4Rs
Resuscitation
Reduction
Restriction
Rehabilitation
6As
Analgesia
Assess neurovascular status, soft tissues, photograph
Antisepsis: wound swab, copious irrigation, cover with soaked dressing
Alignment: align fracture and splint
Anti-tetanus
Abx
5Is
Ischaemia
Infection
Increased interfragmentary strain
Interposition of tissue between fragments
Intercurrent disease eg malignancy or malnutrition
GRUesome MURder assists remembering which bone is firstly fractured and then secondly which is dislocated:
G: Galeazzi R: radius fracture U: ulna dislocation
M: Monteggia U: ulna fracture R: radial head dislocation
ARM fracture:
Axillary = Head of Humerus
Radial = mid shaft
Median = Supracondylar
Colle’s fracture makes a C shape in fall position
Smith’s fracture makes an S shape in fall position
Age + SHATTERED
Steroids
Hyper-para/thyroidism
Alcohol and cigarettes
Thin (BMI<22)
Testosterone low
Early menopause
Renal/liver failure
Erosive/ inflammatory bone disease eg RA, myeloma
Dietary Ca low/ malabsorption, DM
LOSS
Loss of joint space
Osteophytes
Sub-chondral sclerosis
Sub-chondral cysts
B comes before H, so bouchards is in proximal IP joint
Holding a Bat you use more of proximal IPJ – B for Bat
Holding a Hair you use more of your distal IPJ – H for Hair (Heberden’s)
P[P]EAR –
Psoriatic Arthropathy
Pseudogout
Enteropathic Arthritis
Ankylosing Spondylitis
Reiter's
PEST OF 6
Parietal
Ethmoid
Sphenoid
Temporal
Occipital
Frontal
TOSS My Gravy Spoon, Darling
Infrahyoid muscles (TOSS) – the strap muscles of the neck
Thyrohyoid
Omohyoid
Sternothyroid
Sternohyoid
Suprahyoid (My Gravy Spoon, Darling)
Mylohyoid
Geniohyoid
Stylohyoid
Digastric
SITS (clockwise from top)
Supraspinatus
Infraspinatus
Teres Minor
Subscapularis
Aunty Iris Made My Uncle Really Mad!
Axillary
Intercostobrachial
Medial cutaneous
Musculocutaneous
Ulnar
Radial (posterior cutaneous and superficial branches)
Median
Brachial plexus nerves and how to remember their spinal roots:
3 musketeers (musc N top 3)
2 assassins (axil N top 2)
5 men (median N all 5)
5 rats (radial N all 5)
2 unicorns (ulnar N bottom 2)
Randy Travis Drinks Cold Beer (brachial plexus subunits)
Roots
Trunks
Divisions
Cords
Branches
BEST muscles
Brachioradialis
Extensors
Supinator
Triceps
"Pimps F*** P********** For Fun"
(let’s say Pimps Feed People For Fun!)
Pronator teres
Flexor carpi radialis
Palmaris longous
Flexor carpi ulnaris
Flexor digitorum superficialis
3 Bs flex the ElBow
Brachialis
Biceps
Brachioradialis
Brachioradialis
Beer Raising muscle (flexor)
Breaks Rules, it’s a flexor muscle But Radial (radial nerve usually innervates extensors)
Meat-LOAF
Meat – reminder that the median nerve supplies these muscles
Lateral two lumbricals
Opponens pollicis
Abductor pollicis brevis
Flexor pollicis brevis
MEDIAN TRAP
M: myxoedema
E: (o)edema
D: diabetes mellitus
I: idiopathic
A: acromegaly
N: neoplasm
T: trauma
A: amyloidosis
P: pregnancy
B.A.D F.I.B.E.R.S
Bent penis: Peyronies
AIDS
DM
FH
Idiopathic (most common)
Booze: ALD
Epilepsy and epilepsy meds
Reidel's thyroiditis
Smoking
Some Lovers Try Positions That They Can’t Handle
Scaphoid
Lunate
Triquetrum
Pisiform
Trapezium
Trapezoid
Capitate
Hamate
Pad and DAb
The Palmar Adduct and the Dorsal abduct
Use your hand to dab with a pad
A OF A OF A
Thenar, lateral to medial
Abductor pollicis longus
Opponens pollicis
Flexor pollicis brevis
Adductor pollicis.
Hypothenar, lateral to medial
Opponens digiti minimi
Flexor digiti minimi
Abductor digiti minimi
SALT (innervation)
Serratus Anterior = Long Thoracic
‘C5,6,7, raise your arms up to heaven’ (the roots)
"Spare TIRE around their abdomen"
Transversus abdominis
Internal oblique
Rectus abdominis
External oblique
How to remember direction of obliques:
When you put your hands in your pockets, your fingers lie on top of the external obliques and fingers point their direction of fibres.
I twice Get Laid On Fridays
Iliohypogastric (T12, L1)
Ilioinguinal (L1)
Genitofemoral (L1, L2)
Lateral femoral cutaneous (L2, L3)
Obturator (L2-L4)
Femoral (L2-L4)
2 nerves from 1 root (L1): Ilioinguinal, iliohypogastric
2 nerves from 2 roots: Genitofemoral (L1.L2), Lateral Femoral (L2,L3)
2 nerves from 3 roots: Obturator (L2,3,4), Femoral (L2,3,4)
Shut Up and Butt Out
The Upper and Outer quadrant of the buttock avoids needle hitting the sciatic nerve.
MAP of Sciatic
Medial compartment: Obturator
Anterior compartment: Femoral
Posterior compartment: Sciatic
SAIL
Sartorius muscle (lateral border)
Adductor longus muscle (medial border)
Inguinal Ligament (superior border)
2 semis go together (membranosus + tendinosus) Tendinosus is on Top (superficial).
Membranosus is Medial so Biceps Femoris is lateral.
Eversion muscles
pErineus longus
pErineus brevis
pErineus terius
Inversion muscles
tIbialis anterior
tIbialis posterior
Stand on your soles. Explosive Gas
Soleus for standing (posture)
Gastrocnemius is for explosive movement!
One, two-- buckle my shoe. Three, four-- kick the door. Five, six-- pick up sticks. Seven, eight-- shut the gate.
S1,2 = ankle jerk
L3,4 = knee jerk
C5,6 = biceps and brachioradialis
C7,8 = triceps
Supine = on your spine
Prone = the other one
Lumbar = Lordosis
Ky is high up the spine!