Anatomy Flashcards
What makes up the upper limbs?
Axilla
Arm
Elbow/cubtial fossa
Fore arm
wrist
hand
What makes up the lower limbs?
Inguinal region/groin
Thigh
Knee/popliteal fossa
Leg
Ankle
Foot
Where does the lower limbs start?
Extends from the pelvis
What muscles of the gluteal Region make up the superficial muscle group?
Gluteus maximus
Gluteus medius
Gluteus minimus
Tensor fascia latae
What is the function of the superficial muscles in the gluteal region?
extensors, abductors and medial rotators of thigh
Which nerves innervate the superficial muscles of the gluteal region?
gluteus maximus = inferior gluteal
all others = superior gluteal
Trendelenburg’s Gait
What gluteal muscles make up the deep muscle group?
piriformis
obturator internus
gemelli
quadratus femoris
What is the function of the deep muscle group in the gluteal region?
lateral rotators of thigh and hip stabilisers
What nerves innervate the deep muscle group in the gluteal region?
Sacral plexus
How do nerves enter the pelvis?
Greater sacral foramen
How do nerves enter the perineum?
Lesser sacral foramen
What makes up the lesser and greater sacral foramen?
sacrotuberous and sacrospinous ligaments
What are the main nerves which enter/exit the pelvis via the gluteal region?
Sciatic (L4-S3)
Pudendal (S2-S4)
Posterior cutaneous nerve of thigh (S1-S3)
What do the sciatic nerves supply?
supplies posterior thigh, all leg and foot muscles & most of the skin via tibial and common fibular branches
What do the pudendal nerve supply?
Principal nerve to perineum
What do the posterior cutaneous nerves of thigh supply?
skin over posterior thigh, popliteal fossa, lateral perineum and upper medial thigh
Where does the sciatic nerve normally exit from in the gluteal region?
leaves pelvis through great sciatic foramen Inferior to piriformis
What does the sciatic nerve separate into in the distal thigh?
tibial nerve
common fibular
What are the boundaries of the femoral triangle?
superior – inguinal ligament
medially – adductor longus
laterally – sartorius
floor – iliopsoas and pectineus
roof – deep fascia (fascia lata)
What are the contents of the femoral triangle?
Femoral Nerve
Femoral Artery
Femoral Vein
Lymphatics
What are the three compartments of the thigh?
anterior, medial &anterior posterior compartments
What are the three compartments of the leg?
Anterior,lateral & posterior compartments
What is found in the anterior compartment of the thigh?
1.flexors of thigh
pectineus, iliopsoas, sartorius
2.extensors of leg
quadriceps femoris
3.all femoral nerve (L2, L3, L4) psoas major (L1,L2,L3)
What is found in the medial compartment of the thigh?
- adductors of thigh
adductor longus, adductor brevis, adductor magnus, gracilis, obturator externus
2.all obturator nerve (L2, L3, L4)
hamstring part of adductor magnus (tibial nerve)
What is found in the posterior compartment of the thigh?
1.extensors of thigh & flexors of leg
semitendinosus, semimembranosus & biceps femoris
- all tibial division of sciatic nerve (L5, S1, S2)
short head biceps femoris (common fibular division of sciatic)
What is found in the anterior compartment of the leg?
1.dorsiflexors of ankle & extensors of toes
tibialis anterior, extensor digitorum longus, extensor hallucis longus, fibularis tertius
2.all deep fibular nerve (L4, L5)
What is found in the lateral compartment of the leg?
1.evert foot & weakly plantarflex ankle
fibularis longus, fibularis brevis
- all superficial fibular nerve (L5, S1, S2)
Where is the popliteal fossa?
Posterior to knee
What are the boundaries of the popliteal fossa?
superolaterally – biceps femoris
superomedially – semimembranosus
inferiorly – gastrocnemius
roof – popliteal fascia
What are the contents of the popliteal fossa?
lots of fat
terminal small saphenous vein
popliteal vessels
tibial and common fibular nerves
What makes up the calcaneal tendon (ankle tendon)?
ii. what does it attach to?
tendons of gastrocnemius and soleus together
ii. attaches to calcaneal tuberosity of the calcaneus
what nerves do the ankle jerk reflex test?
tests S1, S2 nerve roots
What is the route of the superficial lymphatics?
follow saphenous veins
drain to superficial inguinal lymph nodes
then external iliac lymph nodes
What is the route of deep lymphatics?
follow deep veins
(popliteal lymph nodes)
deep inguinal lymph nodes
external iliac lymph nodes
What do the motor nerves of the femoral nerve innervate? (L2,3,4)
quadriceps femoris, sartorius, iliacus & pectineus
What do the motor nerves of the tibial part of the sciatic nerve (L4-S3)?
- muscles of the posterior compartment of thigh:
true hamstrings -
semimembranosus
semitendinosus
2.long head of biceps femoris muscles of the posterior compartment of leg: gastrocnemius soleus plantaris popliteus tibialis posterior
3.muscles of the sole of the foot:
flexors of the digits (digitorum & hallucis longus)
ALL intrinsic muscles of the sole of the foot
(via medial and lateral plantar branches)
what do the motor nerves of the obturator nerve innervate? (L2,3,4)
ALL of the medial compartment of thigh ALL adductors (except hamstring part of magnus) & gracilis
What do the motor nerves of the
common fibular part of the sciatic nerve innervate? (L4-S2)
short head of biceps femoris
What is superficial fibular branch of the common fibular nerve?
muscles of the lateral compartment of leg: fibularis longus & brevis
What is superficial fibular branch of the deep fibular nerve?
muscles of the anterior compartment of leg:
Tibialis anterior, extensor digitorum longus, extensor hallucis longus, fibularis tertius
muscles of the dorsum of the foot:
extensor digitorum brevis (EDB)
extensor hallucis brevis (EHB)
which nerves innervate the rest of the lower limb?
Branches of the lumbosacral plexus
What are the three principal types of muscles?
- Skeletal
- Cardiac
- Smooth
What are the three main properties of the skeletal muscles?
Striated
Unbranched
Multinucleate - Nuclei are at the periphery of the fibre, just under sarcolemma
what is the sarcolemma?
the cell membrane of muscle cells
what is the name of bundles that muscle fibres are organised into?
Fascicles
What is the name of the connective tissue which surrounds the whole muscle?
Epimysium
What is the name of the connective tissue which surrounds a fascicle?
Perimysium
what is the name of the connective tissue which surrounds a single muscle fibre?
Endomysium
what is a sarcomere?
ii. what do they form?
the ‘unit of contraction’, of the muscle cell, that is, they are the smallest contractile elements in the striated muscle cell
ii. thousands of these are placed end-to-end to form a myofibril
What line to sarcomeres extend from?
one Z line to another one
What is a motor unit?
one motor neurone and all of the muscle fibres that it innervates
Finish the sentence: the fewer the number of muscle fibres in a motor unit the finer the what?
the finer the control of movement
What are the 3 types of skeletal fibres?
Type I - relatively slowly contracting fibres that depend on oxidative metabolism
Type II a - They are relatively fast contracting, but are also reasonably resistant to fatigue. (intermediate between Type I and Type II b)
Type II b - fast contracting fibres that depend on anaerobic metabolism
What do Type I skeletal fibres contain a lot of?
Mitochondria and Myogoblin
How are cells nourished in the cartilage?
diffusion through the extracellular matrix
How are cells nourished in the bone?
nourished by blood vessels that pervade the tissue.
What are the cells called that found in the cartilage?
ii. what are immature forms of these cells called?
Chondrocytes
ii. Chondroblasts
Where do chondrocytes reside in the extracellular matrix?
Lacuna
What does the ECM contain?
- water (75%)
2. 25% organic material. ( Type II collagen and Proteoglycan aggregates)
What colour is Hyaline cartilage?
Grossly, it is blue-white in colour and translucent
What colour is Elastic cartilage?
Grossly it is light yellow in colour
what colour is fibrocartilage?
Grossly, fibrocartilage appears white.
Where is most of the calcium in the body stored?
bones
What is bone made of?
- bioapatitie (65%)- a form of calcium phosphate, mostly hydroxyapatite
- Collagen
- Water
What are the two types of bone found in a long bone which can be viewed with the naked eye?
- Cortical bone - makes up the diaphysis (shaft)
2. Cancellous or trabecular bone occupies the ends of the bone (the epiphyses)
What are the five main parts of a long bone from proximal to distal?
Proximal epiphyses
Metaphysis
Diaphysis
metaphysis
Distal epiphyses
What are the main parts of a long bone from superficial to deep?
Periosteum
compact bone
Marrow cavity
bone marrow
What is the main difference between compact and trabecular bone?
ii. what type of bone are they both?
the presence of spaces (marrow cavities) adjacent to trabecular bone.
ii. Lamellar
what is the main type of cell found in the bones?
osteocytes
What are cement lines?
lines that are often visible surrounding the osteon are termed
What do Trabecular bones lack?
generally lacks Haversian canals
What are osteoprogenitor cells?
ii. where are they found?
serve as a pool of reserve osteoblasts
ii. located on bone surfaces e.g. periosteum
What are Osteoblast cells?
ii. where are they found?
bone forming cells
ii. Found on surface of developing bones
What are Osteocytes?
Bone cell trapped within the bone matrix
What are Osteoclast cells?
ii. where are they found?
large (up to 40µm or more) multinucleated cells. which are responsible for bone resorption
ii. Surface of bones
What do osteoblasts secrete?
osteoid - mixture of collagen, glycosaminoglycans (GAGs), proteoglycans and other organic components of the matrix
What are differences between lamellar and woven bone?
Woven bone:
- Not as strong as lamellar bone
- the collagen fibres are laid down in a haphazard fasion
Lamellar bone:
- collagen fibres orientated all in one direction
what type of joints are there in the upper limb?
- Acromoclavicular Joint
- Glenohumeral joint
- Elbow joint :HUMEROULNAR JOINT and radial humeral joint
- Proximal radioulnar joint
- Radiocarpal Joint
- Distal radioulnar joint
- sternoclavicular joint
what does the radial bone move over during supination?
ulna
where does the Lateral (radial) collateral ligament attach from?
lateral epicondyle of humerus to annular ligament
What are the main joints in the hand?
- Distal interphalangeal (IP) joint ( fingers)
- Proximal interphalangeal (IP) joint (fingers)
- metacarpophalangeal joints (MCP) - condyloid type joint
- carpometacarpal (CMC) joint - saddle type joint
What are the axio appendicular muscles?
ii. which nerves innervate these muscles?
- Trapezius - CN XI
- Latissimus dorsi - Thoracodorsal nerve
- Rhomboid minor - Dorsal scapula nerve
- Rhomboid major - Dorsal scapula nerve
- Serratus anterior - Long thoracic nerve
- Pectoralis Major - Medial pectoral nerve
What are 4 the rotator cuff muscles?
ii. what is their function?
Supraspinatus
Infraspinatus (Greater tuberosity)
Teres minor
Subscapularis – (Lesser tuberosity)
ii. They hold the head of the humerus in the glenoid fossa
How much of the head of the humerus is in contact with the glenoid fossa at any time?
1/3rd
What are the muscles which make up the anterior compartment of the arm?
ii. which nerve innervates this compartment?
Biceps brachii
Brachialis
Coracobrachialis
ii. Musculocutaneous
What is the role of the anterior compartment of the arm?
Flexion of arm and forearm
What muscle makes up the posterior compartment of the arm?
ii. which nerve innervates this?
Triceps brachii
ii. Radial nerve
what is the role of the posterior compartment of the arm?
Extension of arm and forearm
What muscles make up the superficial layer of the anterior compartment of the forearm?
PRONATOR TERES
FLEXOR CARPI ULNARIS
PALMARIS LONGUS
FLEXOR CARPI RADIALIS
what muscles make up the intermediate layer of the anterior compartment of the forearm?
FLEXOR DIGITORUM SUPERFICIALIS
What muscles make up the deep layer of the anterior compartment of the forearm?
FLEXOR POLLICIS LONGUS
FLEXOR DIGITORUM PROFUNDUS
PRONATOR QUADRATUS
which nerves innervate the anterior compartment of the forearm?
ii. what is the action of the anterior compartment of the forearm?
ALL Median nerve, except flexor carpi ulnaris and medial half of flexor digitorum profundus
ii. Flexion of the wrist and digits, pronation, abduction and adduction of the wrist.
Which muscles make up the superficial layer of the posterior compartment of the forearm?
BRACHIORADIALIS
EXTENSOR CARPI RADIALIS LONGUS
EXTENSOR CARPI RADIALIS BREVIS
ANCONEUS
EXTENSOR DIGITORUM
EXTENSOR CARPI ULNARIS
EXTENSOR DIGITI MINIMI
Which muscles make up the deep layer of the posterior compartment of the forearm?
SUPINATOR
EXTENSOR POLLICIS BREVIS
ABDUCTOR POLLICIS LONGUS
EXTENSOR POLLICIS LONGUS
EXTENSOR INDICIS
Which nerves innervate the posterior compartment of the forearm?
ii. what is the action of the posterior compartment of the forearm?
all radial nerves
ii. Extension of the wrist and digits, supination, abduction and adduction of the wrist.
Which muscles make up the thenar eminence?
ii. Which nerves innervate it?
Abductor pollicis brevis
Flexor pollicis brevis
Opponens pollicis
ii. Recurrent branch of the median nerve
Which muscles make up the Hypothenar eminence?
ii. which nerves innervate it?
Abductor digiti minimi
Flexor digiti minimi brevis
Opponens digiti minimi
ii. Deep branch of the ulnar nerve
What do the lumbricals attach to?
ii. which nerves innervate the lumbricals?
to tendons of Flexor digitorum profundus
ii. Median n. (lateral 2)
Ulnar n. (medial 2)
what are the two main interorossei muscles?
ii. which nerves innervate the lumbricals?
Dorsal interossei – Abduction of digits
Palmar interossei – Adduction of digits
ii. ulnar nerve
where does the brachial plexus originate from?
ii. what is its route?
Brachial plexus originate from anterior rami of C5-T1
ii. Passes through the axilla to the medial arm
what do the cords of the brachial plexus move around?
Brachial artery
What does the brachial plexus consist of from proximal to distal?
Think: Really Tired Drink Coffee Now
Roots (C5 - T1)
Trunks ( Superior, Middle, Inferior)
Divisions ( 3 anterior and 3 posteriors)
Cords ( Lateral, Posterior and Medial)
Nerves (MUSCULO-CUTANEOUS, AXILLARY, RADIAL, MEDIAN, ULNAR)
Which Root innervates the Lateral third of the hand in anatomical positon?
C6
which root innervates the middle third of the hand in anatomical position?
C7
which root innervates the medial third of the hand in anatomical position?
C8
What is the carpal tunnel formed by?
Flexor retinaculum
Carpals
what does the carpal tunnel consist of?
Flexor digitorum superficialis (x4)
Flexor digitorum profundus (x4)
Flexor pollicis longus (x1)
Median nerve
what is carpal tunnel syndrome?
Compression of median nerve
Weakness in the thenar muscles
Numbness in digits 1-3 and lateral half of digit 4
Name the arteries from the subclavian to the deep palmar arch.
- Subclavian artery
- axillary artery
- Brachial artery
- Elbow anastomosis
- Radial/ulnar artery
- Superficial palmar arch
- Deep palmar arch
How many vertebrae are there in the human spine?
33
what are the 5 sections of the vertebral column?
Cervical
Thoracic
Lumbar
Sacral (fused)
Coccygeal (fused)
How cervical vertebrae are there?
7
How many thoracic vertebrae are there?
12
How many lumbar vertebrae are there?
5
How many sacral vertebrae are there?
5
How many coccygeal vertebrae are there?
4
How many curves are there in a healthy spine?
4
What are the two main sections of a typical vertebra?
- Vertebral body
2. Vertebral arch
What is the name of the C1 vertebra?
the Atlas
What is the name of the C2 vertebra?
ii. what specialised anatomical process does it have?
the Axis
ii. dens
What is the role of the C1 and C2 vertebra?
Allows head rotation
What is atypical about C7 vertebra?
- Small foramina transveraria
2. Long spinous process non bifid
What type of joint is the intervertebral discs?
Secondary cartilaginous joints
What type of joints are facet joints?
Synovial
What is the function of facet joints and intervertebral discs?
Allow for flexion,extension & lateral flexion of spine
What type of facet joints does the cervical spine have?
Horizontal facet joints
What type of facet joints does the lumbar spine have?
More vertical facet joints
What do intervertebral disc lose as people age?
Water content
What are the two main sections of the intervetrebral disc?
Outer annulus fibrosis
inner Gelatinous nucleus pulposus
What parts of the spine are affected the most by degeneration of the intervetrebral discs ( loss of water)?
L4/5
L5/S1
where does the spinal cord end?
L1 (cauda equina)
Which nerve roots contribute to the the sciatic nerve?
L4, L5 & S1,2,3
What is sciatica?
Radiation of nerve pain along sensory distribution of sciatic nerve
What muscles make up the erector spinae? ( muscles of the spine)
- ilioscostalis
- Longissimus thoracis
- Spinalis thoracis
What are the ligaments of the spine?
- Anterior longitudinal ligament
- Posterior longitudinal ligament
- Ligamentum flavum
- Supraspinous ligament
- Interspinous ligament
What does the ‘bony architecture’ of the hip joint consist of?
ii/
Femoral head
Acetabulum
Synovial ball and socket
What is the acetabular labrum?
Fibrocartilaginous rim along the margin of the acetabulum
What ligaments are found in the hip joint?
iliofemoral ligament
Ischiofemoral ligament
Pubofemoral ligament
Name all the hamstring muscles.
Semitendinosus
Semimembranosus
Long head and short head bicep femoris
Name all the Gluteus muscles.
- Gluteus Minimus
- Gluteus medius
- Gluteus Maximus
which muscles are involved in the flexion of the Hip joint?
- Illiopsoas
- Sartorius
- Tensor fasciae latae
- Rectus femoris
- Pectineus
- Adductor longus
- Adductor brevis
- Adductor magnus - anterior part
- Gracilis
which muscles are involved in the adduction of the Hip joint?
Adductor longus
Adductor brevis
Adductor Magnus
Gracilis
Pectineus
Obturator extemus
What muscles are involved in the extension of the Hip joint?
Hamstrings
Adductor magnus - Posterior part
Gluteus maximus
which muscles are involved in the abduction of the hip joint?
Gluteus medius
Gluteus minimus
Tensor fasciae latae
which muscles are involved involved in the medial rotation of the hip joint?
Gluteus medius - anterior part
Gluteus minimus - anterior part
Tensor fasciae latae
What is the relationship of the sciatic nerve to the acetabulum?
Sciatic nerve runs posterior acetabulum at the levek of the ischium
What sciatic nerve division is most likely affected by hip dislocation?
common fibular division
What is the gluteus Medius’s origin?
Between the anterior and posterior gluteal lines of ilium
inserts into the greater trochanter of the femur
What is the gluteus Minimus’s origin?
Between the anterior and inferior gluteal lines of ilium
inserts into the greater trochanter of the femur
What is the course of the superior gluteal nerve?
originates from the L4-S1 anterior rami
Leaves pelvic cavity via the greater sciatic foramen superior to piriformis
Passes between gluteus minimus and medius
What arteries supply the femoral head and neck?
Medial circumflex artery ( primary blood supply)
Lateral circumflex artery
Retinacular arteries
all are branches of the profunda femoris (deep femoral artery)
Name the deltoid ankle ligaments.
Anterior tibiotalar ligament
Posterior tibiotalar ligament
Tibionavicular ligament
Tibiocalcaneal ligament
What type of joint is the shoulder joint?
ii. What attaches to form the shoulder joint?
Ball and socket synovial joint
ii. Humeral head and the scapular glenoid
what is the shoulder girdle formed by?
Scapula
Clavicle
proximal humerus
Supporting muscles ( includes deltoid and the muscles of the rotator cuff)
Why does the shoulder joint is dependent on the surrounding musculature for stability?
Due to lack of inherent bony stability
What is the rotator cuff formed by?
Supraapinatus (posterior) - attaches to the greater tuberosity
Infraspinatus (posterior)- attaches to the greater tuberosity
Teres Minor ( posterior) - attaches to the greater tuberosity
Subscapularis ( anterior side)- attaches to the lesser tuberosity and is the principal rotator
What is the role of the rotator cuff?
Holds the humeral head in place and provides essential movements such as pulling the humeral head into the glenoid to provide a stable fulcrum for the powerful muscle to abduct the arm.
What two joints does the elbow joint consist of?
Humero-ulnar joint ( responsible for flexion/extension)
Radio-capitallar joint (responsible for supination/pronation along with the proximal and distal radioulnar joints)
What effect does the triceps muscle have on the elbow?
ii. Where does it insert to help the elbow?
Helps elbow extension
ii. Olecranon process
What effect do the biceps muscle and brachialis have on the elbow?
ii. Where do they insert to help the elbow?
Help flex the elbow
Which muscles cause the supination of the elbow?
Biceps and supinator muscles
Which muscles cause the pronation of the elbow?
Contraction of the pronator teres muscle proximally
Contraction of the pronator quadratus muscle distally
Where does the common extensor origin arise from?
the lateral epicondyle
Where does the common flexor origin arise from?
the medial epicondyle
what type of joint is the knee?
hinge joint
what is the knees planes of movement?
extension and flexion
and a small degree of rotation
what muscles are found in the anterior compartment of the lower limb?
ii. which nerves innervate them?
iii. what are the actions of these muscles?
- Tibialis anterior:
ii. Deep peroneal nerve
iii. Dorsiflexes ankle joint, inverts foot - Extensor digitorum longus
ii. Deep peroneal nerve
iii. Extends lateral four toes, dorsiflexes ankle joint - Peroneus tertius
ii. Deep peroneal nerve
iii. Dorsiflexes ankle, everts foot - Extensor hallucis longus
ii. Deep peroneal nerve
iii. Dorsiflexes ankle joint, extends big toe
what muscles are found in the peroneal compartment of the lower limb?
ii. which nerves innervate them?
iii. what are the actions of these muscles?
- Peroneus longus
ii. Superficial peroneal nerve
iii. Everts foot, assists in plantar flexion - Peroneus brevis
ii. Superficial peroneal nerve
iii. Plantar flexes the ankle joint
what muscles are found in the Superficial posterior compartment of the lower limb?
ii. which nerves innervate them
iii. what are the actions of these muscles?
- Gastrocnemius
ii. Tibial nerve
iii. Plantar flexes the foot, may also flex the knee - Soleus
ii. Tibial nerve
iii. Plantar flexor
what muscles are found in the deep posterior compartment of the lower limb?
ii. which nerves innervate them
iii. what are the actions of these muscles?
- Flexor digitorum longus
ii. Tibial
iii. Flexes the lateral four toes - Flexor hallucis longus
ii. Tibial
iii. Flexes the great toe - Tibialis posterior
ii. Tibial
iii. Plantar flexor, inverts the foot
what Structures are posterior to the lateral malleolus and superficial to superior peroneal retinaculum?
Sural nerve
Short saphenous vein
what structures posterior to the lateral malleolus and deep to superior peroneal retinaculum?
Peroneus longus tendon
Peroneus brevis tendon
what is the calcaneofibular ligament attached?
lateral malleolus
What is the anatomical order in which the needle passes in order to reach cerebrospinal fluid?
superficial to deep:
skin
supraspinatus ligament
interspinous ligament
ligamentum flavum
epidural space
subdural space
subarachnoid space
which muscle cell types only have one nuclei?
cardiac and smooth
Which one of the following structures are not closely related to the adductor longus muscle?
Long saphenous vein
Tendon of iliacus
The profunda branch of the femoral artery
Pectineus muscle
Femoral nerve
tendon of iliacus
what does the tarsal tunnel contain from anterior to posterior?
tibialis posterior tendon
flexor digitorum tendon
posterior tibial artery
posterior tibial vein
tibial nerve
flexor hallucis longus tendon
which nerve supplies the sartorius muscle?
anterior division of femoral nerve