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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
Q

effect of intrascapular Neck of Femur Fracture

A

leg is shortened and internally rotated

26
Q

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?

A

Medial collateral ligament, medial meniscus, PCL

27
Q

flexor digitorum profundus function

A

flexes the metacarpophalangeal (MCP) and distal interphalangeal (DIP) joints of the medial 4 fingers.

28
Q

what type of joint is the knee

A

synovial hinge joint

29
Q

What does a patients’ FRAX score measure?

A

10-year probability of experiencing a major osteoporotic fracture

30
Q

What range of results from her DEXA scan would be indicative of osteopenia?

A

Between -1 and -2.5

31
Q

osteoprotegrin function

A

However in the presence of OPG, Rank-ligand binds to OPG, so
blocks RANK-RANK formation- inhibits osteoclast activity preventing excessive bone resorption

32
Q

e.g of suture,gomphoses and syndesmoses

A

suture = junctions between skull bones
gomphoses =Peg and socket joints e.g. teeth
syndesmoses = connected by membranes E.g. between radius and ulnar

33
Q

what is bone matrix made up of

A

Bone matrix is made from mineral- calcium hydroxyapatite and
collagen protein.

34
Q

where do osteblasts and osteocytes originate from

A

osteoblasts = mesenchymal stem cells
osteocytes =Mesenchymal stem cell, derived from osteoblasts

35
Q

what is released in bone resorption

A

calcium and phosphate

36
Q

what regulates osteoblasts

A

cytokines and growth factors

37
Q

endochondral ossification

A
  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
Q

intramembranous ossification

A

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
Q

types of fracture

A

transverse
oblique
spiral
comminuted
segmental
avulsed
impacted
torus
greenstick

40
Q

3 stages of fracture healing

A

inflammation (0-7 days)
repair (2-3 weeks)
remodelling (months to years)

41
Q

haematoma formation

A

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
Q

fibrocartilaginous callus formation

A

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
Q

types of fracture fixation

A

Slings
* Casts and splints
* Extra-medullary devices à plates and screws
* Intra-medullary devices à nails
* External fixation

44
Q

what is osteoperosis

A

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
Q

osteomalacia

A

Softening of the bones that happens when mineralisation doesn’t happen
properly – deficiency in vit. D or calcium

46
Q

bone remodelling process

A

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
Q

segond fracture

A

small flake of bone pulled of lateral tibia

48
Q

FGF-23 function

A

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
Q

Which nerve innervates the triceps brachii?

A

radial nerve

50
Q

what nerve supplies the muscles that abduct the arm

A

the axillary nerve supplies the deltoid muscle which is a major abductor of the arm

51
Q

what catalyses purines to xanthanine to uric acide

A

purine oxidase

52
Q

what do pyrimidines breakdown into

A

C02 and NH3

53
Q

effects of high uric acid breakdown

A

kidney stones and gout crystals

54
Q

Allopurinol function

A

blocks action of xanthanine oxidase

55
Q

Woven bones def

A

having a disorganised structure, made
quickly in development and is temporary?

56
Q

muscles of thenar eminence.

A

OAF; Opponens pollicis (1), Abductor pollicis brevis (1), Flexor pollicis brevis (1)

57
Q

root of common peroneal

A

L5

58
Q

Where does gastrocnemius originate and insert on the posterior aspect of the lower
leg?

A

Origin - Condyles of the femur (accept medial/lateral) (1)
Insertion - Calcaneus

59
Q

Trendelenburg sign is produced by observing a positive unilateral pelvic drop. What nerve is affected by this?

A

superior gluteal

60
Q

what does superior gluteal nerve innervate

A

Gluteus medius and gluteus minimus

61
Q

what does Musculocutaneous nerve innervate

A

Biceps brachii (must say ‘brachii’) (1)
- Coracobrachialis (1)
- Brachialis

62
Q

Which levels of the spinal cord
are responsible for the ankle jerk reflex?

A

s1/2

extra (10 decks)

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