Formative Flashcards
Which type of cartilage degenerates first in osteoarthritis?
Hyaline/articular cartilage
What are clinical signs of osteoarthritis?
Crepitus Pain Reduced range of movement Swelling Stiffness Mal-alignment of the joint
What does the Trendelenburg test? (which muscles hold the pelvis in a horizontal position)
Gluteus medius and minimums - superior gluteal nerve
Stability of ipsilateral pelvis
What are pathological features that are identifiable by radiology in osteoarthritis and rheumatoid arthritis?
LOSS (narrowing of joint space, osteophytes, subchondral cysts, sclerosis)
LESS (narrowing of joint space, bony erosion, synovial inflammation/soft tissue swelling, subluxation)
Which muscles /muscle groups in the hand does the ulnar nerve supply?
Hypothenar group: opponents digiti minimi, flexor digiti minimi, abductor digiti minimi)
Interossei (planar and dorsal)
Adductor pollucis
Lumbricals 3 and 4
What tests can be done to assess the ulnar nerve in the hand?
Digit adduction: hold sheet of paper between the digit and resist it being pulled out
Digit abduction: abduct the digits and resist examiner pushing against them
Froment’s sign: test thumb adduction and look for flexion at DIP
Describe events of wound healing within the first 48 hours
Haemostasis/blood clotting
Fibrin clot formation
Neutrophils migrate towards fibrin clot
Epithelial cells from wound edges migrate and proliferate along the dermis
What are clinical findings of a localised wound infection?
Erythema Swelling of the wound Pus formation/leakage Pain/tenderness Raised local temperature Loss of function Local lymphadenopathy in area drained
Which pathogen is most likely to cause a wound infection?
Staphylococcus Aureus
What effect would anterior thigh compartment syndrome have on the leg and foot?
Loss of function - cold and clammy
Femoral artery main blood supply; if compressed in anterior compartment then leg/foot won’t receive blood supply
Which local factors affect wound healing?
Infection Poor vascular supply Mechanical factors (early mobility) Foreign bodies Large wound size
What elements are being assessed in a multifactorial falls risk assessment?
Vision Osteoporosis History of falls Gait, balance, mobility Home hazards Cognitive impairment Urinary incontinence Cardiovascular examination
What interventions that can reduce future falls?
Medication review
Individualised strength and balance training (physio)
Vision assessment
Home hazard assessment
What’s the main risk factor for malignant melanoma in the UK?
UV exposure
In what layer of the epidermis are melanocytes found and what’s their usual role?
Stratum basale
Protect DNA of skin cells from UV radiation induced damage
Which axillary lymph nodes would a melanoma on the back of the arm spread to first?
Humeral nodes
What are hand signs of a median nerve lesion?
Hand of benediction (unable to flex digits 1-3 when trying to make a fist)
Weakness of thumb opposition
Ulnar deviation of the wrist on flexion
What examination finding in a hand is indicative of carpal tunnel median nerve damage?
Weakness of thumb opposition
Which part of the brachial plexus relates to rib 1 and therefore compression at rib 1 will present how?
Lower part (C8-T1 roots) T1 predominantly supplies small muscles of the hand = unable to grip a piece of paper between two fingers
What movement of the hip does gluteus medius do?
Abduction
Which bone cells develop from: mesenchyme and monocyte progenitor cells?
Mesenchyme -> osteoprogenitor cells -> osteoblasts -> osteocytes
Monocyte progenitor cells -> osteoclasts (macrophage lineage)
What type of drug is Denosumab and what’s it’s molecular target?
Monoclonal antibody
RANKL = prevents it binding to RANK for osteoclast activation
How does botulism result in flaccid paralysis?
Disrupts ACh release from the presynaptic membrane - degrades SNARE protein complex which is responsible for docking and fusion of vesicles
In which region of the sarcomere is ATP hydrolysed to ADP + Pi?
In the A band (overlap between thick and thin filaments, where Myosin head can bind Actin and ATP)
