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GBE > Limbs > Flashcards

Limbs Flashcards

1
Q

What is intermittent claudication?

A

Cramping leg pain develops when walking + relieved mit rest

Caused by inadequate blood flow to leg muscles by atherosclerosis

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2
Q

What 3 things are contained in superficial fascia of the lower limb?

A

Great (long) saphenous vein
Lesser (short) saphenous vein
Cutaneous nerves

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3
Q

What is the origin and end of the great (long) saphenous vein?

A

Union of dorsal venous arch of foot + dorsal veins of great toe
Into saphenous opening in fascia lata to drain into femoral vein

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4
Q

What is the origin and end of the lesser (short) saphenous vein?

A

Arises from lateral dorsal venous arch of foot + empties ==> popliteal vein
Supplies leg + superficial lateral foot

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5
Q

What muscle is the patella within?

A

Quadriceps muscle

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6
Q

Which direction is the patella naturally pulled?

A

Laterally

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7
Q

Which articulation surface of the patella is larger?

A

Lateral

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8
Q

What tendon is directly below patella?

A

Patella Tendon/Ligamentum patellae

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9
Q

What muscles pull knee joint:

a) Laterally?
b) Medially?

A

a) Vastus lateralis, vastus intermedius

b) Vastus medialis

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10
Q

What is the Q angle in the knee joint?

A

Angle between quadriceps tendon + patellar tendon in full extension

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11
Q

What is the Q angle in
a) Females?
b) Males?
Why difference?

A

a) 17 degrees
b) 14 degrees
Females wider hip

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12
Q

In what 5 conditions can the Q angle increase?

A 
Genu valgum
Increased femoral anteversion
External tibial torsion
Laterally position tibial tuberosity
Tight lateral retinaculum
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13
Q

What is a retinaculum?

A

Band of thickened deep fascia around tendons that holds them in place

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14
Q

What is a meniscus?

A

Flat circular fibro cartilaginous band

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15
Q

What is the shape of the:

a) Medial meniscus?
b) Lateral meniscus?

A

a) Larger backward C shape

b) Small, more rounded

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16
Q

What is the function of the meniscus?

A

Meniscus bathed synovial fluid
Squash when under load - release fluid
Load removed - absorb fluid
Joint well lubricated

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17
Q

Which meniscus is more likely to get injured?

A

Medial meniscus

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18
Q

What is the name of the tear of the meniscus?

A

Bucket handle tear

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19
Q

In the last 15 degrees of extension, which way does the femur rotate?
Why?

A

Medially
All ligaments tightened
Locking mechanism in extended position
Ligaments used maintain position rather muscle

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20
Q 
What is the:
a) Origin
b) Attachment
c) Movement
d) Innervation
of the popliteus muscle?
A

a) Lateral condyle of femur
b) Attaches to posterior of tibia, lies above soleal line
c) Flexion + internal rotation of knee joint
d) Tibial nerve (L4-S1)

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21
Q

What are the collateral ligaments of the knee + their attachments?

A

Fibular Collateral ligament - lateral epicondyle of femur to lateral surface of head of fibula
Tibial Collateral Ligament - medial epicondyle of femur to medial surface of tibia

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22
Q

What are the:
a) Lateral
b) Medial
collateral supports of the knee?

A

a) Retinaculum of vastus lateralis (anterior)
Tendon of biceps femoris (posterior)
b) Retinaculum of vastus medialis (anterior)
Tendons of sartorius, gracilis, semi-tendinous (posterior)

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23
Q

What is the pes anserinus muscle and where does it attach?

A

Trio of sartorius, gracilis, semi-tendinous

Attach medial aspect of shaft of tibia

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24
Q

What is :
a) Genu Varum?
b) Genu Valgum?
Risk of what illness?

A

a) Bow Leg
b) Knock knee
Osteoarthritis

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25
Q

What is the attachment of the anterior cruciate ligament (ACL)?

A

Extends from anterior intercondylar area of tibia to posterior prt of medial surface of lateral condyle of femur

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26
Q

What is the attachment of the posterior cruciate ligament (PCL)?

A

Posterior intercondylar area of tibia to anterior prt of lateral surface of medial condyle of femur

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27
Q

What test can you carry out to test condition of cruciate ligaments?

A

Lachman test

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28
Q

Are ACL and PCL taut/relaxed in extension/flexion?

A

ACL - extension: taut, flexion: relaxed
PCL - extension: relaxed, flexion : taut
In extension, PCL becomes relaxed in locking mechanism

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29
Q

What is Donaghue’s unhappy triad?

A

ACL rupture
Rupture of medial collateral ligament
Rupture of medial meniscus

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30
Q

What 4 bursae communicate with knee joint?

A

Suprapatellar Bursa
Popliteus Bursa
Gastrocnemius Bursa
Semi-membranous Bursa

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31
Q

What bursae of the knee separates the pes anserinus from the tibia?

A

Anserva bursa

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32
Q

What is knee bursitis?

A

Inflammation of bursae

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33
Q

What is classed as the:

a) Arm?
b) Forearm?

A

a) Shoulder joint to elbow joint

b) Elbow joint to hand

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34
Q

What bones make up the pectoral girdle and what is its use?

A

Clavicle and scapula

Bony platform for movements of upper limb

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35
Q

What are the 3 joints of the upper limb and pectoral girdle?

A

Sternoclavicular joint - only articulation of upper limb with axial skeleton
Acromioclavicular joint
Glenohumeral joint

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36
Q

What is the only ‘proper’ joint of the upper limb/pectoral girdle?

A

Sternoclavicular joint

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37
Q

What is the clavicle bone made up of?

A

Long bone, no medullary cavity

Trabecular bone surrounded by compact bone

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38
Q

When does ossification of clavicle start and end?

A

1st bone to start in embryo

Last to finish - 18-20 yrs in male, 21-25 females

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39
Q

What type of joint is sternoclavicular joint:

a) Anatomically?
b) Functionally?

A

a) Saddle joint

b) Ball + socket

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40
Q

What is cleidocranial dysostosis?

A

Congenital defect, affects bone development
Clavicle can be completely absent
Defect in RUNX2/CBFA1 gene

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41
Q

What muscle can pull the medial part of the clavicle upwards, causing a clavicular fracture?

A

Sternocleidomastoid muscle

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42
Q

What nerve runs through the suprascapular notch in the scapula?

A

Suprascapular nerve

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43
Q

What is the function of the glenoid cavity in the scapula?

A

Articulates with head of humerus to form glenohumeral joint

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44
Q

What is the function of the acromion in the scapula?

A

Articulates with clavicle at acromioclavicular joint

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45
Q

What muscles
a) Attach at
b) Originate from
the coracoid process in the scapula?

A

a) Pectoralis minor

b) Coracobrachialis + biceps brachii (long head)

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46
Q

If a patient has a scapula fracture, what should you check and why?

A

Airways, Breathing, Circulation

Scapula v hard fracture as layered in muscle so such large fracture, probs damage to thorax

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47
Q

What is Os acromiale?

A

Distal acromion fails to fuse

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48
Q

What makes up the coracoclavicular ligament?

A 
Trapezoid ligament (lateral)
Conoid ligament (medial)
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49
Q

What movements can the scapula-thoracic ‘joint’ carry out?

A 
Elevation (shrug shoulders)
Depression (push shoulders down)
Retraction (shoulders back)
Protraction (shoulders forward, like listen to lung)
Upward rotation (arms up)
Downward rotation (arms down)
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50
Q

What are the deep posterior axioappendicular muscles?

A

Levator Scapulae
Rhomboid Minor
Rhomboid Major

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51
Q

What is the origin of:

a) Levator Scapulae?
b) Rhomboid Minor?
c) Rhomboid Major?
d) Serratus Anterior?

A

a) Posterior tubercles of transverse processes of C1-4 vertebraes
b) Spinous processes of C7-T1 vertebraes
c) Spinous processes of T2-T5 vertebrae
d) External surfaces of 1st- 9th ribs

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52
Q

What is the insertion of:

a) Levator Scapulae?
b) Rhomboid Minor?
c) Rhomboid Major?
d) Serratus Anterior?

A

a) Medial border of scapula superior to spine
b) Medial border of scapula adjacent to spine
c) Medial border of scapula inferior to spine
d) Medial border of scapula

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53
Q

What is the action of: (In relation to scapula)

a) Levator Scapulae?
b) Rhomboid Minor?
c) Rhomboid Major?
d) Serratus Anterior?

A

a) Retract + elevate
b) Retract + rotate
c) Retract + rotate
d) Protract + rotate

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54
Q

What is the serratus anterior muscle innervated by + where is it located?

A

Long thoracic nerve

Lateral + superficial

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55
Q

What is the cause of a winged scapula?

A

Paralysis of serratus anterior

Usu due to lesions of long thoracic nerve

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56
Q

How treat winged scapula?

A

Strength training + physical therapy
If X improvement ==> surgery
Graft of intercostal nerve/ fix scapula to rib cage

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57
Q

What is the triangle of auscultation?

A

Area on back devoid of muscle

Best place to listen to lung sounds

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58
Q

What are the superficial posterior axioappendicular muscles?

A

Trapezius

Latissimus Dorsi

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59
Q

What is the origin of:

a) Trapezius?
b) Latissimus Dorsi?

A

a) C7-T4 (transverse), T5-T12 (ascending) spinous processes

b) Spinous processes T7-T12, 9-12th rib, thoracolumbar fascia, iliac crest

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60
Q

What is the insertion of:

a) Trapezius?
b) Latissimus Dorsi?

A

a) Acromion + medial 1/2 of spine of scapula (transverse)
Medial 1/2 of spine of scapula (ascending)
b) Floor of intertubercular sulcus of humerus

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61
Q

What is the action of: (In relation to scapula)

a) Trapezius?
b) Latissimus Dorsi?

A

a) Elevates, retracts, depresses scapula

b) Extends, adducts, medially rotates humerus

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62
Q

What type of joint is the glenohumeral joint?

A

Synovial

Ball + socket

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63
Q

What movements can occur at gleno-humeral joint?

A

Flexion + extension
Adduction + abduction
Medial + lateral rotation

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64
Q

What is scapula humeral rhythm?

A

Ratio of glenohumeral movement to scapulothoracic movement during arm elevation

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65
Q

What are the superficial anterior axioappendicular muscles?

A

Pectoralis Major

Serratus anterior

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66
Q

What is the origin of:

a) Pectoralis Major?
b) Serratus anterior?

A

a) Anterior aspect of medial half of clavicle, manubrium, body of sternum, superior 6 costal cartilages, aponeurosis of external oblique muscle
b) External surfaces of 1st-9th ribs

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67
Q

What is the insertion of:

a) Pectoralis Major?
b) Serratus anterior?

A

a) Crest of greater tubercle of humerus

b) Medial border of scapula

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68
Q

What is the action of:

a) Pectoralis Major?
b) Serratus anterior?

A

a) Adducts arm at glenohumeral joint, medially rotates humerus, flexes shoulder joint
b) Protracts + upwardly rotates pectoral girdle

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69
Q

What are the 2 heads of the pectoralis major?

A

Clavicular and sternoclavicular

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70
Q

What is Poland’s syndrome?

A

Congenital where pectoralis major hypotrophies (underdevelops)
Can also cause webbing of fingers

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71
Q

What are the deep anterior axioappendicular muscles?

A

Pectoralis minor

Subclavius

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72
Q

What is the origin of:

a) Pectoralis minor?
b) Subclavius?

A

a) Anterior ends of 3rd-5th ribs

b) Superior surface of costal end of 1st rib and adjacent 1st costal cartilage

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73
Q

What is the insertion of:

a) Pectoralis minor?
b) Subclavius?

A

a) Coracoid process of scapula

b) Inferior surface of middle 1/3 of clavicle

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74
Q

What is the action of:

a) Pectoralis minor?
b) Subclavius?

A

a) Protracts + downwardly rotates pectoral girdle

b) Anchors + depresses clavicle, protects underlying nerves + vessels

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75
Q

What is the origin of the deltoid muscle?

A

Spine of scapula
Acromion of scapula
Lateral 1/3 of clavicle

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76
Q

What is the insertion of the deltoid muscle?

A

Deltoid tuberosity of humerus

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77
Q

What is the action of the deltoid muscle?

A

Spinal - extends + laterally rotates arm
Acromial - Abducts arm
Clavicular - Flexes + medially rotates arm

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78
Q

What are the 4 main muscles of the posterior scapula?

A

Supraspinatus + Infraspinatus

Teres major + minor

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79
Q

What is the origin of:

a) Supraspinatus?
b) Teres major?
c) Infraspinatus?
d) Teres minor?

A

a) Supraspinous fossa of scapula
b) Posterior aspect of inferior angle of scapula
c) Infraspinous fossa of scapula
d) Posterior aspect of superior 1/2 of lateral border of scapula

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80
Q

What is the insertion of:

a) Supraspinatus?
b) Teres major?
c) Infraspinatus?
d) Teres minor?

A

a) Greater tubercle of humerus
b) Crest of lesser tubercle of humerus
c) Greater tubercle of humerus
d) Greater tubercle of humerus

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81
Q

What is the action of: (in relation to arm)

a) Supraspinatus?
b) Teres major?
c) Infraspinatus?
d) Teres minor?

A

a) Initiates abduction of arm
b) Medially rotates arm
c) Laterally rotates arm
d) Laterally rotates arm

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82
Q

What is the origin of the subscapularis muscle?

A

Subscapular fossa of scapula

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83
Q

What is the insertion of the subscapularis muscle?

A

Lesser tubercle of humerus

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84
Q

What is the action of (in relation to arm) the subscapularis muscle?

A

Medially rotates arm

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85
Q

What muscles make up the rotator cuff and what is it?

A

SITS - Supraspinatus, Infraspinatus, Teres minor, Subscapularis
Surrounds shoulder joint + keeps head of humerus within socket

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86
Q

What makes up the coracoacromial arch?

A

Acromion, coracoacromial ligament, coracoid process

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87
Q

Which part of the shoulder do dislocations happen most frequently?

A

Anterior

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88
Q

When is surgery needed in a shoulder dislocation?

Type of surgery?

A

Ongoing pain after immobilisation/torn ligaments

Arthroscopic - surgical procedure on joint using arthroscope, type of endoscope inserted into joint by small incision

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89
Q

What are the complications of shoulder surgery?

A

Bankart lesion (anterior glenoid labrum)
Hill-Sachs fracture (depression of posterolateral head of humerus),
Rotator cuff tears
Axillary nerve injury

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90
Q

What is the origin of the biceps brachii muscle?

A

Long head - Supraglenoid tubercle

Short head - Coracoid process

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91
Q

What is the insertion of the biceps brachii muscle?

A

Radial tuberosity

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92
Q

What is the action of the biceps brachii muscle?

A

Supinates + flexes forearm

Stabilises shoulder

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93
Q

Where is the 3rd head of the biceps brachii located and in how many people?

A

Extends from superomedial prt of brachialis

10% peeps

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94
Q

In what position does the forearm have to be for the biceps brachii to be a flexor?

A

Elbows 90 degrees and forearm supinated

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95
Q

In what position does the forearm have to be for the biceps brachii to be a extensor?

A

Forearm pronated

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96
Q

What is the origin of:

a) Coracobrachialis?
b) Brachialis?

A

a) Coracoid process

b) Anterior aspect of distal 1/3 of humerus

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97
Q

What is the insertion of:

a) Coracobrachialis?
b) Brachialis?

A

a) Middle 1/3 of medial aspect of humerus

b) Coronoid process + tuberosity of ulna

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98
Q

What is the action of:

a) Coracobrachialis?
b) Brachialis?

A

a) Adducts + flexes arm, stabilises shoulder

b) Main flexor of forearm, workhouse of elbow flexors

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99
Q

What are the muscles in the anterior compartment of the arm?

A

Biceps brachii
Coracobrachialis
Brachialis

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100
Q

What are the muscles in the posterior compartment of the arm?

A

Triceps brachii

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101
Q

What nerve innervates the muscles of the anterior arm?

A

Musculocutaneous nerve

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102
Q

What is the origin of triceps brachii?

A

Long head - infraglenoid tubercle of scapula

Medial + lateral head - Posterior surface of humerus

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103
Q

What is the insertion of triceps brachii?

A

Olecranon of ulna

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104
Q

What is the action of triceps brachii?

A

Main extensor of forearm
Extension
Adduction of arm

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105
Q

What type of joint is the elbow?

A

Hinge joint

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106
Q

What muscles:

a) Flex elbow?
b) Extend elbow?

A

a) Brachialis, biceps brachii, brachioradialis (x cross elbow joint)
b) Triceps brachii, anconeous

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107
Q

What is the arrangement of the humerus epicondyles and olecranon of ulna during:

a) Extension?
b) Flexion

A

a) Epicondyles and olecranon aligned

b) Epicondyles form triangle + align vertically mit olecranon

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108
Q

What are the muscles of supination?

A

Biceps brachii

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109
Q

What are the muscles of pronation?

A

Pronator teres

Pronator quadratus

110
Q

What is the origin of the muscles of pronation?

A

Pronator teres - Medial epicondyle of humerus

Pronator quadratus - Anterior aspect of distal 1/4 of ulna

111
Q

What is the insertion of the muscles of pronation?

A

Pronator teres - Lateral aspect of radius

Pronator quadratus - Anterior aspect of distal 1/4 of radius

112
Q

What connects the radius and ulna?

A

Interosseous membrane

113
Q

What ligament holds radius head in place?

A

Annual ligament

114
Q

What are the 3 articulating surfaces within the elbow joint?

A

Humeroradial - between capitulum of humerus + concave fovea of radius
Humeroulnar - between trochlea of humerus + trochlea notch of ulna
Proximal radio-ulnar - between articular head of radius + radial notch of ulna

115
Q

What are the 3 ligaments of the elbow joint?

A

Ulnar collateral ligament - anterior band between medial epicondyle + coronoid, oblique band deepens trochlea socket
Radial collateral ligament - fan-like. extends from lateral epicondyle + blends mit radial anular ligament
Radial anular ligament - holds radial head in radial notch supporting pronation/supination

116
Q

What are the vessels in the cubital fossa?

A

Median nerve
Brachial artery + vein
Biceps tendon

117
Q

What is the arrangement of the funny bone?

A

Ulna nerve runs on medial aspect on media epicondyle of humerus

118
Q

What are the 5 bursae around the elbow joint?

A

Subcutaneous bursae of lateral + medial epicondyle
Bursa of anconeus
Subtendinous bursa of triceps brachii
Olecranon bursa

119
Q

What are 4 clinical issues at the elbow?

A

Olecranon fracture
Distal humerus fractures/Supracondylar fractures
Tennis elbow
Elbow dislocation

120
Q

What are the deep fascia of the lower limb?

A

Fascia lata - deep fascia of thigh
Popliteal fascia - small saphenous vein in superficial
Crural fascia - Deep fascia of leg
Plantar fascia - continuous with crural, attach calcaneus

121
Q

What are 2 features of the fascia lata?

A

Thicker laterally to form iliotibial tract

Superiorly attached to hip bone + soft tissue

122
Q

What are the 6 nerves of the lower limb?

A 
Superior gluteal
Inferior gluteal
Femoral
Obturator
Tibial
Common peroneal/fibular
123
Q

What nerves does the sciatic nerve split into?

A

Tibial

Common peroneal/fibular

124
Q

Compression of what nerve causes foot drop?

A

Deep peroneal/fibular nerve

125
Q

What are the main arteries of the lower limb?

A 
External iliac
Femoral
Profunda femoris
Popliteal
Posterior Tibial 
Peroneal
Anterior Tibial
Dorsalis Pedis
Plantar arteries
126
Q

What are the 4 pulse points of the lower limb?

A

Femoral pulse
Popliteal pulse
Dorsalis pedis pulse
Posterior tibial pulse

127
Q

What are the main veins of the lower limb?

A 
External iliac
Femoral
Profunda Femoris
Great Saphenous
Popliteal
Short Saphenous
Anterior Tibial
Fibular
Posterior Tibial
Dorsal Ventral Arch
128
Q

What are the:

a) Superficial lymphatic vessels?
b) Deep lymphatic vessels?

A

a) Medial, follow great saphenous, orginate foot dorsal
Lateral, follow shrt saphenous, orginate foot lateral
b) Follow ant + post tibial artery, peroneal artery

129
Q

What do the:
a) Superficial lymphatic vessels
b) Deep lymphatic vessels
drain into?

A

a) Medial ==> Sub-inguinal nodes
Lateral ==> Popliteal nodes
b) Popliteal nodes

130
Q

What are the classifications of the inguinal nodes?

A

Above line where great saphenous terminates:
Sub-inguinal nodes (superficial + deep)
Below line where great saphenous terminates:
Superficial inguinal nodes

131
Q

Where are the popliteal nodes located?

A

In fat reserves of popliteal fossa

132
Q

What is the name of a:

a) greatly inclined femur?
b) less inclined femur?

A

a) Coxa valga

b) Coxa vara

133
Q

What is the normal angle inclination of the femur?

A

140-160 degrees

134
Q

By how many degrees is the femur normally angled forward?

A

12-15 degrees

135
Q

What are the anterior ligaments of the hip joint and their attachments?

A

Iliofemoral - iliac portion of acetabulum to intertrochanteric line
Pubofemoral - superior ramus of pubis to intertrochanteric line of femur

136
Q

What are the posterior ligaments of the hip joint and their attachments?

A

Ischiofemoral - ischium to posterior femoral neck of hip joint
x attach to bone

137
Q

What is the blood supply to the hip joint?

A

Medial + lateral circumflex femoral arteries

Branch of obturator supplies head (not main one)

138
Q

What way does a patient walk if they have hip joint dislocation?

A

Trendelenburg sign

Hip drops to 1 side when walking

139
Q

What is avascular necrosis?

A

Insufficient blood supply causes bone death + loss of cartilage

140
Q

What muscles:

a) Flex hip?
b) Extend hip?

A

a) Tensor fascia lata

b) Gluteus maximus, Semi membranous + tendinous, Biceps femoris long, adductor magnus (extensor)

141
Q

What ligament arises from gluteus maximus?

A

Sacrotuberous ligament

142
Q 
What is the:
a) Nerve supply
b) Arterial supply
c) Attachment
of gluteus maximus?
A

a) Inf gluteal nerve (L%-S2)
b) Inf + sup gluteal artery
c) Lower prt attaches to gluteal tuberosity on femur

143
Q 
What is the:
a) Nerve supply
b) Arterial supply
c) Origin
d) Insertion
of tensor fascia lata?
A

a) Sup gluteal nerve (L5-S1)
b) Ascending branch of lateral circumflex femoral artery, sup gluteal artery
c) ASIS, anterior prt of iliac crest
d) Iliotibial tract

144
Q

What makes up the iliotibial tract?

A

Tensor fascia lata

Gluteus maximus

145
Q

Damage of what nerves can cause Trendelenburg sign?

A

L4-L5

146
Q

What muscles abduct the hip?

A

Gluteus minimus + medius

147
Q 
What is the:
a) Nerve supply
b) Arterial supply
c) Insertion
of gluteus medius?
A

a) Sup gluteal nerve
b) Sup gluteal artery
c) Lateral surface of greater trochanter

148
Q 
What is the:
a) Nerve supply
b) Arterial supply
c) Insertion
of gluteus minimus?
A

a) Sup gluteal nerve
b) Sup gluteal artery
c) Greater trochanter

149
Q

What are the lateral rotators of the gluteal region?

A

Piriformis, Sup + Inf Gemellus, Quadratus Femoris

150
Q 
What is the:
a) Nerve supply
b) Arterial supply
c) Origin
d) Insertion
of piriformis?
A

a) S1+S2 spinal nerve
b) Sup + inf gluteal, Internal pudendal
c) Pelvic surface of sacrum
d) Sup border of greater trochanter

151
Q 
What is the:
a) Nerve supply
b) Arterial supply
c) Origin
d) Insertion
of sup gemellus?
A

a) L5-S2
b) Inf gluteal, Internal pudendal
c) Ischial spine
d) Medial surface of greater trochanter

152
Q 
What is the:
a) Nerve supply
b) Arterial supply
c) Origin
d) Insertion
of inf gemellus?
A

a) L5
b) Medial circumflex femoral
c) Ischial tuberosity
d) Medial surface of greater trochanter

153
Q 
What is the:
a) Nerve supply
b) Arterial supply
c) Insertion
of obturator internus?
A

a) L5-S2
b) Internal pudendal, obturator
c) Medial surface of greater trochanter

154
Q

What is the:
a) Nerve supply
b) Arterial supply
of quadratus femoris?

A

a) L5

b) Medial circumflex femoral, inf gluteal

155
Q

What are the:
a) Nerves
b) Arteries
of gluteal region?

A

a) Sup + inf gluteal, sciatic, perforating cutaneous nerves, posterior cutaneous nerve of thigh
b) Sup + inf gluteal arteries

156
Q

What are the anterior muscles of the thigh?

A 
Psoas Major
Iliacus
Rectus Femoris
Vastus lateralis, intermedialis, medialis
Pectineus
Sartorius
157
Q

What makes up the:

a) Iliopsoas muscle?
b) Quadriceps femoris muscle?

A

a) Psoas major, iliacus

b) Rectus femoris, vastus lateralis, intermedialis, medialis

158
Q

What muscles should gluteal injections be injected into and why?

A

Gluteus medius

Avoid sciatic nerve

159
Q

What are the medial muscles of the thigh?

A

Adductor brevis, longus, magnus
Gracilis
Obturator externus

160
Q

What are the posterior muscles of the thigh?

A

Semi- membranous + tendinous

Biceps femoris - long + shrt head

161
Q

What makes up the femoral triangle?

A

Base - inguinal ligament
Medially - Adductor Longus
Laterally - Sartorius

162
Q

What are the contents of the femoral triangle?

Lateral ==> medial

A 
Femoral nerve + terminal branches
Femoral artery 
Femoral vein
Femoral canal
Deep inguinal nodes
163
Q

What muscles make up the popliteal fossa?

A

Semi-membranous + tendinous
Gastrocnemius - medial + lateral head
Plantaris
Biceps femoris

164
Q

What structures are contained within popliteal fossa?

A 
Termination of shrt saphenous vein
Popliteal artery + veins
Tibial + common fibular nerves
Posterior cutaneous nerve of thigh
Popliteal lymph nodes
165
Q

What is a Baker’s cyst?

A

Fluid filled sac forms on posterior surface of knee joint

166
Q

What are the 3 arches of the foot and the middle bone of each?

A

a) Medial longitudinal - talus
b) Lateral longitudinal - cuboid
c) Transverse - intermediate cuneiform

167
Q

What are the medial longitudinal set of bones in foot?

A

Calcaneus, Talus, Navicular, Cuneiforms

1st, 2nd, 3rd metatarsals

168
Q

What are the lateral longitudinal set of bones in foot?

A

Calcaneus, Cuboid

4th, 5th metatarsals

169
Q

What is:

a) Pes planus?
b) Pes cavus?

A

a) Flat foot, collapsed foot

b) Overly arched foot, high arch

170
Q

What fascias support the foot?

A

Plantar fascia - from calcaneal tuberosity to digits

Bands held together by superficial transverse metatarsal ligaments

171
Q

What is plantar fasciitis?

A

Heel pain predominantly in morning/after rest

Worse with prolonged standing

172
Q

What is the most commonly ruptured ligament in the foot?

A

Bifurcate ligament

From calcaneus ==> navicular + cuboid

173
Q

What are the main ligaments of the foot?

A

Long + shrt plantar ligaments

Spring ligament

174
Q

What tendons support the arch of the foot on the:

a) Medial side?
b) Lateral side?

A

a) Tibialis Anterior + Posterior

b) Fibularis longus

175
Q

What are the intrinsic muscles of the foot?

A

Extensor hallucis longus
digitorum longus
brevis

176
Q

What are 5 common forefoot pathologies?

A 
Claw toe
Mallet toe
Hammer toe
Curly toe
Hallux valgus - callus on big toe protruding medially
177
Q

What nerves supply the dorsum of the foot?

A

Superficial + Deep fibular nerve
Saphenous nerve
Sural nerve

178
Q

What nerves supply the sole of the foot?

A

Medial + Lateral plantar
Sural nerve
Saphenous nerve

179
Q

What blood supplies the dorsum of the foot?

A

Arcuate ==> Dorsal metatarsal - fuse with plantar ==> common digital ==> split into 2 for adjacent digits

180
Q

What blood supply the sole of the foot?

A

Posterior tibial rise to Lateral + Medial plantar
Lateral ==> plantar arch
Medial ==> Big toe + 1/2 of 2nd toe

181
Q

What surface does the blood of the foot drain from?

A

Dorsal surface

182
Q

What veins drain the foot?

A

Superficial dorsal arch
Runs medially over medial malleolus ==> great saphenous vein
Runs laterally under lateral malleolus ==> lesser saphenous vein

183
Q

What is between the tibia and fibula of the leg?

A

Interosseous septum

184
Q

What is the anterior compartment of the leg bounded by:

a) Anteriorly?
b) Laterally?

A

a) Crural fascia

b) Intermuscular septum

185
Q

What are the joints on the top and bottom of the fibula?

A

Top - synovial

Bottom - fibrous, syndesmosis

186
Q

What are the bones of the:

a) Hindfoot?
b) Midfoot?
c) Forefoot?

A

a) Talus, Calcaneus
b) Cuneiforms, Navicular, Cuboid
c) Metatarsals, Phalanges

187
Q

What are the tarsal bones of the foot?

A

Calcaneus, Talus, Cuneiforms, Cuboid, Navicular

188
Q

What part of the calcaneus does the talus bone of foot sit on?

A

Sustentaculum tali

189
Q

What are the dorsal retinaculae of the ankle and its attachment?

A

Extensor retinaculae:
Superior - distal ends of fibula - tibia
Inferior - Y shaped, medial malleolus ==> calcaneus ==> 1st metatarsal

190
Q

What are the lateral retinaculae of the ankle and its attachment?

A

Superior fibular retinaculum

Inferior fibular retinaculum - extension of inferior extensor

191
Q

What are the medial retinaculae of the ankle and its attachment?

A

Flexor retinaculum - medial malleolus ==> calcanues

Holds flexor tendons

192
Q

Where is the tarsal tunnel located?

A

Behind flexor retinaculum

193
Q

What are the muscles of the anterior compartment of leg and their attachments?

A

Tibialis anterior - base of 1st metatarsal + dorsum of medial cuneiform
Extensor hallucis longus - base of distal phalanx
Perineus persicus - base of 5th/4th metatarsal bone
Extensor digitorum longus - distal phalanx of 2-5 digits

194
Q

What is the movement anterior compartment of the foot muscles?

A

Eversion of foot

195
Q

What are the muscles of the lateral compartment of leg and their attachments?

A

Fibularis longus - sole of foot, medial cuneiform + base of 1st metatarsal
Fibularis brevis - base of 5th styloid process

196
Q

What is the movement lateral compartment of the foot muscles?

A

Plantar flexion

Foot eversion

197
Q

What is the acronym to remember the vessels + tendons that run in the tarsal tunnel?

A

Tom, Dick an Harry

Tibialis posterior, flexor Digitorum longus, posterior tibial Artery, tibial Nerve, flexor Hallucis longus

198
Q

What 3 bones make up the ankle joint?

A

Tibia, Fibula, Talus

199
Q

What are the 3 main ligament groups in the ankle joints?

A

Syndesmosis
Deltoid (medial)
Lateral ligament complex

200
Q

What are the main movements of the ankle joint?

A

Dorsiflexion - 20 degrees
Plantar flexion - 45 degrees
roughly in sagittal plane

201
Q

What are the:
a) Lateral
b) Medial
ligaments of the ankle joint?

A

a) Anterior talofibular, Calcaneofibular, Posterior talofibular
b) Deltoid

202
Q

What are the superficial extensor muscles of the posterior compartment of the arm?

A

Extensor Digitorum
Extensor Digiti Minimi
Extensor Carpi Ulnaris
(Extensor Carpi Radialis Longus + Brevis)

203
Q

What are the origins of the 3 main superficial extensor muscles of the posterior compartment of the arm?

A

Lateral epicondyle of humerus

204
Q

What is the innervation of the 3 main superficial extensor muscles of the posterior compartment of the arm?

A

Deep branch of radial nerve

205
Q

What is the attachment of the:

a) Extensor Digitorum?
b) Extensor Digiti Minimi?
c) Extensor Carpi Ulnaris?
d) Extensor Carpi Radialis Longus + Brevis?

A

a) Extensor hood of each finger
b) Extensor hood of little finger
c) Base of metacarpal V
d) Metacarpal II + III

206
Q

What are the deep muscles of the posterior compartment of the arm?

A 
Supinator
Abductor Pollicis Longus
Extensor Pollicis Longus
Extensor Pollicis Brevis
Extensor Incidis
207
Q

What is innervation of deep muscles of the posterior compartment of the arm?

A

Supinator - Deep radial nerve

APL, EPL, EPB, EI - Pos interosseous branch of radial nerve

208
Q

What is the attachment of the deep muscles of the posterior compartment of the arm?

A 
Supinator - Posterior surface of radius
APL - Lateral side of base of metacarpal I
EPB - Base of proximal phalanx of thumb
EPL - Distal phalanx of thumb
EI - Extensor hood of index finger
209
Q

How many heads does the supinator muscle have and what nerve runs between it?

A

2

Radial nerve

210
Q

What are the borders of the anatomical snuff box?

A

Medial (ulnar) border - tendon of extensor pollicis longus

Lateral (Radial) border: Tendons of extensor pollicis brevis + extensor pollicis longus

211
Q

What are the contents of the anatomical snuff box?

A

Radial artery
Superficial branch of radial nerve
Cephalic vein

212
Q

What are the 3 muscles of the mobile wad?

A

Brachioradialis
Extensor Carpi Radialis Longus
Extensor Carpi Radialis Brevis

213
Q

What arteries supply the posterior forearm?

A

Anterior and posterior interosseous arteries

214
Q

What are the superficial muscles of the anterior forearm?

A

Flexor Carpi Ulnaris
Radialis
Palmaris Longus
Pronator Teres

215
Q

What is the origin of the superficial muscles of the anterior forearm?

A

Medial epicondyle of humerus

216
Q

What is the arterial supply of the superficial muscles of the anterior forearm?

A

FCU - Ulnar

FCR, PL, PT - Median

217
Q

What tendons are visible in forearm?

A

FCR, FCU, PL

218
Q

What tendon in forearm is often absent (how much) and what can it be used for?

A

PL - 14% pop

Donor tendon in surgery

219
Q

What are the intermediate and deep muscles of the forearm?

A

Intermediate - Flexor Digitorum Superficialis

Deep - Flexor Digitorum Profundus, Flexor Pollicis Longus, Pronator Quadratus

220
Q

What muscles flex joints of fingers?

A

Flexor Digitorum Profundus - Distal joints

Flexor Digitorum Superficialis - Middle phalanges

221
Q

What are arteries of anterior forearm?

A

Radial and ulnar artery

222
Q

What are the movements of the wrist?

A

Flexion + Extension
Abduction + Adduction
Circumduction

223
Q

What are the ligaments of the wrist joint?

A

Palmar radiocarpal
Dorsal radiocarpal
Ulnar collateral
Radial collateral

224
Q

What are the common fractures of the wrist?

A

Fracture distal end radius
Complete transverse fracture
FOOSH
Distal radial fracture mit dorsal angulation + impaction - dinner fork

225
Q

What is the fracture of scaphoid misdiagnosed by and why?

A

Sprained wrist

Bone resorption due as scaphoid severs radial artery, bone heals v slowly

226
Q

What is a non-union fracture?

A

Wrist fracture failing to heal

227
Q

What are the symptoms of carpal tunnel syndrome?

A

Tingling/Reduced/Absent sensation

Progressive loss of coordination + strength of thumb

228
Q

How is carpal tunnel syndrome treated?

A

Surgically cut medial side of flexor retinaculum to relieve pressure.

229
Q

What are the lower limb myotomes for:

a) Hip flexion + extension?
b) Ankle flexion + extension?
c) Knee flexion + extension?
d) Foot inversion, eversion + intrinsic?

A

a) L2-3 : L5-S1
b) L3-4: L5-S1
c) L4-5: S1-2
d) L4-5: L5-S1: S2

230
Q

What is the pneumonic to remember the 6 main divisions of the lumbar plexus?

A 
I - Iliohypogastric
I - Ilioinguinal
G - Genitofemoral
L - Lateral cutaneous
O - Obturator
F - Femoral

I I Got Laid On Friday

231
Q

What are the:
a) Anterior
b) Posterior
divisions of the femoral nerve?

A

a) Ant. cutan. branches, Sartorial, Pectineus

b) Saphenous, Quadriceps femoris

232
Q

What is the spinal root of femoral nerve?

A

L2-4

233
Q

What is the spinal root of obturator nerve?

A

L2-4

234
Q

What is the spinal root of lateral femoral cutaneous nerve?

A

L2-3

235
Q

What are the:
a) Anterior
b) Posterior
divisions of the obturator nerve?

A

a) Adductor longus, brevis, gracilis, manchmal pectineus

b) Obturator externus, Adductor magnus

236
Q

What does the lateral femoral cutaneous nerve supply?

A

Cutaneous innervation of skin on anterior + lateral thigh to level of knee

237
Q

What are the:
a) Anterior
b) Posterior
divisions of the sacral plexus?

A

a) Tibia

b) Common peroneal, Sup + inf gluteal

238
Q

What nerves come directly off sacral plexus?

A 
Pudendal
Perforating cutaneous
Post, cutan. n of thigh
Perineal
Pelvis splanchnic
Piriformis
239
Q

What 2 nerves make up the sciatic nerve?

A

Tibia + common peroneal

240
Q

What does the:
a) Sup gluteal nerve
b) Inf gluteal nerve
supply?

A

a) Gluteus medius, minimus, Tensor fasciae latae, hip joint

b) Gluteus maximus`

241
Q

What is meralgia paresthetica?

A

Tingling, numbness, burning in outer thigh due compression of lat. femoral cutaneous nerves

242
Q

What is the spinal root and innervation of the post cutaneous nerve of thigh?

A

S1-3

Skin on posterior surface of thigh + leg

243
Q

What is piriformis syndrome?

A

Compression of sciatic nerve by piriformis muscle

244
Q

What is tarsal tunnel syndrome?

A

Compression of tibial nerve in tarsal tunnel

245
Q

What can compression of common fibular/peroneal nerve cause?

A

Foot drop

246
Q

What are the 3 creases on the palm?

A

Thenar
Distal transverse
Proximal transverse

247
Q

What is the pneumonic to remember bones of wrist?

A 
Scaphoid (Some)
Lunate (Lovers)
Triquetrum (Try)
Pisiform (Positions)
Trapezium (That)
Trapezoid (They)
Capitate (Can't)
Hamate (Handle)
248
Q

What are all the movements of the thumb?

A

Abduction + Adduction
Extension + Flexion
Opposition + Reposition

249
Q

What are the extrinsic muscles of the hand?

A

Forearm flexors:
Flexor carpi radialis + ulnaris
Flexor digitorum profundus + superficialis
Palmaris longus

250
Q

What the compartments of the hand that contain the intrinsic muscles?

A 
Thenar
Adductor
Hypothenar
Central compartment (lumbricals)
Interosseous compartments (between metacarpals)
251
Q

What muscles comprise of the thenar muscles and what nerve innervates?
Movements?

A

Recurrent branch of median nerve
Opponens Pollicis - opposes thumb
Abductor Pollicis Brevis - abducts thumb
Flexor Pollicis Brevis - flexes MCP joint

252
Q

What movements do the intrinsic and extrinsic muscles of hand control?

A

Intrinsic - Fine motor functions

Extrinsic - Crude movement + forceful grip

253
Q

What are the hypothenar muscles and what innervates them?

Movements?

A

Ulnar nerve
Opponens Digiti Minimi - Opposition of pinkie
Abductor Digiti Minimi - Abduct pinkie
Flexor Digiti Minimi Brevis - Flexes MCP of pinkie

254
Q

How many lumbrical muscles are there, innervation + shape?

A

4 - one for for each finger
I, II - Median nerve, unipennate
III, IV - Ulnar nerve, bipennate

255
Q

Where are the metacarpals located and what is their role?

A

Between metacarpals
Dorsal - Abduction of fingers at MCP joint
Palmar - Adduction of fingers at MCP joint
Also assist lumbricals in flexion of MCP joint

256
Q

What nerve innervates lumbricals?

A

Ulnar nerve

257
Q

What nerves innervate hand and how do they enter hand?

A

Median - via carpal tunnel

Ulnar - between hamate bone + pisiform bone in Guyon canal

258
Q

What muscles do the nerves of the hand innervate?

A

Median - Motor fibres to 3 thenars + 1st + 2nd lumbricals

Ulnar - Motor fibres to hypothenar, 3rd + 4th lumbricals, adductor pollicis, all interosseous

259
Q

What arteries supply hand?

A

Ulnar + radial arteries

Form superficial + deep palmar arches

260
Q

What is Skier’s thumb?

A

Damage to ulnar collateral ligament of MCP joint
Supports thumb in gripping + pinching - chronic instability if damaged
Fall onto outstretched thumb whilst gripping something

261
Q

What is mallet finger?

A

Tear of tendon that straightens end of joint of finger

262
Q

What is trigger finger?

A

Thumb/finger clicks/locks as bent towards palm

Thickening of mouth of tendon ==> roughness on surface, tendon catches in tunnel mouth

263
Q

What is Dupuytren’s Contracture? (AKA Viking’s/Celt disease)

A

Disease of palmar fascia
Progressive shortening, thickening + fibrosis
4th + 5th digit most affected

264
Q

What are myotomes?

A

Groups of muscles innervated by same set of spinal nerves

265
Q

What vessels are contained within the axilla?

A 
Axillary artery ( + branches)
Axillary veins ( + tributaries)
Brachial plexus ( + branches)
Axillary lymph nodes
Biceps brachii (shrt head) + coracobranches
266
Q

What are the spinal origins of the brachial plexus?

A

C5-C8 and T1

267
Q

What is the origin of the dorsal scapular nerve and what does it supply?

A

C4-5

Innervates rhomboids + manchmal levator scapulae

268
Q

What is the origin of the long thoracic nerve and what does it supply?

A

C5-7

Serratus anterior

269
Q

What does damage to long thoracic nerve cause?

A

Winged scapula

270
Q

What is the origin of the suprascapular nerve and what does it supply?

A

C5

Innervates supra+infraspinatus muscle + glenohumeral joint

271
Q 
What does damage to:
a) Median nerve
b) Radial nerve
c) Ulnar nerve
cause?
A

a) Carpal tunnel syndrome
b) Sat night/ Honeymoon palsy, Wrist drop, Wartenberg syndrome
c) Claw hand

GBE (4 decks)

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