Block A Disorders Flashcards
(41 cards)
1
Q
Erb Duchenne’s Palsy
A
- Upper trunk lesion to C5 and C6
- Waiter’s Tip hand
- Adducted shoulder, medially rotated arm, extended elbow
- Paralysis of deltoid, bicpes, and brachialis
2
Q
Klumpke’s Palsy
A
- Ulnar Nerve Injury
- Injury to inferior trunk of BP
- more rare, when a person grabs a tree limb when falling
- C8 and T1 are affected
- Paralysis of short hand muscles (innervated by ulnar nerve) resulting in clawing of the hand
3
Q
Wrist Drop
A
- Radial Nerve lesion
- If you damage deep branch of Radial N only, there is no wrist drop
- You must injure radial nerve proper because it supplies Extensor Carpi Radialis Longus (ECRL)
- ECRL is strong enough alone to prevent wrist drop
4
Q
Ape Hand Posture
A
- Median Nerve Injury
- Upper fingers curved slightly
- Thumb is adducted; inability for opposable thumb (ie thenar atrophy)
5
Q
Thenar Atrophy
A
- Median Nerve Injury
- Seen with Ape Hand
*
6
Q
Positive Froment’s Sign
A
- Evidence of Distal Ulnar Nerve Injury
- Have difficulty holding a piece of paper
7
Q
Ulnar Claw
A
- Distal Ulnar Nerve Injury
- 4th and 5th digits are extended at MCP, and flexed at DIP and PIP joints
8
Q
Tennis Elbow
A
- Lateral Epicondylitis
- Can result in compression of the Radial Nerve
- Repetitive use of the extensor muscles in the forearm
9
Q
Hirschsprung’s Disease
A
Category - Neurocristopathies (Trunk NCC)
- NCC Migration/Morphogenesis Defects
Defect - aganglionic colon; NO PERISTALSIS
10
Q
DiGeorge Syndrome
A
Category
- Neurocristopathies (Cranial NCC)
- NCC Migration/Morphogenesis Defects
Defect
- Thyroid and Parathyroid deficiencies (leads to immunodef)
- Cleft palate
- defects in cardiac outflow tract/aortic arches
11
Q
CHARGE Syndrome
A
Category
- Neurocristopathies (Trunk/Cranial NCC)
- NCC Migration/Morphogenesis Defects
Defect
- C - Coloboma (eye closure)
- H - Heart (Tetralogy of Fallot)
- A - atresia choanae (nasal airway blockage)
- R - retardation (growth and development)
- G - Genitourinary problems
- E - Ear abnormalities
12
Q
Waardenburg Syndrome
A
Category
- Neurocristopathies (Trunk/Cranial NCC)
- NCC Migration/Morphogenesis Defects
Defect
- Heterochromia (1 blue and 1 brown eye) or pale blue eyes
- Partial albinism (white forelock of hair, polisis)
- Deafness
13
Q
Pheochromocytoma
A
Category
- NCC Tumors
Defect
- tumor of chromaffin tissue in the adrenal medulla
14
Q
Neuroblastoma
A
Category
- NCC Tumors
Defect
- Tumor of adrenal medulla and/or autonomic ganglia
15
Q
Medullary Carcinoma of the Thyroid
A
Category
- NCC Tumors
Defect
- tumor of parafollicular (calcitonin-secreting) cells in thyroid
16
Q
Carcinoid Tumors
A
Category
- NCC Tumors
Defect
- Tumors of enterochromaffin cells of digsestive tract
17
Q
Neurofibromatosis
(von Recklinghausen disease)
A
Category
- NCC Tumors
Defect
- Peripheral nerve tumors all over the body
18
Q
Albinism
A
Category
- NCC (other)
Defect
- because NCCs give rise to melanocytes
- total or partial lack of pigment
*
19
Q
Rachischisis/Cranioschisis
A
Category
- Congenital Anomalies of CNS
Defects
- Closure defect of spinal cord
- Cranioschisis - closure defect in area of the brain
20
Q
Spina Bifida Occulta
A
Category
- Congenital abnormalities of the spinal cord
Defects
- Non-fusion of the embryonic halves of vertebral arches (not fused in median plane)
- Spinal Dermal Sinus - dimple/hair/fat deposit at L5/S1
- NO SYMPTOMS (affects 10% of population)
- NO NEUROLOGIC DEFICITS
21
Q
Spina Bifida Cystica
A
Category
- Congenital Abnormalities of the spinal cord
Defects
- Protrusion of spinal cord/meninges through defect in vertebral arch
- Increass in AFP indicative of SB or anecephaly
Types
- with meningocele - sac contains meninges and CSF ONLY
- NO NEUROLOGIC DEFECTS
- w/ meningomyelocele - sac contains spinal cord and/or roots
- YES NEURO DEFECTS
- w/ Myeloschisis (worst case) - flattened neural plate
- spinal cord is exposed
- fusion failure at 4th week
22
Q
Transverse Fracture
A
Fracture occurs from blunt force trauma
23
Q
Spiral Humeral Fracture
A
Differential forces placed on a bone (falling onto an outstreched arm
24
Q
Surgical Neck Fracture
A
- Falling in an outstretched arm (for osteoporosis pts)
- Possible damage to axillary n. and posterior humeral circumflex artery
25
Smith's Fracture
Fracture of distal radius with **anterior displacement**
Falling onto flexed wrist" or you get hit from dorsal surface
Less Common
26
Colles Fracture
Posterior displacement in distal radius fracture
VERY COMMON
"Dinner Fork" fracture
27
Greenstick Fracture
Incomplete break - occurs in young pts; when you have developing bone
Like trying to break a wet twig
28
1. What ligament is torn in Nurse Maid's Elbow
2. Which joint does it affect?
Radial had dislocates from anular ligament
Occurs when child's forearm is pulled forcibly
(dislocation of proximal radioulnar joint
29
What is the most commonly fractured carpal bone?
SCAPHOID
It does not have a lot of collateral flow so it can become necrotic
30
What are the contents of the Carpal Tunnel? What test can you perform to ensure there is not a more proximal median n. lesion?
* Carpal Tunnel contains
* 9 flexor tendons (4 FDS + 4 FDP + 1 FPL)
* Median N (not palmar cutaneous branch)
* If pt has no sensation in palm, then there is a lesion in Median N. more proximal.
31
What happens in Depuyten's Contracture?
Palmar Aponeurosis contains the wrong type of collagen
Most often affects the 4th and 5th digits
32
What is a Chordoma?
Notochord fails to degenerate after it contributes to the nucleus pulposis in the IV disks, and forms **highly neoplastic tumor called chordoma**
33
What embryological defect results in communication between right and left atria? What 2 flavors of this defect are there?
Category
* Atrial Septal Defects
Defect
* Patent forament ovale - most common ASD; foramen ovale fails to close
* Anatomic PFO - (probe patent) - no actual mixing of blood bc of pressure difference, but you can actuallyl stick your probe through it like in cadaver lab
* Physiological PFO - mixing of blood
34
What is the worst type of ASD? What failed to form in this defect?
Category
* ASD
Defect
* Common atrium - very severe defect
* Neither septum primun nor secundum formed
* Result is enlarged fetal heart
35
What 2 major categories of VSDs are there? Explain the embryology behind both types? Which is worse and why?
Category
* VSD - mixing of blood between ventricles
Defect
* Muscular VSD - muscular component of septum fails to proliferate sufficiently
* Membranous VSD - membranous portion fails to close **superior aspect of ventricle**
* Are more severe because they are associated with defects in great vessels as well (common precursor NCC)
36
What is a persistent Truncus Arteriosis? What is the underlying embryology behind this failure?
Category
* VSD
Defect
* Failed separation of aorta and pulmonary trunk (common outflow tract)
* Both ventricles empty into common outflow trunk
* Results from *migrational failure of cardiac NCC *that normally enter 4th and 6th pharangeal arches
37
What is the underlying embryology behind a transpositionof great vessels? How does the body compensate for this?
Category
* VSD
Defect
* Jet of cells that "push and spiral" great vessels
* Often is accompanied by "back up" shunting mechanism to allow for *some *oxygenation of blood
* ASD (PFO)
* Compensatory VSD
38
What are the 4 defects with Tetralogy of Fallot? What causes this?
Category
* Heart defects
Defect
1. Pulmonary Stenosis - Narrowing of the Pulmonary Trunk
2. VSD
3. Overriding Aorta - aorta opens into RV and portion of LV (eg big boy flab into the middle seat)
4. Enlarged RV - RV hypertrophy
Cause - inappropriate migration of Cardiac NCC "Misallocation of funds" - you have a larger aorta and a smaller pulmonary trunk (NCC didn't split the great vessels down the middle (equal allocation of funds)
39
Category
*
Defect
*
40
Category
*
Defect
*
41
Category
*
Defect
*
