REVISION SESSION KEY POINTS Flashcards
What are the 3 types of cartilage and what are the key differences?
- fibres
- locations
- extras
Fibrocartilage
- Type 1 collagen
- Mixture fibrous and cartilaginous tissue
- pubic symphysis, IVD’s
- TMJ - only synovial joint not line by hyaline
Hyaline
- Type 2 collagen
- contains GAG’s
- articular cartilage
- undergo endochondral ossification to form bone
Elastic
- lots of elastin fibres
- forms parts of the ear, larynx and epiglottis
What is periosteum and endosteum?
Periosteum - dense irregular CT - lines outer surface of bones - contains osteoblasts for bone healing - Sharpey's fibres connect it to bone Endosteum - single cell layer that lines inner surface of bone - forms medullary carroty in which marrow is stored
Briefly describe bone formation.
What are the 2 types of ossification?
Osteoid secreted by osteoblasts - calcified by hydroxyapatite deposition
endochondral - hyaline cartilage laid down, cartilagenous later grows and calcified by chondrocytes
intramembranous - MSC in CT matrix –> osteoprogenitor cells, osteoid secretion by osteoblasts, development of periosteum and differentiation into osteocytes
What are the layers of the scalp?
S = skin C = connective tissue A = aponeurosis of occipto-frontalis L = loose connective tissue P = periosteum
What are the individual functions of the muscles of mastication?
masseter = elevation
temporatlis = elevation, retraction
medial pterygoid = side to side, elevation
lateral pterygoid = side to side, protrusion
Functions of the rotator cuff muscles
Supraspinatus = 15 degrees of abduction
Infraspinatus = external rotation
Teres minor = external rotation
Subscapularis = internal rotation
Painful arc syndrome
pain in the middle of abduction
inflammation of the rotator cuff tendons
subacromial bursa
these structures get closer together during abduction
Upper limb dermatomes
C4 - deltoid C5- lateral upper arm C6 - lateral forearm C7 - middle finger C8 - little finger / medial hand T1 - medial forearm
Blood supply of the upper limb
Anterior arm = brachial artery
Posterior arm = profunda brachii artery
Anterior forearm = ulnar and radial artery
Posterior forearm = radial artery
Hand = deep and superficial palmar arches from ulnar and radial arteries
What is Camper’s Chiasm?
flexor digitorium superficialis splits into two - allowing flexor digitorum profundus to insert between them
Nerve supply of the muscles of the hand
All ulnar nerve Expect thenar muscles (LOAF) which are median Lateral 2 lumbricals Opponens pollicis Abductor pollicis brevis Flexor pollicus brevis
What is the nerve supply of coccygeus?
Anterior ram of S2 and S3
Where are campers and scarpa’s fascia. What is the difference?
Below the umblicus
Above umbilicus there is a single sheet of CT
Fatty superficial layer = camper’s
Deep membranous layer = Scarpa’s
Where is the arcuate line?
Midway between the umbilicus and pubic symphysis
What is the advantage of a median incision?
What is the advantage of a transverse incision?
What is the advantage of a grid iron incision?
Median
- incision made through line alba
- can extend entire length of abdomen
- major nerve avoided plus minimal blood loss
Transverse
- incision made inferior and laterally to umbilicus in rectus abdominus
- repairs well
Grid iron
- McBurneys point (1/3/ from ASIS to umbilicus
- splits the fibres of the muscles without cutting them
- excellent healing
How long is the inguinal canal/
6 cm between superficial and deep ring
What is the deep inguinal ring?
Where is it located?
Opening in the transversalis fascia
Mid point of the inguinal ligament - half way between the pubic tuber and the ASIS
What is the superficial inguinal ring and where is it located?
triangular opening in external oblique
found immediately superior to the pubic tubercle
What are the contents of the inguinal canal?
- spermatic cord or round ligament of the uterus
- genital branch of gentiofemoral nerve
- ilioinguinal nerve
- pampiniform plexus
- testicular artery, cremasteric artery, artery to vas deferens
Epigastric vessels and hernias
Direct hernia = through abdominal wall, medial to epigastric vessels
Indirect hernia = through deep ring, lateral to episgastric vessels
Dermatomes of the lower limb
L2 = anterior thigh L3 = knee L4 = medial leg L5 = big toe S1 = little toe S2 = posterior thigh
Describe the arterial supply of the lower limb
AA –> external iliac –> common femoral
Superficial femoral –> popliteal
Popliteal
–> anterior tibial (anterior compartment
–> pereneo-tibial –> posterior tibial and fibular arteries
anterior tibial –> dorsalis pedis (passes anteriorly over ankle)
posterior tibial –> medial and lateral plantar arteries
Where are the 4 lower limb pulses palpable?
femoral - 2cm inferior to the mid inguinal point
popliteal - int he pipliteal fossa
dorsalis pedis - lateral to extensor hallucis longus tendon
posterior tibial - posterior to the medial malleolus
Borders and contents of the femoral triangle
lateral = sartorius
medial = adductor longus
superior = inguinal ligament
femoral nerve, femoral artery, femoral vein, femoral canal (deep lymph nodes)
What do the collateral ligaments of the knee do?
lateral collaterals prevents lateral/varus force on the knee joint
medial collaterals prevents medial/valgus force on the knee joint
vairus = air in between the legs –> rickets
Contents of the popliteal fossa
(medial) popliteal artery popliteal vein tibial nerve common fibular (lateral)
Which movement of the foot causes Pott’s fracture?
Which ligament is invloved?
Forced eversion
deltoid ligament (strong so tend not to rupture and cause fracture instead)
fracture of tibia and fibula
