Exam 4 - Limbs (upper & lower) Flashcards

1
Q

describe the angle of the femur

A

sits at in inward angle of about 130 degrees

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2
Q

where is the greater sciatic foramen (above piriformis) in relation to the nearby ligament? whats in it?

A

above the piriformis, above sacrospinous lig
- superior gluteal vessels & nerve

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3
Q

where is the lesser sciatic foramen? what’s in it?

A

under piriformis, above sacrospinous lig, around obturator foramen
- obtuator internus, pudendal n

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4
Q

where is the greater sciatic foramen (below piriformis) in relation to the nearby ligament? whats in it?

A

under piriformis, above sacrospinous lig
- sciatic n, inferior gluteal vessels & nerve

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5
Q

where is the sublinguinal space? what’s in it?

A

under inguinal lig
- femoral vessels & nerve, psoas

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6
Q

where is the inguinal canal? what’s in it?

A

above inguinal lig
- reproductive vessels & nerves

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7
Q

which side is the tibia on? what about fibula?

A

tibia = big toe (medial)
fibula = pinkie (lateral)

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8
Q

extension vs flexion of hip

A

flex hip = leg forward
extend hip = leg back

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9
Q

abduct vs adduct hip

A

abduct = leg away from body
adduct = leg towards body

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10
Q

extension vs flexion of knee

A

extend = knee back
flex = knee to supine position

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11
Q

dorsiflexion vs plantar flexion of foot

A

dorsi = foot up
plantar = foot points down

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12
Q

what is the fascia lata?

A

connective tissue lining the thigh
- attaches to inguinal lig
- thickens on the sides to make the IT band
- limits bulging, increases muscle efficiency, helps venous and lymph return
- contains an opening for the saphenous v to reach femoral v

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13
Q

what are the three compartments of the thigh? three compartments of the leg?

A

thigh = anterior, medial, posterior
leg = anterior, lateral, posterior

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14
Q

spinal levels of lateral-femoral cutaneous n

A

L2-3

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15
Q

spinal levels of femoral n

A

L2-4

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16
Q

spinal levels of obturator n

A

L2-4

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17
Q

spinal levels of superior gluteal n

A

L4-S1

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18
Q

spinal levels of inferior gluteal n

A

L5-S2

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19
Q

spinal levels for the n. to the piriforimis

A

L5-S2

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20
Q

spinal levels for the n. to the obturator internus

A

L4-S1

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21
Q

spinal levels for the perforating cutaneous n

A

S2-S3

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22
Q

spinal levels for the. to the quadratus femoris and inferior gemellus

A

L4-S1

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23
Q

spinal levels for the sciatic n.

A

L4-S3

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24
Q

spinal levels for the posterior cutaneous n. of thigh

A

S1-S3

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25
Q

INN of gluteus max

A

inferior gluteal n

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26
Q

INN of gluteus medius & minimus

A

superior gluteal n

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27
Q

INN of tensor fascia latae

A

superior gluteal n

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28
Q

INN of piriformis

A

n. to piriformis

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29
Q

INN of obturator internus

A

n. to obturator internus

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30
Q

INN of superior gemellus

A

n. to obturator internus

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31
Q

INN of inferior gemellus

A

n. to quadratus femoris

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32
Q

INN of quadratus femoris

A

n. to quadratus femoris

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33
Q

what is the main function of the gluteal region muscles?

A

abduct hip
- also does some rotation of hip

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34
Q

what does action does the gluteus maximus do that the other ones don’t?

A

extends hip

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35
Q

what is important to avoid in intragluteal injections?

A

above piriformis to avoid sciatic and other structures
- occurs in superior & lateral quadrant

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36
Q

what is piriformis syndrome?

A

overuse of piriformis makes it inflammed which compresses the sciatic n.
- causes glute pain or radiating pain to posterior leg

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37
Q

what three muscles are apart of the triceps coxae?

A

obturator internus
superior gemellus
inferior gemellus

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38
Q

where is the subinguinal space?

A

b/w the pelvis, iliopsoas, pectineus, and inguinal lig

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39
Q

where is the femoral triangle?

A

b/w the inguinal lig, adductor longus, sartorius

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40
Q

where is the adductor canal?

A

b/w sartorius, adductor longus & magnus, vastus medialis

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41
Q

where is the adductor hiatus?

A

opening in adductor magnus

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42
Q

where do femoral hernia’s occur?

A

thru the femoral triangle in the saphenous vein opening
- part of the ileum pushes thru opening

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43
Q

what muscles are in the anterior compartment of the leg? (7)

A

IT band
iliopsoas
sartorius
quadriceps femoris (4)

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44
Q

what main nerve supplies the anterior compartment of the thigh?

A

Femoral Nerve (L2-4)

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45
Q

what main actions do the muscles in the anterior compartment of the thigh do?

A

flex hip
extend knee

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46
Q

where is the sartorius?

A

ASIS (lateral) -> medial side of tibia

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47
Q

where is the rectus femoris?

A

illium -> patella tendon
- inbetween vastus lateralis & medius

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48
Q

where is the vastus lateralis?

A

top of femur (lateral side) -> patella tendon

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49
Q

where is the vastus medialis?

A

top of femur (medial side) -> patella tendon

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50
Q

where is the vastus intermedius?

A

top of femur (under other quad muscles) -> patella tendon

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51
Q

what spinal levels does the patellar reflex test? what is this doing to the body when you hit the patellar tendon?

A

L3-L4
- stretches the quad muscles, in response to this, the body thinks it’s falling so it quickly flexes the leg

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52
Q

what muscles are in the medial compartment of the thigh? (6)

A

pectineus
adductor longus
adductor brevis
adductor magnus
gracilis
obturator externus

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53
Q

what is the main INN of the medial compartment of the thigh?

A

Obturator Nerve (L2-4)

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54
Q

what main actions do the muscles of the medial compartment of the thigh do?

A

adduct the hip, medially rotate

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55
Q

where is the pectineus?

A

pubis -> top part of femur

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56
Q

where is the adduct. longus?

A

pubis -> linea aspera
- inserts lower than adduct. brevis

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57
Q

where is the adduct. brevis?

A

pubis -> linea aspera
- inserts higher than adduct. longus
- below the adduct. longus

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58
Q

where is the adduct. magnus?

A

pubis -> entire shaft of femur
- below all the other adductor muscles

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59
Q

where is the gracilis?

A

pubis -> medial tibia

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60
Q

what are the two heads of the adductor magnus?

A

adductor part (superior)
hamstring part (inferior)

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61
Q

what are the INN exceptions for the medial compartment of the thigh?

A

pectineus = femoral n
adduct. magnus (hamstring) = tibial division of sciatic

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62
Q

what muscles are in the posterior compartment of the thigh? (3)

A

semimembranosus
semitendinosus
biceps femoris

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63
Q

what is the main nerve for the posterior compartment of the thigh?

A

Tibial Nerve (L5-S2)

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64
Q

what is the main action of the posterior compartment of the thigh?

A

Extend hip
Flex knee

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65
Q

Where is the semitendinosus?

A

bottom of pelvis -> medial tibia
- above semimembranosus
- MEDIAL SIDE OF THIGH

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66
Q

Where is the semimembranosus?

A

bottom of pelvis -> medial tibia
- below semitendinosus
- MEDIAL SIDE OF THIGH

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67
Q

Where is the biceps femoris?

A

bottom of pelvis -> fibula
- LATERAL SIDE OF THIGH

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68
Q

what are the two heads of the biceps femoris?

A

Long Head (more medial)
Short Head (more lateral)

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69
Q

what is the INN exception for the posterior compartment of the thigh?

A

biceps femoris (short head) = common fibular n

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70
Q

what three muscles attach to the pes anserinus of the knee? what is the action of these muscles here?

A

semitendinosus, gracilis, sartorius
- stabilizes the lateral knee

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71
Q

what muscles flex the hip?

A

ANTERIOR COMPARTMENT (iliopsoas, sartorius, rectus femoris)
- adductor longus & brevis = medial

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72
Q

what muscles extend the hip?

A

POSTERIOR COMPARTMENT (semi’s, biceps femoris)
- adductor magnus = medial

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73
Q

what muscles adduct the hip?

A

MEDIAL COMPARTMENT (pectineus, gracilis, adductors)
- quadratus femoris = butt

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74
Q

what muscles abduct the hip?

A

BUTT MUSCLES (glutes, piriformis, obturator, gemellus)

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75
Q

what muscles medially rotate the hip?

A

BUTT MUSCLES (glutes)
- semitend & mem = posterior
- adductor long & brevis = medial

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76
Q

what muscles laterally rotate the hip?

A

BUTT MUSCLES (glutes, piriformis, obturator, gemellus, quad)

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77
Q

where is the pubofemoral ligament?

A

attaches the pubis to femur

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78
Q

where is the iliofemoral ligament?

A

attaches hip to femur (on top of head)
- anterior side

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79
Q

where is the ischiofemoral ligament>

A

attaches hip to femur (on top of head)
- posterior side

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80
Q

what makes the cruciate anastomosis? (4)

A
  • medial circumflex femoral a (deep femoral)
  • lateral circumflex femoral a (deep femoral)
  • first perforating a. (deep femoral)
  • inferior gluteal (int. iliac)
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81
Q

what is important about the cruciate anastomosis?

A

these arteries come off of the deep femoral a. and internal iliac a. and has a branch that goes directly to the popliteal a.
- this allows for blood flow even if the femoral a. is obstructed

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82
Q

what is the blood flow of the thigh?

A

external iliac -> femoral (deep femoral) -> popliteal a.
internal iliac -> superior & inferior gluteal a., obturator a.

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83
Q

what blood supplies the anterior compartment of the thigh?

A

femoral & deep femoral a

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84
Q

what blood supplies the medial compartment of the thigh?

A

obturator & deep femoral a.

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85
Q

what blood supplies the posterior compartment of the thigh?

A

deep femoral a.

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86
Q

where is the ACL?

A

ANTERIOR of cross
- crosses from front of tibia to back of femur
- medial -> lateral

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87
Q

where is the PCL?

A

POSTERIOR of cross
- crosses from back of tibia to front of femur
- lateral -> medial

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88
Q

what is the function of the ACL?

A

prevent over extension of the knee
- prevents anterior displacement of tibia

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89
Q

what is the function of the PCL?

A

prevent over flexion of the knee
- prevents posterior displacement of tibia

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90
Q

where is the LCL? what’s it’s function?

A

lateral side of knee (connects femur to fibula)
- limits adduction of joint
- we don’t want to be lookin like a frog

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91
Q

where is the MCL? what’s it’s function?

A

medial side of knee (connects femur to tibia)
- limits abduction of joint
- we don’t want an inward knee (duck girl frrrr)

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92
Q

what is the unhappy triad of the knee?

A

torn MCL, ACL, medial meniscus
- occurs due to the tibia rotating medially (tears MCL) and hyperextension of the knee (tears ACL)

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93
Q

what are the three main muscles of the knee?

A

gastrocnemius
popliteus
plantaris

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94
Q

what nerve INN the knee muscles?

A

tibial n

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95
Q

what is the action of the three knee muscles?

A

flex knee

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96
Q

what muscles flex the knee?

A

POSTERIOR THIGH (semi, biceps)
- KNEE MUSCLES (gastroc, poplietus)
- sartorius = anterior
- gracilis = medial

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97
Q

what muscles extend the knee?

A

ANTERIOR THIGH (quad femoris)

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98
Q

what are the three ways you can stabilize an extended knee?

A

flat surfaces of femur & tibia together
shift gravity forward (pulls ACL)
lock knee joint (standing = med. rotate femur, sittiing = laterally rotate tibia)

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99
Q

what are the boundaries of the popliteal fossa?

A

semitend / mem
lateral head of gastrocnemius
biceps femoris
medial head of gastrocnemius

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100
Q

what three things run through popliteal fossa?

A

tibial n.
popliteal v.
popliteal a.

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101
Q

what muscles are in the anterior compartment of the leg? (4)

A

tibialis anterior
ex. digitorum longus
ex. hallucis longus
fibularis tertius

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102
Q

what main nerve INN the anterior compartment of the leg?

A

Deep Fibular n.

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103
Q

what are the main actions of the anterior compartment of the leg?

A

dorsiflex foot
extend toes & ankle

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104
Q

where is the tibialis anterior?

A

lateral tibia -> metatarsal 1

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105
Q

where is the ex. digitorum longus?

A

lateral tibia -> digits 2-5

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106
Q

where is the ex. hallucis longus?

A

top of fibula -> digit 1
- under ex. digitorum longus

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107
Q

where is the fibularis tertius?

A

bottom of fibula -> metatarsal 5

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108
Q

what are the lateral compartment leg muscles? (2)

A

fibularis longus
fibularis brevis

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109
Q

what nerve INN the lateral compartment of the leg?

A

Superficial Fibular Nerve

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110
Q

what is the main action of the lateral compartment leg muscles?

A

Evert foot
Plantarflex

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111
Q

where is the fibularis longus?

A

top part of lateral fibula -> goes on top of foot from lateral side and crosses to medial side and attaches to metatarsal 1

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112
Q

where is fibularis brevis?

A

bottom part of lateral fibula (under longus) -> metatarsal 5

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113
Q

what are the posterior compartment of the leg muscles? (6)

A

Gastrocnemius
Plantaris
Soleus
Flex. Digitorum Longus
Flex. Hallucis Longus
Tibialis Post.

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114
Q

what are the muscles of the triceps surae? (3)

A

gastrocnemius
plantaris
soleus

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115
Q

what is the main nerve that INN the posterior compartment of the leg?

A

TIbial Nerve

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116
Q

what is the main actions of the posterior compartment of the leg?

A

Plantarflex Foot
Flex Toes & Ankle
Invert Foot

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117
Q

where is the gastrocnemius?

A

bottom of femur -> calcaneus
- two heads!!

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118
Q

where is the plantaris?

A

bottom of lateral femur -> calcaneus
- used as a harvest tendon!!

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119
Q

where is the soleus?

A

top of tibia (med) -> calcaneus

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120
Q

where is the tibialis posterior?

A

top of tibia & fibula -> navicular of foot (big toe, medial side)
- under all the posterior muscles!

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121
Q

where is the flex. digitorum longus?

A

tibia (med) -> digits 2-5

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122
Q

where is the flex. hallucis longus?

A

middle of fibula (lat) -> digit 1

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123
Q

what goes through the tarsal tunnel? (opening to the foot)

A

“Tom, Dick, And Very Nervous Harry”
Tibialis posterior
Flexor digitorum longus
Posterior Tibial a.
Posterior Tibial v.
Tibial n.
Flexor Hallucis Longus

124
Q

what is the talocrural joint?

A

tibia, talus

125
Q

what is the subtalar joint?

A

talus, calcaneous

126
Q

what is the midtarsal joint?

A

midfoot, forefoot

127
Q

what is the MP joint?

A

metatarsal, phalanges

128
Q

what is the IP joint?

A

b/w phalanges
- PIP (proximal, middle)
- DIP (distal, middle)

129
Q

inversion vs eversion of foot

A

inversion: foot tilts inward (big toe off ground)
eversion: foot tilts outward (pinkie off ground)

130
Q

abduct vs adduct of foot

A

abduct: foot pointed outwards
adduct: foot pointed inwards

131
Q

pronation vs supination of foot

A

pro: eversion, dorsiflex, abduct (foot outward, up, away body)
sup: inversion, plantarflex, adduct (foot inward, down, toward body)

132
Q

what joints of the foot can plantarflex and dorsiflex?

A

all of them
- talocrural
- midtarsal
- MP, IP

133
Q

what joints of the foot can invert and evert?

A

not the toes
- subtalar
- midtarsal

134
Q

what joints of the foot can abduct and adduct?

A

not the toes (lots of this is coming from knee)
- subtalar
- midtarsal

135
Q

what muscles dorsiflex the foot?

A

ANTERIOR LEG COMPARTMENT (extensors)

136
Q

what muscles plantarflex the foot?

A

POSTERIOR COMPARTMENT (flexors)
- fibularis longus & brevis (lateral)

137
Q

what muscles pronate the foot?

A

ANTERIOR COMPARTMENT (lateral side muscles, ex digit & fibularis tertius)
LATERAL COMPARTMENT (fibularis long & brev)

138
Q

what muscles supinate the foot?

A

POSTERIOR COMPARTMENT (deep muscles, tibialis post, flex hall, flex digit)
- tibialis anterior

139
Q

what is the plantar fascia?

A

superficial CT to protect sole of foot
- creates a plantar aponeurosis that is a central thickening that goes from the calcaneus to the toes

140
Q

what muscles go to the pinkie toe on the posterior side?

A

abductor digit minmi
flexor digiti minimi
lumbricals
adductor hallucis
plantar & dorsal interossei

141
Q

what muscles go to foot digits 2-4 on the posterior side?

A

flexor digitorum brevis & longus
lumbricals
adductor hallucis
plantar (not digit 2) & dorsal interossei (not digit 5, digit 2 gets 2)

142
Q

what muscles go to foot digit 1 on the posterior side?

A

abductor hallucis
flexor hallucis brevis & longus
adductor hallucis

143
Q

what muscles go to the pinkie toe on the anterior side?

A

extensor digitorum longus
fibularis tertius

144
Q

what muscles go to foot digits 2-4 on the anterior side?

A

extensor digitorum longus
extensor digitorum brevis

145
Q

what muscles go to foot digit 1 on the anterior side?

A

extensor hallucis longus
extensor hallucis brevis

146
Q

what muscles are in the dorsal compartment of the foot?

A

extensor digitorum brevis
extensor hallucis brevis

147
Q

what INN the dorsal compartment foot muscles?

A

deep fibular n

148
Q

what muscles are in the medial compartment of the foot? (big toe)

A

abductor hallucis
flexor hallucis brevis

149
Q

what INN the medial compartment foot muscles?

A

medial plantar n.

150
Q

what muscles are in the lateral compartment of the foot?

A

abductor digiti minimi
flexor digiti minimi

151
Q

what INN the lateral compartment foot muscles? (pinkie toe)

A

lateral plantar n.

152
Q

what muscles are in the interosseous compartment of the foot?

A

plantar & dorsal interossei

153
Q

what INN the interosseous compartment of the foot?

A

mainly lateral plantar n.
- some deep fibular n. for digits 2-3

154
Q

what muscles are in the central compartment of the foot? (bottom of foot)

A

quadratus plantae
lumbricals
flexor digitorum brevis

155
Q

what INN the central compartment of the foot?

A

quadratus planate = lateral plantar n
lumbricals = medial plantar (2), lateral plantar n (3-5)
flexor digitorum brevis = medial plantar n

156
Q

what makes up the medial arch of the foot? what is the keystone of this arch?

A

TALUS
flexor hallucis longus
tibialis posterior
tibialis anterior
intrinsic muscles

157
Q

what makes up the lateral arch of the foot? what is the keystone of this arch?

A

CUBOID
fibularis longus
intrinsic muscles

158
Q

what makes up the transverse arch of the foot? what is the keystone of this arch?

A

INTERMEDIATE CUNEIFORM
tibialis posterior
fibularis longus
intrinsic muscles

159
Q

where is the spring ligament? why is the ligament so important? what arch does this support?

A

tail of calcaneus -> navicular
- supports the head of the talus (which supports body weight)
- allows up to walk with a little spring in our step
- MEDIAL ARCH

160
Q

where is the long plantar ligament? what arch does this support?

A

back of calcaneous to base of metatarsals 2-5
- LATERAL ARCH

161
Q

where is the short plantar ligament? what arch does this support?

A

front of calcaneous to cuboid to support this joint
- LATERAL ARCH

162
Q

what muscles give dynamic arch support?

A

tibialis posterior and anterior
flexor hallucis longus
fibularis longus
intrinstic muscles

163
Q

what muscles give passive / static arch support?

A

plantar aponeurosis
short plantar ligament
long plantar ligament
spring ligament

164
Q

what are the two ways pes plantus (flat feet) can develop?

A
  • flexible flat feet = no arch when weight applied
  • rigid flat feet = no arch w/ or w/o weight, bone deformity
165
Q

how does flexible flat feet occur?

A

weak tibialis posterior
paralysis of superficial fibular n.
loosening of ligaments w/ age

166
Q

what is the blood flow of the leg?

A

popliteal branches into anterior (lateral) & posterior (medial) tibial arteries
- post. tibial branches into fibular a.

167
Q

what is the nerve flow of the leg?

A

tibial n. = medial plantar n., lateral plantar n.

168
Q

what / where does the lateral plantar n. supply?

A

pinkie toe & half of 4th digit

169
Q

what / where does the medial plantar n. supply?

A

big toe, digits 2-3, and half of digit 4

170
Q

what muscles does the medial plantar n. supply?

A

abductor hallucis
flexor hallucis
flexor digitorum
first lumbrical

171
Q

what blood supplies the anterior compartment of the leg?

A

anterior tibial a.

172
Q

what blood supplies the lateral compartment of the leg?

A

anterior tibial a.

173
Q

what blood supplies the posterior compartment of the leg?

A

posterior tibial a.

174
Q

what is the acromioclavicular ligament?

A

attaches acromion of scapula to the clavicle

175
Q

what is the coraclavicular ligament?

A

attaches the clavicle to the coracoid of the scapula

176
Q

what is the sternoclavicular ligament?

A

attaches the sternum to the clavicle

177
Q

what is the interclavicular ligament?

A

b/w the sternum and clavicle, more of a cushion

178
Q

what is the costoclavicular ligament?

A

attaches the costal cartilage to the clavicle

179
Q

what movement causes a shoulder dislocation? where does the humerus usually end up because of this motion?

A

extending and laterally rotating arm
- goes anterior to glenoid and long head of triceps

180
Q

what is shoulder separation? what two ligaments are most prone to tearing because of this? what action causes this?

A

clavicle to acromion (scapula) dislocation
- coraclavicular & acromioclavicular lig
- medially directed force acting on arm

181
Q

what action do the upper fibers of the trapezius do?

A

extend head (pull back)
shrug shoulders (both or one at a time)
rotate face

182
Q

what action do the middle fibers of the trapezius do?

A

retract scapula (bring together)

183
Q

what action do the lower fibers of the trapezius do?

A

depress scapula
help upper fibers rotate scapula
elevate arm above head (90-180)

184
Q

what is the INN of the trapezius?

A

accessory n

185
Q

what action do the levator scapulae do?

A

elevate scapula

186
Q

what is the INN of the levator scapulae?

A

dorsal scapular n

187
Q

what action do the rhomboids do?

A

elevate & retract scapula

188
Q

what is the INN of the rhomboids?

A

dorsal scapular n

189
Q

what action do the latissimus dorsi do?

A

adduct arm
medial rotate arm
extend arm

190
Q

what is the INN of the latissimus dorsi?

A

thoracodorsal n

191
Q

what action does the pect. major do?

A

adduct arm
flex arm
extend arm
medial rotate arm

192
Q

what is the INN of the pect. major?

A

lateral and medial pectoral n

193
Q

what action does the pect. minor do?

A

rotate scapula
protract scapula (pull forward)

194
Q

what is the INN of the pect. minor?

A

medial pectoral n

195
Q

what action does the deltoid do?

A

abduct arm (15-90)

196
Q

what is the INN of the deltoid?

A

axillary n

197
Q

where is the subclavius? what does it do?

A

first rib to middle of clavicle
- depresses clavicle

198
Q

what is the INN of the subclavius?

A

n. ot subclavius

199
Q

where is the serratus anterior? what does it do?

A

ribs to middle scapula
- protract (pull forward) & rotate scapula
- PREVENTS winging

200
Q

what is the INN of the serratus anterior?

A

long thoracic n.

201
Q

what two nerves causes winged scapula?

A

damage to the accessory n. or long thoracic n.

202
Q

what does damage to the accessory n. cause? how does this affect the severity of the winged scapula?

A

paralysis of trapezius
- winging not worse when you press against wall (dorsal pressure)

203
Q

what does damage to the long thoracic n. cause? how does this affect the severity of the winged scapula?

A

paralysis of serratus anterior
- winging becomes worse with dorsal pressure

204
Q

what side of the scapula is the subscapularis on? what does it do to the arm?

A

interior side
- medially rotates arm

205
Q

what is the INN of the subscapularis?

A

subscapular n

206
Q

what side of the scapula is the supraspinous on? what does it do to the arm?

A

posterior, on top
- abduct arm (first 15)

207
Q

what is the INN of the supraspinous?

A

suprascapular n

208
Q

what side of the scapula is the infraspinous on? what does it do to the arm?

A

posterior, on bottom
- laterally rotate arm

209
Q

what is the INN of the infraspinous?

A

suprascapular n.

210
Q

what action does the teres minor do? whats it’s INN?

A

laterally rotate arm
- axillary n

211
Q

what action does the teres major do? whats it’s INN?

A

medially rotate arm
- subscapular n.

212
Q

what nerve and blood vessel run right by the surgical neck of the humerus? (common spot for breaks)

A

axilllary n.
posterior circumflex humeral a.

213
Q

where is the quadrangular space located? what goes through it?

A

below teres minor, humeral side of long head of triceps (lat)
- axillary n, posterior circumflex humeral a

214
Q

where is the triangular space? what goes through it?

A

below teres minor, scapular side of long head of triceps (med)
- circumflex scapular a

215
Q

where is the triangular interval located? what does through it?

A

below teres major, humeral side of long head of triceps (lat)
- radial n, deep brachial a

216
Q

what branches does each of the three parts of the axillary artery give off?

A

1st = superior thoracic
2nd = thoracoacromial, lateral thoracic (UNDER PECT MINOR)
3rd = subscapular, ant. humeral circumflex, post. humeral circumflex

217
Q

what is the general layout of the brachial plexus?

A

roots
trunks (upper, middle, lower)
divisions
cords (lateral, posterior, medial)
terminal nerves

218
Q

what are the three trunks of the brachial plexus? what is their spinal level? what part of the axillary artery are the trunks at?

A

upper trunk C5,6
middle trunk C7
lower trunk C8, T1
* subclavian artery (before it becomes axillary) *

219
Q

what are the four terminal nerves of the brachial plexus? spinal levels?

A

musculocutaneous C5-7
median C5-T1
ulnar C7-T1
radial C5-T1

220
Q

what are the C5 root branches?

A

dorsal scapular n (rhomboids)
long thoracic n (serratus ant)

221
Q

what are the branches off of the upper trunk?

A

suprascapular (supraspinatus, infraspinatus)
n. to subclavius (subclavius)

222
Q

what are the branches off of the lateral cord? spinal level?

A

C5-7
lateral pectoral n. (pect major)

223
Q

what are the branches off of the medial cord? spinal level?

A

C8-T1
medial pectoral n. (pect major & minor)
medial brachial cut.
medial antebrachial cut.

224
Q

what are the branches off of the posterior cord? spinal level?

A

C5-C8
axillary (deltoid, teres major)
superior subscapular (subscapularis)
thoracodorsal (lat dorsi)
inferior subscapular (subscapularis, teres major)

225
Q

where in the brachial plexus is Erb’s Palsy?

A

C5-C6 upper trunk

226
Q

what main nerves does Erb’s palsy affect? (4)

A

suprascapular
dorsal scapular
axillary
musculocutaneous

227
Q

what muscles are paralyzed due to Erb’s palsy? what action does this create?

A

supraspinatus
infraspinatus
deltoid
teres minor
biceps
* causes medially rotated arm *

228
Q

where in the brachial plexus is Klumpke’s palsy?

A

C8-T1 lower trunk

229
Q

what main nerve does klumpke’s palsy affect?

A

ulnar n.

230
Q

what muscles are paralyzed due to Klumpke’s palsy? what action does the create?

A

intrinstic hand muscles
- CLAW HAND (picking up child by one arm)

231
Q

what is nursemaid’s elbow?

A

pulling on childs arm as they fall, elbow dislocates
- common in children due to less connected ligament (annular ring lig) to radius

232
Q

what are the muscles of the anterior arm? (3)

A

biceps brachii (long, short heads)
coracobrachilais
brachialis

233
Q

where is the biceps brachii?

A

scapula to radius (pinkie)

234
Q

where is the coracobrachialis?

A

scapula to humerus

235
Q

where is the brachialis?

A

humerus to ulna (thumb)

236
Q

what nerve INN the anterior compartment of the arm?

A

musculocutaneous n. (C5-7)

237
Q

what is the INN exception of the anterior compartment of the arm?

A

brachialis is ALSO inn by radial n.

238
Q

what main action does the anterior compartment of the arm do?

A

flex forearm

239
Q

what muscles are in the posterior compartment of the arm?

A

triceps brachii (long, lateral, medial heads)

240
Q

where is the triceps brachii?

A

scapula to olecranon (ulna)

241
Q

what is the INN of the posterior compartment of the arm?

A

radial n. C5-T1

242
Q

what main action do the posterior compartment arm muscles do?

A

extend forearm

243
Q

abduct vs adduct arm

A

abduct = arm away from body
adduct = arm towards body

244
Q

flex vs extend arm

A

flex = arm in front of body
extend = arm behind body

245
Q

what muscles abduct the arm?

A

supraspinatus (0-15)
deltoid (15-90)
trapezius (90-180)
serratus ant.
subscapularis

246
Q

what muscles adduct the arm?

A

pect. major
lat. dorsi
teres major & minor
coracobrachialis

247
Q

what muscles flex the arm?

A

deltoid
pect major

248
Q

what muscles extend the arm?

A

deltoid
pect major
lat dorsii
teres major
some triceps (long head)

249
Q

what muscles medially rotate the arm?

A

subscapularis
pect major
lat dorsi
teres major

250
Q

what muscles laterally rotate arm?

A

infraspinatus
teres minor

251
Q

what branches does the brachial a. give off in the arm?

A

deep brachial (radial collateral, middle collateral)
superior ulnar collateral
inferior ulnar collateral
radial
ulnar

252
Q

what happens during an axillary n. neuropathy?

A

deltoid weakness (can’t abduct 15-90)

253
Q

what happens during radial neuropathy?

A

depends on break!!!
- towards top before it INN triceps = weak elbow extension (Crutch Palsy)
- towards bottom after it INN triceps = numbness in forearm

254
Q

what happens during an ulnar neuropathy?

A

weak intrinsic hand muscles
ulnar claw hand
- can feel tingles on pinkie side of hand

255
Q

what are the boundaries of the cubital fossa?

A

brachioradialis
pronator teres
b/w epidondyles

256
Q

what runs through the cubital fossa?

A

“TAN”
- tendon of biceps
- brachial a.
- median n.

257
Q

what artery runs right under the basilic vein? (important when giving IVs)

A

superficial ulnar a

258
Q

what two main hand bones are part of the wrist joint?

A

scaphoid
lunate

259
Q

what type of movement does the wrist joint have?

A

abduct, adduct, flex, extend

260
Q

what type of movement does the midcarpal joint have? (proxiamal & distal ph)

A

limited flex, extend

261
Q

what type of movement does the CMC joint have for digits 2-5? (metacarpal & hand bone)

A

very little motion

262
Q

what type of movement does the CMC joint have for digit 1? (metacarpal & hand bone)

A

saddle shaped!
- flex, extend, abduct, adduct, opposition (bring thumb towards palm)

263
Q

what type of movement does the MP joint have for digits 2-5?

A

flex, extend, abduct, adduct, circumduction

264
Q

what type of movement does the MP joint have for digit 1?

A

hinge joint!
- flex, extend

265
Q

what type of movement does the IP joint have for all the digits?

A

hinge joints!
- flex, extend

266
Q

what branches does the ulnar artery give off?

A

common interosseous (anterior & posterior interosseous)
- runs to the superficial palmar arch & deep palmar arch

267
Q

what muscles are in the superficial anterior forearm compartment? (4)

A

pronator teres
flexor carpi radialis
flexor carpi ulnaris
palmaris longus

268
Q

where is the pronator teres?

A

bottom of medial humeral head -> ulnar head (lateral)

269
Q

where is the flexor carpi radialis?

A

bottom of medial humerus -> 2nd metacarpal (pointer)

270
Q

where is the flexor carpi ulnaris?

A

bottom of medial humerus -> 5th metacarpal (pinkie)

271
Q

where is the palmaris longus?

A

bottom of medial humerus -> palmar aponeurosis

272
Q

what is the muscle in the intermediate anterior forearm compartment? (1)

A

flexor digitorum superficialis

273
Q

where is the flexor digitorum superficialis?

A

top of ulna & radius -> 2-4 digits

274
Q

what muscles are in the deep anterior forearm compartment? (3)

A

flexor digitorum profundus
flexor polliciis longus
pronator quadratus

275
Q

where is the flexor digitorum profundus?

A

top of ulna (thumb) -> 2-4 digits

276
Q

where is the flexor pollicis longus?

A

top of radius (pinkie) -> digit 1

277
Q

where is the pronator quadratus?

A

bottom of ulna -> bottom of radius

278
Q

what is the action of all anterior forearm compartment muscles?

A

flex & abduct wrist (& associated digits)

279
Q

what is the INN of the anterior forearm compartment?

A

median n.

280
Q

what is the INN exceptions for the anterior forearm compartment?

A

flexor carpi ulnaris = ulnar n.
flexor digitorum profundus = half is ulnar n.

  • they are more towards the sides of the arm*
281
Q

what are the muscles in the superficial posterior forearm compartment that has INN by the radial n?

A

brachioradialis
extensor carpi radialis longus
extensor carpi radilais brevis

282
Q

where is the brachioradialis?

A

bottom of lateral humerus -> bottom of radius (lateral)

283
Q

where is the extensor carpi radialis longus?

A

bottom of lateral humerus -> 2nd metacarpal

284
Q

where is the extensor carpi radialis brevis?

A

bottom of lateral humerus -> 3rd metacarpal

285
Q

what are the muscles in the superficial posterior forearm compartment that has INN by the posterior interosseous n? (3)

A

extensor digitorum
extensor digiti minimi
extensor capri ulnaris

286
Q

where is the extensor digitorum?

A

bottom of lateral humerus -> digits 2-5

287
Q

where is the extensor digiti minimi?

A

bottom of lateral humerus -> digit 5 (pinkie)

288
Q

where is the extensor carpi ulnaris?

A

bottom of lateral humerus -> 5th metacarpal

289
Q

what are the muscles in the deep posterior forearm compartment? (5)

A

supinator
abductor pollicis longus
extensor pollicis brevis
extensor pollicis longus
extensor indicis

290
Q

what is the INN of the deep posterior forearm compartment?

A

posterior interosseous n

291
Q

where is the supinator?

A

bottom of lateral humerus -> top of radius (lateral)

292
Q

where is the abductor pollicis longus?

A

bottom of ulna -> palm of metacarpal 1 (thumb)
* crosses to anterior side and across *

293
Q

where is the extensor pollicis brevis?

A

bottom of radius -> digit 1 (thumb)

294
Q

where is the extensor pollicis longus?

A

bottom of ulna -> digit 1 (thumb)
* crosses over *

295
Q

where is the extensor indicis?

A

bottom of ulna -> digit 2 (pointer)

296
Q

what is the INN exception for the deep posterior forearm compartment?

A

supinator = deep branch of radial

297
Q

what is the action of all the posterior forearm compartment muscles?

A

extend & abduct wrist (& associated digits)

298
Q

supinate vs pronate forearm

A

supinate = palm up
pronate = palm down (twist radius over ulna)

299
Q

what abducts the wrist?

A

flexor carpi radialis
extensor carpi radialis longus & brevis

300
Q

what adducts the wrist?

A

flexor carpi ulnaris
extensor carpi ulnaris

301
Q

what muscles extend the arm?

A

extensor carpi radialis longus & brevis
extensor digitorum
extensor capri ulnaris

302
Q

what muscles flex the arm?

A

flexor capri radialis
flexor carpi ulnaris
flexor digitorum supficialis
flexor digitorum profundus
palmaris longus

303
Q

what muscles supinate the arm?

A

biceps brachii
supinator

304
Q

what muscles pronate the arm?

A

pronator teres
pronator quadratus

305
Q
A