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Medsoc teaches > MSK > Flashcards

MSK Flashcards

1
Q

clavicle

A

connects with the sternum and the scapula via different ligaments
the clavicle attaches to the acromion of the scapula via the acromioclavicular joint
attaches to the sternum via the sternoclavicular ligament
attaches to the coracoid process of the scapula via the coracoclavicular ligament

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2
Q

fractured clavicle

A

more common in children
weakest part of the clavicle=mid-lateral side
the sternocleidomastoid muscle elevates the medial fragment of the clavicle resulting in shoulder drop on the affected side.
complications:brachial plexus injury, lung puncture

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3
Q

scapula

A

glenoid cavity-articulates with the head of the humerus to form shoulder joint
acromion-bony projection that articulates with clavicle to form AC joint
inferior angle and superior angle and spine(points of reference for palpation)
medial and lateral border aswell
coracoid process -muscle attachment
sub scapular fossa

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4
Q

humerus

A

head-articulates with glenoid cavity
greater and lesser tubercles-points of attachment for muscles, can be palpated
anatomical neck-joins heads of the greater and lesser tubercles
surgical neck-junction between the tubercles and the shaft
medial and lateral epicondyles-points of attachments for muscles, can be palpated
capitulum-articulates with the head of the radius
trochlea-articulate with trochlea notch of ulna
olecranon fossa-articulates with olecranon of ulna
coronoid fossa-articulates with corned process of ulna

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5
Q

glenohumeral joint dislocation

A

anterior dislocation more common
caused by trauma
complication:axillary nerve damage
posterior dislocation present as ‘lightbulb’ appearance=rare

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6
Q

proximal humeral fracture

A

damage to the axillary nerve

classic=4 part fracture

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7
Q

humeral shaft fracture

A

radial nerve injury

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8
Q

radial collateral ligament

A

radius->humerus

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9
Q

lateral(ulnar) collateral

A

ulna->humerus

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10
Q

medial collateral

A

ulna->humerus

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11
Q

annular ligament

A

wraps around radius and attaches to ulna

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12
Q

radius

A

head-articulates with capitulum of humerus and with the ulna
radial tuberosity-insertion of the biceps brachii
styloid process-lateral/radial styloid process
radoiocarpal joint

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13
Q

ulna

A

olecranon-forms prominence of the elbow and articulates with the olecranon fossa of the humerus
coronoid process-raised projection of the trochlear notch, articulates with the coronoid fossa of the humerus
styloid process
head-articulates with the ulna notch of the radius to form the distal radioulanr joint

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14
Q

annular ligament displacement

A

ligament slips off the radial head and gets stuck between the radius and humerus
common in children

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15
Q

radial head dislocation

A

common in children

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16
Q

Colle’s fracture

A

FOOSH injury
dorsal displacement
dinner fork

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17
Q

Smith’s fracture

A

opposite of a Colle’s fracture
caused by a direct blow to to the dorsal forearm or by falling onto a flexed wrist
volar displacement

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18
Q

scaphoid fracture

A

most vulnerable bone in the wrist
painful, swollen wrist after fall and tenderness in the anatomical snuff box
arterial blood supply to scaphoid starts distally and moves proximally
fracture of the scaphoid can lead to Avascular necrosisAVN of the scaphoid

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19
Q

pectoral girdle muscles

A 
upper limb->trunk 
moves pectoral girdle
anterior:
pectoralis major
pectoralis minor 
subclavian
serrates anterior 
Posterior:
latissimus dorsi 
trapezius
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20
Q

shoulder muscles

A

scapula->humerus
rotator cuff muscles
-supraspinatus: first 15 of abduction
-teres minor:adducts and laterally rotates
-infraspinatus: lateral rotation
-subscapularis: adducts and medially rotates
deltoid-abduction above 15
teres major-adduction and extension at shoulder joint

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21
Q

muscles of the arm

A 
flexors(anterior)
-biceps brachii 
-brachialis 
-coracobrachialis 
extensors(posterior)
-triceps brachii
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22
Q

muscles of the forearm

A 
flexors(anterior)
-brachioradialis 
-pronator teres 
extensors(posterior)
-extensor digitorum
-extensor carpi radialis
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23
Q

tennis elbow

A

lateral epicondylitis

  • degeneration of the common extensor tendon
  • cause:chronic/repeated stress on the tendon from overuse
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24
Q

golfer’s elbow

A

medial epicondylitis

  • degeneration of the common flexor tendon
  • cause:chronic/repeated stress on tendon from overuse
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25
Q

roots of brachial plexus

A

C5-T1

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26
Q

winged scapula

A

long thoracic nerve injury
paralysis of serrates anterior
abduction of the shoulder above horizontal level is also impaired

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27
Q

Musculocutaneous nerve damage

A 
C5-C7
results in reduced sensation of lateral forearm and paralysis of:
-biceps brachii 
-brachialis
-coracobracialis
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28
Q

axillary nerve damage

A

C5-C6
innervates deltoid and teres minor
officers badge
atrophy of deltoid muscle

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29
Q

median nerve

A

all of the brachial plexus C5-T1

innervates flexors of the forearm and thumb muscles

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30
Q

hand of benediction

A

when a patient tries to make a festering and little fingers flex, but the index and middle finger cannot flex at the MCP joint or the interphalangeal joint

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31
Q

claw hand

A

can’t flex the little finger and ring finger

32
Q

ape hand deformity

A

thumb is stuck in adduction and extension

33
Q

anterior interosseous syndrome

A

weakness of the pincer movement of the index finger and thumb =cannot make the ok sign . Cannot flex the DIP joints of the thumb and index finger

34
Q

median nerve damage

A

C6-T1

pronation of the forearm, flexion of the wrist and flexion of the digits

35
Q

radial nerve damage

A

C5-T1
damage caused by :
fracture of the shaft of the humerus
compression of the humerus “Saturday night palsy”
sx-
wrist drop
paraesthesia on dorsolateral aspect of the hand and lateral 3 and 1/2 fingers

36
Q

Ulnar nerve damage

A

c8-T1
damaged caused by:
-cubital tunnel syndrome
-fracture of the medial epicondyle of the humerus
guyot’s canal(area of compression)-little finger tingling
sx
claw hand

37
Q

erb-duchenne palsy

A

C5-C6 root damage
waiters tip deformity
internally rotated shoulder and pronated forearm

38
Q

Klumpke’s palsy

A 
C8-T1
atrophy of:
interosseous muscles
thenar muscles
hypothenar muscles
reduced sensation of medial hand and medial forearm
39
Q

volkmann’s ischaemic contracture

A

laceration of the brachial artery
emergency
paralysis of muscles die to inadequate blood supply
permanent shortening of muscle fibres due to fibrosis

40
Q

axial skeleton

A

bones of the head
neck
trunk

41
Q

appendicular skeleton

A

bones of the limb
pectoral girdle
pelvic girdle

42
Q

Spongy bones

A
  • long bone
  • bony trabecular located along lines of compressive and tensile stresses
  • major type of bone tissue in short, flat and irregular bones
  • red and yellow bone marrow
43
Q

compact bone

A

long bone
-arranged in osteons(Haversian system)
each osteon has:
-concentric lamellae
-Haversian canal through the middle which contains blood vessels
osteons are connected via perforating canals
compact bone is covered by periosteum which consists of:
-outer fibrous layer
-inner osteogenic layer

44
Q

red bone marrow

A

haemopoeitic tissue and the site of red blood cell production

45
Q

yellow bone marrow

A

fat or adipose tissue, can be converted to red bone marrow especially after severe blood loss

46
Q

bone formation cells

A

osteoblasts=bone builders
osteocytes=derived from osteoblasts(trapped in bone matrix)
osteoclasts=break down bone tissue

47
Q

initial bone formation

A

bones are formed from the embryonic mesenchyme
bone formation follows two patterns:
intramembranous ossification
endochondral ossification

48
Q

intramembranous ossification

A

1-cells of mesenchyme cluster together
2-differentiate into osteoprogenitor cells, which then turn into osteoblasts
3-create a type of bone tissue called osteoid:
primarily from the secretion of collagen
subsequently mineralised with calcium
these crystallise onto the tissue ,strengthening the bones
4-formation of the trabeculae
5-development of the periosteum

49
Q

intramembranous ossification bones

A

flat bones of the face, most cranial bones,and the clavicles

50
Q

endochondral ossification

A

1-development of cartilage model
2-growth of cartilage model
3-development of primary ossification centre
4-bone replaces cartilage
5-development of secondary ossification centre
6-formation of articular cartilage and epiphyseal plate
most bones are formed this way
replacement of cartilage with bone
mesenchyme forms general shape of bone
develop into chondroblasts which secrete cartilage extracellular matrix
produce a cartilage model (hyaline)

51
Q

interstitial (endogenous) growth

A

involves increase in the number of cells(chondrocytes) by continual mitotic cell divisions with secretion of matrix material

52
Q

appositional (exogenous) growth

A

mainly involves deposition of more matrix material by periosteal chondroblasts with little or no increase in the number of cells

53
Q

bone growth in length

A

occurs at the metaphyseal surface of the epiphyseal plate
stops between the age of 18-25-epiphyseal plates close between ages of 18 and 25 (the epiphyseal cartilage ceases dividing and the cartilage is replaced by bone leaving the epiphyseal linen older patient harder to see due to remodelling)

54
Q

bone growth in thickness

A

occurs at bone surface
involved in the secretion and depostition of bone matrix by osteoblasts
osteoblasts lay down bone matrix
this results in a groove forming alongside a periosteal blood vessel
this become a tunnel containing the vessel
remodelled and forms a new osteon
new outer circumferential lamellae is laid down
enlargement of the medullary cavity

55
Q

vitamin a

A

stimulates osteoblast activity

56
Q

vitamin c

A

synthesis of collagen

57
Q

vitamin d

A

absorption of calcium in the gut

58
Q

vitamin K and B12

A

synthesis of bone proteins

59
Q

thyroid hormone

A

produced by thyroid gland

promote bone growth by stimulating osteoblasts

60
Q

insulin

A

promotes bone growth by increasing synthesis of bone proteins

61
Q

growth hormone

A

directly stimulates chondrocytes increasing the rate of cell differentiation

62
Q

gigantism

A

over secretion of growth hormone in childhood
often due to pituitary tumour
lack of/under secretion of oestrogen

63
Q

acromegaly

A

over secretion of GH after the closure of the epiphyseal plates after puberty
often due to pituitary tumour
affects the extremities
sx:
spade like hands and feet, prominent brow

64
Q

pituitary dwarfism

A

short stature due to under secretion of GH during childhood

65
Q

osteoporosis

A

loss of bone mass due to demineralisation through increased bone resorption

66
Q

rickets

A

lack of vitamin D or renal dysfunction
poorlymineralised and calcified bones
bowed legs, deformities

67
Q

osteomalacia (Adult rickets)

A

similar condition to rickets that is experienced in adults

68
Q

calcium homeostasis PTH

A
  • released from the parathyroid gland in response to hypocalcaemia
  • PTH binds to osteoblast
  • mineral bone is broken down increasing levels of calcium
  • stimulates DCT in nephron to remove phosphates from plasma
69
Q

vitamin D

A
  • initially synthesised from cholesterol in skin keratinocytes exposed to UVB radiation
  • becomes calcitriol
  • increases absorption of calcium into the plasma
70
Q

calcitonin

A

opposes action of PTH when plasma becomes high \calcitonin’s main target is bones where it inhibits osteoclasts

71
Q

hypocalcaemia

A 
total <2.2mmol/L
caused by 
-hypoparathyroidism 
-chronic kidney disease
-hyperventilation 
sx
-muscle spasms
-paraesthesia
-cardiac arrhythmias
72
Q

hypercalcaemia

A 
total >2.6mmol/L
caused by 
-hyperparathyroidism
-malignancy
-excessive ingestion of vitamin D
sx
-bones moans groans and stones 
-confusion,drowsiness,coma
73
Q

skeletal muscle

A

long, cylindrical
multiple nuclei,located peripherally
striated sarcomere
t tubules-from triad with sarcoplasmic reticulum
cross bridge formation-Ca2+ binding to troponin
motor neurones control contraction

74
Q

cardiac muscle

A

branched
one or two nuclei located centrally
striated sarcomere
t tubules form dyad with sarcoplasmic reticulum
electrical coupling of cells via gap junctions
extracellular Ca2+ is required for contraction
cross bridge formation-Ca2+ binding to troponin
autonomic nerves(beta-adrenergic agonists) control contraction

75
Q

neuromuscular junction

A

AP travels down presynaptic neurone
voltage gated calcium ion channels in presynaptic membrane open
influx of calcium
vesicles containing Each move towards and fuse to presynaptic membrane
Each released into synaptic cleft and diffuses towards post-synaptic membrane
Ach binds to nAChR on post synaptic membrane
this causes ligand gated sodium ion channels on post synaptic membrane to open
sodium ions flow into postsynaptic neurone, depolarising the sarcolemma
this causes voltage-gated sodium ion channels to open
further influx of sodium ions
Ach broken down by AChE into acetate and choline, closing the sodium ion channels
choline transported back into presynaptic neurone via co-transport with sodium.Acetyl CoA converts choline back into ACh

Medsoc teaches (9 decks)

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