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1
Q

Where are skeletal muscle cells nuclei

A

at the periphery just under the cell membrane (sarcolemma)

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2
Q

the membrane around one fibre
around a group of fibres
around a muscle

A

endomysium
perimysium
epimysium

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3
Q

what is a sarcomere

A

unit of contraction - smallest contractile elements in a striated muscle cell

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4
Q

what is a motor unit

A

one motor unit and the muscle fibres it innervates

the fewer the number of muscle fibres it innervates the preciser the movement

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5
Q

Type 1 fibres

A 
red
lots of mitochondria
dont fatigue 
less force produced
slowly contracting 
aerobic respiration
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6
Q

intermediate fibres

A

relatively resistant to fatigue

fast contracting

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7
Q

type 2 fibres

A 
white 
fast contracting 
high force produced
not a lot of mitochondria 
anaerobic resp
fatigue easily
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8
Q

chondobasts become what

A

chondrocytes which are cartilage cells and live in the extracellular matrix in lacuna

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9
Q

what does the extracellular matrix consist of and that broken down is what

A

75% water

20% - 60% type 3 collagen - finer and 3D meshwork and 40% proteoglycan aggregates made up of GAGs

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10
Q

hyaline cartilage
elastic
fibrocartilage

A

blue/white. translucent. commonest
hello
white. type 2 collagen

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11
Q

haemopeisis occurs where

A

in bone marrow

from 20s only in axial and limb girdle

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12
Q

what is the outer bone called

what are the ends of the bone called

A

cortical

cancellous/trabecullar bone (mashed network)

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13
Q

lines surrounding osteons called what

A

cement lines

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14
Q

osteoproginater cells
osteoblasts
osteoclasts
osteocytes

A

surface of cells. reserve for osteoblasts
surface of bone. bone forming
large multinucleate. surface. bone reabsorption
within bone matrix

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15
Q

why type of drugs are COX2 inhibitors
what does the COX enzyme do
lead to a decrease in what

A

NSAIDs
responsible for inflam and pain
peptic ulcers

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16
Q

synarthrosis joint
amphyathrosis joint
diathrosis joint

A

fibrous
cartilaginous
synovial

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17
Q

nociceptive pain
inflam pain
pathological pain

A

adaptive - early warning system
adaptive - activation of immune system
maladaptive - abnormal nervous system function

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18
Q

polymyositis has what kind of infiltration

Derm?

A

endomysial lymphatic infiltration. CD8. segmental fibre necrosis

immune complex and complement deposit within and around capillaries in muscle, perifasicular muscle fibre injury, B and CD4 cells

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19
Q 
actin 
myosin 
H zone 
A band
I band
A 
thin - light
thick - dark
just myosin 
all of myosin and overlapping actin 
the actin that isn't in A
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20
Q

what happens when muscle is not given a chance to relax and is continuously stimulated

A

tetanus

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21
Q

isotonic contractions

isometric contractions

A

body movements and movement of objects - muscle tension is constant but muscle length increases

supporting objects in fixed position, maintaining body posture - muscle length is constant but tension increases

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22
Q 
Knee jerk
Ankle jerk
biceps jerk
brachioradialis 
triceps jerk
A 
L3, L4 femoral nerve
S1, S2 tibial nerve 
C5-C6 musculocutaneous nerve
C5-C6 radial nerve
C5-C6 radial nerve
23
Q

what is renal dystrophy

A

bone changes due to CKD

less phosphate excretion and inactive Vit D - secondary hyperparathyroidism

24
Q

what is a BMU

A

bone multicellular unit - location of osteoclasts and osteoblasts at sire or remodelling

25
difference between a benign and a malignant soft tissue swelling
benign - soft, fluctuation in size, well defined, fluid filled cyst malignant - larger, rapid growth, solid, ill defined, irregular surface, assoc LD and systemic upset
26
what is a lipoma
neoplastic proliferation of fat
27
what is a sarcoma who does it occur in ix treatment
malignant soft tissue tumour arising from connective tissue 50-70s biopsy surgical reaction and adjacent chemo/radio
28
what is osteopaenia
intermediate stage of osteoporosis
29
3 points for cartilage | 3 for bone
semi rigid deformable, permeable, avascular | rigid, non permeable, cell surrounded by vessels
30
whats an osteon
functional unit of bone composed of lamella
31
what are harverson canals
carry vessels through bone
32
bone mineralisation involves what kind of crystals | what do osteoblasts secrete
calcium phosphate | osteoid
33
what bone is laid down after a break and what bone replaces it
woven | lamellar
34
CK levels 200-300x BL 20-30 x BL 2-5x BL
dystrophies like DMD, BMD, myotonic dystrophy inflam mypoathies - polymysitis, dermatomyositis neurogenic disorders
35
what are the changed in DMD at a cellular level
alterations in anchorage of acting cytoskeleton to basement membrane leading to uncontrolled calcium entry into cells which triggers the apatotic pathway
36
Signs of myotonic dystrophy
``` myotonia - inability to relax muscles after exercise cataracts frontal balding weakness in muscles obv ptosis - drooping of eyelids hatchet like face low intelligence atrophy of mostly type 1 fibres ```
37
neurogenic muscle disorders at a cellular level small angulated muscle fibres small round muscle fibres
adults | children
38
what happens in motor neurone disease and what does it lead to
progressive degeneration of anterior horn cells | uncontrollable twitching of muscles
39
why does myasthenia gravis occur
dysfunction of acetylcholinesterase - affects neuromuscular transmission
40
what are some of the signs of myasthenia gravis
``` drooping eyelids difficulty swallowing fatigue weakness thyoma or thymix hyperplasia muscle activity gets worse with activity and gets better with rest ```
41
what muscle does froments tests and what is it done in
adductor pollicus | cubital tunnel syndrome
42
what are the three causes of intoeing and investigations
femoral neck antiversion - hip rotational angle internal tibial torsion - foot shape, thigh-foot angle metatarsal adductus - banana shaped feet
43
What does the intermalleolar distance have to be at 11 year old to be referred
over 8cm
44
what are the symptoms of 0-3 months early post and causes
fever, drainage, warmth, effusion | SA, strep, enterococci
45
what are the symptoms at 3-24 months delayed low grade and the causes
persistent pain, device loosening, fistula | coag neg staph
46
>24 months have spread causes
SA, e.coli
47
what is the procedure of prophylaxis for prosthetic joint replacement
1st dose given 60 minutes before start of op 2 doses given within 24 hours after the surgery 1.2g of co-amoxiclav (PA co trimoxazole)
48
what is pseudo locking and when does it occur
stiffness after sitting | patellar dysfunction
49
what should not be given in medial epicondylitis and why
steroid injection - risk of injury to ulnar nerve
50
what does tibialis posterior tendon dysfunction lead to | where does it insert and what does it support
acquired flat foot medial navicular medial arch
51
what two things does hallux valgus cause and what is the treatment
bunion over first metacarpal joint rubbing of great and 2nd to a leads to ulcers and skin breakdown wider and deeper shoes spacer between the great toe and the 2nd toe
52
what is hallux rigidus and what is the treatment
OA of the 1st metatarsal joint | arthrodesis
53
neuroproxia axohotemesis neurotemesis
temp conduction block/demeylination resolves within 2 days nerve cell axon dies distally from point of injury - regenerates at 1mm/day nerve transected - surgery

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