Download - MSK Questions
MSK QUESTIONS
Type of collagen in bone?• Type 1 collagen(also in skin)
• Type 2 collagen in Cartillage ( Collagen + Ground substance / Proteoglycan)
What cells produce cartillage & what cells maintain it?• Produce
• Chondroblasts
• Maintain• Chondrocytes
What are the 3 types of cartilage & where are they
• Hyaline• Joint surfaces
• Elastic• External ear, Epiglottis
• Fibrocartilage• Joints with not much movement• (Pubic symphysis, Intervertebral disks, Glenoid labrum of shoulder)
What is a bursa & what causes bursitis
• Bursa• Fluid filled sac • that provides friction free movement between bones & tendons or
muscles • around a joint
• Bursitis• Inflammation of sac• Due to repetitive use, trauma or systemic arthritis
What is osteoarthritis & what are its risk factors
• Osteoarthritis• Degenerative condition• Loss of articular cartilage & synovitis due to inflammation
• Risk factors• Idiopathic• Trauma• Inflammatory disease• Joint defects
- Age (biggest)- Gender- Race- Bone mass- Obesity
What is Rheumatoid arthritis & Risk factors
• RA• Chronic, Systemic inflammation• Involves synovial joints
• Risk factors• Autoimmune (RhF + IgG ATTACK)• Gender (Women 2-3x more at risk)• Age• Genetic predisposition
High RF – More severe & active the joint disease
Fun Fact:
Major RA & OA signs at the joint
RA
• Inflammation• Reduced joint space
• Lax tendons & ligaments • Erosion of bone• Degeneration of cartillage
• See these typically on hand or wrist radiographs
All due to Pannus Tissue invasion
OA
• Osteophytes (abnormal bony outgrowths)
• Reduced joint space• Bony cysts• Eburnation (bone
exposed & worn)
What is gout• Hyperuricaemia (high uric acid in the blood)• Causes deposition in joints, tendons & soft tissues &
therefore inflammation
(un)Fun Fact- Attack normally occurs
in 1st metatarsal joint- This becomes swollen,
red & shiny
What is nursemaid’s elbow• Aka – Pulled Elbow• Radial head dislocation
• As head isnt fully formed• Dislocates through annular ligament
Identify where the carpal bones are
What are the carpal bone
Scaphoid Lunate Triquetral Pisiform Hamate Capitate Trapezoid Trapezium
Why is a scaphoid fracture bad?• Because it hurts! (Obv)• Avascular Necrosis common complication
• Distal blood supply• Therefore closer to wrist, worse outcome
Most common fracture of the thumb• Bennett’s
• Proximal metacarpal 1
What is the golden rule of Anterior forearm innervation• Everything is MEDIAN n.• EXCEPT
• Flexor Carpi ULNARIS (Ulnar)• Flexor Digitorum Profundus (medial ½ is Ulnar!)
What is the golden rule of Posterior forearm innervation• Everything is RADIAL n.
What are the boundaries to the Cubital Fossa
Floor- Brachialis & Supinator
Roof- Fascia & Bicipital aponeurosis- VEINS for venepuncture
(Median Cubital Vein – which links Cephalic & Basalic)
What can you palpate in anatomical snuffbox• Scaphoid (Tenderness = Fracture!)• Radial artery (palpable pulse)• Radial styloid process• Trapezium• Base of 1st metacarpal
What is the golden rule of hand muscle innervation
• Everything is ULNAR n• Except
• Thenar muscles (ones by the ….)• Lumbircals 1 & 2
What passes through the carpal tunnel
• 9 flexor tendons- Flexor digitorum superficialis (x4)- Flexor digitorum profundus (x4)- Flexor pollicis longus
• Median N
What is carpal tunnel syndrome, and how does it cause these symptoms?• Compression of the median n. which runs through the
tunnel• Therefore
• Sensory loss• Thenar wasting
• Ulnar doesn’t go through the tunnel (goes through Guyons canal)
Draw BASIC blood supply forearm & hand
At the wrist, what tendons are these arteries next to
• Ulnar• Flexor Carpi ULNARIS - Under or lateral
• Radial• Flexor Carpi RADIALIS - Lateral
BONUS Q• Which artery supplies most of the blood to the hand?
How does damage to T1 root present• Wasting of small muscles of the hand
• Dorsal Interossei Wasting
• Possible cause• Pancoast tumour• Cervical Rib
Nerve to these 3 sensory areas& possible injury to them
XX
X
X
XX
X
XXX
MEDIAN
RADIAL
ULNAR
How do you lose powerful elbow flexion?
• Loss of Musculocutaenous N• Muscles supplies: Brachialis, Bicep Brachi, (coracobrachialis)
What is Klumpke’s Palsy• C8 & T1 Root damage/compression• What happens?
• Paralysis & wasting ALL small muscles of hand (1st dorsal interosseus)
• Clawing digitis 2-5
What is Erb’s Palsy• C5 & C6 damage
• E.g. childbirth injury• Results
• ‘Waiters tip’ appearance upper limb
Erbs Palsy