Anatomy Flashcards
Glenoid retroverted approximately?
5 Degrees relative to scapular plane
What separates the suprascapular artery (superior) from the suprascapular nerve (inferior)?
superior transverse scapular ligament
An important anterosuperior restraint and should be preserved with irreparable cuff tears to prevent
anterosuperior escape.?
Coracoacromial ligament
First bone to ossify (at 5 weeks’ gestation?
Clavicle
The last bone to fuse?
Clavicle, medial epiphysis at 25 years of age
If you repair anterosuperior glenoid labral variants, what movement loss is pronounced?
loss of external rotation can result
Humeral head height is approximately………………………. superior border of ……………………………….. (important for arthroplasty)
Humeral head height is approximately 5.6 cm above superior border of pectoralis major tendon (important for arthroplasty)
Trapezoid ligament (anterolateral) and conoid ligament (posteromedial) approximately …………..
…………..respectively, from AC
join
Trapezoid ligament (anterolateral) and conoid ligament (posteromedial) approximately 25 and 45 mm, respectively, from AC join
Glenohumeral and scapulothoracic motion with arm elevation ratio?
2:1
Main function of Rotator cuff?
Rotator cuff depresses and stabilizes the humeral head against the glenoid.
primary static stabilizer to valgus stress at the elbow?
Ulnar collateral ligament (especially anterior band)
Which ligament mainly implicated in Posterolateral rotatory instability (PLRI) of elbow?
lateral ulnar collateral (LUCL)
Main priniciple of radial shaft fractures ?
Restoration of radial bow
What is the Space of Poirier?
central weak area in the floor of carpal tunnel that is implicated in lunate volar dislocation in perilunate injuries of
the wrist
Guyon canal:
contains ulnar nerve and artery; borders are flexor retinaculum (deep), volar carpal ligament (superficial), pisiform
(ulnar/proximal), hook of hamate (radial/distal).
most important finger pulleys?
A2 pulley, overlying the proximal phalanx, is the most critical to function, followed by A4, which covers the middle phalanx.
Medial winging:
long thoracic nerve (C5-C7) injury leading to serratus anterior dysfunction
Lateral winging:
spinal accessory nerve (cranial nerve XI) injury leading to trapezius dysfunction
Preclavicular brachial plexus branches:
dorsal scapular nerve, long thoracic nerve, suprascapular nerve, nerve to subclavius
The radial nerve traverses the radial groove in the posterior humerus approximately ……….medial epicondyle and …………………. from lateral
epicondyle.
The radial nerve traverses the radial groove in the posterior humerus approximately 20 cm from medial epicondyle and 14 cm from lateral
epicondyle.
The Ulnar nerve passes from the anterior compartment of the arm to the posterior by ………………..
piercing through the medial intermuscular septum at the arcade of Struthers (8-10 cm from the medial
epicondyle)
The ulnar nerve splits the two heads of the …………. as it enters the forearm, and the median nerve splits the two heads of the ………………………..
The ulnar nerve splits the two heads of the FCU as it enters the forearm, and the median nerve splits the two heads of the pronator
teres.
Continuation of the Musculocutaneous nerve and lies lateral to cephalic vein and emerges between biceps and brachialis.?
Lateral antebrachial cutaneous nerve
Digital arteries arise from
superficial palmar arch and run dorsal to the digital nerves.
Median nerve sites of potential compression:
ligament of Struthers, pronator teres, FDS aponeurosis, bicipital aponeurosis, accessory
head of FPL, carpal tunne
AIN syndrome is?
motor only with no sensory symptoms.
Ulnar nerve sites of potential compression:
arcade of Struthers, medial intermuscular septum, cubital tunnel, medial epicondyle, two
heads of FCU, anconeus epitrochlearis, Guyon canal
ulnar paradox?
More clawing with distal ulnar nerve compression as FDP function to ring and small maintained
Radial nerve sites of potential compression:
fibrous bands at elbow joint, recurrent leash of Henry, ECRB, arcade of Frohse, supinator
………………………… the forearm during lateral approach to elbow/posterior approach to forearm to move the PIN anteriorly and radially.
Pronate the forearm during lateral approach to elbow/posterior approach to forearm to move the PIN anteriorly and radially.
……………………… the forearm during anterior approach to forearm to move PIN posteriorly and laterally.
Supinate the forearm during anterior approach to forearm to move PIN posteriorly and laterally.
What separates greater and lesser sciatic foramina?
sacrospinous ligament
Pediatric femoral nail insertion: piriformis starting point threatens?
posterosuperior retinacular vessels (potential for femoral head avascular necrosis [AVN]).
Which zone does Slipped capital femoral epiphysis occurs through?
(zone of hypertrophy
Fibrocartilaginous labrum deepens acetabulum, enhancing stability. Labral functions include
load transmission, maintenance of vacuum seal, regulation of synovial fluid hydrodynamics, and joint lubrication.
the strongest ligament in the body ?
Iliofemoral ligament (Y ligament of Bigelow) is the strongest ligament in the body and attaches the AIIS to the intertrochanteric line in an inverted Y manner.
difference between the medial and lateral tibial plateau?
the medial tibial plateau is concave and the lateral plateau is convex. This results in a joint with greater osseous
congruity medially than laterally.
what is a Accessory or “bipartite” patella?
failure of fusion of the superolateral corner of the patella and is commonly confused with
patellar fractures
what area of menisci are vascular?
Peripheral one third of the menisci are vascular and are amenable to repair (red zone); the inner two thirds are nourished by synovial fluid
(white zone) and have limited healing capacity.
ACL bundles?
ACL has anteromedial (tight in flexion) and posterolateral (tight in extension) bundles; PL bundle tested with pivot shift exam.
PCL bundles?
PCL has anterolateral (tight in flexion) and posteromedial (tight in extension) bundles.
Posterolateral corner (PLC):
fibular collateral ligament, popliteus tendon, and popliteofibular ligament; other PLC structures include biceps femoris tendon, lateral head of gastrocnemius, biceps
femoris, arcuate ligament, and posterolateral capsule.
Dial test:
rotational instability at 30 degrees = PLC injury, at 30 and 90 degrees = combined PLC + PCL injury
Primary blood supply to the talar body?
artery of the tarsal canal (posterior tibial artery).
Position of the ankle is critical when the lateral ligament complex is tested. Plantar flexion tightens the ……………………….., and inversion with neutral flexion tightens the ……………………………….
Position of the ankle is critical when the lateral ligament complex is tested. Plantar flexion tightens the anterior talofibular ligament, and inversion with neutral flexion tightens the calcaneofibular
ligament.
Ankle syndesmosis (connection between the tibia and fibula) supported by four ligaments:
anterior and posterior inferior tibiofibular ligaments, a transverse tibiofibular ligament, and an
interosseous ligament.
What ligament supports head of talus and is attenuated in pes planus?
Plantar calcaneonavicular ligament (spring ligament)
The Lisfranc ligament connects the medial (shortest) cuneiform to the second (longest)
connects the medial (shortest) cuneiform to the second (longest) metatarsal.
order of the structures coursing along the posterior border of the medial
malleolus?
(tibialis posterior, flexor digitorum longus, PT artery, PT nerve, flexor hallucis longus). “Tall Doctors Are Never Happy”
the nerves exiting the pelvis below the piriformis?
Use the mnemonic “POP’S IQ” to remember the nerves exiting the pelvis below the piriformis (pudendal, nerve to obturator internus, posterior femoral cutaneous, sciatic, inferior gluteal, nerve to
quadratus femoris).
…………………..supplies the skin of the medial side of the front of the knee and patellar ligament and can be damaged during total
knee replacement surgery or patella tendon harvest.
Infrapatellar branch supplies the skin of the medial side of the front of the knee and patellar ligament and can be damaged during total
knee replacement surgery or patella tendon harvest.
Retractors placed behind the transverse acetabular ligament or screw placement in anteroinferior quadrant of acetabulum can injure?
obturator nerve and artery.
Most proximal branch of the lateral plantar nerve?
nerve to the abductor digiti quinti (Baxter nerve)
…………………………(a branch of the superficial peroneal nerve) crosses the EHL in a lateral-to-medial direction and supplies sensation to the dorsomedial aspect of the
great toe.
The dorsal medial cutaneous nerve
what is the Corona mortis?
Corona mortis is an anastomotic connection between the inferior epigastric branch of the external iliac vessels and the obturator
vessels in the obturator canal.
Whay are the Medial and lateral femoral circumflex vessels named like this?
relative to iliopsoas tendon.
blood supply of menisci?
medial and lateral geniculate arteries
Blood supply of cruciate ligaments?
middle geniculate artery
Superior gluteal nerve passes between gluteus medius and minimus approximately …………proximal to tip of greater trochanter.
Superior gluteal nerve passes between gluteus medius and minimus approximately 5 cm proximal to tip of greater trochanter.
50% of total neck flexion and extension occurs at
occiput-C1
50% of total neck rotation occurs at
C1-C2.
Vertebral artery travels in the transverse foramina of ?
C6 to C1 (not C7 but C7 does have transverse foramen)
Diameter of the cervical spine canal is normally?
17mm
what diameter is relative stenosis in c spine?
13mm
narrowest pedicle ?
T5
the major stabilizer of the atlantoaxial join?
Transverse ligament
Annulus fibrosus:
obliquely oriented, composed of type I collagen
Central nucleus pulposus:
made of type II collagen and softer than the annulus
In the cervical spine, the numbered nerve exits at a level………………
above the pedicle of the corresponding vertebral level (e.g., the C2 nerve exits
at the level of vertebrae C1-C2)
In the lumbar spine, the nerve root traverses the respective disc space above the named vertebral body and exits the respective
foramen …………….
under the pedicle.
Central disc herniation impinges upon
the traversing nerve root
lateral disc herniation impinges
on the exiting nerve root.
L5 nerve root is relatively fixed to the anterior sacral ala and can be damaged by sacral fractures and errant anteriorly placed
iliosacral screws
Disruption of the inferior cervical ganglia can lead
Horner syndrome (ptosis, miosis [pupillary constriction], and anhidrosis)
Injury to the recurrent laryngeal nerve can occur with …………..anterior cervical approaches; paralysis is identified by a ……………….caused by unilateral vocal cord paralysis, visualized
with ……………………….
Injury to the recurrent laryngeal nerve can occur with right-sided anterior cervical approaches; paralysis is identified by a hoarse, scratchy voice caused by unilateral vocal cord paralysis, visualized
with direct laryngoscopy.
the most common complication with a posterior cervical approach.
Postoperative C5 palsy
Injury to the lumbar plexus, particularly the superior hypogastric plexus of the sympathetic plexus that lies over the L5 vertebral body,
can cause?
sexual dysfunction and retrograde ejaculation.
Safe zone for anterolateral halo pins ?
is approximately 1 cm superior to the orbital rim in the outer two thirds of the orbit below the
equator of the skull
