Drawings: Limbs Flashcards
What is the inferior, uncolored space containing 4 and 5 called?
What are its contents (4 and 5)?
What are its borders (6 laterally, 7 medially and 8 superiorly)?
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Lateral Triangular Space
4 is the radial nerve, 5 is the deep brachial artery
lateral border (6) is humerus
medial border (7) is long head of triceps
superior border (8) is teres major
What is the green highlighted portion of this drawing?
What does it contain (1 and 2)?
What are its borders (6, 7, 8 and 9)?
Quadrangular Space
- contains Posterior Circumflex Humeral Artery (1) and Axillary Nerve, Brachial Plexus (2)
Borders:
- lateral: humerus (6)
- medial: long head of triceps (7)
- inferior: teres major (8)
- superior: teres minor (9)
What is the orange highlighted portion of this image?
What does it contain (number 3)?
What are its borders (numbers 7, 8 and 9)?
Medial Triangular Space
- contains the Circumflex Scapular Artery (3)
Borders:
- lateral: long head of triceps (7)
- inferior: teres major (8)
- superior: teres minor (9)
What is # 1?
What is it made of?
Ulnar Carpal Eminence
- pisiform bone and hamulus of hamate
What is #3?
What covers it?
What does it contain?
Guyon’s Canal
- palmar carpal ligament covers it
- contains ulnar nerve and artery
What is #4?
flexor retinaculum
What is #5?
median nerve
What is #2?
What is it made up of?
Radial Carpal Eminence
- scaphoid and trapezium tubercles
What is the set of orange structures labeled #6?
tendons of flexor digitorum superficialis
What is the set of orange structures labeled #7?
tendons of flexor digitorum profundus
What is #8?
tendon of flexor pollicis longus
What is the pink line labeled 4 and what are its lateral and medial attachments, 1 and 11?
Inguinal Ligament (of Poupart)
- anterior superior iliac spine laterally
- pubic symphysis medially
What is #3?
ilipsoas muscle
What is #5?
femoral nerve
What are 6 and 8?
femoral artery and vein
what is #7?
genitofemoral nerve, femoral branch
What is #2?
lateral femoral cutaneous nerve
What is the green structure labeled #9?
Rosenmüller’s Lymph Node
What is the area labeled 10?
What covers it (labeled 12)?
Lacuna Lymphatica
lacunar ligament covers it
What are areas 13 and 14?
13 - Lacuna Vasorum
14 - Lacuna Musculonervosa
What are the borders of the femoral triangle?
2, 9 and 12
Include the lateral and medial ‘angles’… 1 and 7.
2 superiorly inguinal ligament
12 laterally sartorius
9 medially adductor longus
- inguinal ligament runs from ASIS (1) to pubic symphysis (7)
What nerve, artery and vein enter from the top of this region? (3, 4, and 5)
Through what “hole”? (6)
Femoral Nerve, Artery and Vein
- enter through the subinguinal hiatus
(artery and vein through lacuna vasorum, nerve through lacuna musculonervosa)
What makes up the “floor” of this region?
- labeled 13… but not that clear
Iliopectinal Fossa
made up of the iliopsoas medially and the pectineus laterally
What is # 10 which drains into #5 partway through this region via #8?
Name all three… 10, 5 and 8
The great saphenous vein (10) drains into the femoral vein (5) via the saphenous ring (or hiatus) (8) which is a hole in the fascia lata
What is #11?
Describe its route through #14 as it branches off of #3 and joins #10 at #18.
The saphenous nerve (11) branches off of the femoral nerve (3) within the femoral triangle and enters the adductor canal (14).
It then leaves the adductor canal midway down the thigh and joins the great saphenous vein (10) superficially (18)
What is #14 and what does it contain?
Where does it end? (not labeled here with a number… could be confused for 15 because this drawing is weird. Oops.)
Adductor Canal (14)
Contains the femoral artery and vein (4 and 5) as well as the saphenous nerve (11).
It ends at the Adductor Hiatus which is a hole in the between the oblique and medial heads of the adductor magnus.
What is #15?
And what are numbers 16 and 17 called?
Popliteal Fossa (15)
The femoral artery and vein (4 and 5) become the popliteal artery and vein (16 and 17) after passing the popliteal fossa.
What is this pink structure labeled 1?
What space does it divide?
Piriformis Muscle
divides the greater sciatic foramen into the supra- and infrapiriform hiatuses
What is the opening labeled 2?
(above the pink structure)
What does it contain?
Suprapiriform Hiatus
- contains the superior gluteal artery, vein and nerve
What is the orange structure labeled 3?
And where on the pelvis does it connect, labeled 8?
Sacrospinous Ligament
connects sacrum to ischial spine
What is the green structure labeled 4?
What part of the pelvis does it connect the sacrum to? (unlabeled)
Sacrotuberous Ligament
- connects sacrum to ischial tuberosity
What is the hole labeled 5?
What does it contain?
And the fibrous sheet labeled 6?
Obturator Canal
- contains obturator artery, vein and nerve
- fibrous sheet is obturator membrane which almost completely closes obturator formen of pelvic bone
What is the space labeled 7?
What does it contain?
Lesser Sciatic Foramen
- contains Pudendal Nerve (re-enters after exiting infrapiriform hiatus) and Internal Pudendal Artery and Vein
What is the space below the pink structure labeled #9?
What does it contain?
Infrapiriform Hiatus
contains:
- Sciatic Nerve
- Inferior Gluteal Artery, Vein and Nerve
- Pudendal Nerve (exits here, re-enters lesser sciatic foramen)
- Internal Pudendal Artery and Vein
- Posterior Cutaneous Femoral Nerve (less important for this midterm)
What are the three compartments of the thigh?
Labeled A, B and C
A - Extensor Compartment
B - Adductor Compartment
C - Flexor Compartment
What are the four muscles that are often grouped together in the anterior thigh called as a whole?
Identify them individually by their names and numbers in this drawing.
What innervates them all?
Quadriceps Femoris
- 1 is rectus femoris
- 2 is vastus intermedius
- 3 is vastus medialis
- 11 is vastus lateralis
- all innervated by the femoral nerve
What is #4?
Considering its position in this picture, what part of the thigh must this cross section be from?
Why?
Sartorius Muscle
- because it is medial here, this must be a middle to distal CS of the thigh because the sartorius originates laterally at the ASIS and runs inferomedially across the anterior thigh to insert at the pes anserinus
- sartorius is the LONGEST muscle in the body
What is #14?
What does it contain?
Adductor Canal
- contains the femoral artery and vein and the saphenous nerve
What is 15?
Great Saphenous Vein
What is #5?
adductor longus
What is #6?
Adductor Magnus
What is #7?
Gracilis
What nerve innervates 5, 6, and 7?
obturator nerve
What are the posterior muscles of the thigh known as collectively?
(Compartment C)
And what innervates them all… labeled 13 here?
Hamstrings
- innervated by sciatic nerve
What is #8?
Semimembranosus
What is #9?
Semitendinosus
What is #10?
Biceps Femoris
What is #1?
biceps femoris
What is #2?
Common Fibular Nerve
What is #3?
popliteus muscle
What is #4?
gastrocnemius
What is #5?
tibial nerve
What is #6?
popliteal artery and vein
What are numbers 7 and 8?
7 is semimembranosus
8 is semitendinosus
What are numbers 10 and 11 in the little image in the bottom right?
What vein does number 10 drain into?
10 is the lesser saphenous vein runs superficial to 11, the popliteal fascia
it drains into the popliteal vein within the popliteal fossa
How did Agota tell us to describe the popliteal fossa in a few concise sentences?
(hint: what is it, what are its borders, what covers it and what does it contain?)
- The popliteal fossa is a diamond shaped area at the back of the knee.
- It is bordered superiorly by the biceps femoris on the lateral side and the semimembranosus on the medial side. Its inferior borders are both made up of the gastrocnemius.
- It is covered by the popliteal fascia.
- It contains the popliteal artery and vein as well as the tibial and common fibular nerves. (Also some lymph nodes, but maybe that’s more than enough.)
What is #9?
the drawing is a bit off actually… 9 should be above the bifurcation that creates 2 and 5
the sciatic nerve which becomes the tibial nerve and common fibular nerve just superior to the popliteal fossa somewhere
What is 4?
Pointing to the yellow structure behind/beneath 3.
infrapatellar fat pad
What is 5?
infrapatellar bursa
what is 6?
prepatellar bursa
What is 8?
tendon of quadriceps femoris
What is 9?
What is special about this structure that makes it different from 5 and 6?
suprapatellar bursa
this bursa is continuous with the joint cavity
What is 10?
medial meniscus
What is the un-numbered purple structure right in front of 5?
patellar ligament
What is 2?
medial patellar retinaculum
continuous with joint capsule
What is 3?
How is it characterized?
medial mensicus
- larger and more lunate/sickle-shaped
- connects directly to joint capsule so is more injurable
What is 4?
tibial collateral ligament
what is 5?
where does it connect?
anterior cruciate ligament
- from lateral condyle of femur to intercondyloid eminence of tibia
what is 6?
where does it connect?
posterior cruciate ligament
- medial femoral condyle to tibial posterior intercondylar area
What is 7?
(the orange structure)
joint capsule
- lined inside with synovial membrane, outside with fibrous membrane
What is 8?
Popliteus muscle
What is 9?
How is it different than 4?
Fibular or Lateral Collateral Ligament
- tibial collateral ligament sits directly on the joint, wherease fibular collateral ligament sticks out somewhat and there is a space between it and the joint capsule
What is 10?
How is it characterized?
Lateral Meniscus
- smaller, more C-shaped… closer to being a closed circle than the medial meniscus
- more loosely connected, not directly attached to joint capsule
What is 11?
(green across front of joint)
transverse ligament
What is 12?
lateral patellar retinaculum
continuous with joint capsule
What is 1?
extensor digitorum longus
- more lateral and superficial
What is 3?
extensor hallucis longus
- more medial and deep
what is 2?
tibialis anterior
- anteriormost extensor, right next to tibia
What are 6 and 17?
What connects them?
6 is tibia
17 is fibula
- connected by interosseous membrane
what is 4?
what does it innervate?
deep fibular nerve
innervates all extensors
What is 5?
anterior tibial artery and vein
What are 12 and 16?
12 is great saphenous vein (medial)
16 is small saphenous vein (posterior)
What is 7?
tibialis posterior
What is 8?
Flexor Digitorum Longus
What is 9?
flexor hallucis longus
What is 10?
What does it innervate?
tibial nerve
- innervates all flexors
What is 11?
Posterior Tibial Artery and Veins
What is 13?
Soleus Muscle
What is 14?
gastrocnemius
What is 15?
Plantaris Muscle
What is 19?
peroneus longus
What is 18?
peroneus brevis
What is 20?
What does it innervate?
common peroneal nerve
- innervates peroneus muscles
What is 1?
(purple)
Where does it insert?
Tendon of Flexor Digitorum Longus
- inserts on plantar surface at base of distal phalanges II-IV
What is 2?
(green)
Where does it insert?
Tendon of Tibialis Posterior
- inserts on medial cuneiform and first metatarsal
What is 3?
(red and blue)
Posterior Tibial Artery and Vein
What is 4?
Tibial Nerve
- divides into medial and lateral plantar nerves
What is 5?
(orange)
Where does it insert?
Flexor Hallucis Longus Tendon
- inserts on base of distal phalanx I
What is the feature created by the purple and green lines at number 6?
Crural Chiasma
- flexor digitorum longus tendon crosses over tibialis posterior tendon
What is the feature formed by the purple and orange lines at #7?
Plantar Chiasma
- flexor digitorum longus tendon crosses over flexor hallucis longus tendon
Name all the colored structures in order starting from closest to medial malleolus.
- Tibialis Posterior Tendon
- Flexor Digitorum Longus Tendon
- Posterior Tibial Artery and Vein
- Tibial Nerve
- Flexor Hallucis Longus Tendon
What is 1?
origin and insertion?
Biceps Brachii
- long head is lateral and originates on supraglenoid tubercle
- short head is medial and originates on coracoid process
- both insert on radial tuberosity and bicipital aponeurosis
What is 2?
origin and insertion?
Brachialis
- anterior humerus to coronoid process/ulnar tuberosity
What is 3?
Origin insertion?
triceps brachii
- long head - infraglenoid tubercle
- lateral head - above humerus’ radial groove
- medial head (deep) - below humerus’ radial groove
- insertion (all 3) - olecranon process
What is 4?
and the nerve just posterior to it, number 9?
What does this innervate?
Humerus
- radial nerve runs just posterior to humerus, in radial sulcus
- radial nerve innervates triceps, and posterior compartment of arm (all extensors)
What are 5 and 6?
What is the name of the space in which they are found?
Brachial Artery and Vein
- found in the median bicipital groove
What is 7?
What does it innervate?
Median Nerve
- innervates all forearm flexors (except carpi ulnaris)
What is number 8?
What does it innervate?
Ulnar Nerve
- innervates hypothenar, interossei, lumbricals, adductor pollicis, flexor carpi ulnaris (and part of flex. digi. prof.)
What is 10?
basilic vein
What is 14?
Where can it be found at the top of the arm?
Cephalic Vein
- found in deltopectoral groove
What are 11 and 12?
11 - medial intermuscular septum
12 - lateral intermuscular septum
What is 13?
Brachial Fascia
What is 1?
insertion?
pronator teres
- inserts on middle of lateral radial surface
What is 15?
What does it innervate?
What is interesting about its course?
Musculocutaneous Nerve
- innervates all flexors of upper arm
- it perforates coracobrachialis
What is 2?
insertion?
flexor carpi radialis
- inserts on base of 2/3 metacarpals
What is 3?
insertion?
Palmaris Longus
- inserts on palmar aponeurosis
What is 4?
insertion?
flexor digitorum superficials
- inserts on base of middle phalanges 2-5
What is 5?
insertion?
Flexor carpi ulnaris
- inserts on pisiform, hamulus, and base of metacarpal 5
What is 6?
insertion?
Flexor Pollicis Longus
- inserts on base of distal phalanx of thumb
What is 7?
Insertion?
Flexor Digitorum Profundus
- inserts on base of distal phalanges 2-5
What is 8?
Because this is a mid-forearm cross section, why is 8 in parentheses?
Origin and insertion?
Pronator Quadratus
- in parentheses because pronator quadratus is only seen distally in the forearm, just proximal to wrist between radius and ulna
- originates on medial anterior ulna and inserts on lateral anterior radius
What is 9?
insertion?
Extensor Carpi Ulnaris
- inserts on dorsal 5th metacarpal
What is 10?
extensor digiti minimi
- inserts on base of 5th proximal phalanx
What is 11?
insertion?
extensor digitorum
- inserts on ‘extensor expansion’ of middle and distal phalanges 2-5
What is 12?
insertion?
abductor pollicis longus
- inserts on 1st metacarpal
What is 13?
insertion?
Supinator
- inserts on lateral proximal radial shaft
What deep extensors are missing from this cross section because of their shorter length (in radioulnar order)?
Origins and insertions?
extensor pollicis brevis - radius/interosseous membrane to proximal phalanx 1
extensor pollicis longus - posterior mid-ulnar shaft/interosseous membrane to distal phalanx 1
extensor indicis - posterior distal ulnar shaft/interosseous membrane to extensor hood
What is 15?
insertion?
Flexor Carpi Radialis Longus
- inserts on 2nd metacarpal
What is 14?
insertion?
Extensor Carpi Radialis Brevis
- posterior base of 3rd metacarpal
What is 16?
insertion?
Brachioradialis
- inserts on radial styloid process
What is 17?
median nerve
- innervates all flexors except carpi ulnaris
What is 18?
ulnar nerve
- innervates flexor carpi ulnaris and most of hand
What is 19?
ulnar artery and veins
What is 20?
deep branch of radial nerve
- radial nerve innervates extensors
What is 21?
radial artery and veins
What are 23 and 24 and the structure that connects them (22)?
23 is radius
24 is ulna
22 is interosseous membrane
