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MSK > Anatomy and clinical implications > Flashcards

Anatomy and clinical implications Flashcards

1
Q

Complications of a clavicle fracture

A

malunion , neuro- vascular damage and Pneumothorax, sternocleidomastoid muscle will elevate the middle third creating a shoulder drop at the distal third.

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2
Q

Damage to the Long thoracic nerve which innervates the Serratus anterior muscle causes what?

A

Winged scapula , middle and inferior borders are protruded

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3
Q

ipsilateral wrist drop caused by damage to what nerve

A

Radial nerve damage - in the humerus spinal groove

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4
Q

Fracture to the distal radius, pushed anteriorly

A

Smiths fracture

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5
Q

Fracture to the distal radius , distal fragment pushed posteriorly

A

Colles fracture

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6
Q

supraspinatus

A

abduction of arm for first 15 degrees

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7
Q

infraspinatus

A

external rotation of shoulder

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8
Q

subscapularis

A

internal rotation of shoulder and adduction

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9
Q

Teres minor

A

external rotation

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10
Q

How do you test the rotator cuff muscles

A

lower a fully abducted arm - a positive result is when the arm drops uncontrollably from 30 degrees

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11
Q

inflammation of base of flexor tendons , and pain when flexing

A

medial epicondylitis and golfers elbow

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12
Q

Tennis elbow

A

lateral epicondylitis

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13
Q

Nursemaids elbow

A

Subluxation (partial dislocation) of the annular ligament or radial head
to relocate 90 degrees flex arm in a supine position then push in

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14
Q

Axillary nerve
Nerve roots
motor
sensory

A

C5,C6
motor - deltoid and teres minor
sensory- skin over the lower deltoid

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15
Q

Ulna nerve
nerve roots
motor
sensory

A

C8,T1
motor to the flexor carpi ulnaris, flexor digitorum profundus and flexors of the hand
sensory - little finger and half of the ring finger - claw hand

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16
Q

Radial nerve
nerve roots
motor
sensory

A

all nerve roots
motor to extensors of arm, forearm and hand
sensory to posterior forearm and posterior hand ( not little finger or tips of fingers)
this can be compressed by crutches in the axilla , loss o finger extension

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17
Q

Musculocutaneous nerve
nerve roots
motor
sensory

A

C5,C6,C7
motor to the arm flexors ( BCB)
sensory to the lateral cutaneous nerve which runs with the cephalic vein

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18
Q

Median nerve
nerve roots
motor
sensory

A

all nerve roots
motor to flexors of the forearm and hand muscles
sensory to lateral palm and lateral 3 half finger on palmar surface

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19
Q

carpel tunnels syndrome is caused by damage to which nerve and what test can diagnose this

A

compression of the median nerve - test called Tinels test - tap it and fingers tingle - hand of benediction

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20
Q

Cubital tunnel syndrome caused by damage to which nerve

A

ulna nerve ,

wrist adduction is lost if damage to medial epicondyle

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21
Q

Guyans canal damage to what nerve

A

Ulnar nerve causing numbness in little finger and half orf ring finger , no dysfunction of movement in her hand likely to be this.
ulnar artery goes through here too

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22
Q

What is Erbs palsy

A

severing of upper trunk of brachial plexus so C5 and C6

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23
Q

What is klumpkes palsy

A

severing of lower trunk of brachial plexus C8 and T1

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24
Q

Dermatome

A

an area of skin innervated by a single spinal nerve

25
Q

Myotome

A

a group of muscles innervated by a single spinal nerve

26
Q

How is compartment syndrome relieved?

A

Fasciotomy - release of fascia around the muscles so blood vessels aren’t compressed

27
Q

What is a sign of lack of blood to the arm causing a claw like hand

A

Volkmans ischemic contracture

28
Q

Complications of a humeral head fracture

A

axillary nerve damage causing atrophy and loss of sensation to the deltoid muscle,

29
Q

Complications of an olecranon fracture

A

avulsion of triceps ligaments , ulnar nerve injury

radial nerve innervates triceps muscles that connects onto the olecranon process

30
Q

What nerve supplies the dorsal interossi and palmar interossi muscles?

A

Ulnar nerve
dorsal interossi - 4 muscles back of hand abduct the fingers away from midline and assist in flexion
palmaar interossi muscles - adduct the fingers in between consist of 4 or 3

31
Q

Two muscles that extend the forearm and attach to the olecranon are .. …..

A

Triceps brachia and anconeus innervated by the radial nerve

32
Q

A 58-year-old male presents to the GP six weeks following a motor bike accident where he sustained a fracture of his right distal radius. Today he complains of a two-day history of an inability to fully extend his right thumb at both the metacarpophalangeal and interphalangeal joints.
Rupture of which muscle is likely to have caused his presentation?

A

Extensor pollicis longus - extends the thumb at the MCPJ and IPJ
also with in synergy with the extensor policies brevis muscle

33
Q

What are the borders of the anatomical snuff box?

A

extensor pollicis longus, extensor pollicis brevis and abductor pollicis longus

34
Q

Boutonnieres deformity is caused by what?

A

Injury to the tendons characterised by PIP flexion and DIP extension - extensor digitorum tendon

35
Q

Which carpal bone is involved in osteoarthritis of the base of the thumb?

A

Trapezium

36
Q

What nerve supplies the muscles that pulls on the radial tuberosity?

A

Musculocutaneous nerve supplies biceps brachii muscle that attaches

37
Q

What are the borders of the axilla?

A

Anterior border - pectorals major and minor
Medial border - serratus anterior and thoracic wall (ribs)
lateral border - intertubecular sulcus
posterior border - scapularis , teres major , latissimus dorsi
superior most anterior - clavicle

38
Q

on x-ray the left wrist. What x-ray findings of the left radius distal metaphysis would be consistent with a diagnosis of a Smith’s fracture?

A

Extra- articular fracture with solar angulation

39
Q

Nathan presents to the emergency department after falling from a ladder. He is most tender just proximal to the first metacarpal and in between the extensor pollicis longus and the extensor pollicis brevis tendons.
A: What bone has Nathan fractured to give this presentation?

A

scaphoid bone - awn

40
Q

difficulty opposing the thumb to the index finger is damage to what nerve?

A

Anterior Interosseous nerve is branch of median nerve, supplies opponens pollicis

41
Q

What muscle at the interphalangeal joint is required for the opposition of the thumb?

A

Flexor Pollicis Longus

42
Q

How would you test for the biceps brachia muscle?

A

Resist elbow flexion or forearm supination while palpating the muscle bulk on the anterior surface of the arm.

43
Q

Besides adipose tissue, what separates the olecranon from the skin?

A

The olecranon bursa

44
Q

Problems with a humeral shaft fracture

A

radial nerve - in posterior groove between the two triceps heads , wrist drop

45
Q

What common paediatric injury at the elbow means that the humerus dose not line up with the capitellum ( narrowest point of the humerus) FOOSH

A

supracondylar fracture

46
Q

What is elbow joint effusion?

A

This is where intra-articular fracture occurs presenting a convex anterior fat pad

47
Q

What is a fracture of the 5th metacarpal neck called?

A

Boxer fracture

48
Q

Gamekeepers thumb is when?- I did this fucking remember

A

avulsion or rupture of UCL of 1st MCPJ , hyperabduction of the pole

49
Q

What FOOSH injury presents a risk of AVN and the bone that has a retrograde blood supply ?

A

Scaphoid

50
Q

What nerve is thenar atrophy associated with?

A

Median nerve

51
Q

What nerve is hypothenar atrophy associated with?

A

Ulnar nerve

52
Q

what is the cascade sign(positive)

A

when all fingers point to scaphoid

53
Q

frozen shoulder

A

inflammation of ligaments resisting abduction

54
Q

Popeye sign

A

caused by rheumatoid arthritis as tendons fragile

55
Q

what muscle supinates the elbow

A

bicep brachaii

56
Q

what is de quervains tenosynovitis and how to diagnose it

A

tendons on the thumb affected

diagnosed by frinklesteins test , around thumb then ulnar deviation

57
Q

Symptoms of de Quervain’s tenosynovitis include

what test

A

Pain near the base of your thumb.
Swelling near the base of your thumb.
Difficulty moving your thumb and wrist when you’re doing something that involves grasping or pinching.
A “sticking” or “stop-and-go” sensation in your thumb when moving it.

frinklesteins test
inflammation of the synovium

58
Q

features of acromegaly

A

Increased sweating, coarsening or thickening of facial features, increased prominence of jaw +/- forehead

MSK (4 decks)

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