Anatomy 3 Flashcards
1
Q
Nerve roots forming the lumbar plexus
A
L1 - L4
2
Q
The 2 major nerves of the lumbar plexus are…
and where do they emerge?
A
Femoral nerve (emerges lateral to psoas major) Obturator nerve (medial to psoas)
3
Q
Which 2 muscles are attached to the iliotibial tract
A
Gluteus maximus
Tensor fascial lata
4
Q
Nerve roots forming the sacral plexus
A
Ventral rami of L4 - S4
5
Q
The 2 major nerves of the sacral plexus are…
A
Sciatic nerve
Pudenal nerve
6
Q
The lumbosacral trunk are formed by the union of…
A
L4 and L5
then joins the sacral plexus
7
Q
Root values of the superior gluteal nerve
A
L4-S1
8
Q
Root values of the inferior gluteal nerve
A
L5-S2
9
Q
Where does the sciatic nerve emerge in the gluteal region?
A
Inferior to the piriformis
10
Q
The terminal branches of the sciatic nerve
A
Tibial nerve (more medial) Common fibular nerve (more lateral)
(bifurcates in the popliteal fossa)
11
Q
Articular surfaces of the knee joint
A
Medial and lateral condyles of the femur
Tibia
Posterior surface of the patella
12
Q
The lateral collateral ligament extends from… to…
A
Lateral epicondyle of the femur
to
lateral surface of the head of the fibula
13
Q
The lateral collateral ligament (LCL) of the knee is separated from the lateral meniscus by…
A
the tendon of the popliteus muscle
14
Q
The medial collateral ligament (MCL) extends from… to…
A
Medial epicondyle of the femur
to
medial condyle and upper part of the medial surface of the tibia
*Also attaches firmly to the medial meniscus at its midpoint
15
Q
Which ligament prevents…
- the femur from rolling posteriorly on the tibia
- hyperextension of the knee
A
Anterior cruciate ligament
*the ACL has a relatively poor blood supply so is prone to injury and poor repair
16
Q
Which ligament prevents…
- the femur from rolling anteriorly on the tibia
- hyperflexion of the knee
A
Posterior cruciate ligament
PCL = the stronger of the 2 cruciate ligaments
17
Q
Functions of the menisci
A
- deepen the articular surfaces of the tibia, increasing joint stability
- act as shock absorbers
- proprioception
- load transmission
18
Q
The unhappy triad of knee injuries
- occurring after impacts to the knee from a lateral direction
A
- medial collateral ligament tear
- medial meniscus tear
(this puts load on the ACL) - Anterior cruciate ligament tear
19
Q
Which bursa communicates with the articular cavity of the knee joint
A
suprapatellar bursa
20
Q
Finger names and numbers
A
D1 = thumb D2 = index D3 = long D4 = ring D5 = small
21
Q
Why is the scaphoid bone at high risk of avascular necrosis?
A
It has a retrograde blood supply (from distal to proximal)
(The more proximal the fracture, the more likely AVN)
((Fractures must be immobilised properly))
22
Q
What can be palpated in the anatomical snuffbox?
A
Radial artery
Radial styloid process
Scaphoid
Trapezium
23
Q
What test should be done before using the radial artery for arterial lines?
A
Allens Test
- occlude ulnar and radial arteries at the wrist
- open and release fist until blanched
- release ulnar artery (should re-perfuse in 15s)
24
Q
What type of joint is the hip joint?
A
Multiaxial
Ball and socket type synovial joint
25
Which ligament closes the circle made with the U shaped acetabular labrum?
Transverse acetabular ligament
26
Artery to the head of the femur is carried in the...
Ligament of head of femur
attaches to the head of the femur at the pit/fovea for the ligament of head of femur (the only point not covered with articular cartilage)
27
Blood supply to the head of the femur
1. artery to the head of the femur - a branch of the obturator artery (more important in children)
2. Medial and lateral circumflex arteries - branches of profundal femoris
* blood supply is disrupted in an intracapsular fracture
28
Nerve supply to the head of the femur
Femoral nerve
Obturator nerve
Gluteal nerve
29
The joint capsule of the knee is strengthened by 5 capsular ligaments, these are...
1. patellar ligament
2. LCL
3. MCL
4. oblique popliteal ligament (expansion of semimembranosus tendon
5. Arcuate popliteal ligament
(cruciate ligaments are intra-articular structures)
30
Crescentic plates of fibrocartilage on the articular surfaces of the tibia =
Menisci
| medial meniscus = larger
31
The line formed by:
the medial edge of the femoral neck + the inferior edge of the superior pubic ramus
on X-ray is called...
Shenton's line
- loss of contour of Shenton's line is sign of a #NOF
32
What type of joint is the knee?
Sophisticated hinge
- mainly flexion and extension
- but also rotation, varus/valgus and AP translation
33
What type of bone is the patella?
Largest sesamoid bone in the body
34
Insertion of fibularis tertius
Base of 5th (pinky) metatarsal
| its tendon looks like it is part of extensor digitorum longus
35
Branches of the common fibular nerve
Common fibular n. comes round the lateral side of the leg to the anterior surface and then splits into...
Superficial fibular nerve (more lateral)
Deep fibular nerve (more medial - runs with anterior tibial artery)
36
Muscles forming the floor of the femoral triangle
| medial to lateral
Pectineus
Psoas major
Iliacus
37
Arterial supply to the anterior leg is by...
Anterior tibial artery
38
The anterior tibial artery becomes...
Dorsalis pedis (once it passes under extensor retinaculum)
39
What is the distal insertion of iliopsoas?
Lesser trochanter
40
Insertion of the tendons of fibularis longus and brevis
Posterior to lateral malleolus
the brevis is deep to longus
the tendons remain separate
41
Common reasons for common fibular nerve injury
| and presentation
tight plaster cast
fracture of fibular neck
Causes footdrop as innervation is lost to dorsiflexors
42
What type of joint is the ankle
Hinge type synovial
43
Articular surfaces of the ankle joint
Malleolar mortise (distal tibia + fibula)
+
Trochlea of the talus bone
44
The malleolar mortise is formed by...
The lower end of the tibia + fibula
+
The transverse part of the posterior tibio-fibular ligament
45
The malleolar grip (of the ankle joint) is strongest during...
dorsiflexion
46
Which of the ankle ligaments is the strongest?
Medial (deltoid)
47
Name the two ligaments of the ankle joint
Medial/deltoid ligament of the ankle joint
| Lateral ligament of the ankle joint
48
During which movement of the subtalar joint are ankle sprains most common?
+ which ligament is usually damaged?
Excessive inversion to a plantarflexed + weight-bearing foot
Lateral ligament is usually damaged as it is weaker, and it resists inversion
49
What types of joint are the superior and inferior tibio-fibular joint?
Superior = plane type synovial joint
Inferior = fibrous joint
50
Borders of the popliteal fossa
upper lateral = biceps femoris
upper medial = semimembranosus
lower lateral + medial = lateral + medial heads of gastrocnemius
51
Contents of the popliteal fossa
```
Fat
Popliteal artery and vein
Tibial nerve
Common fibular nerve
Popliteal lymph nodes and lymphatic vessels
```
52
Origin and insertion of the Achilles tendon
Attaches the gastrocnemius, plantaris and soleus muscles to the calcaneus bone
((also sometimes called the calcaneal tendon))
53
Arterial supply to the posterior compartment of the leg
Posterior tibial artery
| a branch of the popliteal artery
54
Main branches of the popliteal artery
```
Posterior tibial artery (more medial)
Fibular artery (more lateral)
```
55
What passes through the "door to the foot" (tarsal tunnel)
```
Tibialis posterior tendon
flexor Digitorum longus tendon
posterior tibial Artery + Vein
tibial Nerve
flexor Hallucis longus tendon
```
56
Location of the "door to the foot"
posterior to the medial malleolus
57
After passing through the "door to the foot", the tibial nerve divides into its two terminal branches, the...
medial and lateral plantar nerves
58
Where is the subtalar joint?
| What movements occur there?
btw Talus and Calcaneus
eversion and inversion
59
The joint formed by formed by the articulation of the calcaneus with the cuboid, and the articulation of the talus with the navicular is called...
The transverse tarsal joint
(the movements occurring here and at the subtalar joint are essential for coping with walking on uneven ground or balancing on one leg)
60
The two terminal branches of the posterior tibial artery which supply the foot are called...
Medial + lateral plantar artery
61
Why are toe flexors important?
They are essential for the push off from the ground phase of the gait cycle
62
The axis of the foot runs through the...
2nd toe
| so the 2nd toe has 2 abductors and no adductors
63
Functions of the medial + lateral longitudinal and transverse arches of the feet
Distribute body weight
| Act as shock absorbers
64
Function of the plantar calcaneonavicular "spring" ligament
Stops the navicular and calcaneus bones from being forced apart by body weight on the talus
- This maintains the medial longitudinal arch
(it also contributes to the subtalar joints)
65
Passive factors maintaining the integrity of the arches of the feet
Shape of the united bones
Plantar calcaneonavicular "spring" ligament
Long plantar ligament (deep to plantar aponeurosis)
Short plantar ligament (deep to long plantar ligament)
*acquired flat feet (fallen arches) are likely due to dysfunction of dynamic or passive factors
66
Dynamic factors maintaining the integrity of the arches of the feet
Intrinsic muscles of the foot
Long flexor tendons
Tendons of tibialis anterior and fibularis longus
*acquired flat feet (fallen arches) are likely due to dysfunction of dynamic or passive factors
67
The nerve running with the small saphenous vein is called the...
Sural nerve
| formed by contributions from the common fibular and tibial nerve
68
Lordosis and kyphosis are present in which regions of the spine?
Cervical lordosis
Thoracic kyphosis
Lumbar lordosis
69
the group of muscles that a single spinal nerve innervates
Myotome
70
an area of skin that is mainly supplied by a single spinal nerve.
Dermatome
71
Clinical features of spinal claudication vs. vascular claudication
Spinal: worse walking downhill as spinal canal becomes smaller in extension. Takes several minutes to ease after stopping walking
Vascular: worse walking uphill as more exertion
*Check pulses
72
Structure of a tendon
COLLAGEN BUNDLES covered by endotenon
forming...
FASCICLES covered by paratenon (contains a fine network of blood vessels)
forming...
TENDON covered by epitenon
73
Inflammation/degeneration of muscle/tendon/ligament at insertion to bone
Enthesiopathy
e.g. plantar fasciitis,
golfer's/tennis elbow,
Common in seronegative spondylorthropathies
74
The connective tissue btw tendon/ligament/muscle and bone
Enthesis
75
Names of the condyles of the humerus (medial and lateral)
Medial = trochlea
Lateral = capitulum
76
Root values of the femoral nerve
L2-4
| obturator also L2-4
77
Strongest elbow flexor
Brachialis
78
Location of brachioradialis
From wrist to arm
| Radial side of forearm
79
Location of the 3 elbow ligaments
Annular ligament: wraps around head of radius
Lateral/radial collateral ligament (merges with annular)
Medial/ulnar collateral ligament
80
2 muscles wrap around the distal ends of ECR longus and brevis, they are...
APL and EPB
| EPL originates more proximaly and is more medial
81
Superficial leg veins
| + what they drain into
short saphenous (posterior) --> popliteal vein
great saphenous (medial) --> femoral vein
82
Location of pectineus in relation to adductor longus
lateral
| but on same plane
83
Location of adductor brevis in relation to adductor longus and adductor magnus
Between them
