1: Step 1 Msk

Front 1

fracture of surgical neck of humerus damages what nerve

Back 1

axillary

Front 2

fracture of shaft of humerus affects what nerve and what artery

Back 2

radial nerve and deep brachial artery

Front 3

damage to medial epicondyle affects what nervr

Back 3

ulnar

Front 4

colles fracture is of what bone

Back 4

distal radius

Front 5

fall on hand, damage to scaphoid bone will affect what nerve? hamate bone?

Back 5

scaphoid = median
hamate = ulnar artery and nerve

Front 6

dislocation of shoulder ususally in what direction ? what nerve is affected?

Back 6

anterior inferior; will damage axillary nerve

Front 7

tennis elbow involves what part of humerus

Back 7

lateral epicondyle

Front 8

golfers elbow affects what part of humerus

Back 8

medial epicondyle

Front 9

what nerve innervates ALL muscles of posterior forearm

Back 9

radial

Front 10

anterior forearm muscles are innervated by _______ nerve.
Except for _________ which is innervated by the _______ nerve, and the ________ which is innervated by both

Back 10

all innervated by the median nerve except the flexor carpi ulnaris which is innervated by ulnar nerve.

flexor digitorum profundus is both.

The "other" muscles that are innervated by median include: protnator teres, flex. carpi radialis, palmaris longus, flex. digitorym superficialis, flex. pollucis longus, pronator quadratus

Front 11

inability to fully extend fingers is called what

Back 11

dupuytrens contracture: progressive thickinging and fibrosis of palmar fasia, pulls fingers towards palm esp 3rd and 4th fingers.

Front 12

compartment syndrome in the forearm flexor muscles will cause what?

Back 12

volkmanns contracture

Front 13

carpal tunnel syndrome caused by compression to waht

Back 13

median nerve.

Front 14

what aretery crosses the anatomical snuff box

Back 14

radial.

Front 15

injury to long thoracic nerve causes what?

Back 15

winged scapula - paralysis of serratus anterior

Front 16

what nerve damage causes winged scapula?

Back 16

long thoracic (C5-C7)
paralysis of serratus anterior

Front 17

what hand muscle:
abducts thumb

Back 17

abductor pollicis brevis

Front 18

what hand muscle:
flexes thumb

Back 18

flexor pollicis brevis

Front 19

what hand muscle:
opposes thumb

Back 19

opponens pollicis

Front 20

what hand muscle:
adducts thumb

Back 20

adductor pollicis

Front 21

what hand muscle:
abducts little finger

Back 21

abductor digiti minimi

Front 22

what hand muscle:
flexes little finger

Back 22

flexor digiti minimi brevis

Front 23

what hand muscle:
oposes little finger

Back 23

oponens digiti minimi

Front 24

what hand muscle:
flexes metacarpal joints and extend interphalangeal joints

Back 24

lumbricals (median n = 2 lateral) (ulnar n = 2 medial

Front 25

what hand muscle:
abduct fingers, flexes metacarpal joints, extends interphalageal joints

Back 25

dorsal interrossei (ulnar n)

Front 26

what hand muscle:
adducts fingers, flexes metacarpal joints, extends interphalageal joints

Back 26

palmar interossei (ulnar n.)

Front 27

qhat nerve innervates the palmar and dorsal interrosei?

Back 27

ulnar

Front 28

what nerve innervates lumbricals (4)

Back 28

2 medial = ulnar
2 lateral = median

Front 29

what nerve is responsible for abduction, flexion and opposition of thumb?
adduction of thumb?

Back 29

median does opposition, flexion, abduction

ulnar does adduction

Front 30

suprascapular n. comes from which cervical segmetns? what muscles

Back 30

C5=C6
supra and infraspinatus

Front 31

what spinal segments supply ulnar n.

Back 31

C7-T1

Front 32

thoracodorsal n. is what spinal segemtns

Back 32

C7-C8

Front 33

injury to posterior cord (eg. from using crutches) will cause what?

Back 33

wrist drop

Front 34

wrist drop occurs after what cord is damaged? also occurs after what nerve is damaged

Back 34

posteiror cord

radial nerve (C5-T1)

Front 35

spinal segmetns of radial nerve

Back 35

(C5-T1)

Front 36

what nerve damage causes 'ape hand'

Back 36

injury to median nerve. lose opposition of thumb

Front 37

spinal segements of ulnar n.

Back 37

C7-T1

Front 38

what nerve damage causes claw hand?

Back 38

ulnar nerve
wasted hypohenar eminence, loss of adduction of thumb,

also claw hand seen in lower trunk injury

Front 39

Erb duchenne paralysis (Erb palsy) de to damage to what?

Back 39

upper trunk, often during breech delivery, "waiters tip hand"

Front 40

lower trunk injury causes what?

Back 40

claw hand; Klumpke's paralysis. may be caused by cervical rib syndrome or during breech delivery

Front 41

name muscles of rotator cuff

Back 41

SiTS
supraspinatus
infraspinatus
teres minor
subscapularis

Front 42

the deep brachial artery runs with which nerve?

Back 42

radial

Front 43

superficial palmar arch is what artery?
deep palmar arch?

Back 43

superficial = ulnar
deep = radial

Front 44

ape hand =
wrist drop =
claw hand =
waiters tip hand =

Back 44

ape = median (in medieval time, men were like apes)
wrist drop = radial (don't drop the radio dial)
claw hand = ulnar (claws in lunar)
waiters tip = upper trunk (think upper class have waiters)

Front 45

fracture shaft of humerus - what nerve

Back 45

radial n.

Front 46

loss of sweating on back of arm and forearm; damaged nerve is ______ and has cell bodies located in __________

Back 46

radial nerve is damaged;

sympathetic chain ganglion

Front 47

what rotator cuff muscle
laterally rotates arm

Back 47

infraspinatus
(and teres minor)

Front 48

what rotator cuff muscle
helps deltoid abduct arm

Back 48

supraspinatus

Front 49

what rotator cuff muscle
adducts and laterall rotates arm

Back 49

teres minor

Front 50

what rotator cuff muscle
adducts and medially rotates arm

Back 50

subscapularis

Front 51

action of infraspinatus

Back 51

laterally rotate arm

Front 52

action of supraspinatus

Back 52

helps deltoid abduct arm

Front 53

action of teres minor

Back 53

adducts and laterally rotates arm

Front 54

action of subscapularis

Back 54

adducts and medially rotates arm

Front 55

what nerve supplies thenar muscles

Back 55

recurrent branch of median nerve

Front 56

what nerve supplies interrosei and adductor pollicis

Back 56

deep ulnar nerve

Front 57

what nerve runs in Guydon's canal

Back 57

ulnar

Front 58

what muscle is in the hypothenar eminince

Back 58

abductor digiti minimi

Front 59

the flexor retinaculum runs betweeh what two nerves

Back 59

median nerve (underneath) and the palmar cutaneous branch of median nerve underneath

Front 60

the median nerve gives off palmar cutaneous just before what structure

Back 60

flexor retinaculum

Front 61

dermatome of shoulder

Back 61

C4

Front 62

dermatome of axilla

Back 62

T2

Front 63

dermatomoe of thumb

Back 63

C6

Front 64

dermatome of last 2 fingers

Back 64

C8

Front 65

dermatome of middle finger

Back 65

C7

Front 66

superficial laceration of thumb on palmar surface will damage what nerve

Back 66

recurrnat branch of median nerve

Front 67

what nerve is compressed by supracondylar fracture of humerus

Back 67

median nerve

Front 68

what is compressed by cervical rib or PANCOST TUMOR of LUNG

Back 68

Lower trunk of brachial plexus

Front 69

midshaft fracture of humerus gets what nerve

Back 69

radial

Front 70

upper trunk lesion = what hand?

Back 70

waiters tip (remember upper class)

Front 71

lower trunk lesion = what hand?

Back 71

Klumpke's palsy (TOTAL claw hand)

Front 72

posterior cord/radial n lesion

Back 72

wrist drop

Front 73

long thoracic nerve lesion

Back 73

winged scapul

Front 74

axillary nerve lesion

Back 74

deltoid paralysis

Front 75

ulnar n. lesion

Back 75

claw hand

Front 76

medial n. lesion

Back 76

ape hand/pope hand

Front 77

spinal segments for
axillary n.

Back 77

C5, C6

Front 78

spinal segments for
radial n.

Back 78

C5 - C8

Front 79

spinal segments for
median n.

Back 79

C6-C8, T1

Front 80

spinal segments for
ulnar

Back 80

C8-T1

Front 81

spinal segments for
musculocutaneous n.

Back 81

5-7 (flexion of arm at elbow)

Front 82

dorsal interossei do what to fingers?
palmar interossei?

Back 82

dorsal = abduct
palmar = adduct


DAB, PAD

Front 83

type 1 muscle fibers vs type 2? which one is slow twitch?

Back 83

think: One slow red ox =
type 1 is slow twitch, with increased myoglobin, increased mitochondria, and increased oxidative phosphorylation ==> sustained contraction

Front 84

weight training will cause which muscle type to hypertrophy?

Back 84

type 2 (fast twitch)

Front 85

achondroplasia ==> what is mutaion nad what are sx?

Back 85

FGFR3 mutation
common cause of dwarfism, seen in advanced paternal age; short limbs due to failure of long bone growth

Front 86

genetic deficiency of carbonic anhydrase II will cause what disease?

Back 86

osteoPETROSIS- thick dense bones with decreased marrow space

SERUM CA++, ALK PHOS, PHOSPHATE ARE ALL NORMAL!!

Front 87

Explain mechanism of osteomalacia

Back 87

in adults
vit d deficiency => decreased Ca++ ==> increased release of PTH ==> decreased phosphate
causes soft bones due to defective minearalization

in kids, this is called rickets

Front 88

increased hat size, hearing loss, paramyxovirus, normal Ca++, phos, PTH but alk phos is very high; may cause CHF

Back 88

Pagets disease:
abnormal bone architecture due to increased activity of osteoblasts and osteoclasts; mosic bone pattern

Front 89

caused by hyperparathyroidism; "brown tumors" high ALP, high Ca, low Phosphorus

Back 89

osteitis fibrosa cystica

Front 90

McCune ALbright syndrome?

Back 90

bone replaced by fibroblasts, collagen and irregular trabeculae;

McCune-Albright is a form of POLYOSTOTIC FIBROUS DISPLASIA, with multiple unilateral bone lesions associated with endocrine problems (precocious puberty) and unilateral pigmented skin lesions (cafe au lait spots)

Front 91

with multiple unilateral bone lesions associated with endocrine problems (precocious puberty) and unilateral pigmented skin lesions (cafe au lait spots)

what syndrome?

Back 91

McCune Albright

Front 92

what bone lesion is assoc with Garners syndrome (FAP)

Back 92

osteoma (b9)

Front 93

peak incidence men 10-20 yo.
commmonly in metaphysis of long bones, esp distal femur; predisposeing factors include:
pagets disease of bone, radiation, familial retinoblastoma; sunburst pattern on x ray
second most common primary malignant tumor of bone (after multiple myeloma)

Back 93

osteosarcoma

Front 94

bone tumor, malignant, common in boys < 15 yo.
onion skin appearance in bone is characteristic
translocation 11;22

Back 94

Ewing's
(going out for ewings and onion rings)

Front 95

ewings sarcoma has what translocation and targets what age group of what sex?

Back 95

males < 15 yo.
11;22

Front 96

expansile glistening mass in medullary cavity; men ages 30-60; malignant cartilagenous tumor

Back 96

chondrosarcoma

Front 97

RA does not involve what joint?

Back 97

DIP

Front 98

RA is autoimmune, what test will be + and what kind of ab do you see?

Back 98

positive rheumatoid factor
IgG antibody

Front 99

RA is what HLA association

Back 99

HLADR4

Front 100

is RA symmetric?

Back 100

YES

Front 101

classic presentation of RA?

Back 101

morning stiffness, symmetric, better with use, systemic sx (fever, fatigue, pericarditis)

Front 102

what syndrome is assoc with RA that involves a classic triad?

Back 102

Sjogrens syndrome:
1. dry eyes
2. dry mouth
3. arthritis

Front 103

what is sicca syndrome

Back 103

like sjogren's but NO ARTHRITIS,
you also have chronic bronchitis and reflux esophagitis

Front 104

parotid enlargement, increased risk of B CELL LYMPHOMA, females age 40-60, associated with RA

Back 104

Sjogren's
1 dry eyes
2. dry mouth
3. arthritis

has autoantibodies SS-A (Ro) and SS-B (la)

Front 105

has autoantibodies SS-A (Ro) and SS-B (la)

Back 105

Sjogrens syndrome

Front 106

gout vs. ra distribution?

Back 106

gout is ASYMMETRIC (RA is symmetric)

Front 107

how does gout present/

Back 107

painful toe (podagra), swollen, red painful. acute attack tends to occur after large meal or alcohol consumption.

Front 108

painful toe (podagra), swollen, red painful. acute attack tends to occur after large meal or alcohol consumption.

Back 108

Gout

Front 109

describe gout crystals vs pseudogout

Back 109

gout = negative birefringent; yellow under parallel light

pseudogout = positive birefringent; ble when parallel light, yellow when perpendicular
plus, pseudogout usually affects large joints (eg. knee) whereas gout gets the big toe

Front 110

Tx for gout?

Back 110

allopurinol, colchicine, NSAIDS (indomethacin), probenecid

Front 111

lesch Nyhan syndrome

Back 111

genetic deficiency of HGPRT which causes build up of uric acid, causes gout; mental retardation with self-mutilation, also B12 deficiency -> megaloblastic anemia; mostly seen in boys bc x linked recessive

Front 112

what are the crystals of gout made of? pseudogout?

Back 112

gout = monosodium urate crystals

pseudogout = calcium pyrophosphate crystals

Front 113

name 3 organisms that cause septic arthritis; chronic arthritis?

Back 113

septic =
s. aureus
strep
neisseria gonorrhea

chronic =
TB, lyme disease

Front 114

monoarticular migratory arthritis with asymmetrical pattern; affected joint is swollen red and painful, infectious arthritis. What type?

Back 114

gonococcal arthritis

Front 115

Cant see , cant pee cant climb a tree.... what disease?

Back 115

Reiters syndrome: conjuctivitis, urithritis, arthritis; bost GI or chlamydia infections

Front 116

Reiters syndrome has what triad?

Back 116

cant see cant pee cant climb a tree
Reiters syndrome: conjuctivitis, urithritis, arthritis; bost GI or chlamydia infections

Front 117

Name 3 arthropathies assoc with HLA B27 (codes for MHC 1) that do not have rheumatoid factor (no IgG abs)

Back 117

ankylosing spondylitis
reiters syndrome
psoriatic arthritis

Front 118

pencil in cup deformity; asymmetric and patchy involvment

Back 118

psoriatic arthritis

Front 119

stiff spine due to fusion of joints, uveitis, aortic regurgitation, males, bamboo spine.
what disease and what HLA

Back 119

ankylosing spondylitis;
HLA B27

Front 120

antinuclear abs, anti ds DNA abs, anti Smith abs, antiphospholipid abs

Back 120

SLE

Front 121

what about antihistone abs?

Back 121

drug induced sle

Front 122

what abs found in drug induced SLE

Back 122

anti-histone

Front 123

"wire loop lesions" in kidney + nephrotic syndrome; 90% female, esp. black, hilar adneopathy, ranauds
MALAR RASH,

Back 123

SLE

Front 124

sarcoidosis... elevated levels of what? what do you see? who is it common in?
Tx?

Back 124

immune mediated widespread noncaseating granulomas; elevated serum ACE levels, common in black females;
tx = steroids

Front 125

Schaumann and asteroid bodies?

Back 125

think sarcoidosis

Front 126

restrictive lung disease, BILATERAL hilar adenopathy, erythema nodosum, bells palsy, hypercalcemia (due to elevated activation of Vit D)

Back 126

Sarcoidosis

Front 127

assoc with temproal arteritis; elevated ESR

Back 127

polymyalgia rheumatica

Front 128

heliotrope rash?

Back 128

dermatomyositis :

inc CK
inc aldolase
positive ANA
anti Jo-1

Front 129

ptosis, diplopia, general weakness; assoc. with THYMOMA. Sx worsen with muscle use

Back 129

myasthenia gravis; autoabs to postsynaptic AchR

Front 130

autoabs to presynatptic Ca++ channel, decreased Ach release, proximal muslce weakess. Sx IMPROVE with muscle use. associated with Small cell lung cancer

Back 130

Lambert Eaton syndrome

Front 131

how do you distinguish MG and Lambert Eaton?

Back 131

MG = sx worsen with muscle use, can be treated with AChE inhibitors, assoc. with thymoma, eye involvement

Lambert = PROXIMAL muscle involvement; Sx IMPROVE WITH USE; assoc with paraneoplastic (Small cell lung cancer) cannot be treated with AChE alone

Front 132

CREST assoc with what disease

Back 132

scleroderma
assoc. with anticentromere

Front 133

anti-centromere abs... you think?

Back 133

CREST (scleroderma)
Calcinosis
Raynaud
Esophageal dysmotility
Sclerodactly
Telangectasioa

often confined to face and hands

Front 134

kids, daycare, large golden crusted lesions, usually staph aureus, sometimes strep pyogenes.
Tx is pencillin, very contagious

Back 134

impetigo

Front 135

impetigo

Back 135

kids, daycare, large golden crusted lesions, usually staph aureus, sometimes strep pyogenes.
Tx is pencillin, very contagious

Front 136

what is melasma?

Back 136

hyperpigmentation assoc with pregnancy

Front 137

necrotizing fascitiis due to what organism?

Back 137

strep pyogenes

Front 138

white plaque, cant be scraped off

Back 138

white plaque, cant be scraped off
hairy leukoplakia associ with HIV and EBV

Front 139

pitting in nails and assoc with arthritis

Back 139

psoriasis

Front 140

pemphigus vulgaris pathophys?

Back 140

IgG ab against desmosomes, positive nikolsky sign (separation of epidermis from dermis)
immunoflourescent thorughout epidermis; involves oral mucosa

Front 141

bullous pemphigoid pathophys

Back 141

IgG against hemidesmosomes;
negative nikolsky sign (no separation of epidermis from dermis with stroking)
abs are bellow the epidermis; linear
immunofluorescence
does not involve oral mucosa

Front 142

dermatitis herpatiformis
what disease assoc. and what abs?

Back 142

igA
celiac disease

Front 143

lichen planus is associ with what disease? what are four P's

Back 143

pruiritic, purple, polygonal papules;
sawtooth infiltrate of lymphocytes at dermal epidermal jxn;

associa with HEP C!!!!!!

Front 144

seen in hyperinsulinemia (eg. diabetes or cushings)

Back 144

acanthosis nigirans

Front 145

actinic keratosis is precursor to what

Back 145

squamous cell ca

Front 146

what is precursor to squamous cell ca

Back 146

actinic keratosis

Front 147

skin tumor with pallisading nuclei

Back 147

basal cell;
common in sun exposed areas; pearly papules

Front 148

S-100 tumor marker

Back 148

melanoma

Front 149

what is precursor to melaoma

Back 149

dysplastic nevus (atypical mole)

Front 150

dysplastic nevus is precursor to what

Back 150

melanoma