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548 terms

Musculoskeletal System

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Excitability
The ability to receive and respond to a stimulus.
Tetanus
A smooth, sustained muscle contraction resulting from high-frequency stimulation.
Intent period
Period of time between stimulation and the onset of muscle contraction.
T tubules
Extensions of muscle cells plasma membrane (sarcolemma) that protrudes deeply into a muscle cells.
Sarcomere
The smallest contractile unit of muscle; contains myofilaments, composed mainly of contractile proteins, actin, and myosin.
Fascicle
A bundle of muscle cells bound together by connective tissue.
Articular capsule
Double-layered capsule composed of an outer fibrous capsule lined by a synovial membrane; encloses the joint cavity of a synovial joint.
Symphysis
A joint in which the bones are connected by fibrocartilage.
Synchondrosis
A joint in which the bones are united by hyaline cartilage.
Syndesmosis
A joint in which the bones are united by a ligament or a sheet of fibrous tissue.
Synastosis
a completely ossified joint; a fused joint.
Diarthrosis
A freely movable joint; also called a synovial joint.
Amphiarthrosis
A slightly movable joint.
Synarthrosis
Immovable joint.
Articulation
A joint; point where two bones meet.
Appositional growth
Type of growth where all bones grow in thickness.
Alkaline phosphatase
What enzyme encourages deposit of calcium salts within the osteoid.
Osteoclasts
bone-destroying cells that contain lysosomes and phagocytic vacuoles.
Sesamoid bone
A special type of short bone embedded within a tendon or a joint capsule.
Osteoid
Unmineralized bone matrix
Osteon
The structural and functional nit of compact bone; also called a Haversian system.
Periosteum
Dense connective tissue covering a bone.
Epiphyseal plate
Plate of hyaline cartliage at the junction of the diaphysis and epiphysis that provides for growth in length of a long bone.
Epiphysis
The ends of a long bone, attached to the shaft.
Diaphysis
The elongated shaft of a long bone.
Ionotropic
Affecting muscle contraction or having an affect on the force of muscle contraction.
Langerhan's cells
Cells that arise from the bone marrow and migrate to the epidermis within the stratum spinosum.
Smooth muscle
Spindle-shaped cells w/ central nuclei; cells arranged closely to form sheets; no striations. Located mostly in the walls of hollow organs. Functions to propel substances or objects (foodstuffs, urine, a baby), along internal passageways.
Cardiac muscle
Branching, striated, generally uninucleate cells that interdigitate at specialized junctions (intercalated discs). Located in the walls of the heart. Functions to contract; propels blood into the circulation; is controlled involuntarily.
Skeletal muscle
Long, cylindrical, multinucleate cells; obvious striations. Locate din skeletal muscles attached to bones or occasionally to skin. Function is voluntary movement; locomotion;manipulation of the environment; facial expression. Voluntary control.
Bone (osseous tissue)
Has a hard, calcified matrix containing many collagen fiber; osteocytes lie in lacunae. Very well vascularized. Located in bones. Functions to support and protect (by enclosure); provides levers for the muscles to act upon; stores calcium and other minerals and fat; marrow inside the bones is the site for blood cell formation.
Elastic cartilage
Similar to hyaline cartilage, but more elastic fibers in matrix. Located in the external ear (pinna); epiglottis, Functions to maintain the shape of a structure while allowing great flexibility.
fibrocartilage
Matrix similar but less firm those in hyaline cartilage; collagen fibers predominate; ligament-like. Located in intervertebral discs; pubic symphysis; discs of knee joints. Has tensile strength w/ability to absorb compressive shock.
Hyaline cartilage
Amorphous but firm matrix; collagen fibers form an imperceptible network; chondroblasts produce the matrix and when mature (chondrocytes) lie in lacunae. Forms most of embryonic skeleton, covers ends of long bones in joint cavities; forms cartilages of nose, trachea, and larynx. Supports and reinforces; stands up to wear and tear; has resident cushioning properties; resists compressive stress.
Elastic protective tissue
Same as for other dense connective tissues, but predominant fiber type is elastin. Found in walls of the aorta, some parts of trachea and bronchi; forms the vocal cords and the ligaments connecting the vertebrae. Provides durability w/ stretch.
Dense irregular connective tissue
Primarily irregularly arranged collagen fibers; some elastic fibers; major cell type is the fibroblast. Located in the dermis of the skin; submucosa of digestive tract; fibrous capsules of organs and of joints; fascia. Able to withstand tension exerted in many directions; provides structural strength.
Dense regular connective tissue
Has primarily parallel collagen fibers; a few elastin fibers; major cell type is the fibroblast. Found in tendons, most ligaments, aponeuroses. Functions to attach muscles to bones or to muscles; attach bones to bones; withstands great tensile stress when pulling force is applied in one direction.
Recticular connective tissue
Has network of reticular fibers in a typical loose ground substance; reticular cells predominate. Found in liver, lymph nodes, bone marrow, and spleen. Fibers form a soft internal skeleton that supports other cell types; some are phagocytic and play a role in body protection.
Adipose tissue
Matrix is as areolar, but very sparse; closely packed adipocytes or fact cells, have nucleus pushed to the side by large fat droplet. Found under the skin; around the kidneys and eyeballs; in bone and w/in abdomen; in breasts. Provides reserve food fuel; insulates against heat loss; supports and protects organs.
Areolar connective tissue
Type of tissue with gel-like matrix with all three fiber types; cells: fibroblasts, macrophages, mast cells, and some WBCs. Widely distributed under epithelia of body, e.g., forms lamina propria of mucus membranes; packages organs; surrounds capillaries. Functions to wrap and cushion organs; its macrophages phagocytize bacteria; play important role in inflammation; holds and conveys connective tissue fluid.
Mesenchyme
Type of connective tissue (embryonic); is gel-like ground substances containing fine fibers; star-shaped. Found primarily in the embryo, and gives rise to all other connective tissue types.
Ground substances
An amorphous material that fills the space between the cells and contains the fibers. It is composed of interstitial fluids, glycoprotein, and glycosaminoglycans (GAGs) a diverse group of large, negatively charged polysaccharides.
Intrathecal
Introduced into or occurring in the space under the arachnoid membrane of the brain or spinal cord.
Theca
An enveloping case or sheath of an anatomical part.
What is the T system of the sarcolemma?
The T system is successive groupings of the three membraneous structures terminal cisterna, T tubule, terminal cisterna. They receive nerve stimulus and provides inlets through which glucose, oxygen, and various ions can be brought into muscle cells.
What is the major role of the sarcoplasmic recticulum?
Regulate intracellular levels of ionic calcium.
Who proposed the sliding filament theory of contraction?
Hugh Huxley (1954)
Latent period
The period between action potential generation and the beginning of mechanical activity, or muscle cell shortening. It is several millions long.
Troponin
Major muscle protein in the thin filament that is actually a complex of three polypeptides. One of these polypeptides (Tn1) binds to actin; another (TnT) binds to tropomyosin and helps it position an action; the third (TnC) binds calcium ions.
Fasciculation
Spontaneous contractions of individual motor units in a muscle, causing a visible twitching or dimpling of the overlying skin' may start and stop for no apparent reason,but may reflect extreme muscle irritation or degenerative nerve system disease.
Thenar
Region of the palm or base of thumb
Prime mover
Muscle that bears the major responsibility for affecting a particular movement; agonist.
Antagonist
Muscle that reverses, or opposes, the action of another muscle.
Synergist
Muscle that aides the action of a prime mover by effecting the same movement or by stabilizing joints across which the prime mover acts to prevent undesirable movements.
Fixator
Muscle that immobilizes one or more bones, allowing other muscles to act from a stable base.
Frontalis
Covers forehead and dome of skull; no bony attachments. Point of origin; galea aponeurotica. Point of insertion: skin of eyebrows and root of nose. With aponeurosis fixed, raises the eyebrows; antagonist of obicularus oculi. Nerve supply: cranial nerve 12.
Occipitalis
Overlies base of occiput; by pulling on the galea, fixes origin of frontalis. Point of origin- occipital bone, point of insertion-galea aponeurotica. Action: fixes aponeurosis and pulls scalp posteriorly. Inervated by cranial nerve 12.
Corrugator supercili
Small muscle; activity associate with that of orbicularis oculi; O: arch of frontal bone above nasalbone; Insertion: skin of eyebrow. Action: draws eyebrows together; wrinkles skin of forehead vertically (as in frowning.)
Cranial Nerve 12.
Orbicularis oris
Thin, flat sphincter muscle of eyelid; surrounds rim of the orbit; paralysis results in drooping of lower eyelid and spilling of tears. Origin-frontal and maxillary bones and ligaments around orbit. Insertion: tissue of eyelid. Action: protects eyes from intense light and injury; various parts can be activated.
Zygomaticus
Muscle pair extending diagonally from corner of mouth to cheekbone. Origin: zygomatic bone. Insertion: skin and muscle at corner of mouth. Action: raises lateral corners of the mouth upward (smiling). Cranial nerve 12
Risorius
Slender muscles running beneath and laterally to zygomaticus. Origin: lateral fascia associated with massater muscles. Insertion: skin at angle of mouth. Action: draws corner of liplaterally; tenses lips; synergist of zygomaticus. CN 12.
ATPase
Enzyme that hydrolyzes ATP.
What are the three pathways by which ATP is generated during muscle activity?
Interaction of ADP w/ creatine phosphate
Aerobic respiration
Anaerobic respiration
Which metabolic pathway does smooth muscle use for ATP synthesis?
Anaerobic pathways
What connective tissue proteins are synthesized by smooth muscle cells?
Collagen and elastin
What is found in the sarcoplasm of a muscle fiber that is not found in other cell types?
Large amounts of stored glycogen and myoglobin.
Fascicle
A bundle of muscle cells bound together by connective tissue.
Sarcoplasmic recticulum
The smallest contractile uit of muscle; contains myofilaments composed of mainly of contractile proteins, actin, and myosin.
Motor unit
A motor neuron and all the cells it stimulates.
Isotonic contraction
A contraction in which muscle tension remains constant and the muscle shortens.
Myofibril
A rodlike bundle of contractile filaments found in muscle cells; composed of individual sarcomeres.
Levator labii superioris
Thin muscle between obicularis oris and inferior eye margin. Origin: zygomatic bone and infraorbital margin of maxilla. Insertion: skin and muscle of upper lip. Action: opens lips, raises and furrows upper lip; flares nostril as in disgust). CN 12.
Depressor anguli oris
Small muscle lateral to depressor labii inferioris. Origin: body of mandible below incisors. Insertion: skin and muscle at angle of mouth below insertion of zygomaticus. Action: Zygomaticus antagonist; draws corners of mouth downward and laterally (as in "tragedy mask" grimace). CN 7
Buccinator
Thin, horizontal cheek muscle; principal muscle of cheek; deep to masseter. Origin: molar region of maxilla and mandible. Insertion: orbicularis oris; fibers form deep portion of lips. Action: Draws corner of mouth laterally; compresses cheek. CN 7.
Osteoblasts
Principal bone building cells; they synthesize collagenous fibers and bone matrix and promote mineralization during ossification. they become trapped in their own matrix and develop into osteocytes that maintain bone tissue.
Nutrient foramina
Small openings in bone that permit the entry of vessels for the nourishment of living tissue.
Where are the principal sites of hematopoiesis?
Red bone marrow of the sternum, vertebrae, portions of the ox coxae, and proximal epiphyses of the femora and humeri.
Loose bodies
Small pieces of bone or cartilage within a joint capsule; usually reflect joint trauma or the wearing away of part of the articular cartilage, which exposes the surface of bone beneath, causing it to die or separate; symptoms are painful catching or locking of the joint; unless surgically removed, promote osteoarthritis.
Give examples of multiaxial joints
Ball and socket-shoulder and hip joints.
Give examples of biaxial joints
Condyloid joints- radiocarpal joints, metacarpaphalangeal, atlantoccipital joint

Saddle-carpometacarpal joints of thumbs
Give examples of uniaxial joints
1. Hinge -elbow, interphalangeal, knee joints.
2. Pivot joints- joint between the axis and atlas- proximal radioulnar joint.
Give examples of plane joints
Intertarsals, intercarpal, sternoclavicular and joints between vertebral articular processes.
Gomphoses
A fibrous joint represented solely by the articulation of a tooth with its bony alveolar socket.
Bursae
Flattened fibrous sacs lined w/ synovial membrane and containing a thin film of synovial fluid Common is sites where ligaments, muscles, skin, or muscle tendons rub against bone.
Articulate
To from the kind of joint or connection that allows movement.
Synovial joints
Joints which separated bones by a fluid-filled cavity. Permits substantial freedom of movement, and all synovial joints are freely moveable diarthrotic joints.
Condyle
Large, rounded articulating surface.
Head
Prominent, rounded articulating end of bone.
Facet
Flattened or shallow articulating surface.
Process
Any bony extension.
Tubercle
Smal, rounded process.
Tuberosity
Large, roughened process.
Trochanter
Massive process found only on the femur.
Spine
Sharp, slender process.
Crest
Narrow, ridge-like projection.
Epicondyle
Projection above a condyle.
Fossa
Shallow depression.
Sulcus
Groove that accommodates a vessel, nerve, or tendon.
Fissure
Narrow, slit-like opening.
Meatus
Tubelike passageway.
Alveolus
Deep pit or socket.
Foramen
Rounded opening through a bone.
Sinus
Cavity or hollow space.
Fovea
Small pit or depression.
Red bone marrow of the sternum, vertebrae, portions of the ossa coxae, and the proximal epiphyses of the femora and humeri.
Principal site of hematopoiesis.
True in that linear bone growth does cease as the epiphyseal lines replace the epiphyseal plates and ossification occurs between the epiphyses and diaphyses. However, diametric bone growth and enlargement of bony processes occur at any time to accommodate an increase in body mass.
T or F. Bone growth ceases as a person reaches physical maturity.
C. Marfan's syndrome
This genetic disorder causes a defect of the connective tissue.

A. Turner's syndrome
B. Cystic fibrosis
C. Marfan's syndrome
D. Hemophilia
E. Huntington's chorea
There are 206 bones in the human body. Axial skeleton contains 80 bones and the appendicular skeleton includes 126 ones.
How many bones are in the human body?
Metaphysis
Portion of long bone that connects the epiphysis to the diaphysis. In growing bone, this region is referred to as the epiphyseal plate or growth plate. In mature bone, this region is called the epiphyseal line.
Medullary cavity
This is the hollow space of the diaphysis. Contains fatty yellow bone marrow.
Endosteum
Lines the medullary cavity and contains osteogenic and osteoclast bone cells.
The formation of bone can happen in one of two ways:
1. Intramembranous ossification-refers to the formation of bone within fibrous connective tissue.
2. Endochondral ossification-refers to the formation of bone in hyaline cartilage.
In which ways can we form bone?
The flat bones of the skull, mandible, and fontanels.
What are examples of bones that ossified through intramembranous ossification?
The long bones of the upper and lower extremities.
What are examples of bones that ossified through endochondral ossification?
Zone of resting cartilage
Zone of proliferating cartilage
Zone of hypertrophic cartilage
Zone of calcified cartilage
What are the stages or zones that lead to bone growth in length?
Synchondroses, symphyses, and synovial joints.
What are examples of cartilagenous joints?
Ball and socket joints
Hinge joints
Pivot joints
Saddle joints
Condyloid joint
Gliding joint
What are examples of synovial joints?
Osteoporosis
This is a decrease in bone mass due to a demineralization of calcium. It is more common in women, especially after menopause. Because of the decrease in bone quantity, the bones may become brittle. This can cause multiple compression fractures of the vertebrae, leading to humpback (hyperkyphosis).
Osteomalacia
Softening of the bones as a result of a vitamin D deficiency in adults. Vitamin D is needed for normal calcium absorption. Pseudofractures may result.
Rickets
Softening of the bones as a result of vitamin D deficiency in children. Condition can result in multiple costochondral bumps called the rachitic rosary and also a protrusion of the skin called pigeon breast or pectus carinatum.
Osteitis deformans
Also known as Paget's disease and is an increase in bone density. This disease affects the spine, skull, and pelvis of geriatric patients and is idiopathic.
Osteitis fibrosa cystica
Also known as "Von Reckinghausen's disease of the bone," this disease causes osteolytic lesions of the bone.
Osteopetrosis
This condition is an increase in bone density that occurs because of the inactivity of osteoclasts.
Gout
Also known as the "disease of the kings," this is a defect in the way purines are metabolized. This results in uric acid crystals building up in the joints, especially the metatarsophalangeal joint of the big toe. This is called podagia.
Osteoid osteoma
Benign bone tumor that commonly occurs in the neck of the femur, the distal end of the femur, and the proximal tibia. More common in males between the ages of 10 to 25.
Osteoma
Benign tumor that occurs in the skull, the bones of the face, and the paranasal sinus.
Enchondroma
Benign tumor made of cartilage and is most commonly found on the hands and feet.
Osteochondroma
Benign tumor occurs at the distal end of the femur and the proximal end of the tibia, and is most common in males under the age of 25.
Giant cell tumor
Benign tumor that occurs at the distal end of the femur and the proximal tibia. These tumors most commonly occur in women between the ages of 20 and 40. Giant cell tumors look like soap bubbles on X-ray.
Osteosarcoma
This type of malignant bone tumor usually affects the proximal and distal femur, the proximal tibia, and the distal humerus. Osteosarcomasa are very malignant, with the capacity to metastasize to lung tissue. These primary bone tumors are the most common and usually affect people between the ages of 20 and 40, although they can occur at any age.
Chondrosarcoma
This is a malignant tumor of cartilage. Tumors of this type are most often primary and occur in people who have multiple endochondromas (benign cartilage tumors). These tumors normally affect the vertebrae, bones of the pelvis, ribs, femur, and tibia.
Ewing's sarcoma
This malignant bone tumor is the most common primary lesion between the ages of 10 and 20 and affects males more than females. These tumors affect the diaphysis of the long bones in the lower extremity.
Multiple myeloma
This is a malignancy of plasma cells. Multiple myeloma result sin hypercalcemia as a result of the destruction of bone tissue. This destruction creates "punched-out lesions" in the axial skeleton. This disease is most common in males ages 50 to 70.
Osteoarthritis
A noninflammatory type of joint disease. This condition is most commonly related to or the result of wear and teat or the joint caused by repetitive stress. Presents with a decrease in joint space and bone "lipping and spurring."
O.A. presents with pain and stiffness in the morning after awakening and after rest, usually relieved by activity.
What are the signs and symptoms associated with OA?
Rheumatoid arthritis
A systemic, chronic inflammatory form of arthritis of autoimmune origin. Starts as an inflammation of the synovial joint linings, with edema, hyperplasia, and then hypertrophy of the synovial joint lining. Granulation tissue forms and erodes adjacent bone tissue (pannus).
R.A. presents as pain and swelling, especially in the proximal interphalangeal and metacarpophalangeal joints of the upper and lower extremities and the knees. Ulnar deviation due to joint destruction and ligament laxity is a common sign.
What are the signs and symptoms of R.A.?
Ankylosing spondylitis
Also known as Marie-Strumpell disease and is a systemic inflammatory disease mainly males between the ages of 10 and 20.
A.S. commonly presents as sacroiliac joint and spine pain, especially at night, and pain int he larger joints of the extremities. If untreated, kyphosis is common.
What are the signs and symptoms associated with A.S.?
Rieter's syndrome
An inflammatory disease that is usually the result of a venereal disease or intestinal disease.
Rieter's syndrome presents with inflammation of the urethra, eyes, and joints of the lower extremity.
What are the signs and symptoms of Rieter's syndrome?
Avascular necrosis
A nonneoplastic disease of bone that is caused by a lack of blood supply to the bone. This condition can be the result of trauma, embolisms, or even sickle cell anemia. In children, if this is present on the femur head, the femur head will not develop properly. Instead of having a normal round ball-shaped femur head, the head will be shallow and flat. This condition is called Legg-Calve-Perthes disease.
Osteogenesis imperfecta
Also known as brittle bone disease, is a congenital abnormality caused by a defect in the production of collagen. It is especially serious in infants because the baby can be born with multiple fractures.
1. Tertiary or neurosyphilis
2. Springomyelia
3. Diabetic neuropathy
What causes Charcot's joints?
Springomyelia
A disease affecting the central canal of the spinal cord. This can be the result of a cyst, congenital malformation, infection, tumor, or trauma.
Colles' fracture
Fracture of the distal radius bone of the forearm, causing a posterior displacement of the distal fragment.
Smith's fracture
Fracture of the distal radius of the forearm with an anterior displacement of the distal fragment.
Chauffeur's fracture
Also known as "backfire fracture" is an impacted or avulsion fracture of the styloid process of the radius.
Clay shoveler's fracture
Also known as a "coal miner's fracture, " is an avulsion fracture of the spinous processes of C6 or T1. This fracture is named for the fractures that would occur in workers who had repeated stress on the cervical region caused by shoveling. Trauma would also cause these fractures.
Burst fracture
Also known as the "Jefferson's fracture," is a fracture of C1 or the atlas. These fractures occur when there is a compression-type force placed upon the atlas, causing bilateral fractures in both the posterior and anterior arches of the atlas.
Hangman's fracture
A fracture of axis or C2. These fractures occur with a severe hyperextension injury, causing a traumatic spondylolisthesis. These fractures are common in high-speed deceleration injuries seen in car accidents or someone who is hanged.
Spondylolisthesis
Anterior slipping of the vertebrae as a result of trauma.
Lordosis
Also known as "swayback." It is an increase in normal lumbar curvature.
Kyphosis
Also known as "humpback," it is an abnormal increase in the normal thoracic curve.
Scoliosis
A lateral curvature of the spine. It can begin between the ages of 3 and 10, although it can also happen after skeletal maturity. It is very important to treat early because rapid progression occurs at the ages of 12 to 16.
C. Springomyelia
A disease affecting the spinal cord that is a result of a cyst, malformation, tumor, or trauma would be

A. neurosyphilis
B. diabetes
C. springomyelia
D. diabetic neuropathy
E. Charcot's joint
E. Charcot's joint
A condition in which the entire joint is destroyed is called

A. Neurosyphilis
B. Diabetes
C. Springomyelia
D. Diabetic neuropathy
E. Charcot's joint
D. Osteogenesis imperfecta
A "brittle bone" disease that may present with a blue sclera is

A. Avascular necrosis
B. Ankylosing spondylitis
C. Reiter's syndrome
D. Osteogenesis imperfecta
E. Rheumatoid arthritis
A. Ankylosing spondylitis
The condition is also known as Marie-Strumpell disease is

A. Ankylosing spondylitis
B. Reiter's syndrome
C. Rheumatoid arthritis
D. Osteogenesis imperfecta
E. Multiple myeloma
B. Chondrosarcoma
_______ is a malignant tumor of cartilage.

A. Multiple myeloma
B. Chondrosarcoma
C. Ewing's sarcoma
D. Osteosarcoma
E. Osteochondroma
E. Enchondroma
A benign tumor of cartilage that is commonly found on the hands and feet is

A. Multiple myeloma
B. Chondrosarcoma
C. Osteosarcoma
D. Osteochondroma
E. Enchondroma
C. Giant cell tumor
A benign tumor that appears as "soapy bubbles," on the femur and tibia is a (an)

A. Osteochondroma
B. Enchondroma
C. Giant cell tumor
D. Osteoid osteoma
E. Gout
C. Osteitis fibrosa cystica
The disease that causes osteolytic lesions of the bone and is referred to as "Von Recklinghausen's disease" is

A. Osteochondroma
B. Osteoid osteoma
C. Osteitis fibrosa cystica
D. Osteopetrosis
E. Osteoporosis
D. Rickets
Osteomalacia in children is called

A. Ewing's sarcoma
B. Paget's disease
C. Marie-Strumpell disease
D. rickets
E. Von Recklinghausen's disease
B. Osteoporosis
A decrease in bone mass caused by a demineralization of calcium is called


A. Osteomalacia
B. Osteopetrosis
C. Osteoma
D. Osteoporosis
E. Osteochondroma
Actin
Thin filament in muscle tissue
Myosin
Thick filament in muscle tissue
Fascia holds the muscle together, protects the muscle, stores water and fat, reduces heat loss, and is a frame work for blood vessels, nerves, and lymphatic vessels.
What is the function of fascia?
Aponeurosis
Broad, flat tendon
Troponin
A regulatory protein that attaches the tropomyosin protein to actin.
Tropomyosin
A regulatory protein that covers the myosin binding sites of actin, preventing myosin from touching actin.
Titin
A structural protein that attaches the Z disks to the M line. This protein is responsible for much of the muscle's elasticity and extensibility because it can be stretched and can recoil back into position.
Myomesin
Protein that forms the sarcomere's M line and attaches myosin filaments to one another.
Nebulin
Is a structural protein that wraps around actin filaments and attaches them to Z disks.
Dystrophin
A structural protein that attaches actin to the integral proteins of the sarcolemma.
After a contraction, the enzyme acetylcholinesterase is released into the synaptic gap and quickly breaks down acetylcholine. Sodium channels close and the muscle cell will repolarize. Ca active transport pumps will pump the Ca in the sarcoplasmic recticulum. Then calsequestrin will bind to Ca to allow it to be stored. Myosin detaches from actin and troponin-tropomyosin complex returns to block the myosin binding sites on actin.
How does a muscle relax?
Isotonic contractions and isometric contractions.
How are muscle contractions classified?
1. Slow twitch or slow oxidative fibers
2. Fast twitch A (fast oxidative-glycolytic fibers) or Fast twitch B fibers (fast glycolytic fibers)
What types of fibers do muscles have?
Botulism
Muscular disease caused by Clostridium botulinum. The toxin blocks the synaptic cleft, preventing the neurotransmitter from reaching the motor end plate of the muscle.
Signs and symptoms of botulism include abdominal cramps, muscle weakness, muscle paralysis, nausea, vomiting, difficulty swallowing, and difficulty breathing. These signs and symptoms appear 8 to 40 hours after infection.
What are the signs and symptoms of botulism?
Tetanus
Muscle disease caused by Clostridium tetani. Once inside the body, the organism releases exotoxins.
SS include severe muscle spasms, especially in face and neck muscles, these spasms can become very violent and break bones. Symptoms of tetanus, also called "lockjaw" appear around 5 to 10 days after infection.
What are the signs and symptoms of tetanus?
Spasticity
An increase in stiffness and tone (spasm).
Flaccidity
A loss of muscle tone; commonly the beginning of atrophy.
Atrophy
Wasting away of the muscle tissue. Can the be the result of nonuse, lack of nervous impulses, or poor nutrition.
Cramps or muscle spasms
Involuntary muscle contractions that will not relax. This "hypertonicity" of muscles most often results in trigger points or "knots".
Myofascial trigger points or pressure points
These spots within a tight, taut band of muscle or fascia are very tender, hyperirritable, and painful upon compression. A "twitch response" is commonly sen, where the tight, taut muscles contract o twitch uncontrollably.
Contractures
Muscles that are permanently shortened and have become hard and immovable. The muscle will be surrounded by thickened fascia, commonly the result of nonmovement or damage to the nerve supply.
Volkmann's contracture and Dupuytren's contracture
What would be examples of contracture syndromes?
Volkmann's contracture
An ischemic contracture of the wrist and fingers. this is the result of an injury that alters arterial flow to the muscles. The wrist, proximal interphalangeal joints, and distal interphalangeal joints are affected. These structures will be in a flexed position, with stiffness and atrophy to the muscle.
Dupuytren's contracture
A condition affecting the palmar fascia, causing it to shorten and thicken. The result is a flexion deformity with loss of finger function, especially to the fourth and fifth phalanges.
Strain
An over stretching or tearing of a muscle tendon.
First-degree strain
Degree of strain where the tendon fibers are overstretched by not torn. Pain will be present, with possible inflammation.
Second-degree strain
Degree of strain where the tendon fibers are partially torn. this strain injury will present with pain, swelling, and muscle splinting in the surrounding muscles.
Third-degree strain
Degree of strain where the tendon is completely ruptured.
Shin splints
A very painful condition involving a strain injury to either the tibialis anterior muscle or the tibialis posterior muscle or both. It is caused by jumping or running on hard or uneven surfaces, causing a tear in the muscles or the interosseous membrane between the tibia and fibula bones of the leg. The periosteum surrounding the bone can be affected and become inflamed. If the stress continues or worsens, the tearing of these muscles can occur.
lateral epicondylitis
Is an overuse or strain injury of the extensor carpi radialis brevis and extensor carpi radialis longus muscle tendons. Aka tennis elbow.
Medial epicondylitis
Also known as Little Leaguer's elbow, is an overuse or strain injury of the pronator teres, flexor carpi radialis, and flexor carpi ulnaris muscle tendons. Also called golfer elbow.
Anterior compartment syndrome
An injury caused by repetitive stress, overuse, or trauma resulting in a buildup of excess fluid in the anterior compartment of the leg. Edema and bleeding in the compartment cause pressure, which impedes blood flow and can cause nerve damage and muscle death. This condition is extremely painful and very dangerous. the muscles of the anterior compartment of the tibia includes the tibialis anterior, extensor hallucis longus, and extensor digitorium longus.
Myositis ossificans
A disease that deposits bone into muscle, causing pain and swelling. Trauma, such as a contusion, fracture, or dislocation, can cause myositis ossificans. The trauma causes a hematoma that can pool blood within soft tissue. The iron and calcium in the blood harden and resemble bone.
Myositis ossificans circumscripta
A localized deposit of calcium, commonly occurring in the quadriceps muscles of the anterior thigh, usually following a trauma.
Myositis ossificans progressiva
This is a rare and frequently fatal form of myositis ossificans. This condition is characterized by the progressive ossification of the muscles of mastication. The affected person cannot chew, and this results in starvation.
Fibromyalgia
A chronic inflammatory disorder that affects connective tissue and muscle tissue.
SS of fibromyalgia include chronic muscle pain all over the body, with tender trigger points and difficulty sleeping. The condition can be caused by emotional problems, stress, GI problems, insomnia, chronic fatigue, and sleep disorders.
What are the SS of fibromyalgia?
Muscular dystrophy
A group of genetic X-linked disorders that cause the muscles to become weak, atrophy, and waste away. The structural protein dystrophia in muscle cells is affected. There are many types, distinguished by age of onset, types of symptoms, and muscle groups affected.
SS of MD include muscle weakness, uncoordinated movements, falls, and difficulty breathing and swallowing.
What are the signs and symptoms of MD?
Duchenne's MD
Most common and severe type of MD, usually occurring in male children and presenting in the first year of life. This form of MD is steadily progressive and eventually fatal. The most common sign is hypertrophy of the gastrocnemius and soleus muscles.
Myasthenia gravis
An autoimmune disorder in which antibodies in the neuromuscular junction prevent neurotransmitters from reaching the muscle motor end plate. usually affects women between the ages of 20 and 40 and men over 60.
SS of myasthenia gravis include double vision and difficulty talking, chewing, swallowing, walking, and breathing. The person may often have problems with drooling. SS usually get better with rest and are exacerbated with activity.
What are the signs and symptoms of myasthenia gravis?
B. Buccinator
This muscle lets you kiss.

A. Orbicularis oculi
B. Buccinator
C. Levator labii superioris
D. Zygomaticus minor
E. Corrugator supercilii
E. Corrugator supercilii
This muscle wrinkles the eyebrow

A. Orbicularis oculi
B. Buccinator
C. Levator labii superioris
D. Zygomaticus minor
E. Corrugator supercilii
C. Levator labii superioris
This muscle raises the top lip

A. Orbicularis oculi
B. Buccinator
C. Levator labii superioris
D. Zygomaticus minor
E. Corrugator supercilii
C. Brachialis
This muscle flexes the forearm at the elbow.

A. Biceps brachii
B. Teres minor
C. Brachialis
D. Coracobrachialis
E. Infraspinatus
E. Deltoid
This muscle abducts the arm

A. Latissimus dorsi
B. Teres major
C. Infraspinatus
D. Brachialis
E. Deltoid
B. Rectus femoris
This is an extensor muscle of the leg.

A. Adductor longus
B. Rectus femoris
C. Deltoid
D. Pronator teres
E. Biceps brachii
A. Biceps femoris
This muscle flexes the leg.

A. Biceps femoris
B. Vastus lateralis
C. Deltoideus
D. Teres major
E. Infraspinatus
Surgical neck
Region of the humerus just below the anatomical neck, where the shaft of the humerus begins to taper. Is so named because of the frequency of trauma-induced fractures that occur at this location.
Flexion
A movement that decreases the angle between two bones.
Extension
A movement that increase the angle between two bones.
Adduction
Movement toward the midline or a body part.
Rotation
Movement of a bone around its own axis, without lateral displacement.
Pronation
Forearm rotation that results in the palm of the hand being directed backward.
Supination
Opposite rotation of palm from pronation.
Circumduction
A circular, cone-like movement of a body segment.
Spina bifida
Developmental flaw in which the laminae of the vertebrae fail to fuse. Spinal cord may protrude through the opening.
C. Storage of carbohydrates
Which of the following is not a function of the skeletal system?

A. production of RBC
B. Storage of minerals
C. Storage of carbohydrates
D. Protection of vital organs
C. The epiphyseal plate
Mitosis resulting in elongation of bone occurs at

A. the articular cartilage
B. the periosteum
C. the epiphyseal plate
D. the diploe
A. Both adrenal cortisol and osteoclasts break down bone tissue.
Which hormone-bone cell combination may result in osteoporosis?

A. adrenal cortisol-osteoclast
B. estrogen-osteoblast
C. Thyroid hormone-osteoclast
D. Thyrocalcitonin-osteoblast
B. The synovial membrane
Synovial fluid that lubricates a synovial joint is produced by

A. a meniscus
B. the synovial membrane
C. a bursa
D. the articular cartilage
E. the mucus membrane
D. A facet
A flattened or shallow articulating surface of a bone is called

A. a tubercle
B. a fossa
C. a fovea
D. a facet
B. Most bones are endochondral, meaning that they began as a hyaline cartilage model before they ossified.
Which type of cartilage is the precursor to endochondral bone?

A. Costal
B. Hyaline
C. Fibroelastic
D. Articular
A. coronal
Which suture extends from the anterior fontanel to the anteriolateral fontanel?

A. Coronal suture
B. lamboid suture
C. squamous suture
D. longitudinal suture
C.
A facial bone that is not paired is

A. the maxilla
B. the lacrimal bone
C. the vomer
D. the nasal bone
E. the palantine bone
B. the vertebrae
Hematopoesis would most likely take place in

A. the hyoid bone
B. vertebrae
C. the maxilla
D. the scapula
D. clavicle
Which of the following bones is not part of the axial skeleton?

A. hyoid bone
B. sacrum
C. sphenoid bone
D. clavicle
E. manubium
C. the palantine bone
The optic foramen is located within

A. the ethmoid bone
B. the occipital bone
C. the palantine bone
D. the sphenoid bone
A. the intercarpal joint
An example of a gliding joint is

A. the intercarpal joint
B. the radiocarpal joint
C. the intervertebral joint
D. the phalangeal joint
A. squamous part
The mandibular fossa is a feature of which part of the temporal bone

A. Squamous part
B. Petrous part
C. Tympanic part
D. Articular part
C. ethmoid bone
The superior and middle conchae are bony structures of which bone?

A. palantine bone
B. nasal bone
C. ethmoid bone
D. maxilla
C.
Which of the following does not contain a paranasal sinus?

A. frontal bone
B. ethmoid bone
C. Vomer
D. Sphenoid bone
E. Maxilla
A. The maxillae and mandible
Teeth are supported by

A. the maxillae and mandible
B. the mandible and palantine bones
C. the maxillae and palantine bones
D. the maxillae, mandible, and palantine bones
D. the temporal bone
The mastoid process is a structural prominence of

A. the sphenoid bone
B. the parietal bone
C. the occipital bone
D. the temporal bone
E. the ethmoid bone
D. Most synchondrotic joints ossify following the period of linear bone growth.
A joint characterized by an epiphyseal plate is called

A. A synovial joint
B. A suture
C. A symphysis
D. A synchondrosis
C. Each of the long bones within the appendages of the body has a diaphysis, epiphyses, articular cartilage, and medullary cavity.
Which of the following bones is characterized by the presence of a diaphysis and epiphyses, articular cartilages, and medullary cavity?

A. scapula
B. sacrum
C. tibia
D. patella
A. Osteoclasts break down bone tissue and osteoblasts build up bone tissue.
Remodeling of a bone is a function of

A. osteoclasts and osteoblasts
B. osteoblasts and osteocytes
C. chondrocytes and osteocytes
D. chondrocytes and osteoblasts
E. With its numerous perforations, the cribiform plate of the ethmoid bone permits passage of the olfactory cranial nerves from the olfactory epithelium of the nasal cavity
The cribiform plate is a specialized portion of which of the bone?

A. sphenoid bone
B. maxilla
C. temporal bone
D. vomer
E. ethmoid bone
D. The capitulum is a structure of the humerus.
Which of the following is not part of the os coxae?

A. acetabulum
B. ischium
C. pubis
D. capitulum
E. obturator foramen
B. The coracoid process is an extension of the scapula from which several muscles attach.
A fractured coracoid process would involve

A. the clavicle
B. the scapula
C. the ulna
D. the radius
E. the tibia
C. The false, or greater, pelvis is the distance between the two anterosuperior iliac spines. What this means is that adult women have relatively wider hips than do adult men.
The false pelvis is

A. inferior to the true pelvis
B. found in men only
C. narrower in men than in women
D. not really part of the skeletal system
A. The lateral malleolus is the knob of bone on the lateral side of the ankle. The lateral malleolus is on the distal end of the fibula, and the medial malleolus is on the distal end of the tibia.
A fracture of the lateral malleolus would involve

A. the fibula
B. the tibia
C. the ulna
D. a rib
E. the femur
A. The navicular bone is sandwiched between the talus and the three cuneiform bones.
Which of the following bones articulates distally with the talus in the foot?

A. navicular bone
B. first metatarsal bone
C. calcaneus
D. first cuneiform bone
E. cuboid bone
B. The subscapular fossa is the slightly indented anterior surface of the scapula.
On a skeleton in the anatomical position, which of the following structures faces anteriorly

A. Spinous process of the scapula
B. Subscapular fossa
C. Infraspinous fossa
D. Linea aspera of femur
E. Spinous process of a thoracic vertebra
E. The sagittal suture extends from the frontal bone to the occipital bone, between the two parietal bones.
The sagittal suture is positioned between

A. The sphenoid and temporal bones
B. The temporal and parietal bones
C. The occipital bones
D. The occipital bones
E. The right and left parietal bones
A. There are actually six styloid processes in the body-one on each of the paired ulna, radius, and temporal bones.
Which of the following bones lacks a styloid process?

A. Sphenoid bone
B. Temporal bone
C. Ulna
D. Radius
D. The pituitary gland is supported inferiorly by the sella turcica of the sphenoid bone.
Surgical entry through the roof of the mouth to remove a tumor of the pituitary gland would involve

A. The mastoid process
B. The pterygoid process
C. The styloid process
D. The sella turcica
False; only the tibia.
T or F. The tibia and fibula articulate with the femur at the knee joint.
False; epiphyses.
T or F. The proximal and distal ends of a long bone are referred to as diaphyses.
True
T or F. Menisci occur only in certain synovial joints.
False; rotational.
T or F. Supination and pronation are specific kinds of circumductional movements.
False; red blood marrow
T or F. Yellow bone marrow in certain long bones of an adult produces red blood cells, white blood cells, and platelets.
False; calcium and phosphorus
T or F. Bone matrix is composed mainly of calcium and magnesium, which may be withdrawn in small amounts as needed elsewhere in the body.
True
T or F. Thyroid hormone may promote either osteogenesis or osteolysis.
True
T or F. A furrow on abone that accommodates a blood vessel, nerve, or tendon is known as a sulcus.
False; transverse foramina
T or F. Cervical vertebrae are characterized by the presence of articular facets.
True
T or F. The two ossa coxae articulate anteriorly with each other at the symphysis pubis and posteriorly with the sacrum.
False; fibia
T or F. The lateral malleolus of the tibia stabilizes the ankle joint.
False; endochondral
T or F. Most of the bones of the skeleton form through intramembranous ossification.
True
T or F. There are a total of 56 phalanges in the appendicular skeleton.
True
T or F. Articular cartilage and synovial membranes are found only in synovial joints.
False; some joints are immovable
T of F. All joints or articulations in the body permit some degree of movement.
False; lessening the angel at a hinge joint.
T or F. Flexion means "contraction of a skeletal muscle."
False; osteoclasts
T or F. Osteoblasts actually destroy bone tissue in the process of demineralization.
True
T or F. A person has seven pairs of true ribs and five pairs of false ribs, the last two pairs of which are designated as floating ribs.
True
T or F. A stress fracture along the intertrochanteric line involves the femur.
False; generally, but not always
T or F. Surgery of a meniscus could be performed only on either knee joint.
B. Smooth muscle fibers
Muscle fibers characterized by a lack of striations, a single centrally located nucleus in each cell, and involuntary contractions are referred to as

A. skeletal muscle fibers
B. Smooth muscle fibers
C. Cardiac muscle fibers
D. Autonomic muscle fibers
C. The are called A bands because of their anisotropic property (polarise visible light).
The anisotropic dark bands of muscle fibers are called

A. Z bands
B. I bands
C. A bands
D. D bands
D. the sarcomere is the structural unit of the myofibril; it is the region of my fibril between two successive Z lines.
The structural unit of the myofibril is

A. the myofibril
B. myosin
C. the A band
D. the sarcomere
A. Calcium ions bind to troponin and cause a conformational change in the tropomyosin, which exposes the actin binding site to myosin cross bridges.
Muscle contraction is initiated when

A. Ca binds to the troponin
B. Actin is removed from troponin
C. Actin is made available to troponin
D. Ca is removed from the troponin
C. The terminal cisternae, or lateral sacs, store Ca ions.
The source of Ca for the muscle is

A. the T tubule
B. the central sac
C. the terminal cisternae
D. The sarcoplasmic recticulum
A. Without release of Ca, the tropomyosin blocks the actin binding site.
In a relaxed muscle

A. tropomyosin blocks attachement of myosin heads to actin.
B. the concentration of sarcoplasmic recticulum Ca is low.
C. tropomyosin is moved out of the way so that the myosin heads can attach to actin.
D. myosin ATPase is activated.
D. When there is no action potential, the calcium ions are actively returned and stored on the sarcoplasmic reticulum.
Muscle relaxation occurs

A. as Ca is released from the sarcoplasmic recticulum
B. as long as Ca is attached to troponin.
C. As action potentials are transmitted through the transverse tubules.
D. As the sarcoplasmic recticulum actively removes Ca from the cytoplasm.
B. A triad consists of a T tubule, which is an extension of the sarcolemma, and the terminal cisternae on both sides of the T tubule.
A muscle triad consists of

A. a T tubule and a sarcomere
B. a T tubule and two terminal cisternae
C. a T pump and two calcium pumps
D. three myofibrils
A. A motor unit consists of a single motor neuron and the specific skeletal muscle fibers it innervates
A single motor neuron and all the skeletal muscle fibers it innervates constitutes

A. a motor unit
B. a muscle triad
C. a sarcounit
D. a neuromuscular junction
A. During isometric contraction, the length of the muscle stays the same because the antagonistic force equals the force of the contracting muscle.
A muscle that develops tension against some load but hat does not shorten is undergoing

A. Isometric contraction
B. Isotonic contraction
C. Neither a nor b
D. Both a and b
C. T tubules are extensions of the sacrolemma.
The channels that extend from the cell wall into the interior of a skeletal muscle cell form

A. the endoplasmic recticulum
B. Myofibers
C. T tubules
D. Tropomyosin
B. ATP binds to the myosin globular head. The enzyme ATPase within the head changes ATP to ADP and energy. The energy is used to recock the head.
The globular heads on the myosin proteins of the myosin filaments

A. Are made up of troponin molecules
B. Are believed to be attached to ATP molecules
C. Shorten during the contraction process
D. Have a high affinity for calcium ions released from the cisternae of the sarcoplasmic reticulum.
C. Calcium ions bind to troponin, which in turn causes tropomyosin to move aside so that myosin cross bridge can attach to the actin binding site.
Troponin is a protein that

A. is bound to myosin to form a complex that is normally inhibited in the resting muscle fiber.
B. forms the binding site for the myosin heads when they attach to actin
C. Has a high affinity for calcium ions
D. Contains numerous molecules of ADP.
C. Motor units operate on the all-or-none law; that is, when a motor unit is recruited, all of the muscle fibers in that motor unit contract.
According to the all-or-none law,

A. all the contractile elements in a muscle fiber contract when the muscle fiber is stimulated.
B. All the muscle fibers in a muscle contract when the muscle is stimulated
C. None of the preceding are true
True
T or F. Muscle accounts for approximately 40% of a person's weight.
False; actin is found in all muscle tissues, but in smooth muscle tissue it is not regularly arranged.
T or F. Actin is found only in the striated fibers of cardiac and skeletal muscle tissues.
True
T or F. Slow twitch fibers are more resistant to fatigue than the other muscle fiber types.
True
T or F. Fasciculi are enclosed in a covering of perimysium.
True
T or F. A sarcomere is the region of a myofibril that lies between two consecutive Z lines.
True
T or F. An action potential in a muscle fiber is initiated by stimulation across the neuromuscular junction.
True
T or F. Sustained contractions of skeletal muscle is known as tetanus.
False; fast twitch fibers are used primarily for resistance activities.
T or F. Fast-twitch fibers are primarily used in endurance activities.
False; a muscle triad consists of a T tubule and two cisternae.
T or F. A muscle triad consists of a sarcoplasmic reticulum, a T tubule, and a terminal cisternum.
True
T or F. A motor unit consists of a single motor neuron and the muscle fibers it innervates.
False; lifting a dumbbell is an example of isotonic contraction.
T or F. Lifting a dumbbell is an example of isometric contraction.
False; thin myofilaments are composed chiefly of action proteins; thick myofilaments are composed chiefly of myosin proteins.
T or F. Thin myofilaments are primarily composed of myosin proteins.
False; the primary cause of muscle soreness is damage to the thick and thin myofilaments.
T or F. Accumulation of lactic acid is the principal cause of sore muscles.
True
T or F. To initiate muscle contraction, calcium ions bind to and change the shape of the troponin protein molecules, which then pull the tropomyosin proteins off the myosin binding sites of the actin helix.
True
T or F. Synergistic muscles work together to perform a certain motion or action. Antagonistic muscles work in opposition to another group of muscles.
False; motor units follow the all-or-none law of physiological activity.
T or F. The strength of a muscle contraction is increased by recruiting more muscle fibers within a motor unit.
True
T or F. During muscle contraction, the I bands get smaller and the Z lines get closer together, but the A bands do not change in size.
False; the energy released from ATP molecule recocks the myosin head after the power stroke.
T or F. The energy provided by ATP molecules allows the myosin head to hind to the exposed binding site on the actin molecule.
False; terminal cisternae store calcium ions; T tubules conduct the action potential from the cell membrane into the center of the cell.
T or F. The transverse tubules (T tubules) store calcium ions needed for muscle contraction.
True
T or F. A tendon is a structure that binds the fascia of a muscle to the periosteum of a bone.
Inversion
Muscle action that turns the sole inward.
Eversion
Muscle action that turns the sole outward.
Frontalis
Facial muscle that originates in the galea aponeurotica and inserts in the skin of eyebrow; wrinkles forehead and elevates the eyebrow.
Occipitalis
Facial muscle that originates in the occipital bone and mastoid process and inserts in the galea aponeurotica; functions to move the scalp backward.
Corrugator
Facial muscle that originates in the fascia above the eyebrow, inserts in the root of the nose; functions to draw eyebrows toward midline, as in scowling.
Orbicularis oculi
Facial muscle that originates in the bones of medial orbit and inserts in the tissue of the eyelid; functions to close the eye, as in blinking.
Nasalis
Facial muscle that originates in the maxilla and nasal bone and inserts in the aponeurosis of nose; functions to dilate nostrils.
Levator labii superioris
Facial muscle that originates in the maxilla and zygomatic bone and inserts in the orbicularis oris. Functions to elevate the upper lip, as in exposing the upper teeth.
Zygomaticus
Facial muscle that originates in the zygomatic bone and inserts in the orbicularis oris at lateral part of upper lip. Functions to elevate the corners of the mouth
Risorius
Facial muscle that originates in the fascia of the cheek and inserts at the orbicularis oris at corner of the lips. Functions to draw corners of mouth laterally.
Depressor anguli oris
Facial muscle that originates in the mandible and inserts at the inferolateral part of the orbicularis oris. Functions to depress corner of mouth, as in frowning.
Depressor labii inferioris
Facial muscle that originates in the mandible and inserts in the orbicularis oris and skin of the lower lip. Functions to depress lower lip, as in exposing the lower teeth.
Mentalis
Facial muscle that originates in the mandible and inserts in the orbicularis oris. Functions to elevate and protrude lower lip, as in pouting.
Platysma
Facial muscle that originates in fascia of neck and clavicle and inserts in the inferior border of mandible. Functions to depress lower lip and tenses the skin of the neck.
Buccinator
Facial muscle that originates in the maxilla and mandible and inserts in the orbicularis oris. Functions to compress the cheek, as in sucking from a straw.
Temporalis
Muscle of mastication that originates in the temporal fossa and inserts in the coronoid process of mandible; functions to elevate the jaw.
Masseter
Muscle of mastication that originates in the zygomatic arch and inserts in the lateral ramus of mandible; functions to elevate the jaw.
Medial pterygoid
Muscle of mastication that originates in the sphenoid bone and inserts in the medial ramus of mandible; depresses jaw; moves laterally
Lateral pterygoid
Muscle of mastication that originates in the sphenoid bone and tuberosity of maxilla and inserts in teh anterior side of mandibular condyle; protracts jaw.
Sternocleidomastoid
Muscle of the neck that originates in the sternum and clavicle and inserts int eh mastoid process of temporal bone; flexes neck; turns head to side.
Digastric
Muscle of the neck that originates in the inferior border of mandible and mastoid process of temporal bone; depresses jaw to open the mouth; elevates hyoid bone.
Mylohyoid
Muscle of neck that originates in the inferior border of the mandible and inserts in the hyoid bone and median raphe; elevates hyoid bone and floor of the mouth.
Stylohyoid
Muscle of the neck that originates in the styloid process of temporal bone and inserts in hyoid bone; elevates and retracts tongue.
Hyoglossus
Muscle of the neck that originates in the hyoid bone and inserts in the side of tongue; depresses side of tongue.
Sternohyoid
Muscle of the neck that originates in the manubrium and inserts in the hyoid bone; depresses hyoid bone
Thyrohyoid
Muscle of the neck that originates in the thyroid cartilage and inserts in hyoid bone; depresses hyoid bone; elevates thyroid cartilage.
Omohyoid
Muscle of the neck that originates in the superior border of the scapula and inserts in the clavicle and hyoid bone; depresses hyoid bone.
External abdominal oblique
Abdominal wall muscle that originates in the lower eight ribs and inserts in the iliac crest and linea alba; compresses abdomen and lateral rotation.
Internal abdominal oblique
Abdominal wall muscle that originates in the iliac crest, inguinal ligament, and lumbar fascia, and inserts in the linea alba and costal cartilages of last three or four ribs. Compresses abdomen and causes lateral rotation
Transversus abdominis
Abdominal wall muscle that originates in the iliac crest, inguinal ligament, and lumbar fascia, and inserts in the xiphoid process, linea alba, and pubis. Compresses abdomen.
Rectus abdominis
Abdominal wall muscle that originates in the pubic crest and symphysis pubis and inserts in the xiphoid process and costal cartilages of fifth to seventh ribs; flexes vertebral column.
Quadratus lumborum
Vertebral column muscle that originates in the iliac crest and lower three lumbar vertebrae and inserts in the twelfth fib and upper four lumbar; extend lumbar region and laterally flexes.
Iliocostalis lumborum
Vertebral column muscle that originates in the crest of ilium and inserts in the lower six ribs; extends lumbar region.
Iliocostalis throacis
Vertebral column muscle that originates in the lower six ribs and inserts in the upper six ribs; extends the thoracic region.
Iliocostalis cervicis
Vertebral column muscle that originates in the angles of three to six ribs and inserts in the transverse processes of fourth to sixth cervical vertebrae; extends cervical region.
Longissimus thoracis.
Vertebral column muscle that originates in the transverse processes of lumbar vertebrae and inserts in the lower nine ribs and transverse processes of all the thoracic vertebrae; extends thoracic region.
Longissimus cervicis
Vertebral column muscle that originates in the transverse processes of upper five thoracic vertebrae and inserts in the transverse processes of second to six cervical vertebrae; extends cervical region.
Longissimus capitis
Vertebral column muscle that originates in the transverse processes of upper four or five thoracic vertebrae and inserts in the transverse processes of second to sixth cervical vertebrae; extends head; acting separately, turns face toward that side.
Spinalis thoracis
Vertebral column muscle that originates in the spinous processes of upper lumbar and lower thoracic vertebrae and inserts in the spinous processes of upper thoracic vertebrae; extends vertebral column.
Charley horse
A cramp or stiffness in a muscle, especially in the back of the thigh,a s a result of a sprain, tear, or bruise of the muscle.
Fibromyositis
An inflammation of both skeletal muscle tissue and the associated connective tissue. Lumbago, or rheumatism, is this condition in the lumbar area of the back.
Graphospasm
Writer's cramp
Poliomyelitis
A viral disease that often attacks and destroys the cell bodies of the somatic motor neurons of the skeletal muscles, causing paralysis.
Torticollis (wryneck)
Persistent contraction of a sternocleidomastoid muscle, drawing the head to one side and distorting the face. May be acquired or congenital.
C. Flexion decreases a joint angle. In anatomical position, the angle of the shoulder joint is 180 degrees. Contraction of the pectoralis major decreases this angle.
A flexor muscle of the shoulder joint is

A. supraspinatus
B. the trapezius
C. the pectoralis major
D. the teres major
C. Although positioned along the humerus, the biceps brachii originates on the coracoid process of the scapula and inserts on the radial tuberosity.
Which of the following muscles does not attach to the humerus?

A. teres major
B. supraspinatus
C. biceps brachii
D. brachialis
E. pectoralis major
D. The platysma inserts on the inferior border of the mandible.
Which of the following muscles does not insert upon the orbicularis oris?

A. depressor labii inferioris
B. zygomaticus
C. risorius
D. platysma
E. levator labii superioris
D. Although located in the back, the spinalis is not part of the erector spinae muscle group.
The erector spinae muscle group does not include

A. the iliocostalis
B. the longissimus
C. the spinalis
D. the semispinalis
C. The coracobrachialis flexes and adducts the arm at the shoulder joint.
All of the following muscles are synergists in flexing the elbow joint except

A. the biceps brachii
B. the brachialis
C. the coracobrachialis
D. the brachioradialis
B. The deltoid has its origin along the acromion and spine of the scapula.
Which of the following muscles attaches to the acromion of the scapula?

A. teres major
B. deltoid
C. supraspinatus
D. rhomboideus major
E. infraspinatus
B. The latissimus dorsi originates on the vertebrae and inserts ont eh intertubercular groove of the humerus
Which of the following muscles does not attach to the scapula?

A. deltoid
B. latissimus dorsi
C. coracobrachialis
D. teres major
E. rhomboideus major
A. Spanning two joints, the rectus femoris functions to flex the hip joint and extend the knee joint. Of the four quadricep femoris muscles, it is the only one to span two joints.
Of the four quadriceps femoris muscles, which contracts over the hip and knee joints?

A. rectus femoris
B. vastus medialis
C. vastus intermedius
D. vastus lateralis
B. The position of the tibialis posterior and its long tendon of insertion permits it to support the arches of the foot as it functions to plantar flex and invert the foot.
Which of the following muscles plantar flexes and inverts the foot as it supports the arches?

A. flexor digitorum longus
B. tibialis posterior
C. flexor hallucis longus
D. gastrocnemius
A. Corrugator derives from a word meaning "to wrinkle"; as both corrugator muscles are contracted, the skin between the eyebrows wrinkles, as in scowling.
An eyebrow is drawn toward the midline of the face through contraction of which of the following muscles?

A. corrugator
B. risorius
C. nasalis
D. frontalis
E. The strength of attachment is highly variable from person to person and is not used as a means of naming muscles.
Which of the following is not used a s a means of naming muscles?

A. location
B. action
C. shape
D. attachment
E. strength of contraction
A. The supine position is with the palms of the hands down, as indicated by the name of the supinator muscle.
Rotation of the hand so that the palm faces posteriorly is the action of which muscles?

A. supinators
B. abductors
C. adductors
D. flexors
E. extensors
A. the diaphragm, the external intercostal muscle, and the interchondral portion of the internal intercostal muscle are synergistic during the inspiration phase of normal breathing.
The muscles that are synergistic to the diaphragm during inspiration are

A. the external intercostal muscles
B. the internal intercostal muscles (excluding the interchondral part)
C. the abdominal muscles
D. all of the above
B. The paired temporalis muscles function with the masseter muscles in closing the jaws. The paired lateral and medial pterygoid muscles are also included in the muscles of mastication.
A muscle of mastication is

A. the buccinator
B. the temporalis
C. the mentalis
D. the zygomaticus
E. the orbicularis oris
D.
Which of the following muscles does not originate on the lateral epicondyle of the humerus?

A. extensor carpi radialis brevis
B. extensor digitorum
C. extensor digiti minimi
D. all of the preceding originate on the lateral epicondyle
D. Of the three gluteal muscles, only the gluteus maximus extends and laterally rotates the hip joint.
The muscle that extends and laterally rotates the thing is

A. the iliacus
B. the gluteus medius
C. the psoas major
D. the gluteus maximus
E. the gluteus minimus
E. the lattissimus dorsi originates on the vertebrae and inserts ont eh intertubercular groove of the humerus.
Which of the following muscles does not attach to the rib cage?

A. serratus anterior
B. rectus abdominis
C. pectoralis major
D. serratus posterior
E. latissimus dorsi
D. The sartorius originates on the anterosuperior iliac spine and inserts ont eh medial surface of the tibia.
Which of the following muscles does not have its origin on the pubis?

A. gracilis
B. adductor brevis
C. pectineus
D. sartorius
D. Each of the three gluteal muscles has its origin on some part of the ilium.
The gluteus minimus muscle originates on the which bone?

A. Coccyx
B. Ischium
C. Femur
D. Ilium
E. Pubis
E. The rhomboideus major lies deep to the trapezius muscle.
Which of the following muscles is deep in position?

A. platysma
B. pectoralis major
C. tensor fasciae latae
D. external abdominal oblique
E. rhomboideus major
True
T or F. When contracted, the zygomaticus draws the angle of the mouth upward, as in a smile.
True
T or F. Contraction of the orbicularis oris compresses the lips together.
False; extension increases the angle of a joint; abduction moves an appendage away from the midplane of the body.
T or F. Extension and abduction are interchangeable terms in that both action results in an appendage's being moved away from the body.
True
T or F. The digastric muscles are important in chewing because, when contracted, they lower the mandible and open the mouth.
False; the iliocostalis muscles extend the vertebral column, and the rectus abdominis flexes the vertebral column.
T or F. Flexion of the vertebral column results when the iliocostalis muscles are contracted.
True
T or F. The triceps brachii originates from processes on the humerus and on the scapula.
True
T or F. When contracted, the semimembranous flexes the leg at the knee joint and may also extend the thigh at the hip joint.
True
T or F. A pulled groin muscle could involve the gracilis.
False; the sartorius acts on both the hip and knee joints.
T or F. The sartorius acts only on the hip joint.
True
T or F. The muscles of the quadriceps femoris are antagonistic t the hamstring muscles.
False; the gluteus maximus inserts on the gluteal tuberosity of the femur and iliotibial tract.
T or F. All three gluteal muscles insert on the greater trochanter of the femur.
False; the pectoralis minor does not attach to the humerus; it inserts on the coracoid process of the scapula, and, when contracted, it pulls the scapula forward and downward.
T or F. When contracted, the pectoralis minor rotates and adducts the humerus.
True
T or F. Three muscles-the gastrocnemius, soleus, and plantaris-function synergistically in plantar flexion of the foot.
True
T or F. The palmaris longus is anterior in position and functions to flex the hand.
True
T or F. From superficial to deep, the anterior abdominal wall consists of the external abdominal oblique, internal abdominal oblique, and transverse abdominis muscles.
Serratus anterior
Muscle that acts on the pectoral girdle that originates in the upper eight or nine ribs and inserts in the anterior medial border of scapula; pulls scapula forward and downward.
Pectoralis minor
Muscle that acts on the pectoral girdle that originates in the sternal ends of third, fourth, and fifth ribs and inserts in the coracoid process of scapula; pulls scapula forward and downward.
Subclavius
Muscle that acts on the pectoral girdle that originates in the first rib and inserts in the subclavian groove of clavicle;draws clavicle downward.
Trapezius
Muscle that acts on the pectoral girdle that originates in the occipital bone and spines of cervical and thoracic vertebrae and inserts in the clavicle, acromion, and spine of scapula. Elevates, depresses, and adducts scapula; hyperextends neck; braces shoulder.
Levator scapulae
Muscle that acts on the pectoral girdle that originates in the first to forth cervical vertebrae and inserts in the superior border of scapula; elevates scapula.
Rhomboideus major
Muscle that acts on the pectoral girdle that originates in the spines of second to fifth thoracic vertebrae and inserts in the medial border of scapula; elevates and adducts scapula.
Rhomboideus minor
Muscle that acts on the pectoral girdle that originates in the spines of seventh cervical and first thoracic vertebrae and inserts in medial border of scapula; elevates and adducts scapula.
Pectoralis major
Muscle that acts on the brachium that originates in the clavicle, sternum, costal cartilages of second to sixth ribs and inserts in the greater tubercle of humerus. Flexes, adducts, and rotates humerus medially at shoulder joint.
Latissimus dorsi
Muscle that acts on the brachium that originates in the spines of sacral, lumbar, and lower thoracic vertebrae; lowers ribs, and inserts in the intertubercular groove of humerus. Extends, adducts, and rotates humerus medially at shoulder joint; adducts arm.
Deltoid
Muscle that acts on the brachium that originates in the clavicle, acromion, and spine of scapula and inserts in the deltoid tuberosity of humerus; abducts the arm; extends or flexes humerus at shoulder joint.
Supraspinatus
Muscle that acts on the brachium that originates in the supraspinatus fossa of scapula and inserts int eh greater tubercle of humerus; abducts and laterally rotates humerus at shoulder joint.
Infraspinatus
Muscle that acts on the brachium that originates in the infraspinatus fossa of scapula and greater tubercle of humerus; rotates arm laterally at shoulder joint.
Teres major
Muscle that acts on the brachium that originates from the inferior angle and lateral border of scapula and inserts in the intertubercular groove of humerus. Extends, adducts, and rotates humerus medially at shoulder joint.
Teres minor
Muscle that acts on the brachium that originates from lateral border of scapula and inserts in the greater tubercle of humerus; rotates humerus medially at shoulder joint.
Subscapularis
Muscle that acts on the brachium that originates from the subscapular fossa and inserts from the lesser tubercle of humerus; rotates humerus medially at shoulder joint.
Coracobrachialis
Muscle that acts on the brachium that originates from the coracoid process of scapula and inserts in the shaft of the humerus; flexes and adducts humerus at shoulder joint.
Biceps brachii
Muscle that acts on the antebrachium that originates from the coracoid process and tuberosity above glenoid fossa of scapula and inserts in the radial tuberosity; flexes elbow joint; supinates forearm and hand at elbow joint.
Brachialis
Muscle that acts on the antebrachium that originates from the anterior shaft of humerus and inserts in the coronoid process of ulna; flexes elbow joint.
Brachioradialis
Muscle that acts on the antebrachium that originates from the lateral supracondylar ridge of humerus and inserts proximal to styloid process of radius; flexes elbow joint.
Triceps brachii
Muscle that acts on the antebrachium that originates from the tuberosity below glenoid fossa and lateral and medial surfaces of humerus and inserts in the olecranon of ulna; extends elbow joint.
Anconeus
Muscle that acts on the antebrachium that originates from the lateral epicondyle of humerus and inserts in the olecranon of ulna; extends elbow joint.
Supinator
Muscles that act on the wrist, hand, and fingers that originates from the lateral epidcondyle of humerus and crest of ulna and inserts in the lateral surface of radius; supinates hand.
Pronator teres
Muscles that act on the wrist, hand, and fingers that originates from the medial epicondyle of humerus and inserts in the lateral surface of radius; pronates hand.
Pronator quadratus
Muscles that act on the wrist, hand, and fingers that originates from the distal fourth of ulna and inserts in the distal fourth of radius; pronates hand.
Flexor carpi radialis
Muscles that act on the wrist, hand, and fingers that originates from the medial epicondyle of humerus and inserts at the base of second and third metacarpal bones; flexes and abducts hand at wrist.
Palmaris longus
Muscles that act on the wrist, hand, and fingers that originates from the medial epicondyle of humerus and inserts at the palmar aponeurosis; flexes wrist
Flexor carpi ulnaris
Muscles that act on the wrist, hand, and fingers that originates from the medial epicondyle of humerus and olecranon of ulna and inserts at the carpal and metacarpal bones; flexes and adducts wrist.
Flexor digitorum superficialis
Muscles that act on the wrist, hand, and fingers that originates from the medial epicondyle of humerus and coronoid process and inserts in the middle phalanges of digits II-V; flexes wrist and digits.
Flexor digitorum profundus
Muscles that act on the wrist, hand, and fingers that originates from the proximal two thirds of ulna and interosseous membrane and inserts in the distal phalanges of digits II-V; flexes wrist and digits.
Flexor pollicis longus
Muscles that act on the wrist, hand, and fingers that originates from the shaft of radius coronoid process of ulna, interosseous membrane and inserts in the distal phalanx of thumb; flexes joints of thumb.
Extensor carpi radialis longus
Muscles that act on the wrist, hand, and fingers that originates from the lateral supracondylar ridge of the humerus and inserts in the second metacarpal bone; extends and abducts wrist.
Extensor carpi radialis brevis
Muscles that act on the wrist, hand, and fingers that originates from the lateral epidcondyle of the humerus and inserts in the third metacarpal bone; extends and abducts the wrist.
Extensor digitorum communis
Muscles that act on the wrist, hand, and fingers that originates from the lateral epicondyle of the humerus and inserts in the posterior surfaces of digits II-V; extends wrist and phalanges.
Extensor digiti minimi
Muscles that act on the wrist, hand, and fingers that originates from the lateral epicondyle of humerus and inserts in the extensor aponeurosis of fifth digit; extends joints of fifth digit and wrist.
Extensor carpi ulnaris
Muscles that act on the wrist, hand, and fingers that originates from the lateral epicondyle of the humerus and olecranon of ulna and inserts on the base of fifth metacarpal bone; extends and adducts wrist.
Extensor pollicis longus
Muscles that act on the wrist, hand, and fingers that originates from the lateromedial shaft of ulna and inserts at the base of distal phalanx of thumb; extends joints of thumb; abducts joints of hand.
Extensor pollicis brevis
Muscles that act on the wrist, hand, and fingers that originates from the distal shaft of radius and interosseous membrane and inserts at the base of first phalanx of thumb; extends joints of thumb; abducts joints of hand.
Abductor pollicis longus
Muscles that act on the wrist, hand, and fingers that originates from the distal radius and ulna and interosseous membrane and inserts at the base of the first metacarpal bone; abducts joints of thumb and joints of hand.
Iliacus
Muscle that moves the thigh at the hip joint that originates at the liac fossa and inserts in the lesser trochanter of femur along with psoas major; flexes and rotates thigh laterally at the hip joint; flexes joints of vertebral column.
Psoas major
Muscle that moves the thigh at the hip joint that originates at the transverse process of lumbar vertebrae and inserts the lesser trochanter of femur, along with iliacus; flexes and rotates thigh laterally at the hip joint; flexes joints of vertebral column.
Gluteus maximus
Muscle that moves the thigh at the hip joint that originates at the iliac crest, sacrum, coccyx, aponeurosis of lumbar region and inserts at the gluteal tuberosity and iliotibial tract; extends and rotates thigh laterally at the hip joint.
Gluteus medius
Muscle that moves the thigh at the hip joint that originates at the lateral surface of ilium and inserts at the greater trochanter of femur; abducts and rotates thigh medially at the hip joint.
Gluteus minimus
Muscle that moves the thigh at the hip joint that originates at the lateral surface of lower half of ilium and greater trochanter of femur; abducts and rotates thigh medially at the hip joint.
Tensor fasciae latae
Muscle that moves the thigh at the hip joint that originates at the anterior border of ilium and iliac crest and inserts at the iliotibial tract; abducts thigh at the hip joint.
Gracilis
Medial muscle that moves the thigh at the hip joint that originates at the inferior edge of symphysis pubis and inserts at the proximomedial surface of the tibia; adducts thigh at hip joint; flexes and rotates leg at knee joint.
Pectineus
Medial muscle that moves the thigh at the hip joint that originates at the pectineal line of pubis and inserts distal to lesser trochanter of femur; adducts and flexes thigh at hip joint.
Adductor longus
Medial muscle that moves the thigh at the hip joint that originates at the pubis, below pubic crest and inserts at the linea aspera of femur; adducts, flexes, and laterally rotates thigh at hip joint.
Adductor brevis
Medial muscle that moves the thigh at the hip joint that originates at the inferior ramus of pubis and inserts at the linea aspera of femur; adducts, flexes, and laterally rotates thigh at hip joint.
Adductor magnus
Medial muscle that moves the thigh at the hip joint that originates at the inferior ramus of ischium and inferior ramus of pubis and inserts at the linea aspera and medial epicondyle of femur; adducts, flexes, and laterally rotates thigh at hip joint.
Sartorius
Muscle of the thigh that act on the leg that originates at the anterosuperior iliac spine and inserts at the medial surface of tibia; flexes leg and thigh; abducts and rotates thigh laterally; rotates leg medially at hip joint.
Rectus femoris
Muscle of the thigh that act on the leg that originates at the anteroinferior iliac spine and inserts at the patella by common tendon, which continues a patellar ligament to tibial tuberosity; extends the leg at the knee joint.
Vastus lateralis
Muscle of the thigh that act on the leg that originates at the greater trochanter and linea aspera of femurand inserts at the patella by common tendon, which continues a patellar ligament to tibial tuberosity; extends the leg at the knee joint.
Vastus medialis
Muscle of the thigh that act on the leg that originates at the medial surface of linea aspera of femur and inserts at the patella by common tendon, which continues a patellar ligament to tibial tuberosity; extends the leg at the knee joint.
Vastus intermedius
Muscle of the thigh that act on the leg that originates at the anterior and lateral surfaces of femur and inserts at the patella by common tendon, which continues a patellar ligament to tibial tuberosity; extends the leg at the knee joint.
Biceps femoris
Muscle of the thigh that act on the leg that originates at the long head; ischial tuberosity; short head; linea aspera of femur and inserts at the head of fibula and lateral epicondyle of tibia; flexes leg at knee joint; extends and medially rotates thigh at hip joint.
Semitendinosus
Muscle of the thigh that act on the leg that originates at the ischial tuberosity and inserts at the proximal portion of medial surface of shaft of tibia; flexes leg at knee joint; extends and medially rotates thigh at hip joint.
Semimembranosus
Muscle of the thigh that act on the leg that originates at the ischial tuberosity and inserts at the medial epicondyle of tibia; flexes leg at knee joint; extends and medially rotates thigh at hip joint.
Tibialis anterior
Muscles of the leg that moves the ankle, foot, and toes that originates in the lateral condyle and body of tibia and inserts in the first metatarsal bone and first cuneiform bone; dorsiflexes ankle; inverts foot and ankle.
Extensor digitorum
Muscles of the leg that moves the ankle, foot, and toes that originates in the lateral condyle of tibia and anterior surface of fibula and inserts in the extensor expansions of digits II-V; extends digits II-V; dorsiflexes foot at ankle.
Extensor hallucis longus
Muscles of the leg that moves the ankle, foot, and toes that originates in the anterior surface of fibula and interosseous membrane and inserts at the distal phalanx of digit I; extends joints of the big toe; assists dorsiflexion of foot at ankle.
Peroneus tertius
Muscles of the leg that moves the ankle, foot, and toes that originates in the anterior surface of fibula and interosseous membrane and inserts at the dorsal surface of fifth metatarsal bone; dorsiflexes and everts foot at ankle.
Peroneus longus
Muscles of the leg that moves the ankle, foot, and toes that originates in the lateral condyle of tibia and head and shaft of fibula and insert in the first cuneiform and metatarsal bone I; plantar flexes and everts foot at ankle.
Peroneus brevis
Muscles of the leg that moves the ankle, foot, and toes that originates in the lower aspect of fibula and inserts in the metatarsal one V; plantar flexes and everts foot at ankle.
Gastrocnemius
Muscles of the leg that moves the ankle, foot, and toes that originates in the lateral and medial condyle of femur and inserts at the posterior surface of calcaneous; plantar flexes foot at angle; flexes knee joint.
Soleus
Muscles of the leg that moves the ankle, foot, and toes that originates in the posterior aspect of fibula and tibia and inserts in the calcaneous; plantar flexes foot at ankle.
Plantaris
Muscles of the leg that moves the ankle, foot, and toes that originates in the lateral supracondylar ridge of femur and inserts at the calcaneous; plantar flexes foot at ankle.
Popliteus
Muscles of the leg that moves the ankle, foot, and toes that originates in the lateral condyle of femur and upper posterior aspect of tibia; flexes and medially rotates leg at knee joint.
Flexor hallucis longus
Muscles of the leg that moves the ankle, foot, and toes that originates in the posterior aspect of fibula and inserts in the distal phalanx of big toe; flexes joint of distal phalanx of big toe.
Flexor digitorum longus
Muscles of the leg that moves the ankle, foot, and toes that originates in the posterior surface of tibia and inserts in the distal phalanges of digits II-V; flexes joints of distal phalanages of digits II-V.
Tibialis posterior
Muscles of the leg that moves the ankle, foot, and toes that originates in the tibia and fibula and interosseous membrane and inserts in the navicular, cuneiform, cuboid, and metatarsal bones II-IV; plantar flexes and inverts foot at ankle; supports arches of foot.
Carpal tunnel syndrome
Syndrome that results from compression of the median nerve at the wrist, within the carpal tunnel. Compression neuropathy causes sensory and motor changes in the median distribution of the hand. Usually occurs in women ages 30 and 60 and poses a serious occupation problem
Atrophic nails, numbness, burning, or tingling, pain, shiny, dry skin, and weakness.
Signs and symptoms of carpal tunnel syndrome.
Tinel's sign (tingling over the median nerve on light percussion); Phalen's wrist-flexion test, in which holding arms vertically and allowing both hands to drop into complete flexion at the wrists for 1 minute reproduces the symptoms of carpal tunnel syndrome.

A blood pressure cuff inflated above systolic pressure on the forearm for 1 to 2 minutes provokes pain and paresthesia along the distribution of the median nerve. EMG detects a median nerve conduction delay of more than 5 msec.
Diagnostic test of choice for carpal tunnel syndrome.
NSAIDS and corticosteroid injections at the site.
Drug therapy for carpal tunnel syndrome.
Splinting for 1-2 weeks, surgical compression of nerve by resecting the entire transverse carpal tunnel ligament or by using endoscopic surgical techniques.
Therapy for carpal tunnel syndrome.
Compartment syndrome
Occurs when the pressure within a muscle and its surrounding structures increases. If the pressure becomes greater than diastolic blood pressure, circulation can be impaired or interrupted completely. Tissue damage occurs after 30 minutes; after 4 hours, irreversible damage may occur.
Primary gout
Type of gout that originates from a metabolic cause that's genetic inborn, usually occurs in men older than age 30 and in postmenopausal women.
Secondary gout
Type of gout that originates from drug therapy or from a metabolic cause that isn't genetic or inborn, and occurs in elderly adults.
Arthrocentesis reveals the presence of monosodium urate monohydrate crystals of needlelike intracellular crystals of sodium urate in synovial fluid taken from an inflamed joint or a tophus.
Blood studies show uric acid levels above normal. Uric acid is usually higher in secondary gout than in primary.
X-ray examination shows damage of the articular cartilage and subchondral bone in chronic gout and outward displacement over the overhanging margin fro the bone contour.
Diagnosis of gout.
B. Hormone imbalance, faulty metabolism, and poor dietary intake of calcium cause primary osteoporosis. Alcoholism, malnutrition, osteogenesis imperfecta, rheumatoid arthritis, liver disease, scurvy, lactose intolerance, hyperthyroidism, and trauma cause secondary osteoporosis.
Which is the most common cause of osteoporosis?

A. Alcoholism
B. Hormonal imbalance
C. Malnutrition
D. Osteogenesis imperfecta
D. take analgesics to relieve pain. Choice analgesics are aspirin or another NSAID to help relieve inflammation, unless contraindicated.
A patient is having an acute attack of gout. What action should the patient take?

A. force fluids
B. relaxation techniques
C. encourage bed rest
D. take analgesics
C. The usual pattern of gout involves painful attacks with pain-fre periods. CHronic gout may lead to frequent attacks with persistently painful joints.
Which phrase best explains the usual pattern of nonchronic gout

A. Frequent painful attacks
B. Generally painful joints at all times
C. Painful attacks with pain-free periods
D. Painful attacks with less painful periods, but pain never subsides.
D. Weight loss will decrease uric acid levels and decrease stress on joints. Weight loss won't decreases purine levels, increase uric acid levels, or decrease inflammation.
A patient is recovering from an attack of gout. What advice should be given to the patient with regards to losing weight?

A. Weight loss will decrease purine levels.
B. Weight loss will decrease inflammation.
C. Weight loss will increase uric acid levels and decrease stress on joints.
D. Weight loss will decrease uric acid levels and decrease stress on joints.
C. The action of colchicine is to decrease inflammation by reducing the migration of leukocytes to synovial fluid.
What is the effects of colchicine on gout?

A. Increases estrogen levels in the blood stream
B. Decreases the risk of infection
C. Decreases inflammation
D. Decreases bone demineralization
A. The most common symptom of osteoarthritis is joint pain after exercise or weight-bearing, usually relieved by rest.
What would you expect to find in a patient with osteoarthritis upon admission?

A. Joint pain after exercise relieved by rest
B. Symmetrical swelling of the joints of both hands.
C. Morning stiffness lasting longer than 30 minutes.
D. Fever
A. Many elderly patients already have diminished hearing and salicylate use can lead to further or total hearing loss. Salicylates don't increase pain in joints, decrease calcium absorption, or increase bone demineralization.
A patient is taking salicylates for osteoarthritis. the presence of which of the following indicates that further assessment is needed?

A. Hearing loss
B. Increased pain in joints
C. Decreased calcium absorption
D. Increased bone demineralization
C. Asymmetrical joint involvement is present in osteoarthritis. Elevated sedimentation rate, multiple subcutaneous nodules, and such signs and symptoms of inflammation as heat, fever, and malaise are all present in rheumatoid arthritis.
You are assessing a patient diagnosed with osteoarthritis. Which of the following signs would you most likely see?

A. Elevated sedimentation rate
B. Multiple subcutaneous nodules
C. Asymmetrical joint involvement
D. Signs and symptoms of inflammation such as heat, fever, and malaise
A. In the late stages of osteoarthritis, the patient often describes joint pain as grating. As the disease progresses, the cartilage covering the ends of bones is destroyed and bones rub against each other. Osteophytes, or bone spurs may also form on the ends of bones.
Which of the following would a patient in the late stages of osteoarthritis most likely use to describe his joint pain?

A. grating
B. dull ache
C. deep aching pain
D. deep aching, relieved with rest
D. With a herniated nucleus pulposus, or herniated disk, the nucleus of the disk puts pressure on the annulus, causing pressure on the nerve root.
A patient is diagnosed with herniated nucleus pulposus, or herniated disk. Which statement should be included in teaching a patient about a herniated disk?

A. The disk slips out of alignment
B. The disk shatters, and fragments place pressure on nerve roots.
C. The nucleus tissue itself remains centralized and the surrounding tissue is displaced.
D. The nucleus of the disk puts pressure on the annulus, causing pressure on the nerve root.
A. Compression of nerves by the herniated disk causes back pain that radiates into the leg, with numbness and weakness of the leg.
A patient complains of low back pain that radiates down the right leg, with numbness and weakness of the right leg. Which disorder is related to these complaints?

A. Herniated nucleus pulposus
B. Muscular dystrophy
C. Parkinson's disease
D. Osteoarthritis
C. Conservative treatment of a herniated nucleus pulposus may include bed rest, pain medication, and physiotherapy. Aggressive treatment may include surgery such as a bone fusion.
Conservative treatment of a herniated nucleus pulposus would include which measures?

A. Surgery
B. Bone fusion
C. Bed rest, pain medication, physiotherapy
D. Strenuous exercise, pain medication, physiotherapy
C. The most common areas of herniation are L4-L5, L5-S1.
Which area is common for vertebral herniation?

A. It is the L1-L2, L4-L5 vertebrae
B. It is the L1-L2, L5-S1 vertebrae
C. It is the L4-L5, L5-S1 vertebrae
D. It is the L5-S1, S2-S3 vertebrae
D. Tests used to diagnose a herniated nucleus pulposus include myelography, MRI, and CT scan.
A 50 year old patient is admitted to the emergency department with severe lower back pain, weakness, and atrophy of her leg muscles. Suspecting a herniated disk, which diagnostic test should you order?

A. CXR, MRI, CT scan
B. Lumbar puncture, CDR, MRI, CT scan
C. Lumbar puncture, CDR, myelography
D. Myelography, MRI, CT scan
C. With compartment syndrome, the patient can't perform active movement, and pain occurs, with passive movement.
A patient with a recent fracture is suspected of having compartment syndrome. Assessment findings may include which symptom?

A. Body-wide decrease in bone mass
B. A growth in and around the bone tissue
C. Inability to perform active movement; pain with passive movement.
D. Inability to perform passive movement; pain with active movement.
A. The hemorrhage in compartment syndrome causes edema, increased venous pressure, and decreased venous and arterial circulation.
You are assessing a patient with a hemorrhage from compartment syndrome. Which of the following symptoms would you expect to find?

A. edema
B. decreased venous pressure
C. increased venous circulation
D. increased arterial circulation
B. Following development of compartment syndrome, there is an increase in pressure within the affected compartment that compromises circulation to the muscle tissue and to nerves. This may lead to death of these tissues and can occur within 2 to 4 hours. Decreasing pain levels, preventing further complication, and decreasing the swelling in the affected extremity are important goals of treatment, but not priority.
A patient has developed compartment syndrome following application of a cast to a fractured tibia. Which of the following responses is the most accurate for prompt action in treating compartment syndrome?

A. Decrease the level of pain
B. Prevent tissue death, which can occur within 2 to 4 hours.
C. Prevent further complications
D. Decrease the swelling in the extremity
C. Fasciotomy, which involves cutting the fascia over the affected area to permit muscle expansion.
Treatment of compartment syndrome includes which measure?

A. Amputation
B. Casting
C. Fasciotomy
D. Observation; no treatment is necessary
D. Paresthesia is described as numbness and tingling.
Which of the following are considered signs of paraesthesia?

A. Fever and chills
B. Change in range of motion
C. Pain and blanching
D. Numbness and tingling
B. Paresthesia is the earliest sign of compartment syndrome.
Which symptom is considered an early sign of compartment syndrome?

A. heat
B. paresthesia
C. skin pallor
D. swelling
D. Signs of a fracture may include redness, warmth, numbness or loss of sensation, and new site of pain. Coolness, tingling, and loss of pulses are signs of a vascular problem.
Which symptoms are considered signs of a fracture?

A. Tingling, coolness, loss of pulses
B. Loss of sensation, redness, coolness
C. Coolness, redness, new site of pain
D. Redness, warmth, pain at the site of injury
B. A correct neurovascular assessment should include capillary refill, movement, pulses, and warmth.
Which areas should e included in a neurovascular assessment?

A. Orientation, movement, pulses, warmth
B. Capillary refill, movement, pulses, warmth
C. Orientation, pupillary response, temperature, pulses
D. Respiratory pattern, orientation, pulses, temperature
C. If pulses aren't palpable, verify the assessment with Doppler US.
If pulses aren't palpable, which intervention should be performed first?

A. Check again in 1 hour
B. Alert the doctor immediately
C. Verify the findings with a Doppler US
B. Fracture pain is sharp and related to movement.
A patient comes to the emergency room complaining of dull, deep bone pain unrelated to movement. Which statement is correct to hep decide if the bone pain is caused by a fracture?

A. these are classic symptoms of a fracture.
B. Fracture pain is sharp and related to movement.
C. Fracture pain is sharp and unrelated to movement.
D. Fracture pain is dull and deep and related to movement.
C. Classic fractures that occur with trauma are those of the humerus and clavicle.
A patient is involved in MVA and is being sent to a trauma center. for which classic fractures that typically occur from trauma should the staff be prepared to assess?

A. Brachial and clavicle
B. Brachial and humerus
C. Humerus and clavicle
D. Occipital and humerus
D. A transverse fracture commonly occurs with such bone diseases as osteomalacia and Paget's disease. Linear, longitudinal, and oblique fractures generally occur with trauma.
A 75 -year old patient with Paget's disease is undergoing tests for a suspected fracture. Which type of fracture would you expect to see?

A. Linear
B. Longitudinal
C. Oblique
D. Transverse
C. Spiral fractures are commonly seen in the upper extremities and are related to physical abuse.
A 20-year old female patient is complaining of severe pain in her right upper arm. If you suspect domestic abuse, which X-ray finding would you expect to see?

A. Longitudinal
B. Oblique
C. Spiral
D. Transverse
C. Femoral shaft fractures may cause hemorrhage, with as much as 1,00 to 1,500 ml of blood loss.
You are evaluating a patient with a femoral shaft fracture. Which serious complication is seen with this condition?

A. Constipation
B. Decreased urine output
C. Hemorrhage
D. Pain
D. SS of fat emboli include tachypnea, tachycardia, SOB and petechial rash on the chest and neck. The fat molecules enter the venous circulation and travel to the lung, obstructing pulmonary circulation.
A patient is diagnosed with a fat emboli. Which signs and symptoms would you expect to find with evaluating the patient?

A. Tachypnea, tachycardia, SOB, and paresthesia
B. Paresthesia, bradypnea, bradycardia, petechial rash on chest and neck
C. Bradypnea, bradycardia, SOB, petechial rash on chest and neck
D. Tachypnea, tachycardia, SOB, petechial rash on chest and neck.
B.
Treatment of a fat emboli includes which f the following?

A. Albuterol, oxygen, I.V. fluids, steroids
B. Oxygen, I.V. fluids, steroids, antibiotics
C. Morphine, oxygen, I.V. fluids, antibiotics
D. theophylline, morphine, oxygen, I.V. fluids
D. To prevent DVT after hip surgery, subcutaneous heparin and penuatic compression boots are used. BR can cause DVT.
Which intervention would help prevent deep vein thrombosis after hip surgery?

A. Bed rest
B. egg crate mattress
C. Vigorous pulmonary care
D. Subcutaneous heparin and pneumatic compression boots.
D.
At the scene of an accident, which intervention applies to a patient with a suspected fracture?

A. Don't move the patient
B. Move the patient to safety immediately
C. Sit the client up to facility to his airway
D. Immobilize the extremity and move the patient to safety.
A. Unilateral leg pain and edema with a positive Homan's sign might be symptoms of DVT.
A patient with a right hip fracture is complaining of left-sided leg pain and edema and has a positive Homan's sign. Which condition would show those symptoms?

A. DVT
B. Fat emboli
C. Infection
D. Pulmonary embolism
A. A fat emboli usually presents as acute respiratory distress. Symptoms include, CP, cyanosis, dyspnea, tachypnea, and apprehension.
Which symptom would indicate a patient with a fracture of his left femur has a fat emboli?

A. Dyspnea
B. Sudden HA
C. Muscle spasm in the left thigh
D. Numbness in the left leg
D. Open reduction means that the tissue must be surgically opened and the fractured bones realigned. Th maintain proper alignment, a screw, plate, nail, or wire is inserted to prevent the bones from separating.
Which statement explains an open reductio of a fracture femur?

A. Traction will be used.
B. A cast will be applied
C. Crutches will be used after surgery
D. Some form of screw, plate, nail, or wire is usually used to maintain alignment.
B. A dislocated hip will create problems with walking, and pain is often due to a pinched nerve in the joint.
Dislocation of the hip involves which symptoms?

A. Pain relived with pressure
B. Pain in the inguinal area, abnormal gait
C. Internal rotation of the knee, abduction of the leg.
D. Pain the hip, the thigh appears longer than the unaffected leg.
D. The tissues need to be debrided to eliminate necrotic tissue and allow new tissue to form. A bone graft would be done after debridement. Hyperbaric oxygen therapy is a new treatment modality that has been use din the successful treatment of osteomyelitis
A patient has been treated with IV antibiotics for osteomyelitis. The treatment has not been effective. Which intervention would be the most appropriate for this client?

A. Bone grafts
B. Hyperbaric oxygen therapy
C. Amputation of the extremity
D. Debridement of necrotic tissue
A. A bone scan views the entire skeletal structure, indicating areas of possible metastases, CT scan, MRI, and PET scan visualize only one body area at a time.
For a patient diagnosed with Ewing's sarcoma, which test is most useful in determining the extent of metastasis?

A. Bone scan
B. Computed tomography (CT)
C. MRI
X. PET
Gibbous
An angular deformity of collapsed vertebrae and is frequently caused by metastatic cancer or tuberculosis of the spine.
Atrophy of the biceps and triceps; neck pain that radiates down the arm to the hand; neck stiffness; straightening of normal lumbar curve with scoliosis away from the affected side; weakness of affected upper extremities; weakness, numbness, and tingling of the hand.
For a suspected herniated nucleus pulposus in the cervical area, what symptoms would you expect to see?
CSF fluid (cytology) will be positive for elevated protein levels; deep tendon reflexes are depressed or absent in the upper extremities or Achilles tendon; EMG shows spinal nerve involvement; Lasegue's sign is positive; Myelogram shows compression of the spinal cord; X-ray shows narrowing of disc space.
Discuss diagnostic test results for a suspected herniated nucleus pulposus.
Lasegue's sign
Another name for the straight leg maneuver used in the diagnosis of lumbosacral radiculopathy.
Osteoarthritis
Also known as degenerative joint disease, this is characterized by degeneration of cartilage in weight-bearing joints, such as the spine, knees, and hips. it occurs when cartilage softens with age, narrowing the joint space. This allows bones to rub together causing pain and limiting joint movement.
Crepitiation, enlarged, edematous joints, Heberden's nodes, increased pain in damp, cold weather, joint stiffness, limited ROM; pain that is relieved by resting the joints; smooth, taut, shiny skin.
Signs and symptoms of osteoarthritis.
Arthroscopy revels bone spurs and narrowing of joint space; hematology reveals elevated ESR; X-rays show joint deformity; narrowing of joint space, and bone spurs.
Diagnostic tests to order for osteoarthritis.
Osteomyelitis
A pyogenic bone infection. It may be chronic or acute and commonly results from a combination of local trauma-usually quite trivial but resulting in hematoma formation-and an acute infection taking place elsewhere in the body. Although this disease remains localized, it can spread through the bone to the marrow, cortex, and periosteum.
Blood cultures X 3; SR and CRP are elevated (CRP appears to be a better diagnostic tool); WBC shows leukocytosis.
Diagnostic tests commonly ordered for evaluating osteomyelitis.
Frontal bone
Bone that forms the anterior roof of the cranium, the roof of the nasal cavity, and the supraorbital margin over the orbit of each eye.
Occipital bone
Bone that forms the posterior and much of the inferior portion of the cranium. It contains the foramen magnum, through which the spinal cord attaches to the brain, and the occipital condyles, which articulates with the first cervical vertebra.
D
The respiratory and digestive system linings are composed of this type of tissue:
a. nervous
b. connective tissue
c. muscle
d. epithelial
e. fibrous
B
Connective tissue is classified on the basis of the
a. type of cells in the tissue
b. type of matrix found between the cells
c. presence or absence of goblet cells
d. number of cell layers found in the tissue
e. all of the above
D
Which of the following tissues is composed of cells which are most tightly packed?

a. connective tissue
b. nerve
c. muscle
d. epithelial cells
e. all tissue types tightly pack their cells.
A
The most abundant structural protein secreted by connective tissue is:

a. collagen
b. hemoglobin
c. cellulose
d. glycogen
e. elastin
B
Which type of cell junction is found between the cells where the underlying cells need to be isolated, such as the stomach, intestines, or testes?

a. gap junctions
b. tight junctions
c. hemidesmosomes
d. desmosomes
e. adherens junction
A
The most abundant tissue in the human body is:

a. connective
b. epithelial
c. nerve
d. muscle
e. bone
E
Which of the following cells are not found in connective tissue?
a. fibroblasts
b. osteocytes
c. chondrocytes
d. adipocytes
e. squamous
C.
Ares of rapid diffusion, such as the alveoli of the lungs and capillaries of the vascular system are lined with:

a. simple columnar epithelium
b. stratified cuboidal epithelium
c. simple squamous epithelium
d. stratified squamous epithelium
e. transitional epithelium
D
Adipose, ligaments, tendons, bone, blood, and lymph are all types of

a. nervous tissue
b. muscle tissue
c. epithelial tissue
d. connective tissue
B
This tissue is primarily composed of the proteins actin and myosin

a. cartilage
b. muscle
c. bone
d. nerve
e. epithelial
E
Which of the following statements regarding keratin is untrue?

a. keratin prevents dehydration through the skin
b. keratin is the protein which forms hair and nails
c. keratin is the most abundant in the corneal layer of the skin
d. keratin is found in the cells of the epidermis of the skin
e. keratin gives skin its coloration
E
Which of the following regarding the integument is true?

a. it serves as the body's first line of physical and chemical defense
b. it is important in the regulation of the body temperature
c. It is the largest organ of the body
d. it is important in preventing dehydration
e. all the above
D
Skin cells exposed to sunlight are able to produce vitamin

a. A
b. B1
c. B6
d. D
e. E
A
The protective nature of the skin is due to its composition of
a. stratified squamous epithelium
b. simple squamous epithelium
c. simple columnar epithelium
d. fibrous connective tissue
d. osseous tissue
E
Which of the following is NOT found in the dermal layer of the skin?

a. sweat glands
b. hair follicles
c. blood vessels
d. sensory receptors
e. melanocytes
E
Which of the following are causes of concern regarding skin cancer?

a. a mole where one half looks differently than the other half.
b. a mole with a border which has irregular or rough edges
c. a mole whose coloration is not even
d. a mole with a diameter equal to or larger than a pencil eraser
e. all of the above.
B
Lacunae are

a. the matrix-producing cells of cartilage and bone
b. spaces int eh matrix of bone tissue in which bone cells are found.
c. fibers that add strength to the matrix of cartilage
d. proteins that make up most of the matrix of connective tissue
e. none of the above.
A
Haversian canals are found in:

a. bone tissue
b. muscle tissue
c. the dermis
d. the epidermis
e. nerve tissue
E
The development of the skeleton from cartilage to bone:

a. is called ossification
b. continuous until an individual's early to mid 20's
c. ends with calcification of the epiphyseal plates
d. involves the replacement of chondrocytes by osteoblasts
e. all of the above
E
Bone tissue performs all of the following functions except:

a. stores calcium and other minerals
b. produces blood cells
c. provides structural support
d. protects vital organs
e. stores glycogen
A
Red blood cells are produced

a. inside spongy bone
b. in the Haversian canals
c. in the yellow bone marrow
d. by adipocytes
e. by the sarcoplasmic recticulum
A
Synovial joints are found int eh following except the

a. spine
b. hands
c. knees
d. elbows
e. shoulders
B
Which of the following is stored int eh sarcoplasmic recticulum? and necessary for muscle contraction?

a. ATP
b. calcium ions
c. actin
d. myosin
e. sarcomere
C
An example of an antagonistic pair of muscles is:

a. left quadriceps/ left triceps
b. right biceps/right quadriceps
c. left biceps/ left triceps
d. right hamstring/right triceps
e. right biceps/ right hamstring
E
Which of the following play a role in muscle contraction?

a. ATP
b. troponin
c. calcium
d. tropomyosin
e. all of the above
D
Z lines are the boundaries of the:

a. sarcoplasmic recticulum
b. myosin myofilaments
c. Haversian canals
d. sarcomere
e. neuromuscular junctions
C
Which of the following is not a true statement?

a. cardiac muscle is found only in the heart
b. skeletal muscle is also called striated or voluntary muscle
c. cardiac muscle is nonstriated and involuntary
d. smooth muscle regulates the diameter of the blood vessels.
e. The biceps are skeletal muscles
D
When a muscle contracts:

a. the actin filaments shorten
b. the myosin filaments shorten
c. both the actin and myosin filaments shorten
d. the actin and myosin filaments slide past one another.
e. the actin filaments actually get longer while the myosin filaments shorten.
D
Which of the following is incorrect?

a. Z lines separate one sarcomere from the next.
b. myosin filaments are large than actin filaments
c. ATP and calcium ions must be present for a muscle contraction to occur.
d. weight training stimulates a muscle fiber to divide and produce more muscle cells.
e. the sarcomere is the functional unit of muscle contraction.
C
Skeletal muscle fibers are signaled to contract by the release of

a. epinephrine by sensory neurons
b. adrenaline by associative neurons
c. acetylcholine by motor neurons
d. seratonin by cerebral neurons
e. endorphins by motor neurons.
B
The quadriceps are examples of

a. flexors
b. extensors
c. adductors
d. abductors
e. rotators
Rhabdomyolysis
The breakdown of muscle fibers that results in the release of muscle fiber content into the circulation. Myoglobin is released into the bloodstream and then is filtered by the kidneys. Myoglobin may occlude the structure of the kidney, causing damage, such as acute tubular necrosis or kidney failure.