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Gross Anatomy > Final Exam > Flashcards

Final Exam Flashcards

1
Q

Hip joint

A

This joint forms the connection between the lower extremity and the pelvis

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2
Q

Less; more

A

The hip joint is (more;less) moveable than the shoulder joint but is (more;less) stable

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3
Q

Inflammatory and degenerative diseases

A

What is the hip joint susceptible to?

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4
Q

The articulating surfaces of the hip joint

A
  1. ) the articulating surface of the acetabulum is horseshoe shaped and is deficient inferiorly at the acetabular notch
  2. ) the cavity of the acetabulum is deepened by the presence of the acetabular labrum, which increases the depth of the articulation by about 10%
  3. ) the part of the acetabular labrum which bridges the notch is known as the transverse acetabular ligament
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5
Q

Ball and socket

A

What is the hip joint classified as?

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6
Q

Capsular

A

The strong, fairly loose ______ _______ permits free movement at the joint but cannot maintain the integrity of the joint without reinforcing ligaments.

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7
Q

Iliofemoral

A
  • A very strong ligament which reinforces the capsular ligament anteriorly and inferiorly
  • strongest ligament in the body

Extrinsic
Rope

Nerve supply: femoral, obturator and sciatic nerves

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8
Q

Pubofemoral

A
  • reinforces the capsule anterior and inferiorly
  • attaches from the superior ramus of the pubis to the intertrochanteric line
  • prevents abduction
  • extrinsic
  • rope
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9
Q

Ischiofemoral

A
  • Reinforces the capsule posteriorly
  • runs from the body of the ischium to the neck of the greater trochanter of the femur
  • prevents hyperextension and abduction
  • extrinsic
  • rope
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10
Q

Transverse Acetabular ligament

A
  • intrinsic
  • formed by the acetabular labrum as its bridges the acetabular notch
  • the ligament converts the notch into a tunnel, through which blood vessels and nerves enter the joint
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11
Q

Capitis Femoris Ligament (ligament of the head of the femur)

A
  • weak intrinsic
  • function mainly to conduct a blood vessel to the head of the femur
  • it is of little importance in strengthening the joint
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12
Q

Movement of the hip joint

A
  • when the leg is flexed at the knee joint, flexion at the hip joint is limited by the anterior surface of the thigh coming into contact with the anterior abdominal wall
  • leg is extended at the knee joint, flexion at the hip is limited by the tendons of the hamstring muscles
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13
Q

Development Dysplasia (congenital dislocation)

A

Used to describe an ongoing process with is variable in its manifestations and not always detectable at brith. Hips can be found normal at brith and can be abnormal later in life

-more common if females

If not corrected this can occur:

  • pain
  • abnormal gait
  • unequal leg length
  • osteoarthritis
  • twisting of the femur (femoral anteversion = knee turned medially)
  • contracture of the hip muscle
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14
Q

Traumatic dislocations

A

This is rare because the articulation is so strong and stable however dislocation may occur during trauma

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15
Q

Posterior dislocation

A

This dislocation is the most common which allows the femoral head to pass through a tear in the capsular ligament and over the acetabulum, ending up on the ilium; These types of dislocations comprise the sciatic nerve

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16
Q

Anterior dislocation

A

This dislocation allows the head of the femur to end up in the obturator foramen; these types of dislocations may comprise the obturator nerve

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17
Q
  • femur
  • tibia
  • patella

*NOT the FIBULA

A

What bones form the articulation of the knee joint?

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18
Q

Three separate joints that become the knee joint

A
  1. ) between the patella and femur
  2. ) between the lateral condyles of the femur and tibia
  3. ) between the medial condyles of the femur and tibia
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19
Q

Lateral and medial tibial plateaus

A

The articulating surfaces of the tibial condyles are often referred to as _______ _______.

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20
Q

Ginglymus (hinge)

A

What is the knee joint classified as?

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21
Q
  • femoral nerve
  • obturator nerve
  • common fibular nerve
  • tibial nerve
A

What is the nerve supply of the knee joint?

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22
Q

Capsular ligament

A

Forms a loose fibrous investment of the knee joint, completely surrounding it. There are a few openings found in the anterior aspect of the ______ ______, which allows the synovial membrane to pass through and form several bursae which are significant

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23
Q

Subcutaneous prepatellar

A

This bursae lies between the patella and the skin

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24
Q

Subcutaneous infrapatellear bursae

A

This bursae lies between the tibial tubercle and the skin

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25
Q

Deep infrapatellar bursae

A

This bursae is found between the ligamentum patella and the tibial tubercle

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26
Q

Suprapatellar bursae

A

This bursae lies between the femur and the common tendon of insertion of the quadriceps (base of the patella)

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27
Q

Ligamentum Patella

A

This is an anterior ligament of the knee joint and represents the original distal common tendon of insertion of the quadriceps

Runs from the apex of the patella to the tibial tubercle

Important role in maintaining the alignment of the patella

Extrinsic

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28
Q

Collateral ligaments

A

These ligaments (lateral and medial collateral) are taut when the knee joint is fully extended and thus contribute to stability when standing

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29
Q

Lateral (fibular) collateral ligament

A

Located on the lateral side of the knee joint

Attaches from the lateral epicondyle of the femur (proximally) to the head of the fibula (distally)

Function:

  • wall
  • extrinsic
  • prevent lateral movement
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30
Q

Medial (tibial) collateral ligament

A

Located on the medial side of the knee joint

Attaches to the medial epicondyle of the femur (proximally) and to the medial side of the tibia just below the medial condyle (distally)

Function:

  • wall
  • extrinsic
  • prevents medial movement
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31
Q

Oblique and accurate popliteal ligaments

A

Found on the posterior aspect of the knee joint

Function:

  • wall
  • extrinsic
  • prevent hyperextension
  • stabilize the posterior aspect of the joint
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32
Q

Cruciate ligaments (ACL, PCL)

A

2 Very strong ligaments which cross each other like and “X” in the center of the joint

They are named according to their tibial attachments

They are the main bonds between the femur and tibia*****

-intrinsic

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33
Q

Anterior cruciate ligament (ACL)

A

The weaker of the 2 and runs from the lateral condyle of the femur (proximally) to the anterior intercondylar area of the tibia (distally)

Function:

  • prevents antihero displacement of the tibia under the femur
  • rope
  • intrinsic
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34
Q

Posterior Cruciate ligaments (PCL)

A

Stronger of the 2 and runs from the medial condyle of the femur (proximally) to the posterior intercondylar area of the tibia (distally)

Function:

  • prevents posterior displacement of the tibia under the femur
  • rope
  • intrinsic
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35
Q

Menisci or semilunar cartilages

A

the ______ have a well developed blood supply from the time of birth until about 18 months of age. ONCE infant begins to walk they loose 75% of their vascular supply.

Nutrition of the _____ is from the synovial fluid for the central portion of the _____.

Functions:

  • deepen the articulating surface
  • shock absorber
  • mechanoreceptor to increase positional sense of the knee joint
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36
Q

Medial meniscus

A

Is “C” shaped and firmly adheres to the tibial collateral ligament

It’s less mobile on the surface of the tibia

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37
Q

Lateral Meniscus

A

Nearly circular in shape and smaller than the medial meniscus

More freely moveable on the surface of the tibia

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38
Q

Coronary ligaments

A

Associated with the menisci

Are a portion of the joint capsular ligament which attaches to the edge of the menisci and helps to hold them in place

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39
Q

Transverse ligament

A

Joins the anterior edges fo the medial and lateral menisci and allows them to work together

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40
Q

Flexion and extension

A

What are the main movements of the knee joint?

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41
Q

Popliteus muscle

A

To unlock the knee the ______ ______ must contract to rotate the tibia medially and thus cause flexion at the knee joint

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42
Q

Prepatellar (housemaid’s) bursitis

A

Caused by friction between the skin and the patella

May also occur from a direct blow or falling on a flexed knee

If chronic, the bursae will become distended with fluid and form a swelling anterior to the knee

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43
Q

Subcutaneous infrapatellar bursitis

A

Caused by excessive friction between the skin and tibial tubercle

Also known as “clergyman’s knee”

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44
Q

Suprapatellar Bursitis

A

Caused by bacteria from an abrasion or penetrating wound

Infection may spread to the knee joint cavity

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45
Q

Ligament sprains

A

Very common especially when the foot is fixed on the ground

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46
Q

Unhappy triad

A

Refers to a blow to the lateral aspect of the joint while it is in weight bearing that can cause damage to the medial collateral (MCL), anterior cruciate (ACL), and medial meniscus

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47
Q

Damage to the medial collateral ligament (MCL)

A

Most commonly injured ligament of the knee joint

Occurs from a lateral blow and rotational forces during trauma

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48
Q

Damage to medial meniscus

A

More vulnerable to injury than the lateral meniscus

Patients will complain of their knee “clicking”, locking up, pain when going up stairs

Larger tears need surgery

Can lead to damage of the articular cartilage and osteoarthritis

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49
Q

Damage to anterior cruciate ligament (ACL)

A

Can be damaged in sports that require twisting and jumping

Patients will hear a “pop” and a sensation that their knee has “given out”

This type of injury will produce a condition in which the tibia can be pulled excessively forward under the femur (Positive anterior drawer test)

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50
Q

Damage to the posterior cruciate ligament (PCL)

A

Is injured much less commonly than the ACL

This type of injury, the tibia can be pulled or moved excessively backward under the femur (positive posterior drawer test)

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51
Q

Tibia

A
  • weight bearing bone
  • articulates with the condyles of the femur and head of the fibula (proximally
  • articulates with the talus and distal end of the fibula (distally)

Fibula not part of the articulation with the knee joint

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52
Q

Ossification of the Tibia

A

4 ossification centers

Primary
-shaft

Secondary

  • centers for the proximal end
  • distal end
  • tibial tuberosity/tubercle
53
Q

Osgood-Schlatter’s Disease

A

A condition in which there is disruption of the epiphyseal plate of the tibial tuberosity that occurs around puberty in active adolescents

An example of what is known as apophyseal injury or a traction apophysitis

Bilateral

Avulsion fractures of the tubercle are common

54
Q

Fibula

A
  • not weight wearing bone

- articulation with the ankle joint and the proximal and distal tibiofibular joints

55
Q

Ossification of the fibula

A

3 ossification centers

Primary
-shaft

Secondary
-distal and proximal ends of the bone

56
Q

Fractures of the tibia and fibula

A

These fractures are common

These bones can act as a splint

Fractures of the medial and/or lateral malleoli can occur in contact sports

BOTH bones are good for bone grafting

57
Q

Fracture of the tibia

A

Is the commonly fractured bone of the lower extremity because of its unprotected medial aspect of the bone

Bumper fracture = direct trauma

Poor blood supply

58
Q

Fracture of the fibula

A

Usually fracture just proximal to the lateral malleolus or just distal to the head of the bone

Damage to the neck affects the common fibular nerve = paralysis of anterior and lateral leg musculature

59
Q
  • 7 tarsal bones
  • 5 metatarsals
  • 14 phalanges
A

What are the bones of the foot?

60
Q

Calcaneus (heel)

A

Largest and strongest of the tarsals

Articulates with the talus and the cuboid

61
Q

Calcaneus tuberosity

A

A large prominence on the calcaneus and allows among others for the insertion of the tendon calcaneus (Achilles tendon)

62
Q

Fibular trochlear

A

Found on the lateral side of the calcaneus and separates the tendons of the fibularis longus and brevis from each other

63
Q

Sustentaculum Tali

A

A prominent ledge of the medial aspect of the calcaneus that has articular facets associated with it

64
Q

Calcaneal sulcus

A

A deep groove on the calcaneus which separates the articular facets of the bone

65
Q

Talus (ankle)

A

The only tarsal bones that articulates with the tibia and fibula to form the ankle joint

Articulates inferiorly with the calcaneus to form the subtalar joint

Articulates anteriorly with the navicular

66
Q

Os Trigonum

A

During ossification of the talus, under certain circumstances a secondary ossification center may develop for the lateral tubercle of the bone.

This occurs when the lateral tubercle WILL NOT fuse with the bone

Common in soccer players and ballet dancers

Asymptomatic

67
Q

Navicular (Boat)

A

Found on the medial side of the foot

Projection on its medial side is the _______ tuberosity

Articulates posteriorly with the talus, anteriorly with the 3 cuneiform bones, and laterally with the cuboid

68
Q

Cuboid

A

Is situated on the lateral border of the foot

Articulates posteriorly with the calcaneus; anteriorly with the 5th metatarsal;medially with the lateral cuneiform and navicular

69
Q

Cuneiforms (wedge shaped)

A

3 small bones

Medial =largest
Second/intermediate =smallest
Third/lateral

70
Q

Fracture of the talus

A

This fracture usually occurs through the neck during sever dorsal flexion at the ankle (car accident)

Avascular necrosis happens of the head of the bone

71
Q

Fracture of the calcaneus

A

This fracture of the bone occurs from a hard fall on the tuberosity (heel)

Typically comminuted

disable or may disrupt the subtalar joint (talus and calcaneus)

72
Q

1st metatarsal

A

What is the largest and strongest metatarsal?

73
Q

2nd metatarsals

A

What is the longest metatarsal?

74
Q

5th metatarsals

A

What metatarsal has a prominent tuberosity on its base which is the attachment of the fibularis brevis and Tertius muscles?

75
Q

Crural fascia

A

The term used to designate the deep and superficial fascia of the leg

76
Q

Superior and inferior extensor retinacula

A

This binds the tendons of the anterior leg muscles and prevent the tendons from bowstringing when the foot is dorsal flexed

77
Q

Fibular Retinacula

A

Binds down the tendons of the lateral leg muscle

78
Q

Flexor retinaculum

A

Binds down the tendons of the deep posterior leg muscles

79
Q

Interosseous membrane

A

A strong ligament which connects the interosseous borders of the tibia and fibula

80
Q

Anterior tibial artery to enter the anterior compartment of the leg

A

The large opening in the upper portion of the interosseous membrane permits what?

81
Q
  1. ) serves as an attachment for muscles

2. ) Stabilizes the tibia and fibula

A

What are the 2 functions of the interosseous membrane?

82
Q

Plantar flexion

A

Is carried out when the heel is raised off the ground and the dorsum of the foot is moved away from the anterior aspect of the leg

83
Q

Dorsal flexion

A

Is carried out when the toes are raised off the ground and the dorsum of the foot and the anterior aspect of the leg are brought closer together

84
Q

Version (pronation)

A

Carried out when the lateral aspect of the foot is elevated (plantar surfaces of the foot face laterally)

85
Q

Inversion (supination)

A

Carrie donut when the medial aspect of the foot is elevated (plantar surfaces of both feet face each other)

86
Q

Arches of the foot

A
  • Medial longitudinal arch
  • lateral longitudinal arch
  • transverse arch (through metatarsals)
87
Q

Deep fibular nerve

A

What is the nerve supply of the anterior leg compartment?

88
Q

Extensor Hallucis Longus

A

What muscle is found eep to and in between the tibialis anterior and extensor digitorum longus

89
Q

Common fibular nerve

A

This is the smallest of the 2 terminal branches of the sciatic nerve

90
Q

L4, L5, S1, S2

A

What is the segmental innervation of the common fibular nerve?

91
Q
  1. ) Sural communicating- joins the sural branch of the tibial nerve and helps supply skin on the posterior aspect of the leg
  2. ) Lateral Sural cutaneous- supplies skin on the proximal lateral posterior aspect of the leg
  3. ) articular to the knee joint
A

What are the branches of the common fibular nerve?

92
Q

Common fibular nerve

A

What is the most commonly injured nerve of the lower extremity?

93
Q
  • all anterior and lateral leg muscles may be involved
  • loss of dorsal flexion of the foot causing foot drop
  • loss of eversion of the foot
  • loss of extension of the toes
  • diminished foot inversion
  • loss of sensation over the dorsum of the foot and lateral aspect of the leg
A

What are the clinical problems that might occur with the common fibular nerve?

94
Q

Deep fibular nerve

A

This is the nerve that is found in the anterior compartment of the leg and is the medial terminal branch of the common fibular nerve

95
Q

L4, L5, S1

A

What is the segmental innervation of the Deep fibular nerve?

96
Q

Anterior tibial artery

A

What does the deep fibular nerve descend with?

97
Q

The nerve terminates at the front of the ankle into a medial and lateral branch found on the dorsum of the foot

A

Where does the dee fibular nerve terminate?

98
Q

The web space between the 1st and 2nd digits

A

What is the cutaneous supply of the deep fibular nerve?

99
Q

Ski boot syndrome

A

A condition that indicates compression of the deep fibular nerve as it leaves the anterior compartment and becomes superficial at the anterior aspect of the ankle

Motor

  • loss of dorsal flexion of the foot and extension of toes
  • diminished inversion of the foot

Sensory
-loss of sensation to skin in the web space between digits 1 and 2

100
Q

Anterior tibial artery

A

Supplies structure of the antihero compartment of the leg. The vessel is the smaller branch of the popliteal artery

101
Q
  • begins at the lower portion of the popliteal fossa and passing thro an opening in the proximal portion of the interosseous membrane
  • the artery descends along the anterior aspect of the interosseous membrane
  • the vessel leaves the anterior compartment of the leg and as it become superficial and continues on the dorsum of the foot to become the dorsal pedis artery
A

What is the pathway of the anterior tibial pathway?

102
Q

Dorsal pedis artery

A

This artery is a continuation of the anterior tibial artery in the dorsum of the foot?

103
Q

Superficial fibular nerve

A

What is the nerve that supplies the lateral leg compartments?

104
Q

Fibularis longus and fibularis brevis

A

What 2 muscles are well developed and can noted why we walk slightly more everted?

105
Q

Superficial fibular nerve

A

This is the lateral terminal branch of the common fibular nerve

106
Q

L4, L5, S1

A

What is the segmental innervation of the superficial fibular nerve?

107
Q

The nerve descends along the lateral aspect of the leg between the fibularis longus and fibularis brevis and the extensor digitorum longus to the distal end of the leg

A

What is the pathway of the superficial fibular nerve?

108
Q

The skin of the distal part of the anterior leg and the dorsum of the foot (except those areas supplied by the deep fibular and sural nerves)

A

What is the cutaneous supply of the superficial fibular nerve?

109
Q

Anterior tibial artery and fibular branch of the posterior tibial artery

A

The lateral leg muscles receive their vascular supply from _____ _____ _____ and the _____ _____. The reason why it is because the lateral leg doesn’t have any blood vessels directly in the compartment.

110
Q

The calf or triceps surae

A

The gastrocnemius + soleus = ___ _____

111
Q

Gastrocnemius and soleus

A

What muscle tendons fuse together to form the prominent Achilles’ tendon or tendon calcaneus?

112
Q

Tibial nerve

A

What are the posterior legs muscles (superficial and deep) supplied by?

113
Q

Fabella

A

Is a seasmoid bone which is found imbedded in the lateral head of the origin of the gastrocnemius and articulates with the lateral condlye of the femur

114
Q

Achilles Tendonitis

A

Due to microscopic tears in the collagen fibers of the tendons, usually just proximally to the attachment on the calcaneus. This is due to repetitive activities.

Flat feet are more prone to this condition due to the fact that their foot is more hypereverted

115
Q

Rupture of the tendon calcaneus

A

Typically occurs in poorly conditioned individuals with a history of Achilles Tendonitis. Usually happens with forceful plantar flexion when the knee is extended.

116
Q

Calcaneal tendon reflex

A

S1 and S2 is the segmental innervation for this test

117
Q

Wearing high heeled shoes

A

An individual who wear high heeled shoes a lot may develop a shortening of the calf muscles

118
Q

Plantaris

A

This muscle is missing in about 5% of the population and is part of the posterior leg muscles

119
Q

Tibial nerve

A

Is the large and more medial of the 2 terminal branches of the sciatic nerve.

120
Q

It crosses the popliteal fossa, superficial to the popliteal artery and vein

In the leg the nerve descends deep to the soleus and passes behind the medial malleolus between the tendons of the flexor digitorum and flexor hallucis longus

As the nerve enters the plantar surface of the foot it divides into the medial and lateral plantar nerves

A

What is the pathway of the tibial nerve?

121
Q

L4, L5, S1, S2, S3

A

What is the segmental innervation of the tibial nerve?

122
Q

No, because of its protected position int he popliteal fossa and posterior leg

A

Is the tibial nerve commonly injured?

123
Q

Posterior dislocation

A

What type of dislocation of the knee joint causes damage to the tibial nerve?

124
Q
  • unable to flex toes
  • weakened plantar flexion
  • weakened inversion of the foot

There may be loss of sensation of the posterior aspect of the leg and plantar surface of the foot

A

If the tibial nerve is damaged what can occur?

125
Q

Posterior tibial artery

A

The larger of the 2 terminal branches fo the popliteal artery. It provides the blood supply to the posterior leg compartments and the plantar surface of the foot

126
Q
  • the vessel descends deep to the soleus with tibial nerve and passes behind the medial malleolus
  • as the vessel enters the plantar surface of the foot it divides into the medial and lateral plantar arteries
A

What is the pathway of the posterior tibial artery?

127
Q

Fibular artery

A

Is the larges and most important branch of the posterior tibial artery, it descends along the fibula and supplies the muscles of the deep posterior and lateral leg compartment, as well as giving off a nutrient branch to the fibula.

128
Q

Peripheral Arterial Disease (intermittent Claudication)

A

A condition in which there’s a narrowing or occlusion of the posterior tibial artery and/or its branches

Gross Anatomy (4 decks)

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