Anatomy Division 1 Flashcards
posterior (dorsal) primary rami innervate…
intrinsic back muscles and skin(tiny nerve branch)
anterior (ventral) primary rami innervate…
limbs and trunk(large remaining portion of spins nerve)get named!
afferent
sensory nerveDORSAL ROOTScell bodies in dorsal root ganglion
efferent
motor nerveVENTRAL ROOTScell bodies in spinal cord
acetabulum is made up by how many bones?
3 (ilium, ischium, pubis)
acetabulum is lined with ___ cartilage
hyaline
acetabular labrum is made from ____
fibrocartilage
where is acetabular notch
inferior aspect
name the 3 main ligaments of the hip and their function
iliofemoral ligament (Y ligament) - prevents hyperextension
pubofemoral - prevents hyperabduction
ischiofemoral - prevents hyperflexion
inguinal ligament path
ASIS to pubic tubercle
blood supply to the head of the femur (2)
- artery to the head of the femur
2. retinacular aa. (from circumflex femoral artery – majority medial circumflex a.)
lumbosacral plexus nerves (levels, 1 sensory, 3 motor)
(L1-S4)
sensory: clunial nn. (middle out of holes of sacrum)
motor: superior gluteal, inferior gluteal, sciatic
hip extensors (3)
glutei max, min, med (superficial group)
deep hip muscles (5)
piriformis, superior gemellus, obturator internus, inferior gemellus, quadrates femoris
-THESE ARE SUPERIOR TO INFERIOR-
Gluteus Maximus m.
O: posterior ilium, sacrum, sacrotuberous ligament
I: IT band and gluteal tuberosity
A: hip extension (esp. in hip flexion), and hip ER
I: inferior gluteal n. (L5, S1, S2)
Gluteus Medius & Minimus mm.
O: external surface of ilium
I: med-lateral aspect, min - anterior aspect of greater troch
A: hip ABD and IR
I: superior gluteal n. (L4, L5, S1)
TFL m.
O: ASIS and iliac crest
I: ITB
A: ABD and hip flex
I: superior gluteal n. (L4, L5, S1)
superior gluteal nerve injury –>
positive trendelenburg
piriformis m.
O: anterior sacrum (through greater sciatic foramen)
I: greater trochanter (superomedial)
A: Hip ER and ABD
I: n. to piriformis
superior gemellus m.
O: ischial spine
I: trochanteric fossa
A: hip ER
I: n. to obturator internus
obturator internus m.
O: obturator membrane
I: trochanteric fossa
A: hip ER
I: n. to obturator internus
inferior gemellus m.
O: ischial tuberosity
I: trochanteric fossa
A: hip ER
I: n. to quadrates femoris
quadrates femoris m.
O: ischial tuberosity
I: quadrate tubercle on intertrochanteric crest
A: hip ER
I:n. to quadrates femoris
piriformi anatomical relationships superior –> inferior
superior gluteal artery and nerve, piriformis, sciatic nerve, inferior gluteal nerve and artery
three thigh compartments
anterior, medial, posterior
Levels and divisions of the sciatic nerve
(L4-S3)
tibial division and fibular division
splits in popliteal fossa
Biceps Femoris m.
O: ischial tuberosity (long head) & linea aspera (short head)
I: head of fibula
A: extends hip, flexes knee, leg ER
I: sciatic n. (tibial division for long head & fibular division for short head)
Semimembranosus m.
O: ischial tuberosity
I: posteromedial tibia
A: extend hip, flex knee, IR leg
I: tibial division of sciatic n.
Semitendinosus m.
O: ischial tuberosity
I: medial proximal tibia
A: extend hip, flex knee, IR leg
I: tibial division of sciatic n.
popliteal fossa borders
superolateral: biceps femoris
superomedial: semimembranosis
inferolateral: lateral head of gastrocnemius
inferomedial: medial head of gastric
floor: femur and popliteus
popliteal fossa contents (4)
- small saphenous v. draining into popliteal v.
- popliteal a.
- tibial and common fibular nn.
- posterior cutaneous n. of the thigh
genicular anastomosis contains 4 arteries
superior and inferior genicular aa.
medial and lateral of both
LE myotomes
L1-L2: Hip flexion L3: Knee Extension L4: Ankle DF L5: great toe extension S1: ankle PF and eversion S2: knee flexion
Which cutaneous nerve innervates the anterior thigh?
anterior cutaneous branches of femoral n. (L2-L4)
Which cutaneous nerve innervates the lateral thigh?
lateral femoral cutaneous n. (L2-L3)
Which cutaneous nerve innervates the medial leg?
saphenous n. (L3-L4)
distal extent of the femoral nerve
Innervation of anterior compartment of the thigh?
femoral n. (L2-L4)
except posts major = anterior rami of L1-L3
iliopsoas m.
O: psoas major: T12-L5 vertebrae iliacus: iliac fossa I: lesser trochanter A: main hip flexor
sartorius m.
O: ASIS
I: proximal anteromedial tibia
A: hip flexion, ER, ABD, knee flexion
quariceps femoris m.
Rectus femoris: AIIS
vastus lateralis: greater trochanter, lineament aspera
vastus medialis linea aspera
vastus intermedius: anterior shaft of femur
I: quad tendon to tibial tuberosity
A: knee extension and hip flexion for rectus femoris
muscles of the medial thigh compartment (6)
&action, innervation, blood supply
pectineus adductor longus adductor brevis adductor Magnus gracilis obturator externes
A: hip adduction
I: obturator n. (L2-L4)
blood supply: obturator a.
pectineus m.
O: superior pubic ramus
I: pectineal line of femur
A: medial adducts, superficial flexes hip
adductor longus m.
O: body of pubis
I: linea aspera
adductor brevis m.
O: body of pubis & inferior pubic ramus
I: Lena aspera
runs deep to longs and pectineus
adductor Magnus m.
O: ischiopubic ramus, ischial tuberosity
I: linea aspera, adductor tubercle
has a hamstring portion that extends hip (tibial division of sciatic n.)
gracilis m.
O: body of pubis, inferior pubic ramus
I: proximal anteromedial tibia
A: adducts hip, flexes knee
!only adductor to cross the knee!
Pes anserinus
SAY GRACE BEFORE TEA sartorius gracilis bursa semitendinosus
obturator nerve terminates as
cutaneous branch that innervates the medial thigh
vasculature of the thigh
femoral a. (deep a. of thigh branch–> circumflex femoral a.) –> popliteal a. at adductor hiatus
femoral triangle relationships
superior: inguinal ligament
lateral: sartorius m.
medial: adductor longus m.
floor: iliopsoas and pectineus
contains: femoral VAN
Innervation of the knee(2)
- obturator n.
2. saphenous nn.
what nerve innervates the posterior and lateral leg?
sural nere
innervation of the anterior compartment of the leg mm.?
deep fibular n. (L4-S2)
innervation of the lateral compartment of the leg mm.?
superficial fibular n. (L5-S2)
innervation of the posterior compartment of the leg mm.?
tibial n. (L4-S3)
superficial (S1-S2)
deep (L4-S3)
blood supply of anterior compartment of the leg?
anterior tibial a.
blood supply of lateral compartment of the leg?
perforating branches of fibular and anterior tibial aa.
blood supply of posterior compartment of the leg?
posterior tibial and fibular aa.
tibialis anterior m.
O: proximal, lateral tibia and interosseous membrane
I: medial cuneiform and base of 1st met
A: DF and inversion
*helps support medial arch of the foot
extensor hallucis longus m.
O: anterior fibula and interosseous membrane
I: base of distal phalanx of great toe
A: DF and great toe extension
extensor digitorum longus m.
O: proximal fibula, interosseous membrane, lateral tibial condyle
I: middle and distal phalanges of 2-5
A:extends digits, DF and weak eversion
fibularis tertius m.
O: distal fibula and interosseous membrane
I: base of 5th met
A: DF and eversion
not very strong
fibularis longus m.
O: proximal, lateral fibula
I: plantar surface of base of 1st met and medial cuneiform
A: eversion, weak PF
fibularis brevis m.
O: distal 2/3 of lateral fibula
I: base of 5th met
A: eversion, weak PF
*common site for avulsion fracture
gastrocnemius m.
O: posterior surface, superior to respective condyle
I: through calcanea tendon to posterior calcareous
A: PF and weak knee flexion
plantaris m.
O: lateral supracondylar ridge of femur
I: attaches via calcanea tendon
A: weak PF and knee flexor
soles m.
O: soleal line on posterior tibia and posterior fibula
I: calcaneal tendon
A: PF
popliteus m.
O: lateral femoral condyle
I: posterior surface of proximal tibia
A: weak knee flexor, IR of leg or ER of femur when fixed
tibialis posterior m.
O: psoterior tibia, fibula, interosseous membrane
I: navicula, cuneiforms
A: inversion, PF
*helps support medial arch
flexor digitorum longus m.
O: posterior surface of tibia
I: distal phalanges of lateral 4 toes
A: flexes lateral 4 toes
flexor hallucis longus m.
O: distal fibula, interosseous membrane
I: distal phalanx of great toe
A: flexes great toe
medial ankle relationship
Tom Dick And Nervous Harry Tibialis posterior m. flexor digitorum longus m. posterior tibial artery tibial nerve flexor hallucis longus m.
sural n. comes from
common fibular and tibial nn.
vasculature of the leg
popliteal a. –> anterior tibial artery (enters through ant. compartment) –> dorsals pedis a. after crossing ankle
popliteal a. –> posterior tibial a. –> divides into medial and lateral plantar aa.
ligaments of the lateral ankle (3)
- anterior talofibular ligament (flat and weak)
- calcaneofibular ligament
- posterior talofibular ligament
ligaments of the medial ankle
deltoid ligament
- anterior and posterior tibiotalar parts
- tibionavicular part
- tibiocalcaneal part
ankle joint innervation
tibial n. and deep fibular n.
extensor digitorum brevis m.
O: superolateral surface of calcaneus
I: tendons of the EDL and extensor hoods
A: extension of toes 2-4
I: deep fibular n.
Extensor Hallucis Brevis m.
O: superolateral surface of calcaneus
I: proximal phalanx of great toe
A: extend MTP joint of great toe
I: deep fibular n.
Abductor Hallucis m.
O: calcaneus
I: proximal phalanx of great toe
A: abducts great toe
I: MEDIAL PLANTAR n.
What nerve innervates plantar intrinsic m. of the foot
lateral plantar n. EXCEPT 4 are medial plantar n.
flexor digitorum brevis m.
O: calcaneus
I: middle phalanges of 2nd-5th digit
A: flexes MTP and PIP
I: MEDIAL PLANTAR n.
Abductor digiti minimi m.
O: calcaneus
I: proximal phalanx of 5th digit
A: abducts 5th digit
I: lateral plantar n.
Muscles of the layers of the plantar foot
1st:
-abductor hallucis
-flexor digitorum brevis
-abductor digiti minimi
2nd:
-quadratus plantae
-lumbricals
3rd:
-flexor hallucis brevis
-adductor hallucis
-flexor digiti minimi brevis
4th:
-plantar interossei
-dorsal interossei
quadrates plantae m.
O: calcaneus
I: tendons of flexor digitorum longus
A: assists with flexion of digits
I: lateral plantar n.
lumbrical mm.
O: tendons of flexor digitorum longus I: medial side of extensor expansions A: flexes MTP joints and extends IP joints of 2-5 I: -1st =MEDIAL PLANTAR n. -2-4 = lateral plantar n.
flexor hallucis brevis m.
O: cuboid and lateral cuneiform
I: proximal phalanx of great toe
A: flexes MTP of great toe
I: MEDIAL PLANTAR n.
adductor hallucis m.
transverse and oblique head
deep branch of lateral plantar n.
flexor digiti minimi brevis m.
O: base of 5th met
I: proximal phalanx of 5th
A: flexes MTP of 5th
I:superficial branch of lateral plantar n.
plantar interossei mm.
unipennate
PAD
I: lateral plantar n.
dorsal interossei mm.
bipennate
DAB
I: lateral plantar n.
superficial fibular n. (m and s)
motor: lateral compartment of the leg
sensory: dorsum of foot
deep fibular n. (m and s)
motor: anterior compartment of leg, dorsum of foot
sensory: between 1st and 2nd digit only
medial plantar n. (m and s)
motor:
- abductor hallucis m.
- flexor digitorum brevis m.
- 1st lumbrical m.
- flexor hallucis brevis m.
sensory: medial aspect of sole of foot
lateral plantar n. (m and s)
motor: lateral intrinsic foot mm. (all the rest)
sensory: lateral aspect of sole of foot
common plantar/dorsal digit l nn. (on mets) –>
proper plantar/dorsal digital nn. (on phalanges)
arteries of dorsum of the foot
anterior tibial a. –> dorsal pedis a. –>
gives off lateral tarsal artery proximally, deep plantar artery goes down to meet deep plantar arch, and arcuate artery (that connects to lateral tarsal artery) –> dorsal metatarsal aa. –> dorsal digital aa.
posterior tibial artery –> lateral plantar artery –>
- deep plantar arch –> plantar metatarsal arteries and deep plantar artery
- common plantar digital arteries –> proper plantar Digital arteries
posterior tibial artery –> medial plantar artery –>
common plantar digital arteries –> proper plantar digital arteries
spring ligament
plantar calcaneonavicular
-supports head of talus to maintain longitudinal arch
long plantar ligament
- calcaneus to cuboid and MT bases (creates tunnel for PL)
- maintains longitudiinal arch
short plantar ligament
plantar calcaneocuboid
-maintains longitudinal arch
