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OCAPE > Lower Limb and Vetebrae Applied Anatomy > Flashcards

Lower Limb and Vetebrae Applied Anatomy Flashcards

1
Q

What part of the pelvis do we sit on?

A

The ischial tuberosity

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3
Q

When does the head of the femur develop?

A

It develops from a secondary ossification centre, which appaerars during the first year of postnatal life

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4
Q

What is the angle of inclination?

A

The angle between the neck and the shaft of the femur.

Should be 116-140 degrees

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5
Q

When does the head of the femur fuse with the shaft of the femur?

A

16-18 years of age

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7
Q

What is the angle of torsion of the femur?

A

It is viewed from below.

It is the angle of the neck of the femur relative to the femoral comdyles.

About 20 degrees

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8
Q

What is the ligament of the head of the femur?

A

It’s an intracapsular ligament- runs from acetabular fossa to fovea of the femur. It encloses a branch of the obturator artery which delivers a small proportion of blood to the hip joint.

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9
Q

What is coxa vara?

A

When the angle of inclination of the femur is less than 116 degrees

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10
Q

What is coxa valga?

A

When the angle of inclination of the femur is over 140 degrees

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11
Q

What is the primary hip flexor? What are it’s attachments and innervation?

A

Iliopsoas

Origin- Transverse processes and vertebral bodies of T12-L5 and surface of iliac fossa

Insertion- lesser trochanter of femur

Nerve supply- psoas major: anterior rami of L1-L3

iliacus: femoral nerve (L2-L4)

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12
Q

Which muscles are hip extensors?

A

Gluteus Maximus, long head of biceps femoris, semitendinous and semimembranosus

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13
Q

What muscles are the hip abductors? What are it’s attachements and innervation?

A

Gluteus medius and minimus

Superior gluteal nerve (L4,L5,S1)

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14
Q

Which muscles are the hip adductors?

A
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16
Q

Why does damage to the medial circumflex femoral artery result in avascular necrosis of the head of the femur?

A

It is responsible for the majority of the arterial blood supply as the lateral circumflex has to penetrate the thick iliofemoral ligament.

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20
Q

What is the profunda femoris artery a branch of? What are it’s two main branches?

A

It’s a branch of the femoral artery which is the continuation of the external Iliac artery.

It’s two main branches are the medial and lateral circumflex femoral arteries.

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21
Q

What is the muscle in green? Attachments, innervation and function?

A

Piriformis

Origin- S2, S3, S4

passes through greater sciatic foreamen

Insertion- greater trochanter of femur

Function- later rotator

Innervation- sacral nerves 1 and 2

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22
Q

What makes up the crucial anastomosis? Why is this clinically relevant?

A

Circumflex femoral arteries, inferior gluteal artery and perforator branch from profunda femoris.

Damage to the femoral artery proximal to the profunda won’t have serous complications as the anastomoses will make up for it.

Gangene of the foot and ischemia result if there is damage distal to the origin of the profunda femoris artery.

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25
Q

What usually causes sciatica (pain somewhere along the course of the sciatic Nerve)?

A

Herniated intervertebral disc which commonly occurs between L4 and L5 or L5 and S1.

It can be localised pain only felt in the buttock but usually passes down the back of the leg. It may also be accompanied by anaesthesia of the skin if the lower leg if the sensory neurons were damaged also.

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26
Q

Where in the but is it safe to give a intramuscular injection?

A

Upper outer quadrant so avoids sciatic Nerve

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27
Q

What is a safer place to give an intramuscular injection the but?

A

The vastus lateralis in the thigh

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28
Q

What is Shentons line and when do we use it?

A

This line should run in continuity from the upper border of the obturator foreamen to the lower border of the neck of the femur.

In CDH the line is broken.

We use it before the epiphysis has appeared (usually at 1 year old but late in CDH)

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29
Q

What is Perkins line and when do we use it?

A

A horizontal line through the centres of the acetabulae and a vertical line at the outer lip of the acetabulum.

Epiphysis should be below the horizontal and internal to the vertical lines but is instead above and outwards.

As looking at epiphysis, can only be done at 1 year of age .

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30
Q

How is congenital dislocation of the hip detected?

A

By abducting the flexed leg of the baby

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31
Q

Why can’t congenital dislocation of the hip be seen on radiographs?

A

The head of the femur is cartilaginous during first year so can’t be seen on radiographs but you can detect them by drawing Shentons lines on the radiograph.

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32
Q

What is Perthes disease?

A

Bony degeneration of the head of the femur .

Between ages 5-10

Treatment is to hold hip in rested position

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33
Q

What is a positive Trendelenberg sign?

A

When pelvis falls on the side of the raised foot. Signifies a non functioning gluteus medius and minimus on the contralateral side or maybe damage to the superior gluteal nerve as the pelvis isn’t being stabilised.

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34
Q

What does the patella reflex test?

A

L2-L4

Should result in immediate reflex extension of the leg at the knee joint

Absence of the reflex could signify a herniated intervertebral disc

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35
Q

How can a femoral hernia present as a swelling in the groin?

A

After passing through the femoral ring into the femoral canal it can pass along the whole length of the femoral canal towards the saphenous opening of the fascia lata where it is free to balloon into the subcutaneous fat of the thigh

36
Q

What shape are the medial and lateral menisci?

A

Medial- oval

Lateral- circular

37
Q

What ligament is the medial menisci attached to?

A

Tibial/medial collateral ligament- so Medial menisci is less Mobile than Lateral

38
Q

What is housemaids knee?

A

Enlargement of the prepatella bursa

39
Q

What is Clergymans Knee?

A

Enlargement of the superficial infrapatellar bursa

40
Q

What are the attachments and function of the anterior cruciate ligament?

A

Arises from anterior intercondylar region and attaches to lateral femoral condyle.

Limits hyperextension

41
Q

What are the attachments of the posterior cruciate ligament?

A

Arises from posterior intercondylar region and attaches to medial femoral condyle.

Limits hyperflexion

48
Q

Which muscles are repsonsible for flexion of the knee?

A

Popliteus- for lateral rotation of the femur, unlocking the knee

Biceps femoris, semitendinous and semimembranous

49
Q

What is usually damaged during twisting sprains at the knee?

A

Tibial collateral ligament and since it is connected to the medial meniscus, it is usukaky damaged alongside it too

50
Q

What action of the knee is prevented when the medial meniscus is damaged?

A

Full extension of the knee- the torn piece of cartilage gets caught between the articulating surfaces

51
Q

What structure in the knee is damaged in a severe form of injury?

A

Anterior cruciate ligament- usually accompanied with the unhappy triad- tibial collateral ligament and medila meniscus also

52
Q

What structure passes through the top of the interosseus membrane from the popliteal fossa to the front of the leg?

A

Anterior tibial artery

54
Q

What type of joints are the proximal and distal tibiofibular joints?

A

Proximal- synovial

Distal- fibrous

55
Q

What type of joint is the ankle joint? What are the articulating surfaces and the range of movement?

A

Synovial hinge

Between the upper articular surface (trochlea) of the talus and the mortise

Dorsiflexion and plantarflexion

56
Q

What movements does the subtalar joint allow?

A

Synovial joint between the talus and the calcaneus

Inversion and eversion

57
Q

What type of joint is talonavicular joint?

A

Ball and socket, involved in inversion

58
Q

What is the function and innervation of muscles in the anterior compartment of the leg?

A

Function- dorsiflexion of ankle and extension of toes

Innervation- deep peroneal nerve of common personal branch of sciatic nerve

59
Q

Why is planataris muscle important? Attachments and innervation?

A

It plays an important role in running and walking due to its elastic nature- can return over 90% of its energy stored during walking

60
Q

What is the cutaneous innervation of the plantar aspect of the foot?

A
62
Q

What is the cutaneous innervation of lower leg?

A
63
Q

Dermatomes of the leg?

A
65
Q

Where can the pulse of the posterior tibial artery be palpated?

A

Posterior and inferior to medial malleolus

68
Q

What is the fracture called when bones are broken in the region of the malleoli?

A

Potts fracture

69
Q

What causes and is damaged in a sprained ankle?

A

Posterior ligament ruptures only with severe type of injury involving complete disruption of ankle

71
Q

How can we test for a ruptured Achilles’ tendon?

A

Patient should be prone and the triceps surae (gastrocnemius and Soleus) should be pinched which should result in plantarfkexion as an ankle reflex through the tibial nerve (S1-S2).

72
Q

What muscles in the leg can poliomyelitis affect?

A

Dorsiflexors and Evertors of the leg

73
Q

What is club foot?

A

Babys foot is plantarflexed, inverted and adducted

74
Q

What nerve damage causes foot drop?

A

Common peroneal nerve- as it supplies dorsiflexors

75
Q

Where is the common peroneal nerve usually damaged?

A

Where it lies superficially on the neck of the fibula

77
Q

What is another name for club foot?

A

Talipes equinovarus

Talipes- generic name for abnormal position in ankle region

Equinus- abnormal plantarflexed ankle

Varus- abnormal position in which foot points towards midline

78
Q

Which parts of the spinal cord are “lordosis”? What does lordosis mean?

A

Cervical and lumbar

Incraesed anterior convexity

79
Q

Which parts of the spine are “kyphosis”? What does it mean?

A
80
Q

What is scoliosis? What diseases can cause it?

A

Scoliosis is the abnormal curvature of the spine in the coronal plane. It is present in disorders such as muscular dystrophy and polio, where straightening muscles weaken.

81
Q

How does the atlas allow the nodding movement (flexion and extension)?

A

It has superior articulate facets that can support The occipital condyles of the skull.

83
Q

What is the intervertebral disc made up of?

A

Annulus fibrosis- layers of fibrocartikage and collagen fibres- helps to withstand strain in any direction

Nucleus pulposus- gel like fluid contained within annulus fibrosus

No nucleus pulposus Between C1 and C2 ans in sacrum and coccyx

84
Q

What occurs in a herniated intervertebral disc or slipped disc?

A

Degeneration can occur in the disc allowing the nucleus pulposus to herniate through a split in the surface of the annulus- this usually occurs posterolaterally as there is no reinforcement from the posterior longitudinal ligament. Spinal nerves can be compressed as a result.

Commonly occurs in regions T12-L1, L4-L5, L5-S1 so can cause sciatica e.g.

88
Q

What complications can arise from having a cervical rib? (When the transverse process of the cervical rib presents as a rib)

A

Thoracic outlet syndrome- compression of the brachial plexus so parathesia (tingling and numbness) along the ulnar border of forearm, wasting of hypothecate and interossei, ulnar lumbricals and adductors of thumb.

Compression of subclavian artery- paleness and coldness of arm, causes turbulent blood flow through narrowed artery so can cause aneurysm all dikayion/ thrombi

89
Q

What is the conus medullaris and cauda equina?

A
90
Q

What is the lumbar cistern and it’s signficance? What is the filum terminale?

A
91
Q

What does damage to the cauda equine result in?

A

OCAPE (2 decks)

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