Spine Anatomy
At what level does the spinal cord usually end
L1/2
Potassium and Sodium
What are the two main phases of gait
Stance and swing
Which fibres cross at the optic chiasm
Nasal fibres
Ampulla of vater
Where does the C8 spinal nerve exit?
Above T1
What kind of nervous supply does the skin have?
Sympathetic only but it uses Ach
What are the main actions of parathyroid hormone
Promotes the formation of RANKL by osteoblasts which stimulates osteoclast activity
Increases reuptake of calcium and decreases the reuptake of phosphate in the kidney
Increases GIT absorption of calcium and phosphate
A patient has a positive Babinski relfex, in which direction are their toes moving?
Up going
What three medications are part of the triple therapy for gastric ulcers?
amoxicillin (bactericidal), clarithromycin (bacteristatic), and esomeprazole
Where are Lumbar punctures usually performed and what is a landmark for this location
Between L3/4 or L4/5
Landmark is the top of the iliac crest which indicates the location of L4
Define Saltatory condution
How the presence of myelin allows the impulse to jump between the nodes of Ranvier (unmyelinated segments), allowing quicker transmission of the signal
The ribs ossify by first creating a hyaline cartilage scaffold. What type of ossification is this?
Endocondral ossification
Why does referred pain occur?
Neurons from multiple regions of the body converge on the same second order neuron and the brain cannot distinguish where the pain signal has come from. It assumes the signal is somatic eg from skin as this is more common.
Name 4 factors that can prevent wound healing
Foreign body
Malnutrition
Repeated trauma
Infection
Systemic diseases eg diabetes
Poor blood flow
What information do the posterior and anterior root nerves transmit?
Posterior root carries sensory information while anterior carries motor
What is the difference between pain and nociception
Pain is the subjective sensory and emotional response to damage
Nociception is the biological process of the body detecting noxious stimuli
Name four symptoms that would make you concerned of cauda equina syndrome
Loss of bladder function
Loss of bowel function
Saddle anesthesia
Loss of feeling and movement in the lower limbs
Pain
Name three differences in symptoms between upper and lower motor neuron lesions
Tone and reflexes are increased in upper motor lesions but decreased in lower motor neuron lesions
fasculaiations may be present in lower motor neuron lesions but not upper motor lesions
atrophy occurs with lower motor neuron lesions and not upper
What transporter is inserted into the cell membrane following insulin stimulation
GLUT4
Name the layers to be pierced when completing a lumbar puncture
A patient is diagnosed with Brown Sequard syndrome following a hemisection injury. What functions would they lose on each side of the body and why
Ipsilateral loss of discriminative fine-touch, proprioception and vibration from impairment to the dorsal column–medial lemniscus pathway
Contralateral loss of noxious sensation, temperature and non-discriminative touch, one to two spinal segments below the injury because of impairment to the spinothalamic tract
Where are the four main types of collagen found
Type I collagen is most common in tendons and bones
Type II is elastic cartilage that gives joint support
Type III is in muscles, arteries, and organs
Type IV is the basement membrane
A patient hears a signal stronger on their left ear in the Weber test and the Rinne test is normal. What kind of hearing loss do they have?
Sensorineural hearing loss on the right
A 24-year-old medical student presents for routine screening. They have no symptoms and no known history of hepatitis. Their hepatitis B serology is:
Test. Result
HBsAg Positive
Anti-HBs Negative
Anti-HBc IgM Positive
Anti-HBc IgG Negative
HBeAg. Positive
Discuss the patient's hepatitis status, including if they have been previously vaccinated and if they are currently infectious
The patient has no evidence of vaccination and they have a current Hep B infection