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S1 First aid > musculoskeletal > Flashcards

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
Q

in oteoarthritis the nodes are called

A

heberden and bouchard

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26
Q

rheumatoid arthrithis antibody are?

A

HLA-DR4, rf: (IgM antibody that targets IgG Fc region)

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27
Q

leflunomid is used for and its mech of action?

A

rev. inhib, the dihydroortate dehydrogenase, preventing pyramidine synt., suppresses t-cell proliferation

used for rheumatoid arthritis

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28
Q

bisphosphonates: alandronate

A

pyrophoshate analogs, binds to hydroxyapatite, inhibits osteoclasts activity

use is ostoeporosis

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29
Q

diffuse scleroderma is?

A

widespread, associ. with anti-scl 70 antibody( ant_DNA-topoisomerase) and anti-RNA polymerase 3.

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30
Q

limited scleroderma is?

A

limitted skin involvement confined to fingers or face. Also with crest syndrome.

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31
Q

lambert-eatnen myastenic syndrome

A

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

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32
Q

myasthenia gravies is?

A

is an autoimmune disease that target the neuromuscular junctions, autoantibodies target postsynatic ACh receptor

sympotoms are, ptosis, diplopia, weakness (respiratory involvement

33
Q

Ankylosing spondylits?

A

symmetric involvement of the spine an sacroiliac joints leads to ankylosis (joint fusion), uveitis, aortic regurgitation,
bamboo spine

may cause restric. lung diseases

34
Q

seronegative spondyarthritis is?

A

Arthritis without rheumatoid factor (no anti-IgG antibodies). Strong associ. with HLA-B27 (MHC class I serotype). Subtpes PAIR shaire variable recurrence

35
Q

What does PAIR stand for?

A

Psoriadic arthtritis, Ankolysing spondylitis, Inflammatory bowl disease, Reactive arthritis

36
Q

Psoriadic arthtritis

A

assoc. with psorisis and nail lesions. asym. and pathy. Dactylitis and pencil in a cup deformity

37
Q

Inflammatory bowel D

A

Crohn or UC offten associ. with spondyloarthritis

38
Q

Reactive arthritis

A

Formerly Reiter syndrome. Classic triad: -Conjuctivitis, -Urethritis, -Arthritis
Cant see, cant pee, cant bend the knee
ShY ChiCS:
Shigella, Yersenia, Chlamydia, Campylobacters, Samonella

39
Q

Calium pyrophosphate deposition disease

A

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
Q

Erwings sarcoma

A

prim bone tumor <15 Diaphysis of the long bones

t: (11;22) EWS-FLII

11+22=33 (Patrick Erwings jersy no)

41
Q

Chrondrosarcoma

A

Tumor of malignant chrondrocytes

Location: Pelvis, femur and humerus.

42
Q

Oasteosarcoma

A

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
Q

Allergic contact dermatitis is what type of hypersensitivity?

A

is type IV hypersensitivity reaction

44
Q

Rosacea

A

inflammatory skin disorder erthematous papules often seen in alcoholics, can cause nose bullous diformatis ( rhinophyma)

45
Q

Angiosarcoma

A

blood vessel malignancy typically occurring in the breast, head and neck areas. Associ. with Radiotherapy and Post Mastectomy lymphedema

46
Q

Impetigo

A

Very superficial skin infection, S aureus or S pyogenes, honey-crust—-> bullous impetigo

47
Q

erysipales

A

Infect. of upper epidemis and superficial lymphatics, usu. S.pyogenes, well defined demarcation

48
Q

cellulitis

A

Infect. of the deeper demis and sucutis usu. S pygenes and aureus

49
Q

molluscum contagiosum

A

Umbilicated papules caused by poxvirus. Frequently in children

50
Q

Pemphigous

A

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
Q

Phempigoid

A

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
Q

Squamous cell carcinoma

A

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
Q

Melanoma

A

BRAF kinase, S100, sunlight, dysplastic nevi

54
Q

Keratocanthoma

A

middle-aged, resembles squamous CC, present as dome shaped nodule with keratin-filled center.

55
Q

Basal cell carcinoma, BCC

A

Most common skin cancer, sun, locally invasive, rarely met., Waxy, pink, pearly nodules, commonly with telangiectasis, rolled borders, ulceration.

“palisading nuclei”

56
Q

Erythema nodosum

A

Painful, raised inflammatory lesions of subcutaneous fat associ, with sarcoidosis, histo, TB or strep. etc

57
Q

Lichen planus

A

6 Ps: Pink Papules Polygonal, Planer Plaque—–> hypergranulosis, Sawtooth infiltrate of lymphocytes at dermal epidermal juctions. Associ. with hep. C

58
Q

Dermatitis Herpedifomis

A

Pruritric papules at the elbows, knees and buttocks. Associ. with ciliacs

59
Q

Erythema multiforme

A

multiple lesions and papules associ. with Mycoplasma, HSV, drugs

60
Q

De Quervain tenosynovitis

A

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
Q

Osteopetrosis

A

Failure of bone resorption due to defectve osteoclasts—> thickening of bones, dense bones that are more prone to fracture

62
Q

Osteitis deformas/ paget disease

A

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
Q

Rickets

A

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
Q

Osteoclasts

A

RANK receptor on osteoclsts are stimulated by RANKL

65
Q

Avascular necrosis of the femoral head is caused by?

A

medial circumflex femeral artery. Cause: SS

CASTS: Coticosteriods, Alcoholism, SLE, SS

66
Q

Nerve and Artery in the location of:

Axilla/lateral thorax

A

N:Long thoracic, A:long thoracic

67
Q

Nerve and Artery in the location of:

Surgical neck of the humerus

A

Axillary, posterior circumflex

68
Q

Nerve and Artery in the location of: Midshaft of Humerus

A

Radial, Deep brachial

69
Q

Nerve and Artery in the location of:

Distal humerus/ cubital fossa

A

Median Nerve, Brachial

70
Q

Nerve and Artery in the location of: Popliteal fossa

A

Tibial, Popliteal

71
Q

Nerve and Artery in the location of: Posterior to medial malleolus

A

Tibial, posterior tibial

72
Q

Teriparatide

A

recombinant PTH analog. increases osteoblastic activity

Osteoporosis

73
Q

Probenecid

A

inhib. the reabsortion of uric acid in the PCT, also inhibi. the secretion of penecillin—–> can lead to uric acid stones

Gout drug

74
Q

Allopurinol

A

inhibit. Xanthine oxidase, decreasing the conversion of hypoxathin and xanthin

it can increase concentration of azathioprine, 6-MP etc

75
Q

Febuxostat

A

inhibits xanthine oxidase –Gout drug

76
Q

Colchicine

A

Binds and stabilizes tubulin to inhibit microtubule polymerization, impairing neutrophil chemotaxis and degranulation

SE: GI and neuropathic

77
Q

Etanercept

A

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
Q

Imfliximab -mab

A

Anti- TNF-alpha monoclonal antibody.

IBD, RA, ankylosing spondylitis, psoriasis

S1 First aid (20 decks)

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