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G2 2017-2018 > Anatomy - Limbs > Flashcards

Anatomy - Limbs Flashcards

1
Q

What are skeletal muscles attached to?

A

Attached to bones or skin

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2
Q

Describe the cell shape and appearance of skeletal muscle.

A

Single, very long, cylindrical, multinucleated cells with obvious striations

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3
Q

Describe the cell shape and appearance of cardiac muscle.

A

Branching chains of cells, uni or bi-nucleated and have some striations

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4
Q

Describe the cell shape and appearance of smooth muscle.

A

Single, fusiform, uninucleated, no striations

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5
Q

What is the only movement that a skeletal muscle can do? Explain how.

A

Shortening by moving the insertion closer to the origin

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6
Q

What is the origin of a muscle?

A

Attachment point that is NOT moved during a contraction

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7
Q

What is the insertion of a muscle?

A

Attachment point that is moved during a contraction

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8
Q

What can you predict if you know the origin and insertion of a muscle?

A

Its action

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9
Q

What is necessary for a muscle to be a able to move a joint?

A

It needs to cross it

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10
Q

What is necessary for a muscle to be a able to move a bone?

A

It needs to be attached to it

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11
Q

How are the limbs organized?

A

Muscle compartments separated by deep fascia/connective tissue that is stiff

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12
Q

What do the muscles in one muscle compartment in a limb have in common?

A

They usually work together to produce similar actions and usually have a common innervation and vascularization

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13
Q

What happens if the pressure increases within a muscle compartment of a limb? What is this called? What can this lead to?

A

Compression of nerve and blood supply of that compartment = compartment syndrome => tissue necrosis

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14
Q

What kind of patients get compartment syndrome?

A
  1. Athletes2. Trauma
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15
Q

Treatment of compartment syndrome?

A

Fasciotomy

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16
Q

What are the 6 parts of upper limbs?

A
  1. Axilla2. Arm3. Elbow joint/cubital fossa4. Forearm5. Wrist joint6. Hand
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17
Q

How many compartments in arm? List them.

A
  1. Anterior2. Posterior
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18
Q

How many compartments in forearm? List them.

A
  1. Anterior deep2. Anterior superficial3. Posterior deep4. Posterior superficial
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19
Q

What are the 7 parts of lower limbs?

A
  1. Gluteal region2. Hip joint3. Thigh4. Knee joint and popliteal fossa5. Leg6. Ankle7. Foot
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20
Q

How many compartments in thigh? List them.

A
  1. Anterior 2. Posterior3. Medial
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21
Q

How many compartments in leg? List them.

A
  1. Posterior superficial2. Posterior deep3. Lateral4. Anterior
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22
Q

What are the 3 types of mesoderm (from closest to farthest from notochord)? Which 2 do limbs mainly come from?

A
  1. Paraxial2. Intermediate3. Lateral plate
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23
Q

What does the paraxial mesoderm give rise to?

A

Somites

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24
Q

What does the intermediate mesoderm give rise to?

A

Urogenital structures

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25
Q

What does the lateral plate give rise to?

A
  1. Somatic mesoderm2. Splanchnic mesoderm
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26
Q

What does the somatic mesoderm give rise to?

A
  1. Limb skeleton and connective tissues2. Parietal serous membranes
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27
Q

What does the splanchnic mesoderm give rise to?

A
  1. Smooth muscle in internal organs2. CV system3. Visceral serous membrane
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28
Q

What does each somite form?

A
  1. Dermatome2. Myotome3. Sclerotome
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29
Q

What are somites?

A

Bilaterally paired blocks of paraxial mesoderm that form along the neural tube of the developing embryo

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30
Q

What will the sclerotomes give rise to?

A

Vertebral column + skull

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31
Q

What will the dermatomes give rise to?

A

Dermis of skin in back

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32
Q

What will the myotomes give rise to?

A

Skeletal muscles of the body:1. Epimere2. Hypomere

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33
Q

What will the epimere give rise to?

A

Epaxial skeletal muscles = deep back skeletal muscles

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34
Q

What will the hypomere give rise to?

A

Hypaxial skeletal muscles = 1. Abdominal and thoracic wall skeletal muscles2. Superficial back muscles3. Limb skeletal muscles

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35
Q

Which layer of the skin is innervated?

A

Dermis

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36
Q

What are the epimere muscles innervated by?

A

Dorsal rami

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37
Q

What are the hypomere muscles innervated by?

A

Ventral rami

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38
Q

When do limbs start budding in embryologic development?

A

4 to 5 weeks

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39
Q

Which form first in an embryo: upper or lower limbs?

A

Upper limbs

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40
Q

Describe the budding of limbs in embryologic development.

A
  1. Tissue from lateral plate mesoderm migrates and forms the blood vessels, bone, cartilage, and connective tissue of the limbs 2. Hypomere migrates from myotome and forms skeletal muscles on either side of the connective tissue and bones = compartment formation 3. Signaling factors form the proximal/distal, anterior/posterior, and medial/lateral axes of the limbs 4. Endochondral ossification: cartilaginous bones ossify 5. Limbs rotate: upper limbs do so laterally and lower limbs do so medially
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41
Q

What are teratogens?

A

Agents that cause defects in embryonic development

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42
Q

What is the relationship between muscles on opposite side of a bone?

A

Usually perform opposing actions

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43
Q

What used to be a very common embryological limb defect?

A

Thalidomide was being prescribed to pregnant women for nausea in first trimester in the 70s and caused the hand to develop from the proximal portion of the arm

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44
Q

What are the 3 types of back muscles?

A
  1. Superficial2. Intermediate3. Deep
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45
Q

What is another name for deep back muscles?

A

Intrinsic back muscles

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46
Q

What is the common action of the superficial back muscles?

A

Movement of upper limbs and shoulders

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47
Q

What are superficial back muscles innervated by?

A

Anterior rami organized in brachial plexus, except for trapezius which is innervated by the accessory cranial nerve

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48
Q

What are the 2 deep back muscles? a. Locationb. Origin/Insertionc. Action

A
  1. Erector spinae: a. Along spinal cord b. Origin: inferior end of spine, insertion: superior end of spinec. Extend spine and maintain upright posture 2. Transversospinales: a. Deep to erector spinae and runs in Xmas tree pattern run in between transverse process of spineb. ?c. Maintain upright posture
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49
Q

What is the common action of the deep back muscles?

A

Movement and support of trunk: extend spine, posture, some spine/head movements

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50
Q

What are the 4 superficial back muscles?

A
  1. Trapezius2. Latissimus dorsi3. Rhomboid major 4. Rhomboid minor
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51
Q

Trapezius: 1. Origin?2. Insertion?3. Action?

A
  1. Spinal column (upper half)2. Along scapula3. Elevation, retraction, and depression of the scapula aka shoulder
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52
Q

What is the scapula?

A

Shoulder blade bone

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53
Q

Latissimus dorsi: 1. Origin?2. Insertion?3. Action?

A
  1. Spinal column (lower half)2. Front of humerus 3. Adduction, medial rotation and extension of the shoulder = swimming
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54
Q

What is the humerus?

A

Main arm bone

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55
Q

Rhomboids: 1. Origin?2. Insertion?3. Action?

A
  1. Middle part of upper spinal column2. Medial border of scapula3. Retraction and elevation of scapula
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56
Q

Rhomboids’ location compared to trapezius?

A

Deeper

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57
Q

Describe the composition of erector spinae.

A

3 groups of muscles arranged in vertical columns

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58
Q

Describe the composition of transversospinales.

A

3 groups of muscles arranged superficial to deep

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59
Q

What are the 2 muscles of the shoulder?

A
  1. Rotator cuff muscles2. Deltoid
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60
Q

Deltoid: 1. Origin?2. Insertion?3. Action?

A
  1. Scapula to clavicle2. Lateral side of the humerus 3. Arm abduction beyond 15 degrees
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61
Q

Can deltoid muscles initiate abduction from the most adducted position?

A

NOPE

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62
Q

Which muscle can initiate abduction from the most adducted position? What kind of muscle is it?

A

Supraspinatous muscle = rotator cuff muscle

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63
Q

Rotator cuff muscles: 1. Origin?2. Insertion?3. Action?

A
  1. Scapula2. Humerus3. Rotation, abduction, and stabilization of shoulder
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64
Q

How many rotator cuff muscles?

A

4

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65
Q

What is the joint of the shoulder?

A

Glenohumeral joint

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66
Q

What is the axilla? Purpose?

A

ArmpitImportant area that passes structures from neck to upper limb

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67
Q

What are 4 contents of the axilla?

A
  1. Axillary artery and vein2. Brachial plexus3. Lymphatics and lymph nodes4. Axillary tail of breast
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68
Q

Purpose of axillary artery?

A

Biggest blood supply for upper limbs

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69
Q

1 muscle of anterior arm?

A

Biceps brachii

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70
Q

Common action of muscles of anterior arm?

A

Flexion

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71
Q

Innervation of muscles of anterior arm?

A

Muculocutaneous nerve

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72
Q

1 muscle of posterior arm?

A

Triceps brachii

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73
Q

Action of muscle of posterior arm?

A

Extension

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74
Q

Innervation of muscle of posterior arm?

A

Radial nerve

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75
Q

Biceps brachii: 1. Origin?2. Insertion?3. Action?

A
  1. 2 parts of the scapula2. Radius by biceps tendon3. Elbow load bearing flexor and forearm supinator (better when flexed)
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76
Q

Where does the name biceps come from?

A

The muscle has 2 heads aka 2 origins

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77
Q

What is the most superficial muscle of the arm?

A

Biceps brachii

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78
Q

What is the radius?

A

Lateral forearm bone

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79
Q

Which bone moves during supination and pronation of arm?

A

Radius

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80
Q

What is the ulna?

A

Medial forearm bone

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81
Q

Can the ulna pivot?

A

NOPE

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82
Q

What is the most common biceps tendon that ruptures? What is this called? Why?

A

Long head tendon between scapula and bicepsPopeye’s sign because forms a bulge on the arm

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83
Q

How many tendons does the biceps have?

A

3

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84
Q

Triceps brachii: 1. Origin?2. Insertion?3. Action?

A
  1. 3 heads from scapula and humerus 2. Posterior side of ulna at olecron process3. Elbow extension
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85
Q

Where does the name triceps come from?

A

The muscle has 3 heads aka 3 origins

86
Q

What is the cubital fossa?

A

Depression anterior to the elbow joint

87
Q

What are the 4 contents of the cubital fossa? List them from lateral to medial.

A
  1. Tendon of biceps muscle2. Brachial artery 3. Median nerve4. Superficial veins used for venipuncture pass superficially (throughout the cubital fossa)
88
Q

What is the brachial artery?

A

The second part of the axillary artery

89
Q

Main action of forearm anterior muscles?

A

Flexion of wrist and digits

90
Q

Main action of forearm posterior muscles?

A

Extension of wrist and digits

91
Q

Innervation of posterior forearm muscles?

A

Radial nerve

92
Q

Innervation of anterior forearm muscles?

A
  1. Median nerve (mostly)2. Ulnar nerve (1.5 muscles)
93
Q

4 muscles of the superficial anterior forearm? List from lateral to medial

A
  1. Flexor carpi radialis2. Palmaris longus 3. Flexor carpi ulnaris4. Flexor digitorum superficialis (deeper than all first 3 muscles)
94
Q

What does carpi mean?

A

Wrist

95
Q

Where do the 4 muscles of the superficial anterior forearm originate?

A

Medial humerus

96
Q

Action of flexor carpi ulnaris?

A

Flexes and adducts the wrist

97
Q

Action of flexor carpi radialis?

A

Flexes and abducts the wrist

98
Q

Action of flexor digitorum superficialis?

A

Flexes digits = Proximal Interphalangeal (PIP) Joint

99
Q

Action of palmaris longus?

A

Grip

100
Q

Why is the palmaris longus interesting?

A

Missing in 10-15% of the pop

101
Q

Insertion of flexor digitorum superficialis?

A

Middle phalanges of digits (split tendon on each side), except thumb

102
Q

Muscle of deep anterior forearm?

A

Flexor digitorium profundus

103
Q

Action of flexor digitorium profundus?

A

Flexes digits except thumb = Proximal AND Distal Interphalangeal (PIP and DIP) joints

104
Q

Insertion of flexor digitorum profundus?

A

Most distal bone of the fingers

105
Q

Innervation of flexor digitorum profundus?

A

1/2 median nerve1/2 ulnar nerve

106
Q

Innervation of the superficial anterior forearm?

A
  1. Flexor carpi radialis: median2. Palmaris longus: median3. Flexor carpi ulnaris: ulnar4. Flexor digitorum superficialis: median
107
Q

5 muscles of the superficial posterior forearm? List from lateral to medial

A
  1. Brachioradialis2. Extensor carpi radialis brevis3. Extensor carpi radialis longus4. Extensor digitorum5. Extensor carpi ulnaris
108
Q

Action of extensor carpi radialis longus and brevis?

A

Extensors and abductors of the wrist

109
Q

Action of extensor carpi ulnaris?

A

Extensors and adductors of the wrist

110
Q

Action of extensor digitorum?

A

Extensor of digits except the thumb

111
Q

Action of brachioradialis?

A

Elbow flexor

112
Q

Where is the brachioradialis muscle located?

A

Posterior superficial forearm but crosses over lateral elbow

113
Q

Innervation of all 5 superficial posterior forearm muscles?

A

Radial nerve

114
Q

What does radial deviation mean?

A

Wrist abduction

115
Q

What does ulnar deviation mean?

A

Wrist adduction

116
Q

2 muscles of deep posterior forearm? List from lateral to medial

A
  1. Extensor pollicis brevis2. Extensor pollicis longus
117
Q

What does pollicis mean?

A

Thumb

118
Q

Function of extensor pollicis longus and brevis? What does this create?

A

Thumb extensionAnatomical snuffbox

119
Q

What passes through the tendons of the extensor pollicis longus and brevis

A

Branch of radial artery

120
Q

What can cause anatomical snuffbox injuries?

A

FOOSH injuries

121
Q

What does FOOSH stand for?

A

Fall On an OutStretched Hand

122
Q

What is the bone posterior to the anatomical snuffbox?

A

Scaphoid bone

123
Q

What 3 bones are often fractured due to FOOSH injuries?

A
  1. Scaphoid2. Distal radius (Colles’ fracture)3. Clavicle
124
Q

What is the carpal tunnel?

A

Narrow, tunnel-like structure in the wrist with median nerve and flexor tendons from anterior forearm in the center:- Dorsal and lateral sides of the tunnel formed by wrist bones- Ventral side of the tunnel covered by a strong band of connective tissue: flexor retinaculum

125
Q

What is carpal tunnel syndrome (CTS) caused by? Symptoms?

A

Injury to the median nerve due to narrowing/inflammation of the carpal tunnelStarts with sensory symptoms and then severe carpal tunnel will cause impairement/Loss of innervation of muscles distal to the carpal tunnel: thenar muscles on bulge of thumb that allow it to oppose

126
Q

What are the 2 types of muscles of the hand?

A
  1. Extrinsic 2. Intrinsic
127
Q

Innervation of extrinsic hand muscles?

A
  1. Median2. Ulnar3. Radial
128
Q

Action of extrinsic muscles of hand?

A

Power grip

129
Q

Where are the extrinsic muscles of the hand located?

A

Forearm with tendons extending in the hand

130
Q

Where are the intrinsic hand muscles?

A

In the hand

131
Q

Action of intrinsic muscles of hand?

A

Precision grip

132
Q

Innervation of intrinsic hand muscles?

A
  1. Median (thenar eminance)2. Ulnar (all others)
133
Q

Innervation of thenar eminence muscles?

A

Median nerve

134
Q

Intrinsic hand muscles of the pinky?

A

Hypothenar eminance

135
Q

Where is the gluteal region?

A
  • Between iliac crest and inferior border of butt - Posterior and lateral to pelvic bone
136
Q

What passes through the gluteal region?

A

Important nerves from pelvis

137
Q

What are the 2 compartments of gluteal region?

A
  1. Superficial2. Deep
138
Q

What are the 3 muscles of the superficial gluteal region?

A
  1. Gluteus maximus2. Gluteus medius3. Gluteus minimus
139
Q

Gluteus maximus: 1. Origin?2. Insertion?3. Action?

A
  1. Pelvic bone 2. Posterior side of femur and IT band (connective tissue on lateral side of thigh)3. Extension, lateral rotation, and abduction of thigh (getting up from flexed position)
140
Q

Gluteus medius and minimus1. Origin?2. Insertion?3. Action?

A
  1. Pelvic bone (top of crests)2. Top of femur3. Medial rotation and abduction of hip/thigh and secures its position when walking
141
Q

Position of gluteus medius and minimus in relation to gluteus maximus?

A

Deep

142
Q

Innervation of superficial gluteus region muscles?

A

Lumbosacral plexus

143
Q

What happens when people lose the innervation to their gluteus medius and minimus muscles?

A

Their hips drop every time they step forward

144
Q

Muscle of the deep gluteal region? What is special about it?

A

PiriformisMuscle of both the pelvic wall and the gluteal region and forms important landmarks (above and below) in gluteal region where blood vessels and nerves will exit pelvis to travel to gluteal region

145
Q

Common action of muscles of the deep gluteal region?

A

Lateral rotation of the thigh/hip

146
Q

Origin of piriformis? Insertion? Through what?

A

Pelvis and then comes out through the greater sciatic foramen to insert on the femur

147
Q

What are the 2 nerves that pass below the piriformis? Describe location of each.

A
  1. Sciatic nerve: passes below and travels to posterior thigh2. Pudendal nerve: passes below and enters perineum
148
Q

Where do we do injections in the buttocks?

A

Superior lateral quadrant

149
Q

Most vulnerable portion of buttocks where you should NOT do injections?

A

Lower medial quadrant

150
Q

Most common procedure done on gluteal region?

A

Intramuscular injection

151
Q

What are the 3 compartments of the thigh muscles?

A
  1. Anterior2. Medial3. Posterior
152
Q

Action of anterior thigh muscles?

A

Most extend knee (except for sartorius)

153
Q

Action of posterior thigh muscles?

A

Flex knee (some also extend hip and rotate thigh)

154
Q

Action of medial thigh muscles?

A

Adduct thigh

155
Q

Innervation of anterior thigh muscles?

A

Femoral nerve

156
Q

Innervation of posterior thigh muscles?

A

Sciatic nerve

157
Q

Innervation of medial thigh muscles?

A

Obturator nerve

158
Q

5 muscles of anterior thigh? List from lateral to medial

A

Quadriceps femoris group = quads:1. Vastus lateralis2. Rectus femoris3. Vastus medialis 4. Vastus intermedius (deep to rectus femoris)+5. Sartorius

159
Q

Insertion of quads?

A

Common insertion on patella via quadriceps tendon all the way to the tibia

160
Q

What is the patella?

A

Knee cap

161
Q

Largest quadriceps?

A

Rectus femoris

162
Q

Rectus femoris origin? Implication?

A

Pelvic boneCan move 2 joints: flex the hip and extend the knee

163
Q

Location of sartorius muscle?

A

Diagonally in anterior thigh

164
Q

Action of sartorius muscle?

A

Flexes knee and hip, external rotation and abduction of thigh = is there gum on my shoe muscle

165
Q

4 muscles of medial thigh?

A
  1. Gracilis2. Adductor longus3. Adductor brevis4. Adductor magnus
166
Q

Gracilis:1. Shape2. Origin3. Insertion

A
  1. Thin 2. Pelvic bone3. Tibia
167
Q

3 muscles of posterior thigh? What are they called? List from lateral to medial (if looking at back of thigh)

A

Hamstring muscles:1. Biceps femoris2. Semitendinosus3. Semimembranosus

168
Q

What 3 muscles insert on the medial side of the knee? From what compartment are they? Purpose? What is this called? What else is found here?

A
  1. Gracilis (medial thigh)2. Semitendinosus (posterior thigh)3. Sartorius (anterior thigh)=> a muscle from each thigh compartment to stabilize knee on medial side = pes anserinusAlso IT band
169
Q

What does pes anserinus mean?

A

Goose’s foot

170
Q

Where is the femoral triangle?

A

Top of anterior thigh near hip crease

171
Q

4 contents of femoral triangle?

A
  1. Femoral nerve2. Femoral artery3. Femoral vein4. Lymphatics
172
Q

Biggest blood supply of lower limbs?

A

Femoral artery

173
Q

Mnemonic to remember order of contents in femoral triangle?

A

Lateral to Medial: NAVeL

174
Q

Passage of contents of femoral triangle?

A

Continue inferiorly to adductor canal into the popliteal fossa

175
Q

4 contents of popliteal fossa? List from lateral to medial

A
  1. Common fibular nerve2. Tibial nerve 3. Popliteal vein4. Popliteal artery
176
Q

What are the popliteal artery/vein?

A

Continuations of femoral vessels

177
Q

Common injury to lower leg? What is this called?

A

Rupture of common fibular nerve because it wraps around the tibia from the popliteal fossa to the front of tibia and is unprotected (car bumper) = foot drop because you cannot dorsiflex your foot

178
Q

Innervation of posterior leg muscles?

A

Tibial nerve

179
Q

Innervation of anterior leg muscles?

A

Common fibular nerve

180
Q

Innervation of lateral leg muscles?

A

Common fibular nerve

181
Q

Action of superficial posterior leg muscles?

A

Plantar flexion (especially when leg is extended)

182
Q

Action of deep posterior leg muscles?

A

Toe flexion and foot inversion (suponation)

183
Q

Action of anterior leg muscles?

A

Dorsiflexion, foot inversion (suponation), toe extension

184
Q

Action of lateral leg muscles?

A

Foot eversion (pronation) and plantarflexion (weak)

185
Q

Other name for common fibular nerve?

A

Common peroneal nerve

186
Q

2 muscles of superficial posterior leg?

A
  1. Gastrocnemius2. Soleus
187
Q

Where do both muscles of the superficial posterior leg insert? What what tendon (2 names)?

A

Calcaneal tendon = Achilles tendon onto calcaneus bone

188
Q

What is the calcaneus bone?

A

Heel bone

189
Q

Where is the origin of gastrocnemius of the superficial posterior leg? What does this mean?

A

FemurCan also flex the knee

190
Q

How many heads in gastrocnemius muscle?

A

2

191
Q

Origin of soleus?

A

Top of tibia

192
Q

Where does the name soleus come from?

A

Sole because it’s really flat

193
Q

3 muscles of deep posterior leg?

A
  1. Tibialis posterior2. Flexor digitorum longus3. Flexor hallucis longus
194
Q

2 muscles of foot inversion?

A
  1. Tibilias posterior2. Tibialis anterior
195
Q

Action of flexor digitorum longus and flexor hallucis longus?

A

Toe flexion:- Flexor digitorum longus: 4 toes- Hallucis longus: big toes

196
Q

3 muscles of anterior leg?

A
  1. Tibialis anterior2. Extensor digitorum longus3. Extensor hallucis longus
197
Q

Where does the tibialis posterior insert?

A

Medial foot

198
Q

Which muscle is responsible for shin splints?

A

Tibilias anterior

199
Q

Action and insertion of tibialis anterior?

A

Action: foot dorsiflexion and inversionInsertion: medial foot

200
Q

Actions of extensor digitorum longus and extensor hallucis longus?

A

Dorsiflexion and toe extension

201
Q

2 muscles of lateral leg?

A
  1. Fibularis longus2. Fibularis brevis
202
Q

Insertion of lateral leg muscles?

A

Lateral foot and base of big toe

203
Q

Which leg compartment is most important for walking?

A

Anterior leg

204
Q

What causes a similar gait to the one with foot drop?

A

Impaired gluteus abductor (gluteus medius and minimus) muscles

205
Q

2 types of foot muscles?

A

Intrinsic and extrinsic

206
Q

2 nerves innervating the foot muscles? Mostly from which one?

A
  1. Tibial nerve***2. Common fibular nerve
207
Q

What is the tarsal tunnel?

A

Medial side of ankle and similar to carpal tunnel containing the posterior tibial artery and the tibial nerve

208
Q

What does splanchnic mean? What is the opposite?

A

Relating to the visceraOpposite = parietal

209
Q

Other name for hip bone?

A

Pelvic bone

210
Q

What can be found between the triceps heads?

A

Radial nerve

211
Q

What are the 3 boundaries of the femoral triangle?

A
  1. Sartorius2. Adductor longus3. Inguinal ligament

G2 2017-2018 (45 decks)

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