Block 1 Flashcards
(231 cards)
1
Q
What accompanies downward and lateral displacement of scapula?
A
Narrowing of inferior scapulohumeral angle
2
Q
Injury to what nerve causes weakness of rhomboids?
A
dorsal scapular nerve
3
Q
What nerve is injured if weakness during medial rotation and adduction of humerus?
A
thoracodorsal nerve (latissimus dorsi injury)
4
Q
complication of cisternal puncture procedure
A
injure vertebral artery, compress greater occipital nerve, compress suboccipital nerve
5
Q
Large tumor in suboccipital region compresses nerves that do what?
A
parasthesia of skin over neck and head
6
Q
What protein is likely missing in skeletal contraction if tropomyosin can not be removed?
A
troponin
7
Q
What disorder blocks ACh receptors at neuromuscular junctions?
A
Myasthenia Gravis
8
Q
Presentation of Myasthenia Gravis
A
droop of eyelid, double vision, swallow difficulty
9
Q
What disease causes muscles to undergo destructive atrophy (change to fat and connective tissue)?
A
Muscular Dystrophy
10
Q
What disease presents in early childhood and involves a mutation for dystrophin?
A
Duchenne muscular dystrophy
11
Q
Defect of dystrophin in DMD cause what to occur?
A
sarcolemma tears in muscle
calcium influx causes cell degeneration/death
myocytes get replaced with fat and connective tissue
12
Q
Characterization of Becker’s Muscular Dystrophy
A
slow progression of pelvic & leg muscle weakness
13
Q
Positioning of lumbar puncture/spinal cord & dangers
A
recumbent or sit with spine flexion @L3
hemorrhage or traumatic tap cause blood in sample
14
Q
Indication of bacterial infectionn in CSF
A
reduced glucose, increased protein, elevated lymphocyte, cloudy appearance
15
Q
indication of viral infection in CSF
A
increased protein, increased lymphocytes
16
Q
indication of fungal infection CSF
A
reduced glucose, increased protein, increased lymphocytes, filaments in solution
17
Q
What typically cause vertebral arch fractures
A
lateral forces compress lateral mass between occipital condyles
can also rupture transverse ligament
18
Q
Hangman fracture
A
bony column (superior and inferior artiuclar processes of axis)
19
Q
Spondylosis C2
A
defect/stress fracture in pars interarticularis
hyperextension of head on neck
20
Q
Caudal Epidural anesthesia location
A
fat of sacral canal surround proximal portion of sacral nerve
sacral cornua & inferior to S4 spinour process
21
Q
where do osteophytes often occur in vertebrae
A
margins of vertebral body
22
Q
Spondylolisthesis
A
dislocation between adjacent vertebrae
press on or injure spinal cord/nerves
23
Q
Spondylolisthesis common where
A
L5-S1 of IV joint
area prone due to downward tilt
pressure on spinal nerve of cauda equina
24
Q
herniation of nucleus pulposus
A
common low back/limb pain
lower lumbar & lower cervical most common
posterolateral through annulus fibrosis
compress spinal nerve roots one number below involved disk
25
Dowager hump
excessive thoracic kyphosis in older women from osteoporosis
26
Clinical significamce of axonal transport
PNS neuropathies spread (chicken pox, shingles, rabies, herpes)
neurodegrnerative disease
can deliver gene therapy
27
Common demyleinating disorders
peripheral neuropathy, multiple sclerosis, B12 deficiency, re-hydrate too fast
28
muscle action during clavicular fraction
SCM pulls medial aspect superior
Trapezius attach to humerus pulls inferior
deltoid can pull inferior
subclavius serves as protection for subclavian nerve
29
clavicular fracture can injure what surrounding structures?
subclavian nerve, axillary artery
30
Humerus greater tubercle fractures involve what muscles
supraspinatus, infraspinatus, teres minor
31
humerus lesser tubercle fracture involve what muscles and complications
subscapularis muscle
posterior dislocation & bone fragmentation
32
fracture of anatomical neck of humerus complication
damage axillary nerve, posterior humeral circumflex artery & vein (quadrangular space)
33
Midhumeral shaft fracture consideration
injure radial nerve & deep brachial artery
do not paralyze tricep
34
supracondylar humerus fracture consideration
displacement of fragment
injure median nerve & radial nerve
35
Wrist drop injury due to what
radial nerve palsy
compression of radial nerve
36
Decreased reflex response indicates problem in what?
muscle spindle
37
clincal apply of golgi tendon organ reflex
isometric contraction of hypertonic muscle engage inhibitory reflex circuit of spinal cord, inhibits low motorneusons
38
What shoulder muscle more vulnerable to tears and impingement?
supraspinatus
39
Rotator cuff muscle that injury to causes significant bleed
subscapularis
supply by subscapular artery
40
Jobe Test
abduction of arm to 90, internal rotation
assess rotator cuff injury (supraspinatus) if pain/weakness
41
rotator cuff tear
repetitive overhead activity or acute trauma
pain, weakness, limited ROM
42
shoulder impingement syndrome
compress RC tendon betwen humeral head & acromion
inflammation, pain, decreased function
43
frozen shoulder (adhesive capsulitis)
progressive stiffness & loss of motion
freeze, frozen, thaw stages
trauma, stresss, laxity of
44
glenohumeral instability
excess movement
lead to subluxation or dislocation
from trauma, stress, laxity congenitally
45
Poland syndrome
congenital absence of pectoralis majoor, often with hand defect
46
Thoracoacromial artery clinical significance
collateral vessel in case of axillary artery obstruction
47
Lateral thoracic artery clinical significance
Accompanied by long thoracic nerve and both can be damaged during surgery, especially breast reconstruction
48
subclavius muscle clinical significance
Protect the vascular and nerve underneath
49
auxiliary vein clinical importance
Central Venus catheter, can be involved in upper limb DVT
50
clinical significance of pectoral nerves
Injury occurs during mastectomy, or auxiliary, no dissection, results in weakness of pectoral muscles, which affects adduction and internal rotation
51
clinical significance of thoracic nerve
Injury to nerve paralyzes muscle and causes winging of scapula
52
intercoastal, brachial nerve clinical significance
Sacrificed and auxiliary, lymph node, dissection, causing numbness and upper inner arm and causes pain post mastectomy
53
what vein typically allows breast cancer to spread
Auxiliary vein as most Venus drainage flows through it
54
Effect of lymphedema
Swelling thickened leather, like skin with dimple, orange peels, deviation of nipple
55
nerve for sucking reflex
Fourth in coastal nerve into nipple and Ariola
56
pathogenesis of osteoarthritis
Age related decline formation of articular cartilage.
Loss of pro gin, content, and less fluidity next sentence contra trigger, excessive activation of met low protein, aces in increased degradation
57
where does osteoporosis occur?
In the cancellous bone or spongy bone
58
repair of fracture pathology
1) formation of hematoma
2) reinvasion of blood vessels formation of fibrocartilage callus
3) osteoblast form new compact bone
4) osteoclast form new cancellous bone
59
Osteomalacia
Calcium deficiency, causing soft bones and deformation due to paired remodeling
60
rickets
Calcium deficiency and kids due to diet deficient of vitamin D
61
osteogenesis imperfecta
Genetic disorder with defective or insufficient, collagen integration into bone matrix
62
osteoporosis/Albers Schoenberg disease
Defective regulation and impaired function of osteoclast, causing ossification
63
fibroplasia ossican progressive
Ectopic bone formation, subcutaneously, or conversion of connective tissue or muscle to bone
64
osteosarcoma
Osteoprogenitor cells become cancerous
65
osteoarthritis
Articular cartilage worn down by inflammation or overuse with limited repair mechanism
66
rheumatoid arthritis
Auto immune inflammation of synovial membrane causes increased collagenase and metalloprotease, enzyme, and damage, articular, cartilage, and joint
67
Bicipital meiotic reflex
Deep tendon reflex to evaluate spinal cord motor nerve, Afrin nerve and descending motor pathway should be involuntary bicep contraction
Integrity of muscular cutaneous nerve
68
Biceps tendinitis, and tendinosis symptom
Tendinitis is inflammation tendinitis is degradation
From repetitive micro trauma, accompany by rotator cuff or slap tears most men for bicipital groove tenderness with 10° of internal rotation can use corticosteroid injection or surgery
69
Rupture of long head of biceps tendon
Popeye deformity
Long head tendon near attachment of super glenoid tubercle
70
Clinical significance of brachial artery
Main or supply to the arm and continuation of auxiliary artery
Blood pressure and pulse
Most commonly injured upper limb artery, can cause occlusion, limb, claudication, and limb loss
71
cubital fossa clinical significance
Common site for sampling, transfusion of blood, IV
Median cubital vein is most commonly selected
Medium cubit vein for cardiac catheters
72
use of angiography
Image of blood vessels with x-ray dye
73
arteriography use
Areas of stenosis, occlusions, aneurysms, traumatic injuries, blood, clots, blood vessel abnormalities
74
clnical significance of auxiliary artery
When profuse bleeding occurs can compress third part against humorous
Can find arterial pulse for arterial line cardiac surgery
75
arterial anastomosis clinical significance
Allow blood flow if there is injury or occlusion
76
aneurysm degeneration of auxiliary artery
Repetitive trauma
Can compress trunks of brachial plexus
77
auxiliary vein in central line placement
Major Venus system for long-term vascular access
Subclavian vein puncture, using infra clavicular approach
Venipuncture lateral to curvature of middle of clavicle with needle, horizontal to sternal notch
78
Centennial lymph node biopsy
Main lymph node is identified removed and examined to determine if this cancer is metastasized or the original and where it will spread
79
risk of auxiliary, node dissection
Damage to long thoracic nerve, causing winged scapula, damage to subscapular vein, damage to lateral thoracic artery, damage to the dorsal nerve, causing weak medial rotation and adduction
80
Brachial plexus injuries
Affect movement and cutaneous sensation of upper limb
Signs and symptoms dependent on part of plexus
Test ability to perform movements to assess loss of function
Ability to feel pain loss of sensory function
81
injury to superior trunk/C5 and C6
From excessive increase in the angle between neck and shoulder
Referred to as Erb Duchenne palsy
Parisis/paralysis of shoulder and arm muscles lateral upper limb loses sensation, waiters tip
82
acute brachial plexus neuritis
Parsonage turner syndrome, neurologic amyotrophy
Sudden, severe burning pain in shoulder and upper arm
Typically superior trunk
Pain at night, followed by muscle weakness, and sometimes atrophy
Commonly affects middle-aged men, incident can be higher in pediatrics
83
consequence of prolonged hyper abduction
Thoracic outlet syndrome
Chords and vessels of brachial plexus, impinged or compressed core cord process and peck Miner tendon
Pain down the arm, numbness, tingling, redness, weakness of hand
84
Klumpke paralysis
Injury to inferior trunk
Upper limbs suddenly pulled superiorly
Injury or avulsion of C8 and T1 roots
Short muscles of hand, causing claw hand
Nerve injury leading to flexion of fourth and fifth fingers
85
interscalene nerve block
Alternative to general anesthesia for upper limb surgery
Level of C6 vertebral body
Inter scaling groove deep to lateral head of SCM
86
Supra clavicular nerve block
Inter scaling groove superior to clavicle lateral to subclavian artery
Trunks
Anesthesia for entire arm and hand
Highest incident of pneumothorax
87
Infra clavicular nerve block
Chords
Delta pectoral groove below clavicle
Anesthesia distal to elbow
88
auxiliary nerve block
Superior to pulse of auxiliary artery
Anesthesia distal to elbow
Minimal complication
89
locatioin simple squamous
posterior cornea, line blood vesels & lymph, surface of body cavities
90
simple cuboidal locatoin
tubules of kidney
91
simple columnar locatoin
GI tract,fallopian tubes, ductuli efferentes testis
92
pseudostratified locatioin
respiratory tract
93
nonkeratinized stratifies squamous locatoin
mouth, oral pharynx, esophagus, vocal cord, vagina
94
stratified cuboidal locatoin
salivary glands
95
stratified columnar location
larger ducts of exocrine, palpebral conjunctiva of eyelid
96
transitional epithelium location
urinary tract
97
barrett syndrom
complication of GERD, stratified squamous of esophagus becomes simople columnar with goblet cells (metaplasia)
98
consequence of genetic defect of voltage gated Na channel
hyperkalemic periodic paralysis (excess potassium inserum) causing liimb weakness after exercise of food high in K
paramyotonia congenita is periodic paralysis due to cold weather causing abnosmal repeat fire of muscle
99
factors induce hypokalemia
T3, T4 thyroid hormone
B adrenergic stimulation
Hyperinsulinemia
causes increase in Na-K-ATPase
100
metabolic effect hyperkalemia
depolarization
easuer generate AP (esp heart)
close inactivation gate of Na
101
most ccommon cause of muscle tetany
hypocalcemia
lowers threshold potential
calcium is a cofactor forNa channel gating
102
factorrs afect conduction velocity of AP
increased cytoplasm area = easier current
thick nerve conduct faster
myelination amount
103
Guillan Barre disease
demyelination in PNS
104
ion channels that cause IPSP
K & Cl
105
ion channels cause EPSP
Ca & Na
106
Drug induced seizure ,mechanism
inadequate amount of inhibitory influence or excessive excitatory stimulation
107
normal blood pH adult
7.4 +/- 0.05
108
respiratory acidosis
decrease ventilatoin, increased PCO2, partial renal compensation; very common
109
metabolic acidosis
decrease extracellular HCO3- concentration`decrease PCO2, partial respiratory compensation
110
respiratory alkalosis
increase ventilation, decrease PCO2, partial renal compensation
111
metabolic alkalosis
increase extracelluilar HCO3-, increase PCO2, partial respiratory compensation
112
glycine clinical significance
collagen
smallest AA
inhibitory (release block by tetanus toxin)
113
leucine, isoleucine, valine clinical significance
maple syrup urine disease
114
phenylalanine clinical significance
PKU
115
tryptophan clinical significance
serotonin
Niacin/B3
Hartnup disease
116
Serine/threonine clinical significance
O link glycolysation
phosphorylation
117
tyrosine clinical significance
phosphorylation
118
asparagine clinical significancae
N link glycolysation
119
Cysteine clinical significance
disulfide boind
glutathione
120
glutamic acid significance
excitatory NT
GABA derived from (inhibitory NT)
121
lysine significance
histone methylation & acetylation
122
arginine significance
ADP ribosylation
123
Kwashiorkior
kid malnutrition with large liver fdue to fat, edema
protein deprivation grater than total Kcal
124
Marasmus
calorie deprivation greater than reduction in protein
125
cachexia
weakness/wasting boidy from chronic illness
126
beta sheet in fiber proteins, causing neurological disorder
Amyloid, protein deposits and brains of Alzheimer's patients with twisted beta pleated sheet fibers it leads to protein aggregation
Protein aggregation through the beta sheet with poly glutamine strands of Huntington protein is Huntington disease
127
misFolded prion protein
CJD, unknown prions induced formation of an amid fold protein polymerizes into aggregated, packed beta sheets
128
disorder caused by mutation in beta globin gene
Sickle cell disease
Position six of beta chains glutamic acid becomes veiling, which increases aggregation of HB leading to fibers is oxygen cannot be carr
129
disease caused buy vitamin C deficiency
Bruises on limbs, gum, disease, loosen teeth, lethargy, myalgia
Risk factor of poor diet and alcohol and smoking and dialysis
130
cross-linking of Lysol oxidize requires
Cofactor of copper
Coenzyme of PLP also known as vitamin B6
131
common disorder of type one collagen
Osteogenesis imperfecta and Ehlers-Danlos syndrome
132
common disorder of type three collagen
Ehlers-Danlos syndrome
133
common disorder of type four collagen
Alport syndrome and good pasture syndrome
134
common disorder of type five collagen
Ehlers-Danlos syndrome
135
clinical significance of osteogenesis imperfecta
Brittle bone disease, multiple fractures,, hearing loss, delayed wound healing
From mutations of type one collagen miss folding of pro peptides
Clara is from Clara being thinner
136
clinical significance of Dan syndrome
Hyper elasticity of skin, hyper mobility of joints, aortic aneurysm, colon rupture, skin hemorrhage
From mutations in alpha or alpha two chain of type one three or five collagen
Can Lysol hydroxy sufficiency or collagen deficiency
137
Alports syndrome clinical significance
Mutations and alpha three or five chain of collagen
Leads to kidney issues, ocular defects, hearing loss
138
Goodpasture syndrome, clinical significance
Antibodies against alpha chain of type four collagen
Auto immune towards basement membrane of pulmonary and glomerular capillaries
Establishes a protein in the urine
139
Menke disease clinical significance
Steely hair, arterial tortuosity, and rupture, anemia, cerebral degeneration, osteoporosis,
Recessive disorder
Deficient cross-linking of Lysol oxidase with a functional copper deficiency
140
emphysema clinical significance
Excess air in the lung
Mutation in A1 ATT
141
Marfan syndrome clinical significance
Elongated bones, dislocation of lens of eye, cardiovascular abnormality
From mutation in fiber and one which is in the ECM
142
epidermolysis Bullosa simplex clinical significance
Blister formation at Dermo epidermal junction
Mutation gene for keratin five or 14
143
alpha Thalassemia clinical significance
HBH disease
Microcytic and hypochromic anemia
144
beta thalassemia clinical significance
Thalassemia major
Microcytic and hypochromic anemia
145
lactate dehydrogenase classification
Oxidoreductase
146
Pyruvate kinase classification
Transferase
147
alpha amylase classification
Hydrolase
148
Aldolase A classification
lyase
149
phosphoglucose isomerase classification
isomerase
150
pyruvate carboxylase classification
ligase
151
where does phosphorylation occur amino acid?
Serine, throninee and tyrosine
152
ADP ribosylation location AA
Arginine
153
methylation location AA
lysine and arginine
154
cholera
cholera toxin (bacteria) ADP ribosylates G protein
155
pertussis
pertussis toxin (bacteria) ADP ribosylates G protei
156
hemoglobin S disease
Red cell sickling, hemolytic anemia
glutamic acid becomes valine (charge to no charge)
157
Hemoglobin C disease
Glutamic acid becomes lysine at position six of beta chain (positive to negative)
158
Hemoglobin SC disease
significant red cell sickle
159
methemoglobinemia disease
increased ferric hemoglobin in blood
reduce oxygen bind ability
treat with methylene blue
160
iron overload
hemochromatosis
161
polycythemia
increaseed RBC
162
anemia
decreased RBC
163
leukocytosis
high WBC
164
leukopenia
low WBC
165
thrombocytosis
high platelet
166
thrombopenia
low platelet
167
pancytopenia
low all types
168
anisocytosis
varied size RBC
169
poikilocytosis
varied shape RBC
170
schistocytes
damaged RBC
171
gray platelet syndrome
bleeding fisorder with absence alpha granules
172
storage pool deficincy
reduced or absence of delta granules
prolong nosebleed
173
hemophilia
rare inherited blood disorder where decrease ability to clot
174
indication of prone lumbar soft tissue technique
thoracic/lumbar paraspinal muscle tension with back oain, chest wall paain
175
indication of lumbosacral prone 2 hand traction soft tissue technique
lumbosacral tension causing back pain, Si pain, pelvic pain
176
indication of thoracic prone 2 handed traction soft tissue tetchnique
reduce muscle hypertonicity, muscle tension, fascial tension, muscle spasm
177
indication of prone regional thoracic myofascial release technique
reduce muscle tension, fascial tension, increase eleasticity of short or fibrotic myofascia
178
indication of mid & low toracic region soft tissueh
reduce muscle hypertonicity, muscle tension, fascial tesion, muscle spasm
179
indication of scapulothoracic myofascial release
increase of shortene, inelastic or fibrotic myofascia, improve regional ROM of paraspinal & shoulder, increase lymph and venous drainage, alleviate congestion with poor respiration
180
indication of pectoral traction
increase venous and lymph drain to alleviate congestion, improve excess shoulder protraction, release tension of clavipectoral fascia
181
indication of thoracic inlet/sibson's fascia myofascial release
reduce tension, incresae venous and lymph drain to decrease local/distal swell, improve overall immune & circulation to area
182
indication of suboccipital tension release
reduce tension of suboccipital triangle, vascular headache, prep for cervical correction
183
indication of cervical soft tissue
reduce muscle hypertonicity, tension, soasm, streth and increas elasticity to improvr ROM, reduce patient guarding
184
indication of stretching cervical technique
stretch myofascial of cervical and upper thoracic, promote venous and lymph drainage
185
Type I mechanics
neutral
sidebend and rotation opposite direction
only thoracic or lumbar spine
186
Type II mechanics
extended or flexed
sidebend and rotation same direction
Only thoracic or lumbar spine
187
appearance of 5 densities on radiography
metal - whitest
calcium - white, appear in bones mostly
soft tissue/fluid - denser it is = greyer, less dense = blacker
fat - lighter shade of grey
air - appears blackest
188
pannicular fascia
loose & dense irregular
variable fat
189
axial & appendicular fascia
muscles & torso, fibers run direction of muscle
190
meningeal fascia
dural & other CNS membranesv
191
visceral fascia
mediastinum, around organs
192
subserous fascia
loose, elastic tissue
organ covering
193
elasticity of fascia
elastic deformation
recoverable deformation
194
plasticity of fascia
plastic deformation
nonrecoverable deformation
195
viscosity
measure of rate of determination of material under load & capability of yielding under stress
196
stress
effect of force over area
197
strain
change in shape as result of sstressc
198
creep
continue deformatoin of viscoeleastic material under constant load (relate to viscosity)
199
Hooke Law
applied stretch or compression to tissue result in proportional change in length
200
Wolff Law
form follow function
201
direct fascial release
engage and move towards restrictive barrier
202
indirect fasciall release
move away from restrictive barrier
203
TART
tenderness, asymmetry, ROM, texture
204
isolytic contraction
external forces overcome muscle contraction (muscle lengthens)
205
isotonic contraction
tone stays same, length changes
206
Isometric contraction
force can vary but muscle length stays samae
207
muscle spindle OMT
reduce firing of muscle proprioceptors to decrease hypertonicity
208
golgi tenson OMT
activate golgi tendon organ to produce muscle relaxation
209
oculocephalic refelex
cause reflex muscle contraction use eye motion to affect cervical muscle
210
Sherrington law
muscle receive nerve impulse to contract, antagonist receive impulse to relax
211
Crossed extensor reflex
flexor muscle in non-treatment extremity contracts
opposite extremity flexor relaxes by involuntary contraction
212
muscle energy principles of treatment
1 - postition part into restrictive barrier
2 - direct patient to contract correct muscle
3- phyisican apply counterforce equal to contraction, maintain force until appropriate contraction
4 - patient relax & physician match
5 - take up slack (move more restrictive)
6 - repeat steps untill restrictive barrier removed
7 - last contraction by patient takes patient into barrier on last time and go to neutral
8 - reevaluate original dysfunction
213
clinical indicatuion of HbH disease
low Hb, decrease MCV, decrease MCH, decrease MCHC
microcytic anemia (jaundice, palpaple spleen)
suggested by low HbA2
214
clinical indication og HbS
anemia after exercise
215
iron deficiency anemia clinical signs
low ferritin
history of bleed/malnutriton
216
B Thalassemia major clinical sign
increased HbA2
217
test for differentiating hemoglobinopathies
pH rate of travel towards electrode
in alkaline - HbS more slow that HbA
in acidic - HbS faster
218
lower than normal activity of Lysl oxidase
Menkes disease
due to deficiency in copper
219
lower than noirmal cleavage of procollagen due to
decreased Nprocollagen peptidase
220
lower enzyme activity of what that is related to cleaveage of procollagen
C procollagen peptidase
221
scurvy due to what enzyme's decreased activity?
lysyl hydroxylase
222
Effect of ATP inhibiting enzyme (noncompetitive) on michaelis menten graph
hyperbolic graph decreased Vmax
223
last layer of tissue needle passes during spinal tap
arachnoid
CSF is in the subarachnoid space
224
safest location/direction for epidural
After L2, around L3 in epidural space from dorsal surface travelling ventrally
can also be done in sacral hiatus
225
bacteria in posterior venous plexus travels to what if spinal stenosis
epidural space with internal venous plexus
226
central herrniation of cervical vertebrsae mechanism
compress both ventral roots, weakness bilateral arm, normal sensory
227
functional consequence damage SC at S2-S4
impair parasympathetic innervation
228
functional consequence damage SC L2-S2
weakness & sensory loss lower limb
229
functional consequence damage SC C5-T1
weakness & sensorly loss upper limb
230
functional consequence damage SC C2-C4
weakness of neck muscle & sensory loss in neck dermatomes
231
functional consequence damage SC T1-L2
impaired sympathetic innervation
