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LOCO2 > Anatomy Booklet > Flashcards

Anatomy Booklet Flashcards

1
Q

What is clinically significant about C7?

A
  • easily palpable landmark identified for counting vertebra

- prominent spinous process

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2
Q

What is clinically significant about T7?

A
  • xiphoid

- tip of scapula

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3
Q

What is clinically significant about L1?

A
  • conus medullaris (end of spinal cord)
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4
Q

What is clinically significant about L3?

A
  • aorta bifurcation
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5
Q

What is clinically significant about L4?

A
  • iliac crest
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6
Q

What is a ‘hangman’s fracture’?

A
  • hyperextension of the head on the neck

- severe = C2 body displaced anteriorly with respect to C3 = injures spinal cord/brainstem

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7
Q

What is the difference between trabecular and cortical bone?

A
  • also cancellous vs. compact bone
  • spongy vs. tough
  • trabecular is less dense, weaker, more flexible, greater SA:V
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8
Q

How does osteoporosis occur with age?

A
  • vertebral bodies have high proportion of trabecular bone to compact bone
  • net loss and remaining bone deteriorates in quality
  • skeletal muscle loss = less force and support adding to loss of bone
  • late stage = vertebral bodies especially in thoracic region collapse and get excessive kyphosis
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9
Q

What areas does osteoporosis most commonly affect?

A
  • neck of femur
  • vertebral bodies
  • metacarpal
  • radius
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10
Q

What is the significance of striation?

A
  • vertebral bodies moderate osteoporosis early on via vertical striation
  • later stages more spongy trabecular bone lost so striated pattern lost
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11
Q

How do the vertebra change during ageing?

A
  • middle aged = decrease in bone density and strength so IV disc more convex and articular surface bows inward
  • loss of height
  • loss of disc space
  • therefore increase in compressive forces at periphery of bodies
  • osteophytes develop
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12
Q

What is lumbar spinal stenosis?

A
  • narrowing of vertebral foramen
  • caused by genetics or age related
  • spinal nerves exiting lumbar region increase in size but intervertebral foramina decrease in size
  • may compress 1 or more of spinal nerve roots
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13
Q

How may lumbar spinal stenosis be surgically treated?

A

decompressive laminectomy

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14
Q

What is spinal enthesopathy?

A
  • paraspinal ligaments undergo degeneration then ossify
  • does not involve sacroiliac joint
  • left side of spine spared/less involved = may have to do with pulsating aorta
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15
Q

What 6 elements do you check in a clinical exam of the spine?

A
  • gait (wide based, leaning forwards)
  • alignment (dislocation/scoliosis/kyphosis/lordosis)
  • posture (same as above, sapsm, loss of lordosis)
  • skin (hairy tufts, soft masses, port-wine spots, growths, café-au-lait spots)
  • palpate bony structures (focal tenderness = fracture)
  • palpate soft tissues
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16
Q

What would tenderness be a sign of?

A
  • osteoarthritis/dislocation

- if diffuse tenderness = sprain/muscle sprain

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17
Q

What is the function of the upper limb?

A
  • movement

- not very stable so prone to dislocations

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18
Q

What is important about the sternoclavicular joint?

A

Only joint holding upper limb to the axial skeleton

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19
Q

What is one of the most commonest bones to fracture?

A
  • clavicle

- direct or indirect force

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20
Q

What happens post clavicle fracture?

A
  • SCM pulls medial fragment upwards

- trapezius unable to hold lateral fragment upwards against arm weight and gravity so shoulder drops

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21
Q

What is the commonest joint to dislocate?

A
  • glenohumeral joint
  • between glenoid fossa of the scapula and head of humerus
  • mostly anterior dislocations
  • classic feature is loss of rounded shoulder profile as arm is dragged inferiorly
  • in young/athletic
  • glenoid labrum tears
  • rotator cuff tears if over 40 years
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22
Q

What nerve is at risk in a glenohumeral dislocation? What are the signs of damage?

A
  • axillary
  • close to inferior part of joint capsule
  • deltoid muscle paralysis
  • loss of sensation in skin area covering central deltoid (regimental patch)
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23
Q

What commonly causes rotator cuff injuries?

A
  • repetitive use of the upper limb above horizontal
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24
Q

What is the mechanism of a rotator cuff injury?

A
  • tendons are relatively avascular so repetitive injuries required to accumulate into a complete tear
  • fibrocollagenous scar left = weaker than dense regular arrangement of original tendon
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25
Q

Which rotator cuff tendon is most commonly damaged?

A
  • supraspinatus

- passes under acromion of scapula where it can be impinged

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26
Q

What are the different types of humeral fractures?

A
  • most are proximal around surgical neck = common in elderly/osteoporosis
  • middle aged and older = avulsion fractures of greater tubercle, due to falls on acromion
  • mid shaft fractures = result of direct force
  • supracondylar/intercondylar fractures = falls on flexed elbow
  • children = epiphyseal growth plates open so fracture dislocation of proximal humerus may occur as rotator cuff stronger than plate
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27
Q

What is an avulsion fracture?

A

Injury to a bone where a tendon/ligament attaches to it

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28
Q

What joints makes up the elbow?

A
  • humero-ulnar
  • humero-radial
  • proximal radio-ulnar
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29
Q

How does a posterior dislocation of the elbow joint occur?

A
  • hyperextension or blow driving ulna posteriorly/laterally
  • distal humerus driven through weaker joint capusula anteriorly
  • ulnar collateral ligament torn
  • associated fractur of radius head coronoid process or olecranon process of ulna
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30
Q

Define subluxation

A

Partial dislocation

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31
Q

How can subluxation of the radial head occur?

A
  • in infants

- small size of radial head compared to annular ligament into which it fits

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32
Q

What is a Colles’ fracture?

A
  • distal radius fracture
  • most common fracture under 45 years
  • falls on outstretched hand which is pronated and extended
  • dinner fork deformity presentation
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33
Q

What other common injury is caused by the same mechanism as the Colles’ fracture?

A
  • fracture of the scaphoid
  • most common carpal fracture
  • blood supply to scaphoid compromised = avascular necrosis
  • ## retrograde blood supply to proximal pole which may die whilst nutrient arteries enter distal portion of bone so heals
34
Q

What is a Smith’s fracture?

A
  • distal radius
  • falling onto flexed wrists
  • or direct blow to dorsal forearm
  • less common than Colles’
  • garden spade deformity presentation
35
Q

What is the function of the lower limb?

A
  • stability
36
Q

What type of joint is the pubic symphysis?

A
  • fibrocartilage joint
37
Q

What type of joint is the sacroiliac joint?

A

Synovial joints

38
Q

How may pelvic avulsion fractures occur?

A
  • during sports where there is sudden acceleration/deceleration
  • hamstrings attach to ischial tuberosity of pelvis
    which can be torn away at apophyses
39
Q

What are apophyses?

A

Bony projections that lack secondary ossification centres

40
Q

What are the features of femur fractures?

A
  • age as neck of femur has high proportion of trabecular bone = osteoporosis
  • neck of femur is narrowest and weakest part and at a angle to line of weight bearing (gravity pull)
  • usually intracapsular fracture
  • get shortening of limb and usually externally rotated
41
Q

What is the blood supply to the head and neck of the femur?

A

Medial circumflex artery

42
Q

What is the major clinical problem femoral fractures?

A
  • retinacular arteries arising from medial circumflex arteries are often torn which supply blood to head and neck of femur
  • sometimes only blood supply is via artery in ligament of the head = avascular necrosis of head of the femur
43
Q

How may dislocation of the femoral head occur?

A
  • uncommon as hip joint stable
  • road traffic accidents if sat down and flexed knee hits dashboard forcing femoral head posteriorly
  • joint capsule ruptures out of acetabulum
  • limb shortened
  • medially rotated
  • associated with fractures to femoral head/neck/acetabulum
44
Q

How do femoral shaft fractures occur?

A
  • require high energy trauma
  • associated with other injuries
  • source of blood loss and release of fat emboli
  • traction for re-aligning bone pieces
  • large thigh muscles go into spasm and contract displacing fragments
45
Q

How can the patella be fractured?

A
  • direct forces = falls

- indirect = embedded in quadriceps tendon so pull of muscles can cause fracture or fragment displacement

46
Q

What is a bipartite patella?

A

Unfused superolateral corner

47
Q

How can a tibia be fractured?

A
  • indirect trauma to tibial shaft when bone turns with foot during a fall
  • severe torsion = diagonal fracture of tibial shaft with fibula fracture
48
Q

How may fractures of the malleoli occur?

A
  • very common at all ages
  • 1 malleoli involved = stable
  • bimalleoli = unstable and added complication is fracture dislocation to talo-crural joint (ankle)
  • lateral more common than medial
  • excessive inversion of foot so ligaments tear on lateral side
49
Q

What is plantar fasciitis?

A
  • Inflammation of the plantar fascia
  • result of overuse
  • plantar surface of foot and heel pain
  • irritated by calcaneal spur at point of attachment
50
Q

What is the function of the upper limb?

A
  • movement

- not very stable so prone to dislocations

51
Q

What is important about the sternoclavicular joint?

A

Only joint holding upper limb to the axial skeleton

52
Q

What is one of the most commonest bones to fracture?

A
  • clavicle

- direct or indirect force

53
Q

What happens post clavicle fracture?

A
  • SCM pulls medial fragment upwards

- trapezius unable to hold lateral fragment upwards against arm weight and gravity so shoulder drops

54
Q

What is the commonest joint to dislocate?

A
  • glenohumeral joint
  • between glenoid fossa of the scapula and head of humerus
  • mostly anterior dislocations
  • classic feature is loss of rounded shoulder profile as arm is dragged inferiorly
  • in young/athletic
  • glenoid labrum tears
  • rotator cuff tears if over 40 years
55
Q

What nerve is at risk in a glenohumeral dislocation? What are the signs of damage?

A
  • axillary
  • close to inferior part of joint capsule
  • deltoid muscle paralysis
  • loss of sensation in skin area covering central deltoid (regimental patch)
56
Q

What commonly causes rotator cuff injuries?

A
  • repetitive use of the upper limb above horizontal
57
Q

What is the mechanism of a rotator cuff injury?

A
  • tendons are relatively avascular so repetitive injuries required to accumulate into a complete tear
  • fibrocollagenous scar left = weaker than dense regular arrangement of original tendon
58
Q

Which rotator cuff tendon is most commonly damaged?

A
  • supraspinatus

- passes under acromion of scapula where it can be impinged

59
Q

What are the different types of humeral fractures?

A
  • most are proximal around surgical neck = common in elderly/osteoporosis
  • middle aged and older = avulsion fractures of greater tubercle, due to falls on acromion
  • mid shaft fractures = result of direct force
  • supracondylar/intercondylar fractures = falls on flexed elbow
  • children = epiphyseal growth plates open so fracture dislocation of proximal humerus may occur as rotator cuff stronger than plate
60
Q

What is an avulsion fracture?

A

Injury to a bone where a tendon/ligament attaches to it

61
Q

What joints makes up the elbow?

A
  • humero-ulnar
  • humero-radial
  • proximal radio-ulnar
62
Q

How does a posterior dislocation of the elbow joint occur?

A
  • hyperextension or blow driving ulna posteriorly/laterally
  • distal humerus driven through weaker joint capusula anteriorly
  • ulnar collateral ligament torn
  • associated fractur of radius head coronoid process or olecranon process of ulna
63
Q

Define subluxation

A

Partial dislocation

64
Q

How can subluxation of the radial head occur?

A
  • in infants

- small size of radial head compared to annular ligament into which it fits

65
Q

What is a Colles’ fracture?

A
  • distal radius fracture
  • most common fracture under 45 years
  • falls on outstretched hand which is pronated and extended
  • dinner fork deformity presentation
66
Q

What other common injury is caused by the same mechanism as the Colles’ fracture?

A
  • fracture of the scaphoid
  • most common carpal fracture
  • blood supply to scaphoid compromised = avascular necrosis
  • ## retrograde blood supply to proximal pole which may die whilst nutrient arteries enter distal portion of bone so heals
67
Q

What is a Smith’s fracture?

A
  • distal radius
  • falling onto flexed wrists
  • or direct blow to dorsal forearm
  • less common than Colles’
  • garden spade deformity presentation
68
Q

What is the function of the lower limb?

A
  • stability
69
Q

What type of joint is the pubic symphysis?

A
  • fibrocartilage joint
70
Q

What type of joint is the sacroiliac joint?

A

Synovial joints

71
Q

How may pelvic avulsion fractures occur?

A
  • during sports where there is sudden acceleration/deceleration
  • hamstrings attach to ischial tuberosity of pelvis
    which can be torn away at apophyses
72
Q

What are apophyses?

A

Bony projections that lack secondary ossification centres

73
Q

What are the features of femur fractures?

A
  • age as neck of femur has high proportion of trabecular bone = osteoporosis
  • neck of femur is narrowest and weakest part and at a angle to line of weight bearing (gravity pull)
  • usually intracapsular fracture
  • get shortening of limb and usually externally rotated
74
Q

What is the blood supply to the head and neck of the femur?

A

Medial circumflex artery

75
Q

What is the major clinical problem femoral fractures?

A
  • retinacular arteries arising from medial circumflex arteries are often torn which supply blood to head and neck of femur
  • sometimes only blood supply is via artery in ligament of the head = avascular necrosis of head of the femur
76
Q

How may dislocation of the femoral head occur?

A
  • uncommon as hip joint stable
  • road traffic accidents if sat down and flexed knee hits dashboard forcing femoral head posteriorly
  • joint capsule ruptures out of acetabulum
  • limb shortened
  • medially rotated
  • associated with fractures to femoral head/neck/acetabulum
77
Q

How do femoral shaft fractures occur?

A
  • require high energy trauma
  • associated with other injuries
  • source of blood loss and release of fat emboli
  • traction for re-aligning bone pieces
  • large thigh muscles go into spasm and contract displacing fragments
78
Q

How can the patella be fractured?

A
  • direct forces = falls

- indirect = embedded in quadriceps tendon so pull of muscles can cause fracture or fragment displacement

79
Q

What is a bipartite patella?

A

Unfused superolateral corner

80
Q

How can a tibia be fractured?

A
  • indirect trauma to tibial shaft when bone turns with foot during a fall
  • severe torsion = diagonal fracture of tibial shaft with fibula fracture
81
Q

How may fractures of the malleoli occur?

A
  • very common at all ages
  • 1 malleoli involved = stable
  • bimalleoli = unstable and added complication is fracture dislocation to talo-crural joint (ankle)
  • lateral more common than medial
  • excessive inversion of foot so ligaments tear on lateral side
82
Q

What is plantar fasciitis?

A
  • Inflammation of the plantar fascia
  • result of overuse
  • plantar surface of foot and heel pain
  • irritated by calcaneal spur at point of attachment

LOCO2 (26 decks)

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