MuscSkCT - FA Anat/Phys p438 - 450 Flashcards
excess anterior gliding of tibia due to — injury. excess posterior gliding of tibia due to — injury.
ACL, PCl
Pain, “popping” on external rotation is due to — during what exam?
medial meniscal tear McMurray test
valgus force causes — space widening of tibia — injury.
(lateral = valgus) medial MCL
lateral or medial meniscus injury is more common?
lateral
A carpet layer complains of pain in his knees during day but not at night and rapid swelling on the front of kneecap. what is the path?
Prepatellar bursitis
Another name for Baker’s cyst?
popliteal cyst, (can also be associated with Lyme disease and RA)
Pt fails the “empty/full can” test and therefore the — muscle can not raise the arm to — degree.
Supraspinatus (suprascapular nerve) up to 15 degree before Deltoid takes over
Name all the Rotator cuff muscles and their function?
Supraspinatus - (suprascapular nerve) abducts arm initially Infraspinatus - laterally rotates arm teres minor (axillary nerve)—adducts and laterally rotates arm. Subscapularis (upper and lower subscapular nerves)—medially rotates and adducts arm.
Name all the wrist bones?
Scaphoid, Lunate, Triquetrum, Pisiform, Hamate, Capitate, Trapezoid, Trapezium A . (So Long To Pinky, Here Comes The Thumb).
Repetitive flexion (forehand shots) can cause what injury?
Medial epicondylitis
— is classically seen in cyclists due to pressure from handlebars. Which nerve is involved?
Guyon canal syndrome Compression of ulnar nerve
Repetitive extension (backhand shots) can cause what injury?
Lateral epicondylitis
— is the most commonly fractured carpal bone and is prone to — owing to retrograde blood supply.
Scaphoid avascular necrosis
— is associated with pregnancy, rheumatoid arthritis, hypothyroidism; may be associated with repetitive use.
Carpal tunnel syndrome
What nerve and at what level causes Flattened deltoid if injured?
Axillary (C5-C6)
Dislocation of — may cause acute carpal tunnel syndrome.
lunate
Pt can’t supinate or flex forearm and has loss of sensation over lateral forearm. Nerve and levels?
Musculocutaneous (C5-C7) lose biceps reflex
A fall on an outstretched hand that damages the —- can cause ulnar nerve injury.
hook of the hamate
Which nerve does not cause a loss of sensation from an arm injury?
Recurrent branch of median nerve (C5-T1) “Ape hand”
Pt has post Tinel sign. what is the Dx and what n./level?
(tingling on percussion) in carpal tunnel syndrome Median (C5-T1) “Ape hand” and “Pope’s blessing”
Pt with decr grip strength and loss of sensation over posterior arm/forearm after using crutches. What n. at what levels?
due to compression of axilla —Radial n (C5-T1)
Radial deviation of wrist upon flexion (proximal lesion)
Ulnar (C8-T1) “Ulnar claw” on digit extension
a boy brought in because he cannot do fine movements of his right hand. He was climbing a tree and he fell from a branch. He tried to grab a branch with his right hand. what injury? 1. radial 2. axillary 3. lower trunk of brachial plexus 4. suprascapular nerve
3
Same boy brought in again this time by his nanny. She said as they were taking a walk, he did not see a huge hole so he almost fell in, so she had to pull the child up while his hand was extended and pronated, what nerve injury? 1, median 2. radial 3. ulnar 4. axillary
radial nursemaid elbow
lets talk about different fractures of humerus! 1. supracondylar 2. surgical 3. midshaft
- median 2. axillary 3. radial
Which n. affected? 1. lateral epicondyle fracture 2. medial epicondyle fracture
- later is median 2. medial is ulnar
a football player, blow to his shoulder while he was trying to throw a ball. his deltioid is flattened, no >15 degree abduction. What kind of sensation loss?
axillary N loss of sensation over deltoid and lateral arm
you are examining a patient and you know he cannot flex his elbow (forearm flexors injury). you check the nerves and his musculocutaneous nerve is fine. What muscle is injured?
brachioradialis by radial nerve MC is for biceps brachii and brachialis
name 3 muscles that MC innervate
brachialis coracobrachialis bicep brachii
name 3 muscles of forearm flexors
Brachialis, Bicep brachii, brachioradialis
interscalene nerve block was performed while trying to repair upper trunk injury, a patient suddenly develop ipsilateral diaphragmatic paralysis. why?
phrenic passes through interscalene sheath
A breast cancer patient develops what cancer after axillary LN ressection? and what type of nerve injury and what are the signs?
angioscarcoma long throacic nerve signs: winged scapula
Pudendal nerve block at where?
ischial spine
pudendal n. innervates what?
sensory: perineum motor: urethral and anal sphincters
Sensory of lateral and anterior thigh
lateral femoral cutaneous
what’s the origin of pudendal
S2-S4
muscle of inferior gluteal
maximus
what n. for minimus and medius?
sup gluteal
what n. for sensory of scrotum and labia major and medial thigh sensation?
genitofermoral L1-L2
whats for sensory of medial thigh and motor adduction
obturator
whats root for obturator?
L2-L4
What is the nerve root for peroneal and tibial?
L4-S2 is peroneal L4-S3 is tibial
pelvic surgery nerve injury?
obturator
pelvic fracture?
femoral
baker cysts?
tibial n - proximal lesion
tarsal tunnel syndrome
tibial n - distal lesion
difficulty climbing stairs and cannot rise up from seated positon
inf gluteal n
how can you cause superior gluteal injury?
intramuscular injection into upper medial gluteal region
Location of proper IM injection in LL?
Superolateral quadrant of gluteal region
Trendelenburg sign, explain?
sup gluteal contralateral hip drops when stand on ipsilateral. pelvic tilts bc weight bearing leg cannot maintain alignment of pelvis through hip abduction
shoulder dislocation (anterior dislocation of humerus)
affects axillary n
posterior hip dislocation
inf gluteal n
thigh adduction - n?
obturator
thigh abduction
sup gluteal n
hip extension
inf gluteal n
what does femoral nerve do?
hip flexion and leg extension (so opp of inf. gluteal)
foot drop
common peroneal n
wrist drop
radial n
patient with trauma to lateral leg, only superficial fibular nerve in injured. what can he not do?
cannot evert + dec sensation of dorsum and distal third of anterior leg
patient with charcot marie tooth, he has what type of symptoms?
foot drop due to common peroneal nerve involvement
knee trauma penetrating injury
tibial n
baker cysts is mostly associated with?
chronic inflammation
greater sciatic foramen is divided by piriformis. what goes above(1) and what goes below (3) and which goes into lesser sciatic foramen
above is superior gluteal
below is siatic nerve, pudendal and inferior gluteal pudendal goes through lesser siatic
disc generally herniate through which direction?
posterolaterally, bc of thin post longitudinal lig and thicker ant longitudinal lig
herniation of L2-L3 affects which n?
L3
Herniation @ what level = dec patellar reflex, weak knee extention
L3-L4
herniation @ what level = weakness of dorsiflexion, difficulty in heel walking
L4-L5
dec in Achilles reflex - which n affected
S1
weakness of plantarflexion
S1
lumbar puncture is performed?
L3-L4, L4-L5
conus medullaris ends at
L1, L2
Injury to axilla/lat thoracic wall affects which n/a?
long thoracic n, lat thoracic a
injury to surgical neck of humerus affects which n/a?
axillary n, post circumflex a
injury to midshaft humerus - which n/a?
radial N, deep brachial a
injury to distal humerus/cubital fossa
median N, brachial a
popliteal fossa
tibial N, popliteal A
Posterior to medial mallious
Tibal and post. tibal
medial epicondyle?
ulnar n
cremaster reflex level
L1-L2
anal sphincter level
S3 -S4
achilles reflex
S1-S2
triceps reflex?
C7-C8
patellar reflex?
L3-L4
biceps reflex?
C5-C6
sensory to posterolateral leg
common peroneal nerve —> lateral sural cutaneous nerve
Pudendal nerve block at where?
ischial n
phosphorylation of myosin is done by what enzyme and will this lead to contraction or relaxation?
myosin light chain kinase, contraction
dephosphorylation of myosin is done by what enzyme and what will this lead to?
myosin light chain phosphatase, relaxation
inc Ca2+ calmodulin complex activates which enzyme?
myosin light chain kinase
bones of axial and appendicular skeleton and base of skull are considered as what type of bone formation?
endochondral ossification
where do u see membranous ossification?
bones of calvarium and facial bones
woven bone is formed directly without
cartilage
cartilaginous model of bone is first made by
chondrocytes
Osteoblastic activity is measured by?
bone ALP
osteocalcin
propeptides of type I procollagen
How do osteoclasts destroy bone? By secreting ____ & ____
by secreting H+ and collagenases
____ decreases osteoclast activity
Osteoprotegerin , a RANK L decoy receptor, binds RANK-L.
At low levels ___ stimulates osteoblasts and indirectly, osteoclasts. At high levels, the same ____ has catabolic effects
PTH
_____ (-) apoptosis in bone forming osteoblasts and induces apoptosis in bone resorbing osteoclasts
Estrogen
______ causes closure of epyphyseal plates during puberty
Estrogen
_____ senses length and speed of musc stretch
_____ senses musc tension
Muscle spindle proprioceptic receptors
GTO (Golgi Tendon Organ)
