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MSK System
WVSOM: Musculoskeletal System
| Question | Answer |
|---|---|
| In the body, what do myotomes and dermatomes come from | somites |
| Dorsal mass from the different limb buds become which type of muscles | extensors |
| Which nerve is needed for a strong grip | median nerve |
| Which nerve gets most of the flexors in the forearm | median nerve |
| which nerve gets most of the intrinsic muscles of the hand | ulnar nerve |
| Nerve to deltiod and teres minor | axillary nerve |
| nerve to the lateral compartment of the leg | superficial fibular nerve |
| nerve to anterior compartment of the leg | deep fibular nerve |
| which nerve gets the hamstring muscles | tibial nerve |
| Dorsiflexion of the foot and extension of the toes is done via which nerve | deep fibular |
| Weakness is seen in UPN lesiosn or LMN lesions? | BOTH |
| What makes up a muscle spindle | sensory receptors made up of muscle fibers encased by CT and nerves |
| Do muscle spindles increase tone to the muscle being stretched or its antagonist | muscle being stretched |
| What decreases tone to a muscle being stretched and activates its antagonist | Golgi Tendon organs |
| Slow twitch muscles carry out which type of metabolism | oxidative metabolism |
| What are the other names for slow twitch msucles | type 1 or red |
| Which type of muscle would you use for controlled, precise movements | Type 2 or white |
| I-bands contain which type of fibers | actin |
| H-bands contain which type of fibers | myosin |
| Which band in a sarcomere contains both myosin and actin | A-band |
| On what structure does a depolarization from a nerve travel across a muscle | transverse tubule |
| DHPR's receptors are which type | voltage gated |
| RyR receptors are which type of receptors | Calcium gated (ligand-gated) |
| What is the purpose of Tn-I in the troponin complex | inhibitory, prevents binding of actin to myosin. Can be released by binding of Ca+ to Tn-C |
| What encricles the Z-disc of each sarcomere and connects them to the sarcolemma | Desmin |
| What connects muscle fibers to the ECM and CT | dystrophin |
| Which is the worst of the two muscular dystrophies, has an early on set and is most deadly | Duchenne |
| What are sharpeys fibers | connect periosteum to bone (type 1 collagen) |
| What is a Howship's Lacuna | depression in bone left by osteoclast |
| PTH has what effect on osteoclast activity and thus Ca+ levels in the body | increase osteoclast and thus increases serum Ca+ |
| Calcitonin has what effect on osteoclast activity and thus what effect on serum Ca+ levels | Lowers activity of osteoclast, thus lowering serum Ca+ |
| Which embryoligical structure do long bones come from | lateral mesoderm |
| A synovial joint is made of how many layers? Name them. Describe them | 2, external and internalExternal - fibrous dense CTInternal - squamous cuboidal cells |
| What are the five steps in bone repair | Hematoma, Callus, hyaline cartilage, immature bone, mature bone |
| What do ligaments connect | BONE TO BONE |
| Positive ANA antibodies, malar/discoid rashm low levels of C3/C4 | Systemic Lupus |
| Small joints, seen more in females, autoimmune rxn, goes away with activity on the morning | Rhuematoid Arthritis |
| What is the major cytokine we're concerned about with rhuematoid arthritis | TNF-alpha |
| What is Rhuematoid factor | Antibodies to the Fc region of IgG |
| Th-17 produce which cytokine? What does it do | IL-17, proinflammatory mediator and recruits nuetrophils |
| Pannus formation is seen in which disease | Rhuematoid |
| Which arthritis spontaneously goes into remission | juvenile |
| Age of onset less than 16, symptoms for 6 wks or longer, HLA associations, fewer/larger joints, maybe asymetric | Juvenile arthritis |
| HLA-B27 is a DEFINITE dignostic finding in... | Ankylosing Spondylitis |
| seronegative means what | no rhuematoid factor |
| Chronic inflammatory disease of SI, vertebrae and entheses | Ankylosing spondylitis |
| Describe Schobers test and what it is used to diagnose | test to see if theres distance between vertebral levels in spinal flexion. Use in ankylosing spondylitis |
| Reiters disease is also known as... | Reactive arthritis |
| What triggers reactive arthritis | GI or urogential infections |
| Lambert Eaton syndrome is related to which autoimmune disease | Myasthenia Gravis |
| True or False: HLA-B27 correlation is seen in reactive arthritis | TRUE, not as strong as A.S. though |
| Crepitus in weight bearing joints, loss of articular cartilage, loss of ROM, and worsens with repeated motion | Osteoarthritis |
| Name two major predispostions to osteoarthritis | diabetes and obesity |
| Damage to which cell types cause osteoarthitis | chondrocytes |
| Polyarthritis and olgioarthritis are used to dezcribe which disease and refer to what | Early symptoms/onset Juvenile ArthritisPoly = 5+ jointsOlgio = 4 joints or less |
| HLA-DR4 and DR1 | Rheumaoid Arthritis |
| A proliferation of synovium and granulation tissue over the articular cartilage of a joint is called what? Seen in which disease | Pannus, rhuematoid arthritis |
| Elevated sedimentation rate and hypergammaglobulinemia are seen in which disease | rhuematoid arthritis |
| Associated with ulcerative colitis and HLA-B27 | Enteropathic Arthritis |
| You have a joint that has a cloudy synovial fluid when aspirated and cultures gonococci producing arthritis | supprative arthritis |
| Psuedogout is produced by the deposition of what | calcium pyrophosphate crystals |
| True or False: Ganglion cyst have communication with the joint space | False |
| A true neoplasm, occurs 80% in the knee, and causes pain, swelling, loss of ROM, and locking | Pigmented Villonodular Synovitis |
| Where are the two best places in the body for anaerobes to grow. What is the millivoltage in these areas | Dental Plaque (-200) and Colon (-300) |
| The overgrowth of anaerobes decreases the ability of the body to take care what | peroxide and free radicals |
| What is the only communicable anaerobe | closdridium (in hospitals) |
| foul smelling infections with necrotic tissue due to gas formation is typical of which type of infection | anerobes |
| Which anaerobe is known "below the waist" | Bacteroides fragilis |
| Gram negative rods, LACK ENDOTOXIN, have collagenase and hyaluronidase, with a capsule | Bacteroides fragilis |
| Gram negative coccibacilli to short rods, with brick red floresence in a UV light | Prevotella |
| Which anerobe is known as "above the waist" pathogen and causes brain abcesses and lung irritation | Prevotella |
| Gram negative rods, long sleder fusiform rods that look like points. Causes trench mouth | Fusobacterium nucleatum |
| Commonly seen in the head, neck and chest and causes necrotizing gingivitis | Fusbacterium nucleatum |
| Gram positive branching rods that produce sulfer granules in abcesses and cultures | Actinomyces israelli |
| What are the two drugs of choice for anerobes | metronidazole (pro-drug) and clindamyacin (50s inhibitor) |
| Alpha Toxin is produce from which organism. What does it do | Clostridium perfinges - degrades mammillian cell membranes |
| The lower the redox potential, the more ______ is released from clostridium | toxin |
| Box-car like rods | clostridium perfinges |
| Cellulitis and food poisoning | clostridium perfinges |
| The suppresion of inhibitory nuerotranmitters is caused by which organism | Clostridium tetani (tetanospasim) |
| Most toxic chemical known to man is made by which organism | clostridium botulism |
| floppy baby syndrome is caused by which organism | clostridium botulism |
| Which organism produces a toxin that prevents the release of ACh from Alpha-motor nuerons | Clostridium botulism |
| what causes the clinical disease of pseudomembranous colitis | Clostridium difficile |
| What organism produces toxin A? What does it do? | C. difficile. Causes fluid production and tissue damage |
| Which clostridium species has become resistant to flouroquinolone and being linked to a lot of deaths | C. Difficile |
| Gas gangrene is caused by | clostridium perfinges |
| Diabetes mellitus, abdominal surgery and perineal infection are all possibel cuase of which type of necrotizing fascitis | Type 1 |
| What causes type 2 necrotizing fascitis | Group A strep (flesh eating) |
| Rapid progression, resembling gas gangrene w/o the gas, and due to possible superantigens | Type 2 NF |
| Which properties of Group A strep give it the ability to cause type 2 NF | beta-hemolytic, lipase enzymes and superantigenic capabilites |
| Which drug are you using to treat type 2 NF | pennicillin |
| Leukocytosis with a left shift is diagnostic of ... | NF |
| Motile gram negative rods, live in fresh water and are oxidase positive | Aeromonas hydrophilia myonecrosis |
| Non-traumatic gas-gangrene is caused by which organism | clostridium septicum |
| What is non-traumatic gas gangrene associated with | colon cancer, diverticulitis, and abdominal (GI) surgery |
| The damage that occurs in myalgias is caused by what | immunological response |
| What are some tell-tale signs of infectous arthritis | ONE JOINT, usually the knee (maybe hip), swollen hot and painful, occurs in joint with previous damage or trauma/surgery |
| What are the two most common organisms in infectous arthritis | staph aureus and neisseria gonorrhoeae(Staph epi in children and prostetics/replacements) |
| In which population does osteomyelitits commonly occur | children who are growing |
| A history of chills, fever, and inflammation over the area of trauma may cue you in to which disease | osteomyelitis |
| Osteomyelitis is overall caused by trauma which causes a disruption in which strucutures | blood vessels, which lead to hematoma |
| Long course of antibiotics naficillin or oxacillin given over the course of weeks, parentally, is a course of treatment for which bone disease | osteomyelitis |
| Most common organism in osteomyelitis | staph aureus |
| What is the most common form of spinal muscle atrophy | Werdnig-Hoffman disease - usually results in death by age 3 (autosommal on chromosome 5) |
| Most common muscular dystrophy | Duchenne's |
| Where does duchennes start and progress to | pelvic girdle to the shoulder girdle |
| Which gene and protien are effected in Duchennes | Gene: Xp21 Protien: 427kD |
| Which muscular dystrophies occur in the proximal muscular of the limbs and trunk | Limb girdle muscular dystrophy |
| Which disease presents with abnormalties in gait progressing to facial muscle problems and ptosis | Myotonic muscle dystrophy |
| Cataracts, frontal balding, gonadal atrophy, cardiomyopathy, and smooth muscle invovlement may all be seen in which disease | myotonic muscle dystrophy |
| sustained involuntary contraction of a group of muscles is the cardinal symptom for which disease | myotonic muscle dysrophy |
| What is the only dystrophy that actually shows pathologic changes in muscles | myotonic muscular dystrophy |
| autosomal dominant syndrome of dramatic hypermetabolic state (tachycardia, tachypnea, muscle spasms, hyperpyrexia) | Malignant hyperpyrexia |
| Which muscle disorder can be caused by induction by anethesia | Malignant Hyperpyrexia |
| Hypotonia and myotonia during excercise or exposure to cold | paramyotonia congenita |
| myotonia caused by fatigue or stress | Myotonia congenita |
| Toxic myopathies are most dependant on what | the patients sensitivity |
| What is the example of paraneoplastic syndrome associated with NMJ disorder (myashtenia gravis) | Lambert Eaton Syndrome (squamous cell carcinoma of the lung) |
| What are the three subgroups of inflammatory muscle disease | Infectous, non-infectous inflammatory muscles (children; look for rash), systemic inflammatory (muscle WITH other organs) |
| Four types of skeletal muscle tumors | embryonal, botryoid, alveolar, and pleomorphic |
| boytroid tumors are morphological variant of which other type of muscle tumor | embryonal |
| Which muscle tumor type occurs in older generations (45+) | pleomorphic |
| which skeletal muscle tumor type has the worst prognosis | pleomorphic |
| Where do Leiomyoma's and leiomyosarcomas most occur | female genital tract |
| Herringbone pattenrn and dystrophic calcification are seen in which muscle tumors | Leimyomas or sarcomas |
| Class I mitchondrial myopathies involve what | genes for mitochondiral protiens |
| Class II mitchondrial Myopathis invovle what | point mutations in mtDNA |
| Class III mitochondrial myopathis invovle what | deletions of mtDNA |
| How does Colchinine work | binds to intercellular portien tubulin preventing polymerization (prevents migration of inflammatory cells) |
| Which gout drug has a really low TI and severe GI problems | Colchicine |
| Which gout drug is used a preventative measure | colchicine |
| When are NSAIDS used for gout | in an acute attack |
| Reduction is LTB4 is accomplished by which drug | colchicine |
| What are the two commonly used NSAIDS | INdomethacin and phenylbutazone |
| Major s/e's from indomethacin | CNS and GI |
| major s/e's from phenylbutazone | hematological |
| How does allopurinol work | inhibits xanthine oxidase |
| Which drug can inhibit immunosupressants and produce an intial gout attack when first administered | allopurinol |
| How does probenecid work | decreases uric acid reabsorbtion in the kidney |
| Which drug works to protect the kidneys and prevent stones | allopurinol |
| Name the order in which you use sulfinyrazone, probenecid, and allopurinol | allopurinol > probenecid > sulfinyrazone |
| Which drugs should you give before starting a course of allopurinol | colchicine and NSAIDS |
| Which medication stops probenecid from working | aspirin |
| 6-metacaptopurine and azathioprine must be stopped before the start of which drug | allopurinol (blocks their metabolism, causes toxic build up) |
| which drug to you need to access kidney function before giving | probenecid |
| Defects in the FGFR3 receptor cause what disorder | achondroplasia |
| a thin sclera with a blue hue is indicative of what | osteogenesis imperfecta |
| which bone disorder can lead to deafness | osteogenesis imperfecta |
| osteogenesis imperfecta is a disorder of what? | collagen type 1 |
| which is the worst form of osteogenesis imprefecta to have | Type 2 |
| A disorder where there is a gradual compression of the marrow cavity | osteopetrosis |
| A decrease in osteoclast function, also known as marble bone disease or alber-schonberg disease | osteopetrosis |
| Erlenmeyer shaped flask appearance of bones is seen in which disorder | osteopetrosis |
| Which is worse the recessive or dominant form of osteopetrosis | recessive (linked to malignancies, where dominant is linked to benign) |
| Which bone disorder is associated with paramyxovirus | Pagets |
| Increase of bone reabsorbtion resulting in thickned but weak bones | pagets |
| What are the three stages of Pagets | Osteolytic, mixed osteolytic, and osteosclerotic |
| mosaic pattern of lamellar bone | Pagets |
| Lionlike facies with anemia and high alkaline phosphatase | Pagets |
| do to the constant remodeling of bone in pagets, you can develop what disease | osteosarcoma |
| When does Rickets occur | before the closure of the epiphysis |
| Which bone disorder is a major concern after fracture | osteomyelitis |
| What is the most common organism in osteomyelitis | staph aureus |
| Clinical feature os luekemia and fever with erythema and swelling are indicative of which bone disorder | osteolyelitis |
| Squamous cell carcinoma of the skin is linked to which bone disease | osteomyelitis |
| Parathyroid adenoma and parathyroid hyperplaisa are linked to which bone disease | Osteitis fibrosa cystica |
| Clubbing and periosteal new bone formation are seen in which bone disorder | hypertrophic osteoarthropathy |
| Bronchogeneic carcinoma is a paraneoplasmtic syndrome seen in which bone disorder | hypertrophic osteoarthopathy |
| Which bone tumor is seen with Gardner syndrome | osteoma |
| osteoid osteoma is defined as growth in which part of a bone | diaphysis |
| A central radiolucency surrounded by a sclerotic rim is seen in which bone tumors | osteoid osteoma |
| Osteoblastoma is seen in which bones | vertebrae |
| Where does osteochondroma orginiate from | epiphyseal growth plates |
| Multiple enchondromas in the hands and feet are seen in which disease | olliers disease |
| Increased risk of malignant tranformation, ovarian carcinoma, and brain gliomas is seen in which syndrome | Maffucci |
| What is the most common primary malignant tumor of the bone | osteosarcoma |
| Codmans triangle is associated with which disorder | osteosarcoma |
| Sunburst patterns are seen in which disorder | osteosarcoma |
| Large firm white-tan masses with necrosis and hemorraghe | osteosarcomma |
| Which disorder has a "soap bubble appearance" to it | Giant-cell tumor of bone |
| Look for giant cell tumors in which part of the bone | epiphysis |
| Mostly found in the diaphysis, this disorder has Homer-wright psuedorosettes on a micro scale | Ewing Sarcoma |
| Malignant neoplasm of undifferentiated cells arising within the marrow cavity | EWing sarcoma |
| Reduction of PG's, LT's, COX2, IL1 and TNF is done by which class of drugs | Anti-inflammatory steoirds |
| Which drug has extremely high antiinflammatory properties but no effect on salt retention | Dexamthasone |
| True or False: The anti-inflammatory properties of glucocorticoids can be sperated from the other systemic effects | False |
| MOst common side effect of anti-inflammatory steroids | osteoporosis |
| Alternate day dosing is done with which class of drugs | anti-inflammatory steroids |
| Anti-inflammatory steroids increase or decrease a immune system | decrease |
| Redistribution of fat is seen in which class of drugs | anti-inflammatory steroids |
| Which type of NSAIDS produce more side effects, selective or non-selective | non-selective |
| Is Aspirin a non-selective or selective COX inhibtor? Reversible or non-reversible | Non-selective, non-reversible |
| Death from aspirin overdose occurs due to what | respiratory failure |
| Giving bicarb to increase excretion is done for poisoning from which drug | aspirin |
| Which drug is bad to take in conjunction with warfin or heparin | Aspirin (blood thinner) |
| What is the aspirin equal that lacks antipyretic effects but has fewer side effects | Difunisal |
| When woudl you administer N-acetylcysteine | during a aspirin overdose to prevent liver damage |
| WHich drug is NOT an NSAID and inhibtis COX enzymes mostly in the CNS | Acetominophin |
| How is acetominphin eliminated | phase 2 reactions |
| Celebrex and Mobic are the only two ________ left on the market | COX 2 inhibitors |
| Indomethacin can cause a closure of what childhood disorder | PDA |
| Methotrexate is the gold standard drug for which disease | Rhuematoid Arthritis |
| What is methotrexate commonly used in conjuction with | COX2 inhibitor |
| Which drug do you need to preform constant eye exams when administering | hydrochloroquine |
| Misoprostol is given along with which drugs for what purposes | NSAIDS for GI protection. It is a PGE analog to protect the lining |
| How does Leflunomide work | inhibits pyrimidine synthesis |
| How does etanercept work | artificially synthesized TNF receptors bind up free TNF |
| How does Infliximad work | artificial antibody to TNF |
| When do you never want to give TNF inhibitors | when the patient has hear problems |
| What is an oblique view used to look for in the spine | pars interarticularis |
| At what level does disk disease mostly occur | L4-L5 |
| Pedicles are a common place of ..... | metastisis |
| a non-communiated fracture has how many segments | 2 |
| Salter Harris stage 1 | just through the growth plate, nothing else |
| Salter Harris stage 2 | Growth plate and metaphysis |
| Salter HArris Stage 3 and 4 | through epiphysis, depends on fragments |
| Soft tissue tumors tend to be caused by... | trauma |
| Most common soft tissue tumor of adulthood | lipoma |
| A rapidly growing benign condiiton that can resemble a sarcoma, probably from trauma, with vascular channels an anundant mitoses | Nodular fasciitis |
| Bone that matures peripherally, especially after trauma, is a key feature of | Myositis Ossification |
| What is the zonation effect | development of bone peripherally in myositis ossification |
| Common in mothers giving birth, have irregular borders and commonly reoccur when excised | Deep seated fibromas (desmoids) |
| What is the most common of the RARE tumors in adults | fibrosarcoma |
| Herringbione pattern | fibrosarcoma |
| Most common soft tissue sarcoma | Malignant Fibrous Histicytoma |
| A round bluish to purple over growth appears and pursist for a couple years. Feels hard and nudular, what is it? Can it be cancerous | Dermatofibroma, never turn to cancer |
| Congential fusion of two or more cervical vertebrae in infants | Klippel Feil Syndrome |
| Klippel Fell Syndrome has a high association with problems in which area of the body | G-U tract |
| Clinical Triad of short stature, low hairline, and restriction of neck movement | Klippel-Fell Syndrome |
| In children less then four, with back pain, you shoudl always order what | an MRI |
| What are the three types of scoliosis | congenital, idiopathic, and nueromuscular |
| Whhat are the two types of kyphosis | structural and flexible |
| Which type of kyphosis is voluntarily correctible | flexible |
| Which type of kyphosis is normally progressive | structural |
| A defect in the pars interarticularis | spondyloysis |
| A forward slip of one vertebrae over another is known as what | spondylolisthesis |
| Mutations in COL2A1 cause | chondrodysplasia |
| MOst common type of LETHAL chondrodysplasia | Thanatophoric Dysplasia |
| Elastic tissue disease effecting fibrilllin 1 | Marfan syndrome |
| Arm span greater than height, long thin limbs, hyperextendible joints, and pectus excavatum or carinatum are clinical signs of... | Marfans syndrome |
| Marfans patients are most likely to die from complications involving which system | respiratory and cardic |
| Two common fracures of childhood, NOT indicative of abuse | Toddler(tibia) and clavicle |
| Which torion is caused by children sitting in the W position | Internal femoral torsion |
| At what age is there normal adult alignment and gait patterns | 7 |
| Which childhood disorder is most seen in the first born | Metatarsus Adductus |
| This disease has abnormal claf muscles which may atrophy over time. 75% of cases are congeneital | Equinovarus |
| Bone which is pulled away from non-mature bone by a strong tendon is refered to as which disease in children | Sever disease |
| What is caused by loss of blood flow to the hip socket or femoral head | Transient Synovitis |
| Microfractures in the insertion of the pattelar tendon are diagnostic of which disease | Osgood Schlatter |
| This disorder usually presents late in childhood and has a positive McMurray test | Discoid LAteral meniscus |
| Avascular necrosis of bone under articular cartilage | Osteochondrosis dessicans |
| Idipathic avascular necrosis of the capital femoral epiphysis | LCPD (Leg-clave-perthes disease) |
| What is the most common his disorder in adolescents | Slipped Capital Femroal Epiphysis |
| Which classification system is used for open fractures | Gustilo |
| Colle's fracture | fracture of distal radius with dorsal angulation |
| Fracture of the base of 5th metatarsal | Jones Fracture |
| Fx of 5th metacarpal with vulgar angulation | boxer fracture |
| "Come Rub My Tree Of Love" | Capitulum (2), Radial Head (4), Medial (6)Epicondlye(8), Trochlea(10), Olecranon(12) |
| True or False: A "Babygram" is an appropraite way to look for fractures in a child suspected of being abused | FALSE |
| Most common fracutre location in a bone | diaphysis |
| Child abuse acccounts for what percentage of femoral fracutres | 60-80% |
| Epiphysiseal and Metaphysiseal fractures are indicative of what in a child | abuse |
| Second most common fracture after long bones | skull |
| Do skull fractures occur more in cases of abuse or accident | abuse |
| How is osteoporosis defined by the WHO | bone density less than 2.5 std dev from normal |
| methylmethacrylate has been advocated to help in which situation | helping internal fixation in bone repair |
| How many views and which ones are used in a hip fracture | A-P view and cross table lateral (internal rotation to help with fx pattern) |
| What is the problem with Technetium bone scanning | takes 2-3 days to become positive |
| Operative delay of 24-48 hours causes an increase in what for hip fractures | one year mortality rates |
| How should displaced fractures be treated | operativley |
| When do displaced hip fractures not need surgery | in the dimented or non-ambulatory |
| In what situation do you have a subtrocanteric fx | Typically higher energy injuries seen in younger patients |
| What levels do compression fx's usually occur | T8-L2 |
| What type of fx's are treated non-operativly and symptomatically | spinal compression fractures |
| Most common cause of compartment syndrome | fracture (proportional to degree) |
| 2nd most common cause of compartment syndrome | blunt trauma |
| What is the absolute pressure diagnostic of compartment syndrome | 30mmHg |
| At what time do you reach irreversible damage in compartment syndrome | 8hrs |
| What is the most important clinical sign of possible compartment syndrome | pain (out of proportion to the injury) |
| When compartment syndrom is suspected, which compartments need to be measured | ALL OF THEM |
| What are the compartments of the lower leg | Anterior, LAteral, posterior, deep posterior |
| At what level should a limb with compartment syndrome be elevated | level of the heart |
| What is the minimum distance that should be between two cuts in lower leg compartment syndrome | 8cm |
| What nerve do you need to be concious of when you make an incision over the lateral compartment of the leg | superficial fibular |
| What structures do you need to be careful of when making an incision in the poseterior compartment | saphneous nerve and vein |
| What is the most common cause of litigation | compartment syndrome |
| What are the four muscles of the rotator cuff | teres minor, supraspinatus, subscapularis, and infraspinatus |
| Innervation of teres minor | axillary nerve |
| Innervation of supscapularis | upper subscapular nerve |
| innervation of infraspinatous and supraspiantous | suprascapular nerve |
| Higher recurrance rates of shoulder dislocation in patients under what age | 20 |
| A squared off appearance is diagnostic of what type of injury | dislocation |
| Which x-rays are needed in order to diagnose dislocation | AP, lateral and axillary |
| What fracture may be associated with a shoulder dislocation | greater tuberosity |
| What type of injury is associated with electrical shock or siezure | posterior shoudler dislocation |
| "Bankart” lesion refers to ... | avulsion of anterior-inferior labrum off glenoid rim. May be associated with glenoid rim fracture (“bony bankart”) |
| Humeral Head impression fracture is caused how | posterior impaction fracure of back of humerus |
| What motion can an anterior dislocated shoudler NOT carry out | external rotation |
| Most common nerve injury in a anterior dislocation | axillary dislocation |
| What are two criteria for shoulder surgery | young patients with high demand or recurrent instability |
| Which teo test are used in diagnosing impingement syndrome | Hawkins and Neers |
| Subacromial bursectomy, Acromioplasty and Coracoacromial ligament release are all surgical treatments for which disorder | impingement syndrome |
| Which muscle are you testing with the "empty-can test" | supraspinatous |
| Placing you hand (palm side down) just off of your back is testing which muscle | subscapularis |
| Which muscle in the rotator cuff is used for internal rotation | subscapularis |
| Idiopathic global limitation of humeroscapular motion resulting from contracture and loss of compliance of the glenohumeral joint capsule | Frozen shoudler syndrome |
| What are the most common implicated predispostions to frozen shoudler syndrome | diabetes and thyroid disorder (hypothyroidism) |
| What should always be included in a examination of frozen shoulder syndrome | shoulder and cervical spine |
| What are the 4 stages of frozen shoulder syndrome | Stage 1 (no name), freezing, frozen, thawing |
| Manipulation under anethesia is an effective treatment for which syndrome | frozen shoudler |
| Patients with diabetes have a lowered response to which treatment for forzen shoudler | manipulation under anesthesia |
| True or False: Surgery can be used to accelerate the nartural course of frozen shoudler syndrome | True |
| McMurray Test is used to test what? How is it done | Medial Meniscus. Felx Knee to 80-90 degrees and rotate internal-external. Positive is a click or pop |
| What is the Gold standard in menisci surgical tx | arthoscopy |
| What are the two speacil test for collateral ligaments | Valgus (push in) and Varus (push out) |
| Injuries to which ligaments are treated with a hinged brace and non-impact excercise | collateral ligaments |
| Forced hyperextension of the knee can cause damage to which ligament | ACL |
| Lateral Pivot shift test is used in injury to which ligament | ACL |
| For ACL and PCL injuries, at which grade do you have to do surgery | Grade 2 that doesn't heal well or a grade 3 |
| Most common cause of constant knee pain | Patellofemoral Pain Syndrome |
| In what knee syndrome do you have to MAKE SURE you treat the underlying cause | Patellofemoral Pain Syndrome |
| What is the third line of tx for osteoarthritis | Arthroplasty - patient will let you know when they want it |
| First injured in lateral sprain with dorsiflexed ankle | calcaneofibular ligament |
| First injured in lateral sprain with plantarflexed ankle | ATF |
| Talar tilt is used to ascess which ligament | CFL |
| True or False: In a AP view of the ankle you want to see overlap of the Tibia and Fibia | TRUE! |
| Shenton’s Line of the ankle and The dime test, are used to assess what | fibular length |
| Forced eversion of the ankle causes damage to which ligament | deltoid |
| Which three x-rays are needed to assess the ankle mortise | AP, lateral and Oblique |
| Unstable medial ankle sprains are defined by what | talar subluxation |
| Definition of a Weber A fracture | fibular fracture BELOW (distal to the mortise)BEST ONE |
| Definition of a Weber B fracture | fibular fracture at the level of mortise |
| Definition of a Weber C fracture | fibular fracture ABOVE (proximal) to mortiseWORST ONE |
| When do you not operate on a fibular fracture | when it is NOT displaced, stable, and the syndesmosis is not disrupted |
| Where does rupture mostly take place on an achilles tendon | Avascular zone: 2-6cm proximal to insertion |
| What it Thompsons test used to diagnose | Achilles rupture |
| When is surgical repair indicated for Achilles ruptures | when the patient is young and active |
| When is surgery NOT inicated for an achilles | Weaker tendonHigher risk re-rupture Slower return to sportNo surgical morbidityLower cost |
| Describe Short Leg cast strategey for achilles reuptures | SLC is applied w/ ankle in plantarflexionCast is brought out of equinus over 8-10 weeksWalking is allowed (in the cast) at 4-6 weeks |
| What nerve is important to avoid in an achilles repair | sural nerve |
Created by:
lowryc
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