Theme 2 - The Musculoskeletal system Flashcards

1
Q

What bones make up the pectoral girdle?

A

Scapula and clavicle

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2
Q

How many bones are there in the hand and what type?

A

Carpal x8
Metacarpal x5
Phalanges x14

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3
Q

Apply the following labels to the humerus

A
Greater tubercle
Lesser tubercle
Deltoid tuberosity
Intertubular sulcus/bicipotal groove
Lateral epicondyle
Medial epicondyle
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4
Q

Apply the following labels to the scapula

A
Spine 
Superior angle
Inferior angle
Coracoid
Acromion
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5
Q

Apply the following labels to the radius and ulna

A

Heads
Styliod processes
Tuberosities
Olecranon

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6
Q

What are the 5 joints of the wrist and hand?

A
radiocarpal
midcarpal
carpometacarpal
metacarpalpharlageal 
interphalangeal
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7
Q

Excluding the wrist and hand what are the other main upper limb joints?

A

glenohumeral

elbow

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8
Q

From where do the flexor muscles of the wrist and digits originate?

A

Medial epicondyle

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9
Q

From where do the extensor muscles of the wrist and digits originate?

A

Lateral epicondyle

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10
Q

What are the two types of curves in the spine and at what point do they develop?

A

Kyphoses - Fetal

Lordoses - Childhood

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11
Q

What are the 3 ligaments in the spinal column?

A

Anterior longitudional ligament
Posterior longitudional ligament
Ligamentum flava

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12
Q

What ligament of the vertebral column resists hyperextension and what is the clinical significance of this ?

A

anterior longitudional

This is what’s injured during whiplash

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13
Q

What are the two components of the intervertebral discs ?

A

Nucleus pulposus

Annulus fibrosus

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14
Q

What are facet joints?

A

Joints between vertebral arches

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15
Q

What does the type of movement of the facet joints depend on?

A

Angle of the joint

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16
Q

What are the two divisions of the muscles of the back and what to they broadly do?

A

Intrinsic - posture vertebral comumn

extrinsic - move upper limbs and ribs

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17
Q

Origin of latissimus dorsi? 3

A

Thoracolumbar fascia

Spinous processes of lower 6 T

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18
Q

Insertion and function of lattissimus dorsi?

A

Bicipital groove - Adduction and medial rotation

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19
Q

Origin of trapezius? 2

A

Occipital protuberance

Spinous processes CVII - TXII

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20
Q

What are the 3 sections of Trapezius and what do they insert into?

A

Upper - Clavicle
Middle - Acromion
Lower - Spine of scapula

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21
Q

Function of trapezius?

A

rotates scapula

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22
Q

What muscles are responsible for elevating and retracting the scapula?

A

Levator scapulae

Rhomboids

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23
Q

What are the 3 layers of deep muscle in the back?

A

Splenius - most superficial (in neck)
Erector Spinae - main group
Multifidus - deepest

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24
Q

What are the 3 muscle blocks of erector spinae and from where do they originate?

A

Spinales -
Longissimus
Iliocostalis

Erector Spinae aponeurosis

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25
What are the 3 muscle blocks of erector spinae and from where do they insert?
Spinales - spinous processes Longissimus - transverse processes Iliocostalis - ribs
26
From what do muiltifidous origionate and then insert?
Transverse processes to spinous processes
27
What is the nerve supply of the extrinsic and intrinsic muscles?
Extrinsic - anterior primary ramus | Intrinsic - posterior primary ramus
28
What stem artery supplies the upper limb?
Subclavian
29
What muscle divides the subclavian artery and into how many partys
Scalenus anterior -3
30
What comes of the 1st/2nd/3rd parts of the subclavian arteries?
1st - Thyrocervical - scapular | 3rd - Dorsal scapular artery
31
Where does the subclavian artery end and what does it become?
As it crosses the border of the first rib | axillary artery
32
What divides the axillary artery and into how many parts?
Pec minor - 3
33
Where does the axillary artery end and what does it become?
Boreder of teres major - brachial artery
34
What significant 2 arteries emerges from the axillary artery and from what section?
3 - subscapular | ant/post circumflex humoral
35
What is at risk following a fracture to the neck of the humerus?
ant/post circumflex humoral artery
36
Where does the brachial artery divide and what does it become?
cubital fossa | radial and ulna artery
37
What branch of the brachial artery supplies the extensor muscles?
Profunda brachii
38
What nerve accompanies the profunda brachii artery in the spiral groove?
radial nerve
39
Two arteries run down the forearm, what are they and which way around?
Lateral - radial | Medial - ulnar
40
Through what anatomical feature does the radial artery pass and what does it form in the hand?
Snuff box | Deep palmer arch
41
What artery forms the superficial palmar arch
Ulnar
42
What is the venous return in the forearm and what does it drain into?
Deep veins - Paired veins, Venae comitantes Superfical - Cephalic, basilic Axillary vein
43
Label the superficial veins
Dorsal venous arch basilic cephalic median cubital
44
Draw the brachial plexus including all supplies
``` Roots Trunks Divisions Cords Terminal Branches ```
45
Sketch the dermatomes of the upper limb?
C4. C5, C6, C7, C8, T1, T2
46
What does altered sensation in a dermatome region indicate?
damage to specific spinal nerve of spinal cord segment (i.e. proximal nerve injury)
47
Draw the cutaneous innervation by the terminal branches
``` axillary radial musculocutaneous medial cutaneous ulnar median ```
48
Label the ligaments of the shoulder joint.
``` Acromioclavicular Coracoacromial Glenohumeral - Superior - Middle - Inferior Coracoclavicular ```
49
Origin, insertion and nerve supply of deltoid
Spine of scapula + acromion + clavicle Deltoid tuberosity Axillary nerve
50
Label the elbow joint
``` Olecranon Capitulum Trochlea Trochlea notch Radial notch Head of radius ```
51
Label the ligamenets of the elbow
``` Radial collateralligament Annular ligament Ulnar collateral ligament Lateral epicondyle Medial epicondyle ```
52
Label the Cubital fossa
``` Lateral epicondyle Brachioradialis Pronator teres Lateral cutaneous nerve to the forearm Brachialis Brachial artery Median nerve ```
53
Thye median cubital vein is a branch of what vein?
Basilic
54
Label what 4 muscles origionate from the common felxor origin in the forearm?
Pronator teres Flexor carpi radialis Palmaris longus Flexor carpi ulnaris
55
What clinical condition is associated with the common flexor origin in the forearm?
Golfers elbow - epicondylitis at the CFO
56
Label the intermediate layer of the forearm
Flexor digitorum superficialis
57
Label deel flexor layer of the forearm
Flexor pollicis longus | Flexor digitorum profundus
58
Label superficial extensor muscles
Extensor carpi radialis longus/brevis Extensor digitorum Extensor digiti minimi Extensor carpi ulnaris
59
What clinical condition is assocciated with the common extensor origin?
Tennis elbow - epicondylitis ot CEO
60
What is the function of brachioraidilis
Flexion when half pronated - beer drinking
61
Label the deep layer extensor muscles
``` Supinator Abductor pollicis longus Extensor pollicis brevis Extensor pollicis longus Extensor indicis ```
62
What two muscles are involved in wrist abduction?
Flexor carpi radialis | - Extensor carpi radialis (longus + brevis)
63
What two muscles are involved adduction of the wrist?
Flexor carpi ulnaris | - Extensor carpi ulnaris
64
Label the muscles involved in pronation and supernation
Pronator teres Pronator quadratus Biceps brachii Supinator
65
Label the contents of the carpal tunnel
Median nerve Flexor policis longus Flexor digitorum superficialis Flexor digitorum profundus
66
What is carpal tunnel syndrome?
Compression of the median nerve
67
What does the median nerve supply?
Motor supply to anterior compartment except FCU/medial part of FDP Sensory supply to lateral palm + d1, d2, d3, ½ d4
68
label the carpal bones
``` Lunate Scaphoid Triquetral/triquetrium Trapezium Trapezoid Capitate Hamate Pisiform ```
69
What is the most common fracture to the carpal bones?
Scaphiod fracture
70
Label the joints of the hand
``` Saddle joint Wrist (radiocarpal) Metacarpal/intercarpal Carpometacarpal Metacarpophalangeal Interphalangeal ```
71
What ligaments reinfoce the radiocarpal joint?
Ulnar and radial collateral ligaments (limits abduction/adduction) Ligaments on the palmar/dorsal surfaces (limits extension/flexion)
72
What movement does the saddle joint enable
Opposition
73
What are the Condylar joints?
MCP
74
What are the hinge joints?
Proximal interphalangeal joints | distal interphalangeal joints
75
What muscle is the palmar aponeurosis continuous with?
palmaris longus
76
What are the flexor tendons in the hand,and which digits do they flex?
Flexor digitorum superficialis (d2-5) Flexor digitorum profundus (d2-5) Flexor pollicis longus (d1)
77
What prevents bowing of the hand tendons?
Flexor retinaculum
78
To where on the digit does the flexor digitorum profundus attach?
base of distal phalanx
79
To where on the digit does the flexor digitorum superficialis attach?
base of middle phalanx
80
What are the extensor tendons to digits 2-5?
Extensor digitorum Extensor indicis Extensor digiti minimi
81
What are the extensor tendons to digit 1?
Extensor pollicis longus Extensor pollicis brevis Abductor pollicis longus
82
Label the borders of the anatomical snuffbox
Abductor pollicis longus Extensor pollicis brevis Extensor pollicis longus
83
What artery passes through the anatomical snuffbox?
Radial
84
What bands of the extensor digitoris tendons insert into the middle and distal phalanges?
``` Medial band (into middle phalanx) Lateral band (into distal phalanx) ```
85
What muscles insert into the extensor hoods?
Lumbricals and interossei
86
What do the lumbrical muscles do?
Extend interphalangeal joints and flex MCP joints | - Precision grip (hold pen / pinch)
87
How many palmar interossei muscles are there and what do they do?
3 (no D1 or D3) | Adduct metacarpals
88
How many dorsal interossei muscles are there and what do they do?
4 (D2, D3x2, D4) | Abduct metacarpals
89
What do the thenar and hypothenar muscles do?
fine movements of the D1 and D5
90
Label the thenar muscles
Opponens pollicis Abductor pollicis brevis Flexor pollicis brevis
91
Label the hypothenar muscles
Opponens digiti minimi Abductor digiti minimi Flexor digiti minimi
92
Label the head, origins and insertions of adductor pollicus
``` Oblique head Transverse head Base 2nd and 3rd metacarpal + carpal bones 3rd metacarpal Proximal phalanx ```
93
What artery supplies the DEEP palmar arch and which digits does it supply?
radial | 1 and 1/2 of 2
94
What artery supplies the SUPERFICIAL palmar arch and which digits does it supply?
ulna | 1/2 of 2 and 3,4,5
95
What will possibly happen to the hand following injury to the ulnar nerve?
Clawed hand
96
Label the pelvis
``` ASIS AIIS Pubis Ischiopubic ramus Obturator foramen Ischial tuberosity Greater sciatic foramen Acetabulum ```
97
Label the femur
``` Neck Head Lesser trochanter Linea aspera Gluteal tuberosity Greater trochanter Intertrochanteric crest Lateral/medial condyles Medial epicondyle Lateral epicondyle Intertrochanteric line ```
98
Label the tibia, fibula and foot
``` Lateral and medial condyles Tibial tuberosity Medial malleolus Lateral malleolus Tarsals Metatarsals Phalanges ```
99
From shallow to deep what are the gluteal muscles?
Gluteus maximus Gluteus medius Gluteus minimus
100
How the function of the gluteal muscles differ>
maximus extends and medially rotates | medius and minimus abduct and medially rotate
101
What is the origin, insertion and innervation of gluteus maximus?
Ilium gluteal tuberosity/iliotibial tract Inferior gluteal nerve
102
What is the origin, insertion and innervation of gluteus medius and minumus?
Ilium greater trocanter superior gluteal nerve
103
What muscle form the equivelant of the rotator cuff in the hip?
Piriformis
104
What is the origin, insertion and innervation of piriformis?
Sacrum greater trocanter sacral plexus
105
What muscles make up the anterior compartment of the thigh?
Quadracepts (VVVR) | Sartorious
106
What muscles make up the quadracepts?
Rectus femoris vastus lateralis vastus medialis vastus intermedius
107
label the muscles of the anterior compartment of the thigh
``` Rectus femoris vastus lateralis vastus medialis vastus intermedius Sartorious ```
108
What is the origin, insertion and innervation of the quadracepts?
AIIS and femus Tibial tuberosity femaoral nerve
109
What is the origin, insertion and innervation of the sartorious?
ASIS tibia femoral artery
110
What muscles make up the hamstrings?
Biceps femoris (ong and short head) Semitendinosus Semimembranosus
111
What is the origin, insertion and innervation of the hamstrings?
ischial tuberosity tibia fibula sciatic nerve
112
Label the medial compartment of the thigh
``` Pectineus Adductor Longus Gracilis Adductor Brevis Adductor Magnus ```
113
What is the origin, insertion and innervation of the medial compartment of the thigh?
pubis and ischium Linea aspera obturator nerve
114
One of the medial muscles of the thigh has two parts, which one and what are these?
Adductor magnus | adductor part and hamstring part
115
What muscles are involve in flexion of the thigh?
Rectus femoris Sartorius Iliopsoas
116
What musles are involed in extension of the thigh?
Gluteus maximus Hamstrings Hamstring part of adductor magnus
117
What muscles are involed in abdcution of the thigh?
Gluteus medius | Gluteus minimus
118
What muscles are involved an adduction of the thigh?
``` Adductor longus Adductor brevis Adductor part of adductor magnus Pectineus Gracilis ```
119
From what plexus the femoral nerve origionate?
Lumbar L2-L4
120
From what plexus the obturator nerve origionate?
Lumbar L2-L4
121
From what plexus the sciatic nerve origionate?
Sacral L4-S3
122
Label the sciatic nerve and its branches
Sciatic nerve Tibial nerve Sural nerve Common fibular nerve
123
What does the commun fibula nerve divide into?
Superficial fibular | Deep fibular
124
Label the femoral triangle
``` Femoral nerve Sartorius Inguinal ligament Femoral artery/vein Adductor longus ```
125
What are the two "gateways" at either end of the femoral artery?
inguinal ligament | adductor hiatus
126
What are the two major superficial veins in the limb?
Short and long saphenous vein
127
What does the great spahenous vein dran and where does it lead to?
Dorsal medial arch of foot into femoral vein
128
What does the short spahenous vein dran and where does it lead to?
dorsal lateral arch of foot into popliteal vein
129
What bony factors help strengthen the knee joint?
Bony expansions - Locking mechanism - Femoral angle
130
What soft tissue factors help strengthen the knee joint?
Ligaments - Menisci - Muscles
131
Label the bony expansions of the knee
Femoral condyles Epicondyles Intercondylar fossa Tibial condyles (tibial plateau)
132
What is the puropse of the knee's locking mechanism?
Reduces amount of energy required when extended
133
What is genu varum?
Bow legged - Medial displacement of the tibia
134
What is Genu valgum?
knock knees - lateral displacement of tibia
135
What are the extracapsular ligaments of the knee?
Medial collateral | Lateral collateral
136
What are the intracapsular ligaments of the knee?
Anterior cruciate | Posterior cruciate
137
What does the lateral colateral ligamant do?
Prevents medial displacement of tibia
138
What does the medial colateral ligamant do?
Prevents lateral displacement of tibia
139
What do the anterior and posterior cruciate ligaments do?
Anterior -Prevents anterior displacement of tibia on femur | Posterior - Prevents posterior displacement of tibia on femur
140
How is the anterior cruciate ligament often injured and what test could you perfom to confirm this?
sharp twisting of knee | Lachman test
141
What 3 functions do the menisci perform in the knee?
Deepen the articulating surfaces/stability Shock absorbers Provides smooth viscous film for joint
142
What do the menisci attach to?
intercondylar area of tibia
143
What 3 ligaments is a rugby tackle to the lateral side of the knee likely to damage?
ACL Medial collateral medial meniscus
144
label the attachment and ligaments of the patella
``` Quadriceps tendon Lateral patellar retinaculum Medial patellar retinaculum Tibial tuberosity Patellar ligament ```
145
What does the patella do?
Protects quadriceps tendon from stresses during locomotion
146
What does the popliteus do, how?
Unlocks the knee by laterally rotating the femur
147
What are bursae?
Synovial fluid filled sac lined by synovial membrane
148
label the bursae
Suprapatellar bursa Prepatellar bursa Infrapatellar bursa
149
What is Bursitis?
Housemaids knee or clergymens knee - Inflammation of bursae Due to repetitive movements or direct pressure Leaning forward on the knees brings the prepatellar bursa in contact with floor back on heels leads to contact with infrapatella
150
Label the bones of the foot
``` Calcaneus Talus Cuboid Navicular Cuneiforms Sesamoid bones Sustentaculum tali Calcaneal tuberosity ```
151
What type of joint is the ankle joint and what movements are there?
Synovial hinge joint | Dorsi/plantar flexion
152
What ligaments stabilise the ankle?
Lateral ligament – lateral malleolus to talus/calcaneus | Medial/deltoid ligament – medial malleolus to talus/calcaneus/navicular
153
What is the subtalar joint between and what does it do?
Between talus and calcaneus (+ navicular) | Allows inversion/eversion during locomotion
154
What movement does the transverse tarsal joint allow?
Allows eversion/inversion and pronation/supination
155
What is the function of the arches of the foot? 3
Shock absorbers during locomotion Act as springboards Distribution of weight
156
What is pes planus?
Fallen medial longitudinal arch can lead to pes planus (flat feet)
157
What are the compartments of the lower leg and what muscle supplies them?
Anterior - Deep fibular nerve Posterior - Tibial Lateral - Superficial fibular nerve
158
Label the anterior compartment of the leg
Tibialis anterior Extensor digitorum longus Extensor hallucis longus
159
What do the leg anterior compartment leg muscles inser into?
``` Extensor digitorum longus - Middle + distal phalanges Tibialis anterior - Medial cuneiform + 1st metatarsal Extensor hallucis longus - Distal phalanx of great toe ```
160
Label the superficial posterior compartment of the lower leg
Soleus Plantaris Tendo calcaneus Gastrocnemius
161
What is th origin of Gastrocnemius?
condyles of femur
162
Origin of plantaris?
Femur
163
Origin of soleus?
tibia and fibia
164
Label the deep posterior compartment of the lower leg
Flexor digitorum longus Tibialis posterior Flexor hallucis longus Flexor retinaculum
165
Lable the insertion of the porterior compartment leg muscles
Flexor digitorum longus Tibialis posterior Flexor hallucis longus
166
label the lateral compartment of the leg
Fibularis longus Fibularis brevis Fibular retinaculum
167
Label the insertions for the lateral compartment of the leg
Fibularis longus | Fibularis brevis
168
Label the long tendons of the foot (lateral)
``` Extensor digitorum longus Extensor hallucis longus Fibular retinaculum Extensor retinaculum Fibularis longus/brevis ```
169
Label the long tendons of the foot (medial)
``` Flexor digitorum longus Flexor hallucis longus Tibialis posterior Flexor retinaculum Tibialis anterior ```
170
label the blood supply to the posterior compartmnt of the leg?
Popliteal artery Anterior tibial artery Posterior tibial artery Fibular artery
171
What is the origin, insertion and innervation of the deltoid?
Spine of scapula, acromion and clavicle Deltiod tuberosity Axillary nerve
172
What is the origin, insertion and innervation of the biceps?
Long head - supraglenoid tuberosity Short - coracoid process radial tuberosity Muscocutaneous nerve
173
What are the rotator cuff muscles?
Supraspinatus Infraspinatus Teres minor Subscapularis
174
The rotator cuff muscles surround the joint on all sides except which side and what is the significance of this?
Inferior | Most common dislocation
175
Label the rotator cuff muscles
Supraspinatus Infraspinatus Teres minor Subscapularis
176
Label the origins of the rotator cuff muscles
Supraspinous fossa Spine  Infraspinous fossa
177
Where do the 3 posterior rotator cuff muscles insert onto?
Greater tubercle
178
Origin and insertion of subscapularis?
Subscapular fossa and lesser tubercle
179
Label the rotator cuff muscles (slide 23)
Supraspinatus Infraspinatus Teres minor
180
What is the function of supraspinatus
Initiates abduction
181
What is the origin, insertion and innervation of teres major?
Inferior angle of scapula Medial lip of bicipital groove Lower subscapular
182
Give an example of a common rotator cuff injury
Supraspinatus impingement | Common in throwers
183
What cord of the brachial plexus is associated with supply to Subscapularis, teres major and lat dorsi
Posterior
184
What forms the borders of the anatomical snuffbox?
Extensor pollicis brevis Extensor pollicis longus Abductor pollicis longus
185
What disease affects the palmar fascia?
Dupuytren's
186
What causes a trigger finger?
Flexor tendon gets caught at A1 pulley | Usually by degenerative nodule
187
4 signs of ulnar nerve damage
clawing wasting hypothenar web spaces forearm wasting paradoxical thenar wasting
188
If someone has subacromial impingement where/what movements are going to cause them pain?
Abduction and rotation | pain over deltoid
189
Extrinsic and intrinsic causes of subacromial impingement?
Extrinsic - bony spurs | Intrinsic - tendonopathy
190
Treatment of subacromial impingement
Non-surgical - physio and activity modification | Surgical - subacromial decompression/debridement
191
Which rotator cuff muscles are most likely to tear?
supra and infra spinatus
192
Two types of shoulder replacement
Anatomic | Reverse
193
Symptoms any typical demographics of frozen shoulder
stiffness loss of passive motion normal x-ray Female 40-60 diabetic
194
Treatment of frozen shoulder
Non surgical -Natural history 2 years -hydrodilation Surgical -Capsular release
195
What horn does the lower motor neuron arise from?
Anterior
196
What myotome and movement is associated with each of these roots? C5, C6, C7, C8, T1
C5 - deltoid - abduction C6 - anterior - elbow flexion C7 - posterior - elbow extension, wrist flex/ext C8 - posterior forearm - finger extension and flexion T1 - intrinsic hand - finger abduction
197
Which nerve roots correspond with the following reflex tests? Biceps, supinator, triceps
C5 - biceps C6 - supinator C7 - triceps
198
What could cause a nerve root impingement?
Herniated disc
199
4 types of nerve injury
Avulsion - tear from attachment to spinal cord Rupture - tear but not on attachment to spinal cord Neuroma - tumor Neurapraxia - myelin damage
200
4 types of injury to the brachial plexus
Erbs Palsy - babbys on delivery (waiter's tip) Pancoasts tumor Inflammatory - brachial neuritis Thoratic outlet syndrome
201
What are the tree sires of compression for thoracic outlet syndrome?
Between anterior and middle scalene muscles Beneath clavicle in the costoclarvicular space Beneath tendon of Pectorlis minor
202
Two types of thoracic outlet syndrome and their symptoms
Neurigenic - pain, numbness, parethesia | Vascular - forearm fatige, swelling cyanosis
203
What and muscles are innervated by the median nerve?
L ateral 2 lumbricals O pponens pollicis A bductor pollicis brevis F lexor pollicis brevis
204
What is thenar wasting a possible sign of?
Carpal tunnel syndrome
205
Possible causes of carpal tunnel syndrome
``` Diabetes Pregnancy Hypothyroidism Rheumatoid arthritis Repetitive strain ```
206
Draw the differences in sensory innervation loss in carpal tunnel vs lesion in forearm
Loss of palmar sensation in carpal tunnel
207
Is ulnar clawing more severe when the lesion is proximal or distal?
Distal
208
"Saturday night palsy" relates to which nerve?
Radial
209
Where is the conus medularis?
L1/2
210
Main differences between lesion on conus medularis vs cauda equina>
Cauda equina - Pain more severe, asymeteric losses. Bladder and sexual function loss later and less severe. Conus medularis - Pain less severe, bilateral losses, bladder and sexual function loss earlier and more severe
211
Draw the lumbar plexus
L2, L3, L4 - femoral nerve | L4, L5 Obturator
212
Draw the sacral plexus
L4 - S3 - Sciatic L4, L5, S1 - Superior gluteal S1, S2 - inferior gluteal
213
Draw Posterior leg innervation
Sciatic Sural - medial/lateral Lateral dorsal cutaneous
214
What does ATOMFC stand for?
``` A ir Obstruction T ension pneumothorax O pen pneumothorax M assive haemothorax F lail chest C ardiac tamponade ```
215
Another name for bunions?
Hallux Valgus
216
Type of drug that prevents bone loss - up to 3 examples.
Bisphosphonates Allendronate Zolendronate dosidium pamidronate
217
Two drugs that treat gout
Allopurinol | Colchicine