:)

Question 2

which is this muscle?

innervation?

movement [2]

Answer 2

which is this muscle: sartorius

innervation: femoral nerve

movement [2]: flexes hip AND knee

Question 3

what are the 3 different muscles that insert at the medial aspect of the knee? [3]

which compartment are they all originally from? [3]

what is name for this meetin of three muscles? [3]

Answer 3

• Sartorius - anterior
• Gracilis - medial
• Semitendinosus - posterior

= pes anserinus !!

Question 4

what are the 3 articulations of knee joint? [3]

which is bone is not part of the knee joint? !!! [1]

Answer 4

what are the 3 articulations of knee joint? [3]
–lateral femoral and tibial condyles with corresponding meniscus
–medial femoral and tibial condyles with corresponding meniscus
–patella and femur

fibula not part of knee joint!!

Question 5

what are the 3 articulations of knee joint? [3]

which is bone is not part of the knee joint? !!! [1]

Answer 5

what are the 3 articulations of knee joint? [3]
–lateral femoral and tibial condyles with corresponding meniscus
–medial femoral and tibial condyles with corresponding meniscus
–patella and femur

fibula not part of knee joint!!

Question 6

what is the Q line?

where is at a line between? [2]

what s the angle in men? (compared to vertical) [1]
whats the angle in women? (compared to vertical) [1]

Answer 6

Q line: asis –> centre of patella

what s the angle in men: 14 degress
whats the angle in women: 17 degrees

Question 7

whats it called when have a small q angle?
whats it called when you have a large q angle?

which condyle does this cause increased presssure on for small q [1] / large q [1]?

Answer 7

whats it called when have a small q angle: genu varum - medial condyle
whats it called when you have a large q angle: genu valgum - lateral condyle

Question 8

whats it called when have a small q angle?
whats it called when you have a large q angle?

which condyle does this cause increased presssure on for small q [1] / large q [1]?

Answer 8

whats it called when have a small q angle: genu varum - medial condyle
whats it called when you have a large q angle: genu valgum - lateral condyle

Question 9

Answer 9

Question 10

what is a sesamoid bone? [1]

Answer 10

what is a sesamoid bone: bone that develops in ligament

Question 11

Answer 11

Question 12

reflex test of patella: tests which nerve? [1] & which spinal segments[1]

Answer 12

reflex test of patella: tests femoral nerve and spinal segments L2-L4

causes contraction of quads

Question 13

what are the names of the collateral ligaments of knee? [1]
how do they differ? [1]
which one is more prone to damage? [1]

Answer 13

what are the names of the collateral ligaments of knee? [2]
medial/ tibial collateral ligament & fibula collateral ligament

how do they differ? [1]

• *fibula collateral ligament:** seperate to the knee capsule
• *tibial collateral ligament:** part of the knee capsule

which one is more prone to damage? [1]
tibial collateral ligament bc if damage the knee it also damages the ligament

Question 14

Answer 14

Question 15

what is the role of the cruciate ligaments?

Answer 15

connecting the tibia and the femur to prevent displacement of the tibia relative to the femur

Question 16

what is the medial menisci attached to [2] (anteriorly / posteriorly)

what is the lateral menisici attached to? [1]

Answer 16

what is the medial menisci attached to [2]

• *anteriorly: ACL
  posteriorly: tibial collateral ligament**

what is the lateral menisici attached to? [1]
pcl
NOT ATTACHED TO LATERAL COLLATERAL LIGAMENT

Question 17

which structures make up the unhappy triad? [3]

Answer 17

• Medial meniscus
• ACL
• Tibial collateral ligament

Question 18

lower motor neurons innervate skeletal muslces (alpha-motor neurones)

where do you find the cell body of the motor unit of the NMJ? [1]

one alpha motor neuron innervates: [1]

• one muscle fibre
• a number of muscle fibres

Answer 18

where do you find the cell body of the motor unit of the NMJ? [1]
ventral (anterior) horn of the spinal cord

one alpha motor neuron innervates: [1]

• one muscle fibre
• *- a number of muscle fibres:** forms the motor end plate (presynaptic NMJ)

Question 19

label A

Answer 19

Question 20

what happens after Ach binds to Ach receptor?

Answer 20

• Ach binds to Ach-receptor
• opens Ach-receptor
• allows Na channel to open & Na goes through
• causes depolarisation of muscle membrane
• causes release of Calcium from sarcoplasmic reciticulum
  … other steps…
• muscle contraction

Question 22

Where do you find:

L type calcium channels [2]

N type calcium channels [1]

Answer 22

L type calcium channels [2]
heart
vascular smooth muscle

N type calcium channels [1]
pre-synaptic terminals - very close to the vesicles

Question 23

explain mechanism of docking at NMJ and release of Ach occurs at presynaptic vesicle

Answer 23

vesicles docks by:

• synaptobrevin interacts with syntaxin and SNAP25: holds the vesicle close to pre-synaptic membrane (but doesnt fuse) = docking.
• Ca2+ binds to synaptotagmin: interacts with SNAP25/ syntaxin complex and tightens interaction between the vesicle and presynaptic membrane complexs & causes it to merge & release of Ach = confirmational change occurs.

Question 24

what does quantal release of Ach mean? [1]

Answer 24

every vesicle contains same amount of ACh: same amount of NM is released with each AP. get a 1:1 transmission of nerve & muscle.

Question 25

what is nicotinic Ach receptor structure like? [2] how many Ach have to bind before the Ach-receptor opens? [2] what is an end plate potential? [1] at what point does an AP occur in muscle? [1]

Answer 25

_what is nicotinic Ach receptor structure like? [2]_ **- 5 subunits: 2 identical alpha subunits, 1 beta, 1 delta (**& 1 gamma or epsilon) _how many Ach have to bind before the Ach-receptor opens? [2]_ **2** what is an end plate potential? [1] **when Na+ move into the muscle & cause depol** at what point does an AP occur in muscle? [1] **- 40mV**

Question 26

what are the two types of NMJ blockers [2] explain them

Answer 26

_What are the two types of NMJ blockers [2]:_ **1. D tubocuraine: _non-depolarising muscle relaxant_** blocks the nicotonic Ach-R & prevents AP occuring - Acetylcholinesterase inhibitor works as an antidote to it * *_2. depolarisng muscle relaxant_** - **stimulate** **Ach-R** like **Ach** and activate muscle **(muscle twitch)** - but **do not detach: no more Ach can bind (paralysis) - **even if membrane is repolarised (from Na channels / NaKATPase), the drug causes it to be**desensitised** - but breaks down after a while, so not perm. paraylses

Question 27

what are the two types of NMJ blockers [2] explain them

Answer 27

_What are the two types of NMJ blockers [2]:_ **1. D tubocuraine: _non-depolarising muscle relaxant_** blocks the nicotonic Ach-R & prevents AP occuring - Acetylcholinesterase inhibitor works as an antidote to it * *_2. depolarisng muscle relaxant_** - **stimulate** **Ach-R** like **Ach** and activate muscle **(muscle twitch)** - but **do not detach: no more Ach can bind (paralysis) - **even if membrane is repolarised (from Na channels / NaKATPase), the drug causes it to be**desensitised** - but breaks down after a while, so not perm. paraylses

Question 28

Where is T1 dermatome? [1] where is T2 dermatome? [1]

Answer 28

Where is T1 dermatome? [1] **medial forearm** where is T2 dermatome? [1] **axillary forearm**

Question 29

Answer 29

Question 30

Answer 30

Question 31

what is the cubital fossa's boundaries? [3]

Answer 31

Question 32

Answer 32

Question 33

Answer 33

Question 34

which muscles bring about flexion of MCP and extension of interphalangeal joints? which innervation?

Answer 34

lumbricals - 1/2 ulnar / 1/2 median

Question 35

what is the order of neurovasculature of femoral things? [3]

Answer 35

femoral artery = pulsating just belowing midinguinal point femoral nerve = lateral to artery femoral vein = medial VAN

Question 36

what do you measure to find true length of lower limb [2]

Answer 36

ASIS --\> distal tip of medial malleolus BOTH SIDES

Question 38

what is difference between T1 & T2 imaging: - which one shows normal anatomy? pathology? - what do each show fat [1] & CSF [1] as? - which one is more sensitive to water content?

Answer 38

what is difference between T1 & T2 imaging? - which one shows normal anatomy? **T1 = normal T2 = pathology** - what do each show fat as? **T1: fat = white, liquid; CSF = pale grey T2: fat = pale grey , CSF & fluid = white** - which one is more sensitive to water content? * *T2 - good 4 oedema**

Question 39

- which position is most stable for the a) hip b) knee (flex / extension) - where does the line of central pressure lead through the body? [4]

Answer 39

hip and knee both **extended = most stable** •Centre of pressure is: –in **front** of **ankle / talus** –just in **front** of **knee** –just **behind** **hip** –just **behind** **ear**

Question 40

when locomoting: which muscles prevent the pelvis dropping to the unsupported side? [1] which muscles help to move the body weight? [1]

Answer 40

when locomoting: which muscles prevent the pelvis dropping to the unsupported side: **hip abductors (gluteus minimus & medius)** which muscles help to move the body weight: **hip adductors**

Question 41

how does is weight distributed in after going through verterbral body? [3] what specifically enables use to undetake bipedal standing & walking more efficient? [1]

Answer 41

**_how does is weight distributed in after going through verterbral body?_** •Weight of upper body transmitted centrally through vertebral column (1) •Ilium transfers weight to femurs (2-3) •Pubic rami form ‘struts’ or braces that maintain integrity of arch (4) **_what specifically enables use to undetake bipedal standing & walking more efficient? [1]_** Diagonal angle of femurs re-centres support directly under the body to make bipedal standing more efficient and to help walking. Quadripeds require simultaneous support from both sides.

Question 42

what is scissor gait:

Answer 42

•Thigh **swings** **across** body during swing phase •**Difficulty** in putting **heel** on **ground** –Toe walking –Unstable

Question 43

what is high stepping gait characterised by? [2] which nerve damage causes this? [1]

Answer 43

- **dorsiflexor** **paraylsis** - foot drop (unless leg is lifted higher by exaggerated knee bend) - common peroneal nerve injury - **whole foot** tends to be **slapped** on **ground** rather than heel strike

Question 44

what is staccator gait like?

Answer 44

- **plantaflexor** **paraylsis** - no forward thrust - **unaffected** **limb** _never advances_ **beyond** **affected** **limb**. just the knee flexors & hip flexors lift it up and swing it forwa

Question 45

when conducting a gait analysis, what do u look for? [5]

Answer 45

**Gait analysis:** Balance Co-ordination Walking rhythm Change of speed/direction Stride length