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Msk-First-Aid-For-The-Usmle-Step-1
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First Aid for the USMLE Step 1 2020, Thirtieth
Step 1 2019 pages 437 - 476.pdf
versus edition-1 pages 489 - 531.pdf
40 pages (49.54 MB)
43 pages (15.18 MB)
1/11/20, 10:48:33 AM
1/11/20, 10:51:56 AM
BY u/verified-idiot
To the only girl i've ever loved, to soufia.
BLUE new in FA 2020
YELLOW text of FA 2019 was edited; the note box next to the yellow highlight will show the
difference between them the old text and the new text of FA 2020
Some pages might look scary! because of note boxes and highlighting , but it is not, my
recommendation for you is to study your book and after than look for the new stuff and edits.. I
DONT recommend comparing while you are studying since it will consume your time.
Go to First Change (page 1)
file://NoURLProvided[1/11/20, 10:54:39 AM]
,HIGH-YIELD SYSTEMS
Musculoskeletal, Skin,
and Connective Tissue
“Rigid, the skeleton of habit alone upholds the human frame.” ` Anatomy and
—Virginia Woolf Physiology 446
“Beauty may be skin deep, but ugly goes clear to the bone.” ` Pathology 459
—Redd Foxx
` Dermatology 473
“The function of muscle is to pull and not to push, except in the case of
the genitals and the tongue.” ` Pharmacology 485
—Leonardo da Vinci
“To thrive in life you need three bones. A wishbone. A backbone. And a
funny bone.”
—Reba McEntire
This chapter provides information you will need to understand certain
anatomical dysfunctions, rheumatic diseases, and dermatologic
conditions. Be able to interpret 3D anatomy in the context of radiologic
imaging. For the rheumatic diseases, create instructional cases or
personas that include the most likely presentation and symptoms: risk
factors, gender, important markers (eg, autoantibodies), and other
epidemiologic factors. Doing so will allow you to answer the higher
order questions that are likely to be asked on the exam.
445
,446 SEC TION III MUSCULOSKELETAL, SKIN, AND CONNEC TIVE TISSUE `ÀNATOMY AND PHYSIOLOGY
``
MUSCULOSKELETAL, SKIN, AND CONNECTIVE TISSUE—ANATOMY AND PHYSIOLOGY
Rotator cuff muscles Shoulder muscles that form the rotator cuff: SItS (small t is for teres minor).
A
Supraspinatus (suprascapular nerve)—
Supraspinatus
abducts arm initially (before the action Acromion
of the deltoid); most common rotator
Humerus
Glenoid cuff injury (trauma or degeneration and Coracoid
impingement tendinopathy or tear [arrow
Greater tubercle
in A ]), assessed by “empty/full can” test Infraspinatus
Infraspinatus (suprascapular nerve)—
externally rotates arm; pitching injury Teres minor
teres minor (axillary nerve)—adducts and
externally rotates arm Lesser tubercle Subscapularis
Humerus
Subscapularis (upper and lower subscapular
nerves)—internally rotates and adducts arm
Innervated primarily by C5-C6.
Arm abduction
DEGREE MUSCLE NERVE
0°–15° Supraspinatus Suprascapular
15°–100° Deltoid Axillary
> 90° Trapezius Accessory
> 100° Serratus Anterior Long Thoracic (SALT)
, MUSCULOSKELETAL, SKIN, AND CONNEC TIVE TISSUE `ÀNATOMY AND PHYSIOLOGY SEC TION III 447
Upper extremity nerves
NERVE CAUSES OF INJURY PRESENTATION
Axillary (C5-C6) Fractured surgical neck of humerus Flattened deltoid
Anterior dislocation of humerus Loss of arm abduction at shoulder (> 15°)
Loss of sensation over deltoid and lateral arm
Musculocutaneous Upper trunk compression biceps (C5-6) reflex
(C5-C7) Weakness of forearm flexion and supination
Loss of sensation over lateral forearm
Radial (C5-T1) Compression of axilla, eg, due to crutches or Wrist drop: loss of elbow, wrist, and finger
sleeping with arm over chair (“Saturday night extension
palsy”) grip strength (wrist extension necessary for
Midshaft fracture of humerus maximal action of flexors)
Repetitive pronation/supination of forearm, eg, Loss of sensation over posterior arm/forearm and
due to screwdriver use (“finger drop”) dorsal hand
Median (C5-T1) Supracondylar fracture of humerus proximal “Ape hand” and “Pope’s blessing”
lesion of the nerve Loss of wrist flexion, flexion of lateral fingers,
Carpal tunnel syndrome and wrist laceration thumb opposition, lumbricals of index and
distal lesion of the nerve middle fingers
Loss of sensation over thenar eminence and
dorsal and palmar aspects of lateral 31⁄2 fingers
with proximal lesion
Ulnar (C8-T1) Fracture of medial epicondyle of humerus “Ulnar claw” on digit extension
“funny bone” (proximal lesion) Radial deviation of wrist upon flexion (proximal
Fractured hook of hamate (distal lesion) from lesion)
fall on outstretched hand Loss of wrist flexion, flexion of medial fingers,
abduction and adduction of fingers (interossei),
actions of medial 2 lumbrical muscles
Loss of sensation over medial 11/2 fingers
including hypothenar eminence
Recurrent branch of Superficial laceration of palm “Ape hand”
median nerve (C5-T1) Loss of thenar muscle group: opposition,
abduction, and flexion of thumb
No loss of sensation
Humerus fractures, proximally to distally, follow the ARM (Axillary Radial Median)
C5
C6
C7
Axillary nerve C8
T1
Median nerve
Axillary nerve
Musculocutaneous nerve Ulnar nerve
Intercostobrachial
Radial nerve nerve
Radial nerve Radial nerve
Medial brachial
Radial nerve in
cutaneous nerve Palm of hand
spiral groove
Median nerve Musculocutaneous
Ulnar nerve Medial antebrachial
nerve
cutaneous nerve Median nerve
Radial nerve
Ulnar nerve
Radial nerve
Recurrent branch
of median nerve Radial nerve
Dorsum of hand
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