Gross Anatomy & Embryology - Musculoskeletal & Connective Tissue

Front 1

What are the epidermis layers from the surface to the base?

Back 1

"Californians Like Girls in String Bikinis"

Stratum:
1. Corneum
2. Lucidum
3. Granulosum
4. Spinosum
5. Basalis

Front 2

Describe the apical and basolateral surfaces of an epithelial cell.

Back 2

APICAL surface: portion of the cell exposed to the lumen
BASOLATERAL surface: portion of the cell exposed to the ECF (extracellular fluid)

Front 3

List 5 epithelial cell junctions.

Back 3

1. Zona occludens (tight junctions)
2. Zona adherens (intermediate junctions)
3. Macula adherens (desmosomes)
4. Gap junction
5. Hemidesmosome

Front 4

What is a zona occludens?

Back 4

A tight juctions prevents diffusion across paracellular space; composed of claudin and occludins.

Front 5

What is a zona adherens?

Back 5

An intermediate junctions that surrounds perimeter just below zona occludens; cadherins connect to actin

Front 6

What is a macula adherens (desmosomes)?

Back 6

Cadherins attach juxtaposed cells; the cadherins are attached to desmoplakin (plaques) that in turn are attached to intermediate filaments (keratin) on the cytoplasmic side

Front 7

What are gap junctions?

Back 7

Allows adjacent cells to communicate for electric and metabolic functions.

Front 8

What are hemidesmosome?

Back 8

Connects cells to underlying extracellular matrix

Front 9

What are integrin?

Back 9

Maintains integrity of basement membrane; binds to lamin in BM

Front 10

What is a common football injury caused by clipping from the lateral side?

Back 10

Knee injury ("Unhappy triad")
Damage to MCL (medial collateral ligament), ACL (anterior collateral ligament) and medial meniscus

Front 11

How can you tell between the MCL and the LCL?

Back 11

The MCL is attached to the tibia and the LCL is attached to the fibula.

Front 12

What does the a positive anterior drawer test indicate?

Back 12

Tear in of the ACL

Front 13

How do you test the MCL?

Back 13

While patient is supine and knee slightly flexed push medially against the knee pulling the ankle laterally.
Abnormal passive abduction indicates a torn MCL
AKA test: abduction stress test, valgus stress test

Front 14

What are the muscles of the rotator cuff and their action?

Back 14

SItS

1. Supraspinatus - helps deltoid abduct the arm; abduct the shoulder
2. Infraspinatus - externally/laterally rotate arm
3. teres minor - adduct and externally/laterally rorate the arm
4. Subscapulararis - internally/medially rotate the arm

Front 15

What upper extremity innervation is involved with this common lesion: trauma located between the base of the neck and the deltiod (trapezius muscle area)?

Back 15

Upper Trunk

Front 16

What upper extremity innervation is involved with this common lesion: compression by cervical disk lesion?

Back 16

C7 root

Front 17

What upper extremity innervation is involved with this common lesion: lesioned by fracture of surgical neck; dislocation of the humerus; intramuscular injections?

Back 17

Axillary nerve

Front 18

What upper extremity innervation is involved with this common lesion: compressed by cervical rib or by Pancoast Tumor of Lung?

Back 18

Lower trunk of brachial plexus

Front 19

What is a Pancoast Tumor of the Lung?

Back 19

An apical lung cancer in the superior sulcus which invade neural structures around the trachea, including the cervical sympathetic plexus,leading to severe pain in distribution of the ulnar nerve and Horner's syndrome on the same side of lesion. (eponym)

Front 20

What is Horner's Syndrome?

Back 20

Associated with Pancoast Tumor of the lung due to involvement of paravetebral sympathetic chain and the inferior cervical ganglion.
syndrome includes: Enophthalmos (dry eye), ptosis (eyelid drooping), miosis (constricted pupil), and anhydrosis (loss of sweating), unilateral (eponym)

Front 21

What upper extremity innervation is involved with this common lesion: by midshaft fracture of humerus?

Back 21

Radial nerve in spinal groove

Front 22

What upper extremity innervation is involved with this common lesion: compressed in axilla by incorrect use of a crutch?

Back 22

Radial nerve

Front 23

What upper extremity innervation is involved with this common lesion: streched by subluxation of radius?

Back 23

Radial nerve (deep branch)

Front 24

What upper extremity innervation is involved with this common lesion: compressed by subcondylar fracture of humerus; pronator teres syndrome?

Back 24

Median nerve

Front 25

What upper extremity innervation is involved with this common lesion: by repeated minor trauma; fractured of medial epicondyle of humerus?

Back 25

Ulnar nerve

Front 26

What upper extremity innervation is involved with this common lesion: compressed in deep forearm?

Back 26

Anterior interosseous n.

Front 27

What upper extremity innervation is involved with this common lesion: by superficial laceration?

Back 27

Recurrent branch of the median n.

Front 28

What upper extremity innervation is involved with this common lesion: compressed in carpal tunnel syndrome and by dislocated lunate?

Back 28

Median n.

Front 29

What upper extremity innervation is involved with this common lesion: by trauma to heel of the hand; fracture of hook of hamate?

Back 29

Ulnar n.

Front 30

What is the location of this brachial plexus lesion: Waiter's tip (Erb's palsy)

Back 30

Upper trunk

Front 31

What is the location of this brachial plexus lesion: Total claw hand (Klumpke's palsy)?

Back 31

Lower trunk

Front 32

What is the location of this brachial plexus lesion: Wrist drop?

Back 32

Posterior Cord

Front 33

What is the location of this brachial plexus lesion: Winged Scapula?

Back 33

Long thoracic nerve

Front 34

What is the location of this brachial plexus lesion: Deltoid paralysis?

Back 34

Axillary nerve

Front 35

What is the location of this brachial plexus lesion: Saturday night palsy (wrist drop)?

Back 35

Radial nerve and/or posterior cord

Front 36

What is the location of this brachial plexus lesion: difficulty flexing elbow, variable sensory loss?

Back 36

Musculocutaneous nerve

Front 37

What is the location of this brachial plexus lesion: decrease thumb function ("ape hand", pope blessing)?

Back 37

Median nerve

Front 38

What is the location of this brachial plexus lesion: Intrinsic muscles of hand, claw hand?

Back 38

Ulnar nerve

Front 39

How is the brachial plexus protected from a clavicle fracture (which is relatively common)?

Back 39

Because the brachial nerve is protected by the subclavius muscle.

Front 40

What nerve is involved and what type of motor and sensory deficit would you have if you had a: fractured surgical ned of humerus, dislocation of humeral head?

Back 40

1. Nerve: Axillary n (C5,6)
2. Motor: Arm abduction at shoulder
3. Sensory: over deltoid muscle

Front 41

What nerve is involved and what type of motor and sensory deficit would you have if you had a: fracture at midshaft of humerus: "Saturday night palsy" (extended compression of axilla by back of chair or crutches)?

Back 41

1. Radial n (C5-8)
2. Wrist extension at MCP joints, supination, thumb extension and abduction
3. Sensory: posterior arm and dorsal hand and dorsal thumb

**Sign: wrist drop

Front 42

What nerve is involved and what type of motor and sensory deficit would you have if you had a: fracutre of supracondylar humerus (proximal lesion) or carpal tunnre syndrome; dislocated lunate (distal lesion)?

Back 42

1. Nerve: Median (C6-8, T1)
2. Motor: opposition of thumb (proximal), lateral finger flexion, wrist flexion (distal)
3. Sensory: dorsal and palmar aspects of lateral 3 1/2 fingers, thenar eminence (proximal), dorsal and palmar aspects of lateral 3 1/2 fingers

**Signs: "ape hand" (proxinal) "Pope's blessing", ulnar deviation of wrist upon wrist flexion (distal)

Front 43

What nerve is involved and what type of motor and sensory deficit would you have if you had a: fracture of medial epicondyle of humerus (proximal) or fracture of hook of hamate (falling onto outstretched hand-distal)?

Back 43

1. Nerve: Ulnar (C8, T1)
2. Motor: medial finger flexion, wrist flexion (proximal) & Abduction/adduction of fingers, adduction of thumb, extension of 4th and 5th fingers/lumbricals (distal)
3. Sensory: Medial 1 1/2 fingers, hypothenar eminence (proximal)

**Signs: radial deviation of wrist upon wrist flexion (proximal) & ulnar claw hand (when asked to straighten fingers-distal)

Front 44

What nerve is involved and what type of motor and sensory deficit would you have if you had a: upper trunk compression?

Back 44

1. Nerve: Musculocutaneous (C5-7)
2. Motor: Flexion of arm at elbow
3. Sensory: lateral forearm