28.1 - 28.3

Question 1

The pubic tubercle forms the attachment for the ___ ligament.

Answer 1

Inguinal

Question 2

There are 3 ___ lines on the ilium of the hip bone - these form attachments for the ___ muscles.

Answer 2

Gluteal lines

Gluteal muscles

Question 3

There are many sites of epiphyses in the hip bone. In children, the muscle is usually stronger than the bony attachment, so forces to these sites can result in ___ fractures.

Answer 3

Avulsion

Question 4

The shaft of the femur is smooth for the direct attachment (i.e. muscle fibres direct from bone, surface is not rough for tendons) of ___ ___.

Answer 4

Vastus intermedius

Question 5

There is a ridge on the posterior aspect of the femur called the ___ ___. There is a spiral line at the lesser trochanter that is continuous with the ___ margin of this ridge. There is a line from the greater trochanter down the ___ margin of the ridge.

Answer 5

Linea aspera
From lesser trochanter - spiral line posteriorly that is continuous with medial margin
From greater trochanter - line down lateral margin of ridge

Question 6

There are 3 gluteal lines on the hip bone. Between the posterior line (i.e. the most medial line) and the sacrum is the attachment for ___ ___. Attachments for ___ ___ and ___ ___ are more lateral.

Answer 6

Between posterior gluteal line and sacrum is attachment for gluteus maximus
Attachments for gluteus medius and gluteus minimus are more lateral

Question 7

The thigh is surrounded by deep fascia called ___ ___. There is a thickening of the fascia to form a band from the pelvis to the lateral aspect of the tibia called the ___ band. Deep fascia enters the thigh towards the femur to form septa and compartments.

Answer 7

Fascia lata

Thickening of fascia down from pelvis (ilium) to lateral aspect of tibia called iliotibial band

Question 8

The femoral triangle is formed by ___ muscle, ___ ___ muscle and the ___ ligament.

Answer 8

Sartorius (lateral pelvis to medial knee)
Adductor longus
Inguinal ligament (superior border of triangle)

Question 9

Psoas major originates from T___ and L___-L___ from tendinous arches that form across vertebral bodies (i.e. a segmental muscle). It forms spaces between fasciculi for nerves of the ___ ___ - these nerves enter the spaces and move laterally to form a plexus in the substance of psoas major.

Answer 9

T12 and L1-L5

Lumbar plexus

Question 10

Psoas and iliacus are surrounded by a ___. Therefore, abscesses can move from the ___ spine to the lower limb.

Answer 10

Fascia

Lumbar spine to lower limb (attachment sites of iliopsoas)

Question 11

In children, there can be an inflammatory response at the epiphysis at the proximal aspect of the tibia (tibial tuberosity, where patellar tendon attaches) resulting in enlargement and pain under the knee joint. This occurs in ___ ___ disease.

Answer 11

Osgood Schlatter disease

Question 12

The medial collateral ligament of the knee down to the medial aspect of the tibia is a vestigial insertion of the ___ part of adductor ___.

Answer 12

Hamstring part of adductor magnus

Question 13

The main lateral rotator muscles of the hip are ___ and ___ ___.

Answer 13

Piriformis and obturator internus

Question 14

The sciatic nerve passes ___ piriformis. The superior gluteal nerve and artery pass ___ piriformis. The inferior gluteal nerve and artery pass ___ piriformis.

Answer 14

Sciatic nerve passes under piriformis
Superior gluteal nerve and artery pass above piriformis
Inferior gluteal nerve and artery pass below piriformis

Question 15

What are the 5 main ethical principles?

Answer 15

Beneficence - do good
Non-maleficence - avoid/minimise harm
Respect for autonomy
Justice
Respect for human dignity - all humans are of equal moral worth

Question 16

The tibia is a triangular bone. The subcutaneous ___ surface is palpable. The subcutaneous ___ and ___ surfaces are surrounded by muscle and not palpable.

Answer 16

Anteromedial surface - palpable

Lateral and posterior surfaces - surrounded by muscle

Question 17

The ___ meniscus can slide posteriorly off the tibial plateau onto an area with hyaline cartilage. The ___ meniscus is susceptible to injury in extreme flexion e.g. in squats.

Answer 17

Lateral

Lateral

Question 18

Approx. 1/3 down the posterior aspect of the tibia is the ___ line for attachment of the ___ muscle (superficial calf muscle). It attaches and passes down with ___ to form the ___ tendon.

Answer 18

Soleal line
Soleus muscle
Gastrocnemius muscle
Achilles tendon

Question 19

The medial/tibial malleolus terminates more ___ (proximal or distal) compared to the lateral/fibular malleolus.

Answer 19

Proximal

I.e. medial malleolus is higher up than lateral malleolus

Question 20

The deep fascia of the leg is called ___ fascia. In the region of the ankle, the fascia forms ankle ___. This holds tendons down to prevent bow-stringing and forms tarsal tunnels.

Answer 20

Crural

Ankle retinaculae

Question 21

Shin splints occur because muscles of the anterior leg (e.g. tibialis anterior) attach directly to the ___ surface of the tibia.

Answer 21

Lateral

Shin splints = periostitis due to microtrauma from running on hard surfaces

Question 22

The flexor retinaculum is on the ___ aspect of the ankle. The 2 extensor retinaculae are on the ___ aspect of the ankle. The fibular retinaculae are on the ___ aspect of the ankle. Fascia are important for locomotion because they store ___ energy.

Answer 22

Flexor retinaculum - medial
Extensor retinaculae - anterior
Fibular retinaculae - lateral
Elastic

Question 23

Nerve supply to the muscles of anterior leg is by the ___ ___ ___ (L___/___). Damage to the nerve supply of the muscles in the anterior leg results in ___ ___.

Answer 23

Deep fibular nerve (L4/5)

Foot slap

Question 24

The muscles from anterior and posterior aspects of the leg are protected by ___ sheaths at the malleoli. Sheaths start above the ___ (usually), and continue down below them. There is NO ___ sheath for the ___ tendon. What surrounds this tendon?

Answer 24

Synovial sheaths
Start above the retinaculum and continue down below them
NO synovial sheath for the Achilles tendon
Instead there is a paratenon (soft tissue, not synovial) surrounding the tendon
It is also protected superficially and deeply by bursae

Question 25

The ___ nerve or its branches may be compressed under the flexor retinaculum. This is called ___ ___ ___.

Answer 25

Tibial nerve or its branches
Tarsal tunnel syndrome
The flexor retinaculum is on the medial aspect of the ankle