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Neurological, neuromuscular and musculoskeletal disease > PBL 39 > Flashcards

PBL 39 Flashcards

1
Q

What are the lateral, medial, superior, roof and floor borders of the antecubital fossa made from?

A

Lateral: brachioradialis muscle
Medial: pronator teres muscle
Superior: epicondyles of the humerus
Roof: Bicipital aponeurosis, fascia, subcutaneous fat and skin
Floor: brachialis (proximally), supinator (distally)

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2
Q

Contents of the antecubital fossa

A

Really, Need, Beer, To, Be, At, My, Nicest

  • Radial nerve
  • Brachial tendon
  • Brachial artery
  • Median nerve
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3
Q

Arterial supply to the upper limb

A

Subclavian –> Axillary –> Brachial –> Radial & Ulnar

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4
Q

The cephalic and basilic veins are connected at the elbow by the…

A

Median cubital vein

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5
Q

What are the 5 groups of lymph nodes in the axilla?

A 
Pectoral (anterior)
Subscapular (posterior)
Humeral (lateral)
Central
Apical
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6
Q

What are the 3 bones of the shoulder?

A

Scapula
Humerus
Clavicle

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7
Q

What is the joint at which the scapula articulates with the humerus?

A

Glenohumeral joint

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8
Q

What is the name of the joint at which the scapula articulates with the clavicle?

A

Acromioclavicular joint

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9
Q

What are the main landmarks of the proximal humerus?

A 
Head
Neck
Greater tuberosity
Lesser tuberosity
Intertubercular groove
Surgical neck
Deltoid tuberosity
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10
Q

Which nerve is affected in a surgical neck fracture and what is the consequence of this?

A

Axillary nerve

Sergeant’s stripes loss of sensation to the shoulder tip - paralysis to the deltoid and teres minor

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11
Q

What are the landmarks of the distal humerus?

A 
Lateral epicondyle
Medial epicondyle
Trochlear notch
Olecranon fossa
Capitulum
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12
Q

Function of the clavicle

A

Attach the upper limb to the trunk = shoulder girdle

  • Protects the neurovascular structures supplying the upper limb
  • Transmits force from the upper limb to the axial skeleton
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13
Q

What are the two ligaments which make up the coracoclavicular ligament?

A

Conoid ligament

Trapezoid ligament

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14
Q

The pectoral region contains 4 muscles, what are they?

A
  • Pectoralis major
  • Pectoralis minor
  • Serratus anterior
  • Subclavius
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15
Q

Action and innervation of the pectoralis major

A

Action: Adducts and medially rotates the upper limb and draws the scapula anteroinferiorly.

  • The clavicular head also acts individually to flex the upper limb.

Innervation: Lateral and medial pectoral nerves

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16
Q

Action and innervation of the pectoralis minor

A

Action: Stabilises the scapula by drawing it anteroinferiorly against the thoracic wall.

Innervation: Medial pectoral nerve

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17
Q

Action and innervation of the serratus anterior

A

Function: Rotates the scapula, allowing the arm to be raised over 90 degrees. It also holds the scapula against the ribcage.

Innervation: Long thoracic nerve. (SALT) – LESION = WINGS

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18
Q

Action and innervation of the subclavius

A

Function: Anchors and depresses the clavicle.

Innervation: Nerve to subclavius.

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19
Q

What are the three main ligaments that strengthen the acromioclavicular joint?

A

Acromioclavicular ligament

Coracoclavicular ligaments: conoid and trapezoid

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20
Q

What are the extrinsic muscles of the shoulder?

A

Superficial: Trapezium
Superficial: Latissimus dorsi

Deep: Levator scapulae
Deep: Rhomboid major and minor

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21
Q

What is the innervation and action of the trapezius? Upper, middle and lower fibres.

A

Upper fibres: elevate the scapula and rotates it during ABduction of the arm
Middle fibres: retract the scapula
Lower fibres: pull scapula inferiorly

INNERVATION: ACCESSORY NERVE

22
Q

Innervation and action of latissimus dorsi

A

Nerve supply: thoracodorsal nerve

Action: extends, adducts, and medially rotates the upper limb

23
Q

Innervation and action of the levator scapulae?

A

Nerve supply: dorsal scapular nerve

Actions: elevates the scapula

24
Q

What is the nerve supply and action of the rhomboid minor and major?

A

Nerve supply: dorsal scapular nerve

Action: retract and rotates the scapula

25
Q

What are the intrinsic muscles of the shoulder?

A 
Deltoid
Teres major
Teres minor
Subscapularis
Supraspinatus 
Infraspinatus
26
Q

Which muscles make up the rotator cuff?

A

Teres minor
Supraspinatus
Infraspinatus
Subscapularis

27
Q

What is the innervation and action of the deltoid?

A

Innervation: axillary nerve

Action: flexion and medial rotation, extension and lateral rotation, major abductor of the arm after the first 15 degrees (takes over from the supraspinatus)

28
Q

What is the action and innervation of teres major?

A

Adducts and extends at the shoulder, and medially rotates the arm

Innervation: Lower subscapular nerve

29
Q

What is the action and innervation of the supraspinatus muscle?

A

Abducts the arm 0-15 degrees, and assists deltoid for 15-90 degrees

INNERVATION: Suprascapular nerve

30
Q

What is the action and innervation of the infraspinatus muscle?

A

Laterally rotates the arm

INNERVATION: Suprascapular nerve

31
Q

What is the action and innervation of subscapularis?

A

Medially rotates the arm

Innervation: upper and lower subscapular nerves

32
Q

What is the action and innervation of teres minor?

A

Laterally rotates the arm

Innervation: Axillary nerve

33
Q

What are the muscles located in the anterior compartment of the upper arm?

A

Mneumonic BBC: biceps, brachialis, coracobrachialis

34
Q

Where does the biceps brachii attach?

A

The radial tuberosity

35
Q

What is the nerve supply and function of the biceps brachii

A

Nerve supply: musculocutanous nerve

Function: supinator and flexion of the arm at the elbow and the shoulder

36
Q

What is the nerve supply and function of the coracobrachialis?

A

Nerve supply: musculocutaneous nerve

Function: flexion of the arm at the shoulder

37
Q

What is the nerve supply and function of the brachialis?

A

Nerve: musculocutaneous nerve
Function: flexion at the elbow

38
Q

What is the muscle in the posterior compartment of the upper arm?

A

Triceps brachii

39
Q

What is the function and nerve supply to the triceps brachii?

A

Function: extension of the arm at the elbow

Nerve supply: radial nerve

40
Q

What are the names of the ligaments found at the elbow?

A

Annular ligament
Radial collateral ligament
Ulnar collateral ligament

41
Q

Which muscles does the musculocutaneous nerve innervate?

A

Brachialis
Biceps brachii
Corachobrachialis

42
Q

Which muscles does the axillary nerve innervate?

A

Teres minor

Deltoid

43
Q

Which muscles does the radial nerve innervate?

A

Triceps

Posterior compartment of forearm

44
Q

Which muscles does the median nerve innervate?

A

Anterior compartment of forearm, thenar muscles, lateral two lumbricals

45
Q

Which muscles does the ulnar nerve innervate

A

Small muscles of hand (apart from thenar and lateral two lumbricals)
Hypothenar muscles
Flexor carpi ulnaris
Medial half of flexor digitorum profundus

46
Q

Pyschological aspects of pain: behavioural, cognitive and affective

A

Behavioural: fear avoidance (stay in bed to avoid pain)

Cognitive: somatisation (viewing the situation as worse than it actually is)

Affective: anxiety/depression

47
Q

What are the main stages of a systematic review?

A
  1. Define a question and agreeing an objective method
  2. A search for relevant data from research
  3. Extraction of relevant date from research
  4. Assess the quality of data by judging it against criteria identified at first stage
  5. Analyse and combine data which give an overall result from all of the data
48
Q

What are the main stages of a systematic review?

A
  1. Define a question and agreeing an objective method
  2. A search for relevant data from research
  3. Extraction of relevant date from research
  4. Assess the quality of data by judging it against criteria identified at first stage
  5. Analyse and combine data which give an overall result from all of the data
49
Q

Why do we use systematic reviews?

A
  1. Allow us to efficiently integrate existing information and provide data for rational decision making
  2. Establish whether findings are consistent and can be generalised across populations
  3. Meta-analyses increase power and precision of estimates of treatment effects and exposure risks
  4. Limit bias and improve reliability & accuracy of conclusions
50
Q

When is ethical approval needed for research?

A
  • When participants are under 18 y/o
  • When participants are over 18 y/o but are considered vulnerable
  • When research involves access to records of personal or sensitive confidential information
  • When research involves use of administrative or controlled data
51
Q

A critical appraisal assesses a research study for its:

A
  • Bias
  • Applicability
  • Limits
  • Value
52
Q

What are the 3 questions to ask for each type of research design when performing a critical appraisal?

A
  1. Are the results of the study valid?
  2. What are the results?
  3. Can I apply the results to this patient’s care?

Neurological, neuromuscular and musculoskeletal disease (36 decks)

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