MSK EXAM Q

Question 1

Hip flexors (thigh, anterior)

Answer 1

The thigh muscles anteriorly are

• Iliopsoas inserts at lesser trochanter from the femoral nerve and it is a strong hip flexor.
• Quadriceps femoris that consists of rectus femoris which flexes the hip joint and extends the knee joint blood supply is femoral nerve. Q.Femoris has 3 other parts such as vastus medialis, intermedius and lateralis.
• Sartorius inserts at the medial side of tibia. Sartorius is also known as tailors muscle which flexes, externally rotates and abducts the hip and also flexes knee innervating femoral nerve.
• Pes anserinus which is a insert site for three muscles such as sartorius, gracilis and semitendinosus.

Question 2

Hip extensors (thigh, posterior)

Answer 2

Gluteus maximus which extends the hip for climbing, the nerve and blood supply is inferior gluteal nerve & artery. Inserts at gluteal tuberosity.

Hamstrings are hip extensors as well and consists of 3 parts such as biceps femoris (short), semimembranosus and semitendinosus. Semis are inserted at ischial tuberosity and the biceps femoris inserts at the head of fibula. Extends the hip and flexes & rotates knee. Blood & Nerve supply from tibial nerve except the bicep femoris

Question 3

Blood supply to hip and thigh

Answer 3

External iliac artery turns into femoral artery after passing under inguinal ligament.

Femoral artery aids in hip flexion and knee extension in anterior thigh region emerging from psoas major and iliacus

Main thigh supply is deep femoral artery and vein - common site for catheterization.
Femoral artery passes through adductor hiatus becoming popliteal artery.

Popliteal artery boundaries are hamstrings and gastrocnemius.

Superior gluteal nerve innervates hip abductors maintain level of pelvis during single leg stance. High abduction and internal rotation - injury leads to contralateral pelvis.

Inferior gluteal nerve innervates gluteus maximus aiding in hip extension.

Question 4

Hip abductors muscles and innervation

Answer 4

Gluteus medius and minimus inserts at greater trochanter and tensor fascia lata muscles.

Innervated by superior gluteal nerve maintains the hip stability and single leg stance.

Hip abductors internally rotate hips and abduct, injury leads to contralateral pelvis.

Question 5

Hip adductors muscles and innervations

Answer 5

Inserts at femur
Three adductors
-Brevis
-Longus
-Magnus
Pectineus
Gracilis

Adductor magnus part of hamstrings for extension and adductors are needed to stabilise one leg stance together with abductors

Adductor magnus has the adductor and hamstrings which inserts and at femur and adductor tubercle. Adductor hiatus passags of femoral artery into the popliteal space to become popliteal artery

Obturator nerve innervation through the obturator canal - hip adduction

Question 6

Arm muscles, functions and innervations

Answer 6

Anterior compartment: BBC. - Musculocutaneous nerve
Triceps brachii - Extends the arm and forearm inserts at infraglenoid tubercle of scapula
Biceps brachii - Inserts at supraglendoid tubercle at scapula & short head at coracoid process, flexes are & forearm allowing supination
Brachialis - Flexes forearm
Coracobrachialis - Flexes and adducts arm.

Posterior compartment is triceps brachii innverated by radial nerve. Triceps origin is infraglenoid tubercle at scapula extending arm and forearm.

Brachial artery is the main arm nerve supply running medially on arm then dividing into radial and ulnar arteries.

Forearm veins; brachial veins are deep and run along the brachial arteries. Two superficial veins are cephalic and basilic. Medial cubital vein crosses between them

Question 7

Hip joints, arrangement of bones & roles of stability

Answer 7

The hip joint is a synvoial ball and socket joint where the bony components are the head of femur and acetabulum. The function of this joint is to link the lower limp to the pelvis, transmits upper body weight to the lower limb, stability and the 2nd most movable joint in body.

Joint capsule has 2 layers such as the outer fibrous layer and the inner synovial membrane which attaches around the margin of acetabulum and to femoral neck. Capsular ligaments stabilise and strengthen the joint, all ligaments are tight with hip extension. Three capsular ligaments are Illiofemoral (strongest), Ischiofemoral & pubofemoral.

Acetabulum labrum is the lips surrounding the acetabulum, a fibrocartilage structure which increases articular area by 10% allowing insertion of head of femur.

Question 8

Shoulder joints, arrangement of bones & roles of stability

Answer 8

Sternoclavicular joint is a saddle synovial joint allowing biaxial movement and has articular discs.
Acromioclavicular joint is a synovial plane joint allowing sliding movement, has incomplete dics where extrinsic ligament help stabilise joint.
Glenohumeral joint is a ball and socket joint where the head of humerus attach and theres the glenoid fossa of scapula. Very unstable and needs ligaments to stabilize such as glenoid labrum

Ligaments of shoulder joints around the glenohumeral joint
Coracoclavicular
Acromioclavicular
Coracoacromial

Question 9

Hand anatomy of bones, ligaments & muscles

Answer 9

The hands joint is the intercarpal joint (synovial plane joint). Proximal row bones are scaphoid, lunate, pisiform bones. Distally are trapezium, trapezoid, captitate and hematate. Carpal tunnel narrow space inside the wrist surrounded by bones and ligaments protects the finger tendons, nerves and blood vessels passing from forearm to hand. Carpal tunnel syndrome compresses and swells median nerve caused by thickening of tendon.

Bony features of hand s metacarpals and phalanges for sensation and manipulation. Interphalangeal joints allow flexion and extension. Metacarpo-phalangeal joints allow flexion, extension, circumduction, adduction & abduction. Arterial supply from radial and ulnar arteries. Cephalic vein laterally and basilic vein medially.

Anterior median nerve supply some hand muscles and ulnar nerve supplies most hand muscles.

Intrinsic hand muscles for fine motor movements and precise grip. Interossei muscles are for digit abduction and adduction. Lumbricals flex metacarpophalangeal joint.

Question 10

Foot anatomy of bones, ligaments & muscles.

Answer 10

Bones of the foot are phalanges, metatarsals, cuboid, navicular, talus, calcaneus & medial intermediate and lateral cuneiforms. Foot has arches such as the medial, lateral and transverse longitudinal arches which aid in stability and flexibility absorbing and distributing force.

Extrinsic foot muscles control various foot muscles where each muscle has a belly and a long tendon attaching to foot which are held by retinaculum.
Posterior are flexors: deep flexors of foot pass through tarsal tunnel such as tibialis posterior, flexor digitorum, flexor hallucis with the tibial artery and nerve, tendons pass through medial malleolus. Ankle plantar flexes and toes flexed. The tibialis posterior tendon spring ligament supports head of talus and flat foot deformity is when the spring ligament is ruptured therefore cant support head of talus.

Anterior foot muscles: Extensors such as tibialis anterior, extensor digitorum longus & extensor hallucis longus. Dorsiflexion and extension of EHL and 2-5 EDL