Case 1 Flashcards by Rhian Jones

What are the names of C1 and C2 vertebrae?

C1=Atlas C2=Axis

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The activity of osteoclasts is stimulated and inhibited by what?

Stimulated by PTH

Inhibited by Calcitonin

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What does a Volkman’s canal do?

Connects the Haversian canals and the inner surface of compact bone.

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What is the periosteum?

Loose CT surrounding the bone - it is where tendons and ligaments insert.

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Which nerve roots make up the Sciatic Nerve?

L4, L5, S1, S2, S3

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What does the tibial portion of sciatic innervate?

All muscles in the posterior compartment in the thigh, (except the short head of biceps femoris)

All muscles in the posterior compartment of the leg

All muscles in the sole of the foot.

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What does the common fibular portion of the sciatic innervate?

Short head of biceps femoris

All muscles in the anterior and lateral compartments of the leg

Extensor digitorum brevis in the foot.

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What is the dominant component of dense regular connective tissue?

Examples of structures with this type of CT?

Collagen fibres type I

Ligaments and Tendons

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What is Tay-Sachs disease?

Lysosomal storage disease. An enzyme defect causes Myelin to accumulate.

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Why is conducting pain information slowly an advantage?

We can respond to the source of pain before the pain sensation becomes intense.

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Why does articular cartilage lack a perichondrium?

It is subject to compression and any blood vessels would be occluded.

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What are the scientific terms for

a) Knock knees
b) Bowed legs

a) Genu Valgus
b) Genu Varus

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What nerve are you testing for in the ankle relfex?

Tibial Nerve (S1, S2)

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What is the difference between an extracapsular and intracapsular fracture of the head of the femur?

Extracapsular fractures - The blood supply to the head of the femur is intact, so NO avascular necrosis occurs.

Intracapsular fractures - occur within the capsule of the hip joint. It can damage the medial femoral circumflex artery and cause avascular necrosis of the femoral head.

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What is the Inter-trochanteric line? What ligament attaches to it?

Ridge of bone that runs in a inferomedial direction on the anterior surface of the femur, connecting the two trochanters together.

The iliofemoral ligament attaches here.

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What is the most commonly injured knee ligament?

MCL via a force sustained to the lateral side of the knee.

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What induces endothelial cells to move selectins (cell adhesion proteins) to their apical surface (facing the blood)?

Histamine and interleukin.

This allows neutrophils to bind via their selectin ligands and leads to adhesion, activation, margination, transmigration process.

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What is the test for ruptured ACL?

Anterior drawer test

What is the test for ruptured calcaneal tendon?

Thompson test

Name the superior to inferior components of the Pes Anseurius.

Sartorius Gracilis Semitendinosus “SGT”

What four things activate plasminogen?

tPA [tissue Plasminogen Activator]

Streptokinase

Factor XIa

Factor XIIa

What are the five layers of the skin?

stratum corneum

stratum lucidum

stratum granulosum

stratum spinosum

stratum basale

“Come Lets Get Sun Burnt”

Of the five layers of skin, which layer is only present in thick skin?

stratum lucidum

What is Stratum Corneum?

The thick layer of dead keratinocytes at the surface of the skin.

What layer of the skin are melanocytes found in?

Stratum basale only

What structure is likely to be compressed in tarsal tunnel syndrome?

Tibial nerve. Causes paraesthesia across the heel, plantar aspect of the foot and radiates to the hallux and 2nd and 3rd digits.

What muscle and nerve is being tested with the patella reflex?

Patella ligament causes the rectus femoris to contract. L2-L4.

Name some systemic factors that compromise wound healing.

Poor nutrition (e.g. lack of vitamin C prevents collagen production) Circulatory status - poor perfusion delays healing Metabolic status Hormones (glucocorticosteroids) / Diabetes compromises healing

Name some local factors that compromise wound healing.

Infection Mechanical factors (excessive movement delays healing) Foreign bodies Size, location and type of wound

How does the Peri-aqueductal Grey (PAG) control pain?

The PAG projects into the *_raphe nuclei_* which release ***serotonin*** (opiod) in the dorsal horn. Serotonin ***_binds to the nociceptive fibres and prevents substance P release_***. This reduces transmission from the _nociceptoer_ to the _spinothalamic tract_ so less ascending pain impulses reach the brain.

What are these cells derived from? a) Osteoblasts b) Osteocytes

a) Osteoprogenitor cells b) Osteoblasts

What muscles are involved in abduction of the glenohumeral joint? (3)

Supraspinatour (15\*c) Deltoid (90\*c) Serratus Anterior

What are the two classifications for pain? What does each branch into?

What classification of neurone is a motor neurone? a sensory neurone?

motor --\> multipolar sensory --\> unipolar

What is the 'transverse ligament' in the knee?

Connects the two mensci anteriorly in the knee joint.

There are two types of cartilagenous joints [1] synchondrosis [2] symphysis Give examples of each and the type of cartilage involved in the joint.

[1] epiphysial plates, 1st rib & manubrium. _HYALINE_ cartilage. [2] sternal angle, IV discs, pubic symphysis _FIBRO_ cartilage

The adductor magnus has an 'adductor' part and 'hamstring' part. Where do each of these originate from on the pelvis? Innervation?

***Adductor part*** = ischiopubic ramus. Obturator nerve L2,3,4 ***Hamstring part*** = ischial tuberosity. Tibial portion of sciatic L2,3,4 \*inserts onto _adductor tubercle_\*

What muscles in the foot are supplied by the ***medial plantar nerve***? (The rest are supplied by the lateral plantar nerve)

***_L_*** umbrical (1st) ***_A_*** bductor hallucis ***_F_*** lexor digitorum brevis

Give an examples of a condyloid & ellipsoid joint.

Condyloid - ***wrist*** Ellipsoid - ***metacarpophalangeal***

How many layers are in the epidermis in a) thin skin? b) thick skin?

thin = 4 thick = 5

What three things are involved in the 'neuromatrix theory of pain'?

Cognitive evaluative Sensory Affective

In the 'neuromatrix theory of pain' there is a medial and lateral pain system. What does each recieve from?

*_Medial pain system:_* Medial thalamic nuclei, anterior congulate nucleus (ACC) and insula. *_Lateral pain system:_* 1^o and 2^o somatosensory cortices nd lateral thalamic nuclei.

In compact bone, what is the name given to the space found within the dense matrix that the osteocytes occupy?

Lacunae