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MRCP Part 1 > Anatomy & Physiology > Flashcards

Anatomy & Physiology Flashcards

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1
Q

Contraction of which muscle causes Ankle Clonus ??

A

Gastronemius (plantar flexion of foot)
(UMN lesion)

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2
Q

Name the muscles causing the following actions
- Extension of lateral 4 toes ??
- Foot Abduction ??
- Evert & Plantar flex the Ankle
- Dorsiflex & Invert the Foot ??

A
  • Extensor Digitorum Longus
  • Fibularis brevis
  • Peroneus longus
  • Tibialis anterior
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3
Q

What is the expected blood volume in ml/kg for a healthy 25 yr old man & woman & Neonate ??

A

75 ml/kg & 65 ml/kg & 85 ml/kg respectively.
- It is determined by muscle mass, fat mass & TBSA
- Increased in pts. with heart failure related to salt & H2O retention
- Reduced in cases of Renal/ GI loss

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4
Q

Which organ drives most of the response to Hypoxia ??

A

Carotid body
- Found near bifurcation of carotid artery; contains Glomus cells
- Type 1 glomus cells detect O2 partial pressure.
- When partial pressure falls < 8kPa, output from glomus increases via afferent fibres of Glossopharyngeal N

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5
Q

How does Aortic arch baroreceptor work ??

A

They are Stretch receptors
- Decreases firing rate when arterial BP decreases => Autonomic response from the Medulla => results in Increase in Sympathetic outflow & Decreases Parasympathetic outflow

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6
Q

How does the Left Atrial stretch receptors work ??

A

Low pressure => (+) ADH production from Hypothalamus
Increased volumes within atria => ANP production => Increases Na= & H2O excretion

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7
Q

How to calculate Osmolality ??

A

Osmolality = (2 * serum[Na]) + [Glucose, in mmol/l] + [Urea, in mmol/l]

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8
Q

Define Osmolarity & Osmolality

A

OsmolaRity : No. of Solute particles per litre of Solvent
OsmolaLity : No. of Solute particles in 1 kg of solvent

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9
Q

Is there a difference b/w Osmolarity & Osmolality ??

A

Dilute solutions : Insignificant
Conc. solutions [eg. high glucose] : Significant & the difference b/w the 2 is calculated

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10
Q

What is the normal S. Osmolality ??

A

275 to 295 mOsm (solute)/Kg (of solvent)

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11
Q

What drives the initial generation of action potential in Muscle cells ??

A

Na+ influx (ACh opens ACh- gated cation channels => large quantities of Na+ to diffuse to the interior of muscle fibre memb. => Depolarization

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12
Q

What is the main pathology seen in Cystic Fibrosis ??

A

Defective Cl- channels known as [CF Transmemb. Conductance Regulator]
- When Cl- cannot be extruded on to the cell surface => secretion becomes abnormally thickened

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13
Q

What is Osmosis ??

A

Passage of SOLVENTS towards a higher conc. of solutes across a semi-permeable membrane

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14
Q

What is Reverse Osmosis ??

A

Passage of SOLUTES from a high to a low conc. across a Semi-permeable memb.

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15
Q

What is Diffusion ??

A

Movt. of molecules from a high conc. to a low conc. in a solvent pool

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16
Q

What is the commonest cause of transfusion-associated morbidity in the UK ??

A

Transfusion Associated Circulatory Overload (TACO)
- It is important to consider fluid balance, with appropriate use of DIURETICS when required
2nd MC is TRALI

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17
Q

Which is the primary stimulator of Resp. Chemoreceptors in brain ??

A

Increased H+ ions
- Medullary chemoreceptors are sensitive to H+ conc. in CSF
- causes increases in RR
In COPD pts., these central receptors can become desensitized to decreases in pH over time => causes CO2 retention in COPD

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18
Q

What changes in the blood are detected by Peripheral chemoreceptors ??

A

Aortic bodies: O2 & CO2 changes
Carotid bodies: O2, CO2 & pH changes

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19
Q

Anatomical relations of Kidneys ??

A

BOTH Kidneys- Posterior: Q lumborum, Diaphragm, Psoas maj., Transversus abdominis
Right Kidney
- Anterior: Hepatic flexure of Colon
- Superiorly: Liver, Adrenal gland
Left Kidney
- Anterior: Stomach, Pancreas tail
- Superiorly: Spleen, Adrenal gland

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20
Q

Features of Kidney anatomy ??

A

11cm long, 5cm wide & 3cm thick
- Located in deep gutter alongside the vertebral projections on the anterior surface of Psoas major
- Left is placed 1.5cm higher then Rt.
- Upper pole: is at 11th rib level (beware of Pneumothorax during nephrectomy)
Hilum:
- Left: L1 level
- Right: L1- L2 level
Lower border = L3 level

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21
Q

Name the fascial coverings of Kidney ??

A

[Kidney + Suprarenals] is enclosed within a common layer- Investing Fascia derived from Transversalis fascia
- It is divided into Anterior & Posterior layers (Gerotas fascia)

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22
Q

Name the tissues that are in direct contact with Rt. & Left kidneys respectively ??

A

Direct contact: Rt. Suprerenal gland, Duodenum, Colon
Layer of peritoneum b/w: Liver, Distal part of Small Intestine
DIrect contact: Lt. Suprarenal gland, Pancreas, Colon
Layer pf peritoneum b/w: Stomach, Spleen, Distal part of SI

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23
Q

What are the main composition of
- ICF ??
- ECF ??

A
  • K+, Mg2+, Organic phosphates (eg. ATP)
  • Na+, Cl-, HCO3-, Albumin

S. Osml= 275- 295 mOsm/Kg H2O
Plasma Vol.= TBV * [1- Hct]

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24
Q

Explain the fluid compartment ??

A

Total body mass = [55- 60%] Water + [40- 45%] non-water mass
Out of [55- 60%] Water
- 1/3rd ECF + 2/3rd ICF
Out of 1/3rd ECF
- 75% Interstitial fluid
- 25% Plasma
Out of 2/3rd ICF
- 10% id RBCs
Blood vol.- Plasma + RBCs (6l)

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25
Structures at Renal Hilum ??
[Anterior ===> Posterior] Renal vein => Renal artery => Ureter
26
Str. of Glomeruli ??
Responsible of filtration of plasma by Size & Charge selectivity Composed of - Fenestrated capillary endothelium - BM with Type 4 collagen & Heparan sulfate - Visceral epithelial layer has Podocyte Foot processes
27
Explain the Features of - Charge barrier - Size barrier
1)- GF barrier has (-)ve charged glycoproteins that prevent entry of (-)ve charged molecules (eg. Albumin) 2)- Fenestrated capillary endothelium (prevents entry of >100nm molecules /blood cells; Podocyte foot processes interpose with GBM; Slit diaphragm (prevents entry of molecules > 40- 50nm)
28
What is the Effect of - PGs ?? - Angiotensin II ??
'PDA ACE' - PGs Dilate Afferent arteriole - A-II Constricts Efferent arteriole
29
Elaborate the Arterial & Venous system of Kidneys
Receives 25% of resting Cardiac O Renal A => Segmental A => Interlobar A => Arcuate A => Interlobular A => AFFERENT arteriole => Glomeruli => Efferent Arteriole => Peritubular capillaries & Medullary Vasa recta =========> Interlobular V => Arcuate V => Interlobular V => Renal Vein
30
Hallmark of Kidney blood supply ??
Left Renal Vein receives 2 additional veins - Lt. Suprarenal vein - Lt. Gonadal vein Left Kidney is taken during live donor transplant as it has a LONGER renal vein
31
Which part of Kidney is very sensitive to Hypoxia ??
Renal MEDULLA (as it receives significantly less blood flow than cortex) - TUBULAR Cells are more prone to Ischaemia
32
How does Kidneys regulate its Blood flow ??
Myogenic control of arterial tone - By Sympathetic input & Hormones (eg. Renin) - Cortical blood flow >> Medullary blood flow (ie Tubular cells more prone to ischaemia)
33
What is Renal Clearance ??
Vol. of Plasma from which a substance is removed per minute by the kidneys
34
How is GFR calculated ??
Total vol. of plasma per unit time leaving the capillaries & entering the Bowman's capsule. - Assuming that solute is freely diffused eg.- Inulin In practice, CREATININE is used as it is subjected to little PCT secretion normal GFR = 125ml/min
35
What features should a substance have in order to use it for GFR calculation ??
- Inert - Free filtration from plasma at the glomerulus (not protein bound) - Neither Absorbed nor Secreted at tubules - Plasma conc. constant during urine collection Eg.- Inulin, Creatinine
36
GFR formulae ??
[Urine conc.*Urine Vol.](mmol/l)/ Plasma conc. (mmol/l) - Clearance of a substance is dependent not only on its Diffusivity across BM but also on Tubular secretion &/or reabsorption
37
Which substance is used to measure Renal Plasma flow & why ??
Solutes like Para-AminoHippuric Acid is used as they are cleared with a single passage through the kidneys
38
Transport physiology of PCT ??
Early PCT- contains brush borders - Reabsorbs ALL Glucose & AminoA - Most HCO3-, Na+, Cl-, PO4-, K+, H2O & Uric acid - Generates & Secretes NH3, which enables kidney to excrete (via secretion) more H+ PTH= (-) Na+/PO4- co-transport => Increased PO4- excretion AT-II = (+) Na+/H+ exchange => Increased Na+, H2O & HCO3- reabsorption (permits Contraction Alkalosis) 65-70% Na+ & H2O is reabsorbed
39
Transport physiology of Thin Descending L of H ??
Reabsorbs H2O (passively) via Medullary Hypertonicity (IMPERMEABLE to Na+) - Concentrating segment => makes urine Hypertonic
40
Transport physiology of Thick Ascending L of H ??
- Reabsorbs Na+, K+ & Cl- - Indirectly induces reabsorption of Mg2+ & Ca2+ through (+) lumen potential generated by K+ backleaks - IMPERMEABLE to H2O - Makes urine LESS conc. as it ascends - 10- 20% of Na+ reabsorbed
41
Transport physiology of Collecting Duct ??
- Reabsorbs Na+ in exchange for K= & H+ secretion (regulated by ALDOSTERONE) - ADH- acts at V2 receptors => insertion of Aquaporin H2O channels on APICAL side - 3- 5% of Na+ is reabsorbed
42
Transport physiology of DCT ??
Early DCT - Reabsorbs Na+, Cl- - IMPERMEABLE to H2O - Makes urine fully dilute - PTH = increase Ca2+/Na+ exchange => increased Ca2+ reabsorption - 5- 10% of Na+ reabsorbed
43
Name to what substance is the following part of nephron is impermeable to - Thin Descending L of H ?? - Thin Ascending L of H ?? - Thick Ascending L of H ?? - Early DCT ??
- Impermeable to Na+ & is the Concentrating segment - Impermeable to H2O but highly permeable to Na+ & Cl- ions -Impermeable to H2O & makes urine less conc. as it ascends up. Energy dependent reabsorption of Na+ & Cl- helps to maintain osmotic gradient -Impermeable to H2O & makes urine fully dilute
44
In which parts of kidney does PTH act & on what transporters ??
Early PCT - (-) Na+/PO4 co-transport => Increased PO4- excretion Early DCT - Increases Ca2+/Na+ exchange => Increases Ca2+ reabsorption
45
Mention the MC types of Urinary Casts
RBC Cast : Glomerulonephritis, Renal Ischaemia & Infarction WBC Cast : Acute Pyelonephritis, Interstitial nephritis Granular (Muddy brown) Cast : ATN Epithelial Cast : ATN Hyaline Cast : - Common & Non-specific; - may be seen after Exercise or Dehydration Waxy Cast : Advanced CKD Fatty Cast : Nephrotic Syndrome
46
Name on which receptors does the following substances act - SGLT-2 inhibitor - Angiotensin II - Acetazolamide - Loop Diuretics - Thiazide - Amiloride - Triamterene - ADH - Aldosterone (K+ sparring D inhibits this receptors)
- (-) Na+/Glucose transporter at PCT - (+) Na+/H+ at PCT - (-) CA - (-) Na+/K+/2Cl- at Thick Ascending L - (-) Na+/Cl- at DCT - (-) Na+ channels at CD - (-) Na+ channels at CD - acts at V2 receptors at CD => inserts Aquaporin H2O channels on Apical side - Increases Epithelial Na+ channel (ENaC) activity at CD => Lumen negativity => K+ secreted; & in Alpha-intercalated cells at CD => Lumen (-)vity => Increase H+ ATPase activity => Increases H+ secretion => Increase HCO3-/Cl- exchanger activity
47
What is the effect of Urinary pH on Stone formation ??
Urine pH varies from 5 to 7 - Post-prandially, pH falls as Purine metabolism will produce Uric acid; later it becomes more alkaline (Alkaline tide) Stone type = U acidity = Mean U pH. - Uric Acid. = Acid = pH 5.5 - Cystine = Normal = pH 6.5 - CaPO4 = Normal-Alkaline = pH >5.5 - Struvite = Alkaline = pH > 7.2 - Ca Oxalate= Variable.= pH 6
48
MCC of AKI ??
ATN: Necrosis of renal tubular epithelial cells, severely affects the functioning of the kidney 2 causes: Ischaemia & Nephrotoxins - Ischaemia- Shock & Sepsis - Nephrotoxins: Aminoglycosides, Myoglobin secondary to rhabdomyolysis, Radiolucent agents, Lead
49
Phases of ATN & HP features of ATN ??
- Oliguric - Polyuric - Recovery HP features - Tubular epithelial necrosis: Loss of nuclei & detachment of tubular cells from BM - Dilatation of Tubules - Necrotic cells obstruct the tubule lumen
50
What is Collagen & its main types ??
Main structural protein found in connective tissue & is the MC protein found in body; synthesised by FIBROBLASTS Type 1: Bone, Skin, Tendon Type 2: Hyaline cartilage, Vitreous humour Type 3: Reticular fibre, Granulation tissue Type 4: Basal lamina, Lena, Basement membrane Type 5: Most Interstitial tissue, Placental tissue
51
What are the Associated pathological conditions with Collagen defect ??
Type 1: Osteogenesis Imperfecta Type 3: Vascular variant of Ehler- Danlos syndrome Type 4: Alport & Goodpasture synd. Type 5: Classical variant of Ehler- Danlos syndrome
52
What is the structure of Collagen ??
Composed of 3 polypeptide strand, woven into helix; a combination of Glycine + Proline/Hydroxyproline + another Amino Acid - Additional strength: H+ bonds - MC type is Type 1 - Tissue with increased level of flexibility have increased Type 3 - Vit C is imp. for cross-linking
53
What is Homocystinuria ??
Rare A R disease caused by deficiency of Cystathionine Beta Synthase - Leads to severe elevation in Plasma & Urine Homocysteine conc. Rx. - Vit B6 (PYRIDOXINE) supplements
54
55
56
Features & of Homocystinuria ??
Fine fair hairs Musculoskeletal - Marfanoid body habitus - Osteoporosis. - Kyphosis CNS: Learning difficulty & Seizures Ocular: Infranasal lens dislocation, severe myopia Increased risk of Arterial & V TE Malar flush, Livedo reticularis
57
Vit B6 & the consequences of deficiency ??
Water soluble vitamin; which is converted to Pyridoxol phosphate (PLP) which is a co-factor for many reactions including - Transamination, Deamination, Decarboxylation Peripheral Neuropathy, Sideroblastic anaemia
58
Ix. of Homocystinuria ??
Increased Homocysteine levels in serum & urine Cyanide-Nitroprusside test: also (+)ve for Cystinuria
59
What is Vit. B1 called ??
Thiamine is a water soluble vit. One of its phosphate derivatives, Thiamine Pyrophosphate (TPP) is a co-enzyme in various aerobic reactions - Imp. for Catabolism of Sugars & Amino acids - Deficiency are therefore seen in HIGHLY Aerobic tissues like Brain (Wernickes-Korsakoff) & Heart (Wet beri-beri)
60
Vit. B3 & the consequences of its deficiency ??
Niacin is a H2) soluble vit. Is a precursor of NAD+ & NADP+ & plays an essential metabolic role - HARTNUP'S disease: Hereditary disease which reduces absorption of Tryptophan - Carcinoid Synd.- Increased Tryptophan metabolism to Serotonin Deficiency causes PELLAGRA - Dermatitis, Diarrhoea, Dementia
61
Angular cheilitis is caused by which vit. deficiency ??
Riboflavin (Vit. B2) - Is a cofactor of Flavin adenine dinucleotide (FAD) & Flavin Mono- nucleotide (FMN)
62
Consequences of B1 deficiency ??
- Wernicke's E: Nystagmus, Ataxia, Ophthalmoplegia - Korsakoff's: Wernocke's + Amnesia + Confabulations - Dry beriberi: Peripheral neuropathy - Wet beriberi: Dilated Cardio-M
63
Iron distribution in Body ??
Total Body Iron: 4g Hb : 70% Ferritin & Haemosiderin : 25% Myoglobin : 4% Plasma Fe : 0.1%
64
Tell the following about Fe - Absorption ?? - Transport ?? - Storage ??
Upper SI (Duodenum) 10% of dietary Fe absorbed Fe2+ (Ferrous) absorbed much better than Fe3+ (Ferric) Transport:- Bound to Transferrin as Fe3+ Storage form :- Ferritin Excretion: via Intestinal tract De-squamation
65
Mechanism of Met. Alkalosis ??
RAAS activation is the key factor ECF depleted (Vomiting, Diuretics) => Na+ & Cl- loss => RAAS activation => Raised Aldosterone levels => Reabsorption of Na+ in exchange for H+ in DCT In Hypo K+, K+ shifts from cells to ECF => H+ moves into cell to maintain Neutrality => Alkalosis
66
What are the Vomiting centres ??
NTS in Medulla => receives inf. from - CTZ located in area Postrema in 4th ventricle - GI tract via Vagus. - CNS - Vestibular system. CTZ & adjacent vomiting centre nuclei receive input from 5 receptors - H1 , M1, NK-1 (Neurokinin), D2, 5-HT3 (Serotonin)
67
Name against which receptors doe the following drugs - Chemotherapy- induced vomiting - Motion sickness - Hyperemesis gravidarum
- 5-HT3 (Serotonin), D2, NK-1 antagonists - H1 & M1 antagonists - H1 antagonists
68
What are the stages of Sleep cycle ??
Sleep occurs in 4-6 cycles per night; each lasting 90 min + 2 main stages - NREM sleep. - REM sleep (duration of REM increases through the night) Circadian rhythm is driven by Suprachiasmatic Nucleus (SCN) of Hypothalamus - Low light => decrease SCN activity => increase NE from Superior Cervical Ganglion => Increase Melatonin from Pineal gland
69
Mention the Sleep stages & the waves a/w it.
AWAKE: - Eye open- Beta (high freq. low amp.) - Eye closed- Alpha N-REM Sleep - N1 (5%): Light sleep; THETA - N2 (45%) Deeper; Sleep Spindles & K complexes; Bruxism occurs - N3 (25%): Deepest NREM (slow-wave ; DELTA; Bedwetting, Sleep walking. & Night TERROR REM Sleep - Loss of Motor tone, Increased brain O2 use - Extraocular eye movt. due to activity in PPRF - Memory Processing function - Dreaming, NightMARES - Penile/ Clitoral tumescence
70
In which phase of sleep do we see the following waves - Beta wave ?? - Alpha wave ?? - Theta wave ?? - Sleep spindles & K complex ?? - Delta wave ?? - Night terrors ?? - Nightmares ?? - Bruxism ??
- Eyes Open (Highest freq. & Lowest amp.) - Eyes Closed - NREM- N1 - NREM- N2 - NREM- N3 (Lowest freq. & Highest amp.) - NREM- N3 - REM - NREM- N2
71
Which phase of Sleep cycles does the following affect ?? - [-OH], BZPs, Barbiturates ?? - Aging ?? - Depression ?? - Narcolepsy ??
- Decrease N3 & REM - Decrease N3 & REM, increase sleep-onset latency, Early morn. awakening - Decrease N3 & Increase REM sleep & Decrease REM latency; repeated nighttime awakenings & early morn awakening (Terminal Insomnia) - Decrease REM latency
72
Functions of Hypothalamus ??
Maintain homeostasis by regulating "TAN HATS" - Thirst & water balance - Adenohypophysis control (Anterior Pituitary) - Neurohypophysis control (Poste. P) - Hunger. - Autonomous Nervous S - Temperature. - Sexual urges
73
Function of Thalamus ??
Major RELAY for all Sensory information except Olfaction
74
What are the parts of Cerebellum ??
Modulates movt., aids in Coordination & Balance - Medial (eg Vermis) controls Axial & Proximal limb muscles B/L - LATERAL (ie. hemisphere) controls Distal limb muscles I/L Tests: Rapid alternating movt. (Pronation/Supination), Finger-to-nose, Heel-to-shin, Gait, Look for Intention tremors
75
Functions of Basal Ganglia ??
Voluntary functions & Adjusting posture - Striatum = Putamen (motor) + Caudate nucleus (cognitive) - Lentiform nucleus = Putamen + Globus pallidus
76
From what level does the CNs exits from ??
CN 1, 2, 3, 4: arise from Above Pons (3 & 4 exits from Midbrain) CN 5, 6, 7, 8: exits from Pons CN 9, 10, 11, 12: Medulla 4 CNs are positioned Medially - 12, 3, 4, 6
77
Where are the CNs nuclei located ??
Located in TEGMENTUM portion of Brainstem (b/w Dorsal & Ventral portions) - Midbrain: Nuclei of CN 3, 4 - Pons: CN 5, 6, 7, 8 - Medulla: CN 9, 10, 12 - Spinal Cord: CN 11 Lateral nuclei = SENSORY (aLar plate) Medial nuclei = MOTOR (Basal plate)
78
Functions of Superior & Inferior Colliculi ??
Superior C : Direct eye movt. to stimuli (noise, movt.) or Objects of interest Inferior C : Auditory
79
Name the blood supplies of CNs
MEDIAL CNs - CN 3, 4 : PCA - CN 6 : Basilar - CN 12 : Anterior Spinal LATERAL CNs - CN 5, 7, 8 : Labyrinthine & AICA - CN 9, 10, 11 : Vertebral & PICA
80
Name the following about CNs - Sensory CNs ?? - Motor CNs ?? - Mixed ??
- CN 1, 2, 8 (Olfactory, Optic, Vestibulo-cochlear) - CN 3, 4, 6, 11, 12 (Oculomotor, Trochlear, Abducens, Accessory, Hypoglassal) - CN 5, 7, 9, 10 (Trigeminal, Facial, Glossopharyngeal, Vagus)
81
Name the Afferent & Efferent CNs of the following reflexes respectively
Accommodation & Pupillary : 2 === 3 Corneal: V1 Ophthalmic (Nasociliary branch) == B/L 7 (temporal & zygomatic branches- Orbicularis oculi JAW Jerk: V3 (sensory- Masseter muscle spindle) == V3 Motor- Masseter) LACRIMATION: V1 (loss of reflex does not preclude emotional tear) == CN 7 Cough: CN-10 == CN-10 + Phrenic & Spinal nerves GAG: CN-9 == CN-10
82
Name the Mastication muscles
3 muscles close the jaw - Masseter, Temporalis, Medial Pterygoid Jaw Protrusion - Lateral Pterygoid ALL are supplied by CN- V3
83
How may Spinal nerves are there in our body ??
31 pairs of Spinal nerves - Cervical: 8. - Thoracic: 12 - Lumbar: 5. - Sacral: 5 - Coccygeal: 1 Nerves C1 to C7 exit ABOVE the corresponding Vertebrae (eg., C3 exits above 3rd C vertebrae) C8 nerve exits from BELOW C7 & ABOVE T1 ALL other nerves exit BELOW (eg., L2 exits below the 2nd L vertebrae)
84
Layers the LP needle has to pass through to reach the Subarachnoid space ??
Adults: S Cord ends at lower border of L1- L2 vertebrae Site of LP: L3- L4 or L4- L5 - Skin - Fascia & fat - Supraspinous ligament - Interspinous ligament - Ligamentum flavum - Epidural space: Epidural anaesthesia needle stops here) - Dura mater - Arachnoid mater - Subarachnoid space: CSF collection occurs here
84
What is Conus medullaris syndrome & Cauda equina syndrome ??
COMPRESSION of - Terminal end of S Cord C medularis: Conus medullaris syndrome - Lumbosacral nerve roots: Cauda E C/F - Radicular low back pain, Saddle/ Perianal anaesthesia, Bladder & Bowel dysfunction & LL weakness LL weakness - Symmetric + UMN signs: Conus M - Asymmetric + LMN signs: Cauda E
84
Erb-Duchenne paralysis
Damage to C5, C6 roots - Winged Scapula - Caused by BREECH Presentation
85
85
Klumpke's Paralysis
Damage to C8, T1 root - Loss of Intrinsic muscles of hand - caused by TRACTION (ABDucted arm pulled away from body) - Adults: Hanging from tree
86
Proximal Median Nerve injury ?? Distal Median N Injury ??
- Sensory loss over Thenar eminence + Motor loss of - Wasting of thenar eminence (sensation preserved) & sensory loss over 2nd & 3rd finger tips
87
Proximal Radial Nerve injury ?? Distal Radial N Injury ??
- Humerus # : Wrist drop + Weakness of thumb & finger extension - At wrist: Loss of sensation over Dorsal & radial portion of the hand, dorsal thumb & dorsum of index finger. Motor function is intact
88
Cervical Spondylolysthesis ??
Forward displacement of vertebrae (often after a Trauma) - Dorsal column features seen: Loss of vibration & joint proprioception
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MRCP Part 1 (26 decks)

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