Miller's Anatomy Review Flashcards

Ortho anatomy review

1
Q

Brachial plexus location

A

Runs between anterior and middle scalene muscles and deep to pectoralis minor

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2
Q

Pre vs post fixed brachial plexus

A

Pre fixed = cord starts more proximal, post fixed more distal

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3
Q

Erb’s point

A

Convergence of C5 and C6, point involved in Stingers

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4
Q

Pre-ganglionic injury

A

Proximal to DRG, poor prognosis, rhomboid paralysis, rotator cuff dysfunction, Horner syndrome, elevated hemi-diaphragm, EMG = absent motor but intact sensation

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5
Q

Post-ganglionic injury

A

EMG: motor AND sensory not intact, total plexus injury has worse prognosis, Klumke is bad, Erb’s is best prognosis

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6
Q

Musculocutaneous nerve pierces coracobrachialis how far

A

3-8cm from coracoid tip

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7
Q

Sites of radial nerve compression

A

“FLEAS” Fascial band at radial head, Leash of Henry, ECRB, Arcade of Frohse (proximal edge of supinator), Supinator distal edge

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8
Q

Median nerve sites of compression

A

“SPLAT” Supracondylar process/ligament of Struthers, Pronator teres, Lacetus fibrosis, FDS aponeurosis, Transverse carpal ligament

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9
Q

Ulnar nerve sites of compression

A

Arcade of Struthers, medial intermuscular septum, medial epicondyle, Osborne’s ligament, FCU heads, anconeus epitrochlearis

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10
Q

Guyon’s canal zones of compression

A

Zone I: sensory and motor, Ganglion cyst or hamate fracture. Zone 2: motor only, Ganglion cyst or hamate fracture. Zone 3, sensory only, ulnar artery thrombosis or aneurysm

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11
Q

Ulnar nerve paradox

A

Proximally innervated FDP causes clawing when intrinsics are out in distal ulnar nerve palsy

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12
Q

Medial scapular winging

A

Long thoracic nerve injury

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13
Q

Lateral scapular winging

A

Spinal accessory nerve injury, commonly associated with neck surgery

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14
Q

Supraspinatus footprint

A

12-13mm

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15
Q

Most harmful phase of throwing for rotator cuff

A

Deceleration

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16
Q

Teres major innervation

A

Lower subscapular nerve

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17
Q

Quadrangular space

A

Axillary nerve, posterior circumflex passes between T. minor, T. Major, long head of triceps and humerus

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18
Q

Triangular space

A

Circumflex scapular artery passes between T. minor, T. major and long head of triceps

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19
Q

Triangular interval

A

Radial nerve, profunda brachii pass between T. major, long head of triceps and humerus

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20
Q

Judet approach interval

A

Infraspinatus and teres minor

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21
Q

Anterior bundle of UCL stabilizes valgus stress in what degrees of motion?

A

30-90 degrees

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22
Q

When does posterior bundle of UCL tighten

A

Flexion

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23
Q

Elbow flexion with most supination strength

A

90 degrees

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24
Q

Distribution of load seen in radius vs ulna proximal and distal

A

Proximal: 60% radius, 40% ulna, distal 80% radius, 20% ulna

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25
Diseases with positive ulnar variance
Ulnar abutment syndrome, TFCC tears and Medelung deformity
26
Disease with negative ulnar variance
Keinbock’s
27
Components of TFCC
Dorsal/volar radioulnar ligaments, articular disc, meniscus homologue, ECU subsheath
28
Proximal carpal row movement with radial deviation
Flexes, extends in ulnar deviation
29
Where does the lunate dislocate through
Space of Poirier, weak spot in volar wrist ligaments
30
VISI vs DISI
VISI seen in SL injury, DISI in SL injury
31
Chronic zone I extensor tendon injury
Mallet finger
32
Chronic zone III extensor tendon injury
Boutonniere deformity
33
Lumbar plexus
T12-L4, anterior surface of quadratus lumborum
34
Sacral plexus
L4-S3
35
Femoral nerve
L2-L4, lies between iliacus and psoas, largest branch of lumbar plexus, enters deep to inguinal ligament
36
Sephenous nerve
Terminal sensory branch of the femoral nerve
37
Obturator nerve
L2-L4, exits pelvis via obturator canal
38
Peroneal nerve
L4-S2, most lateral division of sciatic nerve
39
Tibial nerve
L4-S3, medial division of sciatic nerve
40
Pectineus innervation
Obt/femoral nerve
41
Adductor magnus innervation
Obt/tibial nerve
42
Biceps femoris innervation
Long head = tibial nerve, short head = peroneal nerve
43
MFCA landmark
Comes off deep femoral artery, then adjacent to Quadratus femoris and piriformis fossa (ascending branch)
44
Sacrotuberous ligament
Oriented vertically and resists shear forces
45
Sacrospinous ligament
Resists external rotation
46
Greater sciatic notch content
Piriformis, originates off ventral surface of scacrum, then travels through the notch, sciatic nerve likely deep to it, SGA, SGN, IGA, IGN, pudendal nerve etc
47
Lesser sciatic notch content
Obturator internus, sciatic nerve likely superficial to it, nerve to obturator internis, pudendal nerve and internal pudendal vessels, these exit greater notch and re-enter lesser notch
48
Corona mortis
Anastamosis from external iliac artery to obturator 6cm lateral to pubic symphysis
49
Safe zone for SGN
5cm proximal to greater trochanter
50
Hamstring attachment
Semimembranosus more proximal and lateral on tuberosity, conjoint tendon consists of semitendinosus and biceps femoris is more distal and medial
51
Ilioinguinal approach
Anterior column, anterior wall fractures. 3 windows relative to IP and vessesl. Lateral window lateral to iliopsoas. Middle window is between IP and EIA. Medial window medial to EIA. Stoppa modification is a more extensive medial window.
52
Medial approach to hip interval
Adductor longus and gracilis, mostly seen in kids
53
Meniscus with highest weight bearing burden
Lateral 70%, medial 30%
54
Ligament of Humphrey and Wrisberg
Lateral meniscus posterior horn attachment to PCL
55
ACL size
33mm x 11mm
56
ACL bundles on femur
AM is proximal, PL is distal, separated by bifurcate ridge
57
ACL bundles on tibia
Named for attachment position on tibia
58
PCL size
38mm x 13mm
59
PCL bundles on femur
AL anterior on femur, PM posterior on femur
60
PCL bundles on femur
PM distal, AL proximal
61
sMCL attachments
Proximal and posterior to medial epicondyle, 5-7cm distal to joint line
62
POL function
Primary stabilizer against internal rotation and valgus from 0-30 degrees, test with Slocum test (knee externally rotated 30 degrees and anterior drawer performed)
63
LCL isometric?
No, tighter in extension
64
LCL attachment
Proximal and posterior to lateral epicondyle of femur, most anterior attachment on fibular head (then PFL, then biceps femoris)
65
Popliteus attachment
Distal anterior and deep to LCL on femur, 18.5mm apart
66
PCL isometric?
No, larger resistence to ER as knee flexes more, hence dial test positive for PCL with greater flexion to 90 degrees
67
Patella stabilizers
0-30 degrees = MPFL, trochlea takes over at 30 degrees of flexion
68
Medial layers of the knee
1) Sartorial fascia, saphenous nerve on its posterior border
69
Basset’s ligament
Thickening of AITFL that can cause impingement pain in ankle sprains
70
ATFL and CFL are tight in:
ATFL in plantarflexion, CFL in dorsiflexion
71
Spring ligament
Plantar calcaneonavicular ligament, stabilizes longitudinal artch of foot and acts as hammock for talar head
72
Knot of Henry
FHL is HIGHER than FDL when they cross at knot of Henry
73
Primary blood supply to talar body
Artery of tarsal canal, retrograde flow
74
PTT locks foot by what mechanism
When foot is everted, the TN and CC joints are parallel and foot is supple. When PTT fires, TN and CC are not longer parallel and the foot is rigid
75
Tarsal tunnel
Tibial nerve travels between FDL and FHL
76
Baxter’s nerve
1st branch of the LPN