January Exam - FMA Flashcards
What are the bones/articular surfaces in the trunk/lumbar spinal joint?
BONUS: How do they differ to other bones in the spine? Why?
- The lower 5 vertebra of the spine, referred to as L1-5.
- L5 connects to the top of the Sacrum which fits between the two pelvic bones.
- B: Compared to the rest of the spine, lumbar vertebra are taller and bulkier, partly due to its responsibility concerning weight bearing.
Joint type/classification for trunk/lumbar spinal joint
- Facet joints = synovial plane
- Anterior intervertebral joint = cartilaginous symphysis
Outline ligaments in the trunk/lumbar spinal joint
BONUS: Outline each of their function(s)
- All vertebrae are joined together by anterior + posterior longitudinal ligaments that extend along the whole length of the vertebral column joining the respective surfaces of the vertebral bodies.
- Each facet joint is surrounded by a joint capsule which is largely made up of ligament.
- Lumbar ligaments are arranged in layers and multiple directions which aid in connecting this part of the spine to the sacrum and pelvis.
- Ligamentum flavuum
What is lumbar flexion?
Outline the movement’s prime mover(s)
- Bending towards lower limbs/feet in the lower back
- Rectus Abdominis, internal oblique, and external obliques
What is lumbar extension?
Outline the movement’s prime mover(s)
- Bending away from lower limbs/feet in the lower back
- Erector spinae group
What is lateral lumbar flexion?
Outline the movement’s prime mover(s)
- Bending of the lower back from side-to-side
- Erector spinae group, Oblique abdominals, Quadratus lumborum
Outline prime mover(s) involved in lumbar rotation
Internal and external oblique abdominals
Outline nerve supply in the trunk/lumbar spinal joint
Lumbar spinal nerve roots form the nerves that go to the lower limbs and the pelvis. At each ‘level’ of vertebra, two nerve roots leave the spine from both sides (L+R).
Outline main blood supply in the trunk/lumbar spinal joint
The main blood supply to the spinal cord is via the single anterior spinal artery (ASA) and the two posterior spinal arteries (PSA).
EX: A pair of lumbar arteries arises from the back of the aorta in front of each of the upper four lumbar vertebrae.
What are the two supporting structures for both the lumbar and cervical spinal joint?
- The spinal canal, which is the tunnel formed through the connected rings found on each vertebra itself provides a protective structure for the spinal cord
- Intervertebral discs are a special structure which sits in between each vertebra and primarily function as shock absorption.
Outline the main bones/articular surfaces in the neck/cervical spine
- In terms of spinal column itself, the vertebra C1-C7 which descends in order.
- The spinous processes are the projections on the back of the vertebra and are the pointy things which you can sometimes feel if you rub down the middle of someone’s back.
Outline the bones/articular surfaces which are UNIQUE to the neck/cervical spine
- Transverse processes are the projections on the left + right of the vertebra and unique to the cervical spines
- The c.spine have holes known as Transverse Foramen.
- These provide a passageway for arteries to provide blood supply to the back of the brain.
Outline ligaments found in the cervical spinal joint/neck
- Several long sections connect on the front and the back of all the vertebra, the Anterior and Posterior Longitudinal Ligaments.
- Like a long elastic band, the ligamentum flavum connects to each of the lamina bones’ front surface.
- Each facet joint is surrounded by a joint capsule which is largely made up of ligament.
What is cervical flexion?
Outline the movement’s prime mover(s)
- Bending the neck towards the chest
- Sternocleidomastoid
What is cervical extension?
Outline at least 2 of the movement’s prime movers
- Bending the neck backwards, away from the chest and bringing the chin upwards
- Upper trapezius, splenius group, the semispinalis group, and the erector spinae
What is cervical lateral flexion?
Outline the movement’s prime mover(s)
- Bending of the lower back from side-to-side
- Sternocleidomastoid
Outline prime mover(s) involved in cervical rotation
Sternocleidomastoids, upper trapezius, and splenius group
Joint type/classification for neck/cervical spinal joint
- Synovial plane (c5-c6)
Outline ligaments of the hand
BONUS: Describe their function
- Collateral ligaments are on either side of each finger and the thumb to prevent abnormal bending of these digits.
- The volar plate, the strongest ligament in this part of the body, surrounds the knuckles and enables straightening of the joints whilst preventing them from bending back too much/hyperextension.
- Pulleys are tunnels in the digits that are made of ligaments which help hold the tendons of the fingers against the bones.
What is the non-ligament supporting structure present in the hand?
What is its function?
Articular cartilage
The joints of the fingers and hand are covered in articular cartilage, which functions as to absorb shock and is smooth and rubbery in texture to facilitate motion
What are the main bones/articular surfaces in the hand?
- Palm = metacarpals = 1 to 5 from thumb to little finger
- Fingers = Phalanges - proximal, middle & distal from base to tip apart from thumb that has only 2
Outline main blood supply in the hand
- The blood supply to the hand comes from 2 main sources: the ulnar and radial arteries which both originate from the brachial artery
- The ulnar and palmer carpel arteries each split off into a superficial palmer branch and a deep palmer branch
• The radial artery is where pulse can be taken
Outline main nerve supply in the hand
- There are 3 main nerves in the hand: the median nerve, the ulnar nerve and the radial nerve
- They originate in the shoulder and travel down the arm to the hand
Joints and typings of the hand?
- At the base of the fingers are carpometacarpal joints which are synovial plane (3-5) and saddle (1-2) joints
- Joints between the metacarpals and proximal phalanges are the metacarpophalangeal joints and these are condyloid synovial joints
- Between the phalanges are the interphalangeal joints (proximal and distal) - these are synovial hinge joints
What type of movement do the 3 joints in the hand facilitate?
- Metacarpophalangeal joints allow flexion, extension, adduction, abduction
- The carpometacarpal joint allows for opposition and circumduction in the thumb
- Interphalangeal joints provide flexion and extension towards/away from the palm
Can you identify the prime mover(s) involved in thumb abduction, adduction, flexion and opposition?
Thenar muscles
(- Adbuctor - Adductor - Flexor - Opponens ...policis brevis)
Can you identify the prime mover(s) involved in finger abduction and adduction?
Interossei & lumbrical Intrinsic muscles (located in between metacarpals)
Can you identify the prime mover(s) involved in flexion at the MCP joint & extension at IP joint
Intrinsic muscles (located in between metacarpals)
What is the joint type/classification of the hip?
Ball-and-socket synovial
What are the main bones/articular surfaces in the hip/pelvic girdle?
- The pelvic girdle, also known as the os coxae, consists of the fused bones identified individually as the ilium, ischium, and pubis.
- The sacrum articulates superiorly with the fifth lumbar vertebra at the lumbosacral joint.
Outline the non-ligament supporting structures in the hip
- Articular cartilage facilitates shock absorption and frictionless movement within the hip joint.
- Is found on the femoral head and the socket portion of the acetabulum
- Bursa are thin sacks of tissue which contain fluid to lubricate the area to reduce friction between the movement of different structures.
- They are found on the sides, front of the hips and then the bones of the buttocks which we primarily sit on.
Outline ligaments preset in the hip
- Most important Ls in the hip area = hip’s joint capsule, which helps keep top of femur in attached to acetabulum.
- These are the main source of stability for the hip.
- Ligamentum Teres connects the femoral head to the socket portion of acetabulum and has a tiny artery which runs through it and provides blood supply to a portion of the femoral head.
- A unique type of ligament is found in the HJ and is attached almost completely around the edge of the acetabulum. The Labrum, through its ring-sized shape, creates a deeper socket for the acetabulum.
In the context of the hip joint, what are bursa and where are they found?
Thin sacks of tissue which contain fluid to lubricate the area to reduce friction between the movement of different structures.
They are found on the sides, front of the hips and then the bones of the buttocks which we primarily sit on.
What is hip flexion?
Outline prime movers
Bringing the hips towards the knees, or rather when the knees move towards the chest
The iliopsoas, rector femis
What is hip extension?
Outline prime movers
Technically, this is when we are stood up straight (also known as neutral position) or during elevation from sit to stand.
Gluteus maximus, hamstrings
What is hip abduction?
Outline prime movers
Moving leg(s) away from one another
Gluteus medius
What is hip adduction?
Outline prime movers
Moving leg towards the other
Hip adductors, gluteus medius and gluteus minimus
What is internal hip rotation?
Outline prime movers
Movement of hip towards centre of body
Gluteus medius and gemelli muscle
What is external hip rotation
Outline prime movers
Movement of hip away from centre of body
Gluteus maximus and superior gemellus
Outline the hip’s nerve supply
All the nerves which travel through the thigh/LLs pass by or through the hip.
Lumbar plexus: Includes Femoral (anterior) and Obturator (inside hip). L1-4.
Sacral plexus: Posterior portion of the hip, including the sciatic nerve which is largest in the body. S1-S4.
Outline blood supply to the hip
Medial and lateral femoral arteries
The ligamentum teres also has a small artery present to aid in blood supply for the femoral head
What joints are present in the wrist? Their type?
- Radiocarpal + Ulnocarpal: Synovial ellipsoid
- Midcarpal joint: Synovial plane
What is elbow flexion?
Outline prime movers
Bringing hand towards shoulder
Biceps brachii and brachialis, forearm (pronator teres)
What is elbow extension?
Outline prime movers
Straightening of arm
Triceps brachii and ancoenus
What is RU supination?
Outline prime movers
Palms facing upwards
Biceps
What is RU pronation?
Outline prime movers
Palms facing downwards
Pronator teres, pronator quadratus (forearm)
What are non-ligament supporting structures present in the elbow and RU joint?
Articular cartilage is thinner here since it is not a weight bearing joint and is slippery to allow joint surfaces to slide against one another with ease.
It covers the end if the humerus, and tops of the radius and ulna.
Outline main blood supply for the elbow and RU joint
Largest artery is the Brachial which travels across the front of the elbow. These split into the Radial and Ulnar artery which supply blood to the hand.
Outline nerve supply for the elbow and RU joint
Radial, Ulnar (aka funny bone) and Medial Nerves. Each nerve travels through its own tunnel as it crosses the elbow, meaning they must bend along with the elbow - which it does a lot – and can lead to nerve entrapment. C5-7.
What are the bones present in the elbow?
- Humerus: upper arm
- Radius: forearm (thumb side)
- Ulna: forearm (pinky side)
Outline the 4 ligaments present in the elbow
- Medial collateral ligament: inside of elbow - connects the ulna to humerus
- Lateral collateral ligament: outside of elbow – connects radius to humerus
- Annular ligament: forms a ring around head of radius bone
- Quadrate ligament: connects radius to ulna
What type of joint is the knee?
Tibiofemoral Joint - complex synovial modified hinge (since when flexed can perform slight medial and lateral rotation)
Bones/articular surfaces present in the knee
Femur, tibia and patella
What is knee flexion?
Outline prime mover(s)
Bending of the knees
Hamstring group (Biceps femoris, semitendinosus and semimembranosus)
What is knee extension?
Outline prime mover(s)
Straightening of the knee
Quadriceps (femoris) group
What is knee internal rotation
Outline prime mover(s)
Turning of the knee inwards towards body
Biceps femoris, semimembranosus and semitendinosus
What is knee external rotation
Outline prime movers
Turning of the knee outwards, away from body
Biceps femoris
Outline nerve supply within the knee
Femoral, sciatic, and obturator nerves
Outline blood supply for the knee
Femoral artery, posterior tibial artery, anterior tibial artery and popliteal artery which is the largest blood supply within the LL.
How many bursae in the knee and where are they?
4
Surrounding patella/kneecap
Outline extracapsular ligaments in the knee
- Patellar Ligament
- Medial collateral ligament (MCL)
- Lateral collateral ligament (LCL)
Outline intracapsular ligaments in the knee
- ACL
- PCL
- Transverse Ligament
- Medial and lateral meniscus
Joint type/classification of the ankle
Hinged synovial joint
Outline bones in the ankle
- Tibia: AKA the shin bone
- Fibula: The bone that laterally runs alongside the tibia
- Talus: ‘Sits’ above the heel bone and is the second largest tarsal bone
Outline articular surfaces in the ankle
- Distal end of tibia
- Body of talus
- Medial malleolus of the tibia (like a protruding hammer head)
- Lateral malleolus of fibula (like a protruding hammer head)
What are the malleoli of the ankle?
Articular surfaces in the ankle, the two bony prominences on either side(/both laterally and medially)
Like how a hammer head protrudes
Outline ligaments present within the ankle joint
- Medial/deltoid
- Lateral
- Syndesmotic
- 2 posterior fibular
Outline non-liagament supporting structures in the ankle
- Articular cartilage
- Bursae (3)
Where are the bursae of the ankle located?
- Achilles
- Malleoli
- Between achilles tendon and top of heel bone
Outline main blood supply in the ankle
- Anterior & Posterior Tibial Arteries
- Peroneal Artery
Outline main nerve supply in the ankle
- Posterior tibial nerve
- Superficial and deeper peroneal nerve(s)
What are the three joints present in the shoulder and their classification?
- Glenohumeral: Synovial ball + socket
- Acromioclavicular (AC): Synovial plane joint
- Sternoclavicular (SC): Synovial saddle
Outline bones and articular surfaces present in the shoulder joint?
Bones: clavicle, scapula, humerus
Articular surfaces: Glenoid fossa, humeral head
Outline ligaments in the shoulder
- Costoclavicular ligaments
- Joint Capsule
- Glenoid labrum
What are the 2 main bursae in the shoulder?
- Subacromial
- Subdeltoid
Outline main blood supply to the shoulder
Subclavian and axillary arteries
Outline main nerve supply to the shoulder
Brachical plexus network (including med, rad, uln). C5-T1.
What is shoulder flexion?
Outline prime movers
Arm above the head
Deltoid, pectoralis major
What is shoulder extension?
Outline prime movers
Sticking arm out behind you
Deltoid, latissimus dorsi
What is shoulder abduction?
Outline prime movers
Arm away from the body at 90 degrees
Deltoid
What is shoulder adduction?
Outline prime movers
Bringing arm towards the body
Latissimus dorsi, pectoralis major, teres major
What is external shoulder rotation?
Outline prime movers
Swinging arm out from body, elbow at 90 degrees
Teres minor, spinatus muscles
What is internal shoulder rotation?
Outline prime movers
Swinging arm in from body, elbow at 90 degrees
Latissimus dorsi, pectoralis major
What is shoulder circumduction?
Outline prime movers
Full circular UL motion
Latissimus dorsi, deltoid
Outline at least one main ligament in the foot
Plantar fascia – the longest ligament of the foot. The ligament, which runs along the sole of the foot, from the heel to the toes, forms the arch
Plantar calcaneonavicular ligament – a ligament of the sole of the foot that connects the calcaneus and navicular and supports the head of the talus.
Calcaneocuboid ligament – the ligament that connects the calcaneus and the tarsal bones and helps the plantar fascia support the arch of the foot.
What are the 3 general regions of the foot?
- Forefoot
- Midfoot
- Hindfoot
What are the 5 joints in the foot?
- Subtalar - Syn. elliposid
- Midtarsal - Syn. Ball & Socket + Syn. saddle
- Tarsometatarsal - Syn. Plane
- Metatarsophalangeal - Syn. Ellipsoid
- Interphalangeal - Syn. Hinge
Main bones of the foot?
- Talus
- Calcaneus/Heel
- Tarsals
- Metatarsals - 5 each
- Phalanges
Main blood supply to the foot?
Anterior + Posterior tibial arteries
What is inversion?
Outline prime movers
Moving foot inwards
Tibialis posterior, tibialis anterior
What is eversion?
Outline prime movers
Moving foot outwards
The peroneus longus and brevis
What is plantar flexion?
Outline prime movers
The top of your foot points away from your leg
Triceps surae/calf muscles
What is dorsiflexion?
Outline prime movers
Pushing your heel forward and pulling your toes toward you
Tibialis anterior
What is wrist flexion?
Outline prime movers
Limp wrist lol
Flexor carpi ulnaris, flexor carpi radialis
What is wrist extension?
Outline prime movers
Hand towards body
Extensor carpi radialis brevis, extensor carpi radialis longus
What is wrist radial deviation?
Outline prime movers
Hand towards the thumb/radius
Extensor carpi radialis brevis, extensor carpi radialis longus
What is wrist unlar deviation?
Outline prime movers
Hand towards ulnar/pinky
Flexor carpi ulnaris, extensor carpi ulnaris
