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sf1 nbme > First Aid Chapter > Flashcards

First Aid Chapter Flashcards

1
Q

rotator cuff muscles

A

supraspinatus, infraspinatus, teres minor, subscapularis

SItS

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2
Q

Innervation of supraspinatus

A

suprascapular nerve

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3
Q

Innervation of infraspinatus

A

suprascapular nerve

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4
Q

Innervation of teres minor

A

axillary nerve

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5
Q

Innervation of subscapularis

A

upper and lower subscapular

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6
Q

Rotator cuff muscle responsible for abduction

A

supraspinatus

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7
Q

Rotator cuff muscle responsible for external rotation of arm

A

infraspinatus

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8
Q

Rotator cuff muscle responsible for both adducting and externally rotating the arm

A

teres minor

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9
Q

Rotator cuff muscles responsible for both internal rotation and adduction of the arm

A

subscapularis

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10
Q

Arm abduction muscles, in order of activation / ROM

A

supraspinatus -> deltoid -> trapezius -> serratus anterior

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11
Q

Exceptions to all motor innervation to the hand being ulnar nerve

A

Thenar muscles and lateral two lumbricals are median nerve

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12
Q

Roots the Axillary Nerve derives from

A

C5-C6 (this is the only unintuitive one)

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13
Q

Proximal to Distal Fractures of the Humerus: surgical neck, mid-shaft, and supracondylar. What are the affected nerves?

A

Surgical neck - axillary
Midshaft - radial
Supracondylar - median

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14
Q

Causes of injury to Axillary Nerve

A

1) fractured surgical neck of humerus

2) anterior dislocation of humerus

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15
Q

Causes of injury to Median Nerve

A

1) supracondylar fracture of humerus

2) carpal tunnel syndrome and wrist laceration

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16
Q

Causes of injury to Ulnar Nerve

A

1) fracture of medial epicondyle of humerus

2) fractured hook of hamate from FOOSH

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17
Q

Causes of injury to Recurrent branch of median nerve

A

1) superficial laceration of palm

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18
Q

Traction/tear of upper trunk

A

Erb Palsy

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19
Q

Traction/tear of lower trunk

A

Klumpke Palsy

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20
Q

Compression of lower trunk and subclavian vessels

A

Thoracic outlet syndrome

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21
Q

Lesion of long thoracic nerve

A

Winged scapula

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22
Q

Muscle deficits of Erb Palsy

A

Deltoid (+supraspinatus), infraspinatus, and biceps brachii

“hERB gets DIBs on TIPs” (waiter’s tip)

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23
Q

Muscle deficits of Klumpke palsy and thoracic outlet syndrome

A

Intrinsic hand muscles: lumbricals, interossei, thenar, and hypothenar

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24
Q

Lesion causing ulnar claw

A

distal ulnar nerve

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25
Q

Lesion causing Pope’s Blessing

A

proximal median nerve

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26
Q

Lesion causing median claw

A

distal median nerve

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27
Q

Lesion causing ok gesture

A

proximal ulnar nerve

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28
Q

Leads to atrophy of the thenar eminence

A

median nerve lesion

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29
Q

Leads to atrophy of the hypothenar eminence

A

ulnar nerve lesion

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30
Q

Test for MCL injury

A

Knee extended or at 30 degrees. Abduction force. Medial space widens

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31
Q

Test for LCL injury

A

Knee extended or at 30 degrees. Adduction force. Lateral space widens

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32
Q

McMurray Test

A

During flexion and extension of knee with rotation of tibia/foot….

Pain/popping on internal rotation indicates a lateral meniscal tear. Pain/popping on external rotation indicates a medial meniscal tear.

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33
Q

Most common high ankle sprain

A

anterior inferior tibiofibular ligament

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34
Q

Most common (low) ankle sprain

A

anterior talofibular ligament (or also calcaneofibular ligament)

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35
Q

Clinical findings: L3-L4 herniation

A

weakness of knee extension; decr. patellar reflex

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36
Q

Clinical findings: L4-L5 herniation

A

weakness of dorsiflexion; difficulty in heel walking

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37
Q

Clinical findings: L5-S1 herniation

A

weakness of plantarflexion; difficulty in toe walking; decr. achilles reflex

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38
Q

Neurovascular pairing with long thoracic nerve in axilla/lateral thorax

A

lateral thoracic artery

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39
Q

Neurovascular pairing with axillary nerve in surgical neck of humerus

A

posterior circumflex artery

40
Q

Neurovascular pairing with radial nerve in midshaft of humerus

A

deep brachial artery

41
Q

Neurovascular pairing with median nerve in distal humerus/cubital fossa

A

brachial artery

42
Q

Neurovascular pairing with popliteal artery in popliteal fossa

A

tibial nerve

43
Q

Neurovascular pairing with tibial nerve in posterior to medial malleolus

A

posterior tibial artery

44
Q

In the sarcomere, which band does not contract

A

A band

[A band is Always the same length]

45
Q

Which bands shorten when the sarcomere contracts?

A

H and I bands between Z lines

[HIZ shrinkage]

46
Q

Sensory axons associated with muscle spindles

A

Type Ia and II

47
Q

Sensory axons associated with golgi tendon organs

A

Type Ib

48
Q

Cartilagenous model of bone is first made by chondrocytes. Osteoclasts and osteoblasts later replace with woven bone and then remodel to lamellar bone. In adults, woven bone always pathologic.

A

Endochondral ossification (bones of axial skeleton, appendicular skeleton, and base of skull)

49
Q

WOven bone formed directly without cartilage. Later remodeled to lamellar bone.

A

Membranous ossification (bones of calvarium, facial bones, and clavicle)

50
Q

Effects of parathyroid hormone on bones

A

Low/Intermittent levels: anabolic effects on osteoblasts and osteoclasts.

Chronically high levels: cause catabolic effect (osteitis fibrosa cystica)

51
Q

Defective in achondroplasia

A

endochondral ossification

52
Q

Effects of estrogen on bones

A

inhibits apoptosis in bone-forming osteoblasts and induces apoptosis in bone-resorbing osteoclasts. Causes closure of epiphyseal plate during puberty.

53
Q

Metacarpal neck fracture or boxer’s fracture

A

Common fracture caused by direct blow with a closed fist. Most commonly seen in 4th and 5th metacarpals

54
Q

Contents of carpal tunnel

A

1) median nerve
2) flexor pollicis longus (tendon)
3) flexor digitorum superficialis (tendons)
4) flexor digitorum profundus (tendons)

55
Q

Tests for carpal tunnel

A

1) positive Tinel Sign (percussion of wrist/nerve causes tingling)
2) Phalen Manuever (90 deg flexion of wrist causes tingling)

56
Q

Guyon Canal Syndrome

A

Compression of ulnar nerve at wrist.

57
Q

Baker Cyst (popliteal fluid collection in gastrocnemius-semimembranosus bursa) is related to what conditions?

A

chronic joint disease

58
Q

Iliotibial band syndrome

A

overuse injury of lateral knee that occurs primarily in runners. Pain develops secondary to friction of iliotibial band against lateral femoral epicondyle

59
Q

Increased pressure within a fascial compartment of a limb. Venous outflow obstruction and arteriolar collapse. Anoxia and necrosis. Causes include significant long bone fractures, reperfusion injury, animal venoms. Presents with severe pain and tense, swollen compartments with limb flexion. Motor deficits are late sign of irreversible muscle and nerve damage.

A

Limb compartment syndrome

60
Q

Common cause of shin pain and diffuse tenderness in runners and military recruits. Caused by bone resorption that outpaces bone formation in tibial cortex.

A

Medial Tibial Stress Syndrome (Shin Splints)

61
Q

Plantar fasciitis

A

inflammation of plantar aponeurosis characterized by heel pain and tenderness

62
Q

Overuse injury caused by repetitive strain and chronic avulsion of the secondary ossification center of proximal tibial tubercle. Occurs in adolescents after growth spurt. Common in running and jumping athletes. Presents with progressive anterior knee pain.

A

Osgood-Schlatter Disease (traction apophysitis)

63
Q

Patellofemoral syndrome

A

Overuse injury that commonly presents in young, female athletes as anterior knee pain. Exacerbated by prolonged sitting or weight-bearing on a flexed knee. Treatment: NSAIDs, thigh muscle strengthening

64
Q

Radial Head Subluxation (aka Nursemaid’s elbow)

A

Common elbow injury in children <5 years. Caused by a sudden pull on the arm -> immature annular ligament slips over head of radius. Injured arm held in extended/slightly flexed and pronated position.

65
Q

Achondroplasia

A

Failure of longitudinal bone growth (endochondral ossification) -> short limbs. Membranous ossification not affected (large head).

66
Q

Osteoporosis

A

Spongy and compact bone lose mass and interconnections despite normal bone mineralization and lab values. Most commonly due to increase bone resorption due to decreased estrogen levels and old age. Can be secondary to drug usage or other conditions.

67
Q

Potential complication of osteoporosis. Acute back pain, loss of height, kyphosis. Also can present with fractures of femoral neck, distal radius (Colles fracture)

A

vertebral compression fractures

68
Q

Osteopetrosis

A

Failure of normal bone resorption due to defective osteoclasts. Thickened, dense bones prone to fracture. Mutations impair ability of osteoclast to generate acidic environment necessary for bone resorption. Overgrowth of cortical bone fills marrow space. Narrowed foramina can lead to cranial nerve impingement and palsies.

69
Q

Osteomalacia/Rickets

A

Defective mineralization of osteoid or cartilaginous growth plates. Most commonly due to vitamin D deficiency.

70
Q

Osteitis deformans (Paget disease of bone)

A

Common, localized disorder of bone remodeling caused by increased osteoclastic activity followed by increased osteoblastic activity that forms poor-quality bone.

71
Q

[Humerus] Bicipital groove for the tendon of the long head of biceps brachii

A

intertubercular sulcus

72
Q

[Humerus] passage for radial nerve and deep brachial artery

A

radial groove

73
Q

[Humerus] attachment site for rotator cuff muscles

A

greater and lesser tubercles

74
Q

[Humerus] common site for fractures that involve damage to axillary nerve

A

surgical neck

75
Q

[Radius] common dislocation from annular ligament in children (housemaid’s elbow)

A

head of radius

76
Q

Commonly fractured wrist bone that presents with ischemia due to retrograde flow of blood

A

scaphoid

77
Q

Fracture of this bone/bone feature is associated with ulnar nerve damage (guyon canal syndrome)

A

hook of hamate

78
Q

Covered by suprascapular ligament; suprascapular artery travels above, suprascapular nerve travels below

A

Suprascapular notch (scapula)

79
Q

Projection of scapula over glenohumeral joint and articulates with clavicle

A

Acromion (scapula)

80
Q

Nerve Roots of Reflex – biceps/brachioradialis

A

C5-C6

81
Q

Nerve Roots of Reflex – triceps

A

C7-C8

82
Q

Nerve Roots of Reflex – patellar

A

L3-L4

83
Q

Nerve Roots of Reflex – achilles

A

S1-S2

84
Q

Nerve Roots of Reflex – cremasteric

A

L1-L2

85
Q

Nerve Roots of Reflex – anal wink

A

S3-S4

86
Q

Six P’s of Compartment Syndrome

A

1) pain
2) pulselessness
3) paresthesia
4) paralysis
5) pallor
6) paikilothermia (can’t regulate temp)

87
Q

Fracture of the distal end of the radius and ulna styloid. Distal fragment of radius often displaced posteriorly from shaft of radius, resulting in a dinner-fork deformity

A

Colle’s Facture

88
Q

Fracture of the ulna and an anterior dislocation of the radial head at the elbow. Physical exam commonly reveals radial head displacement into the cubital fossa

A

Monteggia Fracture-Dislocation

89
Q

Fracture of the distal third of the radius with dislocation of distal radioulnar joint and intact ulna

A

Galeazzi Fracture-Dislocation

90
Q

Principle inhibitory neurotransmitter in the spinal cord

A

glycine

91
Q

principle excitatory neurotransmitter in the central nervous system

A

glutamate

92
Q

principle inhibitory neurotransmitter in the brain

A

GABA

93
Q

Location of adult lumbar punctures

A

L3-L4 or L4-L5

94
Q

Location of child lumbar punctures

A

L4-L5 only

95
Q

Developmental region giving rise to the PNS

A

neural crest

96
Q

Trochanteric bursitis

A

inflammation of the gluteal tendon and bursa lateral to greater trochanter of femur

97
Q

defective bone development that is usually attributable to renal disease or disturbances in calcium and phosphorus metabolism

A

osteodystrophy

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