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LOCO SSS2 Flashcards

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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:

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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]

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A

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

22
Q

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

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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]

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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]

Study These Flashcards
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
what is the order of neurovasculature of femoral things? [3]
femoral artery = pulsating just belowing midinguinal point femoral nerve = lateral to artery femoral vein = medial VAN
26
27
28
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]
* Sartorius - **anterior** * Gracilis - **medial** * Semitendinosus - **posterior** **= pes anserinus !!**
29
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
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
nerve roots of patella reflex? [1] what does it cause to occu? [1]
causes **contraction of quads L2-4 nerve** ## Footnote **Myotome: L3-L4**
31
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]
Q line: **asis --\> centre of patella** what s the angle in men: **14 degress** whats the angle in women: **17 degrees**
32
Where do you find: L type calcium channels [2] N type calcium channels [1]
L type calcium channels [2] **heart vascular smooth muscle** N type calcium channels [1] **pre-synaptic terminals - very close to the vesicles**
33
Where is T1 dermatome? [1] where is T2 dermatome? [1]
Where is T1 dermatome? [1] **medial forearm** where is T2 dermatome? [1] **axillary forearm**
34
what is staccator gait like?
- **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
what is the medial menisci attached to [2] (anteriorly / posteriorly) what is the lateral menisici attached to? [1]
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
which structures make up the unhappy triad? [3]
* Medial meniscus * ACL * Tibial collateral ligament
37
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]
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
what are the internal [1] and external signals [2] for bone remodelling?
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
what substance causes increases of calcium absorbtion from gut? [1]
**1,25 dihydroxyvitamin D**
40
how does PTH cause Ca2+ reabsorbtion from bones via the increase of activity and no. osteoclasts? [3]
**Ca2+ reabsorbtion from bones - increases activity and no. osteoclasts** PTH binds to osteoblasts osteoblasts produce RANKL osteoclasts have RANKL receptor activates osteoclasts
41
which substance, released from C cells in thyroid gland causes decrease in Ca2+ reabsorbtion? [1]
**calcitonin**
42
explain how intramembranous ossificatin occurs xo
- **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
how does appositional growth of bone occur? (to the side)
- **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
which cell signals bone remodelling? [1] what hormone does ^ cell secrete? [1] how does the process occur? [2] (basic)
_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
supinator
46
how does endochondral ossification occur?
**- 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 osteoclast**s 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.**

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