Musculoskeletal/skin- Anatomy and physiology Flashcards Preview

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Flashcards in Musculoskeletal/skin- Anatomy and physiology Deck (85):
1

What are tight junctions composed of?

claudins and occludins

2

What are adherens junctions composed of?

Cadherins (Ca2+ dep) and actin cytoskeleton

3

What do desmosomes connect to?

support keratin interactiosns, desmoplakin

4

What are the channel proteins in gap junctions?

connexons (permit electrical and chemical communication

5

What do integrins interact with?

bind collagen and laminin of basement membrane

6

What type of injury is indicated by the anterior drawer sign?

ACL injury

7

What are the sites of attachment of the ACL and PCL?

ACL- attaches anterior tibia to lateral condyle of femur (prevents anterior movement of tibia)
PCL- attaches posterior tibia to medial condyle of femur (prevents posterior movement of tibia)

8

What type of injury is indicated by the posterior drawer sign?

PCL injury

9

What is the unhappy triad injury?

lateral force applied to a planted leg
ACL, MCL, medial lemniscus

10

What is the McMurray test of knee pain?

pain on external rotation- medial meniscus
pain on internal rotation- lateral meniscus

11

What injury is indicated by abnormal passive abduction? (valgus stress)

MCL injury

12

What injury is indicated by abnormal passive adduction?

LCL injury

13

What bony marker is used to do a pudendal nerve block?

ischial spine

14

What boney landmark is used for a lumbar puncture?

iliac crest

15

What is the innervation and action of the supraspinatus muscle?

Innervation: suprascapular
Abducts arm initially

16

What is the innervation and action of the infraspinatus muscle?

suprascapular nerve
latterally rotates arm

17

What is the most common rotator cuff injury?

injury to supraspinatus

18

What rotator cuff muscle is a common pitching injury?

infraspinatus

19

What is the innervation and action of the teres minor?

axillary nerve
adducts and laterally rotates arm

20

What is the innervation and action of the subscapularis?

subscapular nerve
medially rotates and adducts arm

21

What nerve roots innervate the rotator cuff muscles?

C5-C6

22

What are the wrist bones?
(So long to pinky, here comes the thumb)

scaphiod
lunate
triquetrum
pisiform
hamate
capitate
trapezoid
trapezium

23

What wrist bone can be palpated in the anatomical snuff box?

scaphoid

24

What is the most commonly fractured carpal bone? What damage can fracture lead to?

Scaphoid
can lead to avascular necrosis

25

What carpal bone is commonly dislocated? What nerve is damaged by this?

lunate
median nerve damaged (acute carpal tunnel)

26

What nerve and carpal bone can be injured by falling on an outstretched hand?

hook of hamate
ulnar nerve

27

What is Guyon canal syndrome? Who typically gets this?

compression of ulnar nerve
cyclists- pressure from handlebars

28

What nerve is damaged by carpal tunnel syndrome?

median- paresthesia, pain, numbness along distribution

29

What is damaged by Erb Palsy and what are the functional defecits

upper trunk, C5-C6 roots
abduction, lateral roatation, flexion/supination

30

What is damaged by klumpke palsy? What are functional deficits?

lower trunk, C8-T1 roots
claw hand (lumbricals, interossei, thenar, hypothenar)

31

What muscle and nerve are lesioned with a winged scapula?

long thoracic nerve
serratus anterior

32

What is injured from thoracic outlet syndrome? How does this present?

lower trunk, subclavian vessels
same as Klumpke palsy (+ischemia, pain, edema)

33

Describe the sensory distribution of the median nerve?

palm + distal dorsal of 2nd and 3rd digits

34

Describe the sensory distribution of the radial nerve?

dorsal surface of thumb+ proximal 2nd and 3rd

35

Describe the sensory distribution of the ulnar nerve?

4th and 5th digits

36

What are the muscles of the thenar eminence? What nerve supplies? How would you describe atrophy?

opponens pollicis, abductor pollicis brevis, flexor pollicis brevis
median nerve
"Ape hand"

37

What are the muscles of the hypothenar eminence? What nerve supplies?

opponens digiti minimi, abductor digiti minimi, flexor digiti minimi brevis
ulnar

38

What do the dorsal interosseus muscles do?

abduct fingers

39

What do the palmar interosseus muscles do?

adduct fingers

40

What do the lumbrical muscles do?

flex at the MCP joint, extend PIP and DIP

41

What nerve is injured by fracture of the surgical neck of the humerus?

Axillary

42

What nerve is injured by midshaft fracture of the humerus?

Radial

43

What nerve is injured by compression of the axilla?

Radial

44

What nerve is injured by supracondylar fracture of the humerus?

Median

45

What nerve is injured by medial epicondyle ("funny bone") fracture of the humerus?

Ulnar

46

What lesion results in a claw with 4th and 5th digits at rest?

distal ulnare nerve
ulnar claw

47

What lesion results in a "pope's blessing" when making a fist?

proximal median nerve lesion

48

What lesion results in claw of 2nd and 3rd digits when at rest?

distal median nerve
median claw

49

What lesion results in an "OK gesture" when making a fist?

proximal ulnar nerve lesion

50

How do proximal vs distal lesions of the median /ulnar nerves present?

Distal lesions- clawing at rest (extend at MCP, flex at DIP and PIP)
Proximal lesions- less pronounced, present during voluntary flexion

51

lesion of what nerve results in wrist drop?

radial nerve

52

What does superficial laceration of the palm result in?

laceration of recurrent branch of median
loss of thenar muscle group, no loss of sensation

53

What lesion presents as decreased adduction of the leg?

Oburator (L2-L4)

54

What lesion presenst as decr thigh felxion and leg extension?

Femoral (L2-L4)

55

What lesion presents as foot drop, loss of sensation on dorsum of foot?

Common peroneal (L4-S2)

56

What lesion presents as inabiilty to curl toes and loss of sensation on sole?

Tibial (L4-S3)

57

What lesion presents as loss of hip extension? (difficulty climbing stairs, rising from seated position)

inferior gluteal (L5-S2)

58

What lesion presents as tilt of pelvis when standing on one foot?

Superior gluteal (lesioned on standing foot)

59

What artery supplies the surgical neck of the humerus?

posterior circumflex (axial n)

60

What artery supplies the midshaft of the humerus?

deep brachial (radial n)

61

What nerve and artery are present along the distal humerus?

brachial artery, radial n

62

What nerve and artery are present in the poplitieal fossa?

Popliteal artery, tibial nerve

63

What nerve and artery are present in the posterior to medial malleolus?

posterior tibial arterh, tibial nerve

64

What nerve is commonly injured with knee trauma?

Tibial nerve

65

What nerve is commonly injured by trauma or compression of the lateral aspect of the leg?

common peroneal

66

What nerve is commonly injured by pelvic fracture

femoral nerve

67

What nerve is commonly injured by pelvic surgery?

obturator nerve

68

What nerves are commonly injured by posterior hip dislocation?

superior gluteal and inf gluteal

69

What does Ca2+ bind in muscle?

Troponin C

70

What is the voltage-sensitive receptor of skeletal muscle? What does it attach to?

Dihydropyridine on cell membrane
attached to ryanodine receptor of sarcoplasmic reticulum

71

What is the H zone?

Myosin only, at center
shortens with contraction

72

What is the I band?

Actin only
shortens with contraction

73

What is the A band?

length of myosin, doesnt change

74

What type of metabolism predominates in type 1 vs Type 2 muscle?

Type 1: oxidative phosphyorylation (slow twitch)
Type 2: anaerobic glycolysis (fast twitch- hypertrophy with weight training)

75

What type of muscle has more mitochondria and myoglobin?`

Type 1- slow twitch

76

When doe myosin of smooth muscle contract?

Contracts in phosphorylated form- myosin light-chain kinase active

77

What activates myosin-light-chain kinase?

Ca2+ calmodulin complex
(from L-type voltage gated Ca2+ channel opening)
results in muscle contraction

78

What activates myosin-light-chain phosphatase?

cGMP (Via NO)
results in muscle relaxation

79

What do osteoblasts and osteoclasts do?

osteoblast: build bone
osteoclasts: dissolve bone

80

Describe the origin and appearance of osteoclasts

multinucleate giant cells, secret acid and collagenases
from monocytes/macrophages

81

Describe the origin of osteoblasts? Where are stem cells located?

mesenchymal
periosteum

82

Compare endochondral vs membranous ossification?

Endochondral: cartilagenous model made by chondrocytes, replaced by woven bone, remodeled to lamellar bone
membranous: woven bone formed drirectly, remodeled to lamellar bone (calvarium + facial bone(

83

What is the effect of estrogen on bone?

inhibits apoptosis of osteoblasts
induces apoptosis of osteoclasts

84

What are the effects of parathyroid hormone on bone?

Low, intermittent levels- anabolic (build bone)
chronic high levels- catabolic (osteitis fibrosa cystica)

85

What is osteitis fibrosa cystica?

results in chronic high PTH levels