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Semester 2 > MSK Session 2 > Flashcards

MSK Session 2 Flashcards

0
Q

What type of muscle is the diaphragm?

A

Skeletal

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1
Q

What two types of muscle are there?

A

Striated

Non-striated

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2
Q

Give an example of each type of skeletal muscle arrangement.

A 
Circular: orbicularis oris
Convergent: pec. major
Parallel: sartorius
Unipennate: extensor digitorum longus
Multipennate: deltoid
Fusiform: biceps brachii
Bipennate: rectus femoris
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3
Q

How are skeletal muscles attached to bones?

A

By tendons

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4
Q

What does skeletal muscle continually contract?

A

To maintain posture

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5
Q

What is the mechanical efficiency of skeletal muscle?

A

~20%, rest dissipated as heat

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6
Q

What is the gross anatomy of skeletal muscle?

A

Epimysium –> perimysium –> endomysium

Muscle –> fascicle –> muscle fibre

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7
Q

What is fasciculation?

A

Low level muscle twitch often seen in the face when tired/nervous or more severely in motor neurone disease

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8
Q

What is a first class lever?

A

Where the force and load are on opposite sides of the fulcrum like a see-saw e.g. neck

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9
Q

What is a second class lever?

A

Where the force and load are to the left of the fulcrum like a wheelbarrow e.g. in the foot where the ball is the fulcrum

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10
Q

What is a third class lever?

A

Most common type of lever where the force and load are to the right of the fulcrum, like a fishing rod

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11
Q

What can be said about the length along which force acts in a third class lever?

A

Large

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12
Q

What are agonists?

A

Prime movers

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13
Q

What are antagonists?

A

Oppose prime movers

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14
Q

What act together to allow fine, smooth movement?

A

Agonists and antagonists

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15
Q

What are synergists?

A

Muscles that assist prime movers by neutralising extra motion to keep motion in one direction

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16
Q

What are fixators?

A

Muscles that stabilise the action of prime movers by fixing non-moving joints when prime mover is acting over two joints

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17
Q

What are compartments?

A

Groups of muscles surrounded by connective tissue

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18
Q

What is compartment syndrome?

A

When pressure builds up inside a compartment due to the inability of the surrounding CT to undergo rapid expansion and causes nerve compression

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19
Q

What can cause compartment syndrome?

A

Bleeding

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20
Q

What effect can long-term training have on the connective tissue surrounding a compartment?

A

Expansion

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21
Q

What is isotonic muscle contraction?

A

Constant tension with variable muscle length that changes to move a load

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22
Q

What happens in concentric isotonic muscle contraction?

A

Muscle shortens

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23
Q

What happens in eccentric isotonic muscle contraction?

A

Muscle exerts force whilst extended e.g. walking downhill

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24
Q

What is isometric muscle contraction?

A

Muscle remains a constant length but has variable tension

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25
Q

Describe isometric contraction in hand grip.

A

Forearm muscles do not change length but exert force

Small muscles also used which rapidly increase BP - risky for elderly and hypertensive

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26
Q

What are the three types of muscle fibre?

A

Type I - slow oxidative
Type IIa - fast oxidative
Type IIb - fast glycolytic

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27
Q

What is used to identify muscle type?

A

Mitochondrial staining on post mortem/needle biopsy sample

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28
Q

What characterises slow oxidative muscle?

A 
Aerobic
High myoglobin levels
Red colour
Lots of mitochondria
Rich capillary supply
Fatigue resistant - used in endurance activities and posture
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29
Q

What characterises fast oxidative muscle?

A 
Aerobic
High myoglobin levels
Red to pink colour
Many mitochondria
Rich capillary supply
Moderate fatigue resistance - used for walking and sprinting
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30
Q

What characterises type IIb muscle?

A 
Anaerobic glycolysis
Low myoglobin levels
White (pale) colour
Few mitochondria
Poorer capillary supply
Rapidly fatiguable - used for short intense movement
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31
Q

What is proprioception?

A

Awareness of self

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32
Q

How do specialised muscle fibres in the belly of a muscle allow proprioception to take place?

A

Sense stretch and send signals back to brain reporting tension and strain levels in the muscle

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33
Q

What can be considered as the feedback control of movement as well as feedback from the joints?

A

Proprioception

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34
Q

What is a motor unit?

A

Motor neurone and the muscle fibre it innervates

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35
Q

Where is the output of a motor neurone?

A

Through ventral root

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36
Q

How does the number of muscle fibres controlled by a motor neurone vary with control?

A

More control = fewer fibres innervated by a single neurone

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37
Q

What is cross talk?

A

Method of communication b/w neurones and muscle using signalling molecules

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38
Q

How does atrophy of a neurone or a muscle cause atrophy of its corresponding component?

A

Signals are either not released or not needed

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39
Q

Which signalling molecule maintains communication b/w motor neurone and muscle and is very important in the NMJ?

A

Neutrophin-3

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40
Q

What causes baseline muscle tone in muscles at rest?

A

Motor neurone activity

Muscle elasticity due to protein content

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41
Q

What controls baseline muscle tone?

A

Motor control centres in the brain

Afferent fibre signals originating from the muscle

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42
Q

What is hypotonia?

A

Low level of muscle tone

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43
Q

What can cause hypotonia?

A

Primary degradation of the muscle
Lesions of cerebellum and cerebral/shock causing damage to motor cortex involved in feedback mechanism
Lesion of sensory afferents from the muscle spindles
Lesions of lower motor neurones e.g. polyneuritis
Spinal neural shock

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44
Q

What does polyneuritis affect?

A

Multiple motor neurones in body in different places

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45
Q

How is ACh exocytosed from the NMJ?

A

AP sweeps around membrane –> opens calcium channels –> calcium in

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46
Q

What happens when 2 ACh bind to the alpha-subunit of nicotinic receptors on the effector muscle?

A

Conformational change of ligand gated sodium –> sodium in –> depolarisation –> calcium release from SR

47
Q

Why are anaesthetics used?

A

Less tissue damage is caused if the tissue is relaxed

48
Q

What is given in addition to anaesthetics to counteract the initial contraction they cause by inhibiting AChE?

A

Neuromuscular block

49
Q

What is spatial summation?

A

Type of recruitment learned throughout life

50
Q

How does spatial summation work?

A

More motor neurones are activated so more muscle fibres are recruited to develop more force

51
Q

Where do reflex pathways in spatial summation come from?

A

Muscle spindles
Joint receptors
Golgi tendon organs of muscle fibres

52
Q

What do Golgi tendon organs sense?

A

Changes in muscle tension

53
Q

What is temporal summation?

A

Recruitment where increased frequency of AP to muscle fibres causes summation

54
Q

What is the difference between fused and infused tetanus?

A 
Unfused = twitch
Fused = continuous force = no relaxation
55
Q

What is present in all soil that interferes with feedback control of muscle tension to cause continual contraction?

A

Clostridium tetani

56
Q

What is electromyography?

A

Electrodes placed above/in muscles to record their electrical activity

57
Q

Why is the amplitude in an electromyography equivalent to the force of contraction?

A

Increased recruitment of motor units

58
Q

What is seen in an EMG that indicates MND?

A

Graph doesn’t match up

59
Q

How is relaxation of a muscle achieved by lower cytoplasm calcium content?

A

Pumping calcium back into SR via calcium pumps

Binding to calmodulin

60
Q

What are sources of energy for muscle contraction?

A

Short term ATP stores in muscle fibre
Creatine phosphate
Aerobic and anaerobic glycolysis
Oxidative phosphorylation

61
Q

What energy source for muscle contraction can be measured for suspected muscle damage?

A

Creatine phosphate

62
Q

How does anaerobic glycolysis cause muscle cramp?

A

Conversion by LDH of pyruvate to lactate which acts on nerve endings coupled with a decrease in pH

63
Q

When does peripheral fatigue occur?

A

Muscle glycogen stores are depleted

Within one minute of blood flow interruption

64
Q

What is contracture?

A

State of continuous contraction when ATP is depleted

65
Q

What causes rigor mortis?

A

Myosin X-bridges unable to detach from actin filaments

66
Q

What is the time frame of rigor mortis?

A

Slow onset, peaks at 12-13 hours and can give v. exact time of death

67
Q

What forms the anterior border of the axilla?

A

Pec. minor and major

68
Q

What makes up the medial border of the axilla?

A

Serratus anterior

Thoracic wall

69
Q

What forms the posterior border of the axilla?

A

Scapularis
Teres major
Latissimus dorsi

70
Q

What forms the lateral border of the axilla?

A

Intertubecular sulcus

71
Q

What forms the apex of the axilla?

A

Cervico-axillary canal bounded by the first rib, clavicle and superior edge of scapula a

72
Q

What transverses the apex of the axilla?

A

Arteries
Veins
Lympahtics
Nerves

73
Q

What forms the base of the axilla?

A

Concave skin
Subcutaneous tissue
Axillary fascia from 4th rib to axillary fossa

74
Q

What enters and leaves the clavipectoral triangle?

A

Cephalic vein enters

Medial and lateral pectoral nerves leave

75
Q

What is found in the quadrangular space?

A

Post-circumflex humeral artery

Axillary nerve

76
Q

What is the main artery supplying the upper limb?

A

Axillary artery

77
Q

What are the parts of the axillary artery?

A

Medial, posterior and lateral to pec. minor

78
Q

Describe the path of the axillary artery.

A

Lateral border of 1st rib –> medial border of pec. minor –> lateral border of pec. minor –> inferior border of teres major

79
Q

What arteries branch off from the axillary artery?

A 
Super thoracic 
Thoraco-acromial
Lateral thoracic
Subscapula artery
Anterior and posterior circumflex humeral arteries
80
Q

What is the collateral route enabling venous return if IVC is obstructed?

A

Thoraco-epigastric veins

81
Q

Brachial and basilic vein –> subclavian vein –> second part of axillary vein –> initial distal end

A

Describe the path of the axillary vein.

82
Q

Which veins drain into the axillary vein?

A

Thoraco-epigastric
Cephalic
Corresponding veins to the thoraco-acromial artery

83
Q

Moving anteriorly to posteriorly in the axilla, how are the artery, nerve and vein arranged?

A

Vein
Artery
Nerve
(VAN)

84
Q

What 5 groups of lymph nodes are present in the axilla?

A 
Pectoral
Subscapular
Humeral
Central
Apical
85
Q

Where are the pectoral lymph nodes found and what area do they drain?

A

3-5 nodes on medial wall

Breast

86
Q

Where are the subscapular lymph nodes located and what do they drain?

A

6-7 nodes on posterior axillary fold

Posterior wall and scapula

87
Q

Where are the humeral lymph nodes found and what do they drain?

A

4-6 nodes on lateral wall

UL

88
Q

Where are central and apical lymph nodes found?

A 
Central = 3-4 nodes deep to pec. minor
Apical = all other groups and lympahtics not already classified
89
Q

What are the components of the brachial plexus?

A 
Roots
Trunks
Divisions
Cords
Terminal branches
90
Q

Where do the roots of the brachial plexus arise?

A

Paired spinal nerves that leave the spinal cord via the intervertebral foramen of the vertebral column which divide into an anterior part

91
Q

What is the fate of the posterior division of the spinal nerves that have left the spinal cord?

A

Innervate skin and musculature of the trunk

92
Q

What do the roots of the brachial plexus pass between to enter the base of the neck?

A

Anterior and medial scalene muscles

93
Q

What happens in the brachial plexus at the base of the neck?

A

Roots converge to form three trunks

94
Q

What path do the trunks of the brachial plexus take?

A

Move laterally crossing the posterior triangle of the neck

95
Q

What happens to the brachial plexus within the posterior triangle of the neck?

A

Each trunk divides into anterior and posterior branches

96
Q

What path do the divisions of the brachial plexus take?

A

Pass into the axilla

97
Q

What happens to the brachial plexus in the axilla?

A

Divisions combine to form three nerves which are the cross of the brachial plexus

98
Q

What are the cords of the brachial plexus named relative to?

A

Axillary artery

99
Q

What do the cords of the brachial plexus give rise to?

A

Major branches

100
Q

What happens to the brachial plexus in the axilla and proximal part of the UL?

A

3 cords become 5 branches

101
Q

What is the function of the five major branches of the brachial plexus?

A

Provide innervation to the muscle and skin they pass over

102
Q

What are the five major branches of the brachial plexus?

A 
Ulnar nerve
Radial nerve
Median nerve
Axillary nerve
Musculocutaneous nerve
103
Q

What are the nerve roots of the ulnar nerve?

A

C8 and T1

104
Q

What are the nerve roots of the radial nerve?

A

C5-8 and T1

105
Q

What are the nerve roots of the median nerve?

A

C6-8 and T1

106
Q

What are the nerve roots of the axillary nerve?

A

C5 and 6

107
Q

What are the nerve roots of the musculocutaneous nerve?

A

C5-7

108
Q

What does the ulnar nerve innervate?

A

Muscles of hand
Flexor carpi ulnaris
Medial half of flexor digitorum profundus
Sense in anterior and posterior medial 1.5 fingers and palm area

109
Q

What does the radial nerve innervate?

A

Triceps brachii
Extensor muscles in posterior compartment of forearm
Sense in posterior aspect of arm and forearm
Sense in posterior and lateral aspect of hand

110
Q

What does the median nerve innervate?

A

Flexor muscles in forearm
Thenar muscles
2 lateral lumbricals that move index and middle fingers
Sense in lateral palm and lateral 3.5 fingers on palmar surface of hand

111
Q

What branches does the median nerve give rise to?

A

Palmar cutaneous branch

Digital cutaneous branch

112
Q

What does the axillary nerve innervate?

A

Deltoid
Teres major
Long head of biceps brachii
Sense in regimental badge area

113
Q

What branch does the axillary nerve give rise to?

A

Superior lateral cutaneous nerve of arm

114
Q

What does the musculocutaneous nerve innervate?

A

Brachialis
Biceps brachii
Corachobrachialis
Sense in lateral half of anterior forearm and small lateral portion of posterior forearm

115
Q

What branch does the musculocutaneous nerve give rise to?

A

Lateral cutaneous branch of forearm

116
Q

What shape do the musculocutaneous, median and ulnar nerve form in the brachial plexus?

A

M

Semester 2 (45 decks)

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