MSK Flashcards
what are symptoms of axillary nerve injury?
(C5-6) flat deltoid, failure with abduction of arm >15 degrees, usually with neck fracture of humerus or anterior dislocation
Radial nerve injury?
C5-T1, wrist drop, loss of extension of wrist, elbow, finger , dec grip strength, , loss sensation posterior forearm and dorsal hand
Median nerve injury?
supracondylar fracture, carpel tunnel, loss of wrist flex and fingers, thumb opposition. Loss of sensation over thenar eminence and palmar aspect of 3.5 fingers
Ulnar injury?
fracture median epicondyle- hamate- loss wrist flexion, flexion medial fingers, adduction of the fingers
what is erbs palsy?
(C5/6)lateral traction neck during delivery, arm is adducted, medially rotated, pronated and extended
what is klumpke palsy?
lower trunk C8-T1, you get claw hand, upward force of the arm at delivery or adults, grabbing tree branch during fall, lumbricals, interossei, thenar and hypothenar
what does the McMurray test for?
Meniscal tears- popping or pain with external rotation is a medial menicus tear, while popping or pai with internal rotation is a lateral menicus tear
what is a baker’s cyst?
fluid collection (secondary to inflam-osteoarthritis or rheumatoid) in gastrocnemius and semimembranous bursa- popliteal fluid collection
What is the most common lower ankle sprain? What is the most common high ankle sprain?
low- anterior talofibular ligament
high- anterior inferior tibiofibular ligament
what nerve injury is associated with pelvic fracture?
femoral nerve (L2-4), anterior thigh and medial thigh sensation, , dec thigh flexion and leg extension
what does the sciatic nerve split into?
common peroneal and tibular nerves (injury from herniated disc)
what causes trendelenburg gait?
superior gluteal nerve injury (L4-S1), the hip that drops- the injury is on the other side
what does the pudenal nerve supply?
(S2-4) perineum-urethral and anal sphincters
what is De Quervain tenosynovitis
non inflam thickening of abductor pollicis brevis and extensor pollicis brevis, pain on Finkelsteins , radial styloid with active or passive stretch of thumb
What is Legg-Calve Perthes?
usually 5-7 year olds necrosis of femoral head, x-ray often normal, hip pain with limp
What is slipped capital femoral epiphysis?
epiphyses slips relative to femoral head, usually obese 12 year old due to axial forces, hip/knee pain and surgery needed
which direction to lumbosacral discs usually herniate?
posterolateral into the central canal so affect nerve underneath (ie L3/4 affects L4)
what are the common lumbosacral radiculopathies?
- L3/L4- difficulty with knee extension, dec patellar reflex
- L4/5- difficulty with heel walking and dorsiflexion
- L5/S1- difficulty with toe walking and plantar flexio, dec achilles reflex
What are type 1 and type 2 muscle fibers?
Type 1: red, high mitochondria and myoglobin, red, for endurance, oxidative phosphorylation
Type 2: white: low mitochondria, low myoglobin, weight training, sprinting, white fibers, anaerobic glycolysis
How does estrogen work in bone metabolism?
-inhibits osteoclasts and increases osteoblasts. Fusion of epiphyseal plate in puberty
What is achondroplasia?
failure of endochondral and membranous ossification- failure of long bones and big head relative to rest of body (membranous), constitutive activation of FGFR inhibits chondrocytes. Most sporadic, can be AD, homozyg lethal
What is osteomalacia/Ricketts?
failure of bone mineralization, vitamin D deficiency
-widening epiphyses, metaphyseal cupping, rachitic rosary (bead-like costo-chondral junctions)
What is Pagets disease?
increased osteoclast then osteoblast formation, , poor quality bone
- Ca, PTH and phosphorus all normal
- hearing loss is common secondary to auditory foramen narrowing
Why do you get osteonecrosis (avascular necrosis) of the femoral head?
medial circumflex femoral artery
-legg calve perthes, slipped capital femoral epiphyses, alcohol, corticosteroids,sickle cell, gaucher disease
