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Block 4 > Anatomy: Bones and Muscles of the Lower limb > Flashcards

Anatomy: Bones and Muscles of the Lower limb Flashcards

1
Q

What are the 3 portions of a long bone called, from joining end to long end?

A

Epiphysis

Metaphysis

Diaphysis

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2
Q

Describe 3 things about a sesamoid bone

Give an example of a sesamoid bone

A

Patella

Found within tendons

Reduce wear

Improve muscle efficiency

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3
Q

Describe 3 things about a flat bone

Give an example of a flat bone

A

Scapula

Large surface area for muscle attachment

Weight/force transfer region

Protection (pelvic girdle and skull)

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4
Q

What is Wolff’s Law?

A

Bone is deposited and reabsorbed in accordance with the stresses placed upon it (it is able to remodel)

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5
Q

Name the 2 types of bone?

within a single bone

A

Cancellous/trabecular/spongy bone

Cortical bone

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6
Q

What 6 things make up the axial skeleton?

A 
Skull
Ribs
Sternum
Vertebrae 
Sacrum
Coccyx
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7
Q

What 3 things make up the appendicular skeleton

A

Hip bones (pelvic girdle)
Pectoral girdle
Limbs (upper and lower)

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8
Q

Define Amelia

A

No limb growth

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9
Q

Define Meromelia

A

Partial limb

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10
Q

Define Phocomelia

A

Seal-like limb/flipper

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11
Q

Define Polydactyly

A

Additional digits

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12
Q

Define Syndactyly

A

Webbing/joining of digits

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13
Q

Name the 2 large groups of bone to bone joint

A

Fibrous joints

Cartilaginous Joints

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14
Q

What are the 3 types of fibrous joints?

Give an example and characteristic of each type of joint

A

Suture

  • do not move
  • skull

Gomphosis

  • small degree of movement
  • teeth to jaw

Syndesmosis

  • fibrous sheet of tissue that keeps 2 long bones in proximity to each other
  • forearm
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15
Q

What are the 2 types of cartilaginous joints?

Give an example and characteristic of each type of joint

A

Epiphysis

  • mainly in children
  • growth plate of a bone

Symphysis

  • movable discs between joints
  • vertebral discs
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16
Q

Describe 3 things about hyaline cartilage

A

Found at the ends of 2 adjoining bones

Avascular, smooth and slippy

Sits withing a joint capsule

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17
Q

What lines a joint capsule and produces synovial fluid?

A

Synovium (serous membrane)

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18
Q

What is a bursae?

A

Pockets of synovium and synovial fluid found in regions of friction/wear

Inflammation of the bursae causes bursitis

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19
Q

Where are synovial sheaths found?

A

Around tendons at points of wear/friction/direction change

Inflammation of the synovium causes synovitis

Inflammation of the sheath and the tendon causes

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20
Q

What is a nerve plexus?

A

A region where the ventral rami of spinal nerves join and exchange neurons

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21
Q

What wraps the compartments in the forearms?

A

Connective tissue fascia

Wraps around the muscles and tissues to form anterior and posterior compartments

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22
Q

Anterior compartments are mainly responsible for….

A

Flexor function

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23
Q

Posterior compartments are mainly responsible for….

A

Extensor function

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24
Q

What does the anterior thigh compartment contain?

A

Hip flexor and knee extensor

Femoral nerve (L2, L3, L4)

Femoral artery

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25
Q

What is a retinacula?

A

Thick bands of fascia that connect tendons to bone and stop them lifting off when activated

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26
Q

Venous drainage runs from….

A

Superficial to deep

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27
Q

The origin site of a muscle is

A

Generally more fixed and proximal

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28
Q

The insertion site of a muscle is

A

Normally more mobile and distal

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29
Q

Give 5 roles of connective tissue

A

Structural support

Metabolic support

Cell adhesion

Medium of exchange

Defense, protection and repair

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30
Q

What 2 things is connective tissues made from?

A

Cells

Extracellular matrix

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31
Q

What 2 things is extracellular matrix formed of?

Give properties of each

A

Fibrous proteins

  • collagen
  • elastin

Ground substances

  • transparent
  • colourless
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32
Q

What 3 things is ground substance formed from?

Give properties of each

A

Proteoglycans

  • repeated disaccharides (GAG) around a protein core
  • GAG attracts water

Glycoproteins
-allow cells to adhere to the ECM

Water
-attracted by GAG

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33
Q

What provides the rigidity of bones?

A

Mineralised extracellular matrix (hydroxyapatite)

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34
Q

What provides the resilience of bones?

A

Type 1 collagen fibres

part of the fibrous proteins component of ECM, other component is ground substance remember

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35
Q

Name the 5 functions of bone

A

Movement

Mineral homeostasis

Support

Protection

Site of haematopoiesis

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36
Q

Describe the structure and function of the periosteum

A

Dense, irregular connective tissue layer covering the bones where tendons and ligaments insert

Out fibrous layer

Inner cellular layer
-osteoprogenitor cells and osteoblasts

Helps the bone grow in thickness, # repair nourishes bone tissue

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37
Q

Where is the endosteum?

A

Lines the inside of the bones

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38
Q

What are the 2 types of bone (mature/immature)

A

Woven bone

Lamellar bone (mature)

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39
Q

Describe the structure of woven (immature) bone

A

First bone formed at any site

Collagen fibres are arranged randomly

Occurs at site of # healing

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40
Q

Describe the structure of lamellar (mature) bone

A

Collagen fibres remodel into orderly arrangement

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41
Q

What are the 2 types of mature (lamellar) bone?

A

Trabecular

Cortical

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42
Q

Describe the characteristics of trabecular bone and how structure is related to function

A

Looks like beams and struts.

Orientated along the lines of stress and redistributes stress along the bone.

Spaces make the bone lighter and give space for bone marrow as well

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43
Q

Describe the characteristics of cortical bone and how structure is related to function

A

Dense and compacted bone

Arranged into Haversian systems (osteons)

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44
Q

What is a lamellae?

A

A bony plate made up of collagen fibres arranged in parallel

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45
Q

Describe the composition of lamellar bone

A

And outer circumferential lamellae runs along the shape on the bone

Concentric lamellae form around Haversian canals, which contain blood vessels, lymph vessels and nerves.

Collagen fibres in the Haversian systems (osteons) form around the Haversian canals in parallel to each other

Volkmann’s canals run transversely and allow communications between the Haversian systems and between the periosteum and the osteons

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46
Q

What type of cell are osteoprogenitor cells derived from?

A

Mesenchymal stem cells

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47
Q

What do osteoprogenitor cells turn into?

A

Osteoblasts

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48
Q

What do osteoblasts mature into?

A

Osteocytes

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49
Q

What type of cell produces osteoid?

A

Osteoblasts

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50
Q

What is in osteoid?

A

Type 1 collagen

Proteoglycans

Glycoproteins

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51
Q

List 2 features of osteocytes

A

Mature bone cells

Do not undergo cell division

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52
Q

Give 2 functions of osteocytes

A

Mechanotransduction (detecting stresses and triggering action of other bone cells)

Calcium homeostasis

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53
Q

Name the space that an osteocyte sits in within the bone

A

Lacunae

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54
Q

What are the channels within bone called?

What sits within these channels?

A

Canaliculi

Dendritic processes of osteocytes

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55
Q

What role do osteoclasts have?

A

Remodeling, growth and repair of bones

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56
Q

What do osteoclasts derive from?

A

Monocyte-macrophage system

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57
Q

What do osteoclasts secrete?

A

Enzymes and acid

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58
Q

Name the space the osteoclasts sit in

A

Howship’s lacunae

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59
Q

Which type of cell secretes RANKL?

A

Osteoblasts

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60
Q

When do osteoblasts secrete RANKL?

A

In response to calcitrol and PTH

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61
Q

Where is the RANK receptor located?

A

Osteoclasts

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62
Q

What 2 things do osteoblasts secrete?

A

RANKL

OPG

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63
Q

Which hormone increases the amount of OPG?

A

Oestrogen

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64
Q

What does OPG do?

A

Mops up excess RANKL so that bone re-absorption does not get out of control

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65
Q

Fill in the gaps:

Many different hormones regulate bone remodelling. Osteoblasts secrete _____ in response to ______ and ___. RANKL binds to ____ receptors on ______ and stimulates bone reabsorption. _____ secrete OPG: this mops up excess ______ so that bone reabsorption does not get out of control.

A

Many different hormones regulate bone remodelling. Osteoblasts secrete RANKL in response to calcitriol and PTH. RANKL binds to RANK receptors on osteoclasts and stimulates bone reabsorption. Osteoblasts secrete OPG: this mops up excess RANKL so that bone reabsorption does not get out of control.

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66
Q

What are the 2 types of bone development?

A

Intramembronous ossification

Endochondral ossification

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67
Q

Draw out the pathways for the 2 types of ossification

A

Intramembranous:
mesenchyme –> bone

Endochondral:
mesenchyme –> cartilage –> bone

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68
Q

What is mesenchyme?

A

Undifferentiated embryonic connective tissue

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69
Q

Which bones undergo intramembronous ossification?

A

Flat bones of the skull, clavicle and mandible

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70
Q

How are the flat bones of the skull, clavicle and mandible formed?

A

Intramembranous ossification

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71
Q

Which enzyme leads to calcification of the ECM?

A

Hydroxyapatite

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72
Q

Where are primary ossification centres found?

A

Diaphysis of weight bearing bones

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73
Q

In endochondral ossification, what does the mesenchyme develop into?

A

Chondroblasts (cartilage building cells)

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74
Q

Where are secondary ossification centres found?

A

Epiphyses of weight bearing bone

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75
Q

What is the difference between primary and secondary ossification sites

A

Primary found at diaphysis and forms bony structure all around. Develop as a foetus.

Secondary found and epiphysis and doesn’t lay bone down on articular surfaces and epiphyseal growth plate. Develop after birth

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76
Q

What are the 6 stages of fracture healing?

A

Haematoma

Granulation tissue

Callus

Woven bone

Lamellar bone

Remodelling

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77
Q

What are the 2 types of bone growth?

A

Longitudinal growth

Appositional growth

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78
Q

Where does longitudinal growth occur?

A

At the epiphyseal growth plates of weight bearing long bones

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79
Q

Name the 5 zones in the epiphyseal growth plate

A

Resting zone

Proliferation zone

Hypertrophic zone

Calcification zone

Ossification zone

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80
Q

In which zone of the epiphyseal growth plate to chondrocytes undergo mitosis?

A

Proliferation zone

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81
Q

What are cartilage cells called?

A

Chondrocytes

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82
Q

In which zone of the epiphyseal growth plate are chondrocytes stacked like coins in columns?

A

Proliferation zone

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83
Q

In which zone in the epiphyseal growth plate do chondrocytes die?

A

Calcification zone

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84
Q

In which zone in the epiphyseal growth plate do osteoprogenitor cells invade?

A

Ossification zone

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85
Q

What is the name given to a fracture of the epiphyseal growth plate?

A

Salter-Harris fracture

86
Q

What is a fracture?

A

A breach in the integrity of part or the whole of a bone

87
Q

What 3 factors aid fracture healing?

A

Stability of the fracture

Apposition of bone ends

Adequate blood supply

88
Q

What 4 factors delay fracture healing?

A

Excessive movement of bone ends

Poor blood supply

Infection

Foreign bodies

89
Q

What forms the ball and socket join of the hip?

A

Femoral head (ball)

Acetabulum of pelvis (socket)

90
Q

Name the 4 symptoms visible in a posterior hip dislocation

A

Limb shortened

Limb flexed

Limb adducted

Internal rotation

91
Q

Name the 2 symptoms visible in an anterior hip dislocation

A

Limb abduction

External rotation

92
Q

What makes up the bony pelvis?

A

Sacrum

2 hip bones

93
Q

What joints connects the sacrum to the 2 hip joints?

What type of joints are they?

A

Sacroiliac joints

Synovial joints

94
Q

What joints the anterior portions of the hip bones together?

What type of joint is this?

What are some common features of this type of joint?

A

Pubic symphysis

Secondary cartilaginous type joint

These joints are found typically in the midline and typically symphysis type joints e.g. IV discs

95
Q

What is a ligament?

A

Fibrous tissue that connects bone to bone

96
Q

What is a tendon?

A

Fibrous tissue that connects muscle to bone

97
Q

Where is the sacrospinous muscle?

A

Connects sacrum to spine of ischium

98
Q

Where is the sacrotuberous ligament?

A

Connects the sacrum to the ischial tuberosity

99
Q

What 2 foramen are made by the sacrospinous and sacrotuberous ligaments?

A

Great and lesser sciatic foramen

100
Q

Which muscle divides the greater sciatic foramen?

What is the function of this muscle?

A

Piriformis muscle

Lateral rotatory muscle of the hip

101
Q

What does the greater sciatic foramen connect with?

A

Pelvic cavity

Gluteal region

102
Q

What does the lesser sciatic foramen connect with?

A

Perineal region

Gluteal region

103
Q

Which 3 bones fuse together at the acetabulum?

A

Ilium

Ischium

Pubis

104
Q

Which muscles insert on the greater trochanter of the femur?

A

Gluteus medius

Gluteus minimus

105
Q

Which muscle has an attachment point at the lesser trochanter of the femur?

A

Iliopsoas muscle

a hip flexor muscle

106
Q

Along which bony prominence do all 3 thigh compartments attach?

A

Linea Aspera of the thigh (posterior)

107
Q

What 3 ligaments help stabalise and reinforce the external hip joint?

Can they be viewed anteriorly or posteriorly?

A

Iliofemoral
Pubofemoral
(anterior)

Isciofemoral
(posterior)

108
Q

Name the 3 layers of joints/connections around the hip joint from deep to superficial

A

Synovial membrane

Fibrous membrane

3 ligaments

109
Q

What would a valgus hip do to the knee?

A

Knee would move away from midline (bow legs)

110
Q

What would a varus hip do to the knee?

A

Move the knee towards the midline

111
Q

Name the 3 compartments of the thight

A

Anterior

Posterior

Medial

112
Q

What fascia covers all 3 compartments of the thigh?

A

Fascia lata

113
Q

What is the iliotibial tract?

A

Lateral thickening of fascia lata

114
Q

Which vein runs superficial to the fascia lata?

A

Saphenous vein

115
Q

Which large muscle inserts into the iliotibial tract?

A

Gluteus maximus

116
Q

What nerve innervates the gluteus maximus?

A

Inferior gluteal nerve

L5-S2

117
Q

What are the proximal attachments of the gluteus maximus?

A

Ilium

Sacrum

Sacral ligaments

118
Q

What are the distal attachments of the gluteus maximus?

A

Femur

Iliotibial tract (ITT)

119
Q

What nerve supplies gluteus medius?

A

Superior gluteal nerve

L4-S1

120
Q

What nerve supplies gluteus minimus?

A

Superior gluteal nerve

L4-S1

121
Q

Which muscles insert on the greater trochanter?

A

Gluteus medius

Gluteus minimus

122
Q

What sign is illicited when gluteus medius and minimus are damaged?

What nerve could be responsible?

A

Trendelenburg sign
-when patient lifts right leg, left hip droops as loss of stabilising muscles

Superior gluteal nerve

123
Q

Which nerves innervate the lateral rotators of the hip?

A

L4 - S2

124
Q

Which 4 muscles laterally rotate the hip?

A

Piriformis

Gemelli (superior + inferior)

Quadratus femoris

Obturator internus

125
Q

Which 3 muscles are in the posterior compartment of the thigh?

A

Semimembranous

Semitendinous

Biceps femoris

126
Q

What is the common point of origin for the hamstring muscles (posterior thigh compartment)?

A

Ischial tuberosity

127
Q

Where is the safe zone for IM injections in the gluteal region and how would you identify it?

A

Sits superolaterally

  1. Vertical line through highest point of iliac crest
  2. Line from PSIS to greater trochanter
128
Q

Which 4 muscles are found in the medial thigh compartment?

A

Pectineus

Adductor longus

Adductor magnus

Adductor brevis

129
Q

What are the 3 types of muscle?

A

Skeletal

Cardiac

Smooth

130
Q

Give 6 features of skeletal muscle

A

Cylindrical cells

Striated

Multinucleated

cm in length

Limited regeneration

Voluntary control

131
Q

Give 6 features of cardiac muscle

A

Branched cells with intercalated discs

Striated

Mono/binucleate

Length: 100 μm

No regeneration

Spontaneous contraction

132
Q

Give 6 features of smooth muscle

A

Spindle shaped

Central nucleus

Length: 20-200 μm

Regenerate

Vessels, hollow organs, glands

Regulated by ANS & endocrine system

133
Q

By what process do muscles get bigger?

A

Cell hypertrophy

134
Q

What is the epimysium?

A

A tough dense connective tissue that surrounds a muscle

135
Q

What smaller structures make up a muscle?

A

Muscle fascicles

136
Q

What covers the muscle fascicles?

A

Perimysium

137
Q

What is the perimysium?

A

Slightly lose connective tissue surrounding muscle fascicles

138
Q

What is contained within the perimysium?

A

Muscle fascicle

Blood vessels

Lymphatics

Nerves

139
Q

What smaller structures make up a muscle fascicle?

A

Muscle fibres

140
Q

What surrounds the muscle fibres?

A

Endomysium

thin lose connective tissue

141
Q

Why are muscle fibres sometimes called muscle cells?

A

Because they are individual muscles cells that have their membranes fused together to form multinucleated cells

142
Q

What is found in the endomysium?

A

Muscle fibres

Capillaries

Nerve fibres

143
Q

What makes up muscle fibres?

A

Myofibrils

144
Q

How are myofibrils arranged?

A

Arrangements of myofilaments (actin and myosin)

145
Q

What is a motor unit?

A

A motor neuron and the muscle fibres it innervates

146
Q

What is myasthenia gravis?

A

An autoimmune disease that effect the nicotinic acetylcholine receptors on post-synaptic membranes of muscle fibres

Affects extraocular muscles, facial muscles, bulbar muscles

147
Q

How would you test for myasthenia gravis?

A

Raise your finger up and see if the extraocular muscles start to droop and cause ptosis

148
Q

How is myasthenia gravis treated?

A

Acetylcholinesterase inhibitors

NEOSTIGMINE

149
Q

What is neostigmine and what is it used to treat?

A

Acetylcholinesterase inhibitor

Prevents the breakdown of acetylcholine so has more effect on the nicotinic acetylcholine receptors of muscles

Used to treat myasthenia gravis

150
Q

What is botulinum toxin and what can it cause?

A

Produced by C. botulinum

Degrades the protein complex that binds ACh vesicles to the presynaptic cell membrane

Results in total blockade of ACh release, causing flaccid paralysis

151
Q

What is the cell membrane of the muscle fibre called?

A

Sarcolemma

152
Q

What are invaginations in the sarcolemma (cell membrane) of the muscle fibres called?

A

T-tubules

153
Q

What are T-tubules closely aligned with?

What do these store?

A

Sarcoplasmic reticulum

Store calcium

154
Q

What is the name for the region in the middle of the sarcomere where thin and thick filaments overlop?

A

A band

155
Q

What is the name for a thick filament within a sarcomere?

A

Myosin

156
Q

What is the name for a thin filament within a sarcomere?

A

Actin

157
Q

What is found in the I band of a sarcomere?

How many per sarcomere?

A

Think actin filaments only

2 per sarcomere wither side of the A band

158
Q

What is the M line in a sarcomere?

A

The point at which thick myosin filaments connect with a cell membrane

159
Q

Which 3 proteins make up the thin filaments of muscle?

A

Actin

Tropomyosin

Troponin

160
Q

Which of the 3 proteins on a thin filament attaches to myosin?

A

Actin

161
Q

What protein surrounds actin?

What does it cover?

A

Tropomyosin

The myosin binding sites

162
Q

What protein is attached to tropomyosin?

What are its 3 parts?

A

Troponin

I
C
T

163
Q

What are the 3 parts of troponin responsible for?

A

Troponin I - helps tropomyosin block the myosin binding site on actin
INHIBITION

Troponin C - binds CALCIUM

Troponin T - aTTaches troponin to tropomyosin

164
Q

What protein is absent in Duchenne Muscular dystrophy?

A

Absence of dystrophin

165
Q

Name the most dorsal vein in the foot

A

Doral venous arch

166
Q

What 2 branches does the dorsal venous arch give off?

A

Small saphenous vein

Great saphenous vein

167
Q

Where does the small saphenous vein run near to?

A

Runs laterally from the dorsal venous arch of the foot

Goes behind the lateral malleolus

168
Q

Where does the great saphenous vein run near to?

Why is the great saphenous important to remember?

A

Runs medially from the dorsal venous arch of the foot

Goes in front of the medial malleolus

Can be used for grafting

Venous cut-down cannulation access if no other access available e.g. burns to rest of the body

169
Q

Describe the course of the great saphenous vein from distal to proximal

What nerve does it ascend near?

A

Dorsal venous arch of the foot

Ascends medially at the ankle

Anterior to the medial malleolus

Along the posterior region of the medial tibial border alongside saphenous nerve

Passes 7-10cm posterior to the patella

Passes through the saphenous opening lateral and inferior to the pubic tubercle

Joins the femoral vein in the femoral triangle

Ascends near the SAPHENOUS NERVE

170
Q

Describe the course of the short saphenous vein from distal to proximal

What nerve does it ascend near?

A

Dorsal venous arch of the foot

Ascends laterally at the ankle

Runs posterior to the lateral malleolus

Ascends midline posterior leg alongside sural cutaneous nerve

Travels deep into popliteal fossa via crural fascia and into popliteal vein

Ascends near the SURAL CUTANEOUS NERVE

171
Q

Where do the greater and small saphenous veins join deep veins, and what veins do they join?

A

Greater saphenous vein

  • saphenous opening in the femoral triangle
  • joins the femoral vein

Small saphenous vein

  • popliteal fossa
  • joins popliteal vein
172
Q

What 4 muscles form the border of the popliteal fossa?

A

Lateral above the knee
- biceps femoris

Medial above the knee

  • semimembranous
  • semitendonous

Below the knee
- lateral and medial heads of the gastrocnemius

173
Q

What nerve descends through the popliteal fossa?

A

Sciatic nerve

174
Q

Which muscle sits on the anterior border of the popliteal fossa?

A

Plantaris

175
Q

What 2 nerves does the sciatic nerve split into?

How do they descend in relation to the sciatic?

A

Common fibular nerve
- superficial and laterally

Tibial nerve
- medially and deep

176
Q

Which 2 muscles insert into the greater trochanter of the femur? What do they do?

A

Gluteus medius and minimus

Stable the lower limb during walking

177
Q

What muscle inserts into the lesser trochanter of the femur?

A

Iliopsoas

Hip flexion

178
Q

What attaches at the linea aspera (femur)?

Where is it?

A

3 intermuscular septa (compartments of the thigh)

Attachment point for many thigh muscles

179
Q

What is Wolff’s Law?

A

Bone is deposited and reabsorbed in accordance with the stresses placed upon it

180
Q

What is the acetabular labrum?

A

Horseshoe shaped fibrocartilage rim of tissue that surrounds the acetabulum

(Pelvic portion of hip joint)

181
Q

What 3 ligaments reinforce the hip joint?

What do they sit on top of?

When are the ligaments the tightest?

A

Iliofemoral

Pubofemoral

Ischiofemoral

Sit on top of synovial membrane and fibrous membrane

Tightest when standing

182
Q

Describe the blood supply to the femoral head

A

Deep femoral artery gives off medial and lateral femoral circumflex arteries

Anastomose to form circumflex femoral arteries that flow back up towards the femoral head

183
Q

What divides the greater sciatic foramen?

A

Piriformis muscle

184
Q

What structures pass through the greater sciatic foramen above the piriformis?

A

Superior gluteal nerve

185
Q

What structures pass through the greater sciatic foramen below the piriformis?

A

Sciatic nerve

Inferior gluteal nerve

Posterior femoral cutaneous nerve

Quadratus femoris nerve

186
Q

Give the root values of the superior gluteal nerve

A

L4 - S1

187
Q

Give the root values of the superior gluteal nerve

What does it supply?

A

L4 - S1

Gluteus medius
Gluteus minimus

188
Q

Give the root values of the interior gluteal nerve

A

L5 - S2

Gluteus maximus

189
Q

Which ligament separates the greater and lesser sciatic foramen?

A

Sacrospinous ligament

190
Q

When the distal part of a limb points laterally, what is this type of deformity called?

A

Valgus

l - laterally

191
Q

When the distal part of a limb points medially, what is this type of deformity called?

A

Varus

thrust towards

192
Q

Which vein runs superficial to the iliotibial tract?

lateral aspect of the thigh

A

Saphenous veins

193
Q

Which large muscle inserts into the ITT?

A

Gluteus maximus

194
Q

Which nerves arise from the sacral plexus?

What are their root values?

A

Superior gluteal nerve (L4 - S1)

Inferior gluteal nerve (L5 - S2)

Posterior cutaneous nerve of thigh (S1 - S3)

Pudendal nerve (S2 - S4)

Sciatic nerve (L4 - S3)

195
Q

Which 4 muscles laterally rotate the hip?

A

Obturator internus

Quadratus femorus (S + I)

Gemilli

Piriformis

196
Q

How do you find the safe zone for IM injections in the gluteal region?

A

Vertical line through highest point of iliac crest

Line from PSIS to greater trochanter

Superiorlaterally to the 2 lines

197
Q

What are the borders of the adductor canal?

In which compartment is the adductor canal found?

What are the contents of the adductor canal?

A

Sartorius
Vastus medialis
Adductor longus/magnus

Anterior compartment of the thigh

Saphenous nerve
Superficial femoral artery
Superficial femoral vein

198
Q

Which muscle is a powerful flexor of the hip that inserts onto the lesser trochanter?

A

Iliopsoas

199
Q

Which 3 muscles form the pes anserinus tendon?

Where does it insert?

A

Sartorius

Gracilis

Semitendonous

Medial aspect of the tibia

200
Q

The subclavian nerve passes ______ to the middle scalene

A

Anterior

201
Q

The subclavian vein passes _______ to the anterior scalene

A

Anterior

202
Q

What structures passes through the quadrangular space?

Humerus

A

Axillary nerve

Posterior circumflex artery

203
Q

What is the anatomical order in which a needle must pass in order to reach CSF during a spinal anaesthetic?

A

Skin

Supraspinous ligament

Interspinous ligament

Ligamentum flavum

Epidural space

Subdural space

Subarachnoid space

204
Q

Which rotator cuff muscle causes internal rotation?

A

Subscapularis

205
Q

Where do the movements of inversion and eversion of the foot take place?

A

At the talonavicular joint

206
Q

Which nerve supplies the pectoralis major?

What does this muscle do?

A

Medical and lateral pectoral nerve

Adducts and medially rotates the shoulder

207
Q

Which nerve supplies the pectoralis minor?

What does this muscle do?

Where do the 3 heads of pec minor insert into?

A

Medial pectoral nerve

Depresses and protracts the scapula

Ribs 3, 4, 5

208
Q

Which nerve supplies the deltoid muscle?

How can this nerve be damaged?

A

Axillary nerve

Shoulder dislocation
Surgical neck of humerus #
IM injection

209
Q

What are the 4 borders of the axilla?

A

Anterior - anterior axillary fold and pectoral muscles

Posterior - posterior axillary fold, subscapulaaris and scapula

Medial - serratus anterior and lateral thoracic wall

Lateral - intertubercular groove

210
Q

Which nerve supplies sorratus anterior?

Where does this muscle go to/from?

How would damage in a patient show/what test would you do?

A

Long thoracic nerve

Medial scapula border - ribs 1-8

If broken, scapula will ‘wing’ - get patent to put hands on wall and lean in

211
Q

Which nerve supplies the anterior compartment of the arm?

A

Musculocutaneous (radial/brachialis)

212
Q

Which nerve supplies the posterior compartment of the arm?

A

Radial nerve

Block 4 (11 decks)

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