Muscles, Cartilage, and Bone Flashcards
(96 cards)
0
Q
Type I Skeletal Muscle
A
Slow, red, oxidative
Slow, continuous contractions over prolonged periods
Many MT and myoglobin
Aerobic oxidative phosphorylation of FAs
1
Q
Skeletal Muscle (Structure)
A
Large, elongated multinucleated fibers
Primary growth is hypertrophy
2
Q
Type IIa Skeletal Muscle
A
Fast, intermediate, oxidative-glycolytic
MT and myoglobin, AND glycogen
Oxidative AND anaerobic glycolysis
3
Q
Type IIb Skeletal Muscles
A
Fast, white, glycolytic Rapid contraction, fast-fatigue Usually small muscles, with large # of NMJs Few MT and myoglobin Abundant Glycogen
4
Q
Smooth Muscle
A
Grouped, mononucleated fusiform cells
Weak, rhythmic, involuntary contractions
Lack striations
Hypertrophy AND hyperplasia
5
Q
Cardiac Muscle
A
Irregular branched cells, central nuclei (sometimes 2) Striated Intercalated disks Strong, involuntary contractions CanNOT regenerate, can ONLY hypertrophy
6
Q
List the structure of muscle from smallest to largest
A
Myofilament–> sarcomere–> myofibril–> muscle cell–> muscle fiber–> muscle fasciculus–> whole muscle
7
Q
Myofibrils
A
Functional component of contraction
Composed of repeating units of sarcomeres
8
Q
Myofilaments
A
Thick and thin
Thick: myosin filaments
Think: actin filaments
9
Q
What makes the striated appearance of skeletal muscle?
A
Z-lines: alpha-actinin that borders sarcomeres
10
Q
Which bands in the sarcomere shorten?
A
H
I
Z
11
Q
How does Tetanus happen?
A
If muscle fiber stimulated continuously–> do not allow enough time to reaccumulate Ca in SR–> sustained high Ca in cytoplasm–> sustained muscle contraction
12
Q
What determines the maximum force or tension a muscle can produce?
A
Tension: proportional to number of cross-bridges formed and that could be formed
Force and Tension: length of muscle
13
Q
What acts as the cross-bridge gatekeeper in smooth muscle?
A
Calmodulin
14
Q
How do smooth muscle cells maintain tonic tension? Does this require extra ATP?
A
When Ca2+ decreases, myosin is de-P –> de-P can still interact w/ Latch-Bridges
Does NOT require ATP
15
Q
What are Latch-Bridges?
A
Residual attachments that allow for maintenance of tonic tension in smooth muscle
Do NOT require ATP
16
Q
What stimulates/inhibits Glycogen Synthase and Glycogen Phosphorylase?
A
Glycogen Synthase: Stimulated by increased levels of glycogen substrates (Glu-1-P)
Glycogen Phosphorylase: inhibited by products of glycolysis (Glu-6-P) and ATP
17
Q
What does Insulin lead to in the the liver?
A
Depresses gluconeogenesis and increases glycogen production
18
Q
What does insulin do in skeletal muscle?
A
Increases glucose transport into cells–> metabolic pathways–> ATP
19
Q
What does decrease in Insulin lead to in liver/muscles/adipose tissue?
A
Liver: mobilizes glycogen
Adipose: mobilizes FAs
Muscle: glycogenolsis
20
Q
Stages of starvation (3)
A
- Rapid muscle protein turnover–> release of a.a. As brain switches energy sources–> less protein breakdown.
- Muscle uses FA and Ketones for energy
- 3rd week: muscle uses FAs ONLY
21
Q
Which is the predominating energy source in skeletal muscle during greatest energy demands (sprinting)?
A
Anaerobic metabolism
Glucose and glycogen
22
Q
What is the predominating energy sources when energy are low (walking)?
A
Oxidation of circulation glucose and FAs
23
Q
Describe the 3 stages of energy usage in Aerobic exercise
A
- Hepatic glycogenolysis (40%)
- Gluconeogenesis
- FA oxidation
24
Scurvy
Vit. C deficiency
Bone disease in children
Hemorrhages and healing defects in children AND adults
25
Riskets/ Osteomalacia
Vit. D deficiency--> hypocalcemia and activation of PTH-->
Rickets(children): bowing of legs
Osteomalacia: loss of bone mass in adults (osteopenia)
26
Lab: Erythrocyte Sedimentation Rate (marker for?)
Systemic inflammation
27
Lab: Creatine Kinase (marker for?)
Muscle injury
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Lab: CK isozyme- Myocardial bound (marker for?)
CK-MB
| Cardiac injury or regenerating muscle
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Lab: Antineutrophil Cytoplasmic Ab (ANCA) (marker for?)
c-ANCA (cytoplasmic): Wegener granulomatosis
p-ANCA (perinuclear): Microscopic polyangiitis, Churg-Strauss vasculitis, focal necrotizing and crescentic glomerulonephritis
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Lab: C-reactive protien (marker for?)
Direct marker for systemic inflamm.
31
Lab: Antinuclear antibod (marker for?)
Nonspecific
Numerous autoimm. diseases
Falsely positive in 5-10%
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Lab: Rheumatoid factor (marker for?)
Rheumatoid arthritis and other autoimm. and chronic inflamm. diseases
Falsely positive 5-10%
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Lab: Anticyclic citrullinated peptide (marker for?)
Rheumatoid arthritis
34
Lab: Alkaline phosphatase (marker for?)
Bone turnover
35
Lab: Serum calcium (marker for?)
Disordered Ca2+ homeostasis
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Lab: Parathyroid Hormone (marker for?)
Parathyroid gland function
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Lab: PTH-related hormone (marker for?)
Protein secreted by neoplastic cells, mimics PTH
| It's activity may lead to disordered Ca2+ and/or Phosphate homeostasis
38
What can changes can/not be seen in muscles after exercise? (VEGF, bFGF, Myoglobin O2 sat, PO2, Capillary density)
1 hour after exercise.....
Myoglobin O2 Sat and PO2 decrease--> leads to increase VEGF
VEFG upregulation--> stimulates angiogenesis
bFGF unchanged
Capillary density unchanged in such a small amount of time
39
Atlanto-occipital Joint
Synovial joint b/t Atlas (C1) and occipital condyles that allow the head to nod "Yes"
40
Atlantoaxial Joint
Synovial joint b/t Atlas (C1) and Axis (C2) that allows you to nod "No"
41
Facet Joints
Synovial joints b/t inferior and superior articular facets of spine
42
What is hyaline cartilage primarily made of?
Type II collagen
43
Joints of the shoulder
Acromioclavicular--> fallong on outstretched arm
| Glenohumeral --> Anterior OR Posterior displacement.
44
What can result from Anterior/Posterior dislocation of humeral head?
Anterior--> Damage Axillary N.
| Posterior--> due to electrocution (RARE)
45
Joints of Elbow and their ligaments
Ulnohumeral: reinforced by medial collateral ligament
Radiohumeral: reinforced by lateral collateral ligament
Radioulnar: reinforced by annular ligament
46
"Pulled Elbow"
When person is forcibly pulled up by arm when forearm is protonated
Tears Annular ligament
Pronation/Supination limited
Reduce: Supinate arm while flexed
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Colles Fracture
Distal radius and usually styloid process of ulna
Bone fragments displaced Dorsally and Distally
"Dinner Fork" deformity
Caused by FOOSH
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Medial Knee
Medial lemniscus firmly attached to Medial (Tibial) Collateral Ligament
Lateral trauma--> Excessive Valgus
Injury to BOTH ligament AND lemniscus
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Lateral Knee
Lateral lemniscus NOT firmly attached to Lateral Collateral (Fibular) Ligament
Medial trauma--> Excessive Varus deformity
Injure Lateral Ligament (lateral meniscus tear less likely)
50
Anterior Knee
Anterior Cruciate Ligament
Anterior Tibia--> Lateral condyle of Femur
Prevents excessive anterior mov't when knee is flexed
TEST: Anterior Drawer Test
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Posterior Knee
Posterior Cruciate Ligament
Posterior Tibia--> Medial condyle of femur
Prevents excessive posterior movement
TEST: Posterior drawer test
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"Unhappy Triad"
Injury: Hit from lateral side--> Twists flexed knee
MCL (Tibial ligament)
Medial lemniscus
ACL
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Ankle
Talocrural joint
Inversion: Lateral ligament (Anterotalofibular ligament)
Eversion: Medial ligament (deltoid). Can result in Pott fracture of Fibula and Medial Malleolus
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Pterion in skull
Where 4 bones of skull come together:
Frontal, parietal, temporal, sphenoid
Structurally weak
Near Middle Meningeal Artery
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Basilar vs. Linear Skull fractures
Linear: MOST common. From blunt trauma
Basilar: Linear, most often involves Temporal bone--> Raccoon eyes (blood collects in orbit), Battle Sign (behind ears), blood in sinuses, CSF leakage through nose/ears
56
Fractures/Dislocations of the Vertebrae
Cause: MOST common Hyperflexion of neck
Most common injury: crush or compression fracture of vertebral body
Hyperextension (Whiplash)--> Stretches Anterior Ligaments and causes fractures and dislocations of vertebrae.
57
Cervical vs. Thoracic/Lumbar vertebrae dislocations
Cervical: inclined horizontally--> Anterior dislocations withOUT fractures
Thoracic/Lumbar: arranged vertically--> Dislocation often seen WITH fractures.
58
Spondylolysis
Defect or fracture in Pars interarticularis (connects inferior and superior articular processes)
Due to genetic defect or micro-fractures (gymnasts)
X-Ray: Posterior Oblique view!!! "Scotty Dog" looks like it has a collar
59
Fractures of the pelvis
Anterior-posterior compression: Pubic symphysis and Rami fractures
Lateral compression: Pubic rami, ala of Ilium
Acetabulum fractures: Fall onto feet
60
Valgus vs. Varus
Valgus: Knocked-knee
Varus: Bow-legged
61
Fracture of Greater Tuberosity
Often assoc. w/ separation of shoulder
| 3/4 Rotator cuff muscles attach here (Supraspinatus, Infraspinatus, Teres Minor)
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Fracture of Neck of Humerus can injure....
Axillary Nerve
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Fracture in distal half of humerus can injure....
Radial Nerve, along Radial/Spiral Groove
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Fracture Humerus, just superior to elbow can injure....
Brachial artery--> ischemia
| Median Nerve--> hand and forearm contractures
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Fracture in Medial Epicondyle can injure....
Ulnar Nerve
66
Scaphoid Fracture
Very little displacement
Pain in "Snuff Box"
Often MISSED on X-ray and misdiagnosed--> Repeat in 10 days!
Improperly treated fractures--> Avascular Necrosis and Arthritis
67
Fracture of Femoral Head can injure...
Medial Circumflex Femoral Artery
Avascular Necrosis
Limb will appear shortened and laterally rotated
More common in women due to Osteoporosis
68
Pott Fracture
Medial (Deltoid) ligament in Ankle is overstretched
Due to Eversion
Strong Medial ligament does NOT tear-->
Fractures of Medial Malleolus and Fibula
69
Fracture of 5th Metatarsal
Extreme Inversion
Tears Lateral Ligament
Can fracture lateral malleolus
70
Coxa valga and Coxa varus
Angle b/t shaft and head of femur
Coxa valga: Angle is too large
Coxa vara: Angle is too acute--> difficult to abduct leg and leg shortening
71
Legg-Calve-Perthes Disease
```
Idiopathic avascular necrosis of Capital Femoral Epiphysis
Decreased range of motion
Upper leg pain
Self-limited--> revascularizes
Male, 3-12yrs
```
72
Slipped Capital Femoral Epiphysis (SCFE)
Adolescents that have weakened epiphyseal plate
Femoral head epiphysis slowly slips away from femoral neck
Commonly seen in obese adolescents
Hip pain referred to knee
73
Muscles of Mastication
```
Innervated by CN V3
Temporalis: elevates and retracts
Masseter: elevates and protrudes
Medial pterygoid: elevates and protrudes
Lateral pterygoid: depressed and protrudes, side-to-side
```
74
Which muscles open jaw?
Mostly gravity
Lateral pterygoid
Suprahyoid and infrahyoid muscles
75
"Glossus" and "Palat"
"Glossus"--> innervated by CN XII (Hypoglossal)
EXCEPT Palatoglossus (CN IX)
"Palat"--> innervated by CN IX (vagus)
EXCEPT Tensor veli palatini (CN V3)
76
Action of Sternocleidomastoid
Tilts head to ipsilateral side
| Flexes and rotates head to contralateral side
77
Extrinsic and Intrinsic muscles of Larynx
Extrinsic: move hypoid bone and larynx superiorly and inferiorly
Intrinsic: vocal cords and Rima glottids
78
Motor and Sensory innervation of Inner laryngeal muscles
Motor: BELOW via Recurrent Laryngeal Nerve--> Damage--> hoarsness
Sensory: ABOVE via Internal Laryngeal Nerve--> Damage--> anesthesia of laryngeal mucosa--> problems w/ aspiration and swallowing
79
Rotator Cuff muscles
Supraspinatus
Infraspinatus
Teres Minor
Subscapularis
80
Anterior Compartment of Arm
```
Flexors
Musculocutaneos Nerve
Biceps brachii: flex and supinate
Brachialis: flex
Coracobrachialis: flex and adduct
```
81
Posterior compartment of arm
Extensor
Radial Nerve
Triceps brachii: extend forearm
82
Anterior compartment of forearm
Pronates forearm and flexes forearm, wrist, and fingers
| Median Nerve EXCEPT Flexor Carpi Ulnaris and Medial part of Flexor Digitorum Profundus (Ulnar N.)
83
Posterior compartment of forearm
Extensors and supinators
EXCEPT Brachioradialis (flexes forearm)
Radial N.
84
Thenar and Hypothenar muscles innervation
Thenar: Median N. EXCEPT Adductor pollicis (Ulnar N.)
Hypothenar: Ulnar N.
85
Gluteal muscles
Glutei: extend and abduct thigh. Innervated by Gluteal Nerves
Maximus: Extends. Inferior Gluteal N.
Medius & Minimus: Abducts and Medially rotates. Superior Gluteal N.
Smaller gluteal muscles Laterally Rotate thigh.
86
Anterior compartment of Thigh
Anterior: Flexor of hip & Extensors of knee. Femoral N and Sup. Gluteal N (Tensor fascia lata). Femoral Artery.
87
Posterior compartment of thigh
Posterior: Hamstrings. Extensors of thigh. Flexors of knee.
Arteries: Profunda femoral artery, Inf. Gluteal artery, Perforating Arteries
Nerves: Sciatic, Common Fibular
88
Medial compartment of thigh
Adductors
Artery: Obturator
Nerve: Obturator
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Lateral compartment of leg
Ankle evertors
| Nerve: Superficial peroneal/Fibular
90
Anterior compartment of leg
Dorsiflexors of ankle & extensors of toes
Artery: Ant. Tibial vessels
Nerve: Deep peroneal/Fibular
91
Posterior compartment of leg
Superficial and deep compartments
Plantar flexors & Flexors of toes
Superficial: Posterior Tibial artery, Saphenous Vein, Sural Nerve
Deep: Peroneal and Posterior Tibial Artery, Tibial Nerve.
92
Piriformis Syndrome
Sciatic N. enters Greater Sciatic foramen closely to piriformis muscle
If overdevelop gluteal muscles--> compress nerve
Sciatic-like symptoms
More common in Women
93
Trandelenburg Sign
Damage to Superior Gluteal N. --> Gluteus medius and minimus
TEST: observe pt's back while pts raises each foot off ground. If RIGHT pelvis falls when RIGHT foot is lifted--> LEFT Sup. Gluteal N. is damaged.
94
What structures pass through the diaphragm?
T8: IVC
T10: Esophagus and Vagus N.
T12: Aorta, Thoracic Duct, and Azygous Vein
95
Which nerves innervate the diaphragm?
C3, C4, C5 make up the Phrenic Nerve.
Irritated diaphragmatic pleura/ peritoneum--> Referred Shoulder Pain
"3,4,5 keeps the diaphragm alive!"
