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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
What is the attachment of the anterior cruciate ligament (ACL)?
Extends from anterior intercondylar area of tibia to posterior prt of medial surface of lateral condyle of femur
26
What is the attachment of the posterior cruciate ligament (PCL)?
Posterior intercondylar area of tibia to anterior prt of lateral surface of medial condyle of femur
27
What test can you carry out to test condition of cruciate ligaments?
Lachman test
28
Are ACL and PCL taut/relaxed in extension/flexion?
ACL - extension: taut, flexion: relaxed PCL - extension: relaxed, flexion : taut In extension, PCL becomes relaxed in locking mechanism
29
What is Donaghue's unhappy triad?
ACL rupture Rupture of medial collateral ligament Rupture of medial meniscus
30
What 4 bursae communicate with knee joint?
Suprapatellar Bursa Popliteus Bursa Gastrocnemius Bursa Semi-membranous Bursa
31
What bursae of the knee separates the pes anserinus from the tibia?
Anserva bursa
32
What is knee bursitis?
Inflammation of bursae
33
What is classed as the: a) Arm? b) Forearm?
a) Shoulder joint to elbow joint | b) Elbow joint to hand
34
What bones make up the pectoral girdle and what is its use?
Clavicle and scapula | Bony platform for movements of upper limb
35
What are the 3 joints of the upper limb and pectoral girdle?
Sternoclavicular joint - only articulation of upper limb with axial skeleton Acromioclavicular joint Glenohumeral joint
36
What is the only 'proper' joint of the upper limb/pectoral girdle?
Sternoclavicular joint
37
What is the clavicle bone made up of?
Long bone, no medullary cavity | Trabecular bone surrounded by compact bone
38
When does ossification of clavicle start and end?
1st bone to start in embryo | Last to finish - 18-20 yrs in male, 21-25 females
39
What type of joint is sternoclavicular joint: a) Anatomically? b) Functionally?
a) Saddle joint | b) Ball + socket
40
What is cleidocranial dysostosis?
Congenital defect, affects bone development Clavicle can be completely absent Defect in RUNX2/CBFA1 gene
41
What muscle can pull the medial part of the clavicle upwards, causing a clavicular fracture?
Sternocleidomastoid muscle
42
What nerve runs through the suprascapular notch in the scapula?
Suprascapular nerve
43
What is the function of the glenoid cavity in the scapula?
Articulates with head of humerus to form glenohumeral joint
44
What is the function of the acromion in the scapula?
Articulates with clavicle at acromioclavicular joint
45
What muscles a) Attach at b) Originate from the coracoid process in the scapula?
a) Pectoralis minor | b) Coracobrachialis + biceps brachii (long head)
46
If a patient has a scapula fracture, what should you check and why?
Airways, Breathing, Circulation | Scapula v hard fracture as layered in muscle so such large fracture, probs damage to thorax
47
What is Os acromiale?
Distal acromion fails to fuse
48
What makes up the coracoclavicular ligament?
``` Trapezoid ligament (lateral) Conoid ligament (medial) ```
49
What movements can the scapula-thoracic 'joint' carry out?
``` 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) ```
50
What are the deep posterior axioappendicular muscles?
Levator Scapulae Rhomboid Minor Rhomboid Major
51
What is the origin of: a) Levator Scapulae? b) Rhomboid Minor? c) Rhomboid Major? d) Serratus Anterior?
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
52
What is the insertion of: a) Levator Scapulae? b) Rhomboid Minor? c) Rhomboid Major? d) Serratus Anterior?
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
53
What is the action of: (In relation to scapula) a) Levator Scapulae? b) Rhomboid Minor? c) Rhomboid Major? d) Serratus Anterior?
a) Retract + elevate b) Retract + rotate c) Retract + rotate d) Protract + rotate
54
What is the serratus anterior muscle innervated by + where is it located?
Long thoracic nerve | Lateral + superficial
55
What is the cause of a winged scapula?
Paralysis of serratus anterior | Usu due to lesions of long thoracic nerve
56
How treat winged scapula?
Strength training + physical therapy If X improvement ==> surgery Graft of intercostal nerve/ fix scapula to rib cage
57
What is the triangle of auscultation?
Area on back devoid of muscle | Best place to listen to lung sounds
58
What are the superficial posterior axioappendicular muscles?
Trapezius | Latissimus Dorsi
59
What is the origin of: a) Trapezius? b) Latissimus Dorsi?
a) C7-T4 (transverse), T5-T12 (ascending) spinous processes | b) Spinous processes T7-T12, 9-12th rib, thoracolumbar fascia, iliac crest
60
What is the insertion of: a) Trapezius? b) Latissimus Dorsi?
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
61
What is the action of: (In relation to scapula) a) Trapezius? b) Latissimus Dorsi?
a) Elevates, retracts, depresses scapula | b) Extends, adducts, medially rotates humerus
62
What type of joint is the glenohumeral joint?
Synovial | Ball + socket
63
What movements can occur at gleno-humeral joint?
Flexion + extension Adduction + abduction Medial + lateral rotation
64
What is scapula humeral rhythm?
Ratio of glenohumeral movement to scapulothoracic movement during arm elevation
65
What are the superficial anterior axioappendicular muscles?
Pectoralis Major | Serratus anterior
66
What is the origin of: a) Pectoralis Major? b) Serratus anterior?
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
67
What is the insertion of: a) Pectoralis Major? b) Serratus anterior?
a) Crest of greater tubercle of humerus | b) Medial border of scapula
68
What is the action of: a) Pectoralis Major? b) Serratus anterior?
a) Adducts arm at glenohumeral joint, medially rotates humerus, flexes shoulder joint b) Protracts + upwardly rotates pectoral girdle
69
What are the 2 heads of the pectoralis major?
Clavicular and sternoclavicular
70
What is Poland's syndrome?
Congenital where pectoralis major hypotrophies (underdevelops) Can also cause webbing of fingers
71
What are the deep anterior axioappendicular muscles?
Pectoralis minor | Subclavius
72
What is the origin of: a) Pectoralis minor? b) Subclavius?
a) Anterior ends of 3rd-5th ribs | b) Superior surface of costal end of 1st rib and adjacent 1st costal cartilage
73
What is the insertion of: a) Pectoralis minor? b) Subclavius?
a) Coracoid process of scapula | b) Inferior surface of middle 1/3 of clavicle
74
What is the action of: a) Pectoralis minor? b) Subclavius?
a) Protracts + downwardly rotates pectoral girdle | b) Anchors + depresses clavicle, protects underlying nerves + vessels
75
What is the origin of the deltoid muscle?
Spine of scapula Acromion of scapula Lateral 1/3 of clavicle
76
What is the insertion of the deltoid muscle?
Deltoid tuberosity of humerus
77
What is the action of the deltoid muscle?
Spinal - extends + laterally rotates arm Acromial - Abducts arm Clavicular - Flexes + medially rotates arm
78
What are the 4 main muscles of the posterior scapula?
Supraspinatus + Infraspinatus | Teres major + minor
79
What is the origin of: a) Supraspinatus? b) Teres major? c) Infraspinatus? d) Teres minor?
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
80
What is the insertion of: a) Supraspinatus? b) Teres major? c) Infraspinatus? d) Teres minor?
a) Greater tubercle of humerus b) Crest of lesser tubercle of humerus c) Greater tubercle of humerus d) Greater tubercle of humerus
81
What is the action of: (in relation to arm) a) Supraspinatus? b) Teres major? c) Infraspinatus? d) Teres minor?
a) Initiates abduction of arm b) Medially rotates arm c) Laterally rotates arm d) Laterally rotates arm
82
What is the origin of the subscapularis muscle?
Subscapular fossa of scapula
83
What is the insertion of the subscapularis muscle?
Lesser tubercle of humerus
84
What is the action of (in relation to arm) the subscapularis muscle?
Medially rotates arm
85
What muscles make up the rotator cuff and what is it?
SITS - Supraspinatus, Infraspinatus, Teres minor, Subscapularis Surrounds shoulder joint + keeps head of humerus within socket
86
What makes up the coracoacromial arch?
Acromion, coracoacromial ligament, coracoid process
87
Which part of the shoulder do dislocations happen most frequently?
Anterior
88
When is surgery needed in a shoulder dislocation? | Type of surgery?
Ongoing pain after immobilisation/torn ligaments | Arthroscopic - surgical procedure on joint using arthroscope, type of endoscope inserted into joint by small incision
89
What are the complications of shoulder surgery?
Bankart lesion (anterior glenoid labrum) Hill-Sachs fracture (depression of posterolateral head of humerus), Rotator cuff tears Axillary nerve injury
90
What is the origin of the biceps brachii muscle?
Long head - Supraglenoid tubercle | Short head - Coracoid process
91
What is the insertion of the biceps brachii muscle?
Radial tuberosity
92
What is the action of the biceps brachii muscle?
Supinates + flexes forearm | Stabilises shoulder
93
Where is the 3rd head of the biceps brachii located and in how many people?
Extends from superomedial prt of brachialis | 10% peeps
94
In what position does the forearm have to be for the biceps brachii to be a flexor?
Elbows 90 degrees and forearm supinated
95
In what position does the forearm have to be for the biceps brachii to be a extensor?
Forearm pronated
96
What is the origin of: a) Coracobrachialis? b) Brachialis?
a) Coracoid process | b) Anterior aspect of distal 1/3 of humerus
97
What is the insertion of: a) Coracobrachialis? b) Brachialis?
a) Middle 1/3 of medial aspect of humerus | b) Coronoid process + tuberosity of ulna
98
What is the action of: a) Coracobrachialis? b) Brachialis?
a) Adducts + flexes arm, stabilises shoulder | b) Main flexor of forearm, workhouse of elbow flexors
99
What are the muscles in the anterior compartment of the arm?
Biceps brachii Coracobrachialis Brachialis
100
What are the muscles in the posterior compartment of the arm?
Triceps brachii
101
What nerve innervates the muscles of the anterior arm?
Musculocutaneous nerve
102
What is the origin of triceps brachii?
Long head - infraglenoid tubercle of scapula | Medial + lateral head - Posterior surface of humerus
103
What is the insertion of triceps brachii?
Olecranon of ulna
104
What is the action of triceps brachii?
Main extensor of forearm Extension Adduction of arm
105
What type of joint is the elbow?
Hinge joint
106
What muscles: a) Flex elbow? b) Extend elbow?
a) Brachialis, biceps brachii, brachioradialis (x cross elbow joint) b) Triceps brachii, anconeous
107
What is the arrangement of the humerus epicondyles and olecranon of ulna during: a) Extension? b) Flexion
a) Epicondyles and olecranon aligned | b) Epicondyles form triangle + align vertically mit olecranon
108
What are the muscles of supination?
Biceps brachii
109
What are the muscles of pronation?
Pronator teres | Pronator quadratus
110
What is the origin of the muscles of pronation?
Pronator teres - Medial epicondyle of humerus | Pronator quadratus - Anterior aspect of distal 1/4 of ulna
111
What is the insertion of the muscles of pronation?
Pronator teres - Lateral aspect of radius | Pronator quadratus - Anterior aspect of distal 1/4 of radius
112
What connects the radius and ulna?
Interosseous membrane
113
What ligament holds radius head in place?
Annual ligament
114
What are the 3 articulating surfaces within the elbow joint?
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
What are the 3 ligaments of the elbow joint?
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
What are the vessels in the cubital fossa?
Median nerve Brachial artery + vein Biceps tendon
117
What is the arrangement of the funny bone?
Ulna nerve runs on medial aspect on media epicondyle of humerus
118
What are the 5 bursae around the elbow joint?
Subcutaneous bursae of lateral + medial epicondyle Bursa of anconeus Subtendinous bursa of triceps brachii Olecranon bursa
119
What are 4 clinical issues at the elbow?
Olecranon fracture Distal humerus fractures/Supracondylar fractures Tennis elbow Elbow dislocation
120
What are the deep fascia of the lower limb?
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
What are 2 features of the fascia lata?
Thicker laterally to form iliotibial tract | Superiorly attached to hip bone + soft tissue
122
What are the 6 nerves of the lower limb?
``` Superior gluteal Inferior gluteal Femoral Obturator Tibial Common peroneal/fibular ```
123
What nerves does the sciatic nerve split into?
Tibial | Common peroneal/fibular
124
Compression of what nerve causes foot drop?
Deep peroneal/fibular nerve
125
What are the main arteries of the lower limb?
``` External iliac Femoral Profunda femoris Popliteal Posterior Tibial Peroneal Anterior Tibial Dorsalis Pedis Plantar arteries ```
126
What are the 4 pulse points of the lower limb?
Femoral pulse Popliteal pulse Dorsalis pedis pulse Posterior tibial pulse
127
What are the main veins of the lower limb?
``` External iliac Femoral Profunda Femoris Great Saphenous Popliteal Short Saphenous Anterior Tibial Fibular Posterior Tibial Dorsal Ventral Arch ```
128
What are the: a) Superficial lymphatic vessels? b) Deep lymphatic vessels?
a) Medial, follow great saphenous, orginate foot dorsal Lateral, follow shrt saphenous, orginate foot lateral b) Follow ant + post tibial artery, peroneal artery
129
What do the: a) Superficial lymphatic vessels b) Deep lymphatic vessels drain into?
a) Medial ==> Sub-inguinal nodes Lateral ==> Popliteal nodes b) Popliteal nodes
130
What are the classifications of the inguinal nodes?
Above line where great saphenous terminates: Sub-inguinal nodes (superficial + deep) Below line where great saphenous terminates: Superficial inguinal nodes
131
Where are the popliteal nodes located?
In fat reserves of popliteal fossa
132
What is the name of a: a) greatly inclined femur? b) less inclined femur?
a) Coxa valga | b) Coxa vara
133
What is the normal angle inclination of the femur?
140-160 degrees
134
By how many degrees is the femur normally angled forward?
12-15 degrees
135
What are the anterior ligaments of the hip joint and their attachments?
Iliofemoral - iliac portion of acetabulum to intertrochanteric line Pubofemoral - superior ramus of pubis to intertrochanteric line of femur
136
What are the posterior ligaments of the hip joint and their attachments?
Ischiofemoral - ischium to posterior femoral neck of hip joint x attach to bone
137
What is the blood supply to the hip joint?
Medial + lateral circumflex femoral arteries | Branch of obturator supplies head (not main one)
138
What way does a patient walk if they have hip joint dislocation?
Trendelenburg sign | Hip drops to 1 side when walking
139
What is avascular necrosis?
Insufficient blood supply causes bone death + loss of cartilage
140
What muscles: a) Flex hip? b) Extend hip?
a) Tensor fascia lata | b) Gluteus maximus, Semi membranous + tendinous, Biceps femoris long, adductor magnus (extensor)
141
What ligament arises from gluteus maximus?
Sacrotuberous ligament
142
``` What is the: a) Nerve supply b) Arterial supply c) Attachment of gluteus maximus? ```
a) Inf gluteal nerve (L%-S2) b) Inf + sup gluteal artery c) Lower prt attaches to gluteal tuberosity on femur
143
``` What is the: a) Nerve supply b) Arterial supply c) Origin d) Insertion of tensor fascia lata? ```
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
What makes up the iliotibial tract?
Tensor fascia lata | Gluteus maximus
145
Damage of what nerves can cause Trendelenburg sign?
L4-L5
146
What muscles abduct the hip?
Gluteus minimus + medius
147
``` What is the: a) Nerve supply b) Arterial supply c) Insertion of gluteus medius? ```
a) Sup gluteal nerve b) Sup gluteal artery c) Lateral surface of greater trochanter
148
``` What is the: a) Nerve supply b) Arterial supply c) Insertion of gluteus minimus? ```
a) Sup gluteal nerve b) Sup gluteal artery c) Greater trochanter
149
What are the lateral rotators of the gluteal region?
Piriformis, Sup + Inf Gemellus, Quadratus Femoris
150
``` What is the: a) Nerve supply b) Arterial supply c) Origin d) Insertion of piriformis? ```
a) S1+S2 spinal nerve b) Sup + inf gluteal, Internal pudendal c) Pelvic surface of sacrum d) Sup border of greater trochanter
151
``` What is the: a) Nerve supply b) Arterial supply c) Origin d) Insertion of sup gemellus? ```
a) L5-S2 b) Inf gluteal, Internal pudendal c) Ischial spine d) Medial surface of greater trochanter
152
``` What is the: a) Nerve supply b) Arterial supply c) Origin d) Insertion of inf gemellus? ```
a) L5 b) Medial circumflex femoral c) Ischial tuberosity d) Medial surface of greater trochanter
153
``` What is the: a) Nerve supply b) Arterial supply c) Insertion of obturator internus? ```
a) L5-S2 b) Internal pudendal, obturator c) Medial surface of greater trochanter
154
What is the: a) Nerve supply b) Arterial supply of quadratus femoris?
a) L5 | b) Medial circumflex femoral, inf gluteal
155
What are the: a) Nerves b) Arteries of gluteal region?
a) Sup + inf gluteal, sciatic, perforating cutaneous nerves, posterior cutaneous nerve of thigh b) Sup + inf gluteal arteries
156
What are the anterior muscles of the thigh?
``` Psoas Major Iliacus Rectus Femoris Vastus lateralis, intermedialis, medialis Pectineus Sartorius ```
157
What makes up the: a) Iliopsoas muscle? b) Quadriceps femoris muscle?
a) Psoas major, iliacus | b) Rectus femoris, vastus lateralis, intermedialis, medialis
158
What muscles should gluteal injections be injected into and why?
Gluteus medius | Avoid sciatic nerve
159
What are the medial muscles of the thigh?
Adductor brevis, longus, magnus Gracilis Obturator externus
160
What are the posterior muscles of the thigh?
Semi- membranous + tendinous | Biceps femoris - long + shrt head
161
What makes up the femoral triangle?
Base - inguinal ligament Medially - Adductor Longus Laterally - Sartorius
162
What are the contents of the femoral triangle? | Lateral ==> medial
``` Femoral nerve + terminal branches Femoral artery Femoral vein Femoral canal Deep inguinal nodes ```
163
What muscles make up the popliteal fossa?
Semi-membranous + tendinous Gastrocnemius - medial + lateral head Plantaris Biceps femoris
164
What structures are contained within popliteal fossa?
``` Termination of shrt saphenous vein Popliteal artery + veins Tibial + common fibular nerves Posterior cutaneous nerve of thigh Popliteal lymph nodes ```
165
What is a Baker's cyst?
Fluid filled sac forms on posterior surface of knee joint
166
What are the 3 arches of the foot and the middle bone of each?
a) Medial longitudinal - talus b) Lateral longitudinal - cuboid c) Transverse - intermediate cuneiform
167
What are the medial longitudinal set of bones in foot?
Calcaneus, Talus, Navicular, Cuneiforms | 1st, 2nd, 3rd metatarsals
168
What are the lateral longitudinal set of bones in foot?
Calcaneus, Cuboid | 4th, 5th metatarsals
169
What is: a) Pes planus? b) Pes cavus?
a) Flat foot, collapsed foot | b) Overly arched foot, high arch
170
What fascias support the foot?
Plantar fascia - from calcaneal tuberosity to digits | Bands held together by superficial transverse metatarsal ligaments
171
What is plantar fasciitis?
Heel pain predominantly in morning/after rest | Worse with prolonged standing
172
What is the most commonly ruptured ligament in the foot?
Bifurcate ligament | From calcaneus ==> navicular + cuboid
173
What are the main ligaments of the foot?
Long + shrt plantar ligaments | Spring ligament
174
What tendons support the arch of the foot on the: a) Medial side? b) Lateral side?
a) Tibialis Anterior + Posterior | b) Fibularis longus
175
What are the intrinsic muscles of the foot?
Extensor hallucis longus digitorum longus brevis
176
What are 5 common forefoot pathologies?
``` Claw toe Mallet toe Hammer toe Curly toe Hallux valgus - callus on big toe protruding medially ```
177
What nerves supply the dorsum of the foot?
Superficial + Deep fibular nerve Saphenous nerve Sural nerve
178
What nerves supply the sole of the foot?
Medial + Lateral plantar Sural nerve Saphenous nerve
179
What blood supplies the dorsum of the foot?
Arcuate ==> Dorsal metatarsal - fuse with plantar ==> common digital ==> split into 2 for adjacent digits
180
What blood supply the sole of the foot?
Posterior tibial rise to Lateral + Medial plantar Lateral ==> plantar arch Medial ==> Big toe + 1/2 of 2nd toe
181
What surface does the blood of the foot drain from?
Dorsal surface
182
What veins drain the foot?
Superficial dorsal arch Runs medially over medial malleolus ==> great saphenous vein Runs laterally under lateral malleolus ==> lesser saphenous vein
183
What is between the tibia and fibula of the leg?
Interosseous septum
184
What is the anterior compartment of the leg bounded by: a) Anteriorly? b) Laterally?
a) Crural fascia | b) Intermuscular septum
185
What are the joints on the top and bottom of the fibula?
Top - synovial | Bottom - fibrous, syndesmosis
186
What are the bones of the: a) Hindfoot? b) Midfoot? c) Forefoot?
a) Talus, Calcaneus b) Cuneiforms, Navicular, Cuboid c) Metatarsals, Phalanges
187
What are the tarsal bones of the foot?
Calcaneus, Talus, Cuneiforms, Cuboid, Navicular
188
What part of the calcaneus does the talus bone of foot sit on?
Sustentaculum tali
189
What are the dorsal retinaculae of the ankle and its attachment?
Extensor retinaculae: Superior - distal ends of fibula - tibia Inferior - Y shaped, medial malleolus ==> calcaneus ==> 1st metatarsal
190
What are the lateral retinaculae of the ankle and its attachment?
Superior fibular retinaculum | Inferior fibular retinaculum - extension of inferior extensor
191
What are the medial retinaculae of the ankle and its attachment?
Flexor retinaculum - medial malleolus ==> calcanues | Holds flexor tendons
192
Where is the tarsal tunnel located?
Behind flexor retinaculum
193
What are the muscles of the anterior compartment of leg and their attachments?
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
What is the movement anterior compartment of the foot muscles?
Eversion of foot
195
What are the muscles of the lateral compartment of leg and their attachments?
Fibularis longus - sole of foot, medial cuneiform + base of 1st metatarsal Fibularis brevis - base of 5th styloid process
196
What is the movement lateral compartment of the foot muscles?
Plantar flexion | Foot eversion
197
What is the acronym to remember the vessels + tendons that run in the tarsal tunnel?
Tom, Dick an Harry | Tibialis posterior, flexor Digitorum longus, posterior tibial Artery, tibial Nerve, flexor Hallucis longus
198
What 3 bones make up the ankle joint?
Tibia, Fibula, Talus
199
What are the 3 main ligament groups in the ankle joints?
Syndesmosis Deltoid (medial) Lateral ligament complex
200
What are the main movements of the ankle joint?
Dorsiflexion - 20 degrees Plantar flexion - 45 degrees roughly in sagittal plane
201
What are the: a) Lateral b) Medial ligaments of the ankle joint?
a) Anterior talofibular, Calcaneofibular, Posterior talofibular b) Deltoid
202
What are the superficial extensor muscles of the posterior compartment of the arm?
Extensor Digitorum Extensor Digiti Minimi Extensor Carpi Ulnaris (Extensor Carpi Radialis Longus + Brevis)
203
What are the origins of the 3 main superficial extensor muscles of the posterior compartment of the arm?
Lateral epicondyle of humerus
204
What is the innervation of the 3 main superficial extensor muscles of the posterior compartment of the arm?
Deep branch of radial nerve
205
What is the attachment of the: a) Extensor Digitorum? b) Extensor Digiti Minimi? c) Extensor Carpi Ulnaris? d) Extensor Carpi Radialis Longus + Brevis?
a) Extensor hood of each finger b) Extensor hood of little finger c) Base of metacarpal V d) Metacarpal II + III
206
What are the deep muscles of the posterior compartment of the arm?
``` Supinator Abductor Pollicis Longus Extensor Pollicis Longus Extensor Pollicis Brevis Extensor Incidis ```
207
What is innervation of deep muscles of the posterior compartment of the arm?
Supinator - Deep radial nerve | APL, EPL, EPB, EI - Pos interosseous branch of radial nerve
208
What is the attachment of the deep muscles of the posterior compartment of the arm?
``` 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
How many heads does the supinator muscle have and what nerve runs between it?
2 | Radial nerve
210
What are the borders of the anatomical snuff box?
Medial (ulnar) border - tendon of extensor pollicis longus | Lateral (Radial) border: Tendons of extensor pollicis brevis + extensor pollicis longus
211
What are the contents of the anatomical snuff box?
Radial artery Superficial branch of radial nerve Cephalic vein
212
What are the 3 muscles of the mobile wad?
Brachioradialis Extensor Carpi Radialis Longus Extensor Carpi Radialis Brevis
213
What arteries supply the posterior forearm?
Anterior and posterior interosseous arteries
214
What are the superficial muscles of the anterior forearm?
Flexor Carpi Ulnaris Radialis Palmaris Longus Pronator Teres
215
What is the origin of the superficial muscles of the anterior forearm?
Medial epicondyle of humerus
216
What is the arterial supply of the superficial muscles of the anterior forearm?
FCU - Ulnar | FCR, PL, PT - Median
217
What tendons are visible in forearm?
FCR, FCU, PL
218
What tendon in forearm is often absent (how much) and what can it be used for?
PL - 14% pop | Donor tendon in surgery
219
What are the intermediate and deep muscles of the forearm?
Intermediate - Flexor Digitorum Superficialis | Deep - Flexor Digitorum Profundus, Flexor Pollicis Longus, Pronator Quadratus
220
What muscles flex joints of fingers?
Flexor Digitorum Profundus - Distal joints | Flexor Digitorum Superficialis - Middle phalanges
221
What are arteries of anterior forearm?
Radial and ulnar artery
222
What are the movements of the wrist?
Flexion + Extension Abduction + Adduction Circumduction
223
What are the ligaments of the wrist joint?
Palmar radiocarpal Dorsal radiocarpal Ulnar collateral Radial collateral
224
What are the common fractures of the wrist?
Fracture distal end radius Complete transverse fracture FOOSH Distal radial fracture mit dorsal angulation + impaction - dinner fork
225
What is the fracture of scaphoid misdiagnosed by and why?
Sprained wrist | Bone resorption due as scaphoid severs radial artery, bone heals v slowly
226
What is a non-union fracture?
Wrist fracture failing to heal
227
What are the symptoms of carpal tunnel syndrome?
Tingling/Reduced/Absent sensation | Progressive loss of coordination + strength of thumb
228
How is carpal tunnel syndrome treated?
Surgically cut medial side of flexor retinaculum to relieve pressure.
229
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) L2-3 : L5-S1 b) L3-4: L5-S1 c) L4-5: S1-2 d) L4-5: L5-S1: S2
230
What is the pneumonic to remember the 6 main divisions of the lumbar plexus?
``` I - Iliohypogastric I - Ilioinguinal G - Genitofemoral L - Lateral cutaneous O - Obturator F - Femoral ``` I I Got Laid On Friday
231
What are the: a) Anterior b) Posterior divisions of the femoral nerve?
a) Ant. cutan. branches, Sartorial, Pectineus | b) Saphenous, Quadriceps femoris
232
What is the spinal root of femoral nerve?
L2-4
233
What is the spinal root of obturator nerve?
L2-4
234
What is the spinal root of lateral femoral cutaneous nerve?
L2-3
235
What are the: a) Anterior b) Posterior divisions of the obturator nerve?
a) Adductor longus, brevis, gracilis, manchmal pectineus | b) Obturator externus, Adductor magnus
236
What does the lateral femoral cutaneous nerve supply?
Cutaneous innervation of skin on anterior + lateral thigh to level of knee
237
What are the: a) Anterior b) Posterior divisions of the sacral plexus?
a) Tibia | b) Common peroneal, Sup + inf gluteal
238
What nerves come directly off sacral plexus?
``` Pudendal Perforating cutaneous Post, cutan. n of thigh Perineal Pelvis splanchnic Piriformis ```
239
What 2 nerves make up the sciatic nerve?
Tibia + common peroneal
240
What does the: a) Sup gluteal nerve b) Inf gluteal nerve supply?
a) Gluteus medius, minimus, Tensor fasciae latae, hip joint | b) Gluteus maximus`
241
What is meralgia paresthetica?
Tingling, numbness, burning in outer thigh due compression of lat. femoral cutaneous nerves
242
What is the spinal root and innervation of the post cutaneous nerve of thigh?
S1-3 | Skin on posterior surface of thigh + leg
243
What is piriformis syndrome?
Compression of sciatic nerve by piriformis muscle
244
What is tarsal tunnel syndrome?
Compression of tibial nerve in tarsal tunnel
245
What can compression of common fibular/peroneal nerve cause?
Foot drop
246
What are the 3 creases on the palm?
Thenar Distal transverse Proximal transverse
247
What is the pneumonic to remember bones of wrist?
``` Scaphoid (Some) Lunate (Lovers) Triquetrum (Try) Pisiform (Positions) Trapezium (That) Trapezoid (They) Capitate (Can't) Hamate (Handle) ```
248
What are all the movements of the thumb?
Abduction + Adduction Extension + Flexion Opposition + Reposition
249
What are the extrinsic muscles of the hand?
Forearm flexors: Flexor carpi radialis + ulnaris Flexor digitorum profundus + superficialis Palmaris longus
250
What the compartments of the hand that contain the intrinsic muscles?
``` Thenar Adductor Hypothenar Central compartment (lumbricals) Interosseous compartments (between metacarpals) ```
251
What muscles comprise of the thenar muscles and what nerve innervates? Movements?
Recurrent branch of median nerve Opponens Pollicis - opposes thumb Abductor Pollicis Brevis - abducts thumb Flexor Pollicis Brevis - flexes MCP joint
252
What movements do the intrinsic and extrinsic muscles of hand control?
Intrinsic - Fine motor functions | Extrinsic - Crude movement + forceful grip
253
What are the hypothenar muscles and what innervates them? | Movements?
Ulnar nerve Opponens Digiti Minimi - Opposition of pinkie Abductor Digiti Minimi - Abduct pinkie Flexor Digiti Minimi Brevis - Flexes MCP of pinkie
254
How many lumbrical muscles are there, innervation + shape?
4 - one for for each finger I, II - Median nerve, unipennate III, IV - Ulnar nerve, bipennate
255
Where are the metacarpals located and what is their role?
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
What nerve innervates lumbricals?
Ulnar nerve
257
What nerves innervate hand and how do they enter hand?
Median - via carpal tunnel | Ulnar - between hamate bone + pisiform bone in Guyon canal
258
What muscles do the nerves of the hand innervate?
Median - Motor fibres to 3 thenars + 1st + 2nd lumbricals | Ulnar - Motor fibres to hypothenar, 3rd + 4th lumbricals, adductor pollicis, all interosseous
259
What arteries supply hand?
Ulnar + radial arteries | Form superficial + deep palmar arches
260
What is Skier's thumb?
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
What is mallet finger?
Tear of tendon that straightens end of joint of finger
262
What is trigger finger?
Thumb/finger clicks/locks as bent towards palm | Thickening of mouth of tendon ==> roughness on surface, tendon catches in tunnel mouth
263
What is Dupuytren's Contracture? (AKA Viking's/Celt disease)
Disease of palmar fascia Progressive shortening, thickening + fibrosis 4th + 5th digit most affected
264
What are myotomes?
Groups of muscles innervated by same set of spinal nerves
265
What vessels are contained within the axilla?
``` Axillary artery ( + branches) Axillary veins ( + tributaries) Brachial plexus ( + branches) Axillary lymph nodes Biceps brachii (shrt head) + coracobranches ```
266
What are the spinal origins of the brachial plexus?
C5-C8 and T1
267
What is the origin of the dorsal scapular nerve and what does it supply?
C4-5 | Innervates rhomboids + manchmal levator scapulae
268
What is the origin of the long thoracic nerve and what does it supply?
C5-7 | Serratus anterior
269
What does damage to long thoracic nerve cause?
Winged scapula
270
What is the origin of the suprascapular nerve and what does it supply?
C5 | Innervates supra+infraspinatus muscle + glenohumeral joint
271
``` What does damage to: a) Median nerve b) Radial nerve c) Ulnar nerve cause? ```
a) Carpal tunnel syndrome b) Sat night/ Honeymoon palsy, Wrist drop, Wartenberg syndrome c) Claw hand

GBE (4 decks)

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