Loco Flashcards

1
Q

Large range of movement at shoulder

A
Large humeral head - 4:1 ratio 
Support from glenoid labrum 
Physiological scapulothoracic joint 
Large joint cavity 
Rotator cuff stabilise
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2
Q

Shoulder ligaments

A

Superior, middle and inferior glenohumeral
Coracohumeral
Coracoacromial

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3
Q

Which rotator cuff muscle attaches to the lesser tubercle?

A

Subscapularis

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4
Q

SLAP tears

A

Type 1 = partially tear
Type 2 = completely detached glenoid labrum
Type 3 = labrum hanging into joint cavity
Type 4 = labrum hanging into joint cavity and affecting biceps tendon

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5
Q

Basilic vs cephalic vein

A
Basilic = drains medial
Cephalic = drains lateral
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6
Q

Risk factors for DVT

A
Old age 
Sedentary periods 
Major surgery 
Trauma 
Contraceptive pill
Pregnancy
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7
Q

Symptoms of DVT

A
Tenderness
Pain 
Swelling 
Eryhthema 
Oedema
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8
Q

Diclofenac

A

Inhibitor of COX2

Prevents formation of prostagladins, leukotrienes

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9
Q

Enoxaparin sodium

A

Low molecular weight heparin
Binds to antithrombin
Inactivates factor Xa

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10
Q

Warfarin

A

Vitamin K antagonist

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11
Q

Rachitic rosary chest

A

Prominent knobs of bone at the costochondral joints

Due to lack of mineralisation due to vitamin D or calcium deficiency

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12
Q

Harrison’s sulcus

A

Horizontal groove along where the diaphragm inserts into the ribs showing bone weakness

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13
Q

Rickets symptoms

A
Bone tenderness
Increased frequency of fractures
Muscle weakness
Bowed legs 
Skeletal malformations
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14
Q

Rickets treatment

A

Calcium, phsophate and vitamin D supplements
Increased sunlight exposure
Vitamin D fortified milk for infants

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15
Q

Zones of cartilage growth

A
Resting 
Proliferating 
Hypertrophy and maturation 
Degeneration and calcification 
Osteogenesis
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16
Q

Vitamin D pathway

A

ProD3 found in skin
Converted to D3 by UVB light
Vitamin D3 –> 25(OH)vitD in the liver
25(OH)vitD –> 1,25(OH)2vitD in the kidney

17
Q

Action of 1,25(OH)2 vitamin D

A

Binds to nuclear receptor and acts as transcription factor tp promote many processes
Increases calcium and phosphate reabsorption in the gut
Increases calcium mobilisation from the bones
Increased calcium reabsorption from the kindeys

18
Q

How is bone resorption stimulated?

A

PTH and vitamin D stimulate RANKL expression in osteoblasts

Activates osteoclasts and causes them to mature

19
Q

What hormone is released when calcium plasma levels are low?

A

PTH

20
Q

What does PTH cause?

A

Kidney calcium reabsorption and phosphate excretion
Increased calcium release from bones by activating RANKL
Conversion of 25(OH)vitD –> 1,25(OH)2vitD to stimulate increased calcium reabsorption from the gut

21
Q

Process of bone resorption

A

Osteoclast attaches to bone
Secretes proteolytic enzymes and HCl
Bone products exit in interstitial fluid
Osteoblasts secrete new bone matrix into cleared space
Calcification of new matrix in 7-10 days

22
Q

Effect of oestrogen on bone growth

A

Increases gut calcium reabsorption

Inhibits osteoclasts

23
Q

Effect of glucocorticoids on bone growth

A

Decreases gut reabsorption

Increases bone resorption and inhibits formation

24
Q

Ergocalciferol

A

Vitamin D2

25
Q

Cholecalciferol

A

Vitamin D3

26
Q

Lateral ankle ligaments

A

Anterior talofibular
Posterior talofibular
Calcaneofibular

27
Q

Medial ankle ligaments

A

Deltoid ligament
4 fused ligaments
From medial malleolus –> calcaneous and navicular

28
Q

Signs of compartment syndrome

A
Pallor
Pain 
Pulselessness
Paralysis 
Parasthesia 
Polar
29
Q

Diagnosis of compartment syndrome

A

Intracompartmental pressure >30mmHg

30
Q

Treatment of compartment syndrome

A

Fasciotomy
Removal of restriction
IV saline drip for hydration

31
Q

Rhabdomyolysis

A

Breakdown of striated muscle
In this case due to ischaemia
Releases muscle contents into blood
Increased creatine kinase, myoglobin, potassium, calcium

32
Q

Define compartment

A

Group of muscles with the same function and with a common nerve and blood supply that are surrounded by deep fascia

33
Q

Functions of skeletal muscle

A
Support soft tissues - shield organs 
Guard entrances and exits - anal sphincters 
Maintain body temperature 
Store nutrient reserves
Breathing
34
Q

Consequences of sarcopenia

A
Worsening of posture
Immobility due to weakness
Increased bone loss --> osteoporosis 
Falls more likely 
More likely to get fractures
35
Q

Sarcopenia theories

A

Neuromuscular ageing - loss of motor neurones, NMJs and vesicles
Hormone levels - decrease in GH, oestrogen, testosterone, thyroxine and insulin and increase in cortisol
Cellular senescence
Inflammatory factors
Loss of myokines
Obesity

36
Q

Sarcopenia epidemiology

A

Mean age = 73
7-8% prevalence
30% of over 50s

37
Q

Sarcopenia treatment

A

Dietary - creatine, whey protein, vitamin D
Hormone replacement therapy
Resistance training
Strength training