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musculoskeletal Flashcards

1
Q

muscles of the rotatator cuff are? function and innervation?

A

1 supraspinatus/ abduction (impingement, empty a full can),

2 infraspinatus ext. rotation pitching injury,

3 supscapularis in. rotation, adduct

123 are inverated by supscapular nerve

and teres minor ext. rotation, adduct (axillary nerve),

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2
Q

0-15 degree of abduction does?

A

suprapinatus

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3
Q

15-100 degree of abduction does?

A

deltoid

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4
Q

greater than 90 degrees of abduction?

A

Trapezius (accessory)

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5
Q

greater than 100 degrees of abduction?

A

serratus anterior (long thoracic)

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6
Q

name the wrist bones?

A

scaphoid, lunate, triquetrum, pisiform, hamamate, capitate, trapozoid, trapezium

so long to pincky here comes the thum

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7
Q

which ist the most commen fracture in the carpal bones?

+complication?

A

scaphoid, due to fall on the outstretched hand

complication is avascular necrosis and noneunion due retrograde blood supply of the radial artery

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8
Q

which bone injury may cause acute carpal tunnel syndrome?

A

lunate

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9
Q

hand muscles and innervation?

A

thenar mucles (median)- opponens pollices, adbuctor pollices bevis, flexor pollices brevis, superficial head (deap head of the ulnar nerve)

Hypothenar (ulnar)- opponens digiti mini, aductor digit minimi, flexor digiti minimi brevis

OAF: oppose, abduct and flex

dorsal intertossei (ulnar nerve)_ abduct fingers

palmar interossei (ulnar) -abduct fingers

lumbrcalis 1 and 2(median), 3,4 (ulnar) flex MCP, extent PIP and DIP

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10
Q

fractured surgical neck of the humerus and anterior dislocation of the humerus can result in what type of injury and present as?

A

axillary (C5-6),

flattend deltoid, loss of abduction greater than 15 degrees, loss of sensation of the deltoid and the lateral arm

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11
Q

what type of injury will cause upper trunk compression?

A

musculocutanoeus (c5-7) dicreased biceps or triceps reflex

weakness of foram flexion and suppination

loss of sensation of the over the lateral forarm

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12
Q

compression of axilla due crutches sleep with arm chair

miftshaft fracture of the humerus

repetitive pronation/supination of the forarm eg screwdriver use “finger drop”

injury presents as?

A

radial (c5-t1)

wrist drop: loss of elbow, wrist and finger extension

decreased grip strength ( wrist extension necessary for maximal flexion

lost of sensation of posterior arm, forarm and dorsal hand

Radial nerve gives out muscular branches to supply the long head, medial head, and lateral head of triceps brachii muscles before and during its course in the radial sulcus. After it emerges out from the radial sulcus, it supplies the brachialis, brachioradialis and extensor carpi radialis longus.

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13
Q

supracondylar fracture of the humerus leads proximal lesion of the nerve
carpal tunnel syndrome and wrist laceration leads to distal lesion of what nerve and representation?

A

Median (C5-T1)

ape hand and pope blessing

loss of wrist flexion, flexion of lateral hand, thumb opposition, lumbricals index and middle fingers

loss of sensation over the thenar eminance and dorsal palmar aspect of 3 1/2 with proximal lesion

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14
Q

Fracture of the epicondyle of the humerus funny bone proximal lesion
fracture hook hamate dital lesion from the fall on the outstretched hand

A

ulnar claw on the digit

radial devition of wrist upon flexion ( prox. lesion)

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15
Q

what is sceroderma?

A

is a systemic sclerosis. Triad of autoim. noninflam. vasculitis and collagen deposition with fibrosis. there a 2 types:
diff. scleroderma
limited scleroderma: also with crest

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16
Q

what is crest syn.?

A

calcinos cutis, anti-centromere antibodies, raynaud phenomen, esophagial dysmotility, sclerodactyly, and telangiectasia

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17
Q

Lupus is asocisted with

A

libman sacks endocarditis

lupus nepritis/-ros: DNA-anti-DNA immune complex deposition

defieciency of c1q, c4, c2

rash or rain

rash
arthrits
serositis (pleuritis, pericaditis)
hematologic disorders
oral/nasopharyngial ulcers
renal disease
photosensivity
antinuclear antibodies
immone disorder (antidsDNA, anti-Sm, antiphspholid)
neurological disorders (seisures, psychosis)

lupus redness in the cheeks

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18
Q

fibromyalgia is?

A

muscuskeletal pain associated with tender points, stiifness, paresthesia, poor sleep, fatique, cog disturb.

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19
Q

polymyositis dermatomyositis is?

A

nonspecific +ANA, increase CK, +anti-jo-1 (histyl-tRNA synthetase), +SRP(signal recognition particle), +anti-MI-2 (helicase)

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20
Q

polymyositis

A

symmetric prox muscle weakness, cd8

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21
Q

dermatomyositis

A 
like polymyositis (weakness inflam. of muscles and skin), but involves grotton papules, dirty face appearance 
cd4
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22
Q

polymyalgia rheumatica

A

pain and stiffness in proximal muscles, assoc. with giant cell( temporal) arthritis, ESR increased,

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23
Q

what is antiphospholipid syndrome

A

autoimm. disorder (m.c. in SLE)

anticarsiolipin, anti-beta2 glycorpotein 1 antibodies or thrombosis

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24
Q

sjörgren syndrome

A

autoimm. disorder by destruction of the exocrine glands, by lymphocytic infiltration
findins: jointpain, keratoconjuctivitis sicca, xerostomomia, antinuclear antibotis: SS-A( anti-Ro), SS-B (anti-La), parotid inlargement

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25
in oteoarthritis the nodes are called
heberden and bouchard
26
rheumatoid arthrithis antibody are?
HLA-DR4, rf: (IgM antibody that targets IgG Fc region)
27
leflunomid is used for and its mech of action?
rev. inhib, the dihydroortate dehydrogenase, preventing pyramidine synt., suppresses t-cell proliferation used for rheumatoid arthritis
28
bisphosphonates: alandronate
pyrophoshate analogs, binds to hydroxyapatite, inhibits osteoclasts activity use is ostoeporosis
29
diffuse scleroderma is?
widespread, associ. with anti-scl 70 antibody( ant_DNA-topoisomerase) and anti-RNA polymerase 3.
30
limited scleroderma is?
limitted skin involvement confined to fingers or face. Also with crest syndrome.
31
lambert-eatnen myastenic syndrome
is an autoimm. disease that of the neuromuscular junction path: autoantibodies to presynatic ca2+ channel dreases ACh release improve with muscle use prx mucle weakness and autonomic sys. eg dry mouth, impotence
32
myasthenia gravies is?
is an autoimmune disease that target the neuromuscular junctions, autoantibodies target postsynatic ACh receptor sympotoms are, ptosis, diplopia, weakness (respiratory involvement
33
Ankylosing spondylits?
symmetric involvement of the spine an sacroiliac joints leads to ankylosis (joint fusion), uveitis, aortic regurgitation, bamboo spine may cause restric. lung diseases
34
seronegative spondyarthritis is?
Arthritis without rheumatoid factor (no anti-IgG antibodies). Strong associ. with HLA-B27 (MHC class I serotype). Subtpes PAIR shaire variable recurrence
35
What does PAIR stand for?
Psoriadic arthtritis, Ankolysing spondylitis, Inflammatory bowl disease, Reactive arthritis
36
Psoriadic arthtritis
assoc. with psorisis and nail lesions. asym. and pathy. Dactylitis and pencil in a cup deformity
37
Inflammatory bowel D
Crohn or UC offten associ. with spondyloarthritis
38
Reactive arthritis
Formerly Reiter syndrome. Classic triad: -Conjuctivitis, -Urethritis, -Arthritis Cant see, cant pee, cant bend the knee ShY ChiCS: Shigella, Yersenia, Chlamydia, Campylobacters, Samonella
39
Calium pyrophosphate deposition disease
Previously called pseudogout. Deposition of calcium pyrophosphat crystals within the joint space Cystals are rombid and weakly+ birefrigent under polarized light (blue when parallel to light) blue Pś
40
Erwings sarcoma
prim bone tumor <15 Diaphysis of the long bones t: (11;22) EWS-FLII 11+22=33 (Patrick Erwings jersy no)
41
Chrondrosarcoma
Tumor of malignant chrondrocytes Location: Pelvis, femur and humerus.
42
Oasteosarcoma
methaphysis of the long bone, pleomorhic osteoid- producing cells (malignant oteoblasts) Codman triangle (elevated periostium), sunburst pattern 1°<20 2° perdiposing factor like pagets
43
Allergic contact dermatitis is what type of hypersensitivity?
is type IV hypersensitivity reaction
44
Rosacea
inflammatory skin disorder erthematous papules often seen in alcoholics, can cause nose bullous diformatis ( rhinophyma)
45
Angiosarcoma
blood vessel malignancy typically occurring in the breast, head and neck areas. Associ. with Radiotherapy and Post Mastectomy lymphedema
46
Impetigo
Very superficial skin infection, S aureus or S pyogenes, honey-crust----> bullous impetigo
47
erysipales
Infect. of upper epidemis and superficial lymphatics, usu. S.pyogenes, well defined demarcation
48
cellulitis
Infect. of the deeper demis and sucutis usu. S pygenes and aureus
49
molluscum contagiosum
Umbilicated papules caused by poxvirus. Frequently in children
50
Pemphigous
less than 60, Desmosomes, Type II, IgG antibodies aganist desmoglein 1/ or 3 which connects kerotinocytes, Flaccid intradermal bullae reticular pattern around epidermal cells
51
Phempigoid
older than 60, Hemidesmosomes, Type III, IgG antibdies against hemidesmosomes (apidermal basement membrane, antibodies are bullow the epidemis Tense blisters linear pattern at epidermal-dermal juction
52
Squamous cell carcinoma
Second most common. Associ. with sunlight exposure, immunosupression, chronic non healing wound, ulcerative red leasons spreads to the lymphnodes-----> Histo: keratin perls. ACTINIC KERATOSIS, ascaly plaque, is a precurser to squamous cell carcinoma
53
Melanoma
BRAF kinase, S100, sunlight, dysplastic nevi
54
Keratocanthoma
middle-aged, resembles squamous CC, present as dome shaped nodule with keratin-filled center.
55
Basal cell carcinoma, BCC
Most common skin cancer, sun, locally invasive, rarely met., Waxy, pink, pearly nodules, commonly with telangiectasis, rolled borders, ulceration. "palisading nuclei"
56
Erythema nodosum
Painful, raised inflammatory lesions of subcutaneous fat associ, with sarcoidosis, histo, TB or strep. etc
57
Lichen planus
6 Ps: Pink Papules Polygonal, Planer Plaque-----> hypergranulosis, Sawtooth infiltrate of lymphocytes at dermal epidermal juctions. Associ. with hep. C
58
Dermatitis Herpedifomis
Pruritric papules at the elbows, knees and buttocks. Associ. with ciliacs
59
Erythema multiforme
multiple lesions and papules associ. with Mycoplasma, HSV, drugs
60
De Quervain tenosynovitis
Noninflammatory thickining of abductor pollices longus and extensor pollices brevis tendos charaterized by pain or tenderness at radial styloid. increased in golfer, mothers, racquet sport plyers.
61
Osteopetrosis
Failure of bone resorption due to defectve osteoclasts---> thickening of bones, dense bones that are more prone to fracture
62
Osteitis deformas/ paget disease
Common loc. disorder of bone remodeling caused by increased osteoclastic activity followed by osteblastic actvity. Ca++, Ph and PTH are normal. maic pattern, chalk stick fractures Treatment: Biphosphonates
63
Rickets
Defective min. of osteoid or chartelage growth plated--->Vit D def. osteopenia, looser zones on x-ray/pseudofractures, emthaphysial cupping/fraying/ genu varum, bead like costochondral junction, soft skull decreased Vit D and Ca++, PTH increased
64
Osteoclasts
RANK receptor on osteoclsts are stimulated by RANKL
65
Avascular necrosis of the femoral head is caused by?
medial circumflex femeral artery. Cause: SS | CASTS: Coticosteriods, Alcoholism, SLE, SS
66
Nerve and Artery in the location of: | Axilla/lateral thorax
N:Long thoracic, A:long thoracic
67
Nerve and Artery in the location of: | Surgical neck of the humerus
Axillary, posterior circumflex
68
Nerve and Artery in the location of: Midshaft of Humerus
Radial, Deep brachial
69
Nerve and Artery in the location of: Distal humerus/ cubital fossa
Median Nerve, Brachial
70
Nerve and Artery in the location of: Popliteal fossa
Tibial, Popliteal
71
Nerve and Artery in the location of: Posterior to medial malleolus
Tibial, posterior tibial
72
Teriparatide
recombinant PTH analog. increases osteoblastic activity Osteoporosis
73
Probenecid
inhib. the reabsortion of uric acid in the PCT, also inhibi. the secretion of penecillin-----> can lead to uric acid stones Gout drug
74
Allopurinol
inhibit. Xanthine oxidase, decreasing the conversion of hypoxathin and xanthin it can increase concentration of azathioprine, 6-MP etc
75
Febuxostat
inhibits xanthine oxidase --Gout drug
76
Colchicine
Binds and stabilizes tubulin to inhibit microtubule polymerization, impairing neutrophil chemotaxis and degranulation SE: GI and neuropathic
77
Etanercept
TNF alpha inhibitors Fusion protein (decoy receptor for TNF-alpha and IgG1 Fc) produced by recombinant DNA Etanercepts intercepts TNF Rheumatoid arthritis, psorisis, ankylosing spondylitis
78
Imfliximab -mab
Anti- TNF-alpha monoclonal antibody. IBD, RA, ankylosing spondylitis, psoriasis

S1 First aid (20 decks)

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