General anatomy Flashcards
What is the close packed position of the talocrural joint and why?
Full dorsiflexion
The talus is a wedge shaped bone that is thinner superiorly, this means in dorsiflexion, the larger end of the talus gets wedged up between the lateral and medial malleoli meaning that the ankle joint is stable in this position
What are the concave and convex surfaces in the subtalar joint?
Concave = talus
Convex = upper surface of calcaneus
What three movements is ‘pronation’ at the subtalar joint composed of
Abduction
Eversion
Dorsiflexion
What three movements is ‘supination’ at the subtalar joint composed of
Adduction
Inversion
Plantarflexion
What three bursa are in the ankle and where are they situated?
Retrocalcaneal bursa - deep in Achilles tendon just above the calcaneus
Bursa of the medial malleolus - just below the edge of the medial malleolus
Achilles bursa - subcutaneous over the calcaneus
What are the 5 retinaculae in the foot and where are they located?
Superior extensor retinaculum - from tibia to fibula
Inferior extensor retinaculum - y-shaped and attaches to medial malleolus, calcaneus and plantar aponeurosis
Superior peroneal retinaculum - goes from the calcaneus to the lateral malleolus
Inferior peroneal retinaculum - from a continuation of the inferior extensor retinaculum to the calcaneus
Flexor retinaculum - From the medial malleolus to the calcaneus (inferior)
What does the talocrural joint capsule attach to posteriorly
Posterior talofibular ligament
What type of fracture is more likely to occur due to an eversion injury of the ankle and why?
With eversion injuries, it puts the deltoid ligament under strain. The deltoid ligament is an incredibly strong ligament and therefore the medial malleolus can suffer an avulsion fracture
What ligaments are in the lateral collateral ligament complex of the ankle?
Anterior and posterior talofibular ligaments
Calcaneofibular ligament
Which is stronger PTFL or ATFL?
PTFL
What is the spring ligament also known as, where does it go from and to and what does it do?
Plantar calcaneonavicular ligament
Goes from the medial malleolus to the sustentaculum tali, the navicular and the talus
Supports the longitudinal arch of the foot
What is the OIA of peroneus longus
O = Proximal lateral surface and head of fibula
I = 1st metatarsal and medial cuneiform
A = Plantarflexion and eversion
What is the OIA of peroneus brevis
O = Distal lateral fibula
I = Tuberosityof 5th metatarsal
A = Plantarflexion and eversion
What is the OIA of flexor digitorum longus
O = Posterior surface of the tibia
I = Plantar surface of bases of 2-5 distal phalanges
A = Flexes toes 2-5 and helps plantarflex ankle
What is the OIA of extensor digitorum longus
O = Medial surface of fibula, lateral tibial condyle and the interosseous membrane
I = 2-5 distal and middle phalanges
A = Extends the toes
What is the OIA of flexor hallucis longus
O = Posterior surface of fibula middle 1/3
I = Plantar surface of base of 1st toe hallux
A = Flexes all joints of 1st toe and assists with plantarflexion of the ankle
What is the OIA of extensor hallucis longus
O = Anterior surface of the fibula and the interosseous membrane
I = Base and dorsal center of distal hallux of big toe
A = Extends 1st toe and assists with ankle dorsiflexion
What is the OIA of tibialis posterior?
O = Proximal postero-lateral aspect of the tibia, postero-medial aspect of the fibula and the interosseous membrane
I = Navicular and the plantar slip attaches to the medial cuneiform bone
A = Plantarflexes and inverts the ankle and stabilises the medial longitudinal arch
What is the OIA of tibialis anterior?
O = Lateral surface of tibia and the interosseous membrane
I = Medial cuneiform and base of 1st metatarsal
A = Dorsiflexes and inverts the ankle
What is the OIA of gastrocnemius
O = Lateral and femoral condyles
I = Calcaneus via calcaneal/Achilles tendon
A = Knee flexion and Ankle plantarflexion
What is the OIA of soleus
O = Medial border of tibia, head of fibula and posterior border of fibula
I = Posterior surface of calcaneus via calcaneal tendon
A = Ankle plantarflexion
What are the two articulations in the knee?
Tibiofemoral - articulation between the convex femoral condyles and the concave tibial plateau
Patellofemoral - articulation between the trochlear surface of the femur and the posterior facets of the patella
What are three functions of the menisci?
Absorb shock
Increase congruency between femoral condyles and tibial plateau
Aids lubrication
What are the 5 bursae in the knee and where are they located?
Subcutaneous pre-patellar bursa - Between the patella and the skin
Deep infrapatellar bursa - Between the patella tendon and the tibia
Superficial infrapatellar bursa - Between the patella tendon and the skin
Pes anserinus bursa - On the pes anserine landmark on the medial tibia under the tendons of gracilis, sartorius and semitendinosus
Suprapatellar bursa - Between the quadriceps tendon and the femur
What is in the articular capsule of the knee
ACL and PCL
Patellofemoral and tibiofemoral articulations
Infrapatellar fat pads
Suprapatellar bursa
Menisci
Popliteus tendon
What capsular structures are extra-synovial?
Infrapatellar fat pads
ACL and PCL
What are the attachment points for the ACL?
O = Lateral tibial plateau
I = Lateral intracondylar notch/lateral femoral condyle
What are the attachment points for the PCL?
O = Posterior intercondylar area of tibia
I = anterior part of medial femoral condyle
What are the attachment points for the LCL?
O = Lateral femoral condyle
I = Fibular head
What are the attachment points for the MCL?
O = Medial femoral condyle
I = Medial border of tibia
What are the structures of MCL and LCL
MCL = Strong flat band
LCL = Thin, cord-like structure
What is the OIA of semimembranosus
O = Lateral aspect of posterior portion of ischial tuberosity
I = Posterolateral aspect of medial condyle of tibia
A = Hip extension and knee flexion
What is the OIA of semitendinosus
O = Ischial tuberosity and aponeurosis connecting it to biceps femoris
I = Anserine (upper part of medial surface of tibia)
A = Hip extension and knee flexion
What is the OIA of biceps femoris
O = Long head from ischial tuberosity, short head from linea aspera
I = Fibula head
A = Hip extension and knee flexion
What is the OIA of sartorius?
O = ASIS
I = Pes anserine
A = Knee flexion and medial rotation
Hip flexion, external rotation and abduction
What is the OIA of popliteus?
O = Lateral femoral condyle and posterior horn of lateral meniscus
I = Posterior tibial surface
A = Knee medial rotation and aids flexion
Prevents excessive external rotation
Unlocks knee from closed-pack position
Barrier to anterior femoral dislocation
What is the OIA of gracilis
O = Pubis
I = Pes anserine
A = Knee flexion and medial rotation
Hip adduction
What is the OIA of plantaris
O = Inferior aspect of lateral supracondylar line of distal femur
I = Middle 1/3rd posterior calcaneal surface
A = Plantarflexion of the ankle
Flexion of the knee
What is the OIA of rectus femoris
O = AIIS
I = Patella ligament into tibial tuberosity
A = Hip flexion and knee extension
What is the OIA of vastus lateralis
O = Upper 1/2 intertrochanteric line, gluteal tuberosity and greater trochanter
I = Patella ligament into tibial tuberosity
A = Knee extension
What is the OIA of vastus intermedius
O = Lateral and anterior shaft of femur
I = Patella ligament into tibial tuberosity
A = Knee extension
What is the OIA of vastus medialis
O = Medial 1/2 intertrochanteric line and medial linea aspera
I = Patella ligament into tibial tuberosity
A = Knee extension
What is the OIA of articularis genus
O = Anterior distal femoral surface
I = Synovial membrane of knee joint
A = Pulls synovial membrane and suprapatellar bursa upward to prevent impingement
What is the OIA of levator scapulae
O = C1-4 transverse processes
I = Medial scapula
A = Elevates the scapula, medial rotation
What is the OIA of Pectoralis major
O = Anterior medial clavicle and anterior surface of sternum, superior six costal cartilage
I = Greater tubercle of the humerus
A = Adduction, internal rotation, flexion
What is the OIA of pectoralis minor
O = External surface of ribs 3-5
I = Medial border of coracoid process of scapula
A = Stabilisation, depression, protraction and internal rotation of the scapula
What is the OIA of rhomboid minor
O = Nuchal ligament and spinous processes of C7 and T1
I = Medial border of scapula
A = Retraction of the scapula, internal rotation of the scapula
What is the OIA of rhomboid major
O = T2-T5 spinous processes
I = Medial border of the scapula
A = Retraction and internal rotation of the scapula
What is the OIA of deltoid
O = Lateral clavicle (anterior fibres), acromion (middle fibres) and inferior aspect of spine of scapula (posterior fibres)
I = Deltoid tuberosity (mid way down lateral humerus)
A = Anterior fibres = flexion and internal rotation
Middle fibres = abduction
Posterior fibres = extension and external rotation
What is the OIA of trapezius
O = Nuchal ligament, spinous processes C7-T12 and external occipital protuberance
I = Posterior aspect of lateral clavicle (upper fibres), lateral aspect of acromion (middle fibres) and inferior spine of scapula (lower fibres)
A = Upper fibres = elevation of the scapula
Middle fibres = retraction of the scapula
Lower fibres = depression of the scapula
What is the OIA of supraspinatus?
O = Supraspinous fossa of scapula
I = Greater tubercle of the humerus
A= Initiates abduction of the humerus and stabilises the shoulder joint preventing inferior dislocation
What is the OIA of infraspinatus
O = Infraspinous fossa of scapula
I = Greater tubercle of humerus
A = External rotation
What is the OIA of subscapularis
O = Subscapular fossa
I = Lesser tubercle of humerus
A = Internal rotation and adduction of the humerus
What is the OIA of teres minor
O = Upper two thirds of lateral border of scapula’s posterior surface
I = Greater tubercle of humerus
A = External rotation of the shoulder and stabilisation of the shoulder joint
What is the OIA of teres major
O = Posterior surface of inferior angle of scapula and lateral border of scapula
I = Intertubercular sulcus
A = Adducts, medially rotates and extends the arm
What is the OIA of biceps brachii
O = Long head - Supraglenoid tubercle of the scapula
Short head - Coracoid process of the scapula
I = Radial tuberosity
A = Elbow and shoulder flexion
What are the angles of inclination and anteversion, what should they be roughly, and what occurs if they are greater than these values?
Angle of inclination - The angle between the head/neck of the femur and the shaft - typically 125 degrees
Angle of anteversion - The angle between the rotation of head and neck of the femur and the shaft in the horizontal plane - typically 10 degrees
If greater than 130 and 15 degrees respectively, it can decrease stability of the hip joint
Describe the joint capsule of the hip joint including where it attaches
Strong fibrous capsule which is at its thickest anteriorly and superiorly
Attaches to the acetabulum superiorly and posteriorly
Attaches to the transverse ligament at the acetabular notch
Attaches to the intertrochanteric line distally
Tight posteriorly strengthened by ligaments
Briefly describe the iliofemoral ligament, what does it attach to and what does it restrict
Thick strong triangular ligament anterior to the hip joint
Attaches to the ilium (just below AIIS) and the intertrochanteric line of the femur
Limits extension, lateral rotation, abduction (lower band) and adduction (upper band)
Briefly describe the ischiofemoral ligament, what does it attach to and what does it restrict?
Less well-defined spiral ligament posterior to hip joint
Attaches to the the body of ischium, runs behind and below the acetabulum and attaches to the root of the grater trochanter
Limits extension, medial rotation and adduction
What is the OIA of gluteus maximus
O = Gluteal surface and adjacent border of ilium, sacrum, coccyx, fascia covering erector spinae
I = Deep part inserts on gluteal tuberosity of femur and superficial three quarters insert into the iliotibial tract
A = Extension (particularly powerfully from a flexed position such as when running or climbing) and lateral rotation and assists abduction of the hip
What is the OIA of gluteus medius
O = Gluteal surface of ilium
I = Greater trochanter of femur
A = Hip abduction and medial rotation
What is the OIA of gluteus minimus
O = Gluteal surface of ilium, deep to gluteus medius
I = Greater trochanter
A = Hip abduction and medial rotation
What do Gluteus medius, minimus and TFL do if the origins and insertions are reversed and what is the result if these three muscles are weakened
Maintain the level of the pelvis when walking i.e. if you lift your right leg, these muscles on the opposite side contract to lower your pelvis on the left side to level it and ensure it doesn’t drop on the right side.
If these muscles are weak, you get Trendelenburg gait
What is the OIA of psoas major
O = Bodies of vertebrae and discs T12-L5 and front of all lumbar tranverse processes
I = Lesser trochanter of femur
A = Flexes hip and laterally flexes trunk
What is the OIA of iliacus
O = Upper two thirds of iliac fossa
I = Lesser trochanter of femur
A = Flexes hip
What is the OIA of pectineus
O = Superior ramus of pubis and pubic tubercle
I = Pectineal line on upper posterior part of femur
A = Hip flexion and adduction
What is the action of gluteus maximus if origin and insertion are reversed
Extends trunk from a flexed position to an upright position
What is the OIA of adductor magnus, adductor longus and adductor brevis
Adductor magnus:
O = Ischiopubic surface and inferior ischial tuberosity
I = Whole length of linea aspera and medial supracondylar ridge
Adductor longus:
O = Anterior aspect body of pubis
I = middle half linea aspera
Adductor brevis:
O = body and inferior ramus of pubis
I = Upper half linea aspera
Actions of all = adduction of the hip
What is the OIA of gracilis
O = Body and inferior ramus of pubis
I = Medial surface shaft of tibia between sartorius and semitendinosus (pes anserine)
A = adducts the hip and flexes the knee
What is the OIA of piriformis
O = Gluteal surface of ilium and sacrum
I = Greater trochanter
A = Lateral rotation
