Exam questions - muscles / joints

Question 1

1. Axes and planes in anatomy.

Answer 1

Axis frontalis
flexio, extensio

Axis sagittalis
abductio, adductio

Axis verticalis
rotatio interna, rotatio externa

Planum horisontale
superior s. cranialis
inferior s. caudalis

Planum frontale
anterior s. ventralis
posterior s. dorsalis

Planum sagittale
dexter
sinister

Question 2

2. Continuous bone connections

Answer 2

= Synarthrosis

SYNDESMOSIS S. JUNCTURA FIBROSA
→ membranes, ligaments and suturae (serrata, squamosa, plana)
for ex. lig. coracoacromiale, lig. transversum scapulae superius, membrana obturatoria (closes foramen obturatum), lig. sacrospinale/-tuberale

SYNCHONDROSIS S. JUNCTURA CARTILAGINEA
→ Disci intervertebrales: anulus fibrosus & nucleus pulposus
→ Synchondrosis manubriosternalis and xiphosternalis
- also f. ex. b. corpus ossis ilii/ischii and pubis in acetabulum. also b. ramus ossis ischii and ramus inferior ossis pubis

SYNOSTOSIS S. JUNCTURA OSSEA
→ fusion of two bones: os sacrum/coccyges
→ develop after the ossification of synchondroses

Question 3

3. Discontinuous bone connections

Answer 3

= Diarthrosis s. junctura synovialis

• Articulatio cylindrical (Ginglymus) – uniaxial joint. Flexion and extension (door hinge). B. Humerus & ulna
• Articulatio conoidea – uniaxial joint. Rotational movement. B. radius & ulna
• Articulatio trochoidea – uniaxial joint. Rotational movement (pivot). B. Radius & ulna: Art. Radioulnaris proximalis
• Articulatio ellipsoidea – biaxial joint. Flexio, extensio, adductio, abductio (oval shaped). art. atlantooccipitalis
• Articulatio sellaris – biaxial joint. Flexio, extensio, adductio, abductio (saddle). b. os trapezium and proximal metacarpal bone of thumb (Art. carpometacarpalis pollicis)
• Articulatio spheroidea – multiaxial joint. Biaxial joint. Flexio, extensio, adductio, abductio, rotatio (ball-and-socket). B. art. humeri, art. sternoclavicularis (also art. humeroradialis), Artt. metacarpophalangeae (b. caput ossis metacarpalis & basis phalangis proximalis)
• Articulatione plana – allows only gliding movement. (plate). B. vertebrates

Question 4

4. Structure of synovial joint: components and additional structures

Answer 4

→ parts: ligaments - fibrous joint capsule, synovial membrane, articular cartilage, joint cavity filled with synovial fluid
→ bigger consept parts are facies articularis, capsula articularis, cavitas articularis
- Formed by connective tissue (plicae synoviales,villi synoviales, bursae synoviales, bursae mucosae, ligamernta)
- Formed by cartilage (discus/meniscus articularis, labrum articulare)
- Formed by bone (ossa sesamoidea) for. ex. Patella

Classification:
- articulatio simplex (art.coxae)
- articulatio composita (art. cubiti)
- combined joint
- multiaxial: art.spheroidea (art.humeri), art. cotylica s. enarthrosis (art.coxae) /plana
- biaxial: art. ellipsoidea/sellaris
- monoaxial joints: art. trochoidea/ginglymus/conoidea

Question 5

5. Hemiarthrosis

Answer 5

SYMPHYSIS (JUNCTURA) SACROCCYGEA
In articulatio sacrococcygea there are:
1. Ligamentum sacrococcygeum anterius: From os sacrum to os coccygis. Extension of ligamentum longitudinale anterius.
2. Ligamentum sacrococcygeum posterius: From os sacrum to os coccyges
→ Profundum: corresponds to ligamentum longitudinale posterius
→ Superficiale: corresponds to ligamenta flava

Symphysis pubica where both facies symphysialis ossis pubis are joined by fibrous cartilage or discus interpubicus.
→ Lig. pubicum superius
→ Lig. pubicum inferius

• There is eminentia retropubica on the posterior surface of symphysis pubica.

Question 6

6. Artt. sternocostales

Answer 6

• Incisura costalis I – VII
• Cartilago costalis: I – VII directrly connected
  → Ligg. Sternocostalia radiata
  → Lig. sternocostale intraarticulare

Question 7

7. Artt. costoverterbrales

Answer 7

Art. costotransversaria
* Facies articularis tuberculi costae
* Fovea costalis processus transversalis
→ Lig. costotransversarium laterale et superius

Art. capitis costae
* Facies articularis capitis costae
* Fovea costalis superior
* Fovea costalis inferior
→ Lig. capitis costae radiatum

Capsula articularis strength facies articularis superior and inferior

Question 8

8. Canalis vertebralis; walls and openings

Answer 8

posterior:
- ligaments flava
- arcus vertebrae (arcus posterius atlantis)

anterior:
- corpus vertebrae (arcus anterior atlantis)
- ligamenta longitudinale posterius
- discus intervertebrales

lateral:
- foramen intervertebral
- pediculus arcus vertebrae

–> spinal cord goes through

–> continues as canalis sacralis which opening is hiatus sacralis

Question 9

9. Art. atlantooccipitalis

Answer 9

art. ellipsoidea

b. Facies articularis superior atlas & Condylus occipitalis
→ Capsula articularis
→ Membrana atlantooccipitalis anterior (beween os occipitale and arcus anterior atlantis)
→ Membrana atlantooccipitalis posterior (between os occipitale and atlas at the posterior aspect of canalis vertebralis)

Lig. cruciform atlantis; composed of two ligaments
1. Lig. transversum atlantis (sideways behind dens axis)
2. Fasciculi longitudinales (two of these; above and below lig. transversum atlantis)
Ligg. alaria (winged ligaments from apex dentis, beneath Lig. cruciform atlantis)
Lig. apicis dentis (between apex dentis and os occipitale, beneath Lig. cruciform atlantis)
Membrana tectoria (over all the ligaments of art. atlantoaxialis mediana, extension of the lig. lonitudinale
posterius

Question 10

10. Art. atlantoaxialis mediana et lateralis

Answer 10

Art. atlantoaxialis lateralis
b. Processus articularis superior axis &Massa lateralis atlantis, facies articularis inferior atlas
→ Capsula articularis

Art. atlantoaxialis mediana anterior
b. Facies articularis anterior in dens axis & Fovea dentis in atlas
→ Capsula articularis

Art. atlantoaxialis mediana posterior (art. trochoidea = pivot)
b. Facies articularis posterior in dens axis &Lig. transversum atlantis (sideways behind dens axis)

Question 11

11. Cavitas thoracis; walls and openings

Answer 11

Paries posterior:
- columna vertebralis
- membrana intercostales internae

Paries laterales:
- costae
- spatia intercostalis

Paries anterior:
- cartilago costalis,
- membrana intercostales externa
- sternum

Apertura thoracis superior
- Posterior: Corpus vertebrae thoracic T1
- Lateral: Margo internus costae prima
- Anterior: Cartilago costae prima, incisura jugularis manubrium sterni

Apertura thoracis inferior
- Posterior: Corpus vertebrae thoracic T12
- Lateral: Margo internus costae 11 and 12
- Anterior: Cartilago costales 7-10, symphysis
xiphosternalis (art. between proc. xiphoideus
and corpus sterni)

Question 12

12. Art. sternoclavicularis

Answer 12

art. spheroidea = ball-and-socket

b. Incisura clavicularis manubrii sterni n’ Facies articularis sternalis claviculae
- Discus articularis (divides the joint into 2 parts)
- Capsula articularis
→ lig. sternoclaviculare anterius from manubrium sterni to clavicle on the anterior aspect
→ lig. sternoclaviculare posterius from manubrium sterni to clavicle on the posterior aspect
→ lig. costoclaviculare from facies superior costae prima to facies inferior claviculae
→ lig. interclaviculare between extremitas sternalis on both claviculae

Movements:
elevation and depression (sagittal axis)
forward and backwards (vertical axis)
slight rotatio (frontal axis)

Question 13

13. Art. acromioclavicularis

Answer 13

b. Facies articularis clavicularis acromialis & Facies articularis acromialis claviculae
- capsula articularis
- discus articularis
→ lig. acromioclaviculare from acromion to extremitas acromialis
→ lig. coracoclaviculare from processus coracoideus to clavicula

Question 14

14. Art. humeri

Answer 14

B. Caput humeri & Cavitas glenoidalis
- Cavitas glenoidalis is enlarged by Labrum glenoidalis
→ capsula articularis attach to labrum glenoidalis and collum anatomicum
→ lig. coracohumerale from processus coracoideus
to tuberculum majus humeri
→ lig. coracoacromiale forms upper vault of the
articulatio.

Movements:
Flexio et extensio brachii (frontal axis)
abductio et adductio brachii (sagittal axis)
rotatio interna et externa brachii (vertical axis)
circumduction brachii

Question 15

15. Art. cubiti

Answer 15

Art. humeroulnaris (art. cochlearis = screw
type)
B. Trochlea humeri and Incisura
throchlearis ulnae.

Art. humeroradialis (art. spheroidea = ball-
and-socket)
B. capitulum humeri and fovea
articularis radii.

Art. radioulnaris proximalis (art. trochoidea =
pivot)
B. circumferentia articularis
radii and incisura radialis ulnae.

All of these have common capsula articularis that is attached
to the humerus:
- Anteriorly: above fossa radialis and fossa coronoidea
- Posteriorly: above fossa olecrani
- On ulna: incisura throchlearis
- On radius: collum radii

→ lig. collaterale ulnare from epicondylus medialis humeri to incisura throchlearis ulnae
→ lig. collaterale radiale from epicondylus lateralis humeri
and downwards it divides into two bundles, embraces
caput radii (anterior side) and incisura radialis ulnae
(posterior side)
→ lig. anulare radii encircles caput radii and attaches to incisura radialis ulnae on both sides (anterior and posterior)

Movements:
Flexio et extensio antebrachii (frontal axis)
Supinatio et pronatio antebrachii (vertical axis)
Circumductio antebrachii

Question 16

16. Art. radiocarpalis

Answer 16

b. Facies articularis carpalis radii and Facies articularis ossis scaphoidei, ossis lunati et ossis triquetri

• discus articularis attaches to incisura ulnaris radii and processus styloideus ulnae. It separates art. radioulnaris distalis and art. radiocarpalis.
• Capsula articularis

→ Lig. collaterale carpi radiale from processus styloideus radii to os scaphoideum
→ Lig. collaterale carpi ulnare from processus styloideus ulnae to os triquetrum
→ Lig. radiocarpale palmare from processus styloideus radii and epiphysis distalis radii (anterior
surface) to proximal row of ossa carpi and os capitatum
→ Lig. radiocarpale dorsale from epiphysis distalis radii (posterior surface) to proximal row of ossa carpi

Movements:
Flexio et extensio manus (frontal axis)
Abductio et adductio manus (sagittal axis)
Circumductio manus

Question 17

17. Artt. manus

Answer 17

Art. radiocarpalis (art. ellipsoidea = ellipsoid) (lig.collaterale carpi radiale/ulnare, lig. radiocarpale palmare/dorsale)

Art. mediocarpalis (art. plana = plane, amphiarthrosis, S-shaped) (ligg. intercarpalia dorsalia/palmaria/interossea)

Art. ossis pisiformis (art. plana, amphiarthrosis)

Artt. carpometacarpales (artt. planae = plane, amphiarthroses) (lig. carpometacarpalia palmaria/dorsalia)

Art. carpometacarpalis pollicis (art. sellaris = saddle)

Artt. intermetacarpales (artt. planae = plane, amphiarthroses) (ligg. metacarpalia palmaria/dorsalia/interossea)

Artt. metacarpophalangeae (artt. spheroidea = ball-and-socket) (ligg. collateralia/palmaria, lig. metacarpale transversum profundum)

Art. metacarpophalangea pollicis (ginglymus = wheel)

Artt. interphalangeae manus proximalis et distalis (ginglymus = wheel) (ligg. collateralia, palmaria)

Question 18

18. Pelvis major: walls and measurements

Answer 18

Walls:
- Paries posterior: vertebra lumbales IV and V and junctions between them
- Paries laterales: ala ossis ilii dextra at sinistra

Measurements:
- Distantia intercristalis is a distance between crista iliaca dextra et
sinistra, 28-29cm
- Distantia interspinosum is a distance between spina iliaca
anterior superior dextra et sinistra, 25-27cm
- Distantia intertrochanterica is a distance between trochanter
major dextra is sinistra, 30-32cm

Question 19

19. Pelvis minor: walls and measurements

Answer 19

Walls:
- Paries posterior: os sacrum, os coccygis and juncture sacrococcygea
- Paries laterales (2kpl) : foramen ischiadicum majus et minus
- Paries anterior: ramus superior et inferior ossis pubis, ramus ossis ischii, membrana obturatoria, symphysis pubica

Measurements:
- Diameter transversa between the furthest points of linea arcuata, 13,5cm
- Diameter oblique between art. sacroiliaca and
the opposite eminentia iliopubica, 12,5cm
- Diameter recta :
–> Conjugata anatomica between promontorium and upper margins of symphysis pubica, 11,5cm
–> Conjugata vera between promontorium and eminentia retropubica, 10,5cm – 11cm
–> Conjugata diagonalis between promontorium and lower margins of symphysis pubica, 12,5cm – 13cm

Question 20

20. Apertura pelvis superior et inferior

Answer 20

Superior/major:
1. Promontorium
2. Art. sacroiliaca
3. Linea arcuata
4. Eminentia iliopubica
5. Pecten ossis pubis
6. Tuberculum pubicum
7. Lig. pubicum superius

Inferior/minor:
1. Os coccygis
2. Lig. sacrotuberale
3. Tuber ischiadicum
4. Ramus ossis ischii
5. Ramus inferior ossis pubis
6. Lig. pubicum inferius

Question 21

21. Art. sacroiliaca; symphysis pubica

Answer 21

(art. plana = plane, amphiarthrosis) which articular surfaces are:
- Facies auricularis ossis sacri and Facies auricularis ossis ilii
* Capsula articularis
–> Lig. sacroiliacum anterius
–> Lig. sacroiliacum posterius
–> Lig. sacroiliacum interosseum

symphysis pubica
- both facies symphysialis ossis pubis are joined by
fibrous cartilage or discus interpubicus.

 Lig. pubicum superius
 Lig. pubicum inferius

There is eminentia retropubica on
the posterior surface of symphysis
pubica.

Question 22

22. Art. coxae

Answer 22

(art. cotylica s. enarthrosis)
b. Facies articularis capitis femoris and Facies lunata acetabuli
→ Acetabulum is completed by labrum acetabuli
* Capsula articularis attached to linea intertrochanterica and crista intertrochanterica

2 Ligg. Intracapsularia in cavitas articularis:
→ Lig. transversum acetabuli connects the ends of facies lunata acetabuli and crosses incisura
acetabuli
→ Lig. capitis femoris extends from fossa acetabuli where it attaches
to lig. transversum acetabuli to fovea capitis femoris

4 Ligg. extracapsularia
→ lig. iliofemorale between spina iliaca anterior inferior and linea intertrochanterica
→ lig. pubofemorale between ramus superior ossis pubis and linea
intertrochanterica
→ lig. ischiofemorale between corpus ossis ischii and fossa trochanterica
→ zona orbicularis around collum femoris and attaches to spina iliaca anterior inferior

Movements:
flexio et extensio femoris (frontal axis)
abductio et adductio femoris (sagittal
axis)
rotatio interna et externa femoris
(vertical axis)
circumductio femoris

Question 23

23. Art. genus

Answer 23

b. Facies articularis condyli medialis femoris andFacies articularis superior condyli medialis tibiae
b. Facies articularis condyli lateralis femoris and Facies articularis superior condyli lateralis tibiae
b. Facies articularis patellae and Facies patelaris femoris

There is:
- meniscus medialis (semi-circular)
- meniscus lateralis (almost circular)

• capsula articularis
  3 ligg. intracapsularia
  → lig. transversum genus joins two menisci in front
  → lig. cruciatum anterius from condyli lateralis femoris to area intercondylaris anterior tibia
  → lig. cruciatum posterius from condyli medialis femoris to area intercondylaris posterior tibia

7 ligg. extracapsularia
→ Lig. collaterale tibiale from epicondylus medialis femoris to condyli medialis tibia and facies medialis tibia
→ Lig. collaterale fibulare from epicondylus lateralis femoris to lateral side of caput fibula
→ Lig. patellae continuation of tendon of m. quadriceps femoris (attach to tuberositas tibiae)
→ Retinaculum patellae mediale is fibers of m. vastus medialis
→ Retinaculum patellae laterale is fibers of m. vastus lateralis and m. rectus femoris
→ Lig. popliteum obliquum at the dorsal surface, attaches from condyli lateralis femoris to condyle medialis tibia
→ Lig. popliteum arcuatum at the dorsal surface, attaches from caput fibulae to lig. popliteum obliquum

On both sides of the patella there are 2 plicae alares, but below patella there is plica synovialis infrapatellaris.

The synovial membrane forms 9 bursas:
1. Bursa suprapatellaris between femur and tendon of m. quadriceps femoris
2. Bursa musculi poplitei between tendon of m. popliteus and condyli lateralis tibiae
3. Bursa anserina between tendons of m. sartorius, m. gracilis, m. semitendinosus and tibia
4. Bursa subtendinea musculi gastrocnemii medialis lies in front of the proximal attachment of tendon of
m. gastrocnemius cauput medialis
5. Bursa subcutanea prepatellaris between the skin and facies anterior patella
6. Bursa subfascialis prepatellaris lies deep to fascia
7. Bursa subtendinea prepatellaris lies deep to the tendon
8. Bursa subcutanea infrapatellaris between the skin and tuberositas tibiae
9. Bursa infrapatellaris profunda between lig. patella and facies anterior tibiae

Movements:
Flexio et extensio (frontal axis)
Rotatio interna et externa (vertical axis)
Circumductio cruris

Question 24

24. Art. talocruralis

Answer 24

(ginglymus)
b. Facies superior tali and Facies articularis inferior tibiae
b. Facies malleolaris medialis tali and Facies articularis malleoli medialis tibiae
b. Facies malleolaris lateralis tali and Facies articularis malleoli lateralis fibulae

• Capsula articularis
  → Lig. collaterale mediale s. deltoideum from malleolus
  medialis and divides into 4 parts:
• Pars tibiotalaris anterior to caput tali
• Pars tibiotalaris posterior to corpus tali
• Pars tibionavicularis to os naviculare
• Pars tibiocalcanea to sustentaculum tali of the calcaneus

→ Lig. collaterale laterale which consists 3 ligaments
- Lig. talofibulare anterius from malleolus lateralis to caput tali
- Lig. talofibulare posterius from malleolus lateralis to posterior end of talus
- Lig. calcaneofibulare from malleolus lateralis to lateral surface of calcaneus

Flexio et extensio pedis (frontal axis)

Question 25

25. Artt. pedis

Answer 25

Art. subtalaris (art. plana = flat, amphiarthrosis) (Lig. talocalcaneum mediale, Lig. talocalcaneum laterale)

Art. talo(calcaneo)navicularis (art. spheroidea) (Lig. calcaneonaviculare plantare, Lig. talocalcaneum interosseum)

Art. calcaneocuboidea (Lig. bifurcatum _attaches to calcaneus and divides in front in a Y-shaped manner into lig.calcaneonaviculare, lig. calcaneocuboideum, Lig. calcaneocuboideum plantare, Lig. plantare longum)

Art. tarsi transversa s. Choparti (Lig. calcaneonaviculare, Lig. calcaneocuboideum)

Art. cuneonavicularis (art. plana = flat) (Ligg. tarsi dorsalia, Ligg. tarsi plantaria, Ligg. tarsi interossea)

Artt. tarsometatarsales s. art. Lisfranci (Ligg. tarsometatarsalia dorsalia, Ligg. tarsometatarsalia plantaria, Ligg. cuneometatarsalia interossea)

Art. intermetatarsales (Ligg. metatarsalia dorsalia, Ligg. metatarsalia plantaria, Ligg. metatarsalia interossea)

Artt. metatarsophalangeae (Ligg. Collateralia, Ligg. plantaria, Ligg. metatarsale transversum profundum)

Artt. interphalangeae pedis (Ligg. Collateralia, Ligg. plantaria)

Question 26

26. Art. tarsi transversa

Answer 26

b. Art. talonavicularis
b. Os naviculare, Talus, and Calcaneus

• Capsula articularis
  → Lig. calcaneonaviculare plantare connects sustentaculum tali with ossa naviculare
  → Lig. talocalcaneum interosseum from talus to calcaneus in the tarsal sinus

supinatio cum adductio pedis
pronatio cum abductio pedis

and Art. calcaneocuboidea:
b. calcaneus and os cuboideum

• Capsula articularis
  → Lig. bifurcatum attaches to calcaneus and divides in front in a Y-shaped manner into
  lig.calcaneonaviculare (to os naviculare) and lig. calcaneocuboideum (to os cuboideum)
  → Lig. calcaneocuboideum plantare extends from the forepart of calcaneus to plantar surface of os
  cuboideum
  → Lig. plantare longum from in front of the tuber calcanei to plantar surface of ossa metatarsi II - V

Question 27

27. Art. Lisfranci and art. Choparti

Answer 27

Artt. tarsometatarsales s. art. Lisfranci

b. Os cuboideum and Ossa cuneiformia (laterale, intermedium and mediale) and Basis ossis metatarsales
–> Ligg. tarsometatarsalia dorsalia
–> Ligg. tarsometatarsalia plantaria
–> Ligg. cuneometatarsalia interossea

2. Art. tarsi transversa s. Choparti

b. Art. talonavicularis
( b. Os naviculare, Talus, and Calcaneus

• Capsula articularis
  –> Lig. calcaneonaviculare plantare connects sustentaculum tali with ossa naviculare
  –> Lig. talocalcaneum interosseum from talus to calcaneus in the tarsal sinus

supinatio cum adductio pedis
pronatio cum abductio pedis)

and Art. calcaneocuboidea:
(b. calcaneus and os cuboideum

• Capsula articularis
  –> Lig. bifurcatum attaches to calcaneus and divides in front in a Y-shaped manner into
  lig.calcaneonaviculare (to os naviculare) and lig. calcaneocuboideum (to os cuboideum)
  –> Lig. calcaneocuboideum plantare extends from the forepart of calcaneus to plantar surface of os
  cuboideum
  –> Lig. plantare longum from in front of the tuber calcanei to plantar surface of ossa metatarsi II - V)

–> Lig. calcaneonaviculare
–> Lig. calcaneocuboideum

Question 28

28. Mm. superficiales dorsi

Answer 28

Musculus trapezius
O. Protuberantia occipitalis externa
Linea nuchae superior
Ligmentum nuchae
Processus spinosi (vertebrae thoracici)

I. Spina scapulae
Acromion
Extremitas acromialis claviculae

F. The upper part (pars descendes): elevates the scapula
The middle part (pars transversa): move scapula and
clavicle backwards medially towards the vertebral
column
The lower part (pars ascendens): depresses the scapula

Musculus latisiimus dorsi
O. Crista iliaca
Fascia thoracolumbalis
Processus spinosi (vertebrae thoracicae 7-12)
Facies externae costarum 9-12

I. Crista tuberculi minoris humeri

F. Adduction brachii
Extension brachii
Rotation interna brachii

Musculus rhomboideus minor
O. Processus spinosi (vertebrae cervicales 6-7)
I. Margo medialis scapulae
F. Fix the scapula to the thorax and pull it towards
the spine

Musculus rhomboideus major
O. Processus spinosi (vertebrae thoracicae 1-4)
I. Margo medialis scapulae
F. Fix the scapula to the thorax and pull it towards
the spine

Musculus levator scapulae
O. Tuberculum posterius of processus transverus (vertebrae
cervicales 1-4)
I. Angulus superior scapulae
F. Elevatio of scapula

Musculus serratus posterior superior
O. Processus spinosi (vertebrae cervicales 5-7, vertebrae
thoracicae 1-2)
I. Facies externae costarum (2-5)
F. Elevatio costarum

Musculus serratus posterior inferior
O. Processus spinosus (vertebrae thoracicae 11-12 un vertebrae
lumbales 1-2)
I. Facies externae costarum (9-12)
F. Depressio costarum

Question 29

29. Mm. profundi dorsi (mm. breves)

Answer 29

1) Systema intertransversale

Musculi intertransversarii
* Between two processus transversus
F. Unilaterally: lateroflexion
Bilaterally: extension

2) Systema interspinale

Musculi interspinales (cervicis, thoracis, lumborum)
* Between two processus spinosus
F. Segmental extension

3) Systema transversospinale

Musculi rotatores breves (cervicis, thoracis,
lumborum)
* Between processus spinosus and processus
transversus
→ Course to the adjacent upper vertebra
F. Unilaterally: segmental lateroflexion, rotation
Bilaterally: segmental extension

Question 30

30. Mm. profundi dorsi (mm. longi: systema interspinalis et
    systema intertransversalis)

Answer 30

1) Systema intertransversale

Musculus iliocostalis (cervicis, thoracis, lumborum)

Pars lumbalis
O. Crista iliaca
I. Angulus costae (6th lower costae)

Pars thoracica
O. Angulus costae (6th lower costae)
I. Angulus costae (6th upper costae)

Pars cervicalis
O. Angulus costae (6th upper costae)
I. Processus transversus (6th – 3rd cervical vertebrae)

Musculi longissumus (thoracis, cervicis, capitis)

Pars thoracis
O. Os sacrum
crista iliaca
vertebra lumbales (proc. Spinosi)
I. costa 2-12
vertebra toracis (proc. Transversi)

Pars cervicis
O. Proc. Transversi (thor. Vert. 6th – 1st)
I. Proc. Transversi (cerv. Vert. 5th – 2nd)

Pars capitis
O. proc. Transversi (thor. Vert. 3rd – cerv. Vert. 3rd)
I. Proc. Mastoideus
F. (for all) lateroflexio et extensio

2) Systema interspinale

Musculi spinalis (capitis, cervicis, thoracis, ALSO LUMBALIS)

Pars capitis
O. Processus spinosus of 3rd – 1st thoracic and 7th – 6th cervical vertebrae
I. Squama ossis occipitalis

Pars cervicis
O. Processus spinosus of 3rd – 1st thoracic and 7th to 6th cervical vertebrae

I. Processus spinosus of 5th – 2nd cervical vertebrae

Pars thoracis
O. Processus spinosus 2nd, 1st lumbar and 12th – 10th thoracic vertebrae
I. Processus spinosus of 9th – 2nd thoracic vertebrae

F. unilaterally: lateroflexion
Bilaterally: extension

→ Systema intertransversale (1) + systema interspinale (2) from musculi longi = Musculi erector spinae
F. extension trunci

Question 31

31. Mm. profundi dorsi (systema transversospinalis et systema
    spinotransversalis)

Answer 31

3) Systema transversospinale
* From processus transversus to processus spinosus

Musculi rotatores longi
- Jump over one vertebra

Musculi multifidi breves
- Jump over two vertebra

Musculi multifidi longi
- Jump over three vertebra

Musculi semispinales
- Jump over four – five vertebra

F. Unilaterally: segmental lateroflexion
Bilaterlly: segmental extension

4) Systema spinotransversale

Musculus splenius cervicis
O. Processus spinosus of the T6-T3
I. Processus transversus of C1 and C2

Musculus splenius capitis
O. Processus spinosus T3-C3
I. Processus mastoideus (Linea nuchalis superior)

F. Unilaterally: lateroflexion, rotation of the cervical
part of the vertebral column
Bilaterally: Extension of the cervical part of the vertebral column

Question 32

32. Mm. occipitovertebrales

Answer 32

Musculus rectus capitis posterior minor
O. Atlas
I. Linea nuchae inferior

Musculus rectus capitis posterior major
O. Processus spinosus axis
I. Linea nuchae inferior

Musculus obliquus capitis inferior
O. Processus spinosus axis
I. Processus transversus atlantis

Musculus obliquus capitis superior
O. Processus transversus atlantis
I. Linea nuchae inferior

F (for all the 4 muscles): Extensio capitis and lateroflexio capitis

Question 33

33. Mm. superficiales thoracis

Answer 33

Musculus pectoralis major
Pars clavicularis
O. Extremitas sternalis claviculae

Pars sternocostalis
O. Facies anterior sterni, cartilagines costarum 2-7

Pars abdominalis
O. Lamina anterior vaginae musculi recti abdominis

I. crista tuberculi majoris
F. Adductio brachii
Rotatio interna brachii
Flexio brachii – pars clavicularis

Musculus pectoralis minor
O. Facies externa costarum 3-5
I. Processus coracoideus scapulae
F. Moves scapula downwards and medially
In case of hyperventilation breathing elevates ribs

Musculus subclavius
O. Facies superior costae prima
I. Facies inferior claviculae
F. Elevatio costae prima and depression clavicula

Musculus serratus anterior (goes under the scapulae)
O. Facies externae costarum 1-9
I. Margo medialis et angulus inferior scapulae
F. Rotatio scapulae et elevation brachii
Fix scapula to thoracic wall

Question 34

34. Mm. profundi thoracis

Answer 34

Musculi intercostales externi (fulfill from
vertebra column and cartilagines costarum,
fibers forward and medially = fingers when
you put hands in your pocket)

O. Margo inferior of upper costae
I. Margo superior of lower costae
F. Elevatio costarum, inspiration

Musculi intercostales interni (intercostal
space from sternum till angulus costarum,
fibers upwards and medially)

O. Margo superior of lower costae
I. Margo inferior of upper costae
F. Move ribs laterally and downwards,
expiration

Musculi subcostales (similar to intercostales interni but jump over one
rib)
O. margo superior of lover costae
I. Margo inferior of upper costae, jump over one rib
F. Move ribs laterally and downwards, expiration

Musculi levatores costarum
O. Processus transversus vertebrae cervicalis VII et vertebrae
thoracicae I – XI
I. Facies externa costarum
F. Elevatio costales, inspiration

Musculus transversus thoracis
O. Facies posterior processus xiphoidei et corporis sterni
I. Internal surface of costarum III – VI
F. Move arcus costalis together, expiration muscule

Question 35

35. Mm. abdominis

Answer 35

Posterior wall:
Musculus quadratus lumborum
O. Crista iliaca
I. Costa duodecima (12)
F. Extensio trunci
Lateroflexio trunci

Lateral wall:
Musculus obliquus externus abdominis
O. External costarum 5-12
I. Labium externum of crista iliaca
Ligamentum inguinale
Linea alba
Vagina m. recti abdominis
F. Bilaterally: flexio trunci
Unilaterally: lateroflexio, torsio trunci

Musculus obliquus internus abdominis (fibers goes opposite than m.
obliquus externus abdominis)

O. Fascia thoracolumbalis
Crista iliaca
Ligamentum inguinale
I. Margo inferior costarum 10-12
Linea alba
Vagina m. recti abdominis
F. Bilaterally: flexio trunci
Unilaterally: lateroflexio trunci

Musculus transversus abdominis (fibers horizontally)

O. Ligamentum inguinale
Crista iliaca
Fascia thoracolumbalis
Costarum 7-12
I. abowe linea arcuata; posterior lamina (layer)
Below linea arcuata; anterior lamina
F. abdominal press, expiration

Anterior wall:
Musculus rectus abdominis
O. Processus xiphoideus
cartilagines costarum 5-7
I. Ramus superior os pubis
F. Flexio trunci

Musculus pyramidalis
O. Ramus superior os pubis
I. Linea alba
F. Stretches linea alba

Question 36

36. Vagina m. recti abdominis

Answer 36

LAMINA ANTERIOR:

above umibilicus
→ Aponeurosis m. oblique externi abdominis
→ Aponeurosis m. oblique interni abdominis

below umbilicus
→ Aponeurosis m. oblique externi abdominis
→ Aponeurosis m. oblique interni abdominis
→ Aponeurosis m. transversi abdominis

LAMINA POSTERIOR:

above umbilicus
→ Aponeurosis m. oblique interni abdominis
→ Aponeurosis m. transversi abdominis

below umbilicus
→ Fascia transversalis
→ Peritoneum

Question 37

37. Canalis inguinalis (hernia inguinalis recta et hernia inguinalis
    obliqua)

Answer 37

Above ligamentum inguinale.
Length: 4 – 5cm
Diameter: female 0,5cm, male 1,0cm
* In male funiculus spermaticus runs through canalis inguinalis. In female ligamentum teres uteri extends
through canalis inguinalis.

WALLS OF CANALIS INQUINALIS

Paries anterior
- Aponeurosis musculus oblique externi abdominis

Paries posterior
- Fascia transversalis
- Peritoneum

Paries superior
- Musculus obliquus internus
abdominis
- Musculus transversus abdominis
(lower margins)

Paries inferior
- Ligamentum inguinale

Canalis inguinalis openings:

Anulus inguinalis superficialis (has projections in Fossa inguinalis medialis)
Margo superior – curs mediale
Margo inferior – curs laterale
Margo medialis – ligamentum reflexum
Margo lateralis – fibrae intercrurales

Anulus inguinalis profundus (hernia canal for indirect inguinal hernia)
Localise in Fossa ingunalis lateralis

Question 38

38. Canalis femoralis (lacuna vasorum, lacuna musculorum)

Answer 38

FIXAA TÄÄ

• Below ligamentum inguinale in the medial corner of lacuna vasorum. (hernia canal for femoral hernia)
• forms an anulus femoralis in case of herniation
  → covered by:
• nodus lymph. inguin. profundus
• septum femorale
• peritoneum
• occurs 3 times more often in women than in man
• Superficial opening – hiatus saphenus is 2-3 cm below lig. inguinale, it is covered by fascia cribrosa, what is bordered by cornu superius, cornu inferius et margo falciformis

Canalis femoralis walls:

Paries medialis
- Musculi pectineus
- Fascia pectinea

Paries lateralis
- Vena femoralis

Paries anterior
- Cornu superius fasciae latae

Question 39

39. Anulus umbilicalis, linea alba, trigonum lumbale

Answer 39

1. During embryonal period is anulus umbilicalis containing funiculus umbilicalis.

Umbilicus s. umbo:
- fascia transversalis
- peritoneum
- fascia abdominalis propria
- subcutis
- cutis

2. Linea alba:
   * Possible site for hernication

m. obliquus ext. abdominis
m. obliquus int. abdominis
m. transversus abdominis

Male:
above the umbilicus – 2,8 cm
below the umbilicus – 2,5 cm

Female:
above the umbilicus – 5 cm
blelow the umbilicus – 1 cm

3. Trigonum lumbale:
   - Margo inferior – crista iliaca
   - Margo anterior – musculus obliquus abdominis externus
   - Margo posterior – musculus latissimus dorsi

Question 40

40. Paries anterior abdominis (facies interna: plicae et fossae)

Answer 40

= prelum abdominale

Musculus rectus abdominis
O. Processus xiphoideus
cartilagines costarum V – VII
I. Ramus superior os pubis
F. Flexio trunci

Musculus pyramidalis
O. Ramus superior os pubis
I. Linea alba
F. Stretches linea alba

(Fasciae abdominis
Fascia superficialis abdominis
Fascia propria abdominis
Lamina superficialis, -media, -profunda
Fascia transversalis)

Plica umbilicalis mediana
→ Ligamentum umbilicale medianum
Plica umbilicalis medialis
→ Ligamntum umbilicale mediale
Plica umbilicalis lateralis
→ Arteries et veins epigastrica inferior

Fossa supravesicalis dextra et sinistra
- Margo medialis – plica umbilicalis mediana
- Margo lateralis – plica umbilicalis medialis
- Margo inferior – vesica urinaria

Fossa inguinalis medialis dextra et sinistra (hernia canal for direct inguinal hernias)
- Margo medialis – plica umbilicalis medialis
- Margo lateralis – plica umbilicalis lateralis
- Margo inferior – ligamentum inguinale

Fossa inguinalis lateralis dextra et sinistra
- Margo medialis – plica umbilicalis lateralis
- Margo inferior – ligamentum inguinale

Question 41

41. Diaphragma

Answer 41

• Dome shaped muscle between thoracic and abdominal cavity.
• most important muscle for inspiration
• contraction: diaphragm moves downwards (thorax becomes bigger, abdomen becomes smaller )

Places of projections:
Dexter – costa IV
Sinister – costa V
i. Centrum tendineum – central
O. Pars muscularis – peripherical

1. Pars sternalis (O. facies posterior processus xiphoideus)
2. Pars costalis (O. Facies interna costarum 7-12)
3. Pars lumbalis
   - 3.1. Crus mediale dextrum – from vertebrae Lumbales 1-4
   - 3.2. Crus mediale sinistrum – from vertebrae Lumbales 1-3
   - 3.3. Crus intermedium dextrum et sinistrum – from vertebrae Lumbales 2
   - 3.4. Crus laterale dextrum et sinistrum – from ligamentum arcuatum mediale et ligamentum arcuatum laterale

Openings in the diaphragm:
- Hiatus aorticus
- Hiatus oesophageus
- Foramen venae cavae

Coverings of diaphragm
Superiorly:
- Fascia endothoracica
- Pleura diaphragmatica
Inferiorly:
- Fascia diaphragmatica (part of fascia subperitonealis)
- Peritoneum

Sites of weakness of diaphragm:
- Trigonum sternocostale dextrum & sinistrum
- Trigonum lumbocostale dextrum & sinistrum

S. Phren

Question 42

42. Mm. cinguli membri superioris

Answer 42

Musculus deltoideus
* Divided into three parts: Pars clavicularis, Pars acromialis, Pars spinalis

O. Extremitas acromialis claviculae
Acromion
Spina scapulae

I. Tuberositas deltoidea

F. Pars acromialis – abduction brachii
Pars clavicularis et Pars spinalis – adduction brachii
Pars clavicularis et Pars acromialis – flexio brachii
Pars acromialis et Pars spinalis – extension brachii
Pars clavicularis – rotation interna brachii
Pars spinalis – Rotatio externa brachii

Musculus supraspinatus
* Fills fossa supraspinata on scapula.

O. Fossa supraspinata
I. Tuberculum majus humeri
F. Abductio brachii

Musculus infraspinatus
* Fills fossa infraspinata on scapula.

O. Fossa infraspinata
I. Tuberculum majus humeri
F. Rotatio externa brachii

Musculus teres minor
O. Margo lateralis scapulae
I. Tuberculum majus humeri
F. Rotatio externae et extension brachii

Musculus teres major
O. Angulus inferior scapulae
I. Crista tuberculi minoris humeri
F. Adductio brachii
Extensio brachii
Rotatio interna brachii

Musculus subscapularis
Fills fossa subscapularis on scapula.
O. Fossa subscapularis
I. Tuberculum minus humeri
F. Adductio brachii
Rotatio interna brachii

Question 43

43. Mm. brachii (anterior and posterior group)

Answer 43

• Divided into anterior compartimentum (flexors) and posterior compartimentum (extensors)

The anterior muscle compartimentum
Musculus coracobrachialis
O. Processus coracoideus scapulae
I. Diaphysis humeri
F. Flexio brachii
Adductio brachii
Rotatio interna brachii

Musculus biceps brachii
* Two heads: Caput longum et Caput breve

O. Caput longum: Tuberculum supraglenoidale scapulae
Caput breve: Processus coracoideus scapulae
I. Tuberositas radii
F. Flexio antebrachii
Supinatio antebrachii
Caput longum – abduction brachii
Caput breve – flexio brachii

Musculus brachialis
O. Diaphysis humeri
I. Tuberositas ulnae
F. Flexio antebrachii

The posterior muscle compartimentum
Musculus triceps brachii
* Three heads: Caput longum, Caput laterale, Caput mediale

O. Caput longum: Tuberculum infraglenoidale scapulae
Caput laterale: Above sulcus nervi radialis in humerus
Caput mediale: Beneath sulcus nervi radialis in humerus
I. Olecranon ulnae
F. Extensio antebrachii
Caput longum - Extensio et Adductio brachii

Musculus anconeus
* Continuation of caput mediale of musculus triceps brachii

O. Epicondylus lateralis humeri
I. Epiphysis proximalis ulnae
F. Extensio antebrachii

Question 44

44. Mm. antebrachii (anterior group)

Answer 44

1st layer
Musculus pronator teres
O. Epicondylus medialis humeri
Processus coronoideus ulnae
I. Facies posterior et lateralis radii
F. Flexio antebrachii
Pronatio antebrachii

Musculus flexor carpi radialis
O. Epicondylus medialis humeri
I. Basis ossis metacarpi II et III
F. Flexio manus
Abductio manus

Musculus palmaris longus
O. Epicondylus medialis humeri
I. Aponeurosis palmaris
F. Flexio manus

Musculus flexor carpi ulnaris
O. Epicondylus medialis humeri
Olecranon
I. Os pisiforme
F. Flexio manus
Adductio manus

2nd layer
Musculus flexor digitorum superficialis
O. Epicondylus medialis humeri
I. Basis phalangis mediae II – V fingers
F. Flexio phalangis mediae
Flexio phalangis proximalis
Flexio manus

3rd layer
Musculus flexor digitorum profundus
O. Facies anterior ulnae
Membrana interossea antebrachii
I. Basis phalangis distalis II – V fingers
F. Flexio phalangis distalis
Flexio phalangis mediae
Flexio phalangis proximalis
Flexio manus

Musculus flexor pollicis longus
O. Facies anterior radii
Membrana interossea antebrachii
I. Basis phalangis distalis pollicis
F. Flexio phalangis proximalis pollicis
Flexio phalangis distalis pollicis
Flexio pollicis
Flexio manus

4th layer
Musculus pronator quadratus
O. Facies anterior ulnae
I. Fascies anterior radii
F. Pronatio antebrachii
Pronatio manus

Question 45

45. Mm. antebrachii (posterior and lateral group)

Answer 45

The lateral
Musculus brachioradialis
O. Margo lateralis humeri
Septum intermusculare laterale
I. Above processus styloideus radii
F. Flexio antebrachii
Keeps antebrachii in the intermediate position between pronatio and supinatio

Musculus extensor carpi radialis longus
O. Epicondylus lateralis humeri
Septum intermusculare laterale
I. Basis ossis metacarpi II
F. Extensio manus
Abductio manus

Musculus extensor carpi radialis brevis
O. Epicondylus lateralis humeri
I. Basis ossis metacarpi III
F. Extensio manus
Abductio manus

The posterior
1st layer

Musculus extensor digitorum
O. Epicondylus lateralis humeri
I. Basis phalangis mediae II – V fingers
Basis phalangis distalis II – V fingers
F. Extensio digitorum
Extensio manus

Musculus extensor digiti minimi
O. Epicondylus lateralis humeri
I. Basis phalangis medie V finger
Basis phalangis distalis V finger
F. Extensio digiti minimi

Musculus extensor carpi ulnaris
O. Epicondylus lateralis humeri
Olecranon
Facies posterior ulnae
I. Basis ossis metacarpi V
F. Extensio manus
Adduction manus

2nd layer

Musculus abductor pollicis longus
O. Facies posterior ulnae
facies posterior radii
Membrana interossea antebrachii
I. Basis ossis metacarpi I
F. Abductio pollicis

Musculus extensor pollicis brevis
O. Facies posterior radii
Membrana interossea antebrachii
I. Basis phalangis proximalis
F. Extensio phalangis proximalis pollicis

Musculus extensor pollicis longus
O. Facies posterior ulnae
Membrana interossea antebrachii
I. Basis phalangis distalis
F. Extensio pollicis

Musculus extensor indicis
O. Facies posterior ulnae
Membrana interossea antebrachii
I. Basis phalangis mediae II finger
Basis phalangis distalis II finger
F. Extensio indicis

Musculus supinator
O. Epicondylus lateralis humeri
Ulna
I. Embraces radius proximal third from all sides
F. Supinatio antebrachii

Question 46

46. Mm. thenaris et mm. hypothenaris

Answer 46

Musculi eminentiae thenaris
Musculus abductor pollicis brevis
O. Retinaculum musculorum flexorum
Os scaphoideum
I. Basis phalangis proximalis pollicis
F. Abductio pollicis

Musculus flexor pollicis brevis
O. Caput superficiale (from retinaculum musculorum flexorum)
Caput profundum (from os trapezium and os trapezoideum)
I. Basis phalangis proximalis pollicis
F. Flexio pollicis

Musculus opponens pollicis
O. Retinaculum musculorum flexorum
Os trapezium
I. Basis ossis metacarpi I
F. Oppositio pollicis

Musculus adductor pollicis
O. Caput obliquum (from os capitatum)
Caput transversum (from os metacarpale III)
I. Basis phalangis proximalis pollicis
F. Adductio pollicis

Musculi eminentiae hypothenaris
Musculus abductor digiti minimi
O. Retinaculum musculorum flexorum
Os pisiforme
I. Basis phalangis proximalis digiti minimi
F. Abductio digiti minimi

Musculus flexor digiti minimi brevis
O. Retinaculum musculorum flexorum
Hamulus ossis hamati
I. Basis phalangis proximalis digiti minimi
F. Flexio digiti minimi

Musculus opponens digiti minimi
O. Retinaculum musculorum flexorum
Hamulus ossis hamati
I. Os metacarpale V
F. Oppositio digiti minimi

Musculus palmaris brevis
O. Retinaculum flexorum
Aponeurosis palmaris ulnar border
I. The skin on the medial side of the wrist
F. Forms the skin folds on the ulnar side of the wrist

Question 47

47. Mm. manus (middle group)

Answer 47

Musculi lumbricales (4 lumbrical muscles)
O. Tendons of musculi flexor digitorum profundus
I. Tendons of musculi extensor digitorum
Phalanx proximalis II – V fingers
F. Flexio phalangis proximalis
Extensio phalangis mediae
Extensio phalangis distalis

Musculi interossei palmares (3 palmar interosseous muscles)
O. Os metacarpale II, IV, V
I. Phalanx proximalis (II, IV, V fingers)
F. Adductio digitorum (adduct II, IV, V fingers to axis that passes through the
middle finger)

Musculi interossei dorsalis
O. I – V ossa metacarpalia
I. Phalanx proximalis (II, III, IV fingers)
F. Abductio digitorum (abduction of the 2nd and 4th fingers to the axis of the middle finger)

Question 48

48. Fascia brachii

Answer 48

• Continuation of fascia deltoidea. Circulary surrounds the upper
  arm.
• Septum intermusculare brachii mediale et laterale seperates
  ventral and dorsal muscle groups of upper arm. They fasten to
  margo medialis et lateralis humeri.
• Forms lamina profunda fasciae brachii between m. biceps brachii
  and m. brachialis.

Vagina osteofibrosa flexorum
m. brachialis
m. coracobrachialis

Vagina osteofibrosa extensorum
m. triceps brachii
m. anconeus

Vagina fibrosa musculi bicipitis brachii
m. biceps brachii

Question 49

49. Fascia antebrachii

Answer 49

• Continuation of fascia brachii.
• Aponeurosis m. bicipitis brachii reinforces the upper part of fascia antebrachii.
• Retinaculum musculorum flexorum and retinaculum musculorum extensorum are thickening sites in the lower part of the forearm.
• Forms septum intermusculare anterius (between ventral and lateral muscle group) and septum intermusculare posterius (between dorsal and lateral muscle group).
• Lamina profunda seperates the superficial muscles (1st and 2nd layer) from deep muscles (3rd and 4th layer) of
  the ventral muscle group.
  Fascia antebrachii fuses to margo posterior ulnae.

3 osteofibrous sheats:
Vagina osteofibrosa anterior
- around the 3rd and 4th layer (m. flexor digitorum profundus, m. flexor pollicis longus, m. pronator quadratus)

Vagina osteofibrosa posterior
- around the posterior muscle group (m. extensor digitorum / digiti minimi / carpi ulnaris / polices longus and breves / indicis, m. supinator, m. abductor pollicis longus)

Vagina osteofibrosa lateralis
- around the lateral muscle compartimentum (m. brachioradialis, m. extensor carpi radialis longus, m. extensor carpi radialis brevis)

Vagina fibrosae antebrachii is formed around the superficial muscles of the ventral muscle group
- around the 1st and 2nd layer of anterior compartimentum (m. pronator teres, m. flexor carpi radialis, m. palmaris longus, m. flexor carpi ulnaris, m. flexor digitorum superficialis)

3 canals beneath retinaculum musculorum flexorum:

Canalis carpi (m. flexor digitorum superficialis/profundus/pollicis longus, nervus medianus)
Canalis carpi radialis (m.flexor carpi radialis)
Canalis cari ulnaris (nervus, arteria, venae ulnaris)

6 canals beneath retinaculum musculorum extensorum. Tendons of following muscles runs through them:

m. abductor pollicis longus and m. extensor pollicis brevis
m. extensor carpi radialis longus and m. extensor carpi radialis brevis
m. extensor pollicis longus
m. extensor digitorum and m. extensor indicis
m. extensor digiti minimi
m. extensor carpi ulnaris

Question 50

50. Fascia manus

Answer 50

• Continuation of fascia antebrachii.
• Divided into fascia dorsalis manus and fascia palmaris manus. Both form laminae profundae that fuse with the dorsal and palmar surface of the metacarpal bones.
• Fascia palmaris manus is reinforced by aponeurosis palmaris. Forms septum intermusculare mediale (between hypothenar and medial muscle group) and laterale (between thenar and the medial muscle group).

4 fibrous sheats and 4 osteofibrous sheats:

Vagina fibrosa dorsalis
- around tendines musculorum extensorum

Vagina fibrosa thenaris
- around mm. thenaris

Vagina fibrosa media
- around mm. lumbricales tendines m. flexoris digitorum superficialis
- tendines m. flexoris digitorum profundi

Vagina fibrosa hypothenaris
- around mm. hypothenaris

4 vaginae osteofibrosae manus are placed in the intermetcarpal spaces between the metacarpal bones
- mm. interossei palmares
- mm. interossei dorsalis

Question 51

51. Cavitas axillaris ; walls and openings

Answer 51

Paries anterior:
- m. pectoralis major
- m. Pectoralis minor

Paries posterior:
- m. Latissimus dorsi
- m. Teres major
- m. Teres minor
- m. Subscapularis
- m. Triceps brachii (caput longum)

Paries medialis:
- m. Serratus anterior

Paries lateralis:
- m. Coracobrachialis
- humerus

Apertura superior cavi axillaris is limited by:
- clavicula
- Margo superior scapula
- costae prima

Apertura inferior:
- m. Pectoralis major
- m. Latissimus dorsi
- m. Serratus anterior
- m. Coracobrachialis

2 orifices on the dorsal wall of the axilla
Foramen trilaterum, which is limited by
m. teres major
m. teres minor
m. triceps brachii (caput longum)

foramen quadrilaterum (placed laterally from foramen trilaterum), and is limited by
m. teres major
m. teres minor
m. triceps brachii (caput longum)
humerus

3 triangles on the ventral wall of the axilla

1. Trigonum clavipectorale, which is limited by
   - Clavicula
   - m. pectoralis minor (upper boarder)
   - sternum (lateral boarder)
2. trigonum pectorale corresponds to the borders of
   - m. pectoralis minor
3. trigonum subpectorale is limited by
   - m. pectoralis minor (lower border)
   - m. pectoralis major (upper border)
   - m. deltoideus (anterior border)

Question 52

52. Brachium: topography

Answer 52

SULCUS DELTOIDEOPECTORALIS
* Between m. deltoideus and m. pectoralis major
* Downwards sulcus deltoideopectoralis continues as sulcus bicipitalis lateralis

SULCUS BICIPITALIS LATERALIS
* Placed on the lateral border of m. biceps brachii

SULCUS BICIPITALIS MEDIALIS
* Placed on the medial border of m. biceps brachii

Canalis nervi radialis
* Placed on the dorsal surface of the upper arm between humerus and the muscles.
Formed by following sructures
- Sulcus n. radialis humeri
- m. tricipitis brachii (caput mediale et caput laterale)

Question 53

53. Fossa cubiti

Answer 53

• Placed between forearm and upperarm.
  It has 2 borders
• Margo medialis – m. pronator teres (o. epicondylus medialis humeri, processus coronoideus ulnae. i. facies posterior/lateralis radii)
• Margo lateralis – m. brachioradialis (o. margo lateralis humeri, septum intermusculare laterale. i. above processus styloideus radii)

The base of fossa cubiti is formed by
- m. brachialis (o. diaphysis humeri. i. tuberositas ulnae)

Question 54

54. Antebrachicum: topography

Answer 54

The tendon of m. biceps brachii divides into 2 grooves
Sulcus cubitalis anterior medialis
* Between m. pronator teres and m. brachialis
Sulcus cubitalis anterior lateralis
* Between m. brachioradialis and m. brachialis

Topographical formations placed on the dorsal side of the elbow join
Sulcus cubitalis posterior medialis
* On medial border of olecranon
Sulcus cubitalis posterior lateralis
* On lateral border of olecranon

3 grooves on the anterior antebrachial region between the muscles of the superficial layers
Sulcus radialis antebrachii
* Between m. brachioradialis and m. flexor carpi radialis
Sulcus medianus antebrachii
* Between m. flexor carpi radialis and m. flexor digitorum superficialis
Sulcus ulnaris antebrachii
* Between m. flexor digitorum superficialis and m. flexor carpi ulnaris

( Canalis carpi
* Between the middle part of retinaculum musculorum flexorum and sulcus carpi
Through it runs
- m. flexor digitorum superficialis → vagina synovialis communis tendinum musculorum flexorum
- m. flexor digitorum profundus → vagina synovialis communis tendinum musculorum flexorum
- m. flexor pollicis longus → vagina synovialis tendinis musculi flexoris pollicis
nervus medianus

Canalis carpi radialis
* Beneath retinaculum musculorum flexorum
* Laterally from canalis carpi
Through it runs
- m. flexor carpi radialis → vagina synovialis tendinis musculi flexoris carpi radialis

Canalis carpi ulnaris
* Beneath retinaculum musculorum flexorum
* Medially from canalis carpi
Through it runs
- Nervus ulnaris
- Arteria ulnaris
- Venae ulnares )

Question 55

55. Retinaculum musculorum flexorum manus (channels)

Answer 55

3 canals beneath retinaculum musculorum flexorum:

Canalis carpi
* Between the middle part of retinaculum musculorum flexorum and sulcus carpi

Through it runs
- m. flexor digitorum superficialis → vagina synovialis communis tendinum musculorum flexorum
- m. flexor digitorum profundus → vagina synovialis communis tendinum musculorum flexorum
- m. flexor pollicis longus → vagina synovialis tendinis musculi flexoris pollicis
- nervus medianus

Canalis carpi radialis
* Beneath retinaculum musculorum flexorum
* Laterally from canalis carpi
Through it runs
- m. flexor carpi radialis → vagina synovialis tendinis musculi flexoris carpi radialis

Canalis carpi ulnaris
* Beneath retinaculum musculorum flexorum
* Medially from canalis carpi
Through it runs
- Nervus ulnaris
- Arteria ulnaris
- Venae ulnares

Question 56

56. Retinaculum musculorum extensorum manus (channels)

Answer 56

6 canals beneath retinaculum musculorum extensorum. Tendons of following muscles runs through them:
- m. abductor pollicis longus and m. extensor pollicis brevis
- m. extensor carpi radialis longus and m. extensor carpi radialis brevis
- m. extensor pollicis longus
- m. extensor digitorum and - - m. extensor indicis
- m. extensor digiti minimi
- m. extensor carpi ulnaris

Question 57

57. Vaginae synoviales palmares manus

Answer 57

• The synovial sheats (6 on the palmar side and 6 on the dorsal side) are formed around the tendons of the forearm muscles.

Palmar side
From radius towards ulna:
Vagina synovialis tendinis m. flexoris carpi radialis
vagina synovialis tendinis m. flexoris pollicis longi
vagina synovialis communis tendinum musculorum flexorum (m. flexor digitorum superficialis/profundus)
3 vagina synoviales digitorum manus (II, III, IV)

Question 58

58. Vaginae synoviales dorsales manus

Answer 58

Dorsal side
1. Vagina synovialis tendinum musculorum abductor pollicis longi et extensor pollicis brevis
2. vagina synovialis tendinum musculorum extensor carpi radialis longi et brevis
3. vagina synovialis tendinis m. extesoris pollicis longi
4. vagina synovialis tendinum m. extensoris digitorum et extensoris indicis
5. vagina synovialis tendinis m. extensoris digiti minimi
6. vagina synovialis tendinis m. extensoris carpi ulnaris

Question 59

59. Mm. cinquli membri inferioris

Answer 59

ANTERIOR GROUP

Musculus iliopsoas consists of two muscles with same insertion
and function
1) Musculus iliacus
O. fossa iliaca
2) Musculus psoas major (upper part is covered by lig.
arcuatum mediale and the muscle passes through lacuna
musculorum)
O. vertebrae lumbales (I-IV)
I. trochanter minor
F. flexio et rotatio externa femoris

Musculus psoas minor
O. vertebra thoracica XII
vertebra lumbalis I
I. eminentia iliopubica
F. flexio trunci

POSTERIOR GROUP

Musculus gluteus maximus
O. fascia glutea behind linea glutea posterior
facies dorsalis ossis sacri et ossis coccyges
ligamentum sacrotuberale
fascia thoracolumbalis
I. tuberositas glutea
tractus iliotibialis
F. extensio et rotatio externa femoris

Musculus gluteus medius (below m. gluteus maximus)
O. facies glutea between linea glutea anterior et posterior
I. trochanter major
F. abductio femoris
rotatio interna femoris (anterior fibers)
rotatio externa femoris (posterior fibers)

Musculus gluteus minimus (below m. gluteus
medius)
O. facies glutea between linea glutea anterior
et inferior
I. trochanter major
F. abductio femoris
rotatio interna femoris (anterior fibers)
rotatio externa femoris (posterior fibers)

Musculus tensor fasciae latae
O. spina iliaca anterior superior
I. tractus iliotibialis
F. stretch fascia lata
flexio femoris

Musculus piriformis (originates in pelvis minor and goes through foramen ischiadicum
majus)

O. facies pelvina ossis sacri
laterally from II – IV foramina sacralia pelvina
i. Fossa trochanterica
F. abductio et rotatio externa femoris

Musculus obturatorius internus (Originates in pelvis minor and
goes through foramen ischiadicum minus. Distal tendon passes
between m. gemellus superior et inferior.)

O. facies interna membranae obturatoriae
I. fossa trochanterica
F. rotatio externa femoris

Musculus obturatorius externus (Covered by m. pectineus and m.
adductor longus.)

O. facies externa membranae obturatoriae
I. fossa trochanterica
F. rotatio externa femoris
Visible in the front when m. pectineus is removed.

Musculus gemellus superior
O. spina ischiadica
I. fossa trochanterica
F. rotatio externa femoris

Musculus gemellus inferior
O. tuber ischiadicum
I. fossa trochanterica
F. rotatio externa femoris

Musculus quadratus femoris
O. tuber ischiadicum
I. crista intertrochanterica
F. rotatio externa femoris

Question 60

60. Mm. femoris (anterior group)

Answer 60

ANTERIOR GROUP
Musculus quadriceps femoris (consists
four parts with different origos but form
same tendon lig. patellae)

1) Musculus rectus femoris
O. spina iliaca anterior inferior
2) Musculus vastus medialis
O. labium mediale lineae asperae
3) Musculus vastus lateralis
O. labium laterale lineae asperae
4) Musculus vastus intermedius
O. facies anterior femoris

I. tuberositas tibiae
F. extensio cruris
flexio femoris (m. rectus femoris)

Musculus Sartorius (The longest muscle. Its tendon forms pes anserinus
superficialis together with m. gracilis and m. semitendinosus.)

O. spina iliaca anterior superior
I. tuberositas tibiae
F. flexio femoris
flexio cruris
rotatio externa femoris
rotatio interna cruris

→ fascia lata thickening is tractus iliotibialis (used for intramuscular injections)
→ on the upper lateral quadrant is nervus ischiadicus (= biggest nerve in the body)

Question 61

61. Mm. femoris (medial group)

Answer 61

Musculus pectineus
O. pecten ossis pubis
ramus superior ossis pubis
I. linea pectinea femoris
F. flexio, adductio et rotatio externa femoris
Makes medial wall of canalis femoralis.

Musculus adductor brevis
O. ramus inferior ossis pubis
I. labium mediale lineae asperae – upper third
F. flexio, adductio et rotatio externa femoris

Musculus adductor longus
O. ramus superior ossis pubis
I. labium mediale lineae asperae – middle third
F. flexio, adductio et rotatio externa femoris

Musculus adductor magnus
O. ramus inferior ossis pubis
ramus ossis ischii
tuber ischiadicum
I. along the length of labium mediale lineae asperae
epicondylus medialis femoris
F. adductio et rotatio externa femoris (anterior fibers)
rotatio interna et extensio femoris (posterior fibers)

Musculus gracilis
O. ramus inferior ossis pubis
I. tuberositas tibiae
F. adductio femoris
flexio et rotatio interna cruris

Question 62

62. Mm. femoris (posterior group)

Answer 62

Musculus semitendinosus
O. tuber ischiadicum
I. tuberositas tibiae
F. extensio femoris
flexio et rotatio interna cruris

Musculus semimembranosus
O. tuber ischiadicum
I. condylus medialis tibiae
F. extensio femoris
flexio et rotatio interna cruris

Musculus biceps femoris (caput longum et caput breve)
O. tuber ischiadicum – caput longum
labium laterale lineae asperae – caput breve
I. caput fibulae
F. flexio et rotatio externa cruris
extensio femoris – caput longum

Question 63

63. Mm cruris (anterior and lateral group)

Answer 63

ANTERIOR GROUP (only extensor muscles)

Musculus tibialis anterior
O. Condylus lateralis et facies lateralis tibiae
membrana interossea cruris
I. basis ossis metatarsi primi
os cuneiforme mediale
F. extensio, supinatio cum adductio pedis

Musculus extensor digitorum longus
O. condylus lateralis tibiae
fibula
membrana interossea cruris
I. phalanges distales digitorum II – V
F. extensio pedis et digitorum

Musculus extensor hallucis longus
O. fibula
membrana interossea cruris
I. phalanx distalis hallucis
F. extensio hallucis
extensio, (supinatio cum adductio pedis)

LATERAL GROUP

Musculus peroneus longus → behind malleolus lateralis
O. fibula
membrana interossea cruris
septum intermuscular cruris posterius
I. basis ossis metatarsi primi
os cuneiforme mediale
F. flexio, abductio et pronatio pedis

Tendon in 4th layer

Musculus peroneus brevis
O. fibula
septa intermuscularia
I. basis ossis metatarsi V
F. flexio, abductio et pronatio pedis

Question 64

64. Mm cruris (posterior group)

Answer 64

Musculus triceps surae (consists of two muscles) → forms akiles tendon, strongest one in the body

1) Musculus gastrocnemius (superficial)
O. condylus medialis femoris – caput mediale
condylus lateralis femoris – caput laterale

2) Musculus soleus (deep)
O. linea musculi solei
caput fibulae
arcus tendineus musculi solei (connective tissue
above linea m. solei)
I. tuber calcanei
F. flexio, supinatio et adductio pedis
flexio cruris (m. gastrocnemius)

Musculus plantaris → super fine tendon next to akilles
O. condylus lateralis femoris
I. attach to the tendon of triceps surae
F. flexio pedis
flexio cruris

Musculus popliteus
O. condylus lateralis femoris
I. facies posterior tibiae above linea musculi
solei
F. flexio et rotatio Externa (!) (Janne’s book says interna) cruris

Musculus tibialis posterior → closest one to malleolus medialis, behind it
O. facies posterior tibiae et fibulae
membrana interossea cruris
I. os naviculare
ossa cuneiformia
F. flexio, supinatio cum adductio pedis

Tendon in 4th layer

Musculus flexor digitorum longus → 2nd closest to malleolus medialis behind it
O. facies posterior tibiae
membrana interossea cruris
I. phalanx media et distalis digitorum II – V
F. flexio pedis
flexio phalangis distalis
mediae et proximalis digiti
Tendon in 2nd layer

Musculus flexor hallucis longus → behind akilles tendon
O. fibula
membrana interossea cruris
I. phalanx distalis hallucis
F. flexio hallucis
flexio, supinatio et adductio pedis
In 2nd layer

Question 65

65. Mm. pedis: dorsales et plantares

Answer 65

MUSCLES OF THE DORSUM OF THE FOOT
Only 1st and 2nd layers are visible

Musculus extensor digitorum brevis
(O. calcaneus
I. attaches to the tendon of m. extensor digitorum longus
that passes to the II, III, IV digitis)
F. extensio digitorum
1st layer

Musculus extensor hallucis brevis
(O. calcaneus
I. attaches to the tendon of m. extensor hallucis longus)
F. extensio hallucis

MUSCLES OF THE SOLE/PLANTAR OF THE FOOT
MUSCULI HALLUCIS

Musculus abductor hallucis
(O. tuber calcanei
I. basis phalangis proximalis hallucis)
F. abductio hallucis

Musculus flexor hallucis brevis
(O. os cuneiforme mediale
lig. plantare longum
I. basis phalangis proximalis hallucis)
F. flexio hallucis
3rd layer

Musculus adductor hallucis (two heads: caput obliquum and caput
transversum)
(O. caput obliquum - os cuboideum
os cuneiforme laterale
basis ossis metatarsalis II, III
lig. plantare longum
caput transversum - capsulae artt. metatarsophalangeae II – V
I. basis phalangis proximalis hallucis)
F. adductio hallucis
3rd layer

MUSCULI DIGITI MINIMI
Musculus abductor digiti minimi
(O. tuber calcanei lateral side
basis ossis metatarsalis V
I. basis phalangis proximalis digiti minimi)
F. abductio digiti minimi

1st layer

Musculus flexor digiti minimi brevis
(O. basis ossis metatarsi V
lig. plantare longum
I. basis phalangis proximalis digiti minimi)
F. flexio digiti minimi

3rd layer

Musculus opponens digiti minimi
(O. basis ossis metatarsi V
lig. plantare longum
I. facies lateralis ossis metatarsi V)
F. adductio et oppositio digiti minimi

MUSCLES IN THE CENTER OF THE SOLE/PLANTAR OF THE FOOT
Musculus flexor digitorum brevis
O. tuber calcanei
aponeurosis plantaris
I. basis phalangis mediae II – V
F. flexio phalangis mediae et phalangis proximalis

1st layer

Musculus quadratus plantae
O. tuber calcanei
I. attach to the tendons of m. flexor digitorum longus
F. flexio digitorum

2nd layer

Musculi lumbricales (4)
O. tendon of m. flexor digitorum longus
I. phalangis proximalis digitorum II – V
tendons of musculi extensor digitorum
F. flexio phalangis proximalis
extensio phalangis mediae et distalis
2nd layer

Musculi interossei dorsales (4)
O. ossa metatarsalia I – V opposite surfaces
I. phalanx proximalis II, III, IV
F. abductio digitorum

4th layer

Musculi interossei plantares (3)
O. ossa metatarsalia III, IV, V medial side
I. phalanx proximalis III, IV, V medial side
F. adductio digitorum

4th layer

Question 66

66. Fasciae cinquli membri inferioris

Answer 66

Fascia iliaca
* Covers m. iliopsoas.
* A part of fascia subperitonealis.
* Attached to os coxae
* Form osteofibrosus sheat for the muscle.
* Continues downwards below lig. Inguinale and forms arcus iliopectineus

Fascia obturatoria
* Covers m. obturatorius internus from the inner side
* Attached to os coxae
* Forms osteofibrosus sheat for the muscle.

Fascia glutea
Two layers:
o Lamina superficialis
o Lamina profunda

→ Lamina superficialis covers m. gluteus maximus
o Continues downwards to fascia lata

→ Lamina profunda seperates m. gluteus maximus
from the deep muscles
o Forms the fibrous sheat (vagina fibrosa) for m. gluteus
maximus
o Forms the osteofibrous sheat (vagina osteofibrosa) for the
deep muscles
For m. gluteus medius
- M. gluteus minimus
- M. piriformis
- M. gemellus superior
- M. gemellus inferior
- M. obturatorius internus
- M. quadratus femoris

Question 67

67. Fascia lata

Answer 67

• Embraces all muscles of femur
• Continues downwards anteriorly as fascia cruris, downwards posteriorly as fascia poplitea
• Makes thickening tractus iliotibialis
  Attach condylus lateralis tibiae
• 3 intermuscular septa:

1. Septum intermusculare femoris mediale
   - Attaches labium mediale lineae asperae
   - Seperates anterior and medial muscles of femur
2. Septum intermusculare femoris laterale
   - Attaches labium laterale lineae asperae
   - Seperates anterior and posterior muscles of femur
3. Septum intermusculare femoris posterius
   - Attaches labium mediale lineae asperae
   - Seperates medial and posterior muscles of femur

• In trigonum femorale fascia lata forms lamina profunda s. fascia iliopectinea
• Forms the floor of fossa iliopectinea
• Fuses superficial layer of fascia lata and forms vagina fibrosa
• Forms fibrous sheat for
• M. sartorius
• M. gracilis
• M. tensor fasciae latae
• In total fascia lata forms 3 osteofibrous and 4 fibrous sheat

Vaginae osteofibrosae femoris
1. Vagina osteofibrosa anterior
a. M. quadriceps femoris
2. Vagina osteofibrosa medialis
a. M. pectineus
b. M. adductor longus
c. M. adductor brevis
d. M. adductor magnus
3. Vagina osteofibrosa posterior
a. M. biceps femoris
b. M. semimembranosus
c. M. semitendinosus

Vagina fibrosae femoris
For the following structures:
- M. sartorius
- M. gracialis
- M. tensor fasciae lata
- A. et V. femoralis

Question 68

68. Fascia cruris

Answer 68

• Surrounds the muscles of the lower leg.
• Fuses with margo anterior tibia.
• Protects 2 intermuscular septa.

1. Septum intermusculare cruris anterius
   - Seperates anterior and lateral group of lower leg muscles
2. Septum intermusculare posterius
   - Seperates posterior and lateral group of lower leg muscles

• Gives off lamina profunda which seperates m. triceps surae from other posterior group muscles of lower leg

3 osteofibrous and 1 fibrous sheat:

Vaginae osteofibrosae
1. Vagina osteofibrosa anterior (muscles of the anterior group / extensor)
a. M. tibialis anterior
b. M. extensor digitorum longus
c. M. extensor hallucis longus
2. Vagina osteofibrosa lateralis (muscles of the lateral group / peroneal)
a. M. peroneus longus
b. M. peroneus brevis
3. Vagina osteofibrosa posterior (muscles of the posterior group / flexor)
a. M. popliteus
b. M. tibialis posterior
c. M. flexor digitorum longus
d. M. flexor hallucis longus

Vagina fibrosa
* Surrounds m. triceps surae et m. plantaris
* In fascia cruris forms 5 retinacula
- Channels for the tendons of the muscles of the lower leg are placed below retinacula

Question 69

69. Fascia pedis

Answer 69

Lisää extensorum crurikset yms. * Divided into fascia dorsalis pedis and fascia plantaris
pedis

Fascia dorsalis pedis
* Covers the muscles of the dorsum on the foot
* Gives off lamina profunda, which lined mm. interossei dorsales and form the osteofibrous sheats for them (4 osteofibrous sheats)

Fascia plantaris pedis
* Covers muscles of the sole of the foot
* Forms aponeurosis plantaris
* 2 septa project from the aponeurosis to metatarsal bones
- Septum intermusculare mediale
1. Attach to II metatarsal bone
- Septum intermusculare laterale
1. Attach to V metatarsal bone
* Lamina profunda is lined mm. interossei plantares

4 fibrous sheats

Vagina fibrosa dorsalis, which surrounds:
1. Tendines mm. extensorum cruris
2. M. extesorum digitorum brevis
3. M. extensor hallucis brevis

Vagina fibrosa plantaris medialis, which surrounds:
1. M. abuctor hallucis
2. M. flexor hallucis brevis
3. M. adductor hallucis
4. Tendo m. flexoris hallucis longi

Vagina fibrosa plantaris lateralis, which surrounds
1. M. abductor digiti minimi
2. M. flexor digiti minimi brevis
3. M. opponens digiti minimi

Vagina fibrosa plantaris media, which surrounds
1. M. flexor digitorum brevis
2. M. quadratus plantae
3. Mm. lumbricales
4. Tendinea m. flexoris digitorum longi

• Vaginae osteofibrosa pedis is formed between: Lamina profunda fascia dorsalis pedis et fascia plantaris pedis and ossa metatarsalia
• Placed in Vaginae osteofibrosa pedis:
  – Mm. interossei dorsales,
  – Mm. interossei plantares (4 osteofibrous sheats)

Question 70

70. Pelvis topography

Answer 70

Foramen suprapiriforme
* Posterior side of the gluteal region above m. piriformis.
Upper margin: os ischium
Lower margin: m. piriformis (upper margin)
Nervus, arteria and vena glutea superior pass through it.

Foramen infrapiriforme
* Below m. piriformis. Larger than foramen suprapiriforme.
Upper margin: m. piriformis (lower margin)
Lower margin: os ischium
Nervi pass throught it.

Foramen ischiadicum minus
Surrounded by:
Ligamentum sacrotuberale
Ligamentum sacrospinale
Incisura ishiadica minor
* m. obturatorius internus goes throught this.
* m. piriformis goes through foramen ischiadicum
majus

Canalis obturatorius

2-3cm long which unites the pelvic cavity and the anterior
region of femur.

Margo superior:
- Ramus superior ossis pubis
- Sulcus obturatorius
Margo inferior:
- Membrana obturatoria
- M. obturatorius internus
- M. obturatorius externus
Nervus, arteria and venae obturatorius pass through it.

Lacuna vasorum
* Medial part of the thickening of the fascia iliaca (arcus iliopectineus).
Surrounded anteriorly and upwards:
- Ligamentum inguinale
Surrounded posteriorly and downwards:
- Ligamentum pectineale
- Pecten ossis pubis
- Ramus superior ossis pubis
Surrounded medially by:
- Ligamentum lacunare
Surrounded laterally by:
- Arcus iliopectineus
* Arteria, nervus and vena pass through it.

Anulus femoralis (at the medial third) is closed by:
- septum femorale
- nodus lymhoideus inguinalis profundus Pirigovi

margo anterior – lig. inguinale
margo posterior – lig. pectineale
margo medialis – lig. lacunare
margo lateralis – v. femoralis

Lacuna musculorum
* Lateral part of the thickening of the fascia iliaca
(arcus iliopectineus).
Surrounded anteriorly and upwards by:
- Ligamentum inguinale
Surrounded medially by:
- Arcus iliopectineus
Surrounded laterally by:
- Ala osiisi lii
* M. iliopsoas and nervi pass through it.

Question 71

71. Femur topography

Answer 71

Trigonum femorale
* Triangular depression on the anterior surface of the femur.

Margo superior:
- Lig. inguinale

Margo medialis:
- M. adductor longus

Margo lateralis:
M. sartorius
Basement:
- M. iliopsoas
- M. pectineus
–> Sulcus iliopectineus s. fossa iliopectina is a groove between these muscles.

• Vena, arteria and nervus femoralis pass through it.
• Hiatus saphenus is in the medial corer. Fascia lata is perforated (rei’itetty) → fascia cribrosa.
• Venae, nervus pass through fascia cribrosa. Possible site of hernification.
• Sulcus femoralis anterior passes downwards from trigonum femorale.
  → M. sartoroius covers the groove.
• Arteria and nervi pass into sulcus femoralis anterior

Margo medialis (sulcus):
- Mm. adductor longus et magnus
Margo lateralis (sulcus):
- M. vastus medialis
→ These structures continue into canalis
adductorius

Canalis adductorius
7cm long and surrounded by:
Paries medialis
- M. adductor magnus
Paries lateralis
- M. vastus medialis
Paries anterior
- Lamina vastoadductoria (part of fascia lata)
Nervus, arteria, vena pass through it.

Question 72

72. Crus et pes topography

Answer 72

Fossa poplitea
* Rhomboidal shape on the posterior surface of the knee joint.
Margo superior medialis:
- M. semimembranosus
- M. semitendinosus
Margo superior lateralis:
- M. biceps femoris
Margo inferior medialis:
- M. gastrocnemii (caput mediale)
Margo inferior laterale:
- M. gastrocnemii (caput laterale)
Basement:
- Facies poplitea femoris
- Capsula articularis
- M. popliteus, M. anconeus

• Dorsally fossa poplitea covers fascia poplitea.
  –> There is fat tissue – corpusadiposum popliteum

2 grooves in fossa poplitea:
Sulcus popliteus medialis between:
- M. semimembranosus
- M. gastrocnemii (caput mediale)

Sulcus popliteus lateralis between:
- M. biceps femoris
- M. gastrocnemii (caput laterale)

At the upper part of fossa poplitea there is canalis adductorius.
At the lower part of fossa poplitea there is canalis cruropopliteus.
Nodi lymphoidi poplitei, nervus, vena, atreria poplitea is in the fossa poplitea.

Canalis cruropopliteus
* Posterior region of the lower leg.

Paries anterior:
- M. tibialis posterior
- M. flexor digitorum longus
Paries posterior:
- M. soleus
→ Nervus, arteria, venae tibialis posterior et anterior are into it.

Canalis musculoperoneus superior
* Below caput fibulae.

Paries medialis:
- Fibula
Paries lateralis:
- M. peroneus longus
→ N. peroneus pass through it.

( Canalis musculoperoneus inferior
* From the lower part of canalis cruropopliteus.

Paries anterior:
- Fibula

Paries posterior:
- M. tibialis posterior
- M. flexor hallucis longus
→ Arteria and venae peroneae pass through it.)

Topographical formations of the foot

Sulcus plantaris medialis
* Between the musculi hallucis and musculi sole/plantar
(central group)
Paries medialis:
- M. abductor hallucis
Paries lateralis:
- M. flexor digitorum brevis
→ Arterie, nervus and venae plantaris medialis pass through it.

Sulcus plantaris lateralis
* Between musculi digiti minimi and musculi sole/plantar (central group)

Paries medialis:
- M. flexor digitorum brevis
Paries lateralis:
- M. abductor digiti minimi
→ Arterie, nervus and venae plantaris lateralis pass through it.

Question 73

73. Retinaculum musculorum extensorum superius et inferius

Answer 73

Retinaculum musculorum extensorum superius
* In the anteior region of the ankle region between fibula and tibia
* One channel below it
Tendons of muscles of the anterior group (extensors) of the lower leg

Retinaculum musculorum extensorum inferius
* Below retinaculum musculorum extensorum superius
* In front of art. Talocruralis

4 osteofibrous canals
1. M. tibialis anterior
2. M. extensor hallucis longus
3. Aorta, vena, nervus
4. M. extensor digitorum longus

Question 74

74. Retinaculum musculorum flexorum pedis

Answer 74

• Behind malleolus medialis

4 osteofibrous canals
1. M. tibialis posterior
2. M. flexor digitorum longus
3. Aorta, vena, nervus
4. M. flexor hallucis longus

Question 75

75. Retinaculum musculorum peroneorum superius et inferius

Answer 75

Retinaculum musculorum peroneorum superius
* behind malleolus lateralis

1 osteofibrous canal
1. M. peroneus longus et brevis

Retinaculum musculorum peroneorum inferius
* Below Retinaculum musculorum peroneorum superius

2 osteofibrous canals
1. M. peroneus longus
2. M. peroneus brevis

Question 76

76. Vaginae synoviales dorsales pedis

Answer 76

• On the dorsum of the foot

7 tendinons sheat

Below retinaculum m. extensorum superius et inferius 3 synovial sheats
1. Vagina tendinis m. tibialis anterioris
2. Vagina tendinis m. extensoris hallucis longi
3. Vagina tendinum m. extensoris digitorum longi

Below retinaculum m. flexorum 3 synovial sheats
1. Vagina tendinis m. tibialis posterioris
2. Vagina tendinum m. flexoris digitorum longi
3. Vagina tendinis m. flexoris hallucis longi

Below retinaculum m. peroneorum superius et inferius 1 synovial sheat
1. Vagina communis tencinum m. peroneorum

Question 77

77. Vaginae synoviales plantares pedis

Answer 77

• On the sole of the foot are 6 synovial sheats

5 vaginae synoviales tendinum digitorum pedis
→ Surrounds the tendons of m. flexor digitorum brevis et longus

Vaginae tendinis m. peronei plantaris
→ Surrounds tendon of m. peroneus longus on the sole of the foot