MSK detailed Flashcards

1
Q

progression of the brachial plexus

A

anterior rami – trunks – divisions – cords – terminal branches

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2
Q

brachial superior trunk roots

A

C5 and C8

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3
Q

brachial middle trunk root

A

C7

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4
Q

brachial inferior trunk

A

C8 and T1

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5
Q

lateral cord consists of

A

superior trunk and middle trunk

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6
Q

posterior cord consists of

A

middle trunk, superior trunk and inferior trunk

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7
Q

medial cord consists of

A

inferior trunk

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8
Q

ulnar artery pathway

A

inferior deep to superficial pronator teres , palmaris longus, flexor digitorum superficial to reach medial side of the arm and passes superficial to the flexor retinaculum.

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9
Q

radial artery pathway

A

inferior laterally under the brachioradialis, lies lateral to flexor carpi radialis, winds round lateral aspect of radius and cross floor of the anatomical snuff box to pierce the 1st dorsal interosseus muscle.

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10
Q

thumb dermatome

A

C6

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11
Q

basilic vein pathway

A

runs up the postaxial border of the upper limb, pierces the deep fascia halfway between the elbow and axilla to join the brachial veins in forming the axillary vein

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12
Q

cephalic vein pathway

A

; runs up from the anatomical snuffbox along the preaxial border of the upper limb. It runs in the upper arm lateral to the biceps in the deltopectoral groove and perforates the clavipectoral fascia to drain into the axillary

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13
Q

index finger dermatome

A

C7

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14
Q

little finger dermatome

A

C8

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15
Q

lymphatic drainage of the upper arm

A

cubital-> humeral axillary. Most however, apical axillary lymph nodes and some to the deltopectoral lymph nodes.

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16
Q

pectoralis major action

A

adducts and medially rotates shoulder

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17
Q

pectoralis minor action

A

stabilises scapula

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18
Q

pectoralis major innervation

A

lateral and medial pectoral nerves C6, C7, C8).

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19
Q

subclavius action

A

anchors and depresses clavicle

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20
Q

subclavius innervation

A

medial pectoral nerve C8, T1

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21
Q

pectoralis minor innervation

A

medial pectoral nerve C8, T1

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22
Q

serratus anterior action

A

protects scapula and holds it against thoracic wall

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23
Q

serratus anterior innervation

A

long thoracic nerve C6, C7

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24
Q

trapezius innervation

A

spinal accessory nerve

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25
Q

trapezius descending action

A

elevates scapula

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26
Q

trapezius ascending action

A

depresses scapula

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27
Q

trapezius middle action

A

retracts

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28
Q

trapezius ascending and descending action

A

rotate glenoid superiorly

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29
Q

latissimus dorsi action

A

extends, adducts and medially rotates

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30
Q

latissimus dorsi nerve

A

thoracodorsal nerve C6, C7

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31
Q

levator scapulae movements

A

elevates scapula and tilts glenoid inferiorly

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32
Q

rhomboid minor and major movement

A

retracts scapula and rotate it to depress glenoid cavity

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33
Q

rhomboid minor and major nerve innervation

A

dorsal scapular nerve C5).

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34
Q

supraspinatus action

A

abduction

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35
Q

supraspinatus innervation

A

suprascapular nerve C5

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36
Q

infraspinatus movement

A

laterally rotate shoulder joint

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37
Q

infraspinatus innervation

A

(suprascapular nerve C5

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38
Q

teres minor action

A

laterally rotate shoulder joint

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39
Q

teres minor innervation

A

suprascapular nerve C5

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40
Q

teres major action

A

adducts and medially rotates

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41
Q

teres major innervation

A

lower subscapular nerve C6

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42
Q

subscapularis action

A

: medially rotates and adducts shoulder joint:

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43
Q

subscapularis innervation

A

upper and lower subscapular nerves C6

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44
Q

subacromial bursa function

A

facilitates movement of supraspinatus tendon under the coraco-acromial arch and of the deltoid over the joint capsule and the greater tubercle of the humerus.

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45
Q

subscapular bursa function

A

between the tendon of the subscapularis and neck of the scapula. Protects the tendon where is passes inferior to the root of the coracoid process and over the neck of the scapula.

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46
Q

glenohumeral ligaments description

A

internal aspect, strengthens the anterior aspect

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47
Q

coracohumeral ligament description

A

strong band that passes from the base of the coracoid process to the anterior aspect of the greater tubercle. Strengthens capsule superiorly.

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48
Q

transverse humeral ligament description

A

broad fibrous band that runs from the greater to lesser tubercle

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49
Q

coraco-acromial ligament description

A

extrinsic protective, spans the coraco-acromial arch. Prevents superior displacement.

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50
Q

AC ligaments are

A

coracoclavicular ligament, conoid ligament, nearly horizontal trapezoid ligament

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51
Q

coracoclavicular ligaments description

A

anchors the clavicle to the coracoid process of the scapula. Enables scapula and free limb passively suspended

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52
Q

conoid ligament description

A

attached to the root of the coracoid process

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53
Q

nearly horizontal trapezoid ligament description

A

superior surface of the coracoid process and extends laterally and posteriorly to the trapezoid line on the inferior surface of the clavicle

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54
Q

elbow collateral ligament description

A

strong triangular bands that are medial and lateral thickenings.

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55
Q

elbow lateral collateral ligament description

A

fan like radial from the epicondyle of the humorous and blends distally with the annular ligament of the radius

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56
Q

the medial triangular ulnar collateral ligament description elbow

A

extends from the medial epicondyle of the humerus to the coronoid process and olecranon of the ulna.

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57
Q

biceps brachii action

A

supinates forearm, flexes elbow joint, flexes shoulder joint.

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58
Q

biceps brachii nerve innervation

A

musculocutaneous nerve C5, C6).

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59
Q

brachialis action

A

flexes elbow joint

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60
Q

brachialis nerve innervation

A

musculocutaneous nerve C5, C6).

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61
Q

coracobrachialis action

A

helps flex and adduct shoulder

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62
Q

coracobrachialis innervation

A

musculocutaneous nerve (C6))

63
Q

triceps brachii action

A

chief extensor of the elbow

64
Q

triceps brachii innervation

A

(radial nerve C7, C8)

65
Q

anconaeus action

A

assists in extending the elbow, abducts the ulnar during pronation

66
Q

anconaeus innervation

A

radial nerve

67
Q

median nerve journey

A

distally in the arm initially on the lateral side of the brachial artery on the lateral side of the brachial artery until the middle of the arm where it crosses over to the medial side an contacts the brachialis. It then descends into the cubital fossa

68
Q

ulnar nerve journey

A

passes distally anterior to the insertion of the teres major to the long head of the triceps on the medial side of the brachial artery around the middle of the arm. It pierces the medial intermuscular septum with the superior ulnar collateral artery and descends between the septum and medial head of triceps. Passes posterior to the medial epicondyle of the humerus to enter the forearm.

69
Q

musculocutaneous nerve journey

A

arises from lateral cord and pierces the coracobrachialis continuing distally between the brachialis and the biceps. Nerve emerges lateral to the biceps brachii

70
Q

radial nerve journey

A

enters the arm posterior to the brachial artery, medial to the humerus and anterior to the long head of triceps. Descends inferolaterally with the profunda brachii, pierces the lateral intermuscular septum and continues inferiorly in the anterior compartment between the brachialis and the brachioradialis in the cubital fossa. Divides into deep and superficial branches.

71
Q

pronator teres function and innervation

A

: pronates and flexes forearm (median nerve C7)

72
Q

flexor carpi radialis function and innervation

A

flexes and abducts hand at wrist (median nerve C7)

73
Q

palmaris longus innervation and function

A

flexes hand at wrist and tenses palmar aponeurosis (median nerve)

74
Q

flexor carpi ulnaris innervation and function

A

: flexes and adducts hand at wrist (ulnar C8)

75
Q

flexor pollicis longus function and innervation

A

flexes wrist, flexes metacarpophalangeal and interphalangeal joints of the thumb. Supplied by anterior interosseous nerve from median nerve

76
Q

pronator quadratus innervation and action

A

pronates forearm. Supplied by anterior interosseous nerve from median nerve

77
Q

where can the pisiform be palpated?

A

on the anterior aspect of the medial border of the wrist

78
Q

the hook of the hamate can be palpated

A

deep pressure over the medial side of the palm lateral to the pisiform

79
Q

tubercles of the scaphoid and trapezium can be palpated at

A

the base and medial aspect of the thenar eminence

80
Q

cephalic vein course

A

runs superiorly in the lateral bicipital groove and the basilic ascends in the medial bicipital groove.

81
Q

lilium composition of the hip

A

S. acetabulum, body and wing with super iliac crest

82
Q

ischium composition of the hip

A

posterior inferior part Acetabulum , ramus, ischiopubis ramus

83
Q

pubis composition of the hip

A

anterior acetabulum, rami superior and inferior

84
Q

key features of the femur

A

double ridged linea aspera on the posterior aspect. head contains depression for the fovea for the ligament of the head. Greater and lesser trochanter joined posteriorly by the intertrochanteric crest, anteriorly by the intertrochanteric line.

85
Q

ilio-femoral ligament description

A

anteriorly and superiorly Y

86
Q

pubofemoral ligament description

A

inferiorly and anteriorly

87
Q

ischiofemoral ligament

A

posteriorly

88
Q

pectineus action and innervation

A

adducts and flexes hip joint, assists in medial rotation. Femoral nerve.

89
Q

sartorius innervation and action

A

flexes and abducts, laterally rotates hip, flexes knee joint. Femoral nerve

90
Q

ilipsoas innervation and action

A

flexing hip joint, controls deviation of trunk. Lumbar nerves anterior rami

91
Q

quadriceps femoris innervation and action

A

extends knee joint, stabilises hip, aids iliopsoas. Femoral.

92
Q

adductor longus innervation and action

A

adducts hip joint. Obturator nerve.

93
Q

adductor brevis action

A

adduct hip joint and to some extent flexes it.

94
Q

adductor magnus action and innervation

A

– adducts hip joint. Hamstring part extends it. flexor: obturator, extensor: sciatic nerve.

95
Q

gracilis innervation and action

A

adduct hip joint , flexes knee joint, rotates medially. Obturator nerve.

96
Q

obturator externus innervation and action

A

laterally rotates hip, pulls head of femur into acetabulum. Obturator nerve.

97
Q

gluteus maximus action and innervation

A

extends hip joint, assists in lateral rotation. Inferior gluteal nerve

98
Q

gluteus medius and minimus action and innervation

A

abducts and anteriorly medially rotates hip joint. Superior gluteal nerve.

99
Q

tensor fascia latae action and innervation

A

flexes hip joint, stabilize the extended knee. Superior gluteal nerve.

100
Q

piriformis innervation and action

A

: laterally rotate extended hip joint. Anterior rami of S1, S2.

101
Q

obturator internus action and innervation

A

: laterally rotates extended hip join. Nerve to obturator internus S1

102
Q

gemelli S action and innervation

A

laterally rotates extended hip join. L5 S1

103
Q

gemelli inferior action and innervation

A

: laterally rotates hip joint. L5, S1

104
Q

quadratus femoris action and innervation

A

: laterally rotates hip. L5, S1.

105
Q

semitendinosus and semimembranosus action and innvervation

A

extends hip joint, flexes knee joint and rotate the leg medially when the knee is flex, when hip and knee flexed, extends trunk.

106
Q

semitendinosus and semimembranosus innvervation

A

Tibial division of the sciatic nerve.

107
Q

biceps femoris action

A

, long and short heads: flexes knee joint and rotates it laterally when the knee is flexed, extends hip joint

108
Q

long head of the biceps femoris innervation

A

tibial division of the sciatic nerve

109
Q

short head of the biceps femoris innervation

A

sort head common fibular division of sciatic nerve.

110
Q

small toe dermatome is

A

S1

111
Q

Big Toe dermatome

A

L5

112
Q

medial ankle dermatome is

A

L4

113
Q

knee dermatome is

A

L3

114
Q

femoral nerve course

A

Originates in the abdomen from the lumber plexus within the psoas major, descends posterolateral through the pelvis to the midpoint of the inguinal ligament, passes deep, enters the femoral triangle lateral to its vessels. Divides with the terminal branch being the saphenous nerve via the adductor canal to supply the anteromedial aspects of the knee, leg and foot.

115
Q

obturator nerve course

A

descends along the medial border of the psoas major, enters thigh through the obturator foramen with the obturator artery and vein. Divides into anterior and posterior branches. Anteriorly supplies the adductor longus, adductor brevis, gracilis, and pectineus. Posteriorly supplies obturator externus and adductor magnus.

116
Q

lymphatic drainage flow from the superficial inguinal nodes

A

superficial inguinal nodes supplied by the superficial lymphatic vessels supply the external iliac nodes. Some may pass deep inguinal lymph nodes

117
Q

deep inguinal lymph nodes flow

A

deep inguinal lymph nodes located medially however mostly supplied by deep lymphatic vessels and popliteal lymph nodes to the deep.

118
Q

nerve outflow of the sacral plexus exit the pelvis through

A

sacral plexus exit through the greater sciatic foramen, all superior to the piriformis except the superior gluteal nerve. The only nerve that doesn’t is the pudendal nerve that exits via the lesser sciatic foramen.

119
Q

tibial nerve supplies

A

Tibial nerve more superficial of the structures to supply the soleus, gastrocnemius, plantaris and popliteus muscle, via the sural nerve the lateral aspects of leg and foot sensation

120
Q

common fibular nerve supplies

A

Common fibular nerve divides into the deep and superficial nerve, most inferior branches of the posterior cutaneous nerve of the thigh supply the skin that overlies the popliteal fossa.

121
Q

oblique popliteal ligament function and description

A

strengthens capsule posteriorly, arises posterior to medial tibial condyle and passes to attach to the central aspect of the posterior capsule, arises from the semimembranosus.

122
Q

arcuate ligament function and description

A

arises posterior aspect of the fibular head, passes superomedially over the tendon of the popliteus and spread over the posterior surface of the knee joint

123
Q

tibialis anterior function and innervation

A

dorsiflexes ankle, inverts foot, supports medial longitudinal arch of foot. Deep fibular nerve.

124
Q

extensor hallucis longus function and innervation

A

deep fibular nerve. Extends great toe, dorsiflexes ankle

125
Q

extensor digitorum longus action and innervation

A

extends lateral four digits. Dorsiflexes ankle. Deep fibular nerve

126
Q

fibularis tertius action and innervation

A

– dorsiflexes ankle, aids in eversion of foot. Deep fibular nerve.

127
Q

fibularis longus and fibularis brevis action and innervation

A

evert foot, weakly plantarflex ankle. Supports transverse arch of foot. Superficial fibular nerve

128
Q

lateral ligament of the ankle consists of

A

lateral ligament consists of:
anterior talofibular ligament
posterior talofibular
calcaneofibular ligament

129
Q

foot blood supply

A

dorsal pedis -> lateral tarsal -> arcuate -> deep plantar artery + lateral plantar artery to form the deep plantar arch.

130
Q

gastrocnemius lateral and medial head action and innervation

A

plantarflexes when knee is extended, raises heel during walking and flexes knee joint. Tibial nerve

131
Q

soleus action and innervation

A

plantarflexes ankle. Tibial nerve

132
Q

plantaris action and innervation

A

weakly assists gastrocnemius in plantarflexing ankle. Tibial nerve

133
Q

superficial posterior compartment muscles

A

gastrocnemius, soleus, plantaris

134
Q

deep posterior compartment muscles

A

popliteus, flexor hallucis longus, flexor digitorum longus, tibialis posterior

135
Q

popliteus function and innervation

A

weakly flexes knee and unlocks it by laterally rotating femur on fixed tibia. Tibial nerve

136
Q

flexor hallucis function and innervation

A

flexes great toe at all joints, weakly plantarflexes ankle, supports medial longitudinal arch. Tibial nerve

137
Q

flexor digitorum longus function and innervation

A

flexes lateral four digits, plantarflexes ankle, supports medial longitudinal arch. Tibial nerve.

138
Q

tibilais posterior innervation and function

A

plantarflexes ankle, inverts foot and supports medial longitudinal arch. Tibial nerve.

139
Q

lateral nerve of the lateral leg

A

the superficial fibular nerve, the nerve in the lateral compartment, it is the terminal branch of the common fibular nerve.

140
Q

any arteries in the lateral leg?

A

no

141
Q

lateral muscles supplied by

A

fibular artery

142
Q

describe the longitudinal arch of the foot

A
  • medial and lateral parts, with the transverse arch spreading the weight in all directions.
143
Q

medial longitudinal arch of the foot description

A
  • important arch composed of calcaneus, talus and navicular, three cuneiforms and three metatarsals.
144
Q

transverse arch of the foot description

A

medial and lateral parts of the longitudinal arch serves s pillars for the transverse arch.

145
Q

muscles responsible for heel strike

A

ankle dorsiflexors, hip extensors, intrinsic muscles of foot, long tendons

146
Q

muscles responsible for loading response

A

knee extensors, ankle plantarflexes, hip abductors, intrinsic muscles of the foot, long tendons of foot

147
Q

muscle responsible for midstance

A

knee extensors, ankle plantarflexes, hip abductors, intrinsic muscles of the foot

148
Q

preswing toe off muscles in action

A

long flexors of digits, intrinsic muscles of foot, long tendons of foot, flexor of hip

149
Q

initial swing of leg muscles in action

A

flexor of hip, ankle dorsiflexors

150
Q

midswing of the leg muscles

A

hip extensors

151
Q

terminal swing of the leg muscles

A

hip extensors, knee flexors, ankle dorsiflexors, knee extensors

152
Q

highest point of the Iliac crest is between which vertebrae?

A

L4/L5

153
Q

gluteal fold marks the

A

inferior border of the gluteus maximus muscle

154
Q

tuberosity of the navicular can be easily seen and palpated on what side of the foot?

A

medial aspect