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DPT Semester 1 > Anatomy Unit 3 > Flashcards

Anatomy Unit 3 Flashcards

1
Q

<p>What are the bony landmarks on the femur? (12)</p>

A

<ol> <li>head</li> <li>neck</li> <li>greater trochanter</li> <li>lesser trochanter</li> <li>intertrochanteric line</li> <li>linea aspira</li> <li>M/L supracondylar ridge</li> <li>M/L epicondyle</li> <li>intercondylar fossa</li> <li>adductor tubercle</li> <li>patellar surfaces</li> <li>angles</li></ol>

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2
Q

<p>what connects the linea aspira to the lesser/greater trochanters?</p>

A

<ol> <li>pectineal line</li> <li>gluteal tuberosity</li></ol>

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3
Q

<p>name the angles of the femur</p>

A

<ol> <li>angle of inclination</li> <li>angle of torsion</li> <li>Q angle</li></ol>

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4
Q

<p>what attaches to the greater trochanter?</p>

A

<p>abductors and lateral rotators (ERs)</p>

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5
Q

<p>what attaches to the lesser trochanter?</p>

A

<p>iliopsoas muscle</p>

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6
Q

<p>what attaches at the intertrochanteric line?</p>

A

<p>iliofemoral ligament</p>

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7
Q

<p>what is the linea aspira?</p>

A

<p>a ridge on the post femur that the adductors attach to</p>

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8
Q

<p>where is the pectineal line?</p>

A

<p>runs from linea aspera to lesser trochanter</p>

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9
Q

<p>where is the gluteal tuberosity?</p>

A

<p>runs from linea aspera to greater trochanter</p>

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10
Q

<p>what is the angle of inclination?</p>

A

<p>angle between neck and shaft of the femur.</p>

<p>Results in distal femur moving medially to more effectively support the body when standing</p>

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11
Q

<p>what is the Q angle?</p>

A

<p>the angle between the shaft of the femur and tibia.</p>

<p>Determines valgus/varus at the knee</p>

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12
Q

<p>what are ligaments in the hip?</p>

A

<ol> <li>Iliofemoral</li> <li>pubofemoral</li> <li>ischiofemoral</li> <li>ligament of head of femur</li></ol>

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13
Q

<p>pectineus prox attachment</p>

A

<p>pubic bone/superior ramus</p>

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14
Q

<p>pectineus distal attachment</p>

A

<p>femur/pectineal line</p>

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15
Q

<p>pectineus innervation</p>

A

<p>femoral and obturator nerves (L2-3</p>

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16
Q

<p>pectineus action</p>

A

<p>flex, adduct, and IR femur at hip joint</p>

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17
Q

<p>iliacus prox attachment</p>

A

<p>iliac/iliac fossa</p>

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18
Q

<p>iliacus distal attachment</p>

A

<p>femur/lesser trochanter</p>

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19
Q

<p>iliacus innervation</p>

A

<p>femoral nerve (L2, 3)</p>

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20
Q

<p>iliacus action</p>

A

<ol> <li>flex femur at hip</li> <li>flex trunk at thigh</li></ol>

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21
Q

<p>psoas major prox attachmen</p>

A

<p>lower T and upper L vert bodies and transverse p</p>

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22
Q

<p>psoas major distal attachment</p>

A

<p>femur/lesser trochanter</p>

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23
Q

<p>psoas major innervation</p>

A

<p>lumbar plexus (L1, 2)</p>

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24
Q

<p>psoas major action</p>

A

<ol> <li>flex femur at hip</li> <li>can also flex trunk at thigh</li></ol>

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25

sartorius prox attachment

ilium/ASIS

26

sartorius distal attachment

prox/med/post tibia

27

sartorius innervation

femoral n (L2, 3)

28

sartorius action

  1. hip -- flex, ER, ABD
  2. knee -- flex
29

describe the force chain of the quadriceps femoris

quadriceps muscles→ quadriceps tendon→ patella→ tibia/tibial tuberosity

30

rectus femoris prox attachment

ilium/AIIS

31

rectus femoris distal attachment

quadriceps tendon/patella/patellar ligament/tibial tuberosity

32

rectus femoris innervation

femoral nerve (L2, 3, 4)

33

rectus femoris action

  1. hip - flex femur
  2. knee - extend tibia
34

vastus lateralis prox attachment

femur

35

vastus lateralis distal attachment

quadriceps tendon/patella/patellar ligament/tibial tuberosity

36

vastus lateralis innervation

femoral nerve (L2, 3, 4)

37

vastus lateralis action

  1. extend leg at knee
  2. help stabilize patella at the knee
38

what part of the vastus lateralis stabilizes the knee?

vastus lateralis oblique = lateral retinaculum

39

vastus medialis prox attachment

femur

40

vastus medialis distal attachment

quadriceps tendon/patella/patellar ligament/tibial tuberosity

41

vastus medialis innervation

femoral nerve (L2, 3, 4)

42

vastus medialis action

  1. extend leg at knee 
  2. helps stabilize knee
43

what part of the vastus medialis stabilizes the knee?

vastus medialis oblique = medial retinaculum

44

vastus intermedius prox attachment

femur

45

vastus intermedius distal attachment

quadriceps tendon/patella/patellar ligament/tibial tuberosity

46

vastus intermedius innervation

femoral nerve (L2, 3, 4)

47

vastus intermedius action

  1. extend at knee
  2. articularis genu elevates patellar bursa when leg is extending knee
48

medial thigh muscles

  1. adductor longus
  2. adductor brevis
  3. adductor magnus
  4. Gracilis
  5. obturator externus
49

adductor longus prox attachment

pubis/body

50

adductor longus distal attachment

femur/linea aspira

51

adductor longus innervation

obturator nerve (L2, 3, 4)

52

adductor longus action

ADD, flex, IR femur at hip

53

adductor brevis prox attachment

pubis/inferior ramus

54

adductor brevis distal attachment

femur/linea aspira

55

adductor brevis innervation

obturator nerve (L2, 3, 4)

56

adductor brevis action

ADD, flex, IR femur at hip

57

adductor magnus note

has 2 parts:

  1. hamstring part in posterior
  2. adductor part in anterior
58

prox attachment adductor magnus posterior

ischium/ishial tuberosity

59

distal attachment adductor magnus posterior

adductor tubercle

60

adductor magnus posterior innervation

tibial nerve (L4)

61

adductor magnus posterior action

extend femur at hip

62

prox attachment adductor magnus anterior

pubis/inferior ramus

63

distal attachment adductor magnus anterior

femur/linea aspira/medial supracondular ridge

64

adductor magnus anterior innervation

obturator nerve (L2, 3, 4)

65

adductor magnus anterior action

ADD, flex, IR femur at hip

66

Gracilis prox attachment

pubis/body

67

Gracilis distal attachent

prox/medial/posterior tibia

68

Gracilis innervation

obturator nerve (L2, 3)

69

Gracilis action

  1. hip - ADD, flex, IR femur
  2. knee - flex
70

Obturator externus prox attachment

external surface of obturator membrane

71

obturator externus distal attachment

greater trochanter

72

obturator externus innervation

obturator nerve (L3, 4)

73

obturator externus action

ER, ABD femur at hip

74

what inserts at the pes anserinus?

  1. Sartorius
  2. Gracilis
  3. Semitendinosus
75

all medial thigh muscles but ____ and ______ cross the hip anteriorly to flex the thigh at the hip

  1. posterior adductor magnus
  2. obturator externus
76

all medial thigh muscles but _____ contribute to IR of the thigh at the hip when the hip is laterally rotated

obturator externus

77

All medial thigh muscles but ________ and _________ attach distally to the linea aspira for the femur

1. Gracilis 2. Obturator Externus

78

what forms the adductor hiatus?

distal attachments of hamstring and adductors

79

what passes through the adductor hiatus?

femoral artery and vein from anterior thigh to posterior thigh

80

superior boundary of the femoral triangle

inguinal ligament running from ASIS to pubic tubercle

81

medial boundary of the femoral triangle

lateral border of the adductor longus

82

lateral/inf boundary of the femoral triangle

superior border of Sartorius

83

floor of femoral triangle

1. iliopsoas2. pectineus

84

roof of femoral triangle

skin and fascia

85

what passes through the retroinguinal space?

blood and lymph vessels, and nerves from the pelvic cavity to the leg

86

femoral triangle contents

  1. femoral nerve
  2. femoral artery and vein
  3. inguinal lymph nodes
87

lateral border of adductor (femoral) canal

vastus medialis

88

medial border of adductor (femoral) canal)

adductor longus and magnus

89

roof of adductor (femoral) canal

sartorius

90

origin of adductor (femoral) canal

apex of femoral triangle

91

terminus of adductor (femoral) canal

adductor hiatus in aponeurosis of adductor magnus

92

adductor (femoral) canal contents

  1. femoral artery and vein
  2. saphenous nerve
93

what is the saphenous nerve?

cutaneous branch of femoral nerve

94

Main arteries of the thigh

1. femoral artery 2. deep femoral artery 3. obturator artery

95

Femoral Artery route

from external iliac artery at inguinal ligament to adductor hiatus where ir becomes the poplieteal artery

96

deep femoral artery route

branch of femoral to muscles of the medial and posterior thigh and femur

97

obturator artery route

branch of internal iliac artery to muscles of medial and posterior thigh

98

Veins of the thigh

1. Femoral vein 2. Great Saphenous vein

99

Nerves of the Thigh

1. Femoral nerve (L2-4)2. Obturator nerve (L2-4)

100

terminal sensory branch of femoral nerve

saphenous nerve

101
bony landmarks on the Tibia
1. M/L condyle 2. M/L plateau 3. Intercondylar area 4. articular facet for head of fibula 5. tibial tuberosity 6. Gerdy tubercle 7. interosseous border 8. M malleolus 9. fibular noth10. articular surface for talus
102
bony landmarks of fibula
1. head 2. interosseous boder 3. L malleolus 4. articular surface for talus
103
Knee joint articulations
1. femorotibial 2. femoropatellar
104
medial femorotibial articulation
medial condyle of femur to medial condyle of tibia
105
lateral femorotibial articulation
lateral condyle femur to lateral condyle tibia
106
T/F: the patella normally articulates with the tibia
FALSE, not unless something bad happens
107
Knee joint capsule
1. strong capsule 2. open posterior for popliteus tendon 3. intrapellar/alar synovial folds
108
purpose of intrapatellar/alar synovial folds
divides knee joint into M/L articulations
109
Knee extracapsular ligaments
1. patellar ligament 2. M/L patellar retinacula 3. fibular (lateral) collateral 4. tibial (medial) collateral
110
role of collateral ligaments
relaxed when knee is flexed and taught when knee is extended. limit hyperextension and rotation
111
what does the fibular collateral ligament limit?
adduction
112
what does the tibial collateral ligament limit?
abduction
113
Knee intracapsular ligaments
1. Cruciate ligmanets2. Menisci
114
what are the cruciate ligaments
ACL and PCL, crisscross within intercondylar space of joint capsule
115
what do the cruciate ligaments limit?
Medial rotation at knee and keep femur and tibia aligned during Flx/Ext
116
what are the menisci?
fibrocartilage wedges that act as cushions and create a lip to the shallow sockets of the tibia
117
name the menisci ligmanets
1. coronary ligaments 2. transverse ligament 3. M/L meniscus
118
coronary ligament role
attach menisci to ridge of tibial condyle
119
transverse ligament role
interconnects ant surface of the M/L menisci across the intercondylar space
120
which meniscus has more mobility?
lateral
121
movements of the knee joint?
1. Flx/Ext 2. M/L rotation (gliding)
122
Suprapatellar bursa
extension of the joint capsule between M/L edges of patella and femur; and between the quad tendon and the femur
123
what moves the suprapatellar bursa?
articualris genus (derived from vastus intermedius)
124
What is the Q angle?
angle between axis of femur and tibia. Purpose is to move legs more toward central axis of the body
125
Varus = ______
decreased Q angle
126
Valgus = ________
increased Q angle
127
what occurs when the knees are "locked"
knee is fully extended. femur medially rotates into the tibia to lock the knee
128
what unlocks the knee before flexion?
popliteus laterally rotates femur
129
Muscles in the superficial gluteal layer
1. Gluteus Maximus 2. Gluteus medius 3. Gluteus minimus 4. Tensor fascia lata (TFL)
130
prox attachment gluteus maximus
ilium, sacrum, coccyx
131
distal attachment gluteus maximus deep
femur/gluteal tuberosity
132
distal attachment gluteus maximus superficial
IT band/Gerdy tubercle
133
Gluteus maximus innervation
inferior gluteal nerve (L5, S1, 2)
134
Gluteus maximus action
Hip Ext, ER, ABD when synergist w/TFL
135
Gluteus medius prox attachment
ilium/ala
136
Gluteus medius distal attachment
femur/greater trochanter
137
Gluteus medius innervation
superior gluteal nerve (L5, S1)
138
Gluteus medius action
primarily ABD hip
139
Gluteus minimus prox attachment
ilium/ala
140
Gluteus minimus distal attachment
femur/greater trochanter
141
Gluteus minimus innervation
superior gluteal nerve (L5, S1)
142
Gluteus minimus action
primarily ABD hip
143
Tensor fascia lata prox attachment
ilium/ASIS & crest
144
Tensor fascia lata distal attachment
IT band/Gerdy tubercle
145
Tensor fascia lata innervation
superior gluteal nerve (L5, S1)
146
Tensor fascia lata action
Hip flx, ER, ABD in synergy with glut max
147
Muscle in deep gluteal layer
1. piriformis 2. obturator internus 3. S/I gemelli 4. quadratus femoris 5. obturator externus
148
piriformis prox attachment
sacrum
149
piriformis distal attachment
femur/greater trochanter
150
piriformis innervation
lumbosacral plexus (S1, 2)
151
piriformis action
hip ER, ABD
152
obturator internus prox attachment
deep surface obturator membrane
153
obturator internus distal attachment
femur/greater trochanter
154
obturator internus innervation
lumbosacral plexus (L5, S1)
155
obturator internus action
Hip ER, ABD
156
S/I gemelli prox attachment
hip/ischial spine and tuberosity
157
S/I gemelli distal attachment
greater trochanter
158
S/I gemelli innervation
lumbosacral plexus (L5, S1)
159
S/I gemelli action
hip ER and ABD
160
quadratus femoris prox attachment
hip/ischial tuberosity
161
quadratus femoris distal attachment
femur/intertrochanteric
162
quadratus femoris innervation
lumbosacral plexus (L5, S1)
163
quadratus femoris action
Hip ER
164
Obturator externus prox attachment
external surface obturator membrane
165
obturator externus distal attachment
greater trochanter
166
obturator externus innervation
obturator nerve (L3, 4)
167
obturator externus action
Hip ER and ABD of femur
168
Nerves branching from sacral plexus and passing through greater sciatic foramen
1. Superior gluteal2. interior gluteal 3. nerve to obturator internus 4. nerve to quadratus femoris 5. posterior branches of ventral rami S1 and S2 to piriformis 6. clunial nerves, S/M/I cutaneous innervations
169
Arteries of gluteal region
1. Internal Iliac 2. superior gluteal artery 3. inferior gluteal artery 4. obturator artery
170
Veins of gluteal region
1. internal ilia veins 2. superior gluteal vein 3. inferior gluteal vein 4. obturator vein
171
Posterior thigh muscles
1. Semitendinosis 2. Semimembranosis 3. Biceps femoris
172
Semitendinosis prox attachment
hip/ischial tuberosity
173
semitendinosis distal attachment
pes anserinus
174
semitendinosis innervation
tibial nerve (L5, S1, 2)
175
semitendinosis action
1. hip - Ext, IR 2. knee - flex
176
prox attachment biceps femoris long head
hip/ischial tuberosity
177
distal attachment biceps femoris long head
tibia/lateral plateau/fibula
178
innervation biceps femoris long head
tibial nerve (L5, S1, 2)
179
biceps femoris long head action
1. hip - extend, ER2. knee - flex
180
prox attachment biceps femoris short head
femur/linea aspira
181
distal attachment biceps femoris short head
tibia/lateral plateau/ fibula
182
biceps femoris short head innervation
fibular nerve (L5, S1, 2)
183
biceps femoris short head actions
knee - flex, ER
184
Nerves of the posterior thigh
1. sciatic nerve 2. posterior cutaneous nerve
185
branches of sciatic nerve
1. tibial branch 2. fibularbranch
186
tibial nerve destination
anterior division to flexors
187
fibular nerve destination
posterior division to extensors
188
Blood vessels of the posterior thigh
1. Deep artery2. Deep vein
189

What are the groups of bones of the ankle/foot?

  1. Tarsals
  2. Metatarsals
  3. Phalanges
190

Name the tarsal bones

  1. talus
  2. calcaneus
  3. navicular
  4. cuboid
  5. medial/lateral/intermediate cuneiforms
191

What does the talus articulate with to form the ankle joint?

Tibia and fibula

192

what articulations form the intertarsal joints?

talus with calcaneus and navicular

193

name the features of the talus

  1. body
  2. neck
  3. head
194

what does the body of the talus articulate with?

  1. tibia
  2. M/L malleolus 
195

what does the neck of the talus articulate with?

navicular bone

196

what are the features of the calcaneus?

  1. calcaneal tuberosity
  2. sustenticulum tali 
197

name the joints at the lower leg/ankle?

  1. Tibiofibular
    1. proximal (superior)
    2. distal (inferior)
  2. Talocrural
198

proximal tibiofibular joint articulations

head of fibula and lateral epicondyle/plateau of tibia

199

What type of joint is the proximal tibiofibular joint?

planar synovial joint

200

Ligaments of the proximal tibiofibular joint

  1. strong joint capsule
  2. A/P ligaments of the fibular head
  3. Interosseous membrane
201

Movements of the proximal tibiofibular joint

generally doesn't move

allows slight elevation during dorsiflexion to help with shock absorption 

202

Distal tibiofibular joint articulations

medial surface of the distal end of fibula with fibular notch of tibia

203

Distal tibiofibular joint type

syndesmosis (amphiarthrosis) 

204

Ligaments of the distal tibiofibular joint

  1. No joint capsule = not synovial joint
  2. interosseous tibiofibular ligament
  3. A/P tibiofibular ligaments
  4. interior transverse ligament 
205

Articulations at the talocrural joint

  1. fibulotalar - lateral malleolus of fibula with lateral trochlea of talus
  2. tibiotalar - distal end of tibia and lateral edge of medial malleolus with superio and medial trochlea of talus
206

which articulation at the talocrual joint is the weight bearing connection between the tibia and talus?

Tibiotalar 

207

Joint type of talocrural joint

hinge, synovial 

208

Ligaments of the Talocrual joint

  1. interosseus ligament
  2. joint capsule
  3. collateral ligaments (M/L)
  4. Inferior transverse ligament 
209

what are the collateral ligaments of the Talocrural joint?

  1. Lateral (fibular) collarteral ligament
  2. Medial (tibial) collateral (deltoid) ligament
210

Movements at the talocrural joint

Dorsiflexion/plantar flexion with a little wobble when plantar flexion

211

the body of the the talus is _______ anterior than posterior

wider

212

when the ankle is ____________ the _____________ part of the talus body is between the malleoli for a tighter more ________ fit

  • dorsiflexed
  • wider anterior
  • stable 
213

Tibialis anterior prox attachment

tibia/fibula/IO membrane 

214

Tibialis anterior distal attachment

medial tarsals (medial cuneiform & navicular) and base of metatarsal 1 

215

Tibialis anterior innervation

fibular nerve (L4, 5)

216

Tibialis anterior action

  1. at ankle - dorsiflex
  2. at intertarsal joints - inversion 
217

Extensor digitorum longus prox attachment

tibial/fibula/IO membrane

218

Extensor digitorum longus distal attachment

extensor expansion digits 2-5

219

Extensor digitorum longus innervation

fibular nerve (L4, 5)

220

Extensor digitorum longus action

  1. at ankle - dorsiflex
  2. at digits - extension
221

what forms the extensor expansion on digits 2-5?

  1. extensor digitorum longus
  2. lumbricals
  3. plantar interossei
  4. dorsal interossei
222

Extensor hallucis longus prox attachment

tibia/fibula/IO membrane 

223

Extensor hallucis longus distal attachment

extensor expansion of hallux (digit 1)

224

Extensor hallucis longus innervation

fibular nerve (L4, 5)

225

Extensor hallucis long action

  1. at ankle - dorsiflex
  2. at hallux: extend
  3. at intertarsal joints - inversion
226

Fibularis teritus prox attachment

fibula/IO membrane

227

Fibularis tertius distal attachment

base of metatarsal 5 (lateral foot)

228

Fibularis tertius innervation

fibular nerve (L4, 5)

229

Fibularis tertius action

  1. at ankle - dorsiflex
  2. at intertarsal joints - eversion
230

What are the retinaculum?

2 bands located on distal atnerior surface of leg

covers anterior compartment tendons to prevent bowstringing

231

list the retinaculum at the ankle

  1. Superior extensor retinaculum
    1. superior fibular retinaculum
  2. Inferior extensor retinaculum 
    1. inferior fibular retinaculum
232

where is the superior extensor retinaculum?

from tibia to fibula proximal to malleoli

233

What is the superior fibular retinaculum?

an extension of the superior retinaculum

 

234

where is the superior fibular retinaculum?

runs from anterior intermuscular septum to the fibula

contains fibularis longus and brevis tendons

235

where is the inferior extensor retinaculum?

"Y" shaped band from medial ankle (tibia) and foot (navicular) to lateral foot (calcaneus)

236

what is the inferior fibular retinaculum?

an extension of the inferior extensor retinaculum that passes over the fibularis longus and brevis tendons

237

Muscles in the Anterior/Lateral Compartment of Leg

  1. Tibialis anterior
  2. Extensor digitorum longus
  3. Extensor hallucis longus
  4. Fibularis tertius 
238

Lateral compartment Muscles

  1. Fibularis longus
  2. Fibularis brevis
239

Fibularis longus prox attachment

fibula

240

Fibularis longus distal attachment

base of metatarsal 1

medial cuneiform

241

Fibularis longus innervation

fibular never (L5, S1, S2)

242

Fibularis Longus Action

  1. at ankle - plantar flex
  2. at intertarsal joints:
    1. eversion
    2. maintain transverse arch
243

Fibularis brevis prox attachment

fibula

244

Fibularis brevis distal attachment

base of 5th metatarsal

245

Fibularis brevis innervation

fibular nerve (L5, S1, S2)

246

Fibularis brevis action

  1. at ankle - plantar flex
  2. at intertarsal joints - eversion
247

Posterior Compartment of Leg 

Superficial Muscles

  1. Gastrocnemius
  2. Soleus
248

Gastrocnemius prox attachment

medial and lateral condyles of femur

249

Gastrocnemius distal attachment

Calcaneal (Achilles) tendon -> calcaneal tuberosity 

250

Gastrocnemius innervation

Tibial nerve (S1, 2)

251

Gastrocnemius action

  1. at knee - flex
  2. at ankle - plantar flex
252

T/F: the gastrocnemius is primarily made of red muscle fibers and is used for long duration activities 

FALSE - it is white fibers and used in burst activities 

253

Soleus prox attachment

tibia/fibula/IO membrane

254

Soleus distal attachment

calcanel (Achilles) tendon -> calcaneal tuberosity 

255

Soleus innervation

Tibial nerve (S1, 2)

256

Soleus action

plantar flex

257

Posterior Compartment of Leg 

Deep muscles

  1. Popliteus
  2. Tibialis posterior
  3. Flexor hallucis longus
  4. Flexor digitorum longus 
258

Popliteus prox attachment

lateral meniscus

lateral condyle of femur

259

Popliteus distal attachment

lateral edge of tibia

260

Popliteus innervation

tibial nerve (L4, 5, S1)

261

Popliteus action

slightly flex and rotate to unlock the knee from fully extended position

262

Popliteus action

  1. pull the lateral meniscus posteriorly
  2. "unlock" knee from full extension 
263

Tibialis posterior prox attachment

tibia/fibula/IO membrane

264

Tibialis posterior distal attachment

broad attachment at tarsals (calcaneus, navicular, cuneiforms, cuboid)

base of metatarsals 3-4

265

Tibialis posterior innervation

tibial nerve (L4, 5)

266

Tibialis posterior action

  1. at ankle - plantar flex
  2. at intertarsal joints:
    1. inversion
    2. maintain transverse arch
267

Flexor hallucis longus prox attachment

tibial/fibula/IO membrane

268

Flexor hallucis longus distal attachment

distal phalange of digit 1

269

Flexor hallucis longus innervation

tibial nerve (S2, 3)

270

Flexor hallucis longus action

  1. at ankle - plantar flex
  2. at intertarsal joints - inversion
  3. at digit 1 (metatarsal/phalangeal + interphalangeal) - flex
271

T/F: the flexor hallucis longus is a huge stabilizer and important for push off

TRUE

272

Flexor digitorum longus prox attachment

tibia/fibula/IO membrane

273

Flexor digitorum longus distal attachment

distal phalanges of digits 2-5

274

Flexor digitorum longus innervation

tibial nerve (S2, 3)

275

Flexor digitorum longus action

  1. at ankle - plantar flex
  2. at intertarsal joints - inversion
  3. at digits 2 thru 5 - flex
276

What are the boundaries of the popliteal fossa?

  1. superior lateral = biceps femoris
  2. superior medial = semitendinosus and semimembranosus
  3. inferior lateral and medial = gastrocnemius
  4. floor = popliteus 
277

Contents of popliteus fossa

  1. popliteal arteries and veins
  2. Tibial and fibular nerves 
  3. lymph nodes and vessels
  4. popliteus and plantaris muscles
278

Name the different Intertarsal Joints

  1. Subtalar (talocalcaneal) joint
  2. Talonavicular joint
  3. Surgical subtalar 
  4. Transverse tarsal 
279

what type of joint is the Talonavicular joint?

ball and socket, synovial

 

280

What is the role of the talonavicular joint?

transfer weight from the tibia through the talus anteriorly to the balls of the feet

281

The surgical subtalar joint is a combination of what?

the talocalcaneal and talonavicular joint

*also called the talocalcaneonavicular joint

282

What ocurs at the talocalcaneonavicular (surgical subtalar) joint?

location of most movement in inversion/eversion

283

what is the transverse tarasl joint a combination of?

calcaneocuboid + talonavicular compound joint

284

what does the transverse tarsal joint allow?

rotation around a longitudinal axis contributing to inversion/eversion

285

what is the role of all the other intertarsal joints?

absorb shock and dissipate shock from impact of foot with ground

only give a little and don't have appreciable movement

286

Tarsometatarsal joint type?

plane type synovial joint

287

Intermetatarsal joint type

planar synovial

288

Ligaments of the intermetatarsal joints

  1. strong capsule
  2. strong interosseous ligaments
  3. deep transverse ligament distally
289

role of the deep transverse ligament?

ties all 5 metatarsal together distally

290

what joint is at the "balls of the feet"?

mmetatarsophalangeal (MTP) joint

291

MTP joint type?

condyloid synovial

292

Ligaments of the MTP joints

  1. strong capsule
  2. collateral ligaments
  3. plantar ligaments
293

what do the plantar ligaments at the MTP joints limit?

extension

294

(Feet) Interphalangeal joint type?

hinge synovial

295

Ligaments of the interphalangeal joints?

  1. strong capsule
  2. colalteral ligaments
  3. plantar ligaments
296

What are the two types of arches at the feet?

  1. Longitdudinal
  2. Transverse 
297

name the 2 longitudinal arches of the feet?

  1. Medial
  2. Lateral 
298

What do the arches of the feet allow for?

distribution of body weight between heel and balls of feet for 2-point transfer to the ground

299

Roles of arches of feet

  1. Shock absorber 
  2. Act as a springboard = provide propulsive force (recoil) during the push off part of the stance phase
300

which arch is the highest and most important?

Medial longitudinal arch

301

Name the structures of the Medial Longitudinal arch from posterior to anterior

calcaneus -> talus -> navicular -> 3 cuneiforms -> metatarsals 1-3

302

what significant ligament is found in the medial longitudinal arch?

Plantar calcaneonavicular (spring) ligament

303

describe the weight distribution of the medial longitudinal arch

from talus (high point) to calcaneus posterior and heads of metatarsals 1-3 (medial balls of foot) anterior 

304

name the structures of the lateral longitudinal arch from posterior to anterior

calcaneus -> cuboid -> metatarsals 4 & 5

305

describe the weight distribution of the lateral longitudinal arch

from calcaneus (reveived weight from talus)

to cuboid (high point) 

and heads of metatarsals 4 and 5 (anterior)

306

name the structures of the transverse arch from lateral to medial

cuboid, cuneiforms and bases of metatarsal bones

307

what maintains the transverse arch?

  1. shape of bones (broader on dorsum than plantar)
  2. ligaments
  3. tendons
  4. muscles
308

what ligaments help maintain the transverse arch?

deep and superficial transverse and plantar intermetatarsal ligaments

309

what tendons help maintain the transverse arch?

  1. fibularis longus
  2. tibialis posterior
310

what muscle helps maintain the transverse arch?

adductor hallucis

311

what passive factors help maintain the arches of the feet?

  1. plantar aponeurosis
  2. long plantar ligmanet
  3. short plantar (calcaneocuboid) ligament
  4. spring (calcaneonavicular) ligament
312

what is the plantar aponeurosis?

deep fascia running longituindally from heel to balls of feet

313

What muscles are in the thenar group of the intrinsic foot muscles?

  1. abductor hallucis 
  2. flexor hallucis brevis
314

What muscles are in the hypothenar group of the intrinsic foot muscles?

  1. abductor digit minimi
  2. flexor digiti minimi
  3. opponens digiti minmi 
315

What muscles support the medial longitudinal arch?

  1. abductor hallucis 
  2. flexor hallucis brevis
  3. flexor digitorum brevis
  4. flexor digitorum longus
  5. flexor hallucis longus
316

What muscles support the lateral longitudinal arch?

  1. abductor digiti minimi
  2. flexor digiti minimi
  3. opponens digiti minimi
  4. flexor digitorum brevis 
  5. flexor digitorum longus
317

What muscles support the transverse arch?

  1. fibularis longus
  2. tibialis posterior
  3. adductor hallucis 
318

What are the zones that the foot can be divided into?

  1. hindfoot 
  2. midfoot
  3. forefoot
319

what does the hindfoot consist of?

talus and calcaneus

320

What does the midfoot consist of?

  1. navicular
  2. cuboid
  3. cuneiforms
321

What does the forefoot consist of?

metatarsals and phalanges 

322

what creates longitudinal compartments in the foot?

plantar fascia that has vertical septa

323

What are the comparments of the foot?

  1. medial
  2. central
  3. lateral
  4. interosseous
324

where is the medial compartment of the foot?

located in midfoot and forefoot

also called the thenar compartment

325

what is inside the medial compartment of the foot?

  1. medial intrinsic foot muscles and tendons to the hallux 
  2. medial plantar nerve and vessels
326

Where is the central compartment of the foot located at?

midfoot and forefoot 

327

what is in the central compartment of the foot?

intrinsic foot muscles and tendons to digits 1-5

lateral plantar nerves and vessels

flexor digitorum longus and brevis

328

where is the lateral compartment of the foot located at?

midfoot and forefoot

also called the hypothenar compartment

329

what does the lateral compartment of the foot contain?

intrinsic foot muscle and tendons to digit 5

330

Where is the interosseous compartment of the foot?

in the forefoot only

331

what is located within the interosseous compartment of the foot?

  1. metatarsals
  2. interosseous muscles
  3. deep plantar blood vessels
  4. PADs and DABs
332

what is the overall function of the instrinsic muscles of the foot?

work together to maintain the arches of the foot when weight is loaded on them during stance phase 

333

Intrinsic foot muscles in the 1st layer

  1. Abductor hallucis
  2. Flexor digitorum brevis
  3. Abductor digiti minimi
334

Abductor hallucis prox attachment

calcaneus & plantar aponeurosis 

335

Abductor Hallucis distal attachment

proximal phalanx digit 1 (medial side)

336

Abductor Hallucis action

  1. abduct digit 1 (limited by deep and surface transverse ligaments)
  2. maintain medial longitudinal arch 
  3. provide cushioning
337

Abductor hallucis innervation

branch of tibial nerve = medial plantar (S2, 3)

338

Flexor digitorum brevis prox attachment

calcaneus and plantar aponeurosis

339

Flexor digitorum brevis distal attachment

middle phalanx digit 2-5 (medial and lateral sides)

split attachment similar to flexor digitorum superficialis in hand

340

Flexor digitorum brevis action

  1. flex digits 2-5
  2. maintain M/L longitudinal arches
  3. provides cushioning
  4. keeps flexor digitorum longus oriented
341

Flexor digitorum brevis innervation

branch of tibial nerve = medial plantar (S2,3)

342

Abductor digiti minimi prox attachment

calcaneus and plantar aponeurosis

343

Abductor digiti minimi distal attachment

proximal phalanx digit 5 (lateral side)

344

Abductor digiti minimi action

  1. abduct digit 5 (at MTP joint)
  2. maintain lateral longitudinal arch
  3. provide cushioning 
345

Abductor digiti minimi innervation

branch of tibial nerve = lateral plantar (S2, 3)

346

Intrinsic foot muscles 2nd layer

  1. Quadratus plantae
  2. Lumbricals
347

Quadratus plantae prox attachment

calcaneus

348

Quadratus plantae distal attachment

tendon of flexor digitorum longus 

349

Quadratus plantae action

  1. maintain orientation of flexor digitorum longus (straigtens line of pull of FDL)
  2. maintain longitudinal arch
350

Quadratus plantae innervation

branch of tibial nerve = medial plantar (S2, 3)

351

Lumbricals prox attachment

tendons of flexor digitorum longus

352

Lumbricals distal attachment

extensor expansion digits 2-5

353

Lumbricals action

  1. flex at MTP joints of digits 2-5
  2. extend at IP joints of digits 2-5
354

Lumbricals innervation

branch of tibial nerve = lateral and mediial plantar nerve (S2, 3)

355

3rd layer of intrinsic muscles 

  1. Flexor hallucis brevis
  2. Adductor hallucis
  3. flexor digiti minimi brevis 
356

Flexor hallucis brevis prox attachment

cuboid and lateral cuneiform

357

Flexor hallucis brevis distal attachment

split attachment M/L sides of proximal phalange of digit 1

onto sesamoid bones 

358

Flexor hallucis brevis action

  1. maintain orientation of flexor hallucis longus 
  2. maintain medial longitudinal arch
359

Flexor hallucis brevis innervation

branch of tibial nerve = medial plantar (S2, 3)

360

Adductor hallucis prox attachment

  1. oblique head = base of metatarsals 2-4
  2. transverse head = plantar ligment of MTP joints
361

Adductor hallucis distal attachment

Oblique and transverse head = lateral side base of proximal phalange of digit 

362

Adductor hallucis action

  1. Main action = maintain transverse arch of foot
  2. adduct digit 1
  3. provide cushioning 
363

Adductor hallucis innervation

branch of tibial nerve = lateral plantar (S2, 3)

364

Flexor digiti minimi brevis prox attachment

base of metatarsal 5

365

Flexor digiti minimi brevis distal attachment

base of proximal phalange 5

366

Flexor digiti minimi brevis action

flex digit 5

367

Flexor digit minimi brevis innervation

branch tibial nerve = lateral plantar (S2, 3)

368

Muscles in the 4th layer of intrinsic muscle 

  1. Plantar interossei (PADs)
  2. Dorsal interossei (DABs)
369

Plantar interossei (PADs) prox attachment

metatarsals 3-5

370

Plantar interossei (PADs) distal attachment

extensor expansion 3-5

371

Plantar interossei (PADs) action

  1. adduct digit 3-5 (move towards digit 2 as reference)
  2. flex MTP joints of digits 3-5
  3. extend IP joints of digits 3-5
372

Plantar interossei (PADs) innervation

branch of tibial nerve = lateral plantar (S2, 3)

373

Dorsal interossei (DABs) prox attachment

metatarsals 1-5

374

Dorsal interossei (DABs) distal attachment

extensor expansion 2-4

digit 2 has a M/L DAB

digit 3 and 4 have lateral only

375

Dorsal interossei (DABs) action

  1. abduct digit 3-4 (away from 2)
  2. abd/adduct digit 2
  3. flex MTP joints digits 2-4
  4. extend IP joints digits 2-4
376

Dorsal interossei (DABs) innervation

branch of tibial nerve = lateral plantar (S2, 3)

377

What muscles are on the dorsum of the foot?

  1. Extensor digitorum brevis
  2. Extensor hallucis brevis
378

Extensor digitorum brevis prox attachment

calcaneus 

379

Extensor digitorum brevis distal attachment

extensor expansion 2-4

380

Extensory digitorum brevis action

  1. extend digits 2-4
  2. shock absorption, raising height of arches
381

Extensor digitorum brevis innervation

deep fibular nerve (L5, S1)

382

Extensor hallucis brevis prox attachment

calcaneus

383

Extensor hallucis brevis distal attachment

extensor expansion of digit 1

384

Extensor hallucis brevis action

  1. extend digit 1
  2. shock absorption, raising height of arches
385

Extensor hallucis brevis innervation

deep fibular (L5, S1)

386

Motor nerves of the foot

  1. Tibial nerve 
  2. Deep fibular nerve 
387

Tibial nerve route and destinations

divides into M/L plantar nerves

supply intrinsic muscles on plantar surface of the foot

388

Deep fibular nerve route and destinations

to intrinsic foot muscles on dorsum of foot

389

Sensory nerves of the foot

  1. Sural
  2. Saphenous
  3. Fibular
  4. Tibial 
390

Origin and destination of sural nerve

origin = tibial never

destination = lateral malleolus

391

Origin and destination of saphenous cutaneous nerve?

origin = femoral nerve

destination = medial malleolus 

392

Destinations of cutaneous fibular nerve?

  1. Dorsum of hallux
  2. Dorsum of digit 5
  3. Dorsum of foot
393

Destinations of cutaneous tibial nerve?

  1. Plantar hallux
  2. Plantar digit 5
  3. Plantar foot
394

Arteries of the feet

  1. Anterior tibial artery
  2. Fibular artery 
  3. Posterior tibial artery
395

Branches of the anterior tibial artery

dorsal pedis artery 

396

branches of the fibular artery 

perforating branches of fibular artery

397

what do the anterior tibial and fibular artery combine to form?

dorsal arch 

398

Branches of hte Posterior Tibial artery

  1. Medial plantar artery
  2. lateral plantar artery
  3. deep plantar arch
399

what is the first sphincter in the digestive tract?

the mouth (orbicularis oris)

400

how does the mouth contribute to the process of digestion?

  1. mechanical digestion (mastication)
  2. chemical digestion (saliva)
401

where is salvia secreted from?

salivary glands

402

name the salivary glands

  1. submandibular
  2. sublingual
  3. parotid 
403

name the innervations for the salivary glands

  1. submandibular and sublingual = CN7
  2. parotid = CN 9
404

muscles of mastication are innervated by what?

CN 5

405

what nerves are responsible for taste?

CN 7, 9, and 10

406

what nerves are responsible for the somatosensory function of the tongue?

CN 5

407

what does the somatosensory function of the tongue include?

  1. touch
  2. tactile sensation
  3. pain
408

what is the upper esophageal sphincter?

a thickening of the proximal esophageal wall

409

what is the lower esophageal sphincter?

thickening of distal esophagel wall + respiratroy diaphragm crura

410

what is the role of the lower esophagel sphincter?

prevent backflow of stomach acid to the esophagus

411

name the sections of the stomach

  1. cardiac
  2. fundus
  3. body
  4. pyloric regions
412

muscular wall of the stomach is made up of ___ layers

  1. circular muscle
  2. longitudinal muscle
  3. transverse muscle 
413

what are the ridges in the stomach muscle wall called?

rugae

414

what does the stomach secrete and why?

gastric juice = chemical digestion of proteins

415

what is the role of the pyloric sphincter?

regulate flow of chyme into small intestine 

416

the pyloric sphincter regulates flow from the stomach into which portion of the SI?

duodenum

417

name the parts of the SI

  1. duodenum
  2. jejunum
  3. ileum
418

what is the role of the SI?

primary site of absorption for water and nutrients (~90% of all absorption)

419

what is the sphincter of Oddi?

a sphincter that controls the digestive juices from the liver and pancreas into the duodenum

420

role of pancreatic juice in the duodenum

  1. digests large molecules 
  2. buffer the stomach acid that has entered the SI
421

what does the liver secrete into the duodenum?

Bile

422

what is the role of Bile?

digests fat globs into lipid droplets 

423

what is the duodenal flexure?

a sudden right angle at the end of the duodenum

424

what is the role of the duodenal flexure?

it is associated with a suspensory muscle which allows it to change the flow from the duodenum to the jejunum

425

how would you describe the lumen of the SI?

modified for increased SA

  • circular fold (plicae)
  • projections/villi
  • brush border/microvilli
426

what connects the SI to the LI?

ileocecal sphincter

427

name the sections of the LI

  1. cecum/appendix
  2. ascending colon
  3. transverse colon
  4. descending colon
  5. sigmoid colon
428

what is the role of LI?

  1. last 10% of absorption of water
  2. bacterial digestion = absorption of vitamins and minerals
429

last stop of the GI after the LI?

rectum/anus

430

role of the rectum/anus

feces accumulation and defecation

431

name the sphincters at the anus/rectum

  1. internal anal sphincter
  2. external anal sphincter
432

differentiate between the internal/external anal sphincter

  1. internal = smooth muscle and involuntary
  2. external = pelvic diaphragm (puborectalis) - skeletal muscle so it is voluntary
433

the blood flow in the digestive tract can be broken down into what 2 planes?

  1. Anterior midline plane = 3 unpaired arteries to viscera 
  2. lateral plane = 4 paired arteries to viscera 
434

Name the 3 unpaired arteries that make up the anterior midline plane

  1. Celiac Trunk
  2. Superior mesenteric artery
  3. Inferior mesenteric artery
435

what does the Celiac Trunk supply blood to?

  1. stomach
  2. spleen
  3. pancreas
  4. liver
  5. proximal duodenum
436

what does the Superior Mesenteric Artery supply blood to?

  1. distal duodenum
  2. jejunum
  3. ileum
  4. cecum
  5. ascending colon
  6. 1/2 of transverse colon
437

what does the Inferior Mesenteric Artery supply blood to?

  1. 1/2 transverse colon (distal)
  2. descending colon
  3. sigmoid colon
  4. rectum
  5. proximal anus (above pectinate line)

 

438

what do all the structures supplied by the celiac, and S/I mesenteric arteries drain into?

Hepatic portal vein

439

What arteries are in the lateral plane?

  1. inferior phrenic
  2. suprarenal
  3. renal
  4. gonadal
440

what does the inferior phrenic artery supply?

inferior diaphragm

441

what do the suprarenal arteries supply?

adrenal glands

442

what do the renal arteries supply?

Kindeys

443

what is the hepatic portal vein?

a large venous system that drains directly into the liver

444

what does the liver do to blood in the hepatic portal vein?

  1. takes glucose out of the blood and stores it
  2. detoxifies the blood

 

445

T/F: the sugar removed from the blood at the liver is stored to sustain us between meals?

TRUE

446

how would liver disease affect venous blood flow in the hepatic portal vein?

liver BP would increase = backflow into portal system

=portal system shunts to azygous and inferior mesenteric veins 

=high volumes of blood in those veins can result in hemmorrhoids

447

the lateral plane (paired arteries) will not drain to the hepatic portal vein. Instead they drain _______

into veins with corresponding names 

these eventually drain into the inferior vena cava

448

describe lymph flow in the digestive tract

  • lymph capillaries in cavity and organ
  • lymp vessels
  • lymph nodes
  • cisterna chyli
  • thoracic duct
  • left angle between jugular and subclavian veins

 

449

what is the enteric nervous system?

the gut tube's own endogenous nervous system 

450

what does the enteric nervous system allow the gut tube to do?

continue to contract and secrete even after being removed from the body

451

what are the components of the enteric nervous system?

  1. submucosal plexus
  2. myenteric plexus

 

452

what is the role of submucosal plexus?

controls secretion from the glands in the mucosa

453

what is the role of myenteric plexus?

controls contraction of the circular and longitudinal muscles

454

What regulates the activity of the enteric nervous system?

the automonic nervous system (ANS)

455

how does PNS input impact the digestive tract?

increases secretion and contraction

456

what is the main PNS input to the digestive tract from?

CN 10

457

how does SNS input impact the digestive tract?

decreases contraction and secretion

458

describe the layers of the gut tube

  1. lumen surface
  2. muscular wall
  3. adventitia
  4. visceral peritoneum

 

459

sympathetic input to the abdominal organs come from what sources?

  1. chain (paravertebral) ganglia
  2. prevertebral ganglia (unpaired sympathetic ganglia)

 

460

what are the chain (paravertebral) ganglia?

come from lateral horns of T1-L2 

extend from cervical to sacral vertebral cord bilaterally

461

what are the prevertebral ganglia (unpaired sympathetic ganglia)?

associated ganglia with the aorta

names fro blood vessels comming off the aorta they are close too

462

Name the prevertebral ganglia

  1. celiac
  2. aorticorenal
  3. superior mesenteric
  4. inferior mesenteric

 

463

what are plexi in the abdominal region?

both sympathetic and parasympathetic nerves

464

name the plexi in the abdominal region

  1. celiac plexus
  2. superior mesenteric plexus
  3. inferior mesenteric plexus
  4. superior hypogastric plexus
  5. inferior hypogastric plexus

 

465

what are splanchnic nerves?

sympathetic nerves that connect:

  • spinal cord to chain ganglia
  • sympathetic chain ganglia to prevertebral ganglia and plexi

 

466

name the serous membranes in the abdominal cavity

  1. parietal pertioneum
  2. viseral peritoneum
  3. peritoneal cavity
  4. retroperitoneal

 

467

how is visceral peritoneum formed?

lining of the peritoneum is folded around abdominal organs. 

the base of fold binds the organ to the posterior abdominal wall and contains nerves, blood, and lymph vessels

468

What are the prominent peritoneal folds we need to know?

  1. mesentery
  2. mesocolon
  3. falciform ligament
  4. lesser omentum
  5. greater omentum

 

469

what is the mesentery?

peritonel fold that attaches small intestine to the posterior abdominal wall

470

what is the mesocolon?

peritoneal fold that attaches large intestine to the posterior abdominal wall

471

what is the falciform ligament?

peritoneal fold that attaches liver to anterior abdominal wall and diaphragm

472

what is the lesser omentum?

peritoneal fold that attaches stomach and duodenum to liver

473

what is found in the lesser omentum?

portal triad/liver hylus

474

what is the greater omentum?

peritoneal fold that attaches stomach, duodenum, and colon

475

where is there a pectinate line in the GI tract?

at the anal canal

476

describe sensory/innervation and blood supply superior to the pectinate line

  • visceral innervations (involuntary motor, unconscious sensory)
  • inferior mesenteric artery/portal venous drainage

 

477

describe sensory/innervation and blood supply inferior to the pectinate line

  • somatic (voluntary motor, conscious sensory = pain) innervations
  • internal illiac artery and caval venous drainage
    • bypasses the portal system

 

478

Name the accessory organs in the digestive tract

  1. Spleen
  2. Pancreas
  3. Liver
  4. Gallbladder, and Bile ducts

 

 

479

where is the spleen located?

superior left quadrant

within the rib cage

posterior to stomach

anterior to diaphram

480

What is the function of the spleen?

lymphatic organ

remove/recycle old RBCs 

act as blood reservoir

481

where is the pancreas located?

retroperitoneal 

superior right and left quadrants

482

what is the function of the pancreas?

  1. endocrine organ
  2. exocrine organ

 

483

what is the exocrine function of the pancreas?

secretes pancreatic jucie (which contains buffer and digestive enzymes) into duodenum 

484

how does pancreatic juice enter the duodenum?

hepatopancreatic ampulla duct

485

what is the endocrine function of the pancreas?

secretes insulin and glucagon into the blood

486

which pancreatic hormone is anabolic?

insulin 

glucoagon is catabolic

487

how is the pancreas connected to the duodenum?

  1. pancreatic duct and sphincter
  2. accessory pancreatic duct

 

488

the main pancreatic duct is also called what?

  1. hepatopancreatic ampulla (of Vater)
  2. hepatopancreatic sphincter (of Oddi)

 

489

where is the liver located?

largest gland

second largest organ

located inthe superior R/L quadrants

490

what are the functions of the liver?

  1. Digestion
  2. Excretion
  3. glucose storage
  4. blood detoxification
  5. production/secretion of plasma proteins
  6. calcium homeostasis

 

491

what does the liver excrete?

  1. bile acid and salts
  2. cholesterole
  3. bilirubin
492

where is the gallbladder located?

upper R quadrant, visceral surface of liver right lobe in right sagittal fissure

493

gallbladder and bile duct function

store, concentrate, and convey bile from liver to duodenum

494

where is the anal canal located?

perineum in an triangle of the pevic diaphragm

495

what are the attachments of the anal canal?

  1. anococcygeal ligament
  2. central point of the perineum = peroneal body
  3. external sphincter is blended into the levator ani, puborectalis, of the pelvic diaphragm
496

where are the kidneys located?

posterior abdominal wal

retroperitoneal

T12-L3

497

which kidney is higher?

Left kidney

498

describe the cross sectional anatomy of the kidneys

  1. tough outer capsule
  2. cortex
  3. medulla

 

499

what is in the renal cortex?

nephrons

500

what is in the medulla?

  1. pyramids 
  2. renal papillae
  3. collecting ducts
  4. columns

 

DPT Semester 1 (12 decks)

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