Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Year 2 - MSK > Week 3 > Flashcards

Week 3 Flashcards

1
Q

How do bones get a) longer and b) wider?

A

a) from the growth plate (physis) by enchondral ossification
b) from the periosteum by appositional growth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the % contributions of each physis in bone growth in the a) upper limb and b) lower limb?

A

a) 40% from head of the humerus, 20% from base of humerus/heads of radius and ulna, and 40% from base of radius and ulna
b) 12% from head of the femur, 70% from the base of the femur and knee, 18% from the end of the tibia and fibula

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Name some factors that affect the growth plate

A
  • Diet/nutrition
  • Sunshine, vitamins (A, D)
  • Injury
  • Illness
  • Hormones (GH)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Growth is very variable! Up until what age is it especially so?

A

3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are some of the motor milestones for “normal growth”?

A
  • 6-9 months - sits, crawls
  • 8-12 months - stands
  • 14-17 months - walks
  • 24 months - jumps
  • 3 years - manages stairs alone
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

When should a growth disorder first be considered?

A

After multiple milestones have failed to be met

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are some of the common “variations of normal”?

A
  • Genu varum and valgum
  • Intoeing
  • Flat feet
  • Curly toes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How does the angle of knee to hip alignment generally vary during development?

A
  • Age 0-2 - Genu varus
  • Age 2-6/7 - Genu valgum
  • From 7 onwards, slight genu valgum (approx 5%)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are some of the pathologic causes of Genu Varum?

A
  • Skeletal dysplasia
  • Rickets - Vit. D deficiency
  • Tumour e.g. enchondroma
  • Blount’s disease
  • Trauma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is Blount’s Disease?

A

Growth arrest at the medial tibial physis of unknown aetiology

Shows a typical beak-like protrusion on X-rays

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are some of the pathologic causes of Genu Valgum?

A
  • Tumours - enchondroma, osteochondroma
  • Rickets
  • Neurofibromatosis (growth of tumours in the nervous system)
  • Ideopathic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

When would you refer a child suffering from Genu Valgum?

A

If asymmetric, painful, severe

Genu Valgum is usually normal, peaking at age 3 1/2

Chart and monitor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

When is intoeing typically accentuated?

A

When running

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Femoral neck anteversion - normal values, and what might it predispose to?

A
  • Mean is 30-40o at birth, slowly unwinds and settles at around 10-15%
  • Usually of no consequence, but can predispose to patellofemoral problems
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Intoeing - patient presents, what do you do?

A
  • Define cause
  • Reassure
  • Chart/photograph
  • Review
  • Discharge unless persisting and severe
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What needs to be determined when considering flat feet? How is this done?

A

Is it flexible or fixed?

Ask patient to stand on tip toes - if flexible, arch of the foot reappears.

Fixed may be indicative of underlying pathology

17
Q

What scoring system is used to assess hyperflexibility?

A

Beighton’s score - touching thumb to forearm, placing hands flat on floor, hyperextension of knees and elbows

18
Q

What underlying bony connection may present as fixed flat feet?

A

Tarsal coalition

19
Q

Name some common spine conditions

A
  • Mechanical back pain and spondylitis
  • Facet joint arthritis
  • Multi-level degenerate back pain/OA
  • Discogenic back pain
  • Disc prolapse, sciatica and radiculopathy
  • Spinal stenosis and bony route entrapment
  • Trauma and osteoporotic fracture
20
Q

Name some less common spine conditions

A
  • Ankylosing spondylitis
  • Scoliosis
  • Spondylolithesis
  • Benign tumours - osteoid osteoma
  • Malignant tumours - metastatic disease
  • Discitis and osteomyelitis
  • Cauda equina syndrome
21
Q

Describe the anatomy of the vertebral column

A

33 vertebrae

  • 7 cervical
  • 12 thoracic
  • 5 lumbar
  • 5 saccral (fused)
  • 4 coccygeal (fused)

4 curves

  • Cervical lordosis
  • Thoracic kyphosis
  • Lumbar lordosis
  • Saccral/coccygeal kyphosis
22
Q

Which are the atypical vertebra? Why?

A

C1 and C2 (atlas and axis) - no vertebral bodies, articulate with one another via the odontoid process to allow head rotation

C7 (vertebra prominens) - no foramina transversa process

23
Q

Describe the structure of an intervertebral disc

A

Outer layer - anulus fibrosus

Inner layer - nucleus pulposus

24
Q

Briefly describe the pathophysiology of spondylitis and secondary OA

Pain in the spine is worse during flexion/extension

A
  • Intervertebral disc loses water content over time with aging
  • Facet joints become overloaded, resulting in secondary OA
  • Pain is worse during extension of the spine
25
Q

Intervertebral discs lose fluid over time resulting in increasing pain and possibly the development of bulges and prolapses. At what vertebral levels is this most common?

How common are disc bulges?

Is MRI definitively diagnostic?

A

L4/L5 and L5/S1

Disc bulges are very common, 60% of asymptomatic individuals over 45 have disc bulges

MRI is not definitively diagnostic alone!

26
Q

In acute disc prolapse, what is the recommended treatment and how long might this take?

A

Initial rest if required, but focus on mobilisation and a return to normal work as early as possible

Prolapsed discs should settle in around 3 months

27
Q

Motor neurones originate anteriorly/posterior and their cell bodies are contained in the anterior grey horn/dorsal root ganglion.

Sensory neurones originate dorsally and their cell bodies are contained in the anterior grey horn/dorsal root ganglion.

A

Motor neurones originate anteriorly, cell bodies are contained in the anterior grey horn

Sensory neurones originate dorsally, cell bodies are contained in the dorsal root ganglion

28
Q

The spinal canal is formed by the _____

The anterior and posterior spinal nerves come together to form the mixed spinal nerve, which exits the spinal canal via the ______

A

Vertebral foramina

Intervertebral foramen

29
Q

At what level does the spinal cord end and the spinal nerves run as “cauda equina”?

A

L1

30
Q

Compression of a nerve root results in pain running down the sensory distribution of the nerve.

What is the name of the sensory distribution path of a nerve? What is the term used to describe the group of muscles supplied by this nerve?

What is the term used to describe this kind of pain? Specifically in the leg?

A

Sensory distribution of a nerve - dermatome

Group of muscles supplied by this sensory distribution - myotome

Compression resulting in pain running down a dermatome - radiculopathy

Radiculopathy specifically in the leg - sciatica

31
Q

Nerve roots from which vertebral levels make up the sciatic nerve?

A

L4, L5 and S1

32
Q

What disease process brings about nerve compression in Spinal Stenosis?

A

Development of osteophytes and hypertrophied ligaments, as seen in OA

33
Q

Briefly describe Cauda Equina syndrome

A
  • Excess pressure (usually due to prolapsed disc) is placed on ALL lumbosacral nerve roots at the level of the lesion
  • This includes the sacral nerve roots for bladder and bowel control
  • Signs include loss of bladder and bowel control, loss of anal tone and saddle anaesthesia
34
Q

Between what two vertebral levels (and associated anatomical landmarks) should lumbar punctures be performed?

A

Between L4 (posterior iliac crest) and S2 (PSIS)

Year 2 - MSK (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions