Study your flashcards anywhere!

Download the official Cram app for free >

  • 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

How to study your flashcards.

Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key

Up/Down arrow keys: Flip the card between the front and back.down keyup key

H key: Show hint (3rd side).h key

A key: Read text to speech.a key


Play button


Play button




Click to flip

311 Cards in this Set

  • Front
  • Back
name fibers involved in stretch reflex (afferent, efferent)
Ia= afferent, II = efferent
name fibers involved in golgi tendon contraction reflex (Afferent, efferent)
Ib = afferent, II= efferent
describe flexor-withdrawal reflex
ipsilateral flexion (flex away from stimulus), contralateral extension (for balance)
spontaneous bone formation without preexisting cartilage
intramembranous formation
name some examples of bones in intramembranous formation
clavicle, face, skull
ossification of cartilaginous molds
endochondral bone formation
name some bones formed with cartilaginous formation
tibia, femur, fingers
where would clipping occur in unhappy triad injury?
from lateral side
name 3 ligaments torn in unhappy triad
mcl, medla meniscus, acl
where is attachment that anterior and posterior in aCL and PCL refer to
tibial attttachment
how to test ACL tearing
positive anterior drawer sign
how do you know you have torn MCL
abnormal passive abduction
name 4 rotator cuff muscles
supraspinatous, infraspinatous, teres minoir, subscapularis
function of supraspinatous
helps deltoid abduct arm
function of infraspinatous
laterally rotate arm
function of teres minor
aduct and laterally rotates arm
functoin of subscapularis
medially rotate and adduct arm
where is the weakest part of rotator cuff and why?
inferior part (no rotator cuff muscles)
most common rotator cuff injury
anterior (tear supraspinatous)
what will get damaged in anterior dislocation of humerus
axillary nerve, artery
what are the complications of breaking the scaphoid bone and why?
blood supply from distal end, could necrose
what is complication of breaking luntae bone?
compress median nerve
what is complication of breaking hamate bone?
can't flex pinky
describe dupuytren contracture
think palmar skin - progressive finger flexion (first ring and little fingers go)
how is psoas major related to appendicitis
if have appendicits and extend psoas major, will hurt
function of psoas major
flex hip and thigh
function of piriformis muscle
lateral rotator of hip
between what muscles does the dorsalis pedis run
extensor hallicus longus and extensor digitorum longus
what nerve runs with anterior tibial artery?
deep peroneal nerve
what nerve runs with posterior tibial artery?
tibial nerve
what nerve and artery are often injured in a car acident
femoral artery and nerve
what muscle is innervated by the inferior gluteal nerve
gluteus maximus
how do you tell you have a inferior gluteal nerve injury?
lean backwrad when walk, can't rise from seat
what muscles are innervated by superior gluteal nerve
gluteus minimus and medius
what happens when lesion in superior gluteal nerve?
trendelenburg gait (drop on side opposite lesion, flex spine towards lesion)
what is in femoral triangle from medial to lateral
femoral canal (lymph nodes), femoral vein, femoray artery, femoral nerve
what is the most common ankle injury
what commonly happens in eversion injury and why?
fracture fibula because medial ankle ligaments are so strong
name the steps in skeletal muscle contraction
first calcium binds to troponin C and atp hydrolyzed, now myosin can bind actin, release P and power stroke, rebind ATP and then detach from actin
5 characteristics of type I red fiber
slow twitch, high myoglobin, high mitochondria, low glycgen, aerobic oxiddation
5 characteristics of type II white fiber
fast twitch, less myoglobin, less mitochondria, increased glyocgen, anerobic oxidation
define A band
where myosin and actin overlap. does not change size
define I band
actin only (shortens)
define myofibers
large multinucleated skeletal muscle fibers
define myofibrils
tandem array sarcomeres
define Z line
where actin attaches
what do the dihydropyridine receptors and ryanodine receptors do
depolarization gets to dihydropyridine receptor and signals ryanodine to release calcium from sarcoplasmic reticulum
where does depolariztaion travel down in skeletal muscle?
what are steps in smooth muscle contraction?
smooth muscle depolarization, calcium opens, calcium binds to calmodulin, activate MLCK, cross bridge formation
how to relax smooth muscle?
myosin light chain phosphatase to dephosphorylate myosin and relax
birbeck granules in cytoplasm (tennis racket)
histiocytosis X
skull lesion, diabetes insipidus, exophthalamus
chronic histiocytsis X
infants: hepatosplenomegaly, pancytopenia, recurrent infection, lymphadenopathy
acute histiocytosis X
solitary bone lesion, extraskeletal involvement only to lung
eosinophilic granuloma
type of atrophy with target fibers
denervation atrophy
what occurs after reinnervation of denervation atrophy?
cluster of type I next to cluster of type II fibers (Discrete)
what is normal type I and type II fiber arrangement in muscle
all mixed together
atrophy where here is prolonged immobilization and type II fibers lost
disuse atrophy
weakness of face, scapula, humerues
facioscapulohumeral dystrophy
weakness in shoulder and pelvic gridle
limb-girdle dystrophy
define myotonia
can't relax muscles once contract
myotonia, testicular atrophy, cataracts
myotonic dystrophy
what genetic inheritance is myotonic dystrophy?
autosomal dominant
muscle weakness, hypotonia in child
central core disease
what is path of central core disease
loss of mitochondria in type I fibers
weakness in child with tangles of rod-shaped granules
nemaline myopathy
what genetic inheritance is achondroplasia?
autosomal dominant
disease: head and trunk normal size, limbs much shorter
when is ALP elevated in bone lesion?
only with fracture and release of material
most common cause dwarfism
what process is not affected in achondroplasia?
membranous ossification
older patient: no systemic symptoms, pain in weight bearing joints that improve with rest
is osteoarthritis assymetrical or syymetrical?
where are common areas of osteoarthritis?
lower vertebrae, pelvis
define osteophyte
bone sput in perimeter of articulation
arthritis: primary pathology is ulcerated, narrow cargilage
herbeden's nodes and bouchard's nodes
pannus formation in mcp and pip
rheumatoid arthritis
morning stiffness, symmetric joint involvement, fever, pleuritis, pericarditis, fatigue
rheumatoid arthritis
what type of HSE is rheumatoid arthritis?
type III
define ulnar deviation
fingers deviated toward pinky
define boutonniere deformity
hyperflexion PIP, hyperextension DIP
define swan-neck deformity
hyperextension PIP, hyperfelxion DIP
disease: bone and cartilage erosion, increased synovial fluid
rheumatoid arthritis
define osteoid
protein mixture secreted by osteoblast that needs to be calcified
what are the bone enzymes like in osteoporosis?
all normal
diffuse radiolucency of bone
3 causes of osteoporosis
hypercortisol, hyperthyrodsim, calcium deficiency
mechanism of Type I osteoporosis
increased bone resporption due to decrease in estrogen
mechanism of type II osteoporosis
physical inactivity in old people
define osteoporosis
reduction of bone mass despite normal bone mineralizatoin
treatment for severe osteoporosis
bisphosphonates or pulsatile PTH
acute back pain, loss of height, kyphosis, colle's fractures, vertebral wedge fractures
osteoporosis (weight bearing joint problems)
disease with mixed osteomalacia and osteitis fibrosa cystica
renal osteodystrophy
thickened, dense bones with failure of normal bone resorption
mechanism of osteopetrosis
abnormal osteoclast function
enzymes in osteopetrosis
all normal
3 complications of osteopetrosis
increased fractures, anemia, cranial nerve involvement (blindness, deafness)
general thinning of spicules in adults
mechanism of osteomalacia
defective osteoid mineralization due to vitamin D deficiency
child: thick epiphyseal plate, thin occipital/paritel bone (craniotabes), protrusion sternum, decrased height
enzyme/mineral problems in osteomalcia/rickets
decrease vitamin D, decrease calcium, increased PTH, incrase serum phosphate
what can osteomalaica be secondary to
renal osteodystrophy
cystic spaces lined by osteoclasts and filled with fibrous stroma
osteitis fibrosa cystica
mechanism of osteitis fibrosa cystica
enzyme, mineral problems in osteitis fibrosa cystica
high calcium, low phosphporus, high ALP
mosaic pattern of bone (abnormal bone architecture)
paget's disease
increased skull size, hearing loss, and bone pain
paget's disease
bone problem in elderly with hihg output cardiac failure due to AV Shunts in lesions
paget's disease
mechanism of paget's disease
increase in osteoblastic and osteoclastic activity)
enzyme defects in paget's disease
all normal except elevated ALP
cancer with lytic and blastic lesions of bone
breast cancer
multiple localized whorls of collagen within bone
polyostotic fibrous dysplasia
girls with short stature, unilateral pigmented skin lesions, precocious puberty
albright's syndrome
mechanism of albright's syndrome
bone replaced by fibroblasts, collagen, irregulat bony trabeculae
pain and stiffness in shoulders and hips with fever, weight loss, malaise
polymyalgia rheumatica
is there muscule weakness in polymyalgia rheumatica?
what is associated with polymyalgia rheumatica?
temporal arteritis
progressive proximal muscle weakness with muscle biopsy showing inflammation
mechanism of polymyositis
CD8 attack muscle
progress proximal muscle weakness + skin rash
mechanism of dermatomyositis
type III HSE
increased serum CK, increase aldolase, anti-JO1 antibody
raynaud's, arthralgias, myalgias, fatigue, esophageal hypomotility
mixed connective tissue disorde
what is a disorder which is never found in mixed connetive tissue disorder?
renal problems
antibodies to U1-RNP
mixed connective tissue disorder
sand in eyes, parotid enlargmenet, dental carries
sjogren's syndrome
dysphagia, conjunctivitis, dry mougth
sjogren's syndrome
mechanism of sjogren's
progressive lymphocytic destruction of exocrine glands
what 2 complications is sjogren's strongly associated with
rheumatoid arthritis and B cell lymphoma
ani-SSA, anti-SSB
sjogren's syndrome
nasal and vaginal dryness, chronic bronchitis, reflux esophagitis
sicca snydrome (subset of sjogrens)
what population do you normally see lupus in?
black females
fever, fatigue, weight loss, vegetations on both sides of mitral valve, renal failure
what caues wire loop lesions and nephrotic syndorme in lupus?
immune complex deposition
why do you have false positives in syphilis tests with lupus?
presence of antiphopholipid antibodies
what HLA association is lupus
what type of hypersensitiviy is lupus
type III HSE
what difference does drug-induced lupus have from regular lupus?
uncommon renal problems
where are the renal deposits in lupus?
subendothelial (huge so can't cross basement membrane)
anti-histone antibodies
drug-induced antibodies
anti-smith antibodies
specific lupus but not diagnostic
anti-dsDNA antibodies
specific, poor prognosis lupus
sensitive but not specific SLE
arthritis, 100% anemia, mucositis, pericarditis
HLA-B8 association
celiac sprue
steatorrhea, blunted villi, abnormal D-xylose test, lymphocytes in laminia propria
celiac sprue
what population is celiac sprue most common
northern european
what part of intesting most affected by celiac sprue
what skin disorder is associated with celiac sprue
dermatitis herpatiformis
what type of maliganncy is associated with celiac sprue?
t-cell lymphoma
assymetric joint distriution, acute, super-painful after meal, MTP joint in big toe
tophus formation in external ear and achilles tendon
mechanism of gout
precipitation of monosodium urate due to hyperuricemia
define tophus
mass of urate surroudned by inflammatory reaction
negatiely birefringent,needle shaped crystals
4 treatments for gout
allopurino, probenecid, colchicine, NSAIDS
weakly positively birefringent crystals
basophilic, rhoomboid crystals
what type of crystals in pseudgout?
calcium pyrophosphate
what joints affected in pseudogout?
large joints (knee)
HLA in goodpastures's
hemoptysis, hematuria, anemia, crescentic lesions
mechanism of goodpasture's
type II HSE with anti-collagen IV antibodies
what type of staining will you see in goodpasture's
linear staining
noncaseating granuloma
two elevated enzymes in sarcoidosis?
ACE elevation, increased vitamin D activation
what population is associated with sarcoidosis
black females
restrictive lung disease, bilateral hilar lymphadenopathy, bell's palsy, erythema nodosum
shortness of breath, cough, hemoptysis, fever, weight loss, night sweat
laminated concretions of calcium/protein and stellate inclusions in giant cells
interstial fibrosis and gammaglobulinemia
HLA association of seronegative spondyloarthropathies
stiff spine, uveitis, aortic regurgitation
ankylosing spondylitis
urethritis, conjunctivitis, arhtirtis
reiter's syndrome
x-ray: fusion of discs
ankylosing sponydylitis
acute onset arthritis, lower extremity joints, diffuse swelling of solitary finger and toe, after GI or chlamydial infection
reiter's syndrome
5 complications of ankylosing spondylitis
AV block, bladder+bowel dysfunction, pulmonary fibrosis, IBD, psioriasis
skin sclerosis, cardiovascular sclerosis, GI sclerosis
diffuse scleroderma
anti-SCL70 antibody
diffuse scleroderma
what is the speed of progression of diffuse scleroderma?
very fast
fixed facial expression is first sign
diffuse scleroderma
localized thickening of fingers and toes, telangiectasias, esophageal dysmotility, raynaud's phenomenon, calinosis
CREST syndrome
what is skin involvement in CREST syndrome
limited skin, confined to fingers and face
anticentromere antibody
CREST snydrome
what is systemic sclerosis strongly associated with?
primary biliary sclerosis
clubbing, associated with lung cance, mesothelioma, hepatic cirrhosis
hypertrophic osteoarthropathy
athlete after trauma, no bone damage, radiolucent center, painless hard mass
myositis ossificans
intermittend calduication, raynaud's, severe pain, heavy smokres
buerger's disease
treatment for buerger's
stop smoking
asian female <40, fever, arthritis, night sweat, skin nodules, ocular disturbances
takayasu's arteritis
weak pulses in upper extremities
takayasu's arteritis
mechanism of takayasu's arteritis
thickening of aortic arch and/or proximal great vessels
what is ESR best for
most common vasculitis
temporal arteritis
unilateral headache, jaw claudication, impaired vision
temporal arteritis
vasculitis of elderly females
temporal arteritis
abdominal pain, melena, cutaneous eruptions, neurologic dysfunction
polyarteritis nodosa
polyarteritis nodosa
what association is seen w/ polyarteritis nodosa
hepatitis B
what is the mechanism of polyarteritis nodosa
ischemia/infarct of vessels
what will you see on ateriogram in polyarteritis nodsosa
multiple aneurysms and constrictions
what type of necrosis in vasculitis
fibrinoid necrosis
perofratoin of nasal septum, otitis mdia, chronic sinusitis, cough, dyspnea, hemoptysis with granulomas
wegenere's granulomatosis
what is prognosis for wegener's
80% die in 1 year
red cell casts, hematuria, large pulmonary nodules on CXR
wegener's granulomatosis
perofratoin of nasal septum, otitis mdia, chronic sinusitis, cough, dyspnea, hemoptysis without granulomas. p-ANCA/C-ANCA negative
miscroscopic polyangiitis
vasculitis affecting only kidneys
primary pauci-immune crescentic glomerulonephritis
granulomatous vasculitis with eosinophilia in lung and heart in patient with eczema and allergies
churg-strauss syndrome
most common form of childhood vasculitis
non-blanching purpura on legs and arms progressing to trunk in child
henoch-schonlein purpura
arthralgia, abdominal pain, melena in kids
henoch-schonlein purpura
#1 cause acquired heart idsease in kids
kawaski's disease
kid with fever, erythema, congested conjunctiva, coronary aneurysm
kawasaki's disease
name parts of brachial plexus
roots, trunks, divisions, cords, branches
where are roots of brachial plexus?
anterior triangle neck
where are trunks of brachial plexus
posterior triangle neck
where are divisions of brachial plexus
behind clavicle
where are cords of brachial plexus
where are branches of brachial plexus
how are parts of brachial plexus named
in relation to axillary artery
what muscle is just medial to brachial artery?
biceps brachii
vein between deltoid and pec major in anterior/lateral arm
cephalic vein
part of brachial plexus runs with axillary artery that can be compressed with aneurysm
medial cord
what protects brachial plexus from clavicle fracure
subclavius muscle
4 muscles innervated by radial nerve
brachioradialis, extensors of wrists/fingers, supinator,triceps
where and what with artery does radial nerve run?
with deep brachial artery behind humerus
3 thenar muscles
flexor pollicus brevis, abductor pollicus brevis, opponens pollicus
3 hypothenar mucles
flexor digit minimi, abductor digiti minimi, opponens digiti minimi
where to do pudendal nerve block?
ischial spine
mcburney's point is for what?
what is 2/3 from umbilicius to anterior superior iliac spine
landmark where do lumbar puncture
iliac crest
what will you see with radial nerve palsy
wrist drop
long thoracic nerve injury
winged scapula
where is long thoracic nerve
roots of C5, C6, C7
dermatome C2
posterior half of skull cap
dermatom C3
high turleneck
dermatome C4
low collar shirt
dermatome T4
dermatome T7
xiphoid proces
dermatoid T10
deramtome L1
inguinal ligament
dermatome L4
dermatome S2, S3, and S4 function
erection and sensation of penis and anus
pain in right shoulder via phrenic nerve is due to what?
gallbladder pain
nerve root for biceps reflex
nerve root for triceps reflex
nerve root for patella reflex?
nerve root for achilles reflex
what happens in babinski?
dorsiflexion big toe, fan other toes, sign UMN lesion
muscle innervated by long thoracic nerve
serratous anterior
clinical disablity of paralyzing long thoracic nerve
can't abduct past horizontal position
what is purpose of golgi tendon organ
senses tension and provides inhibitory feedback to alpha motor neurons
describe gamma loop
CNS stimulates gamma motor neuron, contract inftrafusal fibres, modulate sensitivity of reflex arc
describe muscle spindle
muscle stretch = intrafusal stretch = stimulate Ia afferent = stimulate alpha motor neuron - reflex contraction (Extrafusal)
reflex: extension of limbs when startled
moro reflex
reflex: nipple seeking
rooting reflex
reflex: grasps objects in palm
palmar reflex
when can primitive reflexes appear again?
frontal lobe lesion
between what 2 muscles does ulnar nerve run at risk?
flexor carpi ulnaris, flexor digitorum profundus
between what 2 muscles does median nerve run at wrist
palmaris longus, flexor carpi radialis
nerve that abducts thumb
median nerve
nerve that adducts thumb
ulnar nerve
what innervates the lumbrical muscles
ulnar nerve
what is purpose of lumbrical muscles?
flex MCPs
break at shaft of humerus
radial nerve injury
what reflexes are lost in radial nerve palsy?
brachioradialis reflex, triceps reflex
where is the sensory loss in radial nerve problem
posterior arm, posterior forearm, dorsal/lateral hand (up to fingertips)
supracondyle fracture of humerus
median nerve
nerve that leads to thenar atrophy, sign of papal benidiction
median nerve
what muscles does the median neve pass through?
pronator teres
what muscles does the radial nerve pass through
what is loss of sensation with meidan nerve
palm of index, middle, thumb, 1/2 ring, dorsal/lateral fingertips
fracture of medial epicondyle
ulnar nerve problem
clawed hand and impaired adduction of thumb
ulnar nerve
paralysis of adduction and abduction of fingers
ulnar nerve
what difference between ulnar nerve palsy in arm and at wrist
at wrist: severe claw hand because spare flexor digitorum profundus so can flex DIP
difference between median nerve problem at arm and at wrist
at wrist - spare flexor pollicus longus so can flex thumb
fracture at surgical neck of humerus
axillary nerve
no abduction of arm possible
axillary nerve
loss of deltoid action
axillary nerve
where is loss of sensation in axillary nerve?
lateral side of arm
what muscle does the ulnar nerve pass through?
flexor capri ulnaris
what muscle does the musclocutaneous nerve pass through?
what 3 mucsles are effected by musculocutaneous dysfunction
coracobrachilais, biceps, brachilias
what reflex is loss in musculocutaneous dysfunction
biceps reflex
paralysis of abductors, medial rotation of arm, forearm is pronated
C5 and C6 roots torn
no eversion and dorsflexion, foot drop
common peroneal nerve
where are nerve roots for common peroneal nerve
where is loss of sensation for common peroneal nerve
anterolateral leg, dorsum of foot
what innevates anterior leg?
deep peroneal nerve
what innervates lateral leg?
superficial peroneal nerve
fracture neck of fibula
loss of common peroneal nerv
function of tibial nerve
invert and plantar flex
lesoin here loses plantar flexion, no inversion
tibial nerve
where is loss of sensation of tibial nerve
soles of foot
lose knee extension, knee jerk
femoral nerve
nerve roots for tibial nerve
lose hip adduction
obdurator nerve
nerve roots femoral nerve
nerve roots obturator nerve
where is loss of sensation of femoral nerve?
anterior thigh, medial leg
what muscles does obdurator nerve innervate?
adductor magnus, adductor longus, adductor brevis
where is loss of sensation of obdurator nerve
medial thigh
what nerve is responsbile for thigh abduction
superior gluteal nerve
posterior femur displacement in car accident
injur sciatic nerve
poor gluteal injection leads to fotdrop, lose all sensation below leg except small medial strip, paralyze hamstrings, all muscles below knee
sciatic nerve injury
embryologic defect that compresses subclavian and C8, T1 of brachial plexus
thoracic outlet syndrome (klumpke's palsy)
atrophy of interosseous muscles, sensory problems medial side of forearm and hand, atrophy of thenar and hypothenar muscles, disappear radial pulse when move head to opposite side, claw hand
C8-T1 root problem