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Part 1 Anatomy > Lower limb > Flashcards

Lower limb Flashcards

1
Q

Limb bud formation

A

week 4 upper
week 5 lower

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2
Q

Hip bone fusion

A

starts 15-7, complete 20-25
ischiopubic ramus 9

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3
Q

Intertrochanteric line and crest

A

line ant
crest post

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4
Q

angle of inclination

A

135 3y
126 adult
120 old
smaller women

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5
Q

Talus articulates

A

no muscular or tendinous attachments
articulates tib fib, calcaneous and navic

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6
Q

Calcaneous articulates

A

talus and cuboid

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7
Q

Cuboid articulates

A

calcaneous, navicular, L cuneiform, 4,5 metatarsals
lat groove for tendon peroneus longus

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8
Q

Navicular articulates

A

talus, cuneiform, cuboid
attaches ligaments of arch of foot

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9
Q

iliotibial tract

A

lateral thickening
shared aponeurosis TFL and glut max
attaches lateral tubercle of tibia

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10
Q

Great saphenous vein course

A

ant to med maleolus, post medial condyle femur, in saphenous opening fascia lata

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11
Q

small saphenous vein course

A

post lateral maleoulus
through dep fascia mid fibula
between heads gastroc
joins popliteal

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12
Q

deep veins leg

A

dorsal venous arch -> ant tibial
plantars -> post tibial and fibular
all then to popliteal

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13
Q

Lymph drainage leg

A

with great saphenous vein to superficial inguinal and external iliac
with small saphenous / deep to popliteal to deep inguinal

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14
Q

Innervation dorsum foot

A

lateral sural
medial malleolus saphenous
rest superficial peroneal/ fibular except web 1st toe deep

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15
Q

Innervation sole of foot

A

calcaneal
lat plantar - also nail bed lat 1.5
med plantar - also nail bed med 3.5

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16
Q

Femoral cutaneous innervation leg

A

anterior cutaneous - ant med thigh
saphenous - med leg and foot

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17
Q

Key dermatomes lower limb

A

L3 knee
L5 sole of foot
S1 lat foot and leg
S2 back of leg
S2/3 penis
S3 what you sit on

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18
Q

Hip adduction/ abduction

A

add L234
ab L5S1

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19
Q

Hip int/ext rot
Ankle inversion/ eversion

A

int/ inv L45
Ext / evers L5S1

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20
Q

Pectineus attachment

A

superior pubic ramus to pectineal line femur

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21
Q

Pectineus innervation and action

A

Femoral and obturator
hip flexion and adduction

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22
Q

Psoas major attachment

A

T12-L5 and all L TPs to lesser trochanter femur

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23
Q

Psoas major and minor innervation and action

A

L1,2 anterior rami
hip flexion + vertebral flexion

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24
Q

Psoas minor attachment

A

T12-L1 to iliopubic eminence via iliopectineal arch and pecton pubis

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25
Q

Iliacus attachment

A

iliac crest and fossa to tendon psoas major and lesser trochanter

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26
Q

Iliacus innervation and action

A

femoral L2,3
hip flexion

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27
Q

Sartorius attachment

A

ASIS to superior medial tibia via pes anserinus

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28
Q

Sartorius innervation and action

A

Femoral L23
flexion, abduction, external rotation

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29
Q

Quadriceps femoris muscles and innervation

A

Femoral nerve
rectus femoris
Vastus - lateralis, intermedialis, medialis

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30
Q

Rectus femoris insertion

A

anterior inferior iliac spine

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31
Q

Vastus lateralis insertion

A

greater trochanter femur

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32
Q

Vastus intermedialis insertion

A

anteriior and lateral surfaces shaft femur

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33
Q

Vastus medialis insertion

A

intertrochanteric line

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34
Q

Medial thigh muscles not supplied by obturator

A

pectineus - femoral
adductor magnus hamstring portion - sciatic

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35
Q

Adductor innervation and action

A

obturator + sciatic for hamstring part magnus
Adduction + extension with magnus

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36
Q

Adductor insertion

A

inferior pubic ramus to
brevis - pectineal line and linea aspera
longus - linea aspera
magnus - supracondylar and adductor tubercle

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37
Q

Gracillis insertion

A

body and inf ramus pubis to sup tibia medially via pes anserinus

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38
Q

Gracillis innervation and action

A

obturator
adduction, flex knee, medial rot

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39
Q

Obturator externus attachment

A

obturator foramen and membrane to trochanteric fossa femur

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40
Q

Obturator externus innervation and action

A

obturator
lateral rotation thigh
stabilise head of femur

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41
Q

Pes anserinus

A

tendon attaching to medial superior tibia
made of sartorius, semitendinous and gracillis

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42
Q

Borders and contents femoral triangle

A

Borders: inguinal ligament, sartorius, adductor longus
Contents NAVL, saphenous vein joins, femoral nerve splits
lunate lymph node

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43
Q

Femoral sheath formed from

A

transversalis and iliopsoas fascia

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44
Q

Femoral sheath contains

A

femoral vein and artery and femoral canal with come lymph vessels

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45
Q

Femoral canal borders

A

lat - septum
post - pectineus and sup ramus
med - lacunar lig
ant - inguinal lig

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46
Q

Femoral artery course

A

mid ing lig
femoral triangle
adductor canal
through adductor hiatus and becomes popliteal

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47
Q

Profunda femoris course

A

inf to ing lig in femoral triangle from femoral
between pectineus and adductor longus
posterior to adductor longus on medial femur - gives off 3-4 perforating arteries

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48
Q

Medial circumflex femur course

A

from profunda med post
between pectineus and iliopsoas
gives off retinacular
main supplier head and neck femur

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49
Q

Lateral circumflex femur course

A

ascending, descending and transverse branches
deep to sartorius and rectus femoris

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50
Q

Obturator artery course

A

80% from internal iliac, 20% from inferior epigastric
through obturator foramen to medial thigh
Splits into A and P - go either side of adductor brevis

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51
Q

Relationship femoral vein to artery

A

distal vein is posterolateral
mid point is posterior
prox is medial

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52
Q

Contents adductor canal

A

Femoral vain and artery
Saphenous nerve
Nerve to vastus medialis

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53
Q

Adductor canal borders

A

ant and lat - vastus medialis
post - adductor longus and magnus
medial and roof - sartorius

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54
Q

Cruciate anastomosis femoral head

A

transverse medial circumflex
transverse lateral circumflex
ascending branch 1st perforating
descending inferior gluteal

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55
Q

Ligaments making sciatic foramen

A

sacrotuberous - converts notch into foramen
sacrospinous - converts foramen into sup and inf

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56
Q

Superficial gluteal muscles

A

TFL, glut med, min and max
all supplied by superior gluteal nerve except glut max which is supplied by inf gluteal

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57
Q

TFL insertion and action

A

ASIS to iliotibial tract
abduct and medially rotate

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58
Q

Gluteus medius insertion and action

A

between post and ant gluteal lines to lat surface greater trochanter
abducts and medially rotate

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59
Q

Gluteus minimus insertion and action

A

between ant and inf gluteal lines to ant surface greater trochanter
abducts and medial rotation

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60
Q

Gluteus maximus insertion and action

A

Ilium, sacrum, coccyx and sacrotuberous ligament to iliotibial tract
extends thigh, external rotation, standing

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61
Q

Deep gluteal muscles

A

lateral rotation and stability +- abduction
insert near intratrochanteric crest (post)
piriformis
obturator internus
inferior and superior gemilli
quadratus femoris

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62
Q

Piriformis insertion, action, innervation

A

ant sacrum, sarotuberous lig to superior border greater trochanter
lat rot, abduct
s1+2

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63
Q

Obturator internus insertion, action, innervation

A

obturator membrane to medial surface greater trochanter
lat rot and abduct
inferior obturator

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64
Q

sup and inf gemelli insertion, action, innervation

A

sup ischial sine, inf ischial tuberosity to medial greater trochanter
lat rot and abd
sup - inf obturator nerve
inf - nerve to quad femoris

65
Q

quadratus femoris insertion, action, innervation

A

lateral ischial tuberosity to intratrochanteri crest
lat rot and steady femoral head
L5/S1

66
Q

Hamstring muscles and prox attachment

A

semitendinous, semimembranous, long head biceps femoris
from ischial tuberosity
innervated tibial division sciatic

67
Q

short head biceps femoris

A

from linea espera and lat supra condylar line femur to lat head fibula with long head
innervated fibular division sciatic

68
Q

distal attachment semimembranous

A

post medial epicondyle tibia
forms oblique popliteal ligament

69
Q

distal attachment semitendinous

A

sup medial tibia in pes anserinus

70
Q

Sciatic nerve course

A

L4-S3
converge inf border piriformis
sciatic foramen inf to piriformis, deep to glut max
descends on adductor magnus, deeps to biceps femoris
bifurcates apex popliteal fossa

71
Q

Sciatic nerve supplies

A

post muscles thigh
all muscles leg and foot
sensory leg except saphenous
all joints

72
Q

Sup gluteal nerve

A

L4-S1
through greater sciatic foramen sup to piriformis
between glut med and min to TFL (supplies all of these)

73
Q

Inf gluteal nerve

A

L5-S2
greater sciatic foramen inf to piriformmis
deep to inf glut max which it supplies

74
Q

Post cut nerve thigh

A

S1-3
greater sciatic foramen inf to piriformis
deep to glut max
supplies post skin and popliteal fossa

75
Q

Borders popliteal fossa

A

sup med semimembranous
sup lat biceps femoris
inf gastroc

76
Q

sup to deep in popliteal fossa

A

nerves: tibial, common fib, post cut nerve thigh
vein
artery
(also lat to med)

77
Q

Muscles and nerve ant compartment leg

A

tibialis anterior
extensor hallucis longus
extensor digitorum longus + fibularis tertius (share synovial sheath)

deep fibular nerve

78
Q

superior extensor retinaculum

A

sup to maleoli

79
Q

inferior extensor retinaculum

A

from calcaneous
houses tendons extensor digitorum longus and fibularis tertius
y shaped

80
Q

tibialis anterior attachments

A

lat condyle tib, lat surface tib, io membrane to cuneiform and base 1st mt

81
Q

extensor hallucis longus attachments

A

ant surface fibula + IO membrane to dorsal distal big toe

82
Q

Extensor digiti longus attachments

A

lat condyle tibia, IO membrane, mid fibula to lat 4 mid and dist phalanges

83
Q

fibularis teritus attachments

A

inf 1/3 fibula + IO membrane to dorsum base 5th MT

84
Q

Cutaneous nerve femoral triangle

A

Genitofemoral

85
Q

Structures under superior extensor retinaculum med to lat

A

Tim has a very nasty disease paratyphoid
Tibialis ant
Extensor Hallucis longus
Artery
Vein
Nerve
Extensor Digutirum longus
Peroneustertius

86
Q

Sacroiliac joint type

A

Synovial plane joint

87
Q

Muscles inserting trochanteric fossa femur

A

obturator externus muscle and internus
superior gemellus and inferior gemellus

88
Q

Fibularis longus

A

eversion + plantarflexion
superior fibular nerve
from head + sup 2/3 fibula to 1st metatrsal base and medial cuneiform

89
Q

Fibularis brevis

A

eversion + plantarflexion
superior fibular nerve
from inf 2/3 lat fibula to dorsal surface tuberosity lat 5th MT

90
Q

Muscles superficial posterior compartment

A

gastroc, soleus, plantaris
innervation tibial S1,2
arterial tibial
attach to calcaneal tendon distally

91
Q

gastrocnemius insertion and action

A

lat condyle and sup to medial condyle femur
plantarflexes in knee extension

92
Q

soleus insertion and action

A

pos head and surface fibula, soleal line and mid 1/3 medial tib
plantarflexes ankle independent knee position

93
Q

Plantaris insertion and action

A

lateral supracondylar line femur, oblique popliteal lig
weakly assists gastroc

94
Q

Deep muscles posterior compartment

A

popliteus, flexor hallucis longus, flexor digitorum longus, tibialis posterior

95
Q

Popliteus attachments

A

lat condyle femur and lat meniscus to posterior surface tibia

96
Q

Popliteus innervation and action

A

tibial L45S1
unlocks knee rotating 5 degrees on tibia
med rot tibia

97
Q

Flexor hallucis longus attachments

A

inf 2/3 post fibula + IO membrane to base distal phalynx big toe

98
Q

Flexor hallucis longus innervation and action

A

tibial S2,3
flexes big toe + weak plantar flexion

99
Q

Flexor digitorum longus attachments

A

medial tibia inf to soleal line to base distal phalanges lat 4 digits

100
Q

Flexir digitorum longus innervation and action

A

Tibial S2,3
flex lat 4 toes and plantarflexes

101
Q

Tibialis posterior attachments

A

post tib fib and io membrane to navicular, cuneiform, cuboid, calcaneous 2,3,4 MT

102
Q

Tibialis posterior innervation and action

A

L4,5
plantarflexion
foot inversion

103
Q

Sural nerve

A

made from tibial and common peroneal
travels between heads gastroc with small saphenous
skin to lat foot and leg

104
Q

Tibial nerve

A

on popliteus the tibialis posterior
bifurcates inf to flexor retinaculum
muscles post leg and knee joint

105
Q

Common peroneal nerve

A

medial border biceps femoris
around neck fibula then divides
skin lat post leg and knee joint

106
Q

Superficial peroneal nerve

A

between fibularis longus and neck fibula
pierces deep fascia distal 1/3 becomes SC
fib longus and brevis and skin dditsal 1/3 ant leg and dorsum foot

107
Q

Deep peroneal nerve

A

between fibularis longus and neck fibula
through EDL to IO membrane
muscles and leg and dorsum foot + skin 1st web

108
Q

Popliteal artery

A

ends inf border popliteus
provides genicular arteries to knee
becomes ant and post tibial

109
Q

Anterior tibial artery

A

from popliteal comes through IO membranes
descends between tibialis anterior and extensor digitorum longus
becomes dorsalis pedis

110
Q

Dorsalis pedis artery

A

divides into plantar and arcuate pierces first IO space via deep plantar to contribute plantar arch

111
Q

fibular artery

A

branch of posterior tibial
travels in post compartment
perforating branches supply lateral compartment

112
Q

Muscles 1st layer foot

A

abductor hallucis
flexor digitorum brevis
abductor digiti minimi

113
Q

Muscles 2nd layer foot

A

Quadratus plantae
Lumbricals

114
Q

Muscles 3rd layer foot

A

Flexor hallucis brevis
Adductor hallucis
Flexor digiti minimi brevis

115
Q

Muscles 4th layer foot

A

Plantar IO - unipenate , lat 3
Dorsal IO - bipenate 1-5

116
Q

Muscles dorsum foot

A

Extensor digitorum brevis
Extensor hallucis brevis

117
Q

Action lumbricals

A

flex proximal phalanx, extension med and distal phalanx
from tendon flex digi longus to medial aspects expansion lat 4 digits

118
Q

Muscles innervated medial plantar S2,3

A

Abductor hallucis, flexor hallucis brevis, flexor digitorum brevis, medial lumbrical

119
Q

Medial plantar nerve

A

between abductor hallucis and flexor digitorum brevis
muscular and cutaneous branches

120
Q

Lateral plantar nerve

A

between quadratus plantae and fexor digitorum brevis
superficial and deep branches

121
Q

Hip Ligaments

A

Iliofemoral - strongest,
AIIS to intertrochanteric line
stops hyperextension
Pubofemoral
from pubic bone to joint capsule and iliofemoral
stops overabduction
Ischiofemoral - post acetabulum to femoral neck
weakest
prevents hyperflexion

122
Q

Main muscles hip flexion

A

illopsoas and adductor magnus

123
Q

Main muscles hip flexion and adduction

A

adductors, gracilis and pectineus

124
Q

Main muscles hip abduction and med rot

A

glut med, min and TFL

125
Q

Nerve supply hip

A

femoral, superior gluteal, obturator, nerve to quadratus femoris

126
Q

Main stabiliser knee and patella

A

quadriceps knee
vastus medialis patella

127
Q

LCL

A

stronger than MCL
separated from meniscus by popliteal tendon
Splits biceps femoris tendon in 2

128
Q

MCL

A

attached to meniscus
posteriorly blends with capsule

129
Q

Oblique popliteal ligament

A

expansion of semimembranous
from posterior medial tibial condyle
blends with knee joint capsule

130
Q

Arcuate popliteal ligament

A

posterior fibular head to posterior surface knee joint

131
Q

Intraarticular ligaments knee

A

ACL, PCL (medial)
coronary - peripheries
transverse - joins menisci ant
post - attaches firmly post

132
Q

Menisci

A

med bigger and more damages, more C shaped, less mobiles
lat almost circular more mobile

133
Q

Innervation knee

A

anterior - femoral, posterior - sciatic / tibial, lat - common fibular

134
Q

Knee bursae communicating with joint

A

suprapatellar, popliteus, anserine, gastrocnemius
GAPS

135
Q

Knee flexion degrees

A

120 ip extended, 140 flexed, 160 passive
hamstrings and short head biceps

136
Q

knee medial rotation degrees

A

10 when flexed, 5 extended
flexed - semimembranosus and tendinous
extended popliteus

137
Q

Knee lateral rotation degrees

A

30-40 when flexed
biceps femoris

138
Q

Tibiofibular joint types

A

prox - plane synovial
dist - compound fibrous
only move on dorsiflexion foot

139
Q

Lateral ligaments ankle

A

ant talofibular - weak, goes ant med
neck of talus
post talofibular - strong, postmed horizontal
lat tubercle talus
calcaneofibular - post inf

140
Q

Deltoid ligament ankle

A

medial, strong
attaches calcaneous, navicular and talus
4 parts
tibionavicular
tibiocalcaneal
A+P tibiotalar

141
Q

Nerve supply ankle

A

saphenous, tibial, sural, superficial and deep peroneal

142
Q

Subtalar joint

A

talocalcaneal
plane synovial
ligaments med lat post and IO(strong)
inversion and eversion

143
Q

transverse talar joint

A

calcaneocuboid (modified saddle/plane) and talonavicular part talocalcaneonavicular (ball and socket)
allows forefoot to rotate on hindfoot

144
Q

Forefoot MTPJ joint type

A

condyloid synovial

145
Q

Forefoot IPJ joint type

A

hinge synovial

146
Q

Superficial to deep ligaments foot

A

plantar aponeurosis
long plantar
short plantar (calcaneocuboid)
calcaneonavicular (spring - continuation deltoid ligament)

147
Q

Medial longitudinal arch foot bones

A

calcaneous, talus, navicular, 3 cuneiform, 1st 3 MTs

148
Q

Lateral longitudinal arch foot bones

A

calcaneous, cuboid, 4+5 MT

149
Q

Transverse arch foot bones

A

bases of metatarsals, cuboid, 3x cuneiform

150
Q

Muscles attaching tibia and fibula

A

Extensor digitorum longus
Tibialis posterior

151
Q

Age capitate ossifies

A

1

152
Q

Age pisiform ossifies

A

10

153
Q

Age upper end humerus fuses with shaft

A

20

154
Q

Age lower end humerus fuses with the shaft

A

15

155
Q

Age medial epicondyle elbow fuses

A

20

156
Q

CRITOE

A

1 3 5 7 9 11
Age ossification centers appear

157
Q

Sciatic artery is a branch of

A

Inferior gluteal artery

158
Q

Bones in the midtarsal joint

A

Talus, calcaneus, navicular, cuboid

159
Q

Drainage into popliteal lymphnodes

A

Dorsolateral foot and leg

Part 1 Anatomy (9 decks)

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