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Bloc H - Movement > May31 M3-Anatomy LL 2 > Flashcards

May31 M3-Anatomy LL 2 Flashcards

1
Q

landmarks on femur other than those near the hip

A
  • gluteal tuberosity (post, below intertroch crest)
  • shaft of the femur
  • linea aspera (a rough line posteriorly, below glut tuberosity)
  • adductor tubercle (bump in back of lower femur, medially
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2
Q

distal femur name of the parts

A
  • medial and lateral epicondyles = bumps in bottom

- medial and lateral condyles = articular surfaces

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3
Q

landmarks on the fibula

A
  • head
  • neck
  • shaft
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4
Q

name of joint tibia - fibula

A

tibiofibular joint

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5
Q

landmarks on tibia

A
  • tibial tuberosity (anterior)

- soleal line (posterior. goes medial distal to lateral proximal. so towards head of fibula)

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6
Q

structure separating tibia and fibula

A

interosseus membrane. has 2 holes one on top and one on bottom

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7
Q

how to do lateral (external) and medial (internal) rotation of the leg (knee)

A
  • flex knee 90 degrees and move foot outwards (but no eversion, inversion)
  • this rotates the leg
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8
Q

valgus deformity is what

A
  • knees bend outwards (tibia bent outwards)

- bow legs

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9
Q

varus deformity is what

A
  • knees bend inwards

- knock knees

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10
Q

genu recurvatum is what

A

hyperextension of the knees in the back due to either of

  • hamstring weakness or injury
  • non-inflammatory CT diseases (Marfan, Ehlers-Danlos)
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11
Q

hamstrings medially to laterally in the back

A
  • semimembranosus
  • semitendinosus
  • biceps femoris (long head covering short head. short head is deeper)
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12
Q

true hamstrings

A
  • semimembranosus
  • semitendinosus
  • long head of biceps femoris
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13
Q

semimembranosus O, I, F, N

A
  • O: ischial tuberosity
  • I: upper tibia (posteromedially)
  • F: extend hip, flex knee. + medial rotation of tibia
  • N: tibial n.
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14
Q

semitendinosus O, I, F, N

A
  • O: ischial tuberosity
  • I: pes anserinus (upper tibia anteromedially)
  • F: extend hip, flex knee. + medial rotation of tibia
  • N: tibial n.
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15
Q

long head of biceps femoris O, I, F, N

A
  • O: ischial tuberosity
  • I: head of fibula
  • F: extend hip, flex knee
  • N: tibial n.
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16
Q

short head of biceps femoris O, I, F, N

A
  • O: posterior surface of shaft of the femur
  • I: head of fibula
  • F: flex the knee only
  • N: common fibular n.
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17
Q

functions of hamstrings in the gait cycle

A
  • extension of hip on stance leg during reversal of fore-aft shear (to swing the swing leg forward)
  • flexion of the knee on swing leg during toe-off and foot clearance phases (end of stance and beginning of swing)
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18
Q

nerves to the thigh

A
  • back: sciatic splits in tibial n. (medial) and common fibular n. (lateral)
  • back: posterior cutaneous n. emerges medial to sciatic n.
  • front: obturator n. (L2,3,4) comes on medial side
  • femoral n. (L2,3,4) comes in middle of anterior thigh
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19
Q

other name for common fibular n.

A

common peroneal n. (peroné = old name for fibula)

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20
Q

other muscle that the tibial n. innervates in the back of the leg

A

adductor magnus hamstring portion

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21
Q

adductor magnus hamstring portion O, I, N and F

A
  • O: ischial tuberosity
  • I: adductor tubercle (near where semimebranosus inserts bc is bottom of femur posteromedially)
  • N: tibial n.
  • F: extend the hip
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22
Q

variations in sciatic n. exiting near piriformis

A
  • pass through piriformis instead of below
  • pass above piriformis instead of below
  • note: post cut nerve of the thigh is always below piriformis medial to scaitic n.
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23
Q

blood supply to the thigh until femoral a.

A
  • aorta gives 2 common iliacs
  • common iliac makes external iliac and internal iliac a.
  • internal iliac a. gives sup and inf gluteal a.
  • external iliac a. becomes femoral a. below inguinal ligament
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24
Q

blood supply to the thigh after femoral a.

A
  • femoral a. gives a deep femoral a. laterally
  • femoral a. gives medial and lateral circumflex femoral aa. medially and laterlaly
  • deep femoral a. gives 4 arteries called perforating aa. that go to the posterior thigh by piercing through adductor magnus adductor portion
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25
Q

what supplies blood to the hamstring

A

perforating arteries

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26
Q

adductor magnus two portion and position relative to each other

A

-adductor magnus adductor portion is lateral
-adductor magnus hamstring portion is medial
(but whole muscle is very medial)

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27
Q

adductor hiatus is what

A

hole created by separation of adductor magnus portions, and adductor magnus hamstring portion sending a tendon to the adductor tubercle

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28
Q

4 condyles in the knee

A
  • lateral femoral condyle
  • medial femoral condyle
  • lateral tibial condyle
  • medial tibial condyle
29
Q

does the tibia have epicondyles

A

no. condyles only

30
Q

medial collateral ligament of the knee does what

A
  • attaches from medial epicondyle of femur to medial surface of tibia
  • attaches to the joint capsule
  • attaches to the medial meniscus
31
Q

menisci are what

A

pads of cartilage between two bones

32
Q

consequence of MCL attaching to the medial meniscus, clinically

A

MCL is more likely to get damaged

33
Q

LCL (lateral collateral ligament of the knee) does what

A
  • attaches from lateral epicondyle to the head of the fibula
  • DOES NOT attach to cartilage (menisci) and is not fixed
  • DOES NOT attach to the joint capsule
34
Q

consequence of LCL not attaching to lateral meniscus, clinically

A

less likely to get injured

35
Q

medial dislocation of the knee definition

A

tibia going medial

36
Q

movements that the MCL and LCL prevent and that the knee can’t do

A
  • prevent ABDuction and ADDuction (of the tibia)
  • limit rotation of the tibia
  • prevent medial and lateral dislocation
37
Q

quadriceps femoris tendon attaches where

A

to patella - to patellar ligament (tendon) - to tibial tuberosity (on tibia)

38
Q

how to test for collateral ligaments

A
  • MCL: hold knee steady, put hand on lateral side of knee, and push knee medially as if trying to ABDuct the tibia
  • LCL: hold knee steady, put hand on medial side of knee, and push knee laterally as if trying to ADDuct the tibia
39
Q

anterior and posterior cruciate ligaments take what trajectory in the knee joint

A

FUMBUL (FUM for post. BUL for ant)

  • forward upward medial (FUM) for PCL. so PCL starts (its bottom) medial in back.
  • backward upward laterally (BUL). so ACL starts (its bottom) lateral in front
40
Q

ACL and PCL connect what two bones

A

femur and tibia

so only LCL connecting femur to fibula

41
Q

movements that the ACL and PCL prevent

A
  • twisting

- anterior and posterior dislocation

42
Q

options for cruciate ligaments surgeries (repairs)

A
  • tendon from cadaver
  • tendon from a muscle of the medial thigh
  • patellar tendon
43
Q

tests for assessment of ACL and PCL

A
  • Lachman’s
  • anterior drawer (ACL)
  • posterior drawer (PCL)
44
Q

shape of the lateral meniscus

A

nearly circular, O-shaped

45
Q

shape of medial meniscus

A

crescent shaped, C-shaped

46
Q

thickness of menisci

A
  • thicker on outside
  • thinner on inside
  • eventually hole (no more meniscus)
47
Q

function of menisci

A
  • wedge-shaped, fibrocartilaginous pads

- cushioning + give depth to the joint (like the labrum of the acetabulum would do), so are kind of a socket

48
Q

diff portions of menisci

A

each has a posterior horn and an anterior horn

49
Q

diff tears of menisci

A
  • radial tear (straight line from inside to outside but not complete cut)
  • vertical tear (perpendicular to radial, somewhere in meniscus)
  • bucket-handle tear (like vertical but curved, lining the very outside surface)
50
Q

blood supply to menisci

A
  • most exterior third has a rich blood supply and can repair if is torn.
  • inner two-thirds lack blood supply (white zone). tears can’t heal + thin, worn cartilage
51
Q

tx for radial tear

A

partial menisectomy if irritating

52
Q

tx for tears near outside surface like vertical, bucket-handle tear

A

sutures (to sew the meniscus back in place)

53
Q

what can happen to little tears like radial tears

A

can get caught and the knee will catch when it is bent. this can cause inflammation

54
Q

capsule of the knee joint wraps around what

A
  • around the whole knee except the LCL (passes deep to it) and the patellar ligament (tendon).
  • the fat around the knee is within the joint capsule
55
Q

what is found deep to the patellar tendon immediately

A

infrapatellar fat pad (is inside the joint capsule)

56
Q

function of fat in the knee joint

A

cushioning

57
Q

joint capsule of the knee is lined by what

A

a synovial membrane

58
Q

bursas in the knee are what

A
  • fluid filled structures found between two surfaces
  • fct = reduce friction between these 2 moving surfaces
  • can get bursitis if there is inflammation of the fluid-filled structure (bursa) as in the hip
  • 11+ bursae in the knee
59
Q

what’s a Baker’s cyst (a gastrocnemio-semimemrabnosus bursa)

A
  • painful swelling behind the knee
  • cause = outpouching of the JOINT CAPSULE (get a synovial popliteal cyst)
  • cause of this outpouching = increase in intra-articular pressure. caused by RA for example
60
Q

where Baker’s cyst occurs and why

A
  • medial part of popliteal fossa (between semimembranosus tendon and medial head of gastrocnemius, near posteromedial femoral condyle)
  • the gastrocnemio-semimembranosus bursa there is weak
61
Q

tx of Baker’s cyst

A

(not much)

  • aspiration
  • CS
  • ice, etc.
62
Q

muscles you find in the popliteal fossa

A
  • semimembranosus
  • semitendinosus
  • biceps femoris
  • gastocnemis medial head and lateral head
  • plantaris
63
Q

nerves in the popliteal fossa

A
  • tibial n. (came from sciatic n.) travels between 2 heads of gastrocnemius
  • common fibular n. (from sciatic n.) is more lateral than tibial n. and runs along the biceps femoris tendon and wraps around the anterior leg below head of fibula
64
Q

in the popliteal fossa, small nerves found between tibial n. and common fibular n.

A

sural nerves (are cutaneous)

  • medial sural n. (comes from tibial n.)
  • lateral sural n. (comes from common fibular n.)
65
Q

cutaneous innervation to glutes region

A
  • medial and middle = clunial nerves

- lateral = lateral cutaneous nerve of the thigh (from lumbar plexus)

66
Q

cutaneous innervation to back of the thigh

A
  • medial = cutaneous branch of obturator n.
  • middle = posterior cutaenous n. of the thigh
  • lateral = lateral cutaneous n. of the thigh
67
Q

cutaneous inn. to back of the leg

A 
upper half:
-medial = saphenous n. (terminal branch of femoral n.)
-middle = medial sural n. 
-lateral = lateral sural n.
lower half: 
-medial = saphenous n.
-lateral = superficial fibular n.
68
Q

what happens with the femoral a. after it gave its branches in the anterior thigh

A

crosses to the back through the adductor hiatus. changes name after hiatus to become popliteal a.

69
Q

branches of popliteal a to the knee

A

4 vessels

  • lateral superior genicular a.
  • lateral inferior genicular a.
  • medial superior genicular a. (closest to hiatus)
  • medial inferior genicular a.
  • they all wrap around the knee and anastomose*

Bloc H - Movement (48 decks)

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