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JL Musculoskeletal > Week 5 > Flashcards

Week 5 Flashcards

1
Q

What joint of the upper limb is commonly dislocated in rugby players?

A

Acromioclavicular

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2
Q

Name a muscle whioh moves the shoulder girdle?

A

Trapezius

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3
Q

What is the origin, insertion and innervation of trapezius?

A

Origin: spinous processes - T12
Insertions: occiput, spine of scapula
Innervation: accessory nerve XI

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4
Q

What is the function of the trapezius muscle?

A

Elevates and depresses scapula

Retracts scapula

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5
Q

What joint of the upper limb is susceptible to OA, RA, dislocation and adhesive capsulitis?

A

Glenero-humeral joint

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6
Q

What is the role of the labrum in the gleno-humeral joint?

A

Increases capture of humeral head so increasing stability

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7
Q

What occurs where the biceps tendon anchors to the labrum in the upper limb?

A

SLAP tear

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8
Q

What is the origin, insertion and innervation of supraspinatus?

A

Origin: supraspinous fossa
Insertion: greater tuberosity of humerus
Innervation: suprascapular n. (C5,C6)

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9
Q

What function does supraspinatous have?

A

Abducts the arm

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10
Q

What is the origin, insertion and innervation of infraspinatus?

A

Origin: infraspinous fossa
Insertion: greater tuberosity of humerus
Innervation: suprascapular n.

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11
Q

What is the function of infraspinatus?

A

Externally rotates the arm

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12
Q

What is the origin, insertion and innervation of teres minor?

A

Origin: dorsal surface of lateral border of scapula
Insertion: greater tuberosity of humerus
Innervation: axillary n. (C5,C6)

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13
Q

What is the function of teres minor?

A

Externally rotates the arm

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14
Q

What is the origin, insertion and innervation of subscapularis?

A

Origin: anterior surface of scapula
Insertion: lesser tuberosity of humerus/shoulder capsule
Innervation: upper and lower subscapular n.

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15
Q

What is the function of subscapularis?

A

Internally rotates the arm

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16
Q

What is the origin, insertion and innervation of deltoid?

A

Origin: clavicle, acromion and spine of scapula
Insertion: deltoid tuberosity on lateral aspect of humerus
Innervation: axillary n.

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17
Q

What is the function of deltoid?

A

Abducts the arm

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18
Q

What is the origin, insertion and innervation for biceps brachii?

A

Origin: short head - coracoid process. long head - labrum/glenoid
Insertion: tuberosity of radius
Innervation: musculocutaneous n.

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19
Q

What is the function of biceps brachii?

A

Flexes the elbow

Supinates forearm

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20
Q

What is biceps brachii susceptible to?

A

Tendonitis

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21
Q

In the elbow joint - what part are kids likely to fracture?

A

Supracondylar region - bone is thinner

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22
Q

What three ligaments are involved in the elbow joint?

A

Medial collateral, lateral collateral and annular ligaments

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23
Q

What is the site of insertion for all of the extensor muscles of the forearm?

A

Lateral epicondyle

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24
Q

What is the lateral epicondyle susceptible to?

A

Enthesiopathies

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25
Q

What is the site of insertion for all of the flexor muscles of the forearm?

A

Medial epicondyle

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26
Q

What can be said about breaks in the forearm?

A

If there is a break in one place there will also be a break somewhere else.

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27
Q

What type of fracture is described as a dinner fork deformity?

A

Distal radius fracture

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28
Q

What group of muscles move the thumb?

A

Thenar muscles

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29
Q

Name the three thenar muscles?

A
  1. Opponens pollicis
  2. Flexor pollicis brevis
  3. Abductor pollicis brevis
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30
Q

What innervates the thenar muscles?

A

Median n.

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31
Q

What group of muscles move the little finger?

A

Hypothenar muscles

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32
Q

Name the main hypothenar muscle?

A

Abductor digiti minimi

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33
Q

What nerve innervates abductor digiti minimi?

A

Ulnarn.

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34
Q

What group of muscles move the fingers and all flex at MCPJs and extend at IPJs?

A

Interossei muscles

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35
Q

What innervates interossei muscles?

A

Ulnar nerve

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36
Q

What is the function of dorsal interossei?

A

ABducts the fingers at MCPJs (DAB)

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37
Q

What is the function of palmar interossei?

A

ADucts the fingers at MCPJs (PAD)

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38
Q

What innervates the lateral lumbrical muscles?

A

Median nerve

39
Q

What innervates the medial lumbrical muscles?

A

Ulnar nerve

40
Q

Name the extrinsic flexor muscle of the fingers which flexes fingers at the proximal interphalangeal joints?

A

Flexor digitorum superficialis

41
Q

What is the innervation of flexor digitorum superficialis?

A

Median nerve

42
Q

What flexor tendons pass through the carpal tunnel?

A

Flexor digitorum superficialis

Flexor digitorum profundus

43
Q

What flexor tendon is the extrinsic flexor muscle of the fingers and flexes the fingers at the distal interphalangeal joints?

A

Flexor digitorum profundus

44
Q

What innervates flexor digitorum profundus at the 4th and 5th digits?

A

Median nerve via anterior interosseus

45
Q

What innervates flexor digitorum profundus at the 2nd and 3rd digits?

A

Ulnar nerve

46
Q

What two annular ligaments in the hand are critical to prevent bowstringing?

A

A2 and A4

47
Q

What three annular ligaments in the hand overlie the MP, PIP and DIP joints respectively?

A

A1, A3 and A5

48
Q

What annular ligament in the hand is most commonly involved in trigger finger?

A

A1

49
Q

What pulley prevents sheath collapse and expansion during digital motion?

A

Cruciate

50
Q

What separates the palmar muscle bellies and flexor tendons from the skin and is susceptible to hypertrophy and fibrosis (Dupuytren’s)?

A

Palmar fascia

51
Q

What is the muscular test for the median nerve?

A

Abductor pollicis brevis

52
Q

What is the cutaneous sensation test for median nerve and what does it supply?

A

Tip of index finger and base of thenar muscles

Supplies radial 3.5 digits

53
Q

What is the muscular test for ulnar nerve?

A

Adductor digiti minimi

Abductor indicis

54
Q

What cutaneous sensation does ulnar nerve supply and what is its test?

A

Ulnar 1.5 digits

Dorsum and volar aspects of little finger

55
Q

What are the two tests for radial nerve muscular supply?

A

Extensor digitorum communis

Extensor indocis

56
Q

What cutaneous sensation does radial nerve supply and what is its test?

A

Variable portion of dorsum of hand

Dorsum of 1st webspace

57
Q

Where does cubital tunnel syndrome occur?

A

At the elbow

58
Q

What nerve passes posterior to medial epicondyle, enters an arch formed by two heads of flexor carpi ulnaris and underneath the arcuate ligament?

A

Ulnar nerve

59
Q

What are the boundaries of carpal tunnel?

A

Carpal bones which form dorsal, medial and lateral constraints
Flexor retinaculum

60
Q

Name two tests which if positive suggest shoulder impingement?

A

Painful arc

Hawkins Kennedy

61
Q

Frozen shoulder?

A

Adhesive capsulitis

62
Q

What does a crescendo arc suggest?

A

Problems related to AC joint - not impingement

63
Q

What is an extremely painful condition related to shoulder impingement that involves crystals?

A

Calcific tendonitis

64
Q

Give four points about traumatic shoulder instablity?

A

T - Traumatic
U - Unilateral
B - Bankart
S - Surgery: bankart repair/laterjet

65
Q

Give five features of Atraumatic shoulder instability?

A 
A - Atraumatic
M - Multidirectional
B - Bilateral
R - Rehabilitation
I - Inferior capsular shift
66
Q

What conditions can cause soft tissue leading to multidirectional shoulder instability?

A

Ehlers-Danlos

Marfans

67
Q

What sign suggests multidirectional shoulder instability?

A

Sulcus sign

68
Q

What are the three sites involved in cubital tunnel?

A
  1. Cubital tunnel
  2. Flexor carpi ulnaris tendon heads
  3. Intermuscular fibrous bands
69
Q

For the cervical spine x-ray - what views are taken?

A
  1. AP
  2. Lateral
  3. Odontoid peg
70
Q

For the scaphoid bone x-ray - what views are taken?

A
  1. AP
  2. Lateral
  3. Two obliques
71
Q

What fracture fragments are incompletely corticated?

A

Acute avulsion fractures

72
Q

What do all avulsion fracture mimics have?

A

A completely corticated contour

73
Q

Where may fat density be seen on normal upper limb x-rays?

A

Anterior to the distal humerus

74
Q

Explain the posterior fat pad sign?

A

If an elbow effusion is present a displaced fat pad becomes visible posterior to the distal humerus

75
Q

Give two features of childrens fractures?

A
  1. Bones are soft so bend or bow - buckle fracture and plastic bowing
  2. Fractures are often incomplete - greenstick fracture
76
Q

What is the weakest part of a developing bone?

A

Physis or growth plate

77
Q

What is the Salter-Harris classification used to grade?

A

Growth plate fractures

78
Q

Name the fracture: elderly with osteoporosis, dorsal angulation of radius, associated ulnar styloid fracture?

A

Colles fracture

79
Q

Name the fracture: children with soft bones (note un-fused growth plates and non-ossified carpal bones?

A

Radial buckle fracture

80
Q

Name the fracture: young males, pain in anatomical snuff box, commonly mid-scaphoid (waist)?

A

Scaphoid fracture

81
Q

Name the fracture: post-menopausal females, sclerosis indicates impaction, often comminuted and can damage axillary nerve?

A

Surgical neck humerus fracture

82
Q

What fracture involves the articular surface of the first metacarpal base?

A

Bennett’s fracture

83
Q

Name three common shoulder problems?

A
  1. Rotator cuff - especially supraspinatus tendonitis (age 35-65)
  2. Subacromial bursitis
  3. Acromioclavicular disease
84
Q

Name three less common shoulder conditions?

A
  1. Frozen shoulder - diabetics
  2. OA/RA of shoulder
  3. Recurrent dislocation
85
Q

What are the basic treatment principles for upper limb arthritis?

A

Rest, analgesia, splintage, steroid injections, replace, fuse, excise

86
Q

Where in the upper limb can arthritis occur that may be due to trauma - it is also very common?

A

Acromioclavicular joint

87
Q

What loss of movement is significant in glenohumeral joint OA?

A

external rotation

88
Q

In what case will an anatomic shoulder replacement fail?

A

When rotator cuff torn and deltoid pulls head upwards putting forces on gleaned to cause OA

89
Q

If there is a rotator cuff tear and the shoulder joint needs replaced what replacement is suggested?

A

Reverse geometry shoulder

90
Q

What arthritis is monoarticular, localised, osteophytes/sclerosis, early joint space narrowing, base of thumb and PIP + DIP joints?

A

Osteoarthritis

91
Q

What arthritis is polyarticular, systemic, erosions, later joint space narrowing, synovitis, tendon rupture, MCP joints and carpus?

A

Rheumatoid

92
Q

What is the number 1 joint in the body for OA?

A

DIP joints

93
Q

OA of what joint results in subluxation of CMC joints?

A

Base of thumb

JL Musculoskeletal (35 decks)

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