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565 Cards in this Set

  • Front
  • Back
why is the knee joint capsule incomplete posteriolaterally?
to allow for passage of the popliteus tendon
what is the proximal attachment of the joint capsule of the knee?
superior to the femoral condyles
what is the distal attachment of the joint capsule of the knee?
below the tibial plateau
how many ligaments reinforce the knee?
7
what are the five intrinsic ligaments of the knee?
patellar ligament
fibular / lateral collateral
tibial / medial collateral
arcuate popliteal
oblique popliteal
what are the two extrinsic ligaments of the knee?
anterior cruciate
posterior cruciate
are the extrinsic ligaments of the knee intra or extra capsular?
intra-capsular
what is the patellar ligament continuous with?
the quadriceps tendon
what are the attachments of the patella ligament?
apex of patella
tibial tuberosity
which ligament serves as the anterior portion of the joint capsule of the knee?
patellar ligament
what is the shape of the fibular collateral ligament?
round
cord-like
what are the two menisci of the knee?
medial meniscus
lateral meniscus
what is the function of the menisci of the knee?
fibrocartilage is shock absorbing
improves congruency of joint
what are the four communicating bursae of the knee?
gastrocnemius bursa
anserine bursa
popliteus bursa
suprapatellar bursa
what are the attachments of the patellar tendon/ligament?
apex of patella
tibial tuberosity
which ligament attaches at the lateral femoral epicondyle and the head of the fibula?
fibular (lateral) collateral
what are the attachments of the tibial (medial) collateral ligament?
medial femoral epicondyle
medial tibial condyle
which ligament attached at the middle of the posterior joint capsule of the knee to the expansion of the semimembranosus tendon?
oblique popliteal
what are the attachments of the arcuate popliteal ligament?
posterior surface of the knee joint
fibular head
what is the function of the fibular collateral ligament?
prevents lateral rotation during extension
lateral stability
what is the function of the tibial collateral ligament?
medial stability
what structure of the knee is attached to the tibial collateral ligament?
the medial meniscus
what is the function of the oblique popliteal ligament?
reinforces knee joint capsule posteriorly
what is the function of the arcuate popliteal ligament?
reinforces knee joint capsule posteriorly
what are the attachments of the anterior cruciate ligament of the knee?
posterior lateral condyle of the femur
intercondylar area of the tibia
what is the function of the anterior cruciate ligament of the knee?
prevents hyperextension
prevents posterior displacement of femur
prevents anterior displacement of the tibia
which ligament of the knee attaches at the medial condyle of the femur (anteriorly) and the intercondylar area of the tibia (posteriorly)?
the posterior cruciate ligament
what is the function of the posterior cruciate ligament of the knee?
prevents hyperflexion
prevents anterior displacement of the femur
prevents posterior displacement of the tibia
which is stronger, the PCL or ACL of the knee?
the PCL
what structure would you find between the skin and the anterior surface of the patella?
subcutaneous prepatellar bursa
where would you find the subcutaneous infrapatellar bursa?
between the skin and the tibial tuberosity
what would you find between the femur and the tendon of quadriceps femoris?
suprapatellar quadriceps bursa
where would you find the infrapatellar bursa?
between the tibia and the patellar tendon/ligament
what structure would you find between the lateral tibial condyle and the popliteus tendon?
popliteus bursa
where would you find the anserine bursa?
separating the tendons of sartorius, gracilis, and semitendinosus from the tibia and tibial collateral ligament
what would you find deep to the tendon of the medial head of gastrocnemius?
gastrocnemius bursa
where would you find the semimembranosus bursa?
between the medial head of gastrocnemius and the tendon of semimembranosus
what is a communicating bursa?
a bursa that is channeled between the internal aspect of the joint capsule
what forms the crural fascia?
the blending of the superficial fascia of the thigh and the fascia lata at the knee
where would you find the crural fascia?
between subcutaneous tissue and muscle
what is the proximal attachment of the crural fascia?
continuous with the fascia lata
what is the distal attachment of the crural fascia?
continuous with periosteum of tibia
what forms the superior extensor retinaculum?
thickening of the crural fascia between fibula and tibia
what is formed by the crural fascia thickening between the calcaneus, medial malleolous and plantar aponerosis?
inferior extensor retinaculum
what three functions does the crural fascia serve?
compression of muscles leads to efficient contraction
assists with venous return
retinaculum prevents tendon bulge
list the four muscles of the anterior compartment of the leg
tibialis anterior
extensor digitorum longus
extensor hallucis longus
fibularis tertius
what is the common action of the anterior compartment of the leg?
dorsiflexion
what is the action of tibialis anterior?
dorsiflexion
inversion
what is the location of extensor digitorum longus?
tendons are between fibularis tertius and extensor hallucis longus
what is the action of extensor digitorum longus?
dorsiflexion
extends toes
what muscle would you find between tibialis anterior and extensor digitorum longus?
extensor hallucis longus
what is the action of extensor hallucis longus?
dorsiflexion
extends big toe
which muscle is the most lateral of the anterior compartment of the leg?
fibularis tertius
what is the action of fibularis tertius?
dorsiflexion
eversion
what is the name given to the grouping of gastrocnemius and soleus?
triceps surae
which three muscles make up the superficial posterior compartment of the leg?
gastrocnemius
soleus
plantaris
what is the common insertion for the muscles of the superficial posterior compartment of the leg?
calcaneus via calcaneal tendon
which superficial posterior leg muscle is the most superior?
gastrocnemius
what joints does gastrocnemius cross?
ankle and knee
where would you find the soleus muscle?
deep to gastrocnemius
how would you isolate soleus?
bend the knee
resisted plantarflexion
what is the clinical relevance of soleus?
it is an endurance / postural muscle
what is the action of plantaris?
weak plantar flexion
weak knee flexion
what would you find between calcaneus and the achilles tendon?
retrocalcaneal bursa
where would you find the calcaneal bursa?
between the skin and the achilles tendon
what is the size of the deep posterior compartment muscles compared to the superficial?
small
the muscles of which compartment of the leg pass deep to the flexor retinaculum?
deep posterior
which muscle in the deep posterior compartment of the leg is the only one not to cross the ankle deep to the flexor retinaculum?
popliteus
name of the muscles of the deep posterior compartment from anterior to posterior
tibialis posterior
flexor digitorum longus
flexor hallucis longus
what is the main action of popliteus
it unlocks the knee
what is the location of popliteus?
floor of the popliteal fossa
deep to plantaris
which deep posterior leg muscle is the deepest?
tibialis posterior
what is the action of tibialis posterior?
plantar flexion
inversion
what is the action of flexor digitorum longus (lower leg)
toe flexion
plantar flexion
where would you find flexor hallucis longus?
posterior to flexor digitorum longus and tibialis posterior
what is the action of flexor hallucis longus?
big toe flexion
plantar flexion
what is the clinical significance of flexor hallucis longus?
has a significant role in movement that require a powerful toe off
describe the articulation of the proximal tibiofibular joint
lateral condyle of tibia
head of fibula
what type of joint is the proximal tibiofibular joint?
plane
when does movement occur in the proximal tibiofibular joint?
slight movement during dorsi/plantar flexion
slight movement during inversion/eversion
what type of joint is the distal tibiofibular joint?
fibrous syndesmosis
name the ligaments of the proximal tibiofibular joint
anterior tibiofibular
posterior tibiofibular
name the ligaments of the distal tibiofibular joint
interosseus
anterior tibiofibular
posterior tibiofibular
what is the name for the ankle joint?
talocrural joint
mortise joint
what type of joint is the talocrural joint?
hinge type synovial
describe the articulation of the talocrural joint
convex trochlea of talus
concave tibia and fibula
describe the shape of the articular capsule of the talocrural joint
it is thinner anteriorly and posteriorly
what are the ligaments supporting the talocrural joint?
medial/deltoid collateral
anterior talofibular
posterior talofibular
calcaneofibular
what is the primary movement at talocrural joint?
dorsi/plantar flexion
what are the attachments of the medial / deltoid ligament of talocrural joint?
P: medial malleolus
D: talus, calcaneous, navicular
what is the function of the medial / deltoid ligament of talocrural joint?
stabilizes the ankle during eversion to prevent dislocation
where would you find the anterior talofibular ligament?
lateral ankle
what are the attachments of the anterior talofibular ligament?
talus
fibula
what is the function of the anterior talofibular ligament?
lateral support for the ankle
where would you find the posterior talofibular ligament?
lateral ankle
what are the attachments of the posterior talofibular ligament?
talus to fibula
what is the function of the posterior talofibular ligament?
lateral support for the ankle
where would you find the calcaneofibular ligament?
lateral ankle
what are the attachments of the calcaneofibular ligament?
calcaneus
fibula
what is the function of the calcaneofibular ligament?
lateral support for the ankle
which of the talocrural ligaments is the weakest and most often sprained?
the lateral ligaments
anterior talofibular ligament most often injured
what are the four factors affecting ankle stability?
tendons / retinacula
strong medial and lateral ligaments
shape of the bones increases congruency
position of the trochlea
list the four main tarsal joints
subtalar
talocalcaneonavicular
calcaneocuboid
transverse tarsal
what motions create supination of the foot?
plantar flexion
inversion
adduction
what motions create pronation of the foot?
dorsiflexion
eversion
abduction
what joints are responsible for supination and pronation of the foot?
the tarsal bones (together)
which tarsal joint is considered the anatomical joint of the ankle?
subtalar
what type of joint is the subtalar joint?
plane
what articulates at the subtalar joint?
talus
calcaneus
what movements occur at the subtalar joint?
inversion
eversion
list the ligaments of the subtalar joint
medial talocalcaneal
lateral talocalcaneal
posterior talocalcaneal
interosseus talocalcaneal
what type of joint is the talocalcaneonavicular joint?
ball and socket
what is the articulation of the talocalcaneonavicular joint?
head of talus
navicular
calcaneus
name the ligaments of the talocalcaneonavicular joint
plantar calcaneonavicular ligament
what ligament attaches the sustentaculum tali of the calcaneus to the navicular bone?
plantar calcaneonavicular ligament
what movements occur at the talocalcaneonavicular joint?
gliding
rotary
what type of joint is the calcaneocuboid joint?
plane
what is the articulation of the calcaneocuboid joint?
calcaneous
cuboid
name the ligaments of the calcaneocuboid joint
plantar calcaneocuboid
long plantar ligament
what movements occur at the calcaneocuboid joint?
inversion
eversion
what forms the transverse tarsal joint?
a combination of talocalcaneonavicular and calcaneocuboid joint
the transverse tarsal joint allows for what movements?
inversion
adduction
eversion
abduction
how many tarsal bones are there?
7
name the tarsal bones
talus, calcaneous, navicular, cuboid, medial, intermediate and lateral cuneiforms
which bones make up the hind foot?
talus
calcaneous
which bones makes up the mid foot
nvicular
cuboid
cuneiforms
which bones make up the forefoot?
metatarsals
phalanges
what type of joints are the tarsometatarsal joints?
plane
which joint is the articulation between the distal tarsal bones and the base of the metatarsals?
tarsometatarsal joints
name the supporting ligaments of the tarsometatarsal joints
dorsal
plantar
interosseous
what type of capsule is the articular capsule of the tarsometatarsal joints?
fibrous
what type of movements occur at the tarsometatarsal joints?
gliding
sliding
what type of joints are the intermetatarsal joints?
plane
which joint is the articulation between the bases of adjacent metatarsals?
intermetatarsal joints
what do the intermetatarsals share with the tarsametatarsal joints?
a fibrous joint capsule
name the supporting ligaments of the intermetatarsal joints
dorsal
plantar
interosseous
what do the intermetatarsal joints allow the foot to do?
conform to uneven surfaces
what type of joints are the metatarsal phalangeal joints?
condyloid
list the articulations of the metatarsal phalangeal joints
between metatarsal heads and bases of proximal phalanges
list the supporting ligaments of the metatarsal phalangeal joints
collateral
plantar
what type of joints are the interphalangeal joints of the toes?
hinge
what type of articular capsule is found at the interphalangeal joints?
fibrous
list the supporting ligaments of interphalangeal joints
collateral
plantar
what are the three arches of the foot?
medial longitudinal
lateral
transverse
what structure of the foot improves weight bearing and the adaptability of the foot?
the arches
what maintains the arches of the foot?
the shape of the bones
strong plantar ligaments and aponeurosis
muscles attached to bones of the arches
what function of the foot is supported by pronation?
shock absorption
what function of the foot is served by supination?
propulsion
list the order of bones that handle weight transmission in the lower leg/foot.
tibia - talus - calcaneous - metatarsal heads (2 through5), sesamoid bones of first digit
what makes up the medial longitudinal arch?
calcaneous
talus
navicular
cuneiforms
metatarsals 1 - 3
which is higher, the medial longitudinal arch or the lateral longitudinal arch?
medial
which muscles support the medial longitudinal arch?
tibialis anterior
tibialis posterior
fibularis longus
which bones make up the lateral longitudinal arch?
calcaneous
cuboid
metatarsals 4 - 5
what happens to the lateral longitudinal arch when standing?
it rests on the ground
which bones form the transverse arch of the foot?
cuboid
cuneiforms
metatarsal bases
which muscles support the transverse arch of the foot?
fibularis longus
what is another name of the spring ligament of the foot?
plantar calcaneonavicular
which arch of the foot does the spring ligament support?
medial longitudinal
which ligament supports the lateral arch of the foot?
long plantar
what is the deep fascia of the foot continuous with?
fascia of the leg
inferior extensor retinaculum
describe the plantar aponeurosis
longitudinal
dense, fibrous connective tissue
where would you find the plantar aponeurosis?
extending the entire length of the plantar surface of the foot
what is the proximal attachment of the plantar aponeurosis?
calcaneous
what is the distal attachment of the plantar aponeurosis?
digital tendons
what divides the foot into the medial, lateral and central compartments?
vertical septa formed by the plantar aponeurosis
why is the plantar aponeurosis clinically significant?
contracture can lead to plantar fasciitis
what are the functions of the plantar aponeurosis?
protects plantar aspect from injury
helps support longitudinal arches
holds parts of the foot together
what are the actions of extensor digitorum brevis and extensor hallucis brevis?
assists their longus counterpart
list the muscles of the first layer of the foot
abductor hallucis
flexor digitorum brevis
abductor digiti minimi
list the muscles of the second layer of the foot
lumbricals
quadratus plantae
list the muscles in the third layer of the foot
adductor hallucis
flexor digiti minimi brevis
flexor hallucis brevis
list the muscles in the fourth layer of the foot
plantar interossei
dorsal interossei
what is the action of the plantar interossei?
adduct digits 2-4
flex MTP joints
what is the action of the dorsal interossei of the foot?
abduction of digits 2-4
flex MTP joints
how many plantar interossei muscles are there?
3
how many dorsal interossei muscles are there?
4
which muscles' tendons would you find in the 4th muscle layer of the foot?
tibialis anterior
tibialis posterior
fibularis longus
what is the shape of the popliteal fossa?
diamond
what is the superomedial border of the popliteal fossa?
semimembranous
semitendinosus
what is the superolateral border of the popliteal fossa?
biceps femoris
what is the inferiomedial border of the popliteal fossa?
medial head of gastrocnemius
what is the inferiolateral border of the popliteal fossa?
lateral head of gastrocnemius
what is the roof of the popliteal fossa?
popliteal fascia
what is the floor of the popliteal fossa?
femur
popliteus
what happens to material that the lysosomes don't recognize?
it remains undigested inside the phagosome
what are the systemic manifestations of chronic inflammation?
elevated WBC count
low grade fever
pain
what is a residual body?
a phagosome containing undigested and undigestable substances
is acute inflammation ever useful?
yes
if it resolves the injury, localizes and destroys the injurious agent and the exudates carry away the debris
what are the two patterns of reversible cell injury?
organelle/cell swelling and intracellular accumulation
what two ways can acute inflammation be harmful?
if it incites an autoimmune response
if it is over reactive
what leads to organelle/cell swelling?
failure of the Na/K pump to maintain the electrochemical gradient. Water flows into the cell due to osmotic imbalance
is chronic inflammation ever useful?
no
what are the three categories of intracellular accumulation?
normal endogenous substances
abnormal endogenous substances
exogenous substances
what are exudates?
fluids that exude from injured tissues or capillaries
when too much fat is produced or there is a metabolic dysfunction, this is what kind of intracellular accumulation?
normal endogenous substances
what is the common result of exudates?
edema
if the cell contains certain things that can't be metabolized, what category of intracellular accumulation is this?
abnormal endogenous
what are the causes of edema due to injury?
vasodilation
increased membrane permeability
inability of the lymphatic system to remover IF at the same rate that it is exuding from the capillaries
if the cell contains substances from an outside source that can't be digested/metabolized, what type of intracellular accumulation is this?
exogenous
what are the five type types of exudates?
serous
fibrinous
membranous
purulent
hemorrhagic
irreversible cell injury usually leads to what process?
autolysis
describe serous exudate
low in protein
it is the initial post-injury exudate
what happens during autolysis?
the lysosome ruptures and the hydrolytic enzymes are released into the cytoplasm
which type of exudate is high in fibrinogen and glues structures together and prevents the spread of infection?
fibrinous
is irreversible cell damage and/or autolysis always bad? If not, give an example.
no, sometimes the lysosomes clear away debris and tissue continues to function, such as tissue regression of the uterus after pregnancy.
describe membranous exudate
contains necrotic cells
What is a mixture?
the physical combination of 2 or more substances
what type of exudate contains pus and sometimes needs to be surgically removed?
purulent
what are the two categories of mixtures?
homogenous and heterogenous
describe hemorrhagic exudate
it contains blood
it happens when blood vessels rupture or when red blood cells more into tissue spaces
what are the two components of a solution?
the solvent and the solute
what are the common contents of ALL exudates?
water
inorganic compounds (electrolytes)
small organic molecules (glucose, amino acids)
what is kinetic energy?
the movement of particles
if exudates are not removed, what is the outcome?
the inflammation will not be resolved
what kind of mixture is whole blood?
a suspension
describe the collagen fibre arrangement of tendons
parallel
long bundles
what kind of mixture is blood plasma?
a colloid
what is a tendon sheath?
a connective tissue that wraps around a tendon in areas of high stress
what kind of mixture is blood serum?
a transparent solution
what is the major physiological characteristic of tendons?
very high tensile strength
what seven components are present in whole blood?
water
cells
protein
glucose
amino acids
urea
ions
what two things make tendons and tendon sheaths susceptible to injury?
friction
hypovascularity
what is missing from blood plasma that is present in whole blood?
cells
what are located between tendons and bones and act as cushions to decrease friction?
fat pads
bursae
what is missing from blood serum that is present in whole blood?
cells and proteins
what is tenosynovitis?
inflammation of an ensheathed tendon
Electrolytes are most vital to which two types of tissue?
muscle and nerve
what does hypovascular mean?
decreased capillaries
reduced oxygen and nutrient supply
most salts disolve in water, but some don't. What happens to them and give one example in the body.
They form rocks or crystals. An example is calcium phosophate which forms bone
what does poor perfusion mean to injured tissue?
increased healing time
What is the definition of an isotonic solution?
a solution in which the solute concentration in the extracellular fluid is equal to the solute concentration of the cytoplasm
describe the tendon sheath
inner and outer layer
fluid between the layers
What is the definition of a hypertonic solution?
a solution in which the solute concentration in the extracellular fluid is greater than the solute concentration of the cytoplasm
what is tendonitis?
inflammatory condition affecting a tendon or musculotendinous unit
What is the definition of a hypotonic solution?
a solution in which the solute concentration in the extracellular fluid is less than the solute concentration of the cytoplasm
what are the two common causes of tendonitis?
age/degeneration
tissue fatigue (RSI)
what happens to a cell placed in a hypertonic solution?
the cell will shrink and may crenate
what are possible causes of tendinitis? (5)
overuse
compression of tendon by other structures
joint calcification
joint hypermobility
postural misalignment
what happens to a cell placed in a hypotonic solution?
the cell will swell and may undergo lysis
what are the long term consequences of tendonitis?
muscle weakness
degeneration and fibrosis of the tendon
decreased range of motion
what are the two categories of solutes?
polar substances and electrolytes
why does tendonitis tend to recur?
repetitive use
inadequate recovery time
The body is divided into which two generalized cellular compartments?
intracellular and extracellular
describe the use of hydrotherapy for tendonitis
acute: cryotherapy
sub acute: contrast
chronic: deep moist heat
which fluid is contained in the intracellular compartment?
cytoplasm / cytosol / intracellular fluid
what are the treatment aims for tendonitis?
maintain mobility and tissue health
prevent reinjury
intracellular fluid represents approximately how much volume of overall body fluid?
25 liters
what are the short term treatment aims for tendonitis?
decrease pain
maintain and restore tissue health
what compartment is also referred to as the internal enviroment of the body?
the extracellular compartment
what are the long term treatment aims for tendinitis? (4)
prevent recurrence
increase range of motion
increase muscle strength
decrease scar formation
extracellular fluid represents approximately how much volume of overall body fluid?
15 liters
which chemical mediators are responsible for chemotaxis of leukocytes?
Kinins
(bradykinin and others)
extracellular fluid is subdivided into five addition fluids, name them.
interstitial fluid
blood plasma
lymph
cerebral spinal fluid
synovial fluid
which chemical mediators stimulate fibroblast activity and the repair of damaged tissues?
prostaglandins
substances flowing between the two body compartments are dependant upon which four things?
concentration gradient
particle size
soluability (hydrophobic vs hydrophilic)
type and number of receptors and carriers
which system is the lymphatic sytem part of?
the circulatory system
what are three characteristics of membranes?
thin, selective and fragile
what are the two parts that compose the lymphatic system?
the network of lymph vessels
the lymphoid organs and tissues
starting with the heart, describe the general pathway of fluids in the body
heart
blood vessels (arteries)
interstitial spaces
cells
back to interstitial spaces
blood vessels (veins)
lymph vessels
back to the heart
what are the two main functions of the lymphatic system?
immunity
fluid balance
which two types of pressure determine the movement of substances between compartments?
osmotic pressure and hydrostatic pressure
what do the lymphoid organs do?
filter fluid
phagocytize debris
produce antibodies
control fluid flow
the make up of the intracellular fluid and extracellular fluid is different because of the amounts of what two substances?
the electrolyte concentration and the amount of proteins
what links the immunity role and the fluid balance role of the lymphatic system?
lymph nodes
the differences between the cytoplasm and the interstitial fluid is caused by these three cell characteristics
the hydrophobic nature of the plasma membrane
the selectivity of membrane proteins
solute pumping.
what forces the excess fluid into the interstitial spaces?
hydrostatic pressure inside the capillaries forces plasma into the IS
What is the product of fertilization?
a zygote
which structures collect interstitial fluid?
~ 3/4 is reabsorbed at the venous end of the capillaries
~ 1/4 is absorbed by lymph capillaries
how long is the pre-embryonic period?
2 weeks
why can't protein be absorbed by the venous capillaries?
the particles are too big
What is the name for period of time spanning 9 weeks of pregnancy until birth?
the fetal period
what happens to the protein in the interstitial fluid?
it is absorbed by the lymph capillaries
what are the 6 stages of pre-embryonic development?
zygote
1st mitotic division
early cleavage
morula
early blastocyst
late blastocyst
what characteristic of the lymph capillaries allows the proteins to be absorbed?
the overlapping endothelial cells have loose junctions
The first mitotic division results in the formation of how many identical cells and what is unique about them?
two cells and they are of unequal size
why does protein need to be taken out of the interstitial space?
because if it remains there it will increase the osmotic pressure and cause more fluids to be drawn out of the capillaries and cause swelling and disrupt the fluid balance
how many cells are there at morula formation and describe the conformation of the cells?
16 (or more) and they form a solid ball
how thick are lymph capillaries?
one cell thick
how soon after fertilization does the morula period occur?
72 hours
where will you not find lymph capillaries?
in the central nervous system
what happens during the blastocyst formation?
The morula separates into two parts
what are three ways that lymph capillaries have adapted to their role in the body?
highly permeable
anchored by protein filaments
large openings
what are the names of the two formations created in the early blastocyst period and what are their locations?
cytotrophoblast (the outer layer of cells)
embyonic disc / inner cell mass (the inner layer of cells)
which lymph pathway is superfical?
the collecting vessels of the extremities
what blastocyst formation will form the placenta?
the cytotrophoblast
which lymph pathway is deeper?
the visceral vessels and trunks
what process or event is the end of the pre-embryonic period?
implantation - the blastocyst implants in the uterine wall
which duct drains the lower and the left side of the body?
thoracic duct
What is gastrulation?
the formation of primary tissue layers
which ducts drains the upper right portion of the body?
the right lymphatic duct
When does gastrulation occur?
Around week 3
which two forces determine the movement of fluids between the compartments of the body?
hydrostatic pressure
osmotic pressure
what germ layers form the notochord?
the mesodermal cells
how many liters of fluid move out of the capillaries each day?
24 liters
what is the notochord?
the first axial support for the embryo
how much fluid is reabsorbed at the venule end of the capillary bed?
20 liters
what are the three germ layers?
ectoderm, mesoderm, endoderm
how much fluid each day does the lymphatic system carry?
4 liters
what is organogenesis and what period does it occur in?
the formation of body organs and systems. It occurs during the embryonic period
increased capillary hydrostatic pressure results in what?
decreased drainage of interstitial fluid to lymph / build up of fluid
What tissues arise from the ectoderm?
The epidermis and the nervous system
decreased capillary osmotic pressure results in what?
decreased drainage of interstitial fluid to lymph / build up of fluid
The epithelium of the digestive and respiratory tract arise from which germ layer?
endoderm
inflammation, venous obstruction or surgical removal of the lymph vessels will lead to what?
local increased interstitial fluid
the mesoderm produces which tissues?
muscle and connective tissue including bone, blood and cartilage
which substance is the key contributor to osmotic pressure?
proteins
what four things are happening at the end of the embryonic period?
the bones are beginning to ossify
skeletal muscles are well formed and contracting spontaneously
internal organs continue to develop
rudimentary blood vessels are there to carry blood between the placenta and the embryo.
what are some contributing factos to decreased plasma proteins?
liver disease
malnutrition
kidney disease
what ectodermic process is initiated as a result of signals from the notochord?
neurulation
how much protein leaks out of capillaries each day?
about half of the proteins in circulation
what is the name of the process which forms the nervous sytem?
neurulation
what is the name for generalized, systemic edema that affects the whole body?
anasarca
what are the five structures developed out of neurolation?
neural plate
neural groove
neural folds
neural tube
neural crest
why does increased capillary permeability lead to reduced osmotic pressure?
because the fluid that leaks out takes proteins with it. Less proteins in the capillary means lower osmotic pressure.
what is described as a thickening of the ectoderm overlying the notochord?
the neural plate
inflammatory exudates contain what kinds of things? (4)
plasma proteins
proteins from disintegrating cells
Ab-Ag aggregates
cellular debris from necrotic cells
what is formed by the invagination of the neural plate?
the neural groove
the substances contained in exudates are removed by what system? Why?
by the lymphatic system, because the particles are too big to be removed any other way
when bilateral ridges from along the length of the neural groove what is this called?
the neural folds
what kind of edema is caused by serous exudates?
pitting edema
what is formed from the fusion of two neural folds?
the neural tube
what kind of edema is often associated with chronic edema?
pitting edema
what is the neural crest?
a group of neural cells on the underside of both neural folds
what kind of edema is associated with fibrinous exudates?
non pitting edema
the neural tube gives rise to what two structures?
The brain and the spinal cord
what kinds of injuries are associated with non pitting edema?
acute or sub acute injuries
the neural crest gives rise to which body structure?
The peripheral nerves
describe the feel of pitting edema
boggy
the mesoderm divides into what three sections?
somites
intermediate mesoderm
lateral mesoderm
describe the feel of non pitting edema
springy
name the three somites
sclerotome
dermatone
myotome
what kind of edema results in trophic skin changes?
chronic
the intermediate mesoderm gives rise to what two structures?
reproductive organs and kidneys
what is lymphangitis?
inflammation of lymph vessels
what are the two categories of the lateral mesoderm?
somatic and splanchnic
what is lymphedema?
excess interstitial fluid in the interstitial space and drainage can not keep up
the sclerotome will form what body structures?
the vertebrae and the ribs
what are some causes of dehydration?
excessive sweating
heavy bleeding
severe burns
vomiting
diarrhea
what will form the dermis of the skin and the dorsal part of the body?
the dermatone
what are signs and symptoms of dehydration?
dry mouth
hot, dry, itchy skin
dizziness
tired
fever
mental confusion
The myotome will form what structure(s)?
The bulk of the skeletal muscles
what is the treatment for dehydration?
IV hypotonic infusion
what part of the lateral mesoderm will form the ventral dermis of the skin, the parietal serosa of the ventral body cavities and limb buds?
somatic
what is water intoxication?
decreased solute concentration in interstitial fluid leads to osmosis into cells due to increased osmotic pressure
what structures will arise from the splanchnic part of the lateral mesoderm? (3)
the cardiovascular system
most connective tissue structures
smooth muscle of the gut and the respiratory tract
what happens to cells during water intoxication?
cells and organelles swell ; metabolic disturbances
what are the two general categories of soft tissue?
contractile and non-contractile
what are the signs and symptoms of water intoxication?
nausea
vomiting
muscle cramps
cerebral edema
what are the properties of soft tissue (4)?
pliabe, resistant
loss of resiliency = loss of function
susceptible to injury
lends itself to manipulation
what can cerebral edema lead to?
disorientation
convulsions
coma
death
what is cytology?
study of cells (both structure and function)
what is the treatment for hyponatremia?
IV hypertonic infusion
what is histology?
study of tissues
which organ systems are responsible for maintaining homeostasis?
circulatory
respiratory
digestive
urinary
what are the four basic types of body tissues?
epithelial
connective
nerve
muscle
what does the osmotic pressure of capillaries do?
draws water back into blood volume
the property of a tissue depends on what four things?
chemical composition
types of cells
arrangement of cells
type of extracellular material
what is net filtration pressure?
hydrostatic pressure less osmotic pressure
describe the structure of epithelial tissue (3)
single or multilayers
continuous
tightly linked cells
what type of edema is a reflection of inflammatory condition due to injury?
local edema
what is the function of epithelial tissue?
forms barriers
lends tensile strength
transfer materials (absorption, excretion, secretion, filtration)
what type of edema is secondary to an organ/system dysfunction?
generalized edema / anasarca
If a tissue were described as bundles of cells in a parallel arrangement that are excitable, what type of tissue would it be?
muscle
what are the four major causes of edema?
increased hydrostatic pressure
decreased plasma proteins
increased capillary permeability
blocked lymphatic vessels
describe the structure of nerve tissue
bundles of cells with elongated projections (axons). It is an excitable tissue
what is acidosis?
build up of waste in cells
what is the function of nerve tissue?
tensile strength and flexibility. The degree of which is determined by the amount and arrangement of fibres
describe the relationship between edema and blood pressure
edema causes decreased blood pressure
the heart works harder
blood pressure goes up
hydrostatic pressure increases
increased hydrostatic pressure spurs on the edema
what are the three shapes of epithelial tissue cells?
cuboidal, squamous, columnar
list four pathologies that increase blood pressure and edema
poorly functioning venous valves
thrombosis
chronic congestive heart failure
anything that causes an increase in blood volume
what are the two arrangements of epithelial tissue cells?
simple (single layer)
stratified (multi layers)
what is hypoproteinemia?
decreased proteins
list the seven special characteristics of epithelial tissue
highly cellular/tightly packed
specialized contacts
polarity
basement membranes
innervated
avascular
regeneration
what is the result of hypoproteinemia in blood volume?
more proteins outside the blood capillaries will lead to higher OP in the interstitial space and water will be drawn into the interstitial space and edema will result
what are the two types of specialized contacts in epithelial tissue?
tight junctions and desmosomes
where will anasarca be most prominent in a mobile patient?
the ankles and lower legs
what are the two basement membranes of epithelial tissue?
basal lamina
reticular lamina
where will anasarca be most prominent in a bed ridden patient?
back
sacral area
lungs
serous cavities
what does the basal lamina do?
it's a selective filter
what process is critical to rapid gas exchange in the lungs?
the air sacs must remain dry
the OP in pulmonary capillaries is greater than the HP
therefore very little fluid filters out
what does the reticular lamina do?
resists stretching and tearing
what causes pulmonary edema?
increased HP in capillaries
OR
increased permeability due to hypoxia and inhaled irritants
what is the 'ground substance' and where is it highly abundant?
collagen fibres found abundantly in the extracellular fluid.
chronic congestive heart failure leads to tissue hypoxia which results in what kinds of systemic symptoms? (4)
decreased exercise tolerance
fatigue
weakness
loss of muscle mass
what is the apical surface?
The surface exposed to the outside, the free surface
what happens systemically if the kidneys don't filter water and wastes properly?
electrolyte and water imbalances
accumulation of urea
salt and water accumulate and increase blood volume
blood pressure increases
edema occurs in dependent parts which can then shift at night and lead to pulmonary edema.
what is the basal surface?
The surface facing internal structures
what is a microbe?
a microscopic living or non-living organism
what is the state of most of the cells of the epidermis?
They are dead
List the layers of the epidermis from deep to superficial
basale
spinosum
granulosum
lucidum
corneum
what are the four categories of organisms based on how they obtain nutrients?
autotroph
heterotroph
saprophyte
parasite
which two layers of the epidermis contain dead cells?
corneum and lucidum
I synthesize organic compounds from inorganic ones
autotroph
I require a supply of organic compounds
heterotroph
which layer of the epidermis is the most superfical layer to receive blood?
granulosum
I eat only dead organic matter
saprophyte
what is unique about the basale layer of cells?
it is regenerating
I live on or in other organisms
parasite
what type of protein is collagen and what does it tell you about its function?
a fibrous protein and therefore lends strength and support to the skin
what are the five classes of infectious microbes?
prions and viruses
bacteria
chlamydiae or Rickettsia
fungi
parasites, protozoa
what is the function of elastin?
provides stretch and flexibility
what does eukaryotic mean?
an organism with cell nucleus surrounded by a membrane
what causes wrinkles or scars to form?
Collagen replaces elastin in the skin.
what is a host?
the organism supporting the nutritional needs and physical environment of another organism
what is present in the dermis that makes it an active part of healing injuries?
white blood cells
list three ways that a parasite can cause harm to its host
deplete nutritional resources
release toxic waste products
incite adverse immune responses
what are the two layers of the dermis?
papillary layer
reticular layer
what is a parasitic relationship?
parasite benefits, host is harmed
which layer of the dermis is the superficial layer?
papillary layer
what is a symbiotic relationship?
both host and parasite benefit mutually
which layer of the epidermis is the source of all epidermal cells?
the basale
infection
parasites present and multiplying within host
which layer of the epidermis is attached to the dermis?
the basale
infected
organism is invaded by parasite
what are the two major functions of the skin?
protective and sensory
infectious disease
state where host is injured
what are the four types of cells in the epidermis?
keratinocytes
melanocytes
Langerhans
Merkel
pathogen
disease causing parasite
which epidermal cells are tough and protective?
keratinocytes
pathogenicity
ability of a parasite to cause disease
where are melanocytes found and what do they do?
in the basale layer and they protect from UV radiation
virulence
severity of disease process
which cell type is found in the spinosum layer and what are their functions?
Langerhans. They are immune cells that destroy foreign substances
describe the 'effect' of prions
neurodegenerative
slow, progressive
loss of coordination
dementia
where do you find Merkel cells and what do they do?
at the junction of the dermis and the epidermis - they sense light touch
what is the treatment for prion infection?
none
resistant to chemical and physical sterilization
what are the six components of the dermis?
blood
lymph vessels
sensory nerve endings
sweat glands
sebaceous glands
smooth muscles
what causes the neurodegeneration in a prion infection?
build up of protein
what do lymph vessels do?
they drain excess interstial fluid and return it to systemic circulation
what does obligate intracellular parasite mean?
it can not replicate outside the cell
what are the smooth muscles of the dermis called?
errector pili
viruses are living or non-living?
non - living
what are the protective functions of the skin?
first line of defense
prevents excess water from leaving or entering
protects against radiation
barrier (chemical, physical, biological)
a virus consists of what three things?
a capsid (a protein coat)
nucleic acid core (DNA or RNA)
a lipoprotein envelope (from the host)
what are the six general functions of the skin?
protective
temperature regulation
metabolic
blood resevoir
excretion
cutaneous sensation
how does a virus synthesize its components?
it hijacks the host cell's mechanisms
what are the three ways that skin regulates temperature?
sweating, shivering, oily secretions
how do viral particles 'spread'? (2)
host cells burst and viral particles are released to infect new cells
budding out of host cells
what type of sweating occurs only at rest?
insensible perspiration
what are the two life cycles of viruses?
lytic cycle
latent cycle
what is the metabolic function of skin?
converts amodified form of cholesterol into a precursor of vitamin D
describe the virus lytic cycle
infection
replication
lysis
release of virions
How much of the total blood volume can the skin hold?
5%
what happens in the latent cycle?
viral DNA is inserted into host chromosomes
replication occurs later and begins lytic cycle
what substances does the skin excrete?
water
salt
nitrogenous wastes (urea, ammonia, uric acid)
what four things can viruses interfere with?
DNA replication
RNA synthesis
protein synthesis
energy production
what does cutaneous sensation allow us to do?
note changes in the environment
what does the body produce to interfere with virus replication?
interferons
what does prokaryote mean?
lacking a true nucleus
bacteria - prokaryote or eukaryotic>
prokaryotes
what classification (by nutrient gathering) does bacteria belong to?
heterotroph
describe the structure of bacteria
cell membrane
simple cell structure
how do bacteria reproduce?
asexually - through mitosis
what kinds of life sustaining functions do bacterial engage in? (5)
energy production
protein synthesis
maintaining boundaries
DNA replication
cellular reproduction
do bacteria need a host cell?
no
are the majority of bacteria harmful or helpful?
helpful
the bacteria that are pathogenic, where do they multiply?
in blood and CSF etc
mostly extracellular
what causes the damage to the host from a pathogenic bacteria?
toxins excreted by the bacteria lead to pathological tissue damage
what are the three shapes of bacteria?
cocci
spirrilla
baccilus
a spherical shaped bacteria
cocci
describe the shape of spirrilla bacteria
helical
elongated shaped bacteria
baccilus
describe / define prions and viruses
obligated intracellular parasite
non living infectious particle or organism
what is an autonomously replicating unicellular organism?
bacteria
describe / define prions, chlamydiae and rickettsia
obligated intrecellular parasites with both viral and bacterial characteristics
what is a free living, eukaryotic saprophyte
fungi
describe / define parasites/protozoa
single celled, smallest members of the animal kingdom
what are the three classification of chronic bronchitis?
simple - no airway obstruction, cough
mucopurulent - pussy mucus
asthmatic - hyperresponsive airways
what is degluition?
swallowing
the presentation of late stage bronchitis is related to what?
hypoxemia
list the two swallowing phases
buccal
pharyngeal-esophageal
compensatory measures in chronic bronchitis lead to what?
pulmonary hypertension
right sided heart failure
chronic respiratory failure
which swallowing phase is voluntary?
buccal
what is the treatment for chronic bronchitis?
smoking cessation
nutrition - fluid blance
mobilization of secretions
which swallowing phase is involuntary?
pharyngeal-esophageal
what is bronchiectasis?
disorders characterized by permanent dilation of the bronchi and bronchioles
what controls the pharyngeal-esophageal phase of swallowing?
medula
pons
cranial nerve/vagus nerve impulses
what are the two types/causes of bronchiectasis?
acquired (TB, CF, chronic bronchitis)
congenital (abnormal bronchi development)
describe the relationship of the esophagus, trachea and larynx
the esophagus lies posterior to the trachea and the larynx
which condition can cause thick, foul smelling greenish frothy sputum?
bronchiectasis
at which vertebral level does the esophagus transect the diaphragm?
T11
what is cystic fibrosis?
inherited disorder of exocrine glands and mucus secreting glands
what is achalasia?
incomplete relaxation of the lower esophageal sphincter in response to swallowing
which organ passageways are commonly obstructed in CF?
respiratory airways
pancreatic / GI ducts
what results from achalasia?
food stasis in the esophagus
can lead to inflammation and esophagitis
in someone in CF, the changes in mucus are secondary to what?
chloride ion transportation defect which leads to a disturbance in fluid and electrolyte transport
what is gastroesophageal reflux?
backward movement of the contents of the stomach
what are the two organ systems that have clinical presentations in CF?
digestive
respiratory / pulmonary
what causes the burn of gastroesophageal reflux?
stomach acids come in contact with the unprotected mucosal surface of the esophagus
what is the common cause of pulmonary embolism?
thrombi from the deep veins in lower legs and pelvis
what is esophagitis?
inflammation of the esophageal mucosal wall
where does a pulmonary embolism lodge?
right side of heart or lungs
what are signs and symptoms of esophagitis?
heartburn
chest pain (replicates angina pectoris)
belching
what is pulmonary hypertension?
elevated pressure in the pulmonary arterial system
what is esophageal diverticulum?
posterior outpouching of the esophageal wall due to weakness of the muscularis
list states that predispose to secondary pulmonary hypertension
increased left atrial pressure
increased pulmonary blood flow
increase pulmonary vascular resistance
what is the main issue with diverticula?
food is retain in the outpouching which can ferment and cause bacteria to grow
what is plural effusion?
accumulation of fluid in the pleural cavity
what are the two types of hiatal hernias?
sliding
rolling
what is pneumothorax?
air in the pleural cavity
describe a hiatal hernia
protrusion of a segment of the stomach above the diaphragm
what is atelectasis?
collapse of part or all of a lung
what are the symptoms of a hiatal hernia?
discomfort
pain
dysphagia
what mechanical issue can cause pleural inflammation?
loss of serous fluid leads to friction between the visceral and parietal layer
describe a sliding hiatal hernia
upward displacement of the esophagogastric junction. The hernia slide upwards when supine and moves back down in the upright position
which actions aggravate pleural pain?
deep breathing
coughing
describe a rolling hernia
-a defect or weakness of the diaphragmatic esophageal hiatus
-the fundus bulges through the diaphragmatic opening and does not move back
pleural effusion is a form of......?
edema
how much can the stomach hold?
up to 4L
what is hemothorax?
accumulation of blood in the thoracic cavity
a type of pleural effusion
what is the name for the proximal area of the stomach and what is its purpose?
fundus
storage
what happens to the pressure gradient with pnuemothorax?
intrapleural pressure approaches zero (no longer relatively negative)
what is the name for the distal area of the stomach?
pylorus
what are the three types of pneumothorax?
spontaneous
traumatic
tension
what are the major contributing factors for esophageal cancer?
smoking
alcohol consumption
food stasis
persistent achalasia
what is the cause of primary spontaneous pneumothorax?
blebs on the lung that rupture and leak air into the pleural cavity
what is the prognosis for esophageal cancer?
poor due to late diagnosis
what is tension pneumothorax?
injury to respiratory structures or chest wall leads to air entering the pleural cavity but not leaving
how many layers of muscle does the stomach have?
3
what is the cause of neonate/primary atelectasis?
lack of surfactant
List the layers of stomach muscles from outer to inner
longitudinal layer
circular layer
oblique layer
what is the cause of secondary or acquired atelectasis?
airway obstruction - mucus plug
lung compression - tumour
what is the role of the mesenteries of the stomach
anchor the stomach to the body wall and other organs
which area of the lung is most often affected by lung cancer?
bronchial epithelium
where would you find mucus neck cells and what do they do?
in the stomach
secrete mucus
what are some types of non-small cell lung carcinoma?
squamous cell carcinoma
adenocarcinoma
large cell carcinoma
where would you find parietal cells and what do they do?
in the stomach
secrete hydrochloric acid and intrinsic factor
what structures make up the urinary system?
kidney
ureter
bladder
urethra
where would you find chief cells and what do they do?
in the stomach
secrete digestive enzymes
where are the kidneys located?
upper lumbar region
lateral to T12 - L3
what does the enteroendocrine gland in the stomach secrete?
gastrin
the concave surface of the of the medial kidney is knows as that what?
renal hilus
where are secretions in the stomach released into?
gastric pits
what travels in and out of the renal hilus and sinus?
lymphatics
renal blood vessels
ureters
nerves
what is the main pro-enzyme released by chief cells?
pepsinogen
name the layers of support for the kidney from innermost to outermost
renal capsule
adipose capsule
renal fascia
which substance mediates the activation of pepsinogin?
hydrochloric acid
the renal arterial blood supply branches from which artery?
abdominal artery
what stimulates the secretion of HCl and pepsinogen?
gastrin
which structure is the functional unit of the kidney?
the nephron
what inhibits gastrin secretion?
secretin
CCK (cholecystokinin)
where in the kidney would you find the majority of nephrons?
in the medulla
name the three sites and phases to the regulation of gastric secretions
brain - cephalic phase
stomach - gastric phase
intestine - intestinal phase
name the two parts of the nephron
the glomerulus
renal tubule
which areas of the brain are responsible for the cephalic phase of gastric secretion?
cortex
hypothalamus
vagal nuclei in medulla
what collects the filtrate from the glomerular capillaries?
Bowman's capsule
when is the gastric phase initiated?
when food reaches the stomach
what structures would you find wrapped around the nephron and what is their function?
peritubular capillaries
they reabsorb substances from the filtrate
low acidity and peptides in the stomach will do what?
excite the secretion of gastrin
what are the three layers of the glomerular membrane?
1. endothelial layer (inside capillary)
2. basement membrane (collagen and proteoglycans)
3. epithelial layer (forms podocytes)
which substance promotes the secretion of acids and enzymes necessary for protein digestion?
gastrin
which three forces move fluid out of the glomerulus into Bowman's capsule?
glomerular hydrostatic pressure
blood colloid osmotic pressure
capsular hydrostatic pressure
what are the two components to the intestinal phase of gastric secretion?
excitation
inhibition
which three fluids are involved in clearing wastes out of the body?
blood
glomerular filtrate
urine
describe the excitation part of the intestinal phase of gastric secretion
a brief period of enhanced secretion when the stomach begins to empty into the duodenum
name the three processes involved in urine formation
glomerular filtration
tubular reabsorption
tubular secretion
describe the inhibition part of the intestinal phase of gastric secretion
gastric secretion is stopped after chyme is emptied as it is no longer needed
what is the equation explaining net filtration pressure?
NFP = GHP - (OP + capsular HP)
what are some factors in the cephalic phase that will inhibit gastric secretions?
depression
lack of cortical stimulation
the glomerular filtration is rate is defined as...?
the amount of fluid passing through the glomerular membrane per minute
what are some factors in the gastric phase that will inhibit gastric secretions?
emotional upset
stress
excess acid
what happens if the glomerular membrane becomes hyperporous?
substances such as proteins and blood cells pass through
what are some factors in the intestinal phase that will inhibit gastric secretions?
distension of the intestine
presence of digestion producta
what happens if the glomerular membrane becomes hyporporous?
there is a build up of metabolic wastes in the blood
a high fat meal enhances the secretion of...
bile
pancreatic juice / lipase