Don't Panic

Question 1

What are the main nervous branches of the LL?

Answer 1

Femoral –> Saphenous
Obturator
Sciatic
–> Tibial –> Medial and lateral plantar
–> Common fibular –> Deep and superficial fibular

Question 2

What muscles does the deep branch of the radial nerve supply? (8)

Answer 2

Extensor digiti minimi
Extensor digitorum
Extensor indicis 
Extensor pollicis longus and brevis 
Abductor pollicis longus
Extensor carpi radialis brevis
Extensor capri ulnaris
Supinator

Question 3

What 6 muscles are innervated by the median nerve? (Not the Anterior interosseous nerve)

Answer 3

Flexor capri radialis 
Palmaris longus
Flexor digitorum superficialis 
Pronator teres
Thenar muscles
Lateral 2 lumbricals

Question 4

What 3 muscles are innervated by the anterior interosseous nerve? (a deep branch of the median nerve)

Answer 4

Flexor digitorum profundus (to index and middle finger)
Pronator quadratus
Flexor pollicis longus

Question 5

What tendons pass through the carpal tunnel?

Answer 5

4 x FDP
4 x FDS
1 x FPL

Question 6

What muscles are supplied by the recurrent branch on the median nerve?

Answer 6

The thenar muscles:

1. Opponens pollicis
2. Abductor pollicis brevis
3. Flexor pollicis brevis

Question 7

What 5 muscles does the ulnar nerve innervate?

Answer 7

Flexor carpi ulnaris
Hypothenar muscles
Medial 2 lumbricals 
Flexor digitorum profundus (to ring and little finger)
Adductor pollicis

Question 8

What 6 muscles are innervated by the Deep Fibular nerve?

Answer 8

Tibialis Anterior
Extensor hallucis longus
Extensor digitorum Longus
Fibularis tertius 
(branches)
Extensor digitorum brevis
Extensor hallucis brevis

Question 9

What 2 muscles are supplied by the Superficial fibular nerve?

Answer 9

Fibularis longus

Fibularis brevis

Question 10

What 7 muscles are supplied by the tibial nerve? (Before it branches into the medial and lateral plantar nerves)

Answer 10

Gastrocnemius
Plantaris
Popliteus 
Soleus 
Flexor digitorum longus
Flexor hallucis longus
Tibialis posterior

Question 11

What muscles of the foot are supplied by the medial plantar nerve?

Answer 11

Abductor hallucis
Flexor Digitorum brevis
Flexor hallucis brevis
Lumbricals of 2nd digit

Question 12

What muscles are supplied by the lateral planar nerve?

Answer 12

All muscles of the sole including quadratus plantae via the deep branch

Question 13

Effect of anticholinestease on ANS?

Answer 13

Sludge
Hypotension
Bronchoconstriction
Pupillary constriction
Bradycardia

Question 14

What are the adrenergic neuron neurotransmitters?

Answer 14

Catecholamines e.g. Noradrenaline, adrenaline and dopamine

Question 15

What are the 2 methods of NA release?

Answer 15

Calcium facilitated exocytosis

NET (norepinephrine transporter) bring amphetamine into the presynaptic terminal and NA out

Question 16

What are the 2 methods of NA uptake?

Answer 16

Alpha2-adrenoreceptors on the presynaptic terminal

VMAT (vesicular monoamine transporter) repackages NA

Question 17

What is the method of NA degradation?

Answer 17

MAO (monoamine oxidase inhibitors) break down NA to metabolites when the concentration get’s too high

Question 18

What 3 enzymes are used to control glycolysis?

Answer 18

1. Hexokinase
2. Phosphofructokinase
3. Pyruvate kinase

Question 19

Boundaries of the femoral ring?

Answer 19

Medially: Lacunar ligament
Laterally: Femoral vein
Anterior: Inguinal ligament
Posterior: Pectineal ligament

Question 20

Which NAID should be used in patients with gastrointestinal upset?

Answer 20

Paracetamol

Question 21

Distal attachment of iliopsoas?

Answer 21

Lesser trochanter

Question 22

Distal attachment of both obturator externus and internus?

Answer 22

Greater trochanter

Question 23

Distal attachment of gluteas maximus?

Answer 23

Iliotibial tract and gluteal tuberosity

Question 24

What is the cause of osteoporosis?

Answer 24

increased reabsorption of bones making it more fragile and likely to fracture

Question 25

From anterior to posterior what order to the structures lie behind the medial malleolus?

Answer 25

``` Tibialis posterior Flexor digitorum longus Posterior tibial artery and vein Tibial nerve Flexor hallucis longus ```

Question 26

Lipoproteins in the transport of cholesterol and TG mechanism, go!

Answer 26

1. Chylomicrons transport TG (triacylglycerol) and cholesterol from the GI to tissues. - Split by lipoprotein lipase to release free fatty acids (FFAs) - FFAs taken up by muscle and adipose tissue 2. Chylomicron remnants taken up in the liver - Cholesterol stored, oxidised to bile acids or released to VLDL 3. VLDL transport cholesterol and newly synthesised TG to tissues - TGs removed from VLDL leaving LDL with a high cholesterol (taken up by cells or liver) 4. HDL absorbs cholesterol from cell breakdown and transfer it to VLDL and LDL

Question 27

What are the 4 actions of cholestyramine?

Answer 27

- Sequesters bile acids to prevent enterohepatic recirculation - Decrease absorption of exogenous cholesterol - Increase the metabolism of endogenous cholesterol into bile acids - Increase LDL receptor numbers in the liver resulting in their removal from the blood.

Question 28

What are the main actions of fibrates?

Answer 28

Activators of lipoprotein lipase which lowers TG content of VLDL Clearance of LDL in liver Production of HDL Reverse cholesterol transport

Question 29

What is the main function of statins?

Answer 29

HMG-CoA reductase inhibitors hence prevent the synthesis of cholesterol

Question 30

What are the 3 actions of PGE and PGI?

Answer 30

Potent vasodilators Potentiate histamine and bradykinin actions in pain sensory nerve Synergise with other inflammatory mediators (i.e. bradykinin and histamine)

Question 31

What are the 5 main groups of NSAIDs? | Examples and properties

Answer 31

Salicylates: Direct COX acetylation e.g. aspirin Propionic acid: Has lower GI toxicity than aspirin, not a prodrug e.g. Ibuprofen, naproxen Fenamates: e.g. Mefenamic acid Paracetomol: Weak COX inhibitor, good analgesis +antipyretic, well tolerated by GIT, poor anti-inflammatory actions, problems with overdose Selective COX-2 inhibitors: E.g.Coxib