera attached to it, which allows doctors to visualize and access the inside of a joint without making large incisions. This minimally invasive procedure is commonly used for diagnosing and treating various joint conditions, such as repairing torn ligaments or removing damaged cartilage. The arthroscope enables surgeons to perform precise surgical interventions with less pain, faster recovery time, and reduced risk of complications compared to traditional open surgery methods.

Epidural steroid injections do not provide permanent relief of pain associated with spinal stenosis. While these injections can temporarily reduce inflammation and provide short-term pain relief, the effects are not permanent. Spinal stenosis is a chronic condition that typically requires ongoing management and treatment. Other non-surgical options, such as physical therapy and medication, as well as surgical interventions, may be necessary for long-term pain relief in cases of spinal stenosis.

An open reduction and internal fixation is a surgical procedure that involves realigning and stabilizing broken bones using metal plates, screws, or rods. It requires making an incision and directly manipulating the bones. On the other hand, a closed reduction is a non-surgical procedure where the bones are manipulated back into their proper position without making an incision. Therefore, the statement is true as an open reduction and internal fixation involves surgery, while a closed reduction does not.

Ibuprofen is a non-steroidal anti-inflammatory drug (NSAID) because it is commonly used to reduce inflammation, relieve pain, and lower fever. It works by inhibiting the production of certain chemicals in the body that cause inflammation. Valium is a benzodiazepine used to treat anxiety and muscle spasms, tramadol is an opioid pain medication, and Fosamax is a bisphosphonate used to treat osteoporosis. Therefore, Ibuprofen is the only option that fits the category of a non-steroidal anti-inflammatory drug.

The shoulder joint is made up of two main joints: the acromioclavicular joint and the glenohumeral joint. The acromioclavicular joint is where the clavicle (collarbone) meets the acromion (part of the scapula or shoulder blade). The glenohumeral joint is the main joint of the shoulder, where the head of the humerus (upper arm bone) articulates with the glenoid cavity of the scapula. Therefore, the correct answer is both A (acromioclavicular joint) and B (glenohumeral joint).

After an open reduction and internal fixation (ORIF) procedure, common post-operative care instructions that a provider may note in the plan include bandage and dressing care to ensure proper wound healing and prevent infection. Physical therapy and home exercises are also important to promote mobility and strengthen the affected area. Pain management is crucial to ensure the patient's comfort and aid in the recovery process. High impact exercise and stair climbing are not typically recommended immediately after an ORIF procedure as they may put excessive stress on the healing bones.

Osteoarthritis is a painful condition that commonly affects older patients due to joint "wear and tear". It is a degenerative disease that occurs when the protective cartilage on the ends of bones wears down over time, causing pain, stiffness, and swelling in the affected joints. This condition is different from osteoporosis, which is characterized by a loss of bone density, and tendinitis and rheumatoid arthritis, which involve inflammation of the tendons and joints, respectively.

Arthritis is a condition characterized by the inflammation of a joint. Inflammation refers to the body's response to injury or infection, where the affected area becomes red, swollen, and painful. In the case of arthritis, this inflammation occurs in the joints, leading to stiffness, pain, and reduced mobility. Therefore, the correct answer is "inflammation, Inflammation."

Osteoarthritis is a degenerative joint disease that generally worsens with time, despite therapeutic measures. It is characterized by the breakdown of cartilage in the joints, leading to pain, stiffness, and reduced range of motion. As the disease progresses, the cartilage continues to deteriorate, causing increased pain and disability. While therapeutic measures such as medication, physical therapy, and lifestyle modifications can help manage symptoms and slow down the progression of osteoarthritis, they cannot completely halt or reverse the underlying degenerative process. Therefore, the condition tends to worsen over time.

The statement is false because not all broken bones require surgery to be set. In many cases, a broken bone can be set without surgery by using casts, splints, or other non-invasive methods. Surgery is usually only necessary for complex or severe fractures that cannot be properly aligned or stabilized without surgical intervention. Therefore, it is incorrect to say that all broken bones require surgery to be set.

The thoracic spinal nerve 10 (T10) exits the vertebral column between the 10th and 11th thoracic vertebrae (T10 and T11).

Viscosupplementation is a procedure where a thick fluid called hyaluronate is injected into the knee joint. This fluid acts as a lubricant and shock absorber, providing relief to individuals with osteoarthritis by reducing pain and improving joint mobility. Corticosteroid injection involves the injection of corticosteroid medication into the joint to reduce inflammation and pain. Arthroscopy is a surgical procedure that allows the doctor to view and treat the inside of a joint. Lidocaine injection involves the injection of lidocaine, a local anesthetic, into the joint to numb the area and provide temporary pain relief.

Hydrocodone is a narcotic analgesic because it is a synthetic opioid that acts on the central nervous system to relieve pain. It is commonly prescribed for moderate to severe pain and is classified as a controlled substance due to its potential for abuse and addiction. Calcitonin, Ibuprofen, and Gabapentin are not narcotic analgesics but are used for different purposes such as treating osteoporosis, reducing inflammation, and managing seizures or nerve pain, respectively.

A bulging disc does not always involve the rupturing of an intervertebral disc. A bulging disc occurs when the disc protrudes outwards, causing it to extend beyond its normal position. While a ruptured disc involves a tear or break in the outer layer of the disc, a bulging disc may not necessarily involve this. It is possible for a disc to bulge without rupturing, causing symptoms such as pain or discomfort in the affected area.

Joint replacement and arthroscopy are typically not considered as the first-line treatment options for mild osteoarthritis of the elbow. These treatments are usually reserved for more severe cases where conservative measures have failed. In mild cases, the initial treatment options may include pain management, physical therapy, and lifestyle modifications. Therefore, neither joint replacement nor arthroscopy is an appropriate treatment for a patient with mild osteoarthritis of the elbow.

The iliotibial tract (IT band) is a thick band of connective tissue that runs along the outside of the thigh. It starts at the hip and extends down to the knee. It is responsible for stabilizing the knee during movement and providing support to the hip and thigh muscles. Therefore, it can be found on the lateral aspect of either thigh.

Elderly patients are more likely to sustain a hip fracture because aging leads to decreased bone density and muscle strength, making the bones more fragile. Patients with osteoporosis are also at a higher risk as this condition causes weakened bones. Patients who have balance issues are more prone to falls, which can result in a hip fracture. On the other hand, young athletes are less likely to sustain a hip fracture as they tend to have stronger bones and better balance compared to the elderly or those with osteoporosis.

A Fluoroscan works by using low doses of x-rays to obtain real-time moving images of the interior of an object. This means that the device emits a small amount of x-ray radiation which passes through the object being examined. The x-rays are then detected on the other side of the object and converted into an image that can be viewed in real time. This allows for the visualization of internal structures and can be used for various medical and diagnostic purposes.

Spondylolisthesis refers to the slippage of one vertebra forward or backward onto the adjacent vertebra due to the gradual degeneration of the pars interarticularis. Spondylosis refers to degenerative changes in the spine, while spondylolysis refers to a fracture or defect in the pars interarticularis. Spinal enthesopathy refers to inflammation or degeneration of the ligaments or tendons attaching to the spine. Therefore, the correct answer is Spondylolisthesis.

inward curve of the lumbar spine

In the Lachman's test, the leg is bent. Specifically, the knee is flexed to about 20-30 degrees. This position allows the examiner to better assess the integrity of the anterior cruciate ligament (ACL) by stabilizing the femur and applying an anterior force to the tibia. An abnormal forward movement or a lack of a firm endpoint indicates a potential ACL injury.

Decreasing weightbearing exercise is not a way to decrease the risk of osteoporosis because weightbearing exercise is important for maintaining bone density and strength. Regular exercise, especially weightbearing exercises like walking or weightlifting, helps to stimulate the bones and promote bone formation. By decreasing weightbearing exercise, individuals may be more prone to bone loss and a higher risk of osteoporosis. Therefore, it is important to engage in weightbearing exercises to reduce the risk of osteoporosis.

Duloxetine is an antidepressant that may be used to treat nerve pain. It belongs to a class of medications known as selective serotonin and norepinephrine reuptake inhibitors (SNRIs). SNRIs work by increasing the levels of serotonin and norepinephrine in the brain, which can help to alleviate symptoms of depression and also reduce nerve pain. Duloxetine is commonly prescribed for conditions such as fibromyalgia, diabetic neuropathy, and chronic musculoskeletal pain.

Carpal Tunnel Syndrome is the condition where the median nerve is compressed or irritated as it passes through the carpal tunnel in the wrist. This compression can result in the loss of sensation and motor control in the hand and fingers. The repeated use of the wrist and hand, especially in activities that involve repetitive motions or prolonged periods of flexion and extension, can contribute to the development of Carpal Tunnel Syndrome.

The correct answer is impingement. Impingement refers to a condition where the acromion (a part of the shoulder blade) rubs against the tendon and the bursa (a fluid-filled sac), leading to irritation and pain. This rubbing or impingement can occur due to various factors such as inflammation, repetitive overhead movements, or structural abnormalities in the shoulder joint. The term "shoulder impingement" or "impingement syndrome" is commonly used to describe this condition.

This question is testing knowledge of medical imaging techniques and their corresponding conditions. X-rays are commonly used to diagnose arthritis, as they can show joint damage and bone spurs. MRI scans are effective in detecting disc herniation, which is a condition where the intervertebral discs in the spine are damaged or displaced. DEXA scans, also known as bone density scans, are used to diagnose osteoporosis, a condition characterized by weak and brittle bones. Ultrasound is not typically used to diagnose nerve compression, making it the incorrect match in this question.

Both spellings are acceptable

After an outpatient surgery, a provider might prescribe Codeine (Tylenol #3), 800 mg Motrin, and Percocet to relieve pain and provide comfort. Codeine is an opioid medication that acts on the central nervous system to reduce pain. 800 mg Motrin is a nonsteroidal anti-inflammatory drug (NSAID) that helps reduce inflammation and relieve pain. Percocet is a combination medication that contains oxycodone (an opioid) and acetaminophen (a pain reliever). Together, these medications can provide effective pain relief and improve the patient's comfort after surgery.

The correct answer is Facet joint block injection, Epidural steroid injection, Selective nerve root block (SNRB), Sacroiliac joint block injection. These procedures involve the injection of a steroid, which is an anti-inflammatory agent. Steroids are commonly used to reduce inflammation and relieve pain in various conditions affecting the joints, nerves, and surrounding tissues. Facet joint block injection involves injecting steroids into the facet joints of the spine to reduce inflammation and alleviate pain. Epidural steroid injection involves injecting steroids into the epidural space around the spinal cord to reduce inflammation and relieve pain. Selective nerve root block (SNRB) involves injecting steroids around the specific nerve root to reduce inflammation and alleviate pain. Sacroiliac joint block injection involves injecting steroids into the sacroiliac joint to reduce inflammation and relieve pain.

Tennis elbow and shoulder impingement are conditions that typically resolve with rest. Tennis elbow is caused by overuse of the forearm muscles, commonly seen in activities like playing tennis. Resting the affected arm allows the muscles and tendons to heal and reduces inflammation. Similarly, shoulder impingement occurs when the tendons in the shoulder become irritated and inflamed, often due to repetitive overhead movements. Resting the shoulder helps to alleviate the symptoms and promote healing. Osteoarthritis and frozen shoulder, on the other hand, may require more than just rest for resolution.