Week 1

Question 1

What are the superficial muscles of the gluteal region? Innervation?

Answer 1

Gluteus maximus; inferior gluteal nerve (L5,S1,S2)

Rest are superior gluteal nerve(L5,s1)
Gluteus medius
Gluteus minimus
Tensor fasciae latae

Question 2

What is the function of the gluteus maximus?

Answer 2

To extend thigh mainly from flexed position (sitting)

Question 3

What is the function of the gluteus medius, minimus and tensor fascia latae ?

Answer 3

Abduct and medially rotate thigh and keep pelvis level when ipsilateral limb is weight bearing e.g when walking keeps pelvis straight when leading leg moving.

Question 4

Name the deep muscles of the gluteal region

Answer 4

Piriformis
Obturator internus
Superior and inferior gemelli
Quadratus femoris

Question 5

What type of joint is the hip?

Answer 5

Synovial joint that is ball and socket

Question 6

What is the blood supply to the femur head?

Answer 6

Medial circumflex femoral artery primarily and the retinacular arteries

Question 7

What are the boundaries of the popliteal fossa?

Answer 7

Superolateral; biceps femoris
Supermedial; semimebranosus
Inferior; gastrocnemius
Roof; popliteal fascia

Question 8

What two tendons combine to form the achilles tendon (calcaneal)?

Answer 8

Gastrocnemius and soleus tendons

Question 9

With what nerve is the problem that causes trendelbergs gait?

Answer 9

Superior gluteal nerve

Question 10

What factors influence the tension produced in a skeletal muscle?

Answer 10

Number of muscle fibres contracting (contraction increasing iwth more fibres)
Length of fibre, freq of stimulation and summation of contractions, thickness of muscles

Question 11

Explain how tension increases with increased frequency of stimulation

Answer 11

AP of neurone on muscle causes contraction after the AP has ended. Therefore if have lots of AP in quick succession then can get cumulative wave contraction effect to produce a larger contraction.

If no relaxation between muscle stimulation then get large sustained contraction known as tetanus

Question 12

Max muscle tension develops at optimum muscle length, what is optimum muscle length?

Answer 12

When there is most overlap between actin and muosin binding sites so when contraction occurs all sites are being utilised. Usually this is the resting length

Question 13

What are the two primary types of muscle contraction?

Answer 13

Isotonic contractions; length of muscle changes to allow a constant muscle tension e.g body movements like moving objects

Isometric contraction; CONSTANT MUSCLE LENGTH to allow constant muscle tension e.g fixed positions and posture like planking

Question 14

What mechanism is utilised during contraction in skeletal muscle to help prevent muscle fatigue

Answer 14

Asynchronous motor unit recruitment during submaximal contractions

Question 15

Define the motor unit

Answer 15

Motor unit is all the single type muscle fibres stimulated by a single alpha motor neurone

Question 16

Give the features of a Type 1 muscle fibre

Answer 16

Slow-oxidative fibre, that is dependent on aerobic metabolism for ATP, resistant to fatigue used mainly for prolonged work aerobic like walking and posture

Question 17

Give the features of a Type 3 muscle fibre

Answer 17

High ATPase activity, fast glycolytic, easy fatigued due to inability to produce high ATP, hence dependent on enzymes for anaerobic glycolysis. High intensity activites

Question 18

Define the term reflex action

Answer 18

Stereotyped response to a specific stimulus, simplified form of a coordinated movement located at various levels of the motor system

Question 19

How can stretch reflexes be used to localise lesions?

Answer 19

As there are different nerves that are stimulated by the reflexs if one is absent you can tell which vertebral level neurone has an issue

Question 20

What is the function of an electromyography is diagnosing neuromuscular disease?

Answer 20

Detects electrical activity in muslce so used to differentiate between primary muscle disease and muscle weakness

Question 21

What is the function of muscle enzymes is diagnosing neuromuscular disease?

Answer 21

Creatine kinase raised indicates damage in a muscle

Question 22

Women presents witha butterfly rash across her face, she has a blood test that is ANA+ diagnosis?

Answer 22

Systemic lupus erythematosus

Question 23

Man with psoriasis presents with pain in the joints of her left hand, its hot and tender, and has occurred over the last few hours. Likely diagnosis?

Answer 23

Gout, due to psoriasis being risk factor and male. Also the sudden onset rules out osteoarthritis and the fact it is unilateral rules out rheumatoid arthritis

Question 24

What are some of the toxins produced by staph aureus?

Answer 24

Enterotixin (food poisoning)
SSST
PVL (panton valentine leukocidin)

Question 25

Lab cultures a coagulase positive, golden grape colony on agar. The sample was taken from an inflammed bone. Diagnosis and treatment>

Answer 25

Osteomyelitis

Flucoxacillin for 6 weeks

Question 26

What is the treatment for gram negative pathogens like ecoli, klebsiella, proteus, enterobacter?

Answer 26

Gentamicin

Question 27

Man presents with a fracture of his femur near the knee, the area was previously painful and upon xray there is a soap bubble appearance around the fracture site. Diagnosis? Treatment?

Answer 27

Giant cell tumour

Intralesional excision with bone cememnt