1. Date : 18th JANUARY, 2012 : 2-00 PM- 4-00 PM
Tutorial-1
Block: 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 moved
B. the velocity of muscle movement
C. the blood flow to the muscle being moved
D. the tension developed by the muscle being moved
E. the change in the joint angle produced by the movement

10. Question 2
During a normal voluntary movement,
A] large muscle fibers are recruited before the small muscle
fibers
B] fast muscle fibers are recruited before the slow muscle
fibers
C] weak muscle fibers are recruited before the strong
muscle fibers
D] poorly perfused muscle fibers are recruited before the
richly perfused muscle fibers
E] 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 him
A] bone formation by osteoblasts
B] the composition of bone collagen
C] calcification of the bone matrix
D] bone resorption by osteoclasts
E] 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 over
B] it does not last as long as the action potential
C] it produces more tension when the muscle contracts
isometrically than isotonically
D] it produces more tension when the muscle contracts
isotonically than isometrically
E] it decreases in magnitude with repeated stimulation