Exam 3 Material Flashcards
Deltoid
- Function
- Innervation
- Blood Supply
- Arm abduction, flexes & medially rotates humerus with anterior fibers, extends & laterally rotates arms with posterior fibers
- Axillary nerve
- Acromial and deltoid branches of thoracoacromial artery. ant/post circumflex humeral, subscapular, deltoid branch of deep brachial
Gracilis
- Origin
- Insertion
- Function
- Innervation
- Blood Supply
- inferior ramus & body of pubis, ischial ramus
- medial surface of tibial shaft just inferior to medial condyle
- • adducts thigh • flexes & medially rotates leg (when walking)
- Obturator nerve
- Deep femoral, common femoral, medial circumflex femoral
Klippel -Feil syndrome
cervical vertebral fusion. Two or more non -segmented fused cervical vertebrae facets and spinous processes
anteroposterior narrowing of the vertebral bodies and hemivertebrae.
short neck, low posterior hairline and limited neck motion.
Upper limb buds develop opposite the ________(1)________, whereas the lower limb bud develop opposite the _________(2)_________
- caudal cervical segment,
- lumbar and upper sacral segment.
Linea semilunaris abdominal incision
Incision is made at the linea semilunaris
Hypodermis
layer of subcutaneous adipose tissue
Identify
Resorptive Osteocyte
Bone cell maturation
•Calcium in plasma present in three forms
Combined with plasma proteins – non diffusible
Combined with anionic substances in plasma – diffusible but non ionised
Ionised form – diffusible (most important form)
Identify and describe
Merkel’s Cells
Least numerous
Detect touch sensations
Most abundant in skin where fingertips
Have desmosomes and contain keratin filaments
Nucleus is lobed
Cytoplasm contains neurosecretory granules
Fibularis longus
- Origin
- Insertion
- Function
- Innervation
- Blood Supply
- head & upper portion of lateral fibula
- by long tendon underfoot into 5th metatarsal & medial cuneiform
- • plantar flexes & everts foot • may help keep foot flat on ground
- Superficial fibular nerve
- Anterior tibial artery, Muscular branches of fibular artery
Camper’s fascia
- external, fatty
- males: loses most of its fat, fuses with Scarpa’s layer to form Dartos fascia
- females: retains the fat, forms part of labia majora
Biceps Femoris
- Origin
- Insertion
- Function
- Innervation
- Blood Supply
- long head (a): ischial tuberosity short head (b): linea aspera & distal femur
- by common tendon into head of fibula & lateral condyle of tibia
- extends thigh & flexes knee • laterally rotates leg when knee is flexed
- Sciatic nerve
- Perforating arteries of deep femoral artery
Femoral (L2,3,4)
Location
Structures
runs deep to psoas and passes along its lateral border to enter the thigh
skin of the anterior thigh, medial part of leg, hip and knee joints. Quadriceps femoris, pectineus, sartorius muscles (anterior muscle compartment of the thigh)
Arteries of the anterior & lateral compartments
Anterior tibial artery:
passes forward into the anterior compartment of the leg through an aperture in the interosseous membrane
leaves the leg by passing anterior to the distal end of the tibia and ankle joint and continues onto the dorsal aspect of the foot as the dorsalis pedis artery
perforating arteries from the fibular artery supply the lateral compartment
Vitamin D deficiency • Risk factors
Inadequate exposure to sunlight (common during winter; in elderly)
Nutritional deficiency – decreased intake/ fat malabsorption/ exclusively breast fed infants
Chronic renal disease, chronic liver disease results in decreased hydroxylation of vitamin D
Intramembranous bone formation
involves development within layer of condensed mesenchyme
Mesenchymal cells condense to form primary ossification center (POC)
Osteoblasts differentiate from POC and secrete osteoid
Osteoblasts become trapped in their own matrix and become osteocytes
Ossification centers expand into spicules as more osteoblasts aggregate
Bone trabeculae (fused spicules) is the name given to the bone developing at these sites
Spongy bone develops as bony trabeculae join together
Blood vessels invade the area at the same time that undifferentiated mesenchymal cells give rise to bone marrow cells
Periosteum forms from surrounding mesenchymal cells
Numerous ossification centers fuse together forming bone
Examples of bone formed in this fashion include most of the flat bones of the skull
Pectoralis Major
- Origin
- Insertion
- Function
- Innervation
- Blood Supply
- Sternal end of clavicle, sternum, Cartilage of ribs 1-6, apo-neurosis of external obliques
- intertubercular groove of humerus
- arm flexion, medial arm rotation, arm adduction against resistance, pulls ribcage upward w/ scapula fixed
- Lateral & Medial Pectoral nerves
- Pectoral branch of Thoracoacromial artery, perforating branches of internal thoracic artery, superior and lateral thoracic arteries
Thoracolumbar fascia
Location
Fibers
Continuous with?
Three layers?
Deep investing membrane throughout most of the posterior thorax and abdomen
formed of longitudinal and transverse fibers that bridge the aponeuroses of internal oblique and transversalis muscles.
continuous with the deep fascia of the neck
three layers, anterior, middle, and posterior
Myotomes
musculature of limbs develop from
myogenic precursor cells migrate into _____ and differentiate into _____
as long bones from
Musculature of the limbs develops from hypaxial divisions of myotomes
Myogenic precursor cells migrate into the limb bud and differentiate into myoblasts
As long bones form, myoblasts aggregate and form a muscle mass in each limb bud that separates into flexor and extensor compartments
primary lymph vessel
thoracic duct, which transports lymph and chyle from the abdomen cavity via the aortic opening of the diaphragm to the junction of left subclavian vein and left internal jugular vein
Alar ligaments
laterally From dens to skull
Obturator (L2,3,4)
Location
Structures
passes medial to psoas
skin on medial side of the thigh, adductor muscles (medial muscle compartment of the thigh)
Medial compartment
- Muscles
- Motor and Sensory Innervation
- Openings (Canal)
- Blood Supply
- General Functions
- pectineus, gracilis, adductors, obturator externus
- obturator and tibial nerves
- subsartorial (adductor/Hunter’s) canal
- obturator artery
- adduction of the hip, except obturator externus
Thoracic outlet syndrome
Caused by
– Extra rib attaching to C7
– Muscular abnormalities
– Injury
Semimembranosus
- Origin
- Insertion
- Function
- Innervation
- Blood Supply
- ischial tuberosity
- medial condyle of tibia
- • extends thigh & flexes knee • medially rotates leg
- Sciatic nerve
- Perforating arteries of deep femoral
Extra-capsular femoral fracture
does not affect blood supply to the joint
plantar aponeurosis
- supports the longitudinal arch of the foot
- protects deeper structures in the sole
Actions of Vitamin D • On the intestine
– stimulates intestinal absorption of calcium and phosphate by increased synthesis of a specific calcium binding protein calbindin
– may also stimulate an ATP-dependent calcium pump, which transports calcium into the blood stream.
Genitofemoral (L1,2)
Location
Structures: genital branch and femoral branch
can be seen splitting into genital and femoral branches as it travels along psoas
genital branch: supply cremaster and scrotum
femoral branch: skin of the femoral triangle
Posterior cruciate ligament
attaches where?
function?
Attaches on the posterior part of the intercondylar area of the tibia and ascends anteriorly to attach to the medial wall of the intercondylar fossa of the femur
prevents post. tibial displacement and ant. femoral displacement
5 genicular arteries from the popliteal artery
- superior medial
- superior lateral
- inferior medial
- inferior lateral
- middle
Can smooth muscle have Tetanus?
Partially
Hypervitaminosis D
characterized by hypercalcemia
Vitamin D also increases phosphate absorption
Increase in serum calcium and phosphate results in an increased tendency for ectopic (soft tissues) mineralization
Prolonged hypervitaminosis D (prescription medications) can lead to calcification in soft tissues like kidney
Vastus medialis
- Origin
- Insertion
- Function
- Innervation
- Blood Supply
- linea aspera, intertrochanteric line
- patella & tibial tuberosity via patella ligament
- • extends knee • stablizes patella (inferior fibers)
- Femoral nerve
- Femoral artery
Extensor digiti minimi
- Origin
- Insertion
- Function
- Innervation
- Blood Supply
- lateral epicondyle of humerus
- extendor expansion of 5th digit
- extends 5th digit
- Posterior interosseous nerve, deep branch of radial nerve
- Radial recurrent, ant. and post. interosseous
Infraspinatus
- Origin
- Insertion
- Function
- Innervation
- Blood Supply
- Infraspinous fossa of scapula
- greater tubercle of humerus, posterior to supraspinatus
- holds head of humerus in glenoid cavity, stabalizes shoulder joint, lat. rotates humerus
- Suprascapular nerve
- Circumflex scapular artery, suprascapular artery
Basal region of osteoclasts
Houses organelles and numerous nuclei of the cell
Flexor digitorum longus of the Lower Limb
- Origin
- Insertion
- Function
- Innervation
- Blood Supply
- posterior tibia
- tendon runs behind medial malleolus & insert into distal phalanx of toes 2-5
- • plantar flexes & inverts foot • flexes toes • helps foot “grip” ground
- Tibial nerve
- Posterior tibial artey
Dermis function
Strength and elasticity
Contains epidermal appendages, nerve corpuscles, glands
Contains smooth muscle cells that move hairs
Smooth muscle cells form a loose plexus the the reticular layer of erectile organs. (Normally dense irregular)
Compartment syndrome causes
45% of all cases of CS are caused by tibial fractures.
Other causes include longbone fracture, burn injuries, vascular injury, crush injury, and tight casts or dressings
Both intra and extracapsular fractures result in external rotation of the leg with some shortening Why?
The fracture caused a decrease in the angle, thus creating a shorter right limb. This decrease in angle between neck and shaft is called acquired coxa vara
Identify the Injury:
Hangman’s Fracture
Tibialis anterior
- Origin
- Insertion
- Function
- Innervation
- Blood Supply
- lateral condyle & upper 2/3 of tibial shaft, interosseous membrane
- by tendon into inferior surface of medial cuneiform & 1st metatarsal
- • prime mover of dorsiflexion • inverts foot • assist in supporting medial longitudinal arch
- Deep fibular nerve
- Anterior tibial artery
Patellar Ligament
continuation of quadriceps femoris tendon inferior to patells.
Extrinsic back muscles sometimes called Superficial back muscles- contains 2 main muscle groups:
Superficial appendicular or superficial extrinsic group
Superficial respiratory or Intermediate extrinsic group
Both groups of extrinsic muscles are innervated by “named” branches of ventral/anterior rami of spinal nerves and receive their blood supply from branches of major arteries
Transversospinalis muscle group
Semispinals (capitis, cervicis, thoracis)
Multifidus
Rotatores Cervicis, thoracis, lumborum
Thoracostomy
Chest tube inserted to drain fluid or air from pleural cavity
Bone repair
Fractured bone = damage to matrix, bone cells, blood vessels
Hemorrhaging is followed by blood clotting, and macrophages remove much of the debris via phagocytosis
Fibroblasts proliferate in the periosteum and endosteum and surround the area internally and externally to isolate it
Clear zone of osteoclasts
What do microfilaments do?
Region of cytoplasm that surrounds the ruffled border
Microfilaments, anchor osteoclast to boney surface and help isolate osteoclastic activity
PTH on phosphate levels:
incr. plasma levels by incr. bone resorption
decr. plasma levels by incr. excretion from kidneys
Interterritorial matrix
• Composition is a mixture between territorial matrix and capsular matrix.
Three nerves are commonly damaged in Radical mastectomy
Long thoracic
Thoracodorsal
Intercostobrachial
Hair follicle and hair formation
Matrix cells contribute to
Keratinogenous zone
Internal root sheath and full keratin hair?
Separated from underlying dermis by?
Matrix cells contribute to formation of the internal root sheath and the hair shaft
Keratogenous zone: matrix cells undergo keratinization as soon as they pass through this zone
The fully keratinised hair consisting of hard keratin is not followed by the internal root sheath
It is separated from the underlying dermis via a thick basal lamina (glassy membrane)
Episiotomy
The pelvic and perineal muscles may tear during childbirth
Tearing of the perineal body may result in severe post partum complications
To prevent excessive damage specifically to the external anal sphincter the muscles are cut
Typically the cut is made obliquely through the muscles
Contents of tarsal Tunnel
Tom: Tibialis Posterior
Dick: Flexor Digitorum Longus
And: Posterior tibial Artery
Very: Posterior tibial vein
Very: Posterior Tibial Vein
Nervous: Tibial nerve
Harry: Flexor hallucis longus
Supinator
- Origin
- Insertion
- Function
- Innervation
- Blood Supply
- lateral epicondyle of humerus
- lat. ant. & post. surfaces of proximal 1/3 of radius
- forcibly supinates arm w/ biceps brachii, weakly supinates working alone
- Posterior interosseous nerve
- Posterior interosseous, Radial recurrent artery, Recurrent interosseous artery
Proximodistal
- Signaling center
- Molecular signal
- Apical Ectodermal Ridge (AER)
- Fibroblast growth factors (FGF-2,-4,-8)
Label the Embryonic remnants at the blank arrows
Fibrocartilage Locations in body
Intervertebral disc
Pubic symphysis
Medial and lateral menisci
Attachment of ligament to bone
Intersections of some tendons and ligaments
Articular discs
Scarpa’s fascia
• Deeper located and membranous
Continues into the thigh and fuses with the fascia lata
Attached firmly to linea alba, pubic symphysis, ischiopubic ramus and posterior perineal membrane
Continues into the perineum as superficial perineal fascia (Colles’)
Vitamin D Resistant Rickets
Symptoms
Cause
Treatment
Similar symptoms as classical rickets + alopecia (hair loss). • Plasma levels of 1,25(OH)2D are elevated.
caused by mutations in the gene encoding the vitamin D receptor in the intestine –> decr. Ca2+ absorption from diet.
Difficult. Regular, usually nocturnal calcium infusions, which dramatically improve growth but do not restore hair growth.
Vastus intermedius
- Origin
- Insertion
- Function
- Innervation
- Blood Supply
- anterior & lateral surfaces of proximal femur
- patella & tibial tuberosity via patella ligament
- extends knee
- Femoral nerve
- Deep femoral artery
Chondrocytes
matured chondroblasts also located in lacuna. Surrounded by matrix
Located deeper to the chondroblasts and are more spherical
Mitosis forms groups of 4-8 chondrocytes. Isogenous groups. Cell nest. Indicates Internal growth
As they mature further, they move apart by their own synthesis of ECM. Results in growth of cartilage.
Ilioinguinal Nerve (L1)
Location
Structures
along the iliac crest enters the inguinal canal
internal oblique-transversus muscles, skin over upper medial thigh, anterior scrotum and labia majora
Deep wound healing
This type of healing occurs in 4 phases:
– Inflammatory Phase
– Migratory Phase
– Proliferative Phase
– Maturation Phase
Scar may happen
Skeletal Muscle twitch duration
20-200 msec
valgus pressure
Excessive force to the lateral side of the knee. Happens in the unhappy triad.
Biceps brachii
- Origin
- Insertion
- Function
- Innervation
- Blood Supply
- long head: tubercle above glenoid cavity and cavity lip of scapu short head: coracoid process of scapula
- radial tuberosity
- flexes elbow joint, supinates forearm. weakly flexes shoulder
- Musculocutaneous
- Brachial artery, ant. circumflex humeral artery
Calcitonin
Produced by the parafollicular cells of the thyroid gland
Inhibits matrix resorption by osteoclast and thus prevents the release of calcium to lower blood calcium levels
Anconeus
- Origin
- Insertion
- Function
- Innervation
- Blood Supply
- lateral epicondyle of humerus
- lateral olecranon process
- abducts ulna during forearm pronation
- Radial nerve
- Recurrent interosseous artery
Retromammary space
Space between the breast and the pec muscles Allows for free movement of the breast
Breast is firmly attached to the pectoral fascia by the suspensory ligaments
Can smooth muscle have rhythmicity?
YES
Plantaris
- Origin
- Insertion
- Function
- Innervation
- Blood Supply
- posterior femur above lateral condyle
- via a long, thin tendon into calcaneus or calcaneal tendon
- • assists in knee flexion • plantar flexion of foot
- Tibial nerve
- Sural arteries, popliteal artery, superior lateral genicular artery
Development of Cartilaginous Bones (give the time for each)
- Osteogenesis of long bones begins
- Ossification of carpal and tarsal bones
- Chondrification centers form
- entire limb skeleton is cartilage
- Week 7
- first year after birth
- Week 5
- Week 6
Sebaceous glands
Simple branched acinar
Secretory portion is located in the deeper dermis
Opens into hair follicle
HOLOCRINE secretion
Product is sebum, clear with H&E staining
Helps prevent the hairs from becoming dry and brittle
Epidermis type of epithelium
Stratified squamous keratinized epithelium
Osteoarthritis
what is it? what does it affect? how does it have that effect?
related to?
proteoglycan content?
effects?
degenerative joint disease affecting weight bearing joints (eg: hips, knees, lower vertebrae) degeneration of articular cartilage
related to aging and injury
Decrease in proteoglycan content, which results in reduced intercellular water content in cartilage matrix
progressive reduction of mobility and increased pain with joint movement
medial meniscus
attached around its margin to joint capsule and collateral ligament of tibia
Neural crest cells
Precursors of Schwann cells
Surround motor and sensory nerve fibers in the limbs
Form the neurolemma and myelin sheaths
Pudendal nerve and internal pudendal artery pass out the _________and in the _________________
greater
lesser sciatic notch
Fibularis brevis
- Origin
- Insertion
- Function
- Innervation
- Blood Supply
- distal fibula shaft
- by tendon behind lateral malleolus into base of 5th metatarsal
- plantar flexes & everts foot
- Superficial fibular nerve
- Anterior tibial artery. Muscular branches of Fibular artery
Capsular matrix
- Highest concentration of sulfated proteoglycans, hyaluronan, biglycans, and several multiadhesive glycoproteins.
- Less collagen fibers
- Basophilic staining with H/E
Absorption and Excretion of Phosphorus
85% of the ~600 g of body phosphorus is present in bone mineral
phosphorus exists intracellularly at concentrations close to those present in ECF (e.g., 1–2 mmol/L)
phosphorus exists in several forms, predominantly as H2PO4 − or NaHPO4 − , with perhaps 10% as HPO4 2−. This mixture of anions will be referred to here as “phosphate.”
widely available in foods and is absorbed efficiently by the small intestine.
absorptive efficiency may be enhanced by 1,25(OH)2D (Vit D).
Excretion of phosphate is through urine – controlled according to plasma concentration levels which can be overridden by PTH
Function and location of menisci
increase the congruency between the tibial and femoral condyles
attached medially to intercondylar region of tibia
Serratus anterior
- Origin
- Insertion
- Function
- Innervation
- Blood Supply
- External surfaces of ribs 1-9
- Medial border of scapula
- Protracts and upwardly rotates pectoral girdle
- Long thoracic nerve
- Superior thoracic and lateral thoracic arteries; thoracodorsal artery
Teres Minor
- Origin
- Insertion
- Function
- Innervation
- Blood Supply
- lateral border of dorsal scapular surface
- greater tubercle of humerus, inferior to infraspinatus
- holds head of humerus in glenoid cavity, stabalizes shoulder joint, lat. rotates humerus
- Axillary nerve
- Circumflex scapular artery, posterior circumflex humeral artery
Cardiac Muscle Excitation
Pacemaker potentials, electrical coupling
Nerve in:
Lateral leg compartment
Anterior leg compartment
superficial fibular
deep fibular
6 P’s of acute limb ischemia
- pain
- paresthesia
- pallor
- paresis (weakness / paralysis)
- pulselessness
- poikilothermia (cold)
valves in veins:
assist with venous return by preventing retrograde flow
prevent flow from deep veins to superficial veins.
Common fibular nerve injury
lateral and anterior compartments affected
foot drop: loss of dorsi flexion and unopposed inversion
due to loss of eversion the lower limb becomes ‘too long’
high stepping gait, swing out the leg
Denticulate ligaments
21 pairs composed of a single narrow fibrous strip that extends from the craniovertebral junction to T12.
Each ligament features 18-20 triangular extensions of pia mater that attach to the dura at their apices Separate the ventral and dorsal rootlets from each other
Eccrine sweat glands
Thick and thin skin
Simple coiled tubular glands
Secretory portion is in the deep dermis, merocrine secretion
Identify the Injury:
Spondylolysis
Somites give rise to:
Sclerotome (vertebrae and ribs)
Myotome (Muscle)
Dermatome (Connective tissue: Dermis)
Label the parts 1 2 3
- Capsular matrix - matrix adjacent to the chondrocyte
- Territorial matrix (TM) - matrix found around isogenous groups
- Interterritorial matrix (IM) - matrix inbetween isogenous groups
Mc Burney’s point Abdominal Incision
2/3 between the umbilicus and ASIS
Appendectomy
- Incision is made through subcutaneous tissue
- The transversalis fascia, extraperitoneal fascia and parietal peritoneum is also cut
- Avoids ilioinguinal nerve (#12) and iliohypogastric nerve
Some examples of non-malignant breast lumps
- Fibroadenomas
- Fibroadenosis
- Breast cysts
Lamellar bodies
form water barrier in epidermis
Femoral sheath
formed by
vessels enclosed
how divided?
relation to femoral nerve?
formed by the inferior prolongation of the transversalis fascia and the iliopsoas fascia from the abdominal region
femoral artery and vein are enclosed in it
divided internally into three smaller compartments by connective tissue.
femoral nerve is lateral to but not contained within the femoral sheath
Stratum Lucidum
Thick skin only
Considered a subdivision of the stratum corneum
In light microscopic view it appears as a light highly refractile eosinophilic band
Appears to contain cells in which the keratinization process is well advanced
Pemphigus vulgaris
Weak blister that messes with the desmosomes between layers of the epidermis.
Rare autoimmune disorder
Antibodies target cadherins and desmoplakins
Separation of epidermal cells (S. Spinosum)
Atrophy of the prickle cell layer.
Blisters formation: (easy to rupture) – Nikolsky’s sign, skin shears of easily when wiped
Central diaphragmatic and mediastinal
nerve and level
C3,4,5 (phrenic nerve)
What part of limb development is at week 8?
Fingers and toes distinct and separated
Perichondrium (P)
Connective tissue covering the entire cartilage
Outer fibrous layer-contains fibroblasts: synthesize collagen type I and matrix. Contains blood vessels
Inner cellular layer: Chondrogenic layer: chondrogenic cells
Calcium Levels
About 98 -99% of total body calcium stored in bones
Erector spinae muscle group
Function (group)
Innervation (segmental)
Blood Supply (segmental)
Acting bilaterally: extend vertebral column and head; as back is flexed, control movement by gradually lengthening their fibers. Acting unilaterally: laterally flexes vertebral column.
Posterior rami of spinal nerves
Vertebral, deep cervical, occipital, transverse cervical, posterior intercostal, subcostal, lumbar and lateral sacral arteries
Apical ectodermal ridge (AER)
Ectodermal thickening at the apex of each limb bud
Inductive influence on limb mesenchyme
Interaction between the AER and mesenchyme is essential for limb development 11
Superior thoracic aperture
Structures passing through
– Left Subclavian artery
– Subclavian (or SCV) vein
– Brachiocephalic trunk
Lymphedema of upper limb
- Can be a consequence of mastectomy or radiation therapy
- Removal of/damage to axillary lymph nodes leads to decreased lymphatic drainage of the upper limb
- Accumulation of interstitial fluid
2 main layers of the Cutis
Epidermis
Dermis
Chondroblasts
Derived from
Location
Shape
holding space
function
derived from chondrogenic cells
Location: just below chondrogenic layer of perichondrium
ovoid and positioned with longitudinal axes parallel to cartilage surface
Lacuna is space occupied by chondroblast
Synthesize cartilage matrix
Bones of the foot
7 tarsals
5 Metatarsals
14 Phalanges
Ruffini’s
shape
general description
what passes through
myelin fibers
respond to
Simplest and have an elongated fusiform shape
Thin connective tissue capsule surrounding a fluid filled space
Collagen fibers from surrounding connective tissue pass through the capsule
Single myelinated fiber enters the capsule, Loses myelin sheath and branches, with each ending having a small knoblike bulb
axonal endings respond to stretch and torque
Anteroposterior
- Signaling center
- Molecular signal
- Zone of polarizing activity (ZPA)
- Sonic hedgehog (Shh)
Skeletal Muscle Excitation
Neuromuscular
What part of limb development is at week 7?
- Mesenchymal tissue in the foot plates condense to form digital ray (toe buds)
- lower limb digits outlined
Vitamin D: Serum calcium • On the kidneys
inhibits calcium excretion by stimulating parathyroid dependent calcium reabsorption
Subclavius
- Origin
- Insertion
- Function
- Innervation
- Blood Supply
- Superior surface of costal cartilage of first rib
- Groove on inferior clavicle surface
- Stabalizes clavicle
- Subclavuculus
- Clavicular branch of thoracoacromial artery, suprascapular artery
Cruciate anastomosis Formed by
- medial circumflex femoral artery
- lateral circumflex femoral artery
- 1 st perforating branch of profunda femoris artery
- branch of inferior gluteal artery
Vitamin D: Serum calcium • On the intestine
–stimulates intestinal absorption of calcium and phosphate by increased synthesis of a specific calcium binding protein (calbindin)
Tarsal tunnel found on the ______________________________.
posteromedial side of the ankle
Thoracocentesis
“pleural tap” to sample fluid from pleural space
Needle inserted into the pleural cavity to obtain a sample of fluid. 9 th ICS →midaxillary line during expiration, directed slightly upwards.
Collateral branches are of no clinical significance, so needle is always superior to the rib
Identify
Merkel’s corpuscle
Compact bone
Lacunae/haversian canal communication
Lamella structure
Lamellae positioning
numerous canaliculi that permit communication between lacunae and with the Haversian canals
Each lamella consists of multiple parallel arrays of collagen fibers.
Adjacent lamellae, have alternating directions of collagen fibers providing great strength despite its light weight
Smooth Muscle force regulation
Balance of MLCK-MLCP. MLCK regulation by PKA, PKC, Ca2+-Cal.
Latch state
Sympathetic chain ganglia
run down the length of the vertebral column lateral to vertebral bodies (bilateral)
communicate with spinal nerve via grey (unmyelinated) and white (myelinated) rami communicantes
Suprasipnatus
- Origin
- Insertion
- Function
- Innervation
- Blood Supply
- supraspinous fossa of scapula
- superior part of greater tubercle of humerus
- stabilizes shoulder joint, helps prevent downward dislocation of humerus
- Suprascapular
- Suprascapular artery and dorsal scapular artery
Bone Nutrition
Greatly affects bone development. Diets low in protein result in deficiency of amino acids essential for collagen synthesis by osteoblasts
Serratus Posterior Superior
Function
Innervation
Blood Supply
Elevates ribs II to V
Anterior rami of upper thoracic (intercostal) nerves T2 to T5
Segmental supply through intercostal arteries
Osteoblasts
entrapped in matrix become osteocytes
may appear as a cuboidal layer (high secreting activity) or flattened (declining secretions)
Cytoplasmic processes contact them with other osteoblasts and osteocytes
Skeletal Muscle Ca2+ sensor
Troponin C
Types of secondary (Mature) bone
Compact bone (dense and heavy)
Spongy/Cancellous bone (filled with interconnected spaces that are filled with bone marrow)
Hypercalcemia
Causes
Diagnosis
- Excessive PTH production • Hypervitaminosis • Excessive 1,25(OH)2D production • Excessive calcium intake
- PTH immunometric assays with blood calcium measurements • Elevated immunoreactive PTH level in a patient with asymptomatic hypercalcemia • Serum phosphate may be low, but may be normal, especially if renal failure has developed.
fascia cruris
fascia in the leg
Axioms
Every muscle that crosses a joint will act on that joint.
A direction of movement at a joint may be the function of more than one muscle, although only one muscle may be the primary mover.
Hilton’s Law
Generally each muscle is innervated by a single nerve, and injury to that nerve will affect only that muscle.
Each muscle has a major arterial supply, but other arteries do contribute to supply the muscle. Thus, blockage of the major artery to a muscle may not adversely affect the muscle because of collateral blood supply.
Internal Intercostals
- Origin
- Insertion
- Function
- Innervation
- Blood Supply
- superior border of rib below
- inferior border (costal groove) of rib above
- • depress rib cage, aid in forced expiration • antagonist of external intercostals
- Intercostal
- Posterior intercostal arteries, anterior intercostal branches of internal thoracic arteries, musculophrenic artery
3 Arteries of the posterior leg compartment
and how each one travels
Popliteal artery: enters the posterior compartment of the leg from the popliteal fossa behind the knee. Immediately splits into an anterior and posterior tibial artery.
Anterior tibial artery: enters the anterior (extensor) compartment.
Posterior tibial artery: travels in the deep flexor compartment.
Median Abdominal Incision
At the linea alba good for exploratory laparotomy; advantage is that no blood vessels cross the area, good suture repair
Menisci: cartilage type and shape
C-shaped fibrocartilage
Functions of Calcium
essential mineral
Calcium in bone provides mechanical stability and serves as a reservoir
Required for bone formation and remodeling: to build strong bones and teeth
Important cofactor for several enzymes and signal for signaling pathways
Neurotransmitter for some neuron signals and plays a prominent role in maintaining the resting membrane potential
Muscles of the Anterior leg compartment
extensor digitorum longus
fibularis tertius
tibialis anterior
extensor hallucis longus
Club Foot (Congenital Talipes )
Talipes equinovarus ( is most common type )
Twice more frequently in males as in females.
Sole of foot is turned medially and the foot is inverted.
Multifactorial pattern of inheritance.
Identify the Injury:
Jefferson Fracture (Burst Fracture of Atlas)
Amelia
Complete absence of limbs
Suppression of limb bud development in the 4th week
Skeletal muscle electrical activity
Spikes
Articular cartilage
Type of hyaline cartilage found at articular surfaces.
DOES NOT have perichondrium
In contact with articular surface of bone on opposite side
Remnant of original cartilage template of developing bone
Persists throughout adult life
Concentration of ionized calcium in ECF (plasma)
1.2mmol/L
Territorial matrix
- Randomly arranged network of type II collagen fibrils with smaller quantities of type IX collagen.
- Lower concentration of sulfated proteoglycans
- Less basophilic than the capsular matrix.
Parathyroid hormone (PTH)
Indirectly stimulates osteoclasts to resorb and release calcium, thus elevating blood calcium levels
May activate osteocytes to initiate osteolysis , whereby they liberate calcium from the walls of their lacunae, thus elevating blood calcium levels
In excess renders bone more susceptible to fracture and subsequent deposition of calcium in arterial walls and certain organs such as the kidney
Coracobrachialis
- Origin
- Insertion
- Function
- Innervation
- Blood Supply
- coracoid process of scapula
- medial surface of humerus shaft
- flexion & adduction of humerus
- Musculocutaneous nerve
- Brachial artery, anterior circumflex humeral artery
Flexor carpi radialis
- Origin
- Insertion
- Function
- Innervation
- Blood Supply
- medial epicondyle of humerus
- base of 2nd and 3rd metacarpals
- powerful wrist flexion, abducts hand, weak elbow flexion
- Medial nerve
- Radial artery. Post. branch of ulnar recurrent artery
Superior thoracic aperture Boundaries
– Body of 1st thoracic vertebra
– 1 st ribs and their costal cartilages
– Jugular notch
Development of Limb Arteries
Limb buds supplied by branches of the intersegmental arteries
Primordial vascular pattern
Can cardiac muscle have tetanus?
NO
Migratory Phase of deep wound healing
Wound becomes a scab. Epithelial cells migrate beneath it to bridge the wound
Fibroblasts synthesize scar tissue (collagen and glycoprotein)
damaged vessels regrow
Secondary Osteoporosis
Develops as a consequence of drug therapy (corticosteroids) or other disease process (malnutrition, weightlessness, metastatic cancer)
Development of Osteons
- Longitudinal ridges form along bone
- Osteogenic cells in periosteum transform into osteoblasts
- Osteoblasts produce bone matrix
- Mone matrix forms ridges
- Ridges meet and close off periosteal capillaries
- Periosteum lining newly formed canal becomes endosteum
- New endosteum starts forming concentric lamellae to form osteon
Does Smooth Muscle have gap junctions?
Mulit-unit: few
Unitary: many
Skeletal Muscle Excitation Contraction Coupling
L-type (DHP receptor) voltage sensor
Store release Ryr
Blood supply to the thigh
Femoral artery
A cluster of four small branches:
– superficial epigastric artery
– superficial circumflex iliac artery
– superficial external pudendal artery
– deep external pudendal artery
With increased inotropism for a given preload there is greater degree of
Force of contraction
Types of Cartilage cells
Chondroblasts
Chondrocytes
Chondroclasts
Calcium reserve
Bone contains about 99% of the body’s calcium
Decalcification of bone results from diet inadequate in calcium, which leads to rickets in children and osteomalacia in adults
During the remodeling of spongy bone, calcium is transferred from the bone into the blood stream
Meromelia
Partial absence of limbs
Disturbance of limb development during 5th week
Innervation of the abdominal wall and inguinal region
nerves travel between which muscles
what branches do the cutaneous segment give off?
Nerves travel between internal oblique and transversus abdominis (compare with intercostal nerves)
Give off lateral and anterior cutaneous branches
Extensor hallucis longus
- Origin
- Insertion
- Function
- Innervation
- Blood Supply
- anteromedial fibula shaft & interosseous membrane
- distal phalanx of big toe
- • extends big toe • dorsiflexes foot
- Deep fibular nerve
- Anterior tibial artery, perforating branch of fibular artery, medial malleolar artery
Adductor hallucis
- adducts the big toe
- lateral plantar nerve
Three main ligaments of the hip joint capsule
ilio-femoral ligament (prevents hyperextension)
pubo-femoral ligament (prevents hyper abduction)
iIschio-femoral ligament (Ischium to femur)
Cremaster muscle
formed by internal abdominal oblique muscle and aponeurosis
Burst Fracture
injury to the spine in which the vertebral body is severely compressed.
great deal of force vertically onto the spine.
margins of the vertebral body spread out in all directions.
Can have retropulsed fragments into the spinal canal may lead to spinal cord injury
Hyaline cartilage Histology
•Matrix has a “glassy” appearance because fibers and ground substance has the same refractive index
NAVELL
E (empty space, potential femoral hernia, expansion of vein) and L (deep lymph node, if present) EL = (‘femoral ring’)
Interstitial growth
occurs only in young cartilage from cell divisions within the cartilage
transverse ligament of the knee
anteriorly interconnects the medial and lateral menisci.
Pronator teres
- Origin
- Insertion
- Function
- Innervation
- Blood Supply
- Medial epicondyle of humerus. coronoid process of ulna
- lateral radius, midshaft
- pronates forearm. weak elbow flexor
- Medial nerve
- Ulnar artery (main, ant. and inf. branches). Radial artery
Arteries to the hip joint
Medial and lateral circumflex femoral arteries – Retinacular branches
Knee injuries-Unhappy Triad
Medial collateral (most common)
Anterior cruciate
Medial meniscus/lateral meniscus
Anterior intercostal a
Follows the inferior border of the rib and anastomoses with the posterior intercostal arteries
nerves that supply a joint will also supply the muscles that move the joint, and the skin over the joint
Hilton’s Law
Spinal Chord blood supply:
Spinal Arteries
Smooth Muscle Contraction termination
Ratio of MLCK to MLCP
Mature bone
Replaces primary bone and made up of Haversian systems, or osteons
Calcified matrix arranged in regular concentric layers of lamellae (3 to 7nm thick). Surrounding Haversian canal
Osteocytes in lacunae are located between the lamellae and occasionally within them
Three Thigh Compartments
Posterior
Anterior
Medial
Arteries of the foot
Lateral plantar artery
Medial plantar artery
Deep plantar artery
Deep plantar arch
Medial and lateral tarsal branches
Arcuate artery
Branches of posterior tibial artery
- circumflex fibular
- fibular artery
- nutrient artery to tibia
- muscular branches
Cremasteric reflex
- Afferent
- Efferent
- Strong in
- ilioinguinal nerve (L1)
- genital branch of the genitofemoral nerve (L1,2)
- Infants and Adolescents
What part of limb development is at week 6?
- Mesenchymal tissue in the hand plates condense to form digital ray (finger buds)
- Upper limb digits outlined
Can skeletal Muscle have Rhythmicity?
NO
Osteoblast synthesis and further differentiation
During synthesis osteoblasts have well developed RER and Golgi apparatus
Matrix secretion eventually entraps the osteoblast in a lacunae with its cytoplasmic process extending into caniculi.
Osteoblast ceases its secretory function, changes its morphology and becomes an osteocyte
Hyperphosphatemia
Clinical effects
Lab findings
- Calcification of soft-tissue, organs (kidney, lungs, heart) • Tetany, • Seizures.
- Fasting serum phosphate concentration >1.8 mmol/L (5.5 mg/dL),
Identify
Mature bone
Callus formation
A fibrocartilaginous callus is formed both internally and externally
Bone is elaborated in the fracture zone via intramembranous bone formation by osteoblasts derived from osteogenic layer of the periosteum and endosteum in the vicinity of the fracture
Chondrocytes also differentiate from this connective tissue and elaborate cartilage, which will be replaced by bone via endochondral bone formation, thus forming a bony callus composed of primary bone
Bony callus is eventually resorbed and replaced with secondary bone as the repair process continues
Hyaline cartilage
Regeneration
Calcification
regenerates very poorly and often the perichondrium forms scar tissue
In old age hyaline cartilages can get calcified
Inflammatory Phase of deep wound healing
Blood clot formed and loosely attaches cut edges
Vasodilatation and increased permeability helps neutrophils and monocytes (which become macrophages) to enter the area
Mesenchymal cells develop into fibroblasts
Sacral/ Caudal Epidural Anesthesia
Provides a reliable and effective block for operations which involve low lumbar and sacral dermatomes
Often used for steroid injections
Landmark – sacral hiatus
Decreased risk of entering subarachnoid space
Coccygeus
- Origin
- Insertion
- Function
- Innervation
- Blood Supply
- spine of ischium
- sacrum & coccyx
- • supports pelvic viscera • supports coccyx & pulls it forward
- S4 & S5
- Inf. gluteal artery
Blood supply of anterior abdominal wall
Internal thoracic
Musculophrenic
superior epigastric
inferior epigastric
superficial epigastric
superficial circumflex iliac
Sciatic nerve
Combination of two nerves • common fibular • tibial
Typically exits the pelvis below the piriformis
Separates proximal to the popliteal fossa
Splenius capitis
Function (group)
Innervation (segmental)
Blood Supply (segmental)
Acting bilaterally: extend neck. Acting unilaterally: Laterally flexes and rotates to the same side
Posterior rami of cervical spinal nerves
Deep cervical, occipital
Medial longitudinal arch
Formed by
Keystone
Supported by
-Formed by the Interlocking of the
- talus,
- calcaneus,
- navicular,
- cuneiform and
- 3 medial metatarsals
- Keystone- head of the talus
- Supported by spring ligament and tendon of flexor hallucis longus
Layer 1 of the foot
abductor digiti minimi
plantar aponeurosis
flexor digitorum brevis
abductor hallucis
Cleft Hand & Cleft Foot (Ectrodactyly)
“lobster claw deformities”
Absence of one or more central digits
Failure of development of one or more digital rays
Remaining digits are partially or completely fused
Rare anomaly
Function of foot arches
Names of Three arches
absorb and distribute downward forces from the body during standing and moving on different surfaces
- Medial longitudinal
- Lateral Longitudinal
- Transverse
Lateral Longitudinal Arch
Formed by
Keystone
Supported by
Acts As
-Formed by
- calcaneus,
- cuboid, and
- lateral 2 metatarsals
- Keystone- cuboid bone
- Supported by the peroneus longus tendon and long and short plantar ligaments
- Acts as a spring in locomotion and supports the body in the erect position
What is it? Give a description
Associated with?
What kind of skin?
Consists of? (3 main parts)
What does the bulb contain?
Hair follicle: Invagination of epithelium extending to hypodermis
Associated with a sebaceous gland and smooth muscle = pilosebaceous organ
Thin skin ONLY
Consists of Infundibulum, Isthmus, Inferior segment
Bulb contains the matrix cells for hair formation as well as melanocyte stem cells
Extensor carpis ulnaris
- Origin
- Insertion
- Function
- Innervation
- Blood Supply
- lateral epicondyle of humerus, coronoid process of ulna, radius shaft
- base of 5th metacarpal
- extends & adducts wrist
- Deep branch of radial nerve
- radial recurrent artery, posterior interosseous artery
Wedge/Compression Fracture
vertebral compression fracture occurring anteriorly and/or laterally. If it is only crushed in the front part of the vertebral body, it becomes wedge shaped
more commonly found in the thoracic spine bc rigidity
Inferior vena cava receives blood indirectly from the
___________(6 Vesses)_________ via what (for each)?
– left inferior phrenic (via renal veins)
– left suprarenal (via renal)
– left gonadal (via left renal)
– femoral and lower limb veins (via external iliac)
– anterior abdominal wall (via external iliac)
– pelvic organs (via internal iliac)
Smooth muscle
- What provides tension over long muscle lengths?
- Passive tension function?
- How does tension compare to skeletal muscle?
Side polar cross bridges actin/myosin
Much passive tension at optimal force/length- reduce overextension e.g. gut
Tension generated is greater than skeletal muscle (due to myosin structure)
Teres Major
- Origin
- Insertion
- Function
- Innervation
- Blood Supply
- post. surface of scapula @ inf. angle
- intertubercular groove of humerus
- posteromedial extension, medial rotation, adduct arm
- Lower scapular nerve
- Circumflex scapular artery, subscapular artery, posterior circumflex humeral artery
Five primary epidermal derivatives in the skin
And which can only be found in thin skin? (indicated by *)
Hair follicles and hair*
Sabaceous glands*
sweat glands
nails
mammary glands
Hyperphosphatemia
Causes
- Decreased renal excretion - Impaired kidney function
- Hypoparathyroidism
- Excessive release of phosphate into the ECF (from the gut, bone or parenteral phosphate therapy)
- A combination of these factors.
Melanocytes
Basal layer
1 melanocyte can communicate with up to 40 keratinocytes
No desmosomal connections but are attached to the basal lamina via hemidesmosome like structures
Melanocyte to keratinocyte ratio 1:4 to 1:10 in different parts of the body
Oxidation of tyrosine to 3,4- dihydroxyphenylalanine (DOPA) and subsequent transformation of DOPA into melanin
PTH increases plasma calcium (Ca++) by:
incr. bone resorption (activates osteoclasts, decr. collagen synthesis by osteoblasts).
Incr. Ca++ reabsorption in the kidneys
Incr. vitamin D synthesis in kidneys –> incr. Ca++ absorption in the GIT
Compact bone: Volkmann’s canals
Connect adjacent Haversian canals to each other and to endosteum at marrow cavity in and outside periosteum
Allow for passage of neurovasculature through compact bone
Common fibular (L4 – S2) innervates
skin and muscles of anterior leg, lateral leg, and dorsal foot
Label the 8 parts of the image
- Osteon or Haversian system
- Haversian canals (hold osteonal artery)
- Volksman canals
- Outer circumfrencial lamillae
- Interstitial lamillae (remodeled haversian system)
- Lacunae
- Endosteum
- Canaliculi (house cytoplasmic processes from osteocytes)
Levator Scapulae
Function
Innervation
Blood Supply
Elevates scapula
C3 to C4 and dorsal scapular nerve
Transverse ascending cervical arteries
Howship’s lacunae
depressions on the bone surface that house osteoclasts
These lacunae result from the osteolytic activities of osteoclasts
Hypophosphatemia
Causes
Symptoms
Note
(1) Inadequate intestinal phosphate absorption – vitamin D deficiency, (2) Excessive renal phosphate excretion – PTH excess.
Nerve, bone, red and white blood cells, membrane, and muscle functional problems.
Serum levels of phosphate and calcium must be monitored closely (every 6 –12 h) throughout treatment.
Quadratus plantae
- assist in flexion of digits
- lateral plantar nerve
- The aponeurosis of the external oblique forms
- The inferior free edge forms
- anterior layer of the rectus sheath
- the inguinal ligament
- The aponeurosis of the internal oblique forms
- The inferior portion joins with the aponeurosis of transversus abdominis to form
- rectus sheath above and below the arcuate line
- the conjoint tendon
fibular (lateral) collateral ligament
lateral famoral condyle to fibular head
Types of growths seen in hyaline cartilage
Appositional growth
Interstitial growth
Thoracolumbar fascia
Anterior, Middle Posterior layers insertions
continuous with?
Covers: ?
The anterior and middle layers insert into the transverse processes of the vertebral column.
While the posterior layer inserts onto the tips of the spinous processes,
indirectly continuous with the interspinous ligaments
covers the paravertebral deep muscles of the back
Extra Cellular Matrix (ECM) Compostition
- Sulphated groups present in GAGs, make it hydrophilic, enabling easy diffusion of nutrition to the cells
- Presence of proteoglycans provide immense strength to the matrix so that cartilage can function as a model for bone formation.
Primary axial artery & its branches
arise from ____________
form ______________ throughout ______________
Arise from dorsal aorta
Form fine capillary network throughout mesenchyme
Flexor digitorum superficialis
- Origin
- Insertion
- Function
- Innervation
- Blood Supply
- medial epicondyle of humerus, coronoid process of ulna, radius shaft
- middle phalanges of fingers 2-5
- flexes wrist & middle phalanges of fingers 2-5
- Median nerve
- Ant. ulnar recurrent, ulnar, radial
VACTERL stands for
Vertebral defects
Anal atresia
Cardiac defects
Tracheo-Esophageal fistula
Renal anomalies
Limb anomalies
Leg compartments
Anterior
Posterior
Lateral
Transverse arch
- Proximal
- Formed by
- Supposted by
- Distal
- Formed by
- Maintained by
- Proximal
- Formed by navicular, 3 cuneiform, cuboid and bases of the 5 metatarsal bones
- Supported by the peroneus longus tendon
- Distal
- Formed by the heads of the 5 metatarsal bones
- Maintained by the transverse head of the adductor hallucis
Cells of the eccrine sweat gland
Clear cells - abundant glycogen stains well with PAS
Dark cells - rER and secretory granules are abundant
Myoepithelial cells - basal aspect of the secretory segment
Back musculature “deep” group
Deep=True=Intrinsic back muscles
Attached to elements of axial skeleton
Functions in movement of back proper and maintenance of upright posture
Innervated by dorsal rami of spinal nerves
Blood supply from branches of aorta and vertebral arteries.
Two methods of bone development
Intramembranous bone formation
Endochondral bone formation
Tensor fascia latae
- Origin
- Insertion
- Function
- Innervation
- Blood Supply
- anterior iliac crest & anterior superior iliac spine
- iliotibial tract
- • flexes & abducts thigh (synergist of iliopsoas & gluteus muscles) • rotates thigh medially • steadies the trunk by pulling iliotibial tract taut (locking the knee)
- Superior gluteal nerve
- Ascending lateral circumflex femoral, superior gluteal
Dermis Reticular layer
Thicker and deep to the papillary layer
Dense irregular connective tissue
characterized by thick irregular bundles of mostly type I collagen and courser elastic fibers
Pudendal (S2-4)
skin and muscles of the perineum
Multifidus
Function
Innervation
Blood Supply
Stabalizes vertebrae
Posterior rami of spinal nerves
Blood supply: segmentally through deep cervical artery, posterior intercostal artery, subcostal arteries, lumbar arteries
Intermediate (respiratory) group of back muscles
Serratus posterior superior
Serratus posterior inferior
Gluteus Minimus
- Origin
- Insertion
- Function
- Innervation
- Blood Supply
- dorsal ilium between anterior & inferior gluteal lines
- superior border of greater trochanter of femur
- abducts & medially rotates thigh
- Superior gluteal
- Superior gluteal
Trapezius
Function
Innervation
Blood Supply
Assists in rotating scapula during abduction of humerus above horizontal. Upper fibers elevate, middle fibers adduct, lower fibers depress scapula.
Accessory motor nerve. Cervical spinal nerves C3 and C4 for proprioception.
Superficial branch of transverse cervical artery
Label the skin types
Identify 1-10
Identify the Injury:
Wedge/Compression Fracture
Label the Incisions
Basal cell carcinoma
Caused by UV light
Proliferation of basal stem cells
Dark nuclei with sparse poorly defined cytoplasm
Cells at the periphery has a characteristic palisaded appearance
Central cells are more randomly arranged
invades the dermis and deeper lying structures
does not typically metastasize
Endochondral bone formation – epiphyseal plate
Epiphyseal plate continues to grow by adding new cartilage at the epiphyseal end while it is being replaced by bone at the diaphyseal end
Contains five histologically distinctive zones
Diaphyseal bone become continuous with epiphyseal bone (connecting the two marrow cavities) at age ~20
Identify the Injury:
Spondylolisthesis
Label the red arrows
Fibrocartilage function
Resists deformation under stress (Support and tensile strength)
Identify and describe
Langerhans cells
Originate from Common lymphoid progenitor (CLP)
Immunological function
No desmosomal junctions
Nucleus stains heavily with hematoxylin (blue) and the cytoplasm is clear
Involved in delayed-type hypersensitivity reactions
Identify
Formative Osteocyte
Identify
Pacinian corpuscle
Stratum Corneum
Several layers of dead keratinocytes
Filled with keratin filaments aggregated into tonofibrils
Abrupt transition from granulosum
Variable number of layers
Basis of classification between thick and thin skin
Identify and describe
Basal layer Melanocytes
Appear clear with large elongated nuclei
Cytoplasmic processes extend between keratinocytes (1:40)
No desmosomal connections but are attached to the basal lamina via hemidesmosome like structures
Identify:
Describe the Immunological function and the TEM structure
Langerhans cells
Immunological function – Encounter, process and express antigens = Antigen presenting cells (APC) – Migrates to the lymph node to present the antigen to T-lymphocytes
TEM Structure-Indented nucleus. tennis racquet shaped birbeck granules. Express both MHC I and MHC II and receptors for IgG
Fibrocartilage general characteristics
found in conjunction with hyaline cartilage and other fibrous tissues
Absence of perichondrium
Fibers arranged perpendicular to the direction of stress
Can undergo calcification
Isogenous groups are in linear fashion (longitudinal columns) due to the compression of collagen fibers
Identify
Basal cell carcinoma
Stratum Granulosum
Most superficial of the non-keratinized cells
Varies from one to three cell layers thick
Contain conspicuous granules
Fibrocartilage
Histogenesis
Cells
ECM
Growth
Mesenchymal cells
Fibroblasts transform to chondrocytes under stress
ECM produced by chondrocytes and fibroblasts. Predominantly type 1 collagen, but also contains type 2. GAGs: mostly chondroitin and dermatan sulphates
Only interstitial growth (due to absence of perichondrium)
Identify the Fracture:
Burst fracture
Bullous Pemphigoid
Damage to Hemidesmosomes – separation of epithelium from the dermis
Chronic autoimmune blistering
Antibodies IgG specific to hemidesmosomes bind to basement membrane, stimulating leukocytic infiltration
Eosinophils release proteases that degrade hemidesmosomes
Fluid accumulation – blister formation
Characteristic by large blisters that don’t easily rupture
Various regions of articular cartilage
- Tangential layer
- Transitional layer
- Radial layer
- Calcified cartilage
Identify:
Meisner’s corpuscle
Hyaline cartilage
- Histogenesis
- Cells
- ECM
- Growth
- Degeneration
- Calcification
- Mesenchyme
- Chondroblasts and chondrocytes
- Type II collagen fibers and GAGs- hyaluronic acid and glycoproteins
- Appositional & interstitial growth
- Does not readily degenerate
- Calcifies – bone formation & aging
Identify
Quiescent Osteocyte
Identify the Injury:
Odontoid fracture
Identify the cartilage type
Elastic Cartilage
Describe
Chondrocyte
Irregular surface
Extebnsive Golgi
Abundant rough ER
Euchromatic nucleus
Lipid droplets and glycogen deposits
Identify the cartilage type
Fibrocartilage
Identify the Injury:
Herniated disc
Identify the cartilage type
Hyaline Cartilage
Identify
Immature bone
Apocrine glands
Found only in armpit and perineum
Coiled tubular glands
Secretory portion is located in the dermis or even hypodermis
Secretory lumen larger than eccrine sweat glands
Secrete pheromones
Secretion mode is merocrine
Ducts are straight and lined by stratified cuboidal epithelium has a narrow lumen
Opens into the hair folicle
