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1
Q

Muller maneuver

A

the opposite of the valsava –> breath against close month and nose –> collapsion o fupper airway

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2
Q

beside external auditory foramen, XII is also pass through

A

Stylomastroid foramen

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3
Q

Rigor mortirs - mechanism

A

not release of actin from myosin (lack of ATP)

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4
Q

full anterior fontanelle in infants

A

in infants, cranial bone are not fully formed –> if meningitis —> increased intracranial pressure –> full anterior fontanelle

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5
Q

ankle - bones

A

Talus, tibia. fibula

calcaneus (under fibula, the heel)

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6
Q

Ankle ligaments - groups

A
  1. lateral ligament complex
  2. Medial ligament complex (deltoid ligament) (strong
    - -> not commonly injured)
  3. ligament that connect distal fibula + tibia
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7
Q

ankle - lateral ligament complex (by frequency of damage)

A
  1. anerior talofibular
  2. calcaneofibular
  3. posterior talofibular
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8
Q

ankle - medial ligament complex

A
  1. anterior tibiotalar
  2. posterior tibiotalar
  3. tibiocalcaneal
  4. tibionavicular
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9
Q

ankle - ligaments that connect distal fibula + tibia

A

ankle syndesomosis:

  1. anterior inf tibiofibular
  2. posterior inf tibiofibular
  3. Tranverse ligament
  4. interrossi ligament (from bone to ankle)
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10
Q

Achilles tendon is formed by … which …. (location)

A

soleus + gastrocnemius muscles combine to form to Achileles tendon which insert on the posterior calcaneus and acts on ankle flexion

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11
Q

ligament that connect distal fibula + tibia at the knee - causes of injury

A

dorsiflexion and/or eversion of the ankle –> unstable ankle with tenderness but not significant swelling)

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12
Q

Boxer’s fracture

A

metacarpal fracture

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13
Q

femoral nerve mononeuropathy can occur due to

A
  1. trauma (pelvic fructure)
  2. compression from hematoma or abscess
  3. stretch injury
  4. ischemia
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14
Q

femoral nerve - sensation

A
  • anterior + medial thight

- medial leg

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15
Q

muscles used when sitting up from supine position

A
  1. external abdominal obliques
  2. rectus abdominis
  3. hip flexors
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16
Q

major muscles responsible for hip motion

A
  1. flexion: ilipsoas, rectus femoris, tensor fascia lata
  2. extension: gluteus maximus, semitendinosus, semimembranosus, long head of biceps
  3. abduction medius/minimus
  4. adduction: adductor brevis/longus/magnus
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17
Q

trapezius is frequently injured by

A

rear-end (whiplash) motor vehicle accidents

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18
Q

psoas muscle - origin / action

A

origin: anterior surface of the transverse processes + lateranl surface of vertebral T12 + L5
action: flex the tight, also contributes to lateral rotation + abduction of the tight

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19
Q

platella fracture signs

A
  1. swollen knee
  2. focal patella tenderness
  3. inability to extend the knee against resistance
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20
Q

platella fracture - how

A
  1. direct blow to anterio aspect

2. indirect: extension force transmitted through quadicipet tendon (landing on feet after falling from height)

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21
Q

patellar ligaemnt attaches

A

patella to tibial tuberosity and is the continuation of the quadricepts femoris tendon

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22
Q

valsva is due to

A

rectus abdominis (most importatnt)

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23
Q

vaslava action on paroxysmal suprventricular tachycardia

A

dmininish (due to increased vagus action

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24
Q

iliac muscle - action + location

A

flexion of the hip in the iliac fossa

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25
Q

anterior dislocation of the arm is follow

A

a blow to an extended abducted arm

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26
Q

latissimus dorsi - location / innervation / function

A

from iliac crest + lumbar fascia to spinous processes of T7-T12 and lower ribs. It inserts at the bicipital groove of the humerus
innervates by thoracodorsal nerve
functions: extension, adduction, internal rotation of humerus

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27
Q

erector spinae muscle - location / action

A

location: large muscle group of the back (longitudinally along the spinous processes
action: bilateral contraction –> spine extension

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28
Q

carpal tunnel contains

A
  • tendons of the flexor digitorum profadus, superficialis, + flexor pollicis longus (flex the thumb)
  • median nerve
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29
Q

transverse ligament (aka?) of carpal tunnel attachments

A
  • hamate + pisiform on the ulnar side
  • trapezium + scaphoid on the radial side
    aka: flexor retinaculum
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30
Q

Dupuytren contracture?

A

slow progressive fibroproliferative disease of palmar fascia (nodules form on fascia)

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31
Q

radial head subluxation (aka?) results from

A

aka: nursemaid’s elbow (MC elbow injury in children 1-4 –> by age 5 the ligament becomes stronger)
from sudden traction on the outstretched + pronated arm of a child –> torsion and displacement of annular ligament

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32
Q

interosseous membrane of forearm

A

thick connective tissue between radius + ulna –> disruption can lead to instability

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33
Q

common peronial nerve is divided to … /action + location of every division

A
  1. superficial (lateral) –> foot eversion, sensation of lateral shin + dorsal foot
  2. deep (anterior) –> foot dorsiflexion, sensation between 1st + 2nd toes
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34
Q

vein traum during supracondylar fructure

A

rare due to their superficial coruse

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35
Q

anatomic snufbox location

A
  • between extensor policis longus tendon (medially)

- tendons of the abductor pollicis longus and extensor pollicis brevis tendons (laterally)

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36
Q

ulnar collateral ligament - injuries occur MC in / treatment

A

throwers (eg. baseball) due to intesne valgus stress at elbow)
treatment: ligament reconstruction (Tommy John surgery)

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37
Q

deep branchial artery passes inferior to … muscle

A

teres major

38
Q

deltoin origin

A

clavicle, acromion, spine of scapule

39
Q

characteristic finding in bicep tenonditis

A

tenderness of the bicipital groove (spearates lesser + greater tubercles)

40
Q

De Quervain tenosynovitis

A

overuse of abductor pollicis longus –> thumb + wrist pain

41
Q

tha largest carpal bone

A

capitate

42
Q

main muscle for foot inversion

A

tibialis posterior

43
Q
  1. prepatellar bursa - location

2. suprapatellar bursa - location

A
  1. between patella + the overlying skin

2. anteriorly between distal femur + quadriceps

44
Q

ACL is most common injured during

A

noncontact injuries –> in sudden deceleration + pivot on the extended knee

45
Q

ACL - artery

A

ACL is supplied by middle geniculate artery –> ACL injuery –> rapid onset hemarthroses

46
Q

movent of knee in bursitis

A

active is decreased or painful

passive is normall

47
Q

fracture of coracoid process of scapula

A

rare / in gun shoots

48
Q

the abnormal curvatures if an adult vertebral column

A
  1. kyphosis –> increase of posterior curvatuire
  2. lordosis –> increase of anterior curvatire
  3. scoliosi –> lateral curvature
49
Q

the curvatures of an adult vertebral column

A
  1. cervical 2. thoracic

3. lumbar 4. sacral

50
Q

tendon of biceps femoris attach to (at the knee)

A

styloid process of the head to fibula

51
Q

supraspinatus muscle is vulneable to injury due to

A

impingement between the acromion + the head of the humerus

supraspinatus tendinopathy is the MC cause of rotator cuff syndrome

52
Q

clavicular fracture - due to / mc location / nerves + vessels

A
  • due to direct trauma
  • MC in middle 1/3
  • neurovascular damage is rare
  • medial part goes up (due to sternocl.), lateral goes down due to weight + pectoralis major (in oppose to trapezius force)
53
Q

clavicle is the point of origin or insertion of numerous muscles including

A
  1. deltoin (inf lateral)
  2. pect major (inferomedial)
  3. subclavius (inf lateral)
  4. trapezius (superolateral)
  5. sternocleid (supromedial)
  6. sternohyoid (inf medial)
54
Q

superior gluteteal location - IM injection / trauma

A

superior lateral: safe
superior medial: superior gluteteal + sciatic nerve
inferior medial: sciatic nerve
inferior lateral: sciatic nerve
but THE MOST SAFE is anterolateral gluteal –> at von Hochstetter triangle

55
Q

rotator cuff muscles - origin on scapule + attachement on humerus

A

supraspinatus - supraspinous fossa to greater tuberosity
infraspinatous - infraspinous fossa to greater tuberosity
teres minor - lateral border of scapula to greater tuberosity
subscapularis - subscapular fossa to lesser tuberosity

56
Q

quatdricepts muscle is connected to the tibia by

repetitive contraction can lead to

A
  • patella to tibial tuberosity and is the continuation of the quadricepts femoris tendon
  • Osgood - Schlatter disease (focal pain + swelling at the tibial tuberosity)
57
Q

Biceps tendon ruptures present as / due to

A

visible or palpable mass in the mid-upper arm (Popeye deformity)
due to sudden extendion of flexed elbow while contraction of the biceptos (eg. lifting of a heavy object)

58
Q

foramen of vertebra

A
  1. vertebral foramen
  2. tranverse foramen
  3. intravertebral foramina
59
Q

lateral epicondylitis (tennis elbow) - overuse of

A

extensor carpi radialis brevis (wrist extension)

60
Q

medial epicondylitis (golfer’s elbow) - overuse of

A

wrist flexors

61
Q

piriformis location / action / clinical significance

A

passes through the greater sciatic foramen + is involved with external rotation –> muscle injury or hypertrophy –> compress sciatic nerve in the foramen –> PIRIFORMIS SYNDROME –> tender muscle in deep palpation or on adduction + internal location
structure passing above piriformis: superior gluteal vessels + nerves
structure passing below piriformis: inferior gluteal vessels, internal pupendal vessels, multiple nerves (esp sciatic)

62
Q

Acromioclavicular joint subluxation

A

from downward blow of the tip of the shoulder –> swelling and upward displacement of clavicle –> not associated with nerves

63
Q

sciatic foramen is divided to … by

A

greater + lesser foramen by sacrospinous ligament

64
Q

greater sciatic foramen borders

A

anterolaterally by greater sciatic notch of the ilium, inferiorly by the ischial spine and sacrospinous ligament, superiorly by the anterior sacroiliac ligaent, posteromedially by the sacrotuberous ligament

65
Q

calcaneovalgus foot

A

dorsiflexed + everted

66
Q

oblique popliteal ligament

A

wide fibrous band that connect posterior distal femur to the posterior proximal tibial

67
Q

seminomembranous muscle attach to (at the knee) / action

A

medial condyle of tibia

knee flexion + hip extension

68
Q

longest muscle of the body / origin / attachment / injury commonly occurs in … and cause …

A

sartorius muscle
origin: anterior iliac spine –> inserts into the pes anserinus of anteromedial tibia (near the tibial tuberosity)
pes anserinus bursitis occurs in renners –> anteromedial knee pain
LATERAL BORDER OF FEMORAL TRIANGLE

69
Q

MCC of spinal stenosis

A

degenerative arthritis –> lead to formation of facet joint osteophytes + hypertrophy of ligamentum flavum (a strong elastic liga,ent supporting the posterior aspect of the spinal canal) + disc herniation –> spinal narrowing (stenosis)

70
Q

synovial sheath of flexor digitorum superficialis + profandus tendons

A

from palm through carpal tunnel to a point 1 cm proximal to transverse carpal ligament –> median nerve lies outside

71
Q

obturator artery on children

A

gives the artery of the ligamentum teres –> supplies a minor portion of femoral head –> important in children because it supplies the region of femoral head proximal to the epiphyseal growth plate (minimal significance in adults)

72
Q

LP - lugament that will traverse

A

off the midline –> ligamentum flavum

in midline –> supraspinous + interspinous ligament

73
Q

Anserine bursitis

A

pain along the medial knee and well defined tenderness approximately 4 cm distal to the anteromedial joint margin of the knee

74
Q

sural nerve in greek / function

A

γαστροκίμιο

pure sensory nerve –> postolateral leg + lateral foot

75
Q

musculocutaneous nerve in arm

A

penetrates the coracobranchialis –> between bicep + coracobranchialis –> goes to elbow between biceps branchi + branchialis

76
Q

ulnar nerve course in forearm

A

between olecranon + medial epicondyle of humerus –> between flexor carpi ulnaris + flexor digitorum profundus

77
Q

Radial nerve course in forearm

A

through the supinator muscle near the head of the radius

78
Q

median nerve course in forearm

A

between the humeral + ulnar heads of the pronator teres muscles –> between flexor digitorum superficialis + flexor digitorum profundus –> carpal tunel

79
Q

hamstrings?

A

muscles at posterior thigh

80
Q

Myotome of upper extremity

A 
C4: shoulder/scapula elevation
C5: shoulder abduction
C5/6: elbow flexion, wrist extension
C7: elbow extension, finger extension
C8: wrist flexion, finger flexion
T1: finger abduction
81
Q

lumpoosacral plexopathy duting fetal descent

A

foot drop + numbness in the lateral aspect of the leg + dorsal foot –> resolition within a year

82
Q

pudendal nerve - course

A

S2-4 –> passes between piriformis + coccygeus muscle as it exis the pelvis through greater schiatic foramen –> reenters pelvis near the ischial spine through lesser sciatic foreamen –> divided to its terminal branches

83
Q

muscle that attach to anterior iliac crest

A

sartorius muscle

84
Q

anatomical mark of LP

A

LP at L3/4 or L4/5 –> L4 vertebral body lies on a line drawn between the highest points of the iliac crests

85
Q

femoral nerve course

A

L2-L4 (the largest branch of plexus) –> between psoas and iliacus –> under iguinal ligament (lateral to artery)
–> branching into anterior + posterior

86
Q

femoral nerve block for anesthesia - location

A

inguinal crease (not ring)

87
Q

bladder cancer - nerve compression

A

it compresses the obturator nerve which is extis the pelvis through obturator foramen

88
Q

pelvic innervation

A
  1. pudendal (S2-4) –> sensory: perineum, motor: urethral+anal sphincter
  2. Lateral femoral cutaneous (L2-3) –> sensroy: anter + lateral tight (injury during hyperflexion of the thighs for pelvic surgery or vaginal delivery
  3. inferior gluteal
  4. Genitofemoral (L1-2) –> sensory: scrotum/labia majora, medial thigh (anterior to psoas, injury during laparotomy), motor to parts of genitalia (eg. cremasteric reflex)
  5. Obturator
  6. Iliohypogastric (T12-L1) –> sensory hypogastric (injury due to Pfnannestiel skin incisions, like cesarean, appendidectomy), motor to anterolateral abdom walls
  7. ilioinguinal (L1) –> sensory from skin of the upper + medial thigh, the root of penis + upper scrotal, labia major
89
Q

lumbosacral radiculopathy - nerves?

A

L2 –> upper antromedial tight sensor , hip flexion (iliopsoas)
L3 –> lower antromedial tight sensor, hip flexion (iliopsoas), hip adduction, knee extension (quadricepts)
L4 –> lower anterolateral thight knee, medial calf+ foot sensor, hip adduction, knee extension (quadriceps), patellar reflex)
L5 –> Buttocks, posterolateral tight, anterolateral leg, dorsal foot sensor, foot dorsiflexion + inversion, foot eversion, toe extension
s1 –> Buttocks, posterior tight + calf, lateral foot sensor, hip extension, knee flexion (hamstrings), foot plantarflexion, achilles reflex

90
Q

conus medularis vs cauda equina syndrome - location / symptoms

A

conus medularis: L1-L2 –> flaccid paralysis of bladder + rectum, impotence + saddle anshesia, leg wekness
cauda equina syndrome: S2-S4 –> back pan radiates to legs, saddle anesthesia, bowel + bladder dysfuntion (LATE), loss of ankle reflex

91
Q

radial nerve enter forearm anterior to lateral epicondyle - after?

A

divides into
superficial–> somatic sensory innervation to the radial half of the dorsal hand
deep –> innervates the extensor muscles of forerm

92
Q

radial nerve trauma in the supinator trauma

A

due to repetitive pronation/sunipation of forearm (screwdriver), dirct, dislocation of radius –> finger drop, not wrist drop, and not sensory symptoms
(between superficial + deep parts of supinator muscle

Musculoskeletal and Connective Tissue (19 decks)

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