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EOYS > LOCO SSS2 > Flashcards

LOCO SSS2 Flashcards

1
Q

at what stage does femoral artery –> popliteal artery? [1]

A

adductor hiatus

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2
Q
A
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3
Q

inverterbral disc structure:

what is annulus comprised of ? [1]

what is nucleus pulposus comprised of? [3]

A

inverterbral disc structure:

what is annulus comprised of ? [1]
15/20 type 1 collagenous laminae, run obliquely

what is nucleus pulposus comprised of? [3]
type II collagen
water
proteoglycans
around 85% water !!

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4
Q

purple structure?

role? [3]

A

ligamentum flavum !

  • Extends from lamina above to lamina below of adjacent vertebra
  • Resists separation of the lamina
  • Stops abrupt flexion
  • High elastic content so assists with straightening after flexion
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5
Q
A
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6
Q
A
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7
Q

what is the enthesis? [1]

A

bone / tendon insertion: tendon to fibrocartilage to calficified fibrocartilage

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8
Q
A
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9
Q

what is A?

A

A = secondary ossification centre

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10
Q

what does the deltoid ligament attach to? [3]

A

medial malleoulus
calcaneus
navicular

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11
Q

which 3 ligaments make the the lateral ligament? [3]

which are they clinically significant? [1]

A

which 3 ligaments make the the lateral ligament? [3]
anterior talofibular
posterior talofibular
calcaneofibular

which are they clinically significant? [1]
because theyre seperate structures - really likely to tear: lateral collateral ligament tear

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12
Q

which muscles of leg cause foot inversion? [2]

A
  • *tibialis posterior -** deep posterior compatment
  • *tibialis anterior** - anterior comparment
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13
Q
A
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14
Q

what maintains the longitduinal arches? [2]

A
  • *dynamic support**
  • muscle contracts as when required
  • muscle tendons insert into apex of arches - when muscles contracts, pulls apex up & counteract body weight
  • includes intrinsic muscles
  • *passive support**
  • constant & ongoing support
  • due to shape of bones: allows them to interlock
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15
Q

explain the arches of the foot? [3]

A
  • *medial longitudinal arch:**
  • open footprin side: middle of foot isnt it
  • contact with ground: big toe & calcaneous
  • resilient due to large no. of bones
  • *lateral longitudinal arch:**
  • flatter
  • less bones
  • talus transmits body weight through it - weight not central though - either goes forward or backwards

transverse arch:
not a true arch - maintained by some mscles and ligaments as longuitnial arches
- bony fit is particularly good

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16
Q

which structures pass under the flxor retincula? [2]

which structures pass under the extensor retincula? [2]

A

which structures pass under the flxor retincula? [2]
tibial nerve
posterior tibial artery

​which structures pass under the extensor retincula? [2]
deep peroneal nerve (fibular nerve)
anterior tibial artery

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17
Q

explain the arches of the foot? [3]

A
  • *medial longitudinal arch:**
  • open footprin side: middle of foot isnt it
  • contact with ground: big toe & calcaneous
  • resilient due to large no. of bones
  • *lateral longitudinal arch:**
  • flatter
  • less bones
  • talus transmits body weight through it - weight not central though - either goes forward or backwards

transverse arch:
not a true arch - maintained by some mscles and ligaments as longuitnial arches
- bony fit is particularly good

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18
Q

explain mechanism of docking at NMJ and release of Ach occurs at presynaptic vesicle

A

vesicles docks by:

  • synaptobrevin interacts with syntaxin and SNAP25: holds the vesicle close to pre-synaptic membrane (but doesnt fuse) = docking.
  • Ca2+ binds to synaptotagmin: interacts with SNAP25/ syntaxin complex and tightens interaction between the vesicle and presynaptic membrane complexs & causes it to merge & release of Ach = confirmational change occurs.
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19
Q

what is scissor gait:

A

•Thigh swings across body during swing phase

•Difficulty in putting heel on ground
–Toe walking
–Unstable

20
Q

at what point does an AP occur in muscle? [1]

A

at what point does an AP occur in muscle? [1]
- depolarisation occurs at 40mV

21
Q
A
22
Q

what are the two types of NMJ blockers [2] explain them

A

What are the two types of NMJ blockers [2]:

1. D tubocuraine: non-depolarising muscle relaxant
blocks the nicotonic Ach-R & prevents AP occuring

  • Acetylcholinesterase inhibitor works as an antidote to it
  • *2. depolarisng muscle relaxant**
  • stimulate Ach-R like Ach and activate muscle (muscle twitch)
  • but **do not detach: no more Ach can bind (paralysis)
  • even if membrane is repolarised (from Na channels / NaKATPase), the drug causes it to bedesensitised**
  • but breaks down after a while, so not perm. paraylses
23
Q

which is this muscle?

innervation?

movement [2]

A

which is this muscle: sartorius

innervation: femoral nerve

movement [2]: flexes hip AND knee

24
Q

what does quantal release of Ach mean? [1]

A

every vesicle contains same amount of ACh: same amount of NM is released with each AP. get a 1:1 transmission of nerve & muscle.

25
Q

what is the order of neurovasculature of femoral things? [3]

A

femoral artery = pulsating just belowing midinguinal point
femoral nerve = lateral to artery
femoral vein = medial

VAN

26
Q
A
27
Q
A
28
Q

what are the 3 different muscles that insert at the medial aspect of the knee? [3]

which compartment are they all originally from? [3]

what is name for this meetin of three muscles? [3]

A
  • Sartorius - anterior
  • Gracilis - medial
  • Semitendinosus - posterior

= pes anserinus !!

29
Q

lower motor neurons innervate skeletal muslces (alpha-motor neurones)

where do you find the cell body of the motor unit of the NMJ? [1]

one alpha motor neuron innervates: [1]

  • one muscle fibre
  • a number of muscle fibres
A

where do you find the cell body of the motor unit of the NMJ? [1]
ventral (anterior) horn of the spinal cord

one alpha motor neuron innervates: [1]

  • one muscle fibre
  • *- a number of muscle fibres:** forms the motor end plate (presynaptic NMJ)
30
Q

nerve roots of patella reflex? [1]
what does it cause to occu? [1]

A

causes contraction of quads
L2-4 nerve

Myotome: L3-L4

31
Q

what is the Q line?

where is at a line between? [2]

what s the angle in men? (compared to vertical) [1]
whats the angle in women? (compared to vertical) [1]

A

Q line: asis –> centre of patella

what s the angle in men: 14 degress
whats the angle in women: 17 degrees

32
Q

Where do you find:

L type calcium channels [2]

N type calcium channels [1]

A

L type calcium channels [2]
heart
vascular smooth muscle

N type calcium channels [1]
pre-synaptic terminals - very close to the vesicles

33
Q

Where is T1 dermatome? [1]

where is T2 dermatome? [1]

A

Where is T1 dermatome? [1]
medial forearm

where is T2 dermatome? [1]
axillary forearm

34
Q

what is staccator gait like?

A
  • plantaflexor paraylsis - no forward thrust
  • unaffected limb never advances beyond affected limb. just the knee flexors & hip flexors lift it up and swing it forwa
35
Q

what is the medial menisci attached to [2] (anteriorly / posteriorly)

what is the lateral menisici attached to? [1]

A

what is the medial menisci attached to [2]

  • *anteriorly: ACL
    posteriorly: tibial collateral ligament**

what is the lateral menisici attached to? [1]
pcl
NOT ATTACHED TO LATERAL COLLATERAL LIGAMENT

36
Q

which structures make up the unhappy triad? [3]

A
  • Medial meniscus
  • ACL
  • Tibial collateral ligament
37
Q

what is the name of the inorganic substance that is precipitated over collagen fibres to calcify it? [1]

what is structure of ^ like on collagen fibres? [1]

A

what is the name of the inorganic substance that is precipitated over collagen fibres to calcify it? [1]
95% calcium hydroxyapatite

what is structure of ^ like on collagen fibres? [1]
- as crystals

38
Q

what are the internal [1] and external signals [2] for bone remodelling?

A

what are the internal and external signals for bone remodelling?

  • *internal factors**
  • osteocytes processes extend in canaliculi & touch their neighbours
  • osteocytes produce sclerostin to indicate bone health ! - stops osteoblasts coming
  • when osteocytes stop producing sclerostin: indicates bad bone health
  • *external factors**
  • serum calcium level: low serum calcium causes the release of parathyroid hormone - causes osteoblasts to make RANK L
  • pro-inflam cytokines: IL1, IL6, IL17 & TNF
39
Q

what substance causes increases of calcium absorbtion from gut? [1]

A

1,25 dihydroxyvitamin D

40
Q

how does PTH cause Ca2+ reabsorbtion from bones via the increase of activity and no. osteoclasts? [3]

A

Ca2+ reabsorbtion from bones - increases activity and no. osteoclasts
PTH binds to osteoblasts
osteoblasts produce RANKL
osteoclasts have RANKL receptor
activates osteoclasts

41
Q

which substance, released from C cells in thyroid gland causes decrease in Ca2+ reabsorbtion? [1]

A

calcitonin

42
Q

explain how intramembranous ossificatin occurs xo

A
  • ossification centre appears in fibrous connective tissue membrane: here mesenchymal cells condense and differentiate as osteogenic cells: osteoblasts
  • Osteoblasts secrete bone matrix (osteoid) & matrix becomes calcified with calcium hydroxyapatite
  • trapped osteoblasts become osteocytes
  • Mesenchyme on outside condenses: periosteum
  • blood vessels growing to supply the bone with nutrients will bring in osteoclasts, which can then remodel the bone into compact/cortical bone on the outside and trabecular bone on the inside.
43
Q

how does appositional growth of bone occur? (to the side)

A
  • osteoprogenitors in periosteum differentiate as osteoblasts – secrete new bone matrix to form compact, cortical bone (osteons) and grow on either side of a blood vessel.
  • these ridges get bigger and eventually form a tunnel with a blood vessel right in the centre.
  • Inside tunnel: Former periosteum becomes endosteum due to being enclosed inside the bone due to bone growth. It still has progenitor cells
  • Osteoblasts make new bone lamellae filling tunnel
44
Q

which cell signals bone remodelling? [1]

what hormone does ^ cell secrete? [1]

how does the process occur? [2] (basic)

A

which cell signals bone remodelling? [1]
-osteocytes

what hormone does ^ cell secrete? [1]
sclerostin

how does the process occur? [2]

  • *-sclerostin** secreted: causes inhibition of osteoblast action
  • cellular process extend in canaliculi and touch their neighbours
45
Q
A

supinator

46
Q

how does endochondral ossification occur?

A

- Mesenchymal cells condense and differentiates into chondroblasts to produce hyaline cartilage model extracellular matrix (so they use collagen type 2 rather than collagen type 1).

  • the perichondrium forms around cartilage model and holds all the mesenchymal cells next to the condensing bone
  • To begin with, ECM is made more from collagen type 2, more proteoglycans: causes cartilage to grow in legnth and width (into the shape of the bone): causes to be further away from nutrient source
  • chondrocytes now in the middle will begin to deteriorate as there is no blood supply into this cartilage
  • this creates cavities, right in the centre, where the cartilage used to be. When they die, this triggers calcification as it triggers a Ph change: It releases vesicles in the chondrocytes with enzyme like alkaline phosphatase which changes the ph and encourages calcification of the matrix.

At this time, a blood vessel known as the nutrient artery can penetrate the perichondrium and begin to bring in osteoclasts from the haemopoietic cells to start remodelling: break down some of the spongy bone to create a marrow, or medullary, cavity in the centre.

Bone on the inside and bone on the outside grow towards each other to completely replace the cartilage.

EOYS (39 decks)

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