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Step 1 > Musculoskeletal/skin- Anatomy and physiology > Flashcards

Musculoskeletal/skin- Anatomy and physiology Flashcards

1
Q

What are tight junctions composed of?

A

claudins and occludins

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2
Q

What are adherens junctions composed of?

A

Cadherins (Ca2+ dep) and actin cytoskeleton

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3
Q

What do desmosomes connect to?

A

support keratin interactiosns, desmoplakin

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4
Q

What are the channel proteins in gap junctions?

A

connexons (permit electrical and chemical communication

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5
Q

What do integrins interact with?

A

bind collagen and laminin of basement membrane

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6
Q

What type of injury is indicated by the anterior drawer sign?

A

ACL injury

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7
Q

What are the sites of attachment of the ACL and PCL?

A

ACL- attaches anterior tibia to lateral condyle of femur (prevents anterior movement of tibia)
PCL- attaches posterior tibia to medial condyle of femur (prevents posterior movement of tibia)

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8
Q

What type of injury is indicated by the posterior drawer sign?

A

PCL injury

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9
Q

What is the unhappy triad injury?

A

lateral force applied to a planted leg

ACL, MCL, medial lemniscus

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10
Q

What is the McMurray test of knee pain?

A

pain on external rotation- medial meniscus

pain on internal rotation- lateral meniscus

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11
Q

What injury is indicated by abnormal passive abduction? (valgus stress)

A

MCL injury

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12
Q

What injury is indicated by abnormal passive adduction?

A

LCL injury

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13
Q

What bony marker is used to do a pudendal nerve block?

A

ischial spine

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14
Q

What boney landmark is used for a lumbar puncture?

A

iliac crest

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15
Q

What is the innervation and action of the supraspinatus muscle?

A

Innervation: suprascapular

Abducts arm initially

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16
Q

What is the innervation and action of the infraspinatus muscle?

A

suprascapular nerve

latterally rotates arm

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17
Q

What is the most common rotator cuff injury?

A

injury to supraspinatus

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18
Q

What rotator cuff muscle is a common pitching injury?

A

infraspinatus

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19
Q

What is the innervation and action of the teres minor?

A

axillary nerve

adducts and laterally rotates arm

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20
Q

What is the innervation and action of the subscapularis?

A

subscapular nerve

medially rotates and adducts arm

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21
Q

What nerve roots innervate the rotator cuff muscles?

A

C5-C6

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22
Q

What are the wrist bones?

So long to pinky, here comes the thumb

A 
scaphiod
lunate
triquetrum
pisiform
hamate
capitate
trapezoid
trapezium
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23
Q

What wrist bone can be palpated in the anatomical snuff box?

A

scaphoid

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24
Q

What is the most commonly fractured carpal bone? What damage can fracture lead to?

A

Scaphoid

can lead to avascular necrosis

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25
Q

What carpal bone is commonly dislocated? What nerve is damaged by this?

A

lunate

median nerve damaged (acute carpal tunnel)

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26
Q

What nerve and carpal bone can be injured by falling on an outstretched hand?

A

hook of hamate

ulnar nerve

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27
Q

What is Guyon canal syndrome? Who typically gets this?

A

compression of ulnar nerve

cyclists- pressure from handlebars

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28
Q

What nerve is damaged by carpal tunnel syndrome?

A

median- paresthesia, pain, numbness along distribution

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29
Q

What is damaged by Erb Palsy and what are the functional defecits

A

upper trunk, C5-C6 roots

abduction, lateral roatation, flexion/supination

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30
Q

What is damaged by klumpke palsy? What are functional deficits?

A 
lower trunk, C8-T1 roots
claw hand (lumbricals, interossei, thenar, hypothenar)
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31
Q

What muscle and nerve are lesioned with a winged scapula?

A

long thoracic nerve

serratus anterior

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32
Q

What is injured from thoracic outlet syndrome? How does this present?

A

lower trunk, subclavian vessels

same as Klumpke palsy (+ischemia, pain, edema)

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33
Q

Describe the sensory distribution of the median nerve?

A

palm + distal dorsal of 2nd and 3rd digits

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34
Q

Describe the sensory distribution of the radial nerve?

A

dorsal surface of thumb+ proximal 2nd and 3rd

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35
Q

Describe the sensory distribution of the ulnar nerve?

A

4th and 5th digits

36
Q

What are the muscles of the thenar eminence? What nerve supplies? How would you describe atrophy?

A

opponens pollicis, abductor pollicis brevis, flexor pollicis brevis
median nerve
“Ape hand”

37
Q

What are the muscles of the hypothenar eminence? What nerve supplies?

A

opponens digiti minimi, abductor digiti minimi, flexor digiti minimi brevis
ulnar

38
Q

What do the dorsal interosseus muscles do?

A

abduct fingers

39
Q

What do the palmar interosseus muscles do?

A

adduct fingers

40
Q

What do the lumbrical muscles do?

A

flex at the MCP joint, extend PIP and DIP

41
Q

What nerve is injured by fracture of the surgical neck of the humerus?

42
Q

What nerve is injured by midshaft fracture of the humerus?

43
Q

What nerve is injured by compression of the axilla?

44
Q

What nerve is injured by supracondylar fracture of the humerus?

45
Q

What nerve is injured by medial epicondyle (“funny bone”) fracture of the humerus?

46
Q

What lesion results in a claw with 4th and 5th digits at rest?

A

distal ulnare nerve

ulnar claw

47
Q

What lesion results in a “pope’s blessing” when making a fist?

A

proximal median nerve lesion

48
Q

What lesion results in claw of 2nd and 3rd digits when at rest?

A

distal median nerve

median claw

49
Q

What lesion results in an “OK gesture” when making a fist?

A

proximal ulnar nerve lesion

50
Q

How do proximal vs distal lesions of the median /ulnar nerves present?

A

Distal lesions- clawing at rest (extend at MCP, flex at DIP and PIP)
Proximal lesions- less pronounced, present during voluntary flexion

51
Q

lesion of what nerve results in wrist drop?

A

radial nerve

52
Q

What does superficial laceration of the palm result in?

A

laceration of recurrent branch of median

loss of thenar muscle group, no loss of sensation

53
Q

What lesion presents as decreased adduction of the leg?

A

Oburator (L2-L4)

54
Q

What lesion presenst as decr thigh felxion and leg extension?

A

Femoral (L2-L4)

55
Q

What lesion presents as foot drop, loss of sensation on dorsum of foot?

A

Common peroneal (L4-S2)

56
Q

What lesion presents as inabiilty to curl toes and loss of sensation on sole?

A

Tibial (L4-S3)

57
Q

What lesion presents as loss of hip extension? (difficulty climbing stairs, rising from seated position)

A

inferior gluteal (L5-S2)

58
Q

What lesion presents as tilt of pelvis when standing on one foot?

A

Superior gluteal (lesioned on standing foot)

59
Q

What artery supplies the surgical neck of the humerus?

A

posterior circumflex (axial n)

60
Q

What artery supplies the midshaft of the humerus?

A

deep brachial (radial n)

61
Q

What nerve and artery are present along the distal humerus?

A

brachial artery, radial n

62
Q

What nerve and artery are present in the poplitieal fossa?

A

Popliteal artery, tibial nerve

63
Q

What nerve and artery are present in the posterior to medial malleolus?

A

posterior tibial arterh, tibial nerve

64
Q

What nerve is commonly injured with knee trauma?

A

Tibial nerve

65
Q

What nerve is commonly injured by trauma or compression of the lateral aspect of the leg?

A

common peroneal

66
Q

What nerve is commonly injured by pelvic fracture

A

femoral nerve

67
Q

What nerve is commonly injured by pelvic surgery?

A

obturator nerve

68
Q

What nerves are commonly injured by posterior hip dislocation?

A

superior gluteal and inf gluteal

69
Q

What does Ca2+ bind in muscle?

A

Troponin C

70
Q

What is the voltage-sensitive receptor of skeletal muscle? What does it attach to?

A

Dihydropyridine on cell membrane

attached to ryanodine receptor of sarcoplasmic reticulum

71
Q

What is the H zone?

A

Myosin only, at center

shortens with contraction

72
Q

What is the I band?

A

Actin only

shortens with contraction

73
Q

What is the A band?

A

length of myosin, doesnt change

74
Q

What type of metabolism predominates in type 1 vs Type 2 muscle?

A

Type 1: oxidative phosphyorylation (slow twitch)

Type 2: anaerobic glycolysis (fast twitch- hypertrophy with weight training)

75
Q

What type of muscle has more mitochondria and myoglobin?`

A

Type 1- slow twitch

76
Q

When doe myosin of smooth muscle contract?

A

Contracts in phosphorylated form- myosin light-chain kinase active

77
Q

What activates myosin-light-chain kinase?

A

Ca2+ calmodulin complex
(from L-type voltage gated Ca2+ channel opening)
results in muscle contraction

78
Q

What activates myosin-light-chain phosphatase?

A

cGMP (Via NO)

results in muscle relaxation

79
Q

What do osteoblasts and osteoclasts do?

A

osteoblast: build bone
osteoclasts: dissolve bone

80
Q

Describe the origin and appearance of osteoclasts

A

multinucleate giant cells, secret acid and collagenases

from monocytes/macrophages

81
Q

Describe the origin of osteoblasts? Where are stem cells located?

A

mesenchymal

periosteum

82
Q

Compare endochondral vs membranous ossification?

A

Endochondral: cartilagenous model made by chondrocytes, replaced by woven bone, remodeled to lamellar bone
membranous: woven bone formed drirectly, remodeled to lamellar bone (calvarium + facial bone(

83
Q

What is the effect of estrogen on bone?

A

inhibits apoptosis of osteoblasts

induces apoptosis of osteoclasts

84
Q

What are the effects of parathyroid hormone on bone?

A

Low, intermittent levels- anabolic (build bone)

chronic high levels- catabolic (osteitis fibrosa cystica)

85
Q

What is osteitis fibrosa cystica?

A

results in chronic high PTH levels

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