Flashcards
Week 2
Cards in this deck (49)
- 1Function of tendons-Connect muscle to bone
-Made up of collagen
-Exert mechanical advantage of muscle contraction over joints (movement) - 2Function of ligaments-Connect bone to bone
-Made up of collagen and elastin
-Stabilises bone/bone interaction - 3Describe the flexor tendon sheaths at the wrist-There is a common synovial sheath at the palm of the hand which produces synovial fluid lubricating tendons and reducing friction
-This splits off into single synovial sheaths for each finger
-A fibrous sheath lies on top of the synovial sheath protecting it
-At the wrist is a flexor retinaculum (band of tissue) that fixes tendons in place - 4What is the tendon sheath?A layer of synovial membrane surrounding the tendon. It runs the length of the finger and protects the tendon from wear and tear
- 5Describe tendinitis What type of pain is felt where?Tendinitis: tendon swelling
-At the entrance, it is the most narrow. The tendon can swell up and is compressed
-Swelling is seen at the metacarpophalangeal joints
-Stiffness is seen at the proximal interphalangeal joints - 6Features of ligaments? What does double-jointed mean?-White, fibrous slightly elastic tissue
-Connects bone together
-Supports internal organs (uterus, liver, bladder)
-Can be torn in joints with wide range of movement
-Result of longer ligaments which means more elastin and wider range of movement - 7What ligaments are present in the knee? Describe them Do they get damaged?-Anterior/posterior cruciate ligaments
-Link the femur and tibia together by running crosswise inside the centre of the knee joint
-Stabilises knee movement in a forward/backward direction
-Commonly damaged in sporting injuries. If beyond repair, part of the tendon can be used instead - 8What is cartilage? 3 types?-Composed of collagen, elastin fibres, chondrocytes and ECM
-Avascular
Types: hyaline, fibrocartilage and elastic - 9Describe each typeHyaline: provides a framework for bone deposition and supplies smooth surfaces for articulation
Fibrocartilage: found in areas requiring tough support (where you don't want movement)
Elastic: found in walls of auditory canal and larynx. Keeps tubes open - 10What type of tissue is in bone?Osseous tissue:
Hard, lightweight, formed mostly from calcium phosphate, collagen gives elasticity - 115 functions of bone?Support: muscle/soft tissue attachment
Protection: of internal organs
Movement
Mineral storage: phosphorous/calcium
Haemopoiesis: blood cell production in bone marrow - 12Describe compact and cancellous (spongy) boneCompact: cellular structure is dense and protective
Cancellous: organised network of tubeculae to give maximum strength at sites of weight bearing. Has air pockets to allow weight to be dissipated - 13Describe the structure of the boneEpiphysis
Metaphysis
Diaphysis (shaft)
Metaphysis
Epiphysis - 14How does the compartmentalisation of bone change?-In the shaft, there is more compact bone
-Medulla (bone marrow cavity) does not extend all the way up)
-At the epithysis, there is more cancellous bone due to more weight bearing - 15What are the 2 surfaces of bone called?Endosteum: single layer of cells lining the inner surface of bone
Periosteum: several cell layers tightly lining the outer surface - 16Briefly describe endochondral ossification1) Embryonic mesenchyme forms a mesenchymal model
2) Intermediate cartilaginous model is formed
3) REPLACED by bone via endochondral ossification - 17What are the primary/secondary ossification centres? What is between the ends and shaft of the growing area?Primary: appear in bone shafts. Present by birth
Secondary: appear at bone ends. Appear after birth
Epiphyseal growth plate - 18How does skeletal muscle produce movement?-Contracting (shortening) of muscle fibres
- 19Describe the... of biceps brachii -origin -insertion -innervation -functionOrigin: long head from suproglenoid tubercle. Short head from coracoid process
Insertion: radial tuberosity and bicipital aponeurosis
Insertion: musculocutaneous nerve
Function: flexion of elbow - 20What do the names biceps and triceps indicate?Biceps: 2 heads
Triceps: 3 heads - 21Describe muscular agonism and antagonism for wrist flexionFlexors act as agonists by contraction. AKA prime movers
Extensors act as antagonists - 22What is muscle toneAll muscles are in a constant state of partial contraction. Prevents us being a heap on the floor.
Paralysis means loss of muscle tone and muscles become flaccid (can't contract) - 23What are pennate muscles?Have long parallel tendons with short muscle fibres arranged between them at an angle.
Can be unipennate, bipennate or multipennate (increasing power) - 242 ways muscles are inserted?Tendons
Aponeurosis - 25Why do sesamoid bones develop?Where tendons are prone to compression. Prevents tendon wearing against bone.
Largest is the patella - 26What is an aponeurosis?A flattened tendon where muscles insert. There is no bony attachment to the skeleton
- 27What can the aponeurotic layer be used for as an indicator in the scalp?-Indicator of seriousness of lacerations
-If cut, the wound will gape widely as only soft connective tissue is left - 28What is Dupuytren's contracture?-Thickening and shortening of the palmar aponeurosis so that tendons to the fingers can't move freely
-Fingers bend towards the palm and can't be straightened
-Little/ring finger most affected
-Progresses slowly
-Usually painless - 29What is fascia?-Sheet of fibrous tissue allowing attachment of muscle (below soft tissue of skin)
-Most facial muscles attach to bone/fascia - 30The face has no deep fascia. Consequence of this?-As skin ages, it looses elasticity
-Wrinkles in the skin appear at right angles to the muscle fibres in facial expression muscles
-Botox acts to paralyse muscles, so wrinkles disappear - 31What is the general structure for taking histories of musculoskeletal disorders?-History of presenting complaint
-Systematic enquiry
-Past medical history
-Family history
-Social history
-Treatment history - 32What is the purpose of history taking?-To assess the possible causes of the problem
-Evaluate the time-course? (is it acute/chronic?)
-Are other systems involved?
-Impact of the condition on the person's current life and expectations? - 33What questions should be asked to screen for musculoskeletal problems?-Pain or stiffness in muscles, joints or back?
-Can you dress yourself completely without any difficulty?
-Can you walk up/down stairs without any difficulty? - 34How do musculoskeletal disorders present?-Pain
-Stiffness
-Loss of function
(-Major trauma) - 35What other questions should be asked about musculoskeletal pain?-Site/circumstances of onset
-Distribution
-Radiation
-Quality and severity
-Precipitating factors
-Relieving factors
-Associated features - 36What questions should be considered in terms of site of pain?-Is it coming from a joint (arthritis)?
-Is it coming from a tendon (tendonitis)?
-Is it coming from the bursa (bursitis)?
-Is the bone pain distinct from joint line?
-Is the pain referred from somewhere else? - 37What should be considered in terms of distribution of pain?-Is it from a single joint/bone/muscle or many?
-Is the pain symmetrical?
-Is the pain asymmetrical? - 38What is pain in the muscle/joint called?Muscle: myalgia
Joint: arthralgia - 39What are the associated features of inflammatory conditions in joints/spine?-Sitffness (generalised/localised)
-Tenderness
-Redness
-Warmth
-Swelling
It is worse in the morning/rest - 40What are the associated features of degenerative conditions in joints/spine?-Instability (weak ligaments, subluxation, loose cartilage)
-Deformity
It is worse on movement - 41What patterns of pain are there in bone and peri-articular?Bone: severe, localised, disturbs sleep
Peri-articular: diffuse, not well-localised, around joint - 42What features would be present, if the neuro-muscular system has been affected?-Myalgia
-Muscle tenderness
-Weakness
-Paraesthesia
-Numbness - 43What are questions should be asked to find out the consequences of musculoskeletal pain?-How does the pain affect the patient?
-What activities are limited?
-Can the patient manage personal hygiene?
-Does the patient use any devices eg. walking-stick
-Is the patient getting depressed? - 44What are the manifestations of extra-articular pain?-Signs of infection eg. fatigue, fever, weight loss, enlarged lymph nodes
-Skin rash (psoriasis)
-Hair loss
-Mucosal ulcers (in palate, tongue, nose)
-Red, dry eyes - 45What should be asked in the past medical history?-Remissions and relapses/flares?
-Persistent predisposition?
-Previous episodes of other musculoskeletal problems
-Previous relevant problems - 46Why is family history important?-Inherited single gene disorders eg. gout
-Multigene disorders eg. RA (environment plays a role)
-If first degree relatives have had any relevant conditions - 47What should be asked in the social history?-Who does the patient live with?
-What is their job?
-Is anyone dependent on them?
-What type of home do they live in?
-What help is available/needed?
-What adaptions may be required (if disease gets worse)?
-What future expectations do they have?
-Do they smoke/take alcohol? - 48What should be asked in the treatment history?-What drugs have you tried?
-Have any other types of drugs been used to control the condition?
-If treatment has stopped, is it due to inefficacy or adverse events?
-Have you been to other doctors?
-Are you on any other drugs?
-Have you had other forms of treatment ie. physiotherapy?
-Are you allergic to any drugs/other substances? - 49What are the 3 main categories for musculoskeletal disorders? Examples?1) Disorders that mostly affect the joints, peri-articular tissues and bones eg. osteoarthritis, gout
2) Multisystem diseases of uncertain aetiology predominantly affecting musculoskeletal system showing extra-articular manifestations eg. RA, ankylosing spondylitis (AS) or lupus
3) Disorders affecting other system but the musculoskeletal system may be affected eg. sickle cell disease, acromegaly or osteomalacia
Information
- Description
- Bone, cartilage and muscle Muscle groups and movement
- Created by
- Dolu Falowo
- Views
- 3
- Rating