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2 TSM > MSK > Flashcards

MSK Flashcards

1
Q

What is the painful arc syndrome?

A

Supraspinatous tendon injury, piain between 60-120 deg

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2
Q

What is teres minor innervated by?

A

Axillary nerve

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3
Q

What are supraspinatous and infraspinatous innervated by?

A

Suprascapular nerve

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4
Q

What is teres major innervated by?

A

Lower subscapular

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5
Q

What is lattissumus dorsi innervated by?

A

Thoracodorsal nerve

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6
Q

What goes thru the quadrangular space of the axilla?

A

Axillary nerve

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7
Q

What nerves are damaged in “erbs palsy”

A

C5, C6

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8
Q

What nerves are damaged in ulnar claw?

A

Ulnar nerve

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9
Q

Complications with hip fracture

A 
Pneuomnia
DVT/PE
Pressure sores
Infection
Avascular necrosis
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10
Q

Example of fibrous cartilage?

A

Between vertebrae = annulus fibrosus

TMJ

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11
Q

What kind of cartilage joint is the pubic symphysis?

A

Fibrocartilagenous

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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
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13
Q

Synovial cartilage is immune privileged site, true or false?

A

True

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14
Q

What disease is caused by dysfunction of hydrogen bonds holding collagen strands together?

A

Scurvy

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15
Q

What type collagen is found in cartilage and skin?

A

2 - cartilage

1 - skin

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16
Q

Chondrodysplasia syndrome is caused by defect in which collagen types?

A

9 and 11

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17
Q

What is dysfunctional in ehler’s danlos syndrome?

A

Covalent cross links of collagen strands

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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

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19
Q

What is a major cell type of connective tissue?

A

Fibroblasts

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20
Q

What is the basic layout of connective tissue?

A

Extracellular matrix and cells

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21
Q

Difference between unilocular and multilocular adipocyte

A

Single and multiple droplets of lipid

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22
Q

What embryological cells do adipocytes come from?

A

Mesenchymal cells

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23
Q

What defines the difference between soft loose and soft dense connective tissue?

A

Low and high collagen content

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24
Q

Example of soft dense connective tissue?

A

Tendon and dermis

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25
Q

Where are reticular connective tissue found?

A

Liver, endocrine glands, lymph nodes, spleen

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26
Q

What is reticular connective tissue made of?

A

Network of fine collagen III fibres AKA reticulin

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27
Q

What kind of cartilage is the larynx made of

A

Elastic artilage

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28
Q

Which bursa is inflammed in “house maid’s knees”?

A

Prepatellar bursa

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29
Q

What structures lie within the femoral triangle?

A

Femoral nerve
Femoral artery
Femoral vein

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30
Q

What muscle forms the base of the femoral triangle?

A

Pectineus and adductor longus

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31
Q

What forms the superior border of the femoral triangle?

A

Inguinal ligament

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32
Q

What forms the medial border of the femoral triangle?

A

Adductor longus

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33
Q

What forms the lateral border of the femoral triangle?

A

Sartorius muscle

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34
Q

What forms the roof of the femoral triangle?

A

Fascia lata

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35
Q

What is the arterial significance of the adductor hiatus

A

Transition of the femorall artery to the popliteal artery

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36
Q

What lies in the popliteal fossa?

A

Popliteal artery and vein

Branches of sciatic nerve = common fibular and tibial nerve

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37
Q

Nerve root number of femoral nerve

A

L2-L4

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38
Q

Nerve root number of sciatic nerve

A

L4-S3

L4 5 S1 2 3

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39
Q

Nerve root number of obturator nerve

A

L2-L4

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40
Q

Which portion of the leg does the common fibular nerve supply?

A

Lateral-anterior leg

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41
Q

Which nerve supplies the quadriceps?

A

Femoral nerve

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42
Q

Which ligament separates the sciatic notch?

A

Sacrospinous

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43
Q

Which nerve supplies pectineus?

A

Obturator nerve

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44
Q

Which nerve runs below piriformis?

A

Sciatic nerve

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45
Q

What are the branches of the popliteal artery

A

Anterior and posterior tibial

Posterior tibial gives off fibular artery branch

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46
Q

What branches does the internal iliac give off

A

Obturator and sup and inf gluteal

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47
Q

What is the route of the medial and lateral circimflex artery in the lower limb

A

Comes from profundus femoris which comes from femoral artery which comes frome external iliac

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48
Q

What supplies the knee?

A

Genicular branches of the popliteal artery

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49
Q

What is the drainage of the long saphenous vein?

A

Femoral vein

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50
Q

What is the drainage of the short saphenous vein?

A

Popliteal vein

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51
Q

What defines an intracapsular or extracapsular femoral fracture?

A

If the fracture is proximal or distal to the intertrochanteric line

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52
Q

What limits the extension of the hip joint?

A

Iliofemoral ligament

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53
Q

Movements of gluteus maximum?

A

Hip extenion
hip abduction
Hip lateral rotation

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54
Q

What gluteal muscles work to abduct the hip joint?

A

Piriformis
Gamellus superior
Obturator internus
Gamellus inferior

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55
Q

What does obturator internus do to the hip joint?

A

Lateral rotation

Abduction

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56
Q

What muscles adduct the thigh?

A

Adductors (magnus, brevis, longus)

Pectineus
Gracilis

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57
Q

How does blood and innervation get to the femoral head?

A

Acetabular foramen

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58
Q

What are the 3 intrinsic ligaments of the femur

A

Iliofemoral ligament
Pubofemoral ligament
Ischiofemoral ligament

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59
Q

What artery lies within the ligament of the head of femur?

A

Acetabular branch of the obturator artery

60
Q

What nerve supplies the gluteus maximus?

A

Inferior gluteal nerve

61
Q

What nerve supplies gluteus minimus and medius

A

Superior gluteal nerve

62
Q

What does the nerve to obturator internus supply

A

Obturator internus

Gemellus superior

63
Q

What does the nerve to quadratus femoris supply?

A

Quadratus femoris

Gemellus inferior

64
Q

What supplies piriformis?

A

Nerve to piriformis (S1 s2)

65
Q

What nerve supplies pectineus?

A

Femoral nerve

66
Q

What nerve supplies obturator externus?

A

Obturator nerve

67
Q

What is trendelenburg’s sign of?

A

Weak abductors

68
Q

What is a feature of trendelenburg’s sign?

A

Hip drops on non-weight bearing side i.e. Rises on weight bearing and injured side

69
Q

Haversian systems are found in what type of bone?

A

Compact lamellar bone

70
Q

What lies within a haversian canal?

A

Nerve and arteries

71
Q

Describe the process of bone mineralisation

A

Osteoblasts secrete osteiod collagen

Hydroxyapatite is deposited and interacts with osteoid + proteoglycans + proteins to form mineralisd bone

72
Q

What is necesary for bone mineralisation?

A

Osteoid collagen + hydroxyapatite + proteins + proteoglycans

73
Q

What are 2 proteoglycans involved in bone mineralisation?

A

Chondroitin sulphate

Keratan sulfate

74
Q

What 2 proteins are necessary for bone mineralisation?

A

Osteocalcin and ostopontin

75
Q

What secretes osteocalcin?

A

Osteoblasts

76
Q

What is the function of osteocalcin?

A

Binds to hydroxyapatite, binds osteoblasts to bone matrix.

77
Q

What are the 4 cell types present in bone?

A

Osteoprogenitor cells
Osteoblasts
Osteocytes
Osteoclasts

78
Q

Function of osteoblasts

A

Secrete organic bone matrix = osteoid

79
Q

What do osteoclasts secrete?

A

H+ and Cl- ions and cathepsin K protease.

80
Q

What stimulates and inhibits osteoclast activity?

A

Parathyroid hormone stimulates it

Clacitonin inhibits it

81
Q

What dysfunction is osteogenesis imperfecta characterised by?

A

Ossification defect

82
Q

What are the 2 types of ossification called

A

Intramembranous

And

Endochondral

83
Q

What is the process of intramembranous ossification?

A

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
Q

Describe endochondral ossification

A

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
Q

What bones form by intramembranous ossification?

A

Flat bones of skull
Mandible
Clavicle

86
Q

What bones form from endochondral ossification?

A

Long bones

87
Q

What does endochondral bone ossification begin with?

A

Hyaline cartilage template

88
Q

Intramembranous ossification begins with chrondoblasts T or F?

A

F, they begin with osteoblasts

89
Q

Early morning joint stiffness is a sign of what type of arthritis?

A

Inflammatory

90
Q

Where does ankylosing spondylitis usually affect?

A

The spine

91
Q

What forms in gout?

A

Monosodium urate crystals within joints

92
Q

What nerve supplies tensor fascia lata?

A

Superior gluteal nerve

93
Q

What artery supplies gemellus superior?

A

Inferior gluteal artery

94
Q

What inserts into the lesser trochanter?

A

Psoas major

95
Q

What inserts into the greater trochanter?

A

Obturator internus
Gemellus sup + inf
Piriformis
Glute med + min

96
Q

Where does gluteus maximus insert into?

A

ITB and gluteal tuberosity of the femur

97
Q

Where does quadratus femoris insert into?

A

Intertrochanteric crest

98
Q

What causes hyperexcitable tetanic contractions?

A

Fall in extracellular calcium

99
Q

What are 2 ways calcium is absorbed in the intestine?

A

Paracellular diffusion

Active transport, bound to calcium binding protein

100
Q

What regulates the activity of calcium binding protein, active calcium absorption in the ddm and jjm?

A

Vitamin D

101
Q

What stimulates distal tubule resorption of calcium?

A

Parathyroid hormone

102
Q

What connects osteocytes to each other?

A

Canaliculi

103
Q

3 hormones that regulate calcium concentration

A

PTH

Calcitriol AKA v1,25 DHCC

Calcitonin

104
Q

What cells secrete PTH?

A

Chief cells in parathyroid gland

105
Q

What is the main effect of PTH?

A

Stimulate plasma Ca2+ increase

106
Q

What is the mechanism of action of PTH on bone?

A

Increase osteoclast activity

Decrease osteoblast synthesis of collagen

107
Q

How does PTH act on the kidney?

A

PTH stimulates the distal tubule to resorb Ca2+

Also stimulates kidney to form 1,25 DHCC

108
Q

How does PTH act on the intestine?

A

Indirectly thru stimulation of 1,25DHCC synthesis

109
Q

How is 1,25 DHCC acquired?

A

Diet or UV mediated synthesis

110
Q

Describe the process of making 1,25 DHCC

A

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
Q

What is the main function of 1,25 DHCC

A

Stimulate intestinal absorption of calcium -> make CaBP

112
Q

What effect does 1,25DHCC have on bones?

A

Stimulate PTH action to resorp bone

113
Q

What is the nett effect of calcitonin?

A

Decrease plasma Ca2+

114
Q

What makes calcitonin?

A

Parafollicular cells in thyroid gland

115
Q

What is the mechanism of action of calcitonin?

A

Inhibit osteoclast activity

116
Q

Calcitonin acts on the intestine to inhibit calcium resorption - T or F?

A

F, calcitonin has no effect on the intestine

117
Q

Lack of estrogen has a ____ effect on bone resorption?

A

Increased

118
Q

Mutation in 1,25 DHCC receptor gives rise to what disease?

A

Vitamin D dependent rickets type II

119
Q

Osteomalacia results in (high)/(low) levels of 1,25 DHCC and (high)/(low) levels of ca2+ absorption?

A

High 1,25 DHCC but low ca2+ intestinal absorption

120
Q

What is the most common cause of mild hypercalcaemia?

A

Hyperparathyroidism -> increases PTH secretion

121
Q

Most common cause of severe hypercalcaemia?

A

Cancer

122
Q

What is a possible cause of severe hypercalcaemia with low PTH?

A

Metastatic cells (not in bone) that secerete PTH-analogues, causing rise in calcium

123
Q

What diseases cause

High pth low calcium

A

Pseudohypoparathyroidism = receptor dysfunction

2ndary hyperparathyroidism thru Vit D malabsorption in gut or decreased renal production of 1,25 DHCC.

124
Q

What diseases cause

Low pth low calcium

A

Hypoparathyroidism

PTH-ineffective disorder
Chief cell dysfunction
Iatrogenic

125
Q

What diseases cause

High pth high calcium

A

Hyperparathyroidism

Tumor

Hyperplastic growth of parathyroid glands

126
Q

Which causes high calcium low PTH

A

Excessive dietary intake of calcium

127
Q

How to calculate calcium phosphate product?

A

Multiply serum calcium x phosphate

128
Q

Knee joint includes the femur, tibia, patella and fibula - T or F?

A

F, fibula is not in the knee joint

129
Q

What muscles flex the knee joint?

A 
Gracilis
Hamstrings
Sartorius
Gastrocnemius
Plantaris
130
Q

What muscles extend the knee joint?

A

Quadriceps femoris

131
Q

What muscle is found attached to the lateral side of the femure?

A

Popliteus

132
Q

Which knee ligament is slack when flexed and tight when extended?

A

ACL

133
Q

What is required for unlocking of the knee?

A

Popliteus - lateral rotation of femur

134
Q

Which muscle is involved in eversion of the foot

A

Fibularis brevis
Fibularis longus
Fibularis tertius

135
Q

Which nerve supplies the anterior leg muscles?

A

Deep fibular nerve

136
Q

Which nerve supplies the posterior leg muscles?

A

Tibial nerve

137
Q

Which artery supplies the anterior leg

A

Anterior tibial artery

138
Q

Which artery supplies posterior leg

A

Posterior tibial artery

139
Q

Which artery supplies the lateral leg?

A

Fibular artery

140
Q

Which nerve runs along with the anterior tibial artery

A

Deep fibular nerve

141
Q

3 parts of the lateral ligament of ankle joint

A

Anterior talofibular
Calcaneofibular
Posterior talofibular

142
Q

What ligament is commonly injured in a “sprained ankle”

A

Lateral ligaments of the ankle

143
Q

3 parts of the medial ankle ligaments

A

Tibionavicular
Tibiocalcaneal
Posterior tibiotalar

Anterior tibiotalar

144
Q

What is the action of sartorius on the knee?

A

Flexion

145
Q

What is the action of sartorius on the hip?

A

Flexion

2 TSM (3 decks)

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