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1 - FINALS > Locomotor > Flashcards

Locomotor Flashcards

1
Q

Movements at the talocrural joint

A

Dorsiflexion and plantarflexion

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2
Q

Movements at the subtalar joint

A

Eversion and inversion

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3
Q

In which position is the ankle most stable?

A

Dorsiflexion due to the talus being wider anteriorly

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4
Q

What are the medial ankle ligaments?

A

Deltoid ligament that is made up of 4 adjacent continuoua ligaments attaching the medial malleolus to the calcaneous and navicular bones

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5
Q

What are the lateral ankle ligaments?

A

Anterior talofibular
Posterior talofibular
Calcaneofibular

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6
Q

Dorsiflexor and toe extensors

A

Tibialis anterior, extensor digitorum longus and extensor hallucis longus

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7
Q

Everters

A

Fibularis longus and brevis

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8
Q

Plantarflexors

A

Gastrocnemius, soleus and plantaris

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9
Q

Toe flexors

A

Flexor digitorum longus, flexor hallucis longus, tibialis posterior

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10
Q

Inverters

A

Tibialis anterior and posterior

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11
Q

Medial arch support

A

Spring ligament, deltoid ligament, tendon of tibialis posterior

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12
Q

Lateral arch support

A

Long plantar ligament and tendons of extensor muscles

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13
Q

Elbow bursae

A

Intratendinous - in triceps tendon
Subtendinous - between olecranon and tendon
Subcutaneous - between bone and skin

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14
Q

Carrying angle

A

5-15 in men

10-25 in women

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15
Q

Elbow flexors

A

Biceps, brachialis, brachioradialis

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16
Q

Elbow extensors

A

Triceps, anconeus

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17
Q

Supinators

A

Biceps, supinator

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18
Q

Pronators

A

Pronator teres, pronator quadratus

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19
Q

Nursemaid’s elbow

A

Dislocation of the elbow where the radius pops out of teh annular ligament
Common in children

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20
Q

Cubital fossa boundaries

A 
Superior = between epicondyles 
Medial = pronator teres
Lateral = brachioradialis
Floor = brachialis and supinator 
Roof = antebrachial fascia
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21
Q

Cubital fossa contents

A

Brachial artery and vein
Median nerve
Biceps tendon
Radial nerve

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22
Q

Reasons for hip stability

A

Deep insertion of femoral head into socket
Strong tight articular capsule
Strong ligaments around capsule
Powerful muscles around joint
Ligamentum teres within articular capsule
Reciprocal pull of medial and lateral rotators
Twisting of fibres in articular capsule

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23
Q

Acetabular labrum

A

Rim of fibrocartilage that is incomplete inferiorly where blood vessels can pass through

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24
Q

Ligaments of the hip

A

Anterior iliofemoral = strongest
Pubofemoral
Ischiofemoral
Posterior ligaments weaker and do not completely cover the femoral neck

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25
Q

Hip flexors

A

Iliopsoas, sartorius, pectineus, quadriceps

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26
Q

Hip extensors

A

Gluteus maximus, hamstrings

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27
Q

Hip abductors

A

Gluteus medius and minimus, tensor fascia lata

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28
Q

Hip adductors

A

Adductor compartment

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29
Q

Hip lateral rotation

A

Gluteus maximus, sartorius, piriformis, obturator internus

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30
Q

Hip medial rotation

A

Gluteus medius and minimus and pectineus

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31
Q

Fracture to the neck of the femur

A

Can disrupt blood supply and lead to avascular necrosis

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32
Q

Sizes of IV discs

A 
Cervical = 3mm
Thoracic = 5mm
Lumbar = 9-11mm
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33
Q

IV disc components

A

Annulus fibrosus = criss cross arrangement of fibrocartilage
Nucleus pulposus = central gelatinous mass

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34
Q

Anterior longitudinal ligament

A

Strong fibrous band covering the anterior sides of the vertebral bodies and IV discs that extends from C1 to the sacrum
Prevents excessive extension

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35
Q

Posterior longitudinal ligament

A

Narrower weaker band within the vertebral canal attached mainly to IV discs extending from C2 to the sacrum
Prevents excessive flexion

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36
Q

Ligamentum flava

A

Extends between the lamina of two adjacent vertebrae and resists separation
Prevents excessive flexion and helps with straightening after flexion

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37
Q

Types of fibrous joints

A

Sutures - skull
Syndesmosis - sheet of fibrous tissue between bones - tibia and fibula
Gomphosis - cone shaped peg in socket - teeth

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38
Q

Types of cartilaginous joints

A

Synchrondosis - connected by hyaline cartilage - epiphyseal growth plate
Symphysis - connected by fibrocartilage - pubic symphysis and IV discs

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39
Q

Articular capsule structure

A

Outer fibrous capsule

inner synovial membrane

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40
Q

Q-angle

A

14 in males

17 in females

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41
Q

Articularis genu

A

From vastus intermedialis to suprapatellar bursa

Prevents it from becoming trapped behind patella

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42
Q

Housemaid’s knee

A

= prepatella bursitis

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43
Q

Baker’s cyst

A

Swelling behind the knee joint

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44
Q

Lateral collateral ligament

A

Strong fibrous cord

Prevents knee adduction

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45
Q

Medial collateral ligament

A

Broad flat ligament

Prevents knee abduction

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46
Q

Anterior cruciate ligament

A

Medial anterior tibia to lateral posterior femur

Prevents tibia moving forward on femur

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47
Q

Posterior cruciate ligament

A

Medial posterior tibia to lateral anterior femur

Prevents tibia moving backward on femur and prevents external rotation

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48
Q

Knee flexors

A

Hamstrings

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49
Q

Knee extensors

A

Quadriceps

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50
Q

Unlocking of the knee

A

By the muscle popliteus
Unlocks by rotating femur laterally on fixed tibia
Allows flexion to proceed

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51
Q

Genu varum

A

= bow legged

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52
Q

Genu valgus

A

= knock kneed

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53
Q

Carpal tunnel contents

A

Median nerve
4 tendons of FDS
4 tendons of FDP
Tendon of FPL

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54
Q

Lumbricals

A

Flex MCP and extend IP joints of digits 2-5

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55
Q

Dorsal interossei

A

Abduct digits 2-4

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56
Q

Palmar interossei

A

Adduct digits 2,4,5

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57
Q

Dupuyten’s contracture

A

Fixed flexion of the hand due to thickening of palmar fascia

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58
Q

When does the subclavian artery become the axillary artery?

A

At the lower border of the first rib

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59
Q

When does the axillary artery become the brachial artery?

A

At the inferior border of teres major

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60
Q

Brachial pulse palpation point

A

Medial to biceps tendon

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61
Q

Superficial palmar arch

A

Main contribution from ulnar artery

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62
Q

Deep palmar arch

A

Main contribution from radial artery

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63
Q

Radial pulse palpation point

A

Lateral to FCR tendon

64
Q

Ulnar pulse palpation point

A

Lateral to FCU tendon

65
Q

Cephalic vs basilic veins

A

Cephalic drains lateral arm

Basilic drains medial arm

66
Q

Erb-Duchenne palsy

A

C5-C6 damage
Loss of lateral arm sensation
Paralysis of deltoid, biceps, brachialis
Caused by backpacking, thrown from motorbike, excessive neck stretching during birth

67
Q

Klumpke’s palsy

A

C8-T1 damage
Paralysis of small muscles of the hand
Caused by upper limb being pulled superiorly

68
Q

Axillary nerve palsy

A

Paralysis of deltoid
Loss of sensation over deltoid
Dislocated shoulder or fracture of neck of the humerus

69
Q

Radial nerve palsy

A

Wrist drop
Loss of sensation to 1st dorsal interosseous web
Fracture to mid shaft of the humerus

70
Q

Ulnar nerve palsy

A

Claw hand
Loss of sensation to little finger
Medial epicondyle fracture

71
Q

Musculocutaneous nerve palsy

A

Paralysis of BBC

Deep injury

72
Q

Median nerve palsy

A

Thenar atrophy
Loss of thumb sensation
Supracondylar fracture or wrist laceration

73
Q

Dorsalis pedis palpation point

A

Lateral to EHL tendon

74
Q

Posterior tibial palpation point

A

Half way between medial malleolus and calcaneal tendon

75
Q

Control of venous return

A

Muscular pumping
Respiratory pumping
Valves
Venoconstriction

76
Q

Femoral nerve

A

L2-4
Motor to quadricpes
Sensory to anterior thigh and medial and anterior leg

77
Q

Lateral cutaneous nerve

A

L2-3

Sensory to lateral thigh

78
Q

Obturator nerve

A

L2-4
Adductor compartment
Sensory to medial thigh

79
Q

Superior gluteal nerve

A

L4-S1

Gluteus medius and minimus and tensor fascia lata

80
Q

Inferior gluteal nerve

A

L5-S2

Gluteus maximus

81
Q

Tibial nerve

A

L4-S3
Quadriceps
Posterior calf
Sensory to posterior leg and sole of foot

82
Q

Common peroneal nerve

A

L4-S2
Superficial –> everters
Deep –> dorsiflexors
Sensory to lateral leg and dorsum of foot

83
Q

Sciatic nerve palsy

A

Foot drop
Wasting of hamstrings, calf muscles and dorsiflexors
Loss of Achilles reflex
Posterior hip dislocation

84
Q

Common peroneal nerve palsy

A

Foot drop
Loss of sensation to lateral leg
Neck of fibula fracture, tight leg casts

85
Q

Tibial nerve palsy

A

Paralysis of plantarflexors
Sensory loss to posterior leg and sole of the foot
Fracture of the tibia or tarsal tunnel compression

86
Q

Femoral nerve palsy

A

Paralysis of quadriceps
Sensory loss to anterior thigh
Pelvic fractures or anterior hip dislocations

87
Q

Sternoclavicular ligaments

A

Anterior sternoclavicular
Costoclavicular
Interclavicular

88
Q

Scapular elevation

A

Trapezius, levator scapulae

89
Q

Scapular depression

90
Q

Scapular protraction

A

Serratus anterior, pectoralis minor

91
Q

Scapular retraction

92
Q

Scapular upward rotation

A

Trapezius, serratus anterior

93
Q

Scapular downward rotation

A

Latissimus dorsi

94
Q

Reasons for large range of movement at the glenohumeral joint

A

Large, baggy joint capsule
Shallow glenoid cavity and large humeral head
Physiological scapulothoracic joint
Strong rotator cuff muscles keep humerus head in contact with glenoid cavity
Glenoid labrum

95
Q

Shoulder flexion

A

Deltoid, pectoralis major

96
Q

Shoulder extension

A

Deltoid, latissimus dorsi

97
Q

Shoulder abductors

A

Deltoid, supraspinatous

98
Q

Shoulder adductors

A

Pectoralis major, latissimus dorsi

99
Q

Shoulder medial rotator

A

Subscapularis

100
Q

Shoulder lateral rotator

A

Infraspinatous

101
Q

Which rotator cuff attaches to the lesser tuberosity whereas all the others attach to the greater?

A

Subscapularis

102
Q

Shoulder dislocations

A

Mainly anterior
Strong flexors and adductors pull humeral head anteriorly
Axillary nerve injury

103
Q

Clinical landmark for lumbar puncture

A

Hand on iliac crests

Marks L4

104
Q

Sciatic nerve surface marker

A

Halfway between greater trochanter and ischial tuberosity

105
Q

Number of vertebrae

106
Q

Primary back curves

A

Thoracic and sacral kyphoses

107
Q

Secondary back curves

A

Cervical and lumbar lordoses

108
Q

Cervical vertebrae distinctive feature

A

Transverse foramina

Bifid spinous process

109
Q

Thoracic vertebrae distinctive feauture

A

Costal facets
Inferiorly projecting spinous process
Heart shaped vertebral body

110
Q

Lumbar vertebrae distinctive feauture

A

Large kidney shaped vertebral body

Sturdy laminae

111
Q

Changes when going from double to single support

A

Abductors of supporting leg become active

Prevent the hip dropping

112
Q

Stages of stance phase of walking cycle

A 
Heel strike
Loading response
Midstance
Terminal stance
Preswing (toe off)
113
Q

Stages of swing phase of walking cycle

A

Initial swing
Midswing
Terminal swing

114
Q

Shuffling gait

A

Short shuffling steps
Rigidity in hip and knee extensors
Parkinson’s disease

115
Q

Scissor gait

A

Thigh swings across body
Difficulty putting heel on the ground
Stroke
Cerebral palsy

116
Q

High stepping gait

A

Knee lifted high in swing phase
Prevents dragging of foot due to foot drop
Peroneal nerve palsy

117
Q

Staccato gait

A

No forward thrust
Unaffected limb never advances beyond affected limb
Tibial nerve palsy

118
Q

Two types of bone

A

Cortical around the outsides

Trabecular bone in the middle

119
Q

Stages of bone maturity

A

New bone = woven

Mature bone = lamellar

120
Q

What is found on the surface of trabecular bone?

A

The endosteum comprising on a later of osteoprogenitor cells

121
Q

Function of canaliculi

A

Allow osteocytes to obtain nutrients from the Haversian canals and connect osteocytes together

122
Q

Periosteum structure

A

Inner periosteum is lined by osteoprogenitor cells

Can develop into a later of cuboidal osteoblasts can develop during bone growth

123
Q

Zones of cartilage at the epiphyseal growth plate

A 
Resting 
Proliferation 
Hypertrophy and maturation 
Degeneration and calcification 
Osteogenesis
124
Q

Appositional growth

A

= growth in width

125
Q

Interstitial growth

A

= growth in length

126
Q

What are Sharpey’s fibres?

A

Dense collagen bundles that insert into the bone matrix at the broad areas of muscle anchorage

127
Q

Proportions of type of bone

A 
Cortical = 80%
Trabecular = 20%
128
Q

Bone matrix composition

A

Type 1 collagen
Proteoglycans
Calcium hydroxyapatite
Water

129
Q

When does ossification begin?

A

6th-7th week of intrauterine life

130
Q

Reasons for bone remodelling

A

Renews before deterioration

Redistributes bone matrix along lines of mechanical stress

131
Q

Which bone is faster to remodel and why?

A

Trabecular
3x faster than cortical
Due to larger surface area

132
Q

How do osteoclasts resorb bone?

A

Attach to bone and from a seal
Release proteolytic enzymes to break down collagen
Release HCl to dissolve bone minerals

133
Q

Action of parathyroid hormone

A

Kidney - increases calcium reabsorption and phosphate excretion
Bone - increases number and actviity of osteoclasts
Gut - increases calcium absoprtion by promoting synthesis of 1,25(OH)2vitD

134
Q

How does PTH increase osteoclast activation?

A

Osteoblasts have receptor for PTH
Causes osteoblasts to express RANK ligand
Osteoclast precursors activated by RANKL and differentiate

135
Q

Calcitonin

A

Released from thyroid gland (C cells) in response to increased plasma calcium levels
Inhibit osteoblast activity

136
Q

Oestrogen and bone metabolism

A

Gut - increased calcium absorption

Bone - inhibits osteoclasts

137
Q

Glucocorticoids and bone metabolism

A

Gut - decreased calcium absorption

Bone - increased resorption and decreased formation

138
Q

Type of calcium channels in nerve terminals

139
Q

Type of calcium channels in cardiac cells

140
Q

What can block N-type calcium channels

141
Q

Enzyme that reforms ACh

A

Choline acetylase

142
Q

Molecule responsible for vesicle recycling

143
Q

Botox toxin

A

Prevents vesicle docking by blocking SNARE proteins

144
Q

Conotoxin

A

Block presynaptic calcium channels

145
Q

Curare - tubocurarine

A

Competitive nicotinic receptor antagonist

146
Q

Succinylcholine

A

Depolarising blocker - binds to receptor and activates it but does not detach

147
Q

Neostigmine, physostigmine

A

Anticholinesterase

148
Q

Synoviocytes

A

Type A = bone marrow derived macrophage - immune surveillance
Type B = fibroblast like connective tissue cell - makes proteoglycans to add to synovial fluid

149
Q

Synovial membrane subintima

A

Connective tissue layer containing a dense network of fenestrated capillaries

150
Q

Synovial fluid

A

= ultrafiltrate of blood with added hyaluronic acid

151
Q

Synovial fluid composition

A

pH = 7.38
Hyaluronate
Glucose = 4.0
Lubricin

152
Q

Function of synovial fluid

A

Reduces friction between cartilages
Distributes force across joint surfaces
Forms reserve volume
Nourishes articular cartilage

153
Q

Synovial fluid biomechanics

A

Thixotropic - gel at rest and becomes less viscous with movement

154
Q

Lubricin

A

Water soluble glycoprotein produced by chondrocytes and synoviocytes
Repels joint surfaces to prevent contact of articular cartilage

155
Q

Articular cartilage structure

A

Hyaline cartilage - type II collagen, proteoglycans - forms gel
Aneural and avascular

156
Q

Articular cartilage function

A

Caps bones in synovial joints
Acts as a shock absorber
Reduces friction

157
Q

Layers of articular cartilage

A

Superficial zone with flat chondrocytes - collagen parallel to surface
Middle zone with oval chondrocytes - collagen randomly arranged
Deep zone with round chondrocytes - collagen perpendicular to surface
Tide mark
Calcified zone - smaller cells
Subchondral bone
Cancellous bone

1 - FINALS (6 decks)

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