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PPE Revision > MSK > Flashcards

MSK Flashcards

1
Q

Describe the unique features of the altas

A
  • No body
  • Lacks spinous process
  • Widest cervical vertebrae
  • Body fused with dens of axis
    • Atlano-axial joint allows for rotation of head
  • Atlanto-occipital joint allows for nodding of head
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2
Q

What are the main features of the axis?

A
  • Dens - prevents horizontal displacement of atlas
  • Large spinous process
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3
Q

What are the distinct features of the cervical vertebrae?

A
  • Bifid spinous process
  • Oval transverse foramen - vertebral arteries and veins
  • Triangular vertebral foramen
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4
Q

Label this diagram of a thoracic vertebrae.

A
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5
Q

What are the features of the thoracic vertebrae?

A
  • 2 demi-facets on each side
  • 1 costal facet on each side
  • Round vertebral foramen
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6
Q

What are the features of lumbar vertebrae?

A
  • No foramina of transverse processes
  • No costal facets or demi-facets
  • Vertebral foramina is small and triangular
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7
Q

What is the remenant of the notocord?

A

Nucleus pulposus

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8
Q

What are the parts of the intervertebral disc?

A
  • Annulus fibrosus
  • Nucleus pulposus
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9
Q

Which artery is at risk of during fracture of head of humerus and mid-humeral fracture?

A
  • Anterior/posterior circumflex humeral artery
  • Profunda brachii
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10
Q

What are the nerve roots for:

  1. Musculocutaneous
  2. Median
  3. Ulnar
  4. Axillary
  5. Radial
A
  1. Musculocutaneous - C5, C6, C7
  2. Median - C6, C7, C8, T1
  3. Ulnar - C8, T1
  4. Axillary - C5, C6
  5. Radial - C5, C6, C7, C8, T1
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11
Q

What is the ulnar claw?

A
  • Lesion of ulnar nerve at wrist
  • Paralysis of medial 2 lumbricals - lumbricals flex MCP & extend IP joints
    • Unopposed extension at MCP due to extendor digitorum
    • Unopposed flexion at distal IP joint by flexor digitorum profundus
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12
Q

What is the ulnar paradox?

A
  • Lesion of ulnar nerve at elbow is a injury but looks better
  • Flexor digitorum profundus (medial part) is paralysed so there’s no flexion at IP joint making ulnar claw much less obvious
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13
Q

What are the muscles of pronation and supination?

A
  • Supination - biceps brachii, supinator
  • Pronation - pronator teres, pronator quadratus
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14
Q

Which muscles are innervated by musculocutaneous nerve?

A
  • Biceps brachii
  • Brachialis
  • Coracobrachialis
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15
Q

Which muscles are innervated by radial nerve?

A
  • Posterior compartment of arm - triceps brachii
  • Posterior compartment of forearm
    • x3 to wrist - ECRL, ECRB, ECU
    • x3 to the fingers - ED, EDM, EI
    • x3 to thumb - EPL, EPB, AbPL
    • +3 - Brachioradialis, anconeus, supinator,
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16
Q

What are the muscles innervated by the median nerve?

A

Forearm

  • Superficial - Palmaris longus, flexor carpi radialis, pronator teres
  • Intermediate - flexor digitorum superficialis
  • Deep - Lateral half of flexor digitorum profundus, flexor pollicis longus, pronator quadratus

Hand

  • Muscles of thenar eminence (LOAF) - Lumbricals 1 & 2, opponens pollicis, abductor pollicis brevis, flexor pollicis brevis
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17
Q

What muscles are innervated by the ulnar nerve?

A

Forearm

  • Superficial - Flexor carpi ulnaris
  • Deep - Medial 1/2 of flexor digitorum profundus

Hand - everything except LOAF (median nerve)

  • Muscles of hypothenar eminence:
    • Opponens digiti minimi
    • Abductor digiti minimi
    • Flexor digiti minimi brevis
  • Adductor pollicis
  • Palmar/dorsal interosseui
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18
Q
A
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19
Q

What is the Hand of Benediction?

A
  • Damage to median nerve
  • Seen when patients asked to make a fist
  • Paralysis of forearm flexors - apart from flexor carpi ulnaris and medial half of flexor digitorum profundus
  • Paralysis of lateral 2 lumbricals
  • Therefore unable to flex index and middle fingers as well as thumb
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20
Q

What are the motor functions of:

  1. C5
  2. C6
  3. C7
  4. C8
  5. T1
A
  • C5 - elbow flexors
  • C6 - wrist extensors
  • C7 - elbow extensors
  • C8 - finger flexors
  • T1 - finger abductors
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21
Q

What are the motor functions of:

  • L2
  • L3
  • L4
  • L5
  • S1
A
  • L2 - hip flexors
  • L3 - knee extensors
  • L4 - ankle dorsiflexors
  • L5 - long toe extensors
  • S1 - ankle plantar flexors
22
Q

Briefly describe embrological development of limbs

A
  1. Limb buds appear on ventro-lateral body wall (somatic mesoderm with ectodermal cover)
  2. Apical ecotdermal ridge secretes signalling molecules (diffusion limited) preventing differenitation of mesochyme and encourage proliferation
    • Proximal parts begins to differentiate due to lack of signalling molecules from AER
  3. AER marks boundary between dorsal/ventral parts & secretes dorsalising/ventralising influences over mesenchymal core
  4. Zone of polarising activity generates asymmetry in limbs
  5. Digial rays occur as AER regresses over areas between digits
  6. Mesoderm condenses, differentiates = cartilagous model then endochondrial ossification occurs
  7. Myogenic precursors are taken into limbs from somites - bring innovation with them
    • Merge into common muscle masses around skeleton then split into individual muscles
23
Q

What are the borders of the axilla?

A
  • Lateral wall - intertubecular groove of humerus
  • Medial wall - serratus anterior and thoracic wall
  • Anterior wall - pectoralis major and minor
  • Posterior wall - scapularis, teres major, lastissimus dorsi
24
Q

What are the contents of the axilla?

A
  • Long head of biceps brachii
  • Corocobrachialis
  • Brachial plexus
  • Axillary artery
  • Axillary vein

‘Big boobs can bring pleasure and arousal after viagra’

25
Q

What are the borders of the cubital fossa?

A
  • Superior - imaginary line between epicondyles
  • Medial - lateral border of pronator teres
  • Lateral - medial border of brachioradialis
26
Q

What are the contents of the cubital fossa?

A
  • Radial nerve
  • Biceps tendon
  • Brachial artery
  • Median nerve

‘Really need beer to be at my nicest’

27
Q

What are the contents of the carpel tunnel?

A
  • Median nerve
  • Flexor pollicis longus
  • Flexor digitorum superficialis
  • Flexor digitorum profundus
28
Q

What are the bones of the wrist?

A
  • Scaphoid (lateral)
  • Lunate
  • Triquetrum
  • Pisiform
  • Trapezium (lateral)
  • Trapezoid
  • Cunate
  • Hamate

‘Some lovers try positions that they cannot handle’

29
Q

Common causes of carpel tunnel syndrome

A
  • T = trauma
  • R = Rheumatoid arthritis
  • A = acromegaly
  • M = myxoedma - swelling of skin and underlying tissues (characteristic of hypothyroidism)
  • P = pregnancy
30
Q

What are the borders of the anatomical snuffbox?

A
  • Medial border = Tendon of extensor pollicis longus
  • Lateral border = Tendon of abductor pollicus longus and tendon of extensor pollicis brevis
  • Proximal border = styloid process of radius
31
Q

What causes pain in the anatomical snuffbox?

A
  • Fracture of scaphoid
32
Q

What is the innervation of serratus anterior? What sign is caused if this nerve is damaged?

A
  • Long thoracic nerve
  • Winged scapula
33
Q

What is the innervation of latissimus dorsi?

A

Thoracodorsal nerve

34
Q

What are the borders of the femoral triangle?

A
  • Superior = inguinal ligament
  • Lateral = medial border of sartorius
  • Medial = lateral border of adductor longus
  • Floor = pectineus, iliopsoas, adductor longus
35
Q

What are the contents of the femoral triangle?

A
  • Femoral Nerve
  • Femoral Artery
  • Femoral Vein
  • Femoral Canal - Lymphatics
36
Q

What is the difference between midinguinal point and midpoint of inguinal ligament? What can be found at these points?

A
  • Mid-inguinal point = midway between pubic symphysis and ASIS - femoral artery
  • Mid point of inguinal ligament - midway between pubic tubercle (start of inguinal ligament) to ASIS (end of inguinal ligament) - femoral nerve
37
Q

What are the borders of the popliteal fossa?

A
  • Superiomedial = Semimembranosus
  • Superiolateral = Biceps femoris
  • Inferiomedial = Medial head of gastrocnemius
  • Inferiolateral = Lateral head of gastrocnemius
38
Q

What are the contents of the popliteal fossa?

A
  • Popliteal artery
  • Popliteal vein
  • Tibial nerve
  • Common fibular nerve
39
Q

What are the deep lateral rotators of the hip?

A
  • Piriformis
  • Obturator internus
  • Obturator externus
  • Quadratus femoris
  • Gemellus superior
  • Gemellus inferior

‘Play golf or go on quests’

40
Q

What are the muscles of anterior thigh?

A
  • Sartorius
  • Quadriceps femoris
    • Rectus femoris
    • Vastus medialis
    • Vastus intermedius
    • Vastus lateralis
  • Iliopsoas
41
Q

What are the nerve roots for the femoral nerve?

A

S2-S4

42
Q

What are the muscles of the medial thigh?

A
  • Pectineus
  • Adductor brevis, longus and magnus
  • Gracilis
43
Q

What are the nerve roots for the obturator nerve? How does it enter the medial thigh?

A
  • S2-S4
  • Through obturator canal in obturator foramen
44
Q

What are the muscles of the posterior thigh?

A
  • Semimembranosus
  • Semitendinosus
  • Biceps femoris
45
Q

What is the nerve roots of the sciatic nerve?

A

L4-S3

46
Q

What are the muscles of the anterior compartment of the leg?

A
  • Tibialis anterior
  • Extensor digitorum longus
  • Extensor hallucis longus
  • Fibilaris tertius
47
Q

What are the muscles of the lateral compartment of the leg?

A
  • Fibularis longus
  • Fibularis brevis
48
Q

What are the muscles of the posterior compartment of the leg?

A
  • Gastrosnemius
  • Soleus
  • Tibialis posterior
  • Flexor digitorum longus
  • Flexor halllucis longus
  • Plantaris
  • Popliteus
49
Q

What is the difference between housemaid’s knee and clergyman’s knee?

A
  • Housemaid’s - inflammation of prepatellar bursa
  • Clergyman’s - inflammation of infrapatellar bursa
50
Q

What is the unhappy triad?

A
  • Force to lateral side of knee
  • Damage to medial collateral ligament, medial meniscus, and anterior cruciate ligament
51
Q
A

PPE Revision (16 decks)

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