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Yr3 Revision > MSK > Flashcards

MSK Flashcards

1
Q

What are the common types of nerve injury?

A

Neuropraxia

Axonotmesis

Neurotmesis

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2
Q

Features of neurapraxia?

A

Nerve intact but electrical conduction is affected
Full recovery
Autonomic function preserved
Wallerian degeneration does not occur

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3
Q

Features of Axonotmesis

A

Axon is damaged and the myelin sheath is preserved. The connective tissue framework is not affected.
Wallerian degeneration occurs.

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4
Q

Features of Neurotmesis?

A

Disruption of the axon, myelin sheath and surrounding connective tissue.
Wallerian degeneration occurs.

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5
Q

What muscles are being tested in the trendenlenburg test?

A

The contralateral Abductors (Gluteus Medius & minimus)

If the pelvis tilts to the right its the L abductors that are weak

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6
Q

Where do the rotator cuff muscles insert onto the humerus?

A

Subscapularis –> Lesser Tubercle

Supraspinatus, Infraspinatus & Teres minor –> Greater Tubercle

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7
Q

What structures are supplied by the following arteries:

  • Middle Genicular
  • Medial Geniculate
  • Medial Femoral Circumflex
  • Lateral Femoral Circumflex
A

Middle Genicular –> ACL

Medical Geniculate –> MCL

Medial Femoral Circumflex –> HEad of femur and neck (fracture –> damage –> necrosis of head of femur)

Lateral Femoral circumflex –> Lateral compartment of thigh

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8
Q

Contents of cubital fossa from Lat to Medial?

A
  • RAdial nerve
  • Biceps Tendon
  • Brachial Art
  • Median Nerve
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9
Q

What vascular structure is found at the sternomanubrial joint level?

A

Aortic Arch

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10
Q

What articulates with head of radius and ulnar superiorly?

A

Capitulum with radius

TRochlea with ulna

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11
Q

What structures pass behind the lateral malleolus? (in order from ant to post)

A 
Tibialis Posterior
Flexor Digitorum longus
Posterior Tibial Artery
Posterior Tibial Vein
Tibial Nerve
Flexor Hallucis Longus
T: tibialis posterior 
D: flexor digitorum longus 
A: artery (posterior tibial)
V: vein (posterior tibial)
N: nerve (tibial)
H: flexor hallucis longus
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12
Q

How do you remember the structures passing behind the lateral malleolus?

A

Tom Dick & Very Nervous Harry:

  • Tibialis posterior
  • flexor Digitorum Longus
  • post tibial Art
  • post tibial Vein
  • tibial Nerve
  • flexor Hallucis longus
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13
Q

What nerves supply sensation to the foot?

A

Tibial nerve –> Plantar Surface
Superficial Peroneal Nerve –> Dorsum
Deep Peroneal Nerve –> Dorsum, just 1st web space
Sural Nerve –> Lateral foot (a branch of both the tibial and common peroneal nerves)

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14
Q

19yr old patient presents with increasing back stiffness over a period of months, shoulder & back pain and enthesitis in his achilles tendon. What’s the likely diagnosis and what blood test would you run?

A

Ankylosing spondilytis
Do HLA-B27

Most common presentations are inflammation of sacroiliac joints, achilles enthesitis and plantar fasciitis

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15
Q

what muscle is most heavily involved in testing lower limb coordination by the heel-shin test

A

Sartorius due to its effect of medial rotation of tibia on the femur

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16
Q

What are the major causes of Acanthosis Nigricans?

A

1) Obesity related
2) DM
3) Cushing’s
4) PCOS
5) Drugs e.g. insulin

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17
Q

What nerves supply the knee joint?

A

Femoral
Sciatic
Obturator

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18
Q

What structures attach to the coracoid process?

A
  • Short head of Biceps Brachii
  • Coracobrachialis
  • Pec minor
  • Coracoacromial, -clavicular and -humeral ligaments
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19
Q

Patient presents unable to grasp a piece of paper between finger and thumb. What nerve is damaged and what is this sign called?

A

Froment’s Sign

Indicative of ulnar nerve palsy

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20
Q

What organism causes most OM in kids?

A

Staph Aureus (unless sickle cell then its salmonella)

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21
Q

Which nerve supplies which lower leg compartment?

A

Ant comp = Deep Peroneal (Fibular)
Lat Comp = Sup Peroneal (Fibular)
Post Comp = Tibial Nerve

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22
Q

What muscles are found in the ant lower leg?

A

Tibialis Ant
Extensor Digitorum Longus
Extensor Hallucis Longus
Peroneus Tertius

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23
Q

What muscles are in lat lower leg?

A

Fibularis Longus & brevis

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24
Q

What muscles are in deep and superficial post lower leg?

A

Deep = Tibialis Post, Flexor Hallucis Longus, Flexor Digitorum Longus & Popliteus

Superifical = Plantaris, Soleus & Gastrocnemius

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25
Q

What are the potential complications of Toxic Epidermal Necrosis?

A
  • Hypothermia
  • 2nd* infection
  • Fluid loss
  • Electrolyte Imbalance
26
Q

Within which tendon is the pisiform found?

A

Flexor Carpi ulnaris

Its a sesamoid bone

27
Q

What tendons are affected in de quervains tenosynovitis?

A

APL & EPB

28
Q

what forms the boundaries of the greater sciatic foramen and what passes through it?

A 
Anterolaterally = Greater sciatic notch of the ilium
Posteromedially = Sacrotuberous ligament
Inferior = Sacrospinous ligament and the ischial spine
Superior = Anterior sacroiliac ligament

Pudendal Nerve

29
Q

What does the pudendal nerve do?

A

Sensation to genitals, perineum and around anus

Motor to some pelvic muscles including ext urinary sphincter and ext anal sphincter

30
Q

What tumour is a Codman’s triangle on X-ray associated with?

A

Osteosarcoma

Codman’s triangle is an elevation of periosteum

31
Q

What is targeted by infliximab and rituximab?

A

Infliximab - TNF-alpha

Rituximab - CD20

32
Q

which of the following muscles don’t insert onto the radius?

  • Pronator Quadratus
  • Biceps
  • Brachioradialis
  • Brachialis
  • Supinator
A

Only the brachialis doesn’t insert onto the radius, it inserts onto the ulna instead

33
Q

Osteonecrosis of jaw is a risk of which drug?

A

Bisphosphonates e.g. Alendronate

34
Q

What passess through the greater and lesser sciatic foramina?

A

PIN:

  • Pudendal Nerve
  • Internal Pudendal Art
  • Nerve to Obturator Internus
35
Q

What effect does the trapezius have on scapular movement?

A

Retraction and upward rotation/elevation

36
Q

Which muscle is tested in froment’s test?

A

Adductor Pollicis

37
Q

What protein is affected in Marfan’s Syndrome?

A

Fibrillin

38
Q

What nerve supplies the hamstrings?

A

Tibial division of Sciatic Nerve

39
Q

Whats the significance of the ischial spine and tuberosity?

A

They attach the sacrospinous and sacrotuberal ligaments which form the greater and lesser sciatic foramina

Sacrotuberal is more superficial and inf when viewed from behind

40
Q

What do we call the lateral fascia lata?

A

Iliotibial tract

41
Q

What do we call the bone notches that contribute to the sciatic foramina?

A

Greater and lesser sciatic notches

42
Q

Osteogenesis Imperfecta is an autosomal dominant condition affecting collagen Type 1, how does it present?

A 
presents in childhood
fractures following minor trauma
blue sclera
deafness secondary to otosclerosis
dental imperfections are common
43
Q

What is Ehler’s Danlos Syndrome?

A

Autosomal Dominant CT disorder affecting Type 3 collagen

44
Q

How does Ehler’s-Danlos Syndrome present?

A

elastic, fragile skin
joint hypermobility –> recurrent joint dislocation
easy bruising
aortic regurgitation, mitral valve prolapse and aortic dissection
subarachnoid haemorrhage
angioid retinal streaks

45
Q

In what condition is collagen Type 4 affected?

A

Goodpasture’s Syndrome

46
Q

Where do the rotator cuff muscles insert?

A

Onto the greater tuberosity of the humerus

Bar the subscapularis which inserts onto the lesser tuberosity

47
Q

What are hard bony nodes forming on the interphalangeal joitns of the fingers?

A 
Proximal = Bouchards
Distal = Heberdens

They are features of OA

48
Q

What conditions would be suggested by joint/back pain that worsens in the morning and is relieved by exercise?

A

Inflammatory e.g. RA or Ankylosing Spondylitis

49
Q

What function does the serratus ant have on the arm?

A

Abduction

50
Q

What forms the roof of the adductor canal?

A

Sartorius

51
Q

Where does the sartorius insert?

A

Onto the medial upper part of the tibia

52
Q

which rotator cuff muscles are responsible for int vs ext rotation?

A

Subscapularis is the only int rotator

All the rest are ext

53
Q

where does the biceps originate and insert?

A

Long head = Supraglenoid Tubercle of scapula
Short head = Coracoid process

Insertion = RAdial Tuberosity

54
Q

what muscles insert onto the intertubecular sulcus of the humerus?

A

Pec major

Lats

55
Q

What ligament connects the head of the radius to the ulna?

A

Annular Ligament

56
Q

What is Sjogren’s syndrome and what is it a complication of?

A

Its an autoimmune condition against exocrine glands –> Dry mucosal membranes
–> dry mouth, vagina, COPD, bronchiectasis etc

Its a complication of RA

57
Q

Whats the most common finding in paget’s disease?

A

Raised ALKP

58
Q

What’s deposited in Pseudogout?

A

Calcium Pyrophosphate Dihydrate

59
Q

Treatment for Gout?

A

1st) NSAIDs or Colchicine
2nd) Steroids (Oral or IA)
Allopurinol as long-term therapy

60
Q

Whats the most common benign bone tumour?

A

Osteochondroma

61
Q

Most common malignant boen tumour?

A

Osteosarcoma

Yr3 Revision (9 decks)

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