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MBChB1 Phase 1 > Week 5 > Flashcards

Week 5 Flashcards

1
Q

What is a joint?

A

Place where 2 or more bones make contact

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2
Q

3 classifications of joints?

A

fibrous
cartilaginous
synovial

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3
Q

What is a fibrous jount? Example?

A

Bones joined by dense fibrous connective tissue
Sutures

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4
Q

What is a cartilaginous joint? Example?

A

Bones joined by cartilage
IVDs

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5
Q

What is a synovial joint? Example? Purpose?

A

Bones not directly joined
Shoulder joint
Allows movement

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6
Q

3 classifications of movement in joints?

A

Synarythoris
Amphiarthrosis
Diarthrosis

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7
Q

What is synarthrosis, example?

A

No movement
Sutures
Gomphosis - teeth

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8
Q

What is amphiarthrosis, example?

A

Little movement
Pubic symphysis
distal tibiofibular

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9
Q

What is diarthrosis, example?

A

Free movement
synovial joints

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10
Q

Give classifications and examples of uniaxial synovial joints.

A

Pivot, hinge, plane (gliding)
elbow, alantoaxial, acromioclavicular

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11
Q

Give classifications and examples of biaxial synovial joints.

A

Condyloid, saddle
Metacarphophalangeal, capometacarpal

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12
Q

Give classifications and examples of multiiaxial synovial joints.

A

ball and socket
hip

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13
Q

What causes an increased risk of osteoarthritis?

A

overuse of joints
obesity
prior RA/gout
obesity
family history

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14
Q

3 types of muscle tissue?

A

skeletal
cardiac
smooth

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15
Q

Describe skeletal muscle?

A

voluntary
most large muscles
striated
tires easily

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16
Q

Describe cardiac muscle?

A

involuntary
walls of heart and aorta/vena cava
striated
doesnt tire easily

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17
Q

Describe smooth muscle?

A

involuntary
walls of hollow viscera e.g. digestive organs, blood vessels, iris
unstriated
doesnt tire easily

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18
Q

Some functions of the muscular system?

A

Locomotion
Respiration
Circulation
Digestion
Urination
Vision

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19
Q

What are muscles composed of?

A

Muscle fibres grouped into fascicles

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20
Q

What do fascicles form?

A

Heads or bellies of muscles

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21
Q

What are muscles connected to bone or other structures by?

A

tendons (round ) or an aponeurosis (flat sheet of fibrous tissue)

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22
Q

What does a muscles range of movement depend on?

A

Length of fibre

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23
Q

How much can muscles contract by of their lenght?

A

30%

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24
Q

What does the strength of a muscle depend on?

A

number of fibres

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25
Q

What are flat muscles, example?

A

parallel fibres with aponeurosis
external obliquw

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26
Q

What are pennate muscles, example?

A

Feather like
uni - digitorum longus
bi - rectus femoris
multi - deltoid

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27
Q

What are fusiform muscles, example?

A

spindle shaped with thick bellt and tapered ends
biceps brachii

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28
Q

What are convergent muscles, example?

A

Broad area converges to single tendon
pectoralis major

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29
Q

What are quadrate muscles, example?

A

four equal sides
rectus abdominis

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30
Q

What are circular muscles, example?

A

Surround body opening/orifice
oribicularis occuli

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31
Q

Where is biceps brachii origins?

A

long head - supraglenoid tubercle
short head - coracoid process

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32
Q

Where does the biceps brachii insert?

A

radial tuberosity

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33
Q

What is the movement of biceps brachii?

A

flexion of shoulder and elbow
supinatesforearm

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34
Q

Layers of the body?

A

skin
subcutaneous tissue
deep fascia
muscle

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35
Q

Function of deep fascia?

A

forms compartments seperating muscles

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36
Q

Function of extrinsic back muscles?

A

act on structures outside of the back

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37
Q

Function of intrinsic back muscles?

A

act on structures within the back

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38
Q

What are extrinsic back muscles innervated by?

A

Anterior rami of spinal nerves

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39
Q

What are intrinsic rami innervated by?

A

dorsal rami of spinal nerves

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40
Q

Origins of trapezius?

A

superior nuchal line
nuchal ligament
c7-t12 spinous process

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41
Q

Insertion of descending trapezius?

A

lateral third of clavicle

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42
Q

insertion of horizontal trapezius?

A

acromion of scapula

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43
Q

insertion of ascending trapezius?

A

spine of scapula

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44
Q

action of descending trapezius on shoulder girdle?

A

descending: keeps shoulder up e.g. carrying heavy bags
tilts scapula for arm elevation

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45
Q

action of horizontal and ascending trapezius on shoulder girdle?

A

pull scapula towards midline

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46
Q

action of descending trapezius on head and neck?

A

when shoulders fixed:
moving head to one side - unilateral action
moving head back - bilateral action

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47
Q

Action of trapezius on vertebral collumn?

A

flattens thoracic kyphosis - bilaterally

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48
Q

What nerve supplies the trapezius?

A

cranial nerve XI accessory

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49
Q

Which 2 muscles allow tilting of scapula and therefore lifting of arm?

A

serratus anterior
trapezius

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50
Q

origins of latissimus dorsi?

A

spinous process t7-t12
thoraco-lumbar aponeurosis
dorsal sacrum surface
dorsal 1/3 of iliac crest

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51
Q

additional origins of latissimus dorsi?

A

10-12th ribs
inferior angle of scapula

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52
Q

insertion of latissimus dorsi?

A

humerus - floor of intertubercular sulcus

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53
Q

Latissimus dorsi action on arm?

A

adduction (brings arm to midline)
extension (moves arm backwards)

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54
Q

Latissimus dorsi action on trunk?

A

elevation when arms fixed on bar (pull up)

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55
Q

Latissimus dorsi action on shoulder girdle?

A

depression
pulls scapula medially

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56
Q

Which nerve supplies the latissimus dorsi?

A

Thoraco-dorsal from BP

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57
Q

What is the origin of rhomboid minor?

A

spinous process of c6-c7

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58
Q

What is the origin of rhomboid major?

A

spinous process of t1-t4

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59
Q

What is the insertion of rhomboid minor?

A

root of scapular spine

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60
Q

What is the insertion of rhomboid major?

A

below scapular spine

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61
Q

Where does rhomboid insert overall?

A

medial margin of scapula

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62
Q

Action of rhomboid on shoulder girdle?

A

retracts scapula - pulls scapula closer to spine
lowers shoulder
fixes scapula to trunk

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63
Q

What does failure of fixing scapula to trunk result in?

A

Wing scapula

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64
Q

What other muscle with rhomboid fixes scapula to trunk?

A

serratus anterior

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65
Q

Which nerve supplies rhomboid?

A

dorsal scapular from BP

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66
Q

Attachments of levator scapulae?

A

c1-c4 transverse processes
scapula superior angle

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67
Q

Levator scapular action on shoulder girdle?

A

elevates scapula
rotates glenoid inferiorly

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68
Q

What does rotating glenoid inferiorly do?

A

allows arm to drop

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69
Q

Levator scapulae action on vertebral collumn?

A

fixed shoulder girdle: extends neck (moves head back)

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70
Q

Levator scapulae nerve supply?

A

dorsal scapular nerve from BP

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71
Q

What is extracellular matrix?

A

non cellular component present in all tissues and organs

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72
Q

2 types of ecm?

A

Interstitial connective tissue matrix
Basement membrane

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73
Q

Function of the interstitial connective tissue matrix?

A

surrounds cells
provides structural scaffolding for tissues

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74
Q

Function of basement membrane?

A

seperates epithelium from surrounding stroma

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75
Q

Where is ECM found?

A

bone
tendon
cartilage
eye
dermis
bm

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76
Q

Functions of ECM?

A
  • mechanical and structural support
  • tensile strength
  • determines cellular microenvironment
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77
Q

How does ecm determine cellular microenvironemnt?

A
  • anchors cells (cell-ecm junctions)
  • paths for cellular migration e.g. wound repair
  • sequesters growth factors
  • residence for phagocytic cells
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78
Q

Which 5 macromolecules make up the acellular composition of ECM?

A

collagen
elastin
proteoglycans
hyaluronan
glycoproteins

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79
Q

How many types of collagens are there?

A

28

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80
Q

What is the structure of collagen?

A

3 collagen polypeptides form triple helix

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81
Q

What are 2 types of collagen formation?

A

fibrillar
sheet/network forming

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82
Q

Where is fibrillar collagen located? WHy?

A

skin/tendon/bone
strength

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83
Q

Where is sheet collagen found, why?

A

bm
support

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84
Q

Where is type I collagen found?

A

dermis
tendons
ligaments
bones
fibrocartilage

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85
Q

Where is type II collagen found?

A

hyaline cartilage

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86
Q

Where is type iii collagen found?

A

liver
bone marrow
lymphoid organs
granulation tissue

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87
Q

Where is type iv collagen found?

A

basement membrane

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88
Q

where is type v collagen found?

A

cornea

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89
Q

Where is elastin abundant?

A

tissues requiring stretch/recoil properties

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90
Q

What does assembly of elastin into functional fibres require?

A

fibrillin

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91
Q

What is fibrillin?

A

structural glycoprotein

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92
Q

Where is loose irregular connective tissue found?

A

lymphoid tissue

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93
Q

Where is dense irregular connective tissue found?

A

dermis

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94
Q

What is ground substance?

A

amorphous, gel like non fibrous substance surrounding cells

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95
Q

function of ground substance?

A

fills spaces between fibres and cells
good at absorbing water
resists compressive forces

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96
Q

what is the composition of ground substance?

A

glycosaminoglycans link together to form proteoglycans

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97
Q

What are glycodaminoglycans composed of?

A

repeated disaccharide units

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98
Q

name 4 glycosaminoglycans?

A

hyaluoran
chondroitin sulphate
keratan sulphate
heparan sulphate

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99
Q

where is hyaluroan primarily found?

A

synovial fluid

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100
Q

where are chondroitin sulphate amd keratan sulphate primarily found?

A

cartilage

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101
Q

where is heparan sulphate primarily found?

A

bm

102
Q

Function of glycosaminoglycans?

A

enable matrices to withstand high compressive forces

103
Q

what are proteoglycans composed of?

A

glycosaminoglycans and a protein core

104
Q

Where is aggrecan found and which GAGs are found in it?

A

cartilage
chondrotin sulphate
keratan suphate

105
Q

Where is perlecan found and which gags are found in it?

A

basement membrane
heparan sulphate

106
Q

Name 4 proteoglycans

A

aggrecan
perlecan
syndecan
decorin

107
Q

Where is decorin foud and what gags are found in it?

A

connective tissue - assembles ecm
chondrotin sulphate
dermatin sulphate

108
Q

function of aggrecan?

A

aggregates cartilage
reacts with cartilage to provide tensile strength and resists deformation

109
Q

name 3 glycoproteins?

A

fibrillin
fibronectin
laminin

110
Q

function of fibrillin?

A

deposits and orientates elastin

111
Q

function of fibronectin?

A

organises ecm
cell attachment to bm

112
Q

function of laminin?

A

organises basement membrane

113
Q

What binds to laminin in basement membrane?

A

integrin in hemidesmosome

114
Q

what is collagen assembled as before cleavage and aggregation?

A

procollagen

115
Q

why is collagen first assembled as procollagen?

A

prevents formation of very large fibres

116
Q

what is elastin first synthesised as?

A

tropoelastin

117
Q

which post translation modifications are done on collagen?

A

glycosylation
hydroxylation

118
Q

What post translational modifications are done on elastin?

A

hydroxylation

119
Q

3 stages of ecm remodelling?

A

deposition
modification
degreagation

120
Q

What are consequences of hyperproliferation of fibroblasts in ecm synthesis?

A

excess ecm:
- tissue fibrosis

121
Q

What happens when pathogens e.g. clostridium species are present in ecm remodelling?

A

produce collegenase
breaks down ecm, they get access to body, invade host

122
Q

What happens when theres excess activation of ecm remodelling?

A

mmps break down collagen in basement membrane
tumor cell invasion occurs

123
Q

3 results of deregulated ecm remodelling?

A

tissue fibrosis
invasion of host by bacteria
tumor cell invasion

124
Q

4 things that make up basement membrane?

A

collagen iv
nidogen
perlecan
laminin

125
Q

3 places to find basement membrane?

A

lines under epithelia/endothelium
surrounds muscle fibres, neurons, adipocytes
seperates 2 sheets of cells e.g. kidney glomerulus

126
Q

Functions of basement membrane?

A

support
permits flow of nutrients
binds to connective tissue

127
Q

What are 4 things that can occur when basement membrane is disordered?

A

cancer
diabetes mellitius
epidermolysis bullosa
goodpastures syndrome

128
Q

How is cancer formed from bm disorder?

A

epithelial tumors become malignant when bm is breached

129
Q

How is diabetes mellitus formed from bm disorder?

A

thickening of bm in glomerulus changes permability

130
Q

How is epidermolysis bullosa formed from bm disorder?

A

attachment of epidermis to bm is disrupted

131
Q

How is goodpastures formed from bm disorder?

A

autoantibodies to collagen iv destory bm in glomerulus and lung
causes lung bleeding and kidney failure

132
Q

function of osteocalcin?

A

promotes mineralisation

133
Q

How can you recognise osteoclasts?

A

large
multiple nuclei
ruffled border

134
Q

How can you recognise osteoblasts?

A

single nuclei

135
Q

How can you recognise osteocytes?

A

one nuclei
long cytoplasmic processes

136
Q

what is cartilage synthesised by?

A

chondrocytes

137
Q

which 3 gags are present in cartilage?

A

chondroitin sulphate
keratan sulphate
hyaluronic acid

138
Q

what makes up cartilage?

A

aggrecan
hyaluronic acid
protein core

139
Q

3 types of cartilage?

A

hyaline
elastic
fibrocartilage

140
Q

3 types of cartilage?

A

hyaline
elastic
fibrocartilage

141
Q

features of hyaline cartilage?

A

few collagen fibres
avascular
has perichondrium - not in articular cartilage

142
Q

what is perichondrium?

A

connective tissue enveloping cartilage
not in joints

143
Q

Where is hyaline cartilage found?

A

septum
larynx
tracheal rings
sternal ends of ribs
epiphyseal surfaces
articular surfaces

144
Q

features of fibrocartilage?

A

abundant collagen fibres
avascular n
no perichondrium

145
Q

where is fibrocartilage found?

A

ivds
sternoclavicular joint
pubic symphysis

146
Q

features of elastic cartilage?

A

elastic fibres
avascular
perichondrium

147
Q

where is elastic cartilage found?

A

external ear
epiglottis
auditory tube

148
Q

imapact of cartilage being poorly vascularised#?

A

can take a while to heal when damaged

149
Q

what happens when ecm is over degregated?

A

osteoarthritis

150
Q

what happens when ecm is over produced?

A

fibrosis

151
Q

what happens when elastin is mutated in ecm?

A

supravalcular aortic stenosis
arterial defects
heart valve narrowed

152
Q

What syndrome is caused when fibrillin-1 is mutated?

A

marfan syndrome

153
Q

What is marfan syndrome?

A

mutation in fibrillin
affects connective tissue
vision problems
heart/aortic defects
long and slender limbs, fingers and toes

154
Q

What is arachnodacttyly?

A

abnormally long and slender limbs, fingers and toes

155
Q

Which type of mutations are in marfan syndrome?

A

autosomal dominant

156
Q

which stain stains elastin

A

van giesen - puple

157
Q

what happens when collagen i is mutated in ecm?

A

elhers-danlos syndrome

158
Q

what is elhers-danlos syndrome?

A

affects connective tissue
affects structure, production and function of collagen
hypermobility, stretchy and fragile skin

159
Q

what happens when collagen iv is mutated in ecm?

A

alport syndrome
goodpastures disease

160
Q

what is alport syndrome?

A

basement membrane is dysfunctional
blood and protein in urine, loss of kidney function

161
Q

What is the ecm of bone?

A

osteoid

162
Q

Structure of cells in skeletal muscle?

A

long and cylindrical

163
Q

How quickly does each muscle type contract?

A

skeletal: very rapid
cardiac: medium speed
smooth: slow, wave like

164
Q

Which cell type makes up cardiac muscle and why?

A

branching cells
allow faster signalling

165
Q

What type of cells make up smooth muscle?

A

fusiform

166
Q

Why is the body in a state of electrical disequilibrium? How?

A

Active transport of ions across cell membrane creates electrical gradient
Excess neg ions on inside, matching pos ions on outside

166
Q

What is the law of conservation of change?

A

The net amount of electrical charge in a system is zero so body is electrically neutral

167
Q

What is a conductor?

A

The material which seperated charges move towards each other

168
Q

What is a conductor?

A

The material which seperated charges move towards each other

169
Q

What is a conductor?

A

The material which seperated charges move towards each other

169
Q

What is a conductor?

A

The material which seperated charges move towards each other

170
Q

What is an insulator?

A
171
Q

What is an insulator?

A

Material preventing movement of seperate charges
Cell membrane

172
Q

What is an insulator? Example?

A

Material preventing movement of seperate charges
Cell membrane

173
Q

What is needed to seperate charge?

A

energy

174
Q

When does static electricity arise?

A

when electric charges are seperated

175
Q

When are electrical gradients created?

A

when energy is inputted to transport ions across a membrane

176
Q

What is a chemical gradient?

A

active transport of ions out of a cell

177
Q

What is the resting membrane potential?

A
178
Q

What is the resting membrane potential?

A

electrical gradient across the cell membrane

179
Q

What is the resting membrane potential?

A

electrical gradient across the cell membrane

180
Q

What is the resting membrane potential?

A

electrical gradient across the cell membrane

181
Q

What is the resting membrane potential?

A
181
Q

What is the resting membrane potential?

A

electrical gradient across the cell membrane

181
Q

What is the resting membrane potential?

A

electrical gradient across the cell membrane

181
Q

What is the resting membrane potential?

A

electrical gradient across the cell membrane

182
Q

What does resting mean in resting membrane potential?

A

membrane potential is steady and not changing

183
Q

What does potential mean in resting membrane potential?

A

electrical gradient created by active transport of ions is a source of potential energy

184
Q

What does difference mean in resting membrane potential?

A

difference in electrical charge in and out of cell

185
Q

What is used to measure the resting membrane potential and how, units?

A

voltmeter
measures difference in electrical charge between 2 points
milivolts

186
Q

Which objects are used with voltmeters?

A

glass micropipettes filled with solutions to conduct charge
one put in cell and one in extracellularfluid

187
Q

What is the ground when measuring resting membrane potential? What charge does it have?

A

extracellular fluid
has neutral charge

188
Q

What is the resting membrane potential in nerves and muscle?

A

between -40 to -90 mV

189
Q

How does k+ contribute to the resting membrane potential?

A

membran is more permeable to k+ ions
k+ leaks out of cell down conc gradient
negative buildup in cell as pr- cannot cross membrane
gradient formed
negative charges attract k+ ions back into cell down electrical gradient
net movement of k+ stops

190
Q

What is the equilibrium potential?

A

membrane potential at which the electrical gradient opposes the chemical gradient

191
Q

what is the equilibrium potential of potassium ?

A

-90 mV

192
Q

When do k+ ions leak out of the cell?

A

electrical equilibrium, chemical disequilibrium

193
Q

Which equations calculates equilibrium potential?

A

Nernst equation

194
Q

What is the equilibrium potential of sodium?

A

60 mV

195
Q

How much more permeable are cells to potassium than sodium

A

40x more

196
Q

What is the normal resting membrane potential?

A

-70 mV

197
Q

How much sodium is pumped out of the cell and how much potassium is pumped in?

A

3 out
2 in

198
Q

Why is Na/K-ATPase known as an electrogenic pump?

A

helps maintain electrical gradient

199
Q

Briefly describe muscle excitation.

A

Nerve impulse reaches neuromuscular junction
Acetycholine is released from the motor neuron
Acetycholine binds with receptors in muscle membrane to allow sodium ions to enter the muscle
Influx of sodium creates action potential in sarcolemma
Action potential travels down T tubule
Sarcoplasmic reticulum releases ca
Ca binds with troponin to move the troponin, tropomyosin complex
Binding sites in actin filament are exposed

200
Q

What is the neuromuscular junction

A

synaptic connection between end of Motor neuron and muscle

201
Q

What is sarcolemma?

A

cell membrane surrounding skeletal muscle fibre or cardiomyocyte

202
Q

what is a motor unit?

A

all the muscle cells controlled by one nerve cell

203
Q

what is the motor unit ratio in the back?

A

1:100
one nerve to 100 muscle cells

204
Q

what is the motor unit ratio in the finger?

A

1:10

205
Q

what is the motor unit ratio in the finger?

A

1:1

206
Q

What is muscle tonus?

A

tightness of a muscle

207
Q

what is muscle tetnay?

A

sustained contraction of a muscle
due to rapid succession of nerve impulses

208
Q

4 stages of tetany?

A

twitch
wave summation
incomplete tetanus
complete tetanus

209
Q

What is refractory period?

A

brief period of time in which muscle cells will not respond to a stimulus

210
Q

Which tissue has a longer refractory period than skeletal muscle and why?

A

cardiac muscle to prevent it going into tetany

211
Q

What are skeletal muscle fibres made up of?

A

myofibrils

212
Q

what are sarcomeres?

A

functional unit of muscle fibre

213
Q

what is the z line in muscles?

A

boundary of sarcomere

214
Q

which filament in muscle is thick?

A

myosin

214
Q

which filament in muscle is thin?

A

actin

215
Q

Which 3 things compose an actin filament?

A

troponin complex
tropomyosin
g actin

216
Q

what is the h band of sarcomere?

A

only myosin

217
Q

what is the sarcomere I band?

A

only actin

218
Q

what is the sarcomere a band?

A

actin and myosin

219
Q

how are power strokes initiated in muscle?

A

myosin head attaches to actin filament to create cross bridge
myosin head bends to move the actin filament towards m line (power stroke) adp and pi also release
atp unhooks myosin head
atp split into ads and pi and myosin ready to attach to another filament

220
Q

what covers actin binding sites when relaxed?

A

tropomyosin

221
Q

How are actin binding sites uncovered from tropomyosin?

A

ca attaches to troponin

222
Q

Where is calcium stored in muscles?

A

sarcoplasmic/endoplasmic reticulum

223
Q

What generates atp in muscle?

A

mitochondria

224
Q

What can creatine store? What does it become when interacting with this?

A

atp
creatine phosphate + adp

225
Q

what is muscle fatigue?

A

lack of oxygen causes atp defecit
lactic acid builds up from anaerobic respiration

226
Q

what is muscle atrophy? causes?

A

weakening/shrinking of muscle
immobilisation, loss of neural stimulation

227
Q

what is muscle hypertrophy, causes?

A

enlargement of muscle
strenuous exercise, steroid hormone

228
Q

what is isometric contraction?

A

produces no movement
standing, sitting, posture

229
Q

what is isotonic contraction?

A

produces movement
walking, moving

230
Q

Which 3 parts of the joint are affected in oa?

A

bone
articular cartilage
menisci

231
Q

what is different about the joint in oa?

A

thickened capsule
cyst formation
synovial hypertrophy
osteophytes
fibrillated cartilage

232
Q

2 parts of musculoskeletal tissue?

A

cellular component
ecm

233
Q

what happens to articular cartilage in oa?

A

inc swelling
colour change
cartilage fibrillation (fraying/splitting)
cartilage erosion to subchondral bone

234
Q

function of chondrocytes?

A

synthesise and maintain ecm

235
Q

2 types of oa?

A

primary - degenerative disorder
secondary - trauma, infection, diabetes

236
Q

oa risk factors?

A

age
genetics
gender (women)
low vit d
joint trauma
obesity

237
Q

oa symptoms?

A

pain when moving
stiffness in morning improving in 30 mins
difficulty moving joints

238
Q

diagnosis of oa?

A

pain
decreased walking distance
sleep disturbance
stiffness

239
Q

what is seen on X-rays of oa?

A

joint space narrowing
osteophytes
subchondral sclerosis
cyst formation

240
Q

what is subchondral sclerosis?

A

hardening of bone beneath cartilage surface

241
Q

non operative oa treatment?

A

medication
physio
walking aids
joint injections

242
Q

types of medication for oa?

A

paracetamol
nsaids

243
Q

types of joint injectuions for oa?

A

corticosteroid - reduce inflammation around joints
viscous supplement - replace modified synovial fluid in joints to increase viscosity of fludi

244
Q

types of surgery for oa?

A

arthroscopy
cartilage transplantation
joint replacement

245
Q

how does joint replacement surgery work?

A

remove worn cartilage and replace with synthetic material
pain relief

MBChB1 Phase 1 (12 decks)

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