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msk extra Flashcards

1
Q

What are the nerve roots of the sciatic nerve?

A

L4-S3

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2
Q

What cell lineage are osteoclasts derived from?

A

Haematopoietic Stem Cells

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3
Q

What type of growth does the skeleton undergo?

A

Appositional Growth

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4
Q

diff between ligament and tendon

A

tendons connect muscle to bone
higher collagen 1
little elastin
organised fibres

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5
Q

muscles of rotator cuff

A

Supraspinatus
Infraspinatus
Teres minor
Subscapularis

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6
Q

what provides bone stiffness

A

mineral

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7
Q

brachial plexus roots

A

C5 - T1

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8
Q

cytokine expressed by osteoblasts that stimulates osteoclast action, and hence bone resorption

A

RANK-L

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9
Q

What bones are formed by intramembranous ossification?

A

flat bones of the skull, the clavicles and most of the cranial bones.

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10
Q

What does Endochondral ossification form

A

remainder of the axial skeleton and the appendicular skeleton.

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11
Q

what nerve affected by a mid shaft humerus fracture

A

radial nerve - causing wrist drop, as it innervates triceps brachii and the extensor muscles in the forearm

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12
Q

innervation of biceps brachii

A

musculocutaneous nerve (C5-C7)

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13
Q

root of axillary nerve

A

C5 and C6

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14
Q

root radial nerve

A

C5 - T1

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15
Q

root of ulnar nerve

A

C8 - T1

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16
Q

root of median nerve

A

C6 - T1

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17
Q

sensory distribution of the median nerve?

A

Palmar surface of the lateral side of the hand. Palmar surface of the lateral 3½ digits. The skin over the dorsum of the distal phalanges of the lateral 3½ digits.

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18
Q

radial nerve sensory nerve distribution

A

dorsal surface of the lateral side of the hand. Skin over the dorsum of the lateral 3½ digits as far as the distal interphalangeal joint.

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19
Q

Ulnar nerve sensory nerve distribution

A

palmar and dorsal surface of the medial side of the hand and the medial 1½ digits.

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20
Q

which muscles travel through the carpal tunnel?

A

flexor digitorium superficialis, flexor digitorum longus, flexor pollicis longus and median nerve

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21
Q

osteoblast function

A

secretes osteoid that gets mineralised and builds bone

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22
Q

lachman’s test function

A

test for acl damage

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23
Q

types of joints

A

hinge, pivot, plane, ball and socket, condyloid, saddle

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24
Q

muscle spindle function

A

sense how much a muscle is stretched

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25
effect of intrascapular Neck of Femur Fracture
leg is shortened and internally rotated
26
two foot slide tackle to the lateral aspect of rob’s knee was appropriate punishment. Rob sustained an unhappy triad injury, classically what injuries are involved in this triad?
Medial collateral ligament, medial meniscus, PCL
27
flexor digitorum profundus function
flexes the metacarpophalangeal (MCP) and distal interphalangeal (DIP) joints of the medial 4 fingers.
28
what type of joint is the knee
synovial hinge joint
29
What does a patients’ FRAX score measure?
10-year probability of experiencing a major osteoporotic fracture
30
What range of results from her DEXA scan would be indicative of osteopenia?
Between -1 and -2.5
31
osteoprotegrin function
However in the presence of OPG, Rank-ligand binds to OPG, so blocks RANK-RANK formation- inhibits osteoclast activity preventing excessive bone resorption
32
e.g of suture,gomphoses and syndesmoses
suture = junctions between skull bones gomphoses =Peg and socket joints e.g. teeth syndesmoses = connected by membranes E.g. between radius and ulnar
33
what is bone matrix made up of
Bone matrix is made from mineral- calcium hydroxyapatite and collagen protein.
34
where do osteblasts and osteocytes originate from
osteoblasts = mesenchymal stem cells osteocytes =Mesenchymal stem cell, derived from osteoblasts
35
what is released in bone resorption
calcium and phosphate
36
what regulates osteoblasts
cytokines and growth factors
37
endochondral ossification
1. in utero mesenchymal stem cells become chondroblasts 2. chondroblasts secrete ECM and becomne trapped becoming chondrocytes, perichondrium forms around cartilage 3. chondrocytes hypertrophy and burst - releasing contents that trigger calcification 4. calcification forms small cavities for osteoblasts to move into 5. osteoblasts deposit new bone into the diaphysis forming bone collar 6. bone collar prevents nutrients from diffusing into cartilage leading to chondrocyte death 7. there are increased cavities and osteogenesis continues, forming the primary ossification centre in shaft. Cartilage forms above and below 8. after birth the secondary ossification centre develops from osteogenic cells in the end
38
intramembranous ossification
1.condensation of mesenchymal cells into a flat sheet - forms straight into bone 2. osteoblast precursos form on surface and differentiate into mature active osteoblasts 3. osteoid formation traps osteoblasts in new trabecular bone matrix - osteocytes > mineralisation 4. compact bone develops above and blood vessels enter trabecular bone
39
types of fracture
transverse oblique spiral comminuted segmental avulsed impacted torus greenstick
40
3 stages of fracture healing
inflammation (0-7 days) repair (2-3 weeks) remodelling (months to years)
41
haematoma formation
Blood vessels in the broken bone tear and haemorrhage * This results in clotted blood (haematoma) at the break site * The severed blood vessels are sealed by the clotting process * Bone cells deprived of nutrients begin to die à osteocytes
42
fibrocartilaginous callus formation
Within days capillaries grow into the haematoma * Phagocytic cells begin to clear away the dead cells * Fibroblasts and osteoblasts enter and begin to reform bone * Fibroblasts produce collagen fibres that connect the broken bone ends, while osteoblasts start to form spongy bone * The repair tissue between broken ends (the fibrocartilaginous callus) is formed of both hyaline and fibrocartilage * Some bone spicules may appear at this point
43
types of fracture fixation
Slings * Casts and splints * Extra-medullary devices à plates and screws * Intra-medullary devices à nails * External fixation
44
what is osteoperosis
Bones become brittle and fragile from a loss of tissue and reduced mineralisation due to increased resorption rates compared to formation (dexa scan below -2.5)
45
osteomalacia
Softening of the bones that happens when mineralisation doesn’t happen properly – deficiency in vit. D or calcium
46
bone remodelling process
Activation - Pre-osteoclasts are attracted to the remodelling sites, activated by RANK ligand produced by osteoblasts Pre-osteoclasts fuse to form multinucleated osteoclasts Resorption - Osteoclasts dig out a cavity (resorption pit) in spongy bone or burrow a tunnel in compact bone by releasing acids and cathepsin K Calcium can be released into the blood for use in various body functions Osteoclasts disappear Reversal - Mesenchymal stem cells appear along the burrow or pit They then proliferate and differentiate into pre-osteoblasts Formation - Then mature into osteoblasts at the surface of the burrow or pit And release osteoid at the site, forming a new soft non-mineralised matrix The new matrix is then mineralised with calcium and phosphorus Quiescence - The site, with resting lining cells, remains dormant until the next cycle. Osteoprotegerin mops up any RANK ligands to prevent
47
segond fracture
small flake of bone pulled of lateral tibia
48
FGF-23 function
Decreases phosphate * Decreases 1-alpha hydroxylation of vitamin D which overall decreases its affects including gut absorption of phosphate * Decreases expression of Na+ transporter in the renal tubules which overall increases renal excretion of phosphate * Cannot work without klotho
49
Which nerve innervates the triceps brachii?
radial nerve
50
what nerve supplies the muscles that abduct the arm
the axillary nerve supplies the deltoid muscle which is a major abductor of the arm
51
what catalyses purines to xanthanine to uric acide
purine oxidase
52
what do pyrimidines breakdown into
C02 and NH3
53
effects of high uric acid breakdown
kidney stones and gout crystals
54
Allopurinol function
blocks action of xanthanine oxidase
55
Woven bones def
having a disorganised structure, made quickly in development and is temporary?
56
muscles of thenar eminence.
OAF; Opponens pollicis (1), Abductor pollicis brevis (1), Flexor pollicis brevis (1)
57
root of common peroneal
L5
58
Where does gastrocnemius originate and insert on the posterior aspect of the lower leg?
Origin - Condyles of the femur (accept medial/lateral) (1) Insertion - Calcaneus
59
Trendelenburg sign is produced by observing a positive unilateral pelvic drop. What nerve is affected by this?
superior gluteal
60
what does superior gluteal nerve innervate
Gluteus medius and gluteus minimus
61
what does Musculocutaneous nerve innervate
Biceps brachii (must say ‘brachii’) (1) - Coracobrachialis (1) - Brachialis
62
Which levels of the spinal cord are responsible for the ankle jerk reflex?
s1/2

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