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  • 1. Date : 18th JANUARY, 2012 : 2-00 PM- 4-00 PM Tutorial-1Block: MUSCULOSKELETAL [MSK] Subject : PHYSIOLOGY
  • 2. Questions• describe transmission of impulses at the neuromuscular junction [NMJ]• List the properties of NM transmission• discuss effects of different neuromuscular blockers on transmission of impulses in a somatic motor system• explain the process of excitation-contraction coupling, muscle contraction & relaxation• what is the importance of RyR1 in skeletal muscle?
  • 3. Questions• explain the characteristics of muscle contraction-muscle twitch, graded response, summation, clonus, tetanus & fatigue and associate them to real conditions in health & disease• explain the length- tension relationship in whole muscle• describe remodelling of muscle to match function
  • 4. Questions• list the types of skeletal muscle fibers in the body and state their characteristics• explain motor unit & its importance• explain the role of muscle spindles on muscle tone
  • 5. TERMS……..define, explain & clinical relevance• ATROPHY HYPOTONIA• HYPERTROPHY HYPERTONIA• HYPERPLASIA ATONIA RIGOR MORTIS DENERVATION SENSITIVITY TETANUS TETANY
  • 6. Basic pathophysiology causing……• Muscle spasm• Delayed Onset Muscle Soreness• Malignant Hyperthermia• Myasthenia gravis• Lambert Eaton Myasthenic syndrome• Muscular dystrophy
  • 7. • Revise Bone Physiology as was taught in BMS.
  • 8. Questions• What are the structures involved in E-C Coupling?• The T-tubular membrane is not in direct communication/contact with the SR membrane. How does the T-tubular depolarization affect the release of calcium from the SR?• What are the other roles of RyR in the body?• What are the functions of : Nebulin Dystrophin Desmin Titin Vimentin Alpha- actinin
  • 9. Question - 1 A 77 year old woman with severe kyphoscoliosis presents with increasing dyspnea consistent with a decrease in chest wall compliance. With contraction of external intercostal muscles during inspiration, the Golgi tendon organ (GTO) provides the CNS with information about :A. the length of the muscle being movedB. the velocity of muscle movementC. the blood flow to the muscle being movedD. the tension developed by the muscle being movedE. the change in the joint angle produced by the movement
  • 10. Question 2During a normal voluntary movement,A] large muscle fibers are recruited before the small muscle fibersB] fast muscle fibers are recruited before the slow muscle fibersC] weak muscle fibers are recruited before the strong muscle fibersD] poorly perfused muscle fibers are recruited before the richly perfused muscle fibersE] anerobic fibers are recruited before aerobic fibers
  • 11. Question 3• A 32-year-old man sees his physician after collapsing suddenly without any other physical distress. Laboratory results demonstrate an elevated serum concentration of potassium. Increased extracellular potassium concentration caused muscle weakness due to• A] hyperpolarization of muscle cells• B] inactivation of sodium channels in muscle cells• C] increased release of neurotransmitters from alpha motor neurons• D] decreased potassium conductance in muscle cells• E] increased duration of action potentials produced by alpha motoneurons
  • 12. Question - 4• An 18-month-old boy presents with delayed dentation, short stature, difficulty and painful walking, and bowing of the legs. He was found to have deficiency of vitamin D and therefore the following are defective in himA] bone formation by osteoblastsB] the composition of bone collagenC] calcification of the bone matrixD] bone resorption by osteoclastsE] the blood supply to the Haversian canals
  • 13. Question - 5• Which of the following best describes the contractile response of the skeletal muscle?A] it starts after the action potential is overB] it does not last as long as the action potentialC] it produces more tension when the muscle contracts isometrically than isotonicallyD] it produces more tension when the muscle contracts isotonically than isometricallyE] it decreases in magnitude with repeated stimulation