Musculo, Skin & CT Flashcards – First Aid for the USMLE STEP 1

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  • What are the epidermis layers from surface to base?
    Stratum Corneum (keratin Stratum Lucidum Stratum Granulosum Stratum Spinosum Stratum Basale Californians Like Girls in String Bikinis
  • what are the spines in the stratum spinosum?
    desmosomes
  • which epidermal layer is the stem cell site?
    Stratum Basale
  • what are the 3 epidermal appendages?
    Sebaceous gland Eccrine gland Apocrine gland
  • mechanism of sebaceous gland secretion?
    holocrine secretion of sebum
  • sebaceous gland associated with what?
    hair follicle
  • eccrine gland secretes what?
    sweat
  • eccrine glands are found where?
    throughout the body Eccrine glands are every where
  • apocrine glands secrete what?
    milky viscous fluid
  • apocrine glands are found where?
    "axillae, genitalia, areolae"
  • when are apocrine glands functional?
    do not become functional until puberty
  • why are apocrine glands malodorous?
    because of bacterial action
  • functions of tight junctions?
    zona occludens: prevents paracellular movement of solutes
  • tight junctions are composed of what?
    claudins and occludins
  • where are adherens junctions?
    zonula adherins: below tight junctions
  • adherens junctions form what?
    belt connecting actin cytoskeletons of adjacent cells with Cadherins
  • what are Cadherins?
    Ca++ dependent adhesion proteins
  • loss of E-cadherin does what?
    promotes metastasis
  • what is the function of desmosomes?
    structural support via keratin interactions
  • atoantibodies to desmosomes cause what?
    pemphigus vulgaris
  • components of desmosomes?
    keratin desmoplakin
  • what happens in gap junctions?
    channel proteins called connexons permit electrical and chemical communication between cells
  • function of a hemidesmosome?
    connects keratin in basal cells to underlying basement membrane
  • autoantibodies to hemidesmosomes cause what?
    bullous pemphigoid
  • what are integrins?
    membrane proteins that maintain integrity of basement membrane by binding to laminin in BM
  • how does unhappy triad happen?
    common injury in contact sportsL lateral force applied to a planted leg
  • unhappy triad includes which injuries?
    "tear of ACL, MCL and meniscus (classically medial, but lateral more common)"
  • treatment for unhappy triad?
    often requires surgical reconstruction
  • A and P in ACL and PCL refer to what?
    sites of tibial attachment
  • positive anterior drawer test means what?
    ACL tear
  • abnormal passive abduction at the knee means what?
    MCL tear
  • what is the important landmark for pudendal nerve block?
    ischial spine
  • what is the important landmark in finding the appendix?
    2/3 of the way from the umbilicus to the anterior superior iliac spine (McBurney's point)
  • what is the important landmark in lumbar puncture?
    iliac crest
  • what are the shoulder muscles that form the rotator cuff?
    Supraspinatus Infraspinatus teres minor Subscapularis SItS (small t is for teres minor)
  • what is the most common rotator cuff injury?
    Supraspinatus
  • action of supraspinatus?
    abducts arm initially (before deltoid)
  • which rotator cuff muscle is a common pitching injury?
    Infraspinatus
  • action of infraspinatus?
    laterally rotates arm
  • action of teres minor?
    adducts and laterally rotates arm
  • action of subscapularis?
    medially rotates and adducts arm
  • rotator cuff muscles are innervated by what?
    C5-C6
  • what are the bones of the wrist?
    Scaphoid Lunate Triquetrum Pisiform Trapezium Trapezoid Capitate Hamate Some Lovers Try Positions That They Can't Handle
  • what is the most commonly fractured carpal bone?
    scaphoid
  • scaphoid is prone to which complication?
    avascular necrosis owing to retrograde blood supply
  • dislocation of which wrist bone may cause acute carpal tunnel syndrome?
    lunate
  • what is carpal tunnel syndrome?
    entrapment of median nerve in carpal tunnel
  • what is the pathogenesis of carpal tunnel syndrome?
    "nerve compression --> paresthesia, pain, and numbness in distribution of median nerve"
  • cause of lesion in upper trunk of brachial plexus?
    trauma
  • cause of lesion in C7 root of brachial plexus?
    compressed by cervical disk lesion
  • cause of lesion in axillary nerve?
    fracture of surgical neck of humerus dislocation of humerus intramuscular injections
  • cause of lesion to lower trunk of brachial plexus?
    compressed by cervical rib or by pancoast tumor of lung
  • lesion of lower trunk of brachial plexus leads to what?
    Klumpke's palsy
  • cause of lesion to radial nerve in spiral groove?
    lesioned by midshaft fracture of the humerus
  • cause of radial nerve compression in the axilla?
    incorrect use of a crutch
  • cause of lesion in proximal median nerve?
    compressed by supracondylar fracture of humerus pronator teres syndrome
  • cause of lesion to deep branch of radial nerve?
    stretched by subluxation of radius
  • cause of proximal ulnar nerve lesion?
    lesioned by repeat minor trauma fracture of medial epicondyle of humerus
  • caused of lesion to anterior interosseous nerve?
    compressed in deep forearm
  • cause of lesion in distal median nerve?
    compressed in carpal tunnel syndrome and by dislocated lunate
  • cause of distal ulnar nerve lesion?
    lesioned by trauma to heel of the hand fracture of hook of hamate
  • cause of lesion to recurrent branch of median nerve?
    lesioned by superficial laceration
  • nerve root of top of shoulder dermatome?
    C4
  • nerve root of lateral humerus dermatome?
    C5
  • nerve root of medial arm --> lateral forearm--> thumb and index finger dermatome?
    C6
  • nerve root of middle finger and middle palm dermatome?
    C7
  • Nerve root of ring/little finger and medial palm dermatome?
    C8
  • Nerve root of medial forearm and distal medial arm dermatome?
    T1
  • nerve root of medial proximal arm and inferior shoulder dermatome?
    T2
  • cutaneous sensory nerve distribution on hand of the ulnar nerve?
    little + 1/2 ring finger on palmar and dorsal surface of hand
  • cutaneous sensory nerve distribution on hand of median nerve?
    "thumb --> half of ring finger on palmar surface inner half of thumb, distal half of index to 1/2 ring finger on doral surface"
  • cutaneous sensory nerve distribution on hand of radial nerve?
    proximal edge of palmar thenar eminence on palmar and whole dorsum of thenar eminence
  • lesion to long thoracic nerve causes what?
    winged scapula
  • lesion to upper trunk of the brachial plexus causes what?
    Waiter's tip (Erbs palsy)
  • lesion to lower trunk of brachial plexus causes what?
    Claw hand (Klumpke palsy)
  • lesion to posterior cord of the brachial plexus causes what?
    wrist drop
  • damage to the axillary branch of the brachial plexus causes what?
    deltoid paralysis
  • damage to radial branch of the brachial plexus causes what?
    Saturday night palsy (wrist drop)
  • damage to musculocutaneous branch of brachial plexus causes what?
    "Difficulty flexing elbow, variable sensory loss"
  • damage to the median branch of the brachial plexus causes what?
    decreased thumb function (pope's blessing)
  • damage to the ulnar branch of the brachial plexus causes what?
    "intrinsic muscles of the hand, claw hand"
  • roots that contribute to the long thoracic nerve?
    "C5, 6, 7"
  • roots that contribute to upper trunk of the brachial plexus?
    C5-6
  • roots that give rise to middle trunk of brachial plexus?
    C7
  • roots that give rise to lower trunk of brachial plexus?
    C8-T1
  • how many divisions in the brachial plexus?
    6
  • trunks that contribute to the lateral cord of the brachial plexus?
    upper middle
  • trunks that give rise to posterior cord of the brachial plexus?
    upper middle lower
  • trunks that give rise to medial cord of the brachial plexus?
    lower
  • nerve roots that give rise to lateral cord of brachial plexus?
    "C5, 6, 7"
  • nerve roots that give rise to posterior cord of brachial plexus?
    "C5, 6, 7, 8, T1,"
  • nerve roots that give rise to medial cord of brachial plexus?
    "C8, T1"
  • trunks that give rise to axillary branch of brachial plexus?
    upper middle lower
  • trunks that give rise to radial branch of brachial plexus?
    upper middle lower
  • trunks that give rise to musculocutaneous branch of brachial plexus?
    upper middle
  • trunks that give rise to median branch of brachial plexus?
    upper middle lower
  • trunks that give rise to ulnar branch of brachial plexus?
    lower
  • cords of brachial plexus that innervate flexors of forearm?
    lateral medial
  • cords of brachial plexus that innervates extensors of forearm?
    posterior
  • nerve roots that contribute to axillary nerve?
    C5-C6
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