FPA- Musc Flashcards
What is the lamina and pedicle?
The lamina is the structure connecting the spinous process and transverse process (SLiT)
The pedicle is the structure between the vertebral body and transverse process (BeTween)
What does the foramen tranversarium allow passage to?
The vertebral arteries and veins
What type of joint is the atlanto-occipital joint and what is its action?
Condyloid synovial joint
40-50% of head flexion and extension
What type of joint is the atlanto-axial joint and what is its action?
Pivot joint around the odontoid process
50% neck rotation, very little flexion extension
What is the purpose and attachments of the alar and transverse ligaments?
Alar- limits range of neck rotation, dens-occipital bone
Transverse- stops dens breaking posteriorly and damaging vertebral cord, attaches to atlas lateral masses
What type of joint is a zygapophyseal joint and what is its purpose?
Plane joint, restricts/facilitates movement based on location e.g. thoracic will limit flexion/extension but allow rotation
Name the other name vertebral column ligaments take when close to the head?
Ligamentum flavum = posterior atlanto-occipital membrane
Supraspinous ligament = ligamentum nuchae
Anterior longitudinal ligament = Anterior atlanto-occipital membrane
Posterior longitudinal ligament = tectorial membrane
What is the function of strenocleidomastoid?
Bilateral flexion, ipsilateral lateral flexion, contralateral rotation
What is the main function of longus colli and capitus?
Maintain cervical lordosis and a segmental stabilizer
What is the main function of scalene muscles
Lateral flexion
What is the main function of the suboccipital muscles?
Assessing flexion, e.g. jolting up while sleeping
What is the general function of erector spinae and transversospinalis?
ES= primary movers
TS= stabilizers
What are the main nerve types in the dorsal and ventral rami?
V= Motor
D= Sensory and intrinsic back motor
What are the two aspects of the intervertebral disc and their functions?
Annulis fibrosis, a layer of fibrocartilage that keeps the vertebrae together for stability
Nucleus pulposis, mucoprotein gel shock absorber that keeps the vertebrae apart for mobility
What are the orientations of thoracic and lumbar zygapophyseal joints respectively?
T= Coronal, allows rotation
L= Sagittal, allows f/e
What is unique about L5 compared to typical lumbar vertebrae?
Wedge shaped
Inferior facet joint is coronally orientated to prevent slipping too far forward
Where does the spinal cord terminate and can be taken advantage of medically?
L2, lumbar spinal punctures can be performed due to the extra space
Where will intervertebral discs typically herniate and why?
Posterolaterally
Annulus fibrosis is thinner posteriorly, posterior longitudinal ligament means it goes lateral
Why is a laminectomy performed?
Increases volume and reduces pressure removing pain
What is the meaning of spondylolysis and spondyloisthesis?
Lysis= fracture of L5
Thesis= L5 moves anteriorly
What is the fiber direction for external oblique, internal oblique and transversus abdominis?
EO= Infero-medially
IO= Supero-medially
TA= Transverse
Q22
- Spinous Process
2.Inferior Facet Process - Superior Facet Process
- Pedicle
- Vertebral Body
- Epiphyseal Ring
- Vertebral Foramen
- Transverse Process
- Superior Facet Process
- Superior Vertebral Notch
- Vertebral Body
- Inferior Vertebral Notch
- Inferior Facet Process
- Spinous Process
- Transverse Process
Q23
- Articular Facets
- Facet for Dens
- Transverse Ligament
- Odontoid Process
- Facet for Dens
- Articular Facets
7/8. Superior and Inferior Articular Facets
Q24
- Costal Part of Transverse Process
- Vertebral Body
- Uncinate Process
- Tubercles
- Pedicle
- Articular Facets
- Lamina
- Bifid Process
- Vertebral Foramen
- Transverse Part of Transverse Process
- Foramen Transversarium
- Superior Articular Facet
- Foramen Transversarium
- Inferior Articular Facet
What type of joint is sternoclavicular joint?
Saddle type synovial
What type of joint is the acromioclavicular joint?
Plane synovial joint
What is the purpose of the coracoclavicular joint at the AC joint?
Prevents upward rotation of the clavicle
Where is the clavicle most often fractured?
Lateral 1/3 and Medial 2/3
What is the function of scapulo-humeral muscles?
Rotation and dynamic stabilizers, holds humeral head down during abduction to prevent grinding
How is the humerus most often dislocated
Anterior, as only tendon of subscapularis and arm pushed posteriorly acts as lever. Drops inferiorly due to gravity
What are the three purposes of scapulohumeral rhythm and what does it involve?
-Preserves length-tension relationship of rotator cuff muscles
-Prevents impingement between humerus and acromion
-Increases ROM at shoulder
Elevation of clavicle at SC joint, Scapular rotation at AC joint, Movement at GH joint, 2:1
What type of joint is both radioulnar joints?
Pivot type synovial
Which collateral ligament attaches to the anular ligament
LCL
What are the functions of the interosseous membrane?
Transmits force between radius and ulna
Increases surface area for muscle attachment
What type of joint is the wrist joint?
Condyloid joint
What are the three ligaments at the wrist to support medially?
Radioulnar, collateral, radiocarpal
What type of joint is the intercarpal joints?
Plane synovial
What kind of joints are the carpometacarpal joints and what are their movements?
Thumb saddle (F/E, Ab/Ad)
Others plane synovial
What kind of joints are metacarpophalangeal joints and what are their movements?
Thumb Hinge (F/E)
Others Condylar (F/E, Ab/Ad)
What kind of joint is the interphalangeal joints?
Hinge
What structures go under the carpal tunnel?
4 tendons each of flexor digitorum superficialis and profundus, median nerve, flexor pollicis longus
What are the boundaries of the snuffbox and what is its contents?
Extensor pollicis longus medially, extensor pollicis brevis and adductor pollicis longus laterally.
Can palpate the scaphoid and contains a branch of the radial nerve, the radial artery and the cephalic vein
What structures run superficial to the carpal tunnel?
Palmaris longus tendon, ulnar artery and nerve (through ulnar tunnel), superficial branch of radial artery, palmar cutaneous branch of median nerve
What structure runs through the flexor retinaculum?
Flexor carpi radialis
What are the 4 layers of the intrinsic muscles of the hand?
- Abductor pollicis brevis, Flexor pollicis brevis, Flexor digit minimi, Abductor digiti minimi
- 4 lumbricals
- Opponens pollicis, Adductor pollicis, Opponens digiti minimi
- Interossei muscles
What are the functions of the lumbricals at the MCP joint and IP joint?
MCP: Flex
IP: Extend
Think Lleyton Hewitt
How are the intrinsic hand muscles innervated?
Median nerve: thenar muscles, radial 2 lumbricals
Ulnar: hypothenar muscles, ulnar 2 lumbricals, adductor pollicis, interossei muscles
What does the radial and ulnar artery supply?
R: Posterolateral
U: Forearm and hand
What are the rami for the axillary nerve?
C5-6
Where does the axillary and radial nerve enter the posterior arm and what are the boundaries of these areas?
Axillary through quadrangular space, superior teres minor, inferior teres major, medial long head of triceps, lateral humeral neck
Radial nerve through triangular space, superior teres minor, inferior teres major, medial long head of triceps
Where is the axillary nerve susceptible to injury?
Shoulder dislocation and fracture of surgical neck as axillary nerve wraps around humerus
What muscles and cutaneous area does the axillary nerve supply?
Deltoid, Teres minor
Over shoulder
What are the rami that supply the radial nerve?
C5-T1
How many rami, trunks, divisions and chords are there and what are their names?
5 rami C5, 6, 7, 8 and T1
3 trunks Superior, Middle and Inferior
2 divisions Anterior and Posterior
3 Chords Medial Posterior and Lateral
What muscles and cutaneous area does the radial nerve supply?
All extensor muscles of arm and forearm
Posterior skin of arm, forearm and lateral 3 digits of back of hand
Where is the radial nerve susceptible to injury and what are the consequences?
Humeral shaft fracture because it runs against the humerus.
Compression (Saturday night palsy) unusual from deep sleep on the arm.
Wrist drop as extensors are not being supplied
What are the rami supply of the musculocutaneous nerve?
C5-6
What muscles and cutaneous area does the musculocutaneous nerve supply?
Flexors of elbow (biceps, brachialis, coracobrachialis)
Lateral aspect of forearm
What is the path of the musculocutaneous nerve?
Pierces coracobrachialis, runs between biceps and brachialis, runs along lateral forearm superficially. Usually deep, rarely injured
What rami supplies the median nerve?
C5-T1
What muscles and cutaneous areas does the median nerve supply?
Most anterior forearm muscles, thenar muscles, lateral 2 lumbricals
Lateral 3.5 digits and nail beds,
What is the path of the median nerve?
Superficial to medial condyle, goes under pronator teres and flexor digitorum superficialis, under carpal tunnel
Where is the median nerve susceptible to injury and what are the consequences?
Compression at carpal tunnel, thenar muscle wasting. Also penetrating injury of forearm
What rami supplies the ulnar nerve?
C8, T1
What muscles and cutaneous areas does the ulnar nerve supply?
Flexor carpi ulnaris, medial half of flexor digitorum profundus, hypothenar muscles, adductor pollicis, medial 2 lumbricals and interossei muscles
Medial 1.5 digits of palmar and dorsal hand
What is the path of the ulnar nerve?
Behind medial epicondyle, between FCU and flexor digitorum profundus, over flexor retinaculum in ulnar tunnel
Where is the ulnar nerve susceptible to injury and the consequences?
Compression at wrist and back of medial epicondyle.
Intrinsic muscle weakness and sensory loss. MCP joint hyperextension, IP joint flexion
What is the hole in the femoral head and the ligament that comes out of it?
Fovea and ligamentum teres
What is the joint type of the sacroiliac joint?
Plane synovial
What is the joint type for the pubic symphysis joint?
Secondary cartilaginous
What ligaments form the greater and lesser sciatic foramen?
Sacrospinous and sacrotuberous ligament
Which femoral condyle and patellar facet is larger?
FC: Medial as more weight bearing over tibia
PF: Lateral
What is flat surface at the top and bottom of the tibia called?
Tibial plateau at knee joint, mortise at ankle joint
The knee joint is said to be a ‘modified’ hinge joint. Why is this?
Because rotation occurs
What does it mean to say the knee joint is a compound and complex joint?
It is a compound joint (three or more articular surfaces) and a complex joint (has an interarticular disc)
Which collateral ligament is congruous with its mensicus?
MCL
Describe the path of the ACL and PCL, and what does it prevent?
ACL anteromedial of tibial plateau, extends superioposteriorly to posteromedial lateral condyle.
PCL posterior tibial plateau, extends anteriorly anterolateal of medial condyle.
ACL prevents posterior rolling of femur on tibia during flexion and hyperextension.
PCL prevents anterior rolling of femur on tibia during extension
How does femur move in locking mechanism?
Femur rotates medially on fixed tibia
What are the joint types of the superior and inferior tibiofibular joints?
Plane synovial for superior, fibrous joint or syndesmosis for inferior
What tendons make up the pes anserinus?
Semitendinosus, gracilis and sartorius
What ligaments and muscles support the GH joint?
Superior, middle and inferior glenohumeral ligaments
Coracohumeral and coracoacromial ligaments
Tendon of long head of biceps
Deltoid and rotator cuff muscles
Describe the path of the lower leg arteries?
Enters pelvis splits into internal and external iliac artery, past inguinal ligament called the femoral artery.
Travels under sartorius for protection.
Pierces the adductor magnus and moves posteriorly, called popliteal artery in popliteal fossa.
Posterior tibial artery and fibular artery along respective bones posteriorly
Anterior tibial artery pierces through interosseous membrane to reach anterior.
What are the contents of the tarsal tunnel from superior to inferior?
Tibialis anterior
Flexor digitorum longus
Posterior tibial artery
Posterior tibial vein
Tibial nerve
Flexor hallucis longus
What rami supply the femoral nerve?
L2-4 (posterior devisions)
What rami supply obturator nerve?
L2-4 (anterior divisions)
What rami supply the sciatic nerve?
L4,5 S1-3
What is the path of the femoral nerve?
Between the iliacus and psoas major, under inguinal ligament. Saphenous branch runs down medial lower leg
What muscles and cutaneous areas does the femoral nerve supply?
Iliopsoas and quadriceps
Middle thigh, medial leg and foot
When is the femoral nerve injured?
Direct trauma
What muscles and cutaneous areas does the obturator nerve supply?
Adductors
Medial thigh
Describe the path of the sciatic nerve?
Exits to posterior via greater sciatic foramen, typically under the piriformis, down posterior thigh. Common fibular nerve goes around laterally near fibular head, splits into superficial fibular more lateral and deep fibular more medial. Tibial nerve runs down posterior leg then enter plantar area via tarsal tunnel.
What does the sciatic nerve supply, specify for major branches?
Posterior compartment of thigh
Tibial nerve posterior lower leg
Superficial fibular lateral compartment (peroneus brevis and longus)
Deep fibular anterior compartment (EHL, ED, TA, PT)
Lateral leg and foot
What is the joint type and function of the subtalar/talocalcaneal and talocalcaneonavicular joints?
2 modified ball and socket, inversion/eversion
What is the joint type and function of the calcaneocuboid joint?
Plane synovial, gliding and contributes to pronation/supination
What does MCL and LCL limit?
M- Abduction, ER, anterior displacement of tibia when ACL damaged
L- Adduction, Varus
What are the three functions of menisci?
Weight distribution, shock absorption and increase surface area
What are the joint types and movements at the MTP and IP joints?
M: condylar F/E Ab/Ad
I: hinge F/E
What ligaments support the feet phalanges?
Deep transverse MT ligament
Volar plates
Collateral ligaments
What innervates zygapophyseal joints?
Medial branches of dorsal rami
