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Mistakes Flashcards

1
Q

Nerve compressed in lunate dislocation

A

Median nerve

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2
Q

Spilled tea cup sign

A

Volar lunate dislocation

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3
Q

Ligaments injured in volar lunate dislocation

A

Scapholunate
Capitolunate
Lunotriquetral

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4
Q

Motor symptoms of median nerve compression at carpal tunnel are?

A

Via recurrent branch of median nerve to thenar muscles

Weakness of ABDUCTOR POLLICIS BREVIS—- thimb abduction lost
FLEXOR POLLICES BREVIS
OPPONENES POLLICES

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5
Q

Sensory loss of carpal tunnel syndrome

A

Palmar digital branches of median nerve— paresthesia in palmar aspect of first 3 and half digits

Weakness of 1st and 2nd lumbrical— no interphalangeal joint extension

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6
Q

Thumb adduction is by?

A

Adductor policis
Ns - deep motor branch of ulnar nerve

Injury- guyons canal syndrome when hook of hamate is fractured

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7
Q

Features of guyons canal syndrome?

A

Ulnar nerve compression in guyons canal

Dorsal and volar interossei lost — finger abduction

Adductor policis— thumb adduction

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8
Q

Nerve supply of extensor pollices longus and brevis

A

Radial nerve

Before entering wrist

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9
Q

Name the muscles of thumb with nerve supply

A

Abductor pollicis brevis— median nerve

Flexor pollicis brevis—superficial head median nerve deep head ulnar nerve

Opponens pollices— median nerve

Adductor pollicis—-ulnar nerve

Extensor pollicis longus and brevis— radial nerve

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10
Q

Primary muscle of wrist extension

A

Extensor carpi radialis brevis
Extensor digitorum

Lateral epicondylitis tennis elbow

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11
Q

Muscle responsible for adduction of fingers

A

Palmar interossei

Originates from metacarpals

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12
Q

Forearm flexors

A

Biceps brachii
Brachialis
Brachioradialis

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13
Q

Boundaries of anatomical snuff box

A

Lateral—- EPB AbPL
Medial— EPL

TENDINOPATHY OF THESE TENDONS ESP LATERAL ONES CAUSES DEQUERVAINS TENDINOPATHY

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14
Q

Osgood schlatter disease

A

Avulsion growth spurt at secondary ossification centre —tibial tubercle due to repeated knee extension

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15
Q

Muscles inserting in pes anserinus

A

Semitendinosus
Gracilis
Sartorius

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16
Q

Origin and insertion of serratus anterior

A

First 8 ribs origin

Medial border of scapula insertion

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17
Q

What is the function of serratus anterior

A

During overhead abduction of shoulder the glenoid cavity must rotate upwards

This is done by trapezius and serratus anterior

Which allows completion of over head abduction

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18
Q

Nerve supply long thoracic nerve

A

C5 c6 and c7

Brachial plexus roots

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19
Q

Injury in clavicular fracture

A

Supraclavicular nerve

Subclavian vessels

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20
Q

Upper brachial plexus injury

A

Waiters tip
Erbs palsy

Injury to musculocutaneous nerve and suprascapular nerve

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21
Q

Hip pain on forced adduction of flexed thigh

And internal rotation of extended thigh on resistance

A

Piriformis syndrome

Because adduction and internal rotation of thigh stretches piriformis

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22
Q

Contents of greater sciatic notch

A 
Piriformis
Above it superior gluteal nerve and vessels
Below it inferior gluteal vessels 
Internal pudendal vessels
Sciatic nerve

Action of piriformis since it inserts in greaters trochanter is to abduct the flexed thigh

Or
Externally rotate the extened thigh

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23
Q

What is trendlenberg gait

A

Weakness of hip stabilisers
Gluteus medius and minimus

Contralateral hip drop when foot is raised

Superomedial gluteal quadrant injections

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24
Q

Superomedial injection in gluteal region injures which nerve

A

Superior gluteal nerves L4 to S1

Weakness of hip stabilisers

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25
Q

Nurse maids elbow

A

Kids traction of arm forearm

Annular ligament gets trapped in between radial head and capitulum

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26
Q

Popeyes deformity

A

Rupture of long head of biceps brachi

Which contracts and accumulates like popeyes arm

due to displaced belly

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27
Q

What is lac operon

A

Sequence of genome in E COLI for metabolism of lactose

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28
Q

Contents of lac operon

A

Ipo zya

I is regulatory gene
P is promotor region
O is operator region

Z y a are three structural genes

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29
Q

What are the products of zya genes in lac operon

A

Z codes for B GALACTOSIDASE- which breaks down lactose to glucose and galactose

Y codes for permease- which increases the e coli permeability for lactose

A codes for B galactoside transacetylase which transfers acetyl grps to b galactoside

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30
Q

What is the property of mrna in E coli

A

M rna in ecoli is polycistronic

Meaning single mRNA contains the information of all zya genes of lac operon and all protein/ enzymes are synthesized together

Mostly prokaryotic mRNA are usually polycistronic

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31
Q

In order what is the structure of lac operon

A 
LAC 1 ( regulator gene)
Cap ( catalytic activator protein)
P gene (promotor gene has RNA POLYMERASE)

O gene which is operator gene where repressor can bind and does not allow RNA polymerase to proceed
Then structural gene z y a

Inducer is lactose— prevents repressor from binding operator site..

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32
Q

Name 3 enz deficiencies for galactosemia

A

Galk deficiency— galactokinase
Galt deficiency- Galactose 1 p uridyl transferase
UDP galactose 4 epimerase for regeneration of UDP glucose

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33
Q

Most common galactosemia enz

A

Galt— ie udp wala

Galactose 1 phosphate uridyl transferase

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34
Q

Features of dangerous type Galactosemia galt

A

Liver and renal accumulation of galactose 1 phosphate which is toxic

Liver enz elevation hyperbilirubinemia hypoglycemia
Renal aminoaciduria and hyperchloremic metabolic acidosis

Sepsis with grm negative rods ie e coli

35
Q

What enz forms galactitol from galactose

A

Aldose reductase

36
Q

What are non glucose monosaccharides metabolised by liver

Whose metabolism is the fastest

A

Galactose mannose and fructose are non glucose monosaccharides metabolised by liver whose intermediaries enter glycolytic pathway at various levels

Of these fructose has the fastest metabolism because it can have two pathways one of which is independent of rate limiting glycolytic enz phosphfructokinase -1

37
Q

Why glucose represses lac operon or shuts down lac operon

A

Because glucose decreases adenyl cyclase levels and intracellular camp levels decreases

CAP catalytic activator protein needs high level of cAMP

38
Q

Leptin gene and receptor mutations would cause

A

Hyperphagia with obesity

Gene mutation has low levels of leptins and
Receptor mutations will have increased levels of leptin

39
Q

Mechanism of action of leptin

A

Two actions on arcuate nucleus of hypothalamus

1 inhibits appetite stimulating neuropeptideY
2 activates appetite inhibiting pomc product alpha MSH

OVERALL EARLY INCREASED SATIETY

40
Q

Enz deficient in hereditory fructose intolerance

A

Aldolase B

NO CATARACTS but reducing sugars in urine hypoglycemia hypophosphatemia and failure to thrive

41
Q

What disease is caused by alpha galactosidase A deficiency?

A

Fabrys disease xlr

Cataracts with neuro symptoms with angiokeratomas

42
Q

Enz deficient in essential fructosruia

A

Fructokinase deficiency

Only reducing sugars in urine

No cataracts ( hereditary fr intolence)
No hypoglycemia ( HFI OR GALACTOSEMIA)
No hypophosphatemia ( hereditary fr intoleance)
43
Q

Enz deficient in von gierkes disease

A

Glucose 6 phosphatase

Hypoglycemia lactic acidosis
Hepatomegaly
Hypertriglyceridemia

44
Q

What causes tay sachs disease

A

Hexosaminidase A deficiency

Cherry red spot
Loss of motor skill

No cataracts

45
Q

What is complex II. In tca and electron transport chain

A

Complex II. Is succinate dehydrogenase complex
Participate in tca as well as etc
In TCA it converts succinate to fumarate and thereby transfers electrons to coenzyme Q via FAD producing reduced FADH2
It can also accept electrons from other sources of FADH2 like fatty acid oxidation

46
Q

Mismatched nucleotides are repaired by

A

Proof reading of DNA polymerase delta and epsilon

47
Q

What if proof reading by dna polymera delta and epsilon misses Mismatch

A

Mismatch repair genese MSH 2 and MLH 1 produces human mutS and mutL homologs that repairs the mismatch

48
Q

Damage mutations by uv light is corrected by

A

Nucleotide excision repair

Because uv light causes pyrimidine esp thymine dimers which interfere with dna replication
These dimers are removed by nucleotide excision repair

49
Q

Removal of RNA primers after DNA Replication before ligase can act to seal everything is done by

A

DNA Polymerase 1 which has 5’-3’ forward exonuclease activity

50
Q

In which directions dna polymerase 3 acts

A

Making dna in 5’-3’ direction

And proofreading in reverse ie exonuclease activity in reverse 3’-5’ direction

51
Q

In lower arm brachial artery accompanies which nerve

A

Median nerve

52
Q

In arm radial nerve accompanies which artery?

A

Deep branch of brachial artery

Remember mid shaft fracture of humerus is associated with wrist drop because of radial nerve injury
And shud raise concern of lacerstion of deep brachial artery

53
Q

What is deep brachial artery?

A

Profunda brachii is deep brachial artery

Accompanies radial nerve
Injured in mid shaft humeral fracture

54
Q

Radial nerve and profunda brachi artery is situated anterior or posterior to humerus?

A

Posterior to mid shaft humerus

55
Q

Nerve root for radial nerve

A

All 5 of brachial plexus

C5 to t1

56
Q

What does cutaneous br of radial nerve supply

A

Skin overlying dorsum of hand dorsal forearm and portion of upper arm

57
Q

Muscles supplied by radial nerves

A

Elbow and wrist extensors like common extensors and triceps
Extrinsic extensors of digits
Brachioradialis and supinator

58
Q

Fracture of surgical neck of humerus can damage which nerve and artery

A

Axillary nerve
And
Posterior circumflex humeral artery in quadrangular space

59
Q

Retroperitoneal hematoma overlying psoas can damage which nerve

A

Femoral nerve which descends through psoas
Emerges laterally btn psoas and iliacus

Enters limb below inguinal ligament

60
Q

Femoral nerve mononeuropathy features

A

Quadriceps weakness— stairs climbing or knee buckling

Decreased patellar reflex

Sensory loss over anterior and medial thigh and medial leg

61
Q

Impaired adduction of thigh nerve injury is

A

Obturator nerve injury

Also has sensory loss in medial thigh

62
Q

Common peroneal nerve injury

A

Dorsiflexed foot — foot drop
Loss of toe extensor- cannot stand on toes
Foot inversion - cannot do eversion

Loss of sensation in lateral leg and dorsum of foot

63
Q

Tarsal tunnel syndrome

A

Posterior tibial nerve neuralgia

Narrow tunnel behind medial malleolus at ankle overlying flexor retinaculum

64
Q

Contents of tarsal tunnel

A

Tibialis posterior
Flexor DL
FHL

Posterior tibial artery and v
Posteiror tibial nerve (L4-S3)

65
Q

What does tibial nerve supply

A

Sensation in sole
Inversion and plantar flexion of foot
Flexion of toes

66
Q

First web space on dorsum is supplied by?

A

Entire dorsum is supplied by superficial peroneal nerve except for first web which is supplied by deep peroneal nerve

67
Q

Femoral head arterial supply

A

Ascending cervical and medial circumflex femoral artery

Which are damaged in neck fracture of femur

68
Q

Circumflex femoral arteries are branches of which artry

A

Profunda femoris

69
Q

Artery of ligamentum teres

A

Is a br of obturator artery

It is important in children because it supplies head proximal to growth plate

70
Q

Ascending cervical artery of femoral head is brn of

A

Lateral circumflex femoral artery

71
Q

Nerve supply of latissimus dorsi and its action is?

A

Thoracodorsal nerve C6-c8

Inserts in biciputal groove
Internal rotation and adduction of humerus
Extension alsom

72
Q

Action of infraspinatus

A

External rotation of arm

Ns is suprascapular nervd

73
Q

Nerve supply of triceps brachi

A

Radial nerve

Extension of elbow

74
Q

Explain nerve root of ulnar nerve

A

Ulnar nerve originates from medial cord of brachial plexus derived from C8-T1 ventral roots

75
Q

Components of cranial nerve 3 occulomotor

A

Somatic - infr super and medial rectus. LPS muscle and inferior oblique ms. So if occulomotor is involved—- eye will be down out and shut (ptosis lid)

Parasympathetic component( remember 3 79 and 10 are cranial parasympathetic outflow)
Supplies ciliary muscle and iris sphincter. Loss leads to fixed dilated pupil with loss of accomodation
76
Q

Component of corneal reflex?
Blink reflex
Protects from foreign bodies

A

Afferent - nasociliary br of V1 of trigeminal nerve.

Centre- pons

Efferent- temporal and zygomatic branches of facial nerve

77
Q

Orbicularis oculi which shuts the eyes is supplied by

A

Facial nerve

Part of efferent portion of corneal reflex

78
Q

Eye opener muscles

A

Occulomotor nerve— Iii supplying LPS Ms opens eyes

Superior tarsal muscle supplied by sympathetic fibres from superior cervical ganglion opens eye

79
Q

Holoprosencephaly causes are?

A

Maternal alcohol
Trisomy 13 patau
Sonic hedge hog gene mutations

Type of developmental field defect ie one embryonic disturbance leads to many malformations because it disrupts the development of many adjacent structures in same field

80
Q

What is association of anomalies?

Example?

A

Multiple anomalies occur together without a unifying cause and also it is not by chance

Eg is vacteral anomalies— vertebral anal atresia cardiac te fistula renal and limb anomalies

81
Q

Spleen is derieved from

A

Mesoderm of dorsal mesentry

82
Q

Which finger does not have palmar interossei muscle

A

3rd finger
Middle finger

Remember palmar interossei causes finger adduction towards middle finger
No need for middle finger to go anywhere hence no adductor needed

83
Q

What is the function of dorsal interossei

A

Opp of palmar

Abduction of fingers

Flash Facts (23 decks)

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