MSS Anatomy & Physiology Flashcards

1
Q

What are the layers of epidermis from surface to base?

A
  • Stratum Corneum (keratin)
  • Stratum Lucidum
  • Stratum Granulosum
  • Stratum Spinosum (spines= desmosomes)
  • Stratum Basale (stem cell site)
  • Californians Like Girls in String Bikinis”
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2
Q

What do Sebaceous glands secrete?

A

Holocrine sec of sebum

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3
Q

What do Eccrine glands secrete?

A

Sweat

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4
Q

What do Apocrine glands secrete?

A

Milky viscous fluid

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5
Q

Where are Apocine glands found?

A

Axillae, genitalia, & areola

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6
Q

When do apocrine glands become functional?

A

Puberty

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7
Q

What causes apocrine glands to be malodorous?

A

Bacterial action

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8
Q

What are sebaceous glands assoc w/?

A

Hair follicles

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9
Q

Where are eccrine glands found?

A

Throughout the body

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10
Q

What is a tight junction?

A

Zona occludens- prevents paracellular movement of solutes, composed of claudins & occluidins

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11
Q

What is adherens junction?

A

zonula adherens- below tight junction, forms “belt” connecting actin cytoskeletons of adjacent cells with CADherins (Ca2+ dependent adhesion proteins)

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12
Q

What does loss of E-cadherin promote?

A

Metastasis

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13
Q

What is a desmosome?

A

Macula adherens- structural support via keratin interactions

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14
Q

What do auto-Ab to desmosomes cause?

A

Pemphigus vulgaris

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15
Q

What is a gap junction?

A

Channel proteins called connexons permit electrical & chemical communication b/w cells

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16
Q

What is a Hemidesmosome?

A

Connects keratin in basal cells to underyling BM

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17
Q

What do auto-Ab’s to Hemidesmosome cause?

A

Bullous pemphigoid

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18
Q

What are Integrins?

A

Mem proteins that maintain inegrity of BM by binding to laminin in BM

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19
Q

What causes the unhappy triad/knee injury?

A

Common injury in contact sports→ lateral force applied to a planted leg

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20
Q

What is involved in the unhappy triad knee injury?

A

Tear of ACL, MCL, & meniscus (classically medially bc MC lateral)

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21
Q

What is the tx for unhappy triad?

A

Often requires surgical ACL reconstruction

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22
Q

What does a positive drawer sign indicate?

A

ACL tear

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23
Q

What does an ABN passive ABDuction of the knee indicate?

A

MCL tear

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24
Q

How do you perform the Anterior/Posterior Drawer tests?

A

The patient should be supine with the hips flexed to 45 degrees, the knees flexed to 90 degrees and the feet flat on table. The examiner sits on the patient’s feet and grasps the patient’s tibia and pulls it forward (anterior drawer test) or backward (posterior drawer test). If the tibia pulls forward or backward more than normal, the test is considered positive

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25
What is the landmark for Pudendal nerve block?
Ischial spine
26
What does is the Pudendal nerve block used for?
To relieve pain of delivery
27
What is the McBurney's point?
2/3 of the way from umbilicous to the anterior superior iliac spine
28
What is the landmark for Lumbar puncture?
Iliac crest
29
What are the Rotator Cuff muscles?
* Supraspinatus * Infraspinatus * Teres minor * Subscarpularis
30
What is the Action of Suprasinatus?
ABDucts arm initially (before deltoid)
31
What is the MC rotator cuff injury?
Supraspinatus
32
What is the action of Infraspinatus?
Laterally rotates arm; pitching injury
33
What is the action of Teres minor?
ADDucts & laterally rotates arm
34
What is the action of subscapularis?
Medially rotates & ADDucts arm
35
What are the rotator cuff muscles innervated by?
C5-C6
36
What are the bones of the wrist?
* **S**caphoid * **L**unate * **T**riquetrum * **P**isiform * **H**amate * **C**apitate * **T**raepzoid * **T**rapezium * "**S**o **L**ong **T**o **P**inky, **H**ere **C**omes **T**he **T**humb"
37
What is the MC fractured carpal bone?
Scaphoid
38
What is Scaphoid fracture prone to?
Avascular necrosis owing to retrograde BS
39
What can dislocation of lunate cause?
Acute carpal tunnel synd
40
What is Carpal tunnel synd?
Entrapment of median nerve in carpal tunnel; nerve compression→ paresthesia, pain & numbness in distribution of median nerve
41
How can Axillary n. be lesioned?
* Fracture of surgical neck of humerus * Dislocation of the humerus * Intramuscular injections
42
How can Radial n. in spiral groove by lesioned?
Midshaft fracture of humerus
43
How can the deep branch of Radial n. be stretched?
Subluxation of radius
44
How can the reccurrent branch of median n. be lesioned?
Superficial laceration
45
How can Ulnar n. be lesioned in the hand?
Trauma to heel of the hand or fracture of hook of hamate
46
How can Median n. be compressed?
Carpal tunnel synd or by dislocated lunate
47
Where can Anterior interosseous n. be compressed?
Deep forearm
48
How can Ulnar nerve be lesioned in elbow?
Repeat minor trauma, fracture of medial epicondyle of humerus
49
How can the Median n be compressed in the elbow?
Supracondylar fracture of humerus or pronator teres synd
50
How can the radial n. be compressed in the axilla?
Inccorect use of a crutch
51
How can the C7 root be compressed?
Cervical disk lesion
52
What is the freq of of clavicle fractures?
Common
53
What protects the brachial plexus from a clavicle fracture?
Subclavius muscle
54
What are the typical injuries that involve Axillary n (C5,C6)?
* Fractured surgical neck of humerus * Dislocation of humeral head
55
Motor deficit of Axillary n (C5,C6)
Deltoid: arm ABDuction at shoulder
56
Sensory deficit of Axillary n (C5,C6)
Over delitoid muscle
57
What is the sign of Axillary n. lesion?
Atrophied deltoid
58
What are the typical injuries that cause Radial n (C5-T1) injury?
* Fracture at midshaft of humerus * "Saturday night plasy": extended compression of axilla by back of chair or crutches
59
What are the motor deficits of Radial n (C5-T1) lesion?
* "Best extensors" * **B**rachioradialis * **E**xtensors or wrist 7 fingers * **S**upinator * **T**riceps
60
What are the sensory deficits of Radial n (C5-T1) lesion?
Posterior arm & dorsal hand & thumb
61
What is the sign of a Radial n (C5-T1) lesion?
Wrist drop
62
What are the typical injuries involved in Median n (C5-C8, T1) lesions?
Fracture of supracondylar humerus (proximal lesion)
63
What are the motor deficits of Median n (C5-C8, T1) lesion?
* Opposition of thumb * Lateral finger flexion * Wrist flexion
64
What are the sensory deficits of Median n (C5-C8, T1) lesions?
Dorsal & palmar aspects of lateral 3 1/2 fingers, thenar eminence
65
What is the sign of a Median n (C5-C8, T1) lesion?
"Ape hand" or "Pope's blessing" hand
66
What are the typical injuries involved in an Ulnar n. (C8, T1) lesion?
Fracture of medial epicondyle of humerus (proximal lesion)
67
What are the motor deficits of an Ulnar n (C8, T1) lesion?
* Medial finger flexion * Wrist flexion
68
What are the sensory deficits of an ulnar n (C8, T1) lesion?
* Medial 1 1/2 fingers * Hyopthenar eminence
69
What is the sign of a Ulnar n (C8, T1) lesion?
Radial deviation of wrist upon wrist flexion
70
What are the typical injuries involved in a Musculocutaneous n. (C5-C7) lesion?
Upper trunk compression
71
What are the motor deficits of Musculocutaneous n. (C5-C7) lesions?
* iceps * Brachialis * Coracobrachialis * Flexion of arm at elbow
72
What are the sensory deficits of Musculocutaneous n. (C5-C7) lesions?
Lateral forearm
73
What causes Erb-Duchene palsy?
Traction or tear of the upper trunk of the brachial plexus (C5 & C6 roots); seen in infants following trauma during delivery
74
What are the findings of Erb-Duchenne?
* Limb hangs by side (paralysis of ABDuctors) * medially rotated (paralysis of lateral rotators) * Forearm is pronated (loss of biceps) * "Water's tip"
75
What is Klumpke's palsy & thoracic outlet synd?
An embryologic or childbirth defet affecting inferior trunk of brachial plexus(C8, T1). A cervical rib can compress the subclavian artery & inferior trunk, resulting in thoracic outlet synd
76
What are the clinical appearances of Klumpke's palsy & thoracic outlet synd?
* Atrophy of the thenar & hypothenar eminences * Atrophy of the interosseous muscles * Sensory deficits on the medial side of the forearm & hand * Disappearance of the radial pulse upon moving the head toward the ipsilateral side
77
What is a "Clawing" distortion of the hand?
Loss of the lumbricals, which flex the MCP joints & extend both the DIP & PIP joints
78
What can cause an Ulnar claw?
Long-standing injury to ulnar n. at hook of hamate (by falling onto outstretched hands)
79
What is Ulnar claw?
Distal ulnar n. lesion→ loss of medial lumbrical function→ inability to extend 4th & 5th digits ("clawing") when trying to open hand
80
What can cause a Median claw?
Carpal tunnel synd or dislocated lunate
81
What is a Median claw?
Distal median n. lesion (after branch containing C5-C7 branches off to feed forearm flexors)→ loss of lateral lumbrial function
82
Which digits are clawed upon attempted finger extension in a median claw?
2nd & 3rd digits
83
What is the "Pope's blessing"?
Proximal median n. lesion causes loss of lateral finger flexion & thumb opposition
84
What happens when trying to make a fist w/ a median n. lesion?
1st, 2nd & 3rd digits remain extended & thumb remains unopposed, which looks like the hand of a benediction or "Pope's blessing"
85
What is "Ape Hand"?
Proximal median n. lesion→ loss of opponents pollicis muscle function
86
What is Klumpke's total claw?
Lesion of lower trunk (C8,T1) of brachial plexus→ loss of function of all lumbricals; forearm finger flexors (fed by part of median n. w/ C5-C7) & fingers extensors (fed by raidal n) are unopposed → clawing of all digits
87
What does the Long Thoracic n (C5-C7) innervate?
Serratus anterior
88
What is the action of Serratus Anterior?
Anchors scapula to thoracic cage. Used for abduction above horizontal position
89
What happens when long thoracic n. gets injured?
Winged scapula & ipsilateral lymphendema. Can be injured during masectomy
90
What are the Thena hand musles?
* **O**pponens pollicis * **A**bductor pollicis brevis * **F**lexor pollicis brevis * Oppose, ABDuct, Flex (**OAF**)
91
What nerve innervates the thenar muscles?
Median
92
What are the hypothenar muscles of the hand?
* **O**pponens digiti minimi * **A**BDuctor digiti minimi * **F**lexor digiti minimi * Oppose, ABDuct, & Flex (**OAF**)
93
Which nerve innervates the hypothenar muscles?
Ulnar n
94
What is the action of Dorsal interosseous muscles?
ABduct the fingers DAB= Dorsals ABduct
95
What is the action of the Palmar interosseous muscles?
ADduct the fingers **PAD**= **P**almars **AD**duct
96
What is the action of Lumbrical muscles?
Flex at the MCP joint, extend PIP & DIP joints
97
What is the cause of injury of an Obturator n. (L2-L4) lesion?
Anterior hip dislocation
98
What is the motor deficit of an Obturator n. (L2-L4) lesion?
Thigh ADDuction
99
What is the sensory deficit of an Obturator n. (L2-L4) lesion?
Medial thigh
100
What can cause Femoral n. (L2-L4) lesions?
Trauma or compression of lateral aspect of leg or fibula neck fracture
101
What are the motor deficits of a Femoral n. (L2-L4) lesion?
* Foot eversion & dorsiflexion * Toe extension * Foot drop * Foot slap * Steppage gait
102
What are the sensory deficits of a Femoral n. (L2-L4) lesion?
Anterolateral leg & dorsal aspect of foot
103
What can cause Tibial n. (L4-S3) lesion?
Knee trauma
104
What are the motor deficits of a Tibial n. (L4-S3) lesion?
Foot inversion & plantarflexion; toe flexion
105
What is the sensory deficit of a Tibial n. (L4-S3) lesion?
Sole of foot
106
What can cause a Superior gluteal n. (L4-S1) lesion?
Posterior hip dislocation or polio
107
What are the motor deficits of a Superior gluteal n. (L4-S1) lesions?
Thigh abduction, + Trendelenburg sign
108
What is Trendelenburg sign?
Contralateral hip drops when standing on leg ipsilateral to site of lesion
109
What can cause an Inferior gluteal n. (L5-S2) lesion?
Posterior hip dislocation
110
What are the motor deficits of an Inferior gluteal n. (L5-S2) lesion?
Can't jump, climb stairs or rise from seated position; can't push inferiorly (downward)
111
What actions are lost if Peroneal n is lesioned?
Peroneal Everts & Dorsiflexes; If injured, foot dropPED
112
What actions are lost of Tibial n. is lesioned?
**T**ibial Inverts & Plantarflexes; if injured, can't stand on TIPtoes
113
Where does Sciatic nerve (L4-S3) run?
Posterior thigh, splits into common peroneal & tibial nerves
114
What are Type I muscle fibers?
115
What do Type I muscle fibers look like?
Red fibers resulting from inc mito & myoglobulin conc (Inc oxidative phosphorylation)→ sustained contraction
116
What are type II muscle fibers?
Fast Twitch
117
What do Type II muscle fibers look like?
White fibers resulting from dec mito & myoglobulin conc (inc anaerobic glycolysis0
118
What does wt training d/t Type II muscle fibers?
Hypertrophy of fast-twitch fibers
119
Which bones are made by endochondral ossification?
Bones of axial & appendicular skeleton & base of the skull
120
What is the pathway of endochondral ossifcation?
Cartilagenous model of bone is 1st made by chondrocytes. Osteoclasts & osteoblasts later replace w/ woven bone & then remodelt ot lamellar bone
121
What kind of bone occurs after fractures & in Paget's dz?
In adults, woven bone
122
Which bones are made by membranous ossification?
Bones of the calvarium & facial bones
123
What is the pathway of membranous ossification?
Woven bone formed directly w/o cartilage. Later remodeled to lamellar bone
124
What do osteoblasts do?
Build bone by secreting collagen & catalyzing mineralization
125
Where do osteoblasts differentiate from?
Mesenchymal stem cells in periosteum
126
What do Osteoclasts do?
Multinucleated cells that dissolve bone by secreting acid & collagenases
127
Where do osteoclasts differentiate from?
Monocytes/ macrophages
128
What do low/intermittent levels of PTH do?
Exerts anabolic effects (building bone) on osteoblasts & osteoclasts (indirect)
129
What does 1° hyperparathyroidism cause?
Chronic high levels of PTH cause catabolic effects (osteitis fibrosa cystica)
130
What is Estrogen's affect on bone?
Inhibits apoptosis in bone-forming osteoblasts & induces apoptosis in bone-resorbing osteoclasts
131
What happens in Estrogen deficiency (surgical or postmenopausal)?
Excess remodeling cycles & bone resorption lead to osteoporosis