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Final Exam Flashcards

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1
Q

Connective tissue function is primarily determined by ___

A

Its extracellular components

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2
Q

Fibroblasts

A

basic cell of most connective tissues, produce extracellular matrix, creates type 1 collagen

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3
Q

Chondroblasts

A

Make cartilage, produce mostly type 2 collagen

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4
Q

Osteoblast

A

make bone, produces type 1 collagen and hydroxyapetit

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5
Q

Osteoclast

A

Monocyte derived, bone resorption

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6
Q

Tenoblasts

A

Make tendon, produce type 1 collagen

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7
Q

Interfibrillar component

A

Composed of PG’s and GP’s, responsible for attracting and binding water, forming a supportive substance for fibrous and cellular components

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8
Q

Fibrillar component

A

Collagen (mainly type 1 or 2), elastin

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9
Q

Type 1 collagen

A

90% of collagen in body, found most in connective tissues, responsible for TENSILE strength and stress of tissues

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10
Q

Type 2 collagen

A

Found mainly in cartilage and intervertebral discs (nucleus pulposus), structures associated with WEIGHT BEARING

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11
Q

Type 3 collagen

A

Mostly found in HEALING tissues

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12
Q

Structure of collagen

A

Triple Helix. tropocollagen –> microfibrils –> fibrils –> fascicles –> fiber(surrounded by endotenon)

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13
Q

Types of GAG’s

A

chondroitan sulfate, keratin sulfate, dermatin sulfate, hyaluronon

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14
Q

Chondroitan Sulfate

A

Compressive forces

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15
Q

Dermatin Sulfate

A

Tensile forces

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16
Q

Keratin Sulfate

A

Found in cartilage

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17
Q

Hyaluronon

A

non-sulfated, no protein core, free GAG

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18
Q

Function of PG’s

A

attract water, create tension to resist forces, regulates collagen fiber size, forms reservoir for nutrients and growth factor determining amnt of collagen in matrix.

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19
Q

Aggrecan is mostly composed of which GAG to resist TENSILE forces?

A

Dermatin sulfate

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20
Q

Aggrecan is mostly composed of which GAG to resist COMPRESSIVE forces?

A

Chondroitan Sulfate (or keratin sulfate)

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21
Q

Types & fucntion of Glycoproteins

A

Lamimin, fibronectin: form scaffolding for the cells, hold receptors in place, adhesion.

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22
Q

Which has more type 1 collagen? Tendons or ligaments.

A

Tendons

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23
Q

Which is the primary PG in tendons & ligaments?

A

Dermatin sulfate

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24
Q

Fibrocartilaginous Tendon Attachments

A

Gradual change of tendon to bone - 4 zones. Exposed to compressive and tensile forces.

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25
Q

Myotendinous junction

A

Comprises interdigitation between muscle cells and collagen fibers. Strong attachment.

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26
Q

Hyaline Cartilage

A

Non-vascular, nutrition from diffusion, doesn’t heal well, very low coefficient of friction.

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27
Q

Articular cartilage

A

Alot of type II collagen (resist compressive forces)

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28
Q

Which GAGs are associated with Aggrecan?

A

Keratan sulfate and chondroitan sulfate (less chondroitan as you age and less keratan)

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29
Q

Layers of Articular Cartilage

A

Zone I (parallel collagen fibers), Zone II & III (transitional & radiate stratum) less organized, Calcified (fibers perpendicular to structure and going into subchondral bone)

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30
Q

Where do osteoblasts come from?

A

Periosteum

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31
Q

SAID

A

Specific Adaptations to Increased Demand

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32
Q

Elastic Region

A

No permanent deformation

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33
Q

Yield point

A

Exits the elastic region

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34
Q

Plastic region

A

Deformation is permanent after the load is removed

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35
Q

Stress

A

force per cross sectional unit of material (S = F/A)

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36
Q

Strain

A

percentage change in length or cross section of a structure. ((L2-L1 )/L1). Deformation of a structure that may accompany stress

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37
Q

Stress Strain Curves are flatter in more elastic or stiffer materials?

A

Elastic

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38
Q

Hysteresis

A

difference in energy applied and recovered

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39
Q

Is more or less force required to deform when loaded rapidly?

A

More

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40
Q

Synarthroses

A

Minimal movement, fibrous (suture, gomphoses, syndesmoses), cartilaginous (symphyses, synchondroses)

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41
Q

Diarthroses

A

Synovial, moving

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42
Q

Things always associated with a synovial joint

A

Synovial Fluid, articular cartilage, capsule, synovial membrane, capsular ligaments, blood vesels, sensory nerves

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43
Q

Stratum fibrosum

A

outer layer of synovial capsule, more type 1 collagen, resist compressive forces, attach to bone, poorly vascularized but richly innervated

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44
Q

Stratum synovium

A

inner layer of synovial capsule, lines the joint space, layered with synoviocytes, (type A & B), highly vascuarized, highly innervated
Has intima & subsynovial tissue

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45
Q

Synoviocytes

A

Type A: macrophages
Type B: inhibit macrophages
both synthesize hyaluronon. Allow repair or removal of damage.

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46
Q

What are the two joint lubrication theories?

A

Fluid-film (layer of fluid between) & boundary (lubricin coats the surface)

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47
Q

Ruffini

A

Sensitivity: Stretch (usually at extremes of motion)
Location: fibrous layer of joint capsule on flexion side of joint, periosteum, ligaments, and tendons

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48
Q

Pacini

A

Sensitivity: compression or changes in hydrostatic pressure and joint movements
Location: throughout the joint capsule, particularly in deeper layer and in fat pads

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49
Q

Golgi

A

Sensitivity: pressure and forceful joint motion into extremes of motion
Location: inner layer (synovium) of joint capsules, ligaments and tendons
Detect tension and when tension is too high they relax (inhibit) the muscle

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50
Q

Unmyelinated free nerve endings

A

Sensitivity: non-noxious & noxious mechanical or biomechanical stress
Location: around the blood vessels in synovial layer of capsule and in adjacent fat pads and collateral ligaments, tendons, and the periosteum

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51
Q

Ostekinematics

A

the movement of a particular bone in space through plane, voluntary

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52
Q

Arthrokinematics

A

articular surface movement on the joint surfaces, not voluntary in nature, accompany the osteokinematics.

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53
Q

Effects of Immobilization on Ligament and Tendon

A

decrease collagen content & cross linking between collagen fibers. Loses interdigitation, 50% loss in tensile strength (8 weeks)

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54
Q

Effects of Immobilization on Articular surfaces & Bone

A

proliferation of fatty tissue in the joint space, adhesions in synovium, atrophy of cartilage, regional osteoporosis, weakening of ligaments at insertion, decrease in PGs, increase in H2O content of articular cartilage, thinning and softening of articular cartilage, swelling (inhibits and weakens the muscles surrounding the joint)

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55
Q

What is needed to restore tendon and ligament strength?

A

Gradual loading

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56
Q

Effects of decreased load on tendon and ligaments

A

decreased: collagen concentration, cross linking, tensile strength

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57
Q

Effects of increased load on tendon and ligaments

A

Increased: cross sectional area, collagen concentration, cross linking, tensile strength, stiffness

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58
Q

Effects of decreased load on bone

A

decreased: collagen synthesis, bone formation
increased: bone resorption

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59
Q

Effects of increased load on bone

A

Denser bone, increases synthesis of collagen and bone

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60
Q

Effects of decreased load on cartilage

A

disordered collagen fibrils, abnormal crosslinking

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61
Q

Effects of increased load on cartilage

A

increased PG synthesis, maybe increased volume (unverified)

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62
Q

Prevention of changes w/ immobilization

A

CPM, dynamic splinting, reduce time, use healthy tissues, graded loading of forces, extend the treatment

63
Q

Class One Lever

A

Axis between the Effort & Resistance, mechanical advantage varies

64
Q

Class Two Lever

A

Resistance between the axis and effort, mechanical advantage > 1

65
Q

Class Three Lever

A

Effort between the axis and Resistance, mechanical advantage < 1

66
Q

Mechanical Advantage

A

EA/RA

67
Q

Desmin

A

Helps with the transmission of forces

68
Q

Titin

A

Helps maintain the position of myosin within the sarcomere

69
Q

What structure releases the calcium that plays a role in muscle contraction

A

Sarcoplasmic Reticuluum

70
Q

Concentric

A

thin filaments slide toward and past thick filaments with formation and reformation of cross bridges. Sarcomere shortens and tension is generated. Bridges formed, broken, formed, etc

71
Q

Eccentric

A

Thin filaments pulled away from thick filaments and cross bridges broken as muscle lengthens. Tension generated as cross bridges are reformed. Bridges broken, re-formed, broken.

72
Q

Large Motor Units

A

Large axon, many fibers (mainly type II), recruited in forceful contractions

73
Q

Small Motor Units

A

Small axon, fewer fibers (primarily type 1), recruited first in most activities

74
Q

Layers of muscle connective tissue

A

Endomysium –> perimysium –> epimysium

75
Q

Superficial Fascia

A

encloses muscles, loose, right under the skin, skin mobility, insulates and contains the muscles

76
Q

Deep Fascia

A

compact connective tissue, regularly arranged, (tracts, retinacula, bands, aponeuroses) Not completely within the muscle.

77
Q

Parallel elastic component

A

the connective tissues that surround the muscle, plus the sarcolemma, titin, nerves and blood vessels. When a muscle lengthens or shortens the tissues also lengthen and shorten because they function in parallel with the muscle contractile unit

78
Q

Active tension can be increased by

A

Neural (frequency, number and size of motor units firing) & Mechanical properties (isometric length/tension relationship and force/velocity relationship)

79
Q

When are multi-joint muscles recruited?

A

To control the fine regulation of torque during dynamic movements involving eccentric more than concentric muscle actions. Complex motions around multiple axes.

80
Q

Muscle Spindle

A

Have intrafusal and extrafusal fibers. Stimulated when the muscle is stretched rapidly. Causes contraction of the muscle.

81
Q

Muscle immobilization

A

Increase epi and perimysium, increases the ratio of the CT to muscle tissue making the muscle stiffer. The muscle tissue itself atrophies. Decrease in the force production. Change in the sarcomeres.

82
Q

How do we increase the tension in a muscle?

A

Increase frequency, number or type of motor units firing (neurological controls)
Put them in the optimal (different) position in order to get more tension.
Use a different type of contraction (eccentric (most), concentric (third), isometric (second))
Change the speed of the contraction (velocity). The slower the greater the force.

83
Q

Reverse Action

A

When you stabilize the distal segment and move the proximal segment (push-up)

84
Q

As the clavicle elevates and depresses the disc is part of the

A

Manubrium

85
Q

As the clavicle protracts and retracts the disc is part of the

A

Clavicle

86
Q

What provides the primary restraint to Ant/Post translation at the SC joint?

A

The posterior capsule

87
Q

Costoclavicular ligament

A

Anterior & posterior lamina: Limit elevation of lateral end of clavicle & help facilitate inferior glide of medial clavicle. (limit upward rot.) Stabilize the clavicle so muscles that attach there can contract on a stable base

88
Q

Function of AC ligaments

A

Approximate the structures (acromion and clavicle), Limit anterior force to lateral clavicle. Superior stronger than inferior.

89
Q

Coracoclavicular

A

Trapezoid and conoid: provide superior and inferior stability, limit upward rotation of the scapula at the AC joint, couple the posterior rotation of the clavicle to scapula rotation during arm elevation

90
Q

Trapezoid portion of coracoclavicular

A

More lateral. primary restraint to translatory motion caused by superior directed forces applied to lateral clavicle

91
Q

Conoid portion of coracoclavicular

A

More medial. primary restraint to translatory motion caused by posterior directed forces applied to distal clavicle. Prevents medial displacements of the scapula on clavicle

92
Q

Type 1 AC sprain

A

Sprain of AC ligament but coracoclavicular is intact

93
Q

Type 2 AC sprain

A

Rupture of AC ligament and sprain of Coracoclavicular ligament

94
Q

Type 3 AC sprain

A

complete rupture of AC and coracoclavicular, separation between the structures and get a step off.

95
Q

Resting position of the scapula

A

30-45 IR, 10-20 upward rotation

starts at T2, inferior aspect is at T7

96
Q

Angle of inclination

A

Between the shaft of the humerus and head/neck of humerus (130-150 degrees)

97
Q

Angle of torsion

A

Between the condyles and head/neck of humerus (30 degrees of retroversion)

98
Q

If retroversion of the humeral head increased you get more ____ but less _____

A

ER, IR

99
Q

If retroversion of the humeral head decreased (anteversion) you get more ____ but less _____

A

IR, ER

100
Q

Rotator cuff interval

A

superior capsule, superior GH ligament, coracohumeral ligament

101
Q

Middle GH ligament function

A

Limit anterior translation w/ arm at side - 60 ABd
Inf pouch – primary for ant and inf when arm goes up in abd
Ant and post bands – resist ER and IR
Ant resists ant translation when arm rises bc it moves ant in abd (arm ER when abd)
Post – for inf bc moves to inf when arm abd, and post when arm comes down

102
Q

Components of Inferior Glenohumeral Ligament Complex (IGHLC)

A

Inferior pouch, anterior/posterior bands

103
Q

Passive stabilization of the GH joint

A

Superior capsule/Sup GH lig/Coracohumeral lig, negative intraarticular pressure, superior tilt of glenoid fossa (bony block), supraspinatus passive tension

104
Q

Functions of MCL

A

STABILIZE AGAINST VALGUS TORQUE, LIMIT ELBOW EXTENSION AT THE END OF THE RANGE, GUIDE JOINT MOVEMENT THROUGH FLEXION KEEP IT FROM GOING TO MEDIAL DIRECTION, SOME RESISTANCE TO LONGITUDINAL DISTRACTION

105
Q

Functions of the anterior bundle of the anterior band of the MCL

A

Primary restraint to valgus at 30, 60, and 90 degrees of flexion and coprimary up to 120 degrees

106
Q

Which ligament is ALWAYS disrupted with elbow dislocation?

A

lateral collateral ligament

107
Q

Functions of LCL complex

A

Limit VARUS, and resist varus w/ supination so the radius doesn’t “roll off”, Stabilize radial head for rotation, stabilize in medial/lateral and posterior/anterior direction and compressive distractive.
Prevent subluxation of humerus by securing ulna to the humerus, & prevents forearm from rolling off when you go into valgus with supination.
Reinforces joint to resist distraction

108
Q

Limits to elbow flexion

A

limited by coronoid in coronoid fossa, muscle bulk, excess tissue, maybe radial head in radial fossa.

109
Q

Resists valgus in extension

A

medial collateral and anterior joint capsule and bones equally

110
Q

Resists valgus in flexion

A

anterior MCL

111
Q

Resists varus in extension

A

50% LCLC 50% joint capsule (more ligamentous than flexion)

112
Q

Resists varus in flexion

A

osseous components mostly, some capsule & ligaments

113
Q

Which ligaments limit supination

A

palmar radioulnar, quadrate, maybe oblique cord

114
Q

Which structures limit pronation

A

dorsal radioulnar ligament, quadrate & if in extension maybe biceps, approximation of radius and ulna

115
Q

Inferior radioulnar joint is a _____ surface on a ______ surface

A

Concave on convex

116
Q

Superior radioulnar joint is a _____ surface on a ______ surface

A

convex on concave

117
Q

Most ADLs require functional range of the elbow from ____

A

30 degrees to 130 degrees flexion, 50 degrees supination and pronation both.

118
Q

Compression of ulnar nerve/Cubital tunnel syndrome

A

ulnar nerve compressed between the two heads of the FCU, radiation of pain into the fingers with numbness and tingling in the 4th and 5th digits and weakness of the intrinsics (thumb too). or can be compressed in the cubital tunnel.

119
Q

Which nerve is compressed in the Pronator Teres

A

Median

120
Q

Which nerve is compressed in the Supinator

A

Radial

121
Q

Which tendon is ulnar to listers tubercle?

A

EPL

122
Q

Radiocarpal joint is a ___ surface on a _____ surface

A

Convex on concave

123
Q

Function of the TFCC

A

increase congruency on ulnar side, tether ECU, increase stability, absorb forces

124
Q

Which muscle tendon does the pisiform lay within?

A

FCU

125
Q

How much of the radiocarpal joint is in contact at any one point?

A

20-40%

126
Q

With axial loading, what percentage of force goes through the radius to the scaphoid and lunate?

A

80%: of that 80% –> 60% scaphoid, 40% lunate

127
Q

Effects of ulnar negative variance

A

thicker TFCC, different dispersion of forces, lack of forces on the lunate = poor nutrition or too much compression = necrosis.

128
Q

Keinbocks disease

A

Avascular necrosis of the lunate

129
Q

Effects of ulnar positive variance

A

Thin TFCC, aborbs less forces, main problem is with impingement = pain.

130
Q

What is the only muscle that attaches to the proximal carpals?

A

FCU

131
Q

Capitate and Hamate on Lunate/Triquetrum is a _______ surface on a _________ surface

A

convex on concave

132
Q

Trapezoid and trapezium on scaphoid is a _______ surface on a _________ surface

A

concave on convex

133
Q

Midcarpal joint favors which motions?

A

Extension and radial deviation

134
Q

Extrinsic Volar wrist ligaments

A

Volar Radiocarpal, Radial Collateral, Ulnocarpal Complex

135
Q

Volar radiocarpal ligaments

A

Radioscapholunate, Radiolunate, Radiocapitate: limit extension, provide support to bones

136
Q

Ulnocarpal complex

A

Ulnar Collateral, Ulnolunate, TFCC

137
Q

Intrinsic Volar wrist ligaments

A

Scapholunate interosseous, lunotriquetral interosseous: largely avascular, important for stability (esp of the scaphoid)

138
Q

Dorsal radiocarpal ligaments

A

dorsal radiocarpal ligament, dorsal intercarpal: Support, prevent excessive flexion, try to prevent dorsal glides

139
Q

Which proximal row carpal shows the most movement? Least?

A

Scaphoid. Lunate.

140
Q

Radial Deviation

A

proximal row moves ulnarly on radius, proximal carpals flex, distal carpals extend

141
Q

Ulnar Deviation

A

proximal row moves radially on radius, proximal carpals extend, distal carpals flex

142
Q

Function wrist ROM

A

60 degrees extension, 54 flexion, 40 ulnar deviation, 17 radial deviation

143
Q

DISI

A

dorsal intercalated segmental instability: scapholunate dorsal interosseous not present or ruptured. Scaphoif flexes, lunate and Tq extend. distal carpals flex.

144
Q

SLAC

A

Scapholunate advanced collapse : capitate migrates down between lunate and scaphoid, very painful.

145
Q

VISI

A

volar intercalated segmental instability: lunotriquetral ligament is injured. Lunate and scaphoid into flexion, and Tq and distal row into extension

146
Q

Degrees necessary for maximum grip force

A

20-25 degrees extension, 5-7 ulnar deviation

147
Q

Which two muscles do NOT pass under the flexor retinaculum.

A

Palmaris longus, FCU

148
Q

Compartments of the extensor retinaculum

A

1: ABPL, EPB
2: ECRL ECRB
3: EPL
4: EDC, EI
5: EDM
6: ECU

149
Q

Proximal carpal arch is maintained by

A

transverse carpal, intercarpal, small intrinsics

150
Q

Distal carpal arch is maintained by

A

deep transverse MC, CMCs

151
Q

What is the only muscle that acts only at the CMC

A

Opponens Digiti Minimi

152
Q

How do anatomic pulleys affect the magnitude and direction of a muscle force?

A

They change the direction, without changing the magnitude of the applied force. Increases the moment arm.

153
Q

What factors can cause the net torque on a segment to change?

A

change the moment arm, the angle of application of force, change the magnitude of the force

Movement Science (1 decks)

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