Limbs and Back Flashcards
Which type of cartilage is found in the knees and hip joints?
Articular
What is the main cell type found in cartilage?
Chondrocytes
What percentage of the tendon is composed of cells?
20%
Shoulder pain and the inability to externally rotate the arm indicates what?
Injury of the infraspinatous
What are the three phases of tendon healing?
I-R-R
- Inflammation
- Repair
- Remodelling
What is the innervation and function of the Latissimus dorsi?
(Superficial group back muscle)
- Thoracodorsal Nerve
Adducts, extends, medially rotates the arm.
What is the innervation and function of the Levator scapulae?
(Superficial group back muscle)
Dorsal Scapular Nerve and C3-C5.
Elevates the scapula.
What is the innervation and function of the Rhomboudeus Major?
(Superficial group back muscle)
Dorsal Scapular Nerve
Rotates and retracts the scapula.
What is the innervation and function of the Rhomboudeus Minor?
(Superficial group back muscle)
Dorsal Scapular Nerve
Rotates and retracts the scapula.
What is the innervation and function of the Trapezius?
Superficial group back muscle
Elevates and rotates the scapula during abduction of the arm above horizontal.
What is the structure of the brachial plexus?
“Rugby Teams Drink Cold Beer”
- Roots
- Trunks
- Divisions
- Cords
- Branches
Name the tarsal bones of the foot.
“Tiger Cubs Need MILC”
- Talus
- Calcaneus
- Navicular
- Medial Cuneiform
- Intermediate Cuneiform
- Lateral Cuneiform
- Cuboid
What bones form the “true ankle”? What movements does it allow?
Tib/Fib and Talus.
Dorsi and Plantar Flexion.
What bones form the “Sub-Talar Joint”? What movements does it allow?
Talus and the Calcaneus.
Inversion and eversion.
Name the contents of the Cubital Fossa (lateral to medial)
“Really Need Beer To Be At My Nicest”
- Radial Nerve
- Biceps Tendon
- Brachial Artery
- Median Nerve
Name the contents of the Femoral Triangle (lateral to medial)
“NAVEL”
- Nerve, Femoral
- Artery, Femoral
- Vein, Femoral
- Empty Space
- Lymph, Deep Inguinal
What are the major landmarks of the Scapula?
- Acromial Process
- Coracoid Process
- Scapula Notch
- Superior, Inferior, Lateral, Medial Borders
- Neck
- Body
- Supraspinatous Fossa
- Infraspinatous Fossa
What are the muscles of the Rotator Cuff?
“TISS”
- Teres Minor
- Infraspinatous
- Supraspinatous
- Subscapularis
Describe the structure and functions of tendons
Composition:
- Water 80%
- Solids 20%
- collagen (I & III), Elastin.
Dense and regularly arranged structures that transmit force and load generated by muscles.
Fibroblasts are the principle cell type. Attach muscle to bone to allow articulation.
What nerves arise from the terminal branches of the Brachial Plexus?
Four.
- Musculocutaneous (Lateral Cord)
- Median (Lateral and Medial)
- Radial (Posterior)
- Ulnar (Medial)
- Axillary (Posterior)
What nerves branch off the Brachial Plexus?
Seven.
- Long Thoracic
- Dorsal Scapular Nerve
- Suprascapular Nerve
- Pectoral Nerves
- Auxillary Nerve
- Thoracodorsal Nerve
- Medial Cutaneous Nerves
Watch a Brachial Plexus tutorial on YouTube.
OR
Draw the bracial plexus.
Go.
Describe 4 x-ray features of Osteoarthritis
- Loss of joint space/ joint space narrowing
- Subchondral Bone Lesions - bone hardens and becomes more white on X-Ray.
- Osteophyte formation
- Subchondral Cysts
Describe the pathophysiology of Osteoarthritis.
Increase in water content in the ECM
Decreased proteoglycan synthesis
Decrease in size of aggrecan/ hyaluronic acid.
Degrading articular cartilage
Inflammation and cytokine release
Erosion due to bone-bone contact
Osteophytes, subchondral lesions and cysts form.
Describe indirect fracture healing.
- 8 hours. Haematoma forms. Acute inflammatory response takes place.
- 3 weeks. Soft callous forms from fibrocartilage.
- 4 months. The hard callous forms as osteoblasts lay down woven calcified bone. The callous is re-vascularised.
- Remodelling. Osteoclasts work with osteoblasts to form compact bone.
Summarise articular cartilage and osteoarthritis
- Cartilage is Hyaline. 20% chondrocytes, 80% matrix.
- Type II collagen
- Avascular and Aneural
- Hyaluronic acid chains
Load transmission with low friction.
- Homeostasis and Healing.
- enzymes
- must breach subchondral bone - Treatments
- physio
- medical (drugs)
- surgical
What does the Axillary Nerve go onto innervate?
Deltoid and Teres Minor
What does the Musculocutaneous Nerve go onto innervate?
Anterior compartment of the arm.
What does the Median Nerve go onto innervate?
Anterior compartment of the forearm and hand. (Mainly the forearm)
What does the Ulnar Nerve go onto innervate?
Anterior compartment of the forearm and hand. (Mainly the hand)
What does the radial nerve go onto innervate?
Posterior compartment of the arm and forearm.
Which muscles can rotate the arm laterally?
Infraspinatous and Teres Minor.
What is the name of the gap located between the Teres Major and Minor, Humerus, and long head of the triceps, through which the axillary nerve travels?
Quadrangular Space
What cells are found in bone?
- Osteogenic cells.
- unspecialised cells originating from the mesenchyme. “Osteoprogenitor cells”. Mature into osteoblasts. - Osteoblasts.
- “building” cells. Lay down bone (osteoid), ossification. Initiate mineralisation. - Osteocytes
- set in bone mineral. Maintains bone metabolism. Mature osteoblasts. Communication maintained by projections through lacunae tight junctions. Arrange in osteons. - Osteoclasts.
- “clear”/ resorbs bone. Derived from macrophages. Multi-nucleated. Marked by a ruffled border. Lots of lysosomes.
What are the main components of bone?
Two main groups.
- Organic - TENSILE STRENGTH
- 95% Type I Collagen
- rich in proteoglycans.
- osteocalin, osteopontins and bone sialoprotein. - Inorganic - COMPRESSIVE STRENGTH
- 75% of bone
- hydroxyapatite.
Describe the gross anatomy/ structure of bone.
Compact/ cortical bone.
- Dense
- organised in haversian systems (calcified rings called lamelae)
- branches called volksman canals
- vascularised through nutrient foramen
Trabecular bone.
- not arranged in circular structures. Forms a lattice/ mesh.
- in line with mechanical stress
- reduction of weight
- accommodates bone marrow
List the functions of calcium.
- Major compenent of ossious tissue.
- Central role in homeostasis
- Muscle contraction
- Cell-Cell adhesion
- Neural excitability
- Intracellular communication
How is calcium distributed in the body?
- Free calcium - 47%
- Bound calcium - 47%
- “Complexed” calcium - 6%
- Clinically, measured as total calcium, or free alone. Only free calcium is clinically relevant.
What is the main site of calcium absorption?
The jejunum.
What regulates calcium absorption?
Calcitriol. Mediates the synthesis of calcium binding proteins.