Term
|
Definition
| (top to bottom) Corneum, Lucidum, Granulosum, Spinosum, Basale |
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Term
|
Definition
Sebaceous- holocrine, hair follicles
Eccrine- sweat, throughout the body (everywhere)
Apocrine- milky viscous fluid, axilla, genitals |
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Term
|
Definition
(zona occludens)
Prevents paracellular movement of solutes
Made of claudins and occludes |
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Term
|
Definition
Belt connecting actin to adjacent cells with cadherins
Loss of e cadherin promotes tumor mets |
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Term
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Definition
Structural support via keratin interactions. Between cells
Autoantibodies > pemphigus vulgaris |
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Term
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Definition
| Channel proteins called connexins permit electrical and chemical communications between cells |
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Term
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Definition
| Maintain the integrity of the BM by binding laminin |
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Term
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Definition
Connects keratin in basal cells to underlying BM
AutoAbs lead to bullous pemphigoid |
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Term
| Clinically important landmarks |
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Definition
Pudendel nerve block- ischial spine
Lumbar puncture- iliac crest |
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Term
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Definition
abducts arm before deltoid, most common injury
Empty can test |
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Term
|
Definition
Laterally rotates arm
Pitching injury |
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Term
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Definition
| Adducts and laterally rotates arm |
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Term
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Definition
| Medially rotates and adducts the arm |
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Term
|
Definition
Scaphoid and Lunate articulate with radius (lunate is smaller)
Dislocation of the lunate can cause acute carpal tunnel syndrome |
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Term
|
Definition
Entrapment of the median nerve
Nerve compression leads to parasthesias, pain and numbness in distribution of median nerve |
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Term
| Upper extremity nerve injuries |
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Definition
Axillary- ant dislocation humerus
Radial- midshaft fracture, crutch compression, subluxation of the radius
Median- compression by supracondylar humerus fracture
Ulnar- fracture medial epicondyle humerus
Recurrent median- lesioned in palmar laceration |
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Term
|
Definition
Thumb side palmar- median
Pinky side palmar- ulnar
Dosrum thumb- radial |
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Term
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Definition
Upper trunk- waiters tip
Lower trunk- Claw hand
Post cord (radial and axillary)- wrist drop
LTN- winged scapula
Axillary- Deltoid paralysis
Radial- Saturday night palsy
Musculocutaneous- diff flexing elbow
Median- dec thumb function, popes hand
Ulnar- claw hand |
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Term
|
Definition
Fracture of the surgical neck of humerus, or ant dislocation
Deltioid weakness and sensory over deltoid lost |
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Term
|
Definition
Fracture at midshaft of the humerus; sat night palsy
BEST extensors: Brachioradialis, extensors of wrist and fingers, supinator, triceps
Posterior arm, dorsal hand and thumb sensory loss |
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Term
|
Definition
Fracture of supracondylar humerus
Opposition of thumb, lateral finger flexion, wrist flexion
Thumb palmar area, 2,3 finger tips dorsally
Ape hand, popes blessing |
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Term
|
Definition
Fracture of medial epicondyle of humerus
Lose medial finger flexion and wrist flexion
*radial deviation of wrist upon wrist flexion |
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Term
|
Definition
Upper trunk compression
Biceps, brachialis, coracobrachialis
Flexion of arm at elbow |
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Term
|
Definition
Traction tear of the upper trunk of the brachial plexus (C5 and C6 nerve roots) following trauma at delivery
Limb hangs medially rotated with forearm pronated |
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Term
| Klumpke's palsy and thoracic outlet syndrome |
|
Definition
Inferior brachial plexus (C8, T1)
Cervical rib can compress the subclavian artery and inferior trunk causing thoracic outlet syndrome
Atrophy of thenar and hypothenar eminencies
Atrophy of the interosseus muscles
Sensory deficits on medial forearm and hand
Disappearance of radial pulse upon moving head towards ipsilateral side |
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Term
|
Definition
Can occur from FOOSH
Inability to extend 4th and 5th digits |
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Term
|
Definition
carpal tunnel syndrome or dislocated lunate
2nd and 3rd digits are clawed |
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Term
|
Definition
Proximal median nerve lesion
Loss of lateral finger flexion and thumb opposition |
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Term
|
Definition
Serratus anterior anchors the scapula to thoracic cage
Used for abduction above horizontal position
Can be injured in mastectomy, which leads to a winged scapula |
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Term
|
Definition
Thenar - opponens pollicus, abductor pollicus brevis, flexor pollicus brevis
Hypothenar- " " digit minimi
DAB- dorsals abduct
PAD- palmars adduct |
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Term
|
Definition
Anterior hip dislocation
Loss of thigh adduction
Sensory loss to medial thigh |
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Term
|
Definition
Pelvic fracture
Loss of thigh flexion and leg extension
Ant thigh and medial leg sensory loss |
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Term
|
Definition
Trauma or compression of lateral aspect of leg or fibular neck fracture
Foot eversion and dorsiflexion; toe extension; foot drop; foot slap, stoppage gait
Lateral leg and dorsal foot |
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Term
|
Definition
Knee trauma
Foot inversion and plantar flexion loss
Sole of foot sensory |
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Term
|
Definition
Posterior hip dislocation or polio
Thigh abduction (trendelenberg sign) |
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Term
|
Definition
Posterior hip dislocation
Cant jump, climb stairs or rise form seated position |
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Term
| Muscle conduction to contraction |
|
Definition
-Depolarization travels along muscle cell and down the T tubule
-Depol of the VS DHP receptor mechanically coupled to the ryanodine receptor on the SR causes CA release
-Released Ca binds to troponin C, moving tropomyosin out of the myosin binding groove on actin filaments
-Myosin releases bound ADP and is displaced on the actin filament (power stroke) |
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Term
|
Definition
The Z disk binds the actin and makes up the I band
The M line binds the myosin and makes up the H band
The A band always remains the same length |
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Term
|
Definition
Slow twitch, red fibers
Inc mitochondria, inc myoglobin
Sustained contraction
"only have 1 back" - postural muscles |
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Term
|
Definition
Fast twitch, white fibers
Low in mitochondria and myoglobin
"2 arms, 2 legs"- wt training muscles |
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Term
|
Definition
Mysosin exists in a cocked position with ADP bound to it.
Once Ca moves the troponin C out of the way, myosin can bind and perform the power stroke. At the end of the power stroke, it requires ATP binding to the myosin to release it, and move it back the cocked position |
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Term
| Endochondral ossification |
|
Definition
Bones of axial and appendicular skeleton, and base of skull
Cartilagenous model of bone is made, then replaced with woven bone later on
In adults, woven bone occurs after fractures and in pager's disease |
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Term
|
Definition
Bones of the clavarium and facial bones
Woven bone formed directly without cartilage
Later remodeled to lamellar bone |
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Term
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Definition
| At low intermittent levels, exerts and anabolic effect on OBs and OCs (indirect). Chronic high PTH causes a catabolic effect (osteitis fibrous cystica) |
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Term
|
Definition
Inhibits apoptosis in bone forming OBs and induces apoptosis in OCs
In estroge deficiency, excess bone remodeling leads to osteoporosis |
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Term
|
Definition
Failure of longitudinal bone growth > short limbs
*Membranous ossification is not effected
Activation of FGFR3 inhibits chondrocyte proliferation
AD inheritance, if not sporadic |
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Term
|
Definition
Trabecular bone loses mass despite normal labs and bone mineralization
Type 1- post menopausal, dec estrogen
Type 2- senile, men and women > 70 |
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Term
|
Definition
Failure of normal none resorption due to defective OCs
Thickened, dense bones that are prone to fractures
Pancytopenia, extra medullary hematopoiesis
CN impingment and palsies as result of narrowed foramina
Can potentially be cured from BM transplant |
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Term
|
Definition
Vit D deficiency
Defective mineralization/calcification of osteoid
Leads to soft bones that bow outwards
Dec serum Ca, inc PTH, dec vit D
Hyperactivity of OBs, inc Alk Phos |
|
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Term
|
Definition
Inc in both OC and OB activity
Serum Ca, phosphorus and PTH are normal
Inc Alk Phos
Woven bone pattern, long bone chalk stick fractures
Inc blood flow from AV shunts may cause high output heart failure
*inc risk of osteogenic sarcoma, hearing loss |
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Term
| Polyostotic fibrous dysplasia |
|
Definition
Bone is replaced by fibroblasts, collagen and irregular bony trabecular
*McCune Albright- multiple unilateral bone lesions assoc with endocrine abnormalities (precocious puberty) and cafe au lait spots |
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Term
| Giant Cell tumor (osteoclastoma) |
|
Definition
20-40 yrs old
Epiphyseal end of long bones
Locally aggressive, benign tumor of around knee
*double bubble appearance on X-ray
Spindle shaped cells with multinuc giant cells |
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Term
|
Definition
Most common benign tumor, males < 25
Mature bone with cartilaginous cap
Originates from the long metaphysics
Malignant transformation to chondrosarcoma is rare |
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Term
|
Definition
Second most common primary malignant bone tumor (MM)
Males, 10-20
Pagets disease, bone infarcts, radiation, familial retinoblastoma
Knee area
*codmans triangle or sunburst pattern, aggressive |
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Term
|
Definition
Boys < 15
Commonly on diaphysis of long bones, pelvis, scapula, ribs
Anaplastic small blue cell tumor
Extremely aggressive, but responds to chemotherapy
Onion skin appearance in bones
*11;22 translocation |
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Term
|
Definition
Men 30-60 yrs old
Located in pelvis, spine, scapula, humerus, tibia or femur
Expansile glistening mass within the medullary cavity |
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Term
|
Definition
Joint wear and tear
Heberdens nodes (DIP), Bouchards nodes (PIP)
Age, obesity, joint deformity are all RFs
Pain in joints after use
Knee cartilage loss is medial, non inflammatory
Tx: NSAIDs, cortisol injections |
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Term
|
Definition
Inflammatory destruction of synovial joints
Type 3 HSN rxn
Pannus formation in joints (MCP, PIP)
Ulnar deviation of fingers
Females, pos RF (IgG), anti cyclic citrullinated Ab
*strong assoc with HLA-DR4 (type 2)
Morning stiffness
Tx: methotrexate, sulfasalazine, TNF-a inhibitors (etanercept, infliximab) |
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Term
|
Definition
Lymphocytic infiltration of exocrine glands
Triad: xeropthalmia, xerostomia (dry mouth), arthritis
Parotid enlargement, inc risk of B cell lymphoma
SS-A (anti Ro), SS-B (Anti-La)
Usually females between 40 and 60 |
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Term
|
Definition
Monosodium urate crystals due to hyperuricemia
Caused by LN syndrome, PRPP excess, dec excretion of uric acid (thiazides), inc cell turnover or von Gierke's
*90% due to underexcretion
Needle shaped and negatively birefringent
Yellow when parallel
Probenacid for underexcreters, allopurinol for over producers
Colchicine blocks leukocyte formation |
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Term
|
Definition
Deposition of calcium pyrophosphate crystals
Basophilic rhomboid crystals that are weakly positively birefringent
Tx: NSAIDs, steroids. colchicine |
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Term
|
Definition
S. aureus, streptococcus, N gonorrhea
Gonococcus precedes an asymetric migratory arthiritis |
|
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Term
|
Definition
Infarction of the bone and marrow
Trauma, high dose corticosteriods, alcohol, sickle cell
Most common site is femoral head |
|
|
Term
| Seronegative spondyloarthorpaties |
|
Definition
Arthritis without RF (no anti-IgG Ab)
Strong assoc with HLA-B27 (type 1)
Occurs more in males |
|
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Term
|
Definition
Joint pain and stiffness assoc with psoriasis
Assymetric and patchy involvement
Sausage fingers, pencil in cup deformity |
|
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Term
|
Definition
Chronic inflammatory disease of spine and sacroiliac joints
*Ankylosis, uveitis, aortic regurgitation
Bamboo spine |
|
|
Term
| Reactive arthritis (reiters syndrome) |
|
Definition
Conjunctivitis, urethritis, arthritis
Post GI or chlamydia infections |
|
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Term
|
Definition
90% are female, between age of 14 and 45
Most common and severe in black females
*libman sacks endocarditis- sterile wart like vegetations on both sides of valves, peripheral lymphadenopathy and Raynauds
*nephritis is a common cause of death
DPGN or MGN (wire lupus)
*false pos on syphilis test due to anti-phospholipid Ab, which cross reacts with cardiolipin
ANA, anti-DS DNA, anti-smith, anti-histone (drug induced) |
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Term
|
Definition
Immune mediated, widespread non caveating granulomas, elevated serum ACE levels
Common in black females
Assoc with interstitial fibrosis (restrictive), erythema nodosum, Bells palsy, uveitis and hypercalcemia (inc activation of vit D in epitheliod macrophages) |
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Term
|
Definition
Pain and stiffness in shoulders and legs
Fever malaise and weight loss
*no Mm weakness
Assoc temporal arteritis
Inc ESR, normal CK |
|
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Term
|
Definition
Progressive symmetric proximal muscle weakness
Endomysial inflammation with CD8 cells
Most often involves shoulders
Inc CK, pos ANA, anti-Jo |
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Term
|
Definition
Similar to polymyositis, but includes a malar rash
Grottons papules and heliotrope rash
Inc risk of occult malignancy
Perimysial inflammation and atrophy with CD4 T cells
Inc CK, pos ANA, anti-Jo |
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Term
|
Definition
Autoantibodies to postsynaptic Ach receptors
Ptosis, diplopia, weakness with inc use
Thymoma, thymic hyperplasia |
|
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Term
|
Definition
Auto Ab to presynaptic Ca Ch, leads to dec Ach release
Proximal muscle weakness, improves with use
Small cell lung cancer |
|
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Term
|
Definition
Metaplasia of Sk Mm to bone following muscular trauma
Suspicious mass at site of known trauma |
|
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Term
|
Definition
Excessive fibrosis and collagen deposition
Puffy and taut skin with absence of wrinkles
Sclerosis of renal, pulmonary arteries (most common COD) |
|
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Term
|
Definition
| widespread skin involvement, early visceral involvement, anti-scl70 (anti-topo1) |
|
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Term
|
Definition
Calcinosis, Raynauds, Esophageal dysmotility, Sclerodactyly, Telangiectasia
Limited skin involvement, often confined to the fingers and face
Anti-centromere Ab (CREST) |
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Term
|
Definition
Macule (<5mm), Patch (>5mm): flat
Papule (<5mm), Plaque (>5mm): raised |
|
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Term
|
Definition
Hyperkeratosis- Inc thickness of SC (psoriasis)
Parakeratosis- retention of nuclei in SC (psoriasis)
Acantholysis- separation of epidermal cells (PV)
Acanthosis- epidermal hyperplasia (Acanthosis nigricans)
Dermatitis- inflammation of the skin (atopic dermatitis) |
|
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Term
|
Definition
Normal melanocyte number, dec melanin production due to dec try kinase activity
*failure of NC migration |
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Term
|
Definition
| Hyperpigmentation assoc with pregnancy or OCP use |
|
|
Term
|
Definition
Irregular areas of dec pigmentation
Dec numbers of melanocytes |
|
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Term
|
Definition
warts caused by HPV
Soft, tan colored cauliflower like papules
Epidermal hyperplasia, hyperkeratosis
Condyloma accuminatum on genitals |
|
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Term
|
Definition
| Pruritic wheals that form after mast cell degranulation |
|
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Term
|
Definition
Pruritic eruption, commonly on skin flexures
Usually starts on the face in infancy, appears in antecubital fossa after that |
|
|
Term
| Allergic contact dermatitis |
|
Definition
|
|
Term
|
Definition
Plaques and papules with silver scaling, especially on knees and elbows
Inc SS, dec SG
Pinpoint bleeding when scales are peeled off |
|
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Term
|
Definition
Flat greasy pigmented squamous epithelial proliferation with keratin filled cysts
Leser-Trelat sign indicates underlying GI malignancy |
|
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Term
|
Definition
Potentially fatal AI skin disorder with IgG against desmoglein 3, part of the desmosomes needed for cell adhesion
*Ab around epidermal cells in a reticular pattern
Can show blisters on oral mucosa
Manual stroking will cause dermis to form blisters |
|
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Term
|
Definition
AI disorder with IgG Ab against hemidesmosomes
Show linear IF
Eosinophils with tense blisters
Spares oral mucosa |
|
|
Term
|
Definition
Pruritic vesicles and bullae
Deposits of IgA at the tips of the dermal papillae
Assoc with celiacs disease |
|
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Term
|
Definition
Assoc with infections: mycoplasma pneumoniae, HSV
Sulfa drugs, B lactams, phenytoin, cancers, AI diseases
Macules, papules, vesicles and target lesions all appear
*dusky center |
|
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Term
|
Definition
Fever, bullae formation and necrosis, sloughing of skin and high mortality rate
Skin lesions may appear as a target
Toxic epidermal necrolysis is a more severe form of SJS |
|
|
Term
|
Definition
Epidermal hyperplasia
Symmetrical hyper pigmented, velvety, thickening of skin, especially on neck or axilla
Assoc with hyperinsulinemia and visceral malignancy |
|
|
Term
|
Definition
Premalignant lesions caused by sun exposure
Small rough erythematous or brownish papules or plaques
*Risk of SCC |
|
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Term
|
Definition
Inflammatory lesions of SubQ fat on anterior shins
Assoc with sarcoidosis, coccidiomycosis, histoplasmosis, TB, streptococcal infections, leprosy and Chron's disease |
|
|
Term
|
Definition
Pruritic, purple, polygonal, planar papules and plaques
Sawtooth infiltrate of lymphocytes at dermal-epidermal junction
*Assoc HepC |
|
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Term
|
Definition
Herald patch followed days later by Christmas Tree appearance
Collarette plaques, self resolves in 6-8 weeks |
|
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Term
|
Definition
UV irradiation causes DNA mutations inducing apoptosis of keratinocytes
UVA is dominant in tanning and photoaging
UVB is sunburn
Can lead to impetigo, BCC, SCC and melanoma |
|
|
Term
|
Definition
Very superficial skin infection, usually from S. aureus, or S progenies
*Highly contagious |
|
|
Term
|
Definition
Acute painful spreading infection of dermis and subQ tissues
S pyogenes or S Aureus
Starts with a break in the skin from trauma or another infection |
|
|
Term
|
Definition
Deeper tissue injury from anaerobic bacteria or S progenies
Crepitus from gas production
Bullae and purple color to skin |
|
|
Term
| Staphylococcal scalded skin syndrome |
|
Definition
*Exotoxin destroys keratinocyte attachments in the SG only (vs TSST which destroys epidermal-dermal junction)
Fever and generalized erythemaouts rash with sloughing of the upper layers of the epidermis that heals completely |
|
|
Term
|
Definition
White painless plaques on tongue that can be scraped off
EBV mediated, HIV pos patients |
|
|
Term
|
Definition
Most common skin cancer
Locally invasive but almost never metastasizes
Pink pearly nodules with telangiectasias, rolling borders and central crusting on ulceration
*palisading nuclei |
|
|
Term
|
Definition
Can be caused by sun or arsenic exposure
Commonly on skin, lower lip, ears and hands
Locally invasive and rarely will metastasize
Ulcerative red lesions with frequent scale
*keratin pearls
Keratoacanthoma- grows rapidly, regress spontaneously |
|
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Term
|
Definition
Significant risk of metastasis
S-100 tumor marker
Depth of tumor correlates to risk of metastasis
*activating mutation of BRAF kinase
Excision with wide margins
*Vemurafenib (BRAF kinase inhibitor) for BRAF V600E mut. |
|
|
Term
|
Definition
LTB4- neutrophil chemotatic factor
LTC4, LTD4, LTE4- inc bronchial tone, asoconstrict, inc vasc permeability
*blocked by Zafirleukast and monteleukast (not LTB4)
*Zileuton blocks lipooxygenase which activates LTs |
|
|
Term
|
Definition
| Dec platelet aggregation, dec vascular tone, dec bronchial tone, dec uterine tone |
|
|
Term
|
Definition
| Inc uterine tone, dec vascular tone, dec bronchial tone |
|
|
Term
|
Definition
| Inc platelet aggregation, inc vascular tone, inc bronchial tone |
|
|
Term
|
Definition
Irreversibly inhibits COX 1 and 2 by acetylation which dec synthesis of TXA2 and Prostaglandins
*inc bleeding time
Tox- gastric ulceration, tinnitus, ARF, interstitial nephritis and upper GI bleeding
Can cause hyperventilation and resp alkalosis |
|
|
Term
|
Definition
Reversibly inhibit COX 1 and 2
Blocks PG synthesis
Tox- interstital nephritis, gastric ulcer, renal ischemia (PGs normally vasodilate aff arteriole) |
|
|
Term
|
Definition
Reversibly inhibits COX-2
Blocks pain and inflammation, but allows gastric mucosa to stay protected
Tox- inc risk of thrombosis, sulfa allergy |
|
|
Term
|
Definition
Reversibly inhibits COX in the CNS, inactivated peripherally
Antipyretic analgesic, but not anti-inflammatory
Tox- hepatic necrosis (depletes glutathione) |
|
|
Term
|
Definition
Alendronate, other-dronates
Pyrophosphate analogs, bind hydroxyapetite in bone
*inhibit OC activity
For Osteoporosis, hypercalcemia, Pagets disease of bone
*Tox- corrosive esophagitis, osteonecrosis of jaw |
|
|
Term
|
Definition
Inhibits Xanthine Oxidase, decreasing conversion of xanthine to uric acid
Gout, lymphoma, leukemia
Increases concentrations of azithioprine and 6-MP
Do not give salicylates |
|
|
Term
|
Definition
| Inhibits Xanthine oxidase |
|
|
Term
|
Definition
Inhibits reabsorption of uric acid in PCT
For underexcreters |
|
|
Term
|
Definition
Binds and stabilizes tubulin to inhibit polymerization
Inhibits leukocyte chemotaxis and degranulation |
|
|
Term
|
Definition
Fusion protein (TNF-a + IgG Fc) produced by recom bacteria
TNF decoy receptor
RA, psoriasis, ankylosing spondylitis |
|
|
Term
|
Definition
Anti-TNF-a monoclonal Ab
Chrons disease, RA, ankylosing spondylitis, psoriasis |
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