Chapter 1 PP Flashcards

1
Q

intermediate

A

-between a superficial and deep structure
-bicep is intermediate between the skin and the humerus

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2
Q

transverse

A

axial

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3
Q

palmar vs dorsal

A

-palmar surface- anterior -> skin ligaments are short, stout, abundant
-dorsal surface- dorsum- posterior (back of hand) -> skin ligaments are long and sparse

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4
Q

plantar vs dorsal

A

-plantar surface- inferior foot (sole)
-dorsal surface- dorsum- superior

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5
Q

inversion vs eversion

A

-

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5
Q

supination vs pronation

A

-supination- return to anatomical position
-pronation- flip away from anatomical position

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6
Q

tension lines

A

-cleavage lines
-keep skin taut yet allow for creasing with movement
-lacerations or incisions made parallel the tension lines heal well with little scarring due to minimal disruption of collagen fibers
-cut made across will disrupt collagen fibers -> gape and heal with keloid scarring
-surgeons make incisions parallel unless adequate exposure, avoiding nerves etc. is to be considered

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7
Q

stretch marks in skin

A

-collagen and elastic fibers form tough flexible meshwork of tissue
-if skin is stretched too much or rapidly -> damage to collagen fibers
-bands of wrinkled skin initially red, become purple, and later white
-abdomen, buttocks, thighs, breasts

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8
Q

burns

A

-tissue injury to thermal, electrical, radioactive, chemical agents
-superficial burns- limited to superficial part of epidermis
-partial thickness burn- damage to epidermis into superficial part of dermis -> hair and sweat glands are not damaged and can contribute to replacements cells for basal layer of epidermis
-full thickness burn- entire epidermis and dermis and perhaps muscle > require skin grafting
-total body surface affected is more significant than degree (depth) generally

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9
Q

heterotopic bone

A

-bone forms in soft tissue not normally present
-due to chronic muscle strain -> small hemorrhagic areas undergo calcification and ossification
-common in horse riders thighs or buttocks

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10
Q

bone adaptation

A

-bones are living organs
-blood vessels, lymphatic vessels, nerves, disease
-unused bone (paralysis) -> atrophy -> can decrease in size
-bone may be absorbed
-hypertrophy (enlargement) when increased weight to support for long period
-mandible atrophys when teeth are extracted

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11
Q

bone trauma and repair

A

-broken ends of bone must be brought together to normal position -> reduces fracture
-fibroblasts proliferate and secrete collagen that forms collar of callus to hold bones together
-callus calcifies to remodel
-callus is resorbed and replaced by bone

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12
Q

degeneration- osteoporosis

A

-organic and inorganic components of bone decrease
-abnormal reduction in quantity of bone or atrophy
-brittle
-lose elasticity

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13
Q

femur

A

-transverse sections of femur show trabeculae
-trabeculae is in spongy bone
-tension and pressure lines
-related to weight bearing function of femur

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14
Q

bony markings

A

appear wherever tendons, ligaments, and fascia are attached or where arteries lie adjacent to or enter bones
-condyle
-crest
-epicondyle
-facet
-foramen
-fossa
-line (linea)
-malleolus
-botch
-process
-protuberance
-spine
-trochanter
-tubercle
-tuberosity

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15
Q

development and growth of long bone

A

-primary ossification center- bone tissue it forms replaces most of the cartilage in the shaft of the bone model
-shaft of bone ossified -> diaphysis
-secondary ossification center- appear in other parts of the developing bone after birth
-parts ossified from here -> epiphyses
-Growth occurs on both sides of the epiphysial plates

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16
Q

vasculature and innervation of long bone

A

-receive blood from articular arteries that arise from vessels around joint
-anastomose (communicate) to form networks to ensure continuous blood supply throughout its range of movement
-articular veins located in joint capsules mostly synovial membrane
-rich nerve supply
-in distal parts of limbs, articular nerves are branches of cutaneous nerves supplying overlying skin
-nerves that supply muscles supply and move joints
-many pain fibers in fibrous layer of joint capsule
-joints transmit proprioception

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17
Q

accessory bone

A

-supernumerary bones
-develop when additional ossification centers appear and form extra bones
-majority of bones form from several centers of ossification and separate parts will fuse
-sometimes centers fail to fuse -> gives appearance of extra bone
-extra bone is just a missing part of main bone
-common in foot and calvarium

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18
Q

assessment of bone age

A

-knowledge of where ossification sites are, time of their appearance, rate at which they grow, time of fusion (synostosis) of the sites -> determines age
-clinical med, forensic science, anthropology
-1. appearance of calcified material in diaphysis and/or epiphyses
-2. disappearance of dark line representing the epiphysial plate (fusion has occurred)
-fusion occurs 1-2 years earlier in girls than boys
-bone age can be determined by radiographic study of ossification center of hand

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19
Q

displacement and separation of epiphyses

A

-displacement of an epiphysis upon injury in child (adult -> fracture)
-displaced epiphyseal plate can be mistaken for fracture without imaging
-separation of epiphyseal plate can be misinterpreted as displaced piece of fracture bone
-sharp
-uneven edges

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20
Q

avascular necrosis

A

-loss of blood supply to epiphysis or other part of bone -> death of tissue
-after every fracture small areas of adjacent bone undergo necrosis
-large fragments in some fractures

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21
Q

degenerative joint disease

A

-breakdown of joint space
-synovial joints can withstand wear but heavy use over many years (synovial fluid) -> degenerative changes
-aging of articular cartilage occurs on the ends of the articulating bones
-usually knee, hip, vertebral column, hands (weight bearing)
-irreversible
-articular cartilage becoming less effective as shock absorber and more vulnerable to repeat fracture/friction during joint movement
-osteoarthritis
-stiffness, discomfort, pain

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22
Q

synovial joints

A

-cavity
-contains a small amount of synovial fluid
-nourishing articular cartilage and lubricating joint surfaces
-most common
-reinforced by accessory ligaments that either separate (extrinsic) or are thickened part of the joint capsule (Intrinsic)
-some have fibrocartilaginous articular discs or menisci present when the articulating surfaces of the bones are incongruous
-6 types classified by shape of the articulating surface and/or type of movement they permit

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23
Q

6 types of synovial joints

A

-pivot- uniaxial, rounded process fits into bony ligamentous socket -> rotation- ex. median atlantoaxial joint
-ball and socket- multiaxial, rounded head fits into concavity- ex. hip joint
-condyloid- biaxial, permit flexion, extension, abduction, adduction, circumduction- ex. metacarpophalangeal joint
-saddle- biaxial- ex. carpometacarpal joint
-hinge- uniaxial, permit flexion and extension- ex. elbow
-plane- usually uniaxial, gliding or sliding- ex. acromioclavicular joint

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24
motor unit
-structural unit of a muscle - muscle fiber -motor units with more fibers -> less precise -actin (thinm and myosin (thick) filaments are contractile (myofibrils) in muscle fibers
25
muscle testing
-helps diagnose nerve injuries -gauge power of person’s movement -Usually tested in bilateral pairs for comparison -2 methods: -1. movement performed that resists movement produced by examiner (active). ---ex. person flexes forearm while the examiner resists the effort - testing flexion -examiner performs movements against resistance produced by the person -ex. person keeps the forearm flexed while the examiner attempts to extend it
26
electromyography
-electrical recording of muscles via EMG -tests muscle action -surface electrodes placed over muscle -amplifies and records differences in electrical action potentials -resting shows baseline activity (tonus) -> only disappears during sleep, paralysis, anesthesia -contracting muscles show variable peaks of phasic activity -analyzes individual muscle during different movements -can be part of treatment for restoring action of muscles
27
muscular atrophy
-wasting of muscular tissue (atrophy) -may result from primary disorder of muscle or from lesion of nerve -may be caused by prolonged immobilization of limb -> cast, sling
28
compensatory hypertrophy and myocardial infarction
-compensatory hypertrophy- myocardium responds to increasing demands by increasing size of fibers (cells) -cardiac fibers damaged during heart attack are necrotic -> scar tissue develops into myocardial infarction (MI), an area of myocardial necrosis -smooth muscle cells can undergo compensatory hypertrophy in response to high demands -> smooth muscle cells in walls of uterus increase in size (hypertrophy) and number (hyperplasia) for pregnant women
29
large elastic arteries
-conducting arteries -aorta and its branches -elasticity in these arteries maintains blood pressure -allows to expand when heart contracts and return to normal between contractions
30
medium muscular arteries
-distributing arteries -walls are mainly smooth muscle circularly arranged -femoral artery -decrease their diameter (vasoconstrict) -> regulates flow of blood to different parts of body as required
31
small arteries/arterioles
-narrow lumina -thick muscular walls -degree of arterial pressure is mainly regulated by degree of tonus (firmness) in smooth muscle of arteriolar walls -if tonus in arteriolar wall is above normal -> hypertension
32
anastomoses, collateral, circulation, and terminal (end) arteries
-anastomoses (communicating connections) between branches of an artery provide many potential detours for blood flow in the case of obstruction by compression, position of joint, pathology, surgical ligation -if main channel is blocked -> smaller channels increase in size -> provide collateral circulation -> ensures blood supply to structures distal to blockage -collateral circulation takes time to develop and usually insufficient for sudden occlusion or ligation -terminal (end) arteries- do not anastomose with adjacent arteries -occlusion of terminal artery cuts off supply to organ or structure completely -functional terminal arteries- arteries with ineffectual anastomoses supply segments of brain, liver, kidney, spleen, intestines
33
arteriosclerosis: ischemia and infarction
-most common disease of arteries- arteriosclerosis (hardening) -atherosclerosis- group of diseases characterized by thickening and loss of elasticity -aTHerosclerosis- form of arteriosclerosis- buildup of fat (cholesterol/plaque) in arterial walls -Ca deposits then form atheromatous plaque -> narrowing -> -thrombosis- formation of clot can occlude artery or by flushed into blood stream -> ischemia -ischemia- reduction of blood supply to organ or region -> infarction - death -thrombus can cause myocardial infarction, stroke, gangrene
34
varicose veins
-walls of veins lose elasticity or deep fascia becomes incompetent in sustaining musculovenous pump -weak -dilate under the pressure of supporting column of blood against gravity -> pooling -swollen, twisted veins -legs usually -incompetent due to dilation or rotation and no longer function properly -hx of DVT -> higher risk -gaiters area- venous disease - pooling, ulcers etc -> itching
35
venous blood return to heart
-vascular sheath- accompanying veins (to arteries) surround arteries in a branching network -veins are stretched and flattened as the artery expands during contractions of heart -> Assists in venous blood return -Musculovenous pump- skeletal muscles compress deep veins -> milking blood superiorly towards heart -multiple perforating veins penetrate deep fascia to shunt blood to deep veins and assist in venous return
36
lymphoid system
-lymph enters lymphatic trunks -> trunks unite to form right lymphatic duct or thoracic duct -right lymphatic duct- drain lymph from bodys right upper quad (right head, neck, thorax, right upper limbs) -thoracic duct- drains lymph from remainder of body -lymph flows from extracellular space through lymph node
37
motor unit
-motor unit- motor neuron + muscle fibers it controls
38
myelinated nerve fibers
-neurolemma has a myelin sheath -consists of continuous series of schwann cells enwrapping an individual axon -myelin sheath gaps- nodes of ranvier- intervals in the myelin sheath where short parts of the axon are not covered by myelin
39
unmyelinated nerve fibers
-neurolemma consists of multiple axons separately embedded within the cytoplasm of each schwann cell -schwann cells do not produce myelin -most fibers in cutaneous nerves (skin) are unmyelinated
40
lymphangitis, lymphadenitis, lymphedema
-lymphangeittis and lymphandenitis- secondary inflammation of lymphatic vessels and lymph nodes -may occur when the lymphatic system is involved in the metastasis of cancer -> lymphogenous dissemination of cancer cells -lymphedema - the accumulation of interstitial fluid that occurs when lymph is not drained from an area -when cancerous lymph nodes are removed from axilla -> lymphedema of upper lime may result
41
damage to central nervous system
-when CNS is damaged injured axons do not recover usually -proximal stumps begin to regenerate -> sending sprouts into area of the lesion -> however -> -growth is blocked by astrocyte (type of glial cell) proliferation at the site of injury -results in permanent disability when there is destruction of a tract in CNS
42
peripheral nerve degeneration
-when peripheral nerves are crushed/severed -> their axons degenerate distal to the lesion bc they depend on cell bodies for survival -crushing nerve injury- the nerve cell bodies survive and the connective tissue coverings of the the nerve are intact -intact connective tissue sheaths guide the growing axons to their destinations -> no surgical intervention for crushing nerve -cut nerves require surgery bc regeneration of axons requires apposition of the cut ends by suture through the epineurium -> individual fascicles are realigned -compromising blood supply to nerve for long period by compression of vasa nervorum-> ischemia -> nerve degeneration -prolonged ischemia -> severe damage similar to crushing or cutting nerve
43
arrangement and ensheathment of peripheral nerve fibers
-endoneurium and neurolemma surround the axons -> bundled by perineurium -> bundled by epineurium
44
dermatome
-unilateral area of skin innervated by the general sensory fibers of single spinal nerve -unilateral area of skin
45
myotomes
-unilateral muscle mass receiving innervation from somatic motor fibers conveyed by a spinal nerve -grouped by joint movement to facilitate clinical testing -unilateral portion of skeletal muscle
46
visceral motor innervation
-ANS -efferent nerve fibers and ganglia of the ANS are organized into 2 divisions: -1. sympathetic (thoracolumbar) division -2. parasympathetic (craniosacral) division -divisions innervate same structures with opposite effect -impulses from CNS involve 2 neurons in both sympathetic and parasympathetic -location of the presynaptic cell bodies and which nerves conduct the presynaptic fibers from the CNS -> distinguish symp from para
47
somatic motor/sensory
-CNS and PNS -innervate all parts of body except the viscera in the body cavities, smooth muscle, and glands -somatic motor- supplies skeletal (voluntary) -somatic sensory- carries sensation like touch, pain, temperature, and position from skin, muscles, joints
48
intermediolateral cell columns
-presynaptic neurons are in the intermediolateral cell columns (IMLs) or nuclei of the spinal cord- lateral horns -paired IMLs are part of gray matter between T1-L2+L3 -postsynaptic cell bodies occur in 2 places: paravertebral and prevertebral ganglia -axons of presynaptic neurons leave spinal cord through anterior roots and enter anterior rami of spinal nerves T1-L2+L3 -after entering rami presynaptic sympathetic fibers leave anterior rami and pass to sympathetic trunks through white rami communicates
49
paravertebral ganglia
-form right and left sympathetic trunks (chains) on each side of vertebral column that extends the length of the column -superior cervical ganglion- superior paravertebral ganglion lies at the base of cranium -ganglion impar- forms inferiorly where 2 trunks unite at level of coccyx
50
prevertebral ganglia
-in the plexuses that surround origins of main branches of abdominal aorta
51
postsynaptic sympathetic fibers
-outnumber presynaptic fibers -those in neck, body wall, limbs, pass from paravertebral ganglia of sympathetic trunks to adjacent anterior rami of spinal nerves through gray rami communicantes -enter all branches of each of the 31 pairs of spinal nerves including posterior rami to stimulate contraction of blood vessels and arrector muscles -Postsynaptic sympathetic fibers that perform these functions in the head have their cell bodies in the superior cervical ganglion at the superior end of the sympathetic trunk -> pass from ganglion by means of a cephalic arterial branch -> form periarterial plexuses of nerves -> follows branches of the carotid arteries or pass to CNs to reach their destination in the head -components of all branches of all spinal nerves -> innervate all bodys blood vessels, sweat glands, arrector, visceral structure
52
suprarenal (adrenal) gland
-suprarenal medullary cells function as special type of postsynaptic neuron that release neurotransmitters into bloodstream to circulate throughout body producing widespread sympathetic response -(rather than release onto the cells of specific effector organ)
53
parasympathetic visceral motor innervation
-presynaptic are located in 2 sites: cranial and sacral site -cranial site- from the gray matter of brainstem, fibers exit CNS within CN 3, 7, 9, 10 -> cranial parasympathetic outflow -sacral site- from gray matter of sacral segments of the spinal cord (S2-S4), the fibers exit CNS through anterior roots of spinal nerves S2-S4 and the pelvic splanchnic nerves that arise from anterior rami -> sacral parasympathetic outflow -weaker than sympathetic -> only head, visceral cavities of trunk, and erectile tissues of genitalia
54
computerized tomography (CT)
-transverse -beam of x-rays passed through body -amount of radiation absorbed by diff types of tissue varies with fat, bone, and water -angiography -3D CT volume reconstruction
55
ultrasonography
-visualization of superficial or deep structure in body -records pulses of ultrasonic waves reflecting off tissues -can be viewed in real time -standard method from embryo and fetus bc no radiation
56
magnetic resonance imaging (MRI)
-better for tissue differentiation -reconstruct the tissue in ANY PLANE (diff from CT) -magnetic field -body pulsed with radio waves -signal emitted from pts tissues are stored in computer -can vary by controlling how radiofrequency pulses are sent and received -scanners can be gated or paced to see blood in real time -MR angiography and venography use MRI and dyes to image blood vessels -MR spectroscopy- investigate metabolic changes in brain after stroke, tumor, etc.
57
positron emission tomography (PET)
-uses cyclotron produced isotopes of extremely short half life that emit positrons -evaluate physiological functions of organs -areas of increased brain activity will show selective uptake of injected isotope
57
eversion vs inversion
-eversion- outside part of foot up -inversion part of the foot up
58
dorsiflexion vs plantar flexion
-dorsiflexion- toes up -plantarflexion- tip toes
59
opposition vs reposition
-opposition- thumb + pinky -reposition- thumb moves away from pinky
60
retrusion vs protrusion
-retrusion- jaw in -protrusion- jaw out
61
lateral flexion
-lateral bending -sway side to side
62
abduction, adduction, extension, flexion of the thumb
-abduction- thumb moves anteriorly -adduction- thumb moves posterior back into anatomical -extension- thumb separates -flexion- thumb bends towards pinky
63
protraction vs retraction
protraction- shoulder forward -retraction- shoulder backward
64
poor blood supply to bones
-bones with poor blood supply -> takes longer to heal or wont heal -> avascular necrosis -bone becomes necrotic -common in hips -femur head has singular blood supply -> if that is disrupted -> possible necrosis -> femoral head collapse
65
compartment system
-fascia surrounds muscles -> keeps together -fascial space allow muscles to glide -scarring -> adhesion of muscles ->pain -fascia doesnt allow for a lot of swelling -> compartment syndrome- injury to muscle that causes swelling and increases pressure -> occludes vessels and nerves -> necrosis -fasciotomy- opens the fascia and lets swelling decrease -> reclose
66
coronary bypass
-use veins to reprofuse -bypass arteries that have been occluded -flip the vein so valves dont resist or remove valves -pulmonic arteries have valves
67
deep vein thrombosis
-DVT -pulmonary embolism- travels to lung -blood clot in deep vein (usually leg) -if you have a hole in your heart -> venous thrombosis can cross over and cause a stroke -> uncommon
68
thrombic emboli
-blood pools in heart when they have art fibrillation -> coagulates -> thrombosis -plaques break off -> stroke