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FA note cards > MSK/Skin/Connective Tissue > Flashcards

MSK/Skin/Connective Tissue Flashcards

1
Q

Cause of axillary nerve damage

A

C5-C6

Fractured surgical neck of humerus; anterior dislocation of humerus

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2
Q

Presentation of axillary nerve damage

A

C5-C6
Flattened deltoid
Loss of arm abduction at shoulder (> 15°)
Loss of sensation over deltoid muscle and lateral arm

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3
Q

Cause of musculocutaneous nerve damage

A

Upper trunk compression

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4
Q

Presentation of musculocutaneous nerve damage

A

C5-C7

Loss of forearm flexion, supination and lateral arm sensation

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5
Q

Cause of median nerve damage

A

C5-T1

Supracondylar fracture of humerus (proximal lesion); carpal tunnel syndrome and wrist laceration (distal lesion)

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6
Q

Presentation of median nerve damage

A

“Ape hand” and “Pope’s blessing”
Loss of wrist flexion, flexion of lateral fingers, thumb opposition, lumbricals of 2nd and 3rd digits
Loss of sensation over thenar eminence and
dorsal and palmar aspects of lateral 31⁄2 fingers with proximal lesion

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7
Q

Cause of ulnar nerve damage

A

C8-T1
Fracture of medial epicondyle of humerus “funny bone” (proximal lesion); fractured hook of hamate (distal lesion) from fall on outstretched hand

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8
Q

Presentation of Ulnar nerve damage

A

“Ulnar claw” on digit extension
Radial deviation of wrist upon flexion (proximal lesion)
Loss of wrist flexion, flexion of medial fingers, abduction and adduction of fingers (interossei),
actions of medial 2 lumbrical muscles Loss of sensation over medial 11/2 fingers including hypothenar eminence

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9
Q

Cause of recurrent branch of median nerve damage

A

Superficial laceration of palm

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10
Q

Erb palsy (“waiter’s tip”)

A

Traction or tear of upper trunk: C5-C6 roots

Deficit in deltoid, supraspinatus, infaspinatus and biceps brachii: adducted, medially rotated, extended and pronated

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11
Q

Klumpke palsy

A

Traction or tear of lower trunk: C8-T1 root
Deficit lumbricals, interossei, thenar, hypothenar
Total claw hand

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12
Q

Winged scapula

A

LTN; serrates anterior

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13
Q

Thenar eminence

A

Opponens pollicis, Abductor pollicis brevis, Flexor pollicis brevis, superficial head (deep head by ulnar nerve)

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14
Q

Hypothenar eminence

A

Opponens digiti minimi, Abductor digiti minimi, Flexor digiti minimi brevis

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15
Q

Dorsal interossei

A

abduct the fingers

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16
Q

Palmar interossei

A

adduct the fingers

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17
Q

Iliohypogastric (T12-L1)

Damage occurs via?

A

Sensory—suprapubic region
Motor—transversus abdominis and internal oblique
Abdominal surgery

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18
Q 
Genitofemoral nerve (L1-L2)
Damage occurs via?
A

Sensory—scrotum/labia majora, medial thigh
Motor—cremaster
Laparoscopic surgery

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19
Q

Lateral femoral cutaneous (L2-L3)

Damage occurs via?

A

Sensory—anterior and lateral thigh

Tight clothing, obesity, pregnancy

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20
Q

Obturator (L2-L4)

Damage occurs via?

A

Sensory—medial thigh (L2-L4)
Motor—obturator externus, adductor longus, adductor brevis, gracilis, pectineus,
adductor magnus
Descends and exits through obturator canal
Pelvic surgery

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21
Q

Femoral (L2-L4)

Damage occurs via?

A

Sensory—anterior thigh, medial leg
Motor—quadriceps, iliopsoas, pectineus, sartorius
Pelvic fracture

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22
Q

Sciatic (L4-S3)

Damage occurs via?

A

Sensory—posterior thigh
Motor—semitendinosus, semimembranosus, biceps femoris, adductor magnus
Herniated disc

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23
Q 
Common peroneal (L4-S2)
Damage occurs via?
A

Sensory—dorsum of foot
Motor—biceps femoris, tibialis anterior, extensor muscles of foot
Trauma or compression of lateral aspect of leg, fibular neck fracture

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24
Q

Tibial (L4-S3)

Damage occurs via?

A

Sensory—sole of foot
Motor—triceps surae, plantaris, popliteus, flexor muscles of foot
Knee trauma, Baker cyst (proximal lesion); tarsal tunnel syndrome (distal lesion)

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25
Q 
Superior gluteal (L4- S1)
Damage occurs via?
A

Exits pelvis via greater sciatic foramen (above piriformis)
Motor—gluteus medius, gluteus minimus, tensor fascia latae (abduction)
Iatrogenic injury during intramuscular injection to upper medial gluteal region

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26
Q 
Inferior gluteal (L5-S2)
Damage occurs via?
A

Exits pelvis via greater sciatic foramen below piriformis
Motor—gluteus maximus (extension)
Posterior hip dislocation

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27
Q

Pudendal (S2-S4)

Damage occurs via?

A

Sensory—perineum
Motor—external urethral and anal sphincters
Stretch injury during childbirth

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28
Q

Abductors of the hip

A

Gluteus medius, gluteus minimus

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29
Q

Adductors of the hip

A

Adductor magnus, adductor longus, adductor brevis

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30
Q

Extensors of the hip

A

Gluteus maximus, semitendinosus, semimembranosus

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31
Q

Flexors of the hip

A

Iliopsoas, rectus femoris, tensor fascia lata, pectineus

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32
Q

Internal rotation of the hip

A

Gluteus medius, gluteus minimus, tensor fascia latae

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33
Q

External rotation of the hip

A

Iliopsoas, gluteus maximus, piriformis, obturator

34
Q

Osteitis fibrosa cystica

A

Primary hyperparathyroidism
Incr: Ca, ALP, PTH
Decr: PO4
Brown tumors (fibrous bone replacement)

35
Q

Osteochondroma

A

Most common benign bone tumor

Bony exostosis with cartilaginous (chondroid) cap

36
Q

Giant cell tumor

A

Benign; 20–40 years old.
Epiphysis of long bones
Locally aggressive; “Soap bubble”
express RANKL

37
Q

Osteosarcoma

A

Most common malignant bone tumors
Codman triangle
(Rb and Li Fraumeni)

38
Q

Ewing sarcoma

A

Boys < 15 years old.
Commonly appears in diaphysis of long bones, pelvis, scapula, ribs.
“Onion skin” periosteal reaction

39
Q

Presentation of osteoarthritis

A

Pain in weight-bearing joints after use

40
Q

Joint finding in osteoarthritis

A

Osteophytes, joint space narrowing, subchondral sclerosis and cysts

41
Q

Presentation of Rheumatoid arthritis

A

Pain, swelling, and morning stiffness lasting > 1 hour, improving with use

42
Q

Joint finding in Rheumatoid arthritis

A

Erosions, juxta-articular osteopenia, soft tissue swelling, subchondral cysts, joint space narrowing.

43
Q

Sjögren syndrome

A

Autoimmune destruction of exocrine glands

44
Q

Antiphospholipid syndrome

A

1° or 2° autoimmune disorder
Dx clinically: hx of thrombosis or spontaneous abortion w/ lab findings of lupus anticoagulant, anticardiolipin, anti-β2 glycoprotein antibodies

45
Q

Sarcoidosis

A

Characterized by immune-mediated, widespread noncaseating granulomas
↑: ACE, CD4 and 8

46
Q

Polymyositis/dermatomyositis markers

A

↑ CK, ⊕ ANA, ⊕ anti-Jo-1, ⊕ anti-SRP, ⊕ anti-Mi-2 antibodies

47
Q

Polymyositis presentation

A

Progressive symmetric proximal muscle weakness w/ endomysial inflammation and CD8

48
Q

Dermatomyositis presentation

A

Like polymyositis but w/ mallar rash, Grotton papule, heliotrope rash, shawl and face rash, mechanics hands

49
Q

Scleroderma

A

Triad of autoimmunity, noninflammatory vasculopathy, and collagen deposition with fibrosis

50
Q

Appearance of scleroderma

A

Sclerosis of skin, manifesting as puffy, taut skin without wrinkles, fingertip pitting

51
Q

Albinism

A

Decreased melanin d/t decreased tyrosinase activity

52
Q

Glomus tumor

A

Benign, painful, red-blue tumor, commonly under fingernails

Derived from thermoregulatory cells

53
Q

Pyogenic granuloma

A

Polypoid lobulated capillary hemangioma that can ulcerate and bleed.
Associated with trauma and pregnancy.

54
Q

Pemphigus vulgaris

A

IgG antibody against desmoglein
Flaccid intraepidermal bullae caused by acantholysis
Type II hypersensitivity reaction
Nikolsky sign ⊕

55
Q

Bullous pemphigoid

A

IgG antibody against hemidesmosomes

IF: linear pattern at epidermal-dermal junction

56
Q

Dermatitis herpetiformis

A

Deposits of IgA at tips of dermal papillae.

Associated with celiac disease

57
Q

Lichen Planus

A

Pruritic, Purple, Polygonal Planar Papules and Plaques
Sawtooth infiltrate of lymphocytes at dermal-epidermal junction
Associated with hepatitis C

58
Q

Basal cell carcinoma

A

Most common skin cancer
Waxy, pink, pearly nodules, commonly with telangiectasias, rolled borders, central crusting or ulceration
“Palisading” nuclei

59
Q

Squamous cell carcinoma

A

Ulcerative red lesions with frequent scale

keratin “pearls”

60
Q

Leflunomide

A

Reversibly inhibits dihydroorotate dehydrogenase, preventing pyrimidine synthesis; suppresses T-cell proliferation
Use: RA and psoriatic arthritis
SE: Diarrhea, hypertension, hepatotoxicity, teratogenicity

61
Q

Bisphosphonates

A

Pyrophosphate analogs; bind hydroxyapatite in bone, inhibiting osteoclast activity
SE: Esophagitis, osteonecrosis of jaw, atypical stress fractures

62
Q

Teriparatide

A

Recombinant PTH analog given subq; increases osteoblast activity
Use: osteoporosis
SE: increased risk of osteosarcoma

63
Q

Etanercept

A

TNF-α inhibitor: Fusion protein (receptor for TNF-α + IgG1 Fc), produced by recombinant DNA
Use: RA, psoriasis, ankylosing spondylitis

64
Q

Anti-TNF-α monoclonal antibody

A

Infliximab, adalimumab, certolizumab, golimumab

65
Q

Mixed connective tissue disease

A

Features of SLE, systemic sclerosis, and/or polymyositis

Associated with anti-U1 RNP antibodies (speckled ANA)

66
Q

Polymyalgia rheumatica Sx and treatment

A

Pain and stiffness in shoulders and hips, often with fever, malaise, weight loss; NO weakness
Low-dose corticosteroids

67
Q

Polymyalgia rheumatica labs

A

Incr ESR, Incr CRP, normal CK

68
Q

McMurray test

A

Pain w/ external rotation of knee: medial meniscus tear

Internal: lateral

69
Q

Prepatellar bursitis

A

Repeated trauma or pressure from excessive kneeling (also called “housemaid’s knee”)

70
Q

Baker cyst

A

Popliteal fluid collection in gastrocnemius-semimembranosus bursa

71
Q

Arm abduction

A

Supraspinatus, deltoid, serrates anterior

72
Q

Measurements of osteoblast activity

A

ALP, osteocalcin, propeptides of type I procollagen

73
Q

Lab changes in osteoporosis

A

None (dx via DEXA)

74
Q

Stages of pagets dx of bone

A

Lytic (clasts)
Mixed
Sclerotic (blasts; clasts have burnt out)

75
Q

anti-Scl-70 antibody

A

aka anti-DNA topoisomerase I antibody

Diffuse scleroderma

76
Q

Vitiligo

A

autoimmune destruction of melanocytes

77
Q

Cherry hemangioma

A

Benign capillary hemangioma of the elderly

78
Q

Cystic hygroma

A

Cavernous lymphangioma of the neck (Turner)

79
Q

Strawberry hemangioma

A

Benign capillary hemangioma of infancy; grows then spontaneously regresses

80
Q

Pityriasis rosea

A

“Herald patch” followed by scaly erythematous plaques, often in a “Christmas tree”distribution on trunk
Self-resolving

81
Q

Radial nerve damage presentation

A

Wrist drop: loss of elbow, wrist, and finger extension
↓ grip strength
Loss of sensation over posterior arm/forearm and dorsal hand

82
Q

Cause of radial nerve damage

A

C5-C7

Midshaft fracture of humerus; compression of axilla (crutches or arm over chair)

FA note cards (16 decks)

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