Limb2: Overview of the limbs Flashcards

1
Q

What bones are in the appendicular sksleton

A

Basically everything outside the skull, hyoid, vertebral column incl. sacrum and coccyx, ribs and sternum

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2
Q

Nervous supply to uppe rnad lower limb

A

Upper limb C5-T1

Lower limb L2-S3

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3
Q

Where are flexors and extensors located anteriorly and posteriorly

A

Upper: Flexors are anterior
Extensors are posterior

Lower: Extensors are anterior
Flexors are posterior

(flexion at the elbow involves bringing hand up toward shoulder, extesnion involves straightening arm )

(leg flexion is bending knee back so that the lower leg goes back, and extension brings it back to standing)

FLEXION: REDCE ANGLE BETWEEN TWO BODY PARTS
EXTENTION: INCREASE ANGEL BETWEEN 2 BODY PARTS

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4
Q

What is meant when said the lower limb rotates internally

A

The lower limb undergoes a permanent pronation resulting in a twisting of the dermatome fields during development

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5
Q

Why are the extensors and flexors the opposite way around in uppe rand lower limb

A

The lower limb internally rotates during its development meaning that, in the thigh and leg, the extensors are anterior and the flexors are posterior.

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6
Q

WHat do compartments share

A

Compartments tend to have a distinct function
Compartments tend to have the same nerve supply
Compartments tend to have the same blood supply

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7
Q

List the 7upper limb compartments

A
Pectoral (= chest) girdle muscles
Intrinsic shoulder muscles
Posterior arm muscles- extensor 
Anterior arm muscle-flexor 
Anterior forarm muscles,- flexor 
Posterior forearm muscles - extensors
Intrinsic hand muscle (palmar anterior and dorsum)
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8
Q

Two movement types at the pectoral/shoulder girdle

A

Movements of the shoulder involve both movements of the arm relative to the scapula at the shoulder joint, and movements of the scapula relative to the chest wall.

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9
Q

Where do muslces acting on the shoulder attach

A

neck, anterior chest, back and arm.

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10
Q

List muscles in the pectoral or shoulder girdle

A

Deltoid, pec major, latissimus dorsi, rotator cuff muscles of shoulder and trapezius

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11
Q

Where does the brachialis mucle lie

A

deep to the bisceps… anterior to humerus. also involved in elbow flexion

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12
Q

What is the only true joint between the limb and the trunk

A

Sternoclavicular joint

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13
Q

What do the radius and ulna bones articular with

A

Proximal- humorus

Distally- carpals

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14
Q

Order of bones in hand, proximal to distal

A

Carpals, meta carpals, phalanges

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15
Q

Shoulder joint also known as

A

glenohumoral joint

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16
Q

Where do the hip abductors and extensors lie

A

In the gluteal region

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17
Q

State the compartments of the lower limb

A

Hip abductors (Gluteal)
Hip extensors (Gluteal)
Hip Flexors
Anterior thigh muscles – extensors
Medial thigh muscles – adductors
Posterior thigh muscles – flexors
Anterior leg muscles – extensors (dorsiflexors)
Lateral leg muscles – foot evertors
Posterior leg muscles – flexors (plantarflexors)
Intrinsic foot muscles – variety of functions

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18
Q

What is leg and what is thigh

A

Leg is knee down,

thigh is hip to knee

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19
Q

Which bone is medal and which lateral in the leg

A

tib medial

fib lateral

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20
Q

Where is the quadriceps, how many of them, what is the function

A

It in the anterior thigh. 4. Powerful EXTENSORS of the knee joint

and also flexors of the hip joint as they are attached to the iium

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21
Q

What are the upper and lwoer suraces of the foot known as

A

upper- dorsal

lower-plantar

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22
Q

What are hamstrings

A

posterior high muscles…….

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23
Q

Where does iliacus and psoas come from and what are their reevance to the lower limb

A

psoas from lumbar

iliacus from the blade of the ileus muslce…

join together and attach to inner side of the thigh

Flexors of the thigh

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24
Q

Where do nerves of the lower limb arise

A

Lumbo-sacral plexus L2-S3

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25
Q

Where are adductor muscles located in the thigh

A

medially

26
Q

Outline the main arteries of the arm

A

Subclavian travels under the clavicle into the axillary region…. becomes
axillary artery
Then goes into arm and becomes brachail artery
At the elbow this divides into the ulnar and radial arteries
Then hand palmar arches and mectarcapl and digit arteries

27
Q

Outline venous drainage of the limbs

A

Superficial and deep….

deep usually run with arteries

28
Q

What modifications can the deep veins of the limb have

A

They can surround arteries (can be 2/3 veins which interlink)….

countercurrent heat exchange
pulsing of artery can help with venous return

29
Q

State the superficial and deep venous drainage systems of the upper limb

A

Dorsal venous arch (sup.); Cephalic vein and basilic vein (sup.); Venae comitantes (deep); Axillary vein (deep); Subclavian vein; Superior vena cava

30
Q

Outline the superficial venous drainage from te hand

A

dorsal venous arch –> basilic and cubital veins….

these then travel arond onto the anterior surface of teh arm… where the basilic vein is medial and the cubital vein is lateral

31
Q

Which vein connects the basilic and cephalic vein

A

Median cubital vein

32
Q

Outline arterial supply to lower limb

A

Aorta –>
common iliac –>
internal and external (external passes into limb) –>
femoral artery (pulse), change from external iliac to femoral artery occurs when it passes underneath the inguinal ligament –>
popliteal artery (when it passes behind knee) –>
posterior and anterior tibial artery, peroneal artery and dorsalis pedis

33
Q

Outline the deep venous drainage of the lower leg

A

Same as the arterial supply

34
Q

Outline the suoerficial venous drainage of lower limb

A

Venous arches on dorsum of foot…. go to:

great saphenous vein which passes the medial ankle, runs on medial side of the leg, round the back of the knee then back to the anterior surface of the leg and drains into teh inguinal region

The small saphenous vein drains at the back of the leg into the polpliteal vein at the knee

35
Q

Where is the femoral triangle why is it important

A

The femoral triangle is the region of the groin where the femoral artery is accessed e.g. access to the cardiac vessels to carry out angiograms and angioplasty. A pulse can be felt in this area.

Underneath the iguinal canal

36
Q

What do perforating veins do

A

Connect superficial and deep veins…. they contain a valve that only allows superficial to deep drainage

37
Q

What happens if valves in perforating veins are compromised

A

blood is pushed from deep to superficial veins leading to varicose veins.

38
Q

What is the use of surgical stockings

A

During recovery from operation you’re not moving so no muscles compressing veins so the venous return is sluggish (lack of the calf pump)…

Can lead to DVT

Elastic surgical socks compress the superficial veins promoting more vigorous deep venous return.

39
Q

Outline which spinal nerves supply which areas

A
C1-4 : neck
C5-T1 : upper limb
T2-L1 : trunk
L2-S3 : lower limb
S2-C2 : perineum
40
Q

Which nerve supplies anterior compartment of thigh

Which supplies medial compartment of thigh

Whcih nerve spplies the remaning parts of the thigh, leg and foot

A

Femoral n. supplies anterior compartment of thigh.

Obturator n. supplies medial (adductor) compartment of thigh.

Sciatic n. (or its terminal branches Tibial and Common Peroneal ns.) supply the remaining compartments (i.e. post. thigh, ant. and post. leg, foot)

41
Q

T/F muscles are usually spplied by adjacent segments

A

T

42
Q

T/F: Same action on joint = same nerve supply

A

T

43
Q

T/f Opposing muscles 1-2 segments above or below

A

T

44
Q

T/FMore proximal in limb = more caudal in spine

A

F More distal in limb = more caudal in spine

45
Q

What is meant by segmental motor suppy to limbs

A
Groups of motor nerve cell bodies in the spinal cord
C5-T1 = upper limb
L2-S3 = lower limb
Plexi for each limb
Anterior divisions = flexor muscles
Posterior divisions = extensor muscles
46
Q

State the segmental motor supply to shoulder

A

abduction C5, adduction C678

external rotation C5, internal rotation C678

47
Q

State the segmental motor supply elbow

A

flexion C56, extension C78

48
Q

State the segmental motor supply to forearm

A

supination C6, pronation C78

49
Q

State the segmental motor supply to wrist

A

flexion C67, extension C67

50
Q

State the segmental motor supply to long tendons to hand

A

flexion C78, extension C78

51
Q

State the segmental motor supply to intrinsic hand

A

T1

52
Q

Outline the segmental supply to lower limb

A

Hip- flex L2/3
etend l4/5

Knee- extend l3/4
flex-l5/s1

Ankle- dorsiflex l4/5 plantarflex 21/s2

53
Q

Differentiate segmental vs cutaneous sensory innveration

A

Segemntal: that particuar areas are supplid by single spinal nerve

Cutaneous: that those sensory nerves can get there by different nerves via plexu

54
Q

What is eversion and inversion

A

Eversion- urning foot ou

Inversion turning soul of foot in

55
Q

Which reflex mediates ankle jerk

A

S1

56
Q

What is compartment syndrome and why can it occur

A

Muscle groups in confined compartments separated by firbous septa… increase in pressure in a compartment cannot spread out

Ischaemia caused by trauma-induced increased pressure in a confined limb compartment

57
Q

What are common places for compartment syndrome to occur

A

Commonly the anterior, posterior and lateral compartments of the leg

58
Q

What is the normal pressur ein the leg

A

25mmHg

59
Q

What happens to vessels in compartment syndrome

A

Increase in preessure to just 50-60mmHg can collapse small vessels which leads to ischaemia but pulse is still presneet

60
Q

What is acut 25mmHg

A

Trauma

61
Q

What is chronic 25mmHg

A

Exercise induced