General Concepts - Overview Flashcards by Caitlyn Myrdal

function of osteocytes

communicate with each other, sensitive to mechanical stress and help stimulate bone remodeling

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list the 4 reasons we stabilize fractures

To reduce pain
To facilitate healing
To improve function
To enable early mobilization

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what is contained in the endosteum of a bone?

bone lining cells (that have the capacity to differentiate into osteoblasts)

mature osteoblasts

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examples of fibrocartilage in the body?

intervertebral disks

2. menisci

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Lateral force to the knee can cause O’Donoghues unhappy triad, which has what ligaments damaged? (3)

MCL
ACL
medial meniscus

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what is an isogenous group in cartilage? what is it indicative of?

two or more cells in a lacuna (result of division)

indicative of growing cartilage (interstitial growth)

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injured myocytes secrete ________, and ________ arrive within an hour and phagocytose necrosis debris. The __________ release: (3) ______, ______, _______

cytokines, neutrophils, neutrophils,

IL1, IL8, TNF-alpha

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in imaging, you see a joint that has:  
Marginal erosions
Overhanging edges
Sclerotic borders
Soft tissue whiteness

what is this most likely?

gout

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depletion of _____ and addition of _____ causes rigor mortis in skeletal muscles

ATP, Ca++

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An experimental drug designed to read through premature stop codons

ataluren

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the ventral rami of limbs form plexuses…. what does this mean for peripheral nerves?

peripheral nerves are derived from multiple spinal levels! good for injury

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mechanism of injury for a meniscal tear:

twisting of knee while weight bearing

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joint between vertebral bodies is called:

joint between articular processes (facet joint) is called:

symphysis

zygaphophyseal joint (synovial)

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what is micromelia and what causes it?

partial absence of a limb

FGF loss in AER (apical ectodermal ridge) later in limb development (after stylopod)

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When knee extended, put valgus and varus stresses on the knee, see if there is movement of the tibia against the femur.
Repeat when knee at 20-30 degrees.

what is this called? what does a positive one indicate?

the Valgus stress test

positive - collateral ligament injury

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squamous cells that cover the inside and outer surfaces of bone. a signal to remodel the bone can trigger there to become active and convert into osteoblasts:

bone lining cells

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what are canaliculi? why are they important?

paths for the processes of osteocytes to make gap junctions with other cells and exchange nutrients and signal

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organic bone matrix gives bone what physical property?

makes it tough

RESIST FRACTURE

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Valgus opening at 30 degrees is diagnostic for isolated _____ injuries

MCL

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what 3 laxity exams can be performed to look for an ACL injury. which of these is the least specific/sensitive?

Anterior Drawer
Lachman test
Pivot shift test

Anterior drawer is not as sensitive or specific.

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_________ is secreted by osteoblasts and binds to RANKL, not allowing for its union with RANK.

what does this do to bone resorption?

osteoprotegerin (OPG)

decreases bone resorption

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_________ muscle contractions are more likely to cause injury

eccentric

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special fracture classification for fractures in skeletally immature patients when it involves the physis

the Salter-Harris classification

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Sensory loss across several dermatomes is indicative of a more _______ problem (the _______ or beyond)

distal

plexus or beyond

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calcitonin _______ osteoclast activity TRH ________ osteoclast activity

decreases increases

_______healing – early mobilization, in _________, they need to be immobilized.

muscle, tendon

what is the ATP synthesis mechanism for strength training actions? endurance training?

creatine phosphate aerobic (mitochondrial) respiration

what are the three phases in secondary fracture healing?

1. reparative 2. restorative 3. remodeling

idiopathic avascular necrosis in growing kids. involves the growing femoral epiphysis see smaller, white, flat femoral head

Legg-calve-perthes disease

Radiograph findings with RA: (2)

1. concentric (even) joint space loss 2. erosions (mouse and cheese) NO osteophytes

what is phocomelia and what causes it?

loss of internal limb structures (like micromelia - FGF loss in AER), but without disrupting the auto pod HOX distribution error

excessive force from the rectus femoris muscle ----> _______ evulsion fracture

AIIS

all deep back muscles are innervated by:

dorsal rami of spinal nerves

where are chrondroblasts found in cartilage?

inside layer of the perichondrium, facing the cartilage

what is amelia and what causes it?

complete absence of limb FGF loss in AER early in development (at stylopod)

excessive force from the __________ muscle ----> less trochanter evulsion fracture

iliopsoas

what can you see on a radiograph of osteoarthritis

Effectively no joint space (bone on bone) Can also sometimes see bony enlargements Bony sclerosis Malalignment

a young male presents with: Hypertrophied calves Stand on toes Exaggerated lumbar lordosis Gower’s maneuver what is it?

``` Mostly male Hypertrophied calves Stand on toes Exaggerated lumbar lordosis Gower’s maneuver ```

most common locations for osteoarthritis

Hands, hips, knees, base of cervical spine, big toes.

imaging modality used for radiographically occult fractures

MRI

strength training increases what part of the composition of muscles? endurance training?

strength = sarcomeres, muscle diameter endurance = angiogenesis, mitochondria

what are the healing steps of muscle?

inflammatory (destruction), muscle fiber regeneration (repair), collagen synthesis (remodeling)

ligament between the spinous process bodies and apices, relatively:

interspinous ligaments, supraspinous ligaments

examples of hyaline cartilage in the body?

1. costal cartilages 2. articular cartilage 3. upper airways

the A band has the ______ filaments and the I band has the _____ filaments.

thick, thin

describe the histo of a tendon:

dense, regular T1 collagen, arranged in parallel to the direction of the pull

appositional growth of cartilage: ____________ secrete ECM

when chondroblasts secrete ECM

name the muscles in the erector spinae group: what is they chief function? secondary?

chief function: extension of back secondary: lateral rotation spinalis longissimus iliocostalis

spine curvatures: convex anteriorly: __________ concave anteriorly: ________

convex anteriorly: lordosis concave anteriorly: kyphosis

what is adactyly? what causes it?

absence of digits later loss of FGF in AER (apical ectodermal ridge)

in an IV drug user that has bacterial osteomyelitis, what is the most likely organism?

E. Clo, pseudomonas, klebsiella

what are the histological markers of most muscular dystrophies?

- different muscle fiber sizes - fibrosis - central nuclei (regeneration) - degenerating and regenerating fibers (lot's of nuclei)

broad yellow ligament extending between laminae, making the posterior wall of the vertebral column:

ligamentum flavum

Radiograph findings with osteoarthritis: (4)

1. joint space loss (not even) 2. osteophytes 3. subchondral sclerosis (white) 4. cysts

Marked laxity of the knee in extension with varus/valgus stress indicates

A knee injury involving both a collateral and cruciate injury

estrogen ________ osteoclast activity

decreases

what types of cartilage do not have perichondrium?

articular cartilage (type of hyaline) fibrocartilage

How would you tell the difference between a sprain/strain? joint instability (_________), ________ is more likely to have weakness.

sprain strain

Gower's maneuver is a sign of:

Duchenne's MD

The perimysium is the CT covering in the center of the muscle between the __________ The endomysium is the CT covering between the muscle fibers, in the center of the fascicle

fascicles muscle fibers (cells)

bilateral symmetric involvement of SI joint arthritis makes you think:

ankylosing spondylitis

in ligament healing... in the phase 3 of remodeling, the ratio of ___________ to _____________ increases

type 1 collagen to type 3 collagen

strains are _______ damage and sprains are _______ damage

muscle, ligament

ONLY ligament that runs the length of the spinal cord: name: where is it:

anterior longitudinal ligament | anterior to the body

injury to the ___________ ligament during ankle sprain could avulse the lateral malleolus of the fibula

anterior talofibular ligament

Many forms of MD are due to problems around the _________ membrane

sarcolemmal

2 parts of ECM of cartilage that make it resistant to compression and tearing:

aggrecan aggregate type 2 collagen

what do the dorsal rami innervate? (3)

1. deep back muscles 2. back skin 3. zygapophysial joints (synovial joints in back vertebrae)

in a person with sickle cell that has bacterial osteomyelitis, what is the most likely organism?

salmonella

what is the exception to the "X-ray first" theory of fracture imaging?

CT is used as the first line for spine fractures

bilateral asymmetric involvement of SI joint arthritis makes you think:

psoriatic arthritis or reactive arthritis

after the neutrophils come and release factors, ________ arrive and phagocytose additional necrotic debris. What do they release? (4) What does this activate?

macrophages IL6, IGF, PDGF, TGF-b satellite cells

a DXA T-score of -_____ or below is osteoporosis

-2.5

what is the exact location of "E-C coupling" for motor movement?

the t-tubule, sarcoplasmic reticulum channel articulation

Treatment for: ________ injury – prolonged immobilization (4-6 weeks) · Complete tear/avulsion – __________, followed by immobilization

tendon, surgery

name the transversospinal muscles: ``` innervation function (unilateral contraction/bilateral) ```

Names: semispinalis, multifidus, rotatores Innervation: dorsal rami spinal nerves Unilateral contraction = CONTRALATERAL rotation Bilateral = extensors

in a neonate that has bacterial osteomyelitis, what is the most likely organism?

H. influenzae

fracture healing type that needs: Anatomic reduction, rigid fixation, direct bone formation

primary fracture healing intramembranous ossification

splenius muscle function: innervation:

extension of head and neck, ipsilateral rotation and bending dorsal rami (it is a deep back muscle)

_______ are responsible for the differences in cutaneous nerve maps and dermatome maps

plexuses

the inorganic component of bone matrix is composed of _____________. what strength does this confer for bone?

hydroxyapatite stiffens, RESISTS BEND/COMPRESSION

the most accurate physical examination maneuver to determine an intact ACL is

the Lachman test

a dermatome is an area of skin supplied by a specific ____________

spinal level, NOT a specific peripheral nerve (think about the plexus)

Pain with forced flexion and rotation of the knee which may cause not only discomfort, but also a pop or click followed by pain. What test is this and what is the likely diagnosis if it is positive?

McMurray's test meniscal tear

critical period of limb development: weeks __-__ what is it called if there is a problem in the critical period?

4-8 malformation

what is the substrate use for muscle fibers in high intensity, short duration exercises? low intensity long duration?

carbohydrates fat

the _________ component of bone matrix is laid down first. What is it composed of? Newly laid down matrix that has not been calcified: ________

organic, type 1 collagen osteoid

History of sudden onset of force applied to outside or inside of knee with foot fixed to ground... what ligament sprain could this be?

a collateral knee ligament

if you think a patient has a bone neoplasm and have a feeling it is osteoid osteoma, what imaging do you need?

what type of gene inheritance is Duchenne's muscular dystrophy? What is the gene?

X-linked recessive short arm of X chromosome, Xp21

what is the most common organism of bacterial osteomyelitis?

s. aureus

interstitial growth of cartilage: ___________ secrete ECM

chondrocytes

sensory loss along the length of a single dermatome is indicative of a more _________ problem

proximal

in the intervertebral disks: ________________ = outer fibrocartilaginous ring imparts structural integrity ________________ = inner gelatinous core (notochord remnant) imparts malleability

annulus fibrosis nucleus pulposus

Describe the proposed explanation for a higher incidence of ACL injury in female athletes

1. decreased muscular strength 2. less NMJ control 3. Body movement mechanics

which types of muscle have sarcomeres?

skeletal and cardiac

tendon and ligament healing steps:

1. inflammatory 2. Reparative 3. Remodeling

what is the general matrix of cartilage?

type 2 collagen and aggrecan aggregate

examples of elastic cartilage in the body?

1. pinna of ear | 2. epiglottis

fracture healing type that needs: Acceptable reduction, micro-motion helpful, cartilage then bone formation

secondary fracture healing endochondral ossification

excessive force from the sartorius muscle ----> _______ evulsion fracture

ASIS

________ detect the mechanical stress on a bone...causing an increase of _______ into the cell. This signal is then communicated to other cells through gap junctions and there is a proliferation of ____________

osteocytes calcium osteoblasts

the presence of intra-capsular floating fat in a joint cavity is called: what are you concerned of with this?

lipohemarthrosis fracture

blood supply to vertebral column:

branches off aorta

excessive force from the hamstring muscles ----> _______ evulsion fracture

ischial tiberosity