MSK Flashcards
1
Q
isotonic contraction definition
A
- tension remains constant, length of muscle changes
- used for body movements
2
Q
isometric contraction definition
A
- constant muscle length, muscle tension increases
- used for supporting objects in fixed positions
3
Q
Epymysium
A
connective tissue which surrounds muscle
4
Q
Perimysium
A
connective tissue which surrounds a single fascicle
5
Q
endomysium
A
connective tissue which surrounds a single muscle fibre
6
Q
What is a fascicle?
A
bunch of myofibrils
7
Q
What is a myofibril?
A
bunch of sarcomeres
8
Q
Where do chondrocytes live?
A
in small spaces called lacuna
9
Q
What is diaphysis made from?
A
cortical bone
10
Q
What is epiphysis and what is it made from?
A
- end bits of bones/longbones
- cancellous/trabecular bone
11
Q
what are volkmann’s and haversian canals?
A
- volmann’s =transverse canals
- heversian -vertical canals
- canals within bone which carry blood vessels
- osteoclasts drill these canals
12
Q
Lambert-Eaton-myasthenic syndrome
A
- autoantibodies against pre-synaptic membrane
- reduced Ca2+ enters presynaptic ganglion
- thus decreased Ach release
- causing muscle weakness
- assiciated with Small cell carc of lung
13
Q
Myasthenia Gravis
A
- Autoimmune attack of nicotinic Ach receptors
- thus reduced amplitude of end plate potential
- causing muscle weakness
14
Q
Guillian-Barre syndrome
A
- post infection cross reactivity between antibodies and nerve cells/myelin sheaths
- causing muscle weakness and paralysis
15
Q
Ganglion cyst
A
-out pouching of a weak portion of joint capsule
16
Q
Anti-CCP
A
RA
17
Q
ANA
A
SLE, Sjogrens, Systemic sclerosis, MCTD, autoimmune liver disease
18
Q
Anti-dsDNA
A
SLE
19
Q
Anti-Sm
A
SLE
20
Q
Anti-Ro
A
SLE, Sjogrens
21
Q
Anti-La
A
Sjogens
22
Q
Anti-centromere
A
limited systemic sclerosis
23
Q
anti-Scl-70
A
diffuse systemic sclerosis
24
Q
Anti-RNP
A
SLE, MCTD
25
Anti-Jo-1
myositis
26
Anti-cardiolipin antibody
Anti-phospholipid syndrome
27
lupus anticoagulant
Anti-phospholipid syndrome
28
ANCA
small vessel vasculitis
| e.g. GPA, EGPA, MPA
29
benign bony outgrowth with a cartilaginous cap
osteochondroma
30
benign metaphyseal cartilagenous tumour due to failure of normal growth plate ossification
enchondroma
31
benign fluid filled cavity within bone
simple bone cyst
32
occurs around knee, soap bubble appearance on x ray
giant cell tumour
33
small nidus of immature bone surrounded by sclerotic halo, really painful
osteoid osteoma
34
malignant primary bone tumour which produces bone
osteosarcoma
35
malignant primary bone tumour which produces cartilage
chondrosarcoma
36
info about chondrosarcoma
- older age groups
- around pelvis/femur
- slow growing
- does not respond to chemo or radiotherapy
37
malignant bone tumour which tends to appear in abnormal bone
fibrosarcoma/malignant fibrous histiocytoma
38
info about fibrosarcoma
- may appear in bone infarcts, fibrous dysplasia, paget's disease
- adolescents and young adults
39
malignant tumour of the primitive cells within the bone marrow
-ewing's sarcoma
40
info about Ewing's sarcoma
- occurs between age 10 and 20
- fever, raised CRP (looks a bit like septic arthritis)
- appears in diaphysis of longbones
- really poor prognosis as metastasises fairly early
41
middle aged patient with back pain and renal failure
myeloma
42
tumours likely to metastasise to bone
- breast carcinoma
- prostate carcinoma (sclerotic lesions)
- lung carcinoma
- renal cell carcinoma
- thyroid adenocarcinoma
43
swelling on flexor tendon with multinucleate cells and haemosiderin
giant cell tumour of tendon sheath
44
what is osteochondritis?
- bleeding/oedema within bone due to repetitive impact/traction
- can cause stress fractures, capillary compression and avascular necrosis
- commonly affects 2nd metatarsal head, navicular, lunate
45
what is grotton's sign?
- erythema over metacarpal heads
| - occurs in dermatomyositis
46
HLA associated with RA
HLA-DR4
47
radiological signs of OA
- loss of joint space
- subchondral sclerosis
- subchondra cysts
- osteophytes
48
features of enteropathic arthritis
```
-arthritis symptoms linked to IBD
may have:
-pyoderma gangrenosum
-uveitis?
-enthesitis
-apthous ulcers
-sacroilitis (crohn's)
```
49
spina biffida occulta definition
- slight defect in spine formation
- tuft of hair of fat pad over defect
- vertebrae may be deformed and may be spinal tethering
50
spina biffida cystica, meningocele and myelomeningocele definition
- content of spinal canal herniate through spinal defect
- herniation of meninges
- herniation of meninges and spinal cord
51
how does polio affect nervous system?
- damages anterior horn cells of spinal cord
| - lower motor neurone deficit
52
Erb's palsy
- injury to C5 and C6
- paralysis of deltoid, supraspinatus, infraspinatus, biceps and brachialis
- 'waiter tip'
53
Klumpke's palsy
- injury to C8 and T1
- paralysis of intrinsic hand muscles
- 'claw hand'
- may be associated horner's syndrome
54
Barlow's test
pushing backwards to try and dislocate hip
55
ortolani test
abducting hip to try and relocate a hip that is dislocated by barlow's test
-will hear clunk of hip reduced = likely DDH
56
what nerve supplies both hip and knee joints
obturator nerve
57
heberden's nodes
-swollen DIPs
58
bouchard's nodes
-swollen PIPs
59
what is DeQuervain's tenosynovitis
-inflammation of the sheath which surrounds extensor pollicis brevis and adductor pollicis longus
60
what is brown sequard syndrome
- injury to hemisection of the spinal cord
- ipselateral paralysis, loss of vibration, position and course touch sensation
- contralateral loss of pain, temperature and light touch sensation
- due to some nerves crossing over in spinal tract and others crossing over in medulla
61
which way is humeral shaft fracture likely to displace?
- medially
| - due to pull of pectoralis major
62
fracture to surgical neck of humerus and loss of sensation to regimental badge patch
axillary nerve injury
63
nightstick fracture
-ulnar shaft fracture
64
monteggia fracture
- fracture of ulna
| - dislocation of radial head at elbow
65
galeazzi fracture
- fracture of radius
| - dislocation of ulna at distal radioulnar joint
66
colles fracture
- fracture of distal radius
- occurs within an inch or articular surface
- dorsal displacement (of radius)
67
smith's fracture
- fracture of distal radius
- volar displacement of radius
- really unstable so ORIF
68
Barton's fracture
- intra-articular fracture of distal radius
| - can have either dorsal or volar displacement of radius
69
high energy wrist extension could cause
- peri-lunate dislocation
- lunate dislocation
- scaphoid fracture
- scapholunate dislocation
all of above require prompt reduction +/- ligament repairs and wiring
70
test of radial nerve
thumbs up
71
test of median nerve
make 'OK' sign
72
test of ulnar nerve
make a starfish
73
spondylosis definition
spinal osteoarthritis
74
spondylolisthesis definition
one vertebrae moves forward over another
| vertebral slip
75
schirmer's test
- test for sjogren's
| - filter paper to eye and measure fluid produced
76
DAS 28 less than 2.6
-remission
77
DAS 28 over 5.1
- active disease
| - will qualify for biologic therapy
78
histology of skeletal muscle
1. long cylindrical fibres
2. striated
3. unbranched
4. multinucleate fibers
79
histology of smooth muscle
1. short spindle shaped
2. non-striated
3. unbranched
4. single central nuclei per fibre
80
histology of cardiac muscle
1. short intercolated discs
2. striated
3. branched
4. single central nuclei
81
HLA associated with SLE
HLA-DR3
82
What might anti-RNP be raise in?
- MCTD
| - SLE
83
most specific antibody for SLE
anti-smith
84
mechanism of action of methotrexate
folate antagonist
85
second line treatment for gout
febuxostat
