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Midterm Exam Flashcards

1
Q

Patella

A

-Triangle Shaped Sesamoid
-Bone in tendon of the quad (Specifically Rec Fem)

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2
Q

Sesamoid

A

A bone embedded in a tendon (usually shaped like a sesame seed)

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3
Q

Patella (Anterior View)

A

-Base (the flat superior edge)
-Apex (the more pointed inferior edge)

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4
Q

Patella (Posterior View)

A

-Vertical Ridge
-Medial Articular Facet
-Lateral Articular Facet
*Facets articulate with the patellar surface of the femur and the medial and lateral condyles of the femur

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5
Q

What are the three articulations of the knee?

A
  1. Lateral condyle of the tibia articulates with the lateral femoral condyle
  2. Medial condyle of the tibia articulates with the medial femoral condyle
  3. Patella articulates with the femur
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6
Q

Available Movements of the Knee

A

-Flexion
-Extension
-Internal Rotation (Limited)
-External Rotation (Limited)
*Rotation occurs ONLY when Knee is flexed

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7
Q

Patellofemoral Joint

A

-Medial and Lateral facets of the patella articulate with the patellar surface of the femur
-Synovial
-Plane
-Patella moves down (inferiorly) during flexion and up (superiorly and laterally) during extension
*The lateral femoral condyle projects farther (anteriorly) than the medial femoral condyle
*This more anterior prominence of the lateral femoral condyle prevents the patella from tracking too far laterally

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8
Q

Tibiofemoral Joint

A

-Medial and Lateral Condyles of the tibia articulate with the medial and lateral femoral condyles
-Synovial
-Modified Hinge (because it allows for some rotation)
-Biaxial

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9
Q

The __________ femoral condyle projects farther (anteriorly) than the __________ femoral condyle

A

Lateral, Medial

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10
Q

This more anterior prominence of the lateral femoral condyle prevents the _____________ from tracking too far ___________.

A

Patella, Laterally

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11
Q

Valgus

A

Lateral deviation of the distal bone(s) of a joint
-When knee is fixed and the tibia (specifically the distal end) has deviated laterally (relative to knee)
-a.k.a. Knock-Knee

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12
Q

Varus

A

(return) Medial deviation of the distal bone of a joint
-When the knee is fixed and the tibia (specifically the distal end) has deviated medially (relative to the knee)
-a.k.a. bow-leg

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13
Q

Lateral Collateral Ligament (LCL) (fibular collateral ligament)

A

-Attached: lateral epicondyle of the femur - fibular
head
-checks/restricts VARUS deviation
-“pencil-like” (easier to palpate)

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14
Q

Medial Collateral Ligament (MCL) (tibial collateral ligament)

A

-Attaches: medial epicondyle of femur - medial condyle of the tibia
-checks/restricts VALGUS deviation
-it is a flat thickening of the joint capsule
-the deep fibres of the ligament are attached to the medial meniscus

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15
Q

Anterior Cruciate Ligament (ACL)

A

-Attaches: medial epicondyle of the femur - medial condyle of the tibia
-checks/restricts valgus deviation
-it is a flat thickening of the joint capsule
-the deep fibres of the ligament are attached to the medial meniscus

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16
Q

Posterior Cruciate Ligament

A

-Attaches: posterior intercondylar area of the tibia - anterior and lateral side of the medial femoral condyle
-slack when the knee is extended and taut when the knee is in full flexion
-checks posterior translation of the tibia on the femur (or anterior translation of the femur on the tibia) and knee flexion

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17
Q

Cruciate ligaments are named for __________________.

A

Where they attach on the tibia. (i.e. the anterior cruciate ligament attaches anteriorly on the tibia)

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18
Q

Medial and Lateral Coronary Ligaments (Attachments)

A

-Attach the medial and lateral menisci to their respective tibial plateaus

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19
Q

Menisci of the knee

A

-C-shaped plated of fibrocartilage attached to the articular surfaces of the tibia
-Centre is thinner than the outer edges
-Slightly mobile and and aid in the spreading of synovial fluid during knee movement
-Function: shock absorbers
-Function: deepen the articulation (provide more stable articulation between the tibia and the femur
-ends of the C-shape are called horns
-medial meniscus is attached to the medial collateral ligament

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20
Q

What is the terrible triad?

A

Anterior Cruciate Ligament (ACL)
Medial Collateral Ligament (MCL)
Medial Meniscus

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21
Q

2 menisci are connected anteriorly by the _____________.

A

Transverse Ligament of the Knee

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22
Q

Menisci of the knee (Function)

A

-Function: shock absorbers
-Function: deepen the articulation (provide more stable articulation between the tibia and the femur

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23
Q

Menisci of the knee (Attachments)

A

-C-shaped plated of fibrocartilage attached to the articular surfaces of the tibia
-Medial meniscus is attached to the medial collateral ligament

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24
Q

Posterior Cruciate Ligament (Checks/Restricts)

A

-Checks posterior translation of the tibia on the femur (or anterior translation of the femur on the tibia) and knee flexion

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25
Q

Posterior Cruciate Ligament (Attachments)

A

-Attaches: posterior intercondylar area of the tibia - anterior and lateral side of the medial femoral condyle

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26
Q

Anterior Cruciate Ligament (ACL) (Attachments)

A

-Attaches: medial epicondyle of the femur - medial condyle of the tibia
-The deep fibres of the ligament are attached to the medial meniscus

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27
Q

Anterior Cruciate Ligament (ACL) (Checks/Restricts)

A

-Checks/restricts valgus deviation

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28
Q

Medial Collateral Ligament (MCL) (Attachments)

A

-Attaches: medial epicondyle of femur - medial condyle of the tibia
-the deep fibres of the ligament are attached to the medial meniscus

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29
Q

Medial Collateral Ligament (MCL) (Checks/Restricts)

A

-Checks/restricts VALGUS deviation

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30
Q

Lateral Collateral Ligament (LCL) (Attachments)

A

-Attached: lateral epicondyle of the femur - fibular
head

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31
Q

Lateral Collateral Ligament (LCL) (Checks/Restricts)

A

-Checks/restricts VARUS deviation

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32
Q

Patellofemoral Joint (joint type)

A

-Synovial
-Plane

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33
Q

Patellofemoral Joint (Articulation)

A

-Medial and Lateral facets of the patella articulate with the patellar surface of the femur

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34
Q

Patellofemoral Joint (Movements)

A

-Patella moves down (inferiorly) during flexion and up (superiorly and laterally) during extension
*The lateral femoral condyle projects farther (anteriorly) than the medial femoral condyle
*This more anterior prominence of the lateral femoral condyle prevents the patella from tracking too far laterally

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35
Q

Tibiofemoral Joint (joint type)

A

-Synovial
-Modified Hinge (because it allows for some rotation)
-Biaxial

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36
Q

Tibiofemoral Joint (Articulation)

A

-Medial and Lateral Condyles of the tibia articulate with the medial and lateral femoral condyles

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37
Q

Pelvis Functions

A

-Protect the internal organs
-Transmit forces from upper body onto the lower limb
-Absorb forces from lower limb

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38
Q

Female Pelvis is _______________ and ________________ than the male pelvis.

A

Shorter, Wider

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39
Q

Coccyx

A

Tailbone (remnant of tail human embryos have until the beginning of 8th week)

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40
Q

Sacrum

A

-Wedge-shaped bone between 2 hip bones

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41
Q

Hip

A

-2 hip bones
-Each hip bone has 3 regions (separated in newborn (connected with cartilage) fused in early adulthood (15-20yrs))
1. Ilium
2. Ishium
3. Pubis

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42
Q

What are the 3 regions of hip bone?

A
  1. Ilium
  2. Ishium
  3. Pubis
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43
Q

Ilium

A

(pl. Ilia) (yellow)
-Large, superior part (2/3rds of the bone)

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44
Q

Ischium

A

(pl. Ischia) (blue)
-Posterior, Inferior

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45
Q

Pubis

A

-Piriformis
-Sciatic Nerve
-Posterior Femoral Cutaneous Nerve

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46
Q

Lateral View of Pelvis Structures

A

-Posterior superior iliac spine (PSIS)
-Posterior inferior iliac spine (PIIS)
-Greater sciatic notch (converted into greater sciatic foramen by sacrospinous ligament)
-Body of ilium
-Ischial spine
-Lesser Sciatic notch
-Body of ischium
-Ischial tuberosity “sitting bone”
-Ramus of ischium
-Obturator foramen
-Inferior pubic ramus
-Pubic tubercles
-Superior pubic ramus (ischopubic ramus)
-Acetabulum
-Anterior inferior iliac spine (AIIS)
-Anterior superior iliac spine (ASIS)
-Iliac crest (runs from the ASIS to PSIS)
Iliac tubercle (tuberculum) (~5cm posterior to ASIS)

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47
Q

Obturator Foramen

A

-Junction of ischium-pubis forms the obturator foramen
-Partly covered by connective tissue membrane
-Opening allows nerves and blood vessels to pass through (obturator vessels and nerve)

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48
Q

Greater sciatic notch (converted into __________________ by __________________ ligament).

A

Greater Sciatic Foramen, Sacrospinous

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49
Q

Medial View Pelvis Structures

A

-Iliac crest
-Anterior superior iliac spine (ASIS)
-Iliac fossa
-Anterior inferior iliac spine (AIIS)
-Iliopubic eminence
-Superior pubic ramus
-Pectineal Line (Pectin Pubis)
-Pubic tubercle
-Inferior pubic ramus
-Obturator foramen
-Ramus of Ischium
-Ischial Spine
-Greater sciatic notch
-Posterior inferior iliac spine (PIIS)
-Auricular (ear) surface of the ilium (for articulation with sacrum)
-Posterior superior iliac spine (PSIS)

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50
Q

Acetabulum

A

-The junction of the Ilium-ischium-pubis forms the acetabulum
-Place where thigh bone (head of femur) articulates with pelvis

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51
Q

Anterior View Pelvis Structures

A

-Iliac crest
-Anterior superior iliac spine (ASIS)
-Anterior inferior iliac spine (AIIS)
-Iliopubic eminence
-Superior pubic ramus
-Obturator foramen
-Pubic tubercle
-Inferior pubic ramus
-Ischial tuberosity
-Pubic symphysis (a.k.a. symphysis pubis)
-Lesser sciatic notch
-Pectineal Line
-Ischial Spine
-Greater sciatic notch
Sacrum

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52
Q

Each ilium articulates with the ____________.

A

Sacrum

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53
Q

Ischiopubic rami

A

Combined form of ramus of the ischium and the inferior pubic ramus

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54
Q

Inguinal Ligament

A

The boundary between the lower limb and the abdomen
-ASIS and pubic tubercle are attachments of inguinal ligament
-Inguinal region is the depression between the abdomen and thigh (referred to as groin)

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55
Q

Hip (Coxafemoral Joint)

A

-Head of femur articulates with the acetabulum
-Synovial
-Multiaxial
-Ball and Socket
-Head of femur projects medially, superiorly, & anteriorly
-Acetabulum projects laterally inferiorly, & anteriorly

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56
Q

Available Motions at Hip Joint

A

-Flexion
-Extension
-Medial Rotation
-Lateral Rotation
-Abduction
-Adduction

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57
Q

Articular Surface of the Acetabulum

A

-Horseshoe Shaped

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58
Q

Articular Cartilage

A

-Covers head of the femur and the horseshoe shaped part of the acetabulum
*Articular cartilage is part of a synovial joint

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59
Q

Ligament of the Head of Femur

A

-a.k.a ligamentum teres, round ligament, foveal ligament
-Connects head of femur to the acetabulum

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60
Q

Acetabular Labrum

A

-Fibrocartilagenous lip that attached to the bony rim of acetabulum
-Functions to deepen acetabulum (make ‘socket’ a deeper socket)

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61
Q

Acetabular Fossa

A

-Centre of acetabulum
-Fossa is occupied by fat pad covered with synovium

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62
Q

Acetabular Notch

A

-Notch between the 2 ends of the horseshoe
-Passage for blood vessels

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63
Q

Transverse Ligament of Acetabulum

A

-Connects (closes) the acetabular notch

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64
Q

Ligaments of the Hip

A

-All the capsular ligaments of the hip are coiled or twisted as they pass from the pelvis to the femur (in a neutral position)
-Extension/hyperextension tightens them further making extension part of the close-packed position and a position of stability in an upright posture
-Conversely, full hip flexion with abduction is an unstable position

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65
Q

Iliofemoral Ligament (Y ligament)

A

Attaches: AIIS, acetabular rim - intertrochanteric line of femur
Checks: extension, abduction, lateral rotation

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66
Q

Pubofemoral Ligament

A

Attaches: superior pubic ramus - iliofemoral ligament
Checks: abduction

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67
Q

Ischiofemoral Ligament

A

Attaches: ischial part of acetabular rim - femoral neck and medial greater trochanter
Checks: hyperextension

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68
Q

Trochanteric Bursa

A

-Between the gluteus maximus muscle and the (postero-lateral) greater trochanter

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69
Q

Ischiogluteal Bursa

A

-Overlying the ischial tuberosity
-Weavers bottom (layman’s term for ischiogluteal bursitis) - people weaving would have to extend one leg forward then the other - the repetitive position changes put excessive pressures on the ischial tuberosity and therefore the bursa

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70
Q

Weavers bottom

A

(layman’s term for ischiogluteal bursitis)
-People weaving would have to extend one leg forward then the other - the repetitive position changes put excessive pressures on the ischial tuberosity and therefore the bursa

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71
Q

Iliopectineal Bursa

A

Between the iliopsoas muscle and the iliopubic eminence

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72
Q

Pubic Symphysis (a.k.a. Symphyis Pubis)

A

-Joint between the 2 pubic bones
-Cartilaginous Joint (there is cartilage between 2 ends)
-Fibrocartilagenous disc between 2 bones which acts as a shock absorber
-Limited movement
-Ligaments: superior pubic ligament, inferior pubic ligament

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73
Q

Sacroiliac Joint

A

-Joints between ilia and sacrum (sacrum is suspended between the ilia)
-Synovial Joints (very strong joint - capsule is strong, ligaments are strong, etc.)
*Does not fit under specific joint category
-Surfaces are irregular in shape and contour (elevations and depressions) which result in. a partial interlocking of the bones
-Limited movement (trade mobility for stability)
-Ligaments: anterior and posterior sacroiliac ligaments

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74
Q

Pelvis is held together by _________________.

A

Ligaments

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75
Q

Ligaments (and the pubic symphysis) progressively _____________ during pregnancy to allow passage of the fetus through the birth canal.

A

Relax

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76
Q

Iliolumbar Ligament

A

-TVP’s L4 & L5 to the posterior iliac crest
-Key stabilizer of L5
-Limits/checks/restricts lateral flexion

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77
Q

Sacrotuberous Ligament

A

-Posterior surface of the sacrum/coccyx to the ischial tuberosity
-Stabilizes the SI joint and provides a surface attachment for gluteus maximus

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78
Q

Sacrospinous Ligament

A

-Lateral sacrum/coccyx to the ischial spine
-Converts the greater sciatic notch into the greater sciatic foramen

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79
Q

What is the only intrinsic muscle on dorsum foot?

A

Extensor Digitorum Brevis

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80
Q

Potential cause of tarsal tunnel syndrome

A

Rheumatoid Arthritis

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81
Q

What is the most anterior tendon behind medial malleolus?

A

Tibialis Posterior

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82
Q

To stretch soleus you need to ___________ ankle and _________ knee.

A

Dorsiflex, Flex

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83
Q

What is the 2nd tendon you will palpate across anterior ankle medial to lateral?

A

Extensor Hallusis Longus

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84
Q

Tendon sheath surround tendon to prevent friction between tendon and ________________.

A

Retinacula

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85
Q

What 2 muscles form a stirrup for the foot by sharing a common distal attachment at base of 1st MT?

A

Peroneus Longus, Tibialis Anterior

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86
Q

Boundary between lower limb and abdomen?

A

Inguinal Ligament

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87
Q

Subcutaneous Prepatellar Bursa

A

-a.k.a. housemaid’s knee
-Between the skin and the anterior part of the patella

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88
Q

Suprapatellar Bursa

A

-Between tendon of the quadriceps muscle and the femur
-Connected to the joint capsule
-Bursa is held in place (and retracted during knee extension) by the articularis genus muscle

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89
Q

Subcutaneous Infrapatellar bursa

A

-a.k.a. clergyman’s knee or carpet layer’s knee
-Between the skin and the proximal tibia (in the area of the tibial tuberosity)

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90
Q

Deep Infrapatellar Bursa

A

-Between the patellar ligament and the anterior tibia (superior to the tibial tuberosity)

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91
Q

Pes Anserine Bursa

A

-Between the tendons of the pes anserinus muscles and the medial tibia
-Pes anserinus muscles: sartorius, gracilis, semitendinosus
-Looks like goose foot

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92
Q

Pes Anserine Muscles

A

sartorius, gracilis, semitendinosus

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93
Q

Medial Semimembranosus Bursa

A

-a.k.a. Bakers Cyst
-Between the tendons of the medial semimembranosus muscles and the medial gastrocnemius

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94
Q

Bursa Deep to the Iliotibial Band

A

-a.k.a. runners knee (layman’s term), IT band friction syndrome (medical term)
-Between the iliotibial band and the lateral femoral epicondyle

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95
Q

Quadriceps

A

-4 quadriceps
-Rectus Femoris, Vastus Lateralis, Vastus Medialis, Vastus Intermedius
-Prime mover for extension of the knee
-All share a common distal attachment at the tibial tuberosity, via the patellar ligament

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96
Q

How many Quadriceps are there?

A

4

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97
Q

What are the 4 Quadriceps?

A

-Rectus Femoris
-Vastus Lateralis
-Vastus Medialis
-Vastus Intermedius

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98
Q

What is a prime mover for extension of the knee?

A

Quadriceps

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99
Q

Rectus Femoris (Attachment)

A

-Superior/Proximal Attachment: AIIS and superior to acetabular rim (straight head and reflected head)
-Inferior/Distal Attachment: Tibial Tuberosity (via patellar ligament)

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100
Q

Rectus Femoris (Actions)

A

-Hip flexion
-Knee Extension

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101
Q

What is the only quadricep muscle to cross the hip joint?

A

Rectus Femoris

102
Q

_____________ is the only quadricep muscle to cross the ________________.

A

Rectus Femoris, Hip Joint

103
Q

Vastus Lateralis (Attachment)

A

-Superior/Proximal Attachment: Lateral lip of the linea aspera
-Inferior/Distal Attachment: Tibial Tuberosity (via the patellar ligament)

104
Q

Vastus Lateralis (Action)

A

Knee joint extension

105
Q

Vastus Medialis (Attachment)

A

-Superior/Proximal Attachment: medial lip of linea aspera
-Inferior/Distal Attachment: Tibial Tuberosity (via the patellar ligament)

106
Q

Vastus Medialis (Action)

A

Knee joint extension

107
Q

Vastus Medialis Obliquus (VMO) (Attachment)

A

Superior/Proximal Attachment: medial distal femur, vastus medialis, adductor magnus
Inferior/Distal Attachment: medial patella

108
Q

Vastus Medialis Obliquus (VMO) (Action)

A

-Knee joint extension
-Pulls patella medially (to prevent excessive lateral tracking)

109
Q

Vastus Intermedius (Attachment)

A

-Superior/Proximal Attachment: proximal 2/3rds of the femur
-Inferior/Distal Attachment: Tibial Tuberosity (via the patellar ligament)

110
Q

Vastus Intermedius (Action)

A

Knee joint extension

111
Q

Vastus Intermedius is ______________ to ________________.

A

Deep, Rectus Femoris

112
Q

Articularis Genu (Attachment)

A

-Superior/Proximal Attachment: anterior distal femur
-Inferior/Distal Attachment: Proximal articular Capsule of the knee joint

113
Q

Articularis Genu (Action)

A

Pulls the capsule proximally during knee extension to prevent pinching of the capsule

114
Q

What is the longest muscle in the body?

115
Q

Sartorius (Attachment)

A

Superior/Proximal Attachment: ASIS
Inferior/Distal Attachment: proximal anteromedial tibia (one of the pes anserinus tendons)

116
Q

Sartorius (Actions)

A

-hip flexion, abduction, and lateral rotation
-Knee flexion, and medial rotation (when knee is already flexed)

117
Q

Pectineus (Attachment)

A

-Superior/Proximal Attachment: anterior pubic bone (pectineal line)
-Inferior/Distal Attachment: just inferior to the lesser trochanter

118
Q

Pectineus (Action)

A

-Hip Adduction
-Hip Flexion (weak)

119
Q

Adductor Brevis (Attachment)

A

Superior/Proximal Attachment: anterior pubic bone
Inferior/Distal Attachment: proximal linea aspera

120
Q

Adductor Brevis (Action)

A

-Hip Adduction
-Hip Flexion (weak)

121
Q

Adductor Longus (Attachment)

A

Superior/Proximal Attachment: anterior pubic bone
Inferior/Distal Attachment: linea aspera (middle 1/3rd)

122
Q

Adductor Longus (Action)

A

-Hip Adduction
-Hip Flexion (weak)

123
Q

Gracilis (Attachment)

A

Superior/Proximal Attachment: anterior pubic bone
Inferior/Distal Attachment: proximal anteromedial tibia (one of the pes anserinus tendons)

124
Q

Gracilis (Action)

A

-Hip Adduction
-Knee Flexion
-Knee Medial Rotation

125
Q

What Muscle is most Medial out of all the Adductors?

126
Q

What is the Only Hip Adductor that Crosses the Knee?

127
Q

What are the 3 Pes Anserinus Muscles?

A
  1. Sartorious
  2. Gracilis
  3. Semitendinosis
128
Q

Adductor Magnus - Anterior Fibres (Attachment)

A

-Superior/Proximal Attachment: anterior pubic bone
-Inferior/Distal Attachment: linea aspera

129
Q

Adductor Magnus - Anterior Fibres (Action)

A

-Hip Adduction
-Hip Flexion

130
Q

Adductor Magnus - Posterior Fibres (Attachment)

A

-Superior/Proximal Attachment: ischial tuberosity
-Inferior/Distal Attachment: adductor tubercle
*Note: In the inferior attachment of adductor magnus (about hand with above the adductor tubercle), is an opening called the adductor hiatus which allows for blood vessels to pass through

131
Q

In the inferior attachment of adductor magnus (about hand with above the adductor tubercle), is an opening called the ___________________ which allows for __________________________________.

A

adductor hiatus, blood vessels to pass through

132
Q

Adductor Magnus - Posterior Fibres (Action)

A

-Hip Adduction
-Hip Extension

133
Q

Biceps Femoris - Long Head (Attachment)

A

-Superior/Proximal Attachment: ischial tuberosity
-Inferior/Distal Attachment: fibular head

134
Q

Biceps Femoris - Long Head (Action)

A

-Hip Extension (and lateral rotation)
-Knee Flexion
-Knee Lateral Rotation

135
Q

All of the Hamstrings are Prime Movers for _________________ and Synergists to Glute Max for _________________.

A

Knee Flexion, Extension

136
Q

Biceps Femoris - Short Head (Attachment)

A

-Superior/Proximal Attachment: linea aspera (mid shaft)
-Inferior/Distal Attachment: fibular head

137
Q

Biceps Femoris - Short Head (Action)

A

-Knee Flexion
-Knee Lateral Rotation

138
Q

Semitendinosus (Attachment)

A

-Superior/Proximal Attachment: ischial tuberosity
-Inferior/Distal Attachment: proximal anteromedial tibia (one off the pes anserinus tendons)

139
Q

Semitendinosus (Action)

A

-Hip Extension (and medial rotation)
-Knee Flexion
-Knee Medial Rotation

140
Q

Semimembranosus (Attachment)

A

-Superior/Proximal Attachment: ischial tuberosity
-Inferior/Distal Attachment: posterior aspect of the medial condyle of the tibia

141
Q

Semimembranosus (Action)

A

-Hip Extension (and medial rotation)
-Knee flexion
-Knee medial rotation

142
Q

What Muscles are Knee Flexors?

A

Hamstrings, Gastrocnemius, Popliteus, Sartorious

142
Q

What Muscles are Knee Extensors?

A

Quadriceps

143
Q

What Muscles are External Rotators of the knee?

A

Biceps Femoris

144
Q

What Muscles are Internal Rotators of the knee?

A

Semimembranosus, Semitendinosus, Gracilis

145
Q

What are the Dorsiflexors of the Ankle (Talocrural Joint)?

A

Tibialis Anterior, EDL, EHL, Peroneus Tertius

146
Q

What are the Plantarflexors of the Ankle (Talocrural Joint)?

A

Triceps Surae, Plantaris, Peroneus Longus/Brevis, Tibialis Posterior, FHL FDL

147
Q

What are the Inverters of the Ankle (Subtalar Joint)?

A

Tibialis Anterior, Tibialis Posterior

148
Q

What are the Everters of the Ankle (Subtalar Joint)?

A

Peroneus Longus/Brevis/Tertius, EDL

149
Q

What are the Flexors of the Metatarsophalangeal Joints?

A

FHL, FHB, FDL, FDB, Lumbricales

150
Q

What are the Extensors of the Metatarsophalangeal Joints?

A

EDL, EDB, EHL, EHB

151
Q

What are the Abductors of the Metatarsophalangeal Joints?

A

Dorsal Interossei

152
Q

What are the Adductors of the Metatarsophalangeal Joints?

A

Plantar Interossei

153
Q

What are the PIP Flexors of the Interphalangeal Joints?

154
Q

What are the DIP Flexors of the Interphalangeal Joints?

155
Q

What are the PIP Extensors of the Interphalangeal Joints?

A

EDL, EDB, Lumbricales

156
Q

What are the DIP Extensors of the Interphalangeal Joints?

A

EDL, Lumbricales

157
Q

What are the 1st toe IP Flexors of the Interphalangeal Joints?

157
Q

What are the 1st toe IP Extensors of the Interphalangeal Joints?

A

EHB, Lumbricales

158
Q

What are the Flexors of the Hip?

A

Prime Mover: Iliopsoas (Psoas Major, Iliacus)
Synergists: Rectus Femoris, TFL, Pectineus, Adductor Longus, Adductor Brevis, Adductor Magnus (Anterior Fibres), Sartorius

159
Q

What are the Extensors of the Hip?

A

Prime Mover: Maximus
Synergists: Hamstrings, (Except Biceps Femoris Short Head), Adductor Magnus (Posterior Fibres)

160
Q

What are the Abductors of the Hip?

A

Prime Mover: Medius
Synergists: Gluteus Minimus Sartorius

161
Q

What are the Adductors of the Hip?

A

Prime Mover:Magnus
Synergists: Adductor Longus, Adductor Brevis, Gracilis

162
Q

What are the External Rotators of the Hip?

A

Prime Mover: Maximus
Synergists: Gemellus Superior, Gemellus Inferior, Obturator Internus, Obturator Externus, Quadratus Femoris, Gluteus Medius (Posterior Fibres), Sartorius

163
Q

What are the Internal Rotators of the Hip?

A

Prime Mover: TFL
Synergists: Gluteus Medius (Anterior Fibres), Gluteus Minimus (Anterior Fibres), Piriformis (With Hip Flexed)

164
Q

What is the Femoral Triangle?

A

Depression in the superomedial thigh (inferior to the inguinal ligament) observable during hip flexion

165
Q

What are the Boundaries of the Femoral Triangle?

A

Superiorly: Inguinal Ligament
Medially: Adductor Longus
Laterally: Sartorius
Floor (Medial to Lateral): Pectineus, Iliopsoas
Roof: Fascia Lata
Contents: Femoral A., Femoral V., Femoral N.

166
Q

Relevant Bones of the Upper Limb

A

-Sternum
-Clavicle
-Scapula
-Humerus
-Ulna
-Radius
-Carpals
-Metacarpals
-Phalanges

167
Q

Shoulder

A

-Scapula, Clavicle
-a.k.a. Pectoral girdle, Thoracic girdle
-Junction between the arm and the trunk

168
Q

Arm

169
Q

Forearm

A

-Ulna, Radius

170
Q

Wrist

171
Q

Hand

A

-Metacarpals

172
Q

Fingers

A

-Phalanges

173
Q

Axial Skeleton

A

Scull, Vertebral Column, Sternum, Ribs

174
Q

Appendicular Skeleton

A

Shoulders, Upper Limbs, Hips, Lower Limbs

175
Q

Clavicle

A

-First bone in body to ossify
-Shaped like S (lateral concave anteriorly, medial convex anteriorly)
-Lateral 1/3rd is flattened (most common location for fracture)
-Connects upper limb to axial skeleton
-Acromial end: end that connects to the scapula
-Sternal end: End that connects to the manubrium (top of breast bone)

176
Q

Acromial end of the Clavicle

A

End that connects to the scapula

177
Q

Sternal end of the Scapula

A

-Relatively flat, triangular bone
-Sits flat against rib cage from (approx.) 2nd-7th ribs (when standing in anatomical position with proper posture)
-Connects the clavicle to the humerus

178
Q

Scapula Landmarks

A

-Acromion (tip of the shoulder)
-Coracoid process (ravens beak)
-Glenoid Fossa (a.k.a. Glenoid cavity) (where head of humerus articulates with scapula)
-Supraglenoid tubricle
-Infraglenoid tubricle
-Lateral border (a.k.a. axillary border)
-Inferior angle (easily palpated, good place to start for many palpations)
-Subscapular fossa
-Medial border (a.k.a. vertebral border)
-Superior angle
-Suprascapular notch
-Spine (of scapula)
-Supraspinous fossa
-Infraspinous fossa
-Root of spine (medial end of spine)

179
Q

Scapulothoratic Joint

A

a.k.a. S-T Joint
*Not a true joint - is a functional joint

180
Q

What is the only joint that is NOT a true joint?

A

Scapulothoratic Joint

181
Q

Scapulothoratic Joint (Movements)

A

-Elevation: Gliding motion with the scapula moving superiorly
-Depression: Gliding motion with the scapula moving inferiorly
-Retraction/Adduction: Gliding motion with the scapula moving toward the spine
-Protraction/Abduction: Gliding motion with the scapula moving away from the spine
Rotation: Glenoid fossa is the point of reference
Upward/Lateral Rotation: Glenoid fossa moves superiorly (inferior angle moves laterally) (ant-post axis, frontal plane)
Downward/Medial Rotation: Glenoid fossa moves inferiorly (inferior angle moves medially)

182
Q

Sternoclavicular Joint

A

a.k.a. S-C Joint
Sternal end articulates with the manubrium
-Saddle
-Synovial
There is an articular disc
-Disk prevents medial displacement of the clavicle and helps dissipate forces

183
Q

Sternoclavicular Joint (Movements)

A

-Superior/Inferior Glide
-Anterior/Posterior Glide
-Rotation (M-L axis)
-Scapular Depression: Sternal end of the clavicle moves superiorly
-Scapular Elevation: Sternal end of the clavicle moves inferiorly

184
Q

What type of joint is Sternoclavicular Joint?

A

-Saddle
-Synovial

185
Q

The ___________________ Joint is the only true articulation between the upper limb and the axial skeleton.

A

Sternoclavicular Joint

186
Q

The Sternoclavicular Joint has an articular disk that helps __________________.

A

Absorb Shock

187
Q

What are the ligaments of the Sternoclavicular Joint?

A

-Anterior Sternoclavicular Ligament
-Posterior Sternoclavicular Ligament
-Interclavicular Ligament
(These reinforce the capsule)
-Costoclavicular Ligament

188
Q

Acromioclavicular Joint

A

a.k.a. A-C Joint
Acromial end of the clavicle articulates with the acromion of the scapula
-Plane
-Synovial

189
Q

What type of joint is the Acromioclavicular Joint?

A

-Plane
-Synovial

189
Q

Acromioclavicular Joint (Movements)

A

-Anterior/Posterior Glide
-Some mild rotation

190
Q

What are the ligaments of the Acromioclavicular Joint?

A

-Acromioclavicular Ligament
-Coracoacromial Ligament
-Coracoclavicular Ligament

191
Q

Coracoacromial Ligament

A

Coracoid Process <-> Acromion
Coracromial arch is formed by the coracoid process, the coracoacromial ligament and the acromion (clinically relevant!)

192
Q

Acromioclavicular Ligament

A

Clavical <-> Acromion

193
Q

Coracoclavicular Ligament

A

Coracoid Process <-> Clavicle

194
Q

Costoclavicular Ligament

A

Inferior Clavicle <-> 1st Rib

195
Q

Humerus (Anterior View) Landmarks

A

-Head
-Anatomical Neck
-Greater Tubercle
-Lesser Tubercle
-Surgical Neck (common fracture site)
-Bicipital Groove (a.k.a. intertubercular groove, intertubercular sulcus)
-Deltoid tuberosity
-Lateral Supracondylar Ridge
-Lateral Condyle
-Radial fossa
-Lateral epicondyle
-Capitulum
-Coronoid Fossa
-Trochlea
-Medial epicondyle
-Medial Condyle
-Medial Supracondylar Ridge

196
Q

Humerus (Posterior View) Landmarks

A

-Radial groove (a.k.a. spiral groove)
-Olecranon Fossa
-Groove for the Ulnar Nerve

197
Q

Glenohumeral (GH) Joint

A

The Glenoid Fossa of the scapula articulates with the head of the humerus

198
Q

What type of joint is the Glenohumeral (GH) Joint?

A

-Ball and Socket
-Synovial

199
Q

Glenohumeral (GH) Joint (Movements)

A

-Abduction/Adduction
-Flexion/Extension
-Internal/External Rotation
-Horizontal Abduction/Horizontal Adduction
-Circumduction
-Scaption

200
Q

Glenoid Labrum (GH Joint)

A

Fibrocartilagenous ring that attaches to the glenoid fossa it deepens the joint (the joint is like a golf ball tee which is unstable) (glenoid fossa articulates with about 1/3rd of the humeral head)

201
Q

Joint Capsule (GH Joint)

A

-Thin and loose
-Weakest inferiorly at the axillary recess
-Weak spot in the capsule anteriorly called the Foramen of Weitbrecht

202
Q

What are the ligaments of the GH Joint?

A

-Coracohumeral Ligament
-Glenohumeral (capsular) ligaments

203
Q

-Coracohumeral Ligament
-Glenohumeral (capsular) ligaments

A

Coracoid process <-> Greater Tubricle

204
Q

What are the bursas of the GH Joint?

A

-Subacromial Bursa
-Subdeltoid Bursa
*Subdeltoid and Subacromial bursa are often used interchangeably

205
Q

Subacromial Bursa

A

Between the acromion and the joint capsule

206
Q

Subdeltoid Bursa

A

Between the deltoid muscle and the joint capsule often connected with the subacromial bursa

207
Q

Scaption (Movement)

A

-Scapula sits at an angle of approx. 45deg relative to the frontal and sagittal planes
-Movement of the arm in this plane is termed scaption
-There is less tension on the capsule and greater elevation is possible than with pure frontal or sagittal plane elevation
-Neither internal nor external rotation of the humerus is needed to prevent impingement
-Many functional activities occur in this plane

208
Q

Scapulohumeral Rythm

A

-Abduction of the arm involves movement at the glenohumeral (GH) joint, the scapulothoracic (ST) articulation, the acromioclavicular (AC) Joint, and the sternoclavicular (SC) joint.
-During normal abduction range , there is a specific relationship in the amount of movement at the GH joint, compared to the ST articulation.
-0-15 deg: no movement of the scapula
-15-120 deg: 2:1 ratio (GH:ST)
-120-180 deg: 1:1 ratio (GH:ST)
-Another way to look at it is that between 15 and 120 deg of abduction, for every 3 deg of movement, 2 deg comes from the GH and 1 deg comes from ST.

209
Q

Biomechanics of Abduction

A

-During abduction of the humerus, the humerus must undergo external rotation (this usually happens around 90deg of abduction)
-This helps the greater tubercle clear the coracoaromial arch (preventing impingement)
-Note: how many structures are in a relatively small space

210
Q

Spine

A

Spine is comprised of several individual bones called vertebrae and divided into 5 different segments

211
Q

How many segments of the spine are there?

A

5 segments

212
Q

What are the 5 segments of the spine?

A

-Cervical Spine has 7 Vertebrae
-Thoracic Spine has 12 Vertebrae
-Lumbar Spine has 5 Vertebrae
-Sacrum is Considered 1 Bone (made of 5 fused vertebrae)
-Coccyx is considered 1 Bone (made of (usually) 4 fused vertebrae)

213
Q

How many Vertebrae are in the Cervical Spine?

214
Q

How many Vertebrae are in the Thoracic Spine?

215
Q

How many Vertebrae are in the Lumbar Spine?

216
Q

How many Vertebrae are in the Sacrum?

A

1 Bone (5 fused vertebrae)

217
Q

How many Vertebrae are in the Coccyx?

A

1 Bone (made of (usually) 4 fused vertebrae)

218
Q

Posterior prominences of the spine are called?

A

Spinous Processes

219
Q

Lateral prominences of the spine are called?

A

Transverse Processes

220
Q

Spine (Available Movements)

A

-Flexion
-Extension
-Rotation (left,right)
Lateral flexion or side bending (left, right)

221
Q

The __________________ fascia is extensive fascia in the low back that covers from the ________________ to the ________________.

A

Thoracolumbar, 12th Rib, Iliac Crest

222
Q

What muscles connect upper limb to the spine?

A

-Upper/middle/lower trapezius
-Latissimus dorsi
-Rhomboids
-Levator Scapula

223
Q

Upper Trapezius (Attachments)

A

-Superior Attachment: Middle 1/3rd of the superior nuchal line, external occipital protuberance (inion) to the C7 SP via the nuchal ligament
-Inferior Attachment: Lateral clavicle, acromion, superior lip of the spine of the scapula

224
Q

Upper Trapezius (Action)(Head/Neck Fixed)

A

-Action: S-T elevation
-Action: S-T upward rotation

225
Q

Upper Trapezius (Action)(Scapula Fixed)

A

-Action: head/neck extension (bilaterally contracting)
-Action: head/neck ipsilateral lateral flexion
-Action: head/neck contralateral rotation

226
Q

Middle Trapezius (Attachment)

A

Medial Attachment: C7-T5 SPs
Inferior Attachment: Superior lip of the spine of the scapula

227
Q

Middle Trapezius (Action)

A

Action: S-T Retraction

228
Q

Lower Trapezius (Attachment)

A

Medial Attachment: T6-T12 SPs
Inferior Attachment: Root of the spine of the scapula

229
Q

Lower Trapezius (Action)

A

-Action: S-T Depression (when acting with pectoralis minor
-Action: S-T upward rotation

230
Q

Latissimus Dorsi (Attachment)

A

-Medial Attachment: SP T6-Iliac crest, lumbar and sacral vertebrae via the thoracolumbar fascia, ribs 9-12, inferior angle of the scapula (this is an inconsistent attachment)
-Lateral Attachment: Floor of the bicipital groove

231
Q

Latissimus Dorsi (Action)

A

-Action: G-H Internal rotation
-Action: G-H extension
-Action: G-H adduction

232
Q

Rhomboids (Attachment)

A

-Medial Attachment: SP C7-T5
-Lateral Attachment: Root of the spine of the scapula to the inferior angle of the scapula

233
Q

Rhomboids (Action)

A

-Action: S-T Retraction
-Action: S-T Downward Rotation
-Action: S-T Elevation
-Action: Help Serratus Anterior Hold the Scapula against the ribs
*Used when forcibly lowering raised upper limbs

234
Q

Levator Scapula $ (Attachment)

A

-Superior Attachment: TVP’s of C1-C4
-Inferior Attachment: Superior angle to the root of the spine of the scapula
*Twists from one attachment to the other (this can make it easier to palpate)

235
Q

Levator Scapula $ (Action) (Head/Neck Fixed)

A

-Action: S-T elevation
-Action: S-T downward rotation

236
Q

Levator Scapula $ (Action) (Scapula Fixed)

A

-Action: Head/Neck Extension (when bilaterally contraction)
-Action: Head/Neck ipsilateral lateral flexion
-Action: Head/Neck ipsilateral rotation

237
Q

Muscles of the Pectoral Region

A

-Pectoralis Major
-Pectoralis Minor
-Subclavius
-Serratus Anterior

238
Q

Pectoralis Major

A

2 Divisions: Upper fibers (clavicular head) and lower fibres (sternocostal head)

239
Q

Pectoralis Major (Attachment)

A

-Medial Attachment (upper fibres: Medial 1/2 of the anterior clavicle
-Medial attachment (lower fibres): sternum, anterior costal cartilages of ribs 2-6
-Lateral Attachment (both heads): Lateral lip of the bicipital groove

240
Q

Pectoralis Major (Action)

A

-Action: G-H Medial Rotation
-Action: G-H adduction
-Action: G-H flexion (from deep extension)
-Action: G-H extension (from deep flexion)
-Action: G-H horizontal adduction

241
Q

Pectoralis Minor (Attachment)

A

Superior Attachment: Coracoid Process
Inferior Attachment: Ribs 3-5

242
Q

Pectoralis Minor (Action)

A

-Action: S-T protraction
-Action: S-T depression (when acting with lower trapezius)
-Action: S-T downward rotation
-Action: If the scapula is fixed, pectoralis minor help to elevate the ribs with forced inhalation

243
Q

Tipping Scapula

A

Inferior angle of the scapula moves posteriorly off of the rib cage (this is likely due to a short pectoralis minor)

244
Q

Force Couple

A

MM working in equal but opposite directions resulting in one turning motion

245
Q

Serratus Anterior (Attachment)

A

-Medial Attachment: Anterior surface of the medial border of the scapula
-Lateral Attachment: Lateral Surfaces of the upper 8 ribs
*Keeps the medial border of the scapula flat against the ribs - if this muscle is weak, a winging scapula can present (the medial border of the scapula moves off the ribcage)

246
Q

Serratus Anterior (Action)

A

Action: S-T Protraction
Action: S-T Upward Rotation (low fibres only)

247
Q

Winging Scapula

A

The medial border of the scapula moves posteriorly off of the ribcage ( this is likely due to a weak serratus anterior)

248
Q

Tight Pectoralis Minor

A

Tipping Scapula

249
Q

Weak Serratus Anterior

A

Winging Scapula

Anatomy (22 decks)

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