Mistakes Flashcards

(83 cards)

1
Q

Nerve compressed in lunate dislocation

A

Median nerve

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2
Q

Spilled tea cup sign

A

Volar lunate dislocation

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3
Q

Ligaments injured in volar lunate dislocation

A

Scapholunate
Capitolunate
Lunotriquetral

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4
Q

Motor symptoms of median nerve compression at carpal tunnel are?

A

Via recurrent branch of median nerve to thenar muscles

Weakness of ABDUCTOR POLLICIS BREVIS—- thimb abduction lost
FLEXOR POLLICES BREVIS
OPPONENES POLLICES

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5
Q

Sensory loss of carpal tunnel syndrome

A

Palmar digital branches of median nerve— paresthesia in palmar aspect of first 3 and half digits

Weakness of 1st and 2nd lumbrical— no interphalangeal joint extension

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6
Q

Thumb adduction is by?

A

Adductor policis
Ns - deep motor branch of ulnar nerve

Injury- guyons canal syndrome when hook of hamate is fractured

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7
Q

Features of guyons canal syndrome?

A

Ulnar nerve compression in guyons canal

Dorsal and volar interossei lost — finger abduction

Adductor policis— thumb adduction

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8
Q

Nerve supply of extensor pollices longus and brevis

A

Radial nerve

Before entering wrist

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9
Q

Name the muscles of thumb with nerve supply

A

Abductor pollicis brevis— median nerve

Flexor pollicis brevis—superficial head median nerve deep head ulnar nerve

Opponens pollices— median nerve

Adductor pollicis—-ulnar nerve

Extensor pollicis longus and brevis— radial nerve

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10
Q

Primary muscle of wrist extension

A

Extensor carpi radialis brevis
Extensor digitorum

Lateral epicondylitis tennis elbow

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11
Q

Muscle responsible for adduction of fingers

A

Palmar interossei

Originates from metacarpals

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12
Q

Forearm flexors

A

Biceps brachii
Brachialis
Brachioradialis

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13
Q

Boundaries of anatomical snuff box

A

Lateral—- EPB AbPL
Medial— EPL

TENDINOPATHY OF THESE TENDONS ESP LATERAL ONES CAUSES DEQUERVAINS TENDINOPATHY

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14
Q

Osgood schlatter disease

A

Avulsion growth spurt at secondary ossification centre —tibial tubercle due to repeated knee extension

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15
Q

Muscles inserting in pes anserinus

A

Semitendinosus
Gracilis
Sartorius

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16
Q

Origin and insertion of serratus anterior

A

First 8 ribs origin

Medial border of scapula insertion

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17
Q

What is the function of serratus anterior

A

During overhead abduction of shoulder the glenoid cavity must rotate upwards

This is done by trapezius and serratus anterior

Which allows completion of over head abduction

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18
Q

Nerve supply long thoracic nerve

A

C5 c6 and c7

Brachial plexus roots

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19
Q

Injury in clavicular fracture

A

Supraclavicular nerve

Subclavian vessels

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20
Q

Upper brachial plexus injury

A

Waiters tip
Erbs palsy

Injury to musculocutaneous nerve and suprascapular nerve

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21
Q

Hip pain on forced adduction of flexed thigh

And internal rotation of extended thigh on resistance

A

Piriformis syndrome

Because adduction and internal rotation of thigh stretches piriformis

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22
Q

Contents of greater sciatic notch

A
Piriformis
Above it superior gluteal nerve and vessels
Below it inferior gluteal vessels 
Internal pudendal vessels
Sciatic nerve

Action of piriformis since it inserts in greaters trochanter is to abduct the flexed thigh

Or
Externally rotate the extened thigh

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23
Q

What is trendlenberg gait

A

Weakness of hip stabilisers
Gluteus medius and minimus

Contralateral hip drop when foot is raised

Superomedial gluteal quadrant injections

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24
Q

Superomedial injection in gluteal region injures which nerve

A

Superior gluteal nerves L4 to S1

Weakness of hip stabilisers

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25
Nurse maids elbow
Kids traction of arm forearm Annular ligament gets trapped in between radial head and capitulum
26
Popeyes deformity
Rupture of long head of biceps brachi Which contracts and accumulates like popeyes arm due to displaced belly
27
What is lac operon
Sequence of genome in E COLI for metabolism of lactose
28
Contents of lac operon
Ipo zya I is regulatory gene P is promotor region O is operator region Z y a are three structural genes
29
What are the products of zya genes in lac operon
Z codes for B GALACTOSIDASE- which breaks down lactose to glucose and galactose Y codes for permease- which increases the e coli permeability for lactose A codes for B galactoside transacetylase which transfers acetyl grps to b galactoside
30
What is the property of mrna in E coli
M rna in ecoli is polycistronic Meaning single mRNA contains the information of all zya genes of lac operon and all protein/ enzymes are synthesized together Mostly prokaryotic mRNA are usually polycistronic
31
In order what is the structure of lac operon
``` LAC 1 ( regulator gene) Cap ( catalytic activator protein) P gene (promotor gene has RNA POLYMERASE) ``` O gene which is operator gene where repressor can bind and does not allow RNA polymerase to proceed Then structural gene z y a Inducer is lactose— prevents repressor from binding operator site..
32
Name 3 enz deficiencies for galactosemia
Galk deficiency— galactokinase Galt deficiency- Galactose 1 p uridyl transferase UDP galactose 4 epimerase for regeneration of UDP glucose
33
Most common galactosemia enz
Galt— ie udp wala | Galactose 1 phosphate uridyl transferase
34
Features of dangerous type Galactosemia galt
Liver and renal accumulation of galactose 1 phosphate which is toxic Liver enz elevation hyperbilirubinemia hypoglycemia Renal aminoaciduria and hyperchloremic metabolic acidosis Sepsis with grm negative rods ie e coli
35
What enz forms galactitol from galactose
Aldose reductase
36
What are non glucose monosaccharides metabolised by liver | Whose metabolism is the fastest
Galactose mannose and fructose are non glucose monosaccharides metabolised by liver whose intermediaries enter glycolytic pathway at various levels Of these fructose has the fastest metabolism because it can have two pathways one of which is independent of rate limiting glycolytic enz phosphfructokinase -1
37
Why glucose represses lac operon or shuts down lac operon
Because glucose decreases adenyl cyclase levels and intracellular camp levels decreases CAP catalytic activator protein needs high level of cAMP
38
Leptin gene and receptor mutations would cause
Hyperphagia with obesity Gene mutation has low levels of leptins and Receptor mutations will have increased levels of leptin
39
Mechanism of action of leptin
Two actions on arcuate nucleus of hypothalamus 1 inhibits appetite stimulating neuropeptideY 2 activates appetite inhibiting pomc product alpha MSH OVERALL EARLY INCREASED SATIETY
40
Enz deficient in hereditory fructose intolerance
Aldolase B | NO CATARACTS but reducing sugars in urine hypoglycemia hypophosphatemia and failure to thrive
41
What disease is caused by alpha galactosidase A deficiency?
Fabrys disease xlr | Cataracts with neuro symptoms with angiokeratomas
42
Enz deficient in essential fructosruia
Fructokinase deficiency Only reducing sugars in urine ``` No cataracts ( hereditary fr intolence) No hypoglycemia ( HFI OR GALACTOSEMIA) No hypophosphatemia ( hereditary fr intoleance) ```
43
Enz deficient in von gierkes disease
Glucose 6 phosphatase Hypoglycemia lactic acidosis Hepatomegaly Hypertriglyceridemia
44
What causes tay sachs disease
Hexosaminidase A deficiency Cherry red spot Loss of motor skill No cataracts
45
What is complex II. In tca and electron transport chain
Complex II. Is succinate dehydrogenase complex Participate in tca as well as etc In TCA it converts succinate to fumarate and thereby transfers electrons to coenzyme Q via FAD producing reduced FADH2 It can also accept electrons from other sources of FADH2 like fatty acid oxidation
46
Mismatched nucleotides are repaired by
Proof reading of DNA polymerase delta and epsilon
47
What if proof reading by dna polymera delta and epsilon misses Mismatch
Mismatch repair genese MSH 2 and MLH 1 produces human mutS and mutL homologs that repairs the mismatch
48
Damage mutations by uv light is corrected by
Nucleotide excision repair Because uv light causes pyrimidine esp thymine dimers which interfere with dna replication These dimers are removed by nucleotide excision repair
49
Removal of RNA primers after DNA Replication before ligase can act to seal everything is done by
DNA Polymerase 1 which has 5’-3’ forward exonuclease activity
50
In which directions dna polymerase 3 acts
Making dna in 5’-3’ direction | And proofreading in reverse ie exonuclease activity in reverse 3’-5’ direction
51
In lower arm brachial artery accompanies which nerve
Median nerve
52
In arm radial nerve accompanies which artery?
Deep branch of brachial artery Remember mid shaft fracture of humerus is associated with wrist drop because of radial nerve injury And shud raise concern of lacerstion of deep brachial artery
53
What is deep brachial artery?
Profunda brachii is deep brachial artery Accompanies radial nerve Injured in mid shaft humeral fracture
54
Radial nerve and profunda brachi artery is situated anterior or posterior to humerus?
Posterior to mid shaft humerus
55
Nerve root for radial nerve
All 5 of brachial plexus | C5 to t1
56
What does cutaneous br of radial nerve supply
Skin overlying dorsum of hand dorsal forearm and portion of upper arm
57
Muscles supplied by radial nerves
Elbow and wrist extensors like common extensors and triceps Extrinsic extensors of digits Brachioradialis and supinator
58
Fracture of surgical neck of humerus can damage which nerve and artery
Axillary nerve And Posterior circumflex humeral artery in quadrangular space
59
Retroperitoneal hematoma overlying psoas can damage which nerve
Femoral nerve which descends through psoas Emerges laterally btn psoas and iliacus Enters limb below inguinal ligament
60
Femoral nerve mononeuropathy features
Quadriceps weakness— stairs climbing or knee buckling Decreased patellar reflex Sensory loss over anterior and medial thigh and medial leg
61
Impaired adduction of thigh nerve injury is
Obturator nerve injury | Also has sensory loss in medial thigh
62
Common peroneal nerve injury
Dorsiflexed foot — foot drop Loss of toe extensor- cannot stand on toes Foot inversion - cannot do eversion Loss of sensation in lateral leg and dorsum of foot
63
Tarsal tunnel syndrome
Posterior tibial nerve neuralgia Narrow tunnel behind medial malleolus at ankle overlying flexor retinaculum
64
Contents of tarsal tunnel
Tibialis posterior Flexor DL FHL Posterior tibial artery and v Posteiror tibial nerve (L4-S3)
65
What does tibial nerve supply
Sensation in sole Inversion and plantar flexion of foot Flexion of toes
66
First web space on dorsum is supplied by?
Entire dorsum is supplied by superficial peroneal nerve except for first web which is supplied by deep peroneal nerve
67
Femoral head arterial supply
Ascending cervical and medial circumflex femoral artery | Which are damaged in neck fracture of femur
68
Circumflex femoral arteries are branches of which artry
Profunda femoris
69
Artery of ligamentum teres
Is a br of obturator artery It is important in children because it supplies head proximal to growth plate
70
Ascending cervical artery of femoral head is brn of
Lateral circumflex femoral artery
71
Nerve supply of latissimus dorsi and its action is?
Thoracodorsal nerve C6-c8 Inserts in biciputal groove Internal rotation and adduction of humerus Extension alsom
72
Action of infraspinatus
External rotation of arm | Ns is suprascapular nervd
73
Nerve supply of triceps brachi
Radial nerve | Extension of elbow
74
Explain nerve root of ulnar nerve
Ulnar nerve originates from medial cord of brachial plexus derived from C8-T1 ventral roots
75
Components of cranial nerve 3 occulomotor
Somatic - infr super and medial rectus. LPS muscle and inferior oblique ms. So if occulomotor is involved—- eye will be down out and shut (ptosis lid) ``` Parasympathetic component( remember 3 79 and 10 are cranial parasympathetic outflow) Supplies ciliary muscle and iris sphincter. Loss leads to fixed dilated pupil with loss of accomodation ```
76
Component of corneal reflex? Blink reflex Protects from foreign bodies
Afferent - nasociliary br of V1 of trigeminal nerve. Centre- pons Efferent- temporal and zygomatic branches of facial nerve
77
Orbicularis oculi which shuts the eyes is supplied by
Facial nerve Part of efferent portion of corneal reflex
78
Eye opener muscles
Occulomotor nerve— Iii supplying LPS Ms opens eyes Superior tarsal muscle supplied by sympathetic fibres from superior cervical ganglion opens eye
79
Holoprosencephaly causes are?
Maternal alcohol Trisomy 13 patau Sonic hedge hog gene mutations Type of developmental field defect ie one embryonic disturbance leads to many malformations because it disrupts the development of many adjacent structures in same field
80
What is association of anomalies? | Example?
Multiple anomalies occur together without a unifying cause and also it is not by chance Eg is vacteral anomalies— vertebral anal atresia cardiac te fistula renal and limb anomalies
81
Spleen is derieved from
Mesoderm of dorsal mesentry
82
Which finger does not have palmar interossei muscle
3rd finger Middle finger Remember palmar interossei causes finger adduction towards middle finger No need for middle finger to go anywhere hence no adductor needed
83
What is the function of dorsal interossei
Opp of palmar Abduction of fingers