Anatomy Flashcards
number of vertebrae =
how many of each type?
33 7C 12T 5L 5S (fused) 4Co (fused)
vertebra with odontoid process
C2
vertebra with no body =
C1
vertebra prominens =
it has no ___
C7
no transverse foramen
types of movement at facet joints
flexion
extension
lateral flexion
part of spine with most movement =
this is because it has the most ___ facet joints
C
horizontal
less flexion and extension in T spine due to
ribs
rotation at L spine is less than at T because
more vertebral facets
spondylosis =
=>
intervertebral disca lose H2O with age
=> overload facet joints and 2ndry OA
spinal pain in spondylosis is worse on ___
spine extension
Rx that can help with non-multilevel spondylosis =
facet joint injections under fluoroscopy
IV disc degeneration is most frequent at these 2 levels
L4/5
L5/S1
acute prolapse of IV discs is most frequent at these two levels
L4/5
L5/S1
acute IV disc prolapse is usually caused by __ motion -> __ tear = “twang” as is richly innervated > pain on __
most resolve in ___
lifting
annulus
coughing
3 months
in spinal cord motor neurones originate ___ , their bodies lie in ___
anteriorly
anterior grey horn
in spinal cord sensory neurones originate ___, their bodies lie in ___
dorsally
dorsal root ganglion
motor and sensory neurones from spinal cord combine in ___
nerve root
mixed nerve roots > mixed ___ > exit spinal collumn via ___
spinal nerve
IV foramen
spinal cord ends at ___ level => ___
L1
cauda equina
weakness, spasticity, increased tone and hyperreflexia are signs of a __
UMN lesion
weakness, flaccidity, decreased reflexes are signs of a ___
LMN lesion
2 pairs of nerve roots at each level in cauda equina =
exiting nerve root
traversing nerve root
in cauda equina exiting nerve root lies _____ and exits ___ of ___
outside thecal sac
under pedicle of corresponding vertebra
in cauda equina traversing nerve root lies ___ but ___ ( in __ recess) and becomes next levels ___
in thecal sac
anteriorly in lateral recess
exiting nerve root
in prolapsed IV disc exiting or traversing nerve root is more commonly compressed?
traversing
in a far lateral prolapse IV disc the ___ may be compressed
exiting nerve root
if nerve root that goes on to form the sciatic nerve is compressed =>
sciatica
signs of a prolapsed IV disc causing spinal cord/nerve root compression
radiculopathy (pain down dermatome)
sciatica
weakness in myotome
decreased reflexes
spinal nerves that supply the myotome for hip flexion
L2,3
spinal nerves that supply the myotome for hip extension
L5, S1
spinal nerves that supply the myotome for knee flexion
L5, S1
spinal nerves that supply the myotome for knee extension
L3, 4
spinal nerves that supply the myotome for ankle dorsiflexion
L4, 5
spinal nerves that supply the myotome for ankle plantarflexion
S1,2
spinal nerves that supply the myotome for ankle inversion
L4,5
spinal nerves that supply the myotome for ankle eversion
L5, S1
nerve roots compressed by osteophytes + hypertrophied ligaments in OA =>
spinal stenosis
s+s of spinal stenosis
radiculopathy/ neurogenic claudication
features of neurogenic claudication
burning
inconsistent distance
better uphill
no quick relief on rest
cauda equina syndrome =
pressure on all lumbosacral nerve roots - including those for bowel and bladder control
s+s of cauda equina syndrome
bilateral LMN signs
bladder and bowel dysfunction
saddle anaesthesia
loss of anal tone
erector spinae muscles (3)
iliocostalis
longissimus thoracis
spinalis thoracis
5 spinal ligaments =
anterior longitudinal ligaments posterior longitudinal ligaments ligamentum flavum supraspinous ligaments interspinous ligaments
of vertebral body + posterior longitudinal ligaments disrupted =
Chance # - v unstable and may need stabilised
level a lumbar puncture is taken at
must puncture the __
posterior iliac crest L4
ligamentum flavum
spinal anaesthesia is administered at which spinal level
must puncture the __
PSIS S2
ligamentum flavum
Sx options for sciatica or leg pain if not settled with ___ of management
discectomy/decompression
3 months
To be eligible for Sx for sciatic must have ++_
clinical s+s
+ve MRI (on its own can be a false +ve)
nerves at risk in pelvic #s
pudendal and pelvic splanchnic (bowel and bladder
sciatic
3 ligaments of pelvis
sacrospinous
posterior SI
sacrotuberous
superior larger pelvic bone =
ilium
head of femur has a ___ blood supply.
____ arteries susceptible to damage in intracapsular hip #s
retrograde
retinacular
ring anastamoses of femur lies at ___ where ___ inserts
base of neck
capsule
gluteus medius and minimus movement =
hip abduction
gluteus maximus movement =
hip extension and external rotation
quadriceps are supplied by which nerve ___
do ___ if suspect rupture
femoral
SLT
biceps femoris, semimembranosus and semi tendinosus supplied by which nerve
sciatic
adductors of the hip are supplied by which nerve
it is responsible for referred pain from __ to __
obturator
hip to knee
adductor hiatus in medial thigh contains
femoral artery and vein (pass through Hunters/subsartorial canal -> popliteal fossa)
and saphenous nerve
4 knee bursae
suprapatellar
infrapatellar
prepatellar
pes ansinerine
anterior compartment muscle of the leg are supplied by which nerve
deep peroneal /fibular nerve
lateral compartment muscles of the leg are supplied by which nerve
superficial peroneal
posterior compartment muscles of the leg are supplied by the ___ nerve
tibial
medial lig in ankle -
laterals = (6)
medial = deltoid lig lateral = calcaneofibular lateral talocalcaneal ant + ant inf + post tibiofibular syndesmotic/interosseous
if have talar shift Rx =
fix with screws
lisfranc joints =
tarsometatarsal joints
Chopart joint =
midtarsal joint (talus to navicular and cuboid)
pronation of the foot =++_
eversion, abduction and dorsiflexion
supination of the foot = ++_
inversion, adduction and plantarflexion
medial arch is formed by __+__
tibialis posterior and plantar fascia
lumbricals assist ___ at MTPJ and ___ of DIP and PIPJ
flexion MTPJ
extension D/PIPJ
2 joints of shoulder
acromioclavicular
glenohumeral
stabilisers of shoulder girdle =
capsule, rotator cuff and labrum
causes of shoulder impingement =
tendonitis
cuff tear
subacromial bursitis
ACJ osteophytes
labrum prevents humeral head ___
external rotation
Bankart lesion =
anterior shoulder dislocation with labrum detachment
if recurrent dislocation rx =
labrum repair
the most common nerve injured in anterior dislocation of the shoulder
which site?
axillary nerve at quadrangular space
badge patch sensation is by __
axillary nerve
anterior shoulder dislocation can press on __/___
axilalry artery
brachial plexus
frozen shoulder aka
loss of ___ esp ___
can inject ___ when painful
adhesive capsulitis
ROM- external rotation
glenohumeral joint
if ___ is ruptured then ACJ becomes vv displaced
coracoclavicular ligaments
anterior muscles of arm and lateral forearm sensation = ___ nerve
musculocutaneous
strongest elbow flexor =
brachialis
strongest forearm supinator =
biceps brachii
anterior arm muscles =
brachialis, biceps brachii, coracobrachialis
supplies all extensors of the upper limb =
if damaged =>
radial nerve
wrist drop
___ is susceptible to stretch injury in humeral shaft #
radial nerve
trochlea and olecranon are involved in which joint?
humero-ulnar
2 joints of the elbow =
humeroulnar
radiocapitellar
common flexor origin of the forearm =
medial epicondyle
medial epicondylitis =
Golfer’s elbow
common extensor origin of the forearm =
lateral epicondyle
lateral epiconylitis =
Tennis elbow
supracondylar # risks ___ +____
brachial artery occlusion
median nerve injury (+radial and ulnar n too)
ulnar # with radio-capitellar dislocation =
Monteggia #
radial # with distal radio-ulnar dislocation =
Galeazzi #
anterior forearm is supplied by ___ nerve except FCU and ___ 1/2 of FDP = ___ nerve
median
ulnar x2
flexor tendon sheaths in hand are covered in __+___ parts of fibrous sheaths
annular and cruriform
trigger finger =
nodule (synovitis) of flexor tendon sheath => inflammed pulley and can’t get past
Rx of trigger finger =
divide pulley
intrinsic muscle of the hand are all supplied by __ nerve
apart from ___ muscles = __ nerve
ulnar
LOAF Lumbricals 1 & 2, Opponens pollicis, Abductor pollicis brevis and Flexor pollicis brevis (OAF = thenar eminence) = median nerve
FDS movement
flexion of PIPJ > MCPJ
FDP movement =
flexion DIPJ
central slip extensor tendon movement =
PIPJ extension
latereal slips extensor tendons converge to cause __
DIPJ extension
interossei and lumbricals insert into ____ and contribute to which two movements?
lateral bands
MCPJ flexion
PIPJ extension
central slip extensor tendon rupture or attrition =
Boutonniere deformity
PIPJ volar plate rupture/attrition, intrinsic muscle tightness =
Swan neck deformity
testing nerves: abductor pollicis brevis (press) and OK sign (FPL+FDP) = __ nerve
median nerve ( + anterior interosseous branch)
testing nerves: 1st dorsal interosseous, Froment’s test (thumb pinch paper and pull) adductor pollicis = ___ nerve
ulnar
testing nerves = triceps, wrist flexion and extension, extend thumb = __ nerve
radial
superficial gluteal muscles and their function
gluteus maximus (extensors)
medius (Abductor and medial rotator)
minimus (Abd + medial rotation)
tensor fascia (abductor)
gluteus maximus is supplied by ___ nerve
inferior gluteus
gluteus minimus + medius and tensor fascia lata are supplied by ___ nerve
superficial gluteal
deep muscles of the gluteal region and their function =
piriformis obturator internus gemelli quadratus femori lateral rotator and hip stabiliser
piriformis
obturator internus
gemelli
quadratus femori are supplied by ___ (nerves)
sacral plexus
nerves enter into gluteal region via:
enter into perineum via:
gluteal = greater sciatic foramen perineum = lesser
aim for the supralateral quadrant of gluteal region for ___
injections
Sciatic = __-___ nerves
supplies __, all ___ and most of skin via ___
L4-S3
posterior thigh
all leg and foot muscles
tibia and common fibular branches
pudendal nerve (__-___) supplies ____ out via __ and in via ____
S2-4
perineum
out = greater sciatic foramen
in = lesser sciatic foramen
posterior cutaneous nerve of the thigh ( __-___) supplies skin over ____, ____, __ + ___
S1-3 posterior thigh skin popliteal fossa lateral perineum upper medial thigh
scaitic nerve usually exits gluteal region inferior to ___ and is the most ___ nerve exiting the greater sciatic foramen
piriformis
lateral
larger and medial branch off of the sciatic nerve
tibial
superior border of femoral triangle
inguinal lig
medial border of femoral triangle
lateral border of adductor longus
lateral border of femoral triangle
medial border of sartorius
floor of femoral triangle =
iliopsoas (lateral)
pectineus (medial)
roof of femoral triangle =
fascia lata
lateral to medial the contents of the femoral triangle
Femoral: Nerve, Artery Vein lYmphatics
anterior compartment of thigh contains __+___ muscles
all supplied by __ nerve (-)
apart from ___ = - nerves
flexors of thigh and extensors of leg
femoral (L2-4)
psoas major = L1-3
flexors of the thigh in the anterior compartment of the thigh
pectineus
iliopsoas (psoas major and iliacus)
sartorius
rectus femoris
extensors of leg in anterior thigh compartment
Quads (vastus lateralis, medialis and intermedius, rectus femoris)
medial compartment of the thigh contains ___ muscles
all supplied by __ nerve (-)
apart from __ part of ___ = ___ nerve
adductors of the thigh
obturator (L2-4)
hamstring part of adductor magnus = tibial nerve
adductors of the thigh in medial compartment of the thigh
adductor longus, brevis and magnus
gracilis
obturator externus
Posterior compartment of thigh contains +__ muscles
all supplied by __ nerve (-_)
apart from ____ = ___ nerve
extensors of thigh
flexors of leg
tibial nerve (L5-S2)
short head biceps femoris = common fibular
extensors of thigh and flexors of the leg in posterior compartment of the thigh
semitendinosus
semimembranosus
biceps femoris