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Gross Anatomy > Exam 3 > Flashcards

Exam 3 Flashcards

1
Q

Primary functions of the lower extremity

A
  1. ) support the weight of the body
  2. ) to provide a stable foundation while standing
  3. ) to allow locomotion (ex: running and walking)
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2
Q

Innominate bone

A

The pelvic bone consists of a single bone on each side known as _________ _________ which articulates the sacrum, femur, and other bones like this

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3
Q

Ilium, ischium, and pubis.

These bones then fuse together to one single bone around 18-20 years old

A

What does each innominate bone consists of?

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4
Q

Acetabulum

A

A large depression on the lateral aspect of each innominate.

It receives the head of the femur to form the hip joint

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5
Q

Acetabular notch

A

The acetabular rim is the outside edge of the acetabulum, which is deficient inferiorly known as _________ ________.

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6
Q

Transverse acetabular ligament

A

Associated with the acetabulum which is a piece of connective tissue that bridges the acetabular I’m with the acetabular notch

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7
Q

Ilium

A

Larges and uppermost portion of the the pelvic bone.

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8
Q
  1. ) anterior gluteal lines
  2. ) posterior gluteal lines
  3. ) inferior gluteal lines
A

What are the three oblique lines of the ilium? They can be found on the external or lateral surface of the bone.

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9
Q

It indicates the bony origins and gluteal muscles

A

What do the three oblique lines of the ilium indicate?

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10
Q

Iliac fossa

A

What is the medial surface of the ilium?

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11
Q

Iliac tuberosity

A

Posterior to the iliac fossa which is the most superior is known as ______ ________. This is where ligaments attach

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12
Q

Auricular surface

A

Posterior to the iliac fossa and more inferior of these surfaces. This is where each innominate articulates with the sacrum

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13
Q

Accurate line

A

Just inferior of the iliac fossa is a curved line that marks the boundary between the major or false pelvis from the minor or true pelvis

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14
Q

Pelvic brim

A

The ilium arcuate line from each innominate forms known as ______ ______.

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15
Q

Iliac crest

A

The superior border of the ilium which terminates anteriorly as the anterior superior iliac spine and anterior inferior iliac spine

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16
Q

Iliac tubercle

A

A distinct bump that is found on the lateral most aspect of the iliac crest

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17
Q

Greater sciatic notch

A

Just inferior to the posterior inferior iliac spine is a deep notch known as __________ _________ ________.

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18
Q

Ischium

A

An “L” shaped bone which consists of body and Ramis

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19
Q

Ischial spine

A

A small projection of the body of the ischium

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20
Q

Lesser sciatic notch

A

A small notch just below the spine

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21
Q

Ischial tuberosity

A

Inferior to the lesser sciatic notch is large roughened area and it bears the weight of the body when sitting (the hamstring muscles originate from here)

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22
Q

Ramus

A

What is the most inferior portion of the ischium?

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23
Q

Pubis

A

Consists of a body and two rami

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24
Q

Symphyseal surface (pubic symphysis)

A

The medial body consists of ________ __________ which articulates with the pubis from the opposite innominate.

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25
Q

Pubic tubercle

A

The superior aspect of the body of the pubis

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26
Q

Pubic Crest

A

A line going from the pubic tubercle to the symphyseal surface

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27
Q

Pubic pecten

A

A prominent ridge of the superior ramus of the pubis

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28
Q

Obturator foramen

A

A large oval opening found at the inferior aspect of each innominate

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29
Q

Obturator groove

A

It’s an indentation found at the superior anterior border of the obturator foramen

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30
Q

Obturator membrane

A

The obturator foramen is closed by a piece of connective tissue called ________ _________.

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31
Q

False or major pelvis

A

Is bounded posteriorly by the lumbar vertebrae, laterally by the ilium and anterior by the abdominal wall; it helps to support and protect much of the abdominal viscera.

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32
Q

True or minor pelvis

A

Is bounded posteriorly by the sacrum and coccyx, laterally and anteriorly by the ilium, Ischium, and pubis; this portion of the pelvis surround the birth canal in females

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33
Q

Pelvic Bone

A

Functions:

  1. ) protects the pelvic viscera
  2. ) transmits body weight to the limbs and absorbs the stresses of muscular activity
  3. ) allows locomotion, by causing the pelvic bone to swing from side to side
  4. ) In females, provides the bony support for the birth canal
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34
Q

Android Pelvis

A

Typical male pelvis

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35
Q

Gynecoid pelvis

A

Typical female pelvis

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36
Q

Anthropoid pelvis

A

Exaggerated male pelvis

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37
Q

Platypelloid pelvis

A

Exaggerated female pelvis

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38
Q
  1. ) pubic rami
  2. ) acetabulum
  3. ) sacroiliac joint
  4. ) most lateral aspect of the ilium
A

What features of the pelvis are most prone to fracture?

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39
Q

High morbidity and mortality rate

A

With fractures of the pelvis is there a high or low morbidity rate?

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40
Q

Hip pointers

A

A common painful contusion injury of the soft tissue associated with the iliac crest.

It’s very common in contact sports and usually result in a painful hematoma

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41
Q

Ossification of the pelvic bone

A

Three primary centers

  • ilium
  • ischium
  • pubis

Five secondary centers

  • iliac crest
  • anterior inferior iliac spine
  • ischial tuberosity
  • pubis symphysis
  • acetabulum

Bone is completed between 20-22 years old

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42
Q

Femur

A

Longest, heaviest bone in the body

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43
Q

Hip joint

A

At the proximal end of the femur is found a rounded head, which articulates with the acetabulum forte pelvic bone to form the _____ _______.

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44
Q

Fovea capitis

A

On the head of the femur is a pit or depression, which is for the attachment fo the capitis femoris ligament

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45
Q
  • spiral
  • pectineal
  • gluteal
A

What three lines come together to form the lines aspera?

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46
Q

Ossification of femur

A

Primary centers
-shaft

Secondary centers

  • head
  • greater trochanter
  • lesser trochanter
  • distal ends of condyles and epicondyles

Bone completes by 15 years in female and 17 1/2 years for males

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47
Q

Angle of inclination

A

The way the neck of the femur meets the shaft of the bone, an angle is formed is known as _____ __ _______.

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48
Q

Cox Valga

A

An increase in the angle of inclination, which can occur with the developmental dysphasia of the hip (congenital)

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49
Q

Coxa Vara

A

A decrease in the angle of inclination, which can occur in fractures to the proximal part of the femur and in the condition of rickets.

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50
Q

Age and sex related

A

What is a major factor in femur fractures?

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51
Q

Subcapital fractures

A

This a fracture through the neck of the femur and are what is commonly called as a broken hip.

Fairly common in older people who suffer from osteoporosis (Estrogen deficiency)

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52
Q

Avascular necrosis

A

Subcapital fractures often interrupt the blood supply to the femoral head, leading to a degeneration of the head.

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53
Q

Obturator artery

A

The head of the femur is supplied by the _______ ______.

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54
Q

Femoral artery (medial and lateral femoral circumflex arteries)

A

The neck of the femur receives a rich blood supply from branches of the _______ _______

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55
Q

Patella

A

This large sesmoid bone develops within the common tendon of insertion of the quadriceps

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56
Q

Gives additional leverage to the quadriceps during the last part of extension of the leg. This helps to increase the power of the extension movement

A

What is the main function of the patella?

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57
Q

Patella fracture

A

Due to direct trauma usually this bone becomes comminuted

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58
Q

Transverse fracture

A

When there is indirect trauma and it becomes displaced

59
Q
  1. ) severe pain
  2. ) swelling and tenderness
  3. ) inability to carry out extension at the knee joint
A

Symptoms of a fracture patella

60
Q

Patella Emarginata

A

A patella in which the superior lateral portion of the bone remains unossified

61
Q

Bipartite or Tripartite Patella

A

A patella in which the superior lateral portion ossified independently

Occurs in 3% of the population

Can be confused with a fracture of the patella

62
Q

Chondromalacia

A

A condition in which there is a softening and fissuring of the articular cartilage on the posterior aspect of the patella

Common in young adults

Complaint is dull pain and worsens with exercise

63
Q

Fascia Lata

A

This is the connective tissue investment (deep fascia) of the thigh region

It provides the quadriceps from bulging during contractions of the muscle

64
Q

Iliotibial Tract

A

Is a thickened lateral aspect of the fascia Lata which received insertions from eh tensor fascia Lata and gluteus Maximus

65
Q

Iliotibial band syndrome (ITBS)

A

An overuse syndrome which occurs at the distal end of the iliotibial band where it repetitively rubs over the lateral condyle of the femur, thus irrational and inflaming the bursa located there.

66
Q

Abduction of the femur

A

Lateral movement of the femur

67
Q

Adduction of the femur

A

Medial movement of the femur

68
Q

Lateral (outward) rotation

A

Is the rotation of the femur around its longitudinal axis, so that the knee is turned outward.

69
Q

Medial (inward) rotation

A

Is the rotation of the femur around its longitudinal axis, so that the knee is turned inward.

70
Q

Iliopsoas

A

What is the psoas major and the iliacus combine to be?

71
Q

Weakness of the psoas major and iliacus

A

Weakness of the ________ ________ or _________ will result in marked disability in carrying out activities such as stair climbing, walking up inclines, getting up from a reclining position.

72
Q

Psoas Minor

A

What is the muscle that is missing out of half of the population?

73
Q

Psoas Minor

A

What is the muscle that often gets mistaken for a nerve (genitofemoral nerve)?

74
Q

Quadriceps

A

The rectus femoris and the three vastus muscles make up the _____________

75
Q

Sartorius

A

This is the longest muscle in the body

76
Q

Articularis genu

A

A distinct bundle of muscle fibers separates from the deepest layer of the vastus inter Medius and become a separate muscles known as _________ _____. Also this attaches to the synovial membrane of the knee joint.

77
Q

Atrophy of the quadriceps

A

Atrophy of ________ will have difficulty extending their leg against resistance and will usually press on the distal end of the femur during walking to prevent flexion from occurring at the knee joint.

Weakness of this muscle can also result in abnormal patellar movements and loss of joint mobility

The patient will have difficulty carrying out extension at the knee joint

78
Q

Charley Horse

A

Used to indicate a cramping or spasm of the quadriceps

Also indicates trauma to the muscles, which can cause a tearing of muscle fibers and lead to painful hematomas and bruising

79
Q

Jumper’s Knee (Patellar Tendonitis)

A

A painful overuse injury of the common tendon of insertion of the quadriceps and/or of the patellar ligament

80
Q

Patellar Reflex

A

Carried out by tapping the patellar ligament and is used to test for the segmental innervation of L2, L3, and L4

81
Q

Gracilis

A

What muscle crosses both the hip and knee joint?

82
Q

Gracilis

A

What muscle can be removed without a noticeable loss of action?

83
Q

Pectineus and Adductor Brevis

A

What muscles both have an insertion of the pectineal line?

84
Q

Pulled groin (adductor strain)

A

A condition in which there is stretching of the origin of an adductor muscle beyond their tensile strength.

May consists of micro tears of the fibers (grade 1), Partial tears (grade 2), complete tears (grade 3)

Symptoms:

  • pain and tenderness in the groin area
  • stiffness in the area
  • weakness of the muscle(s)
  • possible bruising in the area

A strain of the iliopsoas is also classified as a pulled groin

85
Q

Trochanteric bursae

A

Separates the superior part of the muscle from the greater trochanter

86
Q

Ischial bursae

A

Separates the inferior part of the muscle from the ischial tuberosity

87
Q

Weakness of the gluteus Maximus

A

A weakness of this muscle will cause patients to have difficulty getting from a sitting to standing position, straightening from a bending position, walking uphill or up stairs.

88
Q

Trendelenburg Test

A

A simple test which is used if one suspects atrophy and weakness of the gluteus media’s and minimus muscles

The pelvis will drop on the unaffected side when the foot is raised off of the ground

89
Q

Gluteal Gait/ Trendelenburg Gait

A

A type of abnormal locomotion due to atrophy and weakness of the Gluteus Medius and minimus

90
Q

Postural deviations

A

Weakness of the gluteus media’s and minimus muscles can cause this _____ ______.

This results in the vertebral column deviating toward the side where the pelvis is low, giving rise to what is known as a “C” curve of the column

91
Q

Piriformis Muscle syndrome

A

A common cause of pain in the gluteal region due to compression of the sciatic nerve by the Piriformis muscle (sciatica)

92
Q

Lateral rotation

A

What type of rotation of the femur is important in the control of the body’s balance and posture?

93
Q

Lateral; medial

A

The (lateral/medial) rotators are stronger than (lateral/medial) rotators of the femur

94
Q

Goose’s foot

A

What name is given to describe the tendons of insertion of the semitendinosus, Gracilis, and Sartorius

95
Q

Pulled hamstrings

A

Is also known as a hamstring strain and is a common sports injury

The strong muscular contractions required to excel in these sports may lead to a tearing of the muscles, which are classified as grade 1,2, and 3

Contributing factors:

  • running style
  • over developed quadriceps
  • biomechanical factors
  • inadequate warm ups and stretches
96
Q

Avulsion of the ischial tuberosity

A

May result from forcible flexion of the hip when the knee is extended (ex: hurdler)

97
Q

Weak or tight Hamstrings

A

With this condition the body may compensate by changing the position of the pelvic bone, which can place stress on other muscles in the are and may compress spinal nerves

98
Q

Lumbar plexus

A

This plexus is found in the pelvic cavity, embedded for the most part in the psoas major muscle

99
Q

Lumbrosacral Trunk

A

This term given to the nerve axons of L4 and L5 that allows communication between the lumbar plexus and the sacral plexus

100
Q

L4

A

What is common to both lumbar and sacral plexuses?

101
Q

Iliohypogastric Nerve

A

Segmental Innervation : L1 (sometimes T12)

Anterior division

Motor supply: internal oblique and transverse abdominal muscles

Cutaneous supply: lateral aspect of the buttocks

102
Q

Ilioinguinal Nerve

A

Segmental innervation: L1

Anterior division

ONLY cutaneous supply: proximal medial aspect of the thigh

103
Q

Lateral (femoral) cutaneous nerve of the thigh

A

Enters the thigh by passing beneath inguinal ligament

Segmental innervation: L2 and L3

Posterior division

ONLY cutaneous function: lateral aspect of the thigh (both anterior and posterior)

104
Q

Meralgia Paresthesia (lateral femoral cutaneous nerve entrapment)

A

A compression neuropathy of the lateral femoral cutaneous nerve as it leaves the pelvic cavity beneath the inguinal ligament

Symptoms (Lateral aspect of the thigh)

  • pain
  • burning
  • tingling sensation

Common causes:

  • obesity
  • wearing tight fitting clothing
  • any activity which puts the femur in a flexed position

This condition is sometimes confused with trochanteric bursitis

105
Q

Genitofemoral nerve

A

This nerve is only in males

Segmental innervation: L1 and L2

Anterior division

Motor supply: cremaster muscle

Cutaneous supply: genitalia and small area below the inguinal ligament

106
Q

Femoral nerve

A

Largest branch of the lumbar plexus

Segmental innervation: L2, L3, and L4

Posterior division

Motor supply: iliacus, psoas major, Sartorius, quadriceps, and Pectineus

Cutaneous supply: medial and intermediate aspect of the anterior thigh and medial aspect of the leg and foot

Cutaneous branch of the nerve supplies the skiing covering the medial aspect of the leg and foot is known as the saphenous nerve

The nerve gives off articular branches to supply the hip and knee joints

107
Q

Damage to the femoral nerve

A

Nerve can be injured by trauma

When the nerve is comprised the following will occur:
Motor- quadriceps are involved and the leg cannot be extended. Flexion
at the hip is diminished
Sensory: medial and intermediate aspect of the thigh. Medial aspect of
the leg and foot.

Test: assessing both flexion at hip and extension at the leg

108
Q

Within the Adductor canal

A

Where does compression of the saphenous nerve happen?

109
Q

Obturator nerve

A

Segmental innervation: L2, L3, and L4

Anterior division

Motor supply: Pectineus, Adductor magnus, adductor longus and brevis, Gracilis, and obturator externus

Cutaneous supply: medial aspect of the thigh

Articular supply: hip and knee joints

110
Q

Accessory obturator nerve

A

Found in only 20% of the population

Segmental innervation: L3 and L4

When present supplies the Pectineus muscle and hip joint

111
Q

Damage to obturator nerve

A

Nerve may be damaged during a difficult birth or by and anterior dislocation of the hip joint.

Test: adduction of the femur against resistance

112
Q

Sacral plexus

A

Formed from L4 and L5 (lumbosacral trunk) and S1, S2, S3, S4

Sacral nerves enter the pelvis via anterior sacral foramina

113
Q

Posterior femoral cutaneous nerve

A

Segmental innervation: S1, S2, and S3

Anterior and Posterior divisions** UNIQUE

Cutaneous supply: distal part of the buttocks, posterior thigh, and popliteal fossa

114
Q

Superior gluteal nerve

A

Leaves pelvis via superior part of the greater sciatic notch

Segmental innervation: L4, L5, and S1

Posterior division

Motor supply: Gluteus Medius, gluteus minimus, and tensor fascia Lata

No Cutaneous supply

115
Q

Inferior gluteal nerve

A

Leaves pelvis via inferior part of the greater sciatic notch

Segmental innervation: L5, S1, and S2

Posterior division

Motor supply: gluteus Maximus

No Cutaneous Supply

116
Q

Pudendal nerve

A

Segmental innervation: S2, S3, and S4

Anterior division

Main sensory nerve to the external genitalia

Leaves pelvic cavity via greater sciatic notch

117
Q

Sciatic Nerve

A

This nerve is also a continuation of the sacral plexus into the leg and foot

Nerve leaves the pelvis through the greater sciatic notch deep to the Piriformis muscle

Segmental innervation: L4, L5, S1, S2, and S3

Motor supply: adductor magnus, semitendinosus, semimembranosus, and biceps femoris

Also consists of 2 nerves: tibial nerve and common fibular

118
Q

Tibial nerve

A

Formed from the anterior division and supplies the muscles and most of the skin fo the posterior leg and plantar surface of the foot

119
Q

Common fibular nerve

A

Formed from the posterior division which wraps around the neck of the fibula and has two branches (deep fibular and superficial fibular); the branches supply the muscles and skin of the anterior leg, lateral leg, and dorsum of the foot

120
Q
  • fractures of the pelvis
  • posterior dislocation of the hip joint
  • penetrating wounds (badly placed intramuscular injections)
A

How can the sciatic nerve be injured?

121
Q

Clinal features of an injured sciatic nerve

A

Motor:

  • Hamstring muscles are atrophied but weak flexion of the leg is possible due to actions fo the Sartorius and Gracilis
  • all muscles distal to the knee may be involved
  • the foot due to gravity falls into the plantar flexed position (drop foot)

Sensory:
-loss of sensation below the knee EXCEPT for an area along the medial side of the leg and foot

122
Q

Sciatica

A

A condition with pain along the sensory distribution of the sciatic nerve. Pain is typically experienced in the gluteal region, posterior thigh and leg.

Causes:

  • compression, inflammation or subluxation of L4-S3 (herniation)
  • compression neuropathy of the sciatic nerve in the gluteal area (Piriformis syndrome)
  • intrapelvic tumor
123
Q

L1

A

Proximal anterior thigh

124
Q

L2

A

Middle anterior thigh

125
Q

L3

A

Distal anterior thigh; posterior medial leg

126
Q

L4

A

Distal lateral thigh; medial leg and foot; digit one

127
Q

L5

A

Lateral leg; digits 2,3,4

128
Q

S1

A

Posterior lateral thigh and leg; lateral aspect of the foot; digit 5

129
Q

S2

A

Medial posterior thigh and leg

130
Q

S3

A

Perineum

131
Q

Valves

A

What do veins have in the lower extremity that help maintain blood flow in an upward direction?

132
Q

Great saphenous vein

A

This vein arises from the medial aspect of the dorsal venous arch of the foot

  • Passes superiorly in front of the medial malleolus
  • Passes behind the knee and curves forward on to the medial aspect of the leg
  • passes through saphenous opening of the fascia Lata where it receives three tributaries (superficial circumflex iliac vein, superficial epigastric vein, and superficial or external pudendal vein).

Terminates at the femoral vein

133
Q

Lesser Saphenous Vein

A

Arises from the Lateral aspect of the dorsal venous arch.

Ascends behind the lateral malleolus as it passes the ankle joint. It’s accompanied by the sural nerve in the posterior aspect of the leg.

Terminates at the popliteal vein in the popliteal fossa

Termination has some variation and could joint the great saphenous or divide, sending one branch to popliteal vein and one to the great saphenous vein

134
Q

Varicose Veins

A

A condition in which the veins become enlarged, twisted, and painful due to poorly functioning valves.

Causes of this condition:

  • congenitally defective valves
  • pregnancy
  • overweight
  • inflammation of the vein (sometimes with a blood clot)
135
Q

The great saphenous vein

A

What vein is commonly used for coronary artery bypass surgery?

136
Q
  • readily accessible
  • has enough length
  • contains a higher percentage of muscular and elastic fibers than do other superficial veins of the body
A

What are the reasons why the great saphenous vein is used in coronary bypass surgery?

137
Q

Femoral triangle

A

A very important surface landmark of the anterior thigh, which is seen as a depression below the inguinal ligament on the anterior surface of the proximal thigh

Clinically important:

  • hernias are common here
  • it is an arterial pressure point in the case of uncontrolled bleeding of the lower extremity

Contents:

  • Femoral nerve
  • femoral artery and vein (femoral sheath)
  • inguinal lymph nodes (most medial aspect)
138
Q

Superior: inguinal ligament
Lateral: Sartorius
Medial: adductor longus

A

What are the boundaries of the femoral triangle?

139
Q

Femoral sheath

A

Consists of connective tissue which enclose the femoral blood vessels.

It’s a downward protrusion of the fascia covering the pelvic floor

Function: is to allow the femoral artery and vein to glide deep to the inguinal ligament during movements of the hip joint

3 compartments by vertical septa:

  • Lateral compartment for the femoral artery
  • intermediate compartment for the femoral vein
  • medial compartment which is known as the femoral canal
140
Q

Femoral canal

A

The most medial and smallest of the 3 compartments formed from the femoral sheath

The canal contains:

  • adipose tissue
  • lymphatic lymph nodes

Canal is WIDER in females in males

141
Q

Femoral ring

A

This is an opening in the roof of the femoral canal and it is known as the _______ ________.

142
Q

the femoral ring

A

What is the originating site for a femoral hernia?

143
Q

Femoral hernia

A

This type of hernia is a protrusion of abdominal viscera through the femoral ring into the femoral canal.

Eventually it can push through the saphenous opening in into the subcutaneous area of the anterior thigh and cause problems

Gross Anatomy (4 decks)

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