Lectures 6-11

Question 1

Tendon/Ligament Composition

Answer 1

Tenocytes (fibroblasts in ligaments) (20%)
Extracellular Matrix (80%)

Question 2

What is the Extracellular Matrix made of in tendons/ligaments

Answer 2

Elastin (2%)
Proteoglycan (2%)
Collagen (33%)
Water (55-75%)

Question 3

Why is crimp important in tendons?

Answer 3

Allows for the straightening during tensile loading

Question 4

What is the ratio of elastin to collagen in a ligament?
What ligament doesn’t have this ratio?

Answer 4

2:1
Ligamentum Flavum

Question 5

What are the 3 differences between ligaments and tendons?

Answer 5

1. Collagen fibres are not parallel
2. The outer connective tissue layer is called an epiligament
3. Multidirectional tensile force

Question 6

What force are ligaments and tendons strongest in?

Answer 6

Tension

Question 7

What are two viscoelasticity tests?

Answer 7

Stress relaxation test
Creep deformation test

Question 8

What causes tensile strength and stiffness to decline?

Answer 8

Collagen plateau

Question 9

What do steroid do to ligaments and tendons

Answer 9

Negatively impact them due to inhibition of collagen synthesis

Question 10

Is a sprain a ligament or tendon injury?

Answer 10

Ligament injury

Question 11

Is a strain a ligament or tendon injury?

Answer 11

Tendon Injury

Question 12

What is a grade I ligament/tendon injury?

Answer 12

Micro failure to collagen fibres
some pain, no joint instability

Question 13

What is a grade II ligament/tendon injury?

Answer 13

Partial rupture
Severe pain and some joint instability

Question 14

What is a grade III ligament/tendon injury?

Answer 14

Total rupture has occurred
Severe pain and joint completely unstable

Question 15

What is the percentage of vascularisation of tendons and ligaments

Answer 15

1-2%

Question 16

Normal ROM of hip flexion

Answer 16

120 degrees

Question 17

Normal ROM of hip abduction

Answer 17

120 degrees

Question 18

Normal ROM of hip internal/external rotation

Answer 18

20 degrees

Question 19

Why does ROM decrease with age?

Answer 19

Changes in motor control
Loss of motor unit
Decreases in fast twitch muscle fibres

Question 20

What is the centre edge angle (angle of Wiberg)?

Answer 20

35 degrees

Question 21

What is the acetabular anteversion angle?

Answer 21

20 degrees

Question 22

What is the angle of inclination?

Answer 22

125 degrees

Question 23

What is the torsion angle?

Answer 23

15 degrees

Question 24

What affects the mobility and stability of the hip?

Answer 24

Coverage of Acetabulum (angle of Wiberg and Acetabular Anteversion angle)

Alignment of Femur (Torsion angle and angle of inclination

Question 25

What bone externally rotates in the screw home mechanism to add stability in full knee extension?

Answer 25

Tibia

Question 26

In walking gait, what are the two phases? Define them

Answer 26

Stance (65%) - Heel Strike to Toe Off Swing (35%) - Toe Off to Heel Strike

Question 27

In walking gait, what are the 8 actions

Answer 27

1. Heel strike 2. Foot flat 3. Heel rise 4. Push-off 5. Toe-off 6. Acceleration 7. Toe Clearance 8. Deceleration

Question 28

What is the difference between stride and step length?

Answer 28

Stride length is the length from when an event occurs on one side, to when it reoccurs on the same side (right heel strike --> right strike off) Step length is the length from when an event occurs on one side to when it reoccurs on the opposite side (right strike off --> left strike off)

Question 29

What is the role of the subtalar job during gait?

Answer 29

Shock absorbs

Question 30

What are the phases in running gait?

Answer 30

Stance (40%) Float (15%) Swing (30%) Float (15%)

Question 31

Movements during pronation of the foot (e.g plantar flexion, abduction, inversion)

Answer 31

Dorsiflexion, Abduction, Eversion

Question 32

Movements during supination of the foot (e.g plantar flexion, abduction, inversion)

Answer 32

Plantarflexion, Adduction, Inversion

Question 33

What happens to the Plantar Fascia when toes are hyperextended

Answer 33

It shortens causing the arch of foot to rise

Question 34

Distribution of loads under the foot during stance

Answer 34

Heel (60%) Midfoot (8%) Forefoot (28%) Toes (4%)

Question 35

Role of Nucleus Pulposus

Answer 35

Provides the intervertebral disc elasticity and compressibility

Question 36

How does the Nucleus Pulposus get nutrients?

Answer 36

Diffusion (no direct blood supply)

Question 37

What covers the Annulus Fibrosus?

Answer 37

Fibrocartilage

Question 38

Under compression, how much pressure can the Nucleus Pulposus and Annulus Fibrosus withstand?

Answer 38

Nucleus Pulposus - 1.5 times external load Annulus Fibrosus - 0.5 times external load

Question 39

Compare male and female motions of the spine

Answer 39

Males: more ROM in flexion/extension Females: more ROM in lateral flexion

Question 40

Where is the line of gravity in the body while standing

Answer 40

passes anteriorly to the centre of the fourth lumbar vertebrae

Question 41

How does the body maintain balance?

Answer 41

The line of gravity through the body creates a forward bending moment in the spine. The body then maintains balance by increasing core and spinal muscle activity

Question 42

What is sway?

Answer 42

Horizontal movement of the COG

Question 43

What is the sacral angle of the pelvis?

Answer 43

30 degrees

Question 44

How do you minimise pressure on the spine while sitting?

Answer 44

Lumbar support and leaning back

Question 45

What motions increase the load on the spine?

Answer 45

Bending forward or sitting

Question 46

If two objects are the same weight but vary in size, which one will create a greater load on the spine?

Answer 46

bigger size = greater load

Question 47

What type of fibre are found in motor neurons

Answer 47

Muscle Fibres

Question 48

What type of fibre are found in sensory neurons

Answer 48

Skin Fibres Muscle Fibres Tendon Fibres Joint Fibres

Question 49

What type of neuron is commonly found in the posterior root of the nerve

Answer 49

Sensory

Question 50

What type of neuron is commonly found in the anterior root of the nerve

Answer 50

Motor

Question 51

What are peripheral nerves made up of?

Answer 51

Nerves Connective Tissue Blood Vessels

Question 52

What is the role of the myelin sheath in nerves

Answer 52

Increases the speed of conduction Insulates and maintain the axon

Question 53

What is the Epineurium

Answer 53

Protects fascicles from external trauma Maintains oxygen supply

Question 54

What is the Perineurium

Answer 54

Sheath surrounds each fascicle Great mechanical strength Specific biochemical barrier

Question 55

What is the Endoneurium

Answer 55

Protects nerve fibres Composed of fibroblasts and collagen

Question 56

Are peripheral nerves vascularised

Answer 56

Yes

Question 57

In what direction do blood vessels run across the perineurium

Answer 57

Obliquely

Question 58

What is the order of the layers of connective tissue (outside to inside)

Answer 58

1. Epineurium 2. Perineurium 3. Endoneurium

Question 59

Where does the spinal cord end in adults?

Answer 59

L1

Question 60

What vertebrae and areas of the body are affected by Brachial Plexus Palsy

Answer 60

C5-C6 Shoulders, Bicep, Brachioradialis

Question 61

What is Sciatica?

Answer 61

A nerve compression injury Degenerative disk puts pressure on the piriformis, causing pain in the back of the leg

Question 62

What is Endomorphy

Answer 62

Lean <----------> Fat

Question 63

What is Mesomorphy

Answer 63

Slender <-----------> Muscular

Question 64

What is Ectomorphy

Answer 64

Heavy <-----------> Light