Dr. Anderson's Open Ended Qns

Question 1

Which muscle is presumably necessary to “unlock” the knee from its extended position?

Answer 1

Popliteus laterally rotates femur for unlocking at beginning of knee flex ion

Question 2

List the contents of the popliteal fossa (in order from deep to more superficial).

Answer 2

Contents: 
• Fat 
• Several popliteal lymph nodes 
• Popliteal bursa 
• Superficial to deep:  Tibial  nerve  Popliteal  vein  Popliteal  artery  •  Common  peroneal  (fibular) nerve 
• Small saphenous vein

Question 3

Name the nerve supply to each compartment of the thigh. - I have mention both cutaneous and regular innervation as well

Answer 3

Anterior compartment of thigh : femoral nerve

Cutaneous innervation: •Lat. Cutaneous branch of T12 •Genitofemoral nerve •Lateral cutaneous nerve of thigh •Anterior cutaneous branches of femoral nerve •Cutaneous branch of obturator nerve

Medial compartment of thigh: Obturator nerve, Tibial nerve

Posterior compartment of thigh
Cutaneous innervation: •Lateral cutaneous branch of iliohypogastric nerve •Superior clunial nerves: Posterior branches of L1 -3 •Medial clunial nerves: Posterior branches of S1-3 •Inferior clunial nerves: Anterior branches of S2-3 •Cutaneous branches of obturator nerve •Lateral and posterior cutaneous nerves of thigh: •Posterior cutaneous supplies most of the skin on the posterior thigh •Anterior rami of S1-S3 Innervation: •Common peroneal nerve: To biceps femoris brevis •Tibial nerve

Question 4

Name the muscles in each of the compartments of the thigh.

Answer 4

Anterior compartment of thigh:•Iliopsoas •Sartorius •Pectineus •Quadriceps: Rectus femoris, Vastus lateralis, Vastus intermedius, Vastus medialis

Medial compartment of thigh: •Gracilis •Adductor
longus •Adductor brevis •Adductor magnus •Obturator externus

Posterior compartment of thigh: Hamstrings: •Biceps femoris: Long head, Short head •Semimembranosus •Semitendinosus Adductor Hiatus: (??)

Question 5

Name the blood supply to each compartment of the thigh.

Answer 5

Anterior compartment of thigh: •Femoral Artery: •Superficial circumflex iliac •Superficial epigastric •Superficial external pudendal •Deep external pudendal •Descending genicular •Deep femoral (profunda femoris) •Lateral femoral circumflex •Medial femoral circumflex •Perforating arteries: Three plus termination of deep femoral

Medial compartment of thigh: •Obturator artery: Branch of internal iliac artery.

Posterior compartment of thigh: •Perforating arteries (from profunda femoris)

Question 6

Name the basic function(s) of the muscles in each compartment of the thigh.

Answer 6

Anterior compartment of thigh: Actions: •Hip flexion: Rectus femoris and Sartorius •Knee extension

Medial compartment of thigh: Action: •Adduction

Posterior compartment of thigh: Action: •Hip extension •Knee flexion

Question 7

Name the nerve supply to each compartment of the leg.

Answer 7

Superficial posterior compartment of leg: •Tibial nerve: •Supplies all muscles in post. compartment •Divides into medial and lateral plantar nerves inferior & posterior to medial malleolus •Gives off medial sural cutaneous nerve •Joins w/ communicating branch of common peroneal (fibular) nerve to form: Sural nerve: Cutaneous

Deep posterior compartment of leg: •Tibialis nerve

Anterior compartment of leg: •Deep peroneal (fibular) nerve •L4-5 to tibialis anterior. •L5-S1 for remaining muscles. •Runs deep to extensor digitorum longus. •Accompanies anterior tibial artery between extensor halluces longus and tibialis anterior muscles.

Lateral compartment of thigh: •Superficial peroneal (fibular) nerve: •Deep to peroneus longus •Inserts on lateral tuberosity

Question 8

Name the muscles in each of the compartments of the leg.

Answer 8

Superficial posterior compartment of leg: Gastrocnemius, Plantaris(may be absent), Soleus, Triceps surae

Deep posterior compartment of leg: Popliteus, Flexor digitorum longus, Flexor hallucis longus, Tibialis posterior

Anterior compartment of leg: Tibialis anterior, Extensor digitorum longus, Peroneus (fibularis) tertius, Extensor hallucis longus

Lateral compartment of thigh: Peroneus (fibularis) longus, Peroneus (fibularis) brevis

Question 9

Name the blood supply to each compartment of the leg.

Answer 9

Superficial posterior compartment of leg: •Posterior tibial artery: Largest branch of popliteal artery, Divides into medial and lateral plantar arteries deep to origin of abductor halluces muscle •Peroneal (fibular) artery: Most important branch of posterior tibial artery, Supplies lateral compartment and popliteus muscles, Supplies other muscles in posterior compartment

Deep posterior compartment of leg: Posterior tibial artery

Anterior compartment of leg: Anterior tibial artery •Smaller terminal branch of popliteal artery •Begins at inferior border of popliteus muscle •Becomes dorsalis pedis artery at ankle joint

Lateral compartment of thigh: No major arteries in lateral compartment •Muscular branches arise from the peroneal artery: •Branch of posterior tibial

Question 10

Name the basic function(s) of the muscles in each compartment of the leg.

Answer 10

Superficial posterior compartment of leg: ankle plantar flexion??? (google)

Deep posterior compartment of leg: flexes knee, plantarflexes foot, push off for walking and jumping and running, plantar flexion

Anterior compartment of leg: Toe extension •Ankle dorsiflexion

Lateral compartment of thigh: plantar flexion and foot eversion?

Question 11

The lateral sural cutaneous nerve is a branch of which nerve?

Answer 11

• Lateral sural cutaneous nerve: From common peroneal (fibular) nerve
• Medial sural cutaneous: From tibial nerve
• Sural nerve runs with lesser saphenous vein.

Question 12

Which ligament is the primary support for the medial longitudinal arch of the foot?

Answer 12

Ans: Plantar calcaneonavicular(spring)
Support ligaments: •Plantar calcaneonavicular(spring): Primary support for medial longitudinal arch •Long plantar: Primary support for lateral longitudinal arch

Question 13

Name the components of foot inversion and of foot eversion.

Can’t find components, just muscles- confused about the joints and ligaments of the foot that separate the function

Answer 13

Joints: Talocalcaneal (subtalar) joint, Talocalcaneonavicular joint a composite joint of Talocalcaneal joint & Talonavicular joint
Muscles:
Tibialis posterior •Functions in plantar flexion and foot inversion •Helps to maintain medal longitudinal arch
•Peroneus (fibularis) tertius: Part of extensor digitorum longus, Sometimes missing, Foot dorsiflexion and eversion
•Peroneus (fibularis) brevis: Deep to peroneus longus, Inserts on lateral tuberosity, Functions in plantar flexion and foot eversion

Question 14

Name the individual bones that constitute each of the three subdivisions of the foot.

Answer 14

?

Question 15

Name the four components of the medial collateral ligament of the ankle.

Answer 15

Medial collateral: •AKA: deltoid •Components: •Tibionavicular
•Tibiocalcaneal •Anterior tibiotalar •Posterior tibiotalar

Question 16

Which bones form the mortise and tenon joint of the ankle, and which is which?

Answer 16

Talotibial (talocrural) Joint AKA: ankle joint Most congruent joint in the body and it is a synovial hinge joint.
Mortise and tenon joint:
•Mortise: •Fibular malleolus •Tibial malleolus •Distal end of tibia •Tenon:•Head of talus

Question 17

Which nerve(s) innervate(s) the intrinsic muscles on the dorsum of the foot?

Answer 17

Lateral branch of peroneal nerve

Nerve supply:
•Superficial peroneal nerve: Gives rise to medial and intermediate dorsal cutaneous nerves and is cutaneous •Deep peroneal nerve: Lateral branch is motor to intrinsic muscles on dorsum: (Extensor hallucis brevis & Extensor digitorum brevis) Medial branch of deep peroneal is cutaneous
•Sural nerve: Gives off lateral dorsal cutaneous nerve

Question 18

Describe the cutaneous innervation of the dorsum of the foot.

Answer 18

Superficial peroneal nerve, Medial branch of deep peroneal and sural nerve

Nerve supply:
•Superficial peroneal nerve: Gives rise to medial and intermediate dorsal cutaneous nerves and is cutaneous •Deep peroneal nerve: Lateral branch is motor to intrinsic muscles on dorsum: (Extensor hallucis brevis & Extensor digitorum brevis) Medial branch of deep peroneal is cutaneous
•Sural nerve: Gives off lateral dorsal cutaneous nerve

Question 19

List characteristics of the dorsal and of the plantar interosseous muscles of the foot.

Answer 19

A ?

Question 20

List the muscles that make up each of the four layers of the sole of the foot.

Answer 20

First layer: Abductor hallucis, flexor digitorium brevis, adductor digiti minimi
Second layer: quadratus plantae, Lumbrical
Third layer: Flexor hallucis brevis, adductor hallucis, flexor digiti minimi brevis
Fourth layer: Dorsal interossei, Plantar interossei

Question 21

The tendon of which muscle passes between two sesamoid bones located at the base of the first metatarsus?

Answer 21

Tendon of the flexor hallucis brevis.

Question 22

Name the only basicranial bone that is entirely preformed in cartilage?

Answer 22

Ethmoid: •Only basicranial bone that is entirely preformed in cartilage
•Components: •Cribriform plate •Crista galli: Attachment for falx cerebri
•Perpendicular plate •Labyrinth: Superior and middle nasal conchae •Ethmoid air cells

Question 23

The supraorbital foramina (notches) are associated with which facial bone?

Answer 23

FRONTAL BONE: •Paired in fetus •Fused in adult: Metopic suture •Supraorbital foramina (notches)

Question 24

Which fontanelle located at the junction of the sagittal and lambdoidal sutures?

Answer 24

Posterior fontanelle ? GOOGLE

Question 25

The foramina rotundum and ovale are found in which of the regions of the skull?

Answer 25

Found on the sphenoid bone
Sphenoid: •Formed from both cartilage and dermal elements •Components: •Pterygoid plates: Medial and lateral plates hang down, Dermal components attached to endochondral portion of sphenoid base, Lateral, Medial •Body: Hypophyseal fossa : Aka: sella turcica, Four clinoid processes: Joined anteriorly by dorsum sellae(D)
Greater wings: •Lower flaps •Contribute to floor of middle cranial fossa: Location of temporal lobes
•Foraminae: Foramen rotundum (V2), Foramen ovale (V3), Foramen spinosum (Middle meningeal vessels )
•Upper flaps •Foraminae: Optic canal & Anterior clinoid process

Question 26

The tectorial membrane is a superior extension of which ligament?

Answer 26

The posterior longitudinal ligament extends all the way in through the foramen and attaches to the posterior rim of the foramen magnum. This extension from the atlas is referred to as the membrane tectoria.

Question 27

The posterior atlantooccipital membrane is a superior extension of which ligament?

Answer 27

Ligamentum flavum ?I think?
The ligamentum flavum segment that extends from the atlas to the anterior rim of the foramen magnum is the posterior atlantooccipital membrane (AOM).

Question 28

The muscles of the suboccipital triangle are innervated by which nerve?

Answer 28

C1 dorsal ramus provides motor innervation to the suboccipital muscles. The dorsal rami of C2 and C3 provide sensory supply.

Question 29

Describe the location and attachments of the cruciform ligament.

Answer 29

GOOGLE : The cruciate ligament of the atlas (also known as the cruciform ligament) is an important ligamentous complex that holds the posterior dens of C2 in articulation at the median atlantoaxial joint. It lies behind a large synovial bursa (surrounded by loose fibrous capsule) and consists of two bands:

longitudinal band: attaches the body of the C2 (axis) to the clivus and foramen magnum in the midline, lying between the apical ligament and tectorial membrane. It is relatively weak and hence does not contribute any significant stability.
transverse band (also known as the transverse atlantic ligament): attaches to a small tubercle on the medial cortex of the C1 (atlas) lateral masses on both sides anterior to the tectorial membrane and dura. It passes posterior to the dens, with a small intervening synovial capsule, fixing the dens to the posterior margin of the anterior arch of the atlas. It is the strongest ligament in the whole spine 2 and arguably the most important!

https://radiopaedia.org/articles/cruciate-ligament-of-the-atlas?lang=us

Question 30

Which facial muscle functions to close the eyes?

Answer 30

ORBICULARIS OCULI
•Origin: Orbital margin; palpebral ligament; lacrimal bone
•Insertion: Skin around margin of orbit; tarsal plates
•Action: Closes eyelids

Question 31

Name the branches of the facial artery.

Answer 31

Facial artery: •Branch of external carotid artery •Winds around lower border of mandible and becomes superficial •Passes lateral to angle of mouth •Branches: •Superior and inferior labial arteries •Lateral nasal artery •Angular artery Superficial temporal: •Terminal ranch of external carotid artery •Emerges between TMJ and auricle •Enters temporal fossa •Divides into frontal and parietal branches Transverse facial: •Arises from superficial temporal artery •Crosses face superficial to masseter muscle •Anastomoses with facial artery
•Branches supply:Parotid gland, Masseter muscle, Skin of face

Question 32

Which cranial nerve provides most of the sensation to the face?

Answer 32

Sensory Innervation of the face Sensory innervation of the face is via the trigeminal nerve (CN V): •Three branches: •Opthalamic •Maxillary •Mandibular

•Other sensory nerves: •Greater occipital •Lesser occipital •Great auricular (cervical plexus)

Question 33

What nerve provides sensory innervation to the very back of the head?

Answer 33

Greater occipital nerve:  Dorsal ramus of C2,  Sensory to back of skull

Question 34

Which cranial nerve provides motor innervation to muscles of facial expression?

Answer 34

Cranial nerve 7 (Facial nerve) is the primary motor nerve
to muscles of facial expression. •It supplies muscles derived from second pharyngeal arch (hyoid arch). •Branches: •Temporal •Zygomatic •Buccal •Mandibular •Cervical

Question 35

The adductor hallucis is found in the third layer of muscles on the sole of the foot. It is made up of both an oblique head and a transverse head. What is the common insertion of this muscle?

Answer 35

Base of proximal phalanx of the great toe with the flexor hallucis brevis

Question 36

The crural fascia forms retinacula in the foot. The superior retinaculum binds down tendons of muscles located in which compartment?

Answer 36

•Bind down tendons of: Tibialis anterior, Extensor hallucis longus, Extensor digitorum longus, Peroneus tertius

Question 37

The popliteal fossa is formed by the borders of four muscles. Which pair of muscles forms the inferior boundaries of the popliteal fossa?

Answer 37

Ans: Medial and lateral heads of the gastrocnemius

Boundaries: • Superior: Semimembranosus and semitendinosus • Inferior: Medial and lateral heads of the gastrocnemius

Question 38

During knee extension, the patella is pulled proximally by the quadriceps and also laterally. Which muscle is required to counteract the lateral pull on the patella?

Answer 38

Ans: Vastus medialis oblique (?)
During extension: • Patella is pulled proximally by quadriceps • Vastus lateralis tends to pull patella laterally • Vastus medialis oblique counteracts vastus lateralis.

Question 39

Which muscle attaches to both the medial aspect of the femur (linea aspera) and the adductor tubercle, creating the adductor hiatus?

Answer 39

ADDUCTOR MAGNUS:
•Origin: Ischial tuberosity & ischiopubic ramus
•Insertion: Gluteal tuberosity, medial lip of linea aspera; medial supracondylar line & adductor tubercle
•Action: •Adducts hip; upper fibers flex & internally rotate hip; lower fibers extend & externally rotate hip
•Innervation: Ant. division of obturator nerve & tibial branch of sciatic nerve (L2 -4)

Question 40

Which muscle is part of the posterior compartment of the thigh and attaches to the ischial tuberosity proximally and is capable of externally rotating the knee?

Answer 40

BICEPS FEMORIS (LONG HEAD):
•Origin: Ischial tuberosity and lower part of sacrotuberous ligament
•Insertion: Lateral side of head of fibula and lateral condyle of tibia •Action:• Flexes the knee and externally rotates the knee • Long head also extends the hip joint
•Innervation: Tibial portion of sciatic nerve (L5, S1 -2)

Question 41

Which muscle separates the exit of the superior and inferior gluteal arteries from the pelvic cavity?

Answer 41

Piriformis

Question 42

Describe innervation of the gluteal region.

Answer 42

Cutaneous Innervation Upper medial quadrant: Posterior rami of L1-3, Vascular Supply Internal iliac artery: •Arises from common iliac artery •Branches S1-3 Upper lateral quadrant: Iliohypogastric nerve (L1), Anterior rami from internal iliac: Superior gluteal, Inferior gluteal •Branches from femoral artery: T12 Lower medial quadrant: Branches from posterior femoral nerves (S1- •Medial femoral circumflex artery: Ascending branch anastomoses with inferior 3) Lower lateral quadrant: Branches from lateral femoral cutaneous nerve
gluteal artery. •Lateral femoral circumflex artery: Ascending branch anastomoses

Nerve supply: •Mostly supplied by branches of the: •Femoral nerve •Obturator nerve

(S2-3)

Question 43

Identify structures that pass through the greater and lesser sciatic foramina.

Answer 43

Sciatic Foramina Structures passing through lesser sciatic foramen: •Tendon of obturator internus •Nerve to obturator internus •Pudendal nerve •Internal pudendal vessels Sciatic foraminae: •Greater sciatic foramen: Passageway for structures entering or leaving pelvis •Lesser sciatic foramen: Passageway for structures entering or leaving perineum Structures passing through greater sciatic foramen: •Piriformis muscle •Sciatic nerve •Superior/inferior gluteal vessels and nerves •Pudendal nerve •Internal pudendal artery/vein •Posterior femoral cutaneous nerve •Nerves to quadratus femoris and obturator internus

Question 44

The Trendelenburg test is used to evaluate which muscle?

Answer 44

Trendelenburg test: •Evaluates strength of contralateral gluteus medius •Patient stands upright and raises one foot off the ground. •Contralateral gluteus medius should lower contralateral hip and raise ipsilateral hip. •Needed to clear foot from the ground during swing phase of walking

Question 45

Describe the function(s) of the three capsular ligaments of the hip joint.

Answer 45

Resists hyperflexion of hip

Iliofemoral ligament: •Strongest and most important ligament of the hip joint •Called the “Y” ligament of Bigelow •Proximal attachment: Anterior inferior iliac spine •Distal attachment •Intertrochanteric line •Resists hyperextension of the hip Pubofemoral ligament: •Proximal attachment: Pubis near inferior rim of acetabulum •Distal attachment: Neck of femur above lesser trochanter •Resists hyperextension of the hip Ischiofemoral ligament: •Proximal attachment: Ischium near posterior rim of acetabulum •Distal attachment: Neck of femur medial to greater trochanter •Resists hyperextension of the hip

Question 46

Describe the boundaries of the femoral triangle and the contents. Also list the contents of the femoral sheath.

Answer 46

Femoral Triangle
Borders: • Medial border of sartorius muscle
• Medial border of adductor longus muscle
• Inguinal ligament: • From ASIS to pubic tubercle
Contents (lateral to medial): • Femoral nerve (not in femoral sheath)
• Femoral artery (in femoral sheath)
• Femoral vein (in femoral sheath)
• Lymphatics (in femoral sheath in femoral canal)

Question 47

Describe the location and function of the ligamentum teres as related to the hip complex.

Answer 47

Ligamentum teres: •Proximal attachment: Fovea of femoral head •Distal attachment: Transverse acetabular ligament •Supports artery to the head of the femur

Question 48

Which muscle is required to counteract the lateral pull on the patella by the quadriceps during knee extension?

Answer 48

During extension: • Patella is pulled proximally by quadriceps • Vastus lateralis tends to pull patella laterally • Vastus medialis oblique counteracts vastus lateralis.

Question 49

What is the function of the menisci and coronary ligaments in the knee complex?

Answer 49

Functions: • Enhance stability of knee: Deepen articular surfaces • Distribute weight • Reduce friction between articular surfaces
Coronary ligaments: Attach menisci to rims of plateaus • Anterior transverse ligament: Joins menisci and allows them to move together