Anatomy summary Flashcards
what are the muscles in the superficial compartment of the gluteal region
gluteus maximus, medius and minimus and the tensor fascia latae
what is the role and innervation of the muscles in the superficial compartment of the gluteal region
o Extensors, abductors and medial rotators of the thigh
o Innervated by superior gluteal except glut max – inferior gluteal
what is tredenelenberg gait
abductor weakness due to superior gluteal nerve injury (glut med and min)
deep gluteal muscles
piriformis, obturator internus, gemelli, quadratus femoris
deep gluteal function and innervation
o Lateral rotators of the thigh and hip stabilisers
o Innervated by sacral plexus
how do nerves enter the gluteal region
via greater (pelvis) and lesser (perineum) sciatic foramen- formed by the sacrotuberous and sacropinous ligaments
path of the sciatic nerve
greater sciatic foramen, exits inferior to piriformis
most lateral structure exiting the sciatic foramen
passes down into the posterior thigh
separates in distal thigh into tibial and common fibular
what does the sciatic nerve supply
posterior thigh, all leg and foot muscle and most of the skin via tibial and common fibular branches
what is the pudenal nerve
S2-4
principle nerve to the perineum
what does the posterior cutaneous nerve supply
skin over the posterior thigh, popliteal fossa, lateral pernieum and upper medial thigh
what in the gluteal region does the sciatic nerve supply
nothing
what is the blood supply to the sciatic nerve
artery to sciatic nerve
what are the boundaries, floor and roof of the femoral triangle
superior – inguinal ligament
medially – lateral border of adductor longus
laterally – medial border of sartorius
floor – iliopsoas and pectineus
roof – deep fascia (fascia lata)
what are the components of the femoral triangle from lateral to medial
NAVY
femoral nerve, artery, vein, lymphatics
muscles and role of the anterior compartment of thigh
flexors of thigh
pectineus, iliopsoas, sartorius
extensors of leg
quadriceps femoris
innervation of ant thigh
femoral nerve (L2,3,4) expect psoas major (L1,2,3)
actions and muscle of medial thigh
adductors of thigh: adductor longus, adductor brevis, adductor magnus, gracilis, obturator externus
innervation of medial thigh
all obturator nerve (L2, L3, L4)
except hamstring part of adductor magnus (tibial nerve)
muscles and actions of post thigh
extensors of thigh & flexors of leg
semitendinosus, semimembranosus & biceps femoris
innervation of post thigh
all tibial division of sciatic nerve (L5, S1, S2)
except short head biceps femoris =common fibular division of sciatic
muscles and action of ant led
dorsiflexors of ankle & extensors of toes: tibialis anterior, extensor digitorum longus, extensor hallucis longus, fibularis tertius
innervation of ant leg
all deep fibular nerve (L4, L5)
muscles and actions of lat leg
evert foot and weekly plantar flex ankle:
fibularis longus, fibularis brevis
innervation of lat leg
superficial fibular nerve (L5, S2, S2)
actions and muscles of post leg superficial group
plantarflexors of ankle
gastrocnemius,
soleus,
plantaris
innervation of post leg superficial and deep
all tibial nerve
actions and muscles of post leg deep group
flexors of toes & plantarflexors of ankle popliteus, flexor hallucis longus (toes), flexor digitorum longus (digits), tibialis posterior
movements at hip joint
flexion-extension
abduction-adduction
medial-lateral rotation
circumduction
what ligaments form the hip capsule
iliofemoral
pubofemoral
Ischiofemoral (ischium to femor)
blood supply to the hip joint
medial and lateral circumflex femoral arteries
- usually from deep femoral artery
- give off retinacular arteries
artery to head of femur
-branch of obturator
extracapsular knee ligaments
lateral(fibular) collateral ligament
medial (tibial) collateral ligament
intra articular knee ligaments
anterior cruciate (ACL) (lateral to medial- hands in pockets) posterior cruciate (PCL) (medial to lateral)
boundaries of the popliteal fossa
superolaterally – biceps femoris
superomedially – semimembranosus
inferiorly – gastrocnemius
roof – popliteal fascia
contents of the popliteal fossa
lots of fat
terminal small saphenous vein
popliteal vessels
tibial and common fibular nerves
what is the calcaneal tendon
the achilles tendon
what muscles go into the calcaneal tendon
gastrocnemius and soleus
where does the calcaneal tendon attach
calcaneal tuberosity of the calcaneous
what is the ankle jerk reflex testing
S1 and 2
should cause plantar flexion
superficial lymphatics of the lower limb
follow saphenous veins
drain to superficial inguinal lymph nodes
then external iliac lymph nodes
deep lymphatics of the lower limb
follow deep veins
(popliteal lymph nodes)
deep inguinal lymph nodes
external iliac lymph nodes
where do external iliac nodes drain to
common iliac
then lumbar lymphatics
what does the tibial nerve supply (L4-S3)
muscles of the posterior compartment of leg: true hamstrings - semimembranosus semitendinosus long head of biceps femoris
muscles of the posterior compartment of leg: gastrocnemius soleus plantaris popliteus tibialis posterior
muscles of the sole of the foot:
flexors of the digits (digitorum & hallucis longus)
ALL intrinsic muscles of the sole of the foot
(via medial and lateral plantar branches)
what does the obturator nerve supply
ALL of the medial compartment of thigh ALL adductors (except hamstring part of magnus) & gracilis
what does the common fibular nerve supply
short head of biceps femoris
what does the superficial fibular nerve supply
muscles of the lateral compartment of leg:
fibularis longus & brevis
what does the deep fibular nerve supply
muscles of the anterior compartment of leg:
tibialis anterior & fibularis tertius
muscles of the dorsum of the foot:
extensor digitorum brevis (EDB)
extensor hallucis brevis (EHB)
what does damage to the obturator nerve cause
numb/paraesthesia on medial thigh & weakness in thigh adduction
what nerves come out of the sacral plexus
S1-4
Some Irish Sailor Pesters Polly” =Superior gluteal, Inferior gluteal, Sciatic, Posterior cutaneous nerve of thigh, Pudendal
What does damage to the sciatic nerve cause
Numb from gluteal region to ankle,
Weak knee flexion & weak foot movements
Foot drop = deep fibular nerve palsy = loss of dorsiflexors of ankle
Tibial part = not usually injured as its deep and well protected
what does damage to the lumbo sacral trunk cause
Numb calf/foot,
Weakness in ankle dorsiflexion,
what does damage to the femoral nerve cause
Numb thigh,
Loss of patella reflex & Weakness in knee extension,
Limp
what does an L3/4 prolapse cause
(L4 entrapment)
weak quads
reduced knee jerk
pain to median ankle
what does an L4/5 prolapse cause
(L5 entraptment)
reduced extensor hallicus longus and tibialis anterior power
pain to dorsum of foot
what does an L5/S1 prolapse cause
(S1 entrapment)
pain to sole of foot
reduced power plantarflexion
reduced ankle jerks
where is the safest place for a gluteal injection
upper lateral quadrant
what goes into the iliotibial tract
glut max and tensor fascia latae
where do glut med and mini insert
greater trochanter
what is the sensory supply to the foot
dorsum= superficial fibular
1st interdigital cleft= deep fibular nerve
lateral side= sural
medial side + medial leg= saphenous
heel= calcaneal branch of tibial
lateral sole + pinky and half 4th toe= lateral planter nerve
medial sole toes 1-3+1/2= medial plantar nerve
what type of joint is the 1st CMC
saddle- means thumb has 90 degrees of rotation
what are the movement of the thumb
abduction- palm flat facing ceiling, thumb up to point to ceiling
adduction- thumb back down to parallel to ceiling when palm facing upwards
extension- thumb out to side
flexion- thumb into palm
opposition- thumb to touch pinky
reposition- pinky and thumb back to normal places
what innervates the trapezius
CN XI (spinal accessory nerve)
what does the dorsal scapular nerve innervate
levator scapulae
rhomboid minor and major (minor above)
what innervates serratus anterior
long thoracic nerve
what is winged scapula a result of
damage to the long thoracic nerve
where does the rotator cuff muscles attach to
Supraspinatus
Infraspinatus
Teres minor = Greater tuberosity
Subscapularis =Lesser tuberosity
how much of the humeral head is in contact with the glenoid fossa at any time
1/3rd
muscles and action of the anterior compartment of the arm
Biceps brachii
Brachialis
Coracobrachialis
Flexion of arm and forearm
Biceps brachii is also supinates forearm
innervation of the anterior compartment of the arm
musculocutanous nerve
muscles and actions of the posterior arm
triceps brachii
extension of the arm and forearm
innervation of the post arm
radial nerve
muscles of the superior ant foreatm
(from lateral to medial) pronator teres flexor carpi radialis plamaris longus flexor carpi ulnaris
intermediate ant forearm muscles
flexor digitorum superficialis
deep ant forearm muscles
(from medial to lateral)
flexor pollicis longus
flexor digitorum profundus
(deep)
pronator quadratus
what is the innervation for the at forearm
ALL Median nerve, except flexor carpi ulnaris and medial half of flexor digitorum superficialis (Ulnar nerve)
actions of the ant forearm
Flexion of the wrist and digits, pronation, abduction and adduction of the wrist.
muscles in superficial post forearm
(from
- Brachioradialis (“beer drinking” muscle)
- extensor carpi radialis longus,
- extensor carpi radialis brevis,
- extensor digitorum,
- Extensor digiti minimi
- extensor carpi ulnaris,
- Anconeus
muscles of deep post forearm
- Supinator
- Abductor pollicis longus
- Extensor pollicis longus
- Extensor pollicis brevis
- Extensor indicis (extends index finger)
what muscles make up the snuff box
abductor pollicis longus
extensor pollicis longus
extensor pollicis brevis
innervation of post forearm
all radial nerve
actions of post forearm
Extension of the wrist and digits, supination, abduction and adduction of the wrist
what is the common flexor tendon
the medial epicondyle
what is the common extensor tendon
lateral epicondyle of humerus
what makes up the thenar eminence
Abductor pollicis brevis
Flexor pollicis brevis
Opponens pollicis
what is the innervation of the thenar eminence
Recurrent branch of the median nerve
what makes up the hypothenar eminence
Abductor digiti minimi
Flexor digiti minimi brevis
Opponens digiti minimi
what is the innervation of the hypothenar eminence
deep branch of the ulnar nerve
what is the innervation of the lumbricals and where to they attach
Attached to tendons of Flexor digitorum profundus
Median n. (lateral 2)
Ulnar n. (medial 2)
what is the action of the interossei
(DAB and PAD)
Dorsal interossei – Abduction of digits
Palmar interossei – Adduction of digits
(towards/ away from midline of hand)
what is the innervation of the interossei
all ulnar
what cords does the brachial plexus span
C5-T1
what artery does the brachial plexus travel around
brachial
what nerve goes into the coracobrachialis
musculocutaneous
what nerve goes into the quadrangular space
the axially nerve
what nerve is in the middle of the M in the brachial plexus
median
what nerve is behind the M
posterior cord which splits into axially (superior) and radial (inferior)
what nerve at the bottom of the brachial plexus
ulnar
what is the order of the cords
from top to bottom
lateral
posterior
medial
what is the sensory innervation to the hand
thumb + radial 2 +1/2 fingers plamar = median
medial 1 + 1/2 fingers plamar + dorsum sides = ulnar
base of thumb and radial dorsum of hand (thumb + radial 2+ 1/2 fingers - the tips of each fingers) = radial
contents of the carpal tunnel
Flexor digitorum superficialis (x4)
Flexor digitorum profundus (x4)
Flexor pollicis longus (x1)
Median nerve
what forms the carpal tunnel
Flexor retinaculum
Carpals
symptoms of carpal tunnel
Compression of median nerve
Weakness in the thenar muscles
Numbness in digits 1-3 and lateral half of digit 4
vasculature of arm
brachiocephalic subclavian axially brachial: radial - deep palmar arch ulnar- superficial plamar arch
vein- same as arteries, vena comitantes (paired)
arteries of leg
arteries:
abdo aorta
external iliac
femoral artery
popliteal:
anterior tibial- dorsal arch- dorsalis pedis - arcurate and plantar arch
posterior tibial (pulse at medial malleolus) - gives of fibular artery- plantar
veins of the legs
dorsal venous arch small saphenous (lateral) and great saphenous medial ant and post tibial and fibular vein combine to make popliteal which then joins with small saphenous to make femoral vein this combines with great saphenous to make external iliac vein combines with internal to make common iliac
action of lumbricals
waving bye bye like baby
action of trapezius
pulls shoulders down and back CN XI
action of rhomboids
protraction of scapula
what nerve injury and symptoms can result from a humeral (neck) fracture
axillary
- loss of sensation in regimental badge area
what nerve injury and symptoms can result from a humeral shaft fracture
radial
- wrist drop
- loss of sensation in 1st dorsal web space
what nerve injury can result from a colles fracture
median
what nerve injury and symptoms can result from a lateral compression of the pelvis injury
sacral nerve root injury
what nerve injury and symptoms can result from a vertical shear hip fracture
sacral nerve root, lumbosacral plexus
what nerve injury and symptoms can result from a proximal tibia (plateau) fracture
common fibular (peroneal) - foot drop
