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Clinical Medicine Midterms > Spine And Extremities > Flashcards

Spine And Extremities Flashcards

1
Q

Deformity

Hormone abnormality secreted by the anterior pituitary gland

A

Acromegaly

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2
Q

Deformity

Acromegaly growth occurs after

A

Epiphyseal closure in which hand , feet, face are enlarged

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3
Q

Deformity

Where in there is no room for increase in lenght of the long rather, increase in width is observed

A

Acromegaly

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4
Q

Deformity

Hormone abnormality caused by tumor in the anterior pituitary (eg. Adenoma)

A

Gigantism

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5
Q

Deformity

Gigantism occurs

A

Before epiphyseal plate closure, enlarged skeleton perfectly proportioned

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6
Q

Deformity

The growth in length of long bones are proportional with the head and height of the patient

A

Gigantism

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7
Q

Deformity

Gigantism and acromegaly are due to overgrowth of bone and soft tissue stimulated by excess of

A

Somatotropic hormone

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8
Q

Deformity

All dimensions of hands are increased as in acromegaly but condition accompanied by extreme clubbing of fingers and parrot beak nails

A

Hypertrophic osteoarthtopathy

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9
Q

Deformity

Checking for clubbing

A

Schamrot’s sign

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10
Q

Deformity

Hypertrophic osteoarthtopathy

How to check schamrot’s sign

A

Alam mo na yan

+ if absence of diamond shape in between

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11
Q

Deformity

Hypertrophic osteoarthtopathy

Result from

A

Chronic Hypoxemia like

COPD
Bronchial asthma
Ventricular/atrial shunting

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12
Q

Deformity

Hypertrophic osteoarthtopathy

A

Mixing of oxygenated and deoxygenated blood

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13
Q

Deformity

Congenital anomaly of obscure cause
Ask if it is familial

A

Small hands/ acromicria

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14
Q

Deformity

Spider fingers
Arachnodactyly

A

Longer slender hands

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15
Q

Deformity

Longer slender hands

Abnormality in the connective tissue, all long bones are slender and elongated often with hyper-extensible joints

A

Marfan syndrome

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16
Q

Deformity

Longer slender hands

Thumb sign

A

Steinberg sign

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17
Q

Deformity

Longer slender hands

Patient encircle his own wrist with his thumb and little finger

A

Wrist sign

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18
Q

Deformity

Longer slender hands

Results from removal of testis in males

A

Eunuchoidism

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19
Q

Short thick hands

With goiter and hypothyroid
Short, thick, and fat hands

A

Cretinism

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20
Q

Short thick hands

Patients with trisomy 21
Short and thick hands
Thumb diverges from nearer the wrist than N
Little finger is curved

A

Mongolism

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21
Q

Short thick hands

Claw is formed by hyper extension of the metacarpophalangeal joints and flexion of interphalageal articulations

A

Claw hands

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22
Q

Claw hands causes

A

Brachial plexus or ulnar nerve injuries
Muscular atrophy
Spinal cord injury (syringomyelia or acute poliomyelitis )

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23
Q

Short thick hands

Thumb held in extension by its inability to flex (always straight)

A

Ape hand

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24
Q

Ape hand occurs in

A

Syringomyelia
Progressive muscular dystrophy
Amyotrophic lateral sclerosis ALS

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25
Q

Short thick hands

Pronated hand drops from the wrist from weakness of the extensors

A

Wrist drop

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26
Q

Wrist drop due to

A

Radial nerve palsy
Poliomyelitis
Lead poisoning
Arsenic or alcohol

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27
Q

Short thick hands

Ring and little fingers are flex while the other digits move normally and may extend to produce toe posture

A

Benediction hand or preachers hand

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28
Q

Bendiction hand occurs in

A

Ulnar nerve palsy

Syringomyelia

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29
Q

The palm

Yellow color imparted to the skin by carotene
Sclera is still white, unlike in jaundice due to impaired bilirubin

A

Carotenoderma

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30
Q

The palm

Lesion of the median nerve

A

Thenar atrophy

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31
Q

Damage of the ulnar nerve

A

Hypothenar atrophy

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32
Q

The palm

Sign of increased collateral circulation
Cirrhosis
Pregnancy
Valvular heart disease

A

Palmar erythema

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33
Q

Fingernails

Congenital, familial or associated with certain syndromes

A

Polydactyly (supernumerary)

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34
Q

Fingernails

Attached hands or together
Congenital or hereditary

A

Syndactyly

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35
Q

Fingernails

Painless nodules in distal finger joints
A localized osteoarthritis

A

Heberden’s nodes

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36
Q

Fingernails

Middle and proximal finger joints are affected
Digital infection

A

Rheumatoid arthritis (haygarths nodes)

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37
Q

Fingernails

Presence of groove on the nails
Formed in some period of time where one have undergone physical stress disease that affected the growth of the fingernail

A

Beau’s lines of the nails

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38
Q

Fingernails

May include that one is not healthy (not eating or sleeping well)

A

Beau’s lines of the nails

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39
Q

Fingernails

Infection of the nail
Swollen skin over the mantle of the nail and the lateral folds
Painful and tender

A

Paronychia

Usually when chronic it is not painful

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40
Q

Fingernails

Abscess of the terminal pulp space
Swelling of the fingertip and dull pain
Make incision and drain the abscess

A

Felon

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41
Q

Fingernails

Vitamin A deficiency

A

Egg shell nails

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42
Q

Fingernails

Hypertrophy of the nail plates
Due to chronic fungal infection or familial

A

Oncyhauxis

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43
Q

Fingernails

Nails of hepatolenticular degeneration

A

Red half moon in nail beds

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44
Q

Fingernails

Separation of the nail

A

Onycholysis

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45
Q

Fingernails

Subungual hemorrhage
Subacute bacterial endocarditis, trichinosis

A

Splinter hemorrhages

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46
Q

Wrist

Inspect and palpate for

A

Swelling
Tenderness
Deformities

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47
Q

Wrist

Palpate or auscultate for

A

Crepitus or crackling sound

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48
Q

Wrist

Check for visible

A

Skin lesions
Mass
Discoloration

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49
Q

Wrist

Motion

A

Dorsiflexion
Palmar flexion
Slight anatomic medial and lateral movement

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50
Q

Wrist

Feeling of thickening at the wrist joint
Then followed by paresthesias and tingling sensation
Then pain

A

Carpal tunnel syndrome

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51
Q

Wrist

Carpal tunnel syndrome

Due to nerve compression, particularly

A

Median nerve

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52
Q

Wrist

Carpal tunnel syndrome

Part of the pain is caused by

A

Ischemia of blood vessels

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53
Q

Wrist

Carpal tunnel syndrome

Sluggish of the movement due to

A

Compression of the ligament

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54
Q

Wrist

Carpal tunnel syndrome

Involvement of the median nerve will be manifested at the

A

Lateral portion of the hand (thumb, index, middle, half of ring)

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55
Q

Wrist

Carpal tunnel syndrome

If becomes chronic, there may be some atrophy of the muscles observed

A

Thenar atrophy

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56
Q

Wrist

Carpal tunnel syndrome

Percuss the medial side of the palmaris longus tendon to produce paresthesia

A

Tinel’s sign

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57
Q

Wrist

Carpal tunnel syndrome

Causes

A 
Overuse of the hand
Repetitive motion
Trauma
Aging
Amyloid deposits
Sarcoidosis
Gouty tophi
Soft tissue swelling in pregnancy
Myxedema
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58
Q

Forearm

A

With radius and ulnar bone

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59
Q

Forearm

Covered by different

A

Flexor and extensor muscles

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60
Q

Forearm

Motion

A

Supination

Pronation

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61
Q

Forearm

Fracture of the distal portion of the radius
Displacement of the hand dorsally in relation to the forearm

A

Smith’s fracture

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62
Q

Forearm

May also compress the nerve and blood vessels so expect for some numbness, paresthesias

A

Silver fork deformity

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63
Q

Elbow

Swelling

A

More common on extensors or lateral side

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64
Q

Elbow

Rheumatoid nodules

A

Found in the olecranon bursa

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65
Q

Elbow

Motion

A

Extension and flexion - movt of hemeroulnar joint

Pronation and supination - humero-radial and distal radio- ulnar joints

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66
Q

Elbow

Deformity of the elbow, the normal angle is

A

170 degree, reference part is the hand

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67
Q

Elbow

Angle 160 degree
Deviation laterally

A

Cubitus valgus

Valgus=Laterally

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68
Q

Elbow

Angle >170
Deviation from the line of the arm

A

Cubitus Vagus

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69
Q

Elbow

Tennis elbow secondary to tendonitis

A

Arthritis of the elbow

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70
Q

Elbow

Due to bacterial infection, may be accompanied by fever and with possibility of pus

A

Suppurative arthritis

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71
Q

The upper arm

Includes

A

Shaft of the humerus
Biceps
Triceps

72
Q

The upper arm

Traumatic rupture of biceps brachi occurs suddenly from

A

Lifting excessive weight

73
Q

The upper arm

Fracture of the humeral shaft

Caused by a direct blow, there is unmistakable angular deformity

A

Transverse function

74
Q

The upper arm

Fracture of the humeral shaft

No deformity, due to fall on the hand

A

Spiral function

75
Q

The upper arm

Fracture of the humeral shaft

In all case of fractures humerus, feel the __________ and ________ to assess if the brachial plexus is damaged.

A

Radial artery pulse

Radial nerve injury

76
Q

Shoulder joint and girdle

Includes

A

Scapula-humeral joint

77
Q

Shoulder joint and girdle

Sub acute inflammation of the entire rotator cuff
Overuse of the particular shoulder

A

Arthritis

Frozen shoulder

78
Q

Shoulder joint and girdle

Sits muscle

A

Arthritis

Frozen shoulder

79
Q

Shoulder joint and girdle

Paralysis of long thoracic nerve

A

Winged scapula

80
Q

Shoulder joint and girdle

Test for winged scapula

A

Push the wall

If shoulder blade is protruding = lack of innervations of long thoracic nerve

81
Q

Shoulder joint and girdle

Congenital condition with unilateral or bilateral winged scapula

A

Sprengel’s deformity

82
Q

Shoulder joint and girdle

Raise both arms to a vertical position at the sides of the head
Both hands behind the neck
Elbow out to the side

A

Internal rotation and

Abduction

83
Q

Shoulder joint and girdle

Both hands behind to the small of the back

A

External rotation

84
Q

Shoulder joint and girdle

Inspect the scapulae and related muscles posteriorly

A

No joint dse
Arthritis
Complete rupture of suprapinatus tendon
Partial and chronic suprapinatus tendon

85
Q

Shoulder joint and girdle

Pain in shoulder

A

Shoulder joint- arthritis
Tendon - suprapinatus tendonitis
Muscle- muscle strain

86
Q

Shoulder joint and girdle

Pain in shoulder 2

A

Bones- fracture of humeral neck
Nerves- compression
Vascular- aneurysm

87
Q

Shoulder joint and girdle

Pain referred to the shoulder

A

CVS - angina pectoris
Respiratory system - pneumonia
GIT - gastritis, peptic ulcer
GUT- cholelithiasis

88
Q

Shoulder joint and girdle

Tip of the most prominent portion of the lateral side of the clavicle up to the tip of the middle finger

A

Length of arm

89
Q

Shoulder joint and girdle

From anterior superior iliac spine to the tip of medial malleolus with the tape crossing the patella

A

Length of lower extremity

90
Q

The spine

7 cervical vertebrae; 3 are specialized

A

C1 - atlas
C2- axis
C7- vertebral prominence

91
Q

The spine

Movement

A

Rotation - atlas and axis only
Flexion
Extension
Lateral flexion

92
Q

The spine

Pancoast syndrome/superior
Pulmonary sulcus syndrome

Tumor in

A

Pulmonary apex
Upper mediastinum
Superior thoracic aperture

93
Q

The spine

Pancoast syndrome/superior
Pulmonary sulcus syndrome

Ssx

A 
Pain in posterior part of shoulder and axilla
Shooting pain down the arm
Acor paresthesias
Paresis
Atrophy of the arm
Horners syndrome
94
Q

Ssx of Horners syndrome

A 
Ptosis
Anhydrosis
Miosis
Enopthalmus
Loss ciliospinary reflex
95
Q

The spine

Described the complications from degeneration of the vertebra and their intervertebral disks with traumatic rupture or degeneration of the nucleus pulposus

A

Cervical spondylosis/cervical osteoarthritis

96
Q

Spine

Cervical spondylosis/cervical osteoarthritis

Ssx

A 
Pain in the neck, shoulder, occipital, scalp or down the arm
Numbness and tingling of the hands
Muscle atrophy
Crepitus
Degenerative disease of cervical spine
97
Q

Spine

Begins in the occipital region

A

Nuchal headache

98
Q

Spine

Sudden forceful, hyper extension of the neck with the flexion recoil

A

Post traumatic neck pain and headache

Eg. Whiplash

99
Q

Spine

Whiplash the ________ is ruptured. Rarely then spine of ____ is fractured

A

Ligamentum nuchae

C7

100
Q

Spine

Post traumatic neck pain and headache

Ssx

A

Neck pains
Spasm of the neck muscle
Torticollis

101
Q

Spine

C5 function for hyper flexion
Eg. Drivers strikes his head on the bottom

A

Flexion fracture of the neck

102
Q

Spine

Result in immediate death or quadriplegia if the patient survives

A

Flexion fracture of the neck

103
Q

Spine

A fall or blow on forehead may hyperextend the neck,
Rupture anterior longitudinal ligament

A

Partial dislocation from hyper extension

104
Q

Spine

If immediate death does not result, the patient is unable to nod the head and there will be severe occipital pain

Resulting neck pain and paraplegia

A

Fracture of the atlas (c1)

105
Q

Examination of the spine

From the side

A

Inspect the spinal profile

Note cervical, thoracic and lumbar curves

106
Q

Examination of the spine

From behind

A

Inspect for lateral curves, take note of heights of shoulder, iliac crest

107
Q

Examination of the spine

Imaginary line at

A

T1 gluteal cleft

108
Q

Examination of the spine

Percuss the spine for tenderness by thumping it with the

A

Ulnar surface of the fist

109
Q

Examination of the spine

Overlies the posterior iliac spine and guides us to the sacroiliac joint

A

Skin dimple

110
Q

Thoracolumbar spine and pelvis

A

12 T
5 L
5 S
4 C

111
Q

Thoracolumbar spine and pelvis

4 curves of vertebral column viewed laterally

A

Cervical curve- C2- T2
Thoracic curve - T2- T22
Lumbar curve - T12- lumbosacral joint
Pelvic curve - lumbosacral joint - tip of coccyx

112
Q

Spine

Forward co cavity of the thoracic curve is accentuated producing q hunched back

A

Kyphosis

113
Q

Spine

Kyphosis

Smooth curve result from

Rigid kyphosis of adolescence

A

Scheuermann’s Kyphosis

114
Q

Spine

Kyphosis

Smooth curve

Ankylosing spondylitis

A

Marie strumpell disease

115
Q

Spine

Kyphosis

Smooth curve

Osteitis deformans

A

Paget’s disease

116
Q

Spine

Kyphosis

Smooth curve

Others

A

Faulty posture

Senile osteoporosis

117
Q

Spine

Kyphosis

Angular curved (gibbus) caused by

A

Collapse of bodies of vertebra from compression fracture
Metastatic CA
Infectious spondylitis

118
Q

Spine

Accentuated posterior con cavity of the lumbar spine
Deep between lumbar para spinous muscles
Pot belly

A

Lordosis

119
Q

Spine

Lordosis causes

A

Pregnancy
Flexion contractures of the hips
Short Achilles’ tendon

120
Q

Spine

Lateral curvature of the spine

A

Scoliosis

121
Q

Spine

Scoliosis note for

A

Loss of symmetry
Compare tips of scapula
Top of hips
Dimples of venus

122
Q

Spine

Occurs in congenital deformities
Paralysis of back or abdominal muscle

A

Structural scoliosis

123
Q

Spine

Examination

A

Thomas - for lordosis

Gaenslens sign -

124
Q

Test for the hip joint

A

Straight leg raising test
Patrick’s test - flexion, abduction, external rotation
Dislocation of the hip/trendelenburg sign

125
Q

Knee

Patient standing

A

Inspect for

Deformities
Swelling
Muscle atrophy
Position of patella

126
Q

Knee

Patient supine

A

Test for extension and flexion

127
Q

Knee

Leg deviate toward the midline and knees are farther apart

A

Genu varum ( bow leg)

128
Q

Knee

Genu varum

Occurs in

A

Rickets
Pa gets disease
Occupational cowboys
Jockeys

129
Q

Knee

Lateral deviation of the leg from midline

A

Genu valgum (knock knee)

130
Q

Knee

Knees fixed in hyper extension with little ability to flex

A

Genu recurvatum

131
Q

Knee

Synovial fluid in the knee joint

A

Effusion or hydroarthrosis

132
Q

Knee

Blood in the joint cavity

A

Hemarthosis

133
Q

Knee

Pus in the joint cavity

A

Pyarthrosis

134
Q

Knee

Housemaid knees

A

Prepatellar bursitis

135
Q

Knee

Clergyman’s knee

A

Intrapatellar bursitis

136
Q

Knee minimal swelling in popliteal fossa
Knee hold in partial flexion to relieve pain
Extension is painful

A

Popliteal abscess

137
Q

Knee

Pressure diverticulum of synovial sac protruding thru the joint capsule of knee

Complication of RA

Popliteal artery entrapment syndrome

A

Morrant Baker’s Cyst

138
Q

The leg

Trauma causing extreme dorsiflexion of foot
Severe pain and tenderness

A

Soleus tear

139
Q

The leg

Injury incurred when body weight is forcefully applied tothe ball of the foot in plantar flexion

A

Rupture of Achilles’ tendon

140
Q

The leg

Squeeze calf muscles transversely
No motion when tendon is severed

A

Simmonds test

141
Q

The leg

Due to fall on the leg
Direct blow to anterior tibia
Sever pain
Leg cannot bear weight

A

Fracture of tibial shaft

142
Q

The leg

Direct blow on the anterolateral aspect of leg
Pain on anterior leg
Patient can walk

A

Fracture of fibular shaft

143
Q

The leg

Most common cause of compound fracture
Foot turned inward in obvious deformity

A

Fracture of both tibia nd fibula

144
Q

The ankle joint

Swelling or effusion

A

Subcutaneous edema

145
Q

The ankle joint

Rupture of joint capsule
Arthritis will also give you lateral inflammation of the ankle joint

A

Lateral ankle pain

146
Q

The ankle joint

Swelling of the ankle joint

A

Effusion into the ankle joint

147
Q

The ankle joint

Post traumatic lateral ankle pain
Injury done when you suddenly trip while walking

A

Rupture of joint capsule

148
Q

The ankle joint

Motion

A

Dorsiflexion

Plantar flexion

149
Q

Foot

Motion

A

Inversion/eversion

Abduction/adduction

150
Q

Foot

Inward deviation
Inversion of the foot

A

Talipes or club foot

151
Q

Foot

Club foot

Eversion

A

Talipes valgus

152
Q

Foot

Club foot

Plantar flexion
Always on tip toes

A

Talipes equinus

153
Q

Foot

Club foot

Dorsiflexion, heel bone making contact with the ground
Manifest a defect on the neural arch

A

Talipes calcaneus

154
Q

Foot

Club foot

Hollowing on the insteps
Sever aching of the foot

A

Pes cavus

155
Q

Foot

One or more of the pedal arches are lowered
Makes a person become unstable

A

Pes planus

156
Q

Foot

Arch is lowered only while bearing weight

A

Relaxed flat foot

157
Q

Foot

Caused by bone or fibrous ankylosis

A

Rigid flat foot

158
Q

Foot

From the contraction of the paromel

A

Spasmodic flat foot

159
Q

Foot

Flattening of the skin in the toes

A

Cutaneous lesion

160
Q

Foot

Thickening of the dorsal of the foot resulting in conical portion

A

Corn

161
Q

Foot

Undue pressure on the thin skin, especially the covering of the shoes produces a conical structure of keratin pointing into the dermis where it causes pain

A

Hard corn

Heloma durum

162
Q

Foot

Corn on an inter digital surface that undergoes laceration due to moisture and infection

A

Soft corn

Heloma mollis

163
Q

Foot

Thickening of the soles of the foot as a result of continous pressure

A

Callus

164
Q

Foot

Examination

Normal

A

Lateral part of shoes start to wear out

165
Q

Foot

Examination

Flat foot

A

Medial side of the shoes gets worn out

166
Q

Foot

Examination

The toe portion of the shoes due to the tip toed movement

A

Talipes equinus

167
Q

Foot

Examination

Has a cut area of the big toe, laterally due to lateral deviation of the big toe

A

Hallus vagus

168
Q

The toes

Lateral deviation of the great toe
Produces abnormal prominence of the lateral metotarsophalangeal joint

A

Hallus valgus

169
Q

The toes

Inflamed bursa over the prominent metatarsophalageal joint
Toes deviate laterally

A

Bunion

170
Q

The toes

Matatarsalgia from transverse flat foot

A

Spaly foot

171
Q

The toes

Stiffened great toe
Chronic arthritis or epiphysis of the first metatarsophalageal joint from injury or wearing short shoes

A

Hallus rigidus

May causes ankylosis

172
Q

The toes

Fixation of the 2nd toe in flexion
2nd toes is the one affected because it is the longest

A

Hammer toe

173
Q

The toes

Secondary to rheumatoid arthritis

A

Hammer toe

174
Q

Toenails

Ingrown toe nails

Excessive transverse growth of the nail plate causes the lateral edge to lacerate the nail fold is painful,

A

Onychocryptosis

175
Q

Toenails

Rams horn nails
Overgrowth of toe nails
Nail becomes thickened, growth in a conical or on top of the other so that it is irregular and curved like horn of a ram

A

Onychogryphosis

176
Q

Toenails

Great toe is involved
Arises from the dorsal surface of the distal phalanx to penetrate the distal half of the nail bed
Not common

A

Sub- ungual exostosis

177
Q

Involves only

A

Inspection and palpation

Clinical Medicine Midterms (6 decks)

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