Anatomy II MT1 Flashcards
Other names for hip bone
os coxae, innominate bone
Obdurator foramen formed by fusion of
Ishium and pubis
Does the iliac fossa face more medial or lateral?
Medial, iliacus attaches
What type of joint is the sacroiliac joint?
1) Synovial (inferior)- auricular surfaces of ilium and sacrum, hyaline cartilage, capsule with synovial fluid. 2) Syndesmosis (posterior and superior) fibrous, thick bands of CT
Describe ventral and dorsal sacroiliac ligaments
Thickened regions of the sacroiliac joint capsule. Part of SI joint
Describe the interosseus sacroiliac ligament
Between iliac tuberosity and sacrum, syndesmotic portion of SI joint
Describe the sacrotuberous ligament
Sacrum to ischial tuberosity (forms lesser sciatic notch), part of SI joint
Describe the sacrospinous ligament
Sacrum to ischial spine (forms greater sciatic notch), part of SI joint
Describe the iliolumbar ligament
From iliac crest to TVP of L5, limits rotation and anterior gliding of L5 in relation to sacrum, limits side bending of L5 in relation to pelvis
What contributes to stability of the sacrum?
Downward compression of the sacrum (weight of upper body) causes interosseus ligaments to pull ilium bones together to tighten joint.
What limits anterior sacral rotation?
Ligaments: sacrotuberous, sacrospinous, and interosseus sacroiliac
What is nutation?
Rotation or tilting of sacrum around axis through interosseus ligaments
Describe anterior nutation
Sacral promontory moves inferior and anterior, coccyx moves superior and posterior
How does nutation affect the size of the pelvic outlet?
Nutation brings the iliac crests closer together and the ischial tuberosities further apart, increasing the size of the pelvic outlet.
What type of joint is the hip joint?
Synovial ball and socket
Describe the ligaments of the hip joint
1) Transverse acetabular ligament - enlarges articular surface? 2) Ligamentum teres of head of femur - from head of femur to transverse acetabular ligament
Three ligaments that are the main stabilizers of the hip joint? Which one is most important?
1) Iliofemoral - limits hyperextension of the femur (resists body falling back) Y ligament of Bigelow 1 is MOST IMP 2) Ischiofemoral - reinforces hip capsule posteriorly, 3) Pubofemoral - reinforces hip capsule inferiorly
What happens to all three ligaments when the hip is extended?
They wind around the hip joint and tighten
What does the pubofemoral ligament do?
Limit abduction
What limits flexion of the hip joint
Hamstring muscles
What are the implications of the epiphyseal plate to blood circulation in long bones?
Impedes blood circulation between head and neck, supplied by different arteries
What disrupts the femoral epiphyseal arteries?
Corticosteroids, trauma, fracture, dislocation
Describe blood supply to the femoral neck
Medial and lateral epiphyseal arteries. Medial is posterior, Lateral is anterior. The lateral arises from the medial femoral circumflex artery.
What muscle is important relative to the location of the sciatic nerve?
Piriformis, usually sciatic passes below, but can pass above or poke through
What structures do iliohypogastric and ilioinguinal nerves innervate?
Lower ab muscles and skin
What structures does genitofemoral nerve innervate?
Cremaster muscle and thigh skin
What structure does lateral cutaneous nerve to thigh innervate
Lateral thigh skin
What nerves make up the sacral plexus?
Ventral rami from L4,5 and S1,2,3
Describe the roots and branches of the sciatic nerve
Roots: L4,5 and S1,2,3
Branches: Tibial nerve, Common Fibular nerve
Roots of superior gluteal nerve
L4,5 S1
Roots of inferior gluteal nerve
L5, S1,2
Describe roots and innervations of Pudendal nerve
Roots: S2,3,4
Innervations: Anal and urethral sphincters, external genitalia
Roots of posterior cutaneous nerve to thigh
S1,2,3
Roots of nerve to quadratus femoris?
L4,5, S1
Roots of nerve to obdurator interus?
L5, S1,2
What does the sciatic nerve innervate?
hamstrings, 1/2 adductor magnus, muscles of leg/foot
Does the superior gluteal nerve exit superior or inferior to the piriformis muscle? What about the inferior gluteal nerve?
Superior exits superior, inferior exits inferior
Describe the path of the femoral nerve
Through psoas major, inguinal ligament, into thigh, splits into anterior and posterior
Describe the path of the obdurator nerve
Through psoas major, behind common iliac arteries, on lateral side of int. iliac artery and ureter, along the lateral wall of the lesser pelvis to the upper part of the obturator foramen.
Valgus alignment
knock-kneed
Varum alignment
Bow-legged
What is the Pes anserinus
Common insertion of Sartorius, gracilis, and semitendinosus. Medial tibia, deep fascia of the leg
What is the function of the Pes anserinus?
Help stabilize knee posture during partial flexion of the knee
What is a common pathology of the pes anserinus?
Pes anserinus bursitis is a common source of knee pain, usually seen in young adult, physically active individuals, and older adults with osteoarthritis.
What bones make up the knee joint?
2 articulations: 1) femur and tibia, 2) femur and patella. The fibula is not part of the knee joint.
What type of joint is the knee joint?
Pivot hinge (mobile troche-ginglymus). Synovial (covered by fibrous articular capsule.
Function of anterior cruciate ligament?
Limit hyperextension of knee and posterior displacement of femur on tibia
Function of posterior cruciate ligament?
Prevent anterior displacement of femur
Which collateral ligament of the knee does not make contact with the knee joint?
Fibular collateral ligament
What are the functions of the collateral ligaments of the knee?
Limit medial (interior) and lateral (exterior) rotation of the knee. Also resist valgus and varus stresses.
Which bone of the knee joint has articular discs (menisci)?
Tibia
What is the terrible triad?
Anterior cruciate ligament, medial collateral ligament, and medial meniscus
What produces this injury?
Lateral force to knee with foot flexed in external rotation
Describe Oblique popliteal ligament
Extension of semimembranosus, strengthens post. articular capsule, forms floor of popliteal fossa
Describe the 3 knee bursas
1) suprapatellar, bet. femur & quadriceps tendon, 2) prepatellar “housemaid’s knee” 3) infrapatellar “clergyman’s knee”
What is a Baker’s cyst?
swelling of semimembranous bursa
In what position is the knee locked?
In full extension the knee is locked by rotating the femur medially on the tibia. This medial rotation is due to the lateral femoral condyle moving posteriorly in the lateral tibial condyle
What is the clinical significance of a locked knee?
Both the medial and lateral meniscus are compressed and vulnerable to injury when the knee is locked
Describe inferior tibiofibular joint
Fibrous, syndesmosis, held together by (1) anterior tibiofibular lig. (2) posterior tibiofibular lig. (3) interosseus membrane
Describe ankle joint
Hinge, synovial between tibia fibula and talus. Fibula does not bear weight. Allows for plantar flexion and dorsiflexion of foot
What are the ligaments of the ankle joint?
Deltoid ligament, Anterior and Posterior talofibular, Calcaneofibular
Describe the deltoid ligament
Medial ankle, extends from medial malleolus to navicular, calcaneus and talus, resists eversion of foot
What is the function of the anterior and posterior talofibular and calcaneofibular ligaments?
Lateral ankle, resists inversion of foot
Which is more common, an eversion or inversion sprain? Why?
Inversion, because the lateral malleolus is more inferior than the medial malleolus and the deltoid ligament is stronger than the lateral ligaments.
What is the spring ligament?
Spans between calcaneus and navicular, prevents talus from wedging bones apart
Describe the talo-calcaneo-navicular joint?
Head of talus inserts between navicular and calcaneus
Describe talo-calcaneal joint
Talus rests on calcanues
What joints are involved in inversion and eversion?
talo-calcaneo-navicular and talo-calcaneal joints
Describe the calcaneo-cuboid joint
Long plantar ligament, calcaneus to metatarsals 2-5
The long plantar ligament forms a tunnel for what structure?
Fibularis longus tendon
Describe the short plantar ligament
From calcaneus to cuboid
What connects the metatarsal-phalangeal (MTP) joints of all 5 digits?
Deep tranverse ligament
What muscles help to maintain standing posture?
Soleus and erector spinae
Which tendons cross as they enter the foot?
Tendons of flexor hallucis and digitorum longus
Injury of the common fibular nerve causes what?
Foot drop, loss of dorsiflexion and eversion
What muscle does the Common Fibular nerve pass through?
Fibularis longus
What area does the superficial fibular nerve innervate?
lateral compartment, fibularis longus and brevis
What area does the deep fibular nerve innervate?
anterior compartment, tibialis anterior, extensor digitorum and halluces longus and brevis, fibularis tertius
What muscles are innervated by the tibial nerve?
Posterior compartment, gastrocnemius, soleus, flexors digitorum and hallucis longus, tibialis posterior
What nerve root is tested by the patellar reflex test?
L4 nerve root
What nerve root is tested by the Achilles reflex test?
S1 nerve root
What muscles dorsiflex the foot?
Tibialis anterior, extensor digitorum and extensor hallucis longus, fibularis tertius
What muscles plantar flex the foot?
Tibialis posterior, flexor digitorum and flexor halluces longus, fibularis longus and brevis
The Achilles tendon continues under the foot in what structure? What is the origin and insertion?
Plantar fascia/aponeurosis. Extends from anteromedial calcaneus to heads of metacarpals
What is plantar fasciitis?
Inflammatory condition usually localized at calcaneal attachment (and other areas). Calcaneal spurs (with bursa) can develop.
What are embedded within tendons of flexor halluces brevis? Why?
Sesamoid bones. Protects tendon of flexor hallucis longus
What is innervated by the medial plantar nerve?
Muscles of sole of foot and skin of Medial 3 1/2 digits
What is innervated by the lateral plantar nerve?
Muscles of sole of foot and Lateral 1 1/2 digits
Acupressure on what area can relieve headaches?
1st dorsal interosseus (LV3)
Describe the arches of the foot
1) transverse 2) internal (medial) longitudinal 3) external (lateral) longitudinal
If you break your medial cuniform and MT 1 and 2, what arch might be affected?
Medial longitudinal
If you injure your spring ligament, would you most likely have eversion or inversion of the foot?
Eversion
The lateral longtidual arch is supported by what CT and muscles?
CT: plantar aponeurosis, short and long plantar ligaments
M: Abductor digiti minimi, fib. brevus, longus, and tertius
The transverse arch is supported by what CT and muscles?
CT: deep transverse ligaments
M: fib. longus and adductor hallucis
