Exam 3

Question 1

Be able to identify the following landmarks, and note on which bone (ilium, ischium, pubis)
these feature may be found: Iliac crest, Iliac fossa, Acetabulum, Anterior Superior Iliac Spine,
Anterior Inferior Iliac Spine, Posterior Superior Iliac Spine, Posterior Inferior Iliac Spine,
Greater sciatic notch, Lesser sciatic notch. Ischial tuberosity, Obturator foramen, Pubic Tubercle,
Ischial ramus, Ischial spine, Superior pubic ramus, Inferior pubic ramus, Auricular surface

Answer 1

illium- Iliac crest, Iliac fossa, Acetabulum, Anterior Superior Iliac Spine,
Anterior Inferior Iliac Spine, Posterior Superior Iliac Spine, Posterior Inferior Iliac Spine,
Greater sciatic notch

illiac- Lesser sciatic notch. Ischial tuberosity, Obturator foramen, ischial spine, ischial ramus

pubis- pubic tubercle, superior pubic ramis, inferior pubic ramus,
auricular surface= auricular surfaces of illium and sacrum is where the sacroilliac joint goes

Question 2

Be able to identify the following landmarks, and note on which bone (ilium, ischium, pubis)
these feature may be found: Iliac crest, Iliac fossa, Acetabulum, Anterior Superior Iliac Spine,
Anterior Inferior Iliac Spine, Posterior Superior Iliac Spine, Posterior Inferior Iliac Spine,
Greater sciatic notch, Lesser sciatic notch. Ischial tuberosity, Obturator foramen, Pubic Tubercle,
Ischial ramus, Ischial spine, Superior pubic ramus, Inferior pubic ramus, Auricular surface

Answer 2

Question 3

Note the fusion of the ilium, ischium, and pubis at the acetabulum. Note that the ilium and
ischium make a greater contribution (approx. 4/5) to the acetabulum; while the pubis contributes
to 1/5 of the acetabular surface

Answer 3

acetabulum is the large cup shaped socket on the lateral aspect of the hip bone. Articulates with the head of the femur to form the hip joint. all three primary bones forming the hip bone contribute to the formation of the acetabulum

Question 4

Distinguish between the greater pelvis and lesser pelvis

Answer 4

Question 5

Identify the compartments of the thigh, the muscle group in that compartment, and the nerve that
supplies most of the muscles

Answer 5

No real lateral compartment. The muscles that would be in the lateral compartment (gluteus medius and minimus) do not extend past the greater trochanter of the femur tensor fascia lata as well but it continues down the thigh as the IT band, muscle at the hip

Question 6

What is the function of the fascia lata? What is the function of the iliotibial band?

Answer 6

fascia lata function= flex, abdduct medially rotate hip
Innervation= superior gluteal nerve
origin= ASIS
insertion= It band, IT band attaches to lateral condyle of tibia
function of IT band= tensor fascia lata tenses the fascia lata and IT band. When the knee is fully extended, the tensor fascial lata contirbutes to the extending force, adding stability, and plays a role in supporting the femur on the tibia when standing if lateral sway occurs.

Question 7

Pectineus

Identify the muscles of the thigh: anterior, medial, and posterior thigh muscles. Identify the bone
attachments, innervation, and action of each muscle

Answer 7

origin= superior rami of pubis
insertion= pectineal line of femur, just inferior to lesser trochanter
innervation=femoral nerve
actions= adducts and slightly flexes hip joint, assists with lateral rotation

Question 8

illiopsoas
Psoas major
PSoas minor

Answer 8

Psoas major origin: sides of T12-L5 vertebrae, transcerse processes of all lumbar vertebrae
Psoas minor origin: sides of T12-L1 vertebrae
Psoas major insertion= lesser trochanter of femur
Psoas minor= pectineal line and illiopubic eminenece
Innervation for both= anterior rami of lumbar nerve
Action for both= act conjointly in flexion and lateral rotation of hip joint

Question 9

Illiacius

Answer 9

Origin= illiac crest, illiac fossa, ala of sacrum,
insertion= tendons of psoas major, lesser trochanter
innvervation= femoral nerve
action= act conjointly in flexion and lateral rotation of hip joint (exact same as Illiopsoas muscles)

Question 10

Sartorius

Answer 10

origin= ASIS
insertion= superior part of medial surface of tibia
innervation= femoral nerve
action= flexes, abducts, laterally rotates hip joints, flexes knee joint

Question 11

Quadriceps femoris-
Rectus femoris
Vastus lateralis
Vastus medialis
vastus intermedius

Answer 11

Rectus femoris origin: AIIS
vastus lateralis origin: greater trochanter and lateral lip of aspera of femur
vastus medialis origin: interochanteric line and medial lip of linea aspera of femur
vastus intermedius: anterior and lateral surface of shaft of femur
Insertion for all= via quadriceps tendon (common tendinosus) and independent attachemnts to base of patella. medial and lateral vasti also attach to tibia and patella
innervation= femoral nerve
function= extend knee joint, rectus femoris helps illiopsoas with hip flexion as well

Question 12

adductor longus

Answer 12

origin= body of pubis inferior to pubic crest
insertion= middle third of linea aspera of femur
innervation= obturator nerve
adducts thigh

Question 13

adductor brevis

Answer 13

origin= body and inferior ramus of pubis
insertion= pectineal line and proximal part of linea aspera of femur
innervation= obturator nerve
action= adducts thigh and and to some extent flexes it

Question 14

adductor magnus

Answer 14

origin= adductor part: inferior ramus of pubis, ramus of ischium
hamstring part: ischial tuberosity
insertion:
adductor part=gluteal tuberosity, linea aspera
hamstring part= adductor tubercle of femur
innervation=
adductor part: obturator nerve
hamstring part: tibial part of sciatic nerve
action= adducts thigh, and flexes thigh
hamstring part extends it

Question 15

gracilis

Answer 15

origin= body and inferior ramus of pubis
insertion= superior part of medial surface of tibia
innervation= obturator nerve
action= adducts thigh, flexes leg, medialy rotation

Question 16

obturator externus

Answer 16

origin= margin of obturator foramen and obturator membrane
insertion= trochanteric fossa of femur
innervation= obturator nerve
action= laterally rotates hip joints

Question 17

semitendinosus

Answer 17

origin= ischial tuberosity
insertion= superior part of medial surface of tibia
innervation= tibial divison of sciatic nerve part of tibia
action= extend hip joints, flex knee joints, and medially rotate it when flexed.
when hip and knee joints are flexed (like when sitting) the muscles can extend trunk at hip joints

Question 18

semimembranosus

Answer 18

origin= ischial tuberosity
insertion= posterior part of medial condyle of tibia
innervation= tibial division of sciatic nerve part of tibia
main action=extend hip joints, flex knee joints, and medially rotate it when flexed.
when hip and knee joints are flexed (like when sitting) the muscles can extend trunk at hip joints

Question 18

biceps femoris

Answer 18

Long head origin= ischial tuberosity
short head origin= linea aspera and lateral supracondylar line of femur
insertion= lateral side of head of fibula
innvervation:
long head= tibial division of sciatic nerve
short head= common fibular divison of sciatic nerve
action= flexes knee joint and laterally rotates it when flexed. long head extends hip joints.

Question 18

Note that the quadriceps tendon surrounds the patella, classifying it as a sesamoid bone. Note
the role of the patella to increase the torque exerted by the quadriceps muscle group

Answer 18

The patella is the largest
sesamoid bone in the body
The patella
increases the
amount of torque
produced by the
quadriceps group

Question 19

What is the most common direction for a recurrent patellar dislocation? Name an anatomical
feature that helps to prevent this dislocation: (

Answer 19

lateral direction
vastus medialis obliques

Question 20

Describe the location (lateral to medial) of the femoral nerve, artery, and vein in the femoral
triangle

Answer 20

femoral triangle= boundaries are inguinal ligament, adductor longus, sartorius
NAVy lateral to medial

Question 21

What is the purpose and contents of the adductor canal?

Answer 21

Adductor canal a.k.a Hunter’s
Canal
This is a fibrous tunnel that prevents the
femoral vessels from getting squeezed
closed by the contraction of the large
thigh muscles

The apex of the femoral
triangle marks the opening of
the adductor canal
The femoral artery, femoral
vein, the saphenous nerve
and nerve to vastus
medialis (branches of the
femoral nerve) enter the
adductor canal

Question 22

exit of femoral artery and vein from adductor canal? what do they continue as

Note the exit of the femoral artery (and vein) from the adductor canal at the adductor hiatus and
its continuation in the leg as the popliteal artery (and vein)

Answer 22

The femoral artery and vein
exit the adductor canal at the
adductor hiatus; they
continue as the popliteal
artery and vein behind the
knee

Question 23

Identify the great saphenous vein and note its potential as blood vessel material used for coronary bypass procedures. Identify the function of valves in large veins in the lower extremity to assist in blood return against gravity back to the heart.

Answer 23

Large veins of the lower extremity have valves to help keep blood from pooling

Question 24

FUNCTION Describe the structure and function of the collateral ligaments of the knee. Note that the deep fibers of the tibial collateral ligament are attached to the medial meniscus; while the fibular collateral ligament is separated from the lateral meniscus by the tendon of popliteus.

Answer 24

THEY ARE EXTRASCAPULAR LIGAMENTS OF THE KNEE fibular collateral ligament (LCL)= extends inferioly from lateral epicondle of femur to lateral surface of the fibular head tibial collatearl ligament (MCL) = extends from medial epicondyle of the femur to the medial condyle of the tibia. MCL is attaches to medial meniscus, MCL is weaker then the LCL and is more often damaged. This causes the MCL and medial meniscus to tear together the collateral ligaments are taut when the knee is fully extended which gives stability when standing During flexion they become increasingly slack, which permits rotation at the knee

Question 25

identify the location and function of the cruciate ligaments of the knee what does ACL serve as?

Answer 25

THEY ARE INTRASCAPULAR LIGAMENTS OF THE KNEE the cruciate ligamentsare intracapsular but extrasynovial The cruciate ligaments prevent displacement of the tibia in the direction of their names Anterior Cruciate Ligament (ACL): Prevents Anterior Displacement of the Tibia. Weaker of the two ligaments. Posterior Cruciate Ligament (PCL): Prevents Posterior Displacement of the Tibia. weight-bearing flexed knee PCL is main stabilizing factor for femur (walking downhill) The ACL and PCL are not uniform bands—they are made of an anteromedial and a posterolateral portions, which act differently as the knee moves through its range The anteromedial bundle (a) lies parallel to the posterolateral bundle in extension; but tightens up as it wraps around the posterolateral bundle (b) in knee flexion. The anteromedial bundle serves as the primary restraint to anterior tibial movement in the flexed knee. | THEY

Question 26

Describe the anterior drawer test; posterior drawer test

Answer 26

Anterior Drawer Test: Assesses the status of the ACL Posterior drawer test: status of PCL

Question 27

Describe the structure and function of the knee menisci which meniscus is held tighter to tibia?

Answer 27

acts to cushion the bones of the knee joint The menisci are incomplete rings of fibrocartilage attached to the tibial plateau The menisci provide a little more contact for the femoral condyles on the tibial plateau The menisciare cup-shaped;steepest attheir outer margins menisci are attached to the tibial plateteau by the coronary ligaments medial meniscus is held to the tibia more tightly than lateral meniscus, it has less give when a force is applied Tears of the medial meniscus are especially common-its firmer attachment to the tibial plateau leaves it less able to withstand forces put on the knee

Question 28

Note the difference in structure between the medial and lateral menisci. Note the larger anterior-to-posterior distance in the medial meniscus. Describe the significance of this larger distance for the “screw-home” mechanism of the knee

Answer 28

The medial meniscus is larger in the anterior-to- posterior dimension The medial femoral condyle slides posteriorly, slightly more than the lateral femoral condyle, because the medial compartment is larger in the anterior- posterior direction The knee “locks” into place (called the “screw home” mechanism), resulting in a stable, weight-bearing position In full extension, the knee is stable to allow prolonged standing with minimal muscle activity popliteus is needed to move back into flexion when the knee is fully extended

Question 29

Locate the suprapatellar, subcutaneous infrapatellar, and subcutaneous prepatellar bursae of the knee. Which bursa is inflamed in housemaid’s knee and clergyman’s knee? What is a Baker’s cyst?

Answer 29

Inflammation of the subcutaneous prepatellar bursa = housemaid’s knee Inflammation of the subcutaneous infrapatellar bursa = monk’s knee (clergyman’s knee) bakers cyst= popiteal cyst

Question 30

Leg compartments with nerves

Answer 30

Question 31

Tibialis anterior ## Footnote Leg muscles.... Know the muscles in each compartment of the leg; proximal and distal attachments; what nerve innervates the muscle, describe the action of the muscles

Answer 31

origin= lateral condyle and superior half of lateral surface of tibia insertion= medial and inferior surfaces of medial cunfeiform and base of 1st metatarsal innervation= deep fibular nerve action= dorsiflex ankle, invert foot

Question 32

Extensor hallucis longus

Answer 32

origin= middle part of anterior surface of fibula insertion= dorsal aspect of base of distal phalanx of great toe innervation= deep fibular nerve action= extends great toe, dorsiflexes ankle

Question 33

extensor digitorum longus

Answer 33

origin= lateral condyle of tibia insertion= middle and distal phalanges of lateral four digits innervation= deep fibular nerve action= extends lateral four digits, dorsiflexes ankle

Question 34

fibularis (peroneus) tertius

Answer 34

origin= anterior surface of tibula insertion= dorsal surface of base of the 5th metatarsal innercation= deep fibular nerve action= dorsiflexion and eversion of the foot at ankle

Question 35

fibularis longus

Answer 35

origin= head and superior two thirds of lateral surface of fibula insertion= base of 1st metatarsal and medial cuneiform innervation= superficial fibular nerve action= evert foot, plantarflex

Question 36

fibularis brevis

Answer 36

origin= inferior two thirds of lateral surface of fibula insertion= dorsal surface of tuberosity of base of 5th metatarsal innervation= superficial fibular nerve action action= eversion and plantarflexion

Question 37

Gastrocnmeius

Answer 37

lateral head origin= lateral aspect of lateral condyle of femur medial head origin= popiteal surface, superior to medial condyle insertion= posterior surface of calcaneus to calcaneal tendon (achilles) innervation= tibial nerve action= plantarflex when knee is extended

Question 38

soleus

Answer 38

origin= posterior aspect of head of fibula, superior quarter of posterior surface of fibula insertion= posterior surface of calcaneus via calcaneal tendon (achilles) innervation= tibial nerve action= plantarflexes ankle

Question 39

plantaris

Answer 39

origin= inferior end of lateral supracondylar insertion= posterior surface of calcaneus via calcaneal tendon (achilles) innervation- tibial nerve action= weakly assist gastrocnmeius

Question 40

popliteus

Answer 40

origin= lateral surface of lateral condyle of femur insertion= posterior surface of tibia innervation= tibial nerve action= flexes knee and unlocks when standing fully extended

Question 41

flexor hallucis longus

Answer 41

origin= inferior two thirds of posterior surface of fibula insertion= base of ditsal phalanx of great toe innervation= tibial nerve action= flexes great toe, plantarflexes ankle

Question 42

flexor digitorum longus

Answer 42

origin= medial part of posterior surface of tibia inferior to soleal line insertion= bases of distal phalanex of lateral four digits innervation= tibial nerve action= flexes lateral four digits, plantarflexes ankle

Question 43

tibialis posterior

Answer 43

origin= interosseuous membrane, posterior surface of tibia inferior to soleal line insertion= navicular tuberosity and to cuneiforms innervation= tibial nerve action= plantarflexes ankle, inverts foot,

Question 44

What nerve is at risk when the neck of the fibula is fractured? What muscles would be affected, and how would the person’s gait be affected?

Answer 44

The common fibular nerve is at risk when the proximal fibula (near the fibular head) is fractured Damage to the common fibular nerve may lead to a condition called foot drop Foot Drop = Lack of Ankle Dorsiflexion, Toe Extension Compensated by a High-Stepping Gait muscle effected by footdrop are from the anterior compartment= tibialis anterior, extensor digitorum longus, extensor hallucis longus, fibularis tertius

Question 45

Describe the blood supply of the lower extremity (femoral artery, popliteal artery, anterior tibial artery, posterior tibial artery

Answer 45

femoral artery=

Question 46

What is meant by “compartment” syndrome?

Answer 46

Compartment Syndrome= Tissue injury, hemorrhage, edema, may compress muscles and restrict blood supply - Crural fascia is very strong Fasciotomy may be required

Question 47

gluteus maximus ## Footnote Identify the muscles of the gluteal region (gluteus maximus, gluteus medius, gluteus minimis). Note the bone attachment sites, origin, insertion, innervation, action. Identify the deep gluteal muscles (lateral rotators of the hip): piriformis, superior and inferior gemelli, obturator internus, quadratus femoris). Include obturator externus as a lateral rotator of the hip.

Answer 47

Gluteus Maximus –powerful hip extensor (as in stair climbing or rising from a seated position; also lateral rotation of thigh origin= illium, dorsum of sacrum and coccyx insertion= IT band, some fibers insert on gluteal tuberosity innervation= inferior gluteal nerve extends thigh, lateral rotation

Question 48

gluteus medius

Answer 48

origin= external surface of illium between anterior and posterior gluteal lines insertion= lateral surface of greater trochanter of femur innervation= superior gluteal nerve action= abduct and medially rotate tihgh

Question 49

gluteus minimus

Answer 49

origin= external surface of illium between anteiror and inferior gluteal lines insertion= anterior surface of greater trochanter innervation= superior gluteal nerve action= abduct and medially rotate

Question 50

piriformis ## Footnote Identify the deep gluteal muscles (lateral rotators of the hip): piriformis, superior and inferior gemelli, obturator internus, quadratus femoris). Include obturator externus as a lateral rotator of the hip.

Answer 50

origin= anterior surface of sacrum insertion= superior border of greater trochanter innervaiton= branches of anterior rami of S1 and S2 action= laterally rotate extended thigh and abduct flexed thigh

Question 51

superior and inferior gameli

Answer 51

origin: superior= ischial spine inferior= ischial tuberosity insertion= medial surface of greater trochanter innervation= superior gamellus is the nerve to obturator internus, inferior gamellus is nerve to quadratus femoris action= laterally rotate extended thigh and abduct flexed thigh

Question 52

obturator internus

Answer 52

origin= pelvic surface of obturator membrane insertion= medial surface of greater trochanter innervation= nerve to obturator internus action= laterally rotate extended thigh, abduct flexed thigh obturator externus is also a lateral rotator

Question 53

quadratus femoris

Answer 53

origin= lateral border of ischial tuberosity insertion= quadrate tubercle innervation= nerve to quadratus femoris action= laterally rotates thigh

Question 54

Describe the role of gluteus medius and minimis as abductors of the hip and their role in stabilizing the pelvis during gait. Describe the role of the lesser gluteal muscles and the superior gluteal nerve in Trendelenburg gait. Pg. 750

Answer 54

lesser gluteal muscles= gluteus medius and minimus, they abduct the thigh at the hip When the foot is free to move (open chain)- gluteus medius and minimus will abduct the thigh at the hip When the foot is planted (closed chain)- gluteus medius and minimus will contract to keep the pelvis level This allows the contralateral leg to clear the ground when taking a step forward Trendelenburg Sign (aka Trendelenburg Gait) Cause: Injury to Gluteus Medius and/or Gluteus Minimus; e.g. damage to Superior Gluteal Nerve Trendelenburg Sign (aka Trendelenburg Gait) The pelvis sags on the side contralateral to the injured muscle/nerve The contralateral leg moving forward (swing leg) cannot clear the ground (will drag) To compensate, the trunk leans toward the damaged side to help the swing leg clear the ground Trendelenburg gait requires a lot more muscle activity for walking— so walking can be very tiring

Question 55

Why is gluteus maximus commonly used for intramuscular injections? (abundant blood supply to the muscle). Explain why intramuscular injections are done in the upper right quadrant of gluteus maximus (This site avoids chance of the needle contacting the sciatic nerve). Pg. 751-752

Answer 55

Intramuscular injections into Gluteus Maximus are done in the upper right quadrant of the muscle, this avoids contact of the needle with the sciatic nerve glute max used for intramuscular injections for abundant blood supply to the muscle

Question 56

Largest nerve in posterior thigh? Two parts of sciatic nerve ## Footnote Identify the sciatic nerve as the largest nerve in the posterior thigh. Identify the two parts of the sciatic nerve: common fibular nerve and tibial nerve. Note that the physical separation of the sciatic nerve into the tibial and common fibular nerve usually occurs just proximal to the knee.

Answer 56

sciatic nerve two parts are common fibular nerve and tibial nerve . Note that the physical separation of the sciatic nerve into the tibial and common fibular nerve usually occurs just proximal to the knee.

Question 57

What is the function of the acetabular labrum? Identify the articular vs non-articular surfaces of the acetabulum

Answer 57

The depth of the acetabulum is deepened by a complete ring of fibrocartilage along its edge, called the acetabular labrum This provides better coverage for the head of the femur the floor of the acetabulum is not articular, and contains a pad of fat lunnate surface forms artiuclar surface non articular surce is formed by the centrally located acetabular fossa, which forms the floor of the acetabulum

Question 58

illiofemoral ligament (y ligament) ## Footnote Identify the ligaments of the hip joint (iliofemoral, ischiofemoral, pubofemoral) and the movements of the hip they limit. Note the location and role of the Ligament of the Head of the Femur

Answer 58

The hip ligaments allow a considerable amount of flexion, but become taut in full extension; greatly limiting the amount of extension possible at this joint illiofemoral ligament= one of the strongest ligament in the body,The Y ligament strongly resists hyperextension at the hip joint It assists in maintaining balance and upright posture,The Y ligament also resist external rotation and adduction at the hip joint

Question 59

pubofemoral ## Footnote Identify the ligaments of the hip joint (iliofemoral, ischiofemoral, pubofemoral) and the movements of the hip they limit. Note the location and role of the Ligament of the Head of the Femur

Answer 59

The pubofemoral ligament reinforces the capsule inferiorly The pubofemoral ligament resists the movement of abduction and external rotation All three ligaments limit medial rotation of the femur, to some extent

Question 60

ischiofemoral ## Footnote Identify the ligaments of the hip joint (iliofemoral, ischiofemoral, pubofemoral) and the movements of the hip they limit. Note the location and role of the Ligament of the Head of the Femur

Answer 60

The ischiofemoral ligament is the posterior reinforcement of the capsule The ischiofemoral ligament limits the movement of abduction and internal rotation, as well as hyperextension The ischiofemoral ligament is the weakest of the three

Question 61

Note the location and role of the Ligament of the Head of the Femur

Answer 61

The Ligament of the Head of the Femur (LHF) runs from the acetabular notch to the fovea capitis of the femur The LHF plays a minor role in movements of the hip; it somewhat limits abduction of the hip

Question 62

Why is the hip less likely to dislocate than other joints? Note the position of the thigh (adduction, medial rotation) where a blow to the femur may dislocate the hip

Answer 62

strong ligaments and muscle, The hip is more likely to dislocate when force is applied to a femur that is flexed, adducted and medially rotated Dashboard injury Congenital hip dislocation is sometimes seen in infants

Question 63

identify the blood supply to the hip: , and blood supply from the internal lilac artery: What are retinacular arteries, and what role do they serve in the blood supply of the hip?

Answer 63

From the Deep Femoral Artery:Medial Femoral Circumflex Lateral Femoral Circumflex From the Internal Iliac Artery: Obturator Superior Gluteal Inferior Gluteal Branches of the Medial Femoral Circumflex Artery are the most important blood supply to the head of the femur Branches of the Medial Femoral Circumflex are the Retinacular arteries that run in the joint capsule to supply the head of the femur Fractures close to the head of the femur are likely to tear the retinacular vessels and deprive the head of much of its blood supply Failure to re-establish the blood supply after femur fracture may result in avascular necrosis of the bone Usually requires hip replacement

Question 64

Note the relationship of the femoral neck and head to the shaft of the femur. Define the angle of inclination and note the value of the typical angle of inclination of the femur (125 degrees). Identify the cases when the angle is greater than (coxa valga) or less than (coxa vara) the typical value. How does that influence the alignment of lower extremity joints? (Coxa vara may be accompanied by genu valgus to compensate, commonly called “knock-knees”; Coxa valga may be accompanied by genu varus, commonly called “bow-legged”

Answer 64

angle of inclination= the angle between the neck and the shaft of the femur, typical angle is 125 degrees Varus = the distal part of the body segment is located more medially than normal, Valgus = the distal part of the body segment is located more laterally than normal, coxa valga= angle is greater than typical value coxa vara= angle is less than typical value

Question 65

Identify the angle of torsion (anteversion) and describe the impact of this angle on the position of the femur and patella

Answer 65

angle of torsion= a line through the femoral condyles in the transverse plane and another line following the head and neck of the femur. The angle between these two lines is the angle or torsion (averages 12-15 degrees). Values greater than 15 degree called anteversion. Values less than 15 are called retroversion

Question 66

Describe the significance of the bone trabecular pattern breakdown of trabecular pattern can cause what?

Answer 66

the proximal epiphysis contains trabecular bone (cancellous bone)-good for accommodating forces coming from many directions-allows bending Breakdown of the trabecular pattern may be seen in osteoporosis—bone is more vulnerable to fracture

Question 67

Distinguish between visceral and parietal serous membranes (pleura, pericardium, peritoneum) and note their relationship to organs and the body wall.

Answer 67

The lungs are surrounded by a serous membrane called pleura Serous membrane = mesothelium + thin connective tissue; mesothelium secretes serous fluid Serous membranes Pleura - Lungs Pericardium - Heart Peritoneum - Abdominal Organs Serous membranes have two layers outer layer- parietal inner layer- visceral

Question 68

Be able to define the cavities outlined by serous membranes: . Note that the normal contents of these cavities is a small amount of serous fluid

Answer 68

pleural cavity=surrounds the lungs, lined by the plerua pericardial cavity= surrounds the heart, lined by pericardium a peritoneal cavity= surrounds the abdominal organs, lined by the peritoneum Normally, there should only be a small amount of serous fluid in the pleural cavity The presence of blood, pus or air in the pleural cavity is associated with pathology

Question 69

Identify the fissures and lobes of the left and right lungs

Answer 69

right- 3 lobes, 2 fissures left- 2 lobes, 1 fissure fissure= A lung fissure is a deep groove or cleft that separates the lobes of the lungs

Question 70

identify the structures located at the hilus of the lung

Answer 70

(primary bronchus, pulmonary artery, pulmonary vein) Hilus: Site where nerves, blood vessels, primary bronchi enter the lung

Question 71

identify the muscles of respiration: identify accessory muscles of respiration

Answer 71

iidentify the muscles of respiration: diaphragm, intercostals; identify accessory muscles of respiration (e.g. pectoralis minor, anterior and middle scalenes, sternocleidomastoid)

Question 72

identify the divisions of the respiratory tree. . Be able to identify how many primary, secondary, and tertiary bronchi may be located on the left and on the right lungs

Answer 72

identify the divisions of the respiratory tree. (trachea, primary, secondary, tertiary bronchi, etc). right lung: 1 primary bronchi, 3 secondary bronchi, 10 teritary bronchi left lung: 1 primary bonchi, 2 secondary bronchi, 8 tertiary bronchi

Question 73

identify the role of surfactant lack of surfactant leads to what

Answer 73

(reduces surface tension to keep alveoli from collapsing Surfactant is a lipid-protein product that lowers surface tension; thereby helps keep alveoli from collapsing Lack of surfactant leads to respiratory distress syndrome in infants born prematurely (formerly called hyaline membrane disease) Administration of artificial surfactant may help support lung function in premature infants

Question 74

Define what a bronchopulmonary segment is, and describe the clinical significance of them (may be removed if needed in certain lung conditions) and identify how many are located in the left and right lungs.

Answer 74

Bronchopulmonary Segment= A portion of lung that receives its own segmental bronchus and a branch of the pulmonary artery Venous drainage is intersegmental Bronchopulmonary segments may be surgically removed in cases of lung disease or damage right lung= has 10 bronchopulmonary segments left lung= typically 8-9 segments

Question 75

Describe the gross anatomy of the heart. Describe the external and internal features of the atria and ventricles. Describe the differences in myocardial thickness between the right and left ventricles pgs. 366-37

Answer 75

go through heart slides Note the thicker walls of the left ventricle as compared to the right ventricle

Question 76

Identify and describe the structure of all heart valves: aortic, pulmonary, tricuspid, mitral (bicuspid)

Answer 76

The left atrioventricular (AV) valve = bicuspid valve The right atrioventricular valve = tricuspid valve 1. Aortic Valve Location: Between the left ventricle and the aorta. Structure: It has three cusps (leaflets) named the left, right, and posterior cusps. Function: Opens to allow oxygen-rich blood to flow from the left ventricle into the aorta and then to the rest of the body. It prevents blood from flowing back into the left ventricle 2. Pulmonary Valve Location: Between the right ventricle and the pulmonary artery. Structure: Composed of three cusps named the left, right, and anterior cusps. Function: Opens to allow deoxygenated blood to flow from the right ventricle into the pulmonary artery, which carries it to the lungs for oxygenation. It prevents blood from flowing back into the right ventricle 3. Tricuspid Valve Location: Between the right atrium and the right ventricle. Structure: It has three cusps (anterior, posterior, and septal). Function: Opens to allow blood to flow from the right atrium to the right ventricle. It prevents blood from flowing back into the right atrium when the right ventricle contracts 4. Mitral (Bicuspid) Valve Location: Between the left atrium and the left ventricle. Structure: It has two cusps (anterior and posterior). Function: Opens to allow oxygen-rich blood to flow from the left atrium to the left ventricle. It prevents blood from flowing back into the left atrium when the left ventricle contracts12. These valves are crucial for maintaining the unidirectional flow of blood through the heart and ensuring efficient circulation throughout the body

Question 77

# [](http://) Identify the structures of the conduction system (action potential conduction) of the heart; describe the path of the conduction signal from SA node to myocardium Pg. 377-378

Answer 77

conduction system of the heart= generates and transmits impulses that produce the coordinated contractions of the cardiac cycle Path of the Conduction Signal SA Node: The impulse begins at the SA node, causing the atria to contract. Internodal Pathways: The impulse travels through the internodal pathways to the AV node. AV Node: The AV node delays the impulse, allowing the atria to empty their blood into the ventricles. Bundle of His: The impulse moves from the AV node to the Bundle of His. Bundle Branches: The impulse travels down the right and left bundle branches. Purkinje Fibers: Finally, the impulse spreads through the Purkinje fibers, causing the ventricles to contract

Question 78

Describe the flow of blood through the heart-from venous return to the right atrium to left ventricular output

Answer 78

1. venous return to the atrium 2. right atrium to the right ventricle 3. right ventricle to pulmonary artery 4. pulmonary veins to left atrium 5. left atrium to left ventricle 6. left ventricle to aorta

Question 79

rectus abdominis ## Footnote Describe the bone attachments, action and innervation of the abdominal muscles (rectus abdominis, external abdominal obliques, internal abdominal oblique, transversus abdominis

Answer 79

origin= pubic symphysis and pubic crest insertion= xiphoid process innervation= thoraco-abominal nerves action= flex vertebral column (lumbar vertebrae) and compress abdominal viscera

Question 80

external oblique

Answer 80

origin= external surfaces of 5th-12th ribs insertion= linea alba, pubic tubercle, anterior half of iliac crest innervation= thoraco-abdominal nerves action= compresses and supports abdominal viscera, bilaterally compresses abdomen and flexes spine unilaterally- laterally flexes trunk to the same side and rotates trunk to the opposite side

Question 81

internal oblique

Answer 81

orgin= thoracolumbar fascia, anterior, two thirds of iliac crest insertion= inferior borders of 10th-12th ribs, linea alba innervation= thoraco-abdominal nerves action= compresses and supports abdominal viscera, bilaterally compresses abdominal viscera and flexes spine, unilaterally - laterally flexes and rotates the spine to the same side

Question 82

transversus abdominis

Answer 82

origin= internal surfaces of the 7th-12th costal cartilages, thoracolumbar fascia, illiac crest insertion= linea alba innervation= thoracoabdominal nerves action= compresses and support abdominal viscera

Question 83

Muscles of the posterior abdominal wall?

Answer 83

iliacus, psoas major, quadratus lumborum

Question 84

quadratus lumborum

Answer 84

origin= medial half of inferior border 12th ribs and lumbar transverse processes insertion= illiolumbar ligament and internal lip of illiac crest innervation= anterior branches of T12 and L1-L4 nerves action= extends and laterally flexes vertebral column

Question 85

identify landmarks of the abdominal region: arcuate line, linea alba

Answer 85

The anterior and posterior layers of the rectus sheath interlace in the anterior median line to form the linea alba The point where the aponeuroses pass anterior to rectus abdominis is called the arcuate line

Question 86

Describe the contribution of the three lateral muscles to the rectus sheath; note the relationship of their aponeuroses to the rectus abdominis muscle (above the arcuate line): External oblique-anterior to rectus abdominis; internal oblique-aponeurosis splits so that it surrounds rectus abdominis; transversus abdominis-posterior to rectus abdominis. Below arcuate line—aponeuroses of all three lateral muscles are anterior to rectus abdominis pg. 417, Fig 5.6

Answer 86

three lateral muscles- external abdominal oblique, internal abdominal oblqiue, transversus abdominis The lateral muscles have a thin aponeurosis that surrounds a pair of vertically-oriented muscles - Rectus Abdominis The aponeuroses form the rectus sheath, which fuses in the midline to form the linea alba Above the Umbillicus: -the aponeurosis of the external oblique passes anterior to rectus abdominis -the aponeurosis of the internal oblique splits into two layers-one layer passes anterior to rectus abdominis; the other passes posterior to rectus abdominis -the aponeurosis of transversus abdominis passes posterior to the rectus abdominis Below the umbilicus: -The aponeuroses of all three lateral muscles pass anterior to rectus abdominis - The point where the aponeuroses pass anterior to rectus abdominis is called the arcuate line

Question 87

Provide an example of a retroperitoneal organ in the abdominal region (lecture ppt

Answer 87

Some organs become associated with the posterior abdominal wall, and will be only partially covered by peritoneum-These organs are called retroperitoneal Retroperitoneal Organs Kidneys Duodenum Pancreas Ascending colon Descending colon

Question 88

Identify the roles of the greater omentum (lecture ppt)

Answer 88

covers the intenstines as an apron protection, fat storage,

Question 89

Identify the prevertebral muscles and describe their actions

Answer 89

longus colli- bilaterally flex neck, unilaterally flex neck to opposite side longus capitis- bilateraly flexion of neck, lateral flexion laterally rectus capitis anterior-Flexion of head at atlantooccipital joint (bilateral) Lateral flexion of head (unilateral) rectus capitis lateralis- lateral flexion of the head

Question 90

dentify the muscles, bone attachments, actions and innervation of muscles of the suboccipital region: Rectus capitis posterior major, rectus capitis posterior minor, obliquus capitis superior, obliquus capitis inferior Identify the contents of the suboccipital triangle Head and neck Pgs. 934-941 Provide an example of a muscle of facial expression. Identify the Facial Nerve (C.N. VII) as the nerve supplying motor innervation to the muscles of facial expression Identify the four muscles of mastication: Temporalis, Masseter, Medial Pterygoid, Lateral Pterygoid. Note their general bone attachments and location. Identify the nerve supplying motor innervation to the muscles of mastication: Trigeminal Nerve (mandibular branch C.N. V3): Describe the structure of the temporomandibular joint. Note the location of the articular disk, and note how it separates the joint cavity into superior and inferior compartments. Anterior and Posterior Neck Review the superficial anterior and posterior muscles of the neck (platysma, sternocleidomastoid, trapezius); their bone attachment sites, innervation, action. pgs.1008-1011 Review the suprahyoid and infrahyoid muscles (note their attachment to the hyoid bone). pgs. 1018-1022