MSS 1 Exam 1 diseases Flashcards

Question

Post-Mastectomy Lymphedema

Answer 1

Removal of axillary lymph nodes disrupts lymph drainage from upper limb Treated via exercise, compression bandages, and massage

Answer 2

Tumors of connective tissue or its mesenchymal precursors are known as Sarcomas. Most common adult soft tissue sarcoma is Malignant Fibrous Histiocytoma. Uncertain cellular origin, but probably derived from perivascular mesenchymal cells. Tumor consists of mixture of fibroblasts, myofibroblasts, macrophages, and primitive mesenchymal cells. The MASL1 Gene has been associated with this tumor. Tumors typically arise in deep fascia, soft tissues of the neck or extremities, and skeletal muscle. Distant metastases may spread to lung, bone, or liver. Treatment usually by radical resection.

Answer 3

Anaphylaxis is a life-threatening allergic reaction. Starts when IgE antibodies (Abs) bind with allergens. Mast Cell membranes incorporate receptors for IgE. When receptor-bound IgE is exposed to Antigen (Ag), Mast Cells release contents of their granules (histamine, heparin, and other stored molecules). Histamine dilates small blood vessels & increases their permeability so that plasma leaks out. Skin appears red and edematous (swollen with fluid). These cells also activate pathway leading to release of Prostaglandins, Leukotrienes, and Platelet-Activating Factor (PAF). Less severe reaction, called Wheals of Urticaria, or Hives, also caused by release of histamine from mast cells.

Answer 4

Complex collagen synthesis can be impaired by dietary deficiency of Vitamin C (Ascorbic Acid). Leads to Scurvy. Lack of Vitamin C causes non-hydroxylated, unstable collagen fibrils to fail to form a triple helix and have low tensile strength. Dentine (teeth), Osteoid (bone), Connective Tissues, and Tunica Adventitia (outer walls of blood vessels) are affected, but typical hemorrhage and poor wound healing can occur anywhere.

Answer 5

All forms of EDS involve a Genetic Defect in synthesis or assembly of Collagen Fibrils, results being Hyper-Elastic Skin and Hyper-Movable Joints. Vascular EDS, the most severe, is caused by a mutation in the COL3A1 Gene that leads to abnormal Type III Collagen. Mutation in genetic structure leads to mutant enzyme production causing serious effects, including: Aortic Rupture Perforation of Colon Retinal Detachment

Answer 6

Marfan Syndrome is an inherited connective tissue disorder caused by molecular defects in FBN1 Gene that encodes the glycoprotein fibrillin-1. This extracellular protein is a component of microfibrils, which serve as scaffolds for elastic fiber deposition. Abnormal Elastic Tissues in the body mark the disease. Cardiovascular lesions, the most life-threatening, include mitral valve prolapse, and weakening of the tunica media of the aorta (which may spontaneously rupture). Loss of connective tissue support in heart valves creates the so-called Floppy Valve that may contribute to heart failure.

Answer 7

excessive pressure within a compartment Tough deep fascia does not allow for much stretching Buildup of fluid internally (e.g., bleeding, rhabdomyolysis) can increase pressure May impede blood flow and/or impinge nerves within compartment

Answer 8

Can result from wear on an inflamed tendon or injury Often “snap” or “pop” when rupture occurs Popeye deformity occurs when muscle belly becomes displaced and forms a bulge

Answer 9

High risk of damage to brachial artery, ulnar and median nerves, potentially to epiphyseal growth plates in children

Answer 10

Medial Epicondylitis Inflammation of common flexor tendon typically due to repetitive powerful gripping. Common in golf, racket sports, and throwing sports (baseball, football, etc.) which require repetitive squeezing of handle or ball. Feel pain when shaking hands, opening door, or lifting glass (movements that require digit/wrist flexion). ~90% of cases successfully treated with non-surgical approaches (rest, anti-inflammatories, physical therapy

Answer 11

Lateral Epicondylitis Inflammation of common extensor tendon due repetitive forceful wrist extension. Common in tennis, or from repetitive swinging of a hammer or paint brush Feel pain when shaking hands, opening door, or lifting glass (movements that pull on tendon) ~95% of cases successfully treated with non-surgical approaches (rest, anti-inflammatories, physical therapy)

Answer 12

Synovial sheaths which cover tendons of digit flexors. Reduce friction during tendon movement Ulnar Bursa Common sheath of FDP & FDS tendons at wrist Continues along digit 5* Radial Bursa Flexor pollicis longus sheath* Digits 2-4 have separate digital sheaths * Bursae pass through carpal tunnel into forearm. Infections can spread from digit 1 or 5 to palm and then forearm via bursae

Answer 13

``` “Trigger Finger” Inflamed section (nodule) of flexor tendon gets trapped behind fibrous sheath. ``` Digit catches during flexion or becomes locked in flexed position. More prevalent in patients with rheumatoid arthritis or diabetes. Treatments Steroid injections & rest (reduce inflammation) Surgical release (cut proximal fibrous sheath)

Answer 14

Synovial sheaths which cover tendons of digit extensors. Do NOT extend along digits (wrist only) Tendons insert into extensor expansions 6 sheaths (compartments) 1st: abductor pollicis longus & extensor pollicis brevis 2nd extensor carpi radialis brevis & extensor carpi radialis longus 3rd: extensor pollicis longus 4th: extensor digitorum (4 tendons) & extensor indicis 5th: extensor digiti minimi 6th: extensor carpi ulnaris

Answer 15

``` Extensor expansions (“hoods”) Special connective attachments Connect extensor tendons to phalanges Act across MCP, PIP and DIP joints ``` Also attachment site for some intrinsic muscles of hand Dorsal & Palmer interosseus muscles Lumbrical muscles

Answer 16

“Gamer’s Thumb” Thickening of 1st extensor compartment synovial sheath Cause is unknown, but repetitive thumb abduction/extension aggravate condition Pain & swelling limit function of abductor pollicis longus & extensor pollicis brevis Pain can be surgically alleviated by “release” of extensor retinaculum

Answer 17

Tough investing fascia of palm Tensed by palmaris longus Divides into 4 parts over metacarpals II-V. Connect to fibrous sheaths of digits. Transverse connections (Fasciculi) between slips prevent excessive ABduction of metacarpals

Answer 18

Permanent shortening of palmar aponeurosis. Most commonly affects the 4th & 5th digits Connection to fibrous flexor sheath of digit forces digit into flexion Develops slowly, cause is unknown Usually begins after age 40 20% of individuals over age 65

Answer 19

Extensor expansions Intertendinous connections Extensor retinaculum

Answer 20

Surrounded by palmar and dorsal aponeuroses (Fascia) ``` Fibrous septa divides into 5 compartments Thenar Adductor Central Interosseous Hypothenar ```

Answer 21

Adductor pollicis makes up most of soft tissue webspace between pollex and 2nd digit. Adductor pollicis (especially transverse head) commonly injured in defensive wounds from sharp force trauma From victim actively attempting to grab knife with hands

Answer 22

Deep spaces between compartments Thenar Space Between thenar and adductor compartments Midpalmar Space Between central and interosseous compartments Continuous with forearm via carpal tunnel. Potential pathway for movement of infections into forearm.

Answer 23

Boundaries: Inferior - Latissimus Dorsi Superior – Trapezius Lateral - Rhomboid major Overlies 6th intercostal space. Floor has no large muscles. Good place for assessing respiratory sounds with stethoscope.

Answer 24

An orthopedic test of supraspinatus function (i.e., rotator cuff tear). Examiner passively abducts the patient’s shoulder to 90 degrees. Examiner instructs patient to slowly lower the arm. Test is positive if the patient is unable to lower his or her arm in a smooth, controlled fashion (especially below 15 degrees).

Answer 25

Majority of clavicle fractures occur at midshaft Sternocleidomastiod muscle pulls medial fragment superiorly Weight of arm pulls lateral fragment inferiorly Pectoralis major pulls arm and lateral fragment medially (under the medial fragment).

Answer 26

Inability to protract medial scapula. Can be tested by having patient push against wall. Damage to muscle or long thoracic n. Usually trauma related (car accidents, mastectomy)

Answer 27

Rare anatomical variant (~8% of population) Usually unilateral May be misdiagnosed as cancerous mass during mammography

Answer 28

The clavicle is the only post-cranial bone to form via intramembranous ossification (like cranial bones). Individuals with craniofacial growth abnormalities (dysostosis) often exhibit abnormal clavicles

Answer 29

“Separated shoulder” actually damage to scapulo-clavicular ligaments Usually from fall directly on “point” of shoulder. ``` Rockwood classification 3 types Type 1 partial AC tear Type 2 complete AC tear Type 3 complete AC and CC tear ```

Answer 30

Superior Labrum Anterior & Posterior (SLAP) tear Tendon of biceps brachii muscle (long head) connected to labrum. Usually due to excessive and/or repetitive rotation during overhead throwing Twisting tendon puts tension on labrum

Answer 31

“Dislocated shoulder” results from displacement of humeral head from glenoid fossa. Usually from traumatic hyper-extension of abducted arm. In 95% of shoulder dislocations the humeral head is dislocated anteriorly. Posterior and inferior dislocations are possible but rare (greater muscular support). Complications ``` Nerve damage Axillary nerve (37% of cases) Suprascapular nerve (29% of cases) Radial nerve (22% of cases) ``` Hill-Sachs Lesion-Divot created on posterior surface of humeral head from contact with glenoid rim. Interferes with rotational movement of humeral head following reduction

Answer 32

Inflammation of bursae, typically due to direct pressure on bursae. Shoulder Bursitis Usually subacromial bursa Direct pressure of humerus on acromion process (leaning elbow on table drives humerus superiorly) Overhead movement of humerus impinges bursa in subacromial space

Answer 33

Usually in children 1 – 6 years (small radial heads) Rapid pull/jerk on pronated forearm Radial head slips out of annular ligament Child presents with limited limb motion, forearm usually held in flexed-prone position (pain upon supination) Usually easily reduced via traction-supination or hyper-pronation techniques

Answer 34

Three bursae supporting triceps brachii muscle and tendon at elbow Subtendinous bursa Intratendinous bursa Olecranon bursa Elbow Bursitis Typically due to direct pressure on olecranon bursa from resting elbow on hard surface

Answer 35

From punching something hard Usually fifth metacarpal, other digits less commonly broken because force can be directly transmitted to radius

Answer 36

* Autoimmune disease where antibodies are formed against the Ach receptors, preventing Ach binding * Blocks normal muscle-nerve interaction resulting in progressive muscle weakness * Mostly affects face and neck muscles

Answer 37

* Degradation of brain nerve cells and certain motor neurons leading to muscle weakness * Leads to atrophy of muscle and smaller bundles under microscope

Answer 38

* Causes progressive muscle weakness and loss of muscle mass * Caused by replacement of muscle with other tissue types

Answer 39

* Nematode parasitic infection caused by eating undercooked meat * Digestion allows larva to break from the cyst and grow into adults which then invade muscle tissue including heart and diaphragm

MSS 1 Exam 1 diseases Flashcards

(64 cards)