Musculoskeletal Flashcards
What collagen type is affected in the vascular form of Ehlers-Danlos Syndrome?
• common symptoms?
• Complications?
TYPE III collagen affected
Symptoms:
• Easy bruising skin with thin/transparent skin with increased varicosity
Complications:
• These patients are at risk of both Abdominal and Thoracic aneurysms
What type of collagen is affected in the classic type of Ehlers-Danlos Syndrome?
• Symptoms
• Complication
Type V collagen in the classic type - affects mainly the JOINTS AND SKIN
Symptoms:
• Joint Hypermobility
Complications:
• Berry aneurysms etc. (not sure that these would not also be seen in the vascular type)
Where are types 1 and 2 collagen found?
Type I:
• Bone (made by osteoblasts)
• Skin
• Tendon
• Dentin, fascia, cornea, late wound repair
Type II:
• Cartilage (hyaline too)
• Vitreous Body
• Nucleus Pulposus
Where are collagen types III and IV found?
Type III:
• Skin
• Blood Vessels
• Uterus, fetal tissue, and granulation tissue
Type IV: (remember Alport (defective collagen and basket weave, and Goodpastures (autoimmune))
• Basement membrane
• Basal Lamina
• Lens
What causes Marfan Syndrome?
• Defects in fibrillin (a glycoprotein that forms a sheath around fibrillin)
What is the most injured nerve in anterior shoulder dislocations?
• Resultant Deficits?
Axillary Nerve (C5-C6)
Also is commonly injured in humeral neck fractures
**Flattened Deltoid and inability to abduct the arm**
Injury of what nerve causes loos of forearm flexion and supination?
• what sensory loss would be concurrent?
Musculocutaneous (C5-C7)
Sensory loss:
• Loss of sensation on lateral forearm
What hand motions is the Median N. (C5-T1) responsible for?
MOTOR:
• Wrist Flexion
• Lateral Finger Flexion
• Thumb opposition, abduction, and adduction (thenar group = Recurrent MOTOR branch)
• Lumbricals of the 2nd and 3rd digits
SENSORY:
• Palmar fingers 1-3.5
• Dorsal fingers 2-3.5
Loss leads to Ape and and Pop’s blessing
When is the median N. most likely to get injured?
• Supracondylar fracture of the humerus
(Nerve runs with the brachial artery under the median cubital vein)
What happens when you lose your Ulnar N?
Claw Hand
Loss of PADs and DABs
Radial Deviation from loss of Flexor Carpi Unlaris
Loss of Sensation over fingers 3.5-5.
Remember Dr. CUMA
Drop Wrist = Radial Nerve (loss of extensors)
Claw Hand = Ulnar Nerve (no hypothenar or lumbrical)
Median N. = Ape Hand (no thenar, loss of flexors)
Explain the Motions behind Dr. CUMA?
Remember Dr. CUMA
Drop Wrist = Radial Nerve (loss of extensors)
Claw Hand = Ulnar Nerve (no hypothenar or lumbrical)
Median N. = Ape Hand (no thenar, loss of flexors)
Claw Hand = No MIP flexion and No PIP or DIP extension with Ulnar N. loss
What Nerve are you most likely to injure with a medial epicondylar fracture?
Ulnar N.
What two nerves come off of the posterior cord of the brachial plexus?
• which is larger?
• when are these two nerves most likely to be injured?
POSTERIOR CORD:
• Axillary (C5-C6) - humerus sugical neck breaks, anterior dislocation
• Radial (C5-T1) - humerus midshaft breaks/axillary compression
Remember the ARM mnemonic for injuries to the humerus.
Axillary N. injured at the shoulder
Radian N. injured at midshaft fracture
Median N. injured at elblow *medial aspact
Someone has heart surgery and is found to have difficulty breathing on exertion years later. When never that runs along the pericardium was probably hit in the surgery?
Phrenic n. runs along pericardium and could easily get damaged in surgery
