MSK anatomy Flashcards
where might you find Gerdy’s tubercle and what attaches to it?
it is a boney projection on the lateral condyle of the Tibia
it provides the attachment point for the iliotibial (IT) band
where does the round ligament of the head of the femur attach and what it its function
attaches at the fovea on the head of the femur
transmits arteries to the head of the femur
what is the function of the menisci in the knees
to absorb shocks
which meniscus, the medial or lateral, is more likely to be torn/damaged and why?
the medial because it is fixed (attached to the tibial collateral ligament and joint capsule)
the lateral meniscus is not fixed and thus can better absorb shocks and stress
where do you find the tensor fascia lata muscle and what does it do
lies on the upper lateral side of the thigh
medial rotator of the hip and is supplied by the superior gluteal nerve
what nerve roots make up the sciatic nerve
L4 L5 S1 S2 S3
what nerve roots make up the superior gluteal nerve
L4-S1
what nerve roots make up the inferior gluteal nerve
L5-S2
where is the sacral plexus located and what nerve roots make it up
located in the lesser pelvis in front of the sacrum
formed by the ventral rami of L4-S3 plus some of S4
what nerve supplies the tensor fascia lata
the superior gluteal nerve
describe the pathway of the superior gluteal nerve
passes through the GREATER SCIATIC FORAMEN to enter the gluteal region, and passes ABOVE the piriformis (along with superior gluteal artery)
describe the pathway of the inferior gluteal artery
passes through the GREATER SCIATIC FORAMEN to enter the gluteal region, and passes BELOW the piriformis (along with the inferior gluteal artery)
the superior and inferior gluteal arteries are branches of which larger artery?
the internal iliac artery
what is the arterial supply for the posterior thigh
supplied mainly by the perforating branches of the deep femoral artery
what nerve roots make up the lumbar plexus
what are the branches of this plexus we need to know
formed by the central rami of L1-L4
branches are the lateral cutaneous nerve of the thigh and the femoral nerve
what nerve roots make up the lateral cutaneous nerve of the thigh
what does this nerve supply
L2 and L3
supplies the skin on the anterolateral side of the thigh
what nerve roots make up the femoral nerve
what does this nerve supply
L2, L3, L4
supplies all anterior thigh muscles as well as the skin of the anterior and medial thigh
the longest sensory branch of the femoral nerve is the saphenous nerve that supplies the skin on the medial side of the leg and foot
what nerve roots make up the obturator nerve
L2, 3, 4
what is the spacial relationship of the lateral cutaneous nerve of the thigh, the femoral nerve, and the obturator nerve to one another
L. cut. nerve of thigh runs close to the iliac crest, then the thick femoral nerve lies more medial running posterior to the inguinal ligament, then the obturator nerve is most medial and passes through the obturator canal (remember femoral is in the middle of these two)
what is the chief nerve of the medial compartment of the thigh
the obturator nerve
what muscles are supplied by the obturator nerve
the hip joint adductor muscles and the hip and knee joints
describe the pathway of the great saphenous vein and what vein it opens into
runs upwards, anterior to the medial malleolus, along the medial side of the leg and the knee
in the upper part of the thigh it opens into the femoral vein
describe the pathway of the small saphenous vein and what vein it opens into
runs upwards, posterior to the lateral malleolus and in the posterior leg it drains into the popliteal vein
what is the adductor hiatus
an opening in the aponeurosis of the adductor magnus muscle leading from the anterior compartment of the thigh into the popliteal fossa
it transmits the femoral vessels
(located at the distal end of the adductor magnus close to the knee joint and medial)
what is the femoral triangle
a triangular depression on the front of the upper part of the thigh immediately below the inguinal ligament
it is bounded by the thigh muscles and the inguinal ligament
contents of the triangle (from medial –> lateral):
femoral vein (medial)
femoral artery
femoral nerve (later)
“VAN”
what larger artery becomes the femoral artery
the external iliac artery
where does the femoral artery become the popliteal artery
after it passes through the adductor hiatus, in the popliteal fossa
what is the main artery of the head of the femur
medial circumflex femoral artery (branch of the deep artery of the thigh which comes off the femoral artery)
what artery passes through the round ligament of the head of the femur to supply it
obturator artery
what nerve root supplies the following dermatomes areas?
- medial thigh and knee
- anterior knee
- medial border of foot
- dorsum of foot
- lateral border of foot
- L3
- L4
- L4
- L5
- S1
list the hip flexor muscles
iliopsoas
list the hip adductor muscles
adductor brevis
adductor longus
adductor magnus
gracilis
list the hip abductor muscles
gluteus medius
gluteus minimus
tensor fascia lata
list the hip extension muscles
gluteus maximus
list the hip lateral rotator muscles
piriformis (which is a deep gluteal muscle)
other deep gluteal muscles as a group
list the knee extensor muscles
quadriceps femoris (rectus femoris, vastus medialis, vastuc intermedius, vastus lateralis)
gluteus maximus
tensor fascia lata (via IT band)
list the knee flexor muscles
hamstring muscles (semimembranosus, semiteninosus, biceps femoris)
what are the 3 parts of the foot
tarsus, metatarsus, phalanges
how many bones make up the tarsus part of the foot
name them
7
proximal group: talus (above), calcaneus (below)
intermediate group: navicular
distal group: cuboid and 3 cuneiforms (medial, intermediate, lateral)
what is the wrist equivalent of dorsiflexion?
what is the wrist equivalent of plantarflexion?
dorsiflexion in ankle = same as extension of wrist
plantarflexion in ankle = same as flexion of the wrist
what joint performs the inversion and eversion movements of the foot
subtalar/talocalcaneal joint (between talus and calcaneus)
what forms the retinacula around the ankle
thickening of the deep fascia of the leg around the ankle forms the retinacula
what are the two types of retinacula around the ankle
extensor retinacula and fibular retinacula
where are the extensor retinacula
anterior to the ankle joint
where are the fibular retinacula
posterior to the lateral malleolus
what are the functions of the retinacula
to retain the tendon of muscles in place (same function as in the wrist)
what is the only muscle on the dorsum of the foot
extensor digitorum brevis (medial most part is called the extensor hallucis longus)
what is the function of fibularis tertius
eversion of foot and dorsiflexion of ankle
what is the function of tibialis anterior
inversion of foot and dorsiflexion of ankle
what nerve roots make up the common fibular nerve
L4, L5, S1, S2
what are the two main branches of the popliteal artery
anterior and posterior tibial artery
what are the branches of the popliteal artery called in the knee?
genicular arteries–supply the knee joint and form arterial anastamoses around the knee joint
what nerve roots make up the sural nerve
L5, S1, S2
the sural nerve is a branch of which larger nerve
tibial nerve
where does the sural nerve go
all the way to the lateral portion of the foot
how can you remember the order of the tendons in the medial ankle behind the medial malleolus
Tom, Dick And a Very Nervous Harry (from anterior to posterior)
- tendon of Tibialis posteriod
- tendon of flexor Digitorum longus
- posterior tibial Artery (pulse of this artery felt midway between heel and medial malleolus)
- vein
- tibial Nerve
- tendon of flexor Hallucis longus
what are the functions of the plantar aponeurosis
- fixes the skin at the sole of the foot
- protects the deep structures
- helps in maintaining the longitudinal arches of the foot (supports the arch)
what serve roots make up the tibial nerve
L4, L5, S1, S2, S3
where is the posterior tibial artery located
between the superficial and deep muscle groups of the posterior leg (underneath soleus)
the fibular artery is a branch of which artery?
posterior tibial artery
what does the capitulum (on the humerus) articulate with
head of the radius (laterally)
what does the trochlea (on the humerus) articulate with
trochlear notch of the ulna (medially)
why is the medial epicondyle important on the humerus
attachment of common flexor tendon
why is the lateral epicondyle important on the humerus
attachment of the common extensor tendon
what does brachioradialis do? what is it innervated by?
innervated by radial nerve
does flexion of the forearm
what causes medial epicondylitis
forceful and repeated bending of the wrist and fingers may cause tiny ruptures of the common FLEXOR origin (i.e in golfing)
symptoms are tenderness, pain at medial epicondyle made worst by flexing the wrist
what causes lateral epicondylitis
common EXTENSOR origin become painful and tender due to strain or direct impact
tenderness and pain on outer part of lateral epicondyle
does the ulnar nerve pass thru the carpal tunnel?
no
the median nerve does but the ulnar nerve doesn’t… runs medial along the forearm and enters the hand but does not pass thru the carpal tunnel
which two muscles of the forearm are innervated by the ulnar nerve
flexor carpi ulnaris and 1/2 of flexor digitorum profundus
what happens if your radial nerve becomes paralyzed
wrist drop…. no extension of wrist is possible
where do you test the sensory of the radial nerve
touch at the first interdigital space on the hand
what two branches form from the brachial artery
ulnar and radial arteries
what areas of the forearm does the ulnar artery supply
anterior and posterior compartments, along with the radial, as well as forming palmar arterial branches in the palm
(runs medial)
what areas of the forearm does the radial artery supply
mostly supplies the lateral side of the forearm
passes thru ANATOMICAL SNUFF BOX and then passes into hand to take part in deep palmar arch
what goes through the carpal tunnel
nine tendons:
- flexor digitorum superficialis (4 tendons to the fingers)
- flexor digitorum profundus (4 tendons to the fingers)
- flexor pollicis longus (1 to the thumb)
plus the MEDIAN nerve
state the nerve root for:
femoral nerve
L2, L3, L4
state the nerve root for:
obturator nerve
L2, L3, L4
state the nerve root for:
sciatic nerve
L4-S3
state the nerve root for:
pudendal nerve
S2, S3, S4
state the nerve root for:
superior gluteal nerve
L4-S1
state the nerve root for:
inferior gluteal nerve
L5-S2
what does pectineus do?
hip flexion
what test tests for achilles tendon rupture (name)
Thompson’s test
which nerve roots do ankle inversion
L4, L5
which nerve roots do ankle eversion
L5, S1
what nerve roots do knee extension
L3, L4
what nerve innervates supraspinatus and infraspinatus muscles
suprascapular nerve
what nerve innervates teres minor
axillary nerve
what nerve innervates subscapularis
upper and lower subscapularis
which nerve root is responsible for the following reflex:
triceps reflex
C7
which nerve root is responsible for the following reflex:
biceps reflex
C5
which nerve root is responsible for the following reflex:
knee jerk
L4
which nerve root is responsible for the following reflex:
brachioradialis
C6
which nerve root is responsible for the following reflex:
ankle jerk
S1
what does the triangular space contain (shoulder)
circumflex scapular vessels
what does the quadrangular space contain (shoulder)
axillary nerve and posterior circumflex humeral vessels
is the acromion process on the posterior or anterior part of the scapula?
acromion process comes off the scapular spine (posterior)
the coracoid process comes off on the anterior of the scapula
what test tests for de quervains tenosynovitis?
Finkelstein’s test… make fist with thumb inside and then tilt wrist towards ground
what nerve roots do elbow flexion
C5, C6
what nerve roots do wrist flexion
C6, C7
what nerve root does abduction of the little finger
T1
what is golf elbow
medial epicondylitis–> common flexor origin
what does Schobers test test for
ankylosing spondylitis
what does spurlings test test for
cervical nerve root compression
what does hawkins sign test for
shoulder impingement
what does Neer’s sign test for
shoulder impingement (moving arm passively through forward flexion)
what does the sulcus sign test for
shoulder instability
which epicondyle is involved in golf elbow
medial–common flexor tendon
which epicondyle is involved in tennis elbow
lateral–common extension tendon
what does the thomas test test for
hip flexion contracture
what does the femoral stretch test test
stretches the femoral neurovascular bundle in the femoral triangle
what does the thompson test test for
achilles rupture
what does phalen’s test test for
carpal tunnel–push backs of hands together
what does finkelsteins test test for
de quervain’s tenosynovitis –abductor pollicis longus and extensor pollicis brevis
what does allen’s test test for
perfusion of the hands
what might you suspect in a patient with low back pain and loss of bladder/bowel control
spinal cord injury
emergency
what does the tripod test test for
sciatic nerve irritation –lean back on hands when raise leg due to leg pain
list mimickers of back pain not to be missed
abdominal aneurysm
kidney stones
what are the symptoms of horners
myosis
ptosis
anhydrosis
where do you test the following myotomes
- C5
- C6
- C7
- C8
- T1
- C5–deltoid
- C6–wrist extensors (or biceps)
- C7–triceps
- C8–deep finger flexors
- T1–finger abductors
where do you test the following myotomes
- L2/3
- L3/4
- L4
- L5
- S1/2
- L2/3–hip flexors
- L3/4–knee extension
- L4–tibialis anterior
- L5–extensor hallucis longus
- S1/2–gastroc/soleus
what does the swinging light test test
looks for a relative afferent pupillary defect
what spinal nerve segment/peripheral nerve does the following reflect test
achilles
S1
tibial
what spinal nerve segment/peripheral nerve does the following reflect test
babinski
(toe extensor)
L4, L5, S1, S2
tibial
what spinal nerve segment/peripheral nerve does the following reflect test
biceps
C5
musculocutaneous
what spinal nerve segment/peripheral nerve does the following reflect test
brachioradialis
C6
radial
what spinal nerve segment/peripheral nerve does the following reflect test
triceps
C7
radial
what spinal nerve segment/peripheral nerve does the following reflect test
patellar
quadriceps femoris–L4
femoral
what are the 9 geriatric giants
- vision and hearing
- malnutrition
- falls and mobility
- urinary incontinence
- bowel function
- depression
- chronic pain
- memory loss
- iatrogenesis (meds)
what doe rombergs sign test
cerebellar function
stand and close your eyes
what is abnormal in psychosis
thought content
