Exam 3 Flashcards

Question 1

Q

Name the system

transports fluids throughout the body
function to transfer essential materials btw external environment and internal organs
carries oxygen, nutrients, and waste to and from cells

Answer

A

CIRCULATORY SYSTEM

-consist of 2 systems : Cardiovascular and lymphatic systems

Question 2

Q

There are 2 types of systems in the circulatory system. Name the system respectively

collects fluid from tissue spaces and returns it to venous circulation
consist of heart and blood vessels (arteries, capillaries, veins)

Answer

A

LYMPHATIC SYSTEM

- CARDIOVASCULAR SYSTEM

Question 3

Q

Describe the pathway of blood flow to and from the heart

How many valves (from what to what)
What are the 2 types of circulation (what is the flow)?

Answer

A

RIGHT ATRIUM - Right Ventricle - Pulmonary arteries - LUNGS - lung capillary beds - pulmonary veins - left atrium - left ventricle - systemic arteries - systemic capillary beds - systemic veins - RIGHT ATRIUM

**4 valves 
RA to RV (tricuspid valve) 
RV to pulmonary arteries (pulmonary valve) 
LA to LV (mitral valve) 
LV to systemic arteries (Aortic valve)

Question 4

Q

Name the 2 types of circulation respectively
-pumps LOW OXYGEN blood from the RV to the LUNGS (through pulmonary arteries), returns oxygen-rich blood to the left atrium of the heart via pulmonary veins

-pumps OXYGEN RICH blood from LV to all parts of the BODY through the aorta, returns blood to the right atrium of the heart through superior and inferior vena cava and cardiac veins (located on heart)

Answer

A

Pulmonary circulation

- Systemic circulation

Question 5

Q

Name the blood vessel types functions respectively

Arteries
Veins
capillaries

What are the exceptions?

Answer

A

carry OXYGEN-RICH blood under relatively HIGH PRESSURE AWAY from heart to BODY
- exception : PULMONARY ARTERY : carry LOW-OXYGEN blood to LUNGS
carry blood under LOWER PRESSURE than arteries; return LOW-OXYGEN blood to heart
*exception: PULMONARY VEINS carry OXYGEN-RICH blood back to HEART

-connect arterial and venous circulation for nutrient, O2 and waster EXCHANGE

Question 6

Q

Most arteries and veins consist of 3 layers:

Which is which
-inner lining of endothelial cells (single layer) supported by delicate connective tissue; allow DIFFUSION from lumen into vessel wall

outer connective tissue layer
middle smooth muscle layer; most variable layer in thickness and amount of elastic fibers; controls arterial gasometer force (constriction and dilation of vessels)

Answer

A

TUNICA INTIMA

TUNICA ADVENTITIA

TUNICA MEDIA

Question 7

Q

There are 3 types of blood vessels; arteries, veins and capillaries. There blood vessels can be further divided into different types.
WHat is the name of the vessel that RECEIVE the INITIAL CARDIAC OUTPUT? How?
These same vessels can maintain a CONSTANT BP, as heart contracts and relax

Answer

A

LARGE/CONDUCTING ELASTIC arteries

They have many layers of elastic fibers in the TUNICA MEDIA to allow expansion and recoil during the cardiac cycle.
This helps maintain a constant flow of blood, minimizing changes in blood pressure as the heart contracts and relaxes

E.g Aorta, arteries that originate off ARCH of area (left subclavian, left common carotid, brachiocephalic trunk) and pulmonary trunk

Question 8

Q

There are 3 types of blood vessels; arteries, veins and capillaries. There blood vessels can be further divided into different types.
What is the name of the vessel that are composed primarily of the smooth muscle in the tunica media. This allows vessels to DECREASE in diameter (VASOCONSTRICT) and regulate blood flow to different parts of the body

Answer

A

MEDIUM/Distributing MUSCULAR Arteries

-E.g Most of the named arteries including FEMORAL/Thigh and BRACHIAL/arm

**There are 3 types of artery :
Large/conducting elastic artery
medium/distributing muscular arteries
small arteries and arterioles

Question 9

Q

There are 3 types of blood vessels; arteries, veins and capillaries. There blood vessels can be further divided into different types.

1) What has narrow lumina and THICK muscular walls?
2) What helps control the filling of capillary beds and regulate the arterial pressure in the vascular system?

Answer

A

1) Small arteries and arterioles
2) Smooth muscle walls of arterioles

E.g not named or identified during dissection, arterioles can only be observed under high magnification

**There are 3 types of artery :
Large/conducting elastic artery
medium/distributing muscular arteries
small arteries and arterioles

Question 10

Q

There are 3 types of blood vessels; arteries, veins and capillaries. There blood vessels can be further divided into different types.

What are the smallest unnamed veins that drain capillaries.
These join to form SMALL VEINS that empty into larger veins and unite to form what?

Answer

A

VENULES
VENOUS PLEXUS

E.g venules are not named or identified during dissection and can only be observed under MAGNIFICATION. The Dorsal VENOUS ARCH of the foot is an example of a larger venous plexus

*There are 3 types of veins
Venues
Medium veins
Large veins

Question 11

Q

There are 3 types of blood vessels; arteries, veins and capillaries. There blood vessels can be further divided into different types.

Name the vein type

drain venous plexus and accompany medium arteries
contain small amounts of smooth muscle
thickest layer is TUNICA ADVERTITIA

What does this vein have special and function?

Answer

A

MEDIUM VEINS

**have VENOUS VALVES - passive flaps that permit blood to flow toward the heart but not in reverse direction (The valves help flow against gravity)

E.g named superficial veins of upper and lower limbs (cephalon and basilica of upper limb and great and small saphenous of lower limb)

Question 12

Q

There are 3 types of blood vessels; arteries, veins and capillaries. There blood vessels can be further divided into different types.

Name the structure and function of LARGE VEINS

Answer

A

contain smooth muscle
A well developed tunica adventitia

E.g superior vena cava, inferior vena cava, portal vein

Question 13

Q

Distinguishing features of veins from arteries

1) Which have thin walls? Thick wall?
2) Which have large luminal diameter?
3) Which pulsate? Spurt when severed?
4) Which accompany the other?
5) Which have valves? Why?
6) Which can expand? How?

Answer

A

1) Veins have thin walls (especially tunica media)
2) Veins have large luminal diameter
3) Veins do not pulsate or spurt blood when severed
4) Veins tend to occur as multiple vessels that ACCOMPANY v=arteries of the same name The accompany veins (L.venae Comitantes) occur as multiple vessels adjacent to an artery in a common vascular sheath
5) veins have VALVES to prevent backflow of blood
6) Veins contain approximately 80% of blood volume due to their large diameter and ability to EXPAND (arteries don’t have same capacity for expansion)

Question 14

Q

What are the main differences between arteries and veins

Answer

A

ARTERIES

Transport blood AWAY from heart
carry OXYGEN rICH blood (except pulmonary artery - carry low oxygen blood to lungs)
Have relatively NARROW LUMEN
Have MORE MUSCLE and elastic tissue (helps hold their shape)
Transport blood under HIGH PRESSURE
DO NOT HAVE VALVES (except valves of pulmonary artery and aorta

VEINS

Transport blood TOWARD the heart
Carry LOW OXYGEN blood (except for pulmonary veins -carry HIGH OXYGEN BLOOD to heart)
Have relatively LARGE LUMEN
Have relatively LESS MUSCLE and elastic tissue
Transport blood underLOWER pressure
HAVE VALVES throughout main veins of the body to prevent backflow of blood to body

Question 15

Q

What happens at capillary beds?

Answer

A

EXCHANGE OF MATERIALS

Question 16

Q

What micro diameter vessel allow exchange of oxygen and nutrients in tissue spaces.

Answer

A

CAPILLARIES

**They are the smallest vascular channel averaging 50micrometers in length and
8-10 micro meters in diameter(RBC are 7.5micro meter in diameter)
**They are composed of simple endothelial cell tubes

Question 17

Q

What are networks of capillaries that connect arterioles and venules called?
What happens at the arteriole and venule end respectively?

Answer

A

CAPILLARY BEDS
At Arteriole end ; hydrostatic PRESSURE forces fluid containing OXYGEN and nutrients out of the blood into the cellular space for exchange
At VENULE END ; osmotic pressure allows waste and CO2 to be reabsorbed into blood for return to the heart

Question 18

Q

What are the 3 vessels that do microcirculation?

Answer

A

ARTERIOLES
CAPILLARIES
VENULES

Question 19

Q

What are principal vessels?

- Name the 3 main arteries that branch from arch of aorta (carry OXYGEN-RICH blood from LV to rest of body)

Answer

A

-Principal vessels are the MAJOR named vessels of the body
-1) BRACHIOCEPHALIC TRUNK divided into ; a) right subclavian artery (feeds upper limb) and b) right common carotid artery (to head and neck)
2) LEFT COMMON CAROTID ARTERY - supplies head and neck
3) LEFT SUBCLAVIAN ARTERY - supplies upper limb
-

Question 20

Q

-What are the other principal vessels going to and from the heart and what do they supply

Answer

A

1) superior and fervor vena cave - return low-oxygen blood to right atrium of heart
2) Pulmonary veins - carry oxygen rich blood into left atrium of heart
3) Pulmonary trunk - carry low-oxygen blood from the right ventricle to the lungs
4) Aorta - carries oxygen-rich blood from left ventricle to tissues throughout body
5) abdomina aorta - continuation of aorta into abdomen ; gives branches to abdomina organs, divides into common iliac arteries
6) . Common iliac arteries - divide into external and internal iliac (supplies blood to pelvis and lower limb)

Question 21

Q

WHat is the name of the venous system that Lin’s 2 capillary beds before returning to the heart

Answer

A

PORTAL VENOUS SYSTEM

*In certain regions, blood passes through two capillary beds before returning to the heart

Question 22

Q

There are 2 classes of portal venous systems

Name this

This system drains blood from capillary beds of the digestive tract into the hepatic portal vein, which branches into capillary beds (sinusoids) of the liver
This allows materials to be metabolized and DETOXIFIED before returning to the heart

Answer

A

HEPATIC PORTAL SYSTEM

Question 23

Q

-There are 2 classes of portal venous systems

Name this

This system drains blood from capillary beds at the base of the hypothalamus to a capillary plexus around the anterior pituitary gland
This allows Neuro secretory hormones from the hypothalamus to leave the lord and stimulate cells o the anterior pituitary gland to induce the release of pituitary hormones

Answer

A

HYPOPHYSEAL PORTAL SYSTEM

**The 2 portal venous systems are Hepatic portal and HYPOPHYSEAL portal system

Question 24

Q

What is a one-way drainage system for returning excess fluids and cellular debris TO THE BLOODSTREAM

What are the functions of these system

Answer

A

LYMPHATIC SYSTEM

transport large protein molecules that cannot pas through capillaries
returns up to 3L of excess fluid from cellular spaces each day

Question 25

Q

Name the vessel

network of blind/closed tubes that originate in the cellular spaces of tissue
occur almost everywhere blood capillaries are found except teeth, bone, bone marrow, and CNS
lack a basement membrane so tissue fluid, proteins, bacteria and even whole cells enter easily

Answer

A

LYMPHATIC CAPILLARIES

Question 26

Q

What are the following

1) Network of thin-walled, valve-containing vessels that occur throughout the body
2) clear, yellowish fluid that is transported in lymph vessels
3) Masses of lymphatic tissue that filter lymph on its way to the venous system
4) large collecting vessels that unite to form Right lymphatic duct or thoracic duct

Answer

A

1) Lymphatic vessels
2) Lymph
3) Lymph nodes
4) Lymphatic trunks

Question 27

Q

Lymphatic trunks are large collecting vessels that unit to form right lymphatic duct or the thoracic duct; both empty into the venous system in the neck at the junction of the internal jugular veins and the subclavian veins.

How do both drain lymph?

Answer

A

RIGHT LYMPHATIC DUCT - drains lymph from the upper right quadrant of the body
-right side of the head, neck, thorax and right upper limb

THORACIC DUCT
-drains lymph from the rest of the body
Begins at CISTERNAE CHYLI (large collecting sac that merge lymphatic trunks draining the lower half of the body)
-The thoracic duct ascends into and through the thorax and joins the venous system at the LEFT VENOUS ANGLE, the junction of the left internal jugular vein and left subclavian vein

Question 28

Q

Name the clinical problem

1) The most common acquired disease of the arteries that is characterized by thickening and loss of elasticity of arterial walls
2) build up of fat and cholesterol in arterial walls
3) clot formed in a blood vessel or in a chamber of the heart that DOES NOT MOVE to another part of the body (it remains in the place of origin)
4) Blood clot that detaches from place of origin and travels to the blood stream

Answer

A

1) Arteriosclerosis
2) Atherosclerosis (common form of arteriosclerosis)
3) Thrombus
4) Embolus

Question 29

Q

Name the clinical problem

5) obstruction of a blood vessel due to an embolus
6) Area of ischemic necrosis due to TOTAL occlusion of an artery
7) PARTIAL occlusion or narrowing of an artery associated with tissue damage
8) develops if muscle tonus/firmness of arteriole smooth muscles is above normal
9) Abnormally swollen and dilated veins usually occurring in the legs. Walls of veins lose their elasticity and damaged valves allow blood to pool in the veins rather than ascending to the heart
10) swelling of tissue due to excess amount of interstitial fluid. Lymphatic system prevents this accumulation of fluid under normal circumstance

Answer

A

5) Embolism
6) Infarct
7) Stenosis
8) Hypertension (Arteriole smooth muscle control the filling of capillary beds and regulate arterial pressure in the vascular system)
9) varicose veins
10) Edema

Question 30

Q

Name the clinical problem

11) Regions where blood passes directly from arterial to venous sides of circulation without passing through capillaries
12) communications between arteries that supply regions of the body. These communications can occu between multiple branches of a main artery, or btw series of smaller vessels that supply a tissue in addition to its main blood supply
13) DO NOT ANASTOMOSES with adjacent arteries. Arterial occlusion result in TISSUE NECROSIS

Answer

A

11) Arteriovenous anastomoses (AV shunts)- found in regions of skin (esp fingers) for temperature regulation. Also found in the GUT and are open except during digestion
12) Arterial anastomoses - communication provide COLLATERAL CIRCULATION that is important for maintaining blood supply to a region in the case of a blockage e.g occur around the major joints ; shoulder, elbow, wrist, knee and ankle
13) End Arteries - blockage of an end artery interrupts blood flow to the organ or organ segment it supplies (i.e retina). Functional end arteries supply regions of the brain, liver, kidneys and spleen. Vital organs supplied by end arteries usually develop TISSUE NECROSIS after arterial occlusion (e.g retinal artery blockage leads to blindness)

Question 31

Q

1) What is the joint between the femur and tibia called?
2) What is the sesamoid bone anterior to knee joint?
3) What is on the posterior side of knee?
4) What forms he 2 joints of the ankle?

Answer

A

1) KNEE
2) PATELLA/Knee cap
3) Popliteal region
4) -One between tibia, fibula and talus
- another between talus and other bones of foot

Question 32

Q

How does the orientation of upper and lower extremities change with development?

Answer

A

Beginning in 4th week

UE and LE develop as buds with similar structure
arms and legs similar in structure with differences in FUNCTION
Both extremities develop as PROJECTIONS from body axis
Arms and legs initially have same orientation, PERPENDICULAR to SPINAL COLUMN (palms touch, soles touch)

DEVELOPMENT

UE rotate laterally (palms forward) **THUMB IS LATERAL
LE rotate medically (soles of feet back and down) **BIG TOE IS MEDIAL

Question 33

Q

How do dermatomes of lower extremity change through development?

Name the following body parts the nerves innervate 
L1
L3,L4
L4
S1
S1,S2

Answer

A

1)Spinal nerves are initially in SEGMENTAL BANDS (UE- C3-T2; LE L1-S2) that elongates: in adult lower extremity; reflect rotation

2) 
L1 - Inguinal ligament 
L3,L4 - anterior knee (patella) 
L4 - medial side of foot, BIG TOE (HALLUX in Latin) 
S1 - lateral side of foot, LITTLE TOE 
S1,S2 - posterior side of leg and thigh

Question 34

Q

1) What 2 parts do the inguinal ligament attach to?
2) What makes up the bones of the pelvis
3) What makes up the innominate bone
4) Where do the 3 bones that make up innominate bone join

Answer

A

1) Anterior superior iliac spine (palpable) and Pubic tubercle
2) 2 Innominate bones, sacrum and coccyx
3) Ilium, Ischium and Pubis
4) - all 3 join at acetabulum (vinegar cup -socket for hip joint)

Question 35

Q

1) What 2 parts do the inguinal ligament attach to?
2) What makes up the bones of the pelvis
3) What makes up the innominate bone
4) Where do the 3 bones that make up innominate bone join

Answer

A

1) Anterior superior iliac spine (palpable) and Pubic tubercle
2) 2 Innominate bones, sacrum and coccyx
3) Ilium, Ischium and Pubis
4) - all 3 join at acetabulum (vinegar cup -socket for hip joint)

Question 36

Q

1) What is the large opening surrounded by ischium, pubis and what is it covered by?
2) What is the large bony prominence on posterior part of ischium; people SIT on this and can get pressure from prolonged sitting

Answer

A

1) OBTURATOR FORAMEN
- COvered by the OBTURATOR membrane for muscle attachment
2) ISCHIAL TUBEROSITY

Question 37

Q

1) What is the name of the Ligament that join the sacrum with the ischial spine
2) What is the name of the ligament that join the sacrum to the ischial tuberosity

3) What is the MAIN function of these 2 Ligaments

Answer

A

1) Sacrospinous ligament
2) Sacrotuberous ligament

3) Sacrospinous and Sacrtuberous ligaments PREVENT SACRUM from ROTATING due to weight transmitted down the vertebral column

Question 38

Q

NAme the part of the femur

1) Which part of femur is subject to FRACTURE?
2) What is the INDENTATION on the head called ? (For ligament of head to femur)
3) What is located LATERALLY below the neck
4) What is located MEDIALLY below the neck?
5) What is the ridge that connects the 2 trochanter on ANTERIOR side?
6) What is the ridge that connects the 2 trochanter on POSTERIOR side?
7) A large ridge along the length of femur on POSTERIOR side; site of insertion of mUSCLES of thigh
8) A bump located SUPERIOR to the medial epicondyle

Answer

A

1) Neck of femur (NARROW REGION)
2) Fovea capitis
3) Greater trochanter
4) Lesser trochanter
5) INTERTROCHANTERIC line
6) Intertrochanteris CREST
7) LINEA ASPERA
8) Adductor tubercle

Question 39

Q

Name the parts of tibia

1) bumps on anterior side of tibia - for attachment of patella tendon
2) proximal ends of tibia that articulated with femur
3) distal end of tibia
4) oblique ridge on back of tibia

Name the 3 parts of the fibula

Answer

A

1) Tibia tuberosity
2) Medial and lateral CONDYLES
3) Medial malleolus tibia
4) SOLEAL LINE

Fibula

1) Head
2) Neck
3) Lateral malleus fibula

***The lateral malleolus and the medial malleolus forms a joint in between for DORSIFLEXION, PLANTAR FLEXION

Question 40

Q

What connects superficial veins to deep veins; have valves that only allow flow from SUPERFICIAL TO DEEP, Not DEEP TO SUPERFICIAL

Answer

A

PERFORATING VEINS

**SUPERFICIAL Veins drain toward body or to deep veins and the VALVES in perforating veins prevent backflow

**Incompetent perforating veins lead to VARICOSE VEINS

Question 41

Q

ILIOPSOAS

Origin
Insertion
Action
Nerve

Answer

A

Origin - Ilium, Vertebra (T2-L5)
Insertion - Femur
Action - Flex the hip joint
Nerve - Femoral nerve

Question 42

Q

PECTINEUS
Origin
-Insertion 
-Action 
-Nerve

Answer

A

Origin - Pubis
Insertion - Femur
Action - Flex hip joint
Insertion - Femoral nerve

Question 43

Q

SARTORIUS

Origin
Insertion
Action
Nerve

Answer

A

Origin - Ilium (Anterior Superior iliac spine)
Insertion - Tibia
Action - Flex hip Joint, Flex knee
Nerve - Femoral nerve

Question 44

Q

RECTUS FEMORIS

Origin
Insertion
Action
Nerve

**What is special about this muscle?

Answer

A

Origin -Ilium (Anterior Inferior Iliac spine)
Insertion - Patella
Action- Flex hip joint, extend the knee
Nerve - Femoral nerve

**It is BIFUNCTIONAL - cross both HIP and KNEE Joints

Question 45

Q

VASTUS LATERALIS

Origin
Insertion
Action
Nerve

Answer

A

Origin -Femur
Insertion - Patella
Action - Extend the knee
Nerve - Femoral nerve

Question 46

Q

VASTUS MEDIALIS

Origin
Insertion
Action
Nerve

Answer

A

Origin - Femur
Insertion- Patella
Action - Extend knee
Nerve - Femoral nerve

Question 47

Q

VASTUS INTERMEDIUS

Origin
Insertion
Action
Nerve

Answer

A

Origin - Femur
Insertion - Patella
Action - Extend the knee
Nerve - Femoral Nerve

Question 48

Q

What are he quadriceps?
WHat is there insertion?
How do they insert?

Answer

A

Quads- RECTUS femoris, VASTUS lateralis, VASTUS medialis, VASTUS INTERMEDIUS

Insertion - PATELLA

*Quads insert to patella via QUADRICEPS tendon
*Patella is linked to the Tibia via Patella tendon

Question 49

Q

GRACILIS

Origin
Insertion
Action
Nerve

Answer

A

Origin - Pubis
Insertion -Tibia
Action - ADDUCT hip joint, FLEX knee
Nerve - OBTURATOR Nerve

Question 50

Q

ADDUCTOR LONGUS

Origin
Insertion
Action
Nerve

Answer

A

Origin - Pubis
Insertion - FEMUR (linea aspera)
Action- ADDUCT hip joint
Nerve - OBTURATOR

Question 51

Q

ADDUCTOR BREVIS

Origin
Insertion
Action
Nerve

Answer

A

Origin - Pubis
Insertion- Femur (linea aspera)
Action - ADDUCT hip joint
Nerve - OBTURATOR nerve

Question 52

Q

ADDUCTOR MAGNUS (Adductor portion)

Origin
Insertion
Action
Nerve

Answer

A

Origin - Pubis, Ischium
Insertion - Femur (linea aspera)
Action - ADDUCT Hip joint
Nerve - OBTURATOR nerve

Question 53

Q

ADDUCTOR MAGNUS (Hamstring portion)

Origin
Insertion
Action
Nerve

Answer

A

Origin - Ischial tuberosity
Insertion - Femur (Adductor tubercle - Superior to the medial epicondyle)
Action - Extend the hip joint
Nerve - **SCIATIC NERVE (Tibia part)

Question 54

Q

OBTURATOR EXTERNUS

Origin
Insertion
Action
Nerve

Answer

A

Origin - OBTURATOR membrane
Insertion - Femur
Action - LATERALLY rotate femur at hip joint
Nerve - OBTURATOR nerve

Question 55

Q

GLUTEUS MAXIMUS

Origin
Insertion
Action
Nerve

Answer

A

Origin - Ilium, sacrum, coccyx, sacrotuberous ligament
Insertion - Femur, Iliotibial tract (IT band)
Action - Extend, LATERALLY rotate femur (also keeps legs extended via IT tract/band)
Nerve - Inferior gluteal nerve

**LARGEST EXTENSORS OF THIGH
Used in running, climbing stairs and raising from stooped position

Question 56

Q

GLUTEUS MEDIUS

Origin
Insertion
Action
Nerve

Answer

A

Origin - Ilium
Insertion - Femur (Greater trochanter)
Action - ABDUCT and MEDIALLY rotate femur; (support weight when lift opposite leg)
Nerve - Superior gluteal nerve

Question 57

Q

GLUTEUS MINIMUS

Origin
Insertion
Action
Nerve

Answer

A

Origin - Ilium
Insertion - Femur (Greater trochanter)
Action - Abduct and medially rotate the femur, (support weight when lift opposite leg)
Nerve - Superior gluteal nerve

Question 58

Q

TENSOR FASCIA LATA

Origin
Insertion
Action
Nerve

Answer

A

Origin - Ilium (Anterior superior iliac spine)
Insertion - Iliotibial tract (IT band)
Action - Abduct femur (also keeps leg extended via IT tract)
Nerve - Superior gluteal nerve

Question 59

Q

PIRIFORMIS ** (LANDMARK)

Origin
Insertion
Action
Nerve

Answer

A

Origin - Sacrum
Insertion - Femur (Greater trochanter)
Action - LATERALLY rotate femur
Nerve - Nerve to PIRIFORMIS

Question 60

Q

OBTURATOR INTERNUS

Origin
Insertion
Action
Nerve

Answer

A

ORIGIN - OBTURATOR membrane
Insertion - Femur (Greater trochanter)
Action - LATERALLY rotate femur
Nerve - Nerve to OBTURATOR internus

Question 61

Q

SUPERIOR GEMELLUS

Origin
Insertion
Action
Nerve

Answer

A

Origin - Ischial Spine
Insertion - Femur (Greater trochanter)
Action - LATERALLY rotate femur
Nerve - Nerve to OBTURATOR internus

Question 62

Q

INFERIOR GEMELLUS

Origin
Insertion
Action
Nerve

Answer

A

Origin - Ischial tuberosity
Insertion - Femur (Greater trochanter)
Action - LATERALLY rotate the femur
Nerve - Nerve to quadratics femoris

Question 63

Q

QUADRATUS FEMORIS

Origin
Insertion
Action
Nerve

Answer

A

Origin - Ischial tuberosity
Insertion - Femur
Action - LATERALLY rotate the femur
Nerve - Nerve to quadratus femoris

Question 64

Q

SEMIMEMBRANOSUS

Origin
Insertion
Action
Nerve

Answer

A

ORIGIN - ISCHIAL TUBEROSITY
Insertion - Tibia
Action - Flex knee, Extend Hip joint
Nerve - Tibial part of sciatic nerve

Answer 65

A

Origin - Ischial tuberosity
Insertion - Tibia
Action - Flex knee, Extend Hip joint
Nerve - Tibial part of sciatic nerve

Answer 66

A

Origin - Ischial tuberosity (long head), Femur (short head)
Insertion - Tibia
Action - Flex knee, extend Hip joint (LONG HEAD only)
Nerve - Long head: Tibial part of sciatic nerve.
Short head : Common perineal part of sciatic nerve

Answer 67

A

Origin - Ischial tuberosity
Insertion - Femur
Action - Extend hip joint
Nerve - Tibial part of sciatic nerve

Answer 68

A

ORIGIN- Femur
Insertion - Tibia
Action - Laterally rotate the femur (unlock knee)
Nerve - Tibial nerve

Answer 69

A

Origin - Femur
Insertion - Calcaneous
Action - Plantar flex foot (weak flex knee)
Nerve - Tibial nerve

Answer 70

A

Origin - Fibula, Tibia (soleal line)
Insertion - Calcaneus
Action - Plantar flex foot
Nerve - Tibial nerve

Answer 71

A

Origin - Femur
Insertion - Calcaneus
Action - Plantar flex foot
Nerve - Tibial nerve

Answer 72

A

Origin - Fibula
Insertion - Distal phalanx of BIG TOE
Action - Plantar flex BIG toes, Plantar flex foot
Nerve - Tibial nerve

Answer 73

A

Origin - Tibia
Insertion - Distal phalanges of lateral FOUR TOES
Action - Plantar flex lateral FOUR TOES, plantar flex foot
Nerve - Tibial nerve

Answer 74

A

Origin - Tibia, Fibula, Interosseous Membrane
Insertion - Navicular bone, cuneiform, cuboid, metatarsals 2-4
Action - Plantar flexes foot, Inverts foot
Nerve - Tibial nerve

Answer 75

A

1) DIFFERENTIATION - single fertilized egg produce different cell types
2) MORPHOGENESIS - The different cell types are then organized into tissues
3) GROWTH - Cell division
4) MATURATION - fully formed organs continue to develop functionally (even continues after birth)

Answer 76

A

-All have same genome
-restriction of genes that are active in different cell types
-INDUCTION
A) Paracrine factors ; signal transduction pathways - growth factors, receptors, kinase cascades
B) Positional information ; cell-cell interactions

Answer 77

A

MORPHOGENESIS

1) Migration
2) Apoptosis

Answer 78

A

By CELL DIVISION

Answer 79

A

WEEKS 1-3

Fertilization through gastrulation
Primary germ layers (ectoderm, mesoderm, endoderm)

WEEKS 3-8

Embryonic period
Organogenesis ;differentiation of the 3 germ layers (cardiac, nervous, skeletal system, eye, ear, limb buds, face, GI tract, long bud, genitalia)

WEEKS 9-38

Fetal period
Maturation of tissues and organs

Answer 80

A

EARLY FATE DECISIONS (fake decisions)

Inside cells (ICM -inner cell mass) - form EMBRYO 
Outside cells (Trophoblast) - form part of PLACENTA

**Beings with COMPACTION of BLASTOMERES at 8 cell stage

Answer 81

A

1) 2 early fate decisions
A) Joining adjacent cells : fertilized egg - blastocyst - differentiate to ICM (will form embryo) and trophoblast (will form part of placenta)
B) Determines whether ICM cells will form EPIBLAST (form amnion and body of embryo) or HYPOBLAST (form wall of primitive and secondary yolk sac)

2) Fate decision means that the cells become more restricted as to which cell types their progeny will become. Some genes inactivated in some cells while others remain activated

3) Fate decisions lead to formation of 3 germ layers (mesoderm, ectoderm and endoderm) by the ICM
ICM - epiblast - primitive ECTODERM - embryonic ECTODERM
ICM - epiblast - primitive ECTODERM - primitive streak -embryonic ENDODERM
ICM - epiblast - primitive ECTODERM - primitive streak - embryonic MESODERM
ICM - epiblast - primitive ECTODERM - primitive streak - extraembryonic MESDODERM
ICM - hypobast - extraembryonic ENDODERM - YOLK SAC
Trophoblast - Cytotrophoblast - Syncytiotrophoblast

Answer 82

A

1) ECTODERM
2) MESODERM
3) ENDODERM
4) GERM CELLS

Answer 83

A

Day 1 - Fertilization (zygote contain 1 set of chromosome from each parent)
Day 2 - 2 cells
Day 3 - Morula
Day 4 - Early blastocyst
Day 5 - Late blastocyst
Day 6 - BEGINNING of implantation
Day 7 - INVASION of ENDOMETRIUM (embryo is ready to implant to uterus)

*** fertilized egg - blastocyst- TROPHOBLAST and ICM

Answer 84

A

FERTILIZATION

creates a new diploid individual (male and female pronuclei)
Determines SEX of individual
Takes place in AMPULLA of OVIDUCT (Fallopian tube)
Oocyte completes meiosis division
Sperm DNA must decondense
2 pronuclei replicate DNA before first cell division

*** For Implantation to occur, blastocyst must break out of zona pellucid a

Answer 85

A

GOAL : Development of Placenta and BILAMINAR Embryo

Embryo fully embedded in uterine wall
Establishment of placental circulation
Formation of first germ layers
Formation of extraembryonic membranes and cavities

**Trophoblast - cytotrophoblast

BILAMINAR EMBRYO
ICM - HYPOBLAST (forms extraembryonic tissues) and EPIBLAST (forms all tissues of the embryo and amnion)

2 cavities

Epiblast - separate to 2 layers to form amniotic cavity (top layer - amnion, lower layer - embryo)
Cells from by HYPOBLAST line the trophoblast - form primitive yolk sac or extracoelomic cavity

Answer 86

A

1) 2 layer embryo
- Epiblast is primitive ECTODERM (3 germ layers)
- Hypoblast is primitive ENDODERM (yolk sac)

2) Cavities
- Amniotic membrane forms from epiblast creates amniotic cavity
- Yolk sac lined with hypoblast and spinachnic extraembryonic mesoderm

Answer 87

A

GASTRULATION

process leads to development of the 3 primitive germ layers (embryonic ectoderm, endoderm and mesoderm)
cell migration and differentiation converts BILAMINAR disc to TRILAMINAR disc
Begins with the formation of primitive groove
establishment of body axes (movement of cells and elongation of the embryonic disc establishes BODY AXES)

Answer 88

A

the primitive streak begins to appear in the CAUDAL HALF of the BILAMINAR DISC (Anterior end is the primitive node)
Epiblast cells migrate LATERALLY and ANTERIORLY through the primitive streak

Answer 89

A

-Invagination of EPIBALST into the streak (primitive ectoderm) creates the 3 germ layers (ectoderm, mesoderm, endoderm)

some replace the hypoblast to form embryonic ENDODERM
others moving between the epiblast and hypoblast create the embryonic MESODERM
remaining epiblast cells form the ECTODERM

Answer 90

A

Epiblast - Mesoderm - Notochord - SPINE

The ANTERIOR end of the primitive streak is the primitive node (HENSON’s NODE)
Mesodermal cells anterior to the node form a solid cord in the midline called the NOTOCHORD

Answer 91

A

signals from the NOTOCHORD induce the overlying ECTODERM to become NERVOUS😬 TISSUE
signals some of the MESODERMAL cells to become vertebral bodies of the SPINE (nucleus PULPOSUS)
Forms nucleus PULPOSUS of the vertebral disc

**egg - blastocyst - ICM - Epibast - mesoderm - Notochord - Spine (nucleus PULPOSUS of vertebral disc)

Answer 92

A

-With time, the notochord extends anteriorly (gets longer) while the primitive STREAK gets SHORTER

The remnant of the primitive streak is called SACROCOCCYGEAL TERATOMA
*These are generally bending tumors containing tissues derived from all 3 germ layers
*Mostly found in FEMALES

Answer 93

A

1) Oropharyngeal membrane
2) Prechordal plate (prechordal mesoderm)
3) Cloacal membrane

Answer 94

A

-ORGANOGENESIS (differentiation of the 3 germ layers - ectoderm, mesoderm and endoderm)

ECTODERM - nervous system, neural crease walls, skin
MESODERM - paraxial, intermediate, lateral plate, extraembryonic mesoderm)
ENDODERM - epithelial lining of GI tract, lungs, urethra, bladder, parenchyma of thyroid and parathyroid hormone, liver, pancreas, stroma of tonsils and thymus, parts of ear

Answer 95

A

1) Neural TUBE - form central and peripheral NERVOUS SYSTEM
2) Neural crest
- cells at the crest of neural fold form neural crest cells
- variety of structures in the HEAD
- ganglia
- Adrenal medulla
- Melanocytes
3) Surface ectoderm
- form epidermis and appendages of the SKIN
- glands, hair, nails
- mammary and pituitary glands
- tooth enamel

**Neural tube defects (Anencephaly, Spinal bifid - can both be prevented by folic acid)

Answer 96

A

BASICALLY notochord signal ectoderm to form neural plate

Ectoderm above the notochord and prechordal plate forms the NEURAL PLATE beginning at DAY 19
Signals from the notochord induces the overlying ECTODERM to form the NEUROECTODERM of the NEURAL PLATE
neuroectoderm begins to fold into a TUBE

**Ectoderm from notochord and prechordal plate - neural plate - neuroectoderm - neural tube

Answer 97

A

1) Neural fold closes into a tube (begins in the future CERVICAL region at somite 5- fusion proceeds CRANIALLY and CAUDALLY)
2) Cells at the boundary between neural ectoderm and surface ectoderm will become Neural CREST cells (These crest cells separate from the neural tube and migrate to from parts of the PNS)
3) Surface ectoderm - cover the neural tube and rest of embryo and form the EPIDERMIS

Answer 98

A

1) ANTERIOR and POSTERIOR neuropore are the LAST regions to close
2) Neural tube is completely closed by DAY 28

3) NEURAL TUBE DEFECTS
A) Anencephaly - FATAL - failure to properly close the neural tube at the CRANIAL end
B) Spinal bifida - failure to close the neural tube from the CERVICAL region to the CAUDAL end

4) FOLIC ACID can prevent neural tube defects before and during pregnancy

Answer 99

A

1) NEURAL CREST CELLS

2) Neural crest cells migrate to other areas to form specific structures
- Dorsal root ganglion
- Sympathetic ganglion
- Developing suprarenal gland (epinephrine, norepinephrine/ flight or fight)
- preaortic ganglion
- enteric ganglia

Answer 100

A

1) Paraxial mesoderm (PM)
2) Intermediate mesoderm (IM)
3) Lateral plate mesoderm (lpm)
4) Extraembryonic mesoderm (eem)

Answer 101

A

1) Parietal/somatic layer - close to ECTODERM

2) Visceral/splancnic - close to ENDODERM

Answer 102

A

PARAXIAL MESODERM

Development begins at the CRANIAL end and somites increase in number CAUDALLY
*somites increase in number 2-3 a day

***Paraxial mesoderm - somites - axial skeleton/muscle/dermis

Answer 103

A

Cells from Somites form :

1) DERMATOME - Dermis
2) MYOTOME - Muscle
3) SCLEROTOME - tendons/cartilage/bone/vertebra

Answer 104

A

IM found between PARAXIAL and LATERAL plate mesoderm)
forms UROGENITAL structures (parts of urinary system and somatic parts of gonad)

**GERM CELLS
-PRIMORDIAL germ cells arise from EPIBLAST
(In caudal part)
-Migrate through primitive streak to YOLK SAC
-eventually migrate to genital ridge

Answer 105

A

SOMATIC/PARIETAL

forms BODY WALL
DERMIS of body wall
Bones and CT of limbs and sternum
Lining of intraembryonic cavity

VISCERAL/SPLANCHNIC
-Covers organs (forms MESOTHELIUM)

Answer 106

A

1) Between weeks 3-4, lateral folding of embryonic disc creates the INTRAEBRYONIC CAVITY and closes the wall of the gut
2) Blood islands formed by HAMANGIOBLASTS appear in the Mesoderm of wall of YOLK SAC beginning in week 3
3) LIVER
4) STEM cells in BONE MARROW

Answer 107

A

1) Blood vessels are formed from mesoderm cells that differentiate into hemangioblasts
2) HEMANGIOBLASTS
3)
- Vasculogenesis : blood vessels/endothelial cells derived from BLOOD ISLANDS
-Angiogenesis : Sprouting of vessels from existing vessels

Answer 108

A

HEMANGIOMAS

-Tx with prednisone/surgery if bad

Answer 109

A

**Formation of the heart

-folding of the cranial region due to growth of the neural tube brings the developing heart into the THORACIC REGION

Answer 110

A

1) Head and tail fold VENTRALLY
2) Ventral fold in combination with LATERAL folding CLOSES the body wall
3) Forms gut and yolk sac becomes VITELLINE DUCT
4) Pulls amnion completely around embryo

Answer 111

A

Epithelial lining of the GI tract, lung, urethra, bladder
Parenchyma of thyroid, parathyroid, liver and pancreas
Stroma of tonsils and thymus, parts of ear

Answer 112

A

1) All organ systems are DEVELOPED, but need further growth and maturation

2) FETAL PERIOD
- growth in length and weight

Answer 113

A

1) Pregnancy
- 266 days or 38 weeks after fertilization
- 280 days or 40 weeks after the first day of LMP

2) Embryonic period (week 3-8)
- SOMITE number

3) FETAL period (week 8-38)
- crown to rump length
- crown to heel length
- other : head circumference and femur length

Answer 114

A

-HIGHEST risk of birth defects in EMBRYONIC PERIOD (Week 3-8)

**First prenatal visit is WEEK 8

LOWEST RISK (Week 1-3 and Weeks 8-38)
Fetal period is week 8-38

Answer 115

A

1) Ionizing radiation
- Radiographs (x-rays, conventional films, plain films), fluoroscopy - real time moving X-ray
- CT (computer tomography)
- NM (nuclear medicine - use radio-tracers)

2) Non-Ionizing radiation
- MRI (Magnetic Resonance Imaging - use radio waves)
- US (Ultrasound - use sound waves)

Answer 116

A

Nov 8th 1895 : Wilhelmina Conrad Roentgen discovered X-RAY
He termed this new INVISIBLE ray x-ray (x=unknown)
Received 1st Nobel price in physics in 1901
Widespread use for medical imaging by 1913

Answer 117

A

CONVENTIONAL RADIOGRAPHS/Plain films

Answer 118

A

1) AP - anterior posterior
2) PA - posterior anterior (chest films)
3) Lateral (from side profile view)

Answer 119

A

1) Radiopaque/Radiodense : WHITE IMAGE. A totally OPAQUE or DENSE material will absorb all the X-rays, allowing none to pass through. E.g Lead/metal
2) Radiolucent - BLACK IMAGE. Less dense material is between the source and the film so MORE X-RAYs strike the film e.g Air
3) GRAY IMAGE - intermediate degrees of transparency e.g fat and soft tissue

Answer 120

A

1) Air - RADIOLUCENT (black) - absorbs the LEAST x-ray and appears blackest on conventional radiographs
2) Fat - (dark grey)
3) Soft tissue (muscle), fluid (blood)- (light grey)
4) Bone - (Lightest grey/closer to white) most dense naturally occurring material absorbs MOST x-rays
5) Metal - RADIOPAQUE (white) absorbs ALL x-rays e.g bullets, barium

Answer 121

A

MULTIPLE VIEWS (AP, PA, lateral)

radiographs are 2D projections of a 3D patient
Radiographs flatten everything
Multiple views are needed

Answer 122

A

Advantages

FAST
relatively INEXPENSIVE to produce
can be obtained almost ANYWHERE using portable or mobile machines
are still the most widely obtained imaging studies

Disadvantages

Utilizing ionizing radiation
soft tissue is hard to visualize or can’t be visualized at all
Not recommended for pregnant women except in emergency

Answer 123

A

FLUOROSCOPY (Ionizing radiation)

Answer 124

A

COMPUTED TOMOGRAPHY (CT)

**HOUNSFIELD UNITS is the scale used to measure CT density

Answer 125

A

similar to radiography in that it uses IONIZING RADIATION. From a source to produce an image
source and detector rotates 360 degrees around the patient
computer uses a number of algorithms to construct 3D information in 2D slices

Answer 126

A

-because data is MULTI-PLANAR, images can be reconstructed in different planes

SAGITTAL view (L/R) 
CORONAL view (Front and back) 
TRANSVERSE/Axial view (Horizontal)

Answer 127

A

-CT density numbers are measured using the HOUNSFIELD Scale
-the CT number varies according to the density of the tissue scanned (the more dense, the higher the CT density number)
E.g air is -1000 HU and
Bone is 400 to 600 HU

Answer 128

A

1) Denser substances absorb MORE X-RAYS have HIGH CT numbers, demonstrate INCREASED ATTENUATION and display WHITER DENSITIES e.g bone
2) Less dense substances that absorb FEWER x-rays have LOW CT numbers, demonstrate DECREASED ATTENUATION and display BLACKER DENSITIES on CT scans e.g air

Answer 129

A

POST-PROCESSING

BRAIN WINDOWS allow evaluation of brain parenchyma, hemorrhage, CSF spaces and soft tissue at the expense of bony detail
BONE WINDOWS allow detailed examination for FRACTURES but obscure all SOFT TISSUE detail

Answer 130

A

CONTRAST

Contrast-enhanced or enhanced
Yield more diagnostic information that is more easily recognization
radiographic contrast agents administered to increase the differences in density between two tissues

Contrast Reactions
-IV contrast containing high iodine opacity tissues and organs to appear WHITER on images; excreted in the urine by KIDNEYS

Answer 131

A

CONTRAST-ENHANCED CT Scans

*acute tubular necrosis is often reversible but a small number of patients with underlying renal insufficiency can have their renal dysfunction permanently worsen
*Mild side effects - nausea, vomiting, local irritation at the site of injection, itching and hives

Answer 132

A

Advantages
-Excellent resolution for many areas (can see FRACTURES otherwise missed)
0can see multiple planes
-Widely available
-Cheaper than MRI
-Fast (few seconds for whole body)
-Grey scale can be manipulated on viewing screen

Disadvantages

High radiation doses
can require IV contrast (1% are allergic to CT contrast, can affect renal function)
cost more than radiographs
- knee radiographs (4 views) - $154
*Knee CT (no contrast) - $1,200

Answer 133

A

NIKOLA TESLA discovered the rotating magnetic field in 1882 in BUDAPEST, HUNGARY.
Fundamental discovery in physics
In 1956, the “Tesla Unit” was proclaimed by the international electro-technical commission committee of action.
All MRI machines are calibrated in “Tesla Units”.
The strength of a magnetic field is measured in Tesla or Gauss Units
First MRI performed in 1977 on a human beings for 5 hours

Answer 134

A

MRI - Magnetic Resonance Imaging

Answer 135

A

Most scanners today have a magnetic field strength between 0.6 and 3 TESLA
Open MRI scanners have LOWER field strength of 0.1 - 1.0 T
In general, HIGHER field strength magnets have BETTER spatial resolution but are MORE expensive to install and operate compared with LOWER field strength magnets

Answer 136

A

-Images weighted to enhance different characteristics of the soft tissue

- WATER will be DARK on T1-weighted images and BRIGHT on T2-weighted images
- FAT is bright on bth T1 and T2

T1 - Show ORGANS best
T2 - more sensitive for pathological lesions (fluid and blood)

Increased (high) signal intensity = white or bright area
Decreased (low) signal intensity = black or dark area

Answer 137

A

Advantages

No ionizing radiation
can scan multiple planes (axial, coronal, SAGITTAL)
Better soft tissue detail than CT

Disadvantages
-Images CAN NOT be manipulated on the viewing screen like CT
-Narrower than CT, worse for claustrophobic or larger patients
-Noisy
-Can’t be scanned if you have certain kinds of METAL/IMPLANTS
-No movement allowed
-Adverse reactions to contrast
-Long (30-60 minutes)
**need to lie still the entire time, need to reschedule if coughing/sneezing, poor images of abdomen due to breathing and peristalsis (CT of abdomen is better)
-Expensive
*Coils $25k
Scanners $2million
Need specialty trained technologist
Limited number of patients scanned per day
Knee MRI is $2400

Answer 138

A

Anything :

Ferromagnetic
Electronic
Not certified MRI compatible

**The MAGET is ALWAYS on

Safety Issue

Metal that CAN MOVE
Metal in/around he eyes
OLD ANEURYSM CLIPS

Non-Safety Issue

Metal that CAN NOT move
FILLINGS in TEETH
ORTHOPEDIC hardware

**Pacemaker is an Issue because the MRI scan can ; drain the battery, make pacer fire erratically, scramble electronics or reprogram pacer

Answer 139

A

NEPHROGENIC SYSTEMIS FIBROSIS (NSF)

NSF produces fibrosis of skin, eyes, joints and internal organs resembling SCLERODERMA
Patients with preexisting renal dysfunction, especially those on dialysis are at greatest risk
Caution is exercised when administered get gadolinium to patients who have moderate renal disease and typically avoided in patients with severe renal disease
Currently NO EVIDENCE to suggest that patients with normal renal function are at risk of developing NSF and contrast - enhanced MRI imaging remains extremely safe in the vast majority of patients

Answer 140

A

ULTRASOUND (US)

1) SONODENSE - Increased echogenicity (tissue that reflects many echoes and appears BRIGHT/WHITE) e.g bones, stone, fat
2) SONOLUCENT - Decreased echogenicity (tissue that has few or no echoes and appear DARK or BLACK) e.g lymph nodes, tumors

Answer 141

A

usually study of first choice in imaging the FEMALE PELVIS and PEDIATRIC patients
differentiating CYSTIC versus SOLID lesions in all patients
Noninvasive vascular imaging
Imaging of the fetus and placenta during PREGNANCY (It is SAFE)
Real-time, image-guided fluid aspiration and biopsies

Answer 142

A

Advantages

No ionizing radiation
Real-time images
Produces little to no patient discomfort
Easy to use and noninvasive
Inexpensive
Portable

Disadvantages

Bone and air-filled structures interfere with image
Difficulty penetrating obese patients
You can’t do an ultrasound of the skull except in a baby where the skull isn’t there yet)

Answer 143

A

RADIONUCLIDE IMAGING (NUCLEAR IMAGING)

offer potential to identify disease in the earliest stages as well as patient immediate response to therapeutic intervention
Radioactive material called RADIOTRACERS injected into the bloodstream (inhaled or swallowed)
Radiotracer travels through examined area and give off gamma rays detected by a special camera and a computer to create images
DETECT FRACTURES FAST

Answer 144

A

BONE SCANS

uses technetium-99m attached to organic phosphate to find areas of increased uptake due to osteoblastic activity (increased blood flow and inflammation)
After the IV injection, most of the dose is uickly extracted by the bone.
The remaining radiopharmaceutical is excreted by the KIDNEYS and collects in the urinary bladder

Answer 145

A

Advantages

excellent SPECIFICITY
provides physiologic information
provides EARLY DETECTION

Disadvantages

EXPENSIVE
Availability of service
radiation
poor spatial resolution

Answer 146

A

Ionizing radiation in Large doses, (higher than medically radiographic procedure) can produce CELL MUTATIONS that lead to many forms of CANCER and anomalies
Only medically necessary diagnostic examinations should be performed
Shield the most radiation sensitive areas (Gonads, eye lens, thyroid)
X-rays should be avoided in PREGNANCY

Answer 147

A

1) Background radiation - present in environment
Approx 2.4 mSv/yr

2) Chest Radiograph - approx 0.08 mSv (about 1 week of background radiation)
3) Chest CT - approx 7.0 mSv (about 3 years of background radiation)

***50mSv for single procedures or 100mSv for multiple procedures over short time periods are too LOW to be detectable and may be non-existent

Answer 148

A

1) AP
2) Lateral/frog view

**The femurs should be INTERNALLY ROTATED (15 degree)when obtaining an AP PELVIS FILM so as to display the femoral necks in profile

Answer 149

A

Normal AP film
-SHENTON’s line (formed by the medial edge of the femoral neck and the inferior edge of the superior public ramps)

FEMORAL Neck fracture

frequently related to OSTEOPOROSIS
AVASCULAR necrosis of the femoral head occurs in 10-30% of subcapital fx due to disruption of the blood supply
DISRUPTED SHENTON’s LINE
SHORT NECK
Zones of INCREASED DENSITY indicating impaction

Answer 150

A

POSTERIOR HIP DISLOCATION

More than 90% of all hip dislocations
Most common mechanism is high-energy trauma
In 10% of patients, sciatic nerve is injured
Radiographic features:
Femoral HEAD LATERAL and SUPERIOR to acetabulum
Femur in INTERNAL ROTATION and ADDUCTION
Affected femoral HEAD appears SMALLER
Fracture of the posterior rim of the acetabulum may occur

Answer 151

A

ANTERIOR HIP DISLOCATION

Answer 152

A

1) AP
- Good when looking for signs of osteoarthritis which include; joint space narrowing, osteophyte formation and SUBCHONDRAL CYSTS

2) Lateral
- Good for evaluating the PATELLA
- determine presence of effusion which is often seen in joint cavity superior to the patella (SUPRAPATELLAR BURSA)

Answer 153

A

1) Knee injuries are most common due to LARGE SIZE and COMPLEXITY of the KNEE
2) Most commonly injured are the SOFT TISSUE and CARTILAGINOUS structures including ligaments and menisci
3) Best evaluated CLINICALLY or by MRI
4) Next most common injury are FRACTURES - occurring much more often than dislocation

Answer 154

A

PATELLA FRACTURE by blunt force trauma

Answer 155

A

BIPARTITE PATELLA

Answer 156

A

FABELLA

**Normal variant - can be mistaken for fracture

Answer 157

A

1) AP

2) Lateral

Answer 158

A

TIBIA

** Imaging show transverse lucency in the cortex surrounded by cortical thickening

Answer 159

A

1) AP
2) Lateral
3) MORTISE VIEW
- AP view with 15 to 20 degree internal rotation of the foot
- lateral malleolus about same height as the medial malleolus
- Both the lateral and medial joint spaces are visualized
- Talus DOES NOT overlap portion of lateral malleolus unlike the true AP that obscures the lateral aspect of the ankle joint

Answer 160

A

ANKLE

-In case of ligament damage without fractures, seen on plain film as soft tissue swelling over the injury

Answer 161

A

1) AP
2) Internal Oblique
3) Lateral

Answer 162

A

STRESS FRACTURE of the FOOT

**Most common location for a stress fracture of the foot is the 2nd or 3rd metatarsal also called MARCH FRACTURE

Answer 163

A

APOPHYSIS of the proximal 5th metatarsal

**appears on plain radiographs at age 12 for boys and 10 for girls and fuses 2-4 years later

-In ADULT ; UNFUSED Accessory ossification center of the proximal 5th metatarsal

Answer 164

A

PSEUDO-JONES FRACTURE

Answer 165

A

1) CONDROBLASTS and
CONDROCYTES
2) AVASCULAR (get nutrient by DIFFUSSION)
3) High water content - all nutrients enter and metabolites leave cartilage by diffusing through the ECM

similar to CT (cells, fiber, matrix)
Develop from primitive mesenchymal cells
Fibers and matrix depend on type of cartilage (Hyaluronic acid and GAGs)
Soft and pliable
Provides support for soft tissues
resist compression (acts as SHOCK ABSORBER)
Template for bone development

Answer 166

A

1) CHONDROBLASTS
* mesenchymal cells differentiate into chondroblasts and fibroblasts
* fibroblasts form the perichondrium

2) CHONDROCYTES

Answer 167

A

PERICHONDRIUM

The inner cellular layer contains CHONDROGENIC CELLS
can differentiate into chondroblasts
secrete the cartilage matrix
become trapped in LACUNAE as chondrocytes

Answer 168

A

HYALINE CARTILAGE

**TYPE II COLLAGEN, proteoglycans (contain water)
MOST COMMON TYPE
Glassy appearance 
PERICHONDRIUM 
MODEL TEMPLATE for growth of skeleton

Answer 169

A

ELASTIC CARTILAGE

Answer 170

A

FIBROCARTILAGE

Answer 171

A

APPOSITIONAL GROWTH

**Occurs on the PERIPHERY of the cartilage

Answer 172

A

INTERSTITIAL GROWTH

Answer 173

A

FIBROCARTILAGE

Condrocytes and fibroblasts

Answer 174

A

1) All have type II - Hyaline, elastic, FIBROCARTILAGE

2) Only FIBROCARTILAGE has Type I

Answer 175

A

Hyaline (branching elastic fibers)

- Elastic (elastic fibers)

Answer 176

A

All are AVASCULAR (get nutrient by diffusion)
Hyaline
Elastic
FIBROCARTILAGE

Answer 177

A

Hyaline (except Articular cartilage)
Elastic

FIBROCARTILAGE HAS NO Pericondrium

Answer 178

A

ELASTIC CARTILAGE

Answer 179

A

HYALINE CARTILAGE

Answer 180

A

FIBROCARTILAGE

Answer 181

A

HYALINE CARTILAGE

Answer 182

A

ELASTIC CARTILAGE

Answer 183

A

FIBROCARTILAGE

Answer 184

A

1) CANCELLOUS (spongy or trabecular)

In long bones

In center/medulla of the bone
Contains irregular arrangement of cells and matrix forming TRABECULAE

In flat bones (Skull and sternum)
-In center/medulla of bone

2) COMPACT BONE

Answer 185

A

1) PROXIMAL epiphysis
2) Metaphysis
3) Diaphysis
4) Metaphysis
5) Distal epiphysis

**Epiphysis is at the ends of the long bones
articular cartilage growth plate extends the length of bones
epiphyseal line is remnant of the growth plate

Answer 186

A

PERIOSTEUM

Answer 187

A

ENDOSTEUM

Answer 188

A

OSTEOPROGENITOR CELLS

Answer 189

A

OSTEOBLASTS

*secrete OSTEOID
Organic components of the new bone matrix (TYPE I COLLAGEN fibers, several glycoproteins, proteoglycans)
Uncalcified
DOES NOT contain any minerals
Shortyly after its deposition, it is rapidly mineralized and becomes hard bone

Answer 190

A

OSTEOCYTES

In contrast to cartilage, only 1 osteocyte is found in each bony LACUNA
Because mineralized bone matrix is much harder than cartilage, nutrients and metabolites CANNOT freely diffuse through it to the osteocytes (Bone is highly VASCULAR, canaliculi)
GAP JUNCTIONS (connect highly branched cells with processes to their osteocytes through CANALICULI)

Answer 191

A

OSTEOCLASTS

reside in HOWSHIP LACUNAE
shallow depressions in the bone matrix
Enzyme-eroded depressions
BREAKDOWN BONE
creases an acidic environment that causes dimineralization (H-ATPase)
organic compounds degraded enzymatically

Answer 192

A

1) TYPE I collagen fibers
2) Organic component
-OSTEOID
(Proteoglycans, Non-collagenous proteins; osteopontin, osteocalcin, osteonectin, bone sialoprotein).
-RESIST TENSION
3) Inorganic component
-CALCIUM PHOSPHATE
-RESIST COMPRESSION
4) Highly vascularized with blood vessels from periosteum to aid diffusion through calcified matrix

Answer 193

A

DECALCIFIED BONE

Answer 194

A

GROUND BONE

Answer 195

A

-In compact bone
-Composed of lamella/rings surrounding a Haversian canal and the canal itself
-LAMELLA, surrounding the blood vessels and loose CT
-maintained by a single capillary in Haversian canal
-mostly run lengthwise/longitudinally in a long bone
-circumferential lamella on outer and inner surface
-interstitial lamella
(Partial osteons in the middle of the compact bone, remnants of former osteons from remodelling process

Answer 196

A

Canal that runs transversely across the long axis of the long bone
Carry capillaries that interconnect longitudinal haversian capillaries or carry capillaries into the bone from periosteum

Answer 197

A

1- INTRAMEMBRANOUS OSSIFICATION
2- ENDOCHONDRAL OSSIFICATION

**Both begin by forming TRABECULAE of spongy bone (later remodeled into compact bone)

Answer 198

A

INTRAMEMBRANOUS OSSIFICATION

*Mesenchymal cells - osteoblasts - OSTEOID form ossification center - trabeculae (enlarge by APPOSITIONAL GROWTH)
- entrapped osteoblasts become osteocytes

Answer 199

A

ENDOCHONDRAL OSSIFICATION

Answer 200

A

-After the ossification of the cartilage template is complete, all INCREASE IN LENGTH take place at the epiphyseal plate
-At puberty, the epiphyseal plate is sealed and no further increase in length occurs
-Increase in width occurs by appositional growth from the periosteum and resorption of bone at the endosteum
-bone is continuously remodeled by the action of osteoclasts and osteoblasts
(Must maintain balance of deposition and degrading)

Answer 201

A

1) OSTEOPETROSIS

2) OSTEOPOROSIS

Answer 202

A

IMMATURE WOVEN BONE

Answer 203

A

MATURE COMPACT BONE

Answer 204

A

A fracture hematoma forms
A fibrocartilaginous (soft callus) forms (regenerating blood vessels) -FROM fibroblasts and OSTEOPROGENITOR cells (help stabilize the fracture)
A hard/bony callus forms
The bone is remodeled (compact bone at break site)

Fracture hematoma - fibrocartilaginous/soft callus - hard/bony callus - remodeled bone

*progenitor cells not close to blood vessels differentiate to CHONDROBLASTS and for cartilage scaffold/skeleton
*Progenitors near blood vessels differentiate into osteoblasts and convert cartilage to woven. Bone
*Woven bone later converted to lamellar/compact bone

Answer 205

A

1) FASCIA LATA

2) Superiorly attached to the PELViS, INGUINAL LIGAMENT and SARPA’S FASCIA

Answer 206

A

1) ILIOTIBIAL TRACT (IT Tract)
2)
-Keep knee extended
-Provides lateral stability when standing
-extends legs after other muscles like quadriceps have extended the knee
3)
Superior - Ilium
Inferior - Lateral condole of Femur
4)
Tensor fascia LATA
Gluteus Maximus

Answer 207

A

ANTERIOR THIGH COMPARTMENT

1) The quadriceps (largest extensor of leg at hip joint)
- RECTUS femoris (bifunctional -flex hip and extend knee)
- VASTUS INTERMEDIUS - extend knee
- VASTUS lateralis ; extend knee
- VASTUS medialis ; extend knee
* All 4 converge on QUADRICEPS TENDON which attaches to patella
2) ILIOPSOAS - Flex hip joint
3) PECTINEUS - flex hip joint
4) SARTORIUS - flex hip joint and flex knee

Answer 208

A

POSTERIOR THIGH COMPARTMENT

1) HAMSTRING MUSCLES
- semimembranosus; flex knee and extend hip joint
- SEMITENDINOSUS ; flex knee and extend hip joint
- LONG HEAD biceps femoris; flex knee and extend hip joint
- SHORT HEAD biceps femoris; FLEX KNEE ONLY (innervate common perineal part of sciatic nerve)
- Adductor Magnus (Hamstring portion); EXTEND HIP JOINT

*EXCEPTION IN Posterior
2) POPLITEUS - laterally rotate femur (unlock the knee joint)

Answer 209

A

MEDIAL THIGH COMPARTMENT

1) GRACILIS; ADDUCT hip joint and flex knee
2) Adductor longus; ADDUCT hip joint
3) Adductor brevis; ADDUCT hip joint
4) Adductor Magnus (adductor portion); ADDUCT hip joint
* *
5) Adductor Magnus (Hamstring part) ; extend hip joint
* *
6) OBTURATOR externus; laterally rotate femur at hip joint

Answer 210

A

LATERAL THIGH COMPARTMENT

GLUTES

1) Gluteus medius; abduct and medially rotate femur
2) Gluteus minimus; abduct and medially rotate the femur
3) Tensor fascia LATA; Abduct femur (also keep leg extended via IT band)

Answer 211

A

1) SEMITENDINOSUS
2) GRACILIS
3) SARTORIUS

All 3 insert to the TIBIA
*All flex knee

Answer 212

A

ILIOPSOAS
PECTINEUS

*BOTH FLEX HIP

Answer 213

A

ADDUCTOR MAGNUS

1) Adductor part
- Origin - pubis and ischium
- Insertion; Linea aspera of femur
- Action: ADDUCT thigh
- Nerve: OBTURATOR NERVE

2) Hamstring part
- Origin; ischial tuberosity
- insertion; Adductor tubercle of femur
- Action ; Extends thigh
- Nerve; tibial part of sciatic nerve

***GAP is adductor Magnus is called ADDUCTOR HIATUS

Answer 214

A

1)
- Superior; Inguinal ligament
- Medial; Adductor longus
- Lateral; SARTORIUS
- Floor; Adductor longus and PECTINEUS

2) From Lateral to medial (NAVL)
- Femoral Nerve
- Femoral Artery
- Femoral Vein
- lymphatic (in Femoral canal)

3) Femoral sheath is the continuation of TRANSVERSALIS FASCIA; it surrounds femoral artery, femoral vein and femoral canal, NOT FEMORAL NERVE

4)
- site of FEMORAL PULSE and good place for compression of artery (against head of femur and ILIOPSOAS)
- site of insertion of CATHETER FOR ANGIOGRAPHY (cardiac and branches of abdominal aorta)

Answer 215

A

FEMORAL CANAL

Answer 216

A

FEMORAL HERNIA

**Inguina Hernia more common in males

Answer 217

A

-made by comparing location of neck of hernia (entrance to abdomen) to location of inguinal ligament

*Femoral hernia; neck of hernia is BELOW (inferior to) the Inguinal ligament, pubic tubercle
*Inguinal hernia; neck of hernia is ABOVE (superior to) the Inguinal ligament, pubic tubercle

**reduce femoral hernia by cutting the inguinal ligaments to push contents back

Answer 218

A

1- femoral; L2-L4
2-OBTURATOR; L2-L4
3-sciatic; L45, S123

Answer 219

A

A; gluteal region
-posterior cutaneous nerve of thigh

B; thigh
1- lateral femoral cutaneous nerve of thigh ; LATERAL side
2- femoral nerve; ANTERIOR side
3- OBTURATOR nerve; MEDIAL side

C; leg
1- saphenous nerve - MEDIAL side form femoral (all remaining branches are from sciatic nerve)
2- Lateral dural cutaneous nerve - lateral side
3- sural nerve - posterior side

D; foot
1- superficial peroneal nerve - dorsal
2- medial and lateral Plantar nerves (from tibial nerve) - sole of foot

Answer 220

A

A; left ventricle - Aorta -common iliac arteries - internal (to pelvis) and external iliac artery (to lower extremity)

B; external iliac artery - femoral (inguinal ligament) - popliteal (adductor hiatus) - anterior and posterior tibial arteries

**posterior tibial arteries is main blood supply in FOOT

Answer 221

A

1) CRUCIATE anastomosis -located at HIP JOINT (unites branches of internal iliac and femoral artery)
2) GENICULAR anastomoses - located at KNEE JOINT

Answer 222

A

1- MEDIAL femoral circumflex artery
*passes POSTERIORLY btw PECTINEUS and ILIOPSOAS

2- ISCHEMIC NECROSIS OF HEAD OF FEMUR
*medial femoral circumflex artery can be damaged in fracture of neck of femur (broken hip)

Answer 223

A

LATERAL FEMORAL CIRCUMFLEX ARTERIES

Answer 224

A

PERFORATING ARTERIES

Answer 225

A

DESCENDING GENICULAR ARTERY

Answer 226

A

1) Superior -Inferior gluteal artery (from internal iliac)
2) Medial - medial femoral circumflex (from profunda femoris)
3) Lateral - lateral femoral circumflex (from profunda femoris)
4) Inferior - First perforating artery (from profunda femoris)

**femoral artery can be ligated ABOVE the profunda femoris due to cruciate anastomosis which will maintain blood supply around the hip joint BY COLLATERAL CIRCULATION

Answer 227

A

1- flex hip, extend knee

2- extend hip, flex knee

Answer 228

A

GLUTEAL GAIT/ Positive trendelenburg sign

*Pelvis tilts down on non-paralyzed side when you lift foot of opposite, non-paralyzed leg

Answer 229

A

SUPERIOR GLUTEAL NERVES AND VESSELS

Answer 230

A

1) BURSAE
2) Function as SHOCK ABSORBERS, reduce friction of movement of muscle tendons against bones or other tendons

3) BURSAE are found adjacent to ISCHIAL TUBEROSITY and GREATER TROCHONTER
- trochanter bursae
- ischial bursa

Answer 231

A

SCIATIC NERVE

-give injection in UPPER LATERAL QUADRANT of gluteal region to avoid damage to sciatic nerve

** sciatic nerve branches to tibial and common peroneal nerve. Early branching leads to PIRIFORMIS SYNDROME (cause pain)

Answer 232

A

PULLED GROIN

Answer 233

A

POPLITEUS MUSCLE

Answer 234

A

PROFUNDA FEMORIS artery

Answer 235

A

MEDIAL FEMORAL CIRCUMFLEX artery

Answer 236

A

LATERAL FEMORAL CIRCUMFLEX ARTERY

Answer 237

A

HIP JOINT

Answer 238

A

1) lunate articular surface
2) Acetabular notch
3- acetabulum labrum (rim of fibrocartilage)- it bridges the notch
4- transverse acetabular ligament
5- hyaline cartilage

Answer 239

A

1- ILIOFEMORAL LIGAMENT
2- PUBOFEMORAL LIGAMENT
3- ISCHIOFEMORAL LIGAMENT

Answer 240

A

LIGAMENT OF HEAD OF FEMUR

Answer 241

A

CONGENITAL

Dislocate SUPERIORLY
upper lip of acetabulum may fail to form and head of femur may dislocate superiorly
leg is rotated MEDIALLY by action of gluteus medius and minimus which all appear to be shorter

TRAUMATIC

dislocate POSTERIORLY
rare due to strength of intrinsic ligaments

Answer 242

A

KNEE JOINT

Answer 243

A

1- SUPRAPATELLAR BURSA
2- PREPATELLA BURSA
3- SUPERFICIAL INFRAPATELLA BURSA

Answer 244

A

EXTRACAPSULAR LIGAMENTS

1- lateral collateral ligaments; prevent tibia from moving laterally
2- medial collateral ligaments; prevents tibia from moving medially

** Note: Unlike Lateral Collateral ligament, Medial Collateral ligament is firmly attached to medial meniscus. Both Medial and Lateral Collateral ligaments are taut in extension of knee joint and pull femur against tibia; joint is ‘locked’ when extended.

Answer 245

A

INTRACAPSULAR LIGAMENT

1- Anterior cruciate ligament; prevent movement of tibia anteriorly, attached between condyles of tibia,
anterior to intercondylar eminence; passes upward, laterally, and posteriorly to attach to medial side of lateral femoral condyle

2- Posterior cruciate ligament; prevent movement of tibia POSTERIORLY, attached btw condyles of tibia, attachés to lateral side of medial femoral condyle

Answer 246

A

Tear Anterior Cruciate Ligament - can draw tibia anteriorly.

Tear Posterior Cruciate Ligament - can push tibia posteriorly

Answer 247

A

TERRIBLE TRIAD of knee joint

-tear in medial collateral ligament, anterior cruciate ligament and medial meniscus

Answer 248

A

1- INTEROSSEUS MEMBRANE

2- Inferior articulation
Anterior and Posterior Inferior Tibia-fibula ligaments

Answer 249

A

ANKLE JOINT

Answer 250

A

1) DELTOID LIGAMENTS

2) LATERAL LIGAMENTS
- anterior and posterior talk Fibula ligaments to talus
- calcaneofibular ligaments to calcaneous

Answer 251

A

1- ANKLE STRAIN

caused by EXCESSIVE INVERSION
ANTERIOR TALOFIBULAR and CALCANEOFIBULAR ligaments are commonly torn or stretched

2- POTT’S FRACTURE

caused by EXCESSIVE EVERSION
strong DELTOID LIGAMENT doesn’t rupture but medial malleolus is fractured, also break shaft of fibula

Answer 252

A

1- SUBTALAR JOINTS

2- TRANSVERSE TARSAL JOINT

Answer 253

A

1- NORMAL
2- GENU VALGUS - knocked knee (normal in infants 3-5)
3- GENU VARUS - bow-legged (normal in infants to age 3)

Answer 254

A

BOW-LEG

1- blount’s disease (black kids)
2- growth disturbance (epiphyseal dysphasia)
3- Post-trauma
4- Rickets (lack of vitamin D)

Answer 255

A

1- Major invert foot ; Tibialis anterior and Tibialis posterior

2- major evert foot; peroneus longus, peroneus BREVIS, peroneus tertius

3- ANTAGONISTS- Tibialis anterior and peroneus longus
-they both insert to; medial cuneiform and first metatarsal

Answer 256

A

1- superior medial genicular artery; anastomosis with descending genicular artery (from femoral artery)
2- superior lateral genicular artery; anastomoses with descending branching of lateral femoral circumflex artery
3- inferior medial genicular artery; anastomoses with recurrent branch of anterior tibial artery
4- Inferior Lateral genicular artery; anastomoses with recurrent branch of anterior tibial artery

Answer 257

A

POSTERIOR COMPARTMENT OF LEG

Answer 258

A

ANTERIOR COMPARTMENT OF LEG

Answer 259

A

LATERAL COMPARTMENT OF LEG

Answer 260

A

1) LATERAL HEAD of gastrocnemius

2) Flexor hallucis brevis tendon

Answer 261

A

-tap on tendo calcaneous results in plantar FLEXION of foot

Tests S1 AND S2

Answer 262

A

TARSAL TUNNEL SYNDROME

-symptoms; numbness of sole of foot, toes and weakened FLEXION of toes (intrinsic muscles of foot)

Answer 263

A

PERONEUS LONGUS (Major everter)

Origin- fibula
Insertion - medial cuneiform and first metatarsal
Action - evert foot
Nerve - superficial peroneal nerve

Answer 264

A

PERNEOUS BREVIS

Origin - fibula
Insertion - fifth metatarsal
Action - evert foot
Nerve - superficial peroneal nerve

Answer 265

A

1 - superior extensor reticulum

2- inferior extensor reticulum

Answer 266

A

MAJOR INVERTER OF Foot and antagonist to peroneus longus

Origin- tibia
Insertion - medial cuneiform and first metatarsal
Action - invert the foot, DORSIFLEX foot
Nerve - deep peroneal nerve

Answer 267

A

Origin- fibula and interosseus membrane
Insertion - distal phalanx of big toe
Action - dorsiflex foot, extend big toe
Nerve - deep peroneal nerve

Answer 268

A

Origin - tibia, fibula and interosseus membrane
Insertion - extensor expansions of 4 lateral toes
Action - dorsiflex foot, extend toes
Nerve - deep peroneal nerve

Answer 269

A

Origin - fibula and interosseus membrane
Insertion - fifth metatarsal
Action - evert foot, dorsiflex foot
Nerve - deep peroneal nerve

Answer 270

A

Origin - calcaneous
Insertion - extensor expansions of toes 2-4
Action - extend toes
Nerve - deep peroneal nerve

Answer 271

A

INTERMITTENT CLAUDICATION

Answer 272

A

1) Posterior tibial artery taken between medial malleolus and tendo calcaneous
2) Dorsalis pedis pulse taken on dorsum of the foot between medial and lateral malleolus

Answer 273

A

1- Anterior tibial recurrent artery
2- lateral and medial malleolar arteries
3- Dorsal is pedis
4- arcuate artery

Answer 274

A

LIGAMENTS AND ARCHES OF FOOT

Answer 275

A

PLANTAR APONEUROSIS

Answer 276

A

FIBROUS DIGITAL SHEATHS

Answer 277

A

1- Flexor DIGITORIUM brevis
action - flex lateral four toes
Nerve - medial plantar nerve

2- Abductor hallucis
Action - abduct and flex big toe
Nerve- medial plantar nerve

3- Abductor digiti minimi
Action - abduct and flex little toe
Nerve - lateral plantar nerve

Answer 278

A

1) Lumbricals
Action - flex toes at metatarsophalangeal joint and extend toes at interphalangeal joint
Nerve - lumbrical 1 is medial plantar nerve
Lumbicals 2-4 is lateral plantar nerve

2) quadratus Plantar
Action - assist in flexing lateral four toes
Nerve - lateral plantar nerve

Answer 279

A

1- Flexor hallucis brevis (has sesamoid bones)
Action - flex big toe
Nerve - medial plantar nerve

2- flexor digiti minimi brevis
Action - flex little toe
Nerve - lateral plantar nerve

3- adductor hallucis
Action - ADDUCT and flex big toe
Nerve- lateral plantar nerve

Answer 280

A

1- Plantar interosseous muscles (PAD)
Action - ADDUCT toes and flex metatarsophalangeal joint
Nerve - lateral plantar nerve

2- Dorsal interosseous muscles (DAB)
Action - abduct toes and flex metatarsophalangeal joint
Nerve - lateral plantar nerve

Answer 281

A

Divides into medial and lateral plantar arteries

1) Lateral plantar artery - gives rise to plantar arterial arch, located deep in foot, plantar arch gives rise to plantar metatarsal arteries which branch to sides of toes as plantar digital arteries
2) medial plantar artery - smaller branch to medial foot

Answer 282

A

Divides into lateral and medial plantar nerves

1) medial plantar nerve
- sensory branches 3.5 digits and medial part of sole
- motor branches muscles of BIG TOE (flexor hallucis brevis, abductor hallucis, Flexor DIGITORIUM brevis, first lumbrical)

2- lateral plantar nerve ;

sensory branches to lateral 1.5 digits and lateral sole
motor branches to remaining intrinsic muscles of sole of foot

Answer 283

A

MEDIAL LONGITUDINAL ARCH

1- plantar CALCANEONAVICULAR LIGAMENT - spring ligament, most important ligament that keeps head of talus high off ground (stretch this ligament will result in flat feet)
2- Tibialis posterior and Tibialis anterior - insert to medial side of foot and support arch

Answer 284

A

LATERAL LOGITUDINAL ARCH

-smaller than medial

Answer 285

A

TRANSVERSE ARCH

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