Anatomy

Question 1

Describe the main aspects of the bones of the upper limb.

Answer 1

Clavicle: sternoclavicular and acromioclavicular joints
Scapula: 1/5 superior of scapular spine, 4/5 inferior. Coracoid process joins clavicle
Humerus: greater and lesser tubercle, with intertubular sulcus; deltoid tuberosity and radial groove; supra-epicondylar ridges and epicondyles; condyle containing the trochlea
Ulna: trochlear notch (olecranon and coronoid)
Radius: capitulum

Question 2

Shoulder: anterior and posterior axio-appendicular, and scapulohumeral muscles
Name the anterior axio-appendicular muscles and name their nerve supplies.

Answer 2

Pectoralis major - lateral & medial pectoral nerve
Pectoralis minor - medial pectoral nerve
Serratus anterior - long thoracic nerve
Subclavius - subclavian nerve

Question 3

Shoulder: anterior and posterior axio-appendicular, and scapulohumeral muscles
Name the superficial and deep posterior axio-appendicular muscles and name their nerve supplies.

Answer 3

Superficial
Trapezius - CN XI
Latissimus dorsi - thoracodorsal nerve
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Deep
Levator scapulae - dorsal scapular
Rhomboid minor - dorsal scapular
Rhomboid major - dorsal scapular

Question 4

Shoulder: anterior and posterior axio-appendicular, and scapulohumeral muscles
The scapulohumeral muscles (aka intrinsic) muscles consist of the rotator cuff, teres major, and deltoid. Name the muscles and their nerve supply.

Answer 4

Supraspinatus - suprascapular nerve
Infraspinatus - suprascapular nerve
Teres minor - axillary nerve
Subscapularis - subscapular nerve
Deltoid - axillary
Teres major - subscapular nerve

Question 5

Name the fasciae of the upper limb.

Answer 5

Pectoral (sup) and clavipectoral (deep) -> axillary
Deltoid, axillary and infraspinatus -> brachial
Brachial -> antebrachial -> flexor retinaculum (deep) and extensor retinaculum (sup) -> palmar

Question 6

Describe the sections and borders of the axillary artery.

Answer 6

1: lateral border of 1st rib, to medial border of pectoralis minor. 1 branch -> superior thoracic
2: posterior to pectoralis minor. 2 branches -> thoracoacromial and lateral thoracic
3: lateral border of pectoralis minor, to inferior border of the teres major. 3 branches -> subscapularis, anterior / posterior circumflex arteries
(mnemonic - Screw The Lawyer, Save A Patient)

Question 7

Describe the lymphatic drainage of the upper limb.

Answer 7

Pectoral (ant), subscapular (post), humeral (lat) -> ALL drain to central and apical nodes.
Most of upper limb drained by humeral nodes, except from around cephalic vein (straight to apical)

Question 8

Name the four muscles of the arm, and the one accessory muscle of the elbow. Name the functions of the compartments and their innervation.

Answer 8

Anterior (flexes elbow, musculocutaneous nerve)
Biceps brachii, brachialis, coracobrachialis
———-
Posterior (extends elbow)
Triceps brachii - radial nerve
———-
Anconeus - assists posterior compt. - radial nerve

Question 9

Describe the anterior compartment of the forearm.

Superficial (4), intermediate (1), deep (3)

Answer 9

Superficial (flexor-pronators)
Pronator teres, palmaris longus, flexor carpi radialis, flexor carpi ulnaris. Median nerve, except FCU (ulnar nerve)
—
Intermediate: flexor digitorum superficialis. Median nerve
—
Deep: pronator quadratus, flexor pollicis longus, flexor digitorum profundus. Anterior interosseous membrane nerve, except medial FDP (ulnar nerve)

Question 10

Describe the posterior compartment of the forearm.

Superficial (6), deep (1), outcropping deep (4)

Answer 10

Superficial (extensor-supinators)
Brachioradialis, extensors: carpi radialis (longus and brevis), digitorum, digiti minimi, carpi ulnaris.
Longus - wrist and CMC, + brevis in fist
Digitorum - medial four fingers, minimi - small finger
NB - brachioradialis is posterior, but flexes elbow
—–
Deep: supinator
—–
Outcropping deep (thumb)
Abductor / extensor pollicis longus, extensor pollicis brevis, extensor indicis. Self-explanatory
—–
All supplied by the radial nerve

Question 11

Describe the features of the femur, tibia, and tarsal bones.

Answer 11

Femur and tibia articulate at the knee joint. Contains medial malleolus and nutrient foramen on posterior. Interosseous membrane between tibia and fibula.
—
Seven tarsal bones: talus (ankle joint), calcaneus (largest and strongest), navicular and cuboid (medial / lateral), then cuneiforms (medial, intermediate, lateral)

Question 12

Describe the compartments of the thigh, including the muscles, their collective movement, and innervation.

Answer 12

Anterior (flex hip, extend knee)
Pectineus, iliopsoas, sartorius, quadriceps femoris (FILM - rectus Femoris, vastus Intermedius, Lateralis, Medialis), articularis genu
Femoral nerve (except psoas major)
——————-
Medial (adductor group)
adductor longus, brevis, magnus (adductor + hamstring), graciis, obturator externus
Obturator nerve (except magnus hamstring - tibial sciatic nerve)
——————–
Posterior (extend hip, flex knee)
Semitendinosis and semimembranosus (medial rotation), biceps femoris (long and short head, lateral rotation).
Tibial (sciatic), except short head (common fibular)

Question 13

Describe the boundaries and contents of the popliteal fossa.

Answer 13

SuperoMedial - SemiMembranosus, Superolateral - biceps femoris, Inferior - two heads of gastrocnemius
Contains the femoral artery and vein (small saphenous vein drains here). Just superior to fossa, sciatic nerve bifurcation into tibial, common fibular. Posterior cutaneous nerve also passes through.
Subcutaneous tissue also contains the posterior cutaneous nerve of the thigh, and medial / lateral sural cutaneous nerves. Popliteal fascia continuous with fascia lata (superior), and crural (inferior)

Question 14

Describe the boundaries and branches of the popliteal artery.

Answer 14

From adductor hiatus (between femur and adductor magnus) to inferior of the fossa. Here it bifurcates to anterior and posterior tibial arteries.
The popliteal artery gives off five genicular arteries which anastomose around and supply the knee joint. Two superior, two inferior (medial/lateral) and one middle genicular artery.

Question 15

Describe the compartments of the leg, including the muscles, their collective movement, and innervation.

Answer 15

Posterior (plantarflexion, tiptoes)
Superficial (3): gastrocnemius, soleus, plantaris. All insert into calcaneal tendon.
Deep (4): popliteus (unlocks extended knee), flexor hallucis / digitorum longus (flexes toes), tibialis posterior (maintains medial longitudinal arch).
——————-
Anterior (dorsiflexion, extension)
(4): tibialis anterior (inverts foot), extensor hallucis / digitorum longus (extends toes), fibularis tertius (weak)
Deep fibular nerve; anterior tibial artery
——————-
Lateral (eversion, weak plantarflexion)
(2): fibularis longus, brevis
Superficial fibular nerve; perforating arteries

Question 16

Name the ligaments of the knee capsule, both intracapsular and intra-articular. Name their rough locations.

Answer 16

Intracapsular
- Patellar tendon (continuous with quadriceps tendon). Roughly anterior
- Tibial and fibular collateral ligaments (medial, lateral)
- Oblique popliteal (semimembranosus expansion, posterior aspect)
- Arcuate (over popliteus tendon)
————-
Intra-articular
- ACL (prevents posterior displacement of tibia)
- PCL (prevents anterior displacement of tibia)
- Coronary (menisci to tibial condyles)
- Transverse (attaches anterior aspects to menisci)

Question 17

Describe the bony aspects of the hip girdle.

Answer 17

Ilium: has crest (rim) most superiorly. Has superior anterior/posterior iliac spine.
——
Ischium: body (acetabulum) and ramus (inferior aspect of obturator foramen). Has tuberosity and spine.
——
Pubis: two rami, form medial aspect of obturator foramen. Pubic symphysis - secondary cartilaginous joint (sacroiliac is synovial)

Question 18

Name the muscles of the gluteal region and their innervation.

Answer 18

Superficial
Gluteus maximus (inferior gluteal), gluteus medius / minimus and tensor fascia latae (superior gluteal).
Deep
Piriformis (S1-2), obturator internus (nerve of same name), gemelli (‘twins’, two heads; superior by obturator internus, inferior by quadratus femoris), and quadratus femoris (nerve of same name)

Question 19

Describe the typical anatomy of the spinous vertebrae and how they vary in different sections.

Answer 19

Vertebral body, arch, and seven processes.
Pedicles (body -> arch), laminae (arch -> processes)
1 spinous (median), 2 transverse (posterolateral), 4 articular (2 superior, 2 inferior).
———
Cervical: smaller bodies (none in C1). Contains foramina transversaria (arteries, veins, sympathetic plexus). Spinous process is bifid (absent in C7).
Thoracic: body is heart shaped. Has costal facets
Lumbar: massive, kidney bean shaped bodies. Transverse process has accessory process. Superior articular facts have mamillary processes.
Sacral: fused segments with crests

Question 20

Name the components of the IV discs and the ligaments of the spinal canal.

Answer 20

Anulus fibrosus (concentric lamellar rings, of fibrocartilage), and nucleus pulposus (mainly water, allowing spinal compression). NP lies slightly posterior meaning it is easier to herniate.
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Anterior and posterior longitudinal ligaments, limiting extension/flexion of spine

Question 21

Name the intrinsic muscles of the back, and name their innervation.

Answer 21

Splenius, erector spinae (iliocostalis, longissimus, spinalis), multifidus, rotatores, interspinales, intertransversarii, levatores costarum
All supplied by posterior rami, except intertransversarii (both posterior and anterior rami