MSK Flashcards
1
Q
What is the axial skeleton?
A
The bones of the head, neck and trunk.
2
Q
What is the appendicular skeleton?
A
The bones of the limbs, including the pectoral and pelvic girdles.
3
Q
How many bones make up the adult skeleton?
A
206 bones (not including accessory bones)
4
Q
What is the main function of the axial skeleton?
A
To protect the bodys vulnerable and vital organs e.g. brain, spinal cord, heart and lungs.
5
Q
What is the main function of the appendicular skeleton?
A
To provide the body with mobility.
6
Q
Name three of the six main functions of bone.
A
Support Protection Movement Haemopoiesis (red marrow) Mineral storage (bone matrix) Lipid storage in emergencies (yellow marrow)
7
Q
How are bones classified?
A
According to their shape.
8
Q
What the five classifications of bones?
A
Long Short Flat Irregular Sesamoid
9
Q
What is periosteum?
A
A fibrous connective tissue covering a bone.
10
Q
In a long bone, you will find two different kinds of bone. What are these?
A
Compact Bone Spongy bone (also known as trabecular or cancellous bone)
11
Q
Some bones do not have a central mass of spongy bone. In these cases, what is the spongy bone replaced by?
A
A medullary cavity.
12
Q
Briefly describe a long bone and give an example
A
A long bone is tubular in shape and, as the name suggests, longer than it is wide e.g. the humerus.
13
Q
Briefly describe a short bone and give two examples.
A
They are cuboidal in shape. The tarsal bones and carpal bones are short bones.
14
Q
What is the usual purpose of a flat bone? Give an example.
A
Flat bones usually serve a protective function e.g. the cranial bones.
15
Q
What sort of bones will you mainly find in the face?
A
Irregular bones.
16
Q
Name a sesamoid bone and describe the function of a sesamoid bone.
A
The patella is a sesamoid bone and it protects the tendons in the knee from excessive wear and tear.
17
Q
Why do we have surface markings on bones?
A
They provide sites of attachment for fascia, ligaments, tendons or aponeuroses.
18
Q
When do surface markings appear on bones?
A
They appear at puberty and become more obvious through adult life. They are not present at birth.
19
Q
What is a tuberosity?
What is a tubercle?
A
A tuberosity is a rounded elevation. A tubercle is a smaller version of a tuberosity.
20
Q
What is a spine or spinous process?
A
A slender projection on the bone.
21
Q
What is a crest or ridge on a bone?
A
An elevated line or ‘ridge’ across the bone.
22
Q
What is a trochanter?
A
A large projection of the femur.
23
Q
What is a condyle?
What is an epicondyle?
A
A condyle is a large prominence or rounded surface.
An epicondyle is a smaller prominence on or above a condyle.
24
Q
What is a facet?
A
A smooth, flat area where a bone articulates with another bone. It is usually covered with cartilage.
25
What is a fossa?
A hollow or depressed area on a bone.
26
What is a foramen?
A hole or opening in a bone.
27
What is a meatus?
A tunnel or canal in a bone.
28
What is a sinus?
A hollow space in a bone.
29
What is a notch?
A large groove or indentation at the edge of a bone.
30
What is a capitulum?
A small, round, articular head on a bone.
31
What is a trochlea?
A spool-like articular process of a bone.
32
What is a joint?
Where 2 or more bones meet/articulate.
33
What are the two methods of bone development?
Intramembranous ossification and endochondral ossification.
34
What is intramembranous ossification?
Intramembranous ossification is when the bone forms straight from fibrous membrane rather than from cartilage.
35
How do long bones form? (2 word answer)
Endochondral Ossification
36
Explain where primary and secondary ossification centres form in endochondral ossification.
Primary ossification centres form in the diaphysis (the shaft of the bone), laying down more bone from the middle outwards. More secondary ossification centres appear later in the epiphyses.
37
Why do epiphyseal growth plates form?
Epiphyseal growth plates form between the diaphysis and the epiphyses as the bone formed by these separate ossification centres will not fuse.
38
What is an accessory bone?
These develop when additional ossification centres appear and form extra bones. Accessory bones are common in the foot.
39
Briefly describe how a fracture heals.
First, the bones are brought back together (reduction of the fracture). The fibroblasts then secrete collagen to form a callus, holding the bones together. Bone remodelling occurs and the callus calcifies to produce woven bone. Eventually, the bone is remodelled to form linear bone again.
40
What is osteoporosis?
When bones become brittle, usually with old age, making them more prone to fracture.
41
What is avascular necrosis?
Loss of arterial supply to an epiphysis or other part of a bone resulting in death of bone tissue.
42
How are joints classified?
Based on their structure and movements (or lack of) that they exhibit.
43
What are the 3 main types of joint?
Fibrous, Cartilaginous and Synovial.
44
What are the three types of fibrous joints (synarthroses)?
Syndesmoses, Sutures and Gomphoses.
45
What is a suture?
A type of fibrous joint found between the bones of the skull. Movement is very limited and the bones are joined with fibrous tissue.
46
What is a gomphosis?
A type of fibrous joint found where the teeth articulate with the maxillae and the mandible. There is minimal movement and mobility of this joint indicates a pathological state affecting the periodontal ligament.
47
What is a syndesmosis?
A type of fibrous joint where the bones are held together by a fibrous membrane such as the interosseous membrane in the forearm.
48
What are the two types of cartilaginous joints?
Synchondroses (primary) and Sympheses (secondary).
49
What is a primary cartilaginous joint (synchondrosis)?
The bones are joined by hyaline cartilage and there is little or no movement e.g. sterno-costal joints.
50
What is a secondary cartilaginous joint (symphesis)?
It is a strong, slightly moveable joing united by fibrous cartilage e.g. the discs of the spine
51
What is another name for a synovial joint?
Diarthrosis.
52
What is the structure of a synovial joint?
The bones of the joint are united by an articular capsule (composed of a fibrous layer lined by a serous membrane) spanning and enclosing the articular cavity. The joint cavity contains synovial fluid.
53
What are the six types of synovial joints?
```
Hinge
Saddle
Pivot
Ball and Socket
Condyloid
Plane
```
54
What is a hinge joint?
A joint that permits only flexion and extension e.g. elbow
55
What is a saddle joint?
A joint with concave and convex joint surfaces that permits abduction, adduction, flexion and extension e.g. carpo-metacarpal joint.
56
What is a pivot joint?
A joint that allows rotation e.g. the atlanto-axial joint in the neck.
57
What is a condyloid joint?
A joint that permits flexion, extension, adduction, abduction and circumduction e.g. metacarpo-phalangeal joints.
58
What is a ball and socket joint?
A joint that permits movement in several axis and where a rounded head fits into a concave socket e.g. shoulder (gleno-humeral) joint.
59
What is a plane joint?
A joint where sliding movements are permitted e.g. acromioclavicular joint.
60
What three main factors does the stability of a joint depend on?
The shape, size and arrangement of articular surfaces.
61
How do ligaments help to stabilise a joint?
Ligaments prevent excessive movement by pulling the bones together.
62
Apart from ligaments, name another structure that helps to keep a joint stable.
The muscles attached to the bones of the joint.
63
How do joints receive blood?
From the articular arteries that arise from the vessels around the joint.
64
What is Hilton's Law?
Hilton's Law states that the nerves supplying a joint also supply the muscles moving the joint and the skin covering their distal attachments.
65
What is proprioception?
Awareness of movement and position of the parts of the body.
66
How are ligaments prone to damage?
Because of excessive stretching.
67
Describe the anatomical position.
Head, gaze and toes directed forward.
Arms adjacent to the sides with the palms facing forward.
Lower limbs close together with the feet parallel.
68
There are four anatomical planes. Name them.
Median, Sagittal, Coronal and Transverse.
69
What is the median anatomical plane?
The vertical plane dividing the body into right and left halves. It defines the idline of the head, neck and trunk.
70
What is a sagittal plane?
Any vertical plane running parallel to the median plane
71
What is a coronal plane?
Any vertical plane running at a right angle to the median plane, dividing the body into anterior and posterior.
72
What is a transverse plane?
Any horizontal plane running at a right angle to the median and frontal planes, dividing the body into superior and inferior.
73
How many sagittal, transverse and coronal planes are there?
THERE IS AN UNLIMITED NUMBER.
74
What is a longitudinal section?
A section running parallel to the long axis of a part of the body.
75
What is a transverse section?
A cross section of a part of the body cut at a right angle to any of its parts. For example, because the foot's longitudinal axis runs from posterior to anterior, the transverse section lies in the coronal plane.
76
What is an oblique section?
A 'slice' of the body cut at an angle that does not fit one of the anatomical planes.
77
What does superior/inferior refer to?
Superior means nearer the topmost point of the cranium, inferior means nearer the sole of the foot.
78
What does cranial/caudal refer to?
Cranial means nearer to the cranium, caudal means nearer to the 'tail bone' or coccyx.
79
What does posterior/anterior refer to?
Posterior means nearer to the back of the body, anterior means nearer to the front of the body.
80
What does dorsal/ventral refer to?
Dorsal means the back surface of the body, ventral means the front surface of the body.
81
What does rostral mean?
It is used when describing the brain and it means nearer to the anterior part of the head i.e. the face.
82
What does medial/lateral refer to?
Medial means nearer to the median plane of the body. Lateral means further away from the median plane of the body.
83
What are the dorsal and palmar surfaces of the hand?
The dorsal surface is the posterior part of the hand, the palmar surface is the palm of the hand.
84
What are the dorsal and plantar surfaces of the foot?
The dorsal surface is the top of the foot, the plantar surface is the sole of the foot.
85
What do the terms superficial, intermediate and deep describe?
The position of structures relative to the surface of the body. Superficial is the closest to the surface.
86
What does external/internal refer to?
External means further from the centre of the organ or cavity, internal means inside or closer to the centre, independent of direction.
87
What does proximal/distal mean?
These terms are used when referring to positions on a limb or similar structure. Proximal means closer to the attachment point of the limb, distal means further away.
88
What is flexion?
Bending at the joint.
89
What is extension?
Straightening out at the joint.
90
What is dorsiflexion?
Flexion at the ankle joint, lifting the toes off the ground.
91
What is plantarflexion?
Flexion at the ankle joint where you point the toes towards the ground.
92
What is adduction?
Moving towards the median plane.
93
What is abduction?
Moving away from the median plane.
94
What is adduction/abduction of the fingers?
Moving the fingers together/apart.
95
What is adduction of the fingers?
Moving the fingers together.
96
When it comes to the thumb, explain:
a) abduction & adduction
b) flexion & extension
c) Opposition and reposition.
a) Abduction is moving it anteriorly, adduction is moving it posteriorly, back in line with the other digits.
b) Flexion is flexing the thumb in a medial direction across the palm, extension is moving it in a lateral direction away from the palm.
c) Opposition is moving the thumb to meet the little finger, reposition is returning the thumb to its normal position.
97
What is circumduction?
A circular movement involving sequential flexion, abduction, extension, adduction (or in reverse order).
98
What is elevation/depression of the shoulders?
Elevation is moving them superiorly, depression is moving them inferiorly (down).
99
What is pronation/supination of the forearm?
Pronation is rotating the forearm so the palm faces down, supination is the reverse (so the palm faces up).
100
What is medial/lateral rotation?
Medial rotation is rotating the bone towards the midline. Lateral rotation is rotating the bone away from the midline.
101
Muscles are classified according to their shape. Name some types of muscle shapes.
Flat, pennate, fusiform, convergent, quadrate, circular or multi-headed.
102
There are four different muscle groups, each with a different function. One is "agonist". Name the other three.
Antagonist
Synergist
Fixator.
103
What is an agonist muscle?
The main muscle responsible for a certain movement.
104
What is an antagonist muscle?
The muscle that opposes the action of the agonist.
105
What is a synergist muscle?
A muscle that assists an agonist.
106
What is a fixator muscle?
A muscle that steadies the action of the agonist and stabilises it.
107
What are the two main types of muscle contraction?
Isotonic and Isometric.
108
What is isotonic contraction?
Isotonic contraction is when the muscle changes length and moves the load e.g. flexion at the elbow to lift something is caused by contraction of the biceps brachialis, brachialis and the brachioradialis. Concentric means shortening muscle, eccentric means extending muscle.
109
What is isometric contraction?
Constant length and variable tension of the muscle when contracting e.g. gripping something.
110
What are the three types of muscle fibres?
Type I, Type IIa and Type IIb
111
What are the main differences between Type I, Type IIa and Type IIb muscle fibres?
```
Type I (slow oxidative) are aerobic, so are red in colour with many mitochondria, hight myoglobin levels and a rich capillary supply. They are fatigue resistant e.g. posture.
Type IIa (fast oxidative) are also aerobic so have high myoglobin levels, many mitochondria and a rich capillary supply. They are a red/pink colour and are moderately fatigue resistant e.g. walking.
Type IIb (fast glycolytic) are anaerobic so have low myoglobin levels, a poor capillary supply and few mitochondria. They are pale/white in colour and fatigue rapidly e.g. short intense movements.
```
112
What is 'cross talk'?
Signalling molecules communicating between nerve and muscle. Atrophy of a nerve can lead to atrophy of the corresponding muscle.
113
What is hypotonia?
Degeneration of the muscle due to damage such as lesion of lower motor neurons.
114
What is recruitment (concerning nerves)?
Spatial Summation. More motor neurones are activated so more muscle fibres recruited to develop more force.
115
What is temporal summation?
Increased frequency of action potentials causes the threshold to be reached and the muscle to contract.
116
What are the four sources of energy for contraction?
1. Short term stores of ATP in muscle fibre
2. Phosphorylation of ADP by creatine phosphate
3. Anaerobic Glycolysis
4. Aerobic respiration
117
What is meant by excitation-contraction coupling?
The conversion of an electrical stimulus into a mechanical response in the muscle.
118
When is axillary clearance (of lymphnodes) usually used as a treatment?
In patients with breast cancer when it is suspected that the cancer has spread to the lymphnodes.
119
During axillary clearance, which nerve is most at risk to be damaged?
Long thoracic nerve
120
From which roots does the long thoracic nerve arise?
C5, C6 and C7
121
How does paralysis to the long thoracic nerve present and why?
It presents as "winged scapula". The scapula protrudes from the thoracic wall due to paralysis of the serratus anterior muscle.
122
How do you test for winged scapula?
Ask the patient to push their outstretched arms against a wall.
123
How does limb development begin?
The activation of the mesenchyme within the somatic layer of the lateral mesoderm.
124
Where does the limb skeleton form from?
The somatic mesoderm.
125
What does the limb musculature form from?
The somites.
126
When do limb buds appear and what are they?
Limb buds appear towards the end of week 4. They are small projections on the lateral body wall. The lower limb buds form about 2 days after the upper limb buds.
127
In which direction does limb development begin?
the limbs extend ventrally.
128
What do the limb buds consist of?
They consist of a mass of mesenchyme covered
129
What is meant by excitation-contraction coupling?
The conversion of an electrical stimulus into a mechanical response in the muscle.
130
When is axillary clearance (of lymphnodes) usually used as a treatment?
In patients with breast cancer when it is suspected that the cancer has spread to the lymphnodes.
131
During axillary clearance, which nerve is most at risk to be damaged?
Long thoracic nerve
132
From which roots does the long thoracic nerve arise?
C5, C6 and C7
133
How does paralysis to the long thoracic nerve present and why?
It presents as "winged scapula". The scapula protrudes from the thoracic wall due to paralysis of the serratus anterior muscle.
134
How do you test for winged scapula?
Ask the patient to push their outstretched arms against a wall.
135
How does limb development begin?
The activation of the mesenchyme within the somatic layer of the lateral mesoderm.
136
Where does the limb skeleton form from?
The somatic mesoderm.
137
What does the limb musculature form from?
The somites.
138
When do limb buds appear and what are they?
Limb buds appear towards the end of week 4. They are small projections on the lateral body wall. The lower limb buds form about 2 days after the upper limb buds.
139
In which direction does limb development begin?
the limbs extend ventrally.
140
What do the limb buds consist of?
They consist of a mass of mesenchyme covered
