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MSS Exam 1 > General Concepts - Overview > Flashcards

General Concepts - Overview Flashcards

1
Q

function of osteocytes

A

communicate with each other, sensitive to mechanical stress and help stimulate bone remodeling

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2
Q

list the 4 reasons we stabilize fractures

A

To reduce pain
To facilitate healing
To improve function
To enable early mobilization

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3
Q

what is contained in the endosteum of a bone?

A

bone lining cells (that have the capacity to differentiate into osteoblasts)

mature osteoblasts

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4
Q

examples of fibrocartilage in the body?

A
  1. intervertebral disks

2. menisci

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5
Q

Lateral force to the knee can cause O’Donoghues unhappy triad, which has what ligaments damaged? (3)

A
  1. MCL
  2. ACL
  3. medial meniscus
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6
Q

what is an isogenous group in cartilage? what is it indicative of?

A

two or more cells in a lacuna (result of division)

indicative of growing cartilage (interstitial growth)

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7
Q

injured myocytes secrete ________, and ________ arrive within an hour and phagocytose necrosis debris. The __________ release: (3) ______, ______, _______

A

cytokines, neutrophils, neutrophils,

IL1, IL8, TNF-alpha

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8
Q 
in imaging, you see a joint that has:  
Marginal erosions
Overhanging edges
Sclerotic borders
Soft tissue whiteness

what is this most likely?

A

gout

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9
Q

depletion of _____ and addition of _____ causes rigor mortis in skeletal muscles

A

ATP, Ca++

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10
Q

An experimental drug designed to read through premature stop codons

A

ataluren

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11
Q

the ventral rami of limbs form plexuses…. what does this mean for peripheral nerves?

A

peripheral nerves are derived from multiple spinal levels! good for injury

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12
Q

mechanism of injury for a meniscal tear:

A

twisting of knee while weight bearing

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13
Q

joint between vertebral bodies is called:

joint between articular processes (facet joint) is called:

A

symphysis

zygaphophyseal joint (synovial)

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14
Q

what is micromelia and what causes it?

A

partial absence of a limb

FGF loss in AER (apical ectodermal ridge) later in limb development (after stylopod)

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15
Q

When knee extended, put valgus and varus stresses on the knee, see if there is movement of the tibia against the femur.
Repeat when knee at 20-30 degrees.

what is this called? what does a positive one indicate?

A

the Valgus stress test

positive - collateral ligament injury

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16
Q

squamous cells that cover the inside and outer surfaces of bone. a signal to remodel the bone can trigger there to become active and convert into osteoblasts:

A

bone lining cells

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17
Q

what are canaliculi? why are they important?

A

paths for the processes of osteocytes to make gap junctions with other cells and exchange nutrients and signal

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18
Q

organic bone matrix gives bone what physical property?

A

makes it tough

RESIST FRACTURE

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19
Q

Valgus opening at 30 degrees is diagnostic for isolated _____ injuries

A

MCL

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20
Q

what 3 laxity exams can be performed to look for an ACL injury. which of these is the least specific/sensitive?

A

Anterior Drawer
Lachman test
Pivot shift test

Anterior drawer is not as sensitive or specific.

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21
Q

_________ is secreted by osteoblasts and binds to RANKL, not allowing for its union with RANK.

what does this do to bone resorption?

A

osteoprotegerin (OPG)

decreases bone resorption

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22
Q

_________ muscle contractions are more likely to cause injury

A

eccentric

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23
Q

special fracture classification for fractures in skeletally immature patients when it involves the physis

A

the Salter-Harris classification

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24
Q

Sensory loss across several dermatomes is indicative of a more _______ problem (the _______ or beyond)

A

distal

plexus or beyond

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25
Q

calcitonin _______ osteoclast activity

TRH ________ osteoclast activity

A

decreases

increases

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26
Q

_______healing – early mobilization, in _________, they need to be immobilized.

A

muscle, tendon

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27
Q

what is the ATP synthesis mechanism for strength training actions?

endurance training?

A

creatine phosphate

aerobic (mitochondrial) respiration

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28
Q

what are the three phases in secondary fracture healing?

A
  1. reparative
  2. restorative
  3. remodeling
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29
Q

idiopathic avascular necrosis in growing kids. involves the growing femoral epiphysis

see smaller, white, flat femoral head

A

Legg-calve-perthes disease

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30
Q

Radiograph findings with RA: (2)

A
  1. concentric (even) joint space loss
  2. erosions (mouse and cheese)

NO osteophytes

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31
Q

what is phocomelia and what causes it?

A

loss of internal limb structures (like micromelia - FGF loss in AER), but without disrupting the auto pod

HOX distribution error

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32
Q

excessive force from the rectus femoris muscle —-> _______ evulsion fracture

A

AIIS

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33
Q

all deep back muscles are innervated by:

A

dorsal rami of spinal nerves

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34
Q

where are chrondroblasts found in cartilage?

A

inside layer of the perichondrium, facing the cartilage

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35
Q

what is amelia and what causes it?

A

complete absence of limb

FGF loss in AER early in development (at stylopod)

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36
Q

excessive force from the __________ muscle —-> less trochanter evulsion fracture

A

iliopsoas

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37
Q

what can you see on a radiograph of osteoarthritis

A

Effectively no joint space (bone on bone)
Can also sometimes see bony enlargements
Bony sclerosis
Malalignment

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38
Q

a young male presents with:

Hypertrophied calves
Stand on toes
Exaggerated lumbar lordosis
Gower’s maneuver

what is it?

A 
Mostly male
Hypertrophied calves
Stand on toes
Exaggerated lumbar lordosis
Gower’s maneuver
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39
Q

most common locations for osteoarthritis

A

Hands, hips, knees, base of cervical spine, big toes.

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40
Q

imaging modality used for radiographically occult fractures

A

MRI

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41
Q

strength training increases what part of the composition of muscles?

endurance training?

A

strength = sarcomeres, muscle diameter

endurance = angiogenesis, mitochondria

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42
Q

what are the healing steps of muscle?

A

inflammatory (destruction), muscle fiber regeneration (repair), collagen synthesis (remodeling)

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43
Q

ligament between the spinous process bodies and apices, relatively:

A

interspinous ligaments, supraspinous ligaments

44
Q

examples of hyaline cartilage in the body?

A
  1. costal cartilages
  2. articular cartilage
  3. upper airways
45
Q

the A band has the ______ filaments and the I band has the _____ filaments.

A

thick, thin

46
Q

describe the histo of a tendon:

A

dense, regular T1 collagen, arranged in parallel to the direction of the pull

47
Q

appositional growth of cartilage: ____________ secrete ECM

A

when chondroblasts secrete ECM

48
Q

name the muscles in the erector spinae group:

what is they chief function? secondary?

A

chief function: extension of back
secondary: lateral rotation

spinalis
longissimus
iliocostalis

49
Q

spine curvatures:

convex anteriorly: __________

concave anteriorly: ________

A

convex anteriorly: lordosis

concave anteriorly: kyphosis

50
Q

what is adactyly? what causes it?

A

absence of digits

later loss of FGF in AER (apical ectodermal ridge)

51
Q

in an IV drug user that has bacterial osteomyelitis, what is the most likely organism?

A

E. Clo, pseudomonas, klebsiella

52
Q

what are the histological markers of most muscular dystrophies?

A
  • different muscle fiber sizes
  • fibrosis
  • central nuclei (regeneration)
  • degenerating and regenerating fibers (lot’s of nuclei)
53
Q

broad yellow ligament extending between laminae, making the posterior wall of the vertebral column:

A

ligamentum flavum

54
Q

Radiograph findings with osteoarthritis: (4)

A
  1. joint space loss (not even)
  2. osteophytes
  3. subchondral sclerosis (white)
  4. cysts
55
Q

Marked laxity of the knee in extension with varus/valgus stress indicates

A

A knee injury involving both a collateral and cruciate injury

56
Q

estrogen ________ osteoclast activity

A

decreases

57
Q

what types of cartilage do not have perichondrium?

A

articular cartilage (type of hyaline)

fibrocartilage

58
Q

How would you tell the difference between a sprain/strain?

joint instability (_________), ________ is more likely to have weakness.

A

sprain

strain

59
Q

Gower’s maneuver is a sign of:

A

Duchenne’s MD

60
Q

The perimysium is the CT covering in the center of the muscle between the __________
The endomysium is the CT covering between the muscle fibers, in the center of the fascicle

A

fascicles

muscle fibers (cells)

61
Q

bilateral symmetric involvement of SI joint arthritis makes you think:

A

ankylosing spondylitis

62
Q

in ligament healing… in the phase 3 of remodeling, the ratio of ___________ to _____________ increases

A

type 1 collagen to type 3 collagen

63
Q

strains are _______ damage and sprains are _______ damage

A

muscle, ligament

64
Q

ONLY ligament that runs the length of the spinal cord:

name:
where is it:

A

anterior longitudinal ligament

anterior to the body

65
Q

injury to the ___________ ligament during ankle sprain could avulse the lateral malleolus of the fibula

A

anterior talofibular ligament

66
Q

Many forms of MD are due to problems around the _________ membrane

A

sarcolemmal

67
Q

2 parts of ECM of cartilage that make it resistant to compression and tearing:

A

aggrecan aggregate

type 2 collagen

68
Q

what do the dorsal rami innervate? (3)

A
  1. deep back muscles
  2. back skin
  3. zygapophysial joints (synovial joints in back vertebrae)
69
Q

in a person with sickle cell that has bacterial osteomyelitis, what is the most likely organism?

A

salmonella

70
Q

what is the exception to the “X-ray first” theory of fracture imaging?

A

CT is used as the first line for spine fractures

71
Q

bilateral asymmetric involvement of SI joint arthritis makes you think:

A

psoriatic arthritis or reactive arthritis

72
Q

after the neutrophils come and release factors, ________ arrive and phagocytose additional necrotic debris. What do they release? (4) What does this activate?

A

macrophages

IL6, IGF, PDGF, TGF-b

satellite cells

73
Q

a DXA T-score of -_____ or below is osteoporosis

A

-2.5

74
Q

what is the exact location of “E-C coupling” for motor movement?

A

the t-tubule, sarcoplasmic reticulum channel articulation

75
Q

Treatment for: ________ injury – prolonged immobilization (4-6 weeks)
· Complete tear/avulsion – __________, followed by immobilization

A

tendon, surgery

76
Q

name the transversospinal muscles:

innervation
function (unilateral contraction/bilateral)
A

Names: semispinalis, multifidus, rotatores

Innervation: dorsal rami spinal nerves

Unilateral contraction = CONTRALATERAL rotation
Bilateral = extensors

77
Q

in a neonate that has bacterial osteomyelitis, what is the most likely organism?

A

H. influenzae

78
Q

fracture healing type that needs:

Anatomic reduction, rigid fixation, direct bone formation

A

primary fracture healing

intramembranous ossification

79
Q

splenius muscle function:

innervation:

A

extension of head and neck, ipsilateral rotation and bending

dorsal rami (it is a deep back muscle)

80
Q

_______ are responsible for the differences in cutaneous nerve maps and dermatome maps

A

plexuses

81
Q

the inorganic component of bone matrix is composed of _____________.

what strength does this confer for bone?

A

hydroxyapatite

stiffens, RESISTS BEND/COMPRESSION

82
Q

the most accurate physical examination maneuver to determine an intact ACL is

A

the Lachman test

83
Q

a dermatome is an area of skin supplied by a specific ____________

A

spinal level, NOT a specific peripheral nerve (think about the plexus)

84
Q

Pain with forced flexion and rotation of the knee which may cause not only discomfort, but also a pop or click followed by pain. What test is this and what is the likely diagnosis if it is positive?

A

McMurray’s test

meniscal tear

85
Q

critical period of limb development: weeks __-__

what is it called if there is a problem in the critical period?

A

4-8

malformation

86
Q

what is the substrate use for muscle fibers in high intensity, short duration exercises?

low intensity long duration?

A

carbohydrates

fat

87
Q

the _________ component of bone matrix is laid down first. What is it composed of?

Newly laid down matrix that has not been calcified: ________

A

organic, type 1 collagen

osteoid

88
Q

History of sudden onset of force applied to outside or inside of knee with foot fixed to ground…
what ligament sprain could this be?

A

a collateral knee ligament

89
Q

if you think a patient has a bone neoplasm and have a feeling it is osteoid osteoma, what imaging do you need?

A

CT

90
Q

what type of gene inheritance is Duchenne’s muscular dystrophy? What is the gene?

A

X-linked recessive

short arm of X chromosome, Xp21

91
Q

what is the most common organism of bacterial osteomyelitis?

A

s. aureus

92
Q

interstitial growth of cartilage: ___________ secrete ECM

A

chondrocytes

93
Q

sensory loss along the length of a single dermatome is indicative of a more _________ problem

A

proximal

94
Q

in the intervertebral disks:

________________ = outer fibrocartilaginous ring imparts structural integrity

________________ = inner gelatinous core (notochord remnant) imparts malleability

A

annulus fibrosis

nucleus pulposus

95
Q

Describe the proposed explanation for a higher incidence of ACL injury in female athletes

A
  1. decreased muscular strength
  2. less NMJ control
  3. Body movement mechanics
96
Q

which types of muscle have sarcomeres?

A

skeletal and cardiac

97
Q

tendon and ligament healing steps:

A
  1. inflammatory
  2. Reparative
  3. Remodeling
98
Q

what is the general matrix of cartilage?

A

type 2 collagen and aggrecan aggregate

99
Q

examples of elastic cartilage in the body?

A
  1. pinna of ear

2. epiglottis

100
Q

fracture healing type that needs:

Acceptable reduction, micro-motion helpful, cartilage then bone formation

A

secondary fracture healing

endochondral ossification

101
Q

excessive force from the sartorius muscle —-> _______ evulsion fracture

A

ASIS

102
Q

________ detect the mechanical stress on a bone…causing an increase of _______ into the cell. This signal is then communicated to other cells through gap junctions and there is a proliferation of ____________

A

osteocytes

calcium

osteoblasts

103
Q

the presence of intra-capsular floating fat in a joint cavity is called:

what are you concerned of with this?

A

lipohemarthrosis

fracture

104
Q

blood supply to vertebral column:

A

branches off aorta

105
Q

excessive force from the hamstring muscles —-> _______ evulsion fracture

A

ischial tiberosity

MSS Exam 1 (8 decks)

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