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Musculoskeletal, skin, and connective tissue > Anatomy and physiology > Flashcards

Anatomy and physiology Flashcards

(94 cards)

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1
Q

Dislocation of what wrist bone leads to acute carpal tunnel syndrome?

A

Lunate

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2
Q

What wrist bone is most likely to be fractured?

A

Scaphoid

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3
Q

What wrist bone is most susceptible to necrosis due to retorgrade blood supply?

A

Scaphoid

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4
Q

What is the most common sports injury due to lateral force applied to planted leg?

A

Unhappy triad (Lateral meniscus tear is the most common knee injury)

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5
Q

What is the unhappy triad

A

ACL, MCL, and Medial meninscus tear

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6
Q

Where is a baker cyst?

A

Popliteal area

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7
Q

Lateral epicondylitis comes from over use of what motion?

A

Repetitive extension

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8
Q

Medial epicondylitis comes from over use of what motion?

A

Repetitive flexion

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9
Q

Name four causes of carpal tunnel syndrome

A

Overuse, pregnancy, hypothyroidism, RA

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10
Q

Gunyon canal syndrome

A

Ulnar nerve compression (cyclists)

Bikers race down gunyon canal

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11
Q

Mneumonic for brachial plexus roots

A 
3 Muskateers (Musculoskeletal) C5 C6 C7
Assassinated (Axillary) C5, C6
5 rats (radial) C5-T1
5 mice (median) C5-T1
and 2 unicorn (ulnar)-C8, T1
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12
Q

Mnuemonic for brachial plexus

A

Randy Travis Drinks Cold Beers

Roots, trunks, divisions, cords, branches

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13
Q

Axillary nerve damage caused by what injury?

A

Fractured surgical neck of humerus

Anterior dislocation of humerus

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14
Q

Axillary nerve damage presentation?

A

Deltoid damage–>can’t abducted arm past 15 degrees

Loss of sensation over deltoid muscle and lateral arm

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15
Q

Musculocutaneous nerve damage caused by what injury?

A

Upper trunk compression

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16
Q

Musculocutaneous nerve damage presentation?

A

Can’t flex/supinate the forearm

Sensory loss over lateral forearm

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17
Q

Median nerve damage caused by what injury?

A

Supracondylar fracture of humerus (proximal lesion)
Carpal tunnel syndrome
Wrist laceration (distal)

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18
Q

Median nerve damage presentation?

A

Loss of wrist and lateral finger flexion

Loss of sensation over thenar eminence and dorsal/palmar aspects of lateral 3.5 fingers

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19
Q

Ulnar nerve damage caused by what injury?

A

Medial epicondyle of humerus

Hook of the hamate

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20
Q

Ulnar nerve damage presentation?

A

Loss of wrist flexion
Loss of medial finger flexion
Can’t adduct or abduct fingers (interossei)

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21
Q

Erb palsy

A

Waiters tip-C5, C6
internal rotation and adduction of arm
flexion of wrist
Occurs during delivery of big baby or trauma of an adult

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22
Q

Klumpke palsy

A

C8-T1
Humpty klumpty (falls off a wall and grabs a tree branch to break his fall) or upward form on arm during delivery
total claw hand

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23
Q

Thoracic outlet syndrome

A

claw hand+ compression of subclavian vessels (can be due to pancoast tumor or cervical rib)

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24
Q

Winged scapula

A

Lesion of long thoracic nerve- C 5, 6, 7 brings the arms to heaven

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25
Thenar and hypothenar eminence do what?
Oppose, Abduct, and Flex (OAF)
26
TIP and PED mneumonics
Tibial n-inverts and plantarflexes | Peroneal n-everts and dorsiflexes
27
Gene associated with achondroplasia
FGFR3 activation-->inhibition of chrondocyte proliferation
28
Osteopetrosis
Failure of normal bone resorption due to defective osteoclasts Bone marrow transplant may be curative because osteoclasts are derived from monocysts
29
Paget disease
Increase in osteoblast and osteoclast activity Normal lab values except an increase in Alk phos. Increased risk of osteosarcoma Mosaic, chaotic pattern of bone remodeling
30
Most common site of osteonecrosis?
Femoral head (due to infarction of the medial circumflex femoral artery)
31
Buzz words associated with osteosarcoma
Pagets disease is a precursor Codman's triangle Aggressive Bimodal age distribution
32
Buzz words associated with Ewing sarcoma
Young boys Diaphysis of long bones, pelvis, scapula, ribs Small blue cell malignant tumor t(11:22) translocation-->EWS-FL11 fusion protein
33
Genetic HLA associated with RA?
HLADR4
34
Most specific antibody test for RA
Anti-cyclic citrullinated peptide
35
Gout is a precipitation of what into the joints?
Monosodium urate crystals
36
Pseudogout is a precipitation of what into the joints?
Calcium pyrophosphate crystals | Large joints
37
Seronegative spondyloarthropathies
``` PAIR Psoriatic arthritis Ankylosing spondylitis IBD Reactive arthritis (Reiter syndrome) ```
38
Seronegative spondyloarthropathies associted with what gene? demographic? RA+?
HLAB27 More common in males RA -
39
Psoriatic arthritis buzz words
sausage fingers pencil in cup Asymmetric/patchy involvement
40
Ankylosing spondylitis
Chronic inflammation of sacroiliac and spine joints "bamboo spine" Uveitis (eye) Aortic regurgitation
41
What seronegative is associated with IBD
Ankylosing spondylitits or eripheral arthritis
42
Reactive arthritis, aka? classic triad?
``` Reiter syndrome (Post GI/chlamydia infections) Can't see, can't pee, can't bend my knee ```
43
SLE classic presentation
Malar rash, joint pain, fever in female reproductive age and African descent
44
Heart associated dz with SLE
Libman-Sacks endocarditis (nonbacterial, valvular vegetations) Asymptomatic
45
Kidney associated dz with SLE
Lupus nephritis: Type III hypersensitivity (Decrease in C3, C4, CH50) - Nephritis-diffuse proliferative glomerulonephritis - Nephrotic-membranous glomerulonephritis
46
Sensitive (not specific) antibody marker for SLE
ANA (antinuclear antibody)
47
Specific antibody marker for SLE
``` ds DNA (poor prognosis) smith antibody--SnRPs (not prognostic) ```
48
Sensitive for drug-induced lupus
Anti-histone antibodies
49
SLE treatment
NSAIDs, steriods, immunosuppressants, hydroxychloroquine
50
Antiphospholipid syndrome symptoms
History of thrombosis Spontaneous abortion Lupus anticoagulant, anticardiolipin, anti B2-glycoprotein antibodies Treat with systemic anti-coagulation
51
Polymyalgia rhuematica
Pain and stiffness in large joints such as hips, shoulders (Elevated ESR and CRP) No muscle weakness (normal CK) Associated with temporal cell arteritis
52
Polymyositis/Dermatomyositis lab values
Elevated CK, +ANA, +anti-Jo1, +anti-SRP, +anti-Mi2
53
Polymyositis symptoms
Progressive muscle weakness with endomysial inflammation and CD8+ cells. Most often shoulders
54
Dermatomyositis
Same symptoms as polymyositis but with malar rash, gottron papules, heliotrope (periorbital rash) Perimysial inflammation and atrophy with CD4+ T cells
55
What is Myasthenia gravis associated with?
Thymoma and thymic hyperplasia
56
What is Lambert-Eaton myasthenic syndrome associated with?
Small cell lung cancer
57
Most common cause of death in scleroderma?
Pulmonary sclerosis
58
What antibody is associated with diffuse scleroderma?
Scl-70 antibody (anti-DNA topoisomerase I)
59
What antibody is associated with limited scleroderma?
Anti-centromere antibody
60
Acanthosis
Epidermal hyperplasia (^Spinosum)
61
Albinism
Normal melanocyte number, decreased melanin production Decreased tyrosinase activity or defective tyrosine transport. Also can be caused by a failure of neural crest cell migration during dev.
62
Virtiligo
autoimmune destruction of melanocytes
63
Psoriasis
Acanthosis with parakeratotic scaling | Auspitz sign-pinpoint bleeding spots
64
Rosacea
Erythematous papules and pustules No comedones Associated with facial flushing
65
Verrucae
Epidermal hyperplasia, hyperkeratosis, koilocytosis-->^N/C ratio, hyperchromatic nucleus etc.
66
Erysipelas
Upper dermis and superficial lymphatics infection. Typically from Staph pyogenes Well-defined demarcation
67
Necrotizing fasciitis
From anaerobic bacteria or staph pyogenes
68
Scaled skin syndrome
Staphylococcal exotoxin that destroy attachments in the stratum granulosum only
69
Hairy leukoplakia
Irregular, white plaques on tongue that can't be scrapped off. (vs. thrush which is very scrapable)
70
Pemphigus vulgaris
IgG reaction to desmoglein on desmosomes. | + Nikolsky sign, net like IF pattern , oral mucosa involved
71
Bullous pemphigoid
IgG reaction to hemidesmosomes (on BM) Tense blisters, spare oral mucosa, linear patter on IF -Nikolsky sign
72
Dermatitis herpetiformis associated with what disease
Celiac disease
73
Dermatitis herpetiformis pathology
Pruritic pupules, vesicles, and bullae. | Deposits of IgA at tips of dermal papillae
74
Erythema multiforme
Associated with infections (Mycoplasma pneumoniae, HSV) | Many target lesions
75
Steven-Johnson syndrome
Fever, bullae formation, necrosis, sloughing of skin and high mortality rate. Targetoid skin lesions like erythema multiforme. Typically with adverse drug reation can progress to toxic epidermal necrolysis (>30% body surface area)
76
Acathosis nigricans
Associated with hyperinsulinemia and visceral malignancy
77
Lichen Planus
Pruritic, purple, polygonal, planar, papules, plaques | Reticular white lines on mucosal surfaces
78
Sunburn
UVB-burning UVA-tanning/photoaging Causes DNA mutation inducing apoptosis of keratinocytes
79
Basal cell carcinoma
Most common type of skin cancer. Often on upper lip. Pink, pearly nodules with telangiectasias, rolled borders. H/E=palisading nuclei
80
Squamous cell carcinoma
Second most common type of skin cancer. Lower lip, ears, hands H/E-Keratin pearls
81
Actinic keratosis
Scaly plaque that is a precursor to squamous cell carcinoma
82
Keratoacanthoma
Variant of actinic keratosis that grows very rapidly 4-6 weeks and can regress over months
83
Melanoma
S-100 marker. | Four types of melanoma often driven by activating mutation in BRAF kinase
84
What do you give people with metastatic or unresectable melanoma in patients with BRAF V600E mutation?
Vemurafenib-BRAF kinase inhibitor
85
Nerve and artery in the axilla
Long thoracic n., lateral thoracic artery
86
Nerve and artery in the Surgical neck of humerus
Axillary n., posterior circumflex artery
87
Nerve and artery in the Midshaft of humerus
Radial n., deep branchial artery
88
Nerve and artery in the Distal humerus
Median n., Branchial artery
89
Nerve and artery in the popliteal fossa
Tibial n., Popliteal artery
90
Nerve and artery in the Poterior to medial malleolus
Tibial n., Posterior tibial artery
91
What does NO activate in smooth muscle?
Guanylate cyclase
92
What does gunaylate cyclase activate in smooth muscle
cGMP
93
What affect does cGMP has on smooth muscle
Activates myosin-light chain phosphatase
94
What affected does myosin-light chain phosphastase have on smooth muscle
dephosphorylates myosin-->relaxation

Musculoskeletal, skin, and connective tissue (3 decks)

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