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Anatomy (MPAS) > Lecture 12: MSK 3 > Flashcards

Lecture 12: MSK 3 Flashcards

1
Q

General function of lower extremity

A

Responsible for stability (posture) and locomotion

Concentric and Eccentric (muscles shorten and lengthen)

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2
Q

Three regions of lower extremity

A

Pelvic region: between iliac crest and gluteal fold

Thigh: between hip and knee

Lower leg: below the knee

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3
Q

How are bones arranged in pelvic girdle?

A

Bones form a complete ring: basin

See figure

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4
Q

Role of pelvic girdle

A

Weight bearing

Bipedal movement (upright walking)

Protects reproductive organs

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5
Q

What is the hip bone composed of?

A

aka innominate bone

Three bones that fuse together (Y shape in acetabulum)

Ilium

Ischium

Pubis

See figure

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6
Q

Ilium (shape, location, role)

A

Large fan shape

Makes up proximal portion of innominate bone

Protects lower abdominal contents

Provides surface area for attachment of large powerful muscles

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7
Q

Ischium location

A

Posterior and inferior aspect of innominate bone

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8
Q

Pubis location

A

Anterior/inferior aspect of the innominate bone

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9
Q

Where is the sacroiliac joint?

A

Between the auricular surface of the ilium and the auricular surface of the sacrum

See figure

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10
Q

Sacroiliac joint type

A

Partly synovial (anterior)

Partly fibrous (posterior)

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11
Q

Movement allowed by sacroiliac joint

A

Some flexion/extension

Important in walking and full forward flexion

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12
Q

How is the sacroiliac joint supported?

A

Very strong ligaments

  1. Sacroiliac ligaments (ant/post)
  2. Sacrospinous ligament
  3. Sacrotuberous ligament
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13
Q

Where is the symphysis pubis?

A

Point where the two pubic bodies join anteriorly

See figure

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14
Q

How are the pubic bones joined?

A

Two very strong ligaments superiorly and inferiorly

Dense fibrocartilagenous disc in between which allows minimal movement

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15
Q

What does pregnancy do to the pubic symphysis?

A

Softens and loosens the pubic symphysis

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16
Q

Hip joint type

A

Ball and socket

Synovial and multi-axial

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17
Q

What bones articulate in the hip joint?

A

head of the femur and the acetabulum of the innominate bone

It is one of the most secure, yet very mobile joints

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18
Q

What is the acetabulum?

A

Incomplete ring on the lateral surface of the innominate bone

See figure

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19
Q

What closes the acetabulum?

A

transverse acetabular ligament

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20
Q

What is the acetabular fossa?

A

Deepest part of the acetabulum

Does not articulate with the femur

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21
Q

What is the lunate surface of the acetabulum?

A

Horseshoe shaped articular
(hyaline) cartilage

Articulates with the head of the femur

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22
Q

Parts of femur (proximal end) and functions

A

Neck: joins the head to the shaft of the long bone

Greater and lesser trochater: prominences for muscle attachments

Intertrochanteric line: joint and ligaments attach here

See figure

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23
Q

Characteristics of hip joint and capsule

A

Tight, strong, extensive

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24
Q

Where doe the hip joint capsule extend from? What is it reinforced by?

A

Extends from just beyond the outer edge of the acetabulum over femur to attach to level area around intertrochanteric line.

Reinforced by 3 strong thick ligaments which all resist excessive abduction: Ilio-femoral, Ischio-femoral, Pubo-femoral

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25
Q

What bones form the knee joint?

A

Femur, patella, tibia

Fibula is not part of knee joint

See figure

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26
Q

What is the largest and most complex joint in the human body?

A

Knee joint

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27
Q

Knee joint type?

A

Synovial

Modified hinge

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28
Q

Stability of knee joint

A

Lacks bony stability

Stability is dependent on soft tissue structures (muscles, tendons and ligaments)

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29
Q

What bones form the patellofemoral joint (PFJ)?

A

Articulation between the trochlea of the femur and the posterior surface of the patella.

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30
Q

What is the centerpiece of the extensor mechanism?

A

PFJ

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31
Q

Knee movements

A

Modified Hinge Joint: “Screw Home Mechanism”: rotates when it comes into
full extension

Primary: Flexion / Extension (approx. 135 degrees)

Secondary: Medial / Lateral Rotation when flexed
(Approx. 45 degrees when knee flexed to 90 degrees)

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32
Q

Ligamentous support of the knee

A

Medial collateral ligament (MCL)

Lateral collateral ligament (LCL)

Anterior cruciate ligament (ACL)

Posterior cruciate ligament (PCL)

Meniscus

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33
Q

Shape of MCL

A

Fan shaped

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34
Q

What does the MCL attach to?

A

medial femoral epicondyle proximally and medial surface of the tibia distally

Also attached to the medial meniscus

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35
Q

Role of MCL

A

Resists valgus force

See figure

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36
Q

Shape of lateral collateral ligament (LCL)

A

Cord like

Easily palpated

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37
Q

What is LCL attached to?

A

From lateral epicondyle of the femur to fibular head

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38
Q

Role of LCL

A

Resists varus force

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39
Q

Where are cruciate ligaments of knee found?

A

Contained in thin, vascularized envelope formed by synovial lining

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40
Q

Blood supply of cruciate ligaments

A

Poor blood supply

Inadequate ability to heal

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41
Q

Function cruciate ligaments

A

1° restraint: Tibial translation (TT)

2 ° restraint: Int / Ext rotation and Varus / Valgus angulation

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42
Q

Location/attachments of ACL

A

APEX

Attaches to the Anterior portion of the intercondylar eminence.

Runs in a Posterior / Superior direction

Runs towards the External aspect of the joint

Note: medial surface of the lateral femoral condyle

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43
Q

Location/attachment of PCL

A

PAIN

Attaches to the Posterior aspect of the intercondylar eminence

Runs in and Anterior direction toward the front of the knee joint

Runs inward towards the Internal aspect of the

Note: lateral surface of the medial femoral condyle

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44
Q

Medial meniscus (shape, attachments)

A

C shaped

disc like structure with a high outer edge

attached to joint capsule and medial collateral ligament (MCL)

45
Q

Lateral meniscus (shape, attachments)

A

O shaped

disc like structure with a high outer edge

connected to popliteus muscle

46
Q

Function of meniscus

A

1 .Deepen the tibial surface to increase joint stability.

  1. Spreads out the load bearing force on the joint.
  2. Helps in the control of rotational and gliding motion at the tibio-femoral joint.
  3. Helps circulate the synovial fluid thru the joint.
47
Q

Tibia and fibula

A

See figure

48
Q

Bones of foot vs bones of hand

A

Analogous to the bones of the hand but modified for weight bearing and locomotion.

49
Q

What are the bones of the foot?

A

7 tarsals (talus, calcaneous, cuboid, navicular, lateral cuneiform, intermediate cuneiform, medial cuneiform)

5 metatarsals

14 phalanges

See figure

50
Q

Ankle joint type? Composition?

A

Synovial joint

Comprised of 2 joints (Talocrural and subtalar)

51
Q

Stability of ankle joint

A

Stable in dorsi flexion

Unstable in planter flexion

Strong ligaments

Weak muscles

52
Q

Which ankle joint is the true ankle joint?

A

Talocrural

53
Q

Bones that form talocrural joint

A

Between the distal end of the
tibia & fibula and the talus

Referred to as a brick and mortar joint because of its bony configuration

The tibia and fibula form a mortise in which the dome of the talus fits.

See figure

54
Q

Stability of talocrural joint

A

More stable in eversion then inversion

55
Q

Bones that form subtler joint

A

The joint between the superior aspect of the calcaneus and the inferior aspect of the talus.

56
Q

Ankle joint movements

A

Talocrural: dorsiflexion, plantar flexion

Subtalar: inversion, eversion

See figure

57
Q

What are the lateral ligaments of the ankle?

A
  1. Anterior Talofibular
  2. Calcaneofibular
  3. Posterior Talofibular

See figure

58
Q

Where are the medial ligaments of the ankle?

A

Extends from the medial malleolus of the tibia and attaches on the talus, calcaneus, & navicular bones

59
Q

What are the gluteal region muscles?

A

Gluteus Maximus

Gluteus Medius

Gluteus Minimus

Piriformis

See figure

60
Q

What is the largest muscle of the gluteal region?

A

Gluteus maximus

61
Q

Actions of gluteus maximus

A

Extension of the hip

Lateral rotation of the extended hip

Composite motion: push-off in skating

62
Q

Innervation of gluteus maximus

A

Inferior gluteal nerve

63
Q

Role of gluteus medius and minimus

A

Critical stabilizer of pelvis during single leg support such as walking & running

Maintains horizontal pelvic alignment during single leg stance phase

Inability to stabilize results in “waddling” or Trendenlenburg gait pattern.

64
Q

Actions of gluteus medius and minimus

A

Internal Hip Rotation

Abduction of Hip

65
Q

Innervation of gluteus medium and minimus

A

Superior Gluteal Nerve

66
Q

What is the trendelenburg sign?

A

When gluteus medius and minimus are inactive, they cannot provide support

The pelvis falls on the side of the raised limb

67
Q

Where is the piriformis in relation to the gluteal muslces? Where does it arise from?

A

Deep to the gluteal muscles

Exits the pelvis to the gluteal region via the greater sciatic foramen

68
Q

Where is the sciatic nerve in reference to the piriformis?

A

Sciatic nerve is just inferior to piriformis

69
Q

Action of piriformis

A

Lateral rotation of hip

70
Q

Innervation of piriformis

A

Nerve to piriformis

71
Q

Composition of the ilio-psoas?

A

2 separate muscles at the proximal end (poas major and iliacus) join distally and have common attachment on femur

72
Q

Actions of ilio-psoas

A

Flexion of thigh / hip joint

73
Q

Innervation of ilio-psoas

A

Psoas: Ventral rami L1–L3 • Iliacus: Femoral nerve

74
Q

Sartorius location, shape, attachments

A

Superficial, Strap like

Runs from lateral hip to medial knee

Longest muscle in body

75
Q

Action of sartorial

A

Knee & Hip Flexion

NB: when need both at same time

76
Q

Innervation of sartorial

A

Femoral nerve

77
Q

Other name for sartorius

A

“TAILOR SIT MUSCLE”

FABER

FLEXION, ABDUCTION, EXTERNAL, ROTATION OF HIP, FLEXION OF KNEE

78
Q

Which muscles allow hip extension?

A

*Gluteus Maximus

Hamstrings

Adductor Magnus

79
Q

Which muscles allow hip flexion?

A
  • Ilio Psoas
  • Rectus Femoris

TFL

Pectineus

Adductor longus & brevis

80
Q

Which muscles allow hip abduction?

A
  • Gluteus Medius
  • Gluteus Minimus

Tensor Fascia Lata (TFL)

Ilio-Tibial Band (ITB)

81
Q

Which muscles allow hip adduction?

A
  • Pectineus
  • Adductor Magnus
  • Gracilis
  • Adductor longus & brevis
82
Q

Which muscles allow internal rotation of hip?

A
  • Gluteus medius

* Gluteus minimus

83
Q

Which muscles allow external rotation of hip?

A
  • Glut Maximus
  • Piriformis

Obturator Internus & Externus

Superior & Inferiorm Gemelli

Quadratus Femoris

84
Q

What joint do the medial thigh muscles cross?

A

Hip joint

Only one crosses the knee (gracilus)

85
Q

Common action of medial thigh muscles

A

Hip adduction

86
Q

Innervation of medial thigh muscles

A

Obturator nerve

87
Q

What are the medial thigh muslces?

A
  1. Adductor Brevis
  2. Adductor Longus
  3. Adductor Magnus
  4. Pectineus
  5. Gracilis
88
Q

Function of anterior thigh muscles

A

Large, powerful, anti-gravity

Essential for activities of daily living

89
Q

Innervation of anterior thigh muscles

A

Femoral nerve

90
Q

Blood supply of anterior thigh muscles

A

Femoral artery and vein

91
Q

Quadriceps femoris muscle group

A

Rectus femoris

Vasti medialis

Vasti intermedius

Vasti lateralis

92
Q

Rectus femoris (joints crossed, movement)

A

Rectus Femoris: Straight superficial portion that
crosses both hip and knee joints

Power hip flexion / knee extension

93
Q

Vasti components of quadriceps femurs group (location, movement)

A

Surround the shaft of femur and wrap around thigh from back.

Knee extension

94
Q

Where do the quadriceps femoris muscles insert?

A

Tibial tuberosity via the quadriceps tendon - patella - patellar tendon/ligament

95
Q

Innervation of quadriceps femurs group

A

Femoral nerve

96
Q

Hamstring muscles

A

Biceps femoris

Semi-membranosus

Semi-tendinosis

97
Q

Joints crossed by hamstrings, origin

A

Hip and knee

origin: ischial tuberosity (innominate bone)

98
Q

Movement of hamstrings

A

Rotation of flexed knee

Modified hinge joint

99
Q

Innervation of hamstrings

A

Sciatic nerve

100
Q

What muscles are attached to the illiotibial band?

A

Tensor fascia latae

Gluteus maximus

See figure

101
Q

Muscles of anterior compartment of lower leg, innervation

A
  1. Tibialis anterior
  2. Extensor Hallucis longus
  3. Extensor Digitorum longus
  4. Peroneus tertius

All innervated by Deep peroneal nerve

102
Q

Muscles of lateral compartment of lower leg? Innervation? what do they wrap around?

A
  1. Peroneus Longus
  2. Peroneus Brevis

All innervated by Superficial peroneal nerve (L5-S2)
All wrap around lateral malleolus

103
Q

Muscles of superficial posterior compartment of lower leg? Innervation? attachment?

A
  1. Gastrocnemius
  2. Soleus
  3. Plantaris

All innervated by Tibial Nerve

Common distal attachment: Achilles tendon

104
Q

Muscles of deep posterior compartment of lower leg? Innervation? attachment?

A
  1. Tibialis Posterior
  2. Flexor Digitorum Longus
  3. Flesor Hallicus Longus

All innervated Tibial nerve

Arise from posterior fibula & tibia

All wrap around medial malleolus

105
Q

Borders of femoral triangle

A

Inguinal ligament

Sartorius

Adductor longus

106
Q

Floor of femoral triangle

A

Iliopsoas

Pectineus

Adductor longus

107
Q

Contents of femoral triangle (medial to lateral)

A

Femoral Vein

Femoral Artery

Femoral Nerve

108
Q

Blood supply to the lower extremity

A

See figure

109
Q

Innervation of the lower extremity

A

See figure

Anatomy (MPAS) (22 decks)

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