Exam 3 Flashcards
1
Q
What is different about the Aortic Hiatus?
A
There are folds of Connective tissue on each side called a crus, to support the large pressures that go through the aorta
2
Q
What is each compantment of the lower leg seperated by?
A
Connective tissue
3
Q
Where is the belly of the tensor fascae lata (TFL)
A
Superior and promixal attaching to iliotibial tract (IT band)
4
Q
What is the fate of the deep femoral artery?
A
it runs out after the peripheral branches
5
Q
What is piriformis Syndrome?
A
Compresses Sciatic nerve which causes shooting pain down the posterior thigh, lower leg and even foot
6
Q
What is deep to the gluteus Medius?
A
Gluteus Minimus
7
Q
Where/What is the Caval opening?
A
Where the inferior vena cava goes through to get to the abdominal cavity
Located on the right side
8
Q
What compartment does the fibularis longus belong in?
A
Lateral
9
Q
How many phlanges in toe digits 2-5?
A
3
10
Q
Insertion of tensor Faschia Lata
A
iliotibial tract
11
Q
Innervation of Internal oblique
A
intercostal nerves
iliohypogastric nerve
ilioinguinal nerve
12
Q
Under the knee, what is the lateral cord you feel?
A
The tendon to the biceps femoris
13
Q
What is the name of the opening between the esophagus and stomach?
A
Cardiac Orfice
14
Q
What does the gluteus maximus share a tendon with?
A
Tensor Faschia Lata Muscle
15
Q
What does someone have to do if they have a Q angle walking?
A
They have to rotate their hip to bring it more up and down
16
Q
In the popliteal region what is the most lateral muscle?
A
Long head of Biceps Femoris
17
Q
Action of gracialis
A
Adducts and flexes the hip joint
Flexes and internally rotates the knee joint
18
Q
What is the pattern for peristalsis in the stomach?
A
Muscle actions of the stomach (kinda how a snake moves)
Contractions begin in the superior portion of the stomach and moves down to the pyroric region
19
Q
What comes off the common hepatic artery?
A
Hepatic Proper arteries that split in the right and left branches
20
Q
What is the round ligament
A
ligament of the head of the femer
helps pull the head of femer into the acetalbulum
21
Q
What is the round ligament of the liver derived from?
A
The umbilical vein
22
Q
Which quadraceps muscle crosses the knee
A
Rectus femoris
23
Q
What arteries run through the rectus abdominis?
A
epigastric arteries
24
Q
Where does the inferior gluteal nerve live?
A
Inferior to piriformas
25
What muscles abduct the hip?
Gluteus Medius
Gluteus Minimus
Tensor Fashia Lata
26
Describe the location and function of the suprapatellar bursae.
- Above the patella
| - Prevents the patellar tendon from rubbing against the shaft of the femur
27
Why are there two types of fibers in the calcaneal tendon?
Slow twitch are endurance fibers but fast twitch fibers are for power so you can quickly switch gears walking
28
How long does gastric emptying take?
3-4 hours
29
What is a hiatal Hernia?
Some of the stomach can pop through the opening causing acid reflux,
Dangerous when it gets strangled in there
Treatment is surgery to provide support
30
Describe the path of the fibular nerve in the lower leg
1. At the head of the fibula the nerve comes out.
| 2. The deep fibular nerve dives deep into the anterior compartment
31
What do the Vastus medialis, Vastus lateralis, Vastus, intermedias and vastus femoris all do?
all of them work together to do Knee extension
| Kicking is very powerful
32
How do you treat an ACL injury?
- let it heal and strengthen muscles around joint
- Reattach
- Cadaver ligament
- artificial ligaments
- Fishing line in dogs! (won't do in humans prob due to cost)
33
Where is the rectus abdominus located?
Superficial to transverse abdominus and the most superficial muscle on the anterior side
34
Describe the structure of a synovial joint.
Freely movable joints (shoulder, interphalengeal, toe)
1. Layer of thick connective tissue going around called the joint capsule
2. Within the joint capsule is a thin membrane called the synovial membrane which produces synovial fluid that bathes the entire inside of the joint
35
What are the two bellies to the gastrocnemius muscle?
Medial and Lateral
36
What does estrogen do in terms of bone density?
It protects it. That is why post menopausal women are prone to osteoporosis
37
Action of fibularis Longus
Plantar flexion
| Eversion of ankle
38
What are shin splints?
When muscle inflammation within the compartment increases pressure on the nerve supply. compartments cannot expand due to the toughness of the ct surrounding the compartments.
39
What muscles are located in the lateral compartment of the lower leg?
Fibularis longus
| Fibularis Brevis
40
What are some sex differences between the female and male when looking at the pelvis anteriorly?
Female-wider and shallow pelvis
wider pubic arch (childbirth)
Male-narrower and taller
tubercles can be rougher and bumpier
41
What does the sciatic Nerve run?
Entire Posterior Thigh (Hamstrings)
| Entire lower leg
42
What direction does fascicles of the external oblique go?
Superior to inferior
43
What does the Fibular nerve split into?
Superficial-Goes to lateral compartment
| Deep-Goes to anterior compartment
44
Does the sciatic nerve run with any large vessels?
Not until the popliteal fossa
45
What is the function of the spleen?
Lymph node of blood
46
Where do the 4 tendons of exntensor digitorum run?
To digits 2-5 (toes)
47
Where does the CT tissue lie on the tibialis anterior?
Lateral side
48
What does the gluteus maximus attach to on the medial side?
Sacrum
| Posterior ilieum
49
Origin of the femoral nerve
lumbar plexus
50
What action do the muscles contained in the lateral compartment of the leg perform?
Eversion of foot and plantar flexion
51
When does the Q angle increase in women?
At puberty
52
Why isn't everything in the peritoneum?
Hypothesis is that it buys time during critical situations to allow detoxification
53
Define peripheral artery disease how it would affect a posterior tibial artery pulse.
Absence of the posterior tibial pulses is a sign of occlusive peripheral arterial disease in people over 60.
54
Describe the Obturator Internus Muscle
Skinny muscle with a white tendon
| splitting gemellus muscles
55
How does the inferior epigastric run through the rectus abdominis?
It serpentines through
56
Where does the supraduodenal artery run?
superficial to the duodenum and also supplies blood
57
What is dorsiflexion?
Walking on heels lifting foot.
| Shortening angle toward tibia
58
What is deep to the internal oblique muscles?
Transverse abdominus
59
What does the gluteus medias cover?
Most of the posterior ilium
60
What does a Trendelenburg test look assess?
If there is Damage to the superior gluteal nerve
61
How large is the duodenum?
1 ft
62
What is Inversion?
AKA pronation sorta
| Pointing feet in
63
Which nerve is injured when someone picks up left leg during a trendelenburg test?
Right superior gluteal nerve (hip drops on left side)
64
What runs the medial Thigh?
Obturator Nerve
65
Define the popliteal fossa and list the structures you would find in this area.
Pit of the knee
66
What does the anterior tibial artery feed?
Anterior Comparment
67
Location of External Oblique muscle
Inferior to the serratus anterior
68
When giving birth what can affect delivery?
- pubic arch not wide enough
| - the way in which the coccyx is curved
69
Where are the superior and inferior gluteal arteries?
The run with the nerves
70
What is one prolem with the trochanteric bursa?
Can become inflamed due to a lot of rubbing.
When you perform lateral hip rotation the gluteal maximus and gluteus medius muscle pull on the IT band creating friction
71
Action of articularis genus (distal fibers of vastus intermediaus)
Extends the knee joint and prevents entrapment of capsule
72
What nerve is contained in the anterior compartment of the lower leg?
Deep Fibular Nerve
73
What is the other name for fibular nerve?
peroneal nerve
74
Where should you give a intragluteal injection?
Into the upper lateral portion of Gluteus maximus or Medius from the midline of the iliac crest to the lateral (superolateral quadrant of the gluteus)
75
How do you treat Patellar maltracking?
1. Physical Therapy(partial knee extensions to recruit vastus medius)
2. Orthootics for flat feet (eversion of foot-caves in on medial side that pulls down on tibia to angle it as it comes down clipping)
3. weight loss (working vastus lateralis pulling patella over)
4. cortisone injections (reduces inflammation)
76
Where can you palpate the posterior tibial pulse?
between the Posterior surface of the medial malleolus and the medial border of the calcaneon tendon.
77
Proximal Attachment of the gastrocnemius
Superior to the lateral and medial femoral condyles
78
Action of tibialis Anterior
Dorsiflexion
| Inversion of ankle
79
How do you tell the difference between the patellar tendon and patellar ligament?
Ligament-inferior to patellar
| Tendon-superior
80
Describe the location and function of the prepatellar bursae.
- In front of the patella
| - Preventing patella from rubbing on skin too much
81
Where is the trochateric Bursa
Lies lateral to greater trochanter
82
Proximal Attachment of Gastrocnemius
Superior to the lateral and medial femoral condyles
83
Is you reflect the gastronemius what do you see?
Soleus muscle (very wide muscle)
84
Where is the Medial superior genicular artery?
Superior to femoral condyles
85
What are the 3 hamstring muscles?
Biceps Femoris
Semitendinosus
Semimembranosus
86
What happens when you reflect the greater omentum superiorly?
Colon stay stuck to it
87
Distal attachment of the gastrocnemius, plantaris, and soleus muscle
Posterior surface of calcanus via calcanel tendon
88
Describe sciatic Nerve Injury
- piriformas compression
- Stabbling or gunshot in gluteual region
- Intragluteal Injections
89
If you damage the superior gluteal nerve what muscles would be affected?
Glteus Maximus, Gluteal Minimus and
| Tensor faschia Lata
90
What happens to hip as we age?
The labrum degenerates and no cartilage is left
91
How do you tell the difference between the superior and inferior gluteal nerves and arteries?
Arteries lie medial to the nerves
92
How is a meniscus repaired?
Arthoscopic surgery and pull out broken piece
| Meniscus reconstruction
93
Origin of the Tibialis Anterior
Upper, lateral 2/3rd of tibia (lateral condyle)
| posteriorly attaches to interosseus membrane
94
What branches come off the splenic artery?
At the lateral side of the stomach the left gastro-omental artery come offs the splenic and runs inbetween the stomach and greater omentum
95
Describe the structure and function of bursae.
Prevents tissue from rubbing on the bone.
| -Bags of synovial membrane with synovial fluid
96
Where is the inguinal region?
Inferior to internal and external oblique
97
What are the femoral arterial branches?
1. Medial circumflex femoral artery
2. Lateral Circumflex femoral artery
3. Deep femoral artery
98
Where does the plantaris muscle lie in the popliteal fossa?
Superficial to the neurovasculature
99
Proximal Attachment of the plantaris
Lateral condyle of the femur
100
How are abdominal organs packaged?
The Peritoneum
101
What are the two medial tendons you feel under the knee?
Most medial is the semimembranosus and lateral to that is the semitendinosus
102
What is the superior border of the abdominal cavity?
Diaphram
103
What is extension of the hip important for?
Running
Sprinting
Going up stairs
104
pathway of femoral nerve
deep to inguinal ligament lateral to femoral artery
105
Where does the Gluteus Medus attach to laterally?
Greater Trochanter of the Femur
106
What does stabilizing the pelvis really mean?
Maintaining orientation
107
Proximal attachment of semitendonosus and semimembranosus
Ischial tuberosity (Crosses hip)
108
Why are there four layers of muscle in the abdominal region?
Protection
109
On the lateral leg what can you see?
Tensor Fashia Lata
IT band
Gluteus Maximus
110
What is superior to the sciatic nerve?
Piriformis Muscle
111
What is the diaphram made of?
Skeletal Muscle
112
What type of joint is the hip?
```
A ball and socket joint that can
Flex
extend
abduct
adduct
external/internal rotation and circumduction
```
113
Action of Adductor magnus
Adducts, extends and slight flexion of the hip joint
Tendinous insertion also internally rotate
Stabilizes the pelvis in the coronal plane and saggital planes
114
What branches come off the popliteal artery?
- Medial and Lateral superior genicular arteries
- Medial and lateral inferior genicular arteries
- Anterior and posterior Tibial artery
115
Where does the sciatic nerve branch?
Down in the popliteal region into the common fibular nerve and the tibial nerve
116
Proximal Attachment of the Soleus
Lateral tibia and head of fibula
117
Where do the superior and inferior gluteal arteries originate?
Internal iliac artery deep in the lower pelvis
118
Where does the lateral circumflex artery go?
around the front
119
What muscles are innervated by the obturator internus nerve?
Obturator internus and Superior Gemellus
120
What way do the fascicles run in the transverse abdominus?
Transversly, horizontal
121
Where is all of the lower leg blood supply derived from?
The popliteal artery
122
What are the medial thigh muscles?
```
Pectineus
Adductor longus
Adductor Brevis
Gracillis
Adductor magnus
```
123
Where does the posterior tibial artery run?
Posterior to the medial malleolus of the tibia
124
What is the origin of the inferior gemellus and the quadratus femoris?
Ischial Tuberosity
125
Describe the orientation of the deep gluteus
```
Gluteus Minimus
Superior Gluteal Artery and nerve
Piriformis
Inferior Gluteal Artery and Nerve and Sciatic Nerve
superior gemellus
Obturator internus
Inferior Gemellus
Quadratus Femoris
Adductor Magnus
```
126
What are the mesentaries?
The Visceral and parietal layers come together and house blood vessels and lymphatics
127
What compartments do plantar flexion?
Anterior and Lateral
128
What vessel is found in the posterior compartment of the lower leg?
Posterior tibial artery
129
What is a valgus foot?
When the arch is collapsed and you are flat footed
130
Where is the patellar tendon?
The tendon superior to patella connecting all the quadiceps muscle groups
131
Orientation of the plantaris muscle
More superior
Crosses knee joint near the lateral side of the femur. Belly is pretty small. The tendon is sandwiched inbetween the Gastrocnemius and soleus muscle but will then terminate in the calcaneal tendon
132
Where does the splenic artery run from the celiac trunk?
Posterior to the stomach to get to the spleen
133
What two nerves run through the sciatic nerve?
Tibial nerve and Common fibular nerve
134
What muscles insert of the Greater Trochanter of the Femur?
```
Gluteus medius and Gluteus Minimus
Piriformas
Obturator Internus
Superior Gemellus
Inferior Gemmulus
```
135
Action of the gastronemius and plantaris
Plantarflexes the foot and flexes the knee
136
What is the Sciatic nerve?
It is really two nerves packaged together
137
What is hip abduction?
Bridges
138
For the gluteal arteries and nerves what is their relationship?
Artery is medial to the nerve
139
What are the anterior thigh muscles?
Quadriceps femoris
sartorius
pectineus
140
Origin of Gluteus Medius
Posterior ilium between anterior and posterior gluteal lines
141
What muscle do you use for speed?
Gastocnemius
142
What artery comes out inferior to the piriformis?
Inferior gluteal artery
143
What organs go through all of the quadrants of the abdomen?
Colon and small intestine
144
Action of rectus abdominis
Flexes trunk
compresses abdomen
stabilizes pelvis
145
What is patellar tracking dependent on?
Strength ratio of the quadriceps muscles
146
What comes off the common hepatic artery?
Hepatic Proper arteries that split in the right and left branches to each respective lobe
147
Origin of the obturator nerve
Lumbar plexus
148
Innervation of Piriformas
Spinal attachment to first two spinal nerves (Anterior Rami)
149
where are the opening going throigh the abdomen?
Inferior Vena Cava
Esophageal Hiatus
Aortic Hiatus (L and R crus)
150
What actions does gastrocnemius perform?
knee flexion
| plantarflexion
151
Function of femoral nerve
sensory and motor to anterior thigh
152
How do we prevent osteoporosis?
Increase the need for calcium, weight bearing training
| can increase bone density
153
What is the smallest gluteus muscle?
Gluteus minimus
154
Where do the bones fuse at the pelvis?
acetabulum
155
What innervates the Obturator Internus and Superior Gemellus?
Obturator Internus nerve
156
What are the most common type of shin splints?
Anterior Shin Splints
157
What lies superficially to the Trochanteric Bursa?
IT band
158
Where is your appendix located?
Lower right quadrant
159
What is the Anterior Border of the abdominal cavity?
```
Rectus Abdominus
Abdominal muscles (external and internal oblique and transversus abdominus)
```
160
Attachment of the internal and external oblique
Linea alba
161
What branches come off the popliteal artery?
Anterior tibial artery and posterior tibial artery
162
Where does the common fibular nerve go to?
It will branch into the deep fibular and superficial fibular nerve
163
What muscles are located in the anterior compartment of the lower leg?
Tibialis anterior
Extensor hallusis longus
Extensor digitorum longus
Fibularis tertius
164
Where is the duodenum?
Connect to stomach
165
What muscles medially rotate the hip?
Tensor Faschia Lata
Gluteus Medius
Gluteus Minimus
166
Function of the obturator nerve
Sensory and motor to medial thigh
167
Orientation of the Deep Hip lateral Rotators superior to inferior
```
Gluteus minimus
Piriformas
Superior Gemellus
Obturator internus
Inferior gemellus
Quadrator Femoris
```
168
What muscles are innervated by the Quadratus femoris nerve?
Inferior Gemellus
| Quadratus Femoris
169
What does Gluteus minimus attach to laterally?
Greater Trochanter of the femur
170
What type of muscle fibers are found in the gastrocnemius muscle?
Fast Twitch
171
What muscles attach to the calcaneal tendon?
Soleus and Gastrocnemius
172
Location of the spleen
To the left of the stomach bordering the abdominal wall on the left side (not much padding, easy to rupture in car accidents
173
Innervation of gastrocnemius, plantaris, and soleus muscle
Tibial Nerve
174
What muscles laterally rotate the hip joint or thigh?
```
Piriformis
Obturator Internus
Superior Gemellus
Inferior Gemmelus
Quadratus Femoris
```
175
action of Vastus medialis, vastus lateralis and vastus intermedias
Extends the knee joint
176
Where does the greater omentum extend from and to?
Inferior border of the transverse colon to the inferior border of the greater curvature of the stomach
177
What are the layers of the peritoneum?
Pareital (Outside) (Attached to the wall of the abdominal cavity)
Visceral (Attached to abdominal organs)
178
Why isn't there bone protecting abdominal muscles?
More flexability
179
Innervation of tibialis anterior
deep fibular nerve
180
What structure is the lateral comparment of the lower leg next to?
Fibula
181
How do you number cuneiforms?
Medial to Lateral numbering (1,2,3) or you can say medial, intertermediate and lateral
182
How are the superior and inferior glutal nerves named?
By relationship to piriformis muscle
183
Where does the babies head come out of on the pelvis
Pubic arch
184
T/F the seperation between the stomach and esophagus is present?
False, no valve
185
Where does the vasculature join the nerve supply in the leg?
At the adductor hiatus
186
What vessel is contained in the lateral compartment of the lower leg?
Fibular artery
187
What does intraperitoneal mean?
All organs encased within the peritoneum
188
What muscles intert on the greater trochanter of the Femur?
Gluteus Medius
| and minimus
189
Innervation of the gastrocnemius, plantatis and soleus
Tibial nerve
190
If you damage the fibular nerve more proximally at the thigh what happens?
you could affect both compartments
191
What is eversion?
Bring toes out
192
name the muscles of the quadriceps femoris
```
rectus femoris
vastus medialis
vastus lateralis
vastus intermedius
distal fibers of the vastus intermedius
```
193
What muscles would be affected you damged the Inferior Gluteal Nerve?
Gluteus Maximus
194
Where is the umbilicus found?
on the linea alba
195
What organs are in the upper right quadrant?
Most of the Liver
Some pancreas
duodenum
196
Distal Attachment of the Gastrocnemius, plantaris and Soleus
Posterior surface of calcaneus via calcaneal tendon
197
What nerve runs the anterior thigh?
Femoral Nerve
198
T/F the seperation between the stomach and esophagus is present?
False, no spinctor present
199
Which nerve runs the posterior side of the leg?
Tibial
200
insertion of adductor longus and adductor brevis
Femur (linea aspera, medial lip in the middle 3rd of the femur)
201
What goes through the Aortic Hiatus?
Aorta
202
Which liver lobe is the largerst and how far does it extend?
Left and it extends all the way to the abdominal wall
203
What is the action of Gluteus Maximus?
Entends and laterally rotates the hip (thigh)
204
What is the esophageal sphincter?
Seperates stomach from the esophagus
205
What muscle have their origin at the ischial tuberosity?
inferior gemellus
| Quadratus Femoris
206
What is the celiac trunk?
A small arterial trunk originating anteriorly from the aorta to provide blood to the upper GI organs al trunk originating
207
Action of the plantaris and gastrognemius muscle
Flexes the foot and knee
208
What pops out inferior to piriformis muscle?
Sciatic Nerve
209
Insertion of fibularis brevis
Base of 5th metatarsal
210
What runs the gemelli, obturator internus and quadratus femoris?
Sacral Plexus
211
Why is pudendal nerve important?
```
Small but important
It does sensory and motor to genitailia
Quality of life
Health of lower pevis (urinary incontinence)
Runs external sphinctor muscle
Erections, clitorus
Ability to hold urine
```
212
What does hallusis mean?
Big toe
213
What muscle lies inferior to the piriformas muscle?
Superior gemellus
214
What is contained within the spermatic cord?
Vasculature for gonadal arteries and veins and vas deferens
215
What is the most external abdominal muscle?
Rectus Abdomenus
216
What is located deep to the gluteus maximus?
Gluteus Medius
217
Where is the common fibular nerve?
Behind your knee and then splits into the superficial and the deep
218
How would you treat and inflamed trochanteric bursa?
Steriods and inactivity
219
where is the pancreas?
Posterior to the stomach and partly retroperitoneal
220
Where do the internal thoracic arteries originate from?
Subclavian arteries
221
Where can you palpate the tibia?
Palpate the anterior crest on the anterior leg. It's your shin.
222
Where does the medial head of the gastrocneimius attach to?
Medial condyleof femur
223
Why is the abdomen divided into quadrants?
When someone has pain in a certain area we can figure out what organs are involved.
224
Distal attachment of semitendinosus
Medial surface of the superior part of the tibia
225
Why does the pyloric sphinctor only push a small amount of its contents at a time to the duodenum?
1. Surface area (easier to digest)
| 2. Low pH
226
How do you excercise your diaphram?
Lay on your back, hold your legs in a 90 degree position and breath deep. When you inhale you push your diaphram out. (This strengthens your core)
227
What action the the gluteus maximus perform?
Lateral Rotation of the hip
| Extention of the hip
228
Insertion of the tibialis Anterior
Medial cuneiform and base of 1st metatarsal
229
Insertion of fibularis longus
Plantar surface of medial cuneiform
| Base of 1st metatarsal
230
Where does the Tibial nerve run in the lower leg?
posterior compartment
231
What does retroperitoneal mean?
Organs that are located posterior to peritoneum (Kidneys, urinary bladder, ureters, reproductive structures)
232
Describe the course of the popliteal artery
Starts off as femoral artery and once it passes through the adductor hiatus it becomes the popliteal artery.
Off the popliteal artery are genicular arteries running to the anterior side of the knee. Once the popliteal artery gets to the lower leg it splits into the anterior tibial artery which runs through the interosseus membrane to the front and the posterior tibial artery which splits into the fibular artery which feeds the lateral compartment and the posterior tibial artery that feeds the posterior compartment all the way down
233
What is the problem with FES?
The superficial part of the fibular nerve can be targeted and we only want to hit the tracts of the deep fibular nerve for dorsiflexion and not platarflexion
234
What are the folds of the stomach and what is the function?
Rugae
1. More surface area
2. Expansion
235
Which side is the fibula on?
the lateral side of the tibia
236
What muscle is involved when you pull your groin?
Gracilis
237
What increases gastric emptying time and why?
Fatty Meals
| Fat molecules are liberated during digestion and they float causing a lower sence of satiety
238
Origin of Gluteus Maximus
Posterior Ilium
| Dorsal surface of sacrum and coccyx
239
Where is the pudendal nerve?
Medial to the inferior gluteal artery coming out inferior to the piriformis muscle
240
What is the largest gluteal muscle?
Gluteus Maximus
241
Insertion of the Quadratus Femoris
Quadrate Tubercle
242
origin of rectus femoris
Anterior inferior iliac spine
| Acetabulum
243
What is an inguinal hernia?
A thinning of the inguinal hernia. People with a potbelly are prone to it
Heavy lifting
If something get stuck in the hernia it is very serious
244
Origin of transversus abdominus
inner surface of 7-12th costal cartilages
Iliac crest
anterior superior iliac spine
245
When do you do lateral hip rotation?
Stalibization of rough surfaces
| changing direction
246
Proximal Attachment of the Plantaris
Lateral supracondylar line of the femur
247
What is the fovea of the femer?
Allows connection of round ligament
248
Action of fibularis brevis
Plantar flexion
| eversion of ankle
249
Origin of the Piriformis
Anterior surface of the sacrum
250
Describe the tibialis anterior muscle
It is located on the anterior leg immediately lateral to the crest of the tibia. It has a large tendon you can palpate on the ankle when flexing. this muscle pops out when flexing
251
What does the Gluteus maximus attach to superiorly?
IT Band
252
describe the orientation of the Semitendinosus
Longest tendon and in the middle
253
What are the borders of the abdominal cavity?
Your Core-support for you body
254
Explain the Q angle
| in females
A wider pubic arch puts the acetabulum more lateral . More of an angle on the shaft or femer
255
Where is the patellar ligament and what does it connect?
Connects the patella to the tibia
256
where is the anterior tibial artery located?
Anterior to the interosseus membrane inbetween the fibula and tibia
257
What action is antagonistic to dorsiflexion?
plantarflexion
258
Innervation of Adductor longus and adductor brevis
obturator nerve
259
What actions do the muscles of the posterior comparment of the leg perform?
Plantar flexion
260
What are the three compartments of the leg?
Anterior
Posterior
Lateral
261
How far up does the gluteus minimus go on the ilium?
Attaches Halfway up the posterior ilium up to the Anterior Gluteal Line
262
What muscle is deep to rectus femoris?
intermediate vastus
263
What is the difference between gluteus maximus and Gluteus Medius?
Gluteus Maximus -Extends furthur in the superior direction
| Larger and more superficial
264
What is drop foot?
Poor signal conduction down through fibular nerve which affects
Dorsiflexion -Deep part
Plantarflexion-Superficial part.
265
When looking at the pelvis superiorly, how do you distinguish between a male and female?
Larger distance between ishial spines
266
What does the femoral triangle contain?
Femoral nerve
Femoral artery
Femoral Vein
(Remember VAN medial to lateral)
267
Where does the medial circumflex artery go?
goes deep and comes out back side and then fuses with lateral circumflex
268
PAthway of the obturator nerve
Exits through the obturator foramen and runs deep to the pectineus and superficial to the adductor brevis
269
What nerve innervates the Gluteus Maximus?
Inferior Gluteal Nerve
270
What vessels are contained in the anterior comparment of the lower leg?
Anterior Tibial Artery
271
What muscle in the anterior compartment
| gets inflamed during shin splints?
Tibialis Anterior and compresses deep fibular nerve
272
Orientation of the plantaris muscle
More superior
| Crosses knee joint near the lateral side of the femur. Belly is pretty small.
273
How do you treat an ACL injury?
- let it heal and strengthen muscles around joint
- Reattach
- Cadaver ligament
- artificial ligaments
274
Action of Adductor longus
Adducts and flexes up to 70 degrees, extends (past 80 degrees of flexion) hip joint
Stabilizes the pelvis in the coronal and sagittal planes
275
How do you treat drop foot and why?
Use a brace to aid in lifting or functional (FES) electrical stimulation
276
How does gastric emptying work?
Increased pressure in the pyloric antrum from the stomach peristalsis signals a temperoray relaxation of the pyloric sphinctur to allow for slow release
277
Insertion of the Gluteus medius and Gluteus Minimus
Greater Trochanter of Femur
278
What does the gluteal maximus attach to inferiorly?
Gluteal Tuberosity of the Femur
279
Origin of the Obturator Internus
Internal Margin of Obturator Foramen and obturator membrane
280
Describe the location and function of the infrapatellar bursae.
Below the patella
| Prevents the head of tibia and patellar ligament from making contact with tibia
281
Where is the gastroduodenal artery?
Dives deep and runs to the stomach and duodenum
282
What is the most common way to dislocate a hip?
Car accidents
| Other ways include: football trauma, aging
283
What type of muscle fibers are found in the soleus?
Slow Twitch
284
Where is the adductor magnus?
Really deep
285
What is a common site of a break during osteoporosis?
Neck of the femer-neck bears a lot of force
286
What muscle fibers do you use when walking?
Soleus (slow twitch fibers) (plantar flexion)
287
Where do internal thoracic arteries run?
lateral to sternum
288
How many phalanges in your big toe?
2
289
What do you reflect to get to the deep gluteal muscles?
Gluteus maximus and gluteus medias
290
Proximal Attachment of the soleus muscle
Soleal line of the tibia and head of the fibula
291
Where is adductor brevis?
Sandwiched inbetween the Adductor longus and pectineus
292
Where is the extensor hallusis longus?
it is lateral to the tibialis anterior and tendon runs to the big toe.
293
What is the pubic arch?
arch between the ramus
294
What do the superficial epigastric arteries come off of?
Femoral artery-then loops around and goes back up
295
What are the ankle bones called?
Tarsal bones
296
What happens to the femoral artery as it continues down the thigh?
It passes through the hole in the adductor longus muscle called the adductor hiatus
297
What does the falciform ligament attach to?
The abdominal wall anteriorly
298
What is a distinguishing feature of the rectus abdominus?
Tendonous shealths (6 pack)
299
Origin of Gluteus Minimus
lateral ilium between anterior and inferior gluteal lines
300
Where is the semimembranosus in the leg usually?
In the middle
301
Innervation of the anterior thigh muscles?
Femoral Nerve
302
Describe how blood moves down the thigh
1. Abdominal Aorta
2. r and l common iliac arteries
3. r and l external iliac artery
4. r and l femoral artery
5. Femoral branches
303
What is the posterior border of the abdominal cavity?
Spine
Oblique (internal oblique, external oblique and transverse abdominas)
Erector spinae
304
What are the lateral hip rotators?
Piriformas
Gemellus
Obturator Internus
Quadratus Femoris
305
Where will we see the genicular arteries?
popliteal artery in the popliteal fossa.
306
Where do the internal thoracic arteries become superior epigastric arteries?
once they pass costal cartilages and leave the sternum
307
What seperates the lobes of the liver?
Falciform Ligament
308
Describe how you would find a posterior tibial artery pulse.
Between the posterior surface of the medial malleolus and medial border of the calcaneal tendon
It passes deep to the flexor retinaculum so the person must invert foot to relax the retinaculum
309
What artery feeds the pancreas?
pancreaduoduodenal artery
310
What is compressing the abdomen?
Suck in the gut
311
Where does the right gastric artery usually come off?
Proper hepatic artery
312
When does blood supply run with the sciatic nerve
At the popliteal fossa (Artery is on the more medial side)Substantial artery
313
Origin of Fibularis Longus
Fibula head and proximal 2/3rd of lateral fibula
314
What does the inferior epigastric artery connect to?
the external iliac artery
315
What is the acetabular labrum?
The ring of cartilage that allows the femoral head to articulate with the acetabulum
Protects acetabulum from head of femur and helps it fit
316
What is the popliteal artery?
It was the femoral artery beore it goes through the adductor hiatus (hole) and then runs posterior to the knee. It feeds the anterior knee via a branch called the genicular artery with many branches
317
What does the Gluteus Maximus Muscle connect to on the lateral side?
the iliotibial tract
| Gluteal Tuberosity of femur
318
What is the postive Trendelenburg test?
A tilted pelvis to the side of the lifted leg. This happens when the gluteus medius
and minimus muscles cannot contract when the contralateral leg is lifted to maintain a level pelvis (hip addiuction)
319
what is patellar maltracking caused by?
-Caused by delayed activation of the vastus medialis and patella moves laterally to create bone to bone contact (osteoarthritus)(weakend or vastus lateralis is larger and overpowers it moving patella over)
320
What is located immediately lateral to the tibia?
Tibialis anterior (when you flex hard you should feel the belly of the tibialis anterior)
321
What tendon does the gastrocnemius join?
The calcaneal tendon
322
What does the anterior intermuscular septum seperate?
Anterior and lateral comparments
323
Insertion of external oblique
Linea Alba
Pubic tubercle
anterior iliac crest
324
Insertion of Adductor magnus
```
Fleshy insertion (deep part)medial lip of the linea aspera
Tendinous insertion-(superficial part)adductor tubercle of the femur
```
325
What are the cuneiforms?
Three bones in a row on the foot
326
What muscles attach to the posterior ilium?
Gluteus maximus
| Gluteus medius
327
List the lower leg muscles medial to lateral starting at the tibia bone
Tibia Bone (All anterior compartment)
1. Tibialis anterior
2. Extensor hallucis longus
3. Extensor digitorum
328
Describe the Gluteal Blood Supply
- Lower Pelvis-internal iliac artery
- Gluteal arteries run throgh the greater sciatic notch of the ilium (superior makes contact with superior portion of notch and inferior portion of notch
- gluteals anastomose and branch
329
Action of pectineus
Adducts, external rotation and slight flexion on the knee joint
stabilizes the pelvis in the coronal and sagittal planes
330
Action of the soleus muscle
plantarflexus the foot
331
What can mask the pulse of the tibia?
Retinaculum
332
Describe the inguinal ligament
Found in men
| Attaches to anterior superior illiac spine and runs along the pubis bone
333
Why do you palpate both posterior tibial pulse at the same time?
Compare sides to see if one is stronger
334
What arteris anastomose on the greater curvature of the stomach?
Gastro-omental arterys
335
What compartment of the lower leg does the deep fibular nerve go into?
Anterior
336
What part of the pancreas is in the peritoneum?
The head (tail is retroperintonal)
337
What action do the muscles in the anterior compartment of the leg perform?
Dorsiflexion
| Inversion
338
describe the orientation of the Biceps Femoris muscle
Most lateral muscle(2 heads)
| Crosses hip joint and crosses knee
339
Where do the superior epigastic arteries become inferior epigastric arteries?
Pass the umbilicus
340
What goes through the esophageal hiatus?
Esophagus
341
describe the orientation of the Semimembranosus
Most medial
342
Where is gracilis?
Medial side of thigh
343
How many metatarsals are there?
5
344
Action of transversus
| abdominis
Rotates trunk to same side
| compresses abdomen
345
When does the external iliac artery become the femoral artery?
Deep to the inguinal ligament
346
What is plantar flexion?
Walking on tip toes
347
What goes between the shafts of the tibia and fibula?
Interosseus membrane
348
What protects the pudendal nerve?
Sacrotubeous Ligament
349
How are the omentums named?
Based on the curvature of the stomach
350
Location of the internal oblique muscle?
Deep to the external oblique
351
Innervation of the semitendinosus and semimembranosus hamstring muscle
Tibial Division of the sciatic nerve
352
Action of the soleus muscle
Flexes the foot
353
What are the branches of the genicular artery?
1. Medial superior genicular artery
2. Medial inferior genicular artery
3. Lateral superior genicular artery
4. Lateral Inferior genicular arteries
354
List the 3 injuries that occur during an unhappy triad and how this occurs.
Sharp blow to the lateral side of the knee (football and soccer)
1. Blow (snap in half) Medial (tibial) collateral ligament
2. Medial meniscus (has a lateral attachment so it pulls apart)
3.Rupture Anterior cruciate ligament
Surgery is needed (9 months healing time)
355
What is the Lateral border of the abdominal cavity?
External Onlique
Internal Oblique
Tranversus Abdominus
In the superior part some costal cartilages
356
The peritoneum is a _____ _______.
Double Walled Membrane
357
What quadrant is most of the liver in?
Upper right with some going into upper left quadrant
358
Where does the superior gluteal nerve come out?
Superior to the piriformas muscle
359
Define intermittent claudication and how it would affect a posterior tibial artery pulse.
Characterized by leg pain and cramps develops during walking and disappears after rest. It results from ischemia of the leg muscles caused by narrowing or occlusion of the leg arteries.
360
Where does the deep femoral artery run?
Extends down the posterir thigh depp and runs deep to the knee posteriorly
361
Why is a ruptuered spleen so dangerous?
It is a capsulated organ that has a rich supply of blood so you can bleed to death in 20 minutes
362
What is the most superficial Gluteal Muscle?
Gluteus Maximus
363
How do you treat Patellar maltracking?
1. Physical Therapy(partial knee extensions to recruit vastus medius)
2. Orthootics for flat feet (eversion of foot-caves in on medial side that pulls down on tibia to angle it as it comes down)
3. weight loss
4. cortisone injections
3.
364
Action of External and internal oblique
```
Bends trunk to same side
rotates trunk to opposite side
flexes trunk
compresses abdomen
stabilizes pelvis
```
365
What does the right gastric artery follow?
Lesser curvature of the stomach on the right side
366
Innervation of rectus abdominis
intercostal nerves (T5-T12)
367
What bones make up the pelvis?
ilium
ishium
pubis bones
368
Action of Sartorius
Flexes, abducts and external rotation of the hip joint
| Flexes and internal rotation of knee joint
369
What are the 3 main branches off the celiac trunk?
Splenic (Spiral) Artery
Left Gastric Artery
Common hepatic Artery
370
What anastomose on the lesser curvature of the stomach?
Gastric arteries
371
Why do we have the plantaris muscle?
We don't know, doesn't produce a lot of force
372
What is the most superficial muscle on the posterior side of the lower leg?
Gastrocnemius
373
Name the Quadrants of the stomach
Right Upper Quadrant
Left upper quadrant
Right Lower Quandrant
Left Lower quadrant
374
What type of bone is the patella?
Sesmoid meaning it is located in tissue
375
What is in the upper left quadrant?
Some of the liver,
Spleen
Most of the stomach
Most of the pancreas
376
Origin of quadriceps femoris
tibial tuberosity via patellar ligament
377
Does soleus cross the knee?
No
378
What is located at the base of the falciform ligament?
The round ligament of the liver
379
Insertion of Gluteus Maximus
Iliotibial Tract
| Gluteal Tuberosity
380
Action of Tensor Fashia Lata
Flexes and Abducts and medially rotates hip (Thigh)
381
What is the function of the inguinal ligament?
It provides and anchor between leg and torso and provides enforcement for spermatic cord
382
What does the pyloric sphincter seperate?
Stomach from duodenum
383
How do you prevent piriformis sydrome?
Strengthen other muscles so piriformis does not compress sciatic nerve
384
How far does the tibial nerve run?
All the way down to the foot
385
What does the superior gluteal artery provide blood to?
Gluteus Maximus
386
Action of rectus femoris
Flexes hip joint
| Extends knee joint
387
Describe extention of the hip?
Coming up from a squat or in standing position
388
What is the primary problem with osteoporosis?
- not a lot of bone mass so fractures can occur.
| - Breaking a hip tends to put people in a nursing home and the death is on average 2 years
389
Does the tibial nerve run with any large vessels?
Popliteal artery and vein
390
What does the femoral nerve look like?
Branches rapidly as it feeds the leg
391
Where does the femoral artery change its name to popliteal artery?
After it passes through the adductor hiatus
392
What genicular arteries can we see on the posterior side of the leg?
inferiors
393
What part of the biceps femoris crosses the hip joint?
Long head
394
what part of the fibula articulates to the tibia?
the head
395
Action of of the Biceps Femoris hamstring muscle
Extends the long head of the thigh
| Flexes the Leg
396
What direction do the fasicles go in the internal oblique muscle?
Lateral to medial
397
Describe the skeletal articulations of the knee.
Femur and Tibia Bones
1. Tibial Condyles will articulate with femoral condyles superiorly
2. The Patella (kneecap) articulates with the anterior surface of the femur
3. Fibula does not articulate with the femur (only with the tibia)
398
Where does the lesser omentum run and attach to?
Runs along the lesser curvature of the stomach and attaches to the
-esophagus, Hepatoduodenal ligament
Early duodenum
Lesser curvature of the stomach
399
How many subquandrants are there?
9
400
Explain the structure and function of knee menisci
- fibrocartilage
| - function: deepen articular surfaces and provide shock absorption
401
Origin of the Superior Gemellus
Ischial Spine
402
Why do you take the posterior tibial pulse?
Test for claudication or intermittant claudication (leg cramping)
or Occulsive peripheral artery disease in people over 60
403
What is the insertion of the Superior and Inferior Gemellus?
Greater Trochanter of the Femur
| Obturator internus Tendon
404
What does the PCL do?
Prevents posterior movement of the tibia (thicker than ACL) so stronger
less common than ACL
405
What is the peritoneal cavity?
Cavity filled with fluid
406
How do the attachments for the gluteus maximus relate to the movement created by the muscle?
- If you shorten the fasicles of the muscle it would pull on the IT band and give you lateral rotation of the hip (Spinning femur)
- Gluteual Tuberosity is the inferior attachment which extends the hip
407
Explain Q angle
Angle of our femur as it is coming through to knee
408
How are shin splints treated?
Ice, Rest, NSAIDS, massage, gate theory of pain
| Worse Case: Anterior compartment release (Cut connective tissue and spread it out on the anterior crest of the tibia)
409
Action of Gluteus Minimus and Gluteus Medius?
Abducts and medially rotates the Hip (Thigh)
410
What was the old treatment for an inguinal hernia?
Putting a piece of plastic mesh
411
In general, what is the nerve innervation of the medial thigh muscles?
Obturator nerve
412
What does one have to do to take the posterior tibial pulse?
Invert the foot to relax the retinaculum
413
Where does the left gastric become the right gastric?
No specific place
414
What action does the Piriformis, Obturator Internus, Superior Gemellus, Inferior Gemellus and Quadratus femoris perform?
Lateral rotation of the hip (thigh)
415
Who is at a higher risk for Anterior ligament injuries, m or f?
Female, (Q angle, and pelvic
| Male is more straight up and down
416
Where is the fibular or lateral collateral ligament?
attaches to head of fibula and runs to the lateral aspect to the femur
417
What is the Greater Omentum?
A mesentary sheet that extends inferiorly from the inferior border of the stomach
-You will see fat
418
What abdominal Muscles insert on the Linea Alba?
External Oblique muscle
Internal Oblique Muscle
Transversus Abdominus
419
Which Abdominal muscles are innervated by the intercostal nerves?
All 4
420
Which abdominal muscles are innervated by iliohypogastric nerve and ilioinguinal nerve?
Internal Oblique
| Transversus Abdominus
421
Which abdominal muscle does not flex the trunk?
Transversus abdominis
422
What 3 abdominal muscles do both unilateral (ipsalateral and bilateral movements?
Internal, External Oblique and transversus abdominis
423
What abdominial muscles bends trunk to same side and rotates trunk to the opposite side?, flexes trunk , compresses abdomen and stabilizes pelvis?
Internal and external oblique
