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Year 2 LCRS Anatomy Limbs > All of Anatomy Limbs > Flashcards

All of Anatomy Limbs Flashcards

1
Q
A
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2
Q

How do you test the function of the Pectoralis Major muscle?

Which nerves do you test when doing so?

A

Adduct the abducted arm against resistance (+palpate the muscle)

Test the Medial and lateral pectoral nerves (C5, C6, C7, C8, T1)

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3
Q

How would you test the function of the Serratus anterior muscle?

Which Nerve do you assess when doing so?

A

Both Arms of the subject outstretched with palms against the wall, asked to press forward strongly

–> See if scapula keeps attached to the thorax

Long-thoracic nerve C5,6

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4
Q

How would you test the function of the trapezius muscle?

Which nerve do you assess when doing so?

A

Raise both shoulders against resistance

Tests: Accessory nerve (CN XI)

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5
Q

How would you test the function of Latissimus dorsi muscle?

Which Nerve function do you test when doing so?

A

Abduct the Arm to 90°, then adduct against resistance

–> See+ palpate the muscle in the posterior axillary fold

Testing: Thoraco-dorsal nerve (C6,7,8)

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6
Q

How would you test the function of the deltoid muscle?

Which nerves do you test when doing it?

A

Abduct the arm against resistance

(Test Axillary nerve, C5, C6)

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7
Q

How do you test the function of the Teres Major?

Which nerve do you assess when doing so?

A

Adducting the arm against resistance (See+ palpate the muscle in the posterior axillary fold)

Test the: Lower-subscapular nerve C5,6

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8
Q

Identify on a skeleton

  • clavicle
  • scapula (cromion and scapula spine)
  • humerus
  • radius
  • ulnar
  • carpal bones
  • metacarpals
  • phalanages
A
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9
Q

Identify the differnt carpal bones on a skelton

A
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10
Q
A

Acromion of scapula

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11
Q
A

Spine of Scapula

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12
Q

What are the possible movements at the Sapulo-thoracic joint?

A
  1. Protraction
  2. Retraction
  3. Elevation
  4. Depression
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13
Q

Test the function of the trapezius

Which nerve do you test when doing so?

A

Patient: Sitting

Examiner: Stand behind the subject

  • Test: Upper and middle fibers
    • Ask the subject to elevate the lateral ends of clavicle and scapula as in shrugging the shoulder.
    • Examiner places a hand above each shoulder and with a firm downward pressure resists the subject’s action.
  • Test: Upper fibers only
    • Ask the subject to extend the head backwards
    • Examiner places a hand over the back of the head and resists the subject’s action.
  • Nerve: Spinal accessory (XI)
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14
Q

Test the function of Sternomastoid

Which nerve do you test when doing so?

A

Patient: Sitting

Examiner: Stand in front or side

  • Test: One side only
    • Ask the subject to turn the head to opposite side (of the muscle under test)
    • Examiner places the palm of the hand against the side of the head (or face) and resists the subject’s action.
  • Test: Both sides
    • Ask the subject to bend the head forward.
    • Examiner places a hand on the forehead and applies firm pressure to resist the subject’s action.
  • Nerve: Spinal Accessory (XI)
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15
Q

Test the function of the Deltoid muscle

Which Nerve do you test when doing so?

A

Patient: Sitting

Examiner: Faces the subject

  • Test: Main (middle) deltoid
    • The subjects extended upper limb lies at the side of the trunk. Ask the subject to abduct the arm.
    • Examiner places a hand on the lateral side of forearm and resists the subject’s action. The other hand is placed over the deltoid to feel the contraction.
  • Test: Anterior or posterior fibers
    • Ask the subject to flex or extend the upper arm.
    • Examiner resists the subject’s action with one hand and feel the contraction of anterior or posterior fibers of deltoid
  • Nerve: axillary nerve, C5,6
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16
Q

How would you test the function of Serratus Anterior?

A

Patient: standing facing a wall

Examiner: standing behind or on the side of the subject

  • Test:
    • The subject’s both arms outstretched and palms against the wall. Subject is asked to press forward strongly. –> looking for winging scapula
    • Examiner places hand/fingers over the ribs forming the medial wall of axilla and feel the contracting muscle serrations.
  • Nerve: long thoracic nerve, C5,6,7
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17
Q

How would you test the pectoral muscles?

Which nerves do you test when doing so?

A

Patient: Sitting

Examiner: Faces the subject

Test

  • The subject’s upper limb is flexed to 90 at the shoulder whilst the elbow is fully extended elbow.
  • Ask the subject to adduct the arm.
  • Examiner places a hand on the forearm and resists the subject’s action. The other hand is placed over the pectoralis major to feel the contraction.
  • Nerve: Medial Pectoral (C8,T1) & Lateral Pectoral (C5.6.7)
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21
Q

Suface mark the basislic, cephalic and mdeial cubital veins

A
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22
Q

Palpate the pulse of the brachial artery in th arm and in the cubital fossa

A

In the cubital fossa: medial to the biceps tendon

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23
Q

Palpate the radial and ulnar pulse

A
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24
Q

Where would you palpate the subclavian and axillary pulse?

A
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25
Q

Surface mark the dermatomes of the upper limb

A
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26
Q

Test the biceps reflex

Which nerve route would you test by doing so?

A

You would test C5,6 with the musculocutaneous nerve

  1. Subject: sits/ lies supine comfortably, elbow semiflexed, hand pronated
  2. Place the examiners thumb on biceps tendon
  3. Tap with a reflex hammer on the tendon
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27
Q

Recall the nerve route in the biceps tendon reflex

A
  • Muscle spindles stretch by hammer –> stimmultaion of sensory neuron –> synapse directly onto motor neurons in anterior horn
  • Motor goes back to to stretched muscle –> contraction

In biceps reflex: musculoskeletal with C5,6

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28
Q

How do you test the triceps reflex?

Which nerves do you test when doing so?

A

Testing the radial nerve (C7,8)

  1. Subject lies/sits with elbow semiflexed and hand pronated
  2. Examiner supports the elbow with one hand
  3. tap triceps tendon directly with hammer
  4. If intact: see extention of the elbow
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29
Q

How would you test the motor and sensory components of the Axillary nerve?

Which spinal nerves would you test when doing so?

A

Testing: posterior chord of C5,6

Axillary nerve innervates the Deltoid

  • Test for motor Deltoid: Abduction of the shoulder joint

Sensory:

  • Regimental batch testing
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30
Q

How would you test the musculocutaneous nerve integrety?

(Motor and sensory component?)

A

Musculocutaneous = C5,6:

Motor Testing

  • flexor of the elbow

Sensory testing:

  • lateral skin of the forearm
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31
Q

Test the motor and sensory components of the radial nerve at the

  1. Arm
  2. Forearm
A

Radial Nerve= C5-T1

  • Arm
    • Motor: Innervation to extensors of elbow
  • Forearm
    • supinator and wrist extensors (would see wrist lesion in damage)
  • Sensory: dorsum of hand & lateral digits
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32
Q

Test the motor and sensory components of the ulnar nerve in the

  1. Forearm
  2. Hand

Where is it suspectible to damage?

A

Ulnar nerve:

Motor Testing

  • Forearm:
    • flexor carpi ulnaris and
    • flexor digitorium profundus
  • Hand
    • Hypothenar muscles
    • adductor of thumb

Senstory testing:

  • Medial half of palm and 1.5 fingers. Medial side of upper arm & forearm

Suspectible to damage at the elbow

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33
Q

How would you test the motor and sensory function of the median nerve?

A

Motor

  • Wrist flexors
  • Pronators
  • Flexion of digits (thumb, index and middle finger) (in damage: hand of benediction)

Sensory

  • lateral half of palm and three and one half fingers.and nail beds
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34
Q

What is carpal tunnel syndrome?

What does it result in?

A

It is a chronic compression of the median nerve at the wrist (under the flexor retinaculum)

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35
Q

What are the boundaries of the Axilla?

A
  1. Base: skin + fascia from chest to the arm
  2. Apex: between 1st rib, superior border of subscpularis and clavicle
  3. Anterior: Pec Major and minor
  4. Posterior: Scapula + subscapularis, teres majro and latissimus dorsi
  5. Medial: Chest wall (Ribs 1-4) and Serratur anterior
  6. Lateral: intertubercular grove of humerus
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36
Q

What are the contents of the Axilla?

A
  1. Arteries – the axillary artery and its branches
  2. Veins – the axillary vein and its tributaries
  3. Lymphatic vessels and lymph nodes – axillary lymph nodes (important)
  4. Nerves – the infraclavicular part of the brachial plexus, long thoracic and intercostobrachial nerves
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37
Q

What are the boundaries of the cubital fossa?

What are its contents?

A
  1. Lateral: brachioradialis muscle
  2. Medial: pronator teres
  3. superior: line between the humeral epicondyles
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38
Q

What are the contents of the cubital fosa?

A
  1. Biceps tendon
  2. Brachial artery (devides in the cubital fosa)
  3. median nerve
  4. radial nerve
  5. median cubital vein
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39
Q

What are the borders and contents of the antomical snuffbox?

A

Anatomical snuffbox:

  • formed by tendons of extensor pollicis longus and brevis
  • Contains:
    • radial artery
    • close by: radial nerve

Can be used to palpate the scaphoid

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40
Q

Eyplain the surface markings and attachments of the flexor retinaculum

What does it form?

A

It forms the roof of the carpal tunnel

  • attached to the: (connect all 4 points)
  • pisiform
    • distal end of flexor carpi ulnaris tendion
  • hook of the hamate
    • 1cm distal and lateral to pisiform, deep to hypothener muscles
  • tubrecle of scaphoid
    • Fully extens the wrist: along the line of Flexor carpi radialis tendon
  • ridge of trapezium
    • deep to the middle of the roots of thenar muscles, distal to scaphoid
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41
Q

Test the function of flexor digitorium superficialis

Which Nerves are tested when doing so?

A

The examiner holds the proximal interphalangeal joint in extended position while the distal IP joint is flexed against resistance

  • Ulnar Nerve C8+T1 for 4th and 5th digit
  • Median Nerve (C8+T1) for 2nd and 3rd digit
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42
Q

Test the function of flexor digitorium superficialis

Which Nerve do you test when doing so?

A

Median Nerve (C7-T1)

Each digit is tested seperatly

  • non-test fingers are heald in full extension
  • the proximal IP joint of the test finger is flexed against resistance
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43
Q

Test the extensors of the digits

What is the mian muscle when doing so and where does it get its nerve supply?

A

Main muscle: Extensor digitorium (Radial Nerve C7,8)

  • Hand pronated
  • digits are extended at MCP joints
  • examiner applies reisistance to the proximal digits–> extensor tendons should become visible and
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51
Q

How would you test function of the triceps brachii?

Which nerve would you test when doing so?

A

Patient: Sitting or standing

Examiner: Stand or seated behind the subject
(can be done when the patient is supine on the couch)

Test:

  • Start position: The subject slightly abducts the arm at the shoulder (5 -10º) and flexes the elbow to 90º.
  • Ask the subject to straighten (extend) the elbow.
  • Examiner pushes strongly against the back of the forearm to resist subject’s action.
  • With the other hand the contracting long and lateral heads can be palpated (visible as well). The tendon of triceps can also be palpated above the olecranon process

Radial Nerve C6,7

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52
Q

How would you test function of the biceps brachii?

Which nerve would you test when doing so?

A

Patient: Sitting or standing

Examiner: Standing or sitting in front of the subject
(can be done when the patient is supine on the couch)

Test:

  • Start position: The subject slightly abducts the arm at the shoulder (5 -10º) and flexes the elbow to 90º with hand pronated.
  • Ask the subject to supinate the hand.
  • Examiner grasps the subject’s hand firmly and resists this movement.
  • With the other hand the contracting biceps can be palpated (visible as well). The tendon of biceps can also be palpated deeply in the cubital fossa
  • Musculocutaneous nerve C5,6
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53
Q

How would you test the function of the dorsal and plamar interossei?

Which Nerve would you test with that?

A

Ask tha patient to adduct (palmar) /abduct (dorasal) the fingers (against resistance?)

Testing of ulnar nerve C8+T1

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77
Q

Test the extors of the wrist

What is the main muscles involved and where does it gets it blood supply from?

A

Supplied by the radial nerve

  • Extensor carpi radialis longus+ brevis
  • extensor carpu ulnaris

Test

  • let subject extend against resistance
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78
Q

Test the superficial wrist flexors of the forearm

What are the key muscles and what are they supplied by?

A

Mainly

  • Flexor carpi radialis (Median Nerve)

Flexor carpi ulnaris (Ulnar Nerve, C6,7)

Test via wrist extension agaisnt resistance?

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79
Q

What are the possible movements in the shoulder joint?

A
  1. Flexion
  2. Extension
  3. Abduction
  4. Adduction
  5. Circumduction
  6. Rotation
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81
Q

What are the prime movers in flexion of the shoulder?

A
  1. pectoralis major (clavicular head)
  2. deltoid (anterior fibres)
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82
Q

What is the prime mover in extension of the shoulder?

A

Deltoid

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83
Q

What are the prime mover in Abduction of the shoulder?

A

Intially: Supraspinatus, then Deltoid

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84
Q

What are the prime mover in adduction of the shoulder?

A

Pec Major, Latissimus dorsi

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85
Q

What are the prime movers in Internal rotation of the shoulder?

A

Subscapularis

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86
Q

What is the prime mover in external rotation of the shoulder?

A

Infraspinatus

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87
Q

What are the prime movers in flexion of the ellbow?

A

Biceps Brachii, Brachialis, brachioradialis (pronator teres)

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88
Q

What are the prime movers in extension of the ellbow

A

Triceps (anconeus)

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89
Q

What are the prime movers in elevation of the scapula?

A
  1. superior trapezius
  2. levator scapulae
  3. rhomboids
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90
Q

What are the prime movers in depression of the scapula?

A
  1. inferior trapezius
  2. pectoralis minor
  3. serratus anterior
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91
Q

What are the prime movers in Protraction of the scapula?

A
  1. Pec minor
  2. serratus anterior
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92
Q

What are the main movers in retraction of the scapula?

A

Rhomboids

Middle trapezius

Latissimus dorsi

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93
Q

What are the prime movers in upwards rotation of the scapula?

A
  1. Superior trapezius
  2. inferior trapezius
  3. serratus anterior
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94
Q

Which movements are possible at the scapulo-thoracic “joint”?

A
  1. Elevation
  2. Depression
  3. Retraction
  4. Protraction
  5. Upwards rotation
  6. Downwards rotation
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95
Q

What are the prime movers in downward rotation of the scapula?

A
  1. Pec minor
  2. Latissimus dorsi
  3. levator scapulae
  4. rhomboids
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97
Q

Test the functionof the rotator cuff muscles

A
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98
Q

What are the main muscles involved in Felxion of the Elbow?

What is their nerve supply?

A
  1. Anterior Compartment of the Arm
  • Biceps Brachii
  • Brachialis
    • Both supplied by the Musculocutaneus nerve (C5-7)
  • Brachioradialis
    • Supplied by the Radial nerve (C5-7)
  • (Supported by Pronator teres)
    • Supplied by the Median nerve (C5-8+T1)
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99
Q

What are the main muslces involved in extension of the Elbow?

How are they innervated?

A
  • Triceps
  • Anconeus
    • Bot supplied by the Radial Nerve (C5-7)
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100
Q

What are the main muscles involved in supination?

What are they supplied by?

A
  1. Biceps Brachii
    1. Musculocutaneous nerve (C5-7)
  2. Supinator
    1. Radial Nerve (C5-7)
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101
Q

What are the main muscles involved in pronation?

Which nerve are they supplied by?

A
  1. Pronator Teres
  2. Pronator Quadratus
    1. Both supplied by the Median nerve (C5-8+T1)
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103
Q

What are the main muscles involved in Flexion of the wrist?

Which nerves are involved?

A

Flexion of wrist: Median and Ulnar nerve

  1. Flexor carpi radialis (Median Nerve)
  2. Flexor carpi ulnaris (Ulnar Nerve, C6,7)
  3. Long flexors of thumb and finger
  4. Palmaris longus (Median Nerve)
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104
Q

What are the main muscles involved in Extension of the wrist?

Which nerve are they supplied by?

A

Extension (Radial Nerve )

  1. ECRL Extensor Carpi Radialis Longus
  2. ECRB Extensor Carpi Radialis Brevis
  3. ECU Extensor Carpi Ulnaris
  4. Long extensors of the thumb and fingers
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105
Q

Which muscles are involved in radial deviation of the wrist?

Which nerve are they supplied by?

A

Radial Deviation (Abduction) (Radial Nerve C5-8+T1)

  1. FCR- Flexor Carpi Radialis
  2. ECRL- Extensor Carpi Radialis Longus
  3. ECRB- Extensor Carpi Radialis Brevis
  4. APL- Abductor Pollicis Longus
  5. Extensor pollicis brevis
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106
Q

Which Muscles are involved in ulnar deviation of the wrist?

Which nerve are they supplied by?

A

Adduction, Supplied by the Ulnar Nerve C7,8

  1. ECU- Extensor carpi Ulnaris
  2. FCU- Flexor Carpi Ulnaris
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107
Q

Which muscles abduct the Thumb?

A
  1. Abductor pollicis longus
  2. Abductor pollicis brevis
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108
Q

Which musces adduct the thumb?

A
  1. Adductor pollicis
  2. first dorsal interosseous
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109
Q

Which muscles extend the thumb?

A
  1. Extensor pollicis longus
  2. Extensor pollicis brevis
  3. Abductor pollicis longus
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110
Q

Which muscles oppsition the thumb?

A

Opponens pollicis

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111
Q

Which muscles are involved in flexion of the thumb?

A
  1. Flexor pollicis longus
  2. Flexor pollicis brevis
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113
Q

Which movements can occur at the Interphalangeal joints?

What type of joint are they?

A

They are hinge synovial joints allowing

  • Flexion and extension
    *
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114
Q

What are the movements that can occur at the Carpo-metacarpal and intermetarcarpal joints?

A
  1. Flexion/ Extension
  2. Radial/Ulnar deviation
  3. Circumduction
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115
Q

What are the possible movements that can occur at the carpo-phalangeal joints?

A
  1. „Flexion and extension
  2. Abduction and adduction“
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116
Q

How would you test Gluteus Maximus?

Which nerve is it supplied by?

A

It is supplied by the inferior gluteal (L5-S2)

For test:

  • Subject lies prone with knee flexed
  • Subject should extend the thigh at the hip joint
  • Examiner should resist the movment at the distal end of the thigh and palpates glut max
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117
Q

What is the Trendelenberg test?

A

Test for Hip abductors:

  • Subject stands upright on both feet
  • Examiner stands behind.
  • Note the level of both iliac crests.
  • Subject is asked to stand on one leg. A drop in the level of iliac crest on the unsupported side indicates weakness of the hip abductors on the stance (contralateral) side.
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118
Q

How woul you test the force of the hip abductors?

A

By perfoming hte Trendelenberg Test

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119
Q

Test Gluteus Medius

Which Nerve would you test with that?

A

Testing the Superior Gluteal Nerve (L5+S1)

  • Subject lies on side with lower limb fully extended
  • Ask to abduct the limb at the hip joint
  • resist at the distal end of the thigh
  • palpate gluteus medius just inferior to iliac crest
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120
Q

How do you test the quadriceps muscles?

Which nerve do you test when doing so?

A

They are supplied by the femoral nerve (L2-4)

  • Subjects sits on couch with leg flexed at 90°
  • Asked to extend against resistance (supplied at distal end of leg)
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121
Q

How do you test the hamstring muscles of the thigh?

Which nerve do you test when doing so?

A

Sciatic nerve –> L5,S1,S2 (tibial devision except short head of biceps is fibular devision)

  • subject lies prone with knee flexed to 30°
  • Examiner applies pressure at distal end of led and ask the patient to flex the knee further
  • Tendons should be seen at the palpateal fossa+ muscles can be felt
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124
Q

How would you test the function of tibialis anterior?

Which nerve do you test when doing so?

A

Deep Fibular Nerve L4,5

  • Subject is asked to invert (–> turn foot inwards and upwards)
  • Examiner should resist the movement at the forefoot
  • Tendons can be seen+ palpated below + anterior to medial malleolus
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127
Q

Where would you palpate the dorsalis pedis pulse?

A

Just lateral to extensor hallucis longus tendon

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128
Q

Palpate the tibialis posterior pulse

A

Palpate just behind the medial malleolus

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129
Q

Explain the route of the long saphenous vein (and its relationship to the malleolus)

A

Runs upwards 2cm infront of medial malleolus

Along medial side of leg

Hands-with medially to patella

Along medial side of thigh to saphenous opening in inguinal region

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130
Q

Explain the route of the short saphenous vein

What is its relation to the malleoli?

A

Runs from lateral side of foot inferior and posterior to lateral malleolus

Runs posterior and joins the polpiteal vein at the polpiteal fossa

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132
Q

Recall the route of the patellar reflex

A

Sensory afferent goes to spinal chord and synapses onto anterior horn with motor effernt to quadriceps

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133
Q

Test the ankle jerk reflex

Which Nerve does it test?

A

S1-2

  • Patient sits on couch with feet dangling relaxed from couch
  • Stike the calcaneal tendon with the reflex hammer while holding feet slightly dorsiflexed with other hand
  • If it works: plantarflexion
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134
Q

How would you test the adductor group of the hip joint?

Which nerve do you test by doing so?

A

Testing the obturator nerve (L2-4)

Situation

  • Patient: Lies supine with both limbs fully extended.)
  • Examiner: Stands on one side of the subject with the test leg passively abducted to 45 degrees.

Ask the patient to adduct forcefully

Examiner: applies force to resist the adduction of the thigh. With the other hand examiner palpates the medial aspect of the thigh for contraction of the adductors.

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135
Q

How do you test iliopsoas muscle?

Which nerve do you test when doing so?

A

Nerve: Iliacus - femoral nerve, L3,4; Psoas - L1,2,3

  • Patient: Supine. Knee may be flexed to 90 degrees
  • Examiner: Stand in front or side
  • Ask the subject flex the thigh at the hip joint.
  • Examiner: applies pressure at the distal end of anterior thigh to resist the flexion while the other hand holds down the pelvis.
  • Muscles are not accessible for palpation
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136
Q

Outline the borders of the polpiteal fossa

A
  • Superior Borders
    • Lateral
      • Biceps Femoris
    • Medial
      • Semimembranosus
  • Inferior Borders
    • Lateral head of gastrocnemius
    • Medial head of gastrocnemius
  • Skin and fascia (anterior)
  • Femur (posteriorl)
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137
Q

Which structures run through the polpiteal fossa?

A
  • Popliteal artery and vein
  • Tibial Nerve and Common Peroneal Nerve
  • Short saphenous vein
  • Popliteal lymph nodes
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138
Q

What are the borders of the femoral triangle?

A
  • Superiorly – the inguinal ligament
  • Medially – adductor longus
  • Laterally - sartorius
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139
Q

What are the contents of the femoral triangle?

How are they organised?

A

From lateral to medial:

  1. Femoral nerve
  2. Femoral artery
  3. Femoral vein
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140
Q

How can you idenfity the gluteal safe area?

Whay do you need it?

A

t is the area wher IM injections can be performed without hitting the sciatic nerve

Position the index finger on the ASIS and the middle finger on the iliac tubercle –> safe area is the area in between!

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141
Q

Map and test the dermatomes of the lower limb

A
  1. touch the subject on a normal area of skin with both devices you will use for testing
  2. Ask the subject to close the eyes
  3. Examine the dermatomes systematically
  4. Ask the patient if they can feel touch normal, dull or not at all
  5. Repeat on the opposide limb and compare the coressponding dermatomes
  6. Alway test fine touch (with cotton wool)
  7. and coarse touch (wich pin etc) to test both spinal sensory pathways
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143
Q

How would you palpate the femoral artery?

A

Mid-inguinal point

  • between asis and pubic symphisis
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144
Q

How would you palpate the polpiteal artery?

A

Subject lies prone with knee flexed

palpate in the inferior part of the palpiteal fossa in relation to the tibia

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146
Q

How would you test the function of the fibular compartment of the leg?

Which nerve do you test when doing so?

A

Superificial Peroneal nerve: L5,S1,S2

  • Subject should evert (outside and upwards movment) the food
  • Examiner resists movement
  • See+palpate tendons just posterior to lateral malleolsu
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147
Q

How would you test the posterior compartment of the leg?

Which nerve do you test when doing so?

A

Tibial Nerve (S1+2)

  • Ask subject to stand on toes
  • Tendon+ muscles can be palpated
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148
Q

Surface mark the sciatic nerve

A

The nerve leaves the greater sciatic notch and enters the gluteal region at the midpoint between the PSIS and the ischial tubersoity.

It forms a downward curve to pass into the thigh around the midpoint between the greater trochanter and the ischial tubersoity before reaching the popliteal fossa (behind the knee).

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153
Q

Test the patellar tendon

Explain its nerve supply

A

Palpate the patella tendon and hammer it with patient sitting onto couch relaxed, knee 90° flexed

See response and palpate contraction of quadriceps

It tests L4

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164
Q

Test the motor component of the sciatic nerve

A

Any movement in foot

Knee flexion

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165
Q

Test the motor compartment of the gluteal nerves

A

Trendelbergs test

Test with subject abducting the hip and extend the hip

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166
Q

Test the motor component of the femoral nerve

A

Knee extention

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167
Q

Test the motor component of the obturator nerve

A

Hip adduction (against resistance)

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168
Q

Test the motor comonent of the deep peroneal nerve

Where might damage occur?

A
  1. Damage might occur at fractures of the head of fibula

look for foot drop

  • –> test dorsiflexion of foot
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169
Q

Test the motor comparment of the superficial peroneal nerve

A

Eversion of foot

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170
Q

What are the main functions of the bone?

A
  • Structural support (shape+muscle action)
  • protection
  • blood formation
  • mineral storage site
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171
Q

What are the two mechanical properies of bone?

A
  1. Cable-like flexibility –>osteioid due to collagen fibres (resistant to tension)
  2. Pillar-like stiffness –> impregnation of collagen with hytroxyapatite –> complex calcium hydrophosphate (also causes resistance to compression
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172
Q

What is the structure of immature or healing bone?

A

Woven bone

–> quite irregular structure, not as stable

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173
Q

What is the normal structure of a bone in healthy adults?

A

Mature bone: Lamellar bone –>

organised and stable

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174
Q
A
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175
Q
A
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176
Q
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177
Q
A
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178
Q
A
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179
Q

Explain the different arrangements of lamellar bone

A

Arranges into

  1. Cortical bone (hard, outer part), compact lamellar bone
  2. Cancellous bone (spongy/ trabecular bone)
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180
Q

What is an osteon?

How is it organised

A

Small funtion al unit of bone–> organised as laminar organised cells around a centric canal that carries blood vessels

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181
Q

How does the organisation of spongey osteons differ from compact bone osteons?

A

They barely differ and have the same structure –> both Lamellar

but spongy part might be a bit smaller

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182
Q

Explain the structure of an osteocyte

A

It is a big cell with many connections to other cells (gap juctions) to share nutrients

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183
Q

Summarise the bony blood supply

A

A nutrient artery (middle part, but also epyphisis artery and veins) enters the bone through a nutrient canal

Bone is highly vascularised

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184
Q

How do you call the most outer part iof bone?

What is its function?

A

It is the periosteum

  • Vascularised
  • –> important in growth and repair
  • good sensory supply (hurts when fractures)
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185
Q

Explain the developemnt of osteocytes

A

Develop from osteoblasts (that develop from osteogenic cell)

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188
Q

Explain intramembranous formation of bone

A
  • In existing vascular connective tissue
  • Bone matrix (ostein) deposited around collagen
  • Mineralises to form woven bone
  • Remodels to lamellar bone

–> normally in flat bones

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190
Q

Explain endochrondal bone growht

A

Forms around existing fetal cartilage models

  • Cartilage calcifies and chondrocytes (part of cartilage) die
  • Periosteal osteoclasts cut channels for sprouting vessels
  • Osteoblasts enter with vessels to build bone around them
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191
Q

Explain the structure and function of the epiphysal plate

A

It is a cartilage region between shaft and head of bone

–> Cartilage forms and gets ostefied (endochondral) –> enables bone growth

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195
Q

How does bone grows in diameter?

When does this happens?

A

Periosteum is activated to become osteoblasts

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196
Q

Expalint the process of bone healing

A
  1. Haematoma
    • becomes infiltrated by fibrous matrix and invaded by cartilage/bone progenitors
  2. Blood vessels invade damaged structure
  3. Woven bone is forming
  4. Remoddeling in lamellar bone
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205
Q

When do bones start to form?

When do they stop growing?

A

The skeleton starts to form at 6 weeks

Stops growing at Age 25

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206
Q

What are the two types of bone development?

A
  1. Intramembranous –> in existing vascular connective tissue
  2. Endochondral –> exisiting fetal cartilage models
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208
Q

How does bone growth?

A

When bone growth it still needs to carry weight –> not ideal if that is the end of the bone

So:

  • Shaft ossifies first, followed by epiphyses
  • Growth continues by ossification at growing cartilage plate between them
  • Growth cessation when cartilage growth ceases and plate is over-run by ossification
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211
Q

What happens to bone when it is used little and a lot?

A

Increases or decreases bulk and density in response to pattern of use

  • But: when less used: loss of bone mass (ISS)
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212
Q

What shows that bone is an adaptable structure?

A
  • Can grow
  • changes density with use
  • can remoddel depending on pattern of use
  • ability to repair
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213
Q

What is the role in osteocytes in bone repair?

A

•Osteocytes maintain matrix but can activate osteoblasts for new bone building

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216
Q

What happens to the bone at high calcium levels?

A

Calcitonin released by parafollicular thyroid cells;

  1. Inhibition of breakdown of bone matrix by osteoclasts
  2. Promotion of Ca2+ uptake into bone matrix
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217
Q

What happens to bone at low Ca2+ levels?

A

Parathyroid Hormone (PTH) released

  • Promote osteoclast bone resorption
  • increases Ca2+ re-absorption by the kidneys + intestine
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218
Q

What is the shoulder?

Which bones does it include?

A

The area of upper limbn attachment to the trunk made up of

  1. Scapula
  2. Clavicle
  3. Humerus
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219
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A
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221
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222
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223
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224
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225
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226
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227
Q
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228
Q

What is the lateral angle of the scapula?

A

The glenoid cavaty (site of attachement of the humerus bone to form the gelenohumeral joint)

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229
Q

What are the superior and inferior angle of the scapula?

A

The highest and lowest points of the scapula (excluding the acromion)

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230
Q

Red part: What is its role?

A

It is the infraglenoid tubercle, attachment of the long head of the triceps brachii muscle

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231
Q

What is this part of the Scapula?

What is its role?

A

It is the supraglenoid tubercle is the site of attachment for the long head of the biceps brachii muscle

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232
Q

What is the attachment of the scapula and clavicle?

A

It is the acromiom (both of the scapula and clavicle)

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233
Q
A
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234
Q
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235
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236
Q
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237
Q

What is their function?

A

Attachment of the rotator cuff muscles of the geenohumeral joint

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238
Q

Show the anatomical and surgical neck of the humerus

A
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239
Q

What is the relevance of the surgical neck of the humerus? What can be damaged?

A

It is the site where fractures of the humerus most often occur

The axillary nerve and the posterior circumflex humeral artery can be damaged

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240
Q
A
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242
Q

What is the pectoral girdle?

A

It is the region formed by the Sterno-calvicular-joint, Acromio-clavicular joint, Glenohumeral joint and the scapula-thoracic joint + its bones mainly:

  1. Clavicle
  2. Scapula
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243
Q

What are the functions fo the rotator cuff muscles of the shoulder?

A
  1. To stabelise the glenohumeral joint
  2. To deptress the humeral head in movement
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244
Q

What are the four rotator cuff muscles?

A
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245
Q
A
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246
Q
A

Infraspinatus

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247
Q
A
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248
Q
A
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251
Q

What is the glenoid labrum? What is its relation to the head of the biceps brachii

A

It is a fibrocartilaginous collar around the glenoid fossa, to expand the socket of the glenohumeral joint

Supeirorly, the labrum is continous with the long head of the biceps brachii

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252
Q

What is special about the synovial membrane of the gleno-humeral joint?

A

It portrudes through apertures in the fibrous membrane of the joint capsule to form bursae

Bursae lie between the fibrous membrane and tendons of surrounding muscle –> reduce friction

e.g: subtendinous bursa of scapularis

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253
Q

The fibrous membrane of the gleno-humeral membrane is thickened in three places. What are they and what do they form?

A

It forms the superior, middle and inferior glenohumeral ligaments

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254
Q

Which anatomical structure restricts upward movement of the humeral head on the glenoid cavity?

A
  1. The tendon of the long head of the biceps brachii muscle
  2. Coraco-achromial arch + ligament
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255
Q

Explain the lateral, medial, superior, inferior, anterior and posterior borders of the Axilla

A
  1. Apex: between the first rib, the clavicle and the superior border of the subscapularis muscle
  2. Anterior: Pec Major+ Minor
  3. Lateral: intertubercular Groove of humerus
  4. Posterior: Scapula+ subscapularis (superior) + latissimus dorsi + teres major
  5. Medial: 1-4th rib
  6. Base: skin+ fascia from arm to chest
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256
Q

What are the contents of the axilla?

A
  1. Muscles
    1. short head of the biceps brachii
    2. Coracobrachialis muscle
  2. Arteries​
    • Axillary artery (Parts 1-3 with its branches)
  3. Axillary vein
    • Begins at lower margin of the trees major (continuation of the basilic vein), joined by the cephalic vein
    • Passes medial and anterior to axillary artery
  4. Nerves
    • Cords of the Brachial plexus+ branches
  5. Lymph nodes
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257
Q

What are the proximal and distal attachments of the Pectoralis major?

A
  1. Proximal:
    • medial 1/3 of clavicle
    • sternum
    • costal cartilages
  2. Distal
    • lateral lip of intertubercular groove of humerus
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258
Q

How is Pec major innervated?

A

Via the Medial and lateral pectoral nerves (C5, C6, C7, C8, T1)

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260
Q

What is the function of Pec minor?

A

Protracts scapula, pulls tip of shoulder down

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261
Q

Explain the distal and proximal attachemtns of the subclavius muscle

A
  1. Proximal
    • 1st rib
  2. Distal
    • groove on inferior surface 1/3 of the clavicle
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262
Q

Explain the proximal and distal attachments of the Serratus anterior

A
  1. Proximal
    • Rib I-IX
  2. Distal
    • Medial border of the scapula
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263
Q

What is the function of the serratus anterior muscle?

A
  • Holds Scapula onto thorax (stabilisation in arm movement)
  • Lateral rotation of Scapula
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264
Q
A

Serratur anterior

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265
Q
A

Subclavius Muscle

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268
Q
A

Trapezius Muscle

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271
Q

Explain the proximal and distal attachments of the levator scapulae.

What is its function?

A
  1. Proximal attachment:
    • Posterior tubercle of transverse processes C1-4 vertebra
  2. Distal attachment:
    • Superior Angle of Scapula
  3. Function: Elevation of Scapula
  4. Innervated by C4,5, dorsal scapular nerve
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272
Q

What is the Proximal and Distal attachments of the rhomboids?

A
  1. Proximal:
    • Minor: Spinous process C6+7
    • Major: spinous process T1-4
  2. Distal
    • Minor: Medial margin of the scapular spine
    • Major: Medial border of the scapula
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273
Q

What is the function of the rhomboids?

How are they innervated?

A

Innervagted by the dorsal scapular nerve (C4,5)

Function:

  1. Elevates the scapula medially+ cranially
  2. Stabilizes scapula on thorax
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274
Q
A

Rhomboids

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275
Q

Explain the proximal and distal attachments of the latissimus dorsi muscle

A
  1. Proximal
    • Spinous process of T7-12, L1-5
    • sacrum
    • ilium
    • 9-12 rib,
  2. Distal:
    • Floor of intertubercular groove on Humerus
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276
Q
A

Latissimus dorsi

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277
Q

What is the function of the latissimus dorsi?

A

Adducts, Rotation of the Humerus, retroversion of shoulder

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278
Q

What are the proximal and distal attachments of the biceps brachii?

A
  1. Proximal Attachments
    • LONG HEAD: SUPRAGLENOID TUBERCLE OF SCAPULA
    • SHORT HEAD:CORACOID PROCESS OF SCAPULA
  2. Distal Attachment
    1. Radial tuberosity
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281
Q

What are the proximal and distal attachments of the brachialis muscle?

A
  • Proximal Attachment
    • Body of Humerus
  • Distal Attachment
    • Tuberosity of ulnar
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282
Q
A

Brachialis

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283
Q

What are the proximal and distal attachments of the Coracobrachialis?

A
  1. Proximal
    1. Coracoid process of scapula
  2. Distal
    1. anteromedial surface of the humeral shaft
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284
Q
A

Coracobrachialis

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285
Q

What are the proximal and distal attachments of the triceps?

A
  • Proximal
    1. Medial Head
      • Back surface of the humerus, just below the radial groove
    2. Lateral Head
      • Back surface of humerus, just above the radial groove
    3. Long Head
      • Infraglenoid tubercle of scapula
  • Distal
    • Olecranon of ulna
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287
Q

What are the proximal and distal attachents of the Anconeus muscle?

A
  1. Proximal
    1. Lateral epicondyle of humerus
  2. Distal
    1. Olecranon on ulnar
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288
Q
A

Anconeus muscle

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290
Q

What is the radial groove of the humerus?

A

Groove where radial nerve runs in arm

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302
Q

How are the tow attachements (used to be origin and insertion) of muscle in the limbs called?

A

Proximal and distal attachment

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310
Q

Which structures stabalise the instable glenohumeral joint?

A
  1. 4 Rotator Cuff muscles
  2. Long head of the biceps brachii
  3. ligaments
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311
Q

What kind of joint is the gleno-humeral joint?

A

It is a ball and socket synovial joint

(Socket= glenoid fossa), ball= head of humerus

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320
Q

What is the function of Pec Major?

A

Adduction+ medial rotation of the Humerus

Anteversion+ lowering of shoulder girdle

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327
Q

What are the muscles of the anterior shoulder girdle?

A
  1. Pectoralis Minor
  2. Pectoralis Major (can also be classified as shoulder)
  3. Subclavius muscle
  4. Serratus anterior
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328
Q

What are the Muscles of the posterior pectoral girdle?

A
  1. Trapezius
  2. Latissimus dorsi (can be classified as shoulder)
  3. Levator scapulae
  4. Rhomboids (Minor+Major)
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330
Q

What are the proximal and distal attachements of the Trapezius?

A

Proximal attachment:

  • Occipital bone
  • Spinous process es of cervical + thoracic vertebra (up to T12)

Distal:

  • Acromion of Scapula, Clavicle, Spine of Scapula
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331
Q

What is the function of the Trapezius muscle?

How is it innervated?

A
  1. Rotates, elevates, retracts the scapula
  2. Rotates, bends laterally and rotates contralaterally the head

Innervated by CN XI

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340
Q

Which nerve innervates the Muscles of the anterior compartment of the arm?

Where does it originate?

A

The Musculosceletal nerve (C5-7)

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341
Q

Which nerves innervates the Biceps Brachii and the Brachialis muscle?

A

Musculocutaneous Nerve C5-7

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347
Q

Which nerve innervates the triceps?

Where does it origiintate?

A

Innervated by the Radial nerve (C6,7,8)

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350
Q

Which Muscles are part of the posterior compartment of the arm?

What is their function and how are they innervated?

A
  1. Triceps
  2. Anconeus muscle

Innervated by the Radial Nerve (C6,7,8) –> Extension of the elbow

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352
Q

What are the locations where the brachial artery can be felt?

A
  1. In the cubital fossa (medial to biceps tendon)
  2. In the medial biciptial groove (between triceps and biceps)
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353
Q
A

Medial supracondylar ridge of humerus

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354
Q
A

Lateral supracondylar ridge of humerus

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355
Q

What does it articulate with?

A

Capitulum of humerus (lateral)

Articulates with the radius

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356
Q
A

Trochlea of humerus (medial)

Articulates with the ulna

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357
Q
A

Coronoid fossa of humerus

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358
Q
A

Olecranon fossa of humerus

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359
Q
A

Radial Fossa of humerus

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361
Q
A

Olecranon of Ulnar

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362
Q
A

Coronoid process of ulna

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363
Q
A

Styloid process of ulna

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364
Q

What is the head of the ulna?

A

articular surface that joints with the triangular articular disc and the ulnar notch of the radius

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365
Q

Identify the Trochlea and radial notch of the ulna

A
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367
Q

What are the medial and lateral epicondyle of the humerus?

A
368
Q

How are the ligaments in the elbow joint arranged?

A

They should stabelise the joint, but also allow movement of the joint

369
Q

Explain the articulations of the bones in the elbow joint in anatomical position and in flexion

A

The Trochlea of the Humerus articulates witht the Ulna in the anatomical position

The Radius additionally articulates with the capitulum in full flexion

370
Q

What is the carrying angle?

How big is it normally and what is the sex difference?

A

It is the deviation of the long axis of the radius and ulnar in the anatomical position

On average, it is 7°, but larger in women

371
Q

(Elbow)

A

Medial/Ulnar collateral ligaments

372
Q
A

Radial collateral ligament

373
Q
A

Anular ligement of radius

374
Q

What is it?

Which clinical problems can occur with the structure?

A

It is the olecralon bursa, that can get inflammed

375
Q

Name all the proximal and distal carpal bones

A

Proximal Row:

From lateral to medial when vieved anteriorly:

Proximal row

  1. Some - Scaphoid
  2. Lovers - Lunate
  3. Try - Triquetrum
  4. Positions - Psisiform

Distal row

  1. That - Trapezium
  2. They - Trapezoid
  3. Can’t - Capitate
  4. Handle - Hamate
378
Q

What happens during pronation/supination at the proximal radio-ulnar joint?

A

The radial head turn in the radial notch of the ulnar

379
Q

What happens during pronation/supination at the distal radio-ulnar joint?

A

During pronation, the radius rotates over/around the distal ulnar

380
Q

What are the bony compartment of the wrist joint?

A

It is a joint between the

  1. radius
  2. articular disc of the distal end of the ulna
  3. And the three carpal bones:
    • Scaphoid
    • Lunate
    • Triquetrum
381
Q

How is the fibrous connection between the ulnar and the radius called?

What is its function?

A
  1. It is the interosseous membrane of the foream

It

  • gives rise fo muscle attachmetns
  • transfers forces between the bones (radius, ulna, humerus)
382
Q

What are the superficial muscles of the anterior compartment of the arm?

A

The most superficial layer

  1. Pronator Teres
  2. Flexor carpi radialis (FCR)
  3. Palmaris Longus (PL)
  4. Flexor carpi Ulnaris (FCU)

–> PFPF

+ 5. Flexor Digitorium Superficialis (one layer deeper)

383
Q

Which nerves supplies most of the superficial anterior compartment of the forearm?

Which muscle is the exception?

A

Most muscles are supplied by the Median Nerve

  • Pronator Teres, Flexor Carpi Radialis, Palmaris longus, Flexor digitorium superficialis

Exept from Flexor Carpi Ulnaris –> supplied by Ulnar Nerve

384
Q

Which muscles are part of the deep anterior compartment of the forearm?

A
  • Flexor digitorum profundus (FDP)
  • Flexor pollicis longus (FPL)
  • Pronator quadratus (PQ)
386
Q

Which nerves supplied the deep anterior compartment of the forearm?

A

Mainly Median Nerve

  1. Flexor digitorium Profundus for 2nd and 3rd digit
  2. Flexor pollicis longus
  3. Pronator quadratum

Exept

  • Flexor digitorium Profundus of 4th and 5th digit –> ulnar nerve
387
Q

What are the proximal and distal attachment of the brachioradialis?

A
  1. Proximal:
    1. Lateral supracondylar ridge of Humerus
  2. Distal
    1. Styloid process of radius
388
Q
A

Brachioradialis

390
Q

What are the proximal and distal attachments of the supinator muscle?

A

Proximal:

  1. Lateral epicondyle of humerus
  2. Anular ligament of radius
  3. Radial Collateral ligament
  4. Supinator crest of ulnar

Distal

  1. Anterior, lateral and posterior Surface of Radius
392
Q

What are the proximal and distal atachments of the pronator teres muscle?

A

Proximal (common flexor tendon)

  1. Medial supracondylar ridge of humerus (common flexor origin)
  2. Coronoid process of ulna

Distal

  • Lateral surface of radius
393
Q

Which nerve innervates the pronator Teres?

A

Median Nerve (C5-8+T1)

394
Q

What are the proximal and distal attachments of the pronator quadratus?

A
  1. Proximal
    1. Anterior surface of ulnar
  2. Distal
    1. Anterior surface of radius
395
Q

Which nerves innervates the pronator quadratus?

A

Median Nerve (C5-8+T1)

396
Q

What is the Flexor retinaculum of the hand?

What is its function?

A

The transverse carpal ligament

–> tansverse ligament that includes all the flexors of the hand (including the median nerve) and forms the roof of the carpal tunnel

397
Q

What is the anatomical snuff box?

What does it contrain and what is its clinical significance?

A

The area between the tendon of the extensor pllicis longus and the extensor pollicis brevis

It contains the

  • Radial artery
  • scaphoid bone
398
Q

Explain the arterial supply from the Clavicle to the elbow

A
  1. Subclavian artery
    1. •passes over the first rib to become…
  2. Axillary artery
    1. at the lower border of teres major becomes the…
  3. Brachial artery
  4. Gives off a large branch in the arm – Profunda brachii (Picture: green: brachial artery, lext next to it profunda brachii)
399
Q

What happens to the brachial artery at the elbow?

Explain the further supply

A

Brachial artery devides into

  1. Radial artery
  2. Ulnar artery

Both terminate at the Hand to anastomose with each other and and form the palmar arches

400
Q

Explain the route of the ulnar artery

A
  1. descends in the anterior compartment of the forearm
  2. passes into the hand anteriorly, on the ulnar side of the wrist (just lateral to FCU).
  3. The ulnar nerve lies medial to it at the wrist joint, i.e. from medial to lateral, the relationships are FCU, ulnar nerve, ulnar artery.
401
Q

What is the main function of the ulna?

A

To stabelise the forearm

402
Q

Explain the route of the radial artery

A
  • descends lateral aspect of the forearm under the the brachioradialis muscle.
  • It is easily palpable at the wrist
  • It crosses the floor of the anatomical snuff box and ultimately anastomosis with branches of the ulnar artery to form the palmar arches.
403
Q

Summarise the superficial venous drainage of the Arm

A
  1. Superficial venous dorsal network and superficial venous palmar arch drain into
    1. Cephalic vein (Lateral)
    2. Basilic vein (Medial)
  2. The Median cubital vein connects the two veins at the elbow
  3. Basilic vein forms the axillary vein which is joined by the cephalic vein to give the subclacian
405
Q

What are the boundries of the cubital fossa?

A
  1. brachioradialis muscle (lateral),
  2. pronator teres muscle (medial),
  3. the line between the humeral epicondyles (superior).
406
Q

What are the contents of the cubital fossa?

How are they related to one another

A

Deep

  1. Biceps tendon
  2. Brachial artery (medial to biceps tendon)
  3. Median nerve (Medial to brachial artery)
  4. Radial nerve laterally

Superficially

  • median cubital vein
408
Q

What kind of bone is the pisiform bone?

A

Sesamoid bone

409
Q

Which bone of the carpital bone regularly gets fractured that you can feel in the anatomical sniff box?

What is the associated probelm?

A
  1. The scaphoid regularly gets fractured
    • has recurrent blood flow that might get damaged –> necrosis
    • leading to problems+ pain in the wrist
410
Q

What is the anatomical snuff box?

Which structures pass through it?

A
  1. Space between the extensor pollicis longus tendon and the extensor pollicis brevis tendon on the thumb side
  2. The radial artery
  3. (+ radial nerve nearby)
411
Q

What are the superficial muscles of the posterior forearm?

A

7 Muscles

412
Q

What are the deep muscles of the posterior forearm?

A

5 Muscles

  • 3x tumb
  • 1x index finger
413
Q

What is the origin of the superificial extensors of the forearm?

A

extensor carpi radialis brevis, extensor digitorum, extensor carpi ulnaris and extensor digiti minimi= lateral epicondyle of humerus (common tendon origin)

  • extensor carpi radialis longus= supracondylar ridge
417
Q

What are the articulate surfaces of the bones in the ellbow joint covered with?

A

Hyaline cartilage

427
Q

What is a “pulled elbow” in children?

A

The subluxion of the radial head out of the proximal radio-ulnar joint

This can be painful but can easily be repositioned (in supination)

428
Q

Explain the anatomy of the proximal radial-ulnar joint

A

Pivot-type synovial joint, that allows the head of the radius to rotate within the annular ligament at the radial notch of the ulnar

436
Q

When coming to the forearm and wrist, where are most Flexors and where are most Extensors located?

A
  1. Flexors are usually located in the Anterior compartment of the Forearm
  2. Extensors are usually located in the posterior compartment of the forearm
440
Q

Which nerves innervates the Brachioradialis muscle?

A

Radial Nerve (C5-7)

442
Q

Which nerves innervates the supinator?

A

Radial Nerve (C5-7)

452
Q

What does the ulnar artery supply?

A
  • medial muscles of the forearm,
  • via branches including the
    • common interosseous artery,
    • the anterior interosseous artery
    • and the posterior interosseous artery.
455
Q

Explain the route of the deep veins in the forearm

A

Deep veins (venae comitantes) accompany the radial and ulnar arteries. They eventually flow to the brachial vein in the arm

458
Q

What is a sesamoid bone?

A

A bone embedded in tendons/ muscles

459
Q

What kind of bone is the pisiform bone?

A

Sesamoid bone

460
Q

Which bone of the carpital bone regularly gets fractured that you can feel in the anatomical sniff box?

What is the associated probelm?

A
  1. The scaphoid regularly gets fractured
    • has recurrent blood flow that might get damaged –> necrosis
    • leading to problems+ pain in the wrist
461
Q

What is the anatomical snuff box?

Which structures pass through it?

A
  1. Space between the extensor pollicis longus tendon and the extensor pollicis brevis tendon on the thumb side
  2. The radial artery
  3. (+ radial nerve nearby)
462
Q

What are the superficial muscles of the posterior forearm?

A

7 Muscles

463
Q

What are the deep muscles of the posterior forearm?

A

5 Muscles

  • 3x tumb
  • 1x index finger
464
Q

What is the origin of the superificial extensors of the forearm?

A

extensor carpi radialis brevis, extensor digitorum, extensor carpi ulnaris and extensor digiti minimi= lateral epicondyle of humerus (common tendon origin)

  • extensor carpi radialis longus= supracondylar ridge
465
Q

What is the palmar fascia?

A

The fascia of the palm (continous with the forearm), specilises into

  1. Aponeurosis
  2. Fibrous digital sheaths
466
Q

What is the Palmar aponeurosis?

What are its key features?

A

well-defined region of palmar fascial that overlies the long flexor tendons of the hand

–> proximal continuous with flexor retinaculum and palmaris longus

467
Q

What is the fibrous digital sheath of the hand?

A

It is the distal continuation of the fibrous sheaths and contains the flexor tendons and synovial sheaths of each finger

468
Q
A
469
Q
A
470
Q

What is the thenar compartment of the hand?

A

The intrinsic muscles of the hand that move the thumb:

  1. Abductor pollicis brevis
  2. Flexor pollicis brevis
  3. Opponens pollicis

+ (Adductor pollicis)= technically not a thenar muscles but sometimes also counted as one

471
Q
A
472
Q
A
473
Q

What are the hypothenar muscles of the hand?

A

The intrinsic muscles of the hand that move the little finger

  1. Abductor digiti minimi
  2. Flexor digiti minimi
  3. opponens digiti minimi
476
Q

Which nerve supplies the hypothenar compartment of the hand?

A

The Ulnar nerve C8-T1

477
Q

What is the function of the interossei muscle of the hand?

A
  1. The palmar interossei: adduct the digits
  2. The dorsal interossei: abduct the digits
479
Q

What are the lumbrical muscles of the hand?

What is their function?

A

Flexion of metacarpalphalangeal joints

Extionsion of proximal and distal interphalangeal joints

481
Q

Which bones form the attachment for the flexor retinaculum?

A

On the lateral side it attaches to the

  • Trapezium
  • Scarphoid

Medial side

  • Pisiform
  • Hook of Hamate
482
Q

What are the structures passing through the carpal tunnel?

A
  1. Median Nerve
  2. Tendons of the
    • Flexor digitorium superficialis
    • Flexor digitorium profundus
    • Flexor Pollicis longus
483
Q

What are the fibrous digital sheaths in the hand?

Which structures do they contain?

How do you call the fibrous digital sheath together with their structures an the bone?

A

They are the fibrous tubes around the digits containing

  1. Flexor tendons (incl. synovial sheaths)

–> together they are called osseo-fibrous tunnels

484
Q

Explain the organisation of vessels, nerves and tendons in the digits

A

From Deep to superficial

  1. Deep: Bone (phalynxes)
  2. Tendons
    • Flexor tendons anteriorly (surrounded by fibrous + synovial sheath)
    • Extensor tendons Posteriorly
  3. Structures form Deep (in this case posteriorly) to superificial (in this case anteriorly), embedden in Skin(Grayson) ligament
    • Vein
    • Artery
    • Nerve
487
Q

Name the different septa in the hand

A
  1. medial septum (to the little finger metacarpal)
  2. lateral septum (to the middle finger metacarpal)
488
Q

In which compartements do the septa of the hand devide the hand?

A
  1. hypothenar compartment
  2. central compartment
  3. thenar compartment
  4. adductor compartment (contains the adductor pollicis muscle)
489
Q

Explain the routes of the FDP and the FDS in the hand

A
  1. Enter the hand via the Carpal tunnel
  2. Run together in a common synovial sheath
  3. Pass into respective digit in digital synovial sheath
    • FDS splits around the FDP at the proximal phalanx, attaches to the middle phalanx (picture)
    • FDP attaches to the distal phalanx
490
Q

How are the condensations of the fibrous digital sheath at the fingers called?

A

They are called pulleys

  1. Annular pulleys
  2. Cruciform pulleys
492
Q

How is the structure at the back of the hand called that fixates all the extensor tendons?

A

The extensor retinaculum

493
Q

What is the role and function of the intertendenous bands of the hand?

A

these bands limit free movement of one extensor tendon independently of the others.

494
Q

What is the extensor expansion?

A

The long extensor flattening at level of the metacarpals

495
Q

What is the function of the extensor expansion?

A

Involved in movement of the digits

It is an attachment for the interossei and the lumbrical muscles

498
Q

What type of joint is the carpo-matacarpal joint of the thumb?

Which bones are involved?

A

It is the joint between the trapezium and the 1st metarcarpal bone

It is a saddle joint (type of synovial joint)

499
Q

What type of joint are the carpometacarpa joints?

A

They are synovial elipsoid joints

500
Q

How are the main ligaments called that stabelise the MCP and IP joints called?

A

Collateral ligaments, one on each side

  1. One ulnar collateral ligament
  2. Radial collateral ligament
501
Q

Which nerves supplies the thenar muscles of the hand?

A

Recurrent branch of the Median nerve C8-T1

502
Q

What is a mallet finger?

A

Avulsion of extensor digitorum longus tendon at the base of distal phalanx

503
Q

Which nerves supplies the adductor pollicis?

A

The Ulnar nerve (C8-T1)

504
Q

The median nerve passes laterally to the tendon of which muscle just before entering the carpal tunnel?

A

Palmaris Longus

507
Q

Which nerves innervates the interossei muscles of the hand?

A

The deep branch of the Ulnar nerve (C8-T1)

509
Q

What is the innervation of the lumbircal muslces of the hand?

A

2+3 Median Nerve (C8-T1) (index+ middle finger)

4+5 Ulnar Nerve (C8-T1) (ring+ little finger)

514
Q

What is the name of vessels and nerves in the digits?

A

Proper palmar digital vein/artery/nerve

515
Q

How are the extensions of facia that devide the hand into different compartments called?

A

Septa (sing. Septum)

520
Q

What is the function of the pulley in the digits?

A

They allow a more functional use of the long flexor tendon

525
Q

How is the joint between the distal and the proximal row of the carpal bones called?

A

The midcarpal joint

526
Q

What are the main movements occuring at the intercarpal joint?

A

Normally a gliding movement

530
Q

What is the clinical significane of the ulnar collateral ligament of the thumb?

A

It often gets damaged e.g. during skiing when falling onto outstreched thumb

532
Q

Which artery forms the superficial palmar arch of the hand?

A

Ulnar artery

533
Q

The median nerve passes laterally to the tendon of which muscle just before entering the carpal tunnel?

A

Palmaris Longus

534
Q

Explain the origin of the Axilla nerve in the brachial plexus

A

It is a terminal branch of the posterior cord of the brachial pexus (C5-T1)

535
Q

Which muscles does the Axilla nerve supply?

A

It supplies the Deltoid musle + teres minor

536
Q

Which area of the skin gets its sensory innervation from the Axillary nerve?

A
537
Q

Explain the route of the Axillary nerve

A

It emerges from the posterior chord of the brachial plexus at approx. level of the shulder joint and runs under the shoulder joint to innervate the deltoid

538
Q

What is a common injury where the Axilla nerve gets damaged?

A

It gets damaged in shoulder dislocation

539
Q

What are the consequences of damage to the Axillary nerve?

A

Loss of function of Deltoid

“Regimental batch” anesthesia

540
Q

What is the origino of the radial nerve in the brachial plexus?

A

It is the terminal branch of the posterior chord

541
Q

Which muscles are innervated by the radial nerve?

A

Almost all posterior muscles of the Arm and forearm

  • Extensor comparment of the Arm
  • Extensor compartment of forearm
  • Brachioradialis –> supination
542
Q

Explain the sensory innervation of the radial nerve

A

It supplies many areas of the lower posterior arm, the posterior forearm and hand

543
Q

How does the radial nerve gets damged?

Why?

A

It runs closely related to the humerus (radial groove on humerus) –> mighe be damaged in #

544
Q

What are the consequences of radial nerve damage?

A
  1. Motor function loss –> Dependant on site of lesion
    • Loss of extensor function
      • Elbow?
      • Wrist?
      • Finger?
    • –> Wrist drop
    • Loss of power grip –> initial extension needed
  2. Sensory:
    • Anesthesia in lateral dorsal hand
      3.
545
Q

Explain the pathway of the radial nerve

A
  1. Terminal branch of posterior cord of Brachial Plexus
  2. Runs closely related to humerus in radial groove to the lateral epichondyle
  3. Devides at the level of the elbow into
    • Deep branch
      • descends posterior forearm –> externsor muscles innervation
    • Superficial branch
      • sensory branch suppliing the arm, forearm, thenar eminence and part of hand, runs close to the antomical snuffbox
546
Q

Explain the origin of the musculocutaneous nerve in the brachial plexus

A

It is a terminal branch of the lateral chord (C5-7)

547
Q

Explain the route of the musculocuteneous nerve

A

It supplies and pinches the coracobrachialis muscle, runs deep protected by musces and emerges superficially to run down as the lateral cutaneous branch of the forearm

549
Q

What is the sensory function of the musculovutaneous nerve?

A

It supplies the anteriolateral part of the forerm

551
Q

What is the origin of the ulnar nerve of the brachial plexus?

A

It is a terminal branch of the median chord (C8,T1)

552
Q

Explain the route of the ulnar nerve

A

It runs posteriorly in the posterior medial epicondyle groove in the forearm (supercicially, can be palpated)

Runs down forearm medially and enters hand medially

553
Q

What are common sites of damage to the ulnar nerve?

When might they occur?

A
  1. Injuries to medial epicondyle of humerus
  2. Injuries at the wrist –> self harm?
554
Q

Which muscles does the ulnar nerve supply?

A

It supplies the

  • flexor carpu ulnaris
  • Medial half to flexor digitorium profundus
  • Medial 2 lumbricals
  • Inerosseus hand muscles
  • Hypolthenar comparment

–> Most innervation to the hand (except thenar and lateral lumbricals)

555
Q

Explain the cutaneous innervation of the hand

A

Medial part of hand (up to medial part of ring finger)

556
Q

What are the consequences of ulnar nerve damage?

A

“Claw hand”

due to–> loss of lumbrical contraction –> no flexionin MCP joints and no extension in the IP joints

  • limited adduction of thumb
  • Numbness in medial side of hand
558
Q

What is the origin of the median nerve in the brachial plexus?

A

It is the terminal recombinant of the medial and lateral cord

560
Q

Which muscles does the median nerve supply?

A
  • Most flexors of forearm and hand
  • thenar compartment of hand
  • lateral lumbrical muscles
561
Q

Explain the sensory innervation of the median nerve

A

It supplies most of the lateral palmar surface and finger tips of fingers 1-3

563
Q

What are the consequences of median nerve injury?

A
  1. Loss of sensation
  2. Loss of fine movements –> most movements of thumb + 1-2 fingers
  3. –> Benediction Sign (Schwurhand) when trying to flex hand
564
Q

What does damage to the long thoracic nerve cause?

A

Innervation loss of Serratur Anterior –>

Pressing against a wall will lead to “winging” of the scapula resulting from the loss of activity of serratus anterior

566
Q

Which situations might lead to an Erb’s-palsy?

A

Overstretch the neck relative to the shoulder

(might also happen during childbirth)

567
Q

What are the consequences of an Erb’s palsy?

A

“Waiters Tip” position due to:

  • suprascapular nerve, musculocutaneous nerve, axillary nerve palsy
  • paralysis and atrophy of the deltoid, biceps, and brachialis muscles
568
Q

What is a Klupke’s palsy?

A

Damage to the lower roots of the brachial plexus (C8+T1)

569
Q

What is the common cause of a Klupke’s palsy?

A

Over abdcution of the shoulder e.g.

  • due to gripping overhead to break a fall.
  • during childbirth
570
Q

How would someone with Klupke’s palsy present?

A
  1. Claw hand
  2. due to
    • median and ulnar function loss –> muscles of the hand
    • Ulnar: Fingers slightly seperated from one another (no adduction+abduction possible), lumbricals
    • lumbricals+ thenars
571
Q

Which spinal segments do spproximately allow movement in the

  1. Shoulder girdle
  2. Shoulder joint
  3. Elbow joint
  4. Wrist joint
  5. Fingers and thumb
A
572
Q

Explain the formation and organisation of the brachial Plexus

A
  1. C5-T1 roots
  2. C5+6, T7, C8+T1 combine to form the upper, middle and lower trunks
  3. Each roots devides into a Posterior and Anterior devision
  4. The Anterior devisions of the upper and middle trunk joint to give rise to the lateral cord,
    • ​​​Terminal branches: devides into the musculocutaneous nerve and half of the median nerve
  5. ​​​all posterior devisions join to give rise to the posterior cord
    • devides into axillary and radial nerve
  6. ​and the anterior devision of the lower trunk continues as the medial cord
    • ​​devides into ulnar nerve and half of the median nerve
573
Q

What is the thoracodorsal nerve?

Which muscle does it supply and where does it originate?

A

It originates in the brachial plexus from the posterior chord and supplies latissimus dorsi

574
Q

Where do the upper and lower subscapular nerves originate?

What do they supply

A

The originate from the posterior chord of the brachial plexus –>

supply: subscapularis and teres major,

575
Q

Where does the lateral pectoral nerve originate?

What does it supply?

A

It originates from the lateral cords of the brachial plexus and supplies the Pec major+ parts of pec minor

576
Q

Where does the median pectoral nerve originate?

What does it innervate?

A

Is mainly supplies pec minor and arises from the medial cord of the brachial plexus

577
Q

What is the Name of the different sections in the brachial Plexus?

A

Read That Damn Cadaver Book

  • Roots
  • Trunks
  • Devisions
  • Chords
  • Branches
579
Q

What is a branch of the C5 Nerve route of the Brachial Plexus?

What does it innervate?

A

The Dorsal Scapula nerve

  • supplies Rhomboids
580
Q

What is the anatomical relationship of the roots of the brachial plexus to adjacent structures?

A

It i in the posterior triangle of neck

  • between anterior and middle scalene muscle
581
Q

What is the Origin of the Long Thoracic Nerve?

A

Branch from C5-C7 Roots in the Brachial Plexus

582
Q

What does the Suprascapular Nerve Supply?

Where does it originate?

A

Supplied the Suprespinatus and infraspinatus

  • branch of superior trunk of brachial plexus
583
Q

What does the Nerve to Subscapularis supply?

Where does it originate?

A

It is a branch of the Superior Trunk of the brachial Plexus

  • supplies the subscapularis
584
Q

What are the branches of the Lateral chord of the brachial Plexus?

A
  • Lateral pectoral nerve –> Pec major
    • 2 Terminal Branches
      • Musculocutaneous Nerve
      • Part of Median Nerve
585
Q

What are the branches of the Posterior chord of the brachial Plexus?

A

4 Branches + end in radial nerve

  • Superior Subscapular Nerve
    • subscapularis
  • Thoracodorsal Nerve
    • latissimus dorsi
  • Inferior Subscapular Nerve
    • Subscapularis and teres major
  • Axillary Nerve
    • deltoid and teres major
586
Q

What are the branches of the Medial chord of the brachial Plexus?

A

Gives Rise to Ulnar and part of Median Nerve +

  • Medial Pectoral Nerve (pec minor)
  • Medial Cutaneous Nerve of Arm
  • Medial Cutaneous Nerve of Forearm
587
Q

What are the symptoms of carpal tunnel syndrome?

A
  • nocturnal loss of sensation (paresthesia) and pain in lateral volar part of hand
  • radiation of pain into arm
  • loss of power grip
  • Later
    • atrohpy of thenar compartment
    • paresis of abductor pollicis brevis and opponens pollicis
595
Q

What is the motor function of the musculocuatneous nerve?

A

C5-7

–> innervates the flexor compartment of the arm

  • biceps brachii
  • brachialis
  • coracobrachialis
597
Q

When might the musculocutaneous nerve be damged?

A

Normally well protected but might be damaged in lymph node removal in breast cancer

604
Q

What is the ulnar paradox?

A

A more distal lesion of the ulnar nerve causes a less sever claw hand than a more proximal lesion

  • because ulnar also innervates FDP
    • in more distal lesion FDP is paralised and Flexion at IP joints is less
606
Q

Explain the route of the median nerve

A
  1. Originates from the lateral and median cords of the brachial plexus
  2. runs down anteriorly following the brachial artery to the cubital fossa
  3. Enters the hand via the carpal tunnel
609
Q

What is the commonest cause for damage of the median nerve?

A

Carpal tunnel syndrome

612
Q

What is an Erb-Dunchenne Palsy?

A

Injury to the upper rours of the brachial Plexus –> C5+6

625
Q

What is a somatic nerve?

A

Somatic= controlls voluntary movement in body

626
Q

What is a branch of the C5 Nerve route of the Brachial Plexus?

What does it innervate?

A

The Dorsal Scapula nerve

  • supplies Rhomboids
627
Q

What is the anatomical relationship of the roots of the brachial plexus to adjacent structures?

A

It i in the posterior triangle of neck

  • between anterior and middle scalene muscle
628
Q

What is the Origin of the Long Thoracic Nerve?

A

Branch from C5-C7 Roots in the Brachial Plexus

629
Q

What does the Suprascapular Nerve Supply?

Where does it originate?

A

Supplied the Suprespinatus and infraspinatus

  • branch of superior trunk of brachial plexus
630
Q

What does the Nerve to Subscapularis supply?

Where does it originate?

A

It is a branch of the Superior Trunk of the brachial Plexus

  • supplies the subscapularis
631
Q

What are the branches of the Lateral chord of the brachial Plexus?

A
  • Lateral pectoral nerve –> Pec major
    • 2 Terminal Branches
      • Musculocutaneous Nerve
      • Part of Median Nerve
632
Q

What are the branches of the Posterior chord of the brachial Plexus?

A

4 Branches + end in radial nerve

  • Superior Subscapular Nerve
    • subscapularis
  • Thoracodorsal Nerve
    • latissimus dorsi
  • Inferior Subscapular Nerve
    • Subscapularis and teres major
  • Axillary Nerve
    • deltoid and teres major
633
Q

What are the branches of the Medial chord of the brachial Plexus?

A

Gives Rise to Ulnar and part of Median Nerve +

  • Medial Pectoral Nerve (pec minor)
  • Medial Cutaneous Nerve of Arm
  • Medial Cutaneous Nerve of Forearm
634
Q

What are the symptoms of carpal tunnel syndrome?

A
  • nocturnal loss of sensation (paresthesia) and pain in lateral volar part of hand
  • radiation of pain into arm
  • loss of power grip
  • Later
    • atrohpy of thenar compartment
    • paresis of abductor pollicis brevis and opponens pollicis
635
Q

Summarise the route for the arterial blood supply from the hear to the cibital fossa

A
  1. Brachiocephalic artery/Left subclavian
  2. Subclavian artery
  3. Becomes the axillary artery at the border of first rib
  4. Becomes brachial artery at lower border of teres major
  5. Runs medial to the humerus until neck of the radius
636
Q

Where is the brachial artery in the cubital fossa located?

A

It runs fairly central in the cubital fossa but is spereated from the median cubital vein from the biceps tendon/sponeurosis

637
Q

What happens to the brachial artery at the level of the elbow?

A

It devides into radial and ulnar artery

638
Q

Explain the course of the radial artery in the forearm to the hand

A

It travels down the lateral part of the forearm to the hand under brachioradialis

639
Q

Explain the course of the radial artery in the hand

A

It crosses the floor of the anatomical snuffbox, enters the hand and anstomoses with the deep palmar brach of the ulnar artey to form the deep palmar arch

640
Q

Explain the course of the ulnar artery in the forearm

Explain its relationship to the FCU and ulnar nerve

A

Runs in the anterior compartment of the forearm on the median side

When it enters the wrist it is most lateral (from medial to lateral–> FCU, Ulnar Nerve, Ulnar artery)

641
Q

What are the most important branches of the ulnar artery in the forearm?

A

Interosseus arteries

  1. common
  2. anterior
  3. posterior
642
Q

Explain the course of the ulnar artery enterin the hand

A

over the flexor retinaculum, lateral to the pisiform and through the semi-rigid ulnar (Guyon’s) canal with the ulnar nerve

643
Q

What are the branches given off by the ulnar artery in the hand?

A

In the hand it devides into the

  1. Superficial branch
  2. Deep branch

Respectively anastomost with the superficial and deep branches of the radial artery to form the

  1. Deep palmar arch
  2. Superficial palmar arch
644
Q

What is the deep palmar arch?

What does it give rise to and supplied?

A

It is the anastomosis of the deep branches of ulnar+radial artery

  • Gives rise to the palmar metarcarpal arteries
645
Q

What is the superficial palmar arch?

What does it give rise to and supplies?

A

Anastomosis between superficial branches of radial+ ulanr artery:

The superficial palmar arch gives off three common palmar digital arteries. These arteries subsequently divide into palmar digital arteries.

646
Q

Explain the venous drainage in the hand

A

Most is superficially but

  • Deep+ superficial palmar arches have respective venous drainiage
  • Dorsal digital vein gives rise to the dorsal venous arch that devides into basilic and cephalic vein
648
Q

Explain the route of the basilic and cephalic veins in the arm

A

The cephalic vein runs laterally, the basilic vein runs medially, connected by the median cubital vein in the cubital fossa

  • Basilic vein is joined by the brachial vein and then becomes the axillay vein
  • That is joined by tha cephalic vein and becomes the subclavian vein
660
Q

How are the deep veins in the arm called?

Which route do they take?

A

venae comitantes accompany the radial and ulnar arteries. They eventually flow to the brachial vein in the arm

661
Q

Explain the route of the basilic and cephalic veins in the arm

A

The cephalic vein runs laterally, the basilic vein runs medially, connected by the median cubital vein in the cubital fossa

  • Basilic vein is joined by the brachial vein and then becomes the axillay vein
  • That is joined by tha cephalic vein and becomes the subclavian vein
662
Q

What are the two main regions of the lower limb?

A
  1. the gluteal region–> part of the trunk
  2. The “free lower limb”–> (thigh, leg and foot)
663
Q
A

Acetabular notch

664
Q
A

Lunate surface of acetablulum

665
Q

What is the lunate surface of the acetabulum?

A

The articular surface within the acetabular fossa of the acetabulum for the femur

666
Q

Where is the femural head?

What is the fovea?

A

Femural head= articular surface for acetabulum

Fovea: medial depression on the medial side as attachment for the ligament

667
Q
A
668
Q
A
669
Q
A
670
Q
A
671
Q

What is the trochanteric fossa?

A
672
Q

What are the two layers of fascia present in the lower limb?

A
  1. Superficial fascia = subcutaneous tissue
  2. Deep fascia –> Fascia lata
673
Q

What is the fascia lata?

How can it change?

A

The fascia lata extends from the pelvis down the leg underneath the skin like a stocking. A thickened area of it laterally is called the ilio-tibial tract

674
Q

What are the muscles of the gluteal compartment of the thigh?

A
  1. The gluteal muscles
    • Gluteus maximus
    • Gluteus medius
    • Gluteus minimus
  2. The short external rotators of the hip
    • Piriformis
    • Obturator Internus
    • The gemellus
    • Quadratus Femoris
675
Q

What are the borders of the femoral triangle?

A

–Superiorly – the inguinal ligament

–Medially – adductor longus

–Laterally - sartorius

676
Q

What are the contents of the femoral triangle?

What is their organisation?

A

From lateral to medial:

  • Femoral nerve
  • Femoral artery
  • Femoral vein

NAVY

677
Q

What are the muscles of the anterior compartment of the thigh?

A
  • Pectineus
  • Ilio-psoas
  • (Tensor fasciae latae) (functionally anterior, supply gluteal)
  • Sartorius
  • Quadriceps femoris
    • Rectus femoris
    • Vastus medialis
    • Vastus intermedius
    • Vastus lateralis
679
Q

What is the vascular and neural supply to the anterior compartment of the thigh?

A

By the Femoral nerve (L2-4) and the superficial femoral artery

680
Q

What is the quadriceps?

What are its individual components?

What its function and supply?

A

It has 4 parts

  1. Rectus femoris (only part that crosses hip joint)
  2. Vastus lateralis
  3. Vastus intermedialis
  4. Vastus medialis

–> All join to a common tendion that embeds the patells

Supplied by the femoral artery and nerve, involved in extension of the leg and flexion of the hip

681
Q

Explain the route of the quadriceps at the patella

A

All 4 quadriceps muscles tendons join to one common tendon–>

Run to patella that is embedded in them

Continue at the patellar ligament ant attaches to the tibia

682
Q

Which muscles are part of the median compartment of the thigh?

A

the Hip adductors

  • Adductor longus
  • Adductor brevis
  • Adductor magnus
  • Gracilis
  • Obturator externus
683
Q

Where do muscles from the medial compartment of the thigh attach?

What is their main function?

A

They all attach around the pubis

–> Cause adduction of the hip

684
Q

What is the nerve and blood supply of the medial compartment of the thigh?

A

Obturator nerve and artery

685
Q

Where does the obturator artery originate from?

A

It originates from the internal iliac artery

686
Q

What is the adductor hiatus?

Which structure forms it?

A
689
Q

Which muscles are there in the posterior compartment of the thigh?

How are they also known?

A

Posterior muscles, also known as “Hamstrings “

  • semimembranous
  • semitendenous
  • biceps femoris
690
Q

Where to the muscles of the posterior comparment of the thigh originate?

What is their main function?

A

Most of them: from Ischium (tuberosity)

They will flex the knee and extend the hip

691
Q

Which structure forms the floor of the femural triangle?

A

The pectineus (+ part of the iliacus)

692
Q

What is the saphenous opening?

A

It is an opening in the femoral sheath that allows the saphenous vein to join the femoral vein

693
Q

What is the neural and vascular supply of the posterior compartment of the thigh?

A

They are supplied by the inferior gluteal and branches from the profund femoral artery

The neural supply is by the tibial branch of the sciatic nerve

694
Q

Explain the nerve supply to the gluteal muscles of the thigh

A

Gluteal muscles=

  • Superior gluteal nerve to medius and minimus
  • Inferior gluteal nerve to maximus
695
Q

What is the femoral sheath?

A

A layer of fascia that embeddes the femoral artery and vein (not the nerve!) around the femoral triangle

696
Q

What is the adductor canal?

What are other names for it?

A

Also called: Hunters canal:

It is a canal formed by the

  • Vastus medialis (anteriorly)
  • Adductor longus and adductor magnus (posteriorly)
  • Sartorius (medially)

that carries the femoral atery+ vein and the saphenous nerve

Picture: section halfway of femur

697
Q

Generally speaking: Which structure do most structures passing from the pelvis to the thigh go through?

A

The greater sciatic foramen

698
Q

Explain the route of the sciatic nerve from the hip to the knee

A
  • Passes from pelvis to buttock via greater sciatic notch/foramen
  • In the buttock, lies in the inferior and medial quadrant
  • Passes along posterior aspect of the thigh
  • Divides into the tibial nerve and the common peroneal nerve (also called: common fibular nerve)
699
Q

Explain the position of the sciatic nerve in respect to the piriformis muscle

A

Normally: Sciatic nerve enters glueal region below piriformis

but there can be anatomical variation: might pierce the muslce or one part comes off superior to prirformis, one part inferior to piriformis

700
Q

What is the safe area in the thigh/ gluteal area?

Why is it important?

How do you determine it?

A

It is the area wher IM injections can be performed without hitting the sciatic nerve

Position the index finger on the ASIS and the middle finger on the iliac tubercle –> safe area is the area in between!

701
Q

What happens physiologically, when you stand on one leg?

A

Normally: the abductors of the thigh prevent tilting of the pelvis when a limb is raised.

702
Q

Which muscles are the hip adductors?

A

Gluteus medius
Gluteus minimus
Tensor fascia lata

703
Q

What is the Trendelbergs Test?

A

Test for hip abductors:

  1. Subject stands upright on both feet
  2. Examiner stands behind.
  3. Note the level of both iliac crests.
  4. Subject is asked to stand on one leg. A drop in the level of iliac crest on the unsupported side indicates weakness of the hip abductors on the stance side.
705
Q

What is the acetabular notch?

A

The lower part of the acetabulum without bony support

706
Q

How is the acetabular notch stabelised?

A

It is stabelised by the transverse ligament of the acetabulum

707
Q

Explain the difference between the anterior and the posterior part of the capuse of the hip bone

A

The capsule of the hip bone extends further anteriorly that posteriorly

708
Q

Which ligaments stablelise the hip joint?

A
  • Ilio-femoral ligament
  • Pubo-femoral ligament
  • Ischio-femoral ligament
  • The ligament of the head of the femur (less important)
709
Q

Summarise the blood supply to the head of the femur.

Why might this be clinically relevant?

A

Blood supply travels in the joint capsule of the hip joint:

  • Acetabular branch of the obturator artery
  • Lateral circumflex
  • and Medial circumflex femoral arteries

Most of the supply is distally–> in fracture of the femural neck it might lead to vascular acrosis when blood supply is disrupted

710
Q

Explain the couse of the arteries in the thigh from the Aorta to the Knee

A
  1. Aorta –> bifurcates into
    • Right and left common iliac
      • Internal iliac artery
      • External iliac artery becomes
        • Femoral artery beneath the inguinal ligament
        • Bifurcates into
          • Superficial femoral artery
          • Profund femoral artery
711
Q

What are the perfurating arteries of the thigh?

A

Branches of the prfund femoral artery

712
Q

What is the name of the large superficial vein of the tigh?

Where does it run?

A

The long saphenous vein

It runs medially in the thigh

713
Q

Summarise the deep venous drainage of the thigh

A
  1. Popliteal vein becomes the
  2. Femoral vein at the adductor hiatus,
    • joined by the saphenoid vein at the Sapheno-femoral junction and becomes
    • Venae comitantes of the profunda femoris artery
  3. External iliac vein at the inguinal ligament
714
Q

Summarise the lymphatic drainiage of the thigh and areas of prominent lymph nodes

A

•Lymph flows with the superficial and deep veins

There are important:

  • •Superficial inguinal lymph nodes
  • •Deep inguinal lymph nodes
  • •External iliac lymph nodes
  • Polpiteal lymph nodes
715
Q

Which spinal nerves supply the Hip Flexors?

A

L2,3

716
Q

Which spinal nerves supply the Hip Extensors?

A

L4,5

719
Q

Map the dermatomes of the thigh and leg

A
721
Q

The fascia of which muscles forms the iliotibial trace?

A

the facia of gluteus maximus and tensor facia lata

731
Q

What is the main function of the anterior compartment of the thigh?

A

It does hip flexion and knee extension

740
Q

Which structures pass through the adductor hiatus ?

How do they change?

A

The femoral artery and vein pass through the adductor hiatus (whole formed by adductor magnus) and become the popliteal vein and artery

741
Q

What is the sartorius muscle?

What its function?

A

It is the longest muscles in the body

–> runs laterally in the anterior compartment of the thigh and crosses to insert at the medial border of the tibia

–> Tailors muscle : abduction of hip and flexion of the knee

757
Q

What type of joint is the hip joint?

A

It is a synovial joint with hyaline cartilage between the head of the femur and the acetabulum

770
Q

Which spinal nerves supply the Knee extensors?

A

L3,4

771
Q

Which spinal nerves supply the Knee flexors?

A

L5, S1

773
Q

How is the anatomical region between the hip and the knee called, and the knee and the foot called?

A

Between hip and knee= thigh

Between knee and foot= leg

774
Q

The fascia of which muscles forms the iliotibial trace?

A

the facia of gluteus maximus and tensor facia lata

775
Q

How do you call the ridge on the anteior side of the femur?

A

Linea Aspera

–> Attachment for many muscles (adductors of the hip)

776
Q
A

Medial and lateral condyle of femur –> Articulation with tibia

777
Q

Which side of the femur is this?

A

Posterior side

778
Q
A

Interchondylar fossa

779
Q

What is the name of the patella surface on the femur?

A

Femoral Trochlea

780
Q
A
781
Q
A
782
Q

What is the medial/Lateral plateau of the tibita?

A

The flat surfaces of the chondyles

783
Q
A
784
Q
A
785
Q
A
786
Q

Where is it located in the anatomical position?

A

It is located posteriorly

–>When looking on the fibula: Left on the left fibular and right on the right fibula

788
Q

Identify the apex, base, posterior and anterior surface of the patella

A

Anterior surface–> rough

Posterior surface –> smooth

789
Q

Identify the body, neck and head of the talus

A
790
Q
A

Calcaneous

791
Q
A

Calcaneal tuberosity

792
Q
A

Sustentaculum Tali of the Calcaneous

–> supports the talus in formation of the ankle joint

793
Q
A
794
Q

Identify the base, body and head of the Metatarsals

A

Base= at the proximal end

Head= at distal end

795
Q

What are the muscels in the anterior compartment of the leg?

A
  1. Tibialis Anterior
  2. Extensor Digitorium Longus
  3. Extensor Hallucis Longus
796
Q

What is the function of the anterior compartment of the leg?

A

They are involved in Ankle Dorsiflexors (extensors)

797
Q

Summarise the blood and nerve supply to the anterior compartment of the leg

A

Neral supply:

  • Deep Peroneal Nerve

Vascular supply

  • Anterior Tibial Artery
799
Q

What are the muscles of the lateral compartment of the leg?

What is their function?

A
  1. Fibularis /Peroneal longus
  2. Fubularis /Peroneal brevis

–> involved in plantar flexion and eversion of foot

800
Q

What is dorsiflexion and what is plantarflexion in relation to the foot?

A

Dosiflexion= Extension

Plantarflexion= flexion –> going on tiptoes

801
Q

What is eversion and inversion of the foot?

A
802
Q

Explain the course of the tendons of the anteior and lateral compartments of the leg to the foot in relation to the lateral malleuolus

A
  1. Anterior Compartment
    • tendons run anteriorly to laterla malleolus
  2. Lateral comparment
    1. ​tendons run posterior to lateral malleolus
803
Q

Summarise the vascular and neural supply of the lateral compartment of the leg

A

Supplied by the

  • Superficial Peroneal Nerve
  • Peroneal Artery
804
Q

What are the muscles of the superficial posterior comparment of the leg?

A
  1. Gastrocnemius (two heads)
  2. Soleus
  3. Plantaris
805
Q

What are the muscles of the deep posterior compartment of the leg?

A
  • Popliteus

+ Opposite of anterior compartment:

  • Flexor Digitorum Longus
  • Flexor Hallucis Longus
  • Tibialis Posterior
806
Q

Which muscles form the calcaneal tendon?

What is a different name for it ?

A

Achilles tendon

–> Formed by the gastrocnaemius and soleus (minor contribution from plantaris)

809
Q

What are the muscles of teh dorsum of the foot?

A
  1. Extensor digitorium brevis
  2. Extensor hallusis brevis
  3. (dorsal interossei muscles)
810
Q

Explain the muscles in the plantar side of the foot

A
  1. Layer
    1. Abductor hallucis longus
    2. Flexor digitorum brevis
    3. Abductor digiti minimi
  2. Layer
    1. Quadratus plantae
    2. The tendons of flexor hallucis longus and flexor digitorum longus (the long toe flexors)
    3. The lumbricals
  3. Third layer;
    1. Flexor hallucis brevis
    2. Adductor hallucis
    3. Flexor digiti minimi brevis
  4. Fourth layer;
    1. The plantar interossei
    2. The dorsal interossei
811
Q

What are the boundries of the polpiteal fossa?

A

Superior Borders

  • Lateral
    • Biceps Femoris
  • Medial
    • Semimembranosus

Inerior Borders

  • Lateral head of gastrocnemius
  • Medial head of gastrocnemius
  • Skin and fascia (anterior)
  • Femur (posteriorl)
812
Q

What are the contents of the polpiteal fossa?

A
  • Popliteal artery and vein
  • Tibial Nerve and Common Peroneal Nerve
  • Short saphenous vein
  • Popliteal lymph nodes
813
Q

What are the ligaments stabelising the knee joint?

A
  1. Collateral ligaments
    1. medial collateral ligament
    2. lateral collateral ligament
  2. Cruciate ligament
    1. Anterior cruciate ligament
    2. Posterior cruciate ligament
814
Q

Explain the difference between the anterior and posterior cruciate ligaments

A

They are named in relation to attachment to the tibia –> ACL= anteiror on tibia, posterior on femur (PCL the other way around)

815
Q

What kind of structure are the menisci in the knee?

What is their funciton?

A

Are fibro-cartilagenous strucutres in the knee

The menisci act to disperse the weight of the body and reduce friction during movement

816
Q

Why does the median meniscus gets more commonly injured thant the lateral meniscus?

A

There is an attachment between the medial meniscus and the medial ligament

818
Q

What kind of joints are the Proximal and distal tibio-fibular joints?

Why?

A
  1. Proximal= synovial joint
  2. Distal= fibrous joint
    1. allows less movement and more stability for ankle joint
819
Q

What is a sprained ankle?

Which movement causes it?

A

It is damage to the ligaments of the ankles:

The lateral ligaments (3 parts) are commonly damaged by over-inversion.

  • posterior fibular
  • anterior fibular
  • calcaneofibular ligmaent

The broader and tougher tibiocalcaneal(deltoid) ligament is less often damaged.

820
Q

Explain the structure of the ankle joint

A

Talus articulates with the tibia –> weight bearing part The Fibular contributes with the lateral malleolus, to forms the square socket of the ankle joint.

821
Q

Where is the subtalar joint?

A

Joint between the talus and the calcaneous

822
Q

Where is the •Midtarsal Joint?

A

Also called the transverse tarsal joint

talo-calcaneonavicular (red line)

823
Q

What are the arches of the foot?

A

There are 3 ARches

  • Longitudinal arches
    • Medial longitudinal arches (higher than lateral)
    • Lateral longitudinal arch
  • Transverse arch
824
Q

Which structures contribute to the formation of the arches in the foot?

A

Ligaments and long tendons, and intrinsic muscles

825
Q

Explain the Gait cycle

In which phases couly you sub-devide the different phases?

A

Two phases for each limb:

  1. Stance phase
    1. starts with heel strike (A)
    2. ends with heels off (D)
  2. Swing phase
    1. starts with preswing (E)
    2. and ends with terminal swing (G).
828
Q

Summarise the motor segmental supply to the lower limb

A
834
Q

How do you identify if it is a left or right patella?

A

If you lie it down–> The bone lies down on its lateral surface

845
Q

What is a different name for peroneal?

A

Fibularis

854
Q

What is the vascular and neural supply of the posterior compartment of the leg?

A
  • Tibial nerve
  • Posterior Tibial Artery
855
Q

What is the function of the posterior compartment of the leg?

A

•Ankle Plantarflexors

864
Q

Which muscles/structures extend the knee?

Which structures are involeve?

A
  • Quadriceps
    • Quadriceps tendon
    • Patella
    • Patellar tendon
    • Tibial tunerosity
873
Q

Which Neural supply normally supplies the Hip Flexors?

A

L2,3

874
Q

Which spinal nerve level normally supplies muscles for hip Extension

A

L4,5

875
Q

Summarise the motor segmental supply to the lower limb

A
876
Q

Which Spinal nerves make out the Lumbo-sacral pexus?

A

(L1)L2-S3

877
Q

How many pairs of spinal nerves are there?

How are they classified?

A

„There are 31 pairs of spinal nerves

  • 8 Cervical
  • 12 Thoracic
  • 5 Lumbar
  • 5 Sacral
  • 1 Coccygeal

“

878
Q

Where do autonomic fibres fom the spinal chord emerge?

A

They emerge from cranial nerves (PNS)+

  • T1-L2 (SNS)
  • S2-S4 (PNS)
879
Q

Which spinal nerve generally supply the lower limb?

A

L2-S2

880
Q

Which spinal nerves generally supply the perineum?

A

S2-C1

881
Q

Which spinal nerves generally supply the upper limb?

A

C5-T1

882
Q

Explain the involvement of the anterior and posterior rami in the lumbo-sacral plexus

A

The anterior rami of the spinal nerves merge and give rise to the lumbar plexus

The posterior rami (much smaller) normally cutaneous innervation

883
Q

Explain the formation and route of the femoral nerve

A

L2-L4

  • leaves the pelvis under the inguinal ligaments
  • runs in the femoral triangle, in anteriomedial part of the thigh
  • gives rise to many brances, one of them is the saphenous nerve (green in picture)
885
Q

Explain the route of the obturator nerve

Which spinal nerves are involved in its formation?

A

L2-L4

  • descends along posterior abdominal wall
  • passes through the obturator canal/foramen
886
Q

Explain the motor and sensory innervation of the obturator nerve

A

L2-4

Motor

  • medial compartment of the thigh (except pectineus)
  • obturator externus

Sensory

  • sin upper medial aspect of thigh
887
Q

Explain the route of the sciatic nerve from the hip to the thigh

Whhich spinal route are inoveled in its formation?

A

L4-S3

  • leaves pelvis through greater sciatic foramen, around piriformis,
  • passes through gluteal region (inferior)
  • runs down posterior side of thigh
  • gives rise to posterior cutaneous nerve of thigh
888
Q

Explain the route of the sciatic nerve in the polpiteal fossa

A

It devides into

  1. Tibial nerve (runs
  2. Common peroneal nerve
889
Q

Explain the route of the tibial nerve

A
  • emerges from the sciatic nerve in the polpiteal fossa
  • runs down posterior leg
  • travels behind medial malleolus and enters foot
890
Q

What is the motor and sensory function of the femoral nerve?

Which spinal nerves are involved?

A

Motor

It supplies all muscles in the anterior compartment of the thigh

  • also gives branches to iliacus, psoas and pectineus
  • –> extention of the knee

Sensory

  • skin on anterior thigh+ medial side of leg and foot (though saphenous nerve)
891
Q

What does the tibial nerve supply?

Which spinal nerves are involved?

A

Branch of the sciatic nerv L3-S3

  • supplies posterior compartment of leg
  • intrinsic muscles of the foot
893
Q

Explain the function and route of the superior gluteal nerve

Which spinal nerve contribute to its formation?

A

L4-S1

  • supplies gluteal medius and minimus and tensor faccia lata
894
Q

Explain the function and route of the inferior gluteal nerve

Which spinal nerve contribute to its formation?

A

L5-S2

  • supplies gluteus maximus
895
Q

Explain the use of the words anteriro and posterior devisions of the lumbar plexus in the lower limb

A

Anterior devisions–> supply posterior LL (e.g. sciatic nerve)

Posterior devisions –> supply anteiror LL (e.g. femoral nerve)

  • due to permanent pronation during development
896
Q

Explain the segmental motor supply in the (lower) limb

What are its kex characteristics?

A
  • Muscles are supplied by two adjacent segments
  • Same action on joint = same nerve supply
  • Opposing muscles 1-2 segments above or below
  • More distal in limb = more caudal in spine
897
Q

What is the segmental motor supply to the hip?

A
  • Flexion= L2-3
  • Extension= L4-5
898
Q

What is the segmental motor supply to the knee?

A

Extension= L3,4

Flexion= L5,S1

899
Q

Explain the segmental motor supply to the ankle

A
  1. Dorsiflexion = L4,5
  2. Plantarflexion= S1,2
  • inversion= L4
  • Eversion= L5,1
  1. toe flexion= L5,S1
  2. toe extension= S1,2
900
Q

Explain the Main dermatomes in the LL

A

Anterior:

  1. “L3 to the knee, L4 to the floor” –> work you other way around it

Posterior:

  • Medial= S2
  • Lateral= S1, seperated by axial line
901
Q

What is an autonomous sensory zone?

A

Normally: spinal neres largely overla when it comes to cutaneous sensory supply (e.g dermatomes)

But ther are some zones where overlap is minimal, called autonomous sensory zones

906
Q

Name some of the clinically significant sensory autonomous zones of the LL

A

„L3 – front of the thigh (“L3 to the knee”)
L4 – front of the leg (“L4 to the floor”)
L5 – dorsum of the great toe
S1 – lateral aspect of the foot
S2-4 – perineum and perianal region“

907
Q

What does the sciativ nerve supply?

Where does it get its spinal nerves from?

A

L3-S3

  • supplies
    • posterior compartment of tigh
    • leg and foot via tibial and fibular nerve
909
Q

Explain the route of the common fibular nerve in the leg

What does it supply?

A

Branch of the sciatic nerve, runs laterally along the fibula where it is suspectible to damage!

Is soon subdevides into

  1. superficial peroneal nerve (L4-S1)
    • runs down laterally and supplies the lateral compartment of the leg
  2. deep fibular nerve (L5-S2)
    • runs down anteriorly and supplies anterior compartment of leg
910
Q

Explaint the route of the lateral cutaneous branch of the thigh and its result in compression

A
  • passes superficially 2cm medial to the anterior superior iliac spine at the level of the inguinal ligament.
  • It can be compressed at this level causing meralgia paraesthetica.“
912
Q

What is the saphenous nerve?

What happens in damage?

A

Branch of the femoral nerve suppying cutaneous sensory innervation in the medial leg and foot

  • might be damaged at the medial malleolus
  • or at knee (both: often linkes to medical procedures)
913
Q

Explaint the route of Arteries from the aorta into the LL

A
  1. Aorta into
  2. Common iliac artery
  3. into
    1. interal iliac artery
      1. obturator artery
    2. external iliac artery
      1. becomes femoral artery at the inguinal ligament
914
Q

Explain the route of the femoral artery in the thigh

A
  • passes inguinal ligament at mid-inguinal point
  • just below the inguinal ligament it gives rise to the
    • the superficial circumflex iliac artery
    • the superficial epigastric artery
    • the superficial external pudendal artery
    • the deep external pudendal artery
  • Below that it gives of big branch the profunda femoris artery
    • ​perforating artery
    • medial+ lateral circumflex artery
  • Superficial femoral artery passes through adducturo hiatus and becomes the polpiteal artery
915
Q

Explain the route of the polpiteal artery

A
  • runs in polpiteal fossa
  • bifurcates into
    • anterior tibial artery
      • passes anterior in leg, becomes dorsalis pedis at foot (anterior)
    • posterior tibial artery
      • gives off peroneal artery that runs laterally
      • rest: runs posteriorly in leg and entery foot posterior to medial malleolus
        *
916
Q

What are the main arteries of the foot?

Where do they originate from?

A
  1. Anterior tibial artery gives rise to dorsalis pedia
  2. posterior tibial artery gives rise to medial plantar artery
917
Q

What are the main superficial veins of the LL

Explain their route

A
  1. Great saphenous vein
    • forms dorsal venous arch
    • runs anterior to medial malleolus
    • runs medially, in the leg, goes slightly posterior in knee,runs up mediall in thigh and
    • joins femoral vein at the saphenous-femoral junction
  2. Short saphenous vein
    • forms from dorsal venous arch
    • runs posterior to lateral malleolus
    • runs up the leg posteriorly and
    • joins the polpiteal vein in the polpiteal fossa
918
Q

Explain the organisation of deep veins in the LL

A
  • most of them as venae comitantes along the arteries
  • some can be named e.g.
    • anterior and posterior tibial veins
    • polpiteal vein (where SSV joins)
    • femoral vein (where LSV joins)
    • profunda femoris vein
    • external iliac vein
919
Q

What are the characteristics of venae comitatnes?

A
  • •Multiple veins form a network of smaller veins with arteries which they accompany
  • often they are inter-connected
920
Q

Explain the venous blood flow in the lower limb and how this might lead to problems

A

Generally

  • Venous blood flow is suppoerted by muscular pump+ arterial pump
  • Blood flow is from superficial to deep veins, regulated by valves
    • in valve damage: blood flows from deep to superficial leading to varicose veins
929
Q

Which factors would you test to access nerve funciton?

A
  1. •Motor Function
  2. •Sensory Function
  3. •Reflex Function
  4. •Autonomic Function
930
Q

Name an example nerve function testing with a prolapsed disk at L5/S1

A
  • Motor – loss of eversion
  • Sensory – loss of sensation outer border of foot
  • Reflex – loss of ankle jerk (S1)
  • Autonomic – minimal
931
Q

What would a lesion of the common fibular artery at the neck of the fubular cause?

A
  • Motor – foot drop
  • Sensory – dorsum of foot at least
  • Reflex – none
  • Autonomic – minimal
932
Q

Explain the difference between a dermatome and cutaneous sensory innervation

A

Dermatomes describe regions that are supplied by a single spinal nerve route

Cutaneous sensory innervation is carries out by peripheral nerves, that carry information from several spinal nerves

934
Q

Which spinal nerves supplies the knee-jerk reflex?

A

L3

935
Q

Which spinal nerve supplies the ankle jerk reflex?

A

S1

936
Q

When is the femoral nerve suspectible to damage?

A

Mainly by doctors

  • during hip replacements
  • during reparirng of inguinal hernias
  • cannulation of femoral artery/vein
938
Q

Explain the possible situations in which the superior gluteal nerve is damaged and its consequences

A
  • Might be damaged in hip replacements,
  • leading to trendelberg gait
948
Q

What are varicouse veins?

What are the main complications?

A

in valve damage: blood flows from deep to superficial leading to varicose veins

May lead to

  • •Lipodermatosclerosis (skin thickening) (chronic inflammatory cause?
  • Venous ulcers
949
Q

What is compartment syndrome?

What is its cause?

A

Neuromuscular compartments in limbs are enclosed by fibrous sheaths–>

Ischaemia caused by trauma-induced increased pressure in a confined limb compartment

  • •Normal pressure = 25mmHg; only need 50-60 to collapse vessels, so pulse still present (systolic 120mmHg but still causes ischaemia)

•Commonly the anterior, posterior and lateral compartments of the leg

950
Q

What is the difference between acute and chronic compartment syndrome?

A
  • Acute compartment syndrome (trauma associated)
  • Chronic compartment syndrome (exercise-induced)
951
Q

What is knee locking?

A

Full extension of the knee joint

952
Q

What happens during locking of the knee?

A
  • the leg and tibia get laterally rotated (done by biceps femoris)
  • the humerus is medially rotated
    • joint cannot be flexed unless it is unlocked
    • (joint is stable and ligaments are stretched)
953
Q

What happens during unlocking of the knee joint?

A

the popliteus muscle unlocks the knee

Year 2 LCRS Anatomy Limbs (15 decks)

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