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Musculoskeletal
FA complete review Anatomy and Physiology Part II
| Question | Answer |
|---|---|
| List of Lower Extremity nerves: | 1. Iliohypogastric 2. Genitofemoral 3. Lateral femoral cutaneous 4. Obturator 5. Femoral 6. Sciatic 7. Common peroneal 8. Tibial 9. Superior gluteal 10. Inferior gluteal 11. Pudendal |
| What are the nerve roots of the Iliohypogastric nerve? | T12-L1 |
| Which lower extremity nerve has roots T12-L1? | Iliohypogastric |
| What is the sensory innervation of the Iliohypogastric nerve? | Suprapubic region |
| What nerve provides sensory innervation to the Suprapubic region? | Iliohypogastric |
| What is the motor innervation of the Iliohypogastric nerve? | Transversus abdominis and Internal oblique |
| What lower extremity nerve provide motor innervation to the Transversus abdominis and internal oblique? | Iliohypogastric |
| Which muscles are innervated by the motor part of the Iliohypogastric nerve? | Transversus abdominis and Internal oblique |
| What is a common cause of injury to the Iliohypogastric nerve? | Abdominal surgery |
| A patient undergoing abdominal surgery may have lesion to which lower extremity nerve? | Iliohypogastric |
| What is the common clinical presentation of Iliohypogastric nerve lesion? | Burning or tingling pain in surgical incision site radiation to inguinal and suprapubic region |
| Burning/tingling pain in abdominal surgical incision radiating to inguinal and suprapubic region. What nerve is likely damaged? | Iliohypogastric |
| What are the nerves roots of Genitofemoral nerve? | L1-L2 |
| Which lower extremity nerve has roots L1-L2? | Genitofemoral |
| What is the sensory innervation of the Genitofemoral nerve? | Scrotum/labia majora, medial thigh |
| The medial thigh, scrotum(males) and labia major (females) is sensory innervated by the ________________ nerve. | Genitofemoral |
| What is the motor (muscle) innervation of the Genitofemoral nerve? | Cremaster |
| The Cremaster muscle is innervated by the ________________ nerve. | Genitofemoral |
| What type of surgery may result in Genitofemoral nerve lesion? | Laparoscopic surgery |
| What is the common presentation of Genitofemoral nerve damage or injury? | - Decreased anterior thigh sensation beneath inguinal ligament - Absent cremasteric reflex |
| An absent Cremasteric reflex may be due to what nerve injury? | Genitofemoral |
| Diminished anterior thigh sensation beneath the inguinal ligament is often presented in cases of: | Genitofemoral nerve injury |
| Does the Lateral femoral cutaneous nerve has sensory, motor, or both, innervation? | Only sensory |
| What is the sensory innervation of ht Lateral Femoral cutaneous nerve? | Anterior and lateral thigh |
| Which nerve provides cutaneous sensory information to the anterior and lateral thigh? | Lateral Femoral Cutaneous |
| What are the nerve roots of the Lateral Femoral Cutaneous nerve? | L2-L3 |
| Damage to roots L2-L3 will cause what type of sensory deficits? | Decreased anterior and lateral thigh sensation |
| What are examples or conditions that cause an injury or deficit in Lateral femoral cutaneous sensory functioning? | Thigh clothing, Obesity, Pregnancy, and pelvic procedures |
| What are the nerve roots of the Obturator nerve? | L2-L4 |
| Which nerve has nerve roots L2-L4? | Obturator |
| What is the sensory innervation of the Obturator nerve? | Medial thigh |
| What part of the thigh does the Obturator nerve provide sensory innervation? | Medial thigh |
| List of motor (muscle) innervation of the Obturator nerve: | 1. Obturator externus 2. Adductor longus 3. Adductor brevis 4. Gracilis 5. Pectineus 6. Adductor magnus |
| The adductor longus and Adductor brevis, both have motor innervation from which lower extremity nerve? | Obturator |
| Which are the nerve roots of the nerve that provides innervation to the Gracilis, Pectineus, and adductor magnus? | L2-L4 |
| What procedure may result in Obturator nerve injury? | Pelvic surgery |
| What is the presentation of Obturator nerve injury? | Decreased thigh sensation (medial) and adduction |
| Which thigh movement is decreased with Obturator nerve injury? | Adduction |
| A decreased in adduction, may be due to _______________ nerve damage. | Obturator |
| Which lower extremity nerves provide medial thigh sensory innervation? | Obturator, and Genitofemoral nerves |
| What are the nerve roots of the Femoral nerve? | L2-L4 |
| Which two important lower extremities have the same nerve roots, L2-L4? | Obturator and Femoral nerves |
| What is the sensory innervation of the Femoral nerve? | Anterior thigh and medial leg |
| Anterior thing and medial leg receive sensory innervation/information from which lower extremity nerve? | Femoral |
| What is the motor innervation of the Femoral nerve? | Quadriceps, iliacus, pectineus, and sartorius |
| Which lower extremity muscles are innervated by the Femoral nerve? | Quadriceps, iliacus, pectineus, and sartorius |
| Which nerve provides motor innervation to the quadriceps? | Femoral |
| What is the most common cause of Femoral nerve injury? | Pelvic fracture |
| Which nerve may be injured in a Pelvic fracture? | Femoral |
| What is the clinical presentation of Femoral nerve injury? | Decrease in; 1. Thigh flexion 2. Leg extension |
| Which tigh movement is diminished in a Femoral nerve injury? | Flexion |
| A person with difficulty flexing the thin and unable to extend leg, may have what type of nerve injury? | Femoral nerve injury |
| What are the nerve roots of the Sciatic nerve? | L4-S3 |
| Which lower extremity nerve has roots L4-S3? | Sciatic |
| What type of innervation is provided by the Sciatic nerve, motor, sensory, or both? | Only Motor |
| What is the motor innervation of the Sciatic nerve? | Semitendinosus, semimembranosus, biceps femoris, and adductor magnus |
| Which nerve provides motor innervation to the Semitendinosus and Semimembranosus muscles of the leg? | Sciatic |
| Biceps femoris and Adductor magnus are both innervated by the _____________ nerve. | Sciatic |
| What are common causes for Sciatic nerve injury? | Herniated disc, and posterior hip dislocation |
| What is a feature or important anatomical note of the Sciatic nerve? | Splits into Common Peroneal and Tibial nerves |
| The common Peroneal and the _________________ nerve , are both divisions of the Sciatic nerve. | Tibial |
| What are the two divisions (split) of the Sciatic nerve? | Common Peroneal and Tibial nerves |
| Which are the nerve roots of the Common Peroneal nerve? | L4-S2 |
| Which nerve has the nerve roots L4-S2? | Common Peroneal |
| What are the two anatomic divisions of the Common Peroneal nerve? | 1. Superficial Peroneal nerve 2. Deep Peroneal nerve |
| What are the sensory innervation of the Superficial Peroneal nerve? | Dorsum of foot |
| What part of the dorsum of the foot, does the Superficial Peroneal nerve, does not provide sensory innervation? | Webspace between hallux and 2nd digit |
| The dorsum of foot (excepto between the 2nd digit and hallux), has it sensory innervation provided by what nerve? | Superficial Peroneal nerve |
| What is the motor innervation of the Superficial Peroneal nerve? | Peroneus longus and brevis |
| What is the association between the Dorsum of foot and Peroneus longus and brevis? | Superficial Peroneal sensory and motor (respectively) innervation |
| What is the sensory innervation of the Deep Peroneal nerve? | Webspace between hallux and 2nd digit |
| What is the motor innervation of Deep Peroneal nerve? | Tibialis anterior |
| Which nerve provides motor innervation to the Tibialis anterior? | Deep Peroneal nerve |
| What nerve provides sensory information to the webspace between the 2nd digit and the hallux? | Deep Peroneal nerve |
| What are common causes of Common Peroneal nerve injury? | 1. Trauma or Compression of lateral aspect of leg 2. Fibular neck fracture |
| Which lower extremity nerve is at risk of injury in a Fibular neck fracture? | Common Peroneal |
| Which foot movements are performed by the Common Peroneal nerve? | Foot Eversion and Dorsiflexion |
| What is the sensory deficit seen in Peroneal nerve damage? | Dorsum of foot |
| What nerve is injured in Foot drop? | Common Peroneal |
| What is Foot drop? | Inverted and plantarflex at rest, loss of eversion and dorsiflexion |
| What kind of gait is seen in Foot Drop? | Steppage gait |
| Foot is inverted and plantarflex while at rest, and patient is unable to evert and/or dorsiflex foot. Dx? | Foot drop |
| Foot drop, means _____________________ nerve damage. | Common Peroneal |
| What are the nerve roots of the Tibial nerve? | L4-S3 |
| Which nerve of the lower extremity has roots L4-S3? | Tibial |
| What is the sensory innervation of the Tibial nerve? | Sole of foot |
| What is the motor innervation of the Tibial nerve? | - Long head of Biceps femoris - Triceps surae - Plantaris - Popliteus - Flexor muscles of the foot |
| The bottom part of the foot, sole, is innervated sensory by the ________ nerve. | Tibial |
| What are causes of Tibial nerve damage? | Knee trauma, Baker cyst (proximal lesion), Tarsal tunnel syndrome (distal lesion) |
| A person with Tarsal tunnel syndrome, may suffer of what nerve damage? | Tibial |
| What is the function of the Tibial nerve? | Foot inversion and Plantarflexion |
| What are features of Tibial nerve damage? | 1. Inability to curl toes and loss os sensation on sole 2. Foot everted at rest with loss of inversion and plantarflexion |
| A patient unable to feel the flood with the sole of feet, may have _______________ nerve damage. | Tibial |
| What kind of nerve injury is suspected if patient is with foot everted at rest, and unable to invert or plantar-flex foot? | Tibial |
| What is the motor innervation of the Superior gluteal nerve? | Gluteus medius, gluteus minimus, and tensor fascia latae |
| What are the nerve roots of Superior gluteal nerve? | L4-S1 |
| Which nerve has nerve roots L4-S1? | Superior gluteal |
| What is the most common cause of Superior Gluteal nerve injury? | IM injection to the superomedial gluteal region, instead of the anterolateral region. |
| What is the most common feature of a Superior Gluteal nerve injury? | Trendelenburg sign/gait |
| What nerve damage leads to Trendelenburg gait? | Superior gluteal nerve injury |
| Description of the Trendelenburg gait/sign: | Pelvis tilts because weight-bearing leg cannot maintain alignment of pelvis through hip abduction |
| The tilt of the pelvis due to the leg not been able to maintain alignment of pelvis while hip is abducted. | Trendelenburg sign/gait |
| In Trendelenburg gait the lesion is: | 1. Contralateral to the side of the hip that drops 2. Ipsilateral to extremity on which patient stands |
| If the lesion to the Superior Gluteal nerve, which causes developmental Trendelenburg gait, is to the right side the: | Hip will drop to the left, while the patient stands on the right leg |
| Trendelenburg gait, suspect what nerve to be injured? | Superior gluteal |
| What are the nerve roots of the Inferior gluteal nerve? | L5-S2 |
| Which lower extremity nerve has roots L5 to S2? | Inferior gluteal |
| What is the motor innervation of the Inferior Gluteal nerve? | Gluteus maximus |
| The Gluteus maximus is innervated by the _____________________ nerve. | Inferior gluteal |
| Which gluteal muscles are innervated by the Superior gluteal nerve? | Gluteus medius and gluteus minimus |
| Lack of motor innervation to the gluteus medius and minimus, will be likely due to damage to the inferior or superior gluteal nerve? | Superior gluteal |
| If the gluteus maximus is deficient in movement, it will probably be due to Inferior or Superior gluteal nerve damage? | Inferior gluteal |
| What is the clinical presentation of Inferior gluteal nerve injury? | 1. Difficulty climbing stairs 2. Difficulty rising from seated position 3. Loss of hip extension |
| What hip movement is affected by an injured Inferior gluteal nerve? | Hip extension |
| What is the MCC of Inferior gluteal nerve injury? | Posterior hip dislocation |
| Posterior hip dislocation is the MCC of what type of nerve injury? | Inferior gluteal |
| What are the nerve roots of the Pudendal nerve? | S2-S4 |
| Which lower extremity nerve has roots S2 - S4? | Pudendal |
| What is the sensory innervation of the Pudendal nerve? | Perineum |
| What is the motor innervation of the Pudendal nerve? | External urethral and anal sphincters |
| What is the MCC of injury to the Pudendal nerve? | Stretch injury during childbirth |
| Complicated childbirth can cause injury to which lower extremity nerve? | Pudendal |
| What are the clinical characteristics of Pudendal nerve damage? | 1. Decreased sensation in perineum and genital area 2. May cause fecal or urinary incontinence |
| The Pudendal nerve may be blocked in childbirth, to block pain. What landmark is used to apply the anesthetic injection? | Ischial spine |
| What is the association between the Ischial spine and the Pudendal nerve? | During childbirth, the Pudendal nerve can be blocked by injection anestesia using the Ischial spine as anatomical landmark. |
| Which are the abductors of the hip? | Gluteus medius and Gluteus minimus |
| What hip action or movement is performed by the Gluteus minimus and medius? | Abduction |
| List of adductor hip muscles: | Adductor magnus, Adductor longus, and Adductor brevis |
| Adductor _____________, ____________, and _________________, perform hip adduction. | Magnus, Longus, and Brevis |
| Which are the Extensor hip muscles? | Gluteus maximus, semitendinosus, and semimembranosus |
| What action of the hip is performed by the Gluteus maximus? | Hip extension |
| The Gluteus maximus, semitendinosus, and semimembranosus, are the hip ________________. | Extensors |
| What hip action may be affected by injury to the G. maximus? | Hip extension |
| List of Flexor hip muscles: | 1. Iliopsoas, 2. Rectus femoris 3. Tensor fascia lata 4. Pectineus 5. Sartorius |
| Which hip muscles produce internal rotation? | Gluteus medius, Gluteus minimus, and Tensor fascia latae |
| What two hip action or movements are performed by the G. medius and minimus? | Abduction and internal rotation |
| What are the muscles of the hip that perform External rotation? | Iliopsoas, Gluteus maximus, Piriformis,and Obturator |
| What hip action is performed by the G. maximus, Iliopsoas, Piriformis and Obturator muscles? | External rotation |
| Piriformis and Obturator muscles are involved in which hip movement or action? | External rotation |
| List of common Musculoskeletal conditions: | 1. Iliotibial band syndrome 2. Medial Tibial stress syndrome 3. Limb compartment syndrome 4. Plantar fasciitis 5. De Quervain tenosynovitis 6. Ganglion cyst |
| What musculoskeletal condition is associated primarily with "runners"? | Iliotibial band syndrome |
| Overuse injury o lateral knee that occurs primarily in runners. Dx? | Iliotibial band syndrome |
| What causes the pain in Iliotibial band syndrome? | Secondary to fricito of iliotibial band against lateral femoral epicondyle |
| What is a more common name for Medial tibial stress syndrome? | Shin splints |
| What are "Shin splints"? | Common cause of shin pain an diffuse tenderness in runes and military recruits |
| What is the cause of Medial tibial stress syndrome? | Bone resorption that outpaces bone formation in tibial cortex |
| Shin pain and diffuse tenderness, is the basis of shih musculoskeletal condition? | Medial tibial stress syndrome |
| What is Limb compartment syndrome? | Increase pressure within a fascial compartment of a limb lead to venous outflow obstruction an arteriolar collapse which causes anoxia and necrosis |
| What is the pressure gradient in order to consider limb compartment syndrome? | Compartment pressure to diastolic blood pressure gradient of <30 mmHg. |
| What are some of the causes of Limb Compartment syndrome? | Long bone fractures, reperfusion injury, animal venoms. |
| What are clinical symptoms of Limb Compartment syndrome? | - Severe pain and tense, swollen compartments with limb flexion - Motor deficits are late sign or irreversible muscle and nerve damage |
| The motor deficits shown in Limb Compartment syndrome indicate: | Late deficits are indicative of irreversible muscle and nerve damage |
| What limb action/movement elicits pain in Limb Compartment syndrome? | Flexión |
| What is Plantar Fasciitis? | Inflammation of plantar aponeurosis characterized by heel pain an tenderness |
| Heel pain and tenderness, especially severe in the morning and after extended periods of inactivity. Dx? | Plantar fasciitis |
| Inflammation of plantar aponeurosis causing heel pain and tenderness. | Plantar fasciitis |
| Noninflammatory thevenin of abductor pollicis longus and extensor pollicis brevis tendons | De Quervain tenosynovitis |
| What is the characteristic pain in De Quervain tenosynovitis? | Pain or tenerse at radial styloid |
| Pain at radial styloid often indicates which condition? | De Quervain tenosynovitis |
| (+) Finkelstein test. Dx? | De Quervain tenosynovitis |
| What is the Finkelstein test? | (+) when pain at radial styloid is elicited with active or passive stretch of thumb tendons |
| What is a Ganglion cyst? | Fluid-filled swelling overlying joint or tendon sheath, most commonly at dorsal side of wrist |
| Where is the most common location for a Ganglion cyst? | Dorsal side of wrist |
| What is the most common way for the arisal or development of a Ganglion cyst? | Herniation of dense connective tissue |
| The herniation of dense connective tissue at the dorsal side of wrist often lead to development of: | Ganglion cyst |
| Fluid-filled swelling overlying joint or tendon sheath. Dx? | Ganglion cyst |
| What are the Lumbosacral radiculopathy signs? | Paraesthesia and weakness related to specific lumbosacral spinal nerves. |
| What causes Lumbosacral radiculopathy? | Intervertebral disc herniates posterolaterally through annulus fibrosus into central canal due to thin posterior longitudinal ligament and thieche anterior longitudinal ligament along midline of vertebral bodies. |
| What is the common distribution or affection of the nerve affected in Lumbosacral radiculopathy? | It affects below the level of herniation |
| Which are the most common lumbosacral radiculopathy disc levels? | 1. L3-L4 2. L4-L5 3. L5-S1 |
| In L3-L4 lumbosacral radiculopathy, which nerve is affected? | L4 |
| What are the clinical signs of L3-L4 Lumbosacral Radiculopathy? | Weakness of knee extension and, decreased patellar reflex |
| What is the main reflex affected or diminished in L3-L4 Radiculopathy? | Patellar reflex |
| What are the clinical signs of L4-L5 Radiculopathy? | 1. Weakness of dorsiflexion 2. Difficulty in heel walking |
| What are the most significant signs of L5-S1 Radiculopathy? | 1. Weakness of plantar flexion 2. Difficulty in toe walking 3. Decreased Achilles reflex |
| What reflex is affected in L5-S1 Radiculopathy? | Achilles reflex |
| What nerve and artery are paired in the Axilla/ lateral thorax? | Nerve - Long Thoracic Artery - Lateral Thoracic |
| Which are the neurovascular pairing are at the surgical neck of humerus? | Axillary nerve and Posterior circumflex artery |
| Neurovascular pairing at the Midshaft of humerus? | Radial nerve and Deep brachial artery |
| Median nerve and Brachial artery are paired at what location? | Distal humerus/cubital fossa |
| What nerve and artery are paired at the Popliteal fossa? | Tibial nerve and Popliteal artery |
| Neurovascular pairing at the Posterior to medial malleolus? | Tibial nerve and Posterior tibial artery |
| What are T-tubules? | Extensions of plasma membrane in contact with the sarcoplasmic reticulum |
| Extension of plasma membrane in contact with the sarcoplasmic reticulum. | T-tubules |
| What is the role of T-tubules in the motorneuron action potential to muscle contraction? | Allows coordination of contraction of striated muscles |
| Which structure allows the coordination of the of striated muscles? | T-tubules |
| What is the 1st step in striated muscle contraction process? | AP opens presynaptic voltage-gated Ca2+ channels, inducing ACh release |
| AP opens presynaptic voltage-gated Ca2+ channels, inducing ACh release | 1st Step of striated muscle contraction |
| What follows the presynaptic release of ACh in striated muscle contraction? | Postsynaptic ACh binding lead to muscle cell depolarization at the motor end plate |
| Postsynaptic acetylcholine binds to receptors causing cell depolarization at the motor end plate. | 2nd step of striated muscle contraction |
| What structure allows for the depolarization (striated muscle contraction) to travel over the entire cell and deep into the muscle? | T-tubules |
| What is the 3rd step of striated muscle contraction? | Cell depolarization travels along the entire cell and deep into the muscle via the T-tubules |
| What does the striated muscle membrane depolarization cause to the sensitive dihydropyridine receptor? | Conformation changes which allows to be coupled with ryanodine receptor --> Ca2+ release from the SR into the cytoplasm |
| What is the result of coupled Ryanodine receptor after DHPR conformational changes? | Ca2+ release from Sarcoplasmic reticulum into the cytoplasm |
| What component usually blocks Myosin-biding sites on the actin filaments, prior to Ca2+ arrival from SR? | Tropomyosin |
| What is the role or function of Tropomyosin? | Block Myosin-binding sites on actin filament |
| Ca2+ released by the SR, binds to _______________ in order to expose Myosin-binding site on actin filament. | Troponin C |
| Ca2+ binding to Troponin C (TnC) causes ----> | Shifting tropomyosin to expose the myosin-binding sites |
| What does the Ca-Tn- induced myosin-binding site exposures causes? | Myosin head strongly binds to actin forming a crossbridge |
| What is formed by the binding of Myosin head and Actin during striated muscle contraction? | Crossbridge |
| What is release upon formation of Myosin-Actin crossbridge? | Phosphate (Pi) |
| What initiates the Power stroke? | The release of Pi as the actin-myosin crossbridge is formed |
| What is initiated by the Myosin-Actin crossbridge release of Pi? | Power stroke |
| How is force produced in the Power stroke? | Myosin pulls on the thin filament, leading to muscle shortening |
| How which bands are involved in muscle shortening? | Shortening of H and I bands and between Z lines |
| HIZ shrinkage? | Mnemonic used to recall the H and I bands and between Z lines get shrunk during muscle contraction |
| Which band always remains the same length in muscle contraction? | A band |
| What is released at the end of the Power stroke? | ADP |
| ADP is released at: | The end of the Power stroke |
| How is the Myosin head detached from actin filament? | By the binding of new ATP |
| What happens to Ca2+ when Myosin head is detached from the actin filament? | Re-sequestered |
| ATP hydrolysis into ADP and Pi results in: | Myosin head returning to high-energy position (cocked) |
| In muscle contraction, the Myosin head can keep binding to new site on actin to form a crossbridge as long as: | Ca2+ remains available |
| What are the two types of muscle fibers? | Type 1 muscle and Type 2 muscle |
| Which muscle fibers are "slow twitch"? | Type 1 muscle fiber |
| Which muscle fibers are "red" fibers? | Type 1 muscle fiber |
| What are the Type 1 muscle fibers? | Slow twitch; red fibers resulting from increased mitochondria and myoglobin concentration --> sustained contraction |
| What type of exercise results in elevated levels of Type 1 muscle fibers? | Endurance training |
| A marathon runner or cyclist, will likely have higher amounts of Type 1 or Type 2 muscle fibers? | Type 1 muscle fiber |
| Which type of muscle fiber has increased amounts of mitochondria and myoglobin concentration? | Type 1 muscle fiber |
| Which type of muscle fibers are associated with increased oxidative phosphorylation? | Type 1 muscle fiber |
| Which type of muscle fiber produces a sustained contraction? | Type 1 muscle fiber |
| Type 2 muscle fibers are fast or slow twitch? | Fast twitch |
| What color are denominated the Type 2 muscle fibers? | White |
| Which muscle fibers are of fast twitch and white? | Type 2 muscle fiber |
| Which muscle fiber is with low mitochondria and myoglobin concentration? | Type 2 muscle fiber |
| Which muscle fiber type is associated with increased anaerobic glycolysis? | Type 2 muscle fiber |
| What exercises increase the proportion of Type 2 muscle fibers? | Weight/resistance training, and sprinting |
| A bodybuilder will have higher proportion of Type 1 or Type 2 muscle fibers? | Type 2 muscle fiber |
| A 100-m sprinter has elevated proportion of Type ____ muscle fiber. | Type 2 muscle fiber |
| Nitric oxide is stimulates smooth muscle contraction or relaxation? | Relaxation |
| What stimulates smooth muscle contraction? | Elevated levels of Ca2+ |
| Which kinase, MLCK or MLCP, is involved in smooth muscle contraction? | MLCK |
| Which kinase, MLCK or MLCP, is involved in smooth muscle relaxation? | MLCP |
| How is Ca2+ possible to enter the smooth muscle cell? | Using L-type voltage-gated Ca2+ channels |
| After, Ca2+ enters via L-type voltage-gated Calcium channels, the smooth muscle cell, it forms: | Calcium - Calmodulin complex |
| Which enzyme reacts with the Ca2+--Calmodulin complex during smooth muscle contraction? | MLCK |
| L-arginine + NO synthase in the endothelial cells yield --> | Nitric oxide |
| How does NO enter the smooth muscle cell? | NO diffusion |
| What are the two types of bone formation? | 1. Endochondral ossification 2. Membranous ossification |
| Which bones are formed via endochondral ossification? | Bones of axial skeleton, appendicular skeleton, and base of skull |
| Which bones are formed via membranous ossification? | Bones of calvarium, facial bones, and clavicle |
| The bones of the face, are formed via ______________ ossification. | Membranous ossification |
| The axial skeleton is formed via _________________ ossification. | Endochondral ossification |
| Woven bone formed directly without cartilage. | Membranous ossification |
| What is the form by which endochondral ossification occurs? | Cartilaginous model of bone is first made by chondrocytes. Osteoclast and osteoblasts later replace with woven bone and then remodel to lamellar bone |
| Which type of bone formation starts with cartilage model? | Endochondral ossification |
| Cells that create cartilage. | Chondrocytes |
| What instances in adults lead to formation of woven bones? | After fractures and in Paget disease of bone |
| Defective Endochondral ossification leads to which important condition? | Achondroplasia |
| What is the defective form of bone formation in Achondroplasia? | Endochondral ossification |
| What is the end result of healthy bone formation? | Lamellar bone |
| Is Lamellar bone, the initial or final type of bone maturation? | Final |
| Bones in extremities is made via what type of bone formation? | Endochondral ossification |
| Builds bone by secreting collagen and catalyzing mineralization in alkaline environment via ALP. | Osteoblast |
| Where do osteoblasts differentiate from mesenchymal stem cells? | Periosteum |
| What can be used to measure the activity of Osteoblast? | 1. Bone ALP 2. Osteocalcin 3. Propeptides of type I collagen |
| Which bone cells build bone? | Osteoblast |
| Which bone cell dissolve or destroy bone? | Osteoclast |
| Dissolves bone by secreting H+ and collagenases | Osteoclast |
| What bone cell differentiation from a fusion of monocyte/macrophage lineage? | Osteoclast |
| What important receptors are found on osteoclasts? | RANK receptors |
| What stimulates the RANK receptors on osteoclasts | RANKL |
| RANK-L is secreted by: | Osteoblast |
| What blocks RANK receptors on osteoclasts? | OPG (osteoprotegerin) |
| What is an important RANKL decoy receptor? | OPG (osteoprotegerin) |
| What is the result of RANK receptor on osteoblasts blockage? | Decreased osteoclast activity |
| What is secreted by Osteoclasts in order to dissolve (crush) bone? | H+ and collagenases |
| What is secreted by Osteoblasts? | Collagen |
| Collagen is secreted by which bone cell? | Osteoblast |
| Osteoblast work in acidic or alkaline environments? | Alkaline |
| What is a key enzyme for osteoblast activity? | ALP |
| What is the effect of low PTH levels on osteoblasts and osteoclasts? | Anabolic effects (building bone) |
| Chronic high levels of PTH has what type of effects of bone cells? | Catabolic effects, duchas osteitis fibrosa cystica |
| What is a common condition that leads to Osteitis fibrosa cystica? | Primary hyperparathyroidism |
| Which PTH condition is associated with chronic levels of PTH leading to catabolic effects on osteoblasts and osteoclasts? | Primary hyperparathyroidism |
| What is the role of estrogen on bone formation? | Inhibits apoptosis in bone-forming osteoblast and induces apoptosis in bone-resorbing osteoclasts. |
| What is the effect of Estrogen on Osteoblasts? | Inhibition of apoptosis |
| What is the effect of Estrogen on Osteoclasts? | Promote apoptosis |
| _________________ causes closure of epiphyseal plate during puberty. | Estrogen |
| Estrogen deficiency leads to: | Increase cycles of remodeling and bone resorption with increases the risk of osteoporosis. |
| Estrogen excess or deficiency lead to postmenopausal osteoporosis? | Estrogen deficiency |
| How does the deficiency of estrogen cause increase risk of developing osteoporosis? | Increase cycles of remodeling and bone resorption |
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