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C21 Phase 1 > Case 1 - MSK > Flashcards

Case 1 - MSK Flashcards

1
Q

Bones of the gluteal region

A

Ischium
Pubis
Ilium
Sacrum

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2
Q

Muscles of the gluteal region

A 
Gluteus Maximus
Gluteus medius
Gluteus minimus
Tensor Fasciae latae
Piriformus
Obturator internus
Gemelli
Quadratus femoris
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3
Q

Arteries of the gluteal region

A

Inf/Sup gluteal artery

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4
Q

What does the superior gluteal artery supply

A

superficial: Gluteus max.
Deep: Gluteus med, min & tensor fasciae latae

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5
Q

What does the inferior gluteal artery supply

A

Gluteus max, obturator internus, quadratus femoris

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6
Q

What innervates the gluteus maximus

A

inferior gluteus nerve

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7
Q

What innervates the gluteus med, min & tensor fasciae latae

A

superior gluteus nerve

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8
Q

Bones of the thigh

A

Femur

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9
Q

Muscles of the anterior thigh

A 
Pectineus
Sartorius
Psoas major
Iliacus
Quadriceps femoris (rectus femoris, vastus lateralis, vastus medialis, vastus intermediatis)
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10
Q

Muscles of the medial thigh

A 
Adductor longus
Adductor brevis
Adductor magnus
Gracilis
Obturator externus
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11
Q

Muscles of the posterior thigh

A

Semitendinosus
Semimembranosus
Biceps femoris (long & short)

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12
Q

Arteries of the thigh

A

deep femoral artery

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13
Q 
What innervates:
Adductor longus
Adductor brevis
Adductor magnus
Gracilis
Obturator externus
A

Obturator nerve

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14
Q 
What innervates:
Iliacus
Quadriceps femoris (rectus femoris, vastus lateralis, vastus medialis, vastus intermediatis)
Pectineus
Sartorius
A

Femoral nerve

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15
Q

What innervates:
Semitendinosus
Semimembranosus
and the long head of biceps femoris

A

Sciatic nerve

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16
Q

What innervates the short head of biceps femoris

A

Common fibular (sciatic)

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17
Q

Bones of the leg

A

Tibia

Fibula

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18
Q

Muscles of the anterior leg

A

Tibialis anterior
Extensor hallucis longus
Extensor digitorum longus
Fibularis tertius

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19
Q

Muscles of the lateral leg

A

Fibularis longus

Fibularis brevis

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20
Q

Muscles of the posterior leg

A 
Deep: 
Popliteus
Flexor digitorum longus
Flexor hallucis longus
Tibialis posterior
Superficial: 
Soleus
Gastrocnemius
plantaris
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21
Q 
What innervates: 
Popliteus
Flexor digitorum longus
Flexor hallucis longus
Tibialis posterior
Soleus
Gastrocnemius
plantaris
Fibularis longus 
Fibularis brevis
A

Tibial nerve

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22
Q 
What innervates:
Tibialis anterior
Extensor hallucis longus
Extensor digitorum longus
Fibularis tertius
A

Fibular nerve

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23
Q

What artery supplies the superior posterior compartment of the leg

A

Popliteal artery

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24
Q

What artery supplies the anterior compartment of the leg

A

anterior tibial artery

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25
Q

What artery supplies the posterior and lateral compartments of the leg

A

Posterior tibial artery

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26
Q

What artery supplies the posterior compartment of the leg

A

Fibular artery

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27
Q

What are the bones of the foot

A 
Calcaneus
Talus
Navicular
Cuboid
Cuneiforms
Metatarsels
Phelanges
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28
Q

What is the blood supply to the foot

A

dorsalis pedis

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29
Q

What muscles make up the first layer of muscles (most superficial) in the foot

A

Abductor hallucis
Flexor digitorum brevis
Abductor minimi

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30
Q

What muscles make up the second layer of muscles in the foot

A

Quadratus plantae

Lumbricals

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31
Q

What muscles make up the third layer in the foot

A

Flexor hallucis brevis
Adductor hallucis
Flexor digiti minimi brevis

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32
Q

What muscles make up the fourth layer (most deep) in the foot

A

Plantar interossei

Dorsal interossei

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33
Q 
What innervates the:
Abductor hallucis
Flexor digitorum brevis
Flexor hallucis brevis
Lumbricals
A

medial plantar nerve

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34
Q 
What innervates the:
Abductor minimi
Quadratus plantae
Adductor hallucis
Flexor digiti minimi brevis
Plantar interossei
Dorsal interossei
Lumbricals
A

lateral plantar nerve

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35
Q

How can you damage your ACL

A

hyperextending knee joint

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36
Q

How can you damage your PCL

A

force on tibia when knee is flexed

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37
Q

What are the knee’s meniscae made of

A

fibrocartilage

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38
Q

What type of cartilage lines the knee joint

A

hyaline

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39
Q

What are the four knee ligaments called

A

Anterior cruciate
Posterior cruciate
Medial collateral
lateral collateral

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40
Q

Mechanism of action of ibuprofen

A

COX inhibitor which inhibits the production of prostaglandins.

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41
Q

Side effects of ibuprofen

A

Reduced stomach protection
Impaired blood clotting
Potential to causes bronchoconstriction

42
Q

Mechanism of action of codeine

A

Binds to opioid receptors in the brain, increasing patient’s tolerance for pain

43
Q

Mechanism of action of morphine

A

Prevents neurotransmitter release stopping pain being registered

44
Q

5 signs of inflammation

A 
redness
pain
heat
loss of function
swelling
45
Q

Describe von Willebrand disease

A

Clotting disease affecting primary haemostasis. 3 types: type 1-least severe, type 3-most severe

46
Q

Describe haemophilia and each type

A

Clotting impairment caused by decrease presence of clotting factors.
Type A - 8
Type B - 9
Type C - 11

47
Q

What indicates haemophilia

A

increased APPT

All three types act on intrinsic pathway

48
Q

What are the intrinsic blood factors

A

9, 11 and 12

49
Q

What are the extrinsic blood factors

A

7 and tissue factor

50
Q

What are the common blood factors

A

10
2
1

51
Q

What is the main difference between anticoagulants and antiplatelets

A

Anticoagulants work on secondary haemostasis

antiplatelets work on primary

52
Q

What do alpha delta nerve fibres do

A

Detect initial sharp pain

53
Q

What do C nerve fibres do

A

throbbing/burning pain

54
Q

What do alpha beta nerve fibres do in disease

A

detects non-noxious stimuli but in chronic pain, it misfires and detects normal stimuli as painful

55
Q

Scanning methods that are radioactive

A

CT
XRAY
PET

56
Q

Scanning methods that are not radioactive

A

Ultrasound

MRI

57
Q

Types of fractures

A 
Linear
Comminuted
Transverse
Pathological
Greenstick
Spiral
Oblique - displaced
Oblique - non-displaced
58
Q

What neurotransmitter is the most common in excitory neurones

A

glutamate

59
Q

What neurotransmitter is released when high levels of pain is detected

A

substance p

60
Q

What is the spinothalamic tract for

A

pain, temp, simple touch

61
Q

What is the dorsal column for

A

discriminative touch, proprioception, vibration

62
Q

What does naloxone do

A

Counters the activity of opiates, given to people have overdosed on heroin

63
Q

How can a nociceptor be chronically stimulated

A

Substance p builds up in dorsal horn and causes neuronal responsiveness to increase, making light stimulus more painful

64
Q

What is the gate theory of pain

A

Pain signals can be blocked by a neuronal gate before reaching CNS with inhibitory neurones

65
Q

How can pain be controlled by the body

A

Serotonin neurones descend to block a painful stimulus’ access to the CNS

66
Q

What is cutaneous pain

A

Pain originating from the skin

67
Q

What is somatic pain

A

pain within the body (muscle, tendon etc…) usually caused by injury

68
Q

What is visceral pain

A

autonomic sensation from visceral organs (often referred)

69
Q

What is referred pain

A

Pain from organs often perceived to be on the skin, pain is felt away from the site of injury

70
Q

How can pain have a psychological origin

A

Pain can be felt due to stress, particularly in the lower back

71
Q

How can dislocations be observed in the lower limb

A

Internally rotated flexed leg

72
Q

How can fractures be observed in the lower limb

A

Externally rotated leg

73
Q

What increases hip stability

A

acetabular labrum
thick joint capsule
3x strong extraarticular ligaments
1x intraarticular ligaments

74
Q

Types of hip fracture

A

Intracapsular - inside acetabulum

Extracapsular - outside acetabulum

75
Q

3 stages of wound healing

A

Phagocytosis and removal of infection
Angiogenesis, fibroblast proliferation, collagen synthesis
Epithelialisation, remodelling and apoptosis

76
Q

Give an example of where inflammation can occur without infection

A

sunburn

77
Q

Innate immune cells

A 
Macrophages
Mast cells
Eosinophils
Basophils
Complement
Natural killer cells
Neutrophils
78
Q

Adaptive immune cells

A

t cells
t killer cells
help t cells
b cells - antibodies

79
Q

What does TNF alpha do

A

Makes endothelium more leaky
Increases body temp
Mobilises glycogen
Increases compliment activity

80
Q

Name the types of nociceptive pain

A

somatic

visceral

81
Q

Name the types non-nociceptive pain

A

Neuropathic

Sympathetic

82
Q

What are the four phases of nociception

A

Transduction
Transmission
Perception
Modulation

83
Q

Role of the medial thalamic nucleus

A

Evaluates aspect of pain. Activates anterior cingulate cortex which is responsible for the emotional and cognitive response

84
Q

Role of the lateral thalamic nucleus

A

Mediates sensory, discriminative aspects of pain

85
Q

What is it called when scar tissue forms around a foreign body

A

Granuloma

86
Q

Symptoms of compartment syndrome and treatment

A

Symptoms: Severe pain, poor pulse, decreased movement, numbness, pale colour

Treatment: fasciotomy

87
Q

How does osteoarthritis present on an xray

A

sclerosis - whiteness at joints
Osteophytes - bony protrusions
Joint space narrowing - narrow joints

88
Q

How does rheumatoid arthritis present on an xray

A 
Proximal and bilaterally symmetrical
Soft tissue swellings
Osteoporosis - less white on xray
Joint space narrowing
Marginal erosions
89
Q

Stages of natural bone healing

A 
haematoma
Inflammation
Granulation
Callus
Consolidation
Remodelling
90
Q

Types of osteoporosis and their characteristics

A

Primary - age-related, postmenopausal

Secondary - drug related, co morbidities

91
Q

How can you diagnose osteoporosis

A

DEXA scan with a score of less than -2.5

92
Q

Risk factors for osteoporosis

A 
female
over 50
post menopausal
early menopause
no children
93
Q

What is the required DEXA score for osteopaenia

A

-1 - -2.5

94
Q

What does raised ALT suggest

A

hepatocellular damage

95
Q

What does raised AST suggest

A

possible hepatocellular damage

96
Q

What does raised ALP and GGT suggest

A

cholestasis - bile flow impeded

97
Q

What does raised ALP suggest

A

Bone problems eg, primary/secondary bone cancer, multiple fractures, low vit D

98
Q

What does raised GGT mean

A

Possible drugs/alcohol

99
Q

Presentation and possible cause for pre-hepatic damage

A

Raised unconjugated bilirubin, normal urine and stool

Diagnosis - gilberts

100
Q

Presentation and possible cause for hepatic damage

A

Raised conjugated bilirubin, dark urine, normal stools

Hepatocellular injury

101
Q

Presentation and possible cause for post-hepatic damage

A

Raised conjugated bilirubin, dark urine, pale stools

Cholestasis

102
Q

What does low albumin/clotting factors indicate

A

Impaired synthetic function, late presentation liver damage or significant paracetamol overdose

C21 Phase 1 (45 decks)

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