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MSK Exam 1 > Lecture Clinical Notes > Flashcards

Lecture Clinical Notes Flashcards

1
Q

A blow to the top of the head from a falling object or diving accident can fracture both arches of Atlas known as what?

What else could happen that may cause damage to the spinal cord?

A

Jefferson/Burst Fracture

Transverse L. ruptures and Odontoid Process may injure SC

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2
Q

Fracture of the vertebral arch of C2 (Axis) usually occurs how and what is it called?

Fracture of the Odontoid Process can occur how? In what situations will it heal and not heal?

A

Hangman’s Fracture/Traumatic Spondylolisthesis of Axis usually occurs as result of Hyperextension of Head on the Neck (Not whiplash)

Horizontal blow to the head, Transverse L. stronger than Odontoid Process and breaks.

Broken at Base, usually won’t heal (Transverse L. holding it away from blood supply)

Broken inferior to base more likely to heal

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3
Q

What is Spina Bifida Occulta?

What level does it commonly occur?

If it includes neural tissue and Meninges what is it referred to as?

A

Developmental Abnormality in which the Vertebral Lamina fail to fuse and close off the vertebral canal

L5-S1

Spina Bifida Cystica

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4
Q

Why do cervical vertebrae require less force to dislocate?

Why is there usually no damage to SC?

A

Articulating Facets of Cervical Vertebrae are more horizontal than other vertebrae

They have large vertebral foramina

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5
Q

Where does the Head of each Rib and the Tubercle articulate with Thoracic Vertebrae?

A

Superior Articular Facet articulates with Inferior Costal Demifacet of the Thoracic Vertebral Body one numeric segment superiorly

Inferior Articular Facet articulates with Superior Costal Demifacet of the Thoracic Vertebral Body of the same numeric segment

Articular Facet of Tubercle articulates with Transverse Costal Facets

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6
Q

What is spondylosis? Spondylolysis? Spondylolisthesis?

A

Degenerative joint disease involving calcification of the edges of vertebral body

Separation of Vertebral Arch from Vertebral Body

Anterior displacement of the Vertebral Body on the Inferior Vertebral Segment

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7
Q

What is Lumbar Spinal Stenosis and what can it cause?

A

Narrowing of the Lumbar Vertebral Foramen causing copression of 1+ spinal nerve roots

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8
Q

Lumbar Puncture

What level is it performed at?

Why that level?

What does the needle pass through?

A

Between L3/L4 or L4/5 Vertebrae

Avoids needle injuring spinal cord

Needle passes through ligamentum flavum and into lumbar cistern deep to Dura and Arachnoid –> CSF Collected

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9
Q

What are Sacralization & Lumbarization?

A

Partial/Complete incorporation of L5 vertebral segment into the sacrum

Separation of the S1 vertebra from the Sacrum

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10
Q

Abrupt falls on lower back and difficult child birth can result in bruising, dislocation, or fracture of what?

What condition can follow this trauma?

A

Coccyx

Coccygodynia

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11
Q

What are the primary curvatures?

What are the secondary curvatures?

A

Thoracic and Sacral Kyphoses

Cervical and Lumbar Lordoses

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12
Q

Kyphosis refers to what?

Lordosis refers to what?

Scoliosis refers to what?

A

Exaggerated curving of Thoracic Vertebral Column –> Humpback

Exaggerated curving of Lumbar Vertebral Column –> Sway-back

Lateral curving of the spine

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13
Q

Hyperextenion / Whiplash Injury

Which ligament is injured?

A

Excessive stretching/tearing of Anterior Longitudinal L.

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14
Q

Disc Herniation

Where does it typically occur?

What does this cause?

What levels are most common?

A

Posterolaterally where Annulus Fibrosis receives no support from Anterior/Posterior Longitudinal Ls.

Bulge and Compress Spinal Nerve Roots, Cauda Equina, and Spinal Nerves in Vertebral Canal & Intervertebral Foramina (respectively)

L4-5 & L5-S1 (Discs larger and more mobile)

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15
Q

Second Number Rule

What is the rule and what regions does this occur?

A

The vertebral level at which the prolapse occurs will affect the spinal nerve with the second number designation

Cervical and Lumbar

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16
Q

Importance of Anterior Longitudinal L. in Fractures of Vertebral Column

A

Patient should be kept in Hyperextension at all times after fracture of vertebral column

Pull of Anterior Longitudinal L. will help realign bone and prevent further injury to spinal cord.

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17
Q

Cervical Intervertbral Joint between Uncinate Process of the inferior Vertebra and inferior surface of superior Vertebra is described as what?

A

Uncovertebral Joint (of Luschka)

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18
Q

Six Layers Model

What are the superficial 3 layers and deep 3 layers?

Innervated by what?

A

Superficial 3 layers are Extrinsic (innervated by branch of anterior ramus or CN)

Deep 3 layers are Intrinsic (innervated by Posterior Rami)

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19
Q

What injury involves damage to ligamentous attachments between bone?

What injury involves excessive stretching and sometimes tearing of muscle fibers by an overly strong muscular contraction?

A

Muscle Sprain

Muscle Strain

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20
Q

Spinal Cord Injuries

C1-C3

C4-C5

C6-C8

T1-T9

T10-L1

L2-L3

A

No function below head; Respirator necessary for life

No function of limbs; Respiration capable

Loss of hand and variable upper limb function

Paralysis of both lower limbs

Some thigh muscle function; may allow walking with long leg braces

Most lower limb functions present; may be able to walk with short leg braces

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21
Q

Back Pain - Name the Nerve Responsible

Fibroskeletal Structures (Periosteum/Ligaments/Annuli Fibrosi IV Discs) & Meninges

Synovial Joints; Intrinsic Back Muscles; & Spinal Nerves/Nerve Roots

Most common types of pain of these 5?

Muscular Pain result of what?

Joint Pain result of what?

Fibroskeletal Pain result of what?

A

Recurrent Meningeal N.

Posterior Rami

Muscular, Joint, Fibroskeletal Pain

Spasm in Muscular Tissue producing Ischemia

Osteoarthritis or Disease Arthritis

Fractures and Dislocation of Ligamentous Structures

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22
Q

Clavicle is one of the most fractured bones due to direct/indirect injuries received by falling.

Fractures in younger children often incomplete and referred to as what?

A

“Greenstick” fracture

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23
Q

Humerus Fracture

What is the most common fracture site on humerus?

What else can sustain an avulsion fracture by the Infrapsinatus, Teres Minor, & Supraspinatus that inserts at the site?

A

Surgical neck

Greater Tubercle

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24
Q

Compression of what nerve in the elbow relates to the common expression, “funny bone”?

What is the name of the groove?

A

Ulnar Nerve

Groove for the Ulnar N.

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25
Q

Severe abduction of the extended elbow can cause what?

A

Avulsion fracture of the Medial Humeral Epicondyle

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26
Q

What fracture is common in cases of falling? And due to the forceful nature of the Triceps Brachii M. this is considered what type of fracture that is difficult to repair?

A

Fracture of Olecranon / Fractured Elbow

Avulsion Fracture

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27
Q

What is the name for a fracture of the distal end of the Radius that commonly occurs when breaking a fall?

What else is avulsed?

A

Colle’s Fracture

Styloid Process of the Ulna

28
Q

Which carpal bone is most commonly fractured?

Often the fracture is not visible on radiograph and misdiagnosed as severe pain, the distal fragment of this bone is susceptible to what?

A

Scaphoid

Avascular necrosis (usually separated from blood supply)

29
Q

The passage anterior to carpal bones, posterior to flexor retinaculum is known as what?

What is transmitted through the passage?

If swelling of tendons occurs, what can be compressed?

A

Carpal Tunnel

Tendons of Flexor Digitorum Profundus & Superficialias Ms., Flexor Carpi Radialis T, and Median N.

Median N. resulting in Carpal Tunnel Syndrome which produces paresthesia, anesthesia, and pain

30
Q

The depression between the Pisiform and Hamulus of the Hamate is known as what?

What passes through it?

A

Ulnar Canal (Guyon Tunnel)

Ulnar N.

31
Q

What is a Boxer’s Fracture?

A

Fracture of the head of the 5th metacarpal when punching with a closed fist

32
Q

Closing car door on hand commonly occurs in what?

A

Fractures of distal phalanges

33
Q

This injury occurs with repeated throwing of a ball, usually in response to sudden contraction of the Biceps Brachii M.

Where in the area does it occur?

A

Glenoid Labrum Tear

Anterosuperior Aspect

34
Q

Which joint is injured in a “Shoulder Separation”?

This joint is capable of being separated with or without rupture of what Ligament?

A

Acromioclavicular Joint

Coracoclavicular L.

35
Q

Glenohumeral Joint Dislocation

Presence of what structure prevents superior dislocation?

Which directions do most dislocations occur?

A

Coracoacromial Arch

Anteriorly or Inferiorly

36
Q

The elbow can be dislocated posteriorly in response to force transmitted along the long axis of the forearm. What ligament would be damaged?

A

Ulnar Collateral Ligament of the Elbow

37
Q

What is the name for “Student’s Elbow”, “Dart Thrower’s Elbow”, or “Miner’s Elbow” and what does it result from?

What are two of the more common Bursae to become inflamed?

A

Subcutaneous Olecranon Bursitis caused by Excessive friction between skin and the Olecranon

Subcutaneous Olecranon Bursae & Bicipitoradial Bursae

38
Q

What injury is described as Nursemaid’s Elbow or Pulled Elbow?

A

Dislocation of the radial head from the annular ligament

39
Q

What is injured with “Bull Rider’s Thumb”?

A

Sprain of Lateral Collateral L. of the 1st MCP Joint of the and even avulsion of the lateral part of the Proximal Phalanx of the Thumb

40
Q

What is Skier’s Thumb / Game-Keeper’s Thumb?

A

Laxity or rupture of both collateral ligaments of the 1st MCP joint resulting in hyperabduction

41
Q

What is Mallet Finger / Baseball Finger?

A

Sudden hyperflexion of the DIP joint avulsing the attachment of the long extensor tendon with that tendon away from the Distal Phalanx

42
Q

Irritation of Synovial Sheaths can cause accumulation of mucopolysaccharide fluid that can form a usually painless lump known as what?

A

Synovial/Ganglion Cyst

43
Q

Disease resulting in shortening, thickening, and fibrosis of the Palmar Aponeurosis and Palmar Fascia, that results in partial flexion of the 4th and 5th digits

A

Dupuytren Contracture

44
Q

What is Winging of the Scapula caused by?

Which motion is difficult to do?

A

Paralysis of the Serratus Anterior M. (usually result of injury to Long Thoracic N.)

Abducting upper limb beyond horizontal position

45
Q

Which muscles make up the Rotator Cuff and stablize the Glenohumeral Joint?

Which is the most commonly injured?

A

Supraspinatus, Infraspinatus, Subscapularis, Teres Minor

Supraspinatus

46
Q

What make up the borders of the Triangular Space (Superior)? What contents are inside?

What makes up the borders of the Quadrangular Space? What contents are inside?

What makes up the borders of the Triangular Interval (Inferior)? What contents are inside?

A
  • Triangular Space
    • Teres Minor M., Teres Major M., Long Head of Triceps Brachii M.
    • Circumflex Scapular A. and V.
  • Quadrangular Space
    • Teres Minor M., Teres Major M., Long & Lateral Heads of Triceps Brachii M.
    • Posterior Humeral Circumflex A./V. & Axillary N.
  • Triangular Interval
    • Teres Major M. and Long & Lateral Heads of Triceps Brachii M.
    • Deep Brachial A./V. & Radial N.
47
Q

Striking the thumb over the Bicipital Tendon with reflex hammer should produce what?

Failure of the tendon to tighten up and the forearm to flex slightly could suggest injury to what nerve / rami?

A

Bicipital Myotactic Reflex

Musculocutaneous N. / C5 & C6 Anterior Rami

48
Q

Repetitive movement of Long Head of Biceps T. through Intertubercular Groove makes the Tendon susceptible to inflammation known as what?

The Tendon is capable of dislocating out of the groove or even separating entirely from Supraglenoid tubercle resulting in the muscle balling up in the mid arm, this a condition known as what?

A

Biceps Tendinitis

Popeye Deformity

49
Q

Repetitive use of Superficial Extensor muscles of Forearm can results in what condition that causes pain over Lateral Epicondyle and down the posterior Forearm?

Repeated flexion/extension of Wrist strains what of the Lateral Humeral Epicondyle which is called what?

A

Elbow Tendinitis / Tennis Elbow

Periostium of Lateral Humeral Epicondyle

Lateral Epicondylitis

50
Q

What makes up the Lateral/Anterior and Medial/Posterior Borders of the Anatomical Snuffbox?

What are the contents inside?

A

Lateral (Anterior) Border: Abductor Pollicis Longus M. & Extensor Pollicis Brevis M.

Medial (Posterior) Border: Extensor Pollicis Longus M.

Radial A. and Superficial Radial N.

51
Q

What action of the thumb can be lost with injury to Median N.?

Superficial injury of the palm can damage what branch involved with this action?

A

Opposition

Recurrent Branch of Medial N.

52
Q

What are the Functional Positions of the Hand?

A

Power Grip (Palm Grasp)

Hook Grip

Precision Handling Grip

Pinching

Position of Rest

53
Q

Which region of the Axillary A. is susceptible to aneurysm in individuals experiencing repeated rapid arm movements?

What can this result in?

A

Region One

Compression of Brachial Plexus resulting in pain and loss of sensation

54
Q

Where does the Axillary need to be ligated to cut off all blood supply to the arm?

A

Distal to the Subscapular A.

55
Q

What is the most common site of venipuncture? Why?

A

Median Cubital Vein

Superficial location and protection of underlying deep structures by Bicipital Aponeurosis

56
Q

Why are axillary lymph nodes important?

A

Imortant due to frequent invasion by cancer cells from elsewhere in the body (normally breast tissue)

57
Q

Injury to superior part of Brachial Plexus (Upper Plexus Injuries) typically affect which Rami and are result of what?

What will be the result of this injury?

What is the name for this appearance/condition?

A

C5 & C6 Anterior Rami (Rupture/Avulse Spinal Roots off of SC)

Dramatically increasing the angle between the neck and shoulder

Adducted & Medially Rotated Arm and Extended Elbow

Erb-Duchenne Palsy / Waiter’s Tip Position

58
Q

Injury to the inferior part of the Brachial Plexus (Lower Plexus Injury) is usually result of what?

What is typically affected and what condition occurs?

A

Dramatically increasing the angle between the trunk and upper limb

Short muscle of Hand

Results in “Claw Hand” when trying to make a fist (Klumpke Paralysis)

59
Q

Prolonged periods of working with upper limb extended over the Head can cause what?

What are the associated symptoms?

A

Compression of the Cords of the Brachial Plexus

Pain radiating down the arm, loss of sensation, tingling of arms and hand weakness

60
Q

Injury to the Musculocutaneous N. is possible (but rare) with blunt force trauma and causes what to happen?

A

Anterior Brachial muscles paralyzed

61
Q

What results after injury to Axillary N.?

A

Atrophy of Deltoid M. and loss of sensation over superolateral arm (Superior Lateral Brachial Cutaneous N.)

62
Q

What happens when there is injury to the Median N. at the Wrist?

What happens when there is injury to the Median N. at the Elbow?

A

Adducted Thumb and Thenar Eminence Atrophy (Ape’s Hand)

Inhibits flexion of 2nd and 3rd Digits (Hand of Benediction) + Symptoms of Ape’s Hand

63
Q

What four places does Injury to Ulnar Nerve usually take place?

What are the overall results?

A

Posterior to Medial Humeral Epicondyle

Between Ulnar and Humeral Heads of Flexor Carpi Ulnaris (Cubital Tunnel)

Wrist

Hand

Extensive loss of sensory and motor control in hand, Claw Hand when trying to make a fist

64
Q

Ulnar nerve can be compressed when pressure is placed on Hamulus of Hamate B, what is this referred to as?

What does it produce?

A

Handlebar Neuropathy

Sensory loss on medial side of hand and weakness of intrinsic hand muscles

65
Q

What does Injury of the Radial N. result in?

A

“Wrist Drop”, impairment of elbow extension and thumb abduction/extension

MSK Exam 1 (16 decks)

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