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A - Board Reveiew Misc > musculoskeletal first aid > Flashcards

musculoskeletal first aid Flashcards

1
Q

Placing a lateral pressure at the knee is testing what?

A

Medial collateral ligament strength.

Increased stretching on the medial side indicates damage.

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2
Q

Placing a medial pressure at the knee is testing what?

A

Tests for lateral collateral ligament strength.

Increased stretching laterally will indicate damage.

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3
Q

What is the McMurray’s test checking?

A

Internally and externally rotating the leg during range of motion.
Popping on external rotation indicates a medial meniscal tear.

Popping on internal rotation indicates a lateral meniscal tear.

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4
Q

What is the unhappy triad?

A

Medial meniscal tear
Medial collateral ligament
Anterior cruciate ligament.

It should be known though that lateral meniscus injury is more common.

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5
Q

What are the rotator cuff muscles?

A 
SItS
Supraspinatous
Infraspinatius
Teres minor
Subscapularis
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6
Q

Which muscle of the rotator cuff is most commonly damaged?

A

Supraspinatus (suprascapular nerve)
Tested by the empty/full can test.

abducts the arm before the deltoids kick in.

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7
Q

What rotator cuff is commonly injured in a pitching injury?

A

Infraspinatus (suprascapular nerve)

Muscle is responsible for laterally rotating the arm.

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8
Q

What is the action of teres minor?

A

Axillary nerve

Adducts and laterally rotates the arm.

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9
Q

What is the action of subscapularis?

A

Upper and lower subscapular nerves

Medially rotates and adducts the arm.
Innervated mostly by C5 and C6( entire rotator cuff)

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10
Q

Golfers elbow

A

Medial epicondylitis of the arm

Repetitive flexion

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11
Q

Tennis elbow

A

Lateral epicondylitis

Repetitive extension

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12
Q

Most commonly injure carpal bone that is also prone to avascular necrosis?

A

Scaphoid bone.
Also known as the snuff box.

It is suceptible because of its retrograde blood supply.

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13
Q

Dislocation of which carpal bone can cause severe carpal tunnel?

A

Dislocation of the lunate bone.

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14
Q

The hook of which carpal bone can cause ulnar compression if damaged?

A

The hook of the hamate.

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15
Q

Nerve damaged with fractured surgical neck of the humerus or anterior dislocation of the humerus?

A

Axillary nerve

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16
Q

Upper trunk compression leads to damage of what nerve?

A

Musculocutaneous

C5-C7

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17
Q

Midshaft fracture of the humerus or saturday night palsey/walking in crutches.

A

Radial nerve injury.

C5-T1

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18
Q

What nerve is injured with a supracondylar fracture of the humerus?

A

Median nerve
C5-T1

Can be proximal (in humerus) or distal (carpal tunnel)

Will effect the hand differently.

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19
Q

Medial epicondyle of the humerus fractures effect what…?

A

Ulnar nerve C8-T1

Can ead to different problems if proximal compared to distal.

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20
Q

Damage to the recurrent branch of the median nerve leads to what disorder?

A

C5-T1 injury can occur with superficial palm lacerations.

Will present with popes hand as the thenar muscle group will be damaged.

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21
Q

Describe Erbs palsy

A

Destruction/damage of the upper trunk C5-C6 roots

Leads to waiters tip sign (loss of flexors)

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22
Q

Lateral traction on an infants neck when born

A

Erbs palsey
Damage to C5-C6 waiters tip

Arm dangling to side, fully extended, medially rotated and hand flexed/supinated

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23
Q

Grabbing a tree branch to break a fall

A

Damage of the C8-T1 nerve roots.
Leads to Klumpke palsey –> Loss of internal hand muscles.

“Total Claw hand”

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24
Q

How would a pancoast tumor/ thoracic outlet syndrome present?

A

Same as Klumpsky as the lower roots would be damaged.

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25
Q

What could possibly lead to long thoracic nerve damage

A

Would result in a winged scapula and would be seen after a masectomy when removing lymph nodes.

Seratus anterior wont be working correctly.

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26
Q

Describe the general pattern following proximal vs distal nerve injury in the arm.

A

Proximal injuries generally present with difficulty flexing and extinding all of the fingers.

Distal injuries generally cause clawing.

27
Q

How would damage to the superior gluteal nerve compare to the inferior gluteal nerve in prsentation?

A

Superior gluteal nerve would present with lack of abduction while standing “trendelenberg sign”

Inferior gluteal nerve would present with difficutly standing from a sitting position (loss of hip extension)

28
Q

Damage to which nerve would result in the inability to stand on your tip toes?

A

Damage to the tibial nerve.

29
Q

what artery correlates to damage to the surgical neck of the humerus?

A

Posterior circumflex

30
Q

What artery correlates to damage to the midshaft of teh humerus?

A

Deep brachial

31
Q

What artery correlates to damage to the distal humerus/cubital fossa?

A

Brachial artery

32
Q

Depolarization of voltage sensitive …. receptors leads to calcium release from the sarcoplasmic reticulum.

A

Depolarization of the voltage sensitive dihydropyridine receptor mechanically coupled to the ryanodine receptor in muscle cells.

33
Q

Contraction of muscle leads to shortening of which muscle bands?

A

H and I muscle bands between Z lines.
“HIZ Shrinkage”

A band is always the same length!!!

34
Q

What change results in the myosin head becoming “Cocked”

A

ATP binding releases the myosin head from the actin filament and is hydrolyzed to ADP coking the head for the next contraction cycle.

35
Q

How does smooth muscle contract?

A

Depolarization leads to L-type calcium channels opening.

Calcium influx increases the myosin-light chain kinase activity leading to myosin and actin binding and contracting.

36
Q

How does nitric oxide effect smooth muscle?

A

Activates Guanylate cyclase “cGMP” leading to myosin light chain phosphatase activation.

This stops the myosin actin cycle.

37
Q

Describe endochondral ossification

A

Bones of the axial and appendicular skeleton/base of skull

Chondroblasts lay down a cartilage model that is then replaced by osteoblasts “woven bone”
Woven bone is then replaced by lamellar bone.

38
Q

When is woven bone present in adults?

A

After fractures and pagets disease.

39
Q

Achondroplasia

A

Failure of longitudinal bone growth by endochondral ossification. Membranous ossification (skull and face) is not effected.

Typically because of excessive fibroblast growth factor receptor inhibiting chondrocyte proliferation.

40
Q

What type of bone is lost in primary osteoporosis?

A

Loss of trabecular bone mass.

DEXA score of

41
Q

What are the four drug classes that can cause osteoperosis?

A

Anticoagulants
Thyroid Replacement
Anticonvulsants
Long term steroid use

Look for vertebral compression fractures.

42
Q

How does estrogen work in the bones?

A

Stops apoptosis of osteoblasts and promotes apoptosis of osteoclasts.

43
Q

Osteopetrosis

A

Failure to reabsorb bone due to defective osteoclasts

44
Q

Osteomalacia/rickets

A

Vitamin D deficiency

Thus cannot calcify bone/osteoid

Alkaline phosphate will be increased as well as osteoblasts require alkaline environment to try and work in.

45
Q

What is the classic 4 presentations of seronegative spondyloarthropies?

A

HLA-B27 in men
Psoriatic arthritis “Pencil and cup”
Ankylosing Spondylitis (spine and Sacroiliac joints)
Inflammatory Bowel disease
Reactive arthritis (cant see cant pee etc)

46
Q

Libman sacks endocarditis

A

Vegatative non bacterial frowths on heart valve associated with systemic lupus erythematous

47
Q

Elevated serum ACE in black female with enlarged lymph nodes

A

Suspect sarcoidosis.
Look for restrictive lung diseases or bells palsy.

treat with steroids.

48
Q

Temporal or giant cell arteritis is commonly related to which condition?

A

Polymyalgia rheumatica.

49
Q

Ptsosis, diplopia, weakness that worsens with muscle use is likely?

A

Myasthenia gravis

Autoantibodies directed at postsynaptic ACh receptors.

50
Q

What is the underlying problem with lambert-eaton myasthenic syndome?

A

Autoantibodies to presynaptic calcium channel decreasing ACh release

51
Q

Proximal muscle weakness, autonomic symptoms of dry mouth and impotense that improves with muscle use is a sign of?

A

Lambert eaton myasthnia syndrome.

52
Q

Triad of autoimmunity, noninflammatory vasculopathy, collagen deposition with fibrosis.

A

Scleroderma

53
Q

epidermal Skin layers from the surface to the base***

A 
Stratum corneum
Stratum lucidum
Stratum granulosum
Stratum spinosum
Stratum basale

Californians Like Girls in String Bikinis

54
Q

Bullous pemphigoid

A

Connects keratin in basal cells to underlying basement membrane.

55
Q

Cadherins vs integrins

A

Cadhering maintain cell to cell interactions through adherens.

Integrins maintain the connection of cells to the basement membrane

56
Q

Albinism

A

Normal ammount of melanocytes

Decreased/defective tyrosinase activity.

57
Q

Vitiligo

A

Autoimmune destruction of melanocytes.

Think black person gaining white skin.

58
Q

Cellulitis vs erysipelas

A

Cellulitis has spreading borders erisypelas does not.

59
Q

Nikolskys sign

A

Separation of epidermis upon manual stroking of the skin.

Seen with pemphigus vulgaris IgG antibody against desmoglien.

60
Q

Bullous pemphigoid vs pemphigus vulgaris

A

In bullous pemphigoid IgG is directed against hemidesmasomes and wont have nikolskys sign.

Pemphigus vulgaris is way worse and has IgG against desmoglien.

61
Q

Most common skin cancer

A

Basal cell carcinoma

Look for the palisading nucei

62
Q

Skin cancer common with sun exposure

A

Squamous cell carcinoma

Keratin pearls

63
Q

Actinic keratosis

A

Scaly plaque precursor to squamous cell carcinoma

A - Board Reveiew Misc (64 decks)

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