Case scenario

Mr. C, 50 years old, is an amateur soccer player who regularly plays with his friends over weekend. He has chronic anterior right hip pain and weakness over his groin region for 5 years. One day, when he was playing soccer, he was injured by another player who crushed on him from lateral side of his left leg. Then, he fell down on the grassland after twisting his left knee and ankle due to the crush. He started to feel pain and weakness over his left leg from knee to ankle. He could not move his left leg to stand up. When he fell down, he fell on the leg of that player which caused pain, swelling, numbness and weakness over the posterior side of his own left leg. Then, he was send to the emergency room of a nearby hospital. The doctor of the emergency room of the hospital assessed his legs and arranged X-ray check for him. Your supervisor asked you to identify all key anatomical structures in the initial assessment that are related to his hip, knee and ankle discomfort according to the above information. You need to provide clear rationale to support your answers when you report to your supervisor.

Please answer according to the following guidance:

1. What bone(s), bony landmark(s) and joint(s) can be involved in his hip, knee and ankle problems? Please list out accordingly and support with corresponding reasons.

2. What muscle(s) and soft tissue(s) can be involved in his hip, knee and ankle problems? Please list out accordingly and support with corresponding reasons. The relevant origin and insertion should be included.

3. What nerve (nerves) can be involved in his hip, knee and ankle problems? Please list out accordingly and support with corresponding reasons.

4. What artery (arteries) and vein (veins) are involved in his problems mentioned above? Please list out accordingly and support with corresponding reasons.

5. What lower limb functional movements that can be affected according to his leg conditions? Why?

Does anyone have old exams of anatomy and physiology 2086 of professor Lisa Smith?

Q1) After a stroke, a patient complains about numbness( lack of sensing) in her left hand. The stroke most likely affected the ______

1. Precentral gyrus in the right frontal lobe.
2. Postcentral gyrus in the left parietal lobe.
3. Precentral gyrus in the left frontal lobe.
4. Postcentral gyrus in the right parietal lobe.
5. Postcentral gyrus in the left frontal lobe.
6. None of these.

Q2) which of these is NOT a characteristic of the parasympathetic division of the nervous system?

1. It originates in the craniosacral region of the central nervous system
2. The terminal ganglia are very close to their target organs.
3. It has long preganglionic fibers.
4. Its effect more local than effect of the sympathetic division
5. None of these

Q3) Which of these happens third in a cholinergic synaptic transmission?

1. Ach diffuse across the synaptic cleft
2. Postsynaptic potential is produced
3. Sodium enters the postsynaptic cell
4. Synaptic vesicles release Ach
5. Ach binds to ligand- regulated gates

Q4)  _____ are secreted by one cell into the tissue fluid and diffuse to nearby cells where they may affect neighborhood physiology.

1. Endocrine hormones
2. Neurotransmitters
3. Paracrine
4. Neuromodulators
5. None of these

Q5)  Which of the following statement is FALSE?

1. A nerve fiber is enclosed in its own fibrous sleeve called endoneurium
2. The stretch reflex is a tendency of a muscle to contract when it is overstretched.
3. Spinal cord conducts signals up and down the body passing through white matter.
4. A dermatome is a region of the skin served by a specific spinal nerve, although the overlap between receptor fields results in 2 or 3 adjacent segments contributing to innervations.
5. None of these.

Pick a simple movement you perform everyday such as, sitting in a chair, drinking from a glass, etc. Explain how the movement occurs, including nerve roots, muscle contractions, angle of pull, etc. How would the movement change when various forces are applied to the movement (i.e. – drinking from a full glass versus an almost empty glass)?

1. What is the main challenge most fish face when using their swim bladders? How are both the Bohr and the Root effects essential for fish swim bladder function?

Explain the significance of an elevated 2hr post challenge glucose value.

Discuss how cholinesterase inhibitors affect the physiology of neurons and nerve impulses.

Does the motor cortex send an individual axon for each M1 neuron down the corticospinal tract down to lower motor neurons in the spinal cord? And then would lower motor neurons receive all these axons and calculate the population code on their own? Or does the motor cortex calculate the population code of all of its neurons (or all of the neurons that represent the corresponding muscle) and send this information to the muscles? Also at what level are the signals muscle-specific?

Elevated potassium levels in the body (hyperkalemia) is a serious condition, resulting in a severely decreased ability for muscle fibers and neurons to reploarize. The adrenal cortex can respond to this. However, very high osmolarity shuts down this response. Explain this incongruity, by describing the response mechanism of the adrenal cortex.

Response 1:

• Explain the 3 germ layers and tell one part/organ that arises from each layer

Response 2:

• Include 2 developmental changes associated with aging.

Discuss the advantages of separate urinary and genital tracts. and discuss the evolutionary benefits of the current configuration differences between males and females.