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Musculoskeletal and Connective Tissue > Muscles, Cartilage, and Bone > Flashcards

Muscles, Cartilage, and Bone Flashcards

0
Q

Type I Skeletal Muscle

A

Slow, red, oxidative
Slow, continuous contractions over prolonged periods
Many MT and myoglobin
Aerobic oxidative phosphorylation of FAs

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1
Q

Skeletal Muscle (Structure)

A

Large, elongated multinucleated fibers

Primary growth is hypertrophy

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2
Q

Type IIa Skeletal Muscle

A

Fast, intermediate, oxidative-glycolytic
MT and myoglobin, AND glycogen
Oxidative AND anaerobic glycolysis

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3
Q

Type IIb Skeletal Muscles

A 
Fast, white, glycolytic
Rapid contraction, fast-fatigue
Usually small muscles, with large #  of NMJs
Few MT and myoglobin
Abundant Glycogen
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4
Q

Smooth Muscle

A

Grouped, mononucleated fusiform cells
Weak, rhythmic, involuntary contractions
Lack striations
Hypertrophy AND hyperplasia

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5
Q

Cardiac Muscle

A 
Irregular branched cells, central nuclei (sometimes 2)
Striated
Intercalated disks
Strong, involuntary contractions
CanNOT regenerate, can ONLY hypertrophy
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6
Q

List the structure of muscle from smallest to largest

A

Myofilament–> sarcomere–> myofibril–> muscle cell–> muscle fiber–> muscle fasciculus–> whole muscle

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7
Q

Myofibrils

A

Functional component of contraction

Composed of repeating units of sarcomeres

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8
Q

Myofilaments

A

Thick and thin
Thick: myosin filaments
Think: actin filaments

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9
Q

What makes the striated appearance of skeletal muscle?

A

Z-lines: alpha-actinin that borders sarcomeres

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10
Q

Which bands in the sarcomere shorten?

A

H
I
Z

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11
Q

How does Tetanus happen?

A

If muscle fiber stimulated continuously–> do not allow enough time to reaccumulate Ca in SR–> sustained high Ca in cytoplasm–> sustained muscle contraction

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12
Q

What determines the maximum force or tension a muscle can produce?

A

Tension: proportional to number of cross-bridges formed and that could be formed
Force and Tension: length of muscle

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13
Q

What acts as the cross-bridge gatekeeper in smooth muscle?

A

Calmodulin

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14
Q

How do smooth muscle cells maintain tonic tension? Does this require extra ATP?

A

When Ca2+ decreases, myosin is de-P –> de-P can still interact w/ Latch-Bridges
Does NOT require ATP

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15
Q

What are Latch-Bridges?

A

Residual attachments that allow for maintenance of tonic tension in smooth muscle
Do NOT require ATP

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16
Q

What stimulates/inhibits Glycogen Synthase and Glycogen Phosphorylase?

A

Glycogen Synthase: Stimulated by increased levels of glycogen substrates (Glu-1-P)
Glycogen Phosphorylase: inhibited by products of glycolysis (Glu-6-P) and ATP

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17
Q

What does Insulin lead to in the the liver?

A

Depresses gluconeogenesis and increases glycogen production

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18
Q

What does insulin do in skeletal muscle?

A

Increases glucose transport into cells–> metabolic pathways–> ATP

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19
Q

What does decrease in Insulin lead to in liver/muscles/adipose tissue?

A

Liver: mobilizes glycogen
Adipose: mobilizes FAs
Muscle: glycogenolsis

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20
Q

Stages of starvation (3)

A
  1. Rapid muscle protein turnover–> release of a.a. As brain switches energy sources–> less protein breakdown.
  2. Muscle uses FA and Ketones for energy
  3. 3rd week: muscle uses FAs ONLY
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21
Q

Which is the predominating energy source in skeletal muscle during greatest energy demands (sprinting)?

A

Anaerobic metabolism

Glucose and glycogen

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22
Q

What is the predominating energy sources when energy are low (walking)?

A

Oxidation of circulation glucose and FAs

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23
Q

Describe the 3 stages of energy usage in Aerobic exercise

A
  1. Hepatic glycogenolysis (40%)
  2. Gluconeogenesis
  3. FA oxidation
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24
Q

Scurvy

A

Vit. C deficiency
Bone disease in children
Hemorrhages and healing defects in children AND adults

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25
Q

Riskets/ Osteomalacia

A

Vit. D deficiency–> hypocalcemia and activation of PTH–>
Rickets(children): bowing of legs
Osteomalacia: loss of bone mass in adults (osteopenia)

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26
Q

Lab: Erythrocyte Sedimentation Rate (marker for?)

A

Systemic inflammation

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27
Q

Lab: Creatine Kinase (marker for?)

A

Muscle injury

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28
Q

Lab: CK isozyme- Myocardial bound (marker for?)

A

CK-MB

Cardiac injury or regenerating muscle

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29
Q

Lab: Antineutrophil Cytoplasmic Ab (ANCA) (marker for?)

A

c-ANCA (cytoplasmic): Wegener granulomatosis
p-ANCA (perinuclear): Microscopic polyangiitis, Churg-Strauss vasculitis, focal necrotizing and crescentic glomerulonephritis

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30
Q

Lab: C-reactive protien (marker for?)

A

Direct marker for systemic inflamm.

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31
Q

Lab: Antinuclear antibod (marker for?)

A

Nonspecific
Numerous autoimm. diseases
Falsely positive in 5-10%

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32
Q

Lab: Rheumatoid factor (marker for?)

A

Rheumatoid arthritis and other autoimm. and chronic inflamm. diseases
Falsely positive 5-10%

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33
Q

Lab: Anticyclic citrullinated peptide (marker for?)

A

Rheumatoid arthritis

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34
Q

Lab: Alkaline phosphatase (marker for?)

A

Bone turnover

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35
Q

Lab: Serum calcium (marker for?)

A

Disordered Ca2+ homeostasis

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36
Q

Lab: Parathyroid Hormone (marker for?)

A

Parathyroid gland function

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37
Q

Lab: PTH-related hormone (marker for?)

A

Protein secreted by neoplastic cells, mimics PTH

It’s activity may lead to disordered Ca2+ and/or Phosphate homeostasis

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38
Q

What can changes can/not be seen in muscles after exercise? (VEGF, bFGF, Myoglobin O2 sat, PO2, Capillary density)

A

1 hour after exercise…..
Myoglobin O2 Sat and PO2 decrease–> leads to increase VEGF
VEFG upregulation–> stimulates angiogenesis
bFGF unchanged
Capillary density unchanged in such a small amount of time

39
Q

Atlanto-occipital Joint

A

Synovial joint b/t Atlas (C1) and occipital condyles that allow the head to nod “Yes”

40
Q

Atlantoaxial Joint

A

Synovial joint b/t Atlas (C1) and Axis (C2) that allows you to nod “No”

41
Q

Facet Joints

A

Synovial joints b/t inferior and superior articular facets of spine

42
Q

What is hyaline cartilage primarily made of?

A

Type II collagen

43
Q

Joints of the shoulder

A

Acromioclavicular–> fallong on outstretched arm

Glenohumeral –> Anterior OR Posterior displacement.

44
Q

What can result from Anterior/Posterior dislocation of humeral head?

A

Anterior–> Damage Axillary N.

Posterior–> due to electrocution (RARE)

45
Q

Joints of Elbow and their ligaments

A

Ulnohumeral: reinforced by medial collateral ligament
Radiohumeral: reinforced by lateral collateral ligament
Radioulnar: reinforced by annular ligament

46
Q

“Pulled Elbow”

A

When person is forcibly pulled up by arm when forearm is protonated
Tears Annular ligament
Pronation/Supination limited
Reduce: Supinate arm while flexed

47
Q

Colles Fracture

A

Distal radius and usually styloid process of ulna
Bone fragments displaced Dorsally and Distally
“Dinner Fork” deformity
Caused by FOOSH

48
Q

Medial Knee

A

Medial lemniscus firmly attached to Medial (Tibial) Collateral Ligament
Lateral trauma–> Excessive Valgus
Injury to BOTH ligament AND lemniscus

49
Q

Lateral Knee

A

Lateral lemniscus NOT firmly attached to Lateral Collateral (Fibular) Ligament
Medial trauma–> Excessive Varus deformity
Injure Lateral Ligament (lateral meniscus tear less likely)

50
Q

Anterior Knee

A

Anterior Cruciate Ligament
Anterior Tibia–> Lateral condyle of Femur
Prevents excessive anterior mov’t when knee is flexed
TEST: Anterior Drawer Test

51
Q

Posterior Knee

A

Posterior Cruciate Ligament
Posterior Tibia–> Medial condyle of femur
Prevents excessive posterior movement
TEST: Posterior drawer test

52
Q

“Unhappy Triad”

A

Injury: Hit from lateral side–> Twists flexed knee
MCL (Tibial ligament)
Medial lemniscus
ACL

53
Q

Ankle

A

Talocrural joint
Inversion: Lateral ligament (Anterotalofibular ligament)
Eversion: Medial ligament (deltoid). Can result in Pott fracture of Fibula and Medial Malleolus

54
Q

Pterion in skull

A

Where 4 bones of skull come together:
Frontal, parietal, temporal, sphenoid
Structurally weak
Near Middle Meningeal Artery

55
Q

Basilar vs. Linear Skull fractures

A

Linear: MOST common. From blunt trauma
Basilar: Linear, most often involves Temporal bone–> Raccoon eyes (blood collects in orbit), Battle Sign (behind ears), blood in sinuses, CSF leakage through nose/ears

56
Q

Fractures/Dislocations of the Vertebrae

A

Cause: MOST common Hyperflexion of neck
Most common injury: crush or compression fracture of vertebral body

Hyperextension (Whiplash)–> Stretches Anterior Ligaments and causes fractures and dislocations of vertebrae.

57
Q

Cervical vs. Thoracic/Lumbar vertebrae dislocations

A

Cervical: inclined horizontally–> Anterior dislocations withOUT fractures
Thoracic/Lumbar: arranged vertically–> Dislocation often seen WITH fractures.

58
Q

Spondylolysis

A

Defect or fracture in Pars interarticularis (connects inferior and superior articular processes)
Due to genetic defect or micro-fractures (gymnasts)
X-Ray: Posterior Oblique view!!! “Scotty Dog” looks like it has a collar

59
Q

Fractures of the pelvis

A

Anterior-posterior compression: Pubic symphysis and Rami fractures
Lateral compression: Pubic rami, ala of Ilium
Acetabulum fractures: Fall onto feet

60
Q

Valgus vs. Varus

A

Valgus: Knocked-knee
Varus: Bow-legged

61
Q

Fracture of Greater Tuberosity

A

Often assoc. w/ separation of shoulder

3/4 Rotator cuff muscles attach here (Supraspinatus, Infraspinatus, Teres Minor)

62
Q

Fracture of Neck of Humerus can injure….

A

Axillary Nerve

63
Q

Fracture in distal half of humerus can injure….

A

Radial Nerve, along Radial/Spiral Groove

64
Q

Fracture Humerus, just superior to elbow can injure….

A

Brachial artery–> ischemia

Median Nerve–> hand and forearm contractures

65
Q

Fracture in Medial Epicondyle can injure….

A

Ulnar Nerve

66
Q

Scaphoid Fracture

A

Very little displacement
Pain in “Snuff Box”
Often MISSED on X-ray and misdiagnosed–> Repeat in 10 days!
Improperly treated fractures–> Avascular Necrosis and Arthritis

67
Q

Fracture of Femoral Head can injure…

A

Medial Circumflex Femoral Artery
Avascular Necrosis
Limb will appear shortened and laterally rotated
More common in women due to Osteoporosis

68
Q

Pott Fracture

A

Medial (Deltoid) ligament in Ankle is overstretched
Due to Eversion
Strong Medial ligament does NOT tear–>
Fractures of Medial Malleolus and Fibula

69
Q

Fracture of 5th Metatarsal

A

Extreme Inversion
Tears Lateral Ligament
Can fracture lateral malleolus

70
Q

Coxa valga and Coxa varus

A

Angle b/t shaft and head of femur
Coxa valga: Angle is too large
Coxa vara: Angle is too acute–> difficult to abduct leg and leg shortening

71
Q

Legg-Calve-Perthes Disease

A 
Idiopathic avascular necrosis of Capital Femoral Epiphysis
Decreased range of motion
Upper leg pain
Self-limited--> revascularizes
Male, 3-12yrs
72
Q

Slipped Capital Femoral Epiphysis (SCFE)

A

Adolescents that have weakened epiphyseal plate
Femoral head epiphysis slowly slips away from femoral neck
Commonly seen in obese adolescents
Hip pain referred to knee

73
Q

Muscles of Mastication

A 
Innervated by CN V3
Temporalis: elevates and retracts
Masseter: elevates and protrudes
Medial pterygoid: elevates and protrudes
Lateral pterygoid: depressed and protrudes, side-to-side
74
Q

Which muscles open jaw?

A

Mostly gravity
Lateral pterygoid
Suprahyoid and infrahyoid muscles

75
Q

“Glossus” and “Palat”

A

“Glossus”–> innervated by CN XII (Hypoglossal)
EXCEPT Palatoglossus (CN IX)
“Palat”–> innervated by CN IX (vagus)
EXCEPT Tensor veli palatini (CN V3)

76
Q

Action of Sternocleidomastoid

A

Tilts head to ipsilateral side

Flexes and rotates head to contralateral side

77
Q

Extrinsic and Intrinsic muscles of Larynx

A

Extrinsic: move hypoid bone and larynx superiorly and inferiorly
Intrinsic: vocal cords and Rima glottids

78
Q

Motor and Sensory innervation of Inner laryngeal muscles

A

Motor: BELOW via Recurrent Laryngeal Nerve–> Damage–> hoarsness
Sensory: ABOVE via Internal Laryngeal Nerve–> Damage–> anesthesia of laryngeal mucosa–> problems w/ aspiration and swallowing

79
Q

Rotator Cuff muscles

A

Supraspinatus
Infraspinatus
Teres Minor
Subscapularis

80
Q

Anterior Compartment of Arm

A 
Flexors
Musculocutaneos Nerve
Biceps brachii: flex and supinate
Brachialis: flex
Coracobrachialis: flex and adduct
81
Q

Posterior compartment of arm

A

Extensor
Radial Nerve
Triceps brachii: extend forearm

82
Q

Anterior compartment of forearm

A

Pronates forearm and flexes forearm, wrist, and fingers

Median Nerve EXCEPT Flexor Carpi Ulnaris and Medial part of Flexor Digitorum Profundus (Ulnar N.)

83
Q

Posterior compartment of forearm

A

Extensors and supinators
EXCEPT Brachioradialis (flexes forearm)
Radial N.

84
Q

Thenar and Hypothenar muscles innervation

A

Thenar: Median N. EXCEPT Adductor pollicis (Ulnar N.)
Hypothenar: Ulnar N.

85
Q

Gluteal muscles

A

Glutei: extend and abduct thigh. Innervated by Gluteal Nerves
Maximus: Extends. Inferior Gluteal N.
Medius & Minimus: Abducts and Medially rotates. Superior Gluteal N.

Smaller gluteal muscles Laterally Rotate thigh.

86
Q

Anterior compartment of Thigh

A

Anterior: Flexor of hip & Extensors of knee. Femoral N and Sup. Gluteal N (Tensor fascia lata). Femoral Artery.

87
Q

Posterior compartment of thigh

A

Posterior: Hamstrings. Extensors of thigh. Flexors of knee.
Arteries: Profunda femoral artery, Inf. Gluteal artery, Perforating Arteries
Nerves: Sciatic, Common Fibular

88
Q

Medial compartment of thigh

A

Adductors
Artery: Obturator
Nerve: Obturator

89
Q

Lateral compartment of leg

A

Ankle evertors

Nerve: Superficial peroneal/Fibular

90
Q

Anterior compartment of leg

A

Dorsiflexors of ankle & extensors of toes
Artery: Ant. Tibial vessels
Nerve: Deep peroneal/Fibular

91
Q

Posterior compartment of leg

A

Superficial and deep compartments
Plantar flexors & Flexors of toes
Superficial: Posterior Tibial artery, Saphenous Vein, Sural Nerve
Deep: Peroneal and Posterior Tibial Artery, Tibial Nerve.

92
Q

Piriformis Syndrome

A

Sciatic N. enters Greater Sciatic foramen closely to piriformis muscle
If overdevelop gluteal muscles–> compress nerve
Sciatic-like symptoms
More common in Women

93
Q

Trandelenburg Sign

A

Damage to Superior Gluteal N. –> Gluteus medius and minimus
TEST: observe pt’s back while pts raises each foot off ground. If RIGHT pelvis falls when RIGHT foot is lifted–> LEFT Sup. Gluteal N. is damaged.

94
Q

What structures pass through the diaphragm?

A

T8: IVC
T10: Esophagus and Vagus N.
T12: Aorta, Thoracic Duct, and Azygous Vein

95
Q

Which nerves innervate the diaphragm?

A

C3, C4, C5 make up the Phrenic Nerve.
Irritated diaphragmatic pleura/ peritoneum–> Referred Shoulder Pain
“3,4,5 keeps the diaphragm alive!”

Musculoskeletal and Connective Tissue (4 decks)

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