Case 1 Flashcards
What are the names of C1 and C2 vertebrae?
C1=Atlas C2=Axis
The activity of osteoclasts is stimulated and inhibited by what?
Stimulated by PTH
Inhibited by Calcitonin
What does a Volkman’s canal do?
Connects the Haversian canals and the inner surface of compact bone.
What is the periosteum?
Loose CT surrounding the bone - it is where tendons and ligaments insert.
Which nerve roots make up the Sciatic Nerve?
L4, L5, S1, S2, S3
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.
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.
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
What is Tay-Sachs disease?
Lysosomal storage disease. An enzyme defect causes Myelin to accumulate.
Why is conducting pain information slowly an advantage?
We can respond to the source of pain before the pain sensation becomes intense.
Why does articular cartilage lack a perichondrium?
It is subject to compression and any blood vessels would be occluded.
What are the scientific terms for
a) Knock knees
b) Bowed legs
a) Genu Valgus
b) Genu Varus
What nerve are you testing for in the ankle relfex?
Tibial Nerve (S1, S2)
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.
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.
What is the most commonly injured knee ligament?
MCL via a force sustained to the lateral side of the knee.
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.
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:
1o and 2o 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
