2. A&P of MSK system

Question 1

which of the following pathologies are classified as inflammation, hereditary disorder or biomechanical/postural/alignment problems?

Genu valgus/varus
Achondroplasia 軟骨發育不全症
Ankylosing spondylitis 強直性脊柱炎
Neurofibromatosis 神經纖維瘤病
Kyphosis 脊柱後凸
Scoliosis 脊椎側彎
Ehler-Danlos Syndrome 鬆皮症
Leg length discrepancy
Flatfeet 扁平足

Answer 1

inflammation: Ankylosing spondylitis
hereditary disorder: Achondroplasia, Neurofibromatosis, Ehler-Danlos Syndrome
biomechanical/postural/alignment problems: Genu valgus/varus, Kyphosis, Scoliosis, Leg length discrepancy, Flatfeet

Question 2

what are the symptoms of ankylosing spondylitis (a type of arthritis that causes lower back pain)? What may happen to the spine over time?

Answer 2

back pain and stiffness, esp in early morning or after inactivity….Over time, vertebrae in the spinal column may fuse and become rigid (ankylosis)

Question 3

what are the three main energy systems?

Answer 3

ATP-PC system - ATP-PC is stored in muscles and replenished via phosphocreatine (PC) breakdown. cover all super short bursts (<10secs)

lactic acid system - aka anaerobic glycolysis system, uses stored glucose (muscle glycogen) to create energy (30secs-3min)

aerobic system - slowest to act, essential for providing basic energy needs for general prolonged movement and endurance activities (3min-unlimited)

Question 4

atlanto-occipital joint, calf, elbow….which one is first, second, third class lever?

Answer 4

atlanto-occipital - first class
calf - second class
elbow - third class

Question 5

Conventional eccentric training promoted greater response than isokinetic eccentric training on quadriceps muscle mass and strength of recreational athletes undergoing ACL reconstruction. T or F

Question 6

what are the benefits of isokinetic exercises

Answer 6

the equipment allow exercise to be performed at individual maximal strength level at each joint angle and minimises risk of loading above patient’s tolerance

low-velocity isokinetic exercises increase muscle strength, while high-velocity exercises are used for recovery of muscle endurance following an injury

it can alter the amount of resistance given through the range of motion, while isotonic exercises cant….muscle usually stronger in mid-range

Question 7

What are the three types of muscle contraction

Answer 7

isotonic: muscle changes length as tenson remains constant 1) concentric: muscle shorten as it contracts eg shoulder abduction 2) eccentric: muscle lengthen as it contracts eg shoulder adduction
isometric: no change in muscle length of contracting muscle eg plank; one limitation is that strength gains are specific to joint angle

isokinetic contraction allow muscle to exert maximum force within the range of joint movement at constant speed eg breaststroke, dynamometer

Question 8

What is fascia and what are the three types of fascia

Answer 8

Fascia is a fibrous connective tissue that is present throughout entire body, not just muscles

superficial: ard skin
deep: ard muscles, bones, nerves, blood vessels
visceral: ard internal organs

Question 9

What is sliding filament theory of muscle contraction

Answer 9

muscle contracts by actin and myosin filaments sliding past each other. the cross bridge between actin and myosin filaments acts ad an enzyme (myosin ATPase), which hydrolyses ATP stored into ADP and inorganic phosphate and release energy

Question 10

What is the basic unit of striated muscle

Answer 10

sarcomere: made up of actin (light band) and myosin (dark band) filaments

Question 11

What are the three types of myofilaments?

Answer 11

Actin: thin filaments, a type of protein used by cells for structure

Myosin: thick filaments

Titin: elastic filaments

Question 12

what is the cell membrane and cytoplasm of muscle cell called? what does the cytoplasm contain?

Answer 12

Sarcolemma and sarcoplasm. Sarcoplasm contains tubular protein structures called myofibril, which are made up of myofilaments

Question 13

what are the features of skeletal muscle cell?

Answer 13

striated, multi-nucleated

have high energy requirements, so contain many mitochondria to generate enough ATP (Adenosine triphosphate)

Question 14

what are the three types of muscle cells

Answer 14

skeletal
cardiac
smooth

Question 15

what muscles have more than one origin?

Answer 15

biceps (two origins)
triceps (three origins)
quadriceps (four origins)

The pectoralis major has a broad origin, based on which it is divided into three parts: clavicular part, sternocostal part and abdominal part. All three parts converge laterally and insert onto the greater tubercle of humerus.

Question 16

what is meant by the origin and insertion of a muscle?

Answer 16

connecting to stationary bone = origin

connecting to moving bone = insertion

sternocleidomastoid: connecting sternum and clavicle (origin) to mastoid (insertion)

Question 17

what are the six types of synovial joint?

Answer 17

A pivot joint (uniaxial) allows one bone to rotate around another. An example of a pivot joint is the joint between the first two vertebrae (C1 and C2; atlas and axis) in the spine. This joint allows the head to rotate from left to right and back again.

A hinge joint (uniaxial) allows back and forth movement like the hinge of a door. An example of a hinge joint is the elbow. This joint allows the arm to bend back and forth. Knee is also another example.

A saddle joint (biaxial) allows two different types of movement. An example of a saddle joint is the joint between the first metacarpal bone in the hand and one of the carpal bones in the wrist. This joint allows the thumb to move toward and away from the index finger and also to cross over the palm toward the little finger. Sternoclavicular joint is another example.

A plane joint (nonaxial) also called a gliding joint, allows two bones that glide over one another. The joints between the tarsals in the ankles and between the carpals in the wrists are mainly gliding joints. In the wrist, this type of joint allows the hand to bend upward at the wrist and also to wave from side to side while the lower arm is held steady.

A condyloid joint (biaxial) is one in which an oval-shaped head on one bone moves in an elliptical cavity in another bone, allowing movement in all directions except rotation around an axis. The joint between the radius in the lower arm and carpal bones of the wrist is a condyloid joint as is the joint at the base of the index finger (metacarpophalangeal joint).

A ball-and-socket joint (multiaxial) allows the greatest range of movement of any movable joint. It allows forward and backward as well as upward and downward motions. It also allows rotation in a circle. The hip and shoulder are the only two ball-and-socket joints in the human body.

Question 18

what are the three types of joints? Give some examples of each

Answer 18

synovial joints 滑液關節: characterized by the fluid-filled space. Surrounding the joint is a capsule of tough dense connective tissue lined with synovial membrane, which produces synovial fluid that lubricates the joint. Cartilage covers the articulating surfaces of the two bones

fibrous joints 纖維關節: made of tough collagen 膠原蛋白 fibers eg sutures of the skull, syndesmosis joint that holds the ulna and radius of the forearm together (the part between the proximal and distal radioulnar joints)

cartilaginous joint: made of a band of cartilage that binds bones together eg joints between intervertebral disks of spine

Question 19

how many bones are there in the skull, each arm, each leg?

Answer 19

skull = 22
each arm = 30
each leg = 30

Question 20

pectoral girdle contains which two bones?

Answer 20

clavicle and scapula

Question 21

what are the types of bone according to shape?

Answer 21

long (radius, ulna)
short (carpal and tarsal)
flat (scapula, ribs, sternum)
irregular (vertebrae, hip bone)
pneumatic (sphenoid, ethmoid, maxilla) - contain air
sesamoid (patella, pisiform) - small independent bone in tendon

Question 22

what are bursae, where are they located, and what is their function?

Answer 22

they are fluid-filled sacs that cushion the joints and allow joints, tendons and muscles to glide over each other

located near tendons near large joints eg shoulder, elbow, hip and knee joints

they reduce friction and allow body to move without resistance

Question 23

what is the function of ligaments

Answer 23

support, stabilise, and strengthen bone joints

Question 24

how many joints, bones, muscles, tendons, ligaments are there in a human body?

Answer 24

joints 300
bones 206
muscles 600+
tendons 1000+
ligaments 900+

Question 25

what are the three anatomical planes?

Answer 25

Sagittal aka frontal (left and right), coronal aka lateral (anterior and posterior), transverse aka axial (superior and inferior)

Question 26

What bones are included in appendicular skeleton?

Answer 26

the upper and lower limbs, and the shoulder and pelvic girdles

Question 27

What are the three main parts of skeleton?

Answer 27

The head, thorax, and vertebral column

Question 28

Tendon and ligament. Which one is more parallel and elastic?

Answer 28

Tendon

Question 29

How is each plane displayed? Coronal/sagittal/axial

Answer 29

Coronal - front/back
Sagittal - left/right
Axial - superior/inferior

Question 30

the greater the ratio of load arm to effort arm, the more efficient the lever system is. T or F

Answer 30

F…..should be effort arm to load arm

Question 31

what is effort arm and load arm?

Answer 31

EA = distance between fulcrum and effort
LA = distance between fulcrum and load

Question 32

What are the three types of lever system?

Answer 32

there are three relative positions: fulcrum (joint), effort (muscle point of insertion), and load (weight of body and any additional resistance)

the first class lever is when F is in middle eg atlanto-occipital joint

second class lever is when L is in middle eg calf

third class lever is when E is in middle eg elbow

Question 33

Conventional eccentric training promoted greater response than isokinetic eccentric training on quadriceps muscle mass and strength of recreational athletes undergoing ACL reconstruction. T or F

Answer 33

F