MSK random Flashcards by Caitlin McMullen

Motor unit size is subject to a lot of variation. Small motor units tend to have relatively small cell bodies and fewer axons.

Which is the correct order when ranking muscles according to the size of motor units, largest to smallest?

(1) Quadriceps femoris
(2) semimembranosus
(3) opponens pollicis
(4) superior rectus

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A basketball player suffers a severe tear in his Achilles tendon. What will occur at the site of injury?

Fibroblast recruitment for tendon repair

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Where does hematopoiesis predominantly occur?

Epiphsis

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The diaphysis is the central shaft of the bone and primarily contains what and for what?

yellow bone marrow, serving as a store for fats

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What method is responsible for the formation of the skull’s flat bones?

Intranetbranous ossification

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What do Volkmann’s canals connect Haversian canals to?

Endostenum

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What is the shaft of a long bone called?

Diaphysis

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What would an increase in calcitonin lead to?

Decrease osteoclast activity

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Growth of long bones originates in what region?

Epiphyseal growth plate

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While crossing the street, Paul is hit by a car and suffers an injury to his knee. Upon screening by a doctor, it is determined that he has torn his anterior cruciate ligament. What two structures does this ligament connect?

Femur bone to tibia bone

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What connective tissue connects bones to bones?

ligaments

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What connects muscles to bone?

tendons

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Loss-of-function mutation in the gene that produces what would lead to an increase in blood calcium levels?

Calcitonin

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What the cortical bone?

periosteum

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What is bone reabsorbing cells?

Osteoclasts

= Break down bone, releasing calcium back into the blood

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What diseases decrease blood calcium levels?

Parathyroid hormone or calcitonin

Calcitonin

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What is bone forming cells?

Osteoblasts

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Cartilage and synovial fluid decomposition and function deteriorate with age and repeated wear and tear. This describes what?

osteoarthritis

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Synovial fluid proliferation and inflammation. This describes what?

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Deposition of salt crystals eg, uric acid. This describes what?

gouty arthritis

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Where is the infraspinatus located and what is its function?

Positioned posteriorly on the superior back

= helps with the external rotation of the shoulder.

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Where is the subscapularis positioned and what is its function?

Positioned anteriorly on the chest

= helps with internal rotation of the shoulder

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What is the role of the supraspinatus?

Located on top of the shoulder

= needed for the first 20° of shoulder abduction

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What does the teres minor do and where is it located?

Located posteriorly on the superior back

= helps with external rotation of the shoulder

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The process of endochondral ossification is an important means of bone formation Which term best describes the site at which this process occurs?

Metaphysis

What are the typical lab values in osteomalacia?

Calcium: Decreased Phosphate: Decreased ALP: Increased PTH: Increased

What are the typical lab values in osteoporosis?

Calcium: Normal Phosphate: Normal ALP: Normal PTH: Normal

What are the lab values in primary hyperparathyroidism (leading to osteitis fibrosa cystica)?

Calcium: Increased Phosphate: Decreased ALP: Increased PTH: Increased

What are the typical lab values in chronic kidney disease (leading to secondary hyperparathyroidism)?

Calcium: Decreased Phosphate: Increased ALP: Increased PTH: Increased

What are the typical lab values in Paget's disease?

Calcium: Normal Phosphate: Normal ALP: Increased PTH: Normal

What are the typical lab values in osteopetrosis?

Calcium: Normal Phosphate: Normal ALP: Normal PTH: Normal

Which condition is associated with a positive Phalen's sign?

A positive Phalen's sign is associated with carpal tunnel syndrome. This sign is elicited by holding the wrists in full flexion for 60 seconds, which induces numbness or tingling in the fingers

What does a positive Froment's sign suggest?

A positive Froment's sign indicates ulnar nerve palsy = It is tested by asking the patient to grasp a piece of paper between the thumb and index finger. In ulnar nerve palsy, the patient will compensate by flexing the thumb, causing the paper to be pulled out

What condition does a positive Finkelstein's sign indicate?

A positive Finkelstein's sign is indicative of De Quervain's tenosynovitis = It is tested by asking the patient to make a fist with the thumb inside and then deviating the wrist towards the ulnar side. Pain over the radial styloid is considered a positive sign

Dactylitis and DIP swelling are characteristic changes of what?

Psoriatic arthritis

A 32-year-old man presents to the Emergency Department after sustaining a deep laceration to his right arm from a piece of glass. On examination, there is significant weakness in finger abduction and adduction, as well as sensory loss over the medial aspect of the hand, including the little finger. He is unable to cross his fingers, and when attempting to flex his wrist, there is a noticeable radial deviation. The patient is also unable to grip objects effectively What is the most likely location of his injury and the cause?

At the elbow, involving the ulnar nerve = suggest ulnar nerve palsy 1. Cubital tunnel syndrome 2. Traumatic ulnar nerve injury 3. Ulnar neuropathy 4. medial epicondyle fracture why? = (1) Weakness in finger abduction/adduction and inability to cross fingers. (2) Sensory loss over the little finger and medial hand. (3) Radial deviation with wrist flexion (due to loss of ulnar flexion)

'he has lost the ability to abduct his thumb' suggests what?

Median nerve affected

'inability to extend the wrist' suggests what?

Radial nerve affected

'weakness of the ring and little fingers' suggests what?

Ulnar nerve affected

Lost the ability in - Thumb opposition, flexion, and abduction What nerve is affected?

median nerve = mainly via thenar muscles

Lost the ability in thumb adduction What nerve is affected?

ulnar nerve = adductor pollicis muscle

A 52-year-old female presents with weakness and pins and needles in her right hand. On examination, she has wasting of the thenar eminence associated with sensory loss to the palmar aspect of the lateral (radial) three fingers. Which nerve is likely to be affected? Explain why

Median nerve = (1) Thenar eminence wasting = median nerve supplies thenar muscles (2) Sensory loss to the palmar aspect of the lateral three fingers (thumb, index, middle) = classic median nerve distribution (3) Pins and needles = nerve compression (likely carpal tunnel syndrome)

'A 23-year-old man is involved in a fight outside a nightclub and sustains a laceration to his right arm. On examination, he has lost extension of the fingers in his right hand' What nerve has been affected?

Radial nerve

'A 40-year-old lady trips and falls through a glass door and sustains a severe laceration to her left arm. Amongst her injuries, it is noticed that she has lost the ability to adduct the fingers of her left hand' What nerve has been affected?

Ulnar nerve

'A 28-year-old rugby player injures his right humerus and on examination is noted to have a minor sensory deficit overlying the point of deltoid insertion into the humerus' What nerve has been affected?

Axillary nerve

The triceps reflex is mediated by what nerve root?

The bicep reflex is mediated by what nerve root?

A 42-year-old teacher is admitted with a fall. An x-ray confirms a fracture of the surgical neck of the humerus. Which nerve is at risk?

Axillary

'The skin on the palmar aspect of the thumb' What nerve supplies cutaneous sensation to this region?

Median nerve

'The nail bed of the index finger' What nerve supplies cutaneous sensation to this region?

Median nerve

'The skin overlying the medial aspect of the palm' What nerve supplies cutaneous sensation to this region?

Ulnar nerve

C5 role

Shoulder abduction (deltoid) Elbow flexion (biceps)

C6 role

Elbow flexion (biceps) Wrist extension (extensor carpi radialis longus)

C7 role

Elbow extension (triceps) Wrist flexion (flexor carpi radialis) Finger extension (extensor digitorum)

C8 role

Finger flexion – flexor digitorum profundus & superficialis Thumb extension – extensor pollicis longus

T1 role

Finger abduction/adduction – interossei muscles

Heberden’s nodes are where?

DIPS

Bouchard’s nodes are where?

PIPS

A 17-year-old boy attends A&E with severe pain in his right elbow following a fall from his bicycle. There is swelling and bruising at the elbow. He also reports the sensation of pins and needles. Plain radiography shows a fracture of the radius and dislocation of the ulna at the distal radioulnar joint What is the most likely cause of this presentation?

Galeazzi fracture

What tissues in the hand does Dupuytren's contracture primarily affect?

palmar fascia

The Simmonds test is used for what?

Achilles tendonitis

The Hawkins-Kennedy test is used for what?

assess shoulder impingement

The Thomas’ test is used to test what?

fixed flexion deformity of the hip

The special test used in clinical examinations for plantar fasciitis is called what?

Windlass test