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MSK Flashcards

1
Q

In a Clavicle fracture what muscle pulls the medial third Superiorly?

A

Sternocleidomastoid

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2
Q

What happens to the Lateral fragment of the Clavicle in a Clavicular fracture and why?

A

Pulled inferiorly by the weight of the arm as the Trapezius isn’t strong enough to hold it up

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3
Q

Which muscles attach to the Coracoid Process?

A

Biceps Brachii Short Head, Pectoralis Minor and Coracobrachialis

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4
Q

What does the Acromion articulate with?

A

Clavicle

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5
Q

What structure is between the Greater and Lesser Tubercles on the Humerous and what passes through it?

A

Bicipital Groove

Tendon of Biceps Brachii Long Head

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6
Q

Which muscles attach to the medial epicondyle of the Humerous?

A

Pronator Teres, Flexor Carpi Radialis, Palmaris Longus, Flexor Carpi Ulnaris and Flexor Digitorum Superficialis

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7
Q

What allows space for the Radius and Ulnar upon full flexion of the elbow?

A

Radial Fossa an Coronoid Fossa

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8
Q

Whats the name of the surface of the Humerous that articulates with the Radius?

A

Capitulum

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9
Q

Whats the name of the surface of the Humerous that articulates with the Ulnar?

A

Trochlea

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10
Q

What provides space for part of the Ulnar on full extension of the elbow?

A

Olecranon Fossa

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11
Q

What can be damaged in a surgical neck fracture of the Humerous?

A

The Axillary nerve and the Circumflex Humeral artery

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12
Q

What can be damaged in a Mid-Shaft fracture of the Humerous?

A

Radial nerve and Brachial artery

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13
Q

What is a Supracondylar fracture and what can it damage?

A

Its a fracture above the condyles of the Humerous, it can damage the Median nerve

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14
Q

What can be damaged by an Avulsion of the medial epicondyle of the Humerous?

A

Ulnar nerve

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15
Q

What forms the Trochlear Notch?

A

The Coranoid process and the Olecranon

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16
Q

What is a Colles fracture?

A

Dinner fork fracture, a fall onto an extended wrist cause a transverse fracture of the distal 2cm of the radius and posterior displacement of this segment

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17
Q

Whats a Smiths fracture?

A

Fall onto a flexed wrist causes a transverse fracture of the distal 2cm of the radius and anterior displacement of this segment

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18
Q

What causes a Scaphoid fracture?

A

Fall onto palm of abducted hand

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19
Q

What is an added risk of Scaphoid fractures?

A

Can cause damage to the distal blood vessel supplying it, this causes avasuclar necrosis

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20
Q

What is a boxers fracture?

A

A break in the distal neck of either the 4th or 5th metacarpals

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21
Q

Which artery supplies the posterior compartment of the arm?

A

Deep Brachial artery

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22
Q

Which artery supplies the anterior compartment of the arm?

A

Brachial artery

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23
Q

How is the hand supplied with blood?

A

Radial and Ulnar arteries join to for the deep and superficial plamar arches

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24
Q

Which vein runs along the medial aspect of the arm?

A

Basilic Vein

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25
Q

Which vein runs along the lateral aspect of the arm?

A

Cephalic Vein

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26
Q

What does the Musculocutaneous nerve innervate?

A

Coracobrachialis, Biceps Brachii, Brachialis and skin on the lateral edge of the forearm

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27
Q

What does the Axillary nerve innervate?

A

Glenohumoral joint, Teres Minor, Deltoid and the skin of the regimental patch

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28
Q

What does the Meddian nerve innervate?

A

Anterior compartment of the forearm and the skin of the palm

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29
Q

What does the Radial nerve innervate?

A

Posterior Compartments of the arm and skin of the arm and forearm

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30
Q

What does the Ulnar nerve innervate?

A

5th digit of the hand, Intrinsic hand muscles, Flexor Carpi Ulnaris and half of Flexor Digitorum Profundus

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31
Q

What forms the apex of the Axilla?

A

Lateral boarder of the 1st rib, superior boarder of the scapula and posterior boarder of the clavicle

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32
Q

What forms the lateral wall of the Axilla?

A

Bicipital Groove

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33
Q

What forms the medial wall of the Axilla?

A

Seratus anterior and the thoracic wall

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34
Q

What forms the anterior wall of the Axilla?

A

Pectoralis major and minor

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35
Q

What forms the posterior wall of the Axilla?

A

Scapularis, Teres major and Latissimus Dorsi

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36
Q

What can be damaged in Lymphatic clearance of the Axilla and what does this damage cause?

A

Long Thoracic nerve, it innervates Seratus Anterior and damage to it can cause a winged scapula

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37
Q

What is contained in the Cubital Fossa?

A

Biceps Tendon, Brachial artery, Median nerve

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38
Q

What are the boarders of the Cubital Fossa?

A

Superior boarder is the line between the epicondyles, Medial boarder is the lateral boarder of Pronator Teres, Lateral boarder is the medial boarder of Brachioradialis

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39
Q

Whats contained in Guyon’s Canal?

A

Ulnar nerve and the Ulnar artery

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40
Q

What happens if you have constant pressure on Guyon’s Canal and whats it called?

A

Ulnar nerve entrapment, this leads to some ulnar clawing and paraesthesia of the medial 1.5 digits. Called Handlebar Palsy

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41
Q

What are the boarders of the carpal tunnel?

A

Anterior is the Flexor Retinaculum, Posterior is the Carpal bones, Lateral is the Scaphoid and Trapezium, Medial is Hook of Hamate and Pisiformis

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42
Q

What are the contents of the carpal tunnel?

A

4 tendons of both Flexor Digitorum Superficialis and Profundus, Tendon of Flexor Policis Longus, Median nerve

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43
Q

What causes Carpal Tunnel syndrome?

A

Impingement of the Median nerve against the Flexor Retinaculum

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44
Q

What does Carpal Tunnel syndrome lead to?

A

Paraesthesia of the digital cutaneous branch of the median nerve. Causes absent opposition, reduced abduction and flexion

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45
Q

What is in the Anatomical Snuff box?

A

Extensor Policis Longus, Extensor Policis Brevis, Abductor Policis Longus and the Radial artery

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46
Q

How would an injury to the Musculocutaneous nerve present?

A

Weak flexion at the elbow, weak supination at the elbow, desensitization down lateral aspect of forearm

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47
Q

How would an injury to the Ulnar nerve at the wrist present?

A

Abduction and Adduction of fingers impossible, unopposed flexion of IP joints on 3rd and 4th lumbricles

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48
Q

What could cause damage to the Radial nerve at the Axilla?

A

Dislocation of the shoulder, Sustained pressure pushing on armpit

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49
Q

How would damage of the Radial nerve at the Axilla present?

A

Wrist drop, unable to extend elbow, unable to extend fingers

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50
Q

How would damage of the Radial nerve at the Humerous present?

A

Weakened extension of elbow, wrist drop, unable to extend fingers, loss of sensation over lateral 3.5 digits

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51
Q

How would damage to the Radial nerve at the wrist present?

A

Loss of sensation on posterior surface of lateralt 3.5 digits

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52
Q

What could cause damage to the Median nerve at the elbow?

A

Supracondylar Fracture, incorrect Venepuncture

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53
Q

How would damage to the Median nerve at the wrist present?

A

Hand of Benediction, Ape hand

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54
Q

How would damage to the Axillary nerve present?

A

Unable to abduct 15-90 degrees, desensitisation of the regimental patch

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55
Q

Which 3 ligaments help to externally support the glenohumoral joint?

A

Coracoacromial, Coracohumoral, Glenohumoral

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56
Q

What are the 4 main rotator cuff muscles?

A

Supraspinatous, Infraspinatous, Teres Minor, Subscapularis

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57
Q

What happens in a Glenohumoral Dislocation?

A

Powerful adductors pull the head anteriorly in a disslocation

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58
Q

What causes Painful Arc Syndrome and what are the symptoms?

A

Tendon of Subscapularis becomes trapped under Coracoacromial Ligament. Causes pain between 50-130 degrees of abduction

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59
Q

How does a tear in the Supraspinatous present?

A

Unable to abduct from 0-15 degrees

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60
Q

Which muscles cause flexion at the Glenohumoral Joint?

A

Pec Major, Anterior Deltoid, Coracobrachialis, Biceps Brachii

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61
Q

Which muscles cause extension at the Glenohumoral Joint?

A

Posterior Deltoid, Latissimus Dorsi, Teres Major

62
Q

Which muscles cause abduction at the Glenohumoral Joint?

A

Supraspinatous, Middle Deltoid, Seratus Anterior

63
Q

Which muscles cause adduction at the Glenohumoral Joint?

A

Pec Major, Latissimus Dorsi, Teres Major

64
Q

Which muscles cause medial rotation at the Glenohumoral Joint?

A

Pec Major, Subscapularis, Latissimus Dorsi, Teres Major

65
Q

Which muscles cause lateral rotation at the Glenohumoral Joint?

A

Teres Minor, Infraspinatous

66
Q

What does the Annular ligament do?

A

Wraps around the Radius and joins to the Ulnar on either side of the radial notch

67
Q

Whats the name of the hole in the Pelvis and what is it formed by?

A

Obturator Foramen, formed by the Ischium + Pubis

68
Q

Where are the attachments for the Inguinal ligament?

A

Anterior Superior Iliac Spine -> Pubic tubercle

69
Q

What structure on the back of the Pelvis does the Sciatic nerve run through?

A

The Greater Sciatic Notch

70
Q

What part of the Pelvis bears the weight of the body when sitting down?

A

Ischial Tuberosity

71
Q

Where is the Lina Aspera and which muscles attach to it?

A

Situated on posterior aspect of Femur, attachment for Adductor Magnus + Pectineus

72
Q

What is the attachment site for the adductors of the leg and where is it situated?

A

Adductor Tubercle, found superior to the medial epicondyle

73
Q

What is the attachment site for the Achilles Tendon

A

Calcaneus Tuberosity

74
Q

What is the risk of an Intracapsular fracture and how does it present?

A

Damage to the Medial circumflex artery and lead to avascular necrosis, Shortened + laterallyrotated leg

75
Q

What is an extracapsular fracture and how does it present?

A

Fracture outside the capsule of the femur, presents with a shortened and laterally rotated leg

76
Q

How do you get avulsion of the Greater Trochanter? What muscles attach here?

A

Extreme force eg. car crash. Attachment site for Gluteus Medius + Minimus

77
Q

Mid-shaft fractures of Femur take large amount of force, what do they risk and how does it present?

A

Risk of femoral artery damage, Presents with leg shortening due to overlapping fragments

78
Q

What is a Bumper Break and what are the problems it causes?

A

Break to the Tibial condyles (similar height to car bumper), attachment point for Cruciate + Collateral ligaments

79
Q

What causes a Medial Maleolar Fracture?

A

Over eversion of the ankle forces the medial Maleolus against the Talus causing it to fracture, often accompanied by fracture of Lateral Maleolus

80
Q

What causes a Lateral Maleolar Fracture?

A

Over inversion of the ankle forces the lateral Maleolus against the Talus causing it to fracture

81
Q

In what two ways can you get a fracture of the Talus? Why are these fractures easy to repair?

A
  1. Excessive dorsiflexion of the foot causes neck of Talus to snag on Tibia + snap off 2. Jump from height, force transmitted through Calcaneous into Talus which cant handle it and breaks. Fragments held together by Maleoli
82
Q

How do you fracture the Calcaneous and what problems does it cause?

A

High falls can fracture the Calcaneous rather than transmit the force upwards into the Talus, this forces the Talus into the Calcaneous disrupting the joint + leading to arthritis

83
Q

Which arteries are given off by the internal Iliac artery?

A

Obturator, Internal + External Gluteal Arteries

84
Q

The Deep Femoral artery travels posteriorly, what arteries does it give off?

A

Medial + Lateral Femoral Circumflex arteries

85
Q

What does the Superficial Femoral Artery become after it passes though the adductor haitus?

A

Popliteal artery

86
Q

What does the Popliteal Artery Terminate into?

A

Anterior + Posterior Tibial Arteries

87
Q

What is the route of the Great Saphinous Vein?

A

Arises from Dorsal venous arch, passes anteriorly to medial Maleolus the posterior to medial condyle of the femur. Drains into the femoral vein just before the inguinal ligament

88
Q

Whats the route of the Small Saphinous Vein?

A

Arises from Dorsal venous arch, passes posteriorly to lateral Maleolus, Travels up leg between the two heads of Gastrocnemius and drains into Popliteal vein

89
Q

What produces the Popliteal vein?

A

Posterior + Anterior Tibial veins combine to produce the Popliteal vein

90
Q

What causes Vericose veins?

A

Incompetence of valves in superficial veins

91
Q

What forms the boarders of the Popliteal Fossa?

A

Superiomedial - Semimembranous
Superiolateral - Biceps Femoris
Inferiomedial - Medial head of Gastrocnemius
Inferiolateral - Lateral head of Gastrocnemius

92
Q

What causes a Bakers Cyst?

A

Inflammation of the Semimambranous Bursa

93
Q

What are the main clinically relevant terminal branches given off by the Lumbar Plexus? What are their roots?

A

Obturator Nerve (L2-L4), Femoral Nerve (L2-L4)

94
Q

What are the terminal branches given off by the Sacral Plexus? What are their roots?

A 
Superior Gluteal (L4-S1)
Inferior Gluteal (L5-S2)
Sciatic (L4-S3)
Posterior Femoral Cutaneous (S1-S3)
Pudendal (S2-S4)
95
Q

What does the Femoral Nerve innervate?

A

Quadriceps, Sartorius, Pectinieus

96
Q

How could the Femoral nerve be injured at the Hip? How would it present?

A

Missed Femoral stab, Trauma.

Presents with damage to hip flexors + Knee extenders

97
Q

What does the Obturator Nerve Innervate?

A

Adductors Logus, Brevis + Magnus, Gracilis + Obturator Externus

98
Q

How could the Obturator nerve be injured at the pelvis and how would it present?

A

Injured by Surgery or trauma.

Weakened adduction

99
Q

What does the Sciatic nerve innervate?

A

Semimembranosus, Semitendinosus, Biceps Femoris, Adductor Magnus, All of the leg + foot (as Fibular + Tibial nerves)

100
Q

How could the Sciatic nerve be injured in the Gluteal region and how would it present?

A

Incorrect intramuscular injection.

Inability to flex knee, difficulty with all movements of the ankle + foot

101
Q

What does the Tibial nerve innervate?

A

Posterior compartment of the leg

102
Q

How could the Tibial nerve be damaged in the posterior compartment and how would it present?

A

Trauma, Entrapment in narrow space, Compression in Popliteal Fossa (Bakers Cycst)
Loss of Plantarflexion, loss of flexion of toes

103
Q

Which muscles are innervated by the Superficial Fibular nerve?

A

Fibularis Longus + Brevis (Plantarflexion + Eversion of ankle)

104
Q

How could the Superficial Fibular nerve be damaged and how would it present?

A

Fracture of Fibula, Perforating wound to lateral leg.

Loss of Eversion and weakened Plantarflexion

105
Q

Which muscles are innervated by the Deep Fibular Nerve?

A

Tibialis anterior, Extensor Digitorum Longus, Extensor Hallucis Longus, Fibularis Tertius

106
Q

What can cause injury to the Deep Fibular Nerve and how would it present?

A

Overuse of the anterior muscles can cause compression on the nerve.
Presents as foot drop due to loss of ability to Dorsiflex foot

107
Q

What are the 5 Ligaments that stabalise the hip joint?

A

Iliofemoral
Pubofemoral
Ischiofemoral
Ilgament of Head of Femur - Acetabulum -> Capitis of head of femur
Transverse Acetabular - Improves stability of Acetabulum

108
Q

Which muscles cause flexion of the hip joint?

A

Rectus Femoris, Sartorius, Anterior part of Adductor Magnus, Adductor Longus + Brevis, Pectineus

109
Q

Which muscles cause extension of the hip joint?

A

Gluteus Maximus, Semimembranosus, Semitendinosus, Long head Biceps Femoris, Posterior part of Adductor Magnus

110
Q

Which muscles Adduct the hip joint?

A

Pectinius, Adductors Longus, Brevis + Magnus, Obturator Externus, Gracilis

111
Q

Which muscles Abduct the hip joint?

A

Gluteus Medius + Minimus, Tensor Fasciae Latae

112
Q

Which muscles externally rotate the hip joint?

A

Gluteus Maximus, Biceps Femoris, Obturator internal + External, Quadratus Femoris

113
Q

Which muscles internally rotate the hip joint?

A

Gluteus Medius + Minimus, Tensor Faciae Latae

114
Q

What are the 2 main clinically relevant Bursae of the hip?

A

Trochanteric - Sits on Greater Trochanter

Ischiogluteal - Lies between Ischial tuberosity + Gluteus Maximus

115
Q

What are the Menisci of the knee and what are their function?

A

Fibrocartilagenous disks between Femoral condyles + Tibeal Plateu.
Act as shock absorbers + Deepen articular surface

116
Q

What makes up the Unhappy Triad?

A

Medial Meniscus
Medial Collateral Ligament
Anterior Cruciate Ligament

117
Q

What are the attachments of the Anterior Cruciate Ligament? Whats its function?

A

Anterior Intercondylar Eminance of Tibia -> Intercondylar Fossa of Femur.
Prevents Hyper extension of knee joint

118
Q

What are the attachments of the Posterior Cruciate Ligament? Whats its function?

A

Posterior Intercondylar Eminance of Tibia -> Intercondylar Fossa of Femur.
Prevens Posterior movement of joint

119
Q

Which muscles cause flexion of the knee?

A

Semitendinosus, Semimembranosus, Biceps Femoris

120
Q

Which muscles cause Extension of the knee?

A

Rectus Femoris, 3 Vastus muscles

121
Q

Which muscles cause Medial rotation of the knee?

A

Semitendinosus, Semimembranosus, Popliteus, Sartorius

122
Q

Which muscle causes Lateral rotation of the knee?

A

Biceps Femoris

123
Q

What causes damage to the Medial Collateral Ligament? What is a common secondary injury?

A

Blow to Lateral side of knee stretches Medial Collateral Ligament.
Strongly attached to Medial Meniscus so often tears this

124
Q

What causes the Unhappy Triad?

A

Tearing of the ACL leads to medial movement of Femur which tears Medial Collateral Ligament, which tears Medial Meniscus

125
Q

What are the 4 Medial Ligaments of the ankle?

A

Tibionavicular
Tibiocalcaneal
Anterior + Posterior Tibiotalar

126
Q

What are the 3 Lateral Ligaments of the ankle?

A

Anterior + Posterior Talo-Fibular

Calcaneofibular

127
Q

Which muscles cause Dorsiflexion in the ankle?

A

Tibialis Anterior, Extensor Digitorum Longus, Extensor Hallucis Longus

128
Q

Which muscles cause Plantarflexion in the ankle?

A

Gastrocnemius, Soleus, Tibialis Posterior

129
Q

What are the stages of a normal Gait?

A

Push off -> Limb Lift -> Raise Foot -> Final Swing -> Heel Strike -> Stand -> Move to Ball of Foot

130
Q

What happens in a Pott’s fracture?

A

Excessive Eversion of the foot strains the Medial Ligaments until they Evulse the Medial Malleolus, this release of force moves the Talus Laterally breaking off the Lateral Malleolus. The Tibia moves Anteriorly which may lead to the Posterior aspect being sheared off

131
Q

What causes a Antalgic Gait and how does it present?

A

Caused by patients who have Chronic foot pain.

Adapt their Gait so they spend less time in stance phase, they rush to get back into swing phase.

132
Q

What causes Trendelenburgs Gait and how does it present?

A

Damage to the Superior Gluteal Nerve paralyses Gluteus Medius + Minimus, this destabalises the hip so the Pelvis will drop to the side when one leg is lifted up

133
Q

What causes High-Steppage Gait and how does it present?

A

Damage to the Common or Deep Fibular nerve causes loss of Dorsiflexion, Patients lift their leg up higher than normal to prevent their toes from catching on the floor

134
Q

How many bones make up the spine?

135
Q

What are the common features across all Vertebrae?

A

Spinous process
Lamina
Superior + Inferior articular processes
Pedicles

136
Q

What are the 5 sections of the spine and how many vertebrae are in each?

A 
Cervicle - 7
Thoracic - 12 
Lumbar - 5 
Sacrum - 5 (fused) 
Coccyx - 4 (fused)
137
Q

What are the distinguishing features of Cervical Vertebrae?

A

Bifid spinous process
Transverse foramen for vertebral arteries
Triangular vertebral foramen

138
Q

What are the distinguishing features of Thoracic Vertebrae?

A

First 10 have costal facets (rib articulations)
Spinous process points downwards
Circular vertebral foramen

139
Q

What are the distinguishing features of Lumbar Vertebrae?

A

Largest Vertebrae
Short chunky spinous process
Triangular vertebral foramen

140
Q

What are the distinguishing features of the Sacrum?

A

Articulates with the pelvis

Triangular shaped collection of bone

141
Q

What joint does the Atlas form to allow the head to nod up and down?

A

Atlanto-Occipital joint

142
Q

What is the Axis responsible for? What part of the Axis allows it to perform its function?

A

Allows rotation of the head

The Dens

143
Q

What are the two parts of intervertebral disks?

A

Nucleus Polposus

Annulus Fibrosus

144
Q

What are the 4 main ligaments of the spine?

A

Anterior + Posterior Longitudinal Ligament
Interspinous Ligament
Supraspinous Ligament

145
Q

What is Kyphosis?

A

Abnormal convexing of the Thoracic part of the spine causing a hunched back.
Leads to pain and stiffness

146
Q

What is Lordosis?

A

Abnormal concaving of the Lumbar or Cervical part of the spine, causes a saddle back.
Leads to pain and stiffness

147
Q

What is Scoliosis?

A

Three Dimensional deformity of the spine, causes some lateral deviation and twisting of the spine.
Can cause problems with posture

148
Q

What happens in a slipped disk?

A

Nucleus Polposus herniates through Annulus Fibrosus in either a posterior or posteriolateral direction, Posteriolateral will cause pain due to compression of nerve roots + inflammatory response. Posterior direction can cause compression of spinal cord - can lead to paralysis

149
Q

Where are you most likely to see a slipped disk?

A

L4-L5

L5-S1

150
Q

Where are you most likely to see dislocation of the vertebrae due to Whiplash?

Medicine (10 decks)

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