Limbs and back week 2

Question 1

briefly describe tendons

Answer 1

dense regularly arranged tissue that attach muscle to bone
highest tensile strength of all connective tissue
high proportion of collagen
closely packed parallel arranged in direction of force

Question 2

Describe the composition of tendons

Answer 2

dense connective tissue (parallel fibres of collagen I)
sparsely vascularised
cellular (fibroblasts / tenocytes ) - 20%
Extracellular (80%) 70% water, 30% solids - collagen I, ground substance, elastin, collagen III

Question 3

What is the origin and insertion of the supraspinatous muscle?

Answer 3

supraspinous fossa

greater tubercle

Question 4

What is the function of the supraspinatous?

Answer 4

assists in the abduction of the nerve

Question 5

What is the innervation of the supraspinatous?

Answer 5

supra scapular nerve

Question 6

What is the origin and insertion of teres minor?

Answer 6

axillary border

greater tubercle

Question 7

What is the function of teres minor?

Answer 7

external rotation

Question 8

What is the innervation of theres minor?

Answer 8

axillary nerve

Question 9

What is the origin and insertion of infraspinatous?

Answer 9

infraspinatous border

greater tubercle

Question 10

What is the function of the infraspinatous?

Answer 10

external rotation

Question 11

What is the innervation of infraspinatous?

Answer 11

supra scapular nerve

Question 12

What is the origin and insertion of subscapularis?

Answer 12

sub scapular fossa

lesser tubercle

Question 13

What is the function of subscapularis?

Answer 13

internal roation

Question 14

What is the innervation of subscapularis?

Answer 14

supra-scapular nerve

Question 15

What are risk factors associated with tendon injuries?

Answer 15

older age
attrition (wear and tear)
bone spurs
acromion shape
tendonopathy leading to tears
trauma (mostly acute)
genetic

Question 16

What are the two types of tendon injury?

Answer 16

acute and chronic

Question 17

What tests can be used to assess the supraspinatous?

Answer 17

ROM - forward elevation / abduction

Strength - arms out in scapular plane - don’t let me push your arms down

Question 18

What tests can be used to examine infraspinatous and teres minor?

Answer 18

ROM - external rotation with elbow at side

Strength - arms tucked in and resisted external rotation

Question 19

What tests can be used to examine subscapularis?

Answer 19

ROM - thumb behind back

Strength - belly press / push off behind back

Question 20

What are non-operative treatment options for rotator cuff tears?

Answer 20

physiotherapy
injection (steroid / local anaesthetic ) for pain
analgesia

Question 21

What are surgical treatment options for rotator cuff tears?

Answer 21

repair tendon to bone - arthroscopic / open surgery

platelet rich plasma injection?

Question 22

What is involved in the physiotherapy treatment of rotator cuff tears?

Answer 22

early controlled mobilisation

Question 23

what are the joints of the shoulder?

Answer 23

glen-humeral joint

accromio-clavicular joint

Question 24

What are the roots of the axillary nerve?

Answer 24

C5 and C6

Question 25

What muscles are innervated by the axillary nerve?

Answer 25

teres minor and deltoid

Question 26

What are the roots of the musculocutaneous nerve?

Answer 26

C5, C6, C7

Question 27

What muscles are innervated by the musculocutaneous nerve?

Answer 27

coracobrachialis, brachial, biceps bracchi

Question 28

What are the roots of the radial nerve?

Answer 28

C5, C6, C7, C8, T1

Question 29

What muscles are innervated by the radial nerve?

Answer 29

triceps brachia, extensor and supinator muscles

Question 30

What are the roots of the ulnar nerve?

Answer 30

(C7) C8, T1

Question 31

What muscles are innervated by the ulnar nerve?

Answer 31

antebrachial, hypothenar, deep intrinsic muscles of the hand

Question 32

What are the roots for the median nerve?

Answer 32

C6, C7, C8, T1

Question 33

What muscles are innervated by the median nerve

Answer 33

ante brachial, thenar muscles, some lumbricles

Question 34

What are the 3 layers of blood vessels?

Answer 34

tunica intima, tunica media, tunica adventitia

Question 35

Describe the tunica intima

Answer 35

a single layer of squamous epithelium | provides a smooth, friction-reducing lining for the vessel

Question 36

Describe the tunica media

Answer 36

smooth muscle, connective tissue (elastic fibres) | vasoconstriction and vasodilation to control BP

Question 37

Describe the tunica externa

Answer 37

made of fibrous connective tissue | protective and supporting layer

Question 38

Describe anastmoses

Answer 38

arterioles communicating with another form anastomoses anatomical - circle of Willis in the brain functional - mesenteric vessels of the GI tract

Question 39

Describe collateral circulation

Answer 39

enlargement of vascular results in collateral circulation | small arteries anastomose more frequently and can result in extensive networks allowing ongoing perfusion

Question 40

name peripheral pulses

Answer 40

``` temporal carotid brachial popliteal dorsalis posterior tibial ```

Question 41

Give examples of some non-modifiable risk factors for atherosclerosis

Answer 41

increasing age male sex family history

Question 42

Give examples of some modifiable risk factors for atherosclerosis

Answer 42

``` hyperlipidaemia hypertension smoking diabetes obesity ```

Question 43

What is an aneurism?

Answer 43

localised dilation of the affected artery over 50% normal diameter

Question 44

What are some causes of aneurism?

Answer 44

``` atherosclerotic congenital post-stenotic traumatic inflammatory mycotic ```

Question 45

What is an embolism?

Answer 45

the blockage of a blood vessel by solid, liquid, or gas at a site distant from its origin

Question 46

Describe the triple helix structure of collagen

Answer 46

3 polypeptide chains each chain is a polipropine helix each chain folds into triple helix each chain has a repeating glycine-X-Y residue

Question 47

Describe collagen maturation

Answer 47

formation of collagen alpha chain in the ER 3 come together, spontaneously form triple helix moved to golgi pumped out into the extracellular space proteins interact to form fibrils - aggregates larger than the cells that secreted them

Question 48

What are the most common results of sport injuries?

Answer 48

fractures and dislocations major muscle - ligament - tendon injuries head and spinal injuries chest and abdominal injuries