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86 Cards in this Set
- Front
- Back
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What are the Epidermis Layers from the outside in?
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Stratum Corneum
Stratum lucidum Stratum granulosum Stratum spinosum Stratum basalis |
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4 Types of Epithelial Cell Junctions?
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Zona occludens (tight junction)
Zona adherens Macula adherens (desmosome) Gap Junction |
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What is fxn and components of the Zona occludens?
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F: prevents diffusion
C: claudins and occludins |
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What is fxn and components of the Zona Adherens?
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F: surrounds perimeter below occludens
C: cadherins connect to actin |
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What is fxn and components of the Desmosomes (macula adherens)?
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C: cadherins connect to intermediate filaments
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Fxn and Components of Gap Jxn's?
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F: allows adjacent cells to communicate for electric and metabolic fxns
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What kind of connections are on the basolateral surface of epithelial cells?
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Hemidesmosomes
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Fxn of hemidesmosomes?
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connects cells to underlying ECM
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Fxn of Integrins?
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maintain integrity of BM
Binds Lamin in BM |
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What is the Terrible Triad?
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MCL
Medial Meniscus ACL |
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Which knee ligaments are collateral vs cruciate?
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Medial and Lateral are Collateral
Anterior and Posterior are Cruciate |
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What do Anterior and Posterior refer to in ACL and PCL?
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Tibial Attachment
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Sign for ACL tear?
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Positive Anterior Draw sign
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Sign for torn MCL?
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Abnormal Passive abduction
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Shoulder Muscles that form Rotator Cuff?
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Supraspinatus
Infraspinatus Teres Minor Subscapularis |
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Fxn's of the rotator cuff muscles?
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Supraspinatus: abduction
Infraspinatus: Laterally rotates arm Teres Minor: Laterally rotates and adducts arm Subscapularis: Medially rotates and adducts arm |
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What nerve gets compressed by a cervical rib?
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Lower Trunk of the Brachial Plexus
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Incorrect use of a crutch can compress what nerve?
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Radial N in axilla
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A midshaft fracture of the humerus can lesion what?
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Radial N
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What 3 things can screw up the Axillary Nerve?
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Fracture of the surgical neck of the humerus
Dislocation of humerus IM injections |
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Sublux the radius--->?
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Stretched Radial N.
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Supracondylar fracture of humerus--->?
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Compression of Median N.
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Pronator Teres Syndrome compresses who?
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Median N.
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Fracture of Medial Epicondyle of Humerus--->?
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Ulnar N. lesion
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Where is the Anterior Interosseous N. subject to injury?
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Deep Forearm
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Dislocated lunate bone--->
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compressed median nerve
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Superficial laceration of the fat part of the base of my thumb-->?
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Recurrent Br. of Median N
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Fractured hook of hamate--->?
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ulnar n. lesion
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What are the dermatomes of the upper limb?
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Where is the border between median and ulnar nerve innervation on hand?
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Down the middle of my ring finger
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What branch of the Radial nerve innervates the hand and where?
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Superficial Br
Dorsum of hand and thumb. stops by the second knuckle |
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Mnemonic for how the brachial plexus gets divided up?
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Randy Travis Drinks Cold Beer
= Roots Trunks Divisions Cords Branches |
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Nerve roots contributing to Brachial Plexus?
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C5-8 and T1
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Who are the Trunks of the BP? which roots contribute to each trunk?
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Upper (C5 and C6)
Middle (C7) Lower (C8 and T1 |
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Who are the Cords and who contributes to each?
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Lateral (upper and middle)
Posterior (upper, middle, lower) Lower (lower) |
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Who are the branches and what roots and cords are their origins?
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Axillary N (C5 and C6 from Post. Cord)
Radial N (C5-C8 from post cord) Musculocutaneous N (C5-C7 from Lat cord) Median N (C6-T1 from Lat and Med cord) Ulnar N (C8 and T1 from Medial cord) |
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Lesion of the Upper Trunk--->
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Waiter's Tip (erb's palsy)
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Lesion of Lower Trunk--->?
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Total Claw Hand (klumpke's palsy)
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Lesion of Posterior Cord--->?
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Wrist Drop
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Lesion of Axillary N presents as?
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Deltoid Paralysis
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Lesion of Radial N presents as?
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Saturday Night Palsy (wrist drop)
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Lesion of Musculocutaneous nerve-->?
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Difficulty flexing elbow
variable sensory loss |
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Lesion of Median Nerve--->?
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Dec Thumb fxn (ape hand)
Pope's Blessing |
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Lesion of Ulnar N--->?
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Dysfxn of intrinsic muscles of hand---> claw hand
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What protects the brachial plexus from a claviclular fracture?
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Subclavius muscle
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Nerve roots of long thoracic nerve?
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C5
C6 C7 |
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Lesion of Long Thoracic--->?
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Winged Scapula
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What sensory deficit is associated w/ a lesion of the axillary n?
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over deltoid muscle
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What sensory deficit is associated w/ a lesion of the Radial N?
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Posterior Arm
Dorsal Hand Dorsal Thumb |
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What sensory deficit is associated w/ a lesion of the Median N.?
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Dorsal and Palmar aspect of lateral 3 1/2 fingers
Thenar Eminence |
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What sensory deficit is associated w/ a lesion of the Ulnar N?
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Medial 1 1/2 fingers
Hypothenar Eminence |
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What sensory deficit is associated w/ a lesion of the Musculocutaneous N?
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Lateral Forearm
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how do you end up w/ Erb-Duchenne's Palsy (aka waiter's tip)? nerve roots affected?
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Blow to shoulder or trauma during delivery
Upper Trunk lesion, so C5 and C6 |
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Findings w/ Erb's Palsy?
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Limb hangs by side (paralysis of abductors)
Medially rotated (paralysis of lateral rotation) Forearm pronated (loss of biceps) |
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Etiology of Klumpke's Palsy?
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Embryologic or childbirth defect affecting inferior (lower) trunk of brachial plexus (C8, T1)
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What other condition can affect the inferior/lower trunk of the BP? cause?
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Thoracic Outlet Syndrome
from cervical rib compressing subclavian artery and inferior trunk |
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How does Klumpke's present? why?
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Total Claw Hand
loss of fxn of all lumbricals + forearm finger flexors and finger extensors are unopposed = clawing of all digits |
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How does Thoracic Outlet Syndrome present?
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Atrophy of thenar and hypothenar eminences
Atrophy of Interosseous muscles Sensory deficits on medial side of forearm and hand Disappearance of radial pulse upon moving head toward opposite side |
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Fxn of lumbricals in relation to knuckles?
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Flex MCP
Extend DIP and PIP |
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4 distortions of the hand?
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Ulnar Claw
Median Claw Ape Hand Klumpke's Total Claw |
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How does the Ulnar claw present? why?
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Distal Ulnar Nerve lesion--->loss of medial lumbrical fxn and 4th and 5th digits are clawed
aka Pope's Blessing |
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What causes the median claw? how does it look?
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Distal median nerve lesion (after branch containing C5-C7 heads off to feed forearm flexors)--->
Loss of lateral lumbrical fxn and 2nd and 3rd digits clawed |
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What is Ape Hand? what causes it?
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Proximal Median Nerve Lesion--->loss of opponens pollicis muscle fxn--->unopposable thumb (can't abuct)
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Who is the "great extensor nerve?" who does it innervate?
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Radial Nerve
Brachioradialis Extensor or wrist and fingers Supinator Triceps |
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Radial nerve lesion--->?
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wrist drop
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Who are the Thenar Muscles?
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Opponens Pollicis
Abductor pollicis brevis Flexor pollicis brevis |
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Who are the Hypothenar Muscles?
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Opponens digiti minimi
Abductor digiti minimi Flexor digiti minimi |
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Fxn of the interosseous muscles?
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Dorsal's: abduct (DAB)
Palmar's: adduct (PAD) |
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What are tennis and golf elbow?
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Tennis: lateral epicondylitis
Golf: Medial epicondylitis |
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6 Lower Extremity Nerves?
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Obturator
Femoral Common Peroneal Tibial Superior Gluteal Inferior Gluteal |
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Cause of Injury, Motor Deficit and Sensory deficit for Obturator Nerve?
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I: Anterior Hip Dislocation
M: Thigh Adduction S: Medial Thigh |
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Cause of Injury, Motor Deficit and Sensory deficit for Femoral N?
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I: Pelvic Fracture
M: Thigh Flexion and Leg Extension S: Anterior Thigh and Medial Leg |
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Cause of Injury, Motor Deficit and Sensory deficit for Common Peroneal Nerve?
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I: Trauma to lateral aspect of leg or Fibula Neck fracture
M: Foot Eversion and Dorsiflexion; Toe extension S: Anterolateral Leg and Dorsal Foot |
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Cause of Injury, Motor Deficit and Sensory deficit for Tibial Nerve?
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I: Knee Trauma
M: Foot Inversion and Plantar Flexion; Toe Flexion S: Sole of Foot |
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Cause of Injury, Motor Deficit and Sensory deficit for Superior Gluteal?
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I: Posterior Hip Dislocation or Polio
M: Thigh Abduction |
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Sign of Superior Gluteal Nerve Injury?
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Positive Trendelenburg Sign
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Cause of Injury, Motor Deficit and Sensory deficit for Inferior Gluteal Nerve?
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I: Posterior Hip Dislocation
M: Can't Jump, climb stairs or rise from seated position |
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Types of Muscle Fibers?
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Type 1 = slow twitch, red fibers
Type 2 = fast twitch, white fibers |
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Why are Type 1 slot twitch fibers red?
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Inc Mitochondria and Myoglobin Concentration
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What is the purpose of the increased mitochondria and myoglobin in slow twitch fibers?
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Inc oxidative phosphorylation--->Sustained contractions
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What is different about smooth muscle contraction from skeletal?
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When calcium enters the cell it binds to Calmodulin
This activates Myosin Light Chain Kinase MLCK phosphorylates the myosin-actin complex to lead to contraction Myosin Light Chain Phosphatase then dephosphorylates the M-A complex leading to relaxation...and the cycle goes on... |
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What is Long bone growth called?
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Endochondral Ossification
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What is flat bone growth called?
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Membranous Ossification
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What is the process of Endochondral Ossification?
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Cartilaginous model is made by chondrocytes
Osteoclasts and Osteoblasts replace with woven bone and then remodel to get lamellar bone |
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Where do osteoblasts come from?
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Mesenchymal stem cells in periosteum
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Process of membranous ossification = ?
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Woven bone directly formed w/o cartilage
Later remodeled to lamellar |
