MSK buzzwords Flashcards
What are the functions of vitamin D?
Increases calcium and phosphate via resorption in kidney
What are the functions of parathyroid hormone?
- Increases calcium via bone & kidney resorption + vitamin D synthesis
- increases phosphate via bone resorption—> decreased via excretion
What is ergocalciferol?
Plant derivative D2
What is cholecalciferol?
Animal derivative D3
How is cholecalciferol synthesized?
7 dehydrocholesterol —> cholecalciferol via sunlight
How does PTH activation lead to cholecalciferol activation?
Cholecalciferol—> 25-hydroxy via 25 hydroxylase —> Dihydroxy via 1 hydroxylase (PTH activation)
What is the purpose of calcitonin?
Decrease calcium via osteoclasts activity
What is the result of vitamin D liver disease?
Reduce 25-hydroxylase activity
What is the result of vitamin D kidney disease?
Reduce 1-hydroxylase activity
What are the effects of Rickets(vit d deficiency)?
Bow leg deformity
Rachitic rosary
Pigeon chest
What are the effects of Rickets(vit d resistant )?
Alopecia (hair loss)
Elevated 1,25(OH) 2D (decreased Ca. From diet)
What is osteomalacia?
A disease that causes broken bones and can cause them to break more easily. Leads to frequent fractures
What are the causes of hypocalcemia ?
Low PTH —> hypoparathyroidism
High PTH —> Secondary hyperparathyroidism
What is the result of hypervitaminosis?
Vit. D toxicity —> enhanced calcium absorption—> hypercalcemia —> soft tissue calcification
What does hypocalcemia (renal insufficiency) lead to?
Low 1,25 hydroxyl vitamin D
What does hypocalcemia (parathyroidectomy ) lead to?
Low parathormone levels
What does severe hypocalcemia lead to?
Tetany—> cardiac arythmas/breathing —> calcium gluconate IV (immediate treatment) or Ca supplement + Vit D
What are the effects of HYPERcalcemia?
Excessive PTH —> HIGH PTH HIGH CA LOP PO4
Hypervitaminosis D —> HIGH CA HIGH PO4 HIGH (OH) 2D “Bones, moans, stones, abdominal groans”
What is the result of Hyperphosphatemia ?
Poor PO4 Absorption (vitamin D deficiency) + high PO4 Excretion (Excess PTH)
Where is herpes zoster located ?
Located at dorsal root ganglion
What is hyper kyphosis?
“Hunchback” —> increase in thoracic curvature
What is crush fracture?
Compression of vertebral body
What is a wedge fracture?
Small fractures around vertebral body
What is spinal canal stenosis syndrome?
Hypertrophy of Ligamentum flavum
What are lateral displaced scapula?
Damaged dorsal scapular nerve/ rhomboid maj. min.
What causes winged scapula?
Long thoracic nerve
Where is a lumbar puncture made?
Between L4/L5 (subarachnoid space)(past supraspinous ligament ) (incorrect puncture —> go through posterior longitudinal ligament)
What is the landmark for lumbar puncture?
Highest points of iliac crests (tuffier’s line)
What is Disc herniation?
Nucleus pulposis protrusion posterolaterally into intervertebral foramen)
What is the spina bifida occulta?
Tuft of hair + small dimple
What is the spina bifida meningocele?
Protrusion of meninges through unfused vertebral arch
What is a spina bifida myelomeningocoele?
Protrusion of meninges and CNS tissue
What is spina bifida myeloschisis?
Protrusion of spinal cord or spinal nerves and meninges
Where is the spinal cord terminated?
L1/L2
What is a laminectomy?
Removed the portion of the vertebra called the Lamina
Where is caudal anesthetic given?
Sacral hiatus—> epidural space (given during pregnancy)
What causes drooping shoulder ?
Damage to spinal accessory nerve/ trapezius
What is a Hangman’s fracture?
Par inter-articularis ~ spondylolysis of C2 (anterior displacement= Spondylolisthesis)
What is whiplash?
Hyperextension injury + torn anterior longitudinal ligament
What is Jefferson?
Burst fracture of C1/C2 ONLY —> DAMAGE to anterior/posterior arches
What is wedge/compression fracture?
Loss of height - vertebral compression
What is a chance fracture?
Transverse fracture with anterior compression of vertebral body @ T12-L2= forward flexion (lap seatbelt injury)
What is a burst fracture?
Severe compression + vertebral body spread out all direction s (anything below C2)
What is spondylosis ?
Fracture of superior/inferior Articular process/pars interarticularis (dog collar)
What is spondolysthesis?
Vertebra slips anteriorly
What controls epidural drainage?
Internal vertebral plexus of Batson
What are the functions of the dorsal and ventral rami?
Dorsal rami: innervation of deep intrinsic back muscles
Ventral rami: mixed spinal nerves to/from all body minus back and head cranial nerves
What parts comprise the triangle of petit?
Medial border: latissimus dorsi
Lateral border: external abdominal oblique
Inferior border: iliac crest
Floor: internal abdominal oblique
What parts comprise the triangle of auscultation?
Latimuss dorsi + trapezius + scapula
What is the location of indirect inguinal hernia?
Located at inguinal canal
What is the location of the direct inguinal canal?
Located at hesselbach’s triangle
Where is the femoral hernia located?
Located below inguinal ligament
What klippel-feil syndrome?
Reduction/ fusion of cervical vertebrae —> stiff neck + limited motion
What is Chiari II Malformation?
Herniation of medulla and cerebellum into foramen magnum
What is hydrocephalus?
Over production of CSF / interference with absorption
What is tethered cord syndrome?
Defective closure of neural tube + low conus medullaris /thick filum terminale
What is the artery of Adamkiewicz/ great radical air artery?
Blood supply to anterior/posterior spinal arteries
What are somites derived from ?
Derived from Sclerotome
What is the Annulus fibrosis?
Sclerotome component is somite
What is the Remnant of the Notochord?
Nucleus Pulposis
What is the nature of slow type 1 muscle fiber?
Type 1 slow in nature, high myoglobin, high mitochondria, slow conduction
Slow contraction—> found in long muscles of back
What is the nature of the type IIA muscle fibers?
Fast oxidative—> high glycogen+ anaerobic glycolysis
What is the nature of the type IIB muscle fibers?
Fast glycolystic —> low myoglobin + low mitochondria + low oxidative enzyme —> found in extraocular muscles + muscles of digits
What is Titin?
Anchor thick filament to Z line
What is the function of Alpha actinin?
Anchor thin filament to Z line
What is the function of Nebulin?
Anchor THIN Filament to Z-line + Regulate length during development
What is the function of Myomesin/ C Protein?
Connects THICK Filament to M-line
What are the functions of Tropomodulin?
Maintain LENGTH of ACTIN filament
What is the function of Dystrophin?
Link LAMIN of ECM of ACTIN FILAMENT
What is the function of Dystroglycan?
Link b/w Dystrophin + Laminin
What is the sarcoglycan ?
Associated w. membrane dystroglycans —> encode 4 different sarcoglycans