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MSK Flashcards

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1
Q

What are the common types of nerve injury?

A

Neuropraxia

Axonotmesis

Neurotmesis

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2
Q

Features of neurapraxia?

A

Nerve intact but electrical conduction is affected
Full recovery
Autonomic function preserved
Wallerian degeneration does not occur

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3
Q

Features of Axonotmesis

A

Axon is damaged and the myelin sheath is preserved. The connective tissue framework is not affected.
Wallerian degeneration occurs.

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4
Q

Features of Neurotmesis?

A

Disruption of the axon, myelin sheath and surrounding connective tissue.
Wallerian degeneration occurs.

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5
Q

What muscles are being tested in the trendenlenburg test?

A

The contralateral Abductors (Gluteus Medius & minimus)

If the pelvis tilts to the right its the L abductors that are weak

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6
Q

Where do the rotator cuff muscles insert onto the humerus?

A

Subscapularis –> Lesser Tubercle

Supraspinatus, Infraspinatus & Teres minor –> Greater Tubercle

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7
Q

What structures are supplied by the following arteries:

  • Middle Genicular
  • Medial Geniculate
  • Medial Femoral Circumflex
  • Lateral Femoral Circumflex
A

Middle Genicular –> ACL

Medical Geniculate –> MCL

Medial Femoral Circumflex –> HEad of femur and neck (fracture –> damage –> necrosis of head of femur)

Lateral Femoral circumflex –> Lateral compartment of thigh

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8
Q

Contents of cubital fossa from Lat to Medial?

A
  • RAdial nerve
  • Biceps Tendon
  • Brachial Art
  • Median Nerve
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9
Q

What vascular structure is found at the sternomanubrial joint level?

A

Aortic Arch

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10
Q

What articulates with head of radius and ulnar superiorly?

A

Capitulum with radius

TRochlea with ulna

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11
Q

What structures pass behind the lateral malleolus? (in order from ant to post)

A 
Tibialis Posterior
Flexor Digitorum longus
Posterior Tibial Artery
Posterior Tibial Vein
Tibial Nerve
Flexor Hallucis Longus

T: tibialis posterior 
D: flexor digitorum longus 
A: artery (posterior tibial)
V: vein (posterior tibial)
N: nerve (tibial)
H: flexor hallucis longus
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12
Q

How do you remember the structures passing behind the lateral malleolus?

A

Tom Dick & Very Nervous Harry:

  • Tibialis posterior
  • flexor Digitorum Longus
  • post tibial Art
  • post tibial Vein
  • tibial Nerve
  • flexor Hallucis longus
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13
Q

What nerves supply sensation to the foot?

A

Tibial nerve –> Plantar Surface
Superficial Peroneal Nerve –> Dorsum
Deep Peroneal Nerve –> Dorsum, just 1st web space
Sural Nerve –> Lateral foot (a branch of both the tibial and common peroneal nerves)

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14
Q

19yr old patient presents with increasing back stiffness over a period of months, shoulder & back pain and enthesitis in his achilles tendon. What’s the likely diagnosis and what blood test would you run?

A

Ankylosing spondilytis
Do HLA-B27

Most common presentations are inflammation of sacroiliac joints, achilles enthesitis and plantar fasciitis

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15
Q

what muscle is most heavily involved in testing lower limb coordination by the heel-shin test

A

Sartorius due to its effect of medial rotation of tibia on the femur

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16
Q

What are the major causes of Acanthosis Nigricans?

A

1) Obesity related
2) DM
3) Cushing’s
4) PCOS
5) Drugs e.g. insulin

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17
Q

What nerves supply the knee joint?

A

Femoral
Sciatic
Obturator

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18
Q

What structures attach to the coracoid process?

A
  • Short head of Biceps Brachii
  • Coracobrachialis
  • Pec minor
  • Coracoacromial, -clavicular and -humeral ligaments
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19
Q

Patient presents unable to grasp a piece of paper between finger and thumb. What nerve is damaged and what is this sign called?

A

Froment’s Sign

Indicative of ulnar nerve palsy

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20
Q

What organism causes most OM in kids?

A

Staph Aureus (unless sickle cell then its salmonella)

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21
Q

Which nerve supplies which lower leg compartment?

A

Ant comp = Deep Peroneal (Fibular)
Lat Comp = Sup Peroneal (Fibular)
Post Comp = Tibial Nerve

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22
Q

What muscles are found in the ant lower leg?

A

Tibialis Ant
Extensor Digitorum Longus
Extensor Hallucis Longus
Peroneus Tertius

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23
Q

What muscles are in lat lower leg?

A

Fibularis Longus & brevis

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24
Q

What muscles are in deep and superficial post lower leg?

A

Deep = Tibialis Post, Flexor Hallucis Longus, Flexor Digitorum Longus & Popliteus

Superifical = Plantaris, Soleus & Gastrocnemius

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25
What are the potential complications of Toxic Epidermal Necrosis?
- Hypothermia - 2nd* infection - Fluid loss - Electrolyte Imbalance
26
Within which tendon is the pisiform found?
Flexor Carpi ulnaris Its a sesamoid bone
27
What tendons are affected in de quervains tenosynovitis?
APL & EPB
28
what forms the boundaries of the greater sciatic foramen and what passes through it?
``` Anterolaterally = Greater sciatic notch of the ilium Posteromedially = Sacrotuberous ligament Inferior = Sacrospinous ligament and the ischial spine Superior = Anterior sacroiliac ligament ``` Pudendal Nerve
29
What does the pudendal nerve do?
Sensation to genitals, perineum and around anus Motor to some pelvic muscles including ext urinary sphincter and ext anal sphincter
30
What tumour is a Codman's triangle on X-ray associated with?
Osteosarcoma Codman's triangle is an elevation of periosteum
31
What is targeted by infliximab and rituximab?
Infliximab - TNF-alpha | Rituximab - CD20
32
which of the following muscles don't insert onto the radius? - Pronator Quadratus - Biceps - Brachioradialis - Brachialis - Supinator
Only the brachialis doesn't insert onto the radius, it inserts onto the ulna instead
33
Osteonecrosis of jaw is a risk of which drug?
Bisphosphonates e.g. Alendronate
34
What passess through the greater and lesser sciatic foramina?
PIN: - Pudendal Nerve - Internal Pudendal Art - Nerve to Obturator Internus
35
What effect does the trapezius have on scapular movement?
Retraction and upward rotation/elevation
36
Which muscle is tested in froment's test?
Adductor Pollicis
37
What protein is affected in Marfan's Syndrome?
Fibrillin
38
What nerve supplies the hamstrings?
Tibial division of Sciatic Nerve
39
Whats the significance of the ischial spine and tuberosity?
They attach the sacrospinous and sacrotuberal ligaments which form the greater and lesser sciatic foramina Sacrotuberal is more superficial and inf when viewed from behind
40
What do we call the lateral fascia lata?
Iliotibial tract
41
What do we call the bone notches that contribute to the sciatic foramina?
Greater and lesser sciatic notches
42
Osteogenesis Imperfecta is an autosomal dominant condition affecting collagen Type 1, how does it present?
``` presents in childhood fractures following minor trauma blue sclera deafness secondary to otosclerosis dental imperfections are common ```
43
What is Ehler's Danlos Syndrome?
Autosomal Dominant CT disorder affecting Type 3 collagen
44
How does Ehler's-Danlos Syndrome present?
elastic, fragile skin joint hypermobility --> recurrent joint dislocation easy bruising aortic regurgitation, mitral valve prolapse and aortic dissection subarachnoid haemorrhage angioid retinal streaks
45
In what condition is collagen Type 4 affected?
Goodpasture's Syndrome
46
Where do the rotator cuff muscles insert?
Onto the greater tuberosity of the humerus Bar the subscapularis which inserts onto the lesser tuberosity
47
What are hard bony nodes forming on the interphalangeal joitns of the fingers?
``` Proximal = Bouchards Distal = Heberdens ``` They are features of OA
48
What conditions would be suggested by joint/back pain that worsens in the morning and is relieved by exercise?
Inflammatory e.g. RA or Ankylosing Spondylitis
49
What function does the serratus ant have on the arm?
Abduction
50
What forms the roof of the adductor canal?
Sartorius
51
Where does the sartorius insert?
Onto the medial upper part of the tibia
52
which rotator cuff muscles are responsible for int vs ext rotation?
Subscapularis is the only int rotator | All the rest are ext
53
where does the biceps originate and insert?
Long head = Supraglenoid Tubercle of scapula Short head = Coracoid process Insertion = RAdial Tuberosity
54
what muscles insert onto the intertubecular sulcus of the humerus?
Pec major | Lats
55
What ligament connects the head of the radius to the ulna?
Annular Ligament
56
What is Sjogren's syndrome and what is it a complication of?
Its an autoimmune condition against exocrine glands --> Dry mucosal membranes --> dry mouth, vagina, COPD, bronchiectasis etc Its a complication of RA
57
Whats the most common finding in paget's disease?
Raised ALKP
58
What's deposited in Pseudogout?
Calcium Pyrophosphate Dihydrate
59
Treatment for Gout?
1st) NSAIDs or Colchicine 2nd) Steroids (Oral or IA) Allopurinol as long-term therapy
60
Whats the most common benign bone tumour?
Osteochondroma
61
Most common malignant boen tumour?
Osteosarcoma

Yr3 Revision (9 decks)

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