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MSS, Skin & CT > MSS Anatomy & Physiology > Flashcards

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
Q

What is the landmark for Pudendal nerve block?

A

Ischial spine

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26
Q

What does is the Pudendal nerve block used for?

A

To relieve pain of delivery

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27
Q

What is the McBurney’s point?

A

2/3 of the way from umbilicous to the anterior superior iliac spine

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28
Q

What is the landmark for Lumbar puncture?

A

Iliac crest

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29
Q

What are the Rotator Cuff muscles?

A
  • Supraspinatus
  • Infraspinatus
  • Teres minor
  • Subscarpularis
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30
Q

What is the Action of Suprasinatus?

A

ABDucts arm initially (before deltoid)

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31
Q

What is the MC rotator cuff injury?

A

Supraspinatus

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32
Q

What is the action of Infraspinatus?

A

Laterally rotates arm; pitching injury

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33
Q

What is the action of Teres minor?

A

ADDucts & laterally rotates arm

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34
Q

What is the action of subscapularis?

A

Medially rotates & ADDucts arm

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35
Q

What are the rotator cuff muscles innervated by?

A

C5-C6

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36
Q

What are the bones of the wrist?

A
  • Scaphoid
  • Lunate
  • Triquetrum
  • Pisiform
  • Hamate
  • Capitate
  • Traepzoid
  • Trapezium
  • “So Long To Pinky, Here Comes The Thumb”
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37
Q

What is the MC fractured carpal bone?

A

Scaphoid

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38
Q

What is Scaphoid fracture prone to?

A

Avascular necrosis owing to retrograde BS

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39
Q

What can dislocation of lunate cause?

A

Acute carpal tunnel synd

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40
Q

What is Carpal tunnel synd?

A

Entrapment of median nerve in carpal tunnel; nerve compression→ paresthesia, pain & numbness in distribution of median nerve

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41
Q

How can Axillary n. be lesioned?

A
  • Fracture of surgical neck of humerus
  • Dislocation of the humerus
  • Intramuscular injections
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42
Q

How can Radial n. in spiral groove by lesioned?

A

Midshaft fracture of humerus

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43
Q

How can the deep branch of Radial n. be stretched?

A

Subluxation of radius

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44
Q

How can the reccurrent branch of median n. be lesioned?

A

Superficial laceration

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45
Q

How can Ulnar n. be lesioned in the hand?

A

Trauma to heel of the hand or fracture of hook of hamate

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46
Q

How can Median n. be compressed?

A

Carpal tunnel synd or by dislocated lunate

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47
Q

Where can Anterior interosseous n. be compressed?

A

Deep forearm

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48
Q

How can Ulnar nerve be lesioned in elbow?

A

Repeat minor trauma, fracture of medial epicondyle of humerus

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49
Q

How can the Median n be compressed in the elbow?

A

Supracondylar fracture of humerus or pronator teres synd

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50
Q

How can the radial n. be compressed in the axilla?

A

Inccorect use of a crutch

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51
Q

How can the C7 root be compressed?

A

Cervical disk lesion

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52
Q

What is the freq of of clavicle fractures?

A

Common

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53
Q

What protects the brachial plexus from a clavicle fracture?

A

Subclavius muscle

54
Q

What are the typical injuries that involve Axillary n (C5,C6)?

A
  • Fractured surgical neck of humerus
  • Dislocation of humeral head
55
Q

Motor deficit of Axillary n (C5,C6)

A

Deltoid: arm ABDuction at shoulder

56
Q

Sensory deficit of Axillary n (C5,C6)

A

Over delitoid muscle

57
Q

What is the sign of Axillary n. lesion?

A

Atrophied deltoid

58
Q

What are the typical injuries that cause Radial n (C5-T1) injury?

A
  • Fracture at midshaft of humerus
  • “Saturday night plasy”: extended compression of axilla by back of chair or crutches
59
Q

What are the motor deficits of Radial n (C5-T1) lesion?

A
  • “Best extensors”
  • Brachioradialis
  • Extensors or wrist 7 fingers
  • Supinator
  • Triceps
60
Q

What are the sensory deficits of Radial n (C5-T1) lesion?

A

Posterior arm & dorsal hand & thumb

61
Q

What is the sign of a Radial n (C5-T1) lesion?

A

Wrist drop

62
Q

What are the typical injuries involved in Median n (C5-C8, T1) lesions?

A

Fracture of supracondylar humerus (proximal lesion)

63
Q

What are the motor deficits of Median n (C5-C8, T1) lesion?

A
  • Opposition of thumb
  • Lateral finger flexion
  • Wrist flexion
64
Q

What are the sensory deficits of Median n (C5-C8, T1) lesions?

A

Dorsal & palmar aspects of lateral 3 1/2 fingers, thenar eminence

65
Q

What is the sign of a Median n (C5-C8, T1) lesion?

A

“Ape hand” or “Pope’s blessing” hand

66
Q

What are the typical injuries involved in an Ulnar n. (C8, T1) lesion?

A

Fracture of medial epicondyle of humerus (proximal lesion)

67
Q

What are the motor deficits of an Ulnar n (C8, T1) lesion?

A
  • Medial finger flexion
  • Wrist flexion
68
Q

What are the sensory deficits of an ulnar n (C8, T1) lesion?

A
  • Medial 1 1/2 fingers
  • Hyopthenar eminence
69
Q

What is the sign of a Ulnar n (C8, T1) lesion?

A

Radial deviation of wrist upon wrist flexion

70
Q

What are the typical injuries involved in a Musculocutaneous n. (C5-C7) lesion?

A

Upper trunk compression

71
Q

What are the motor deficits of Musculocutaneous n. (C5-C7) lesions?

A
  • iceps
  • Brachialis
  • Coracobrachialis
  • Flexion of arm at elbow
72
Q

What are the sensory deficits of Musculocutaneous n. (C5-C7) lesions?

A

Lateral forearm

73
Q

What causes Erb-Duchene palsy?

A

Traction or tear of the upper trunk of the brachial plexus (C5 & C6 roots); seen in infants following trauma during delivery

74
Q

What are the findings of Erb-Duchenne?

A
  • Limb hangs by side (paralysis of ABDuctors)
  • medially rotated (paralysis of lateral rotators)
  • Forearm is pronated (loss of biceps)
  • “Water’s tip”
75
Q

What is Klumpke’s palsy & thoracic outlet synd?

A

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
Q

What are the clinical appearances of Klumpke’s palsy & thoracic outlet synd?

A
  • 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
Q

What is a “Clawing” distortion of the hand?

A

Loss of the lumbricals, which flex the MCP joints & extend both the DIP & PIP joints

78
Q

What can cause an Ulnar claw?

A

Long-standing injury to ulnar n. at hook of hamate (by falling onto outstretched hands)

79
Q

What is Ulnar claw?

A

Distal ulnar n. lesion→ loss of medial lumbrical function→ inability to extend 4th & 5th digits (“clawing”) when trying to open hand

80
Q

What can cause a Median claw?

A

Carpal tunnel synd or dislocated lunate

81
Q

What is a Median claw?

A

Distal median n. lesion (after branch containing C5-C7 branches off to feed forearm flexors)→ loss of lateral lumbrial function

82
Q

Which digits are clawed upon attempted finger extension in a median claw?

A

2nd & 3rd digits

83
Q

What is the “Pope’s blessing”?

A

Proximal median n. lesion causes loss of lateral finger flexion & thumb opposition

84
Q

What happens when trying to make a fist w/ a median n. lesion?

A

1st, 2nd & 3rd digits remain extended & thumb remains unopposed, which looks like the hand of a benediction or “Pope’s blessing”

85
Q

What is “Ape Hand”?

A

Proximal median n. lesion→ loss of opponents pollicis muscle function

86
Q

What is Klumpke’s total claw?

A

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
Q

What does the Long Thoracic n (C5-C7) innervate?

A

Serratus anterior

88
Q

What is the action of Serratus Anterior?

A

Anchors scapula to thoracic cage. Used for abduction above horizontal position

89
Q

What happens when long thoracic n. gets injured?

A

Winged scapula & ipsilateral lymphendema. Can be injured during masectomy

90
Q

What are the Thena hand musles?

A
  • Opponens pollicis
  • Abductor pollicis brevis
  • Flexor pollicis brevis
  • Oppose, ABDuct, Flex (OAF)
91
Q

What nerve innervates the thenar muscles?

A

Median

92
Q

What are the hypothenar muscles of the hand?

A
  • Opponens digiti minimi
  • ABDuctor digiti minimi
  • Flexor digiti minimi
  • Oppose, ABDuct, & Flex (OAF)
93
Q

Which nerve innervates the hypothenar muscles?

A

Ulnar n

94
Q

What is the action of Dorsal interosseous muscles?

A

ABduct the fingers

DAB= Dorsals ABduct

95
Q

What is the action of the Palmar interosseous muscles?

A

ADduct the fingers

PAD= Palmars ADduct

96
Q

What is the action of Lumbrical muscles?

A

Flex at the MCP joint, extend PIP & DIP joints

97
Q

What is the cause of injury of an Obturator n. (L2-L4) lesion?

A

Anterior hip dislocation

98
Q

What is the motor deficit of an Obturator n. (L2-L4) lesion?

A

Thigh ADDuction

99
Q

What is the sensory deficit of an Obturator n. (L2-L4) lesion?

A

Medial thigh

100
Q

What can cause Femoral n. (L2-L4) lesions?

A

Trauma or compression of lateral aspect of leg or fibula neck fracture

101
Q

What are the motor deficits of a Femoral n. (L2-L4) lesion?

A
  • Foot eversion & dorsiflexion
  • Toe extension
  • Foot drop
  • Foot slap
  • Steppage gait
102
Q

What are the sensory deficits of a Femoral n. (L2-L4) lesion?

A

Anterolateral leg & dorsal aspect of foot

103
Q

What can cause Tibial n. (L4-S3) lesion?

A

Knee trauma

104
Q

What are the motor deficits of a Tibial n. (L4-S3) lesion?

A

Foot inversion & plantarflexion; toe flexion

105
Q

What is the sensory deficit of a Tibial n. (L4-S3) lesion?

A

Sole of foot

106
Q

What can cause a Superior gluteal n. (L4-S1) lesion?

A

Posterior hip dislocation or polio

107
Q

What are the motor deficits of a Superior gluteal n. (L4-S1) lesions?

A

Thigh abduction, + Trendelenburg sign

108
Q

What is Trendelenburg sign?

A

Contralateral hip drops when standing on leg ipsilateral to site of lesion

109
Q

What can cause an Inferior gluteal n. (L5-S2) lesion?

A

Posterior hip dislocation

110
Q

What are the motor deficits of an Inferior gluteal n. (L5-S2) lesion?

A

Can’t jump, climb stairs or rise from seated position; can’t push inferiorly (downward)

111
Q

What actions are lost if Peroneal n is lesioned?

A

Peroneal Everts & Dorsiflexes; If injured, foot dropPED

112
Q

What actions are lost of Tibial n. is lesioned?

A

Tibial Inverts & Plantarflexes; if injured, can’t stand on TIPtoes

113
Q

Where does Sciatic nerve (L4-S3) run?

A

Posterior thigh, splits into common peroneal & tibial nerves

114
Q

What are Type I muscle fibers?

A
115
Q

What do Type I muscle fibers look like?

A

Red fibers resulting from inc mito & myoglobulin conc (Inc oxidative phosphorylation)→ sustained contraction

116
Q

What are type II muscle fibers?

A

Fast Twitch

117
Q

What do Type II muscle fibers look like?

A

White fibers resulting from dec mito & myoglobulin conc (inc anaerobic glycolysis0

118
Q

What does wt training d/t Type II muscle fibers?

A

Hypertrophy of fast-twitch fibers

119
Q

Which bones are made by endochondral ossification?

A

Bones of axial & appendicular skeleton & base of the skull

120
Q

What is the pathway of endochondral ossifcation?

A

Cartilagenous model of bone is 1st made by chondrocytes. Osteoclasts & osteoblasts later replace w/ woven bone & then remodelt ot lamellar bone

121
Q

What kind of bone occurs after fractures & in Paget’s dz?

A

In adults, woven bone

122
Q

Which bones are made by membranous ossification?

A

Bones of the calvarium & facial bones

123
Q

What is the pathway of membranous ossification?

A

Woven bone formed directly w/o cartilage. Later remodeled to lamellar bone

124
Q

What do osteoblasts do?

A

Build bone by secreting collagen & catalyzing mineralization

125
Q

Where do osteoblasts differentiate from?

A

Mesenchymal stem cells in periosteum

126
Q

What do Osteoclasts do?

A

Multinucleated cells that dissolve bone by secreting acid & collagenases

127
Q

Where do osteoclasts differentiate from?

A

Monocytes/ macrophages

128
Q

What do low/intermittent levels of PTH do?

A

Exerts anabolic effects (building bone) on osteoblasts & osteoclasts (indirect)

129
Q

What does 1° hyperparathyroidism cause?

A

Chronic high levels of PTH cause catabolic effects (osteitis fibrosa cystica)

130
Q

What is Estrogen’s affect on bone?

A

Inhibits apoptosis in bone-forming osteoblasts & induces apoptosis in bone-resorbing osteoclasts

131
Q

What happens in Estrogen deficiency (surgical or postmenopausal)?

A

Excess remodeling cycles & bone resorption lead to osteoporosis

MSS, Skin & CT (5 decks)

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