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MRCSalah anatomy > Limb anatomy exam > Flashcards

Limb anatomy exam Flashcards

1
Q

Attachments of gluteus maximus

A

Originates from lateral sacrum, coccyx and gluteal surface of ilium at posterior gluteal line

INsertion: gluteal tuberosity

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2
Q

Attachments of gluteus medius

A

-Originates from gluteal surface of ilium, between posterior and anterior gluteal lines
-Inserts into lateral surface of greater trochanter

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3
Q

Attachments of gluteus minimus

A

Originates from gluteal surface of ilium between anterior and inferior gluteal lines
Inserts on anterior greater trochanter

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4
Q

Attachments of piriformis:

A

Anterior sacrum
INserts superior aspect greater trochanter

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5
Q

What is the attachment of the iliotibial tract/

A

-Origin; Tubercle of iliac crest
-Insertion: lateral tibial condyle

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6
Q

What muscles insert into iliotibial tract?

A

-Tensor fascia lata
-Gluteus maximus

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7
Q

What is the clinical significance of iliotibial tract?

A

-Stabilises knee in extension and in partial flexion. Is important in walking/running

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8
Q

Origin and insertion of quadriceps

A

-Vastus medialis: medial linea aspera–> Medial patella
-Vastus lateralis: lateral linea aspera –> lateral patella

-Vastus intermedius: proximal anterior femoral shaft –> patella

-Rectus femoris:
–> straight head: anterior inferior iliac spine
–> reflected head: acetabular rim
–> insertion: patella and tibial tubercle

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9
Q

Origins and insertions of the hamstrings

A

Origin:
–> All ischial tuberosity except for short head of biceps femoris (linea aspera_

Insertion:
–> biceps femoris: fibular head
–> others: Medial tibia/tibial condyle (membranosus

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10
Q

innervation of hamstring muscles

A

All tibial except for short head of biceps (peroneal)

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11
Q

What are the actions of the hamstring muscles?

A

-All 3 muscles: flexion of leg at knee, extension of thigh at hip

Biceps:
-Lateral rotation of hip and knee

Semitendinosus and semimembranous:
–> medially rotate thigh at hip joint and leg at knee joint

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12
Q

What structures are at risk in supracondylar fracture of the femur?

A

-femoral/popliteal artery
-femoral nerve
-hamstrings/quadriceps/their tendons
-tendons/ligaments of the knee joint

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13
Q

What runs in femoral canal?

A

Fat
lymphatics
Cloquet’s node
Femoral branch of genitofemoral nerve

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14
Q

Point out lateral cutaneous nerve of thigh

A

.

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15
Q

What happens with transection of femoral nerve

A

Loss of knee extension
Also supplies hip flexors (depending on level): pectineus, iliacus, sartorius

Sensation
–> anteromedial thigh (anterior cutaneous branches of femoral nerve)
–> medial leg and foot (saphenous nerve)

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16
Q

What does the saphenous nerve innervate?

A

Medial lower leg
Medial foot

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17
Q

What nerve innervate biceps femoris?

A

Short head: Peroneal nerve
Rest: tibial nerve

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18
Q

Sensation lower leg

A

Thigh
-Lateral: lateral femoral cutaneous nerve (lumbar plexus)
-Medial: medial femoral cutaneous nerve (femoral nerve)
-POsterior: posterior femoral cutaneous nerve

Lower leg

Superficial peroneal: anterolateral, dorsum of foot except first webspace

Deep peroneal: First webspace

Sural: lateral foot and lower leg

Saphenous: medial foot and lower leg

Sole: medial and lateral plantar nerves from tibia (lateral is in ulnar nerve distribution)

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19
Q

Action of nerve innervating biceps femoris

A

: Tibial nerve innervates posterior compartment of the leg and sole of the foot

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20
Q

What is the innervation of gluteus medius?

A

-Superior gluteal nerve (L4-S1)

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21
Q

Attachments of deltoid ligament

A

Superior:
–> medial malleolus

Inferior:
–> Tuberosity of navicular
–> neck and body of talus
–> sustetaculum tali on calcaneum/spring ligament

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22
Q

What are the parts of the deltoid ligament?

A

-Anterior tibiotalar (deep)
-Tibionavicular
-Tibiocalcaneal
-posterior tibiotalar

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23
Q

What are the parts of the lateral collateral ligament?

A

-Anterior talofibular
-POsterior taloribular
-Calcaneofibular

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24
Q

What are the parts of the syndesmosis?

A

-Anterior inferior tibiofibular ligament
-Posterior inferior tibiofibular ligament
-Interosseous membrane
-Inferior transverse tibiofibular (deep fibres of posterior tibiofibular)

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25
What is the midtarsal joint of chopart?What type of joint is it?
-Articulation of calcaneus with the cuboid (calcaneocuboid joint) (saddle) -Articulation of the talus with the navicular (talocalcaneonavicular joint (ball and socket)
26
What movements occur at the subtalar (talocalcaneal) joint?
-Inversion and eversion of the foot
27
Which muscles perform inversion and eversion?
-Inversion: tibialis anterior and posterior (with some help from the extensor and flexor hallucis longus muscles) -Eversion: peroneus longus and brevis
28
What is the type of the subtalar (talocalcaneal) joint?
Synovial plane joint
29
What is the type of the ankle (talocrural) joint?
Synovial hinge joint
30
What are the bones forming the ankle joint
Trochlear surface of the talus, lower end of tibia and fibula
31
Movements at the ankle joint and muscles?
Plantar flexion: -all muscles except popliteus Dorsiflexion: -All muscles naterior compartment
32
Why is the ankle joint most stable in dorsiflexion?
-Wider anterior side of trochlea is immobilised by tibial articulation -In plantarflexion, the narrow posterior side is articulating more and so more movement is possible
33
What is the type of inferior tibiofibular joint?
-A syndesmosis joint
34
What is the associated injury in syndesmotic fracture?
Fractures of the lateral malleolus
35
What makes up the achilles tendon?
-Soleus -Gastrocnemius -Plantaris
36
Structures passing behind medial malleolus
as previous
37
Structures deep to extensor retinaculum
Tibialis anterior Extensor hallucis longus Anterior tibial vessels Anterior tibial nerve Extensor digitorum longus Peroneus tertius Tom has very nice dogs and pigs
38
What are the arteries of the foot?
Dorsalis pedis: -continuation of anterior tibial and begins as anterior tibial crosses ankle joint -Crosses tarsal bones and then passes inferiorly as deep plantar artery Medial and lateral plantar arteries -Supply the sole of the foot -Branches of the posterior tibial artery -lateral plantar artery forms plantar arch with dorsalis pedis
39
Where would you palpate dorsalis pedis and posterior tibial?
-DP: lateral to EHL tendon -PT: halfway betwween posterior border of medial malleolus and achilles tendon
40
Demonstrate the foot pulses on this actor?
-DP found between first two metatarsals -PT: 2-3cm below and behind medial mal
41
What movements does EHL perform?
-Extension of big toe -Dorsiflexion of foot -Assists with inversion of foot
42
What vessels would you find deep to EHL
Anterior tibial artery and vein
43
What nerve lies deep to EHL?
Deep peroneal nerve
44
Where would you test sensation of S1?
`Lateral aspect of foot
45
Where would you test L4?
Medial malleolus
46
Where would you test deep peroneal nerve/superfiical/sural?
-1st webspace -Superfiical : dorsum of foot -Sural: lateral malleolus
47
At what joint does dorsiflexion occur?
-Ankle joint between tibia/fibula and talus
48
What muscles are involved in dorsiflexion?
-Tibialis anterior -EHL -Extensor digitorum longus -Peroneus tertius
49
What muscles are involved in plantarflexion?
-Posterior compartment except for popliteus (superficial and deep)
50
What action occurs when tibialis anterior and posterior contract together?
=Inversion
51
At which joint does inversion occur?
-Subtalar joint
52
What muscles are responsible for ankle eversion?
-Peroneus brevis and longus
53
Which nerve innervates peroneus brevis and longus?
-Superfiical peroneal nerve
54
What motor and sensory function is lost with damage to superficial peroneal nerve?
-Inability to evert the foot and loss of sensation over the dorsum of the foot, apart from the first web space which is innervated by the deep peroneal nerve
55
Identify the lower limb dermatomes
L1: groin crease L2: lateral thigh L3: medial lower thigh L4: medial malleolus (medial lower leg) L5: second toe S1: little toe S2: posterior thigh SOle: --> medial sole; L4 --> mid sole: L5 --> lateral: S1
56
What are the myotomes of the lower limb?
-L2 hip flexion -L3 knee extension -L4: dorsiflexion -L5: toe extensors -S1: plantarflexion
57
Origins of peroneus longus, brevis and tertius
Peroneus longus Origin: superolateral fibula, lateral tibial condyle Insertion: crosses under foot and attaches to bones on the medial side--> medial cuneiform and the base of the 1st metatarsal Peroneus brevis -originates from inferolateral surface of fibular sharft --> Attaches to tubercle on 5th metatarsal Peroneus tertius --> O: medial fibula --> I: 5th metatarsal
58
Tibialis anterior and posterior origin and insertion
Anterior: --> O: lateral surface of the tibia —> I: medial cuneiform bone and the base of metatarsal I. Posterior -O: posterior surface and interosseous membrane of the tibia and fibula. -I: medial tarsal bones.
59
Extensor hallucis longus and extensor digitorum attachments
EHL Attachments: O: fibular shaft. I: base of the distal phalanx of the great toe. Extensor digitorum Originates from the lateral condyle of the tibia and the medial surface of the fibula. The fibres converge into a tendon, which travels onto the dorsal surface of the foot. The tendon splits into four and each tendon inserts onto a toe(middle and distal phalanges)
60
What arches are there of the foot?
Medial longitudinal Lateral longitudinal Transverse
61
What forms the medial longitudinal arch?
Calcaneus, talus, navicular 3 cuneiform 3 medial metatarsal
62
What is the function of the medial longitudinal arch?
High arch concerned with the elastic propulsion of the foot during walking
63
What are the factors maintaining the medial longitudinal arch?
Ligaments --> interosseous ligaments --> plantar aponeurosis --> long plantar ligament --> Deltoid and spring ligaments (plantar calcaneonavicular ligament) Muscles --> Tibialis anterior and posterior --> short muscles of the big toe --> FHL
64
What forms the lateral longitudinal arch?
Calcaneus Cuboid 2 lateral metatarsal
65
What is the function of the lateral longitudinal arch?
Low arch concerned mainly with body weight transmission
66
What supports the lateral longitudinal arch?
Ligaments --> interosseous ligaments --> plantar aponeurosis --> short planter ligament Muscles --> 3 peronei muscles --> short muscles of little toe
67
What are the components of the transverse arch?
-Cuboid, 3 cuneiform -Bases of metatarsals
68
What is the function of the transverse arch?
Elastic propulsion of foot and body weight transmission
69
What are the factors maintaning the the transverse arch?
Ligaments --> interosseous ligaments Muscles --> peroneus longus --> Transverse head of adductor hallucis
70
Identify ligaments on medial and lateral aspects of the ankle?
Deltoid --> anterior tibiotalar (deep) --> tibionavicular --> tibiocalcaneal --> posterior tibiotalar LCL: -->Anteiror talofibular --> posterior talofibular --> calcaneofibular
71
Origin and insertion of deltoid
72
Name structures that run on extensor aspect (dorsum) of foot
TEA DEPt Tibialis anterior EHL Anterior tibial artery Deep peroneal nerve EDL Peroneus tertius

MRCSalah anatomy (15 decks)

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