MSK Flashcards
1
Q
What is the painful arc syndrome?
A
Supraspinatous tendon injury, piain between 60-120 deg
2
Q
What is teres minor innervated by?
A
Axillary nerve
3
Q
What are supraspinatous and infraspinatous innervated by?
A
Suprascapular nerve
4
Q
What is teres major innervated by?
A
Lower subscapular
5
Q
What is lattissumus dorsi innervated by?
A
Thoracodorsal nerve
6
Q
What goes thru the quadrangular space of the axilla?
A
Axillary nerve
7
Q
What nerves are damaged in “erbs palsy”
A
C5, C6
8
Q
What nerves are damaged in ulnar claw?
A
Ulnar nerve
9
Q
Complications with hip fracture
A
Pneuomnia DVT/PE Pressure sores Infection Avascular necrosis
10
Q
Example of fibrous cartilage?
A
Between vertebrae = annulus fibrosus
TMJ
11
Q
What kind of cartilage joint is the pubic symphysis?
A
Fibrocartilagenous
12
Q
What components of hyaline cartilage allow it to be flexible and resilient to compressive forces and also rigid and high in tensile strength?
A
Proteoglycan = flexible and compressible Collagen = rigid and high tensile strength
13
Q
Synovial cartilage is immune privileged site, true or false?
A
True
14
Q
What disease is caused by dysfunction of hydrogen bonds holding collagen strands together?
A
Scurvy
15
Q
What type collagen is found in cartilage and skin?
A
2 - cartilage
1 - skin
16
Q
Chondrodysplasia syndrome is caused by defect in which collagen types?
A
9 and 11
17
Q
What is dysfunctional in ehler’s danlos syndrome?
A
Covalent cross links of collagen strands
18
Q
What is the function of hyaluronic acid?
A
Forms the back bone where aggregated proteoglycans can join to and become immobilise within the collagen matrix.
This allows proteoglycans to attract water while kept under restrain by collagen matrix thereby giving cartilage the properties of being compressible to act as a shock absorber
19
Q
What is a major cell type of connective tissue?
A
Fibroblasts
20
Q
What is the basic layout of connective tissue?
A
Extracellular matrix and cells
21
Q
Difference between unilocular and multilocular adipocyte
A
Single and multiple droplets of lipid
22
Q
What embryological cells do adipocytes come from?
A
Mesenchymal cells
23
Q
What defines the difference between soft loose and soft dense connective tissue?
A
Low and high collagen content
24
Q
Example of soft dense connective tissue?
A
Tendon and dermis
25
Where are reticular connective tissue found?
Liver, endocrine glands, lymph nodes, spleen
26
What is reticular connective tissue made of?
Network of fine collagen III fibres AKA reticulin
27
What kind of cartilage is the larynx made of
Elastic artilage
28
Which bursa is inflammed in "house maid's knees"?
Prepatellar bursa
29
What structures lie within the femoral triangle?
Femoral nerve
Femoral artery
Femoral vein
30
What muscle forms the base of the femoral triangle?
Pectineus and adductor longus
31
What forms the superior border of the femoral triangle?
Inguinal ligament
32
What forms the medial border of the femoral triangle?
Adductor longus
33
What forms the lateral border of the femoral triangle?
Sartorius muscle
34
What forms the roof of the femoral triangle?
Fascia lata
35
What is the arterial significance of the adductor hiatus
Transition of the femorall artery to the popliteal artery
36
What lies in the popliteal fossa?
Popliteal artery and vein
| Branches of sciatic nerve = common fibular and tibial nerve
37
Nerve root number of femoral nerve
L2-L4
38
Nerve root number of sciatic nerve
L4-S3
| L4 5 S1 2 3
39
Nerve root number of obturator nerve
L2-L4
40
Which portion of the leg does the common fibular nerve supply?
Lateral-anterior leg
41
Which nerve supplies the quadriceps?
Femoral nerve
42
Which ligament separates the sciatic notch?
Sacrospinous
43
Which nerve supplies pectineus?
Obturator nerve
44
Which nerve runs below piriformis?
Sciatic nerve
45
What are the branches of the popliteal artery
Anterior and posterior tibial
Posterior tibial gives off fibular artery branch
46
What branches does the internal iliac give off
Obturator and sup and inf gluteal
47
What is the route of the medial and lateral circimflex artery in the lower limb
Comes from profundus femoris which comes from femoral artery which comes frome external iliac
48
What supplies the knee?
Genicular branches of the popliteal artery
49
What is the drainage of the long saphenous vein?
Femoral vein
50
What is the drainage of the short saphenous vein?
Popliteal vein
51
What defines an intracapsular or extracapsular femoral fracture?
If the fracture is proximal or distal to the intertrochanteric line
52
What limits the extension of the hip joint?
Iliofemoral ligament
53
Movements of gluteus maximum?
Hip extenion
hip abduction
Hip lateral rotation
54
What gluteal muscles work to abduct the hip joint?
Piriformis
Gamellus superior
Obturator internus
Gamellus inferior
55
What does obturator internus do to the hip joint?
Lateral rotation
| Abduction
56
What muscles adduct the thigh?
Adductors (magnus, brevis, longus)
Pectineus
Gracilis
57
How does blood and innervation get to the femoral head?
Acetabular foramen
58
What are the 3 intrinsic ligaments of the femur
Iliofemoral ligament
Pubofemoral ligament
Ischiofemoral ligament
59
What artery lies within the ligament of the head of femur?
Acetabular branch of the obturator artery
60
What nerve supplies the gluteus maximus?
Inferior gluteal nerve
61
What nerve supplies gluteus minimus and medius
Superior gluteal nerve
62
What does the nerve to obturator internus supply
Obturator internus
| Gemellus superior
63
What does the nerve to quadratus femoris supply?
Quadratus femoris
| Gemellus inferior
64
What supplies piriformis?
Nerve to piriformis (S1 s2)
65
What nerve supplies pectineus?
Femoral nerve
66
What nerve supplies obturator externus?
Obturator nerve
67
What is trendelenburg's sign of?
Weak abductors
68
What is a feature of trendelenburg's sign?
Hip drops on non-weight bearing side i.e. Rises on weight bearing and injured side
69
Haversian systems are found in what type of bone?
Compact lamellar bone
70
What lies within a haversian canal?
Nerve and arteries
71
Describe the process of bone mineralisation
Osteoblasts secrete osteiod collagen
Hydroxyapatite is deposited and interacts with osteoid + proteoglycans + proteins to form mineralisd bone
72
What is necesary for bone mineralisation?
Osteoid collagen + hydroxyapatite + proteins + proteoglycans
73
What are 2 proteoglycans involved in bone mineralisation?
Chondroitin sulphate
| Keratan sulfate
74
What 2 proteins are necessary for bone mineralisation?
Osteocalcin and ostopontin
75
What secretes osteocalcin?
Osteoblasts
76
What is the function of osteocalcin?
Binds to hydroxyapatite, binds osteoblasts to bone matrix.
77
What are the 4 cell types present in bone?
Osteoprogenitor cells
Osteoblasts
Osteocytes
Osteoclasts
78
Function of osteoblasts
Secrete organic bone matrix = osteoid
79
What do osteoclasts secrete?
H+ and Cl- ions and cathepsin K protease.
80
What stimulates and inhibits osteoclast activity?
Parathyroid hormone stimulates it
Clacitonin inhibits it
81
What dysfunction is osteogenesis imperfecta characterised by?
Ossification defect
82
What are the 2 types of ossification called
Intramembranous
And
Endochondral
83
What is the process of intramembranous ossification?
Mesenchymal cells form membrane and differentiate into osteoblasts
Ossification center forms in membrane
Osteoblasts secrete osteoid
Mineralisation occurs, forming spicules
Osteoblasts become osteocytes as they mature and are trapped in matrix
Angiogenesis
Osteoid is laid down between spicules to fill up the space, forming trabeculae of woven bone
Woven bone forms collar then remodelled into haversian bone
Mesenchyme forms periosteum
Only outter layer of bone becomes compact/haversian bone
Inside persist as trebecular bone.
84
Describe endochondral ossification
Mesenchymal cells generate hyaline cartilage template
Perichondrium and periosteum form from chondroblasts
Bone collar forms (inside)
Chondrocyte proliferate to increase length of template
Cartilage template cavitates to make way for ossification
Primary ossification center forms in cavity
Primary ossification centers mature as more calcium is deposited
Bone grows as more chondrocytes proliferate
Capillaries penetrate periosteum and supply blood
Epiphyses are made from secondary ossification centers.
Osteoblasts form from osteoprogenitor cells
Osteoblasts secrete osteoid
Osteoid mineralises to form trabecullar bone
Trabecular bone fuses with bone collar
Secondary ossification center then ossifies to form epiphyses, while leaving hyaline cartilage on the ends of the bone as articular cartilage.
85
What bones form by intramembranous ossification?
Flat bones of skull
Mandible
Clavicle
86
What bones form from endochondral ossification?
Long bones
87
What does endochondral bone ossification begin with?
Hyaline cartilage template
88
Intramembranous ossification begins with chrondoblasts T or F?
F, they begin with osteoblasts
89
Early morning joint stiffness is a sign of what type of arthritis?
Inflammatory
90
Where does ankylosing spondylitis usually affect?
The spine
91
What forms in gout?
Monosodium urate crystals within joints
92
What nerve supplies tensor fascia lata?
Superior gluteal nerve
93
What artery supplies gemellus superior?
Inferior gluteal artery
94
What inserts into the lesser trochanter?
Psoas major
95
What inserts into the greater trochanter?
Obturator internus
Gemellus sup + inf
Piriformis
Glute med + min
96
Where does gluteus maximus insert into?
ITB and gluteal tuberosity of the femur
97
Where does quadratus femoris insert into?
Intertrochanteric crest
98
What causes hyperexcitable tetanic contractions?
Fall in extracellular calcium
99
What are 2 ways calcium is absorbed in the intestine?
Paracellular diffusion
Active transport, bound to calcium binding protein
100
What regulates the activity of calcium binding protein, active calcium absorption in the ddm and jjm?
Vitamin D
101
What stimulates distal tubule resorption of calcium?
Parathyroid hormone
102
What connects osteocytes to each other?
Canaliculi
103
3 hormones that regulate calcium concentration
PTH
Calcitriol AKA v1,25 DHCC
Calcitonin
104
What cells secrete PTH?
Chief cells in parathyroid gland
105
What is the main effect of PTH?
Stimulate plasma Ca2+ increase
106
What is the mechanism of action of PTH on bone?
Increase osteoclast activity
Decrease osteoblast synthesis of collagen
107
How does PTH act on the kidney?
PTH stimulates the distal tubule to resorb Ca2+
Also stimulates kidney to form 1,25 DHCC
108
How does PTH act on the intestine?
Indirectly thru stimulation of 1,25DHCC synthesis
109
How is 1,25 DHCC acquired?
Diet or UV mediated synthesis
110
Describe the process of making 1,25 DHCC
Vitamin D3 go to liver, acted on to form intermediate, which goes to kidney where it is converted to 1,25 DHCC (upregulated by PTH)
111
What is the main function of 1,25 DHCC
Stimulate intestinal absorption of calcium -> make CaBP
112
What effect does 1,25DHCC have on bones?
Stimulate PTH action to resorp bone
113
What is the nett effect of calcitonin?
Decrease plasma Ca2+
114
What makes calcitonin?
Parafollicular cells in thyroid gland
115
What is the mechanism of action of calcitonin?
Inhibit osteoclast activity
116
Calcitonin acts on the intestine to inhibit calcium resorption - T or F?
F, calcitonin has no effect on the intestine
117
Lack of estrogen has a ____ effect on bone resorption?
Increased
118
Mutation in 1,25 DHCC receptor gives rise to what disease?
Vitamin D dependent rickets type II
119
Osteomalacia results in (high)/(low) levels of 1,25 DHCC and (high)/(low) levels of ca2+ absorption?
High 1,25 DHCC but low ca2+ intestinal absorption
120
What is the most common cause of mild hypercalcaemia?
Hyperparathyroidism -> increases PTH secretion
121
Most common cause of severe hypercalcaemia?
Cancer
122
What is a possible cause of severe hypercalcaemia with low PTH?
Metastatic cells (not in bone) that secerete PTH-analogues, causing rise in calcium
123
What diseases cause
High pth low calcium
Pseudohypoparathyroidism = receptor dysfunction
2ndary hyperparathyroidism thru Vit D malabsorption in gut or decreased renal production of 1,25 DHCC.
124
What diseases cause
Low pth low calcium
Hypoparathyroidism
PTH-ineffective disorder
Chief cell dysfunction
Iatrogenic
125
What diseases cause
High pth high calcium
Hyperparathyroidism
Tumor
Hyperplastic growth of parathyroid glands
126
Which causes high calcium low PTH
Excessive dietary intake of calcium
127
How to calculate calcium phosphate product?
Multiply serum calcium x phosphate
128
Knee joint includes the femur, tibia, patella and fibula - T or F?
F, fibula is not in the knee joint
129
What muscles flex the knee joint?
```
Gracilis
Hamstrings
Sartorius
Gastrocnemius
Plantaris
```
130
What muscles extend the knee joint?
Quadriceps femoris
131
What muscle is found attached to the lateral side of the femure?
Popliteus
132
Which knee ligament is slack when flexed and tight when extended?
ACL
133
What is required for unlocking of the knee?
Popliteus - lateral rotation of femur
134
Which muscle is involved in eversion of the foot
Fibularis brevis
Fibularis longus
Fibularis tertius
135
Which nerve supplies the anterior leg muscles?
Deep fibular nerve
136
Which nerve supplies the posterior leg muscles?
Tibial nerve
137
Which artery supplies the anterior leg
Anterior tibial artery
138
Which artery supplies posterior leg
Posterior tibial artery
139
Which artery supplies the lateral leg?
Fibular artery
140
Which nerve runs along with the anterior tibial artery
Deep fibular nerve
141
3 parts of the lateral ligament of ankle joint
Anterior talofibular
Calcaneofibular
Posterior talofibular
142
What ligament is commonly injured in a "sprained ankle"
Lateral ligaments of the ankle
143
3 parts of the medial ankle ligaments
Tibionavicular
Tibiocalcaneal
Posterior tibiotalar
Anterior tibiotalar
144
What is the action of sartorius on the knee?
Flexion
145
What is the action of sartorius on the hip?
Flexion
