Musculoskeletal Flashcards
1
Q
Sebaceous gland
A
Holocrine secretion of sebum. Hair follicle
2
Q
Eccrine gland
A
Sweat, Everywhere
3
Q
Apocrine gland
A
Milky viscious fluid found in axillae, genitalia and areolae. No function until puberty, malodorous due to bacteria,
4
Q
Pudendal nerve block
A
ischial spine(relieve pain of delivery)
5
Q
Lumbar puncture
A
iliac crest
6
Q
Rotator cuff muscles
A
Supraspinatus(abduction)- most common
Infraspinatus(laterally rotates)-pitching injury
Teres Minor- adducts and laterally rotates
Subscapularis- medially rotates and adducts
c5-c6
7
Q
Dislocation of lunate
A
Median nerve injury
8
Q
Axillary nerve injury
A
surgical neck of humerus
9
Q
Radial nerve injury
A
fracture of midshaft of humerus
compressed in axilla via crutch use
10
Q
Ulnar nerve injury
A
medical epicondyle fracture, fracture of hook of hamate
11
Q
Median nerve injury
A
dislocation of lunate and carpal tunnel syndrome
12
Q
Long thoracic nerve injury
A
injury to serratus anterior. C5-c7 lesion. injured via mastectomy. Winged scapula.
13
Q
Axillary nerve(C5,C6)
A
Deltoid arm abduction.
14
Q
Radial(c5-t1)
A
BEST extensors Brachioradialis Extensors of wrist and fingers Supinator Triceps
Wrist drop
15
Q
Median nerve(c5-T1)
A
loss of opposition of thumb, lateral finger flexion, wrist flexion. Ape/pope hand
16
Q
Ulnar(c8-t1)
A
Wrist flexion and medial finger flexion lost. Ulnar claw. Radial deviation of wrist upon flexion
17
Q
Musculocutaneous
A
Biceps, brachialis, coracobrachialis. Loss of flexion at elbow.
18
Q
Erb Duchenne, Waiters tip
A
Tear of C5-c6, seen in delivery of baby w/ trauma.
Paralysis of abductors, medially rotated, forearm pronated
19
Q
Klumpke’s palsy
A
C8-T1. Thoracic outlet syndrome, cervical rib compression.
Atrophy of thenar/hypothenar eminences
Atrophy of interosseous muscles
sensory lows on medial side of forearm and hand
disappearance of radial pulse upon moving head to ipsilateral side.
20
Q
Clawing
A
Loss of lumbricals which flex at MCP joints and extend both DIP and PIP joints
21
Q
Median claw
A
carpal tunnel or dislocated lunate
22
Q
popes blessing/ape hand
A
proximal median nerve lesion
23
Q
Obturator
A
L2-L4. Anterior hip dislocation injury lesion. Loss of thigh adduction and medial thigh sensory defect
24
Q
Femoral
A
L2-L4 Pelvic fracture. Lesion causes thigh flexion and leg extension deficit. Loss of sensory of anterior thigh and middle leg
25
Common Peroneal
L4-S2. Fibula fracture or compression of lateral leg. Lesions causes foot eversion dorsiflexion. Sensory defect of anterolateral leg and dorsal of foot
PED- Peroneal Everts and dorsiflexes (with injury thus FOOT DROP)
26
Tibial
L4-S3. Knee trauma. Causes foot inversion and plantarflexion. Loss of sensory on sole of foot.
TIP- tibial inverts and plantarflexes
27
Superal gluteal
L4-L1. Due to posterior hip dislocation or polio. Thigh abduction lost. Positive trendelenburg sign, contralateral hip drop
28
Inferior gluteal
L5-s2. posterior hip dislocation. cant jump, climb stairs, or rise from seated position.
29
Osteogenesis imperfecta
Pathologic fractures, hearing loss, blue sclera
30
Achondroplasia
Normal-sized head and vertebral column, shortened arms and legs, normal growth hormone and IGF1 levels.
31
Osteopetrosis
Pathologic fractures, anemia (replaceent of marrow cavity), cranial nerve compression w/ visual and hearing loss
32
Osteomyelitis
Most often in metaphysis. Most often due to Staph aureus 90%.
In sickle cell patients due to salmonella paratyphi.
Fever, bone pain
33
Osteoporosis
Loss of mineralized bone and organic bone matrix.
Compression fractures of vertebral bodies
Colles' fracture of distal radius
Dowager's hump
34
Osteochondroma
Males 10-30 yr. solitary/multiple. Metaphysis. Outgrowth of bone capped by benign cartliage. Most common benign
35
Chondrosarcoma
Males 30-60 in pelvic or femur. Metastasis to lungs. Located in the medullary cavity
36
Osteoma
Males, facial bones. Gardner syndrome assoc.
37
Giant cell tumor
females 20-40yr. epihysis of distal femur or proximal tibia. Reactive multinucleated osteoclasts. Double bubble/soap bubble appearance
38
Ewing Sarcoma
males 10-20. diaphysis of long bones, pelvis, ribs. Small round cell tumor, anaplastic small blue cell. Onion skin appearance. T11:22 translocation. Early metastasis
39
Osteogenic sarcoma
males 10-25. Metaphysis of distal femur. Pagets disease and Rb are risk factors. Codmans triangle from periosteum. Aggressive. Metastasizes to lung.
40
Pagets disease
Bone pain, headaches, hearing/vision loss, increased hat size. Serum calcium, phosphorus and PTH are normal. Increased AVM leading to high output cardiac failure. Increased risk of osteogenic sarcoma
41
polyostotic Fibrous dysplasia
defect in osteoblastic differentiation and maturation. Medullary bone replaced with fibroblasts, collagen and irregular bony trabeculae. Ribs most common. McCune Albright syndrome: cafe au lait spot and precocious puberty.
42
Diseases with morning stiffness
Rheumatoid arthritis, Polymyalgia rheumatica, systemic lupus erythematous.
43
Colles' fracture
Common fracture when falling on outstretched hand. Fracture of distal radius with or without fracture of ulnar styloid.
44
Rotator cuff tear
pain/weakness with shoulder abduction
45
Tennis elbow
pain with lateral epicondyle. pain when gripping something
46
Golfers elbow
pain where the flexor muscles insert near the medial epicondyle. Pain flexing hand muscles and supinating the arm
47
Infectious arthritis
Most common cause is Staph aureus. also can be caused by N. gonorrhoeae, lyme disease. Affected joint is swollen red and painful. STD= synovitis, tenosynovitis, dermatitis.
48
Osteopetrosis
Defective osteoclasts due to mutation in carbonic anhydrase II. Failure to reabsorb bones leads to thickened dense bone prone to fracture. Bone fills marrow space causing pancytopenia, extramedullary hematapoiesis. Can affect vision and hearing
Increased ALP, decreased Calcium
49
Osteitis fibrosa cystica
brown tumors of hyperarathyroidism
increased calcium, decreased phosphate, increased ALP and increased PTH
50
Most common metastasis to bone
Breast
51
Infectious arthritis
S.Aureus, Streptococcus, Neisseria gonorrhoeae. Gonorrhea STD= synovitis, tenosynovitis, dermatitis.
52
Psoriatic arthritis
Joint pain and stiffness associated with psoriasis. Asymmetric and patchy involvement. Sausage fingers, pencil in cup deformity on xray
53
Ankylosing spondylitis
chronic inflammatory disease of spine and sacroiliac joints causing ankylosis(stiff spine,bamboo spine) uveitis and aortic regurgitation. Often associated with IBD
54
Reactive arthritis (Reiter's syndrome)
Conjunctivitis, urethritis, arthritis
Cant see, cant pee, cant climb a tree
Post GI or chlamydia infection
55
SLE
IM DAMN SHARP
```
Immunoglobulines(anti dsDNA, anti-SM, anti-ANA)
Malar rash(facial rash)
Discoid rash
Antinuclear antibody
Mucositis(oropharyngeal ulcers)
Neurologic disorders
Serositis(pericarditis, pleuritis)
Hematologic disorders
Arthritis
Renal disorders
Photosensitivity
```
56
Sarcoidosis
Noncaseating granulomas, elevated ACE, black females. Bilateral hilar adenopathy. Restrictive lung disease, erythema nodosum, Bells palsy, Granulomas with schaumann and asteroid bodies. Hypercalcemia
Treat with steroids.
57
Polymyalgia Rheumatic
pain and stiffness in shoulders in hips w/ fever malaise and weight loss. NO muscular weakness. Women >50. Associated with temporal giant cell arthritis. Increased ESR.
58
Fibromyalgia
women 20-50. Chronic widespread musculoskeletal pain associated with stiffness, parathesia, poor sleep and fatigue.
59
Polymyositis
symmetrical proximal muscle weakness characterized by endomysial inflammation with CD8+ T cells. Shoulders.
Positive anti-Jo-1
60
Dermatomyositis
symmetrical proximal muscle weakness characterized by endomysial inflammation with CD8+ T cells. Shoulders. Also involves malar rash, gottrons papules or heliotrope rash. Perimysial inflammation and atrophy with CD4+ cells
Increased risk of malignacy
Positive anti-Jo-1
61
Scleroderma
Excessive fibrosis and collagen deposition. Absence of wrinkles. 75% females.
Diffuse Scleroderma- widespread skin involvement, rapid progression, Anti-scl-70 topoisomerase I
```
CREST
Calcinosis
Raynauds
Esophageal dysmotility
Sclerodatyly
Telangiectasia
*limited skin involvement, more benign, anticentromere antibody.
```
62
Albinism
Decreased melanin production due to decreased tyrosinase activity. Normal melanocytes.
63
Melasma
hyperpigmentation associated with pregnancy
64
Vitiligo
Irregular complete depigmentation. Decreased number of melanocytes.
65
Verrucae
Warts, HPV. Epidermal hyperplasia, hyperkeratosis, koilocytosis. Condyloma acuminatum on genetalia
66
Melanocytic nevus
Common mole, benign. Intradermal nevi are papular, junction nevi are flat.
67
Urticaria
Hies, pruritic wheals that form after mast cell degranulation
68
Ephelis
Freckle. Normal melanocyte number, increased melanin pigment
69
Atopic dermatitis, eczema
pruritic eruption commonly on skin flexure. Associated with asthma and allergic rhinitis. Starts on face in infancy and appears in cubital fossa therafter.
Type I HSR
70
Allergic contact dermatitis
Type IV HSR. lesion at site of contact
nickel, poison ivy, neomycin
71
Psorias
papule and plaques with silery scaling especially on knees and elbows. Acanthosis with parakeratotic scaling. Increased stratum spinosum, decreased granulosum. Auspitz sign of pinpoint bleeding from exposure of dermal papillae. Associated with Arthritis, possibly HLA, possibly autoimmune.
72
Seborrheic keratosis
flat greasy pigmented squamous epithelial proliferation with keratin filled cysts Looks stuck on. In leser trelat sign, multiple seborrheic keratosis indicates underlying malignancy.
73
Erythema multiform
Associated with infections(mycoplasma, HSV), drugs (sulfa, B-lactams, phenytoin) and cancer/autoimmune.
Presents with multiple types of lesions: macules, papules, vesicles, target lesions.
74
Steven Johnson syndrome
Fever, bulla formation and necrosis, sloughing of skin and high mortality rate. Typically 2 mucus membranes are involved and skin lesions may appear like targets as seen in erythema myltiforme.
Adverse Drug Rx
More severe form is toxic epidermal necrolysis covering >30% of body surface.
75
Polyostotic fibrous dysplasia
Bone is replaced by fibroblasts, collagen and irregular bony trabeculae. McCune-Albright syndrome is a form of polyostotic fibrous dysplasia characterized by multiple unilateral bone lesions associated with endocrine abnormalities(precocious puberty) and cafe-au-lait spots.
76
McCune-Albright syndrome
form of polyostotic fibrous dysplasia characterized by multiple unilateral bone lesions associated with endocrine abnormalities(precocious puberty) and cafe-au-lait spots.
