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MSK Flashcards

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1
Q

clavicle

A

connects with the sternum and the scapula via different ligaments
the clavicle attaches to the acromion of the scapula via the acromioclavicular joint
attaches to the sternum via the sternoclavicular ligament
attaches to the coracoid process of the scapula via the coracoclavicular ligament

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2
Q

fractured clavicle

A

more common in children
weakest part of the clavicle=mid-lateral side
the sternocleidomastoid muscle elevates the medial fragment of the clavicle resulting in shoulder drop on the affected side.
complications:brachial plexus injury, lung puncture

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3
Q

scapula

A

glenoid cavity-articulates with the head of the humerus to form shoulder joint
acromion-bony projection that articulates with clavicle to form AC joint
inferior angle and superior angle and spine(points of reference for palpation)
medial and lateral border aswell
coracoid process -muscle attachment
sub scapular fossa

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4
Q

humerus

A

head-articulates with glenoid cavity
greater and lesser tubercles-points of attachment for muscles, can be palpated
anatomical neck-joins heads of the greater and lesser tubercles
surgical neck-junction between the tubercles and the shaft
medial and lateral epicondyles-points of attachments for muscles, can be palpated
capitulum-articulates with the head of the radius
trochlea-articulate with trochlea notch of ulna
olecranon fossa-articulates with olecranon of ulna
coronoid fossa-articulates with corned process of ulna

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5
Q

glenohumeral joint dislocation

A

anterior dislocation more common
caused by trauma
complication:axillary nerve damage
posterior dislocation present as ‘lightbulb’ appearance=rare

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6
Q

proximal humeral fracture

A

damage to the axillary nerve

classic=4 part fracture

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7
Q

humeral shaft fracture

A

radial nerve injury

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8
Q

radial collateral ligament

A

radius->humerus

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9
Q

lateral(ulnar) collateral

A

ulna->humerus

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10
Q

medial collateral

A

ulna->humerus

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11
Q

annular ligament

A

wraps around radius and attaches to ulna

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12
Q

radius

A

head-articulates with capitulum of humerus and with the ulna
radial tuberosity-insertion of the biceps brachii
styloid process-lateral/radial styloid process
radoiocarpal joint

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13
Q

ulna

A

olecranon-forms prominence of the elbow and articulates with the olecranon fossa of the humerus
coronoid process-raised projection of the trochlear notch, articulates with the coronoid fossa of the humerus
styloid process
head-articulates with the ulna notch of the radius to form the distal radioulanr joint

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14
Q

annular ligament displacement

A

ligament slips off the radial head and gets stuck between the radius and humerus
common in children

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15
Q

radial head dislocation

A

common in children

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16
Q

Colle’s fracture

A

FOOSH injury
dorsal displacement
dinner fork

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17
Q

Smith’s fracture

A

opposite of a Colle’s fracture
caused by a direct blow to to the dorsal forearm or by falling onto a flexed wrist
volar displacement

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18
Q

scaphoid fracture

A

most vulnerable bone in the wrist
painful, swollen wrist after fall and tenderness in the anatomical snuff box
arterial blood supply to scaphoid starts distally and moves proximally
fracture of the scaphoid can lead to Avascular necrosisAVN of the scaphoid

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19
Q

pectoral girdle muscles

A 
upper limb->trunk 
moves pectoral girdle
anterior:
pectoralis major
pectoralis minor 
subclavian
serrates anterior 
Posterior:
latissimus dorsi 
trapezius
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20
Q

shoulder muscles

A

scapula->humerus
rotator cuff muscles
-supraspinatus: first 15 of abduction
-teres minor:adducts and laterally rotates
-infraspinatus: lateral rotation
-subscapularis: adducts and medially rotates
deltoid-abduction above 15
teres major-adduction and extension at shoulder joint

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21
Q

muscles of the arm

A 
flexors(anterior)
-biceps brachii 
-brachialis 
-coracobrachialis 
extensors(posterior)
-triceps brachii
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22
Q

muscles of the forearm

A 
flexors(anterior)
-brachioradialis 
-pronator teres 
extensors(posterior)
-extensor digitorum
-extensor carpi radialis
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23
Q

tennis elbow

A

lateral epicondylitis

  • degeneration of the common extensor tendon
  • cause:chronic/repeated stress on the tendon from overuse
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24
Q

golfer’s elbow

A

medial epicondylitis

  • degeneration of the common flexor tendon
  • cause:chronic/repeated stress on tendon from overuse
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25
roots of brachial plexus
C5-T1
26
winged scapula
long thoracic nerve injury paralysis of serrates anterior abduction of the shoulder above horizontal level is also impaired
27
Musculocutaneous nerve damage
``` C5-C7 results in reduced sensation of lateral forearm and paralysis of: -biceps brachii -brachialis -coracobracialis ```
28
axillary nerve damage
C5-C6 innervates deltoid and teres minor officers badge atrophy of deltoid muscle
29
median nerve
all of the brachial plexus C5-T1 | innervates flexors of the forearm and thumb muscles
30
hand of benediction
when a patient tries to make a festering and little fingers flex, but the index and middle finger cannot flex at the MCP joint or the interphalangeal joint
31
claw hand
can't flex the little finger and ring finger
32
ape hand deformity
thumb is stuck in adduction and extension
33
anterior interosseous syndrome
weakness of the pincer movement of the index finger and thumb =cannot make the ok sign . Cannot flex the DIP joints of the thumb and index finger
34
median nerve damage
C6-T1 | pronation of the forearm, flexion of the wrist and flexion of the digits
35
radial nerve damage
C5-T1 damage caused by : fracture of the shaft of the humerus compression of the humerus "Saturday night palsy" sx- wrist drop paraesthesia on dorsolateral aspect of the hand and lateral 3 and 1/2 fingers
36
Ulnar nerve damage
c8-T1 damaged caused by: -cubital tunnel syndrome -fracture of the medial epicondyle of the humerus guyot's canal(area of compression)-little finger tingling sx claw hand
37
erb-duchenne palsy
C5-C6 root damage waiters tip deformity internally rotated shoulder and pronated forearm
38
Klumpke's palsy
``` C8-T1 atrophy of: interosseous muscles thenar muscles hypothenar muscles reduced sensation of medial hand and medial forearm ```
39
volkmann's ischaemic contracture
laceration of the brachial artery emergency paralysis of muscles die to inadequate blood supply permanent shortening of muscle fibres due to fibrosis
40
axial skeleton
bones of the head neck trunk
41
appendicular skeleton
bones of the limb pectoral girdle pelvic girdle
42
Spongy bones
- long bone - bony trabecular located along lines of compressive and tensile stresses - major type of bone tissue in short, flat and irregular bones - red and yellow bone marrow
43
compact bone
long bone -arranged in osteons(Haversian system) each osteon has: -concentric lamellae -Haversian canal through the middle which contains blood vessels osteons are connected via perforating canals compact bone is covered by periosteum which consists of: -outer fibrous layer -inner osteogenic layer
44
red bone marrow
haemopoeitic tissue and the site of red blood cell production
45
yellow bone marrow
fat or adipose tissue, can be converted to red bone marrow especially after severe blood loss
46
bone formation cells
osteoblasts=bone builders osteocytes=derived from osteoblasts(trapped in bone matrix) osteoclasts=break down bone tissue
47
initial bone formation
bones are formed from the embryonic mesenchyme bone formation follows two patterns: intramembranous ossification endochondral ossification
48
intramembranous ossification
1-cells of mesenchyme cluster together 2-differentiate into osteoprogenitor cells, which then turn into osteoblasts 3-create a type of bone tissue called osteoid: primarily from the secretion of collagen subsequently mineralised with calcium these crystallise onto the tissue ,strengthening the bones 4-formation of the trabeculae 5-development of the periosteum
49
intramembranous ossification bones
flat bones of the face, most cranial bones,and the clavicles
50
endochondral ossification
1-development of cartilage model 2-growth of cartilage model 3-development of primary ossification centre 4-bone replaces cartilage 5-development of secondary ossification centre 6-formation of articular cartilage and epiphyseal plate most bones are formed this way replacement of cartilage with bone mesenchyme forms general shape of bone develop into chondroblasts which secrete cartilage extracellular matrix produce a cartilage model (hyaline)
51
interstitial (endogenous) growth
involves increase in the number of cells(chondrocytes) by continual mitotic cell divisions with secretion of matrix material
52
appositional (exogenous) growth
mainly involves deposition of more matrix material by periosteal chondroblasts with little or no increase in the number of cells
53
bone growth in length
occurs at the metaphyseal surface of the epiphyseal plate stops between the age of 18-25-epiphyseal plates close between ages of 18 and 25 (the epiphyseal cartilage ceases dividing and the cartilage is replaced by bone leaving the epiphyseal linen older patient harder to see due to remodelling)
54
bone growth in thickness
occurs at bone surface involved in the secretion and depostition of bone matrix by osteoblasts osteoblasts lay down bone matrix this results in a groove forming alongside a periosteal blood vessel this become a tunnel containing the vessel remodelled and forms a new osteon new outer circumferential lamellae is laid down enlargement of the medullary cavity
55
vitamin a
stimulates osteoblast activity
56
vitamin c
synthesis of collagen
57
vitamin d
absorption of calcium in the gut
58
vitamin K and B12
synthesis of bone proteins
59
thyroid hormone
produced by thyroid gland | promote bone growth by stimulating osteoblasts
60
insulin
promotes bone growth by increasing synthesis of bone proteins
61
growth hormone
directly stimulates chondrocytes increasing the rate of cell differentiation
62
gigantism
over secretion of growth hormone in childhood often due to pituitary tumour lack of/under secretion of oestrogen
63
acromegaly
over secretion of GH after the closure of the epiphyseal plates after puberty often due to pituitary tumour affects the extremities sx: spade like hands and feet, prominent brow
64
pituitary dwarfism
short stature due to under secretion of GH during childhood
65
osteoporosis
loss of bone mass due to demineralisation through increased bone resorption
66
rickets
lack of vitamin D or renal dysfunction poorlymineralised and calcified bones bowed legs, deformities
67
osteomalacia (Adult rickets)
similar condition to rickets that is experienced in adults
68
calcium homeostasis PTH
- released from the parathyroid gland in response to hypocalcaemia - PTH binds to osteoblast - mineral bone is broken down increasing levels of calcium - stimulates DCT in nephron to remove phosphates from plasma
69
vitamin D
- initially synthesised from cholesterol in skin keratinocytes exposed to UVB radiation - becomes calcitriol - increases absorption of calcium into the plasma
70
calcitonin
opposes action of PTH when plasma becomes high \calcitonin's main target is bones where it inhibits osteoclasts
71
hypocalcaemia
``` total <2.2mmol/L caused by -hypoparathyroidism -chronic kidney disease -hyperventilation sx -muscle spasms -paraesthesia -cardiac arrhythmias ```
72
hypercalcaemia
``` total >2.6mmol/L caused by -hyperparathyroidism -malignancy -excessive ingestion of vitamin D sx -bones moans groans and stones -confusion,drowsiness,coma ```
73
skeletal muscle
long, cylindrical multiple nuclei,located peripherally striated sarcomere t tubules-from triad with sarcoplasmic reticulum cross bridge formation-Ca2+ binding to troponin motor neurones control contraction
74
cardiac muscle
branched one or two nuclei located centrally striated sarcomere t tubules form dyad with sarcoplasmic reticulum electrical coupling of cells via gap junctions extracellular Ca2+ is required for contraction cross bridge formation-Ca2+ binding to troponin autonomic nerves(beta-adrenergic agonists) control contraction
75
neuromuscular junction
AP travels down presynaptic neurone voltage gated calcium ion channels in presynaptic membrane open influx of calcium vesicles containing Each move towards and fuse to presynaptic membrane Each released into synaptic cleft and diffuses towards post-synaptic membrane Ach binds to nAChR on post synaptic membrane this causes ligand gated sodium ion channels on post synaptic membrane to open sodium ions flow into postsynaptic neurone, depolarising the sarcolemma this causes voltage-gated sodium ion channels to open further influx of sodium ions Ach broken down by AChE into acetate and choline, closing the sodium ion channels choline transported back into presynaptic neurone via co-transport with sodium.Acetyl CoA converts choline back into ACh

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