Gross Anatomy- Exam 1 Flashcards
1
Q
what is the hole between the pubis and ischium bones of the pelvis called?
A
obturator foramen
2
Q
what passes through the hole between the pubis and the ischium?
A
obturator nerve and artery
3
Q
what ligament spans from the sacrum to ishium tuberosity?
A
sacrotuberous ligament
4
Q
what ligament spans from the sacrum to the spine of the ishium?
A
sacrospinal ligament
5
Q
what space is superior to the sacrospinal ligament?
A
greater sciatic foramen
6
Q
what space is inferior to the sacrospinal ligament?
A
lesser sciatic foramen
7
Q
what passes through the greater sciatic foramen? where do they go?
A
sciatic nerve
superior and inferior gluteal nerves and arteries
pudenal nerve and artery
nerve to obturater internus
nerve to quatratus femoris
posterior cutaneous nerve of the thigh
from the gluteal region to the thigh and and pelvis
8
Q
what passes through the lesser sciatic foramen? where do they go?
A
pudenal nerve
internal pudal artery
from the gluteal region to the perineum
9
Q
what defines the anterior boarder between the abdomen and anterior thigh? what are its connections?
A
inguinal ligament- anterior superior iliac spine to pubic tubercle
10
Q
what passes by the inguinal ligament? where do they go?
A
femoral artery, nerve, and vein pass deep to it to get from the pelvis into the anterior thigh
11
Q
where is the adductor tubercle of the femur?
A
superior to the medial epicondyle
12
Q
where is the gluteal tuberosity of the femur?
A
posterior lateral ridge
13
Q
where is the line aspera?
A
smaller ridges inferior to gluteal tuberosity
14
Q
what is the strongest ligament in the body? where is it?
A
iliofemoral ligament- ilium to intertrochanter line of the femur
15
Q
what are the articulating surfaces of the femur?
A
head
medial and lateral condyles (below the epicondyles)
16
Q
where is the intertrochanter line of the femur?
A
between the greater and lesser trochanters, lateral to the neck
17
Q
where is the tibial tuberosity?
A
anterior bump, below knee
18
Q
where is the soleal line?
A
posterior ridge
19
Q
what are the articulating surfaces of the tibia?
A
tibial plateau
inferior articular surface
20
Q
what is the ankle joint?
A
between the distal tibia and the talus bone
21
Q
what type of bone is the patella?
A
sesmoid bone- forms inside a ligament
22
Q
where does the patella sit?
A
inferior aspect of the femur- not on the knee joint
23
Q
what is ankle flexion?
A
pointing the toe
24
Q
what is knee flexion?
A
bringing the foot toward the butt
25
what are the stages of a gait cycle?
1. heel strike
2. loading response- put down toes
3. mid stance- balancing on one foot
4. terminal stance- lifting heel
5. pre swing- push off with toe
6- swing- foot in air
26
while one foot is at heel strike, the other is
preswing
27
while one foot is in the loading response, the other is
initial swing
28
while one foot is in mid stance, the other is
mid swing
29
while one foot is in terminal stance, the other is
end swing
30
while one foot is in pre swing, the other is in
heel strike
31
while one foot is in the swing, the other is in
stance stages (3)
32
how is abduction used in the gait cycle?
lean to the weight bearing side to maintain balance
33
where is rocking occurring during the gait cycle? how?
between heel strike and preswing- shift weight from heel to big toe (inversion to eversion
34
what nerve roots are in the lumbar plexus?
L1-L4
35
what lower limb nerves come off of the anterior part of the lumbar plexus?
obturator nerve
36
what lower limb nerves come off of the posterior part of the lumbar plexus?
lateral cutaneous nerve of thigh
| femoral nerve
37
where do the nerves of the lumbar plexus go?
abdomen, lower limb
38
where do the nerves of the sacral plexus go?
lower limb
pelvis
perineum
39
what lower limb nerves come off the posterior part of the sacral plexus?
superior gluteal
inferior gluteal
nerve to piriformis
40
what lower limb nerves come off the anterior part of the sacral plexus?
nerve to quadratus femoris
| nerve to obturator internus
41
what lower limb nerves come off the sacral plexus that are a mix of anterior and posterior divisions?
sciatic nerve- tibial (anterior), common fibular (posterior)
| posterior cutaneous nerve of thigh
42
what structures are between the gluteus medias and maximus?
inferior gluteal vascular bundle (inferior gluteal nerve, artery, vein)
posterior cutaneous nerve of the thigh
sacrotuberous ligament- branches of pudendal nerve
43
what is the piriformis used as a landmark for?
superior gluteal bundle comes out superiorly
inferior gluteal bundle comes out inferiorly
sciatic nerve comes out inferiorly
44
what is the fascia lata? what is it for?
tough connective tissue surrounding leg muscles, forces muscles to go inward during contraction
45
what helps stabilize the knee?
iliotibial tract, aka IT band
46
what is the order of the deep gluteal muscles from superior to inferior?
```
gluteus minimis
piriformis
superior gemellus
obtruator internus
inferior gemellus
quadratus femoris
```
47
what does the superior gluteal nerve supply?
gluteus medius
gluteus minimis
tensor fascia lata
48
what does the inferior gluteal nerve supply?
gluteus maximus
49
what does the obturator internus nerve supply?
obturator internus
| superior gemellus
50
what does the quratus femoralis nerve supply?
inferior gemellus
| quadratus femoralis
51
why is the gluteal region good for large volume injections?
large muscle mass
52
what is in the gluteal region that must be avoided when giving injections?
superior and inferior gluteal vascular bundles
| sciatic nerve
53
what are the hamstring muscles?
semitendinous, semimembranous, long head of biceps femoris
54
what is the role of the pectinus muscle when the femur fractures between the trochanters?
pectinus muscle displaces the medial portion of the bone
55
what muscles merge to make the iliopsoas?
3 posterior abdominal muscles: psoas major, psoas minor, iliacus
56
what are the boarders of the femoral triangle?
superior- inguinal ligament
lateral- sartorius
medial- adductor longus
floor- iliospoas, pectinus
57
what is in the femoral triangle?
femoral nerve, artery, and vein
| deep inguinal lymph nodes and vessels
58
where does the lateral circumflex branch of deep femoral artery go?
ascending branch- gluteal region
| descending branch- knee
59
where does the medial circumflex branch of deep femoral artery go?
head and neck of femur
60
what does the perforationg arteries from the deep branch of the femoral artery go?
adductor mangus
hamstrings
vastus lateralis
61
what are the boarders of the popliteal fossa?
superior medial- semimembranosus/semitendinosus
superior lateral- biceps femoris
inferior medial- medial head of gastrocnemius
inferior lateral- lateral head of gastrocnemius
62
what is in the popliteal fossa?
```
popliteal artery
popliteal vein
end of small saphenous vein
tibial and common fibular nerves
posterior cutaneous nerve of the thigh
popliteal lymph nodes and vessels
```
63
what nerve in the knee is commonly injured? why?
common fibular nerve- wraps around the head and neck of the fibula outside the popliteal fossa
64
what are the ligaments in the knee and where do they attach?
ACL- femur to anterior tibia
PCL- femur to posterior tibia
MCL- medial epicondyl of femur to medial condyl of tibia
LCL- lateral epicondyl of femur to head of fibula
65
what is the meniscus? where is it?
acts as a shock absorber between the femur and tibia
66
what is the Unhappy triad?
lateral extended knee hit or twist of flexed knee-->torn ACL, MCL, and medial meniscus
probalby due to instability in the medial meniscus, and then ACL is last thing to tear
67
what is a more common injury mechanism than the unhappy triad?
lateral meniscus compression injury after a lateral knee hit resulting in ACL and MCL tearing
68
what is ankle flexion?
pointing the toe
69
what is ankle extension?
flexing the foot
70
what is inversion
rolling the ankle outward so the bottom of the foot points in
71
what is eversion?
rolling ankle inward so the bottom of the foot points out
72
what muscles insert via the calcaneal tendon?
plantaris
gastrocnemius
soleus
73
what muscles are in the superficial posterior leg compartment?
soleus
gastrocnemius
plantaris
74
what muscles do plantar flexion?
posterior leg
75
what is the innervation and blood supply for the posterior leg muscles?
tibial nerve
| posterior tibial artery
76
what fiber type is in the gastrocnemius?
fast twitch
77
what fiber type is in the soleus?
slow twitch
78
what is the fools nerve?
the tendon of the plantaris muscle
79
in what order do the deep posterior leg structures come around from the medial malleolus?
```
tibialis posterior
flexor digitorum longus
posterior tibial artery
tibial vein
tibial nerve
flexor hallicus
```
80
tom, dick, and very nervous harry
order deep posterior leg structures come around the medial malleolus
81
what muscles are the anterior leg compartment?
extensor digitorum longus
extensor hallicus longus
tibialis anterior
fibularis tertius
82
what do the anterior leg muscles do?
dorsiflexion
83
what muscles are in the deep posterior leg compartment?
popliteus
tibials posterior
flexor digitorum longus
flexor hallicus longus
84
what is the innervation and blood supply to the anterior leg muscles?
deep fibular nerve
| anterior tibial artery
85
what are shin splints?
inflammation of the anterior tibialis muscle- mild shin splints
86
what separates the superficial and deep posterior leg compartments?
transverse intermuscular septum
87
what muscles are in the lateral leg compartment?
fibularis longus
| fibularis brevis
88
what do the lateral leg muscles do?
foot eversion
89
what is the innervation and blood supply to the lateral leg muscles?
superficial fibular nerve
| perforating arteries of anterior tibial and fibular arteries
90
where do the lateral leg muscles insert?
pass posterior to the lateral malleolus and insert at the base of the 5th metatarsal
91
what are the names of the tarsal bones?
```
calcaneus
talus
navicular
cuboid
lateral cuneiform
intermediate cuneiform
medial cuneiform
```
92
posterior tarsals
calcanius, talus
93
intermediate tarsals
navicular
| cuboid
94
anterior tarsals
lateral, intermediate, and medial cuneiform
95
where is the transverse tarsal joint?
between the posterior tarsals and the intermediate tarsals
96
where is the tarsal metatarsal joint?
between the anterior tarsals and the metatarsals
97
which ligament is torn in ankle sprains?
anterior talofibular ligament- part of lateral ligament of the ankle
98
how many components are in the lateral ligament of the ankle?
3
99
how many components are in the medial ligament of the ankle?
4
100
which ankle ligament is stronger?
medial
101
what is a Pott's fracture?
eversion injury, medial ligament doesn't tear but breaks medial malleolus which causes tibial displacement which causes the lateral malleolus to break too
102
how is the lateral ligament injured?
inversion injuries
103
how is the medial ligament injured?
eversion injuries- not likely since the ligament is so strong
104
what ligaments make up the longitudinal arch?
plantar calcaneonavicular
long plantar
short plantar
105
what makes up the transverse arch?
tendons of tibialis posterior and fibularis longs muscles
106
inflammation of the plantar aponeurosis?
plantar fasciitis
107
where does the plantar aponeurosis attach?
medial tubercle of calcaneus
108
how are heel spurs formed?
plantar aponeurosis is pulling on the calcaneus which induces the bone to grow toward it--causes pain because bone gets close to the nerve that comes around on the medial side of the aponeurosis
109
what muscles are in the medial compartment of the foot?
flexor hallicus brevis
flexor hallicus longus
abductor hallicus
110
what innervates the medial compartment?
medial plantar nerve
111
what muscles are in the central compartment?
```
lumbericals
flexor digitorum brevis
quadratus plantae
adductor hallicus
tendons of the flexor digitorum longus
```
112
what innervates the central compartment?
medial plantar- #1 lumberical, flexor digitorum brevis
| lateral plantar- 2-5 lumbericals, quadratus plantae, adductor hallicus
113
what muscles are in the lateral compartment?
flexor digiti minimi brevis
| abductor digiti minimi
114
what innervates the lateral compartment?
lateral plantar nerve
115
what innervates the interosseous muscles?
lateral plantar
116
what muscles are in the dorsal compartment?
extensor hallicus brevis
extensor digitorum brevis
tendons of digitorum longus
117
what innervates the dorsal compartment?
deep fibular nerve
118
what is the path of the lateral plantar artery?
cross deep to quadrates planate
119
where does the anterior tibial artery become the dorsal pedis artery?
after it passes the extensor retinaculum
120
what does the dorsalis pedis artery do initially?
lateral tarsal branches from dorsalis pedis and goes diagonally across foot
arcuate branches from dorsalis pedis artery and atastamoses with dorsal pedis and lateral tarsal
deep plantar artery is the terminal branch of the dorsalis pedis that goes to the plantar side
121
what forms the deep plantar arch?
anastamosis between deep plantar and posterior perforating branches
122
what supplies blood to the toes?
dorsal- dorsal metatarsal arteries from the arcuate artery
| plantar- branches from deep plantar arch that go to digits
123
cutaneous innervation of posterior thigh
posterior cutaneous nerve of thigh
124
cutaneous innervation of posterior lateral leg
medial sural cutaneous
125
cutaneous innervation of anterior superior lateral leg?
lateral sural cutaneous
126
cutaneous innervation of heel
medial calcaneal branches of tibial
127
cutaneous innervation of anterior lateral thigh
lateral cutaneous nerve
128
cutaneous innervation of medial thigh
anterior cutaneous branches of femoral
129
cutaneous innervation of medial anterior leg
branches of saphenous
130
cutaneous innervation of medial knee
cutaneous branches of obturator
131
cutaneous innervation of anterior inferior lateral leg
medial sural cutaneous
132
cutaneous innervation of lateral foot
sural
133
cutaneous innervation of webbing between first two toes
deep fibular nerve
134
cause of foot drop with inversion, patient slapping foot down with exaggerated thigh lift? injury site?
common fibular nerve compression
deficits in anterior (dorsiflexion) and lateral (eversion) compartments
lateral knee area
135
cause foot drop only with paid between first two toes? injury site?
deep fibular nerve compression
loss of anterior (dorsiflexsion) and cutaneous innervation to first two toes
either fibular head or near extensor retinaculum (ski boot syndrome)
136
how can you tell if a nerve is compressed versus severed?
compression- have pain/tingling
| severed- no feeling at all
137
cause of walking on the lateral aspect of the foot? injury location?
superficial fibular nerve compression- loss of lateral (eversion)
injury near fibular head or nerve stretched in ankle sprain
138
why would pain radiate proximal to an injury?
using other muscles to compensate for the distal deficit
139
what is a positive trandelenburg sign?
standing on one foot, patient leans toward opposite side- due to superior gluteal nerve defect on the side they are standing on
140
what is gluteal gait?
superior gluteal nerve defect compensatory gait- lean to defective side while balancing on that foot to swing the normal side around
141
what nerve if severed prevents walking and standing? why?
sciatic nerve- loss of thigh extensors and all leg muscles
142
loss of knee extenders?
femoral nerve injury
143
gait compensation for femoral nerve injury?
lean forward lean torso forward on affected side to force knee into extension
144
loss of cutaneous innervation on lateral and anterior thigh, medial leg and foot?
femoral nerve injury
145
what is compartment syndrome?
compression of deeper structures in a compartment due to the fascia restricting spread of inflammation
146
what are the effects of compartment syndrome?
damage to distal structures- ischemia, lower tissue temp
| loss of distal pulses
147
what in the leg fascia allows infections to spread?
opening between lateral compartment and popliteal fossa that the fibular nerve goes through
148
what causes varicose veins?
dilation in superficial veins due to insufficinet valves in the deeper veins--become visible in superficial because blood back flows into them
149
what is deep vein thrombosis?
clot in deeper leg vein due to vascular insufficiency that causes sweeping, warmth, and erythema
150
what are possible causes of DVT?
loose fascia
external pressure from something on too tight
inactivity
151
what can cause a pulmonary embolism?
DVT- clot breaks loose and goes to lungs
152
dorsiflexion without plantar flexion
tibial nerve injury
153
what does the inferior gluteal nerve innervate?
gluteus maximus
154
superior gluteal nerve
gluteus medias
gluteas minimas
tensor fascia lata
155
nerve to piriformis
piriformis
156
nerve to obturator internus
superior gamellous
| obturator internus
157
nerve to quadratus femoris
inferior gamellous
| quadratus femoris
158
tibial division of sciatic nerve
semimembranosus
semitendinosus
long head of biceps femoris
159
fibular division of sciatic nerve
short head of biceps femoris
160
femoral nerve
```
sartorius
rectus femoris
vastus lateralis
vastus intermedias
vastus medialis
pectinus
```
161
obturator nerve
gracilis
adductor brevis
adductor of adductor mangos
obturator externus
162
path of femoral nerve
passes behind the inguinal ligament to femoral triangle
163
path of saphenous nerve
branch of femoral nerve at the femoral triangle, goes down medial side of knee behind sartorial, behind medial tibia boarder
164
synarthrosis
immovable joint connected by fibrous connective tissue
| sutures between skull bones
165
amphiarthrosis
slightly movable joint
| IVD, interosseous membranes
166
diarthrosis
freely movable joints
| all synovial joints
167
what are the 3 types of fibrous joints
sutures
syndesmosis
gomphosis
168
suture
synarthrosis- immovable interdigitated or line
| in skull
169
syndesmosis
amphiarthrosis- slightly movable
| interosseous membranes
170
gomphosis
tooth anchored by periodontal ligament
| slightly movable
171
what are the types of cartilaginous joints
symphysis
synchondrosis
synovial joint
172
symphysis
connected by fibrocarilage
strong
slightly movable
pubic symphysis
173
synchondrosis
held together by hyalin cartilage
immovile
growth plates
spheno-occipital joint in infants- midline of cranial base
174
synovial joint
```
diarthrosis
freely movalble
hyaline cartilage
fibrous capsule
rich nerve and blood supply
```
175
what are the 6 types of synovial joint and where are they
```
hinge- elbow
gliding- intercarpal, acromioclavicular
pivot- atlanto-axial
condyloid- radiocarpal, MCP, PIP, DIP
saddle- carpometacarpal o fthumb
ball and socket- shoulder
```
176
what is the ACL connected to
medial meniscus
177
what is the PCL connected to
NOT the lateral meniscus
178
what is the function of the ACL?
tibial forward movement
femur backward movemnt
medial rotation fo femur with planted foot
179
anterior drawer test
pull tibia forward to see if ACL is torn
180
lachman's test
wiggle knee--excessive motion means ACL is torn
181
PCL prevents
tibia moving back
| femur moving foward
182
what is a popliteal cyst
extension of synovial fluid outside the joint
| not symptomatic unless it is pressing on a nerve
183
what is a bursae
pouch of synovial fluid between bone and bone, tendon, ligament, or skin to reduce friction
184
what is a tendon sheath
long pouches that surround tendons to reduce friction
185
hilton's law
nerve innervating the joint also supplies the muscles moving it and the skin around it
186
arthritis
general term for joint degradation causing pain and inflammation
187
osteoarthritis
irreversible damage to articular cartilage of weight bearing joints- usually in older people
188
rheumatoid arthritis
chronic inflmmatory condition affecting many joints and blood, heart, and lungs
