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Misc. Notes Year 2 > MSK notes > Flashcards

MSK notes Flashcards

1
Q

What are the 4 main seronegative arthritides

A

Ankylosing Spondylitis
Reactive Arthritis
Psoriatic Arthritis
Enteropathic Arthritis

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2
Q

What is the innervation of the Gluteus maximus

A

Inferior Gluteal Nerve

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3
Q

Which muscle is continuous with the iliotibial tract

A

Tensor Fascia Lata

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4
Q

The greater and lesser sciatic foramen are passageways into which structures

A

Greater - Pelvis

Lesser - Perineum

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5
Q

Which spinal cord segments make up the sciatic nerve

A

L4-S3

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6
Q

Which spinal cord segments make up the pudendal nerve

A

S2-4

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7
Q

Which three ligaments are part of the hip joint

A

Iliofemoral
Pubofemoral
Ischiofemoral

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8
Q

Name the articulations of the knee joint

A

2x Femorotibial

1x Femoropatellar

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9
Q

Which spinal cord segments are involved in the ankle jerk reflex

A

S1, S2

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10
Q

The tendons of which two muscles make up the calcaneal/Achilles tendon

A

Gastrocnemius & Soleus

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11
Q

Name the differences between skeletal and cardiac muscle in terms of :
Neuromuscular Junctions
Gap junctions
Striations

A

Skeletal and cardiac muscle is striated
Skeletal muscle has Neuromuscular Junctions
Cardiac muscle has Gap junctions

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12
Q

Define a motor unit of skeletal muscle

A

A single alpha motor neuron and all the muscle fibres it supplies

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13
Q

What is A-band

A

Thick filaments along with thin filaments that overlap in both ends of thick filaments

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14
Q

What is I-Band

A

Remaining portion of thin filaments which don’t project into A-band

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15
Q

What is H-zone

A

Lighter area in middle of A-band where thin filaments don’t reach

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16
Q

What is M line

A

A line down the middle of H-zone

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17
Q

How is Ca2+ released in muscle cells

A

When the surface action potential spreads down the transverse T-tubules, Ca2+ is released from the lateral sacs of the Sarcoplasmic Reticulum

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18
Q

What 2 things does gradation of muscle tension depend on

A

Number of muscle fibres

Tension developed by each fibre

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19
Q

What is the optimal length of skeletal muscle

A

The resting length

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20
Q

What are the two contraction types and when are they useful

A

Isotonic - muscle length changes

Isometric - muscle length stays constant

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21
Q

What are the three metabolic pathways to supply ATP in skeletal muscle

A

Creatinine Phosphate - via ADP - immediate
Oxidative Phosphorylation - When O2 is present
Glycolysis - When O2 is absent

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22
Q

What are the three muscle fibre types and when are they used

A

Type 1 -Slow oxidative (slow twitch) - Prolonged low work
Type 2a - Fast oxidative (intermediate) - Prolonged moderate work
Type 2x - Fast Glycolytic (fast twitch) - Short term high intensity

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23
Q

Are muscle spindle fibres intrafusal or extrafusal

A

Intrafusal

Normal muscle fibres are extrafusal

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24
Q

What are the muscle spindle sensory nerve endings called

A

Annulospiral fibres

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25
Q

What is the name of the muscle spindle’s efferent nerve supply

A

gamma motor neurons

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26
Q

What is the most common causative organism in osteomyelitis in a patient with sickle cell disease

A

Salmonella

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27
Q

What is a common causative organism in osteomyelitis if a prosthetic joint and what is the treatment

A

Staph Epidermidis

Vancomycin

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28
Q

What is the incubation period of Clostridium tetani

A

4 days - several weeks

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29
Q

What colour are each of the muscle fibre types on a succinate dehydrogenase stain

A

Type 1 - Dark purple
Type 2a - Light purple
Type 2x - Almost white

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30
Q

How much of hyaline cartilage is water and what is the other component

A

75% water

25% organic material

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31
Q

What is the organic material of hyaline cartilage made up of

A

60% type 2 collagen

40% proteoglycan aggregates

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32
Q

What is the terminal division of a motor neurone called

A

Terminal bouton

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33
Q

What surrounds a terminal bouton

A

Schwann cell

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34
Q

How is choline transferred into the terminal

A

via Na+ symport through the choline transporter

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35
Q

Which enzyme combines choline with ____ to form Ach

A 
Choline Acetyltransferase (CAT) 
Combines choline and acetyl-CoA
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36
Q

What 2 things do the arrival of the action potential at the terminal cause

A

Depolarisation of voltage-activated Ca2+ channels

Allows Ca2+ entry into the terminal

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37
Q

What does e.p.p stand for, in terms of the neuromuscular junction

A

End Plate Potential

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38
Q

What is the end plate potential caused by

A

ACh activates nicotinic ACh receptors located in the muscle end-plate
This opens a gate causing influx of Na+ which is greater than efflux of K+: a depolarization known as the end plate potential (e.p.p.) is generated

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39
Q

What is a synarthrosis

A

A fibrous joint

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40
Q

What is an amphiarthrosis

A

A cartilaginous joint

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41
Q

What is a diarthrosis

A

A synovial joint

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42
Q

What does rapid movement do to the elasticity and viscosity of synovial fluid

A

Increases elasticity

Decreases viscosity

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43
Q

What 2 things break down chondrocytes

A

Metalloproteinase

Proteolytic enzyme

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44
Q

What are the three types of pain

A

Nociceptive
Inflammatory
Pathological

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45
Q

What are the two types of pain fibres and what is the difference between them

A

A-fibres - thinly myelinated - sense fast pain

C- fibres - unmyelinated - sense prolonged pain

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46
Q

Which gene is associated with RA

A

HLA-DR4

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47
Q

What is a pannus

A

The inflamed synovium

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48
Q

How is early RA defined

A

<2 years since the onset of symptoms

49
Q

What is seen in synovial fluid which is a marker for cartilage degradation

A

Type 2 collagen

50
Q

How is hyperuricaemia defined

A

Serum uric acid > 7

51
Q

What is the gold standard investigation for crystal arthropathy

A

Joint Aspirate

52
Q

What crystal builds up in Milwaukee shoulder

A

Hydroxyapatite

53
Q

What stain is a buzzword for Milwaukee shoulder

A

Alizarin red stain

54
Q

What is the single gene defect that results in IPEX syndrome

55
Q

Does inclusion body myositis affect distal or proximal muscles

A

Causes distal muscle weakness

56
Q

Is muscle strength affected by Polymyalgia Rheumatica

A

No, it is normal

57
Q

In Vasculitis, which layer of the blood vessel are dendritic cells activated in

A

Tunica Adventitia

58
Q

What are the two main large cell vasculitis

A

Takayasu & Giant Cell Arteritis

59
Q

What are the two main medium vessel vasculitis

A

Kawasaki disease

Polyarteritis Nodosa

60
Q

Who does Kawasaki disease predominantly affect

A

Children under 5

61
Q

What is the first line treatment for ANCA-associated vasculitis at a systemic level

A

Cyclophosphamide + steroids

62
Q

What is Henoch-Schonlein Purpura

A

IgA mediated vasculitis which affects the GI tract, skin and kidneys

63
Q

Where do motor and sensory neurons originate from

A

Motor - Anterior grey horn

Sensory - Dorsal root ganglion

64
Q

Where does the spinal cord end

65
Q

Which three muscles make up the erector spinae

A

Iliocostalis
Longissimus thoracis
Spinalis thoracis

66
Q

What is a chance fracture

A

Common in car crashes
Fractured bone in front of spine
Torn ligaments at the back

67
Q

When should Genu Valgus be referred

A

If intermalleolar distance is more than 8cm at 11 years old

68
Q

What are the three possible causes of in-toeing

A

Internal tibial torsion
Metatarsus Adductus
Femoral neck anteversion

69
Q

Which score is used to classify joint laxity

A

Beighton score (9 point system)

70
Q

Nerve root for ankle dorsiflexion

71
Q

What is the bowstring test used for

A

Checking for sciatic nerve irritation

72
Q

What is the other test that can be used to check for sciatic nerve irritation, apart from bowstring test

A

Sciatic stretch test

73
Q

What is Heuter-Volkmann’s law

A

Compression forces across an epiphyseal plate inhibit growth and tensile forces stimulate growth

74
Q

What is Volkmann’s ischaemic contracture a complication of

A

Compartment syndrome

75
Q

What is a sequestrum

A

A dead fragment of bone seen in chronic osteomyelitis

76
Q

What is O’Donoghue’s triad (unhappy knee triad)

A

Injury to the anterior cruciate ligament, medial collateral ligament, and medial meniscus

77
Q

What are the 4 meniscal tear patterns

A

Longitudinal
Radial
Bucket handle
Parrot Beak

78
Q

How many grades are there for a knee ligament injury

79
Q

How does an extensor mechanism rupture occur

A

Fall onto knee with quads contraction

80
Q

What is the most common cause of acquired flat foot

A

Tibialis posterior dysfunction

81
Q

Does tibialis posterior pass posterior to the medial or lateral malleolus

82
Q

When is Tinel’s test positive for Baxter’s nerve

A

Plantar Fasciitis

83
Q

Which test is positive for Achilles tendon rupture

A

Simmond’s test

84
Q

When is Mulder’s click test positive and why

A

Morton’s neuroma

Fibrosis of digital nerve

85
Q

All muscles in anterior compartment of forearm are supplied by median nerve with the exception of which two muscles

A

Flexor carpi ulnaris

Medial part of Flexor Digitorum Profundus (supplying ring and little finger)

86
Q

All upper limb extensors are supplied by which nerve

87
Q

Which type of arthritis is a “pencil-in-cup appearance”

A

Psoriatic Arthritis

88
Q

Views taken for a suspected cervical spine fracture

A

AP, Lateral & odontoid peg

89
Q

Views taken for a suspected scaphoid fracture

A

AP, Lateral & 2 obliques

90
Q

How can you differentiate between an avulsion fracture and an avulsion fracture mimic

A

Avulsion fracture mimics have completely corticated borders

91
Q

What is the weakest part of children’s bones

A

Growth plate

92
Q

What are outpouching of synovial fluid or synovial cavity called

A

Synovial fluid - Mucous cyst

Synovial cavity - Ganglion cyst

93
Q

What is the test for De Quiverain’s tenosynovitis

A

Finklestein’s test

94
Q

What are tendon’s mainly made of

A

Type 1 collagen

95
Q

What is Mill’s test done for

A

Lateral Epicondylitis (tennis elbow)

96
Q

What is myositis ossificans

A

Intramuscular Haematoma which calcifies

97
Q

What is a Pilon fracture and what is a common cause

A

Fracture of the distal part of the tibia, involving its articular surface at the ankle joint
Fall from height

98
Q

Which connective tissue disease is the Anti-Smith antibody highly specific for

99
Q

Which type of fracture is described as an incomplete fracture of the shaft of a long bone with bulging of the cortex and who does this tend to affect

A

Buckle fracture

Kids 5-10

100
Q

Ankylosing spondylitis can cause pain at night true or false

101
Q

Can temporal arteritis present with a low-grade fever and vastly elevated CK

A

A low-grade fever may be present but CK and EMG tend to be normal

102
Q

What is Foucher’s sign

A

Increase in tension of a Baker’s cyst seen on knee extension

103
Q

What pathology is indicated by a step deformity after a history of a fall onto the shoulder

A

Acromioclavicular dislocation

104
Q

What is a McMurray test

A

Same as Steinmann’s test but listening out for a click to indicate a meniscal tear

105
Q

Which ANCA is associated with GPA and eGPA respectively

A

cANCA –> GPA

pANCA –> eGPA

106
Q

Which antibodies could be associated with GPA and eGPA respectively

A

GPA –> Anti-PR3

eGPA –> Anti-MPO

107
Q

Which triad would suggest Behcet’s disease

A

Oral ulcers
Genital ulcers
Anterior uveitis

108
Q

Carpal tunnel syndrome will show wasting of which eminence

A

Thenar eminence

109
Q

Osteoporosis is associated with low/high body mass

A

Low body mass

110
Q

Which triad is associated with fat embolism

A

Resp. symptoms
Neuro symptoms
Petechial rash

111
Q

What are CRP levels like in SLE

A

Typically normal

112
Q

A positive straight leg raise test is seen with what kind of pain

A

Sciatic nerve pain

113
Q

What is the imaging modality for choice for osteomyelitis

114
Q

Which drug can be given for Raynaud’s

A

Nifedipine

115
Q

A teenage girl presents with knee pain walking downstairs

A

Chondromalacia patellae

116
Q

What drug treatment should you give for osteoarthritis of the knee/hand

A

Paracetamol + topical NSAID

117
Q

Which antibody will be positive for drug-induced lupus

A

Anti-histone antibody

118
Q

Where does the triceps muscle insert

A

olecranon process of ulna

119
Q

Clubfoot is associated with which 2 serious paediatric conditions

A

Spina Bifida

Cerebral palsy

Misc. Notes Year 2 (30 decks)

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