Key Anatomy Mushkies Flashcards
1
Q
Chest wall surface landmarks?
A
- Superior angle of scapula = T2
- Inferior angle of scapula = T8
- Sternal angle = T4/5
- Subcostal plane = L3
- Nipples = 4th ICS
2
Q
Pleura surface markings?
A
8th, 10th and 12th ribs
3
Q
Lung surface markings?
A
6th, 8th and 10th ribs
4
Q
Oblique fissure surface marking?
A
- T4 in midline posteriorly
- 5th rib laterally
- 6th costal cartilage anteriorly
5
Q
Horizontal fissure surface marking?
A
Follows contour of 4th rib anteriorly
6
Q
Breast surface anatomy?
A
Attached between ribs 2-6, axillary tail follows lower margin of pec major
7
Q
Sternal angle level?
A
T4/5
8
Q
What happens internally at the sternal angle?
A
ABCD S2
- Aortic arch = beginning and end
- Bifurcation of pulmonary arterial trunk
- Carina
- Division of superior and inferior mediastinum
- SVC enters RA
- 2nd costosternal joint
9
Q
What is the breast composed of?
A
Mammary glands and connective tissue stroma
10
Q
Mammary glands fx?
A
Ducts and secretory lobules converge to form 15-20 lactiferous ducts which open onto the nipple
11
Q
Connective tissue of breast fx?
A
- Surrounds mammary glands
- Suspensory ligaments of Cooper are continuous with the dermis and support the breast
- Layer of loose connective tissue (retromammary space) separates the breast from the deep fascia and allows some movement over the underlying structures
12
Q
Arterial supply of the breast?
A
- Laterally = vessels from the axillary artery
- Medially = branches from the internal thoracic artery
- 2nd-4th intercostals via superficial perforating branches
13
Q
Lymphatic drainage of the breast?
A
- 75% drain superolaterally into axillary nodes
2. Remainder into deep parasternal nodes
14
Q
3 main openings in diaphragm?
A
Vena cava = T8
Oesophagus = T10
Aortic hiatus = T12
15
Q
2 congenital hernias in the diaphragm?
A
- Morgagni = anterior
2. Bochdalek = posterior
16
Q
Superior mediastinum boundaries?
A
- Superior = thoracic inlet
- Inferior = angle of louis (T4/5, thoracic plane)
- Lateral = pleura
- Anterior = manubrium
- Posterior = T1-T4
17
Q
Superior mediastinum contents?
A
- Arteries = aortic arch and branches
- Veins = brachiocephalics, SVC
- Nerves = vagi, phrenics, L recurrent laryngeal nerve
- Organs = thymus, trachea, oesophagus, thoracic duct, lymph nodes
18
Q
Anterior mediastinum site and contents?
A
- Anterior to the pericardium
2. Thymus and lymph nodes
19
Q
Posterior mediastinum contents?
A
DATES
- Descending aorta
- Azygous vein and hemiazygous
- Thoracic duct
- Oesophagus
- Sympathetic trunks
20
Q
What does RLN supply?
A
All intrinsic laryngeal muscles except cricothyroid (external branch of superior laryngeal nerve)
21
Q
What does left RLN recur around?
A
Ligamentum arteriosum (remnant of ductus arteriosum)
22
Q
What does right RLN recur around?
A
Right subclavian artery
23
Q
Damage to RLN during what surgery?
A
- Thyroid surgery
- Parathyroid surgery
- Bronchogenic Ca
24
Q
Unilateral RLN palsy result?
A
Hoarseness
25
Bilateral RLN palsy result?
Aphonia
26
Chylothorax?
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
27
Venous system at the thoracic outlet?
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
28
Oesophagus length?
25cm
29
Distance from lips to GOJ?
40cm
30
Path of oesophagus?
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
31
4 locations of narrowing of oesophagus?
1. Level of cricoid = junction with pharynx
2. Posterior to aortic arch
3. Posterior to left main bronchus
4. LOS
32
Histology of oesophagus?
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
33
Gastro-oesophageal sphincter?
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
34
Deep inguinal ring location?
1. 1.5cm above femoral pulse or
| 2. Mid-point of inguinal ligament (ASIS-->PT)
35
Superficial inguinal ring?
Split in external oblique aponeurosis just superior and medial to the pubic tubercle
36
Inguinal canal length?
4cm
37
Inguinal canal borders?
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
38
Conjoint tendon?
Combined insertion of internal oblique and transversus abdominis into pubic crest and pectineal line
39
Contents of male inguinal canal?
Ilioinguinal nerve + spermatic cord
40
Contents of female inguinal canal?
Ilioinguinal nerve + genital branch of genitofemoral nerve + round ligament of uterus
41
Ilioinguinal nerve (L1) fx?
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
42
Genital branch of genitofemoral nerve (L1/L2)?
Supplies cremaster muscle and scrotal skin/labia majus
43
Spermatic cord contents?
1. 3 layers of fascia
2. 3 arteries
3. 3 veins
4. 2 nerves
5. 3 other structures
44
3 layers of fascia of spermatic cord?
1. External spermatic = from external oblique
2. Cremasteric = from internal oblique
3. Internal spermatic = from transversalis fascia
45
3 arteries of spermatic cord?
1. Testicular = from aorta
2. Cremasteric = from inferior epigastric
3. Artery of the vas = from inferior vesicular artery
46
3 veins of spermatic cord?
1. Pampiniform plexus (R --> IVC, L --> left renal)
2. Cremasteric vein
3. Vein of vas
47
2 nerves of spermatic cord?
1. Nerve to cremaster = from genitofemoral nerve
2. Sympathetic fibres from T10-T11
3. Ilioinguinal nerve is ON the cord
48
3 other structures in spermatic cord?
1. Vas deferens
2. Lymphatics of the testis --> para-aortic nodes
3. Obliterated processus vaginalis
49
Inferior epigastric vessels fx?
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
50
Heselbach's triangle?
Area of entry for direct hernia through the posterior wall
1. Laterally = inferior epigastric artery
2. Medially = rectus abdominis muscle
3. Inferiorly = inguinal ligament
51
Femoral sheath fx?
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
52
Borders of femoral canal?
1. Anterior = inguinal ligament
2. Posterior = pectineal ligament of Cooper + pectineus
3. Medial = lacunar ligament and pubic bone
4. Lateral = femoral vein
53
Contents of femoral canal?
Fat and Cloquet's node
54
Layers of abdominal wall?
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
55
Innervation of abdominal wall?
1. Intercostal nerves = T7=T11
2. Subcostal nerve = T12
3. Ilio-inguinal and ilio-hypogastric nerves = L1
56
Blood supply of the abdominal wall?
1. Superiorly
| 2. Inferiorly
57
Blood supply of superior abdominal wall?
Both are terminal branches of the internal thoracic artery
1. Superficial = musculophrenic artery
2. Deep = superior epigastric artery
58
Blood supply fo inferior abdominal wall?
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)
59
Rectus sheath fx?
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
60
L1 surface anatomy aka?
Transpyloric plane of Addison
61
L1 fx?
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
62
L3 fx?
1. Joins lowest point of the 10th ribs
| 2. Origin of IMA
63
L4 fx?
1. Intercristal plane = joins highest points of iliac crests
| 2. Bifurcation of the aorta
64
Umbilicus level?
Normally L3/L4, but has an inconsistent position
65
Liver surface anatomy?
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
66
Gallbladder surface anatomy?
Where the mid-clavicular line meets the right costal margin: 9th costal cartilage
67
Spleen surface anatomy?
Underlies ribs 9-11 on the left
68
D1 Fx?
1. Duodenal cap
2. Commonest places for duodenal ulcers
3. Overlapped by gallbladder (stones can erode into D1 --> ileus)
69
D2 fx?
1. Descending part
| 2. Contains major duodenal papilla (mid --> hindgut)
70
D3 fx?
1. Inferior part
| 2. Can be compressed by SMA aneurysm
71
D4 fx?
1. Ascending part
| 2. Ends at DJ flexure/Ligament of Treitz
72
Posterior duodenal ulcer complication?
Can erode into GDA --> massive haematemesis
73
Anterior duodenal ulcer complication?
Pneumoperitoneum and peritonitis
74
Jejenum Fx?
1. Proximal 2/5ths of small intestine
2. Larger diameter and thicker wall
3. Less prominent arcades
4. Longer vasa recta
75
Ileum Fx?
1. Distal 3/5ths
2. Narrow diameter + thinner wall
3. More prominent arcades
4. Shorter vasa recta
76
Appendix fx?
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%)
77
Appendicular artery?
Runs in the mesoappendix and is a branch of the ileocolic artery
78
Appendicitis pain fx?
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
79
Symptoms from a Meckel's?
PR bleed, diverticulitis, intussusception
80
Distinguishing fx of large bowel?
1. Large diameter
2. Condensation of longitudinal muscle --> taenia coli
3. Epiploic appendages
4. Sacculations/haustra
81
Rectum fx?
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
82
Anal canal fx?
1. 4cm
2. Levator ani muscle to anal verge
3. Upper 2/3rds
4. Lower 2/3rds
5. Dentate line
6. White line
83
Upper 2/3rds of anal canal fx?
1. Lined by columnar epithelium
2. Insensate
3. Supplied by superior rectal artery and vein
4. Internal iliac nodes
84
Lower 1/3rd of anal canal fx?
1. Lined by squamous epithelium
2. Sensate
3. Middle and inferior rectal arteries and veins
4. Superficial inguinal nodes
85
Dentate line?
Squamoumucosal junction
86
White line?
Where anal canal becomes true skin
87
Anal sphincters?
1. Internal
2. External
3. Anorectal ring
88
Internal anal sphincter?
1. Thickening of rectal smooth muscle
| 2. Involuntary Control
89
External anal sphincter?
1. Three rings of skeletal muscle = deep, superficial, subcutaneous
2. Voluntary control
90
Anorectal ring?
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
Common areas for collections?
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
Coeliac trunk level?
L1
93
Coeliac trunk branches?
1. Left gastric artery
2. Common hepatic artery
3. Splenic artery
94
SMA level?
L1
95
SMA branches?
5 branches
1. Inferior pancreaticoduodenal artery
2. Ileal and jejunal vessels
3. Middle colic
4. Right colic
5. Ileocolic
96
Renal vessels level?
L1
97
3 arteries at L1 level?
1. Coeliac trunk
2. SMA
3. Renal vessels
98
IMA level?
L3
99
IMA branches?
1. Left colic artery
2. Sigmoidal branches
3. Superior rectal artery
100
Marginal artery of Drummond?
1. Anastomotic artery between middle colic and ascending branch of left colic
2. May maintain hindgut blood supply even when IMA stenosed
101
Classification of nerve supply of the abdomen?
1. Sympathetic
2. Parasympathetic
3. Enteric
102
Sympathetic nerve supply of abdomen?
Thoracic and lumbar splanchnic nerves
103
Parasympathetic nerve supply of abdomen?
1. Vagus nerve
| 2. Pelvic splanchnic nerves
104
Splanchnic nerves?
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
Enteric nervous system?
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
Lymphatics of the abdomen?
1. Follow arteries
2. Para-aortic nodes associated with each major branch
3. Drain superiorly to the cisterna chyli --> thoracic duct
107
Liver gross anatomy?
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
Gallbladder gross anatomy?
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
Calot's triangle content?
1. Cystic artery
2. Calot/Lund's node
3. Aberrant RHA
110
Borders of Calot's triangle?
1. Superior = inferior edge of liver
2. Medial = CHD and RHD
3. Inferior = cystic duct
111
Ureter course?
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
3 ureteric narrowings?
1. Pelviureteric junction
2. Crossing the iliac vessels at the pelvic brim
3. Vesicoureteric junction
113
Male urethra features?
20cm long, 4 main parts
114
4 main parts of the male urethra?
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
Coverings of the vas deferens in the scrotum?
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
5 types of neck fascia?
1. Superficial
2. Investing
3. Pre-vertebral
4. Pre-tracheal
5. Carotid sheath
117
Superficial neck fascia?
Platysma
118
Investing neck fascia?
Completely surrounds neck, enclosed SCM and trapezius
119
Pre-vertebral neck fascia?
Surrounds vertebral column and associated muscles
120
Pre-tracheal neck fascia?
Surrounds trachea, oesophagus and thyroid
121
Carotid sheath?
Surrounds internal carotid, internal jugular and CN X
122
Thyroid gland gross anatomy?
1. Lies over 3rd and 4th tracheal cartilages
2. Invested in pretracheal fascia
3. Strap muscles lie anterior
4. Parathyroid glands posteriorly
123
Arterial supply of thyroid?
1. Superior thyroid (from ECA)
| 2. Inferior thyroid (from thyrocervical trunk)
124
Venous drainage of thyroid?
Superior, middle and inferior thyroid veins
125
Innervation of the larynx?
Motor and Sensory
126
Motor innervation of the larynx?
1. RLN supplies all intrinsic muscles except cricothyroid
| 2. External branch of superior laryngeal nerve supplies cricothyroid
127
Sensory innervation of larynx?
1. Internal branch of superior laryngeal nerve = above folds
| 2. RLN = below folds
128
Semon's Law?
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
Triangles of the neck?
1. Anterior
2. Posterior
3. Submandibular
130
Anterior triangle of the neck borders?
1. Anterior border of SCM
2. Midline
3. Ramus of the mandible
4. Roof = investing fascia
131
Posterior triangle of the neck borders?
1. Posterior margin of SCM
2. Anterior margin of trapezius
3. Mid 1/3rd of clavicle
132
Submandibular triangle fo the neck borders?
1. Mental process
2. Ramus of the mandible
3. Line between two angles of the mandible
133
Branches of the external carotid?
```
Superior thyroid
Ascending pharyngeal
Lingual
Facial
Occipital
Posterior auricular
Maxillary
Superficial temporal
```
134
Facial nerve path?
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
3 branches of facial nerve as it traverses the temporal bone?
1. Greater superficial petrosal nerve = lacrimation
2. Nerve to stapedius = lesions --> hyperacusis
3. Chorda tympani = anterior 2/3rds taste
136
5 motor branches of the facial nerve?
1. Temporal
2. Zygomatic
3. Buccal
4. Mandibular
5. Cervical
137
Why do UMN lesions spare the forehead?
Suprapontine crossover --> bilateral representation
138
Structure of the hip joint?
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
3 ligaments that make up the fibrous capsule of the hip joint?
1. Ilifemoral ligament
2. Ischiofemoral ligament
3. Pubofemoral ligament
140
Flexion of the hip segment, nerve and muscles?
1. Segment = L2/L3
2. Nerves = Femoral
3. Muscles = Iliopsoas, rectus femoris, sartorius
141
Extension of the hip segment, nerve and muscles?
1. Segment = L4/L5
2. Nerves = Inferior gluteal
3. Muscles = Gluteus maximus
142
Adduction of the hip segment, nerve and muscles?
1. Segment = L2/L3
2. Nerves = Obturator
3. Muscles = Adductors
143
Abduction of the hip segment, nerve and muscles?
1. Segment = L4/L5
2. Nerves = Superior gluteal
3. Muscles = Gluteus medius, gluteus minimus
144
Internal rotation of the hip segment, nerve and muscles?
1. Segment = L2/L3
2. Nerves = Obturator
3. Muscles = Adductors
145
External rotation of the hip segment, nerve and muscles?
1. Segment = L5/S1
2. Nerves = Various
3. Muscles = Short external rotators, gluteus maximus
146
Bloods supply to the femoral head?
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
Femoral triangle contents?
Femoral NAV and canal
148
Femoral triangle borders?
SAIL
1. Lateral = medial margin of Sartorius
2. Medial = medial margin of Adductor longus
3. Base = Inguinal ligament
149
Gluteal muscles?
1. Abductors = superior gluteal nerve
2. Extensors = inferior gluteal nerve
3. Short external rotators
150
Abductor gluteal muscle nerve supply?
Superior gluteal nerve
151
Gluteal abductors?
Gluteus medius and gluteus minimus
152
Extensor gluteal muscle nerve supply?
Inferior gluteal nerve
153
Gluteal extensors?
Gluteus maximus
154
Short external rotators of gluteal regiong?
1. Piriformis
2. Obturator internus
3. Quadratus femoris
4. Superior and inferior gemelli
155
Nerve of the gluteal region?
Sciatic nerve (L4-S3)
156
Sciatic nerve roots?
L4-S3
157
Sciatic nerve features?
1. Enters via greater sciatic foramen below piriformis
2. Found in lower medial quadrant of gluteal region
3. Motor and sensory component
158
Sciatic nerve motor component?
1. Hamstrings
2. Hamstring part of adductor magnus
3. Muscles of leg and foot
159
Sciatic nerve sensory component?
1. Lateral leg and foot
| 2. Sole and dorsum of foot
160
Anterior compartment of thigh function?
1. Flex the hip = L2-3
| 2. Extend the knee = L3-L4
161
Anterior compartment of thigh nerve?
Femoral nerve
162
Femoral nerve noots?
L2-L4
163
Anterior compartment of the thigh muscles?
1. Iliopsoas
2. Sartorius
3. Rectus femoris
4. Vastus muscles
164
Medial compartment of the thigh function?
Adduct and internally rotate the hip
165
Medial compartment of the thigh nerve?
Obturator nerve
166
Obturator nerve roots?
L2-L4
167
Medial compartment of the thigh muscles?
1. Pectineus (femoral nerve)
2. Adductor brevis, longus and magnus
3. Gracilis
4. Obturator externus
168
Posterior compartment of the thigh function?
1. Extend the hip = L4-L5
| 2. Flex the knee = L5-S1
169
Posterior compartment of the thigh nerve?
Tibial division of sciatic nerve (L4-S3)
170
Muscles of posterior compartment of the thigh?
1. Biceps femoris
2. Semitendinosus
3. Semimembranosus
171
Knee joint structure?
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
Knee joint menisci?
1. 2 fibrocartilagenous menisci
| 2. Medial meniscus attached at its margin to medial collateral ligament
173
Knee joint bursae?
4
1. Suprapatellar bursa = continuous with joint capsule
2. Subcutaneous pre-patellar bursa = can --> housemaid's knee
3. Deep and superficial infrapatellar bursae
174
Knee joint ligaments?
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
Knee flexion segment, nerves and muscles?
1. Segment = L5/S1
2. Nerves = Sciatic (tibial)
3. Muscles = Hamstrings (biceps femoris, semitendinosis, semimembranus), Sartorius (femoral nerve)
176
Knee extension segment, nerves and muscles?
1. Segment = L3/L4
2. Nerves = Femoral
3. Muscles = Quadriceps (vastus muscles, rectus femoris)
177
Popliteal fossa boundaries?
1. Superior
2. Inferior
3. Floor = capsule of knee joint
4. Roof = deep fascia (continuous with fascia lata)
178
Superior popliteal fossa?
1. Medial = semitendinosus and semimembranosus
| 2. Lateral = biceps femoris
179
Inferior popliteal fossa?
1. Medial = medial head of gastrocnemius
| 2. Lateral = lateral head of gastrocnemius + plantaris
180
Contents of popliteal fossa?
1. Popliteal artery and vein
2. Tibial nerve
3. Common fibular nerve
181
Blood supply to the knee and leg?
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
Posterior compartment of leg function?
1. Plantarflexion of the foot: S1-2
| 2. Flex the toes and invert the foot
183
Posterior compartment of the leg nerve?
Tibial nerve
184
Posterior compartment of the leg muscles?
1. Superficial = gastrocnemius, plantaris, soleus
| 2. Deep = popliteus, FHL, FDL, tibialis posterior (L5)
185
Lateral compartment of the leg function?
Evert the foot: S1
186
Lateral compartment of the leg nerve?
Superficial fibular nerve
187
Lateral compartment of the leg muscles?
1. Fibularis longus
| 2. Fibularis brevis
188
Anterior compartment of the leg function?
1. Dorsiflexion of the foot: L5-S1
| 2. Extension of the toes and eversion of the foot: S1
189
Anterior compartment of the leg nerve?
Deep fibular nerve = supplies skin between great and 2nd toe
190
Anterior compartment of the leg muscles?
1. Tibialis anterior
2. EHL
3. EDL
4. Fibularis (Peroneus) tertius
191
Brachial plexus roots?
C5-T1
192
Brachial plexus fx?
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
Brachial plexus how many roots?
5
194
Brachial plexus how many trunks?
3
195
Brachial plexus how many divisions?
6
196
Brachial plexus how many cords?
3
197
Anterior compartment of the arm function, nerve and muscles
1. Function = forearm flexion (C5/6)
2. Nerve = musculocutaneous
3. Muscles = biceps brachii, coracobrachialis, brachialis
198
Posterior compartment of the arm function, nerve and muscles?
1. Function = forearm extension (C7)
2. Nerve = radial
3. Muscles = triceps
199
Antecubital fossa fx?
1. Superficial = median cubital vein
| 2. Deep = radial nerve, medial nerve, brachial artery
200
Anterior compartment of the forearm function, nerve and muscles?
1. Function = Wrist and finger flexion (C7-8)
2. Nerve = Mostly median nerve
3. Muscles = Superficial and deep
201
Superficial anterior forearm muscles?
1. Pronator teres
2. Flexor carpi radialis
3. Flexor carpi ulnaris
4. Flecor digitorum superficialis
5. Palmaris longus
202
Deep anterior forearm muscles?
1. Flexor digitorum profundus
2. Flexor pollicis longus
3. Pronator quadratus
203
Anatomical snuffbox borders?
1. Lateral = APL and EPB
2. Medial = EPL
3. Proximal = radial styloid process
4. Floor = scaphoid and trapezium
204
Contents of anatomical snuffbox?
1. Radial artery
2. Cephalic vein
3. Dorsal cutaneous branch of radial nerve
205
Carpal tunnel formation?
Flexor retinaculum and carpal bones
206
Contents of carpal tunnel?
1. 4 tendons of FDS
2. 4 tendons of FDP
3. 1 tendon of FPL
4. Median nerve
207
What does median nerve supply?
LOAF
1. Lateral 2 lumbricals
2. Opponens pollicis
3. Abductor pollicis brevis
4. Flexor pollicis brevis
208
Where does the palmar cutaneous branch of the median nerve travel?
Superficial to the flexor retinaculum --> carpal tunnel syndrome spares sensation over thenar area
