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MSK Flashcards

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1
Q

Order of carpal bones (lat to med by row)

A

scaphoid/lunate/triquetrum/pisiform

trapezium/trapezoid/capitate/hamate

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2
Q

Rotator cuff muscles and action

A

Supraspinatus-abduct
Infraspinatus-lat rotation
Teres minor-adduct/lat rotation
Subscapularis-adduct/med rotation

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3
Q

Brachial plexus segments

A 
Roots-C5 to T1
Trunks-upper/mid/lower (Erb-Duchenne/Klumpke's lesion)
Divisions
Cords-lat/post/medial (wrist drop)
Branches-MC/median/ulnar
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4
Q

Brachial plexus protection from clavicle fracture

A

Subclavius muscle

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5
Q

Dislocation of humeral head

unable to abduct the arm

A

Axillary n. (C5/C6)

dislocation or surgical neck fracture

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6
Q

Midshaft humeral fracture

unable to extend wrist

A

Radial n. (C5-T1)
brachioradialis/supinator/triceps/extensors
post arm/dorsal thumb & hand sensory deficit

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7
Q

Fracture of supracondylar humerus
unable to grab objects with hand
weak wrist flexion

A

Median n. (C5-C8, T1)
opposition of thumb/lat finger flexion/wrist flexion
palmar lat hand sensory deficit
Ape Hand/Pope’s blessing

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8
Q

Fracture of medial epicondyle of humerus

weak wrist flexion

A

Ulnar n. (C8, T1)
medial finger flexion/wrist flexion
hypothenar eminence sensory deficit
radial deviation on wrist flexion

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9
Q

Traumatic delivery of newborn

No abduction/lat rotation/pronation

A

Erb-Duchenne palsy

C5/C6 upper trunk

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10
Q

Thenar/hypothenar eminence atrophy

sensory deficit on medial forearm/hand

A

Klumpke’s palsy

C8/T1 inf trunk

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11
Q

Lesion with ulnar claw

A

loss of medial lumbrical function
cannot extend 4th/5th digits
due to ulnar nerve

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12
Q

Lesion with median claw

A

dislocated lunate/carpal tunnel
cannot extend 2nd/3rd digits
distal median n.

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13
Q

Pope’s blessing lesion

A

proximal median n. lesion

loss of lat finger flexion/thumb opposition

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14
Q

Ape hand lesion

A

proximal median nerve lesion

loss of opponens pollicis m. fxn

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15
Q

Winged scapula

lymphedema on ipsilateral side

A

Long thoracic n. (C5-C7)

loss of serratus ant fxn

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16
Q

Hand muscles innv by median n.

A

Opponens pollicis
abductor pollicis brevis
flexor pollicis brevis

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17
Q

Hand muscles innv by ulnar n.

A

Opponens digiti minimi
abductor digiti minimi
flexor digiti minimi

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18
Q

Loss of thigh adduction

A

obturator (L2-4) n.

ant hip dislocation

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19
Q

Loss of thigh flexion/leg extension

A

femoral (L2-4) n.

pelivc fracture

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20
Q

Foot drop

A 
Common peroneal (L4-S3)
knee trauma
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21
Q

Loss of thigh abduction

A 
Sup gluteal (L4-S1)
post hip dislocation
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22
Q

Trouble walking up stairs

can’t jump

A 
Inf gluteal (L5-S2)
post hip dislocation
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23
Q

Which band of sarcomere shortens with contraction?

A

H and I bands

A band remains constant

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24
Q

Skeletal m. contraction sequence

A

depolarization moves down T tubule
voltage sensitive dihydropyridine receptor/ryanodine receptor releases SER Ca2+
Ca2+ binds troponin C/myosin free to bind
mysosin releases ADP/power stroke

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25
Fast twitch muscles
white color anaerobic glycolysis decreased myoglobin/mitochondria
26
Endochondral ossification
in axial/appendicular skeleton/base of skull bones cartilage made first by chondrocytes later replaced by lamellar bone (via osteoblasts/osteoclasts)
27
Membranous ossification
facial/calvarium bones | woven bones formed directly
28
47 y/o male growth on tibia glistening mass in medullary cavity
chondrosarcoma | malignant
29
Estrogen's role in bone formation
inhibits apoptosis of osteoblasts | induces apoptosis of osteoclasts
30
AD short limbs/lg head assc with older father
Achondroplasia | FGFR3 mutation constitutive expression
31
``` Calcinosis Raynaud's dysphagia sclerodactyly telangiectasia ```
CREST syndrome esophageal dysmotility (dysphagia) anti-Centromere Ab
32
Thick, dense bones multiple fractures pancytopenia facial n. palsy
Osteopetrosis/marble stone disease defective osteoclasts mutation of carbonic anhydrase II bone marrow space filled (pancytopenia)
33
Bowing bones | increased alkaline phosphatase
Osteomalacia/rickets (in children) Vit D deficiency defective mineralization hyperactivity of osteoblasts
34
Increased ALP Mosaic bone pattern chalk stick fractures
Paget's disease of bone hyperactivity of osteoblasts & osteoclasts increased AV shunts and osteogenic sarcoma
35
Osteitis fibrosa cystica
overproduction of PTH | brown tumors of hyperparathyroidism
36
25 y/o growth at epiphyseal end of femur double bubble/soap bubble on x-ray
Giant cell tumor (osteoclastoma) spindle shaped cells with multinculeated giant cells benign tumor
37
16 y/o male growth at the knee metaphysis of femur pt has Paget's disease
Osteosarcoma (osteogenic sarcoma) Sunburst pattern on x-ray malignant tumor Codman's triangle
38
11 y/o male onion skin appearance of bone diaphysis of femur
Ewing's sarcoma highly aggressive assc with t(11,22) translocation
39
47 y/o male growth on tibia glistening mass in medullary cavity
chondrosarcoma | malignant
40
Heberden's nodes (DIP) osteophytes obese 60 y/o
osteoarthritis | Bouchard's nodes also seen (PIP)
41
Ulnar deviation of fingers Baker's cyst MCP/PIP involvement stiffness improves with use
``` Rheumatoid arthritis Type III HS rxn anti-IgG assc with HLA-DR4 tx with TNF-alpha inhibitors ```
42
Dry eyes dry mouth joint pain female 52 y/o
``` Sjoegren's syndrome xerophthalmia/xerostomia/arthritis parotid enlargement increased B cell lymphoma Abs to riobnucleoprotein Ags assc with RA ```
43
Needle shaped/(-) birefringent yellow crystals swollen joints pain with EtOH/food more common in men
Gout monosodium urate crystals can be from Lesch-Nyhan syndrome/Von Gierke's diease painful MTP joint of great toe
44
Rhomboid crystals with weak (+) birefringence knee joint pain 66 y/o
Pseudogout calcium pyrophosphate crystals blue color
45
Bamboo spine stiff spine aortic regurg uveitis
Ankylosing spondylitits chronic inflammatory diease of spine/SI joints assc with HLA-B27
46
Conjunctivitis urethritis arthritis
Reactive arthritis/Reiter's syndrome | post GI/chlamydia infection
47
Progressive symmetric prox muscle weakness shoulder involvement (+) ANA and anti-Jo-1 muscle atrophy
Polymyositis CD8 T cell inflammation Dermatomyositis (CD4 T cells) if malar rash/Gottron's papules/heliotrope rash present
48
Muscle weakness, worsens with use | ptosis
Myasthenia gravis Abs to ACh receptor assc with thymoma
49
Muscle weakness, imrpvoes with use | proximal muslces
Lambert-Eaton syndrome Abs to presynaptic Ca2+ channels assc with small cell lung cancer
50
45 y/o women no wrinkles anti-Scl-70 Ab (+)
Scleroderma sclerosis of organs rapid progression
51
``` Calcinosis Raynaud's dysphagia sclerodactyly telangiectasia ```
CREST syndrome esophageal dysmotility (dysphagia) anti-Centromere Ab
52
MOA of bisphosphonates
bind hydroxyapatite in bone | inhibit osteoclast activity
53
47 y/o male growth on tibia glistening mass in medullary cavity
chondrosarcoma | malignant
54
11 y/o male onion skin appearance of bone diaphysis of femur
Ewing's sarcoma highly aggressive assc with t(11,22) translocation
55
16 y/o male growth at the knee metaphysis of femur pt has Paget's disease
Osteosarcoma (osteogenic sarcoma) Sunburst pattern on x-ray malignant tumor Codman's triangle
56
25 y/o growth at epiphyseal end of femur double bubble/soap bubble on x-ray
Giant cell tumor (osteoclastoma) spindle shaped cells with multinculeated giant cells benign tumor
57
Osteitis fibrosa cystica
overproduction of PTH | brown tumors of hyperparathyroidism
58
Increased ALP Mosaic bone pattern chalk stick fractures
Paget's disease of bone hyperactivity of osteoblasts & osteoclasts increased AV shunts and osteogenic sarcoma
59
Bowing bones | increased alkaline phosphatase
Osteomalacia/rickets (in children) Vit D deficiency defective mineralization hyperactivity of osteoblasts
60
Thick, dense bones multiple fractures pancytopenia facial n. palsy
Osteopetrosis/marble stone disease defective osteoclasts mutation of carbonic anhydrase II bone marrow space filled (pancytopenia)
61
Tx for senile osteoporosis
weight lifting/Ca2+/Vit D | Estrogen/Calcitonin/bisphosphonates/pulsatile PTH
62
AD short limbs/lg head assc with older father
Achondroplasia | FGFR3 mutation constitutive expression
63
Estrogen's role in bone formation
inhibits apoptosis of osteoblasts | induces apoptosis of osteoclasts
64
Origin of osteoclasts
macrophages/monocytes
65
Membranous ossification
facial/calvarium bones | woven bones formed directly
66
Endochondral ossification
in axial/appendicular skeleton/base of skull bones cartilage made first by chondrocytes later replaced by lamellar bone (via osteoblasts/osteoclasts)
67
Fast twitch muscles
white color anaerobic glycolysis decreased myoglobin/mitochondria
68
Skeletal m. contraction sequence
depolarization moves down T tubule voltage sensitive dihydropyridine receptor/ryanodine receptor releases SER Ca2+ Ca2+ binds troponin C/myosin free to bind mysosin releases ADP/power stroke
69
Which band of sarcomere shortens with contraction?
H and I bands | A band remains constant
70
Trouble walking up stairs | can't jump
``` Inf gluteal (L5-S2) post hip dislocation ```
71
Loss of thigh abduction
``` Sup gluteal (L4-S1) post hip dislocation ```
72
Foot drop
``` Common peroneal (L4-S3) knee trauma ```
73
Loss of thigh flexion/leg extension
femoral (L2-4) n. | pelivc fracture
74
Loss of thigh adduction
obturator (L2-4) n. | ant hip dislocation
75
Hand muscles innv by ulnar n.
Opponens digiti minimi abductor digiti minimi flexor digiti minimi
76
Hand muscles innv by median n.
Opponens pollicis abductor pollicis brevis flexor pollicis brevis
77
Winged scapula | lymphedema on ipsilateral side
Long thoracic n. (C5-C7) | loss of serratus ant fxn
78
Ape hand lesion
proximal median nerve lesion | loss of opponens pollicis m. fxn
79
Pope's blessing lesion
proximal median n. lesion | loss of lat finger flexion/thumb opposition
80
Lesion with median claw
dislocated lunate/carpal tunnel cannot extend 2nd/3rd digits distal median n.

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