• Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

Card Range To Study

through

image

Play button

image

Play button

image

Progress

1/80

Click to flip

Use LEFT and RIGHT arrow keys to navigate between flashcards;

Use UP and DOWN arrow keys to flip the card;

H to show hint;

A reads text to speech;

80 Cards in this Set

  • Front
  • Back
Zona occludens (tight jxns) - composed of?
claudins, occludins
Zona adherens (int jxn) - composed of?
actin, E-cadherin (Ca dependent adhesion molecule)
Macula adherens (desmosome) -composed of?
Autoab to these cause what disease?
keratin, desmoplakin, cadherin (desmoglein)
Pemphigus Vulgaris
Gap jxn - composed of?
connexon with central channel
Hemidesmosome - composed of? location
Autoab to these cause what disease?
integrin, laminin in BM
Bullous pemphigoid - dermal, epidermal jxn
What is the unhappy triad?
Force from lat side...
MCL
ACL
Lateral meniscus
Where do you do a pudendal nerve block? LP?
Pudendal nerve block - ischial spine
LP - iliac crest
Rotator cuff muscles, fxn, innervation?
SItS
supraspinatus - abducts before deltoid. suprascapular n.
infraspinatus - lat rotation (pitching). suprascapular n.
teres minor - adducts, lat rotation. axillary n.
subscapularis - adducts, med rotation. subscapular n.
What injury can lesion upper trunk brachial plexus, C7 root, lower trunk?
Upper trunk - trauma
C7 - cervical disk lesion compression
Lower trunk - cervical rib compression, Pancoast tumor (Klumpke's palsy)
What injury can lesion radial n. (upper, spiral groove, lower)
Upper - crutches, Sat night palsy
Spiral groove - midshaft humerus fx
Lower - stretch by sublax of radius
What injury can lesion medial n. in antecubital fossa, wrist, hand?
Antecubital fossa - supracondylar fx humerus
Wrist - carpal tunnel, dislocated lunate
Hand - superficial lac
What injury can lesion ulnar n. at elbow, hand?
Elbow - medial epicondyle humerus fx, repeated minor trauma
Hand - hook of hamate fx
Cutaneous innervation of hand, where to test- median, radial, ulnar?
Radial - dorsum of hand by thumb
Medial - middle finger
Ulnar - pinky
What causes winged scapula?
"C5,6,7 wing your way to heaven" - long thoracic n. (serratus anterior - abducts above the horizontal), mastectomy
What protects the brachial plexus from clavicle fx?
Subclavius muscle
Axillary Nerve (C5-C6) - cause of injury, motor deficit, sensory deficit, sign.
Cause - Fx surgical neck humerus, dislocation humeral head
Motor - No arm abduction.
Sensory - over deltoid
Sign - flat deltoid
Radial Nerve (C5-C8) - cause of injury, motor deficit, sensory deficit, sign.
Cause - midshaft humerus fx, Sat night palsy, crutches
Motor - No wrist/arm extension, or supination.
Sensory - dorsum hand, back of arm.
Sign - wrist drop.
Median Nerve (C5-C8, T1) - cause of injury, motor deficit, sensory deficit, sign.
Cause - supracondylar humerus fx, carpal tunnel, dislocated lunate.
Motor - no wrist flexion, no MCP flexion or DIP/PIP extension lat lumbricals, no abductor pollicis.
Sensory - middle finger.
Sign - ape hand, thenar atrophy, ulnar dev, median claw hand.
Ulnar Nerve (C8, T1) - cause of injury, motor deficit, sensory deficit, sign.
Cause - Funny bone, medial epicondyl fx, hook of hamate fx
Motor - no ulnar dev, abd/ad fingers, flexion MCP or extension DIP/PIP med lumbricals.
Sensory - pinky.
Sign - Ulnar claw hand (papal benediction) when asked to straighten fingers.
Musculocutaneous Nerve (C5-C7) - cause of injury, motor deficit, sensory deficit.
Cause - upper trunk compression
Motor - no flex forearm.
Sensory - lat forearm (lat cutaneous n.)
Axillary Nerve (C5-C6) - cause of injury, motor deficit, sensory deficit, sign.
Cause - Fx surgical neck humerus, dislocation humeral head
Motor - No arm abduction.
Sensory - over deltoid
Sign - flat deltoid
Radial Nerve (C5-C8) - cause of injury, motor deficit, sensory deficit, sign.
Cause - midshaft humerus fx, Sat night palsy, crutches
Motor - No wrist/arm extension, or supination.
Sensory - dorsum hand, back of arm.
Sign - wrist drop.
Median Nerve (C5-C8, T1) - cause of injury, motor deficit, sensory deficit, sign.
Cause - supracondylar humerus fx, carpal tunnel, dislocated lunate.
Motor - no wrist flexion, no MCP flexion or DIP/PIP extension lat lumbricals, no abductor pollicis.
Sensory - middle finger.
Sign - ape hand, thenar atrophy, ulnar dev, median claw hand.
Ulnar Nerve (C8, T1) - cause of injury, motor deficit, sensory deficit, sign.
Cause - Funny bone, medial epicondyl fx, hook of hamate fx
Motor - no ulnar dev, abd/ad fingers, flexion MCP or extension DIP/PIP med lumbricals.
Sensory - pinky.
Sign - Ulnar claw hand (papal benediction) when asked to straighten fingers.
Musculocutaneous Nerve (C5-C7) - cause of injury, motor deficit, sensory deficit.
Cause - upper trunk compression
Motor - no flex arm.
Sensory - lat forearm
Explain Erb's Palsy.
C5-C6 trunk compression.
No axillary n - arm adducted, medially rotated (deltoid, teres minor).

Waiter's Tip.
No musculocutaneous n - no bicep flexion.
Explain Klumpke's Palsy.
C8-T1 trunk compression.
No ulnar or median n. - thenar/hypothenar atrophy, loss of all lumbricals and interossei, loss of wrist/finger flexion.

Not the same as Klumpke's total claw.
What causes Ape Hand vs Median Claw?
Ape Hand- prox, lose opponens pollicis
Median Claw-distal, lose lat 2 lumbricals
Obturator nerve (L2-L4) - cause of injury, motor deficit, sensory deficit.
Cause: Ant dislocation hip
Motor: no thigh adduction.
Sensory: med thigh.
Femoral nerve (L2-L4) - cause of injury, motor deficit, sensory deficit.
Cause: pelvic fx.
Motor: no thigh flexion, knee extension.
Sensory: ant, med thigh.
Common peroneal nerve (L4-S2) - cause of injury, motor deficit, sensory deficit, sign.
Cause: trauma to lat leg, fibula neck fx.
Motor: no eversion, dorsiflex foot.
Sensory: lat leg, dorsum foot.
FOOT DROP
Tibial nerve (L4-S2) - cause of injury, motor deficit, sensory deficit, sign.
Cause: knee trauma
Motor: no inversion, plantarflexion.
Sensory: sole of foot.
NO TIPTOES
Sup gluteal nerve (L4-S1) - cause of injury, motor deficit, sign.
Cause: post hip dislocation, polio, injection in superomed portion of butt
Motor: no thigh abduction.
Trendelenburg - hip drops on contralat side. (gluteus medius, minimus, tensor fascia latae)
Inf gluteal nerve (L5-S2) - cause of injury, motor deficit, sensory deficit.
Cause: post hip dislocation
Motor: can't stand up, jump. (gluteus maximus)
What gives rise to the common peroneal and tibial n? Where do they go?
Sciatic n (L4-S2) - tibial n down popliteal fossa, common peroneal wraps around lat fibula and then splits into deep peroneal and superficial peroneal.
How does action potential generate contraction in skeletal muscle?
AP opens volt-gated Ca channel in neuron causing Ach release. Ach binds to nicotinic receptor, depol transmitted down T-tubule. Dihydropiridine receptor depol, coupled to ryanodine receptor, opens SR to release Ca. Ca binds troponin C, conf change, moves tropomyosin out of myosin-binding groove. Myosin releases bound ADP and displaced on actin filament.
Which parts of sarcomere shorten during contraction? Which stays same?
A- always same
H band, I band - shorten
What is Type 1 muscle vs Type 2? Which type does wt training increase?
"one slow red ox"
Type 1 - slow, red fibers, lots mitos for increased ox phos, endurance.
Type 2 - fast, white, anaerobic glycolysis, wt training causes hypertrophy.
How does action potential generate contraction in smooth muscle? How does NO relax?
AP, smc depol, volt-gated Ca channel open, Ca binds calmodulin, activates myosin light chain kinase, phosphorylate myosin, actin-myosin cycling.

NO, GC, increase cGMP, inhibit MLCK.
What is endochondral ossification vs membranous ossification?
Endochondral - long bones. Cartilage replaced by woven, then lamellar bone. **This is defective in achondroplasia.

Membranous - flat bones. Directly to woven, then lamellar bone.
Type 1 vs Type 2 osteoporosis?
Type 1 - Postmenopausal, increased bone resorption due to low E.
Type 2 - Senile osteo, men and women >70.
Osteopetrosis
-Defect
-Sx
-Labs
-Def carbonic anhydrase II prevents bone resorption by osteoclasts. Thick bones prone to fx.
-CN palsies, pancytopenia due to decreased marrow space, extramed hematopoiesis, fx.
-NORMAL Ca, P, alkP! Ehrlenmeyer flask bones.
Paget's Disease of Bone
-Defect
-Sx
-Labs
-Defect of osteoclast and osteoblasts, abnl bone architecture.
-Increased hat size, hearing loss, fx.
-high alkP, cottonball bones
How can Paget's Disease cause high-output heart failure?
Increased blood flow from AV shunts in vascular bone.
Polyostotic Fibrous Dysplasia
-Defect
-Assoc disease
-Bone replaced by fibroblasts, collagen, irreg bony trabeculae.

McCune Albright - polyostotic fibrous dysplasia, Coast of Maine spots, precocious puberty.
Osteoma
Benign, new piece of bone grows on old piece (skull). Think Gardner's Syndrome (FAP).
Osteoid Osteoma
Benign, interlacing trabeculae of woven bone surrounded by osteoblasts, prox tibia/femur, boys<25.
Osteoblastoma
Benign, same as osteoid osteoma, vertebra
Osteoclastoma (giant cell tumor)
Benign, spindle-shaped cells with multinuc giant cells, epiphysis, knee, age 20-40, soap bubble xray.
Osteochondroma (exostosis)
MOST COMMON benign, mature bone with cartilaginous cap, long metaphysis, boys<25.
Endochondroma
Benign, cartilage neoplasm intramed bone, in hands and feet.
Osteosarcoma
Adolescent boys, metaphysis (knee), Codman's triangle/sunburst pattern.

Rb tumor sup mutation, Paget's can predispose.
Ewing's Sarcoma
Young boys, anaplastic small blue cell, diaphysis, t(11;22), onion skinning, responsive to chemo
Chondrosarcoma
Men 30-60, malig cartilage tumor intramed, glistening mass.
Where does cartilage loss in OA begin in the knee?
Medial side. Bone spurs, eburnation, subchondral sclerosis and cysts, jt space narrowing.
What is histo of rheumatoid nodule? Which ab test are sen vs spec?
Fibrinoid necrosis surrounded by palisading histiocytes.

Sen - RF (anti-IgG)
Spec - anti-CCP (anti-cyclic citrullinated protein)
What is Sicca syndrome?
Dry eyes, dry mouth, dry vagina
Chronic bronchitis
Reflux esophagitis

(No arthritis as in Sjogren's)
Why does EtOH precipitate gout attacks?
EtOH and uric acid compete for same excretion sites in the kidney.
What deformities do you see with psoriatic arthritis?
Dactylitis (sausage fingers)
pencil-in-cup deformitiy on xray
What are Schaumann and asteroid bodies? Where are they found?
Granulomas in sarcoidosis

Schaumann bodies - micro Ca/protein inclusions in giant cells
Asteroid bodies - fireworks
Why do you get hyperCa in sarcoid?
Elevated 1alpha-hydroxylase in epithelioid macs.
Polymyositis - pathophys?
CD8 killer cells attack muscle.
Define hyperkeratosis, parakeratosis, and acanthosis?
Hyperkeratosis - increased thickness stratum corneum
Parakeratosis - hyperkeratosis with retention of nuclei because cells turning over too fast
Acanthosis - hyperplasia of stratum spinosum (acanthocytes are spiny)
Define ephelis.
Ephelis - freckle, increase melanin pigment.
What is the Sign of Leser-Trelat?
sudden appearance of mult seborrheic keratoses (barnacles of old age) signifying underlying malig (GI, lymphoma)
What layer of epidermis does Staph Scalded Skin Syndrome attack?
exfoliatin toxin attacks statrum granulosum only
Dermatitis herpetiformis - histo?
IgA deposits at tips of dermal papillae.
Lichen planus - appearance, histo, assoc?
Pruritic, polygonal, purple, papules. Sawtooth infiltrate of lymphs at dermal-epidermal jxn. Assoc with HepC.
Acanthosis nigricans - histo?
Hyperplasia of stratum spinosum - duh, it's called acanthosis!
What is keratoacanthoma?
Rapidly growing variant of squamous cell carcinoma that regresses spontaneous (4-8wk)
Squamous cell carcinoma - histo?
BCC - histo?
SCC - keratin pearls
BCC - palisading nuclei
Zileuton - MOA?
Montelukast, zafirlukast - MOA?
Zileuton - inhibits lipoxyoxygenase, decreasing syn of ALL leukotrienes.

lukasts - inhibits LTC4, LTD4, LTE4 (bronchocon)
ASA - MOA, use, tox?
Irrev inhibits COX1/2 by acetylation (covalent binding) to decreases TXA2, PGI2, PGE2.

Low dose - plt
Med dose - fever, pain
High dose - inflam

Tox - ulcers, bleeding, Reye's syndrome, nephrotox
NSAID's - MOA, use, tox?
Rev inhibit COX1/2. Block PG syn.

Tox - ulcers, nephrotox, fluid retention, aplastic anemia.
Celecoxib - MOA, use, tox?
Rev inhibits COX2 only.

RA, OA, pt with ulcers.
Tox - increase risk thrombosis, sulfa drug.
Acetaminophen - why only an antipyretic, tox?
Rev inhibits COX1/2 in CNS only, inactivated periph!

Tox - hepatic necrosis
Bisphosphonates - tox?
corrosive esophagitis (except zolendronate)
osteonecrosis of jaw
nausea
diarrhea
Colchicine - MOA, tox?
Inhibits microtubule polym to prevent leukocyte chemotaxis.

Diarrhea
Nephrotox - give steroids to these pt instead
Agranulocytosis
Probenecid - MOA?

Allopurinol - MOA, tox?
Probenecid - Inhibits reabsorption of uric acid in PCT. Increases con of PCN.

Allopurinol - xanthine oxidase inhibitor. Increases con of azathioprine, 6-MP. Drug-induced lupus, Stevens-Johnson.
Etanercept - MOA?
Infliximab, adalimumab - MOA?
Etanercept - Decoy TNFalpha receptor that soaks up all the TNF.

Infliximab - anti-TNF ab