MSK Flashcards
(150 cards)
1
Q
In a Clavicle fracture what muscle pulls the medial third Superiorly?
A
Sternocleidomastoid
2
Q
What happens to the Lateral fragment of the Clavicle in a Clavicular fracture and why?
A
Pulled inferiorly by the weight of the arm as the Trapezius isn’t strong enough to hold it up
3
Q
Which muscles attach to the Coracoid Process?
A
Biceps Brachii Short Head, Pectoralis Minor and Coracobrachialis
4
Q
What does the Acromion articulate with?
A
Clavicle
5
Q
What structure is between the Greater and Lesser Tubercles on the Humerous and what passes through it?
A
Bicipital Groove
Tendon of Biceps Brachii Long Head
6
Q
Which muscles attach to the medial epicondyle of the Humerous?
A
Pronator Teres, Flexor Carpi Radialis, Palmaris Longus, Flexor Carpi Ulnaris and Flexor Digitorum Superficialis
7
Q
What allows space for the Radius and Ulnar upon full flexion of the elbow?
A
Radial Fossa an Coronoid Fossa
8
Q
Whats the name of the surface of the Humerous that articulates with the Radius?
A
Capitulum
9
Q
Whats the name of the surface of the Humerous that articulates with the Ulnar?
A
Trochlea
10
Q
What provides space for part of the Ulnar on full extension of the elbow?
A
Olecranon Fossa
11
Q
What can be damaged in a surgical neck fracture of the Humerous?
A
The Axillary nerve and the Circumflex Humeral artery
12
Q
What can be damaged in a Mid-Shaft fracture of the Humerous?
A
Radial nerve and Brachial artery
13
Q
What is a Supracondylar fracture and what can it damage?
A
Its a fracture above the condyles of the Humerous, it can damage the Median nerve
14
Q
What can be damaged by an Avulsion of the medial epicondyle of the Humerous?
A
Ulnar nerve
15
Q
What forms the Trochlear Notch?
A
The Coranoid process and the Olecranon
16
Q
What is a Colles fracture?
A
Dinner fork fracture, a fall onto an extended wrist cause a transverse fracture of the distal 2cm of the radius and posterior displacement of this segment
17
Q
Whats a Smiths fracture?
A
Fall onto a flexed wrist causes a transverse fracture of the distal 2cm of the radius and anterior displacement of this segment
18
Q
What causes a Scaphoid fracture?
A
Fall onto palm of abducted hand
19
Q
What is an added risk of Scaphoid fractures?
A
Can cause damage to the distal blood vessel supplying it, this causes avasuclar necrosis
20
Q
What is a boxers fracture?
A
A break in the distal neck of either the 4th or 5th metacarpals
21
Q
Which artery supplies the posterior compartment of the arm?
A
Deep Brachial artery
22
Q
Which artery supplies the anterior compartment of the arm?
A
Brachial artery
23
Q
How is the hand supplied with blood?
A
Radial and Ulnar arteries join to for the deep and superficial plamar arches
24
Q
Which vein runs along the medial aspect of the arm?
A
Basilic Vein
25
Which vein runs along the lateral aspect of the arm?
Cephalic Vein
26
What does the Musculocutaneous nerve innervate?
Coracobrachialis, Biceps Brachii, Brachialis and skin on the lateral edge of the forearm
27
What does the Axillary nerve innervate?
Glenohumoral joint, Teres Minor, Deltoid and the skin of the regimental patch
28
What does the Meddian nerve innervate?
Anterior compartment of the forearm and the skin of the palm
29
What does the Radial nerve innervate?
Posterior Compartments of the arm and skin of the arm and forearm
30
What does the Ulnar nerve innervate?
5th digit of the hand, Intrinsic hand muscles, Flexor Carpi Ulnaris and half of Flexor Digitorum Profundus
31
What forms the apex of the Axilla?
Lateral boarder of the 1st rib, superior boarder of the scapula and posterior boarder of the clavicle
32
What forms the lateral wall of the Axilla?
Bicipital Groove
33
What forms the medial wall of the Axilla?
Seratus anterior and the thoracic wall
34
What forms the anterior wall of the Axilla?
Pectoralis major and minor
35
What forms the posterior wall of the Axilla?
Scapularis, Teres major and Latissimus Dorsi
36
What can be damaged in Lymphatic clearance of the Axilla and what does this damage cause?
Long Thoracic nerve, it innervates Seratus Anterior and damage to it can cause a winged scapula
37
What is contained in the Cubital Fossa?
Biceps Tendon, Brachial artery, Median nerve
38
What are the boarders of the Cubital Fossa?
Superior boarder is the line between the epicondyles, Medial boarder is the lateral boarder of Pronator Teres, Lateral boarder is the medial boarder of Brachioradialis
39
Whats contained in Guyon's Canal?
Ulnar nerve and the Ulnar artery
40
What happens if you have constant pressure on Guyon's Canal and whats it called?
Ulnar nerve entrapment, this leads to some ulnar clawing and paraesthesia of the medial 1.5 digits. Called Handlebar Palsy
41
What are the boarders of the carpal tunnel?
Anterior is the Flexor Retinaculum, Posterior is the Carpal bones, Lateral is the Scaphoid and Trapezium, Medial is Hook of Hamate and Pisiformis
42
What are the contents of the carpal tunnel?
4 tendons of both Flexor Digitorum Superficialis and Profundus, Tendon of Flexor Policis Longus, Median nerve
43
What causes Carpal Tunnel syndrome?
Impingement of the Median nerve against the Flexor Retinaculum
44
What does Carpal Tunnel syndrome lead to?
Paraesthesia of the digital cutaneous branch of the median nerve. Causes absent opposition, reduced abduction and flexion
45
What is in the Anatomical Snuff box?
Extensor Policis Longus, Extensor Policis Brevis, Abductor Policis Longus and the Radial artery
46
How would an injury to the Musculocutaneous nerve present?
Weak flexion at the elbow, weak supination at the elbow, desensitization down lateral aspect of forearm
47
How would an injury to the Ulnar nerve at the wrist present?
Abduction and Adduction of fingers impossible, unopposed flexion of IP joints on 3rd and 4th lumbricles
48
What could cause damage to the Radial nerve at the Axilla?
Dislocation of the shoulder, Sustained pressure pushing on armpit
49
How would damage of the Radial nerve at the Axilla present?
Wrist drop, unable to extend elbow, unable to extend fingers
50
How would damage of the Radial nerve at the Humerous present?
Weakened extension of elbow, wrist drop, unable to extend fingers, loss of sensation over lateral 3.5 digits
51
How would damage to the Radial nerve at the wrist present?
Loss of sensation on posterior surface of lateralt 3.5 digits
52
What could cause damage to the Median nerve at the elbow?
Supracondylar Fracture, incorrect Venepuncture
53
How would damage to the Median nerve at the wrist present?
Hand of Benediction, Ape hand
54
How would damage to the Axillary nerve present?
Unable to abduct 15-90 degrees, desensitisation of the regimental patch
55
Which 3 ligaments help to externally support the glenohumoral joint?
Coracoacromial, Coracohumoral, Glenohumoral
56
What are the 4 main rotator cuff muscles?
Supraspinatous, Infraspinatous, Teres Minor, Subscapularis
57
What happens in a Glenohumoral Dislocation?
Powerful adductors pull the head anteriorly in a disslocation
58
What causes Painful Arc Syndrome and what are the symptoms?
Tendon of Subscapularis becomes trapped under Coracoacromial Ligament. Causes pain between 50-130 degrees of abduction
59
How does a tear in the Supraspinatous present?
Unable to abduct from 0-15 degrees
60
Which muscles cause flexion at the Glenohumoral Joint?
Pec Major, Anterior Deltoid, Coracobrachialis, Biceps Brachii
61
Which muscles cause extension at the Glenohumoral Joint?
Posterior Deltoid, Latissimus Dorsi, Teres Major
62
Which muscles cause abduction at the Glenohumoral Joint?
Supraspinatous, Middle Deltoid, Seratus Anterior
63
Which muscles cause adduction at the Glenohumoral Joint?
Pec Major, Latissimus Dorsi, Teres Major
64
Which muscles cause medial rotation at the Glenohumoral Joint?
Pec Major, Subscapularis, Latissimus Dorsi, Teres Major
65
Which muscles cause lateral rotation at the Glenohumoral Joint?
Teres Minor, Infraspinatous
66
What does the Annular ligament do?
Wraps around the Radius and joins to the Ulnar on either side of the radial notch
67
Whats the name of the hole in the Pelvis and what is it formed by?
Obturator Foramen, formed by the Ischium + Pubis
68
Where are the attachments for the Inguinal ligament?
Anterior Superior Iliac Spine -> Pubic tubercle
69
What structure on the back of the Pelvis does the Sciatic nerve run through?
The Greater Sciatic Notch
70
What part of the Pelvis bears the weight of the body when sitting down?
Ischial Tuberosity
71
Where is the Lina Aspera and which muscles attach to it?
Situated on posterior aspect of Femur, attachment for Adductor Magnus + Pectineus
72
What is the attachment site for the adductors of the leg and where is it situated?
Adductor Tubercle, found superior to the medial epicondyle
73
What is the attachment site for the Achilles Tendon
Calcaneus Tuberosity
74
What is the risk of an Intracapsular fracture and how does it present?
Damage to the Medial circumflex artery and lead to avascular necrosis, Shortened + laterallyrotated leg
75
What is an extracapsular fracture and how does it present?
Fracture outside the capsule of the femur, presents with a shortened and laterally rotated leg
76
How do you get avulsion of the Greater Trochanter? What muscles attach here?
Extreme force eg. car crash. Attachment site for Gluteus Medius + Minimus
77
Mid-shaft fractures of Femur take large amount of force, what do they risk and how does it present?
Risk of femoral artery damage, Presents with leg shortening due to overlapping fragments
78
What is a Bumper Break and what are the problems it causes?
Break to the Tibial condyles (similar height to car bumper), attachment point for Cruciate + Collateral ligaments
79
What causes a Medial Maleolar Fracture?
Over eversion of the ankle forces the medial Maleolus against the Talus causing it to fracture, often accompanied by fracture of Lateral Maleolus
80
What causes a Lateral Maleolar Fracture?
Over inversion of the ankle forces the lateral Maleolus against the Talus causing it to fracture
81
In what two ways can you get a fracture of the Talus? Why are these fractures easy to repair?
1. Excessive dorsiflexion of the foot causes neck of Talus to snag on Tibia + snap off 2. Jump from height, force transmitted through Calcaneous into Talus which cant handle it and breaks. Fragments held together by Maleoli
82
How do you fracture the Calcaneous and what problems does it cause?
High falls can fracture the Calcaneous rather than transmit the force upwards into the Talus, this forces the Talus into the Calcaneous disrupting the joint + leading to arthritis
83
Which arteries are given off by the internal Iliac artery?
Obturator, Internal + External Gluteal Arteries
84
The Deep Femoral artery travels posteriorly, what arteries does it give off?
Medial + Lateral Femoral Circumflex arteries
85
What does the Superficial Femoral Artery become after it passes though the adductor haitus?
Popliteal artery
86
What does the Popliteal Artery Terminate into?
Anterior + Posterior Tibial Arteries
87
What is the route of the Great Saphinous Vein?
Arises from Dorsal venous arch, passes anteriorly to medial Maleolus the posterior to medial condyle of the femur. Drains into the femoral vein just before the inguinal ligament
88
Whats the route of the Small Saphinous Vein?
Arises from Dorsal venous arch, passes posteriorly to lateral Maleolus, Travels up leg between the two heads of Gastrocnemius and drains into Popliteal vein
89
What produces the Popliteal vein?
Posterior + Anterior Tibial veins combine to produce the Popliteal vein
90
What causes Vericose veins?
Incompetence of valves in superficial veins
91
What forms the boarders of the Popliteal Fossa?
Superiomedial - Semimembranous
Superiolateral - Biceps Femoris
Inferiomedial - Medial head of Gastrocnemius
Inferiolateral - Lateral head of Gastrocnemius
92
What causes a Bakers Cyst?
Inflammation of the Semimambranous Bursa
93
What are the main clinically relevant terminal branches given off by the Lumbar Plexus? What are their roots?
Obturator Nerve (L2-L4), Femoral Nerve (L2-L4)
94
What are the terminal branches given off by the Sacral Plexus? What are their roots?
```
Superior Gluteal (L4-S1)
Inferior Gluteal (L5-S2)
Sciatic (L4-S3)
Posterior Femoral Cutaneous (S1-S3)
Pudendal (S2-S4)
```
95
What does the Femoral Nerve innervate?
Quadriceps, Sartorius, Pectinieus
96
How could the Femoral nerve be injured at the Hip? How would it present?
Missed Femoral stab, Trauma.
| Presents with damage to hip flexors + Knee extenders
97
What does the Obturator Nerve Innervate?
Adductors Logus, Brevis + Magnus, Gracilis + Obturator Externus
98
How could the Obturator nerve be injured at the pelvis and how would it present?
Injured by Surgery or trauma.
| Weakened adduction
99
What does the Sciatic nerve innervate?
Semimembranosus, Semitendinosus, Biceps Femoris, Adductor Magnus, All of the leg + foot (as Fibular + Tibial nerves)
100
How could the Sciatic nerve be injured in the Gluteal region and how would it present?
Incorrect intramuscular injection.
| Inability to flex knee, difficulty with all movements of the ankle + foot
101
What does the Tibial nerve innervate?
Posterior compartment of the leg
102
How could the Tibial nerve be damaged in the posterior compartment and how would it present?
Trauma, Entrapment in narrow space, Compression in Popliteal Fossa (Bakers Cycst)
Loss of Plantarflexion, loss of flexion of toes
103
Which muscles are innervated by the Superficial Fibular nerve?
Fibularis Longus + Brevis (Plantarflexion + Eversion of ankle)
104
How could the Superficial Fibular nerve be damaged and how would it present?
Fracture of Fibula, Perforating wound to lateral leg.
| Loss of Eversion and weakened Plantarflexion
105
Which muscles are innervated by the Deep Fibular Nerve?
Tibialis anterior, Extensor Digitorum Longus, Extensor Hallucis Longus, Fibularis Tertius
106
What can cause injury to the Deep Fibular Nerve and how would it present?
Overuse of the anterior muscles can cause compression on the nerve.
Presents as foot drop due to loss of ability to Dorsiflex foot
107
What are the 5 Ligaments that stabalise the hip joint?
Iliofemoral
Pubofemoral
Ischiofemoral
Ilgament of Head of Femur - Acetabulum -> Capitis of head of femur
Transverse Acetabular - Improves stability of Acetabulum
108
Which muscles cause flexion of the hip joint?
Rectus Femoris, Sartorius, Anterior part of Adductor Magnus, Adductor Longus + Brevis, Pectineus
109
Which muscles cause extension of the hip joint?
Gluteus Maximus, Semimembranosus, Semitendinosus, Long head Biceps Femoris, Posterior part of Adductor Magnus
110
Which muscles Adduct the hip joint?
Pectinius, Adductors Longus, Brevis + Magnus, Obturator Externus, Gracilis
111
Which muscles Abduct the hip joint?
Gluteus Medius + Minimus, Tensor Fasciae Latae
112
Which muscles externally rotate the hip joint?
Gluteus Maximus, Biceps Femoris, Obturator internal + External, Quadratus Femoris
113
Which muscles internally rotate the hip joint?
Gluteus Medius + Minimus, Tensor Faciae Latae
114
What are the 2 main clinically relevant Bursae of the hip?
Trochanteric - Sits on Greater Trochanter
| Ischiogluteal - Lies between Ischial tuberosity + Gluteus Maximus
115
What are the Menisci of the knee and what are their function?
Fibrocartilagenous disks between Femoral condyles + Tibeal Plateu.
Act as shock absorbers + Deepen articular surface
116
What makes up the Unhappy Triad?
Medial Meniscus
Medial Collateral Ligament
Anterior Cruciate Ligament
117
What are the attachments of the Anterior Cruciate Ligament? Whats its function?
Anterior Intercondylar Eminance of Tibia -> Intercondylar Fossa of Femur.
Prevents Hyper extension of knee joint
118
What are the attachments of the Posterior Cruciate Ligament? Whats its function?
Posterior Intercondylar Eminance of Tibia -> Intercondylar Fossa of Femur.
Prevens Posterior movement of joint
119
Which muscles cause flexion of the knee?
Semitendinosus, Semimembranosus, Biceps Femoris
120
Which muscles cause Extension of the knee?
Rectus Femoris, 3 Vastus muscles
121
Which muscles cause Medial rotation of the knee?
Semitendinosus, Semimembranosus, Popliteus, Sartorius
122
Which muscle causes Lateral rotation of the knee?
Biceps Femoris
123
What causes damage to the Medial Collateral Ligament? What is a common secondary injury?
Blow to Lateral side of knee stretches Medial Collateral Ligament.
Strongly attached to Medial Meniscus so often tears this
124
What causes the Unhappy Triad?
Tearing of the ACL leads to medial movement of Femur which tears Medial Collateral Ligament, which tears Medial Meniscus
125
What are the 4 Medial Ligaments of the ankle?
Tibionavicular
Tibiocalcaneal
Anterior + Posterior Tibiotalar
126
What are the 3 Lateral Ligaments of the ankle?
Anterior + Posterior Talo-Fibular
| Calcaneofibular
127
Which muscles cause Dorsiflexion in the ankle?
Tibialis Anterior, Extensor Digitorum Longus, Extensor Hallucis Longus
128
Which muscles cause Plantarflexion in the ankle?
Gastrocnemius, Soleus, Tibialis Posterior
129
What are the stages of a normal Gait?
Push off -> Limb Lift -> Raise Foot -> Final Swing -> Heel Strike -> Stand -> Move to Ball of Foot
130
What happens in a Pott's fracture?
Excessive Eversion of the foot strains the Medial Ligaments until they Evulse the Medial Malleolus, this release of force moves the Talus Laterally breaking off the Lateral Malleolus. The Tibia moves Anteriorly which may lead to the Posterior aspect being sheared off
131
What causes a Antalgic Gait and how does it present?
Caused by patients who have Chronic foot pain.
| Adapt their Gait so they spend less time in stance phase, they rush to get back into swing phase.
132
What causes Trendelenburgs Gait and how does it present?
Damage to the Superior Gluteal Nerve paralyses Gluteus Medius + Minimus, this destabalises the hip so the Pelvis will drop to the side when one leg is lifted up
133
What causes High-Steppage Gait and how does it present?
Damage to the Common or Deep Fibular nerve causes loss of Dorsiflexion, Patients lift their leg up higher than normal to prevent their toes from catching on the floor
134
How many bones make up the spine?
33
135
What are the common features across all Vertebrae?
Spinous process
Lamina
Superior + Inferior articular processes
Pedicles
136
What are the 5 sections of the spine and how many vertebrae are in each?
```
Cervicle - 7
Thoracic - 12
Lumbar - 5
Sacrum - 5 (fused)
Coccyx - 4 (fused)
```
137
What are the distinguishing features of Cervical Vertebrae?
Bifid spinous process
Transverse foramen for vertebral arteries
Triangular vertebral foramen
138
What are the distinguishing features of Thoracic Vertebrae?
First 10 have costal facets (rib articulations)
Spinous process points downwards
Circular vertebral foramen
139
What are the distinguishing features of Lumbar Vertebrae?
Largest Vertebrae
Short chunky spinous process
Triangular vertebral foramen
140
What are the distinguishing features of the Sacrum?
Articulates with the pelvis
| Triangular shaped collection of bone
141
What joint does the Atlas form to allow the head to nod up and down?
Atlanto-Occipital joint
142
What is the Axis responsible for? What part of the Axis allows it to perform its function?
Allows rotation of the head
| The Dens
143
What are the two parts of intervertebral disks?
Nucleus Polposus
| Annulus Fibrosus
144
What are the 4 main ligaments of the spine?
Anterior + Posterior Longitudinal Ligament
Interspinous Ligament
Supraspinous Ligament
145
What is Kyphosis?
Abnormal convexing of the Thoracic part of the spine causing a hunched back.
Leads to pain and stiffness
146
What is Lordosis?
Abnormal concaving of the Lumbar or Cervical part of the spine, causes a saddle back.
Leads to pain and stiffness
147
What is Scoliosis?
Three Dimensional deformity of the spine, causes some lateral deviation and twisting of the spine.
Can cause problems with posture
148
What happens in a slipped disk?
Nucleus Polposus herniates through Annulus Fibrosus in either a posterior or posteriolateral direction, Posteriolateral will cause pain due to compression of nerve roots + inflammatory response. Posterior direction can cause compression of spinal cord - can lead to paralysis
149
Where are you most likely to see a slipped disk?
L4-L5
| L5-S1
150
Where are you most likely to see dislocation of the vertebrae due to Whiplash?
C5-C6
