Anatomy Flashcards
Foot is dorsiflexed and everted after injury. Pt is unable to stand on tip toes.
Damage to what nerve caused this? What level of the leg?
Tibial nerve injury at the level of the popliteal fossa
TIP (Tibial Inverts and Plantarflexes; if injured can’t stand on TIPtoes)
PED (Peroneal Everts and Dorsiflexes; if injured foot dropPED).
Outstretched hand fall - pt has wrist pain and decreased sensation on multiple palmar fingers.
lunate dislocation - median nerve injury due to acute carpal tunnel symptoms
What muscle facilitates foot inversion?
tibialis posterior
What muscles facilitates toe flexion?
flexor digitorum/hallucis longus
what nerve innervates the gastrocnemius mucle?
tibial nerve (plantar flexor muscles!)
gastrocnemius, coleus and plantaris are innervated by tibial nerve and facilitate what foot movement?
plantarflexion
What is the calcaneovalgus position? Injury to what structure can product this appearance?
foot dorsiflexed and everted - tibial nerve injury (TIP)
What nerve innervates the sole of the foot? dorsum of the foot?
tibial
superficial paroneal nerve except for skin between big and second toe (also innervates skin on lateral leg)
what innervates skin on medial leg?
cutaneous branches of saphenous nerve
pt has sensory loss over sole and weakness in intrinsic foot muscles that prevent standing on toes. Plantar flextion and foot inversion are intact.
what is the injury?
injury to tibial nerve (at the level of the tarsel tunnel!)
what makes up the tarsel tunnel?
tibial nerve travels through tarsel tunnel (between the flexor teinaculum and medial serfaces of he laus and calcaneus)
What is the function of the illeopsoas muscle?
illiacus and psoas mucle join to facilitate hip flexion
What muscle lies immediately deep to the internal oblique and provides suppot to the abominal contents during respiration without interfering with rib cage movement?
transversus abdominus (transversalis)
what muscle helps flex the hip and contributes to lateral rotation and abduction of the thigh?
illeopsoas muscle
what is more common ACL or PCL injury?
ACL (lateral femoral condyle => anterior tibia)
ALan P. Mordue
The patellar tendon is the continuation of the ______.
quaracepts femoris tendin
What makes up the carpal tunnel?
defined as space between carpal bones on dorsal aspect and transverse carpal ligament (aka flexor retinaculum) on the volar/palmar aspect. Structures that travel through tunnel:
- median nerve
- flexor pollicis longus tendon
- flexor digitorum superficialis tendons
- flexor digitorusm profundus tendons
capel tunnel syndrome is associated with impaired ____.
sensation on palmar surface of first 3 digits and radial half of 4th digit
wakness in thumb abduction and opposition and atraphy of the thenar eminence
biceps femoris, semitendinosus and semimembranosus facilitate what movement?
KNEE FLEXION - hamgstring muscles - pulled hammi makes it hard to extend knee!
direct blow to the anterior aspect of the knee from fall or MVA is likely to cause patellar fracture and impaired ____.
KNEE EXTENSION - patellar tendon is extensino of quadraceps femoris tendon - patellar trauma can damage connection of quads to knee and result in inability to straighten leg against gravity.
lateral compartment contains the ____ nerve.
superficial peroneal
anterior compartment contains the _____ nerve and the ____ artery
deep peroneal nerve and the anterior tibial artery
tibial nerve is located in the _____ compartment
deep posterior - alter the posterior tibial artery
superficial peroneal nerve is located in the ____ compartment
lateral
pt has decreased sensation between first and second toe, decreased dorsiflexion of foot, foot drop and claw foot. What is the cause?
injury to deep peroneal nerve or damage to the anterior tibial artery (anterior compartment - contains foot extensor muscles)
Posterior tibial artery, peroneal artery and tibial nerve are located in the _____ compartment.
deep posterior
superficial peroneal nerve and proximal part of deep peroneal nerve are located in the ____ compartment.
lateral
T/F the great sphenous vein is not susceptible to acute compartment syndrome because it runs outisde the deep facia of the leg
true - GSF drains to the femoral vein in the femoral triangle
pt has flattened deltoid, loss of arm abduction at sholder (can’t move arm past 15 degrees), loss of sensatioon over deltoid muscle and lateral arm
What is the cause of injury?
axillary nerve damage - due to:
- fractured surgical neck of humerus
- anterior dislocation of humerus
quarterback takes a blow to the arm as hes about to throw - what is the mostlikely injury?
arm is already externally rotated and abducted - most likely is further anterior dislocation of humerus and axillary nerve damage.
person injures themselves firing a shot-gut what is most likely structure to be damaged?
choracoid process of scapula
cause of broken arm due to fall on outstreched hand
torsion - results in spiral fracture of humerus
claw hand when at rest
distal ulnar nerve injury “ulnar claw”
claw hand while making a fist
proximal median nerve “popes blessing”
pinky and ring fingers extended at rest is due to what nerve injury?
distal median nerve “median claw”
pinky and ring fingers extended while attempting to make a fist is due to what nerve injury?
proximal ulnar nerve
unopposible thumb
median nerve injury “ape hand”
pt has wrist drop and midshaft fracture of humerus - damage to what nerve is most likely? what artery runs along this nerve?
radial nerve
deep brachial artery
both go underneith humerus
wrist drop not due to humeral fracture at the midshaft, with decreased grip strength, and loss of sensation over posterior arm/formarm and dorsal hand is likely caused by _____.
compression of the axilla (armpit) and radial nerve, caused by cruches or sleeping with arm over chair (saturday night palsy)
What artery gives off the anterior and posterior circumflex artery and then become the brachial artery before branching again to form the radial and ulnar arteries in the forarm?
axillary artery
what type of fracture is likely to damage the brachial artery or entrapment of hte median nerve?
supracondylar (displaced) fractures of the humerus
fracture to surgical neck of the humerus can cause damage to what artery and nerve?
axillary nerve and POSTERIOR circumflex artery (run together)
pt. is elderly, falls and is unable to move right hip. Right leg appears shorter than left leg. Fracture of the femoral neck is seen on xray. Pt is at greatest risk of developing ____.
Osteonecrosis due to damaged blood supply to bone.
What blood vessel can be damaged leading to osteonecrosis of the femoral head after femoral neck fracture (e.g. due to fall in pt with osteoporosis)?
medial circumflex femoral artery (retinacular and ascending cervical branches)
the ____ artery gives rise to the artery inside the ligamentum teres, which supplies a small amount of blood the head of the femur.
obterator
what does the latissimus dorsi do to the humerus? what is its innervation?
Originates from illiac crest to T7-12 spinus processes and inserts at bicipital grouve.
INTERNALLY rotates humerus. Also helps with EXTENSION and ADDuction of humerus.
thoracodorsal nerve (C6-C8)
What is the function of the infraspinatus muscle?
externally rotates the arm.
What is the innervation of the infraspinatus muscle?
suprascapular nerve
What is the funciton of the trapezius muscle? Innervation? Common cause of injury?
trapezius is large muscle of the upper back and neck that serves to ELEVATE, ROTATE and STABILIZE the scapula.
Primary innervation is CN IX (spinal accessory)
WHIPLASH
function and innervation of the triceps?
extension of the elbow.
radial nerve (C6-C8, T1)
iliospoas, rectus femoris and tensor fascia lata are muscles involved in hip _____.
flexion
gluteus maximus, semitendinosis, semimembranosis and long head of biceps femoris are muscles involved in hip _____
extension
pt can’t supinate or flex forarm and has deminished sensation over lateral forarm. What is the cause? What nerve is involved?
Upper trunk compression leading to compromise of musculocutaneous nerve (C5-C7)
gluteus medius and minimus are involved in hip _____.
ABduction
what muscles are involved in hip adduction?
adductor brevis longus magnus (need to use after taking a brown long and magical dump)
what is the function of the obterator externus?
lateral rotation of the thigh
arises from anteriomedial surface of obterator foramen and attaches to the greater trochantor of the femur
what ankle ligment is injured from a inversion injury of a plantarflexed ankle
(anterior) talofibular ligament
forced eversion of the ankle is more likely to result in an _____ of the _____ than damage the medial detoid ligment.
(avulsion) fracture of the (medial) malleolus
3YO falls while holding hands. Elbow is extended at the side and arm is pronated. What is the injury?
annular ligament displacement/subluxation (traction on proximal radius causes the annular ligament to tear and become entrapped in the radiohumoral joint).
What nerve is likely to be damaged due to fracture at the neck of the fibula
common peroneal nerve
medial fracture of the orbital wall risks fluid drainage or herniation into the _____.
ethmoid air cells
orbital floor fracture risks fluid drainage or herniation into the _____.
maxillary sinus
fracture of the scaphoid can lead to avascular necrosis at the distal pole (furthest from thumb) due to damage to the ______ .
dorsal scaphoid brach of the radial artery
supracondylar fracture of the humerus with _________ displacement causes radial nerve injury.
anteriolateral
supracondylar fracture of the humerus with _________ displacement causes median nerve and brachial artery injury.
anteriomedial
what is the function of the infraspinatus muscle?
external rotation of the arm- suprascapular nerve innervation
What is the function of the supraspinatus muscle?
abduction of the arm (0-15 degrees) - suprascapular nerve
what is function of teres minor?
adduction and external rotation - axillary nerve
What is the innervation of the subscapularis muscle?
upper and lower subscapular nerves
what is the funtion of the subscapularis muscle?
adduction and internal rotation
teres and intra externally rotate - subscap is the only rotator cuff muscle that causes internaly rotation of the arm
pt has pins and needles in right hand associated with hypothenar flattening and loss of sensation over the 5th digit. Impingement by what structure contributes to this nerve injury?
hook of the hamate - ulnar nerve impingement/neuropathy.
may present as ulnar claw on extension due to weakness of the 4th and 5th digit lumbarcles
damage to the musculocutaneus nerve presents with _____.
difficulty flexing the arm at the elbow and impaired ability to supinate the forarm, with sensory loss to arm and lateral forarm
- motor:innervates the BBC (bicepts brachialis coracobrachialis)
- sensory: lateral forarm through antibrachial cutaneous n.
