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3 - Musculoskeletal > Anatomy 3 > Flashcards

Anatomy 3 Flashcards

1
Q

Nerve roots forming the lumbar plexus

A

L1 - L4

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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)
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3
Q

Which 2 muscles are attached to the iliotibial tract

A

Gluteus maximus

Tensor fascial lata

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4
Q

Nerve roots forming the sacral plexus

A

Ventral rami of L4 - S4

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5
Q

The 2 major nerves of the sacral plexus are…

A

Sciatic nerve

Pudenal nerve

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6
Q

The lumbosacral trunk are formed by the union of…

A

L4 and L5

then joins the sacral plexus

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7
Q

Root values of the superior gluteal nerve

A

L4-S1

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8
Q

Root values of the inferior gluteal nerve

A

L5-S2

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9
Q

Where does the sciatic nerve emerge in the gluteal region?

A

Inferior to the piriformis

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10
Q

The terminal branches of the sciatic nerve

A 
Tibial nerve (more medial)
Common fibular nerve (more lateral)

(bifurcates in the popliteal fossa)

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11
Q

Articular surfaces of the knee joint

A

Medial and lateral condyles of the femur
Tibia
Posterior surface of the patella

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12
Q

The lateral collateral ligament extends from… to…

A

Lateral epicondyle of the femur
to
lateral surface of the head of the fibula

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13
Q

The lateral collateral ligament (LCL) of the knee is separated from the lateral meniscus by…

A

the tendon of the popliteus muscle

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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

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15
Q

Which ligament prevents…

  1. the femur from rolling posteriorly on the tibia
  2. hyperextension of the knee
A

Anterior cruciate ligament

*the ACL has a relatively poor blood supply so is prone to injury and poor repair

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16
Q

Which ligament prevents…

  1. the femur from rolling anteriorly on the tibia
  2. hyperflexion of the knee
A

Posterior cruciate ligament

PCL = the stronger of the 2 cruciate ligaments

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17
Q

Functions of the menisci

A
  1. deepen the articular surfaces of the tibia, increasing joint stability
  2. act as shock absorbers
  3. proprioception
  4. load transmission
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18
Q

The unhappy triad of knee injuries

- occurring after impacts to the knee from a lateral direction

A
  1. medial collateral ligament tear
  2. medial meniscus tear
    (this puts load on the ACL)
  3. Anterior cruciate ligament tear
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19
Q

Which bursa communicates with the articular cavity of the knee joint

A

suprapatellar bursa

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20
Q

Finger names and numbers

A 
D1 = thumb
D2 = index
D3 = long
D4 = ring
D5 = small
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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))

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22
Q

What can be palpated in the anatomical snuffbox?

A

Radial artery
Radial styloid process
Scaphoid
Trapezium

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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)
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24
Q

What type of joint is the hip joint?

A

Multiaxial

Ball and socket type synovial joint

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25
Q

Which ligament closes the circle made with the U shaped acetabular labrum?

A

Transverse acetabular ligament

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26
Q

Artery to the head of the femur is carried in the…

A

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)

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27
Q

Blood supply to the head of the femur

A
  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
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28
Q

Nerve supply to the head of the femur

A

Femoral nerve
Obturator nerve
Gluteal nerve

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29
Q

The joint capsule of the knee is strengthened by 5 capsular ligaments, these are…

A
  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)

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30
Q

Crescentic plates of fibrocartilage on the articular surfaces of the tibia =

A

Menisci

medial meniscus = larger

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31
Q

The line formed by:
the medial edge of the femoral neck + the inferior edge of the superior pubic ramus
on X-ray is called…

A

Shenton’s line

  • loss of contour of Shenton’s line is sign of a #NOF
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32
Q

What type of joint is the knee?

A

Sophisticated hinge

  • mainly flexion and extension
  • but also rotation, varus/valgus and AP translation
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33
Q

What type of bone is the patella?

A

Largest sesamoid bone in the body

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34
Q

Insertion of fibularis tertius

A

Base of 5th (pinky) metatarsal

its tendon looks like it is part of extensor digitorum longus

35
Q

Branches of the common fibular nerve

A

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
Q

Muscles forming the floor of the femoral triangle

medial to lateral

A

Pectineus
Psoas major
Iliacus

37
Q

Arterial supply to the anterior leg is by…

A

Anterior tibial artery

38
Q

The anterior tibial artery becomes…

A

Dorsalis pedis (once it passes under extensor retinaculum)

39
Q

What is the distal insertion of iliopsoas?

A

Lesser trochanter

40
Q

Insertion of the tendons of fibularis longus and brevis

A

Posterior to lateral malleolus

the brevis is deep to longus
the tendons remain separate

41
Q

Common reasons for common fibular nerve injury

and presentation

A

tight plaster cast
fracture of fibular neck

Causes footdrop as innervation is lost to dorsiflexors

42
Q

What type of joint is the ankle

A

Hinge type synovial

43
Q

Articular surfaces of the ankle joint

A

Malleolar mortise (distal tibia + fibula)
+
Trochlea of the talus bone

44
Q

The malleolar mortise is formed by…

A

The lower end of the tibia + fibula
+
The transverse part of the posterior tibio-fibular ligament

45
Q

The malleolar grip (of the ankle joint) is strongest during…

A

dorsiflexion

46
Q

Which of the ankle ligaments is the strongest?

A

Medial (deltoid)

47
Q

Name the two ligaments of the ankle joint

A

Medial/deltoid ligament of the ankle joint

Lateral ligament of the ankle joint

48
Q

During which movement of the subtalar joint are ankle sprains most common?

+ which ligament is usually damaged?

A

Excessive inversion to a plantarflexed + weight-bearing foot

Lateral ligament is usually damaged as it is weaker, and it resists inversion

49
Q

What types of joint are the superior and inferior tibio-fibular joint?

A

Superior = plane type synovial joint

Inferior = fibrous joint

50
Q

Borders of the popliteal fossa

A

upper lateral = biceps femoris
upper medial = semimembranosus
lower lateral + medial = lateral + medial heads of gastrocnemius

51
Q

Contents of the popliteal fossa

A 
Fat
Popliteal artery and vein
Tibial nerve
Common fibular nerve
Popliteal lymph nodes and lymphatic vessels
52
Q

Origin and insertion of the Achilles tendon

A

Attaches the gastrocnemius, plantaris and soleus muscles to the calcaneus bone

((also sometimes called the calcaneal tendon))

53
Q

Arterial supply to the posterior compartment of the leg

A

Posterior tibial artery

a branch of the popliteal artery

54
Q

Main branches of the popliteal artery

A 
Posterior tibial artery (more medial)
Fibular artery (more lateral)
55
Q

What passes through the “door to the foot” (tarsal tunnel)

A 
Tibialis posterior tendon
flexor Digitorum longus tendon 
posterior tibial Artery + Vein
tibial Nerve
flexor Hallucis longus tendon
56
Q

Location of the “door to the foot”

A

posterior to the medial malleolus

57
Q

After passing through the “door to the foot”, the tibial nerve divides into its two terminal branches, the…

A

medial and lateral plantar nerves

58
Q

Where is the subtalar joint?

What movements occur there?

A

btw Talus and Calcaneus

eversion and inversion

59
Q

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…

A

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
Q

The two terminal branches of the posterior tibial artery which supply the foot are called…

A

Medial + lateral plantar artery

61
Q

Why are toe flexors important?

A

They are essential for the push off from the ground phase of the gait cycle

62
Q

The axis of the foot runs through the…

A

2nd toe

so the 2nd toe has 2 abductors and no adductors

63
Q

Functions of the medial + lateral longitudinal and transverse arches of the feet

A

Distribute body weight

Act as shock absorbers

64
Q

Function of the plantar calcaneonavicular “spring” ligament

A

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
Q

Passive factors maintaining the integrity of the arches of the feet

A

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
Q

Dynamic factors maintaining the integrity of the arches of the feet

A

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
Q

The nerve running with the small saphenous vein is called the…

A

Sural nerve

formed by contributions from the common fibular and tibial nerve

68
Q

Lordosis and kyphosis are present in which regions of the spine?

A

Cervical lordosis
Thoracic kyphosis
Lumbar lordosis

69
Q

the group of muscles that a single spinal nerve innervates

A

Myotome

70
Q

an area of skin that is mainly supplied by a single spinal nerve.

A

Dermatome

71
Q

Clinical features of spinal claudication vs. vascular claudication

A

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
Q

Structure of a tendon

A

COLLAGEN BUNDLES covered by endotenon

forming…

FASCICLES covered by paratenon (contains a fine network of blood vessels)

forming…

TENDON covered by epitenon

73
Q

Inflammation/degeneration of muscle/tendon/ligament at insertion to bone

A

Enthesiopathy

e.g. plantar fasciitis,
golfer’s/tennis elbow,
Common in seronegative spondylorthropathies

74
Q

The connective tissue btw tendon/ligament/muscle and bone

A

Enthesis

75
Q

Names of the condyles of the humerus (medial and lateral)

A

Medial = trochlea

Lateral = capitulum

76
Q

Root values of the femoral nerve

A

L2-4

obturator also L2-4

77
Q

Strongest elbow flexor

A

Brachialis

78
Q

Location of brachioradialis

A

From wrist to arm

Radial side of forearm

79
Q

Location of the 3 elbow ligaments

A

Annular ligament: wraps around head of radius

Lateral/radial collateral ligament (merges with annular)

Medial/ulnar collateral ligament

80
Q

2 muscles wrap around the distal ends of ECR longus and brevis, they are…

A

APL and EPB

EPL originates more proximaly and is more medial

81
Q

Superficial leg veins

+ what they drain into

A

short saphenous (posterior) –> popliteal vein

great saphenous (medial) –> femoral vein

82
Q

Location of pectineus in relation to adductor longus

A

lateral

but on same plane

83
Q

Location of adductor brevis in relation to adductor longus and adductor magnus

A

Between them

3 - Musculoskeletal (7 decks)

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