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Semester 2 - MBChB - Leic Med > MSK - Semester 2 > Flashcards

MSK - Semester 2 Flashcards

1
Q

Which week in pregnancy do the limb buds appear?

A

week 4

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2
Q

Limb bud is a core of proliferating __________ cells with an _ _ _ _ derm covering

A

Limb bud is a core of proliferating MESENCHYME cells with an ECTODERM covering

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3
Q

Thickened ectoderm at apex of limb bud forms the ________ ___________ _______

A

Thickened ectoderm at apex of limb bud forms the APICAL ECTODERMAL RIDGE

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4
Q

Differentiate between:

1) apical ectodermal ridge
2) dorsal ectoderm, and
3) zone of polarizing activity

A

1) apical ectodermal ridge - regulates outgrowth (proximal to distal)
2) dorsal ectoderm - regulates dorsal-ventral patterning
3) zone of polarizing activity - controls anterior-posterior patterning

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5
Q

Cell death in what region (apical ectodermal ridge, dorsal ectoderm or zone of polarizing activity) causes the transformation of paddles to hands with separate digits?

A

AER (AER maintained over each future fingertip)

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6
Q

What is ‘syndactyly’?

A

Fusion of digits

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7
Q

What is ‘polydactyly’?

A

Extra digits

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8
Q

What is ‘amelia’?

A

Complete absence of a limb

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9
Q

What is ‘meromelia’?

A

Partial absense of 1 or more limb structures

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10
Q

What is the difference between ‘deformation’ and ‘malformation’?

A

Deformation - healthy formation but pieces of limbs cut off

Malformation - intrinsic error in coordination of morphogenesis

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11
Q

In the 8th week of pregnancy, how do the upper limb and lower limb rotate?

A

Upper limb - dorsally/laterally 90°

Lower limb - ventrally/medially 90°

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12
Q

Define ‘dermatome’

A

Area of skin supplied by a single spinal nerve

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13
Q

What is the difference between a dermatome and a myotome?

A

Dermatome - Area of skin supplied by a single spinal nerve

Myotome - group of muscles supplied by a single spinal nerve

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14
Q

Define ‘myotome’

A

group of muscles supplied by a single spinal nerve

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15
Q

What is the specific type of tissue that differentiates into somites?

A

Paraxial mesoderm

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16
Q

What nerve root supplies the middle finger? (sensory)

A

C7

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17
Q

What nerve root supplies the region of skin over the shoulder?

A

C4

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18
Q

What nerve root supplies medial two digits?

A

C6

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19
Q

What nerve root supplies the medial leg?

A

L4

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20
Q

What nerve root supplies the skin over the knee?

A

L3

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21
Q

What nerve root supplies plantar surface of foot?

A

S1

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22
Q

What nerve root supplies back of leg?

A

S2

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23
Q

What nerve root supplies skin at level of nipples?

A

T4

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24
Q

What is a spinal nerve?

A

Parallel bunch of axons encased in connective tissue that have both MOTOR and SENSORY functions

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25
Q

What do the ventral and dorsal ramus supply?

A

Ventral - muscles and skin of lower and upper limbs; ventral and lateral trunk
Dorsal - deep muscles and skin of dorsal trunk

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26
Q

Which branch of the spinal nerve is given off and reenters the spinal canal through intervertebral foramen to supply vertebrae, ligaments, etc.?

A

Meningeal branch

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27
Q

What is the difference between the peripheral nerve distributions and dermatomes?

A

In one peripheral nerve, there may be fibres from MORE THAN ONE SPINAL NERVE (unlike dermatomes)

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28
Q

What is the action of the C5 myotome?

A

elbow flexion

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29
Q

What is the action of the C6 myotome?

A

wrist extension

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30
Q

What is the action of the C7 myotome?

A

elbow extension

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31
Q

What is the action of the C8 myotome?

A

finger flexion

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32
Q

What is the action of the T1 myotome?

A

finger abduction

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33
Q

What is the action of the L2 myotome?

A

hip flexion

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34
Q

What is the action of the L3 myotome?

A

knee extension

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35
Q

What is the action of the L4 myotome?

A

ankle dorsiflexion

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36
Q

What is the action of the L5 myotome?

A

great toe extension

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37
Q

What is the action of the S1 myotome?

A

ankle plantarflexion

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38
Q

What is a motor unit?

A

Motor neuron + skeletal muscle fibres it innervates

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39
Q

What is the difference between a motor unit and a spinal nerve?

A

Spinal nerve = supplies ONE MYOTOME but contains the neurons of MANY MOTOR UNITS

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40
Q

What is the difference between endoneurium, epineurium and perineurium?

A

Endoneurium - around each axon
Perineurium - around each fascicle
Epineurium - around each spinal nerve (fascicles + blood vessels)

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41
Q

Spinal nerves leave the spinal cord via which region of the vertebrae?

A

Intervertebral foramina

42
Q

C8 spinal nerve exits between which two vertebrae?

A

C7 and T1

43
Q

What is the typical pattern of herpes zoster infection?

A

It always affects skin of a single dermatome only

44
Q

Persons who get shingles are likely to have been infected by what virus?

A

Varicella zoster previously and had chicken pox. Then the virus remains dormant. When host is immunosuppressed, VZV reactivates and travels through peripheral nerve to skin of a single dermatome.

45
Q

The clavicle forms 2 joints with surrounding bones. What are these 2 joints?

A

Sternoclavicular joint

Acromioclavicular joint

46
Q

Where do fractures of the clavicle usually occur?

A

Middle third of clavicle

47
Q

When a fracture of the clavicle occurs, explain how the fragments move and why?

A

Lateral fragment pulled inferiorly due to weight of arm

Medial fragment pulled upward by sternocleidomastoid muscle

48
Q

What is the name of the piece of cartilage on the glenoid fossa to deepen the fossa and increase joint stability?

A

Glenoid labrum

49
Q

Fracture of the surgical neck of the humerus can lead to damage of which major vessels/nerves?

A

Axilliary nerve

Circumflex humeral artery damage

50
Q

Fracture of the humerus mid-shaft can lead to damage of which major vessels/nerves?

A

Brachial artery

Radial nerve

51
Q

Trochlea on the humerus articulates with which bone of the forearm?

A

Ulna

52
Q

Coracoacromial arch is a protective arch formed by which three elements?

A

inferior aspect of acromion
coracoid process of scapula
coracoacromial ligament between the two of them

53
Q

What is the importance of the coracoacromial arch?

A

Prevents upward dislocation of the head of the humerus from the glenoid fossa

54
Q

A supraepicondylar fracture of the humerus is likely to cause damage of which nerve?

A

Median nerve

55
Q

Give one similarity between Colles fracture and Smiths fracture

A

both are transverse fractures of the distal radius

56
Q

What deformity does Colles’ fracture produce?

A

dinner fork deformity due to posterior displacement of the distal fragment

57
Q

How does a Smith’s fracture of the distal humerus occur?

A

A fall onto a flexed wrist causing anterior displacement of the distal fragment

58
Q

In patients with scaphoid fractures, what area tends to be tender?

A

anatomical snuff box

59
Q

What is a major risk in patients with scaphoid fractures?

A

avascular necrosis of the proximal fragment as the blood supply to the scaphoid is from one distal blood vessel only (so reunion cannot be done)

60
Q

What is a “boxer’s fracture”?

A

Break in the neck of either/or the 4th or 5th metacarpals

61
Q

What is the collective name of the muscles that contribute to glenohumeral stability?

A

rotator cuff muscles

62
Q

What are the borders of the anatomical snuff box?

A

Ulnar / medial border - tendon of extensor pollicis longus
Radial / lateral border - tendon of extensor pollicus brevis
Proximal border - styloid process of radius

63
Q

What is the floor and the roof of the anatomical snuff box?

A

floor - scaphoid and trapezium

roof - skin

64
Q

What are the four muscles of the pectoral region?

A

Pectoralis major
Pectoralis minor
Subclavius
Serratus anterior

65
Q

Winged scapula occurs as a result of damage to which nerve?

A

Long thoracic nerve

66
Q

Which muscle is paralysed in “winged scapula”?

A

Serratus anterior

67
Q

What is the role of the subclavius muscle?

A

Anchors and depresses clavicle

68
Q

Pectoralis minor inserts where?

A

The coracoid process of the scapula, so it obviously draws the scapula anteriorly and inferiorly, against the thoracic wall

69
Q

What is the insertion point of pectoralis major?

A

intertubercular sulcus

70
Q

What are the four main muscles of the back?

A

Trapezius
Latissimus dorsi
Levator scapulae
Rhomboid major and minor

71
Q

Which muscle is the most superficial of all the back muscles?

A

Trapezius

72
Q

What can you ask a patient to do in order to test the function of the accessory nerve?

A

Shrug the shoulders
as if the accessory nerve is compromised, the trapezius muscle will be paralysed and patient will not be able to shrug his or her shoulders

73
Q

Where does the trapezius insert (NB there are THREE insertions)?

A

Lateral clavicle
Acromion
Spine of scapula

74
Q

To what does the latissimus dorsi muscle insert?

A

intertubercular sulcus of the humerus, just like the pectoralis major!

75
Q

What are the origins of the latissimus dorsi muscle? (NB there are 4 origins)

A

spinous processes of T6 to T12
iliac crest
inferior 3 ribs
thoraco-lumbar fascia

76
Q

What is the role of the levator scapulae muscle?

A

elevate and rotate scapula

77
Q

What is the origin of the levator scapulae muscle?

A

C1-C4 transverse processes

78
Q

Rhomboid major and minor both insert to what structure?

A

The medial border of the scapula

79
Q

What are the medial, lateral, anterior and posterior borders of the axilla?

A

Medial - thoracic call and serratus anterior
Lateral - intertubercular sulcus
Anterior - pectoralis major and minor
Posterior - scapularis, teres major, latissimus dorsi

80
Q

6 things are contained in the axilla. Name them.

A 
axillary artery
axillary vein
axillary lymph nodes
brachial plexus
biceps brachii tendons
coracobrachialis tendon
81
Q

In axillary clearance, which nerve can be damaged and if damaged what is the name of the clinical findings?

A

Long thoracic nerve

Winged scapula

82
Q

The deltoid muscle inserts where specifically on the humerus?

A

Deltoid tuberosity

83
Q

The deltoid muscle is supplied by which nerve?

A

axillary nerve

84
Q

Which nerve supplies the teres major muscle?

A

Lower subscapular nerve

85
Q

The teres major muscle has what actions on the arm?

A

adducts

medially rotates

86
Q

Name the four muscles of the rotator cuff

A

Supraspinatus
Infraspinatus
Teres minor
Subscapularis

87
Q

Supraspinatus, infraspinatous and teres minor all attach to ___________. They all have a common role as well which is ___________

A

Attachment - greater tubercle

Role - External rotation

88
Q

Name the three flexor muscles of the anterior arm

A

Biceps brachii
Brachialis
Coracobrachialis

89
Q

Abduction of the arm: name the muscles that allow movements at the following angles:
0-15° - ________
15-90° - ____________
90°+ - ______________

A

0-15° - supraspinatous muscle
15-90° - deltoid (middle fibres)
90°+ - trapezius and serratus anterior (scapular rotation)

90
Q

Which nerve supplies all the flexors of the arm?

A

Musculocutaneous nerve

91
Q

Biceps brachii has which 2 roles in arm movement?

A

flexion of the arm at elbow and shoulder

supinator

92
Q

Where does the brachialias muscle insert?

A

coroNoid process of the ulna

93
Q

“Popeye sign” on flexion of the arm is a sign that which tendon has been ruptured?

A

tendon of the long head of biceps brachii

94
Q

Branches of which artery supply the flexors of the anterior arm?

A

brachial artery

95
Q

Which artery supplies the posterior compartment of the arm?

A

profunda brachii artery

96
Q

What are the lateral, medial and superior borders of the cubital fossa?

A

Lateral - medial border of brachioradialis
Medial - lateral border of pronator teres
Superior - imaginary line between the two epicondyles

97
Q

Which vein is in the roof of the cubital fossa?

A

medial cubital vein (connects the basilic and cephalic veins)

98
Q

What are the contents of the cubital fossa?

A 
radial nerve
biceps brachii tendon
brachial artery
median nerve 
(really need beer to be at my nicest)
99
Q

The medial cubital vein situated in the roof of the cubital fossa connects which two veins of the arm?

A

basilic

cephalic

100
Q

Supracondylar fractures can lead to which condition, common in children?

A

Volksmann’s ischaemic contracture

101
Q

How does a supracondylar fracture lead to Volksmann’s ischaemic contracture?

A

Post fracture swelling compresses brachial artery
so ischaemia of muscles of the forearm, muscles become fibrotic and short
arm flexes uncontrollably

Semester 2 - MBChB - Leic Med (5 decks)

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