Flashcards in Musculoskeletal, skin, connective tissue anatomy and phys Deck (45)
What is the unhappy triad?
Common injury in sports due to lateral force on a planted leg.
Damage to ACL, MCL, and medial meniscus (attached to MCL)
What can cause a prepatellar bursitis?
Excessive kneeling on the knee leading to inflammation of the prepatellar bursa.
What is a bakers cyst?
Fluid collection in the popliteal space related to chronic joint disease.
What muscles form the rotator cuff?
SItS (small t is for teres minor)
Supraspinatus abductor and most common injury test with empty full can test..
Infraspinatus Laterally rotates arm -- pitching injury
Teres minor - adducts and laterally rotates arm
Subscapularis -- medially rotates and adduct arm.
What nerve primarily innervates the rotator cuff muscles?
What is golfers elbow?
Excessive flexion causing pain to medial condyle.
As opposed to tennis elbow caused by excessive extension and pain at lateral condyle.
What are the proximal bones in the wrist?
Scaphoid, Lunate, Triquetrum, Pisiform
"So Long To Pinky"
From lateral to medial.
What are the distal bones in the wrist?
Hammat, Capitate, Trapezoid, Trapezium
"Here Comes The Thumb"
From medial to lateral
Which wrist bone is most commonly fractured?
The scaphoid found in the snuff box.
Dislocation of which wrist bone can cause acute carpal tunnel syndrome?
What nerve is damaged on an outstretched hand following pisiform fracture?
The ulnar nerve.
What is Guyon canal syndrome?
Compression of the ulnar nerve at the wrist typically seen in cyclists due to handlebar pressure.
If there is a shoulder injury and the deltoid begins to flatten out which nerve should you suspect is damaged?
The axillary nerve C5-C6
If there is a loss in forearm flexion and supination and loss of sensation over the lateral forearm which nerve should you suspect is damaged?
the use of crutches, or compression of the axilla causing "Saturday night palsy" Is common following the compression of which nerve?
Compression of the radial nerve.
Leads to wrist drop/ loss of wrist, elbow, and finger extension.
As well as decreased grip strength and sensation over posterior arm and forearm.
Damage to which nerve will result in an apes hand or popes blessing with loss of wrist flexion, flexion of th lateral three fingers, thumb aposition?
Median nerve C5-T1
If you have an ulnar claw on digit extension which nerve should you suspect to be gone?
How will the wrist deviate with flexion if the ulnar nerve is gone?
A superficial laceration of the hand will result in which form of muscle loss?
Ape hand with loss of the thenar muscle group including oposition abduction and flexion of the thumb.
Here it is the recurrent branch of the median nerve being damaged.
Which hand nerve is responsible for innervating most of the intrinsic muscles of the hand?
The ulnar nerve.
Damage results in the popes blessing with loss of hand intrinsics.
What is erbs palsy/ Waiters palsy?
Loss of the arm flexors resulting in severe extension of the arm and flexion of the wrist.
Think damage to musculocutaneous or babies that had lateral traction of the neck during delivery effecting C5 and C6.
What is klumpskey palsy?
Traction or tear of lower trunk C8-T1 root.
Think of an upward force on an infants arm during delivery. Damages the ulnar nerve leading to loss of hand intrinsics and a total claw hand.
How will thoracic outlet syndrome present?
Just like klumpskeys with total hand claw because of damage to the ulnar nerve.
What nerve is damaged in a winged scapula?
Long thoracic nerve (C5-C6, C7) damaged leading to inability to anchor scapula to thoracic cage.
Why is clawing made so prominent?
With distal lesions of the median or ulnar nerves the intrinsics of the hand are taken out. The extrinsics are still functional and exagerate the loss of the lumbricals.
When would deficits in the hand due to nerve injury be very minor/under pronounced?
Proximal lesions in the arm would result in less prominant hand distortions compared to distal lesions.
When trying to extend the fingers, only the lateral three are able to extend out of flexion. Where is the lesion?
Lesion is ulnar and the pinky and ring finger are unable to extend leading to whats known as the "ulnar claw"
When making a fist, the thumb, second, and third finger are unable to flex. What has been damaged?
The median nerve proximally, this makes what is known as the popes blessing.
Atrophy of the thenar eminance causing an unnoposable thumb is seen with damage to what?
Median nerve lesions.
Known as an ape hand.
Atrophy of the hypothenar emanance (pinky side) is seen with what sort of nerve lesions?
Ulnar nerve lesions.
How will an injury to the superior gluteal nerve present?
Presents with trendelenburg sign with the pelvis tilting on the contralateral side of the lesion.
What landmark in the pelvis can be used when blocking the pudendal nerve?
The ischial spine aka location of the greater sciatic foramen!
When there is a lumbosacral radiculopathy, which nerve is damaged relative to the vertebral body?
The nerve below the spinal level.
AKA if the L3 L4 vertebral disk is damaged, the L4 nerve is damaged with it.
What direction do intervertebral discs tend to herniate?
Tend to herniate posteriorly due to thin posterior longitudinal ligament compared to anterior.
Describe what weaknesses would be seen with nerve impingement at disc levels L3-L4?
Leg extension weakened, weakened patellar reflex.
Describe what weaknesses would be seen with nerve inpingment at L4-L5 discs
Weakness in dorsiflexion/ difficulty heel walking.
Describe what weaknesses would be seen with disc interuption at L5-S1
Weakness of plantarflexion and difficulty toe flexing with decreased achilles reflex.
Describe the full cycle leading to muscle conduction and contractions
Muscle cleft is depolarized and travels down the T-tubules.
The depolarization activates ryanidine receptors in the T-tubules leading to calcium release through the sarcoplasmic reticulum.
Calcium binds to troponin C moving tropomysin out of the way allowing actin to bind to myosin.
In the muscle sarcomere, contraction leads to shortening of which bands?
H and I bands and between Z lines.
A BAND IS ALWAYS THE SAME LENGTH
Binding of ATP causes the ... to release from the .... in the sarcomere.
Causes the Myosin head to release from the actin and becomes cocked for the next contraction cycle.
What are type 1 muscle fibers?
Slow twitch red fibers.
Lots more mitochondria and myolobin.
"1 slow ox"
What are type 2 muscle fibers?
These are fast twitch white fibers resulting from degreased mitochondra and myoglobin.
Weight training increases fast twitch muscles!!!`
What type of bones in the human body generally undergo membranous ossification?
Bones of the calvarium and facial bones. Woven bone generally formd without cartilage and later remodeled to lamellar bone.
What stem cells do osteoblasts differentiate from?
Mesenchymal stem cells in the periosteum.
Osteoclasts come from macrophages and monocytes.