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Medicine and Surgery Mushkies > Key Anatomy Mushkies > Flashcards

Key Anatomy Mushkies Flashcards

1
Q

Chest wall surface landmarks?

A
  1. Superior angle of scapula = T2
  2. Inferior angle of scapula = T8
  3. Sternal angle = T4/5
  4. Subcostal plane = L3
  5. Nipples = 4th ICS
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2
Q

Pleura surface markings?

A

8th, 10th and 12th ribs

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3
Q

Lung surface markings?

A

6th, 8th and 10th ribs

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4
Q

Oblique fissure surface marking?

A
  1. T4 in midline posteriorly
  2. 5th rib laterally
  3. 6th costal cartilage anteriorly
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5
Q

Horizontal fissure surface marking?

A

Follows contour of 4th rib anteriorly

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6
Q

Breast surface anatomy?

A

Attached between ribs 2-6, axillary tail follows lower margin of pec major

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7
Q

Sternal angle level?

A

T4/5

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8
Q

What happens internally at the sternal angle?

A

ABCD S2

  1. Aortic arch = beginning and end
  2. Bifurcation of pulmonary arterial trunk
  3. Carina
  4. Division of superior and inferior mediastinum
  5. SVC enters RA
  6. 2nd costosternal joint
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9
Q

What is the breast composed of?

A

Mammary glands and connective tissue stroma

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10
Q

Mammary glands fx?

A

Ducts and secretory lobules converge to form 15-20 lactiferous ducts which open onto the nipple

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11
Q

Connective tissue of breast fx?

A
  1. Surrounds mammary glands
  2. Suspensory ligaments of Cooper are continuous with the dermis and support the breast
  3. Layer of loose connective tissue (retromammary space) separates the breast from the deep fascia and allows some movement over the underlying structures
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12
Q

Arterial supply of the breast?

A
  1. Laterally = vessels from the axillary artery
  2. Medially = branches from the internal thoracic artery
  3. 2nd-4th intercostals via superficial perforating branches
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13
Q

Lymphatic drainage of the breast?

A
  1. 75% drain superolaterally into axillary nodes

2. Remainder into deep parasternal nodes

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14
Q

3 main openings in diaphragm?

A

Vena cava = T8
Oesophagus = T10
Aortic hiatus = T12

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15
Q

2 congenital hernias in the diaphragm?

A
  1. Morgagni = anterior

2. Bochdalek = posterior

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16
Q

Superior mediastinum boundaries?

A
  1. Superior = thoracic inlet
  2. Inferior = angle of louis (T4/5, thoracic plane)
  3. Lateral = pleura
  4. Anterior = manubrium
  5. Posterior = T1-T4
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17
Q

Superior mediastinum contents?

A
  1. Arteries = aortic arch and branches
  2. Veins = brachiocephalics, SVC
  3. Nerves = vagi, phrenics, L recurrent laryngeal nerve
  4. Organs = thymus, trachea, oesophagus, thoracic duct, lymph nodes
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18
Q

Anterior mediastinum site and contents?

A
  1. Anterior to the pericardium

2. Thymus and lymph nodes

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19
Q

Posterior mediastinum contents?

A

DATES

  1. Descending aorta
  2. Azygous vein and hemiazygous
  3. Thoracic duct
  4. Oesophagus
  5. Sympathetic trunks
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20
Q

What does RLN supply?

A

All intrinsic laryngeal muscles except cricothyroid (external branch of superior laryngeal nerve)

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21
Q

What does left RLN recur around?

A

Ligamentum arteriosum (remnant of ductus arteriosum)

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22
Q

What does right RLN recur around?

A

Right subclavian artery

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23
Q

Damage to RLN during what surgery?

A
  1. Thyroid surgery
  2. Parathyroid surgery
  3. Bronchogenic Ca
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24
Q

Unilateral RLN palsy result?

A

Hoarseness

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25
Q

Bilateral RLN palsy result?

A

Aphonia

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26
Q

Chylothorax?

A
  1. Accumulation of lymphatic fluid in the pleural cavity
  2. Thoracic duct drains whole lymphatic field below diaphragm and left half of lymphatics above it
  3. Surgical procedures involving the posterior mediastinum or neck can –> lymph leak into thoracic cavity
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27
Q

Venous system at the thoracic outlet?

A
  1. Subclavian veins join IJV behind SCJ
  2. Brachiocephalic veins form SVC behind right 1st sternocostal joint
  3. SVC enters RA at right 3rd sternocostal joint
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28
Q

Oesophagus length?

A

25cm

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29
Q

Distance from lips to GOJ?

A

40cm

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30
Q

Path of oesophagus?

A
  1. Starts at level of cricoid cartilage (C6)
  2. Lies in the visceral column in the neck
  3. Runs in posterior mediastinum and passes through right crus of diaphragm at T10
  4. Continues for 2-3cm before entering cardia
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31
Q

4 locations of narrowing of oesophagus?

A
  1. Level of cricoid = junction with pharynx
  2. Posterior to aortic arch
  3. Posterior to left main bronchus
  4. LOS
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32
Q

Histology of oesophagus?

A
  1. Divided into 3rds = reflects change in musculature from striated –> mixed –> smooth
  2. Lined by non-keratinising squamous epithelium
  3. Z-line = transition from squamous –> gastric columnar
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33
Q

Gastro-oesophageal sphincter?

A

3 main components to prevent reflux

  1. LOS = 4cm long hypertrophied smooth muscle
  2. Extrinsic sphincter = skeletal muscle of R crus of diaphragm
  3. Physiologic sphincter = distal component projects into abdominal cavity and increases intrabdominal pressure –> compression, angle of His also forms a valve preventing reflux
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34
Q

Deep inguinal ring location?

A
  1. 1.5cm above femoral pulse or

2. Mid-point of inguinal ligament (ASIS–>PT)

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35
Q

Superficial inguinal ring?

A

Split in external oblique aponeurosis just superior and medial to the pubic tubercle

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36
Q

Inguinal canal length?

A

4cm

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37
Q

Inguinal canal borders?

A
  1. Floor = inguinal ligament
  2. Roof = arching fibres of internal oblique and transversus abdominis
  3. Anterior = external oblique aponeurosis + internal oblique for lateral 3rd
  4. Posterior = transversalis fascia + conjoint tendon for medial 3rd
  5. Laterally = deep ring
  6. Medially = pubic tubercle
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38
Q

Conjoint tendon?

A

Combined insertion of internal oblique and transversus abdominis into pubic crest and pectineal line

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39
Q

Contents of male inguinal canal?

A

Ilioinguinal nerve + spermatic cord

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40
Q

Contents of female inguinal canal?

A

Ilioinguinal nerve + genital branch of genitofemoral nerve + round ligament of uterus

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41
Q

Ilioinguinal nerve (L1) fx?

A
  1. Enters canal directly though anterior wall, does not pass through the deep ring
  2. Exits through superficial ring
  3. Supplies skin at the root of the penis and the scrotum (or labia majus) and small area of skin of upper inner thigh
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42
Q

Genital branch of genitofemoral nerve (L1/L2)?

A

Supplies cremaster muscle and scrotal skin/labia majus

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43
Q

Spermatic cord contents?

A
  1. 3 layers of fascia
  2. 3 arteries
  3. 3 veins
  4. 2 nerves
  5. 3 other structures
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44
Q

3 layers of fascia of spermatic cord?

A
  1. External spermatic = from external oblique
  2. Cremasteric = from internal oblique
  3. Internal spermatic = from transversalis fascia
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45
Q

3 arteries of spermatic cord?

A
  1. Testicular = from aorta
  2. Cremasteric = from inferior epigastric
  3. Artery of the vas = from inferior vesicular artery
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46
Q

3 veins of spermatic cord?

A
  1. Pampiniform plexus (R –> IVC, L –> left renal)
  2. Cremasteric vein
  3. Vein of vas
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47
Q

2 nerves of spermatic cord?

A
  1. Nerve to cremaster = from genitofemoral nerve
  2. Sympathetic fibres from T10-T11
  3. Ilioinguinal nerve is ON the cord
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48
Q

3 other structures in spermatic cord?

A
  1. Vas deferens
  2. Lymphatics of the testis –> para-aortic nodes
  3. Obliterated processus vaginalis
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49
Q

Inferior epigastric vessels fx?

A
  1. Arise from external iliac vessels immediately superior to the inguinal ligament
  2. Can be seen passing deep to the posterior wall (transversalis fascia)
  3. Sac arises lateral to vessels = indirect hernia
  4. Sac arises medial to vessels = direct hernia
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50
Q

Heselbach’s triangle?

A

Area of entry for direct hernia through the posterior wall

  1. Laterally = inferior epigastric artery
  2. Medially = rectus abdominis muscle
  3. Inferiorly = inguinal ligament
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51
Q

Femoral sheath fx?

A
  1. In the femoral triangle, the femoral artery, vein and lymphatics are enclosed within a femoral sheath
  2. Sheath is continuous superiorly with the transversalis fascia
  3. Each structure has its own compartment
  4. Most medial compartment = femoral canal
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52
Q

Borders of femoral canal?

A
  1. Anterior = inguinal ligament
  2. Posterior = pectineal ligament of Cooper + pectineus
  3. Medial = lacunar ligament and pubic bone
  4. Lateral = femoral vein
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53
Q

Contents of femoral canal?

A

Fat and Cloquet’s node

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54
Q

Layers of abdominal wall?

A
  1. Skin
  2. Camper’s fascia = fatty
  3. Scarpa’s fascia = membranous
  4. External oblique
  5. Internal oblique
  6. Nerves and vessels
  7. Transversus abdominis
  8. Transversalis fascia
  9. Pre-peritoneal fat
  10. Parietal peritoneum
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55
Q

Innervation of abdominal wall?

A
  1. Intercostal nerves = T7=T11
  2. Subcostal nerve = T12
  3. Ilio-inguinal and ilio-hypogastric nerves = L1
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56
Q

Blood supply of the abdominal wall?

A
  1. Superiorly

2. Inferiorly

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57
Q

Blood supply of superior abdominal wall?

A

Both are terminal branches of the internal thoracic artery

  1. Superficial = musculophrenic artery
  2. Deep = superior epigastric artery
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58
Q

Blood supply fo inferior abdominal wall?

A
  1. Superficial = superficial epigastric + superficial circumflex iliac arteries (branches of femoral artery)
  2. Deep = inferior epigastric + deep circumflex iliac arteries (branches of external iliac artery)
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59
Q

Rectus sheath fx?

A
  1. Arcuate line of Douglas = midway between umbilicus and pubic symphysis
  2. Above the arcuate line the sheath completely encloses the rectus muscle
  3. Below the arcuate line the sheath is deficient posteriorly and the rectus is in direct contact with the transversalis fascia
  4. This arrangement allows expansion of pelvic contents into the abdomen
  5. Semilunar lines = aponeurosis of external oblique at its line of division to enclose the rectus
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60
Q

L1 surface anatomy aka?

A

Transpyloric plane of Addison

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61
Q

L1 fx?

A
  1. Midway between jugular notch and pubic symphysis
  2. 9th costal cartilage
  3. Pyloric orifice and D1
  4. DJ flexure
  5. Fundus of gallbladder
  6. L and R colic flexures
  7. Neck of the pancreas
  8. Lower part of left renal hilum, upper part of right
  9. Origin of the SMA and coeliac trunk
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62
Q

L3 fx?

A
  1. Joins lowest point of the 10th ribs

2. Origin of IMA

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63
Q

L4 fx?

A
  1. Intercristal plane = joins highest points of iliac crests

2. Bifurcation of the aorta

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64
Q

Umbilicus level?

A

Normally L3/L4, but has an inconsistent position

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65
Q

Liver surface anatomy?

A
  1. Upper border at the level of the 5th ICS on each side

2. Lower border from the tip of the 10th rib on right to just medial to mid-clavicular line in the left 5th ICS

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66
Q

Gallbladder surface anatomy?

A

Where the mid-clavicular line meets the right costal margin: 9th costal cartilage

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67
Q

Spleen surface anatomy?

A

Underlies ribs 9-11 on the left

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68
Q

D1 Fx?

A
  1. Duodenal cap
  2. Commonest places for duodenal ulcers
  3. Overlapped by gallbladder (stones can erode into D1 –> ileus)
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69
Q

D2 fx?

A
  1. Descending part

2. Contains major duodenal papilla (mid –> hindgut)

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70
Q

D3 fx?

A
  1. Inferior part

2. Can be compressed by SMA aneurysm

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71
Q

D4 fx?

A
  1. Ascending part

2. Ends at DJ flexure/Ligament of Treitz

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72
Q

Posterior duodenal ulcer complication?

A

Can erode into GDA –> massive haematemesis

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73
Q

Anterior duodenal ulcer complication?

A

Pneumoperitoneum and peritonitis

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74
Q

Jejenum Fx?

A
  1. Proximal 2/5ths of small intestine
  2. Larger diameter and thicker wall
  3. Less prominent arcades
  4. Longer vasa recta
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75
Q

Ileum Fx?

A
  1. Distal 3/5ths
  2. Narrow diameter + thinner wall
  3. More prominent arcades
  4. Shorter vasa recta
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76
Q

Appendix fx?

A
  1. Base is consistently found at confluence of the caecal taenia coli
  2. Position of rest of appendix is highly variable (retrocaecal 75%, subcaecal/pelvic 20%, retro/pre-ileal 5%)
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77
Q

Appendicular artery?

A

Runs in the mesoappendix and is a branch of the ileocolic artery

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78
Q

Appendicitis pain fx?

A
  1. Initially visceral pain is carried by sympathetic afferents in the lesser splanchnic nerve which refers to T10 dermatome
  2. Later peritonitis –> somatic pain and localisation to RIF
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79
Q

Symptoms from a Meckel’s?

A

PR bleed, diverticulitis, intussusception

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80
Q

Distinguishing fx of large bowel?

A
  1. Large diameter
  2. Condensation of longitudinal muscle –> taenia coli
  3. Epiploic appendages
  4. Sacculations/haustra
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81
Q

Rectum fx?

A
  1. 12cm
  2. From sacral promontory to levator ani muscle
  3. The 3 taenia coli fuse around the rectum to form a continuous muscle layer
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82
Q

Anal canal fx?

A
  1. 4cm
  2. Levator ani muscle to anal verge
  3. Upper 2/3rds
  4. Lower 2/3rds
  5. Dentate line
  6. White line
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83
Q

Upper 2/3rds of anal canal fx?

A
  1. Lined by columnar epithelium
  2. Insensate
  3. Supplied by superior rectal artery and vein
  4. Internal iliac nodes
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84
Q

Lower 1/3rd of anal canal fx?

A
  1. Lined by squamous epithelium
  2. Sensate
  3. Middle and inferior rectal arteries and veins
  4. Superficial inguinal nodes
85
Q

Dentate line?

A

Squamoumucosal junction

86
Q

White line?

A

Where anal canal becomes true skin

87
Q

Anal sphincters?

A
  1. Internal
  2. External
  3. Anorectal ring
88
Q

Internal anal sphincter?

A
  1. Thickening of rectal smooth muscle

2. Involuntary Control

89
Q

External anal sphincter?

A
  1. Three rings of skeletal muscle = deep, superficial, subcutaneous
  2. Voluntary control
90
Q

Anorectal ring?

A
  1. Deep segment of external sphincter which is continuous with the puborectalis muscle (part of levator ani)
  2. Palpable on PR 5cm from the anus
  3. Demarcates junction between the anal canal and rectum
  4. Must be preserved to maintain continence
91
Q

Common areas for collections?

A
  1. Subphrenic recess
  2. Hepatorenal recess (Morrisons pouch)
  3. Lesser sac
  4. Paracolic gutters
  5. Small bowel (interloop spaces)
  6. Pelvis: Pouch of Douglas
92
Q

Coeliac trunk level?

A

L1

93
Q

Coeliac trunk branches?

A
  1. Left gastric artery
  2. Common hepatic artery
  3. Splenic artery
94
Q

SMA level?

A

L1

95
Q

SMA branches?

A

5 branches

  1. Inferior pancreaticoduodenal artery
  2. Ileal and jejunal vessels
  3. Middle colic
  4. Right colic
  5. Ileocolic
96
Q

Renal vessels level?

A

L1

97
Q

3 arteries at L1 level?

A
  1. Coeliac trunk
  2. SMA
  3. Renal vessels
98
Q

IMA level?

A

L3

99
Q

IMA branches?

A
  1. Left colic artery
  2. Sigmoidal branches
  3. Superior rectal artery
100
Q

Marginal artery of Drummond?

A
  1. Anastomotic artery between middle colic and ascending branch of left colic
  2. May maintain hindgut blood supply even when IMA stenosed
101
Q

Classification of nerve supply of the abdomen?

A
  1. Sympathetic
  2. Parasympathetic
  3. Enteric
102
Q

Sympathetic nerve supply of abdomen?

A

Thoracic and lumbar splanchnic nerves

103
Q

Parasympathetic nerve supply of abdomen?

A
  1. Vagus nerve

2. Pelvic splanchnic nerves

104
Q

Splanchnic nerves?

A
  1. Greater splanchnic nerve = foregut = T5-T10
  2. Lesser splanchnic nerve = midgut - T10-T11
  3. Least splanchnic nerve = kidneys = T12
  4. Lumbar splanchnic nerve = hindgut - L1-L2
105
Q

Enteric nervous system?

A
  1. Independent of CNS but does receive some sympathetic and parasympathetic input
  2. 2 layers = Myenteric plexus of Auerbach and Submucosal plexus of Meisner
106
Q

Lymphatics of the abdomen?

A
  1. Follow arteries
  2. Para-aortic nodes associated with each major branch
  3. Drain superiorly to the cisterna chyli –> thoracic duct
107
Q

Liver gross anatomy?

A
  1. Functionally divided by line through gallbladder fossa and IVC
  2. Split into 8 Couinaud segments = 4 on Right, 3 on Left
  3. Caudate lobe is functionally distinct
108
Q

Gallbladder gross anatomy?

A
  1. Stores and concentrates 50ml of bile

2. Supplied by cystic artery by also receives rich supply from the gallbladder bed –> gangrene is rare

109
Q

Calot’s triangle content?

A
  1. Cystic artery
  2. Calot/Lund’s node
  3. Aberrant RHA
110
Q

Borders of Calot’s triangle?

A
  1. Superior = inferior edge of liver
  2. Medial = CHD and RHD
  3. Inferior = cystic duct
111
Q

Ureter course?

A
  1. 25cm long
  2. Starts at the renal pelvis: L1 on the left, slightly lower on the right
  3. Runs inferiorly on the psoas muscle anterior to the tips of the transverse processes of the lumbar vertebra
  4. Cross sacroiliac joints passing anterior to iliac bifurcation
  5. Pass posteriorly to the ischial spines then anteriorly to the bladder
112
Q

3 ureteric narrowings?

A
  1. Pelviureteric junction
  2. Crossing the iliac vessels at the pelvic brim
  3. Vesicoureteric junction
113
Q

Male urethra features?

A

20cm long, 4 main parts

114
Q

4 main parts of the male urethra?

A
  1. Pre-prostatic = internal urethral sphincter
  2. Prostatic = openings of ejaculatory ducts, widest part
  3. Membranous = external urethral sphincter, narrowest part
  4. Spongy = longest part (for most)
115
Q

Coverings of the vas deferens in the scrotum?

A
  1. Skin
  2. Superficial scrotal fascia (Dartos fascia)
  3. External spermatic fascia
  4. Cremasteric fascia
  5. Internal spermatic fascia
  6. Pre-peritoneal fat
  7. Tunica vaginalis
  8. Vas
116
Q

5 types of neck fascia?

A
  1. Superficial
  2. Investing
  3. Pre-vertebral
  4. Pre-tracheal
  5. Carotid sheath
117
Q

Superficial neck fascia?

A

Platysma

118
Q

Investing neck fascia?

A

Completely surrounds neck, enclosed SCM and trapezius

119
Q

Pre-vertebral neck fascia?

A

Surrounds vertebral column and associated muscles

120
Q

Pre-tracheal neck fascia?

A

Surrounds trachea, oesophagus and thyroid

121
Q

Carotid sheath?

A

Surrounds internal carotid, internal jugular and CN X

122
Q

Thyroid gland gross anatomy?

A
  1. Lies over 3rd and 4th tracheal cartilages
  2. Invested in pretracheal fascia
  3. Strap muscles lie anterior
  4. Parathyroid glands posteriorly
123
Q

Arterial supply of thyroid?

A
  1. Superior thyroid (from ECA)

2. Inferior thyroid (from thyrocervical trunk)

124
Q

Venous drainage of thyroid?

A

Superior, middle and inferior thyroid veins

125
Q

Innervation of the larynx?

A

Motor and Sensory

126
Q

Motor innervation of the larynx?

A
  1. RLN supplies all intrinsic muscles except cricothyroid

2. External branch of superior laryngeal nerve supplies cricothyroid

127
Q

Sensory innervation of larynx?

A
  1. Internal branch of superior laryngeal nerve = above folds

2. RLN = below folds

128
Q

Semon’s Law?

A

Semon’s law states that in a progressive lesion of the recurrent laryngeal nerve, the abductors are paralysed before the adductors. This means that in an incomplete paralysis, the cord will be brought to the midline by the adductors, but in complete paralysis it falls away to the paramedian position

  1. Transection of RLN –> complete paralysis with cords half adducted/abducted, cannot speak or cough
  2. Trauma but not transection of RLN –> partial paralysis with cords adducted, cannot breathe if bilateral
129
Q

Triangles of the neck?

A
  1. Anterior
  2. Posterior
  3. Submandibular
130
Q

Anterior triangle of the neck borders?

A
  1. Anterior border of SCM
  2. Midline
  3. Ramus of the mandible
  4. Roof = investing fascia
131
Q

Posterior triangle of the neck borders?

A
  1. Posterior margin of SCM
  2. Anterior margin of trapezius
  3. Mid 1/3rd of clavicle
132
Q

Submandibular triangle fo the neck borders?

A
  1. Mental process
  2. Ramus of the mandible
  3. Line between two angles of the mandible
133
Q

Branches of the external carotid?

A 
Superior thyroid
Ascending pharyngeal
Lingual
Facial
Occipital
Posterior auricular
Maxillary
Superficial temporal
134
Q

Facial nerve path?

A
  1. Arises in medulla and emerges between pons and medulla to travel in the internal auditory canal
  2. Exits the internal auditory canal and forms the geniculate ganglion in the middle ear
  3. Traverses the length of the temporal bone, giving off t3 branches
  4. Exits temporal bone via stylomastoid foramen and runs into parotid gland
  5. Gives off nerves to posterior belly of digastric and stylohyoid
  6. Divides into 5 motor branches
135
Q

3 branches of facial nerve as it traverses the temporal bone?

A
  1. Greater superficial petrosal nerve = lacrimation
  2. Nerve to stapedius = lesions –> hyperacusis
  3. Chorda tympani = anterior 2/3rds taste
136
Q

5 motor branches of the facial nerve?

A
  1. Temporal
  2. Zygomatic
  3. Buccal
  4. Mandibular
  5. Cervical
137
Q

Why do UMN lesions spare the forehead?

A

Suprapontine crossover –> bilateral representation

138
Q

Structure of the hip joint?

A
  1. Ball and socket synovial joint between the head of the femur and the lunate surface of the acetabulum
  2. Ligamentum teres connects fovea on femoral head to acetabular fossa and transmits the artery of ligamentum teres (from obturator artery)
  3. Fibrous capsule composed of 3 ligaments and extends from margin of acetabulum to intertrochanteric line of the femur
139
Q

3 ligaments that make up the fibrous capsule of the hip joint?

A
  1. Ilifemoral ligament
  2. Ischiofemoral ligament
  3. Pubofemoral ligament
140
Q

Flexion of the hip segment, nerve and muscles?

A
  1. Segment = L2/L3
  2. Nerves = Femoral
  3. Muscles = Iliopsoas, rectus femoris, sartorius
141
Q

Extension of the hip segment, nerve and muscles?

A
  1. Segment = L4/L5
  2. Nerves = Inferior gluteal
  3. Muscles = Gluteus maximus
142
Q

Adduction of the hip segment, nerve and muscles?

A
  1. Segment = L2/L3
  2. Nerves = Obturator
  3. Muscles = Adductors
143
Q

Abduction of the hip segment, nerve and muscles?

A
  1. Segment = L4/L5
  2. Nerves = Superior gluteal
  3. Muscles = Gluteus medius, gluteus minimus
144
Q

Internal rotation of the hip segment, nerve and muscles?

A
  1. Segment = L2/L3
  2. Nerves = Obturator
  3. Muscles = Adductors
145
Q

External rotation of the hip segment, nerve and muscles?

A
  1. Segment = L5/S1
  2. Nerves = Various
  3. Muscles = Short external rotators, gluteus maximus
146
Q

Bloods supply to the femoral head?

A
  1. Intramedullary vessels
  2. Retinacular vessels from the medial and lateral circumflex femoral arteries (distal –> proximal in the capsule)
  3. Artery of the ligamentum teres from the obturator artery (only contributes in children)
147
Q

Femoral triangle contents?

A

Femoral NAV and canal

148
Q

Femoral triangle borders?

A

SAIL

  1. Lateral = medial margin of Sartorius
  2. Medial = medial margin of Adductor longus
  3. Base = Inguinal ligament
149
Q

Gluteal muscles?

A
  1. Abductors = superior gluteal nerve
  2. Extensors = inferior gluteal nerve
  3. Short external rotators
150
Q

Abductor gluteal muscle nerve supply?

A

Superior gluteal nerve

151
Q

Gluteal abductors?

A

Gluteus medius and gluteus minimus

152
Q

Extensor gluteal muscle nerve supply?

A

Inferior gluteal nerve

153
Q

Gluteal extensors?

A

Gluteus maximus

154
Q

Short external rotators of gluteal regiong?

A
  1. Piriformis
  2. Obturator internus
  3. Quadratus femoris
  4. Superior and inferior gemelli
155
Q

Nerve of the gluteal region?

A

Sciatic nerve (L4-S3)

156
Q

Sciatic nerve roots?

A

L4-S3

157
Q

Sciatic nerve features?

A
  1. Enters via greater sciatic foramen below piriformis
  2. Found in lower medial quadrant of gluteal region
  3. Motor and sensory component
158
Q

Sciatic nerve motor component?

A
  1. Hamstrings
  2. Hamstring part of adductor magnus
  3. Muscles of leg and foot
159
Q

Sciatic nerve sensory component?

A
  1. Lateral leg and foot

2. Sole and dorsum of foot

160
Q

Anterior compartment of thigh function?

A
  1. Flex the hip = L2-3

2. Extend the knee = L3-L4

161
Q

Anterior compartment of thigh nerve?

A

Femoral nerve

162
Q

Femoral nerve noots?

A

L2-L4

163
Q

Anterior compartment of the thigh muscles?

A
  1. Iliopsoas
  2. Sartorius
  3. Rectus femoris
  4. Vastus muscles
164
Q

Medial compartment of the thigh function?

A

Adduct and internally rotate the hip

165
Q

Medial compartment of the thigh nerve?

A

Obturator nerve

166
Q

Obturator nerve roots?

A

L2-L4

167
Q

Medial compartment of the thigh muscles?

A
  1. Pectineus (femoral nerve)
  2. Adductor brevis, longus and magnus
  3. Gracilis
  4. Obturator externus
168
Q

Posterior compartment of the thigh function?

A
  1. Extend the hip = L4-L5

2. Flex the knee = L5-S1

169
Q

Posterior compartment of the thigh nerve?

A

Tibial division of sciatic nerve (L4-S3)

170
Q

Muscles of posterior compartment of the thigh?

A
  1. Biceps femoris
  2. Semitendinosus
  3. Semimembranosus
171
Q

Knee joint structure?

A
  1. Weight bearing articulation between the femur and tibia
  2. Articulation between patella and femur (reduced tendon wear, increased moment around knee joint)
  3. Features = 2 menisci, 4 bursae, 5 ligaments
172
Q

Knee joint menisci?

A
  1. 2 fibrocartilagenous menisci

2. Medial meniscus attached at its margin to medial collateral ligament

173
Q

Knee joint bursae?

A

4

  1. Suprapatellar bursa = continuous with joint capsule
  2. Subcutaneous pre-patellar bursa = can –> housemaid’s knee
  3. Deep and superficial infrapatellar bursae
174
Q

Knee joint ligaments?

A
  1. ACL = prevents anterior displacement of tibia relative to the femur
  2. PCL = prevents posterior displacement of the tibia relative to the femur
  3. Collaterals = medial and lateral
  4. Patellar ligament = inferior patella to tibial tuberosity
175
Q

Knee flexion segment, nerves and muscles?

A
  1. Segment = L5/S1
  2. Nerves = Sciatic (tibial)
  3. Muscles = Hamstrings (biceps femoris, semitendinosis, semimembranus), Sartorius (femoral nerve)
176
Q

Knee extension segment, nerves and muscles?

A
  1. Segment = L3/L4
  2. Nerves = Femoral
  3. Muscles = Quadriceps (vastus muscles, rectus femoris)
177
Q

Popliteal fossa boundaries?

A
  1. Superior
  2. Inferior
  3. Floor = capsule of knee joint
  4. Roof = deep fascia (continuous with fascia lata)
178
Q

Superior popliteal fossa?

A
  1. Medial = semitendinosus and semimembranosus

2. Lateral = biceps femoris

179
Q

Inferior popliteal fossa?

A
  1. Medial = medial head of gastrocnemius

2. Lateral = lateral head of gastrocnemius + plantaris

180
Q

Contents of popliteal fossa?

A
  1. Popliteal artery and vein
  2. Tibial nerve
  3. Common fibular nerve
181
Q

Blood supply to the knee and leg?

A
  1. Popliteal artery –> anterior and posterior tibial arteries
  2. Anterior tibial = supplies anterior compartment of the leg, palpable as dorsalis pedis
  3. Posterior tibial = supplies posterior compartment of the leg, gives rise to fibular artery (supplies lateral compartment), palpable behind medial malleolus
182
Q

Posterior compartment of leg function?

A
  1. Plantarflexion of the foot: S1-2

2. Flex the toes and invert the foot

183
Q

Posterior compartment of the leg nerve?

A

Tibial nerve

184
Q

Posterior compartment of the leg muscles?

A
  1. Superficial = gastrocnemius, plantaris, soleus

2. Deep = popliteus, FHL, FDL, tibialis posterior (L5)

185
Q

Lateral compartment of the leg function?

A

Evert the foot: S1

186
Q

Lateral compartment of the leg nerve?

A

Superficial fibular nerve

187
Q

Lateral compartment of the leg muscles?

A
  1. Fibularis longus

2. Fibularis brevis

188
Q

Anterior compartment of the leg function?

A
  1. Dorsiflexion of the foot: L5-S1

2. Extension of the toes and eversion of the foot: S1

189
Q

Anterior compartment of the leg nerve?

A

Deep fibular nerve = supplies skin between great and 2nd toe

190
Q

Anterior compartment of the leg muscles?

A
  1. Tibialis anterior
  2. EHL
  3. EDL
  4. Fibularis (Peroneus) tertius
191
Q

Brachial plexus roots?

A

C5-T1

192
Q

Brachial plexus fx?

A
  1. Roots leave vertebral column between scalenus anterior and medius
  2. Divisions occur under the clavicle, medial to coracoid process
  3. Plexus has intimate relationship with subclavian and brachial arteris
  4. Median nerve is formed anterior to brachial artery
193
Q

Brachial plexus how many roots?

A

5

194
Q

Brachial plexus how many trunks?

A

3

195
Q

Brachial plexus how many divisions?

A

6

196
Q

Brachial plexus how many cords?

A

3

197
Q

Anterior compartment of the arm function, nerve and muscles

A
  1. Function = forearm flexion (C5/6)
  2. Nerve = musculocutaneous
  3. Muscles = biceps brachii, coracobrachialis, brachialis
198
Q

Posterior compartment of the arm function, nerve and muscles?

A
  1. Function = forearm extension (C7)
  2. Nerve = radial
  3. Muscles = triceps
199
Q

Antecubital fossa fx?

A
  1. Superficial = median cubital vein

2. Deep = radial nerve, medial nerve, brachial artery

200
Q

Anterior compartment of the forearm function, nerve and muscles?

A
  1. Function = Wrist and finger flexion (C7-8)
  2. Nerve = Mostly median nerve
  3. Muscles = Superficial and deep
201
Q

Superficial anterior forearm muscles?

A
  1. Pronator teres
  2. Flexor carpi radialis
  3. Flexor carpi ulnaris
  4. Flecor digitorum superficialis
  5. Palmaris longus
202
Q

Deep anterior forearm muscles?

A
  1. Flexor digitorum profundus
  2. Flexor pollicis longus
  3. Pronator quadratus
203
Q

Anatomical snuffbox borders?

A
  1. Lateral = APL and EPB
  2. Medial = EPL
  3. Proximal = radial styloid process
  4. Floor = scaphoid and trapezium
204
Q

Contents of anatomical snuffbox?

A
  1. Radial artery
  2. Cephalic vein
  3. Dorsal cutaneous branch of radial nerve
205
Q

Carpal tunnel formation?

A

Flexor retinaculum and carpal bones

206
Q

Contents of carpal tunnel?

A
  1. 4 tendons of FDS
  2. 4 tendons of FDP
  3. 1 tendon of FPL
  4. Median nerve
207
Q

What does median nerve supply?

A

LOAF

  1. Lateral 2 lumbricals
  2. Opponens pollicis
  3. Abductor pollicis brevis
  4. Flexor pollicis brevis
208
Q

Where does the palmar cutaneous branch of the median nerve travel?

A

Superficial to the flexor retinaculum –> carpal tunnel syndrome spares sensation over thenar area

Medicine and Surgery Mushkies (52 decks)

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