Formative Flashcards
State the two bony surface landmarks used to locate the sciatic
nerve as it leaves pelvis through the greater sciatic foramen.
State the root values of the sciatic nerve.
posterior superior iliac spine and ischial tuberosity
L4 to S3
State two muscles of the thigh that will be paralysed due to a
complete lesion of the sciatic nerve and state the division of the
sciatic nerve which innervates them.
Hence, what principle movement at the hip will be affected?
Biceps femoris – short head (common peroneal nerve), long head
(tibial division)
Semimembranosus, semitendinosus, hamstring part of adductor
magnus (all tibial division of the sciatic nerve).
extension
Describe the blood supply to the hip in any adult and
state how this is varies in children
Medial and lateral circumflex femoral arteries which arise from
the deep femoral artery or occasionally the femoral artery
Artery to the head of the femur plus either via ligamentum teres/ ligament of the head of the femur or from obturator artery
Latter, is more functional in children or diminishes with
age
Give one specific anatomical finding in congenital dislocation of the
hip (developmental dysplasia of the hip).
Femoral head or acetabular dysplasia.
A Colles’ fracture gives rise to a typical “dinner fork” deformity, as a
result of a transverse radial fracture just proximal to the radio-carpal
joint. State two structural deformities (osteological/radiological)
features seen in this fracture.
Posterior displacement and tilt of the distal segment of the radius
Or
radial angulation of wrist
radial shortening
Explain one reason why an elderly lady is at particular risk of bone
fracture.
Bone mass slowly reduces in any adult after the mid 30s
Note: elderly men get osteoporosis also, but this
occurs at a slower rate than in females.
Or
Osteoporosis occurs more rapidly in women due to loss of oestrogen after menopause
Where would you physically test (list the anatomical landmarks) for
suspected injury of the scaphoid bone
Boundaries and base of the “anatomical snuff box”:
Anteriorly – Tendons of extensor pollicis brevis
- Tendon of abductor pollicis longus
Posteriorly – Tendon of extensor pollicis longus
Fracture of the scaphoid bone could lead to a common serious
defect in the hand.
(i) Name this defect and where in the bone does it occur?
(ii) Explain how this defect (named in i) usually occurs?
i. Avascular necrosis of the proximal segment of the
scaphoid.
ii. Blood supply to the bone comes from the distal to the
proximal side.
or blood supply enters bone distally and so proximal
segment of bone loses blood supply
or blood supply from radial artery is disrupted to proximal
segment
List some short or long term complications that may result following a
Colles’ fracture.
- Malunion with angulation
- Shortening of the radius
- Oedema
- Stiffness
- Carpal tunnel syndrome
A runner complains of “a pulled hamstring muscle”.
Which extensor of the thigh has dual innervation from the sciatic nerve and obturator nerve? A Adductor magnus B Biceps femoris C Gluteus maximus D Semimembranosus E Semitendinosus
A
A rugby player incurs a knee injury
Which knee structures are typically involved the “unhappy triad” or “blown knee” injury?
A anterior and posterior cruciate ligament, medial meniscus
B anterior cruciate ligament, medial and lateral collateral ligaments
C anterior cruciate ligament, medial collateral ligament, medial meniscus
D posterior cruciate ligament Lateral collateral ligament, lateral meniscus,
E posterior cruciate ligament, medial collateral ligament, medical meniscus
C
A patient in A+E has been in a road traffic collision, in which her knee hit the dashboard and her femur was pushed posteriorly.
Consider the impact in this injury.
It is more dangerous for the patient to have their femur abducted
than adducted at the time of impact.
Explain why?
Head of femur pushed into and breaking posterior acetabulum (1).
Or Pelvic bone fragments have the potential to cause serious damage to
bladder, bowel etc
