MSK notes

Question 1

What makes up the LOAF muscles?

Answer 1

Lumbricals (1&2)
Opponens Pollicis
Abductor Pollicis Brevis
Flexor Pollicis Brevis

innervated by median nerve

Question 2

Describe innervation of intrinsic hand muscles?

Answer 2

all intrinsic hand muscles innervated by ulnar apart from the LOAF ones.

Question 3

smiths fracture

Answer 3

fracture distal radius with anterior displacement

Question 4

Wallerian degeneration

Answer 4

• axonal degeneration at site of injury
• myelin sheath degenerates
• then phagocytocysed by tissue macrophages

Question 5

Hirutism vs hypertrichosis

Answer 5

Hirutism - androgen dependent hair growth

Hypertrichosis - androgen independent

Question 6

Trendelenburg gait

Answer 6

• superior gluteal nerve
• gluteus medius affected
• nerve side effected is OPPOSITE to side of pelvic drop

Question 7

What may be seen in surgical neck of humerus fracture?

Answer 7

• axillary nerve damage
• difficulty abducting arm
• loss of sensation of deltoid

Question 8

Sharpey’s fibres

Answer 8

• periosteum attached to bone by strong collagenous fibres

Question 9

Feature of rheumatoid arthritis

Answer 9

• cholesterol deposition in nodules

- often spares DIPs

Question 10

triad for reactive arthritis

Answer 10

1. Conjunctivitis
2. Arthritis
3. Urethritis

Question 11

Describe septic arthritis common culprit?

Answer 11

• stap aureus

Question 12

describe septic arthritis?

Answer 12

• single, red, swollen, painful joint
• yellow turbid synovial fluid
• invasion of synovial membrane

Question 13

Describe key features of osteoarthritis?

Answer 13

• shorter duration of morning stiffness
• often worse after movement
• loss of joint space
• subchondral sclera
• osteophytes

Question 14

Psoriatic arthritis

Answer 14

• sausage digits
• nail changes
• pencil in cup deformity
• psoriasis: think purple plaques bilateral elbows

Question 15

Onchylosis

Answer 15

detachment of the nail from nail bed

Question 16

Salter-Harris fracture

Answer 16

fracture to growth plate of child

Question 17

What nerve may be affected during excision of the submandibular gland?

Answer 17

• marginal mandibular nerve

Question 18

Branches of axillary nerve? (3)

Answer 18

1. posterior circumflex humeral
2. subscapular
3. anterior circumflex

Question 19

Long head of triceps attachment

Answer 19

infraglenoid tubercle

Question 20

Contents of cubital Fossa (lateral to medial)

really need beer to be at my nicest ; )

Answer 20

Radial Nerve
Brachial Tendon
Brachial artery
Median nerve

Question 21

Describe clinical features of giant cell arteritis?

Answer 21

1. jaw pain
   —> BS restriction, anaerobic resp, increase in
   [lactic acid]
2. amaurosis fugax
   - –> temporary loss of vision in one eye

Question 22

amaurosis fugax

Answer 22

temporary loss of vision in one eye

Question 23

what passes through the quadrangular space?

Answer 23

• axillary nerve
  - –> posterior circumflex artery

note: posterior circumflex is a branch of axillary

Question 24

A 16-year-old boy is on a date at the cinema, throughout the film he has his arm over his girlfriends seat. When the film ends he finds that he cannot move his wrist very well. On examination he cannot extend his wrist and his anatomical snuff box has reduced sensation. Which nerve has he damaged at the cinema?

Answer 24

A radial nerve palsy is commonly refereed to as a wrist drop.

This is a mononeuropathy which results in the patient being unable to extend their wrist and instead it hangs flaccidly.

saturday night syndrome

Question 25

Quadrangular space syndrome

Answer 25

involves compression of the axillary nerve and posterior circumflex artery

Question 26

A 24-year-old female falls from her horse onto the side of her neck. She has a glasgow coma scale of 15 and can move all limbs. However, at the emergency department she is examined and found to have a medially rotated arm with an extended and pronated forearm with a flexion of the wrist. What injury has she developed?

Answer 26

Erb’s palsy

This is a neuropathy of the arm caused by injury to the upper group of the brachial Plexus.

This is primarily affecting the upper trunk C5-C6 nerves.

loss of shoulder movement

Question 27

Klumpke’s palsy

Answer 27

• ulnar
• loss of finger flexors
• unicorn

Question 28

paresis

Answer 28

weakness of muscles

Question 29

bouchards

Answer 29

hard knobs at middle finger

Question 30

herberden’s nodes

Answer 30

hard knobs furtherest away from finger

Question 31

colles

Answer 31

radial side damaged, median nerve affected

Question 32

what secretes majority of TNF

Answer 32

macrophages

Question 33

dorsalis pedis artery

Answer 33

branch of anterior tibial artery

Question 34

where does psoas major insert?

Answer 34

• lesser trochanter

Question 35

A 24-year-old female patient presents to her GP with a bilateral facial rash, bilateral pain, redness and swelling in the joints of her hands, and mouth ulcers. Her symptoms worsen when exposed to sunlight.

Answer 35

SLE patients usually produce antibodies against double stranded DNA because the body has poor immunological tolerance to intracellular proteins.

Complement component 4 levels are commonly decreased i.

Question 36

A 49-year-old woman presents to her family physician with vaginal dryness and itching. On further questioning, she tells you that she suffers from dry skin, and has noticed that her mouth is more dry than usual. She takes over-the-counter eye drops regularly.

Her Schirmer’s strip shows inadequate tear production.

Her maternal aunt has pernicious anaemia and her late grandmother had rheumatoid arthritis.

Which one of the following is associated with her condition?

Answer 36

Sjogrens syndrome is associated with autoimmune hashimoto’s thyroiditis

Question 37

Anterior cruciate ligament receives blood supply from…

Answer 37

middle genicular artery