Anatomy Flashcards
1
Q
What are the superficial muscles of the gluteal region?
A
- gluteus maximus
- gluteus medius
- gluteus minimus
- tensor fascia latae
2
Q
What is the order of depth of the gluteal muscles?
A
maximus
medius is deep
minimus is deeper
3
Q
What are the actions of the superficial gluteal muscles?
A
extensors
abductors
medial rotators
(Maximus does lateral thigh rotation alone)
4
Q
What is the innervation of the superficial gluteal muscles?
A
- superior gluteal (if damaged then Trandelenburg)
except the Maximus which is inferior gluteal
5
Q
What is in the deep muscle group of the gluteal region?
A
- piriformis
- obturator internus
- gemelli (twin muscles below OI)
- quadratus femoris
6
Q
What are the actions of the deep gluteal muscles?
A
lateral rotators of the thigh and hip stabilisers
7
Q
What is the innervation of the deep gluteal muscles?
A
nerves from the sacral plexus
8
Q
How do nerves enter and exit the pelvis and perineum?
A
pelvis= greater sciatic foramen perineum= lesser sciatic foramen
9
Q
What are the features of the sciatic nerve?
A
- L4-S3
- largest nerve in the body
- supplies posterior thigh, all leg and foot muscle and most of skin
- exits through the greater sciatic foramen, inferior to piriformis, posterior to the acetabulum
- supply is artery to sciatic nerve
- splits into tibial and common fibular in distal thigh
10
Q
What are the features of the pudendal nerve?
A
- S2-S4
- nerve of perineum
- keeps 3ps off the floor (penis, poo and pee)
11
Q
What are the features of the posterior cutaneous nerve of the thigh?
A
- S1-S3
- skin over posterior thigh, popliteal fossa, lateral perineum and upper medial thigh
12
Q
What are the borders of the femoral triangle?
A
top is inguinal ligament
medial is adductor longus
lateral is the sartorius
13
Q
What makes up the floor and the roof of the femoral triangle?
A
floor is iliopsoas and pectineus
roof is deep fascia (fascia lata)
14
Q
What are the compartments of the thigh and the leg?
A
- thigh: anterior, medial and posterior
- leg: anterior, posterior and lateral
15
Q
What are the muscles of the anterior thigh?
A
- flexors: pectineus, ilipsoas and sartorius
- extensors: quadriceps femoris is made up of rectus femoris, vastus lateralis, vastus medialis and vastus intermedius
16
Q
What is the nerve supply to the anterior thigh?
A
femoral nerve (L2-L4) (except psoas major L1-L3)
17
Q
What are the muscles of the medial thigh?
A
- adductors: adductor longus, adductor brevis, adductor magnus, gracilis and obturator externus
18
Q
What is the nerve supply to the medial thigh?
A
obturator nerve (L2-L4) (except the hamstring part of the adductor magnus which is tibial nerve)
19
Q
What are the muscles of the posterior thigh?
A
- extensors of the thigh and flexors of the leg: semitendinous, semimembranous and biceps femoris
20
Q
What is the point about the biceps femoris?
A
there is a short head and a long head and the short head is not a true hamstring as there it doesn’t attach at the ischial tuberosity
21
Q
What is the innervation of the posterior thigh?
A
the tibial division of the sciatic nerve (L5,S1, S2)
except the short head of the biceps femurs which is the common fibular division
22
Q
What are the muscles of the anterior leg?
A
- dorsiflexors of the ankle and extensors of the toes: tibialis anterior, extensor digitorum longus, extensor hallucis longus and fibularus tertius
23
Q
What is the innervation of the anterior leg?
A
deep fibular nerve (L4,L5)
24
Q
What are the muscles of the lateral leg?
A
- evert foot and weakly plantarflex the ankle: fibularis longus and brevis
25
What is the supply to the lateral leg?
superficial fibular nerve (L5,S1,2)
26
What are the muscles of the posterior leg?
- superficial group (plantarflexors of the ankle): gastrocnemius, soleus and plantaris
- deep group (flexors of the toes and plantorflexors of the ankle): popliteus, flexor hallucis longus, flexor digitorum longus and tibialis posterior
27
What is the nerve supply to the posterior leg?
tibial nerve (S1,S2)
28
What deepens the acetabulum?
the abectabular labrum
29
What actions does the hip joint carry out?
- flexion-extension
- abduction
- adduction
- medial and lateral rotation
alltogether this is circumduction
30
What are the main ligaments around the hip joint?
iliofemoral
pubofemoral
ischiofemoral
31
What is the internal ligament of the hip?
ligamentum teres/ligament to the head of the femur
32
What is the blood supply to the hip?
- medial and lateral circumflex femoral arteries from the deep femoral/profunda femoris (main supply)
- a small supply is the artery to the head of femur which comes in the ligament mostly relevant in children (branch of obturator)
33
What are the three articulations of the knee joint?
- two femerotibial
| - one femeropatellar
34
What are the main movements of the knee?
flexion-extension with some medial-lateral rotation when the knee is flexed
35
What are the main ligaments of the knee?
- extra-capsular: patellar ligament, medial and lateral collateral ligaments
- intra-capsular: anterior and posterior cruciate ligaments
36
What are the features of the Achilles?
- calcaneal tendon
- strongest in body
- tendons of the gastrocnemius and soles together
- attached to the calcaneus tuberosity
37
What do the superficial lymphatics of the lower limb do?
- follow saphenous veins
- drain to superficial inguinal
- then external iliac
38
What do the deep lymphatics of the lower limb do?
- follow deep veins
- deep inguinal node
- external iliac nodes
39
What is the difference between the pelvic outlet and inlet?
the outlet is not just bone
| the inlet is all bone
40
Where do the hamstrings attach to the pelvis?
proximal to ischial tuberosity
41
Where does the sartorius attach onto the pelvis?
the ASIS
42
Where does the iliopsoas attach onto the pelvis?
the lesser trochanter
43
When are the hips most likely to dislocate?
- flexed
- adducted
- medially rotated
44
What is the clinical sign of sciatic nerve damage?
dorsiflexor injury
45
What muscle is Trendelenburg's sign caused by?
if a hip abductor is hurt the contralateral hip will drop
46
What are the features of the superior gluteal nerve?
- L4-S1 anterior rami
- via greater sciatic foramen
- superior to piriformis
- between medium and minimus
47
What does the femoral artery go through as it becomes the popliteal artery?
adductor hiatus
48
What are varus and valgus?
varus is knees out
| valgus is knees in
49
What is the Q angle?
the femur relative to the quadriceps
50
What is a maisonneuvre fracture?
there is a syndesmosis tear at the top as there is spread of tibia and fibula
there can be common fibular nerve damage
51
What does the superficial fibular nerve do?
runs lateral
| does eversion
52
What does the deep fibular nerve do?
runs anterior
| does dorsiflexion
53
What is foot drop?
- no dorsiflexion so increased steppage and foot slap
| - fibular nerve injury
54
What is the only joint that attaches the upper limb to the spine?
the sternoclavicular joint which is a saddle type joint
55
How do you tell the radius and ulna apart by thickness?
- proximal ulna is thicker than radius
| - distal radius is thicker than ulna
56
What is at the articulation of the wrist?
radius to scaphoid and lunate
57
What are the ligaments of the elbow?
- medial: three bands make a triangular shape
- lateral: from lateral epicondyle of humerus to annular ligament
- annular: wraps around radius
58
What are the MCP joints and the 1st CMC?
- MCPs are condyloid
| - first CMC is saddle type
59
What are the features of the trapezius?
- three bands: ascending, transverse and descending
- CNXI innervation
- triangle pointing to shoulder
60
What are the features of the rhomboid muscles?
- diagonally down to the lateral side
- major and minor
- innervation is dorsal scapular nerve
61
What are the features of the latissimus dorsi?
- axial skeleton to humerus
- this is an adductor
- innervation is thoracodorsal nerve
62
What are the features of the pectoral muscles?
- pectorals major is innervated by medial and lateral pectoral nerve
- pectorals major does horizontal adduction and extension of shoulder
- pectoralis minor is innervated by the medial pectoral nerve
63
What are the features of the serratus anterior?
- under armpit/ side area
- innervated by the long thoracic nerve
- pulls scapulae forwards and attaches to medial scapular border
64
What does the levator scapulae do?
lifts the scapulae
| innervation= dorsal scapular nerve
65
Where does the humerus sit?
in the glenoid fossa
| 1/3rd touches at any one time
66
What are the 4 rotator cuff muscles?
- supraspinatus (greater tuberosity)
- infraspinatus
- teres minor
- subscapularis (lesser tuberosity)
67
What actions do the rotator cuff muscles perform?
- Teres and infra laterally rotate the humerus
- sub medially rotates humerus
- supra does the first bit of abduction before the deltoid does the rest
68
What is in the anterior compartment of the arm?
- biceps brachii
- coracobrachialis
- brachialis
- innervation is the musculocutaneous nerve
- flexion of arm and forearm
69
What is in the posterior compartment of the arm?
- triceps brachii
- innervation is the radial nerve
- extension of the arm and forearm
70
What is in the anterior compartment of the forearm?
- superficial: pronator teres, flexor carpi radialis, palmaris longus, flexor carpi ulnaris (put four fingers on forearm with numb under)
- intermediate: FDS
- deep: flexor pollicus longus, flexor digitorum profundus and pronator quadratus
71
What is in the posterior compartment of the forearm?
- superficial: brachioradialis, extensor carpi radialis longus, extensor carpi radialis brevis, anconeus, extensor digitorum, extensor carpi ulnaris and extensor digiti minimi
- deep: supinator, extensor pollicis brevis, abductor pollicis longus, extensor pollicis longus and extensor indicis
72
Why is the supinator clinically important?
there is a branch of the radial nerve inside which can be damaged which is detrimental to the muscles of the forearm
73
What is in the thenar eminence?
- abductor pollicis brevis
- flexor pollicis brevis
- opponens pollici
- innervation is recurrent branch of medial nerve
74
What is in the hypothenar eminence?
- abductor digiti minimi
- flexor digiti minimi brevis
- opponens digiti minimi
- innervation is deep branch of ulnar nerve
75
What do the lumbricals do?
- attached to the tendons of the flexor digitorum profundus
| - do fingers in post-box
76
What do the interossei do?
- dorsal do abduction of the fingers (DAB)
| - palmar do adduction of the fingers (PAD)
77
Where does the brachial plexus originate from?
anterior rami of C5-T1
78
What are the sections of the brachial plexus from proximal to distal?
- Roots
- Trunks
- Divisions
- Cords
- Nerves
Really tired drink coffee now
79
What is the carpal tunnel formed of?
flexor retinaculum
| carpals
80
What is the clinical picture of carpal tunnel syndrome?
- compression of the median nerve
- thenar weakness
- numbness in digits 1-3 and lateral digit 4
81
What are the divisions of the vertebrae?
33
- 7 cervical
- 12 thoracic
- 5 lumbar
- 5 fused sacral
- 4 fused coccygeal
82
Which are the main atypical vertebrae?
- C1 has no body
- C2 has a dens attached to the body
- C7 is non-bifid and there are small foramina transveraria
83
What is the first palpable vertebrae?
C7
84
What are the parts of intervertebral discs?
- outer annulus fibrosus
| - inner nucleus pulposus
85
What are the features of facet joints?
- synovial
- allow for rotation
- horizontal in cervical spine
- vertical down lumbar spine
86
What is spondylosis?
- spinal OA
- loss of water content due to ageing
- pain is worse with extension of the spine
- fusion can be done if the affected area is small
87
Where are the most common disc problems?
between L4 and L5
| between L5 and S1
88
What is a disc tear?
the outer annulus fibrosus tears
| there will be worse pain on coughing
89
Where does the cauda equina begin?
around L1 and it runs through the intervertebral foramena
90
How do the transversing and exiting nerves work?
- exiting nerve root runs under the pedicle of the corresponding vertebra
- transversing nerve root is anterior and prepares to become the next exiting nerve root more distally
91
What is sciatica?
nerve pain along sensory distribution of sciatic nerve (L4,5,S1)
the pain goes below the knee
it is burning, electric or shooting
92
What is neurogenic claudication?
pain on walking
relieved by rest
easier to walk uphill
burning pain
93
What is spinal stenosis?
osteophytes compress backwards onto spinal cord
| can lead to neurogenic claudication
94
What is cauda equina syndrome?
- pressure on cauda equina
- loss of bowel and bladder control
- saddle anaesthesia
- loss of anal tone
- bilateral symptoms
- do PR and MRI
95
What are the erector spinae muscles?
iliocostalis, longissimus thoracis and spinalis thoracis
96
What are the ligaments of the spine?
- interspinous
- supraspinous
- longitudinal
- ligamentum flavum
97
What is a chance fracture?
disruption of the posterior ligaments of the spine
98
What is the level of the sciatic nerve?
L4-S3
| goes down posterior leg
99
What is the level of the pudendal nerve?
S2-4
100
What is the level of the posterior cutaneous nerve of the thigh?
S1-3
| sensory supply to the posterior thigh
101
What is lumbar puncture?
taking CSF from the L3/4 space
