MSK

Question 1

movements supplied by spinal nerves

Answer 1

upper limbs: C5- jazz hands , C6- pose (palm under chin), C7- pulling brake on bike, C8- finger flexion/extension, T1- finger ab/adduction

lower limbs:
https://share.icloud.com/photos/0wUJLvw-2pMqRjnxdeN66TAQw

L2: hip flexion, L3: knee extension + adduction, L4: dorsiflexion, L5: grt toe extension + abduction + inversion, S1: ankle plantarflexion + hip extension + eversion, S2: great toe flexion, knee flexion

Question 2

hip joint extra capsular ligament functions

Answer 2

iliofemoral- prevents hyperextension
pubofemoral- prevents excess hip abduction and extension
ischiofemoral- prevents excessive internal rotation of hip joint

Question 3

arthritis surgical treatment

Answer 3

arthroplasty: joint replacement
arthrodesis: joint fusion
excision arthroplasty: surgical removal of joint w/ interposition of soft tissue
osteotomy: sugical cutting of bone to allow realignment

Question 4

Gait cycle phases

Answer 4

STANCE PHASE
Initial contact (heel strike), loading response, mid-stance, terminal stance, pre-swing

SWING PHASE
initial swing, mid-swing, terminal swing

Question 5

Pathological gaits

Answer 5

ANTALGIC GAIT- painful leg, short stance phase of affected leg, walking stick in opposite hand
TRENDELENBURG GAIT- hip abductor weakness due to pain, trauma, neurological weakness, pelvic drop on unaffected side
HEMIPLEGIC GAIT- hemi- brain injury (stroke, cerebral palsy, trauma), flexion in upper limb+ extension in lower limb, short step and circumduction
DIPLEGIC GAIT- neuromuscular disorders e.g cerebral palsy, tight muscle groups and ankles plantarflexed
HIGH STEPPAGE GAIT- foot drop (sciatica/common per nerve palsy), excessive hip flexion, foot slap
PARKINSONIAN GAIT- neurological disease, short shuffling steps, leans over
ATAXIC GAIT- cerebellar disorders (inherited, sensory, intoxication), broad based, uncoordinated, using arms to balance

Question 6

bursitis types

Answer 6

olecranon bursitis: ‘student’s elbow’, generally managed w/ bandaging +/- aspiration

pre-patallar bursitis: ‘housemaid’s knee’, presents w/ pain, usually due to reptitive trauma though can be blunt trauma

infrapatellar bursitis: ‘clergyman’s knee’, also due to microtrauma, usually affects superficial bursa

suprapatellar bursitis: often sign of more significant pathology e.g RA, OA, gout, infection, repetitive microtrauma

semimembranosus bursitis: due to knee joint inflammation, also called ‘baker’s cyst’

Question 7

toe deformities

Answer 7

hammer toe: flexion at PIPJ “ill-fitted pointed shoes, most common on 2nd toe”
mallet toe: flexion at DIPJ, “”
claw toe : hyperextension at MTPJ + flexion at PIPJ and possibly DIPJ, muscle imbalance causes ligament and tendon tightness, often due to neurological damage
curly toe: flexion at all joints, often congenital, thought to be due to tight FDL tendon

Question 8

dislocations of the hip and #nof

Answer 8

NOF: hip shortened, abducted, externally rotated. Due to short external rotator muscles externally rotating, glute medius + minimus abducting and strong thigh muscles pull distal component upwards causing shortening.

Posterior dislocation: limb shortened + internally rotated, head of femur pulled upwards by strong extensors and internally rotated by gluteus medius and minimus pulling on greater trochanter

anterior dislocation: limb in external rotation, abduction and slight flexion