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MRCS A > ANATOMY - Lower limbs > Flashcards

ANATOMY - Lower limbs Flashcards

1
Q

What are the 3 parts of the hip bone?

A

Ilium - superior
Ischium (posterolateral)
Pubis (anteromedial)

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2
Q

Average angle of inclination of NOF to acetabulum

A

126’

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3
Q

What attaches to the base of the patella superiorly?

A

Quadriceps tendon

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4
Q

What attaches to the base of the patella inferiorly?

A

Patellar ligament

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5
Q

What type of bone is the patella?

A

Sesamoid

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6
Q

Cause of fracture of patella

A

Direct trauma
Sudden contraction quadriceps muscle

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7
Q

Cause of dislocation of patella

A

High impact twisting knee injuries (sports)

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8
Q

How much blood can be lost by a femur fracture?

A

1.5L

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9
Q

What is the name of the part in the head of the femur that is not covered in articular?

A

Fovea

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10
Q

What attaches to the fovea?

A

Ligamentum teres

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11
Q

What shape are femur fractures typically?

A

Spiral

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12
Q

What muscle attaches to the gluteal tuberosity of the femur?

A

Gluteus maximus

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13
Q

What part of the femur articulates with the patella facets

A

Medial and lateral condyles

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14
Q

What part of the tibia do the collateral ligaments atach to

A

tibial condyles

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15
Q

what part of the tibia do the menisci attach to?

A

intercondylar fossa

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16
Q

what part of the tibia do the ACL + PCL attach to

A

intercondylar fossa

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17
Q

What important structure is the neck of the fibula associated with?

A

common fibular nn (after this bifurcates)

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18
Q

fibula vs tibia - which is the weight bearing bone

A

tibia

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19
Q

where in the tibia do fractures most commonly occur?

A

shaft

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20
Q

how are tibial shaft fractures classified?

A

Schatzker classification

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21
Q

which tendon passes through the posterior groove of the tibia?

A

Tibialis posterior

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22
Q

where do stress fractures of the foot most commonly occur?

A

2-3 MT necks

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23
Q

which 3 muscle tendons attach at the medial cuneiform

A

fibularis longus
tibialis anterior
tibialis posterior

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24
Q

name all the bones of the foot

A

phalanges x14
5 x MT
medial, intermediate, lateral cuneiform
navicular
cuboid
calcaneus
talus

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25
Q

where does the fibularis tendon insert on the foot

A

inferior surface cuboid in a groove

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26
Q

3 articulations of the talus

A

ankle joint (superior)
anterior - talonavicular
inferior - subtalar (w/ calcaneus)

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27
Q

Which foot bone is AVN risk the highest? Why?

A

Talus
No muscles attach here

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28
Q

cause - calcaneus fracture

A

fall from height

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29
Q

which foot bone forms the heel?

A

calcaneus

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30
Q

2 articulations calcaenus

A

subtalar
calcaneocuboid

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31
Q

What are the 4 gluteal extensors

A

gluteus maximus
gluteus medius
gluteus minimus
tensor fascia lata

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32
Q

what are the 5 deep lateral rotators glutes

A

quadriceps femoris
piriformis
gemeeli - superior + inferior
obturator internus

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33
Q

which extensor of the glutes is the most superficial

A

gluteus maximus

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34
Q

arterial supply gluteal muscles

A

superior + inferior gluteal arteries

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35
Q

What are the gluteal arteries a branch of

A

internal iliac artery

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36
Q

origin/insertion gluteus maximus

A

Ilium, sacrum + coccyx –> IT band + gluteal tuberosity femur

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37
Q

action gluteus maximus

A

extends + lat rotates thigh

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38
Q

Inn gluteus maximus

A

Inferior gluteal nn

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39
Q

origin/insertion gluteus medius

A

ilium –> greater trochanter

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40
Q

action gluteus medius

A

abduct + medial rotate thigh

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41
Q

inn gluteus medius

A

superior gluteal nerve

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42
Q

origin/insertion gluteus minimus

A

ilium –> greater trochanter

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43
Q

action gluteus minimus

A

abduct + medial rotation thigh

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44
Q

inn gluteus minimus

A

superior gluteal nerve

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45
Q

which sign is related to the superior gluteal nerve

A

Trendelenburg sign (usually prevents contralateral pelvic tilt)

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46
Q

which is the most superior of the deep lateral rotators of the glutes

A

piriformis

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47
Q

origin/insertion piriformis

A

anterior sacrum –> greater trochanter

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48
Q

action piriformis

A

lateral rotation + abduction thigh

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49
Q

innervation piriformis

A

nn to piriformis

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50
Q

origin/insertion obturation internus

A

ischium + pubis –> greater trochanter

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51
Q

action obturation internus

A

lateral rotation + abduction thigh

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52
Q

innervation obturator inturnus

A

nerve to obturator internus

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53
Q

origin/insertion superior gemelli

A

ischial spine –> greater trochanter

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54
Q

action superior gemellus

A

lateral rotation + abduction thigh

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55
Q

innervation superior gemellus

A

nn to obturator internus

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56
Q

origin/insertion inferior gemelli

A

ischial tuberosity –> greater trochanter

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57
Q

action inferior gemellus

A

lateral rotation + abduction thigh

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58
Q

innervation inferior gemellus

A

nn to quadratus femoris

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59
Q

origin/insertion quadratus femoris

A

ischial tuberosity –> quadrate tubercle on IT crest

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60
Q

action quadratus femoris

A

lateral rotation

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61
Q

innervation quadratus femoris

A

nn to quadratus femoris

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62
Q

action of anterior thigh muscles

A

extend the leg at the knee joint
some also flex thigh

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63
Q

innervation of anterior thigh muscles

A

femoral nerve L2-4

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64
Q

What are the anterior thigh muscles (8)

A

Iliacus + psoas major –> iliopsoas
sartorius
pectineus
vastus lateralis, vastus intermedialis, vastus medialis, rectus femoris

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65
Q

origin/insertion - iliopsoas

A

iliac crest + lumbar vertebra –> lesser trochanter

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66
Q

action iliopsoas

A

flexes thigh

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67
Q

innervation iliacus + psoas major

A

Iliacus - femoral nn
Psoas major - anterior rami L1-3

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68
Q

which is the longest muscle in the body?

A

sartorius

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69
Q

origin/insertion sartorius

A

ASIS –> superior medial tibia

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70
Q

action sartorius

A

flex
abduct
laterally rotate thigh

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71
Q

innervation sartorius

A

femoral nerve

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72
Q

which anterior thigh muscle forms the base of the femoral triangle?

A

pectineus

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73
Q

origin/insertion pectineus

A

pectineal line pelvis –> inf to lesser trochanter

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74
Q

action pectineus

A

adduction, flexion thigh

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75
Q

innervation pectineus

A

femoral nn

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76
Q

which muscle group are the main extensors of the knee

A

quadriceps femoris

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77
Q

4 muscles making up quadriceps femoris

A

vastus lateralis
vastus intermedialis
vastus medialis
rectus femoris

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78
Q

vastus lateralis origin/insertion

A

greater trochanter + linea aspera –> quadriceps tendon

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79
Q

innervation vastus lateralis

A

femoral nn

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80
Q

vastus intermedialis origin/insertion

A

femoral shaft –> quadriceps tendon

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81
Q

innervation vastus intermedialis

A

femoral nerve

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82
Q

vastus medialis origin/insertion

A

intertrochanteric line + linea aspera –> quadriceps tendon

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83
Q

innervation vastus medialis

A

femoral nerve

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84
Q

origin/insertion rectus femoris

A

ASIS + ilium –> quadriceps tendon

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85
Q

action rectus femoris

A

flexes thigh
extends knee

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86
Q

innervation rectus femoris

A

femoral nerve

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87
Q

action of the medial compartment of the thigh

A

hip abductors

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88
Q

arterial supply of medial compartment thigh

A

obturator artery

89
Q

nerve supply (in general) of medial compartment of the thigh

A

obturator nerve

90
Q

which compartment of the thigh has been injured when a patient complains of groin pain?

A

medial compartment

91
Q

what are the 2 components of the adductor magnus

A

adductor
hamstring

92
Q

origin/attachment adductor magnus

A

ADDUCTOR - inf pubic rami + rami ischium –> linea asoera
HAMSTRING - ischial tuberosity –> adductor tubercle + supracondylar line

93
Q

action - adductor portion adductor magnus

A

adducts + flexes thigh

94
Q

innervation adduction portion adductor magnus

A

obturator nn L2=4

95
Q

action - hamstring portion adductor magnus

A

adducts + extends thigh

96
Q

innervation hamstring portion adductor magnus

A

tibial part sciatic nn L4-S3

97
Q

origin/insertion adductor brevis

A

inferior pubic rami + pubis –> linea aspera

98
Q

action adductor brevis

A

adducts thigh

99
Q

innervation adductor brevis

A

obturator nerve

100
Q

origin/insertion adductor longus

A

pubis –> linea aspera

101
Q

action adductor longus

A

adducts thigh

102
Q

innervation adductor longus

A

obturator nerve

103
Q

origin/insertion obturator externus

A

membrane obturator foramen –> posterior greater trochanter

104
Q

action obturator externus

A

adducts + lateral rotation thigh

105
Q

innervation obturator externus

A

obturator nerve

106
Q

origin/insertion gracilis

A

inferior rami –> medial tibial shaft

107
Q

action gracilis

A

adducts thigh, flexes knee

108
Q

innervation gracilis

A

obturator nerve

109
Q

role of posterior compartment thigh (hamstrings)

A

extend hip
flex knee

110
Q

innervation of posterior compartment thigh

A

sciatic nn L4-S3

111
Q

most lateral muscle in posterior thigh

A

biceps femoris

112
Q

long head biceps femoris - origin/insertion

A

ischial tuberosity –> tendon insertion head fibula

113
Q

innervation long head biceps femoris

A

tibial part sciatic nn

114
Q

short head biceps femoris - origin/insertion

A

linea aspera –> tendon insertion head fibula

115
Q

innervation short head biceps femoris

A

common fibular portion sciatic nn

116
Q

action biceps femoris

A

extends thigh
flexes knee
laterally rotates hip + knee

117
Q

out of semitendinous + semimembranous, which is more superficial

A

semitendinous

118
Q

origin/insertion semitendinous

A

ischial tuberosity –> medial tibia

119
Q

innervation semitendinous

A

tibial portion sciatic nn

120
Q

action semitendinous + membranous

A

flex knee joint + med rotate
extend thigh

121
Q

origin/insertion semimembranous

A

ischial tuberosity –> medial tibial condyle

122
Q

innervation semimembranous

A

tibial portion sciatic nn

123
Q

role of anterior leg muscles

A

dorsiflex + invert the ankle joint

124
Q

innervation of anterior leg muscles

A

deep fibular nn

125
Q

arterial supply anterior leg muscles

A

anterior tibial aa

126
Q

which anterior leg muscle is the strongest dorsiflexor

A

tibialis anterior

127
Q

how to test tibialis anterior is workin

A

asking patient to stand on heels

128
Q

origin/insertion tibialis anterior

A

lateral tibia to medial cuneiform + base 1st MT

129
Q

action tibialis anterior

A

dorsiflex + invert foot

130
Q

innervation tibialis anterior

A

deep fibular nn

131
Q

origin/insertion EDL (extensor digitorum longus)

A

lateral condyle tibia + med fibula –> tendon –> divides into 4 and goes to each do

132
Q

action EDL

A

extends 4 toes
dorsiflex foot

133
Q

innervation EDL

A

deep fibular nn (common peroneal nn)

134
Q

origin/insertion EHL (extensor hallucis longus)

A

medial fibular shaft –> distal phalynx hallux

135
Q

action EHL

A

dorsiflex foot
extend hallux

136
Q

innervation EHL

A

deep fibular nn

137
Q

Which anterior leg muscle is not present in all individuals?

A

fibularis teritus

138
Q

origin/insertion fibularis teritus

A

medial surface fibula –> MT V

139
Q

action fibularis teritus

A

everts + dorsiflexes foot

140
Q

cause of foot drop

A

damage to deep fibular nn –> permanent plantar flexion

141
Q

Name the muscles of the lateral leg (2)

A

fibularis longus
fibularis brevis

142
Q

innervation of lateral leg muscles

A

superficial fibular nn L4-S1

143
Q

origin/insertion fibularis longus

A

sup + lat fibula + lat fibial condyle –> tendon –> medial cuneiform base MT I

144
Q

action fibularis longus

A

evert and plantarflex foot

145
Q

innervation fibularis longus

A

superficial fibular nn L4-S1

146
Q

origin/insertion fibularis brevis

A

inferolat fibular shaft –> tendon –> tubercle MT V

147
Q

action fibularis brevis

A

everts foot

148
Q

innervation fibularis brevis

A

superficial fibular nn l4-S1

149
Q

where does common fibular/peroneal nn bifurcate into superficial + deep fibular n

A

neck of fibula

150
Q

How many muscles in the posterior compartment of the leg?

A

7

151
Q

role of posterior compartment leg

A

plantar flex + invert foot

152
Q

Innervation of posterior compartment leg

A

tibial nn (terminal sciatic nn)

153
Q

how is the posterior compartment of the leg divided

A

superficial and deep compartment by band fascia

154
Q

which mm are in the superficial posterior leg compartment (3)

A

plantaris
soleus
gastrocnemius

155
Q

what % of people dont have plantaris mm

A

10%

156
Q

origin/insertion plantaris mm

A

lat supracondylar line femur –> calcaneal (achilles) tendon

157
Q

action plantaris mm

A

plantar flex ankle
flex knee

158
Q

innervation plantaris mm

A

tibial nn

159
Q

origin/insertion soleus

A

soleal line tibia + prox fibula –> calcaneal tendon

160
Q

action soleus

A

plantar flex foot/ankle

161
Q

innervation soleus

A

tibial nn

162
Q

which is the most superficial muscle in the posterior leg

A

gastrocneumius

163
Q

how many heads gastrocnemius

A

2 (med + lateral)

164
Q

origin/insertion gastrocnemius

A

femoral condyles –> calcaneal tendon

165
Q

action gastrocnemius

A

plantarflexes ankle
flexes knee

166
Q

innervation gastrocnemius

A

tibial nn

167
Q

achilles tendon reflex

A

S1-2

168
Q

What are the names of the 2 bursa associated with the calcaneal/achilles tendon?

A

subcutenaous calcaneal bursa
deep bursa calcaneal tendon

169
Q

what action causes calcaneal tendon rupture

A

forceful plantarflexion

170
Q

what are the 4 deep muscles of the posterior leg?

A

tibialis posterior
popliteus
flexor hallucis longus (FHL)
flexor digitoris longus (FDL)

171
Q

which muscle makes up the base of the popliteal fossa?

A

popliteus

172
Q

origin/insertion popliteus

A

lateral condyle femur + post horn meniscus –> tibia

173
Q

action popliteus

A

unlocks knee so flexion can occur by lateral rotation of femur

174
Q

innervation of popliteus

A

tibial nn

175
Q

which posterior leg muscle is the deepest?

A

tibialis posterior

176
Q

origin/insertion tibialis posterior

A

interosseous membrane = post tib/fib –> plantar surface med Tarsal bones

177
Q

actions tibialis posterior

A

plantarflex + invert foot
maintain medial arch

178
Q

innervation tibialis posterior

A

tibial nn

179
Q

FDL (flexor digitoris longus) origin/insertion

A

medial tibia –> plantar 4 digits

180
Q

action FDL

A

flexes 4 lateral toes

181
Q

innervation FDL

A

tibial nn

182
Q

FHL (flexor hallucis longus) origin/insertion

A

posterior fibula –> plantar big phalynx

183
Q

action FHL

A

flex hallux

184
Q

innervation FHL

A

tibial nn

185
Q

What are the 2 intrinsic muscles on the dorsal foot?

A

extensor digitorum brevis
extensor hallucis brevis

186
Q

Origin/Insertion Extensor Digitorum Brevis

A

calcaneus, interosseous, talocalcaneal ligament + inferior extensor retinaculum –> prox phalynx 1 + long extensor tendons toes 2-4

187
Q

Action EDB

A

aids EDL in extending medial 4 toes

188
Q

Innervation EDB

A

deep fibular nerve

189
Q

Origin/Insertion Extensor hallucis brevis

A

calcaneus, interosseous, talocalcaneal ligament + inferior extensor retinaculum –> prox phalynx 1

190
Q

Action EHB

A

Aids EHL in extending phalynx 1

191
Q

Innervation EHB

A

deep fibular nerve

192
Q

How many intrinsic muscles in the plantar foot?

A

10 (in 4 layers)

193
Q

Muscles in layer 1 plantar foot

A

ABductor hallucis
Flexor Digitorum brevis
Adductor Digiti minimi

194
Q

Abductor Hallucis action

A

abducts + flexes great toe

195
Q

innervation Abductor Hallucis

A

Medial plantar nerve

196
Q

Action flexor digitorum brevis

A

flexes lateral 4 digits at proximal IPJ

197
Q

Innervation flexor digotorum brevis

A

medial plantar nn

198
Q

action abductor digiti minimi

A

abduct flexes digit 5

199
Q

innervation abductor digiti minimi

A

lateral plantar nn

200
Q

How many muscles in the 2nd foot layer?

A

tendon of FDL
Quadratus plantae
4 x lumbricals
= 6

201
Q

quadratus plantae action

A

assists FDL in flexing lateral 4 digits

202
Q

innervation quadratus plantae

A

lateral plantar nn

203
Q

how many lumbricals in 2nd layer foot

A

4

204
Q

2nd layer foot lumbricals action

A

flexes at MPJ + extends at IPJ

205
Q

innervation 2nd layer foot lumbricals

A

most medial = medial plantar nn
rest are lateral plantar nn

206
Q

how many muscles in 3rd layer of foot?

A

3
Flexor hallucis brevis
flexor digiti minimi brevis
adductor hallucis

207
Q

action flexor hallucis brevis

A

flexes prox phalynx of hallux

208
Q

innervation flexor hallucis brevis

A

medial plantar nn

209
Q

action adductor hallucis

A

adducts great toe

210
Q

innervation adductor hallucis

A

deep branch lateral plantar nn

211
Q

action flexor digiti minimi brevis

A

flex 5th proximal phalynx

212
Q

innervation flexor digiti minimi brevis

A

superficial branch lateral plantar nn

213
Q

how many plantar interossei in the foot?

A

3

214
Q

action plantar interossei foot

A

adduct digits 3-5
flex MTPJ

215
Q

innervation plantar interossei foot

A

lateral plantar nn

216
Q

how many dorsal interossei in the foot?

A

4

217
Q

action dorsal interossei foot

A

abduct digits 2-4
flex MTPJ

218
Q

inn dorsal interossei foot

A

lateral plantar nn

MRCS A (36 decks)

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