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Anatomy 1 - MD > FINAL EXAM > Flashcards

FINAL EXAM Flashcards

1
Q

CAUDAL

A

tail end

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2
Q

Coronal / frontal plane

A

anterior / posterior halves

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3
Q

Sagittal plane

A

L + R halves

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4
Q

Axial Plane

A

upper and lower halves

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5
Q

Auricle / Pinna

A

collects sound for localization + directs high freq. sound to eardrum

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6
Q

Ext Auditory Canal

A

increases sound pressure at TM by 5-6 dB

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7
Q

Mastoid Process

A

supports external ear and posterior wall of middle ear

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8
Q

TM

A

vibrates in repsonse to sound
-changes acoustic energy to mechanical energy

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9
Q

Ossicular Chain

A

incus, malleus, stapes
-lever system

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10
Q

Eustachian tube

A

connects middle ear to nasopharynx
-equalizes air pressure
-not part of hearing process

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11
Q

Stapedius Muscle

A

connects stapes to middle ear wall
-contracts in response to loud sounds (Acoustic reflex)

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12
Q

Cochlea

A

converts mechanical energy into acoustic energy

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13
Q

Oval Window

A

sets cochlear fluid into motion by vibration of the footplate of stapes

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14
Q

Round Window

A

pressure relief port for cochlear fluid

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15
Q

Organ of Corti

A

end organ of hearing
-hair cells and stereocilia

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16
Q

Vestibular System

A

controls balance and shares fluid w/ cochlea
-no part in hearing

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17
Q

Hair cells

A

where fibers of auditory/CN 8 are present

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18
Q

Auditory Cortex

A

temporal lobe of the brain where sound is perceieved and analyzed

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19
Q

Parotid gland

A

-function: secretes saliva through Stenson’s duct, facilitates mastication/swallowing [alpha amylase breaks down amylopectin and amylose]
-sympathetic innervation: superior cervical ganglion –> internal carotid artery
-parasympathetic innervation: inferior salivatory nucleus –> auriculotemporal nerve

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20
Q

Tip of the tongue

A

sweet

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21
Q

Anterior/lateral tongue

A

salt

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22
Q

Middle/lateral tongue

A

sour

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23
Q

Posterior Tongue

A

bitter

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24
Q

Cranial nerve supplying Anterior 2/3 Tongue

A

CN 7/ Facial

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25
Q

Cranial nerve supplying Posterior 1/3 Tongue

A

CN 9/Glossopharyngeal

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26
Q

Elevatory nasal muscles

A

-proceris
-levator labii
-superioris alaque nasi

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27
Q

Depressor nasal muscles

A

-alar nasaris
-depressor septi nasi

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28
Q

Compressor nasal muscles

A

transverse consalis

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29
Q

Dilatory nasal muscles

A

posterior and anterior dilator nasaris

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30
Q

External nasal vascular supply

A

-artery = facial
-sellar and dorsal areas = internal maxillary, infraorbital and opthalmic
-veins = same as arteries
-lymphatics = retropharyngeal (posterior) and upper deep cervical/submandibular (anterior)

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31
Q

Internal nasal vascular supply

A

-Kiesselbach plexus = anterior 1/3 septum
-sphenopalatine = posterior inferior
-ethmoid = anterior and posterior superior
-superior labial artery = anterior
-greater palatine = posterior
-veins = same as arteries (direct communication with cavernosus sinus - no valves)

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32
Q

8 Cranial bones

A

-frontal bone
-parietal bone (2)
-temporal bone (2)
-sphenoid
-ethmoid
-occipital

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33
Q

Facial bones (14)

A

-lacrimal (2)
-mandible
-maxilla (2)
-nasal (2)
-palatine (2)
-vomer
-zygomatic (2)
-inferiro nasal conchae (2)

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34
Q

Cranial sutures

A
  1. coronal = parietal + frontal
  2. squamous = parietal + temporal
  3. lamboid = parietal + occipital
  4. occipitomastoid = occipital bone + mastoid process
  5. sagittal = atriculation between 2 parital bones
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35
Q

Motor Spinal Nerves

A

anterior / ventral roots

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36
Q

Sensory Spinal Nerves

A

posterior/dorsal roots

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37
Q

White Matter

A

myelinated axons connecting to grey matter for impulses
-bulk of the brain + superficial spinal cord

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38
Q

Grey Matter

A

unmyelinated neurons that routes sensory/motor input to interneurons of CNS
-major component of CNS
-nerve cell bodies
-glial cells (astroglia + oligodendrocytes)
-capillaries
-axons/dendrites

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39
Q

Motor Tracts

A

-corticospinal tract = voluntary
-extra pyramidal = basal ganglia
-rubro/reticulospinal tracts= smoothing of muscle activity
-upper motor neurons (UMN) = fibers from corticospinal tract that synapse with LMN in anterior horn of spinal cord

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40
Q

UMN vs LMN

A

-UMN
1. no atrphy
2. no fasiculations
3. spasicity
4. DTRS increased
5. contractures
6. EMG normal
-LMN
1. atrophy
2. fasiculations
3. flaccidity
4. DTRS decreased or absent
5. no contractures
6. EMG denervation

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41
Q

Wernicke’s Aphasia (AREA 22)

A

speech preserved with incorrect language content
-rate, intonation and stress are normal
-substitutions of one word for another
-comprehension/repitition are poor

“wacky wernicke”

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42
Q

Broca’s Aphasia (AREA 44 + 45)

A

unable to create gramatically correct + complex sentences
-expressive, motor, nonfluent aphasia
-pts aware of inability to speak
-normal comprehension but some trouble understanding complex sentences

“broken broca”

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43
Q

Limbic System

A

influences the formation of memory by integrating emotional states with stored memories of physical sensations

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44
Q

Telencephalon

A

-limbic
-cerebral cortex
-basal ganglia
-olfactory bulb

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45
Q

Diencephalon

A

between brainstem and cerebrum
-thalamus
-epithalamus
-subthalamus
-hypothalamus

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46
Q

Thalamus

Diencephalon

A

processing center of cerebral cortex
-regulates functional activity if cortex via integration of afferent input to cortex (except olfaction)
-contributes to affectual expression

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47
Q

Epithalamus

Diencephalon

A

conneciton between limbic system to other parts of the brain

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48
Q

Hypothalamus

DIencephalon

A

intergration center of ANS regulating body temperature and endocrine function
-anterior = parasympathetic (maintenance)
-posterior = sympathetic (fight/flight)
-behavioral patterns
-appestate = feeding cneter
-pleasure center

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49
Q

Subthalamus

Diencephalon

A

controls motor functions
-contains subthalamic nuclei + nerve tracts

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50
Q

Basal Ganglia

A

large collections of nuclei that modify movement (min to min basis)
-receives info via motor cortex
-sends to cortex via thalamus
-output = inhibitory (vs cerebellum - excitatory)
-works with cerebellum to balance / coordinate movement

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51
Q

Reticular System

A

-ascending / activating = provides input from all sensory organs to thalamus and cortex is repsonsible for arousal from sleep, wake, attention
-descending = projects to ANS; extrapyrimidal output to voluntary muscles via pontine tegmentum

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52
Q

Medulla

A

controls autonomic function and relays signals between brain and spinal cord
-CN 8 through 12
-Medulla oblongata = RR, BP, HR, reflex arcs, vomiting

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53
Q

Pons

A

relays sensory information between cerebellum and cerebrum
-CN 5, 6, 7
-regulates RR via pneumotaxic center

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54
Q

Archicerebellum

A

maintains equilibrium

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55
Q

Paleocerebellum

A

maintains muscle tone

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56
Q

Neocerebellum

A

controls coordination

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57
Q

Dura Mater

A

-superifical = skull’s inner periosteum
-deep = dura mater proper
-tentorium cerebelli = between/separates cerebellum and brainstem from occipital lobes of cerebrum
-falx cerbi = separates 2 hemispheres of the brain (in longitudinal fissure)

outer meningeal layer

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58
Q

Arachnoid Mater

A

middle meningeal layer
-separated from pia mater by subarachnoid space

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59
Q

Pia Mater

A

delicate, thin, fibrous tissue membrane attached to brain or spinal cord
-outer surface = impermeable to fluid
-pierced by blood vessels traveling to brain and spinal cord
-capillaries nourish brain

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60
Q

Epidural meningeal space

A

if bleeding occurs, it will separate the periosteum from dura

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61
Q

Subdural meningeal space

A

enlarges as the brain atrophies

below dura and above arachnoid

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62
Q

Subarachnoid meningeal space

A

major blood vessels and CSF

between pia and arachnoid

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63
Q

Sympathetic NS

ANS

A

fight or flight
-T1-L3 ateral grey of spinal cord
-noradrenaline
-increases HR, RR, dilate pupils

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64
Q

Parasympathetic NS

ANS

A

basal metabolism
-brainstem and spinal cord
-ACh
-slows HR, RR and constricts pupils

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65
Q

C2 + C3

Dorsal Sensory Roots

A

posterior head and neck

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66
Q

C4 + T2

Dorsal Sensory Roots

A

adjacent to each other in upper thorax

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67
Q

T4 + T5

Dorsal Sensory Roots

A

nipple

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68
Q

T10

Dorsal Sensory Roots

A

umbilicus

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69
Q

Upper extremity

Dorsal Sensory Roots

A

-C5 = anterior shoulder
-C6 = thumb
-C7 = index and middle finger
-C7/8 = ring finger
-C8 = pinky
-T1 = inner forearm
-T2 upper inner arm
-T2/3 = axilla

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70
Q

Lower extremity

Dorsal Sensory Roots

A

-L1 = anterior upper inner thigh
-L2 = anterior upper thigh
-L3 = kneww
-L4 = medial malleolus
-L5 - dorsum of foot + toes 1-3
-S1 = toes 4+5 + lateral malleolus
-S3/C1 = anus

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71
Q

Radial Nerve

Brachial Plexus

A

-posterior cord
-triceps
-extensors
-sensory = dorsum of hand
-saturday night palsy

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72
Q

Median nerve

Brachial Plexus

A

-median and lateral branches of brachial plexus
-anterior interosseus
-palmar cutaneous branch
-all flexors except FCU and FDP
-pronator teres and quadratus

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73
Q

Ulnar Nerve

Brachial Plexus

A

-median branches brachial plexus
-FCU and medial FDP interssei
-adductor policis
-opponens digiti minimi
-abductor digiti minimi
-flexor digiti minimi brevis

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74
Q

Lateral Femoral Cutaneous Nerve

Lumbar Plexus

A

-L2+L3
-pure sensory

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75
Q

Sciatic nerve

Lumbar Plexus

A

-largest of all peripheral nerves
-runs posterior
-divides into peroneal and posterior tibial

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76
Q

Peroneal Nerve

Lumbar Plexus

A

-2 articular branches = accompnay superior and inferior lateral geniculars to knee
-third articular branch = point of division of common peroneal; ascends with recurrent tibial artery through tibials anterior to front of knee
-lateral sural cutaneous nerve = supplies ksin on posterior and lateral surfaces of leg

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77
Q

Tibial Nerve

Lumbar Plexus

A

-motor innervation = muscles of posterior compartment of leg (superficial + deep)
-sensory innervation = posterior aspect of leg and sole of foot
-terminates by bifurcating into medial and lateral plantar nerves in sole of foot

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78
Q

CN 1 - Olfactory

A

-function = smell
-innervation = anterior olfactory nucleus in olfactory tract
-sensory

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79
Q

CN 2 - Optic

A

-function = vision
-innervation = lateral geniculate nucleus in thalamus
-sensory

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80
Q

CN 3 - Oculomotor

A

-function = elevation/adduction of eye
-innervation = oculomotor and edinger nuclei in midbrain
-motor

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81
Q

CN 4 - Trochlear

A

-function = depression of adducted eye (SO4)
-innervation = trochlear in midbrain
-motor

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82
Q

CN 5 - Trigeminal

A

-function = facial sensation / mastication
-innervation = principal in pons, spinal in medulla, mesencephalic in pons/midbrain
-both

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83
Q

CN 6 - ABducens

A

-function: abduction of eye (LR6)
-innervation: abducent in pons
-motor

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84
Q

CN 7 - Facial

A

-function: facial expression, taste, sensation (anterior 2/3 tongue)
-innervation: motor, solitary, superior salivatory in pons
-Both

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85
Q

CN 8 - Vestibulocochlear

A

-function: balance and hearing
-innervation: vestibular and cochlear in medulla
-sensory

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86
Q

CN 9 - Glossopharyngeal

A

-function: taste, salivation, pharynx (posterior 1/3 tongue)
-innervation: nucleus ambiguus, solitary, inferior salivatory in medulla
-Both

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87
Q

CN 10 - Vagus

A

-function: swallow, speech, GI, cardiac, RR
-innervation: nucleus ambiguus, solitary, dorsal motor vagal
-both

88
Q

CN 11 - Accesory spinal

A

-function: pharynx, larynx, SCM, trapezius
-innervation: nucleus ambiguus in medulla + spinal accessory in cervical cord
-motor

89
Q

CN 12 - Hypoglossal

A

-function: tongue movement
-innervation: hypoglossal in medulla
-motor

90
Q

Anterior group muscles of hip

A

-iliopsoas
-tensor fasciae latae

91
Q

Posterior group muscles of hip

A

-gluteus max
-gluteus min
-gluteus medius
-piriformis

92
Q

Anterior group muscles of thigh

A

quadriceps femoris + sartorius

93
Q

Medial group muscles of thigh

A

-pectineus
-adductor longus
-adductor brevis
-gracilis
-adductor magnus

94
Q

Posterior group muscles of thigh

A

-biceps femoris
-semitendinosus
-semimembranosus

95
Q

Quadriceps

A

extension and stability of patella from superiorly
-rectus femoris
-vastus medialis
-vastus intermedius
-vastus lateralis

96
Q

Hamstrings

A

-biceps femoris
-semitendinosus
-semimembranosus

97
Q

Iliotibial band

A

causes hip pain + most common L extremnity injury (esp athletes)

98
Q

Anterior group muscles of the leg

A

-tibialis anterior
-extensor digitorum longus
-extensor hallucis longus

99
Q

Posterior group muslces of the leg

A

-superficial
1. gastrocnemius
2. soleus
-deep
1. tibialis posterior
2. flexor digitorum longus
3. flexor hallucis longus

100
Q

Lateral group muscles of leg

A

-peroneus longus and peroneus brevis

101
Q

Extensor digitorum brevis

Dorsum Foot

A

dorsiflexion of digits
-innervation = deep peroneal nerve (S1-S2)

102
Q

Extensor hallucis brevis

Dorsum Foot

A

dorsiflexion of 1st digit
-innervation: deep peroneal nerve (S1-S2)

103
Q

Plantar Aponeurosis

Sole Foot

A

maintains longitudinal arch of foot and protects nerves/BV

104
Q

Lumbriclas (4)

Sole Foot

A

plantar flexion of 2-5th digits
-innervation: medial plantar nerve (1st digit) + lateral plantar nerve (2-4th digits)

105
Q

Ventricles

A

make and transport CSF

106
Q

Lumbar Plexus

A

anterior + within psoas
-T12-L4
Lately Suzie’s In Heat Inappropriately Ill Gaining Lots of Fun Cuz of Fuckboys
(Lumbar = subcostal, iliohypogastric, ilioinguinal, genitofemoral, Lateral femoral cutaneous, Obturator, Femoral)

107
Q

Obturator Nerve

Lumbar Plexus

A

L2, L3, L4
-sensory: skin medial thigh, hip, knee joints
-motor: adductor muscles

108
Q

Femoral Nerve

Lumbar Plexus

A

L2, L3, L4
-sensory: thigh, leg, foot
-motor: anterior thigh muscles (quads)

109
Q

Lateral Femoral Cutaneous Nerve

Lumbar Plexus

A

L2 + L3
-sensory = skin lateral thigh

110
Q

Genitofemoral nerve

Lumbar Plexus

A

L1 + L2
-sensory: skin scrotum,, labia major, anterior thigh
-motor: cremaster muscle

111
Q

Lumbosacral trunk

A

L4 and L5

112
Q

Subcostal nerve

Lumbar Plexus

A

T12

113
Q

Iliohypogastric nerve

Lumbar Plexus

A

T12 - L1

114
Q

Ilioinguinal nerve

Lumbar PLexus

A

L1

115
Q

Sacral plexus

A

L4-S4
-caudal to lumbar plexus + mostly posterior structures
Some Love Calm Surfing In Peak Flow Think Peace
(sacral = lumbosacral [trunk], common [fibular of sciatic], superior [gluteal], inferior [gluteal], posterior femoral cutaneous, tibial [part of sciaitc], pudendal)

116
Q

Sciatic nerve

Sacral Plexus

A

thickest nerve in the body
-motor: hamstring

L4 - S3

117
Q

Tibial Nerve Branch (sciatic)

Sacral Plexus

A

ventral rami L4-S2
-sensory: posterior leg and sole of foot
-motor: posterior leg and foot

118
Q

Common fibular / peroneal branch (sciatic)

Sacral PLexus

A

dorsal rami L4 - S3
-sensory: anterior/lateral leg + dorsum foot
-motor: lateral tib. anterior and toe extension

119
Q

Superior gluteal nerve

Sacral Plexus

A

L4, L5, S1
-motor: gluteus med/min + tensor fasciae latae

120
Q

Inferior gluteal nerve

Sacral plexus

A

L5, S1, S2
-motor: gluteus maximus

121
Q

Posterior femoral cutaneous nerve

Sacral Plexus

A

S1, S2, S3
-sensory: inferior buttocks, posterior thigh + popliteal fossa

122
Q

Pudendal nerve

Sacral PLexus

A

S2, S3, S4
-sensory: external genitalia and anus
-motor: muscles of perineum

123
Q

Deep veins emptying into IVC

A

-plantar
-tibial
-fibular
-popliteal
-femoral
-ext/common iliac

124
Q

Superficial veins

A

-dorsal venous arch = foot
-great sapphenous = empties into femoral
-lesser sapphenous = empties into popliteal

125
Q

Dorsalis pedis

A

forms when anterior tibial passes under superior extensor retinaculum
-where pulse is felt
-deep branch joins plantar arch
-gives rises to lateral tarsal artery

126
Q

Lateral Plantar artery

A

most of plantar arch
-gives rise to plantar metatarsal and proper plantar digital arteries

127
Q

Loss of dorsalis pedis pulse:

A

-PVD (Burger’s or DM)
-occluded BV (gangrene)
-autoamputation of 1st toe

128
Q

DVT

A

thrombus forms in deep veins of leg/thigh
-600k cases annually
-1/3 form PE (15% death)
-160 / 100k incidence

129
Q

Untreated proximal DVT

A

-30-50% risk for PE
-15% mortality

130
Q

Treated DVT

A

<8% risk for PE
<2% mortality

131
Q

Symptomatic non fatal PE

A

20/100k

132
Q

Fatal PE

A

50/100k

133
Q

Virchow’s Triad

A

factors contributing to thrombosis
-venous stasis
-hypercoagulability
-endothelium damage

134
Q

Principal VTE factors

A

-immoblization
-trauma
-surgery
-infection
-post partum period

135
Q

Other VTE risk factors

A

-incr. 2x when older than 50 y/o
-obesity
-malignancy (20-30%)
-previous VTE (25%)
-varicose veins
-dehydration
-hormonal therapy

136
Q

DVT signs/symptoms

A

-asymptomatic
-pain/tenderness
-erythema
-acute swelling
-pallor (phlegmasia alba)
-cyanosis (phlegmasia cerulea)

137
Q

PE signs/symptoms

A

-dyspnea/tachypnea
-diaphoresis
-hemoptysis
-low grade fever
-pleuritic CP
-cough
-hypotension
-coma
CXR and EKG

138
Q

Venogrpahy for DVT

A

ex gold standard
-20% failure
-contraindication in allergy and decreased renal function

139
Q

Duplex Ultrasound for DVT

A

primary method for diagnosis
-comfortable, inexpensive, no risk
-sensitive for distal DVT
-less sensitive for proximal DVT

140
Q

Superficial veins affectd by DVT

A

greater + lesser sapphenous

141
Q

Deep veins affectd by DVT

A

-iliac
-femoral
-popliteal
-tibial

142
Q

PVD/PAD/PAOD

A

occlusive disease of lower extremity
-common cause = atherosclerosis
-other causes: arteritis, embolism, aneurysm
-arterial narrowing –> decr. blood flow = pain
-decr. supply, incr. demand (fails to satisfy metabolic requirements)
-predictor of coronary/CV risk
-prevalence: 10-25% >55y/o
-4x more likely to die w/in 10 years
-ABPI <0.9

143
Q

Symptomatic PVD survivial rate

A

22%

144
Q

Asymptomatic PVD survival rate

A

78%
(70-80% of pts w PVD)

145
Q

Critical limb ischemia (rest pain)

PVD

A

1-2% of pts w/ PVD
-low ABPI values
-25% mortality
-alive w/ 2 limbs = 50%
-amputation = 25%
-cardiovasc. mortality = 25%
-gangrene/ischemic ulcers

146
Q

Typical PVD Pt

A

-diabetic (3-4x)
-smoker (2.5-3x)
-HTN (>50 + male + fam hx)
-hypercholesterolemia, AF, IHD, CVA, homocysteinuria

147
Q

PVD Risk Factors

A

-age > 70
-age 50-59 w/ hx of DM or smoking
-age 40-49 w/ DM or one other RF
-leg symptoms suggestive of claudication w/ exertion or sichemic pain at rest
-abnormal L ext pulse
-atherosclerosis at other sites ((coronary, carotid, RAD)

148
Q

Intermittent Claudication

PVD

A

reproducible pain on exercise which is relieved by rest/leg elevation
-chronic PVD
-sore legs at night relieved by hanging legs over bed
-10-35% of pts

149
Q

Other signs/symptoms of PVD

A

-burning/aching feet (esp at night)
-cold skin/feet
-increased infections
-non healing ulcers
-asymptomatic

150
Q

Critical Stenosis

PVD

A

impending acute ischemic limb
60% + of pts

151
Q

Abdominal aorta and iliac

PVD

A

30% butt/hip claudication
+/- impotence = Leriche’s syndrome

152
Q

Common femoral

PVD

A

thigh claudication

153
Q

Superficial femoral

PVD

A

60% upper 2/3 calf claudication

154
Q

Popliteal

PVD

A

lower 1/3 calf claudication

155
Q

Posterior Tibial

PVD

A

foot claudication

156
Q

Diagnosis of PVD

A

-invasive (gold standard) = IV DSA ; intervention while imaging w/ iodine based dye
-non invasive = CT/MR angiogram

157
Q

Treatment of PVD

A

-risk factor modification: smoking cessation, decr. BP/BSL/lipids
-exercise: claudication rehab program (45-60 min 3x a week for 12 weeks)
-med management: antiplatelets (aspirin, clopidogrel), phosphdiesterase inhibitor (cilostazol), foot care

158
Q

Percutaneous Coronary Intervention (PCI)

PVD

A

angioplasty+ stent for significant comorbidities whose life expectancy is less than 1-2 years
-poor response to rehab/meds
-disabled by claudication (poor quality of life)
-low risk w/ high success

159
Q

Bypass Surgery

PVD

A

reverse sapphenous vein for femoro-popliteal bypass
-aorto-iliac or femoro-popliteal
-cochrane review = not enough evidence than bypass>PCI

160
Q

Amputation to treat PVD

A

last resort

161
Q

6 P’s of Ischemic Limb

PVD

A

-pain
-pallor
-pulseless
-parasthesia
-perishing cold (poikilothermia)
-paralysis

162
Q

DDx Leg Pain: Vascular

A

DVT or PVD

163
Q

DDx Leg Pain: neurospinal

A

-disc disease
-spinal stenosis (pseudoclaudication)

164
Q

DDx Leg Pain: Neuropathic

A

-DM
-chronic ETOH

165
Q

DDx Leg Pain: musculoskeletal

A

-osteoarthritis
-chronic compartment syndrome

166
Q

Physical exam (PVD)

A

-inspection = thick shiny skin, hair loss/brittle nails, pallor, ulcers
-palpation: cool temp, irregular pulse, slow capillary refill, poor sensation
-auscultation: femoral bruits
-ABPI = systolic ankle BP/sys. brachial BP
-Buerger’s test = elevate leg 45 degrees (observe for pallor), elevate 90 degree dependent position look for red flushed foot
-pallor at 20 degrees = severe PVD

167
Q

Salter Harris Fx 1

A

fx of physis
-hypertrophic zone
-increased width of physis
-undistrubed grwoth
-dx by presentation = point tenderness at epiphyseal plate

(same)

168
Q

Salter Harris Fx 2

A

fx of metaphysis + physis
-epiphysis not involved
-most common
-minimal shortening/rare functional limitations

(above)

169
Q

Salter Harris Fx 3

A

fx of epiphysis + physis
-hypertrophic zone and split down
-damage to reproductive layer
-rarely physical deformity
-good prognosis
-Tillaux FX = SH3 prone to diability

(below)

170
Q

Salter Harris Fx 4

A

fx of epiphysis, physis + metaphysis
-similar to SH3 (intraarticular)
-chronic diability
-premature focal fusion (joint deformity)

(through)

171
Q

Salter Harris Fx 5

A

epiphyseal plate only
-growth disturbances
-poor prognosis
-difficult dx in teens (made after premature closure. ofplate)
-only 2% of SH fx

(crush)

172
Q

Germinal layer of cartilage

A

epiphysis

173
Q

Route of Cartilage growth

A

epiphysis –> metaphysis

174
Q

Route of neovascularization

A

metaphysis –> epiphysis

175
Q

Damage to vascular supply…

A

disrupts bone growth

176
Q

Damage to cartilage…

A

vascular interruption is not permanent

177
Q

SH Fx prone to chronic disability

A

SH 3 + 4

178
Q

Normal femur neck angle

A

125 dgerees

179
Q

Coxa Vara

A

NOF angle <120 degrees

women + short llmbs

180
Q

Coxa Valga

A

NOF angle >135 degrees

181
Q

Trochanteric Anastomosis

A

supplies NOF and head
-superior gluteal
-inferior gluteal
-medial circumflex
-lateral circumflex

“retinacular arteries”

182
Q

Subcapital Fx

(NOF)

A

close to femoral head

common in elderly

183
Q

Cervical Fx

(NOF)

A

midpoint neck

184
Q

Basal Fx

(NOF)

A

close to shaft
-partly intra + extra capsular
-better union than subcapital FX

185
Q

Complete Fx

(NOF)

A

vascular interruption to head of femur
-round ligament isnt strong enough to prevent avascular necrosis

186
Q

Nonunion of NOF Fx due to

A

synovial fluid
-bathes fragments + inhibits osteogenesis

187
Q

Patella stability maintained by:

A

-superiorly: quadriceps
-inferiorly: patellar ligament
-laterally: lateral condyle of femnur
-medially: vastus medialis

188
Q

Patellar dislocation

A

comes out of joint by awkward twist motion
-pulled laterally to remain in line with muscle
-women >men (shallow/wide hips)
-genu valgum (knock kneed)

189
Q

Patella Fx: Direct MOI

A

direct blow/fall/MVA (dashboard)
-small amount of tissue + femur contact drives force to patella
-considerable communition = little displacement

190
Q

Patella Fx: Indirect MOI

A

jumping, rapid flexion against fully contracted quadricep muscles
-less communited
-displaced/transverse

191
Q

Tib Fib Fx

A

-1 bone: little displacement (intact bone acts as splint)
-both bones: distal fragment pulled up by proximal fragment (by gastrocnemius and soleus)
-tibia fx: usually open
-ischemic necrosis w/ delayed union/nonunion = tibial nutreint artery torn in distal 1/3 fx

192
Q

Distal leg Fx

A

common and usually indirect MOI
-Potts
-Dupuytrens

193
Q

Pott’s Fx

Distal leg fx

A

medial + lateral malleolus fx
-ankle rolled in or out beyond ROM
-severe ankle sprain mayb pull bone off with ligament
-forcible ankle eversion
-symptoms = severe ankle pain, unable to bear weight, tenderness at malleoli

194
Q

Dupuytren’s Fx

Distal Leg Fx

A

fx of distal fibula (lateral malleolus) + talus thrust upwards between tibia and fibula
-rupture of tib fib ligamanets
-diastasis of syndesmosis
-lateral dislocation. oftalus
-up and out foot diaplcement

195
Q

Syndesmosis

A

fibrous tissue cord/ligament
-ankle ring= tibial plafond, medial malleolus, deltoid ligaments, syndesmosis, calcaneus, lateral collateral ligaments, lateral malleolus
-fx of single part = usually stable
-fx >1 part = unstable
-no true movement
-ex. distal tib fib joint

196
Q

Syndesmosis Injury

A

tear/strain of anterior tib fib ligament
-high ankle sprain
-football, skiing, basketball
-slow to heal + tender to palpate
-painful external rotation on foot
-MOI: excessive dorsi/plantar flexion
-stress test: kleiger’s
-incorrectly treated at lateral ankle sprain (diff MOI/treatment)
-symptoms: + external rotation test, severe pain, “squeeze” test = pain @ syndesmosis

197
Q

Wevber Classification

A

level of fib fx relative to syndesmosis
-describes lateral malleolus fx + integrity of syndesmosis

198
Q

Weber A

A

below syndesmosis (intact)
-usually stable
-medial malleolus fx
-reduction, cast, ORIF usually needed

199
Q

Weber B

A

level of syndesmosis (intact / partial tear)
-possible medial fx or deltoid damage
-variable stability
-may require oRIF

200
Q

Weber C

A

above syndesmosis (damaged)
-unstable widening of joint
-medial fx or deltoid injury
-ORIF required

201
Q

Foot Fx

A

MTB stress fx
-March fx: distal 1/3 MTB
-applied load >ability to heal
-commonly 2+3rd MTB
-minimal displacement (interosseous muscles act as splint)

202
Q

SCFE

A

posterior + medial displacement of femoral capital epiphysis on NOF
-sudden or gradual defromation of subcapital growth plate
-incidence:
1. 3/100k white
2. 7/100k blacks
3. L>R
4. males: 12-16 y/o
5. females: 10-14 y/o
6. bilateral = 25%

203
Q

Mechanical Etiology SCFE

A

-obesity
-decreased anteversion
-changes. inphyseal plate

204
Q

Inflammatory Etiology SCFE

A

synovial inflammation

205
Q

Hormonal Etiology SCFE

A

-obesity
-hypogonadism
-hypothyroidism
-renal osteodystrophy
-growth hormone therapy

206
Q

SCFE symptoms

A

-limp
-pain (knee, gron, femur)
-decreased internal rotation
-lateral rotation aggravated when hip flexed

207
Q

Hip Fx

A

-high incidence >65 y/o
-320k admissions/year
-15-20% die within 1 year of fx
-F>M
-risk factors:
1. >65 y/o
2. MS/parkinsons
3. osteoporosis
4. hyperthyroid/hypogonadism
5. caffeine, smoking, alcohol
6. low Ca2+ or vitamin D
7. eating disorders
8. steroids, anti convulsants, diuretics

208
Q

Intracapsular Hip Fx

A

risk for nonunion / avascular necrosis (decreased blood supply to femoral head)
-subcapital = most common fx (Xray: increased density at femoral head)
-transcervical
-basicervical

I summon trashy boys

209
Q

Extracapsular Hip FX

A

intertrochanteric + subtrochanteric

EatIng Subway

210
Q

Pauwel’s Classification

A

the more vertical the line of angle increases risk for nonunion (avascular necrosis)
-incr. shear stress across fx

211
Q

Garden 1

Hip FX Classification

A

incomplete fx of NOF

212
Q

Garden 2

Hip FX Classification

A

complete fx w/o displacement

213
Q

Garden 3

Hip FX Classification

A

complete fx w/ partial displacement

214
Q

Garden 4

Hip FX Classification

A

complete fx w/ full dispalcement

215
Q

Achilles Tendon Rupture

A

largest and most powerful tendon in the body formed by gastrocnemoius and soleus
-18/100k
-adults 4050 y/o, M>F, athletic
-snap in heels w/ pain
-25% have previous Achilles inflammation
-seen w/ **steroid/quinolone use, inflammatory arthritis
-diagnosis: weak plantarflexion, gap in tendon, + Thompson test
-Xray** if avulsion suspected
-US/MRI reveals tendon degeneration

Anatomy 1 - MD (6 decks)

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