OK Rezzies It is time for the -
EVMS Unofficial Quiz based on Musculoskeletal Imaging Requisites Chapters 6, 7, and 8
Elbow
1. Line drawn through the center of the radial shaft should bisect the capitellum on any view is known as the ...
2. If the anterior humeral line passes through the anterior capitellum, you should be concerned for?
3. This is one of the more common sites of rheumatoid nodules?
4. Seeing this on a lateral radiograph is abnormal?
a. Anterior fat pad
b. Spinnaker sail sign
c. Posterior fat pad
d. All the above
e. b and c
5. The second most common pediatric elbow fracture
a. Supracondylar
b. Radial head
c. Lateral condylar
d. Medial epicondylar
6. Medial epicondyle entrapment is when the medial epicondylar fragment is between ___ and ___
7. Why is critical to diagnose a medial epicondyle entrapment?
8. Fracture of this is the most common bone fractured in the elbow of adults? What are the 2 most common types of this fracture?
9. Essex-Lopresti fracture is?
10. This epicondylitis is commonly found in baseball pitchers and tennis players? This epicondylitis is found in carpenters and golfers?
11. The distal biceps has a tendon and an aponeurosis. The biceps aponeurosis is also referred to by what other name?
12. What is Panner disease and where is it found?
13. What is Galeazzi fracture? Monteggia?
Wrist
14. Kienbock disease is associated with what type of ulnar variance?
15. Under what conditions can the extensor carpi ulnaris sheath communicate with the DRUJ?
16. What are the common wrist and distal forearm fracture patterns based on age?
17. What are the components of the TFCC?
18. There is ulnar impaction (ulnar abutment) syndrome an ulnar impingement synrome. What are they and how can treatment of one lead to the other?
19. Where does the scaphoid develop avascular necrosis? Why does this happen anatomically?
20. Stress fracture of this structure is found in carpenters and golfers:
21. What was not clearly communicated in the book is that in the setting of an arc of Gilula (pbuh) injury the fractures have Trans- as the prefix and if there is dislocation state whether it is perilunate or lunate. So if you see a scaphoid and triquetral fracture with volarly tilted lunate that maintains alignment with the distal forearm. How would you describe this injury?
22. What portion of the scapholunate ligament is most important? For the lunotriquetral?
23. Pathognomonic scapholunate dissociation can be called when you notice what on a PA radiograph?
24. End stage degenerative changes in the proximal wrist due to scapholunate dissociation is called what? Similar finding associated with scaphoid nonunion is called what?
25. What tendons are involved in de Quervain disease?
26. Symptomatic chondromalacia and subchonral edema in the proximal hamate pole and occasionally the adjacent hamate is seen with what type of hamate?
Hand
27. Why is it important to diagnose a Bennett fracture early?
28. Gamekeeper's thumb is associated with what injury?
29. What is a Stener lesion?
30. What is a volar plate fracture?
31. What is a jersey finger?
32. What is a mallet finger?
33. What happens in a flexor annular pulley injury?
Bonus:
Which 1980's new wave/alternative band is most reflective of Millenials? If you can give a good reason why, I will give you extra bonus points even if you choose the wrong band.
a. Depeche Mode
b. New Order
c. The Smiths
d. The Cure
e. Echo and the Bunnymen
Saturday, August 31, 2019
October Reading
October Reading MSK Requisites Chapters 9 (Spine Trauma), 10 (Pelvis), and 11 (Hip and Femur)
Thursday, August 8, 2019
August Quiz Answers
1. This structure covers the bone surface except at joints and contributes to bone production and remodeling:
a. Apophysis
b. Trabecula
c. Periosteum (1 pt)
d. Metaphysis
2. The patient has a fracture of the base of the 5th metatarsal with a small fragment retracted from the base. This would represent what type of force of trauma?
a. Shear
b. Distraction
c. Compression
d. Tension (1 pt)
3. What is a Die-Punch fragment? Articular surface fragment that is driven into the epiphysis or metahysis. Where does it most commonly occur? Tibial plateau fx (2 pts)
4. What is an osteochondral fracture? Compression or shear fracture of subchondral bone and overlying cartilage that is confined to the peripheral portion of the epiphysis (1 pt)
5. What is an insufficiency fracture? Fracture caused by normal stresses are placed on bone that is weakened by a generalized process such as osteoporosis (1 pt)
6. What is a pathologic fracture? Fracture caused normal stresses to an abnormal bone - like a benign or malignant tumor (1 pt)
7. An intraarticular fracture that has significantly increased risk of developing post traumatic osteoarthritis? fx with step-off or diastasis of greater than 2 mm (1 Pt)
8. What are the 2 types of nonunion? Hypertrophic (sclerotic and associated with excess bone deposition) and atrophic (associated with demineralization) (2 pt)
9. What are 3 common types of causes of orthopedic hardware failure? Inadequate reduction, inadequate hardware, noncompliant patients (3 pt)
10. What is impingement? Abnormal tissue compression (1 pt)
11. What is anisotropic? Not the same in every direction (1 pt)
12. What is the magic angle? Normal ligament or tendon will have intermediate or bright signal when oriented 55 degrees relative to the bore of the magnet on short TE sequences such as GRE, T1 (1pt)
13. How to avoid magic angle? use longer TE such as T2 (1 pt)
14. What are tendons most prone to subluxation? Extensor carpi ulnaris, peroneus brevis and longus, tibialis posterior (3 pt)
15. If you think there is fatty infiltration of a muscle, which sequence will you look at?
a. T2FS
b. T1 (1 pt)
c. STIR
d. GRE
16. What are the 3 grades of muscle strain? Grade 1 - edema between muscle fibers usually along myotendinous junction; 2 - extensive edema and fluid collections; 3 - disruption of the musculotendinous junction with loss of function (3 pt)
17. What is the finding at about 4 weeks after denervation on MRI? Edema in the muscle (high signal on STIR and T2) What about after several months? muscle wasting with fatty infiltration best seen on T1 (2 pt with 1 for each answer)
18. What is an osteochonral defect? A cartilage defect that involves both cartilage and subchondral bone (1 pt)
19. What is the feared complication of physeal injury? growth arrest (1 pt)
20. What is the 1st finding in osteochondritis dissecans on MRI? Subchondral marrow edema (1 pt)
21. Anatomic neck fracture of the humerus is worrisome, why? Blood supply to head is disrupted causing poor healing, avn, and secondary osteoarthritis. (1 pt)
22. Fractures of what parts of the scapula are treated with surgical reduction and fixation? Glenoid, scapular neck, and coracoid (3 pts)
23. Other than AC separation, what are other causes of widened AC joint? Erosion of distal clavicle in RA, hyperparathyroidism, infection, traumatic osteolysis (weightlifters) (4 pt)
24. AC joint is normally how wide with what difference between sides? 5 mm (I don't call widened until 7-8 mm) with no more than 2-3 mm difference between sides (2 pt)
25. Coracoclavicular distance is usually what with what difference between sides? no wider than 11-13 mm with no more than 5 mm difference (2 pt)
26. Which rotator cuff tendon attaches to the lesser tuberosity? Subscapularis (1 pt)
27. If the biceps tendon is dislocated - you should assume there is a tear in what tendon? Subscapularis (1 pt)
28. Denervation of the posterior deltoid and teres minor is associated with fibrous bands in what space? Quadrilateral space with impingement on the axillary nerve (1 pt)
29. Acromioplasty is performed for what? Surgical decompression of the subacromial space in the setting of rotator cuff impingement (this is currently an issue of debate) (1 pt)
30. If you see fluid filled cysts within a muscle belly, you should look for what? Tendon delamination (intrasubstance tears) (1 pt)
31. Where is the critical zone in the rotator cuff and what is it? 1 cm proximal to the distal insertion of the rotator cuff. It is the watershed area between humeral head and muscular blood supply (2 pt)
32. Where does one find a Hill-Sachs lesion on the humerus? Wedge shaped defect in the lateral posterosuperior aspect of the humeral head at or above the coracoid process. (1 pt)
49 points total
a. Apophysis
b. Trabecula
c. Periosteum (1 pt)
d. Metaphysis
2. The patient has a fracture of the base of the 5th metatarsal with a small fragment retracted from the base. This would represent what type of force of trauma?
a. Shear
b. Distraction
c. Compression
d. Tension (1 pt)
3. What is a Die-Punch fragment? Articular surface fragment that is driven into the epiphysis or metahysis. Where does it most commonly occur? Tibial plateau fx (2 pts)
4. What is an osteochondral fracture? Compression or shear fracture of subchondral bone and overlying cartilage that is confined to the peripheral portion of the epiphysis (1 pt)
5. What is an insufficiency fracture? Fracture caused by normal stresses are placed on bone that is weakened by a generalized process such as osteoporosis (1 pt)
6. What is a pathologic fracture? Fracture caused normal stresses to an abnormal bone - like a benign or malignant tumor (1 pt)
7. An intraarticular fracture that has significantly increased risk of developing post traumatic osteoarthritis? fx with step-off or diastasis of greater than 2 mm (1 Pt)
8. What are the 2 types of nonunion? Hypertrophic (sclerotic and associated with excess bone deposition) and atrophic (associated with demineralization) (2 pt)
9. What are 3 common types of causes of orthopedic hardware failure? Inadequate reduction, inadequate hardware, noncompliant patients (3 pt)
10. What is impingement? Abnormal tissue compression (1 pt)
11. What is anisotropic? Not the same in every direction (1 pt)
12. What is the magic angle? Normal ligament or tendon will have intermediate or bright signal when oriented 55 degrees relative to the bore of the magnet on short TE sequences such as GRE, T1 (1pt)
13. How to avoid magic angle? use longer TE such as T2 (1 pt)
14. What are tendons most prone to subluxation? Extensor carpi ulnaris, peroneus brevis and longus, tibialis posterior (3 pt)
15. If you think there is fatty infiltration of a muscle, which sequence will you look at?
a. T2FS
b. T1 (1 pt)
c. STIR
d. GRE
16. What are the 3 grades of muscle strain? Grade 1 - edema between muscle fibers usually along myotendinous junction; 2 - extensive edema and fluid collections; 3 - disruption of the musculotendinous junction with loss of function (3 pt)
17. What is the finding at about 4 weeks after denervation on MRI? Edema in the muscle (high signal on STIR and T2) What about after several months? muscle wasting with fatty infiltration best seen on T1 (2 pt with 1 for each answer)
18. What is an osteochonral defect? A cartilage defect that involves both cartilage and subchondral bone (1 pt)
19. What is the feared complication of physeal injury? growth arrest (1 pt)
20. What is the 1st finding in osteochondritis dissecans on MRI? Subchondral marrow edema (1 pt)
21. Anatomic neck fracture of the humerus is worrisome, why? Blood supply to head is disrupted causing poor healing, avn, and secondary osteoarthritis. (1 pt)
22. Fractures of what parts of the scapula are treated with surgical reduction and fixation? Glenoid, scapular neck, and coracoid (3 pts)
23. Other than AC separation, what are other causes of widened AC joint? Erosion of distal clavicle in RA, hyperparathyroidism, infection, traumatic osteolysis (weightlifters) (4 pt)
24. AC joint is normally how wide with what difference between sides? 5 mm (I don't call widened until 7-8 mm) with no more than 2-3 mm difference between sides (2 pt)
25. Coracoclavicular distance is usually what with what difference between sides? no wider than 11-13 mm with no more than 5 mm difference (2 pt)
26. Which rotator cuff tendon attaches to the lesser tuberosity? Subscapularis (1 pt)
27. If the biceps tendon is dislocated - you should assume there is a tear in what tendon? Subscapularis (1 pt)
28. Denervation of the posterior deltoid and teres minor is associated with fibrous bands in what space? Quadrilateral space with impingement on the axillary nerve (1 pt)
29. Acromioplasty is performed for what? Surgical decompression of the subacromial space in the setting of rotator cuff impingement (this is currently an issue of debate) (1 pt)
30. If you see fluid filled cysts within a muscle belly, you should look for what? Tendon delamination (intrasubstance tears) (1 pt)
31. Where is the critical zone in the rotator cuff and what is it? 1 cm proximal to the distal insertion of the rotator cuff. It is the watershed area between humeral head and muscular blood supply (2 pt)
32. Where does one find a Hill-Sachs lesion on the humerus? Wedge shaped defect in the lateral posterosuperior aspect of the humeral head at or above the coracoid process. (1 pt)
49 points total
Sunday, August 4, 2019
September Quiz Reading
Reading for the September Quiz will be Chapters 6 through 8 of Musculoskeletal Requisites!
Elbow, wrist, and hand!
Elbow, wrist, and hand!
August Quiz
EVMS Reading Quiz for August 2019
1. This structure covers the bone surface except at joints and contributes to bone production and remodeling:
a. Apophysis
b. Trabecula
c. Periosteum
d. Metaphysis
2. The patient has a fracture of the base of the 5th metatarsal with a small fragment retracted from the base. This would represent what type of force of trauma?
a. Shear
b. Distraction
c. Compression
d. Tension
3. What is a Die-Punch fragment? Where does it most commonly occur?
4. What is an osteochondral fracture?
5. What is an insufficiency fracture?
6. What is a pathologic fracture?
7. An intraarticular fracture that has significantly increased risk of developing post traumatic osteoarthritis?
8. What are the 2 types of nonunion?
9. What are 3 common types of causes of orthopedic hardware failure?
10. What is impingement?
11. What is anisotropic?
12. What is the magic angle?
13. How to avoid magic angle?
14. What are tendons most prone to subluxation?
15. If you think there is fatty infiltration of a muscle, which sequence will you look at?
a. T2FS
b. T1
c. STIR
d. GRE
16. What are the 3 grades of muscle strain?
17. What is the finding at about 4 weeks after denervation on MRI? What about after several months?
18. What is an osteochonral defect?
19. What is the feared complication of physeal injury?
20. What is the 1st finding in osteochondritis dissecans on MRI?
21. Anatomic neck fracture of the humerus is worrisome, why?
22. Fractures of what parts of the scapula are treated with surgical reduction and fixation?
23. Other than AC separation, what are other causes of widened AC joint?
24. AC joint is normally how wide with what difference between sides?
25. Coracoclavicular distance is usually what with what difference between sides?
26. Which rotator cuff tendon attaches to the lesser tuberosity?
27. If the biceps tendon is dislocated - you should assume there is a tear in what tendon?
28. Denervation of the posterior deltoid and teres minor is associated with fibrous bands in what space?
29. Acromioplasty is performed for what?
30. If you see fluid filled cysts within a muscle belly, you should look for what?
31. Where is the critical zone in the rotator cuff and what is it?
32. Where does one find a Hill-Sachs lesion on the humerus?
1. This structure covers the bone surface except at joints and contributes to bone production and remodeling:
a. Apophysis
b. Trabecula
c. Periosteum
d. Metaphysis
2. The patient has a fracture of the base of the 5th metatarsal with a small fragment retracted from the base. This would represent what type of force of trauma?
a. Shear
b. Distraction
c. Compression
d. Tension
3. What is a Die-Punch fragment? Where does it most commonly occur?
4. What is an osteochondral fracture?
5. What is an insufficiency fracture?
6. What is a pathologic fracture?
7. An intraarticular fracture that has significantly increased risk of developing post traumatic osteoarthritis?
8. What are the 2 types of nonunion?
9. What are 3 common types of causes of orthopedic hardware failure?
10. What is impingement?
11. What is anisotropic?
12. What is the magic angle?
13. How to avoid magic angle?
14. What are tendons most prone to subluxation?
15. If you think there is fatty infiltration of a muscle, which sequence will you look at?
a. T2FS
b. T1
c. STIR
d. GRE
16. What are the 3 grades of muscle strain?
17. What is the finding at about 4 weeks after denervation on MRI? What about after several months?
18. What is an osteochonral defect?
19. What is the feared complication of physeal injury?
20. What is the 1st finding in osteochondritis dissecans on MRI?
21. Anatomic neck fracture of the humerus is worrisome, why?
22. Fractures of what parts of the scapula are treated with surgical reduction and fixation?
23. Other than AC separation, what are other causes of widened AC joint?
24. AC joint is normally how wide with what difference between sides?
25. Coracoclavicular distance is usually what with what difference between sides?
26. Which rotator cuff tendon attaches to the lesser tuberosity?
27. If the biceps tendon is dislocated - you should assume there is a tear in what tendon?
28. Denervation of the posterior deltoid and teres minor is associated with fibrous bands in what space?
29. Acromioplasty is performed for what?
30. If you see fluid filled cysts within a muscle belly, you should look for what?
31. Where is the critical zone in the rotator cuff and what is it?
32. Where does one find a Hill-Sachs lesion on the humerus?
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