TBL 4 - Long Bone Formation, Shoulder Joint, Intrinsic Shoulder Muscles, Posterior Arm Muscles, and Muscle Tissue Flashcards Preview

ACE Unit 1 > TBL 4 - Long Bone Formation, Shoulder Joint, Intrinsic Shoulder Muscles, Posterior Arm Muscles, and Muscle Tissue > Flashcards

Flashcards in TBL 4 - Long Bone Formation, Shoulder Joint, Intrinsic Shoulder Muscles, Posterior Arm Muscles, and Muscle Tissue Deck (63):
1

Which mesodermic layer generates the chondroblasts and osteoblasts that form the scapula, clavicle, and bones of the upper limb?

The parietal mesodermic layer

2

What is the first step of endochondral ossification?

Thin bony collars form around the diaphysis (shaft) of cartilaginous replicas. The chondrocytes are separated from the capillaries in the perichondrium causing the cartilage to start degrading

3

Describe the primary ossification center

Osteoblasts, angiogenic capillaries and macrophages from the bony collar periosteum enter the diaphysis and replace the cartilage with trabecular bone

4

What is the epiphysis

Ends of the diaphysis where chondrocytes are proliferating creating longitudinal growth plates at the junction of the epiphysis and diaphysis

5

Why is achondroplasia associated with skeletal dysplasia e.g., dwarfism?

The misformed cartilage causes the bones to be misinformed as the replicas are wrong.

6

In neonates, what does the residual trabecular bone in the diaphysis become?

Marrow cavity

7

What eventually forms in the epiphysis

Secondary ossification centers

8

Up to what period do growth plates remain active and when does bony union occur?

Active during puberty. Bony union occurs at skeletal maturity

9

What forms the basic shoulder joint?

1/3 of Head of humerus with glenoid cavity of scapula

10

What is the glenoid labrum and what surrounds the joint?

Concentric rings of Type I collagen that attaches to the rim of glenoid cavity to deepen it slightly and accept more of the humerus. A capsule of loose connective tissue surrounds the joint

11

How would loss of rotator cuff muscle tone affect the glenohumeral joint?

The rotator cuff muscle tonus is important to holding the joint together. Loss of tone would result in more dislocations as is common during anesthesia

12

What covers the superior side of the glenohumeral joint?

The acromioclavicular joint formed by the articulation of the acromion with the lateral end of the clavicle

13

What does the AC joint do? (acromioclavicular)

Allows clavicle to act as a strut. Suspends scapula and allows it to slide along posterior thoracic wall enabling greater freedom of motion

14

What prevents the superior displacement of the joint from the glenoid cavity?

The coraco-acromial ligament connects the coracoid process and accordion forming a strong arch over the humeral head

15

What does the acromioclavicular ligament do

Reinforces superior aspect of the AC joint

16

What does the coracoclavicular ligament do

Stronger than acromioclavicular ligament and prevents dislocation of AC joint

17

Why do forceful superior thrusts of the humerus typically fail to dislocate the glenohumeral joint but fracture the humeral shaft or clavicle?

The humeral shaft or clavicle breaks before the coraco-acromial ligament

18

Why do movements of the medial and lateral fragments of a fractured clavicle result in dropping of the shoulder? What is a greenstick fracture?

The trapezius is unable to hold up the lateral fragment because of the weight of the upper limb.
Greenstick fracture occurs in children in immature bone where the bone bends but does not completely break

19

When does dislocation of the acromioclavicular joint occur and why does physical examination of the injury lead to its description as a “shoulder separation”?

Direct blow to the superolateral side of back or hard fall on shoulder/outstretched upper limb. It is described as a shoulder separation because when the coracoclavicular ligament tears, the shoulder separates from the clavicle and drops because of the weight.

20

Why do most dislocations of the humeral head occur in an inferior direction, and why are such dislocations commonly described clinically as anterior dislocations?

The coraco-acromial arch and rotator cuff muscles prevent upward dislocation so inferior dislocation is common. They are described as anterior because the head of the humerus goes anterior to the glenoid cavity (anterior to the infraglenoid tubercle and long head of triceps)

21

Deltoid attachments

Deltoid - lateral third of clavicle, accordion, and spine of scapula to the deltoid tuberosity

22

What does the axillary nerve innervate?

Deltoid, teres minor

23

How is the axillary nerve commonly injured at the surgical neck of the humerus, and where does loss of sensation occur after the injury?

It courses inferior to the humeral head and around the surgical neck meaning that it would get injured if the humerus fractures or glenohumeral joint dislocates. Also can be compressed when crutches are used improperly. Loss of sensation is on the lateral side of the proximal part of the arm supplied by the superior lateral cutaneous nerve of the arm.

24

What are the roles of the anterior and posterior portion of the deltoid during walking

Anterior part flexes the arm with help from the coracobrachialis
Posterior part extends the arm

25

What muscles abduct the arm

Deltoid with help from the supraspinatous (first 15 degrees)

26

Teres major

Inferior angle of scapula to medial surface of humerus

27

What muscles medially rotate the arm? Laterally?

Teres major and subscapularis. Infraspinatous and teres minor

28

Supraspinatus and infraspinatus

Supra scapular fossa and infraspinatus to greater tubercle of humerus

29

What is the role of the subacromial bursa

Fluid filled and cushions the supraspinatus tendon as it courses between the humeral head and osseoligamentous coraco-acromial arch toward the greater tubercle

30

What does the suprascapular nerve innervate?

The supraspinatus and infraspinatus

31

Teres minor

lateral border of the scapula to the greater tubercle of the humerus

32

Subscapularis

Anterior surface of the scapula to the less tubercle of the humerus

33

What does the lower subscapular nerve innervate?

Teres major and subscapularis, both medial rotators of the arm

34

Why is the upper limb pulled into medial rotation after an avulsion fracture of the greater tubercle?

The muscles still attached, namely the subscapularis and teres major are still attached to medially rotate the arm

35

What is the painful arc syndrome?

Inflammation and calcification of the subacromial bursa. The lesion contacts the inferior surface of the accordion causing pain while abducting arm between 50 and 130 degrees

36

How is degenerative tendinitis of the rotator cuff tested?

The person slowly adducts a fully abducted arm. At 90 degrees, the arm will uncontrollably drop if rotator cuff is damaged

37

Triceps brachii

Long head - infraglenoid tubercle
Lateral head - above radial groove of humerus
Medial head - below radial groove of humerus
Distal - olecranon of proximal ulna

38

What does the radial nerve innervate

Triceps brachii

39

Function of each head of triceps

Long - prevent inferior displacement of humeral head
Medial - workhorse for forearm extension
Lateral head - stronger but only necessary when encountering resistance

40

Why is forearm extension weakened but not lost after fracture along the radial groove of the humerus?

Radial groove on posterior of humerus is where the nerve courses. Only medial head is affected as the long and lateral connect above the radial groove to the nerve.

41

Intrinsic back muscles and extrinsic shoulder muscles come from which mesoderm layer

Paraxial

42

Muscles of the upper limb and intrinsic shoulder muscles come from which mesoderm layer

Parietal of lateral plate

43

Describe the development of muscle tissue.

At 4 weeks, myoblasts line up in rows and at 5 weeks, they fuse into myotubes. They develop into fibers with actin and myosin appeared. The longitudinal sections of the fibers displays cross striations of myofilaments into myofibrils

44

Describe the sarcomere

Successive Z bands delineate it. I bands at the end are the actin. M band in the middle is the myosin. The A band is where actin and myosin connect. Z band is where the thin filaments anchor.

45

What are T tubules and what do they do?

There are invaginations of the muscle cell membrane (sarcolemma) and carry signals from the sarcolemma to the interior of the muscle cell. They form triads with the sarcoplasmic reticulum

46

Describe the synapse of a muscle fiber with a motor axon

Acetylcholine is released from the axon terminal, binds the sarcolemma, and induces muscle contraction

47

What do satellite cells for muscles do?

Sit along the sarcolemma. They are reserve stem cells/resting myoblasts that repair damaged muscle or help with growth. They are more active in slow-twitch muscles

48

How does EMG test muscle action?

Electromyography tests muscle action by measuring the difference in electric action potentials between resting muscle and contracting muscle

49

What is the deficiency that causes Duchenne muscular dystrophy and what are the symptoms of this disease?

Dystrophin deficiency which is a membrane-associated cytoskeletal protein that maintains integrity during contraction. Symptoms include rapid progression of skeletal muscle degeneration, weakness in muscle, worsens with age

50

How does the common hereditary disorder myasthenia gravis affect the induction of postsynaptic action potentials?

It is an autoimmune disease that involves distortion of the sarcolemma at the postsynaptic side. The concentration of acetylcholine receptors is decreased because of antibodies making it less sensitive to acetylcholine

51

Type I muscle fibers

Slow-twitch, fatigue resistant. Used in muscles that use little force, posture muscles, walking

52

Type IIA muscle fibers

Fast-twitch, fatigue resistant. Marathon runners

53

Type IIB muscle fibers

Fast-twitch, fatiguable, glycolytic, sprinters

54

Epimysium

Dense connective tissue surrounding the whole muscle

55

Perimysium

Dense connective tissue surrounding fascicles of muscle fibers

56

Endomysium

Loose connective tissue around each fiber

57

Describe tendons

Dense connective tissue with Type I collagen and fibroblasts and capillaries intervening. They are continuations of the epimysium and distally, continuous with the fibrous layer of periosteum

58

Why are skeletal muscles trained according to their percentages of fiber types?

Train them based on the type of fibers they should contain.

59

Why are muscle-tendon junctions more susceptible to strain injuries in children?

The junction is an area of rapidly growing muscle fiber so it cannot sustain very strong forces leading to more injury

60

What mesodermic layer forms the smooth muscle

Mesenchymal cells of the visceral layer

61

Describe smooth muscle fibers

Staggered to closely pack. Actin bind dense bodies attached to the inner surface of sarcolemma scattered within the sarcoplasm. Myosin associates with actin to create filament sliding

62

How are smooth muscle contractions triggered?

Varicosities along postsynaptic sympathetic fibers release norepinephrine that binds the sarcolemma. Gap junctions between muscle fibers allow the action potential to spread resulting in synchronous conduction

63

How are smooth muscle fiber hyperplasia and hypertrophy distinguished, and how do they contribute to the pathogenesis of hypertension?

Hyperplasia - proliferation
Hypertrophy - increase in cell size
Thickening of the tunica media (location of smooth muscle) could cause hypertension. Thickening is the result of hyperplasia and hypertrophy