Brainscape's Knowledge GenomeTM

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


See full index

MSK > Week 6 > Flashcards

Week 6 Flashcards

1
Q

Whic hcervical verterbrae are ‘typical’ and which are ‘atypical’?

A

Typical - C3-C6

Atypical - C1, C2 and C7

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

Describe three defining characteristics of the typical cervical vertebrae

A

Small body/large triangular vertebral foramen/bifoid spinous process/presence of a transverse foramen (for vertebral artery and vein)/articular facets at 45 degrees to the axial plane

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

C1 is known as the ‘atlas’, it is a bony ring consisting of an anterior and posterior arch connected by two ‘lateral masses’. The inferior articular facets on the lateral masses articulate with C2 whilst the superior ones articulate with what?

A

The occipital condyles of the skull

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

What movements occur at the atlanto-occipital joint (Occipital bone/C1)

A

Nodding of the head, contributes 50% of the total range of flexion and extension of the neck

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

What movement occurs at the C1/C2 joint? What is this joint called?

A

50% of the total rotation of the head and neck (Sjaking the head)

atlanto-axial joint

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Give some defining features of C2

A

The strongest cervical vertebrae/ has a large spinous process/ presence of the odontoid process (dens) which projects upwards

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

The dens is held in place by the transverse ligament of the atlas (c1). What do the dens and the transverse ligament together prevent?

A

Horizontal displacement of the atlas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Give some defining features of C7

A

Has the longest spinous process/NOT a bifid spinous process/small transverse foramen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

In a disc prolapse of C5/C6, which cervical nerve is likely to be damaged and why?

A

C6 because the nerve root exits above the vertebrae, thus this is the one vulnerable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the ligamentum nuchae?

A

A thickening of the supraspinous ligament that extends from the occipital protuberance of the skull to the spinous process of C7

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

Give two functions of the ligamentum nuchae

A

To maintain the cervical lordosis/to assist in supporting the weight of the head/to be a site of muscle attachment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Whats the function of the anterior and posterior longitudinal ligaments of the spine?

A

anterior - prevent hyperextension of the spine posterior - prevents hyperflexion of the spine. NOTE - intervertebral disc prollapse occurs lateral to the pasterior longitudinal ligament

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

50% of nodding (flexion and extension of head and neck) occurs at the atlanto-occipital joint and 50% of shaking the head (rotation of head and neck) occurs at the atlanto-axial joint. Where do the other 50% of these movements take place?

A

The facet joints of the cervical spine - note that 45 degrees of lateral flexion of the neck occurs at these joints too

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

Give some defining features of the thoracic vertebrae

A

Medium size, heart shape vertebral body/small, circular vertebral foramen/prominent transverse processes with costal facets (on transverse processes) for rib attachment (except T11 and T12)/demi facets (T2-T8) or whole facets (T9-T10) on the side of the vertebral body for articulation with the head of the ribs (T11 and T12 have facets on the pecdicles /inferiorly angled spinous processes/

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Why does the thoracic spine have limited flexibility when compared with the cervical and lumbar vertebrae?

A

Because the rib cage is attached to each vertebrae in the thoracic spine.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Ribs __ - __ attach to the sternum. Ribs __ - __ attach toe the ribs above them. And ribs __ - __ are ‘floating ribs

A

1-7/8-10/11-12

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

In vertebrae T2-T8 the superior demi(half)-facet articulates with the head of the adjacent rib whilst the inferior one articulates with the one below. There are some execeptions outside this region, give an example

A

T1’s superior facet is a facet as it is the only one which connects with the first rib

T9 and T10 have one pair of whole facets

T11 and T12 have one pair of whole facets on their pedicles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What movement takes place in the thoracic spine?

A

Lateral flexion and rotation of the trunk (note the thoracic spine also protects vital organs)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Give key characteristics of the lumbar vertebrae

A

Large, kidney shaped vertebral body/triangular vertebral canal/large, blunt transverse process/short, blunt spinous process/facet joints at 90 degrees to the axial plane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is cervical spondylosis?

A

A chronic degenerative osteoarthritis which can put pressure on spinal neves leading to radiculopathy and if not resolved myelopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are some symptoms of radiculopathy - a compression of a spinal nerve resulting in these symptoms?

A

Pain/parasthesia (tingling)/motor weakness along the specific ermatomes and myotomes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is myelopathy?

A

A compression of the spinal cord resulting in global muscle weakness/gait dysfunction/loss of balance/incontinence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is a Jefferson’s fracture and what is the common mechnism of injury?

A

Fracture of the anterior and posterior arches of C1. Mechanism is commonly diving into shallow water (impacting head first onto something)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Normally jeffersons fractures only cause pain but not neurological symtpoms, why is this?

A

The bursting open of the bone fragments means spinal nerves aren’t impinged.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Where specifically does a ‘hangmans fracture’ occur and what is the mechanism of injury?

A

In the pars interarticularis of the C2 - mechanism is forcible hyperextension of the head (hanging)

26
Q

Fracture of the dens can be caused by hyperflexion or hyperextension but most commonly an old person falling forward onto their head. Diagnosed with an open mouth X-ray T/F

A

T - be able to recognise

27
Q

Whiplash injury is a forceful hyper-extension-hyperflexion injury to the cervical spine, it tears cervical muscles and ligaments. What are some secondary symptoms?

A

Oedema/haemorrhage/inlammation/muscle spasm causing neck stiffness/lower back pain

28
Q

What protective factor does the cervical spine have against spinal cord injury?

A

Wide vertebral foramen

29
Q

What will a patient complain of in a left sided (paracentral) C5/6 prolapse?

A

Parasthesia in the C6 dermatome - so parasthesia and pain in the radial border of the left forearm, index finger and thumb/ AND weakness in the C6 myotome - so elbow flexion, wrist extension and supination (canal filling may lead to acute spinal cord injury and thus paralysis)

30
Q

What are some other causes of cervical myopathy other that osteoarthritis

A

congenital stenosis of the spinal cord/cervical disc herniation/spondylolisthesis/trauma/RA of the cervical spine

31
Q

Differentiate symptoms between upper and lower cervical lesions

A

Upper - tend to cause a loss of manual dexterity

Lower - tent to cause spasticity - loss of balance

32
Q

Symptoms of myelopathy (due to compression of the spinal cord) are due to damage of the long tracts in the spinal cord. How can we test for damage to these?

A

Hoffmans test - hold the patients middle finger at the middle phalanx and flick the finger nail. If there’s movement -> positive Hoffman’s test -> bad

Babinski’ sign - Stroke the sole of the foot from heel to toe -> If big toe dorsiflexes -> positive Babinski’s sign -> bad

33
Q

If a patient develops myelopathy at the level of C5 what will be the symptoms?

A

Neck pain/ motor weakness of C5 and all subsequent myotomes/ parasthesia from the C5 dermatome and all subsequeny dermatomes distally

34
Q

What is the most common cause of thoracic cord compression?

A

Metastases (most commonly lung, thyroid, kidney and prostate) - note compression of the thoracic cord does not line up with their nerves because of the body’s kyphosis

35
Q

Vertebral osteomyelitis, discitis and epidural abcess normally occurs via haematogenous spread of bacteria in immunocompromised patients via the vertebral arteries which supply the spinal cord. What is the most common causative organis,?

A

Staph aureus also E. coli and coagulase negative staph

36
Q

The brachial plexus is divided into roots, trunks, dicisions, cords and branches. The roots come first and are formed by the anterior rami of the spinal nerves C_ - __
(This can be remembered by the mnemonic - Real Teenagers Drink Cold Beer)

A

C5-T1 (not the roots the anterior rami!) - remember the posterior rami innervated the skin and deep muscles of the back

37
Q

Betwen what two muscles of the roots pass?

A

anterior and middle scalene muscles

38
Q

You need to know the the origin of the peripheral nerves (i.e. what cord they are fromed from) and also their spinal root values

A

T

39
Q

The spinal nerve roots that contribute to the peripheral nerves of the brachial plexus can be remembered by the mnemonic 3 Muskateers Assassinated 4 Mice 5 Rats and 2 Unicorns USE THE MOVES THAT GO WITH THIS ON THE HAND

A 
3 Muskateers = Musculocutaenous (C5,C6,C7)
Asssassinated = Axillary (C5,C6) 
4 Mice = Median (C6,C7,C8,T1)
5 Rats = Radial (C5-T1)
2 Unicorns = (C8,T1)
40
Q

What cords does each of the branches of the brachial plexus

NOTE - think about these anatomically and the’ll make sense

A

Lateral - musculocutaneous and median
Posterior cord - Axillary and radial
Medial cord - ulnar

41
Q

The ‘M’ shape seen in the brachial plexus are the some of the terminal branches, which are they?

A

Musculocutaneous, median and ulnar nerves

42
Q

Upper brachial plexus injuries normally occur due to an excessive increase of the angle between the neck and shouler often during childbirth due to shoulders being too wide. Which roots are normally affected?

A

C5 and C6. There will be parasthesia in these dermatomes and paralysis of the their myotomes.
Resulting appearance is called ‘Erb’s palsy’

43
Q

Lower brachial plesus injuries often occur due to hyperabduction e.g. falling from a height and grabbing a tree branch. C8 and T1 are most commonly affected. What is the presentation of lower brachial plexus injuries known as?

A

Klumpke’s palsy - patient will present with ulnar claw due to affected myotomes (note - ulnar caw is flexion of the medial fingers - think that the position will be opposite of the movements that are damaged

44
Q

What happens if the long thoracic nerve is damaged?

How do you test for it?

A

Winging of the scapula as innervation to the serratus anterior is lost which protracts the scapula against the ribcage - now it protrudes posteriorly

Ask patient to place the palm of their hand on the wall and push -> winging will be obvious

45
Q

How is the long thoracic nerve most commonly damaged?

A

Surgery - mastectomy/removal of axillary lymph nodes

46
Q

The axilla is made of four walls a base and an apex. What are they

A

apex - clavicle
lateral wall - humerus
medial wall - serratus anterior and intercostal muscles
anterior wall - pec major, pec minor, subclavius
posterior wall - subscapularis, teres major, latissimus dorsi
base - fascia

47
Q

What are the contents of the axilla?

(A’s B’s and C’s

A

Axillary artery (and branches)/ Axillary vein (and branches)/ Axillary lymph nodes/ branches and cords of the brachial plexus/ corachobrachialis/ short head of biceps brachii/intercostobrachial nerve

48
Q

The axillary lymph nodes can be remembered by the mnemonic ‘APICAL’ explain.

A 
Anterior
Posterior
Infraclavicular 
Central
Apical
Lateral
49
Q

Give two causes of axillary lymphadenopathy

What structure is commonly unjured in axillary lumph node dissection?

A

Causes - Infection/breast cancer metasteses/lymphoma/melanoma metasteses

Long thoracic nerve

50
Q

The subclavian artery becomes the axillary artery at the lateral border of what?

A

The first rib

51
Q

What muscle does the axillary artery run under enclosed in its axillary sheath?

A

pec minor

52
Q

The axillary artery has loads of branches but importantly what branches wrap around the surgical neck of the humerus and can be damaged in fractures to the region?

A

Anterior and posterior humeral circumflex arteries

53
Q

What does the axillary artery become at the inferior border of the teres major

A

the brachial artery

54
Q

The axillary vein is formed at the inferior border of the teres major by the union of the paired brachial veins, what important superficial vein drains into it?

A

cephalic vein

55
Q

What vein does the basilic vein drain into?

A

brachial veins

56
Q

What vein connnects the basilic and cephalic veins at the cubital fossa which we commonly use for blood extraction?

A

The median cubital vein

57
Q

NOTE - a good way of identifying cervical vertebrae on an X-ray is to identify C2 via the dens and then count down from there (remember the dens is projecting upward from C2 so will look at the level of C1)

A

T

58
Q

What are the actions of the pec major/?

A

arm adduction, flexion and medial rotation

59
Q

What is the innervation of the pec major?

A

medial and lateral pectoral nerves

60
Q

what is the innervation of the pec minor?

A

medial pectoral nerve

61
Q

The lateral, medial and posterior cords of the brachial plexus are so named for their proximity to what vessel?

A

The axiallry artery

62
Q

What are the contents of the axillary sheath?

A

axillary vein, axillary artery, cords and branches of brachial plexus

MSK (11 decks)

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