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QUESTIONS MAKER UNIT (QMU)
2010/2011
Module 5:
Musculoskeletal SystemQuestions & Answers
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Module 5: Musculoskeletal System 2010/2011
CARTILAGE & BONE
1. All the following are functions of cartilage EXCEPTa. firm and flexible ECM allows cartilage to bear mechanical stress without permanent
distortion
b. its smooth-surfaced provides sliding surface for articulation inside joint cavitiesc. cartilage form epiphyseal plates that play an important role in the growth of flat boned. cartilage acts as a shock absorber due to its resilient characteristic
2. What is the importance of microcavities and irregularities in the articulating surface of anysynovial joints?
a. to content the synovial fluid which serves as synovial fluid reservoirb. squeezed out mechanically during walking to maintain thick layer of synovial fluid on
cartilage surface
c. to increase contact area of the articulating surfaces as to decrease joint stressesd. to absorb nutrients and gases from synovial fluid
3. All the following are effect of absence of collagen EXCEPTa. loss of cell-cell communicationb. cell migration as in metastasisc. loss of cell shaped. limitation to cell locomotion
4. All the following are functions of bone EXCEPTa. bone has an important metabolic function by acting as minerals reservoirb. protection of the external vital organsc. gives attachment to different body muscles helping in locomotiond. support and maintenance of body stature
5. All of the following events occur in zone of ossification in endochondral ossification EXCEPTa. vascular mesenchymal bud arise from cellular layer of periosteum to invade ossifyingzone
b. macrophages differentiated into active osteoclast which phagocytose the calcifiedcartilage matrix and remnants of dead chondrocytes leaving wide empty lacunae
c. osteoblast come to lie side by side lining the formed cavities and start to lay down bonymatrix and promote its calcification
d. release of alkaline phosphatase causing calcification of cartilage matrix
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Module 5: Musculoskeletal System 2010/2011PERIPHERAL NERVES
6. The correct statement about neuron isa. Pseudo-unipolar neuron presents in vestibular gangliab. Polygonal neuron presents in spiral gangliac. Granule cell presents mainly in cerebral cortexd. Pyriform neuron presents in the retina
7. All the following are correct statements concerning potassium ion EXCEPTa. Hydrated form of K+ ions are smaller than hydrated form of Na+b. The permeability of K+ ions is 50-100 times greater than its permeability to Na+c. Potassium ion is one of the chief ions on the inner surfaced. The negative interior of is due to lower diffusion of K+ out of the cell than Na+ diffusion
into the cell in resting state
8. The excitable tissues area.
Nervous tissue
b. Muscular tissuec. Connective tissued. A and Be. B and C
9. The membrane is absolutely impermeable toa. Cl-b. Proteinsc. HCO3d. HPO4
10.All of the following have ectodermal origin EXCEPTa. Astrocytesb. Microgliac. Oligodendrogliad. Ependymal cells
11.Nerve block includes;a. Failure if conduction of nerve impulseb. Loss of excitabilityc. No generation or propagation of nerve impulsesd. All of the above
MUSCULAR TISSUES
12.Regarding the muscular tissue, the following are true EXCEPT:a. Muscle fibers are ectodermal in origin except muscles of the iris and myoepithelial cells
around the acini which are mesodermal in origin
b. Theskeletal muscle includes the diaphragm.c. Lymphatic vessels are present in both epimysium and perimysium.d. The A-band under polarized light is called birefringent
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Module 5: Musculoskeletal System 2010/201113.Concerning the sarcoplasmic reticulum in skeletal muscle, the following are correct EXCEPT:
a. The primary role is to control interaction between actin and myosinb. The sarcotubules contain ATPase enzymec. The terminal cisternae contain calsequestrin proteind. It does not function in cessation of muscle contraction
14.The following are the order of the excitation-contraction coupling:a. Stimulation>release of calcium> inhibition of troponin-tropomyocin
complex>attachment of actin and myocin>ATP is splitted>muscle
contraction>breakdown of ATP>detachment od actin and myocin>muscle relaxation
b. Stimulation>release of calcium>inhibition of troponin-tropomyocin complex>ATP issplitted>attachment of actin and myocin>muscle contraction> detachment of actin and
myocin> breakdown of ATP> muscle relaxation
c. Stimulation>release of calcium>inhibition of troponin-tropomyocin complex>ATP issplitted>attachment of actin and myocin>muscle contraction>breakdown of ATP>
detachment od actin and myocin>muscle relaxation
d.
Stimulation> inhibition of troponin-tropomyocin complex > release of calcium >ATP issplitted>attachment of actin and myocin>muscle contraction>breakdown of ATP>
detachment od actin and myocin>muscle relaxation
15.The following are true of muscle fatigue EXCEPT:a. May be caused by lactic acid that inhibit excitation-contraction couplingb. Occur when the muscle does not respond to a stimulus of the same degreec. Temporary decrease in the work capacity of the nerve of the skeletal muscled. 1-2 minutes of loss of blood could lead to muscle fatigue
16.Regarding the production of muscle energy, the following are true EXCEPT:a.
Both aerobic and anaerobic glycolysis can occurb. Creatine phosphate is the major energy reserve
c. Prolonged fasting can cause loss of muscled. Ca ions can also stimulate glycolysis
17.The following are true regarding the development of skeletal muscle fibers EXCEPT:a. They are developed from a mother cell called myoblastb. The first stage consist of spindle-shaped cells and myofibrilsc. The second stage consist of multinucleated myotubesd. The third stage consist of the nuclei assuming a peripheral position
18.Concerning the smooth muscle, the following are true EXCEPT:a. Leiomyocytes can reach up to 500m long in pregnant uterusb. They are only regulated by the nervous systemc. Thick myofilaments in routine E.M are seen in between thin filamentsd. The vital organelles are at the two poles of the nucleus
19.The following are true regarding the regulation of smooth muscle contraction EXCEPT:a. Myosin kinase leads to phosphorylation of actin filamentsb. Calmodulin leads to activation of myosin kinase, thus muscle contractionc. Phosphatase enzyme split the phosphate that leads to muscle relaxationd. Increase of calcium increase excitability of muscle
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Module 5: Musculoskeletal System 2010/201120.The following are true of the physiological properties of smooth muscle EXCEPT:
a. The action potential with plateau is one of the two types of action potentialb. The smooth muscle fibers are capable of slow wave potentialc. The smooth muscle fibers are capable as a pacemakerd. Vasopressin are capable of inhibiting the excitability of the fibers
21.The following are true concerning muscle denervation EXCEPT:a. Examples of cases are myasthenia gravis and poliomyelitisb. Posterior horn cell releases pathological discharge muscle fasciculationsc. Hypersensitivity to acetylcholine could cause muscle fibrillationsd. Produces long chronaxie in the aspect of its electrical response
22.Regarding the z-line it isa. located in the center of dark band
b. located in the center of light band
c. the functional unit of the skeletal muscle
d. both (b) and ( c ) are correct
23.The main protein in the thick filament of the skeletal muscle fiber isa. myocin
b. actin
c. tropmyocin
d. tropnin-c
24.During muscle relaxation ,a. the cross bridges are attached to the actin active sites
b. myocin binding sites on actin filaments are uncovered
c. troponin-c tropomyocin complex covers the myocin binding sites on actind. troponinT-tropomyocin complex covers the actin active sites
25.Sarcomere is,a. distance between 2 -z lines
b. distance between two successivezlines
c. structural unit of the skeletal muscle
d. distance between two successive H-zones
26.During muscle contraction ,a. myocin filaments slide over actin filaments
b. it is the actin filaments that slide on myocin ones
c. Ca++ bind to troponinC
d. both ( b ) and ( c ) are correct
27.Muscle proteins responsible for its relaxation involvea. myocin
b. actin
c. tropomyocin
d. troponinC
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Module 5: Musculoskeletal System 2010/201128.ATP is utilized by the skeletal muscle in
a. sliding of actin filaments over myocin ones
b. release of Ca++ from sarcoplasmic reticulum (SR )
c. restorage of Ca ++ in SR
d. both ( a ) and ( c ) are correct
29.Motor end plate potential isa. A localized depolarization
b. A propagating wave of depolarization
c. developed in response to somatic nerve stimulation
d. both ( a ) and ( c ) are correct
30.The natural skeletal muscle contraction isa. Tetanic contraction
b. incomplete tetanic contraction
c. Separate contractions
d. both ( b ) and ( c ) are correct
31. In the simple muscle twich ( SMT )a. the latent period equals 0.4 second
b. the total twich time is 0.1 second
c. the contraction period is the longest
d. relaxation period equals 0.01 second
32. In the isometric muscle contraction there isa. No work is done
b. Muscle tension is normal
c. Muscle length is constantd. Both ( a ) and (c ) are correct
33.Warming of the skeletal muscle is associated witha. high force of contraction
b. more Ca++ release from SR
c. increased duration of contraction
d. Both ( a ) and ( b ) are correct
34.Rapid successive skeletal muscle stimulation leads to,a. higher amplitude of contraction
b. depleation of energy stores in the muscle
c. Accumulation of lactic acid with muscle fatigue
d. Both (b ) and ( c ) are correct
35.When a skeletal muscle is free loaded ita. becomes more streched during relaxation
b. showes stronger contraction
c. sluggish contraction occurs
d. Both ( a ) and ( b ) are correct
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Module 5: Musculoskeletal System 2010/201136. In isotonic muscle contraction there is
a. normal muscle length
b. constant muscle tension
c. increased muscle tension
d. No work is done
37. In the smooth muscles ,there isa. well developed SR
b. caveoli instead of T-tubule
c. dense bodies
d. Both ( b ) and ( c ) are correct
38.Regarding the smooth muscle,a. it has spiky action potential only
b. its RMP equals -80 mv
c. its action potential may be spiky or with plateau
d. it utilizes more ATP than skeletal muscle
39. In the smooth muscle there isa. more myocin than actin filaments
b. more actin than myocin filaments
c. troponins like skeletal muscle
d. Z- lines as in skeletal muscle
40. Incomplete tetanus turns into complete tetanus bya. warming
b. cooling
c. fatigued. Both ( b ) and ( c ) are correct
41.Muscle atrophy my occur due toa. lesion of the motor nerve supply
b. immobilization of the muscle
c. direct trauma to the muscle
d. both ( a ) and ( b ) are correct
42.Rigor mortis is,a. A state of post mortim muscle softening
b. A state of muscle spasm just after death
c. Of medicolegal importance
d. both ( b ) and ( c ) are correct
43.Which of the following has the potential amplitudea. ventricular muscle
b. visceral plain muscle
c. skeletal muscle
d. nerve cell
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Module 5: Musculoskeletal System 2010/201144.All of the following obey all or none rule EXCEPT
a. Single nerve fibreb. Single skeletal muscle fibrec. Motor unitd. Single smooth muscle fibre with no gap junctions
UPPER LIMB
45.What is the first bone to ossificate?a. Humerusb. Phalangesc. Radiusd. Clavicle
46.Regarding clavicle, the following are correct EXCEPT:a. The rough area laterally is for the attachment of coracoclavicular ligamentb.
The lateral third is flattened form above downward and curves backwards
c. The conoid tubercle is on the smooth surface of the clavicled. The medial segment is pulled upwards by the sternomastoid muscle
47.The following are true of the borders and angles of the scapula EXCEPT:a. The superior border presents a notch where suprascapular nerve passesb. The lateral border ends by the supraglenoid tuberclec. The inferior angle lies opposite to the 7th ribd. The angle that lies on the 2nd rib is almost a right angle
48.Concerning the humerus, the following are true EXCEPT:a.
The groove on the posterior aspect lodges the radial nerve and the profunda brachiivessel
b. The groove on the posterior aspect of medial epicondyle carries the ulnar nervec. The brahioradialis takes origin from the length of lateral supracondylar ridged. Axillary nerve passes around the surgical neck of the humerus
49.These are the nerve supply of the shoulder joint EXCEPT:a. Axillaryb. Pectoralc. Musculocutaneousd. Suprascapular
50.The following are true of the axillary artery EXCEPT:a. Axillary vein is located medially to it at its 1st partb. If it is ligated proximal to the humeral branch, the blood flow can be re-establishedc. A deltoid branch in thoracoacromial artery of the axillary artery shares in an anastomosisd. It is present in the axilla
51.Regarding arterial supply of the hand, the following are true EXCEPT:a. Radialis indicis supplies the radial side of the thumbb. Superficial palmar arch are completed by radial arteryc. Deep palmar arch lies 3cm proximal to the superficial palmar archd. Palmar metacarpal arteries join in the arterial supply of the hand
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Module 5: Musculoskeletal System 2010/201152.These arteries will establish the circulation if there is ligation of brachial artery EXCEPT:
a. Posterior ulnar collateral arteryb. Ulnar arteryc. Radial arteryd. Interosseous recurrent artery
53.The course and relations of brachial artery are the following EXCEPT:a. Accompanied by two venae commitantsb. Relatively superficial 3/4th of its coursec. Related medially to the basilic veind. Related laterally to the median vein only at the upper half of arm
54.The relations of axillary artery are the following EXCEPT:a. 1st digitation of serratus anterior at the posterior of 1st part of the arteryb. Medial pectoral nerve at the medial aspect of the 2nd part of the arteryc. Both of the pectoralis muscle at the anterior of the 2nd part of the arteryd.
Pectoralis major muscle are at the anterior of the 3
rd
part of the artery
55.The quadrangular space is bounded by all of the following EXCEPT:a. Teres minorb. Teres majorc. Long head of bicepsd. Long head of tricepse. Surgical neck of the humerus
56.Regarding the biceps brachii, one is INCORRECT:a. Has long head attached to the supraglenoid tubercleb.
Has short head attached to the tip of the coracoid processc. Has a tendon inserted into the radial tuberosity
d. It flexes the elbow jointe. It is powerful supinator of the extended elbow
57.The nerve supply of the pectoralis major is by _________ nerve/sa. Medial pectoral
b. Lateral pectoral
c. Both a and b
d. None of the above
58.A patient presents in her fourth pregnancy with a history of numbness and tingling in herright thumb and index finger during each of her previous three pregnancies. Currently, the
same symptoms are constant, although generally worse in early morning. Symptoms could
be somewhat relieved by vigorous shaking of the wrist. Neurologic examination revealed
atrophy and weakness of the abductor pollicis brevis, the opponens pollicis, and the first two
lumbrical muscles. Sensation was decreased over the lateral palm and volar aspect of first
three digits and lateral palm when the wrist was held in flexion for 30seconds. The
symptoms suggest damage to which of the following?
a. Musculocutaneous nerveb. Median nervec. Ulnar nerved. Radial nerve
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Module 5: Musculoskeletal System 2010/201159.The lesser tuberosity of the humerus give attachment to:
a. Teres minorb. Teres majorc. Supraspinatusd. Infraspinatuse. Subscapularis
60.The following tendon cross the carpal tunnel EXCEPTa. Flexor carpi ulnarisb. Flexor digitorum superficialisc. Flexor digitorum profundusd. Flexor pollicis longus
61.The following structure pass deep to the extensor retinaculum EXCEPTa. Abductor pollicis longusb. Extensor pollicis brevisc.
Brachioradialis
d. Anterior interosseous arterye. Posterior interosseous nerve
62.Which muscle will compensate in part for the paralysis of supinator muscle?a. Extensor carpi ulnarisb. Anconeusc. Biceps brachiid. Brachialis
63.During its course in the upper limb, the median nerve lies:a.
In front of lateral epicondyle of humerusb. Medial to brachial artery in cubital fossa
c. Against spiral groove of humerusd. Against surgical neck of humeruse. Superficial to flexor retinaculumf. Behind medial epicondyle of humerus
64.The only muscle of upper limb that has pelvic origin isa. Serratus anteriorb. Pectoralis majorc. Subscapularisd. Latissimus dorsie. Teres major
65.Anastomosis around the scapula connects subclavian artery with:a. First part of axillary arteryb. Second part of axillary arteryc. Third part of axillary arteryd. Brachial artery
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Module 5: Musculoskeletal System 2010/201166.Rotator cuff muscles are composed of the following EXCEPT
a. Teres majorb. Teres minorc. Supraspinatusd. Subscapularise. Infraspinatus
67.Concerning long thoracic nerve, all are correct EXCEPTa. Supplies serratus anterior muscleb. Branch of posterior cord of brachial plexusc. Its root value is C5, 6, 7d. Cutaneous to the lateral wall of thoraxe. It descends to thoracic wall
LOWER LIMB
68.What is the longest and strongest bone in the body?a. vertebrae
b. humerus
c. femur
d. tibia
69.What is the largest sesamoid bone in the body?a. patella
b. clavicle
c. hip bone
d. radius
70.All are true except:a. Peroneus longus support the medial longitudinal arch of the foot
b. Tranverse arch seen at the tarso-metatarsal region
c. Plantar aponeurosis strongly binds anterior and posterior pillar together
d. Lateral longitudinal arch is made up of the calcaneus, cuboid, lateral two metatarsal
71.All are the functions of the arches excepta. spring for easy propelling movement
b. distribution of body weight on several points
c. protect the sciatic nerve from injury
d. protection of the structures at the sole of the foot
72.All are the contents of femoral sheath excepta. femoral nerve
b. femoral vein
c. femoral artery
d. lymph nodes
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Module 5: Musculoskeletal System 2010/201173.All are true except
a. profunda femoris artery give lateral circumflex femoral artery, medial circumflex femoral
artery, and perforating branches
b. profunda femoris artery ends as fourth perforating artery
c. lateral circumflex femoral artery give ascending , descending and tranverse branches
d. medial circumflex femoral artery give ascending, descending and tranverse branches
74.The posterior wall of adductor (subsartorial canal)a. sartorius
b. vastus lateralis and quadriceps femoris
c. pectineus
d. adductor magnus and adductor longus
75.What is boundaries of greater sciatic foramen?a. greater sciatic notch, sacrotuberous ligament, sacrosinous ligament
b. piriformis muscle, quadratus femoris
c. superior and inferior gemellus musclesd. sciatic nerve and posterior cutaneous nerve of thigh
76.What is the nerve supply for gemellus inferior muscle and root value?a. nerve to obturator internus (L5,S1,S2)
b. nerve to quadratus femoris (L3, L4)
c. pudendal nerve (S2,S3,S4)
d. nerve to quadratus femoris (L4,L5,S1)
77.Superior gluteal artery is the continuation ofa. anterior division of the internal iliac artery
b. posterior division of the external iliac arteryc. posterior division of the internal iliac artery
d. anterior division of femoral artery
78.All are true excepta. medial end of superior extensor retinaculum is attached to lower part of the tibia
b. inferior extensor retinaculum is a Y- shaped band lies on dorsum of foot
c. flexor retinaculum is pierced by the lateral calcanean vessels and nerves
d. tibialis posterior pass under the flexor retinaculum
79.All are true about plantar aponeurosis excepta. maintain the tranverse arch
b. attached posteriorly to both tubercles of calcaneus
c. protect the underlying vessels and nerves
d. dense sheet of fibrous tissue
80.All are involve in trochanteric anastomosis excepta. inferior gluteal artery
b. inferior branch of superior gluteal artery
c. ascending branch of medial circumflex femoral artery
d. tranverse branch of lateral circumflex femoral artery
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Module 5: Musculoskeletal System 2010/201181.All the following are correct regarding the relations of femoral arteries EXCEPT
a. Lateral femoral nerveb. Posterior psaos major, pectineus, adductor magnus and posterior wall of rectus sheathc. Medial inguinal lymph nodes groupd. Anterior - skin, superficial fascia, deep fascia,& anterior wall of femoral sheath
82.Great saphenous vein receives all of the following veins before entering into saphenousopening EXCEPT
a. Epigastric veinb. Popliteal veinc. Pudendal veind. Superficial circumflex iliac vein
83.All of the following are branches of profunda femoris artery which share in someanastomosis in lower limb EXCEPT
a. Tranverse branch of lateral circumflex femoral arteryb.
Descending branch of lateral circumflex femoral artery
c. Acetabular branch of medial circumflex femoral arteryd. Ascending branch of medial circumflex femoral arterye. First perforating artery of profunda femoris artery
84.Below shows relations of politeal artery. Which of the following is INCORRECT?a. At upper part of popliteal fossa, popliteal vein and tibial nerve lateral to arteryb. At lower part of fossa, after cross superficial to artery whole course, vein lies between
artery and nerve
c. At lower border of popliteus muscle, artery will terminate to anterior and posterior tibialartery
d.
Popliteal artery is the superficial structure in popliteal fossa (if see from posterior view)
85.Varicose vein is an engorged, dilated vein with blood. What is the cause of this varicosevein?
a. Weak valves congested the veinb. Chemical mediator reactionsc. Decrease oxygen concentration in venoule bloodd. Gravitational pull
86.All the following are branches of dorsalis pedis artery, EXCEPTa. First plantar metatarsal arteryb. First dorsal metatasrsal arteryc. Arcuate arteryd. Plantar metatarsal arteries
87.All the following are the correct match of artery and its continuation artery after terminationEXCEPT
a. Peroneal artery calcanean arteryb. Posterior tibial artery medial and lateral plantar arteriesc. Anterior tibial artery arcuate arteryd. Popliteal artery anterior and posterior tibial artery
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Module 5: Musculoskeletal System 2010/201188.All the following flexors of thigh joint are supplied by femoral nerve EXCEPT
a. Psaos majorb. Illiacusc. Rectus femorisd. Sartorius
89.All the following are muscles originate from area between pubic tubercle and ischialtuberosity EXCEPT
a. Gracilisb. Adductor longusc. Adductor brevisd. Adductor magnus (pubic part)e. Pectineus
90.What is the function of Gluteus Maximus and Tensor Fascia Lata exertions on iliotibial tract?a. Maintain knee in extended positionb.
Important during walking
c. Maintain shape of the thighd. Allow flexion of knee joint
91.Which of the following muscle passes through Greater Sciatic Foramen?a. Obturator internusb. Gemellus inferiorc. Piriformisd. Quadratus femorise. Gemellus superior
92.Above is an ischial tuberosity diagram with its compartment. Which of the following iswrong?
a. Semimembranosusb. Semitendinosus & Biceps Femoris (short head)c. Subcutaneousd. Adductor Magnus (Ischial part)
b.
a.
c. d.
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Module 5: Musculoskeletal System 2010/2011VERTEBRAE
93.All are true about vertebrae column excepta. the thoracic and cervical are termed secondary curves
b. there are 33 vertebrae assuming that 4 coccygeal vertebrae
c. lumbar curve is more marked in female than maled. C1 is known as atlas
94.All true typical vertebrae and ossification excepta. each vertebrae has body that facing anteriorly and vertebaral arch facing posteriorly
b. secondary center of ossification appear at puberty
c. primary ossification start after 7 months
d. each arch has 2 pedicle, 2 laminae, a spinous process
95. X are developed by endochondral bone ossification, occurs in pre existing model cartilage.Which of the following refer to the X?
a. clavicleb. skull vault
c. vertebrae
d. humerus
96.The vertebral column is developed from the Y. Y is,a. dermatome
b. hyaline cartilage
c. membrane
d. para axial mesoderm
BIOMECHANICS
97.Joint stability is maintained by the following excepta. bones
b. ligaments
c. rough surface of bone
d. muscles
98.Which of the following not involve in maintaining stability of the vertebaral column?a. IV disc
b. facet joint
c. number of vertebrae
d. ligaments
99. IV disc in vertebral column do not act as shock absorber.This statement..a. true
b. false
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Module 5: Musculoskeletal System 2010/2011
Answers for MCQ 99
1. C 26. D 51. A 76. D2. B 27. C 52. A 77. C3. D 28. D 53. B 78. C4. B 29. D 54. D 79. A5. d 30. A 55. C 80. D6. D 31. B 56. E 81. B7. D 32. D 57. C 82. B8. D 33. D 58. B 83. C9. B 34. D 59. E 84. D10. B 35. D 60. A 85. A11. D 36. B 61. C 86. D12.
A 37.
D 62.
C 87.
C13. D 38. C 63. B 88. A
14. C 39. B 64. D 89. E15. C 40. D 65. C 90. A16. D 41. D 66. A 91. C17. B 42. D 67. B 92. B18. C 43. D 68. C 93. A19. A 44. D 69. A 94. C20. D 45. D 70. A 95. D21. B 46. B 71. C 96. D22. B 47. D 72. A 97. C23. A 48. C 73. D 98. C24. D 49. B 74. D 99. B25. B 50. B 75. A
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Module 5: Musculoskeletal System 2010/2011
1. Tabulate the differences between the types of cartilage.Cartilage Hyaline Elastic White Fibro
Perichondrium Covered by perichondrium
except inside joint cavities
Always covered by
perichondrium
Never covered by
perichondrium
ECM - Glassy, translucent
- Fibers has same refractive
index with ground substance
- very large number of
interlacing elastic fibers
- demonstrate by orcein
and V.V.G. stains
Contains thick bundles of
type I collagen fibers running
in different directions but
sometimes parallel and
separated by narrow bands
of non-fibrous matrix
Types of fibers Mainly type II collagen and
few elastic fibers
Abundant elastic fibers +
type II collagen
Abundant type I collagen +
few type II
Chondrocytes - present inside lacunae
surrounded by capsule
- at periphery, young
chondrocytes are present
underneath perichondrium
- chondrocytes are scattered
- Chondrocytes are
numerous
- rounded chondrocytes lie in
rows in narrow bands of
non-fibrous matrix
Number of
chondrocytes/
capsule
1-8 1-3 1-2
Sites 1. skeleton of the embryo
2. epiphyseal plates in
growing age
3. costal cartilages
4. nose, larynx, trachea, and
bronchi
5. articular surface of all
synovial and cartilaginous
joints
1. ear pinna
2. external auditory
meatus
3. cuneiform and
caorniculate cartilages in
the larynx
4. epiglotis
1. intervertebral disc
2. symphysis pubis
3. temperomandibular joint
4. sternoclavicular joint
Significance - Firm but flexibles
- Present of cell nest
- fresh elastic cartilage
has yellowish color
caused by elastin in
elastic fibers
- flexible and resilient
- great strength with
flexibility and rigidity
- never covered by
perichondrium as it merges
into surrounding dense
connective tissue of capsule
and ligaments of joints
2. Discuss mechanism of bone remodeling.It means continuous renewal of bone, which is a balanced continuous state of bone
resorption and simultaneous replacement by new bone formation. Bone remodeling is
important for replacement of immature bone to mature bone and maintenance of bonestructure and shape throughout life.
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Module 5: Musculoskeletal System 2010/20113. Describe the biochemical composition of cartilage and synovial fluid (GAG):
i. Collagenii. Proteoglycansiii. Glycoproteini. CollagenCollagen is largely presented as a triple helix made up of three polypeptides (tropocollagen).
In each of three individual collagen chains (polypeptides)of tropocollagen, the triplet Gly-X-Y
is constantly repeated in the sequence i. e., every third amino acid in such sequences is a
glycine, with the X position often being occupied by Pro and the Y position by Hyp.
In triple helices, every third residue lies on the inside of the molecule, where there is only
room for glycine residues. [FUNCTIONS] The hydroxyproline residues stabilize the triple helix
by forming hydrogen bonds between the chains, Strength of collagen comes from these H-
bonding between chains. While the hydroxyl groups of hydroxylysine are partly glycosylated
with a disaccharide (GlcGal) and help linking tropocollagen molecules together
ii. ProteoglycansThese are macromolecules found in the ECM or cell surface, containing up to 95%
carbohydrates. Basic unit of proteoglycans is called aggrecan or proteoglycan monomer,
consist of core protein with covalently attached GAGs. Proteoglycans contain a long strand
of hyaluronic acid to which link proteins are attached non-covalently. In turn, link proteins
interact non-covalently with core protein molecules. However, GAGs are attached covalently
to core protein by glycosidic bonds between sugar reisdue and OH of serine. The GAGs
attached to core protein are chondroitin sulphate (mainly), keratan sulphate, heparan
sulphate & dermatan sulphate.
iii. GlycoproteinGlycoproteins are proteins that have oligosaccharides chain (one or several) attached
covalently to polypeptide backbone. The carbohydrates moieties are smaller and more
structurally diverse than GAGs of proteoglycans. Carbohydrate units may be O-linked (sugar
attached by a glycosidic link to the OH of serine or threonine) or N-linked (sugar attached to
NH2 group of asparagines).Carbohydrate may constitute from 1-7% of glycoproteins. The
sugar units in glycoprotein is N-acetyl amino sugar (e.g. N-acetyl glucosamine or N-acetyl
galactosamine), hexose (e.g. mannose or galactose), L-Fucose (6-deoxy-L-galactose) and
sialic acid.
p/s: In examination, please use complete or full names and not short form
4. Describe the role vitamin D, calcium and phosphorus in bone metabolism.Vitamin D helps in calcium and phosphorus absorption. Meanwhile, excess phosphorus in form
of phosphate will inhibit calcium absorption. When serum calcium level increase, the level of
hormone involved in activation of vitamin D3 will decreased and calcium absorption is
diminished.
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Module 5: Musculoskeletal System 2010/20115. Compare between compact bone and cancellous bone.
6. What is meant by resting membrane potential?RMP is potential difference created across cell membrane by metabolic process of the fibre
during rest
7. Enumerate the differences between an axon and a dendrite in histological structure.Differences between axon and dendrite
Axon DendriteSingle process Single or multiple processes
Cylindrical Tapering to one end
Not branched except at its termination or
collaterals
Has many branches
Originate from axon hillock Originate from any part of perikaryon
May be covered by sheaths No sheaths
Does not contain Nissls granules Contain Nissls granules
Centrifugal impulse Centripetal impulse transmission
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Module 5: Musculoskeletal System 2010/20118. What is the importance of sodium-potassium pump?Importance of Na
+/K
+pump
Maintain Na+/K+ concentration gradients across cell membrane Establish negative electrical potential inside the cells helps to transmit signal throughout
nervous system
Maintain normal level of intracellular K+ - necessary for protein metabolism Keeps osmotic equilibrium to maintain cell volume9. What is meant by temporal summation?Temporal summation is application of multiple subthreshold stimuli can be summated to give a
response (when reaching firing level) [pg 63]
10.Label(1)______________________(2)______________________(3)______________________Ans: (1) Rheobase
(2) Utilization time
(3) Chronaxie
11.What is the relation between the duration and the excitability?The more excitable is the tissue, the less are the intensity, the shorter the duration
12.Compare between the supernormal phase and subnormal phase.Comparison
Supernormal phase Subnormal phase
Threshold to stimulate Decreased Increased
Nerve excitability Increased DecreasedCoincides with After depolarization After hyperpolarization
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Module 5: Musculoskeletal System 2010/201113.Compare between the uses of energy during rest and during activity.Comparison [pg 73]
During rest During activity
- Maintain polarizaed state of themembrane
- Maintain ionic composition across cellmembrane
- Na/K pump mechanism derives energyfrom breakdown of ATP
Energy expenditure is doubled to restore
polarized state of the membrane.
Oxygen consumption is increased.
14.Give a short account ona) Myelinated nerve fibres in CNSb) Unmyelinates nerve fibres in PNS
Ans: (a) Myelinated nerve fibres in CNS
- Enveloped by myelin sheaths ONLY
- Schwann cells are absent in CNS- Oligodendrocytes form myelin sheaths
(b) Unmyelinated nerve fibres in PNS
- Axons are enveloped by Schwann cell sheaths ONLY
- They are usually in diameter
- Single Schwann cell envelopes multiple segments of different axons
15.What is meant by action potential?Action potential is the electrical charges accompanied by wave of depolarization
16.Enumerate the functions of skeletal muscle:1. They move the body as a whole part of it2. They maintain the body posture by their tonic contraction and muscle tone3. Generate heat by contraction which maintains the body temp.4. Stabilize and strengthen the joints of the skeleton by their contraction. (pg.92)
17.Tabulate the difference between slow muscle fibers(Type 1) and fast muscle fibers(Type 2):Slow muscle fibers (Type 1) Fast muscle fibers (Type 2)
Thin fibers Thick fibers
- Large amounts of myoglobin- Numerous blood capillaries- Increasing number of mitochondria
- Absence of myoglobin- Few blood capillaries- Few mitochondria- Extensive reticulum- Large amounts of glycolytic enzymes
- Longer latent period- Contract slowly- Fatigue slowly
- Short latent period- Contract rapidly- Fatigue easily
Maintain body posture against gravity Better at generating burst of speed and force
Eg: back muscle and soleus muscle in marathons
and bicycle for hours
Eg: A sprinter
(pg.92-93)
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Module 5: Musculoskeletal System 2010/201118.Give a short account on the nerve supply of the skeletal muscle:- Nerve-operated and under the control of CNS- Contracts when their motor nerve is intact- Motor nerve fibers reach the skeletal muscle from their anterior horn cells in the grey
matter of the spinal cord
- If the nerve supply is cut, degeneration of muscle with:o Complete loss of functiono Paralysis
(pg. 94)
19.Give a short account on the mechanism of neuro-muscular transmission:- When an action potential arrives at the axon terminal, calcium channels open and there will
be influx of Ca2+
from ECF into the membrane of nerve terminals.
- This will cause vesicles that contain the neurotransmitters to attach to the membrane ofnerve fiber.
- The vesicular membrane will fuse with the nerve cell membrane.- Acetycholine are excocytosed into the synaptic cleft.- The acetycholine then diffuses and binds to acetycholine receptors at the motor end plate.- These ligand-gated channels then open, and allow rapid influx of Na2+ ions to the interior of
the muscle which will excite the generation of action potential. (pg. 98)
20.What happens when sodium ions enter the muscle fiber?It decreases the membrane potential in the local area of the end plate which will produce
local end plate potential (partial depolarization of the membrane). (pg. 99)
21.What happens to acetycholine after its release?It is rapidly destroyed (after one millisecond) by the acetyl cholinesterase enzyme in the
cleft. This short time is sufficient for acetylcholine to excite the muscle fibers. The rapid
hydrolysis of acetylcholine prevents re-excitation of the muscle fibers after recovery from
the previous action potential. (pg 99-100)
22.Tabulate the types of muscular contraction:Isotonic contraction Isometric contraction
Light/moderate Load Heavy
Muscle shorten Length of contraction Muscle does not shorten
Load moves Movement of load Load does not move
There is work done Work No work done
75% Conversion to heat 100%
(pg 104-105)
23.Enumerate the sources of ATP generation in muscles and give a short account on each one:1. Glycolysis: two high energy phosphates are catalyzed in 2 reactions calalyzed by
phosphoglycerate kinase and pyruvate kinase. Both aerobic and anaerobic can occur.
2. Citric acid cycle: one high energy phosphate is generated by succinyl thiokinase step inaerobic conditions only.
3. Oxidative phosphorylation: greatest source of ATP in aerobic conditions
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Module 5: Musculoskeletal System 2010/20114. Creatine phosphate: creatine + ATP ADP + creatine phosphate. Creatine phosphate is a
major energy reserve which is a reversible reaction.
5. Adenylyl kinase : myosin ATPaseATP muscle contraction
ADP + Pi
AMP adenyl kinase ADP (pg. 110)
24.Why do smooth muscles have a greater capacity for regeneration?- Smooth muscle fibers respond to the increased demands by undergoing compensatory
hypertrophy along with skeletal and cardiac muscle fibers.
- They can retain the capacity for mitosis and respond to requests by hyperplasia.- Pericytes along the course of small blood vessels can also form new smooth muscle fibers.
(pg. 117)
25.Tabulate the two types of smooth muscle:Visceral smooth muscle (unitary) Multi-units smooth muscle
GIT, urinary tract, genital tract, blood
vessels
Site Muscle lining the b.v., ciliary muscle, iris
of eye, piloerector muscle
In the form of bundles and presence of
gap junctions
Characteristics Made of separate fibers
Syncytial fashion Contraction Non synsytial fashion
Non-nervous stimuli Controlled by Autonomic nervous system
(pg. 118-119)
26.Compare skeletal muscle and smooth muscle (both histologically & physiologically).Skeletal muscle Smooth muscle
Striation Striated non-striated
Movement Voluntary Involuntary
Site 1. attached to skeleton
2. ocular muscle
3. muscle of face, tongue,
pharynx, diaphragm & upper
2/3 of oesophagus
Visceral smooth muscle:
1. digestive tract2. urinary tract3. genital tract4. many blood vessels
Multi-units smooth muscle:
1. muscle lining blood vessels2. ciliary muscle & iris of eye3. piloerector muscle of hair
Stimulus/i nerve impulse 1. nerve impulse
2. hormone (non-nervous)
3. cytokine (non-nervous)
Innervations central nervous system autonomic nervous system
LM: Shape long, cylindrical cell (fiber) elongated, fusiform (spindle) cell
LM: Nucleus multinucleated, pale, elongated
oval, periphery
single, pale, oval, central
LM: Sacroplasm Scanty, eosinophil; filled with abundant, homogenous eosinophil
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Module 5: Musculoskeletal System 2010/2011numerous longitudinally
oriented myofibrils
Myofibrils Thick & thin myofilaments Thick & thin myofilaments
Proportion of actin:
myosin
Lesser than skeletal muscle Greater than skeletal muscle
Arrangement ofmyofibrils
Fibers are parallel to each otherwith the same registration of
light and dark bands of adjacent
fibers
Group in bundles with irregularorientation, more or less oblique to
long axis of the cell
Troponin Present (part of thin filament) Lack of troponin
Attachment of thin
filaments
Z-lines (presence of alpha-
actinin)
Dense bodies (presence of alpha-
actinin)
Presence of desmin Absent Present
Basal lamina covering
sacrolemma
Present Present
Sacroplasmic reticulum Well developed Not well developedCentrioles Absent Present
Gap junction Absent May present
Sacromere Regular Absent
Triad of tubular system Present Absent
T-tubules Present small at junction
between A and I bands
Absent- caveolae instead
Contraction-Relaxation Faster Slower
Energy needed High Small (only 1 ATP)
Troponin-C Present Absent calmodulin instead
Enzymes involved ATPase enzyme ATPase enzyme
Myosin kinase
Phosphatase
Source of calcium Terminal cisternae of
sarcoplasmic reticulum
Mainly extracellular fluid, in addition
of sarcoplasmic reticulum in some
smooth muscle
Calcium pump Faster Slower
Period of contraction Short Long
Action potential Spike potential Spike potential & action potential
with plateau
RMP -90mV -50Mv
Duration of spike
potential
1-5 msec 10-50 msec
Magnitude of action
potential
130 mV
Rythmic contraction Absent Present
Tonic contraction Present Present
Excitability More excitable Less excitable
Chronaxie Short Long
Force of muscle
contraction
Lesser than smooth muscle Greater than skeletal muscle
Cycling of the Myosin
Cross-Bridges
Faster Slower
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Module 5: Musculoskeletal System 2010/2011P/S: Dont forget to include explanation especially if the comparison is physiologically (which you can
refer to Module 5 page 342-343)
27.Compare electrical changes in skeletal muscles and nerves.Skeletal Muscle Nerve Fiber
RMP -90mV -70mV
Magnitude 130 mV 105mV
Duration of action potential 1-5 msec
Velocity of excitation wave
conduction
3-5 m/sec up to 120 m/sec (in thick
myelinated nerve fibers)
Duration of after potential Longer Shorter
28.Describe the structure and function of motor unit and motor end plate.Motor unit is an anterior horn cell together with its axon and the number of fibers it supplies (about
30-150 muscle fibers). Each motor unit obeys the all or non rule. When the anterior horn cell is
stimulated, its entire muscle fibers contract but not all the motor units in a given muscle contract at
the same time. Increase in intensity stimuli, increase number of active motor units, thus increase in
intensity of response.
Motor end plate is a site of junction between nerve and skeletal muscle fibers. It is a characteristic
specialized nerve ending (effector, motor) by which a motor nerve fiber ends in a skeleton (striated)
muscle. Each nerve fiber branches many times to stimulate several skeletal muscle fibers. This
junction usually occurred at the fibers midpoint, so the action potential travels in both directions.
The function of motor end plate is for the transmission of action potential of nerve fibers to skeletal
muscle as an effector through neurotransmission or synapse.
29.Describe the molecular basis of muscular contraction and excitation-contraction coupling.Molecular basis of Muscular Contraction
- Shortening or contraction of muscle occurs by sliding the thin filaments of the myofibrilsover the thick filament.
- During rest, troponin T tropomyosin complex covers the binding sites for myosin heads onactin filaments, inhibit contraction.
- Binding of Ca2+ to Troponin C causes uncover of myosin binding sites as tropomyosin moveslaterally.
- The heads of myosin link to actin at a right angle, then swiveling of the myosin heads,followed by detaching and reattachment to the next linking site.
- The thick and thin filaments of sarcomere will interdigitate causing shortening of Z-line andH-band widths until they both disappear.
- Energy for muscle contraction is derived from breakdown of ATP.- The heads of myosin molecules have ATPase activity.
Excitation-contraction Coupling
- Stimulation of myelinated motor nerve supplying a skeletal muscle leading to generation ofaction potential, which spreads along both sides of the sarcolemma membrane.
- The action potential spreads to the depth of the myofibrils via T-tubular system (extendingfrom sarcolemma membrane).
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Module 5: Musculoskeletal System 2010/2011- Release of calcium ions from lateral sacs of the sarcoplasmic reticulum and its diffusion to
the thick and thin filaments.
- Binding of Ca2+ to troponin C causing lateral movement of tropomyosin that uncover thebinding sites of myosin heads on actin filaments. ATP is splitted to supply energy for
contraction.
- Sliding of thin filaments over thick filaments due to formation of cross linkages betweenmyosin and actin leading to muscular contraction.
- Every sliding of filaments will cause 1% shortening of muscle length.- More and more shortening is obtained by disconnection, swiveling and reconnection of
myosin heads to the binding sites on actin filaments.
- Active reuptake of Ca2+ by sarcoplasmic reticulum to be stored for the next action potential.Energy is needed for both relaxation and contraction.
- Once the reuptake of calcium occurred, the interaction between myosin and actin stops astropomyosin moves medially to cover the binding sites of myosin heads over actin filaments
and muscular relaxation occurs.
30.What are the factors sharing in stability of shoulder joint:Bony factor Ligamentous factor Muscular factor
The labrum glenoidalethat deepens the
shallow glenoid cavity.
Coraco-acromial archthat prevents the
upward dislocation of
the head of humerus.
Labrum glenoidale Coraco-acromial
ligamentas bridges
over bony arch.
Rotator cuff muscles(SITS) adhere to capsule
of joint.
Splinting effectoftriceps and biceps
muscles.
Long head of bicepsprevents upward
dislocation.
(pg. 195)
31.Tabulate the differences between the small joints of the hand:Intercarpal
joints
Carpometacarpa
l joints
Intermetacarpa
l joints
Metacarpophalangea
l joints
Interphalangea
l joints
Typ
e
Synovial Plane, synovial
EXCEPT 1st
carpometacarpal
(saddle, biaxial,synovial)
Plane, synovial Ellipsoid, biaxial,
synovial
Hinge
Site Between
carpal
bones
(proximal
and distal
form S-
shape
transverse
intercarpals
)
Distal row of
carpal bones and
metacarpal
bones
Between
adjacent parts
of the bases of
the medial 4
fingers
Between metacarpal
bones and the
proximal phalanges
Between the
phalanges of
each finger
(pg.202-203)
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32.Tabulate the difference between radial and ulnar artery:Radial artery Ulnar artery
As one of the two terminal branches of
brachial a. opposite the neck of radius
Beginning As one of the two terminal branches of
brachial a. opposite the neck of radius
Smaller Size Larger
o Descends in the forearmo Passes anterior of radiuso Lies superficial at wristo Reaches the anatomical snuff
box where it lies on scaphoid
bone
o Enters between two heads ofthe first dorsal interosseous
muscle
o Continues in the hand as depppalmar arch
Course o Descends in the forearmo Lies superficial to the flexor
retinaculum
o Enters the hand and continuesas superficial palmar arch
o Radial recurrento Muscular brancheso Nutrient artery to radiuso Ant and post carpalo Superficial palmar brancho Forst dorsal metacarpal branch
Branches o Anterior and posterior ulnarrecurrent
o Common interooseouso Nutrient artery to ulnao Carpal branches
(pg. 173-174)
33.Give a short account of the anastomosis around the surgical neck of humerus:
1. Anastomosis between: Ant circumflex humeral artery of the 3rd part of axillary artery Post circumflex humeral artery of the 3rd part of axillary artery Deltoid branch of the thoracoacromial artery of the 2nd part of axillary artery2. If axillary artery is ligated distal tohumeral and subscapular branches, blood flow can be re-
established by these branches and profunda brachii.
3. If axillary artery is ligated distal to profunda brachii and sup ulnar collaterall arteries, bloodflow can be re-established by: - Inferior ulnar collateral - Ulnar artery
- Radial artery - Interosseous recurrentartery
(pg. 157)
34.Give a short account of the veins of the upper limb:Superficial venous system Deep venous drainage
Palmar and dorsal digital veins onrespective surfaces of the digits:
- join to form dorsal metacarpal veins that
anostomose to form dorsal venous arch
Cephalic vein: lateralcontinuation of dorsalvenous arch:
- ascends along radial side of forearm to
Deep venousarcades in the hand 2 veins accompanying an artery(venae
comitantes) of radial, ulnar and brachial
arteries
The venae comitantes of radial and ulnararteries join to form the vena comitantesof the brachial artery, which unite the
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Module 5: Musculoskeletal System 2010/2011cubital fossa
- passes in deltopectoral groove
- terminate by piercing clavipectoral fascia
and drain into axillary vein
Basilic vein: medialcontinuation of dorsalvenous arch:- ascends along ulnar side of the forearm
- pierces deep fascia in arm and unites with
brachial vein to form axillary vein
Median cubitalvein in cubital fossa:- passes oblique across fossa to connect
cephalic and basilica vein.
- used for IV injections
basilic vein to form the axillary vein
(pg.192)
35.Label the diagram below with its cutaneous branch of specific nerve supply
1)
2)
3)
36.Enumerate structures that passing superficial to flexor retinaculum.37.Give an account on arterial anastomosis around the elbow joint.38.What are the causes of winging scapula?39.Fill in the blanks with suitable wordsi) Two examples of the synovial ball and socket joints
a) _____________________b) _____________________
ii) Deep palmar arch is formed mainly by _______________while superficial palmar arch isformed mainly by _________________.
iii) Axillary artery is a continuation of _______________artery at ___________border of_______________rib.
iv) The ______________________muscle divides the axillary artery into three parts.v) Two structures that pass around the surgical neck of humerus are
a) ______________________b) ______________________
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Module 5: Musculoskeletal System 2010/2011Answers (for Q 35 - 39)
35.1) Median nerve2) Ulnar nerve
3) Radial nerve
36.Structure superficial to flexor retinaculum Ulnar nerve Ulnar vessel Cutaneous branch of ulnar nerve Cutaneous branch of median nerve Tendon of palmaris longus37.Anastomosis around elbow joint (draw a diagram easy to illustrate) In front of medial epicondyle Anterior branch of inferior ulnar collateral a. (brachial a.)
anastomosise with anterior branch of ulnar recurrent a. (ulnar a.)
Behind medial epicondyle Posterior branch of inferior ulnar collateral a. and superiorulnar collateral a. (brachial a.) anastomosise with posterior branch of ulnar recurrent a.
(ulnar a.)
In front of lateral epicondyle Anterior branch of descending profunda brachii a.(brachial a.) anastomosise with radial recurrent a. (radial a.)
Behind lateral epicondyle Posterior branch of descending profunda brachii a.(brachial a.) anastomosise with interosseous recurrent a. (ulnar a.)
38.Winging scapula is due to injury of long thoracic nerve (nerve to serratus anterior) whichlead to paralysis of serratus anterior muscle.
39.Fill in the blank.i) Shoulder joint, hip jointii) Radial artery, ulnar arteryiii) Subclavian, outer, firstiv) Pectoralis minorv) Axillary nerve, posterior circumflex humeral artery40.Learn all the Laws 22 below:-
Law 1: Anterior compartment of thigh is either flexor of hip joint or extensor of knee joint or either
both (EXCEPT for Sartorius which its action is both flexions of hip and knee joints).
Law 2: All 3 adductors (Adductor Magnus, Adductor Brevis & Adductor Longus EXCEPT for harmstring
part of Adductor Magnus) share 3 common movements which are; flexion, adduction &
lateral rotation of hip joint.
Law 3: Main extensor of hip joint is Gluteus Maximus and it is supplied by Inferior Gluteal Nerve.
Law 4: Abductor of hip joints are Gluteus Medius, Gluteus Minimus & Tensor Fascia Lata which also
share the same nerve; Superior Gluteal Nerve. Thus, these muscles are named Muscle
during Walking.
Law 5: Anterior fibers of Gluteus Medius and Minimus causing Medial Rotation of hip joint.
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Module 5: Musculoskeletal System 2010/2011Law 6: Two muscle inserted to Iliotibial tract; Gluteus Maximus (3/4) and Tensor Fascia Lata.
Law 7: According to Module 5, we have 5 small rotators of hip joint which are; Piriformis, Gemellus
Superior, Gemellus Inferior, Obturator Internus and Quadratus Femoris (some books add
obturator externus). The action of these muscles can be determined by their name.
Law 8: All small lateral rotators (2 Gemelli, Piriformis Obturator internus + Obturator externus) are
inserted at Greater Trochanter EXCPET Quadratus Femoris.
Law 9: Specially for Piriformis - origin from sacral vertebrae, thus supplied also by sacral nerves (ant
rami 1st
and 2nd
)
Law 10: Posterior compartment of thigh is flexor of knee joint (EXCEPT Hamstring part of Adductor
Magnus) and extensor of the hip joint (ALL).
Law 11: Both Semis (Semimembranosus & Semitendinosus) share EXTRA movement; medial rotation
of the knee while Biceps Femoris does the opposite that is lateral rotation of the knee.
Law 12: According to Module 5, all anterior compartment of leg do dorsiflexion (extension of foot)
EXCEPT Extensor Hallucis Longus (+ Extensor Digitorum Brevis).
Law 13: All Tibialis do inversion of foot + 2 Flexors of leg (Flexor Digitorum Longus & Flexor HallucisLongus).
Law 14: All Peroneus do eversion of foot.
Law 15: Origin of muscle at Anterior surface of Fibula: Extensor Hallucis Longus, Extensor Digitorum
Longus & Peroneus Tertius
Law 16: As Peroneus Longus and Brevis are Lateral compartment, they share the same site of origin
that is Lateral surface of Fibula.
Law 17: Posterior surface of Fibula placed origin sites for Flexor Hallucis Longus (Lateral to Medial
Crest) and Tibialis Posterior (Medial to Medial Crest).
Law 18: Posterior surface of Tibia placed oringin sites for Flexor Digitorum Longus & Tibialis
Posterior. Thus, we can conclude that, All Posterior compartment of leg originate from
posterior surface of Tibia we Fibula.
Law 19: Base of distal phalanx of thumb is insertion site for Extensor Hallucis Longus (Dorsally) &
Flexor Hallucis Longus (Plantarly).
Law 20: Base of 1st
metatarsal and medial cuneiform bone are insertion sites of Tibialis Anterior
(Dorsal) & Peroneus Longus (Laterally).
Law 21: Base of 5th
metatsrsal bone: Peroneus Tertius (Dorsum) & Peroneus Brevis (Tubercle)
Law 22: Distal phalanges of 4 lateral toes are insertions of Extensor Digitorum Longus (through
Extensor Expension) & Flexor Digitorum Longus (Plantar).
41.State the boundaries of femoral triangle.Lateral boundary: Medial border of sartorius
Medial boundary: Medial border of adductor longus
Base: Inguinal ligament
Apex: Overlap between medial border of sartorius and adductor longus
42.X is the content of lateral compartment of the femoral sheath. State X and its course.X is femoral artery.
- continuation of external ilac artey
-Descends across the femoral triangle to its apex and continues in the adductor canal .Itterminates at the end adductor canal by passing through adductor hiatus.
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43.State the insertion for SGS and the nerve supplying them.Upper part of medial surface of tibia
Sartorius- anterior division of femoral nerve
Gracilis- anterior division of obturator nerve
Semitendinosus- tibial component of sciatic nerve
44.State three muscles in the gluteal region and give one action for each muscle.Gluteus maximus- extension and lateral rotation of the thigh
Gluteus medius- abduction of hip joint
Gluteus minimus- abduction of hip joint
45.Y passed through the lower part of greater sciatic foramen below the piriformis. State Y andits root value.
Y is sciatic nerve ( L4,5,S1,2,3)
46.State two parts of Y and give one example for each part.Y consist of common peroneal part and tibial part.
Common peroneal Short head of biceps
Tibial part semitendinosus
47.Quadriceps femoris consist of four muscles. State the four muscles and the main action ofquadriceps femoris.
Rectus femoris, vastus lateralis,vastus medialis, vastus intermedius main extensor of knee
joint
48.State two muscles that pass on the groove at the back of medial malleolus of tibia. Give twoactions for each muscle.
Tibialis posteriorinversion, plantar flexion
Flexor digitorum longus- flexion of inter-phalangeal joints of lateral four toes, plantar flexion
49.The superficial venous drainage consists of small saphenous vein and V. Explain V, its courseand tributaries.
V is great saphenous vein.
- ascends in front and above medial malleolus.
-ascend along medial border of tibia to the back of medial side of knee.
- continues on the medial aspect of the thigh to the saphenous opening,then pierces
cribriform fascia to empty in femoral vein.
- superficial epigastric,superficial circumflex iliac and superficial external pudendal veins
50.State five structures that present inside the knee joints and mention one structure thatprevent hyperextension.
Medial semilunar cartilage, lateral semilunar cartilage, anterior cruciate ligament, posterior
cruciate ligament and popliteus tendon.
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Module 5: Musculoskeletal System 2010/201151.State the course and relations of the posterior tibial nerve.52.Explain one example of bone that maintains the joint stability.53.Explain the development of vertebral column
Vertebral column is developed from the para axial mesoderm of embryo
- Medial portion of myotomes is the sclerotome migrate medially to surround notochord
- Each sclerotome is differentiated into cranial and caudal halves
- Caudal halve of each sclerotome diffuse with cephalic halve to form mesenchymal
vertebaral body.
- Right and left halve fuse to form one vertebral body
- Notochord degenerate in the region of vertebral body and in vertebral spaces enlarge to
form nucleus pulbosus of the intervetebral disc. The surrounding mesenchyme give
annulus fibrosis.
- Mesenchymal give dorsal and lateral out growth on each sides- The dorsal form the mesenchymal neural arch and the lateral form membranous vertebral
that transformed to cartilaginous in the cervical region.In lumbar region , the costal
element form part of tranverse process.
54.Explain the development muscle of limbs.- Muscle of limb develop from myotomes and body wall mesenchyme that migrate into limb
buds.
- myotomes divided into
55.State two congenital anomalies of vertebrae and muscle.Vertebral column- spina bifida, hemi vertebrae
Muscle- agenesis, variations
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Q1. Types of cartilage and its sites
A Hyaline cartilage Skeleton of embryo
B Elastic cartilage Auricle of ear
C White fibrocartilage Epiglottis
Symphysis pubis
Nose
Costal cartilage
Cuneiform & corniculate cartilages in larynx
Intervertebral disc
Temporamandibular joint
Articular surface of synovial and cartilaginous
joints
Epiphyseal plates
External auditory meatus
Sternoclavicular joint
Q2 NERVE TISSUE SITE
A Bipolar 1 Olfactory mucosa of the nose
B Stellate 2 Cerebral cortex
C Pseudounipolar 3 Spinal ganglia
D Pyramidal 4 Sympathetic ganglia
E Pyriform 5 Common in invertebrates
F Golgi type I 6 Brain and spinal cord
G Golgy type II 7 Purkinje cell layer
H Unipolar 8
Q3.
Epimysium a. Thin fibrous septaPerimysium b. Dense connective tissueEndomysium c. Delicate connective tissue sheets
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Module 5: Musculoskeletal System 2010/2011Q4. MUSCLE NERVE SUPPLY
A Teres major 1 Suprascapular nerve
B Pectoralis minor 2 Radial nerve
C Supraspinatus 3 Lower subscapular nerve
D Deltoid 4 Long thoracic nerve
E Subscapularis 5 Axillary nerve
F Rhomboideus major 6 Dorsal scapular nerve
G Teres minor 7 Medial pectoral nerve
H Serratus anterior 8 Thoracodorsal nerve
Q5. MUSCLE NERVE SUPPLY
A Flexor carpi ulnaris 1 Median nerve
B Pronator teres 2 Radial nerve
C Flexor digitorum profundus 3 Musculocutaneous nerve
D Brachioradialis 4 Ulnar nerve
E 3rd
palmar interosseous 5 Deep branch of radial nerve
F Extensor carpi ulnaris 6 Anterior interosseous nerve
G Extensor carpi radialis longus 7 Deep branch of ulnar nerve
H Palmaris brevis 8 Superficial branch of ulnar nerve
Q6. NERVE SUPPLY ROOT VALUE
A Axillary nerve 1 C5
B Median nerve 2 C5, 6
C Radial nerve 3 C5, 6,7
D Ulnar nerve 4 C6, 7, 8
E Thoracodorsal nerve 5 C5, 6, 7, 8
F Dorsal scapular nerve 6 C7, 8, T1
G Musculocutaneous nerve 7 C8, T1
H Long thoracic nerve 8 C5, 6, 7, 8, T1
Q7. DEFORMITY NERVE INJURY
A Ape hand 1 Ulnar nerve
B Weakness of flexion of the arm 2 Radial nerve
C Loss of lateral slop of the neck 3 Musculocutaneous nerve
D Partial claw hand 4 Median nerve
E Wrist drop 5 Upper trunk of brachial plexus
F Finger drop only 6 Lower trunk of brachial plexus
G Erbs paralysis 7 Spinal accessory nerve
H Klumpkes paralysis 8 Posterior interosseous nerve
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Module 5: Musculoskeletal System 2010/2011Q14. Nerve (root value,origin) and vessel (beginning and tributaries)
1 femoral nerve a lumbar plexus (L2,L3,L4) anterior divisions
2 posterior tibial nerve b internal iliac artery (posterior division)
3 superior gluteal artery c largest branch of lumbar plexus (L2,L3,L4)
4 femoral artery d continuation of medial popliteal nerve
5 obturator nerve e external iliac artery
Q15. Muscles
1 Short head of biceps A upper part of medial surface of tibia
2 Peroneus longus B third layer of muscles of sole
3 Sartorius,gracilis,semitendinosus insert into C common peroneal part of sciatic nerve
4 adductor hallucis D fourth layer muscles of sole
5 plantar interossei muscles E musculocutaneous nerve
Q16. Development of bones, vertebrae and muscles
1 example of abnormal muscle a kyphosis
2 vertebrae developed from b intramembranous ossification
3 example of abnormal vertebrae c agenesis
4 muscles developed from d para axial mesoderm of embryo
(sclerotome)
5 Clavicle e myotomes of para axial mesoderm
Q17. Joint and nerve supply, type of joint
1 Ankle a synovial, plane
2 Hip b femoral,obturator,tibial and commonperoneal nerve
3 superior tibio-fibular c synovial,ball and socket
4 talo-calcaneo-navicular d femoral, obturator,sciatic and nerve to
quadratus femoris
5 Knee e anterior and posterior tibial nerves
Q18. TRUE OR FALSE
1. The triceps muscle is innervated by ulnar nerve.2. The long head of biceps brachii passes over the upper end of the humerus INSIDE the capsule of
the shoulder joint.3. Initial heat is due to migration of ions.4. No response occurs on stimulating nerve with constant current.5. High concentration of calcium ions in ECF increases excitability while low concentration of
sodium ions will decrease it.
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[Italian]Buona fortuna! / In bocca al lupo![Spanish]Buena suerte!
[Greek]! (kal thi!)[Germany] Viel Glck! Alles Gute!
[French]Bonne chance ![Dutch]Succes! Veel geluk!
[Russian]!(Udai)
[Scottish] Guid Luck!
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