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(SALMA) Anatomy Handbook Questions > Anatomy of the limbs > Flashcards

Anatomy of the limbs Flashcards

1
Q

Which muscles are responsible for abduction of the shoulder?

A

Initiation is supraspinatus and then it is assisted by deltoid. Rotation of the scapula is by trapezius.

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2
Q

What muscles are involved in abduction of the shoulder?

A

Supraspinatus initiates abduction, and after 10-15 degrees it is assisted by deltoid

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3
Q

Which nerve supplies trapezius?

A

CN XI (spinal accessory nerve)

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4
Q

Which nerve is damaged by a posterior dislocation of the shoulder and what sensory/motor loss is experienced?

A

Axially nerve; sensory loss in skin over the insertion of deltoid muscle & paralysis of deltoid

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5
Q

What structures stabilise the shoulder joint?

A

Rotator cuff muscles (supraspinatus, infraspiantus, teres minor and subscapularis)

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6
Q

Which bony parts of the shoulder girdle lie subcutaneously and can be palpated easily?

A

Manubrium sternum, clavicle, spine of the scapula and acromium

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7
Q

What is frozen shoulder?

A
  • The tendon of supraspinatus passes through a tight gap between humerus/acromion.
  • If the tendon becomes inflamed it will cause pain as the swollen part passes through the gap.
  • Typically, patient can lift arm a short distance pain free but then, as swollen area passes through the gap, it will be very painful to raise the arm.
  • Once the swollen area has passed through the gap, further raising of the arm is pain free; patient describes a painful arc, termed the ‘frozen shoulder’
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8
Q

What is axillary nerve palsy?

A

Axillary nerve runs against humerus neck and can be damaged with posterior dislocation of shoulder (and fracture of humerus neck)

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9
Q

What is radial nerve palsy? (and what is it commonly known as)?

A

Saturday night palsy

  • Radial nerve runs in spiral groove (mid shaft) against humerus and can easily be damaged by fracture of humerus or direct pressure
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10
Q

When you hit your funny bone, what nerve does it impact?

A

Ulnar nerve

Bang it as it passes behind medial epicondyle of humerus. Leads to severe pain and pins/needles in skin supplied by nerve

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11
Q

Will Saturday night palsy/radial palsy result in weakness of triceps?

A

Saturday night palsy = loss of function of radial nerve as it runs against mid-shaft of the humerus in the spiral groove.

Although the posterior compartment of the arm (formed by triceps) I supplied by the radial nerve, the branches leave the nerve before the spiral groove

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12
Q

What are the 5 groups of axillary lymph nodes?

A 
Anterior (pectoral)
Lateral
Posterior (sub scapular)
Central (intermediate)
Apical (subclavicular/medial)
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13
Q

Which body area drains lymph directly to the axillary lymph nodes?

A

Ipsilateral upper limb and body wall above umbilicus

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14
Q

What is Horner’s syndrome?

A

The T1 nerve root forms the lower root of the brachial plexus; carries fibres of SNS which are destined to supply the face.

Damage to these SNS fibres will result in; drooping of the eyelid, lack of facial sweating and a constricted pupil.

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15
Q

How does blood travel from the left ventricle to the right axillary artery?

A

Aorta –> brachiocephalic artery –> subclavian artery –> axillary artery

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16
Q

How do the cords of the brachial plexus lie in relation to the axillary artery?

A

Cords lie laterally, medially and posterior to the axillary artery (immediately behind pectorals minor muscle)

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17
Q

Where do the muscles of the rotator cuff insert?

A

Supraspinatus, infraspinatus and theres minor - greater tuberosity of humerus (superior, middle and inferior facet respectively)

Subscapularis - lesser tuberosity of humerus

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18
Q

What structures lie along the medial border of the biceps in the middle of the arm?

A

Median nerve, ulnar nerve, medial cutaneous nerve of forearm, brachial artery and basilar vein

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19
Q

What is the carpal tunnel?

A

A tunnel formed by flexor retinaculum and carpal bones of the wrist.

The tunnel transmits 8 flexor tendons for fingers and median nerve

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20
Q

What is carpal tunnel syndrome?

A

Swelling of tendons/arthiritis affecting carpal bone joints can increase pressure –> compresses median nerve.

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21
Q

What happens when you have carpal tunnel syndrome?

A

Manifests as pain and diminished sensation on skin along median nerve distribution

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22
Q

Is the ulnar nerve affected by carpal tunnel syndrome?

A

No, ulnar nerve lies superficial to the retinaculum.

Median nerve travels through carpal tunnel so is impacted

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23
Q

What is repetitive strain injury?

A

De Quervain’s synovitis: common in ppl who carry out some movements repeatedly eg using keyboard.

Synovial sheath of tendons of wrist becomes inflamed and painful.

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24
Q

What are the 3 superficial veins of the forearm?

A
  • Cephalic
  • Basilic
  • Median cubital
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25
Q

Where does the cephalic vein run?

A
  • Superficial vein of the forearm

Runs from back of hand - more/less over radius - groove between bi/triceps - deltoid - clavicle - axillary vein

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26
Q

Where does the basilic vein run?

A
  • Superficial vein of the forearm

Back of hand - more/less over ulna - half way up the arm it becomes brachial vein

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27
Q

Where does the median cubital vein run?

A
  • Superficial vein of the forearm

Connects basilic and cephalic, often used for venipuncture

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28
Q

What are the 3 major nerves entering the forearm?

A
  • Radial
  • Median
  • Ulnar
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29
Q

What does the radial nerve supply?

A
  • Motor to the posterior compartment

- Skin on the thumb/forefingerish on the back of the hand

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30
Q

What does the median nerve supply?

A
  • Motor to all muscles in flexor forearm including lateral part of flexor digitorum profundus (EXCEPT flexor carpi ulnaris/ulnar half of flexor digitorum profundus)
  • Motor to the LLOAF muscles of hand
  • Skin on thumb, forefinger and middle fingerish on palm of hand, first 3ish fingertips on back of hand
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31
Q

What does the ulnar nerve supply?

A
  • Motor to flexor carpi ulnari and medial/ulnar flexor digitorum profundus
  • Motor to all muscles in hand EXCEPT LLOAF
  • Skin to the pinky and hagfish of ring finger on both sides (simple one)
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32
Q

What is LLOAF?

A

Lateral lumbricals
Opponens pollicis
Abductor pollicis brevis
Flexor pollicis brevis

(muscles in the hand supplied by the median nerve)

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33
Q

Where is the common flexor origin?

A

Medial epicondyle of humerus

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34
Q

How do you test muscles supplied by median nerve?

A

Flexion of thumb, forefinger and middle finger

Movement of thenar muscles

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35
Q

Which 3 muscles are in the thenar eminence?

A
  • Abductor pollicis brevis
  • Flexor pollicis brevis
  • Opponens pollicis
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36
Q

Where can you palpate the brachial artery?

A

Medial to the biceps aponeurosis

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37
Q

Where can you palpate the radial artery?

A

Lateral to the most lateral tendon at the wrist (this is the easiest because it is superficial and has bone directly behind it)

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38
Q

Where can you palpate the ulnar artery?

A

Lateral to the pisiform or just proximal to this

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39
Q

What is pronation?

A

Positioning the radius and ulna crossing each other; hand faces backwards

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40
Q

Which muscles perform pronation?

A 
Pronator teres
Pronator quadratus (both in any position of the elbow)
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41
Q

What is supination?

A

Positionng both the radius and ulna parallel to each other; hand faces forward

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42
Q

Which muscles perform supination?

A

Supinator (in any position of the elbow)

Biceps (with elbow flexed)

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43
Q

Which 3 muscles are in the hypothenar eminence?

A
  • Abductor digiti minimi
  • Flexor digiti minimi
  • Opponens digiti minimi
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44
Q

What is PAD DAB?

A

Palmar interossei Adduct = PAD

Dorsal interossei ABduct = DAB

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45
Q

When the scaphoid is fractured, where is there often tenderness?

A

Anatomical snuff box

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46
Q

What can scaphoid fracture lead to?

A

Avascular necrosis (death of tissue due to no blood vessel)

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47
Q

Which carpal bone is most prone to injury and why?

A

Scaphoid because it is in direct contact with radius so putting your hand out to stop yourself falling ver will put all force directly through this

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48
Q

Where are the thenar muscles?

A

At the base of the thumb on the palmar side of the hand

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49
Q

How do you test the interossei muscles?

A

Abdution and adduction of fingers

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50
Q

How does division of the median nerve at the elbow differ from 1 at the wrist?

A

Sensory loss = same
Motor @ wrist (paralyse LLOAF)
Motor @ elbow (paralyses flexrors & LLOAF)

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51
Q

What is the anatomical snuff box?

A

A space proximal to the thumb bounded medially by extensor pollicis longus and laterally by the tendons of the abductor pollicis longus and extensor pollicis brevis

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52
Q

Which bone forms the floor of the anatomical snuff box?

A

Scaphoid

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53
Q

Where do the radial artery and cephalic vein lie in relation to the anatomical snuff box?

A

Radial artery lies IN it

Cephalic vein CROSSES it superficially

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54
Q

What is the difference between golfer’s and tennis elbow?

A

Golfer’s elbow - damage to common flexor origin (medial epicondyle)
Tennis elbow - damage to common extensor origin (lateral epicondyle)

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55
Q

What is the nerve supply of the extensor compartment of the forearm?

A

Radial nerve

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56
Q

If T1 nerve root is damaged, which group of muscles will be paralysed and which area of skin will be anaesthetic?

A

All hand muscles will be paralysed

Skin over medial arm is anaesthetic

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57
Q

Which muscle is the most powerful supinator?

A

Biceps

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58
Q

Which position does the elbow need to be in to maximise the biceps’ force in supination?

A

Elbow flexed to 90 degrees

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59
Q

Which fingers have 2 extensor muscles and tendons?

A

Index and little fingers

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60
Q

How does the radius move during pronation and supination?

A

Distal radius rotates around the ulna

Proximal radius rotates about its own axis

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61
Q

What is the motor supply of the anterior thigh?

A

Femoral nerve

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62
Q

What is the posterior thigh supplied by?

A

Sciatic nerve

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63
Q

What is the medial thigh supplied by?

A

Obturator nerve

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64
Q

Where do the femoral vessels and nerve pass from the back of the abdomen into the thigh?

A

The gap between the inguinal ligament and superior pubic ramus

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65
Q

In the femoral triangle, is the femoral vein medial or lateral to the femoral artery?

A

Medial

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66
Q

In the femoral triangle, is the femoral nerve medial or lateral to the femoral artery/vein?

A

Lateral

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67
Q

In the femoral triangle, what is in the centre: the femoral nerve, artery or vein

A

Femoral artery

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68
Q

What is the surface marking of the femoral artery?

A

Point half way between the pubic tubercle and ASIS

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69
Q

Which vein becomes the superficial femoral vein?

A

Popliteal vein as it passes through the adductor canal

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70
Q

What supplies the anterior thigh skin, hip and knee joint?

A

Femoral nerve

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71
Q

What are the attachments of the adductor muscles?

A

All origin on the pubis

All insert onto the femur

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72
Q

Which nerve supplies the adductor muscles?

A

Obturator nerve

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73
Q

What passes through the adductor canal?

A

Superficial femoral artery

Popliteal vein

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74
Q

What is the adductor canal?

A

A narrow tunnel located in the thigh - acts as a passageway from structures moving between the anterior thigh and posterior leg

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75
Q

Where does the adductor canal run to and from?

A

Extends from the apex of the femoral triangle to the adductor hiatus of the adductor magnus

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76
Q

Which nerve is responsible for paralysis of the quadriceps?

A

Femoral nerve

77
Q

Which direction do the lowermost fibres of vastus medalis run and why?

A

Oblique - to resist lateral displacement of the patella (shaft of femur meets shaft of tibia at an angle, so quads tend to pull patella laterally leading to dislocation hence fibres of vastus medals run like this [and depth of the patella grove])

78
Q

Which nerve roots dos the sciatic nerve arise from?

A

L5 and S1-4

79
Q

What is the area of skin where sensation is transmitted by the sciatic nerve?

A

Lateral thigh and leg into the foot

80
Q

Which area of the buttock may damage the sciatic nerve when injected into?

A

Lower medial quadrant: injection in the upper outer quadrant is safe

81
Q

Which is the most powerful hip extensor?

A

Gluteus maximus (used for climbing uphill)

82
Q

Which muscles abduct the hip and when is abduction vital to norma function?

A

Gluteus minimus and medius.

They hold the pelvis horizontal during walking when 1 leg is off the ground

83
Q

What structures pass through the greater sciatic foramen?

A
  • Sciatic nerve
  • Piriformes muscle
  • Superior/inferior gluteal vessels
  • Pudendal nerves
84
Q

Where can the ischial spine be palpated?

A

Through the vagina or rectum

85
Q

If the sciatic nerve is completely cut, which parts of the lower limb will still have nerve supply?

A

Anterior and medial muscle compartments of the thigh and sensation.

86
Q

Which major vessels supply the buttock with blood?

A

Superior and inferior gluteal arteries

87
Q

Where do the sup/inf gluteal arteries branch from?

A

Posterior branch of the internal iliac artery

88
Q

What is significant about a fractured tibia?

A

Lower 1/3 of tibia has no muscle attachments thus a limited blood supply

89
Q

Where can the dorsal pedis pulse be felt?

A

Between 1st and 2nd metatarsal, on the dorsal of the foot

90
Q

Where can the posterior tibial pulse be felt?

A

Behind the medial malleolus

91
Q

When _____ swells, knee bending becomes restricted and kneeling becomes painful

A

bursa (over the infra-patellar tendon)

92
Q

Where does the leg run from?

A

Knee to ankle! NOT thigh

93
Q

Which nerves supply the anterior compartment of the leg?

A

Deep branch of the common peroneal nerve

94
Q

Which nerves supply the lateral compartment of the leg?

A

Superficial branch of the common peroneal nerve

95
Q

Which artery supplies the anterior compartment of the leg?

A

Anterior tibial artery

96
Q

How many extensor tendons are there to each of the toes?

A

2 tendons to each:

  • Longus tendon (from a muscle in anterior leg)
  • Brevis tendon (from a muscle in the foot)
97
Q

The brevis tendon to which toe is often absent?

A

Little

98
Q

Where are the palpable pulses in the leg?

A
  • Popliteal: behind the knee between the heads of gastrocnemius
  • Posterior tibial: posterior to the medial malleolus
99
Q

Describe the movements at the ankle joint

A

Ankle joint: between tibia/fibula and talus

Only movement: doors flexion and plantar flexion (extension and flexion)

100
Q

What is the peroneal nerve also known as?

A

Fibular

101
Q

What would be the effect of damage to the common peroneal nerve?

A

Paralysis of all muscles in anterior/lateral compartments of the leg
Loss of sensation down the lateral leg from the knee to the ankle and onto the

102
Q

Which muscles attach to the Achilles tendon?

A

Gastrocnemius
Soleus
Plantaris

103
Q

What is the nerve supply of the posterior compartment?

A

Tibial nerve

104
Q

What is the tibial nerve a branch of?

A

Sciatic nerve

105
Q

Where does the long saphenous vein start?

A

It starts at the medial end of the dorsal venous arch on the dorsal of the foot

106
Q

Where does the long saphenous vein join the femoral vein?

A

About 3cm below inguinal ligament

107
Q

How many flexor tendons does each toe have?

A

1 tendon to the hallux (big toe), 2 tendons to each of the other toes;

  • longus (muscle attached to tibia)
  • brevis (muscle attached to calcaneum)
108
Q

How many layers is there at the sole of the foot?

A

4 (cba to learn each 1, Dr Rennie said it wasn’t that important lol)

109
Q

What is the importance of deep veins and their valves?

A

Deep veins transmit blood back to the heart and work using muscle pumps.

Valves only allow blood to flow up vein and from outside of leg to inside.

When muscle is relaxed, deep veins fill w/ blood & when muscle contracts, blood is pumped further up the vein

110
Q

At which joints does flexion and extension of the ankle take place?

A

Joint between tibia/fibula and talus

111
Q

At which joints does inversion and eversion take place?

A

Joint between talus and calcaneum which lies below talus

112
Q

List some anatomical features that maintain arches of the foot

A
  • Shape of bones (wedge)
  • Tendons (coming from leg, pulling arch up)
  • Strong ligaments (running btwn bones on plantar surface)
  • Plantar ligament/fascia (hold front and back of foot closer)
113
Q

What is the rule for nerve supply to a joint?

A

The nerve supplying a joint with sensation is the same as the nerve supplying the muscles which move the joint

eg hip = femoral (eg rectus femurs), obturator (adductors) and tibial component of sciatic (hamstrings)

114
Q

What do the ACL and PCL do?

A

ACL stops tibia moving forwards relative to femur and PCL is backwards

115
Q

what does the pectoral girdle consist of?

A

scapula
clavicle
all muscles attached to these
latissimus dorsi muscle

116
Q

what’s the elevator scapulae’s main function

A

to lift the scapula

117
Q

what is the function of the latissimus dorsi

A

adducts, extends and internally rotates the arm

118
Q

discuss the deltoid’s fibres arising from the acromion

A

multi-pennate arrangement making it a powerful muscle

119
Q

what would be the sensory/motor loss from the axillary nerve

A

sensory: loss of sensation of lateral side of proximal arm
motor: paralysis of deltoid/teres minor muscles & impaired abduction of shoulder

120
Q

which veins form the axillary vein

A

basilic and brachial

121
Q

which nerve supplies the flexors of arm (BBC)

A

musculocutaneous

122
Q

which nerve supplies the extensors of arm

A

radial

123
Q

which nerve supplies the deltoid

A

axillary

124
Q

which nerve supplies the trapezius muscle

A

CN XI (accessory)

125
Q

what does the axilla vein

A

fat/lymph nodes, axillary artery/vein, brachial plexus

126
Q

briefly describe the 4 walls of the axilla

A

ant border: pec major/minor

lat border: intertubecular sulcus

med border: serrates anterior/thoracic wall

post border: scapularis, teres major, lattisimus dorsi

127
Q

which parts of the brachial plexus lie close to the axillary artery deep to pec minor

A

cords

128
Q

is the medial epicondyle a common flexor or extensor origin

A

flexor

129
Q

what is the common extensor origin

A

lateral epicondyle

130
Q

list the 6 superficial posterior forearm muscles (extensors)

A
  1. brachioradialis
  2. extensor carpi radialis longus/brevis
  3. extensor digitorum
  4. extensor digiti minimi
  5. extensor carpi ulnaris
  6. anconeus
131
Q

list the 4 deep post forearm muscles (extensors)

A
  1. supinator
  2. abductor pollicis longus
  3. extensor pollicus longus/brevis
  4. extensor indices
132
Q

list the 4 superficial ant forearm muscles (flexors)

A
  1. pronator teres
  2. flexor carpi radilis
  3. palmaris longus
  4. flexor carpi ulnaris
133
Q

name the intermediate ant forearm muscle (flexor)

A

flexor digitorum superficialis

134
Q

list the 3 deep ant forearm muscles (flexors)

A
  1. flexor digitorum profundus
  2. flexor pollicis longus
  3. pronator quadratus
135
Q

what are the borders of the femoral triangle

A 
superior/base = inguinal ligament
medially = medial border of adductor longus
laterally = medial border of sartorial
136
Q

what is l2-4

A

femoral nerve

137
Q

why are iliacus and psoas major commonly referred to as iliopsoas despite originating in diff areas

A

they come together to form a tendon

138
Q

what does iliopsoas do

A
  • flexes the lower limb at the hip joint

- assists in lateral rotation at the hip joint

139
Q

what do the quads consist of

A

3 vastus muscles

rectus femoris

140
Q

what do the vests muscles do

A

extend knee joint

stabilise patella

141
Q

what are the actions of the sartorial at the hip and knee

A

hip: flexor, abductor, lateral rotator
knee: flexor

142
Q

what are the actions of the pectineus

A

adduction and flexion @ hip

143
Q

what are the muscles in the medial compartment of the thigh collectively known as

A

hip adductors

144
Q

what are the 5 muscles in the medial compartment of thigh

A

gracilis
obturator externus
adductor brevis, longus and magnus

145
Q

where does the obturator nerve arise from

A

lumbar plexus

146
Q

what is the arterial supply of medial thigh

A

obturator artery

147
Q

what is the largest muscle of the medial thigh and where does it lie in relation to others

A

adductor magnus - posterior

148
Q

what are the 2 functional parts of the adductor magnus (and nerve supply)

A
  1. adductor part (obturator nerve)

2. hamstring part (sciatrc nerve)

149
Q

what are the actions of the 2 parts of adductor magnus?

A

both adduct thihh

  • adductor part flexes thigh
  • hamstring part extends thigh
150
Q

what is the action of adductor longus and brevis

A

adducts thigh

151
Q

what is the action of obturator externus

A

adduction and lateral rotation of the thigh

152
Q

what is the action of the gracilis

A
  • adduction of thigh at hip

- flexion of leg at knee

153
Q

what are the 3 muscles in the posterior thigh

A
  1. biceps femors
  2. semitendinosus
  3. semimembranosus
154
Q

what is the action of biceps femoris

A
  • flexion at knee
  • extends thigh at hip
  • laterally rotates hip/knee
155
Q

where is semimembranosus in relation to semitendinosus

A

underneath

156
Q

what is the action of semimembranosus

A
  • flexion of leg at knee
  • extension of thigh at hip
  • medially rotates thigh/leg
157
Q

what are the cruciate ligaments named by

A

their attachments to the tibia

158
Q

what is the subtalar joint aka

A

talo-calcaneal joint

159
Q

what is eversion of a fixed foot accompanied by

A

medial rotation of the leg

160
Q

which 3 muscles are in the anterior leg

A
  1. tibilaris anterior
  2. extensor digitorum longus
  3. extensor hallucis longus
  4. fibulas tertius
161
Q

what do the anterior leg muscles act to do

A

dorsiflex and invert foot at ankle joint (fibulas tertius everts)

162
Q

what do the extensor muscles of anterior leg do

A

also extend toes

163
Q

which nerve are the muscles in anterior leg innervated by

A

deep peroneal nerve (l4-5)

164
Q

what is the strongest dorsiflexor of the foot

A

tibialis anterior

165
Q

what is the largest compartment of leg

A

posterior

166
Q

collectively, what do the muscles of the posterior leg do

A

plantar flex and invert the foot

167
Q

what is the posterior leg innervate by

A

tibial nerve

168
Q

what is the tibial nerve a terminal branch of

A

sciatic nerve

169
Q

what is the most superficial muscle of posterior leg

A

gastrocnemius

170
Q

what is the action of gastrocnemius at the knee

A

flexor (plantar flexes ankle joint)

171
Q

how many deep muscles are in the posterior leg

A
  1. popliteus
  2. tibialis posterior
  3. flexor hallucis longus
  4. flexor digitorum longus
172
Q

what do the deep muscles of the posterior leg act on

A

popliteus - only on knee joint

tibialis posterior, flexor hallucis longus and flexor digitorum longus - on ankle/foot

173
Q

which muscle forms the base of the popliteal fossa

A

popliteus

174
Q

what does the popliteus do

A

laterally rotates femur on tibia

175
Q

what nerve innervates posterior leg

A

tibial nerve

176
Q

what does tibialis posterior do

A

inverts n plantar flexes foot, maintains medial arch of foot

177
Q

what are the 2 muscles in the lateral leg

A

fibularis longus/brevis

178
Q

is fibulas longus deeper or superficial to brevis

A

superficial

179
Q

what is the action of fibularislongus

A

eversion and plantar flexion of foot

180
Q

what is action of fibularis brevis

A

eversion of foot

181
Q

what do the superficial gluteal muscles do

A

abduct and extend lower limb at hip joint

182
Q

what is the largest and superficial muscle of gluteal region

A

gluteus maximus

183
Q

what muscle in gluteal region is fan-shaped

A

gluteus medius

184
Q

where does gluteus medium lie

A

between gluteus Maximus and minibus

185
Q

which muscles prevents pelvic drop of opposite limb (and also abduct and medially rotate)

A

gluteus medius and minimus

186
Q

what is the main extensor of the thigh

A

gluteus maximus (only used when force is required eg running)

187
Q

what is gluteus Maximus innervated by

A

inferior glutea nerve

188
Q

what are gluteus medius/minimus innervated by

A

superior gluteal nerve

(SALMA) Anatomy Handbook Questions (6 decks)

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