Anatomy and Revision Flashcards
1
Q
what is a syndemoses
A
fibrous joint that unites bones with fibrous sheet fibrous membranes
2
Q
what are fontanelles
A
wide sutures in the neonatal skull
3
Q
what are synchondroses
A
primary cartilaginous joints joined by hyaline cartilage
4
Q
what are the articular surfaces in synovial joints convered in
A
hyaline cartilage
5
Q
what are the 5 types of synovial joints
A
pivot, ball and socket, plane, hinge, biaxial
6
Q
least the joint types from least stable and most motile to most stable and least motile
A
synovial- cartilaginous- fibrous
7
Q
what is a subluxation
A
reduced area of contact between articular surfaces
8
Q
what is endochondral ossification
A
process in which hyaline cartilage grows and ossifies into bones
9
Q
list the components of bones from top downwards
A
epiphysis epiphyseal growth plate metaphysis diaphysis metaphysis epiphyseal growth plate epiphysis
10
Q
describe the structure of bones
A
outer cortex surrounding inner medulla (spongy and may contain bone marrow)
11
Q
what is the periosteum
A
fibrous connective tissue ‘sleeve: that is well vascularised and innervated
12
Q
where do the superficial lymphatic of the lower limb follow and drain to
A
follow saphenous veins, drain to superficial inguinal lymph nodes then external iliac lymph nodes
13
Q
what is the path of the deep lymphatics of the lower limb
A
follow deep veins
popliteal lymph nodes
deep inguinal lymph nodes
external iliac lymph nodes
14
Q
how does lymph travel from external to common iliac nodes
A
lumbar lymphatics
15
Q
what does the femoral nerve innervate and what are its nerve root levels
A
L2,3,4 quadriceps femoris sartorius iliacus pectineus
16
Q
what does the tibial part of the sciatic nerve innervate and what are its nerve root levels
A
L4-S3
posterior leg
- true hamstrings: semimembranous, semitendinosus, long head of biceps femoris
- gastrocneumius
- soleus
- plantaris
- popliteus
- tibialis posterior
muscles of sole of the foot
- flexores of digits (digitorum and hallucus longus)
- all intrinsic muscles of the sole of the foot
17
Q
via what does the tibial part of the sciatic nerve innervate the intrinsic muscles of the sole of the foot
A
medial and lateral plantar branches
18
Q
what does the obturator nerve innervate and what are its nerve root levels
A
L2,3,4
all of the medial compartment of the thigh
all abductors (except hamstring part of magnus) and gracilis
19
Q
what does the common fibular part of sciatic nerve innervate and what are its nerve root levels
A
L4-S2
short head of biceps femoris
20
Q
what does the superficial fibular branch of the common fibular nerve innervate
A
muscles of the lateral compartment of the leg;
- fibularis longus
- brevis
21
Q
what does the deep fibular branch of the common fibular nerve innervate
A
muscles of the anterior compartment of the leg
-fibularis longus and brevis
muscles of the dorsum of the foot
- extensor digitorum brevis
- extensor hallucis brevis
22
Q
what type of joint is the acromoclavicular
A
plane types
23
Q
what type of joint is the glenohumeral
A
ball and socket
24
Q
what type of joint is the elbow (humeroulnar and radiohumeral)
A
hinge
25
what type of joint is the proximal radioulnar joint
pivot
26
what type of joint is the radiocarpal
ellipsoid
27
what type of joint is the sternoclavicular
saddle
28
what limits the movement of the radiohumeral joints
is a ball and socket limited by the annular ligament
29
what is the only bone attachment of the upper limb to the axial skeleton
sternoclavicular joint
30
what happens to the bones in the forearm during pronation
radius moves over the ulna which remains still
31
what allows the pivot of the forearm during supination and pronation
annular ligament
32
what degree of rotation does the thumb have
90 degrees
33
what type of joint is the 1st CMC joint
saddle type
34
what type of joint is the 5th MCP
condyloid
35
describe a saddle joint
movement is almost all direction, more stable than a ball and socket
36
what movement is extension of the thumb
thumbs up
37
what movement is flexion of the thumb
back towards the fingers
38
what movement is abduction of the thumb
palm flat facing ceiling, thumb up to ceiling
39
what forms the carpal tunnel
flexor retinaculum, carpals
40
what is the deep fascia of the arm
brachial fascia
41
what is the deep fascia of the forearm
antebrachial fascia
42
what is the deep fascia of the leg
crural fascia
43
what is the deep fascia of the foot
plantar fascia
44
what is another name of the common fibular nerve
common peroneal
45
what nerve commonly causes foot frop
deep fibular
if lateral compartment involvement aswell think common fibular
46
ho can you increase bone mass
weight bearing exercise
| body mass
47
where does the tensor fascia lata run between
ASIS and lateral thickening of IT band
48
what is the fascia lata
a fibrous sheath
49
what other conditions is sjogrens associated with
RA and lupus
50
what type of arthritis never affects the DIPs
RA
51
what is AAV
ANCA associated vasculitis
52
why in sjogrens in PV and ESR much higher than CRP
as increased immunoglobulins thicken the blood
53
why do patients with psoriasis or on chemo have increased risk of gout
as they have increased cell turnover
54
what is undifferentiated CTD
some features of CTD with some positive antibodies without specific CTD antibodies
55
why is the lateral collateral ligament smaller than the medial
as lateral side also has IT band crossing the knee (and hip) joint
56
where do the obturator and femoral nerves both originate from
L2,3,4 in lumbar spinal plexus
57
how do you check for a torn posterior cruciate ligament
look for posterior sag, then do posterior drawer
58
what should you do instead of the anterior drawer test to test ACL
lachmans
59
where should your thumb be in lachmans
tibial tuberosity
60
where will hip pain not go
below knee
61
what do the pedicles connect
the vertebral bodies to the transverse processes
62
what forms the intervertebral foramen
anteriorly by the posterior vertebral bodies and disc
superiorly and inferiorly by the pedicles
posteriorly by the articular processes
63
what is the conus medullaris
tapered end of the spinal chord
64
why is there a C8 nerve but not a C8 disc
In cervical spine nerve come out above the disc, from thoracic spine down the associated nerve come below the disc- creates a gap at C8
65
what is the difference in symptoms between polymyositis and polymyalgia rheumatica
PMR- pain and stiffness, in morning last for few hours, fine after lunchtime. No weakness
Polymyositis- weakness, persists throughout the day. Multisystem disease, may have other symptoms
66
what is drug induced lupus
development of 1 clinical feature of lupus and +ve ANA in a patient who didnt have this diagnosis before taking a drug
symptoms usually fever, myalgia, skin rashes
67
why can septic arthritis lead to osteoarthritis
as puss chondrotoxic
68
what is a sesamoid bone
bone within a tendon
69
what makes up the intervertebral disc
collagen- types 1 and 2
70
where is hip pain usually felt
groin, can refer down leg
71
what hip pain should you worry about
pain at night
72
what are common causes of hip pain
osteoarthritis, RA, arthritides, fracture, referred from back, malignancy
73
what are the rare causes of hip pain
soft tissue (trochanteric bursitis), pagets disease, infection, AVN
74
what is the non pharmacological management for OA
education, exercise, weight loss, appropriate foot wear, physio
75
what is osgood-schlatters
inflammation of the patellar ligament at the tibial tuberosity
76
what happens if a hip replacement gets an infection 3 months after THR
hip taken out, no hip for 6 months
77
what material are uncemented cups
plastic
78
why are holes drilled in to the bone
for cement
79
what is the aim of an uncemented stem/ cup in a THR
bony ingrowth
80
in who is an uncemented implant better
younger patients, easier to remove in revision surgery, less bone loss
81
what are cons of cemented and uncemented
uncemented stem risk of spliting bone
can get inflammatory reaction to cement
82
what should you say after examining a joint in an exam
that you would get the contralateral side, for neurological symptoms and the joint above and below
83
what material is a hip replacement
can be metal on metal- resurfacing, risk of ions released when worn down which cause inflammatory response and bone lysis
can be metal on plastic
84
what materials for a knee replacement
always metal and plastic
85
what will a knee replacement help resolve
pain but not stiffness
86
what ELSE can cause a locked knee
torn acl or effusion
87
what is a good way of testing if knee truely locked
heel height
88
what is hanging rope sign seen in
perthes
89
what is the treatment for an adult with DDH
osteotomy of THR
90
what is hip FADIR painful in
hip impingement
91
why is DDH more common in girls
also receptive to relaxin produced my mother during labour
92
what is a condyloid joint
oviod shaped articular surface- allows flexion, extension, adduction, abduction and circumduction
93
what joints in the hand are condyloid
MCP
94
what epicondylitis is golfers/ tennis elbow
tennis lateral
| golf medial
95
how do you tell whether an elbow dislocation is anterior or posterior
proximal bone is always fixed- distal bone goes anterior or posterior
96
what type of collagen is dupuytrens
type 3
97
what is a bennetts fracture
fracture of base of first metacarpal bone with (usually dorsal) subluxation)
98
what is the principle clinical sign of adhesive capsulitis
loss of external rotation
99
does smoking increase risk of dupuytrens
no
100
what mode of delivery of antibiotics for septic arthritis
IV
101
is staph aureus found in the gut
no
102
is clostridium perfinigens in wounds significant
YES ALWAYS SIGNIFICANT
103
what type of haemolysis is partial
alpha (goes green)
104
where is clostridium perfinigens normally and how could it get into a wound
bowels of humans and animals
faecal matter in soil where injury occurred
105
how do you diagnose osteomyelitis
bone biopsy
106
why are tetanus blood tests negative
as bacteria stick locally to injury
107
what toxin causes tetanus
tetanospasmin (exotoxin)- spreads via blood and lymph, binds irreversibly to neurones, prevents inhibitory motor reflex responses
108
what is the treatment for tetanus
IV tetanus immunoglobulins (anti toxin)
IV penicillin
debridement of injury
benzodiazepine to prevent spasms
109
when do you usually get you tenanus vaccination and how many are there
2-4 months
| 5 vaccines
110
what would you worry about if a patients gets bitten by a dog in india
rabies
111
is taking aspirin/ inbruprofen/ NSAIDs significant in NF
yes- suggested association, can also mask initially inflammatory response so presents worse
112
why in NF caused by strep pyogenes is both benzylpenicillin and clindamycin prescribed
benzylpenicillin- targets bacteria itself
clindamycin- targets toxin produced by bacteria
113
what is the incidence of brachial plexis injury during vaginal delivery
0.2%
114
True or false: It is common for surgery for hip fractures to be avoided due to the significant co-morbidities often present in this patient population.
false - Despite the risk of medical complications with surgery, nearly all patients with a hip fracture undergo surgery as the risks of non‐operative management are just as high
115
what deformity in boxers fractures is not well tolerated and needs manipulation and possibly fixation
rotational deformity
116
describe a mallet finger
an avulsion of the extensor tendon from its insertion into the terminal phalanx and is caused by forced flexion of the extended DIPJ
The patient presents with pain, a drooped DIPJ of the affected finger and inability to extend at the DIPJ
117
nerve often injured in Blow to the lateral aspect of the knee (described as a "Bumper injury" when a pedestrian is struck by a car)
common peroneal nerve
118
nerve often injured in Posterior dislocation of the hip
sciatic nerve
119
nerve often injured in Supracondylar fracture of the distal humerus
median nerve
120
Which types of Salter-Harris fractures are intra-articular?
III and IV
121
what does secondary bone healing involve
an inflammatory response with recruitment of pluropotential stem cells which differentiate into different cells during the healing process
122
what GCS score suggest loss of airway control
8 or less
123
define axonotmesis
Nerve injury sustained due to compression or stretch or from a higher degree of force with death of the long nerve cell axons distal to the point of injury die.
124
what is neurotmesis
A complete transection of a nerve requiring surgical repair for any chance of recovery of function
125
what is neurapraxia
A temporary conduction defect from compression or stretch and resolve over time with full recovery
126
what are the two o's or sjorgens
occular and oral
127
how do you remember sjorgens antibodies
anti ro - row in sjorgens get dry symptoms, row to LAnd, la antibodies
128
what condition causes gottrons papules
dermatomyositis
129
do you get neuro symptoms in mechanical backpain
no
130
what type pain in spinal stenosis
burning
131
what type of pain is claudication
cramping
132
what is the classical appearance of aneurysmal bone cyst
lots of chambers
133
what is the 2nd most common malignant bone tumour
chondrosarcoma
134
do osteosarcomas respond to chemo
no but combining chemo and radiotherapy can help improve survival
135
who gets mortons neuromas
women 40-50s
| predisposed by wearing heels
136
what are the symptoms of mortons neuroma
burning and tingling between 3rd and 4th toes
137
what happens in mortons neuroma
fibrosis of the nerve
138
what are the signs of an ACL injury
twisting, high energy, 'pop', swells, painful but initially gets better
139
what are the signs of a meniscal tear
pain along the joint line, locking
140
what lifestyle choices increase chance of AVN in the hip
smoking and drinking
141
what bug probably caused the septic arthritis and osteomyelitis
STAPH AUREUS
142
what bug causes septic arthritis in sickle cell anaemia
salmonella
143
how can you differentiate initially between septic arthritis and osteomyelitis
septic arthritis- (infection of the synovium) hurts to move
osteomyelitis- hurts all the time
144
what line to intracapsular fractures disrupt
shentons line
145
when are IM nails used
if a shaft of a bone is fractured (subtrochanteric)
146
why is there sparing of PIP in RA
not enough synovial fluid
