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MRCS A > Ortho + Urology > Flashcards

Ortho + Urology Flashcards

1
Q

Froments sign indicates palsy of what nerve ? and what muscle is affected ?

A

Deep ulnar nerve
Adductor pollicus

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2
Q

How are hydroceles surgically managed in adults ?

A

Lords or Jabouley procedure

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3
Q

what nerves are commonly damaged during varicose vein surgery ?

A

sural and saphenous nerves

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4
Q

what nerves are affected in Erbs palsy ?

A

axillary nerve, suprascapular nerve, and musculocutaneous nerve,

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5
Q

Most testicular cancers are germ cell tumours. What are the two types ?

A

Seminoma’s and non seminomatous

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6
Q

prostate cancer tends to metastasise to bone - what types of lesions are seen in bone ?

A

reactive sclerotic [osteoblastic] lesions

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7
Q

The initial 0-15 degrees of shoulder ABduction is perforemed by the SUPRASPINATOUS muscle. What muscles are reponsible for ABduction past 90 degrees ?

A

Trapezius and serratous anterior

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8
Q

Varicose veins commonly affect the short saphenous vein. When managing varicose veins - what is the most common complication ?

A

Sural nerve damage

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9
Q

what nerve innervates the ADductor pollicus

A

deep branch of ulnar nerve (root value C8, T1).

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10
Q

where are the cords of the brachial plexus formed ?

A

The cords of the plexus are formed in the axilla.

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11
Q

what is the main extensor of the fingers ?

A

Extensor digitorum communis

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12
Q

How are hydroceles surgically managed in kids ?

A

trans inguinal ligation of PPV.

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13
Q

where is sinus Tarsai located ?

A

between the talus and calcaneus

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14
Q

what nerve supplies sensation to the anterior scrotum ?

A

ilioinguinal nerve

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15
Q

what lymph nodes do testicular cancers metastasise to ?

A

Para-aortic lymph nodes

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16
Q

The brachial plexus is encloced by what fascia ?

A

extension of the prevertebral fascia.

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17
Q

what two muscles are classiclly affecting in wining of the scapula [long thoracic nerve injury]

A
  1. serratus anterior
  2. trapzium
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18
Q

what is the origin and insertion point for pec minor ?

A

Origin - Upper margins of third to fifth ribs and intercostal fascia
Insertion - coracoid process

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19
Q

C8 and T1 [inferior trunk of brachial plexus] contribute to what nerves ?

A

ulnar nerve and part of median nerve

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20
Q

what is your acronym for the muscles innervated by the radial nerve ?

A

B.E.A.S.T

Brachioradialis
Extensors
Abductor pollicis longus
supinator
triceps

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21
Q

what is the motor function of the musculocutanous nerve ?

A

Flexion of the upper arm

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22
Q

what nerve innervates the posterior compartment of the forearm

A

Radial nerve

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23
Q

what is the common cause of hydroceles in kids ?

A

Patent processus vaginalis

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24
Q

what muscles pronate the forearm ?

A

Pronator Teres
Pronator quadractus

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25
Q

what structures make the boundaries of the anatomical snuff box ?

A
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26
Q

What is Paget–Schroetter disease ?

A

Upper limb DVT most commonly seen in athletes. Tends to affect axillary or suclavian vein

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27
Q

what nerve innervates the ADuctor pollicus muscle

A

Ulnar nerve

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28
Q

Erbs palsy is due to damage to C5-C6. What muscles are affected ?

A

deltoid, biceps, and brachialis muscles

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29
Q

what nerve innervates the suprapsinatous muscle ?

A

Supracapular nerve

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30
Q

what is the spinal level of the psoas major ?

A

T12 - L5

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31
Q

What is the lymphatic drainage of the male spongy urethra

A

Deep Inguinal

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32
Q

what nerve innervates the semimembranosus ?

A

tibia branch of the SCIATIC nerve

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33
Q

what is the attachment of the long head of the triceps muscle ?

A

Infraglenoid tubercule of the scapula

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34
Q

what is the treatment for LA toxicity due to prilocaine ?

A

methylene blue

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35
Q

What muscles make up the posterior compartment of the thigh?

A
  1. Biceps Femoris
  2. Semitenenosus
  3. semimembrenosus
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36
Q

what muscles make up the thenar eminence ?

A
  1. Opponens pollicus
  2. Flexor pollicus brevis
  3. Abductor pollicus brevis
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37
Q

The pectorals major has two head where it originates from - what are these ?

A
  1. Clavicular head
  2. Sternocostal head
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38
Q

The biceps femoris has two heads (long head and short head) - where do these tendons originate and insert ?

A

Long head originates at the ischial tuberosity

Short head originates at the line aspera of the femur

Both insert into the head of the fibula

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39
Q

what is the sensory function of the musculocutaneous nerve

A

Gives rise to the lateral cutaneous nerve that provides sensation to the lateral forearm

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40
Q

what is the Pes anserinus ?

A

a group of three tendons that insert into the medial border of the knee:
1. Sartorius
2. Semitendinosus
3. Gracillis

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41
Q

What is the gold standard treatment for testicular cancer ?

A

Orchidectomy via an inguinal approach

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42
Q

Spot diagnosis:
shows multiple lytic and lucent lesions with clearly defined borders on XR

A

Osteoclastamoma/Giant cell tumour

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43
Q

what are the deep muscles of the posterior leg ?

A
  1. Tibialis posterior
  2. Flexor hallicus longus
  3. Flexor digitorum longus
  4. Popliteus
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44
Q

how are testicular cancers diagnosed ?

A

Ultrasound is first-line
CT scanning of the chest/ abdomen and pelvis is used for staging
Tumour markers (see above) should be measured

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45
Q

There is only one muscle in the intermediate layer of the anterior forearm - What muscle is this ?

A

Flecor digitorum superificialis

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46
Q

where does the majority of the blood supply to the scaphoid come from and what percentage is this ?

A

dorsal ridge/carpal branch vessels that supply 80%.

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47
Q

what muscle and nerves are tested by Froment’s sign ?

A
  1. Ulnar nerve
  2. Adductor pollicis
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48
Q

what is the relevance of the quadrangular space and what structures pass through it ?

A
  • Allows structured to pass from the axilla to the posterior compartment of the upper arm
  • contains the axillart nerve and posterior circumflex humeral artery
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49
Q

what type of stones have a genetic risk associated ?

A

cysteine stones

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50
Q

Staghorn calculi are composed of struvite. what types of bacteria cause staghorn calculi ?

A

Proteus and Klebsiella
They do this by making the urine more alkaline

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51
Q

Testicular malignancy is always treated with orchidectomy via inguinal approach. Why ?

A

This allows high ligation of the testicular vessels and avoids exposure of another lymphatic field to the tumour.

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52
Q

what nerve innervates the pec minor ?

A

Medial pectoral nerve

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53
Q

at what age can you perfom an orchidoplexy for an undescended testicle ?

A

6 - 18 months

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54
Q

what nerve roots form the long thoracic nerve ?

A

C5, C6, and C7 (close to their emergence from intervertebral foramina)

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55
Q

what is the function of the lumbricals ?

A

Flex the MCPs and extend the interphalangeal joints

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56
Q

where is the femoral canal located and what are its borders ?

A

Femoral canal is located in the femoral sheath.
Borders are:
anterosuperiorly by the inguinal ligament
posteriorly by the pectineal ligament
Medially by the lacunar ligament
Laterally by the femoral vein

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57
Q

which type of germ cell testicular cancers have raised AFP ?

A

Non-seminomatous
(AFP elevated in up to 70% of cases)

58
Q

List the parts of the male urethra

A
  1. Prostatic
  2. Membranous
  3. Bulbous
  4. Penile
59
Q

The plantaris is found in what compartment ?

A

within the superficial posterior compartment of the lower leg

60
Q

loss of innervation to what muscles causes a claw hand ?

A

Lumbricals

61
Q

what is a bartons fracture ?

A

Distal radius fracture (Colles’/Smith’s) with associated radiocarpal dislocation

62
Q

how many dorsal interossie muscles are there ?

A

4

63
Q

what type of stones are radiolucent ?

A

urate

64
Q

what is the anatomical course of the musculocutaneous nerve ?

A

Passes obliquely between the biceps brachii and the brachialis to the lateral side of the arm

65
Q

what nerve supplies sensation to the posterior scrotum ?

A

Pudendal

66
Q

What is the lymphatic drainage of the ureters?

A

The upper ureter drains to the para-aortic nodes, the lower ureter drains to the common iliac nodes.

67
Q

what is the spinal level for the sciatic nerve ?

A

L4-S3

68
Q

Fracture of which pole of the scaphoid should always be surgical fixed ?

A

proximal pole of the scaphoid

69
Q

The plantar aspect of the foot is innervated

A

Tibial nerve [medial and lateral plantar nerves]

70
Q

what does the Mirel score measure ?

A

Risk of pathological fracture

71
Q

what muscle does the musculocuteous nerve pierce when it leaves the axilla ?

A

Corochobrachialis

72
Q

In pelvic trauma, what part of the urethra is damaged if you cant palpate the prostate ?

A

Membranous urethra

73
Q

Through which foramina does the genital branch of the genitofemoral nerve exit the abdominal cavity?

A

Deep inguinal ring

74
Q

what is the attachment of the long head of biceps muscles

A

Supraglenoid tubercle of the scapula

75
Q

what structures are found in the adductor canal ?

A

femoral artery, femoral vein (posterior to the artery), nerve to the vastus medialis and the saphenous nerve

76
Q

what nerve innervates Flexor Pollicus brevis

A

Median nerve

77
Q

what nerve innervate the palmar interossei ?

A

Ulnar nerve

78
Q

what is the arterial supply of the triceps

A

Profunda brachii artery

79
Q

The greater sciatic Forman is divided into two parts by what muscle ?

A

Pirifomis

80
Q

what structure seperates the ulnar artery from the median nerve ?

A

Pronator teres

81
Q

What is the most superficial structure in the popliteal fossa ?

A

The tibial and common fibular nerves are the most superficial

82
Q

Spot diagnosis

Low calcium, low phosphate, raised ALP

A

Osteomalacia/Rickets

83
Q

what is the treatment for hydrocele in kids ?

A

Trans inguinal ligation of PPV

84
Q

what bone malignancy has a classic soap bubble appearance on XR ?

A

Osteoclastoma/Giant cell tumours

85
Q

what muscle forms the medial border of the cubital fossa

A

pronator teres

86
Q

Brahcial artery cords are named based on their anatomical relationship to what structure ?

A

Axillary artery

87
Q

what sign associated with a varicocele will make you worry about an abdominal pathology

A

A swelling that does not reduce when lying supine

88
Q

At what age can you diagnose an undescended testicle ?

A

3 months

89
Q

what is the narrowest part of the male urethra ?

A

membranous urethra

90
Q

The Nottingham Prognostic Index can be used to give an indication of breast cancer survival. what is the most important factor in predicting prognosis ?

A

Lymph node involvement/nodal status

91
Q

what is the spinal level of the ureters ?

A

L2 - L5

92
Q

Over what Mirel score is prophylactic nail advised

A

9

93
Q

The genitofermoral nerve originates at what spinal level ?

A

L1/2

94
Q

what are the layers that you pass through during a lumbar puncture ?

A

skin ➡️ subcutaneous tissue ➡️ supraspinous ligament ➡️ interspinous ligament ➡️ ligamentum flavum ➡️ epidural space ➡️ dura mater ➡️ arachnoid mater ➡️ subarachnoid space (contains CSF)

95
Q

what is the innervation for pec major ?

A

medial and lateral pectorial nerves

96
Q

which drug is known to cause non infective epidididymo-orchitis ?

A

Amiodarone

97
Q

what are the borders of the adductor canal ?

A

Anteromedial – Sartorius.
Lateral – Vastus medialis.
Posterior – Adductor longus and adductor magnus.

98
Q

what nerve supplies the nail beds on the first two fingers ?

A

Median nerve

99
Q

what is the action of the lumbricals on the IP joints ?

A

Extension

100
Q

where do the superficial muscles of the anterior forearm originate ?

A

Medial epicondyle of the humerus

101
Q

The genital branch of the genitofemoral nerve innervates what structure ?

A

Scrotum

102
Q

what is the longest part of the male urethra ?

A

Penile [AKA Spongy] urethra

103
Q

How does the genital branch of the genitoinguinal nerve reach the scrotum to innervate the scrotal fascia ?

A

Passes through the deep inguinal ring into the inguinal canal

104
Q

The sural nerve is a cutaneous nerve of the lower limb - what two nerves contrinbute to forming the sural nerve ?

A

Tibial nerve and common peroneal nerve

105
Q

what is the most medial structure in the cubital fossa ?

A

Median nerve

106
Q

List the intrinsic shoulder muscles

A

Deltoid
Teres major

Rotator cuff
Teres minor
supraspinatous
infraspinatous
subscapularis

107
Q

What muscle forms the inferior border of the quadrangular space ?

A

Teres major

108
Q

which muscles are reponsible for lateral rotation of the upper limb ?

A

Teres minor
infraspinatous
posterior fibers of the deltoid

109
Q

what muscles medially rotate the upper limb ?

A

Anterior fibers of the deltoid
teres major
subscapularis

110
Q

what is the innervation to the teres major and minor ?

A

Teres major - subscapular nerves
teres minor - axillary nerves

111
Q

where does the teres major originate ?

A

Inferior border of the scapula

112
Q

what is the innervatin to the dorsum of the foot ?

A
113
Q

what is the deepest structure in the popliteal fossa ?

A

Popliteal artery

114
Q

what do seminoma’s show in histology ?

A

Sheet like lobular patterns of cells with substantial fibrous component. Fibrous septa contain lymphocytic inclusions and granulomas may be seen.

115
Q

What test is used to assess kindey FUNCTION ?

A

MAG3 renogram

116
Q

First line treatment of priaprism is corporeal aspiration. what is the next option if this does not work ?

A

intracavernosal injection of a sympathomimetic agent e.g phenylephrine

117
Q

what is the most common type of prostate cancer ?

A

ACINAR adenocarcinomas

118
Q

The majority of prostate cancers (>95%) are adenocarcinomas. What area of the prostate are these most commonly found ?

A

The peripheral zone

119
Q

What is gold standard imaging for prostate cancer investigation ?

A

MRI

120
Q

What is the lowest gleason score someone with prosate cancer can have ?

A

3+3

121
Q

how is a gleason score calculated ?

A

sum of the most common growth pattern + the second most common growth pattern seen.

122
Q

what is this injury ?

A

Hill-Sachs lesion

A Hill-Sachs lesion is a dent in the head of the upper arm bone (humerus) that occurs when the shoulder is dislocated.

123
Q

what is the CNS distribution for the knee jerk reflex ?

A

L3-L4

124
Q

where does the cephalic vein form ?

A

in the anatomical snuffbox

125
Q

What structure is at risk in olecranon fractures or damage to the medial epicondyle ?

A

Ulnar nerve

126
Q

the lower leg contains anterior, posterior and perineal compartment. what structure is located in the peroneal compartment ?

A

Peroneus Longus and Brevis

127
Q

what is used to investigate a child with vesicoureteric reflux in whom there are concerns about the potential of renal scarring ?

A

DMSA scan

128
Q

what muscles make the floor of the femoral triangle ?

A

Iliopsoas, adductor longus and pectineus

129
Q

extensor hallicus longus nerve root supply

A

L5

130
Q

Flexor digiti minimi brevis originated from where ?

A

Hamate

131
Q

what muscles attach to the lesser trochanter ?

A

Psoas major
Illiacus

132
Q

What muscles attach to the greater trochanter ?

A
133
Q

what nerve innervates the sartorius muscle ?

A

Superficial branch of the femoral nerve

134
Q

what muscles make up the pet anserenius and where is it located ?

A

Sartorius, Gracillis and Semitendinosus

Located medial tibia

135
Q

What vein does the brachial vein drain into ?

A

Basilic vein

*Remember the brachial vein drains into the basilic vein BEFORE the axillary vein is formed.

136
Q

which lower limb compartment is peroneus terminus located ?

A

Anterior

137
Q

what muscle originates from the lateral border of the scapula ?

A

Teres major and minor

*teres major is from the lower lateral border

138
Q

patient cant lift their thumb off the table - what nerve is affected ?

A

PIN [radial nerve]

139
Q

what muscles is used to lift thumb off the table ?

A

EPL

140
Q

what is the blood supply to the ureter ?

A

Proximal third - branches from renal artery
Middle third - ureter artery from aorta
Distal third - Internal iliac

141
Q

what nerve innervates the tibias anterior ?

A

deep peroneal nerve

142
Q

the quadrants lomborum is located posterior to what important structure ?

A

lower pole of the kidney

MRCS A (8 decks)

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