MSS revision Flashcards
What are the names and numbers for the 5 cranial nerves we need to know?
CN V Trigeminal
CN VII Facial
CN X Vagus (see in neck)
CN XI Accessory
CN XII Hypoglossal
What are the contents of the Tarsal Tunnel?
Tibialis Posterior
Flexor Digitorum longus
Posterior tibial artery
Posterior tibial vein
tibial nerve
Flexor Hallus longus
What does the muscles: SGT insert onto and what muscles make up SGT?
pes anserius
Satoris
Gracilis
Semitendonous
What does the posterior tibial artery branch into?
lateral and medial plantar
what does the lateral plantar artery branch into?
deep plantar arch = metatarsal and digital arteries
what does the anterior tibial artery branch into?
Dorsal pedis –> Deep plantar artery and arcuute artery –> dorsal metatarsal and digital arteries
What are the major arteries of the UL?
Subclavian –> axillary –> brachial –> ulnar and radial
what are the major veins of the UL?
cephalic and basilic –> axillary –> brachial -> subclavian
What should you always write when referring to a dermatome?
(dermatome) spinal ROOT
what is the Anterior Drawer test (how and what testing)
Test where the dr PULLS the tibia FORWARDS in relation to femur
tests the ACL stability
if positive (tibia moves excessively forwards) = INDICATES a torn ACL>
what is a positive trendelenurg sign?
When standing on one leg, the pelvis dips down on the unsupported side (due to superior gluteal nerve lesion)
What is carpal tunnel syndrome? (cause and functional issues)
Compression of the median nerve due to overuse, swelling of tendons (and nowhere to release pressure) or pregnancy
Functional issues
-thenar muscle weakness, loss of cutaneous innervation to palm and sensory feedback to how tight to hold items.
-innervates 1st and 2nd lumbicals but movement still possible due to FDP, FDS and ED movement.
How do you find the spot for a lumbar puncture?
ask the patient to lie with back flexed
Find the top of the iliac and draw a line joining the crest and the tip of L4 spinous process
= L4?L5 IV disc
What is the lesion caused by damage to the median nerve?
Carpal tunnel
what is a common lesion that results from a mid-shaft humerus fracture?
Radial Palsy
damage to the radial nerve
muscles innervated by the radial nerve below the lesion will be damaged:
- all EXTENSORS of wrist, thumb and fingers
-brachioradialis, supinator, abductor pollis longus
= wrist drop
If the radial nerve is damaged in the region of the WRIST, what would be the difference in functional loss compared to proximal lesion?
where might the radial nerve be damaged here?
NO Wrist drop
ONLY= sensory loss to hand (lat dorsal side and lateral aspect of base of thumb)
where:
region of the snuffbox
what is the cause of Claw Hand?
what muscles are likely to be affected?
ulnar nerve lesion
muscles
-1st dorsal interosseous= wasted
-dorsal interossei, medial 2 lumbricals, hypothenar muscles and adductor pollicis.
if an ulnar lesion occurs more proximally (above elbow joint) what would be different?
(vs at wrist)
SAME functioal loss of hand but LESS CLAWING of 4th and 5th IP joints.
this is because medial 1/2 of FDP is affected so IP cant flex.
radial deviation during wrist flexion due to loss of FCU
loss of power in wrist abduction as FCU and ECU usually work together
outline the steps in Endochondral ossification (untill birth)
1: Hyaline cartilage template formed
2: cartilage template continues to grow (bone collar from around diaphysis and chondrocyte die)
3: pri ossifcation centre appears (blood vessels enter cavity, bone replaces cartlidge)
4: formation of medullary cavity: diaphyseal wall becomes compact
5: secondary ossification centre appears: cancellous becomes more compact, marrow cavity created.
what are the ligaments of the clavicle and scapula?
coracoclavicular L and acromioclavicular L = Acrominoclavocualr Joint
what are the ligaments of the GH joint?
Coracoacromial ligament = overlies head of humerus to prevent superior displacement
GH ligament = reinforces anterior part of joint capsule
coracohumeral ligament
what are the major stabilisers of the GH joint?
Rotator cuff muscles and Long head of the biceps brachii
what muscles allow for
a) flexion
b) extension
c) supination
d) pronation
of the elbow joint?
a) brachialis, biceps brachii and bracioradials
b) triceps brachii
c) biceps brachii and supinator
d) pronator teres and quadratus
what muscles allow for
a) flexion
b) extension
c) abduction
d) adduction
of the GH joint?
a) pec major, deltoid (ANT fibres)
b) lat dorsi, deltoid (POS fibres) , teres major and long head of biceps brachii
c) supraspinatus (first 15) and then deltoid (central)
d) pec major, lat dorsi
what muscles allow for
a) flexion
b) extension
c) abduction
d) adduction
of the radiocarpal joint?
a) FCR, palmaris longus, FCU, FDS and FDP
b) ECRL, ECRB, ED and ECU
c) AbPL, FCR, ECRL and ECRB
d) FCU and ECU
what muscles allow for
a) flexion
b) extension
c) abduction
d) adduction
e) med rot
f) lat rot
of the Hip joint?
a) iliopsoas, rectus fem, satroius and pectineus
b) gluteus max and hamstrings
c) gluteus (max, med and min) and deep gluteus (piri, S and I gemellis and obturator Internus
d) adductors (long, brevis and magnus), pectinues and gracilis
e) gluteus med and min, adductors, and hamstrings
f) gluteus max, long head of biceps femoris and deep gluteal muscles
what muscles allow for
a) flexion
b) extension
c) lat rot
d) med rot
of the knee joint?
a) hamstrings
b) quadriceps
d) biceps femoris
e) semitendonous and membranous
What muscles allow for
a) medial rotation
b) lat rotation
at GH joint?
a) subscapularis, pec major and teres major
b) infraspinatus and teres minor
what are the ligaments of the elbow joint?
Articular capsule
collateral ligaments (UCL and RCL)
annular ligament = binds radial head to radial notch of ulnar = sup/pro
what are the major stablisers of the elbow joint?
Ligaments (all)
muscles (biceps brachii, triceps and brachialis)
which movement at the radiocarpal joint is more limited? why?
range of abduction (over adduction)
because radial styloid process extends further distally than ulna styloid process
what are the major ligaments of the spine?
posterior longitudinal = avoids hyperflexion
anterior longitudinal = avoids hyperextension
ligamentum flavum = maintains curvatures
suprasinious
interspinious
what is the orientation of facet joints and most faciliated movements at the ZYGAPOPHYSEAL joints of the
a) cervical
b) thoracic
c) lumbar
a) transverse plane, flex, ext and rotation (C1 and C2)
b) coronal plane, rotation (limited flex and ext)
c) sagittal plane, limited range of motion, flex and ext still possible
what are the ligaments of the hip joint?
iliofemoral= holds femoral head in acetabulum whilst standing, limits ext, abd, add and lat rot
pubofemoral= limits ext, abd and lat rot
ischiofem = limits ext, add and med rot
ligament of head of femur= structural support for vessels that provide nutrients
what two joints make up the knee joint and what movements can they do?
Tibiofemoral
-flex, ext and some rot
patellofemoral
- gliding
what ligaments stablise the knee?
extracapsular
-patellar
- MCL and LCL = limit rot and lateral movements and taunt in ext
intracapsular
- ACL = taunt in ext and prevemt post displacement of femur
-PCL = taunt in flexion and prevent anterior displacment
what ligaments stabilise the talocrural joint?
lateral ligaments
- calcaneofibular
-ant and post talofibular
medial/deltoid ligament
what muscles allow for
a) dorsiflexion
b) plantarflexion
at the talocrural joint?
a) tibs ant, ext digitorum longs and ext hallucis longus
b) gastrocnemius, soleus, tibialis post, fibularis longis
what joints make up the transverse tarsal joint and what muscles allow for:
a) inversion
b) eversion
at this joint?
= talocalcaenavicualr joint and calcaneocuboid
a) tibialis ant and post
b) fibularis longus and brevis
what muscles allow for:
a) power grip
b) flexion
c) ext
of the IP joint?
a) extrinsic flexor muscles
b) FDS, FDP, lumbricals and interossei
c) Ext incidis, Ext digiti minimi and ED
What are the three types of joints in the body?
Fibrous
cartliaginious
Synovial
What are the three types of fibrous joints?
sutures (thin layer of CT)
syndesmoses (band of dense, irregular CT
interosseous membrane (thick band of dense, irregular CT)
what are the two types of cartliaginous joints?
Synchondroses - hyaline
Symphyses - fibrocartlidge
What is gastrulation?
transformation of the bilaminar embryonic disc into a –> trilaminar embryonic disc
-What is neurulation and when does it occur?
what
transformation of the neural plate into the neural tube
When
notochord stimulates the ectoderm to invaginate
outline the steps in excitation- contraction for skeletal muscle
AP –> Ca influx across L-gated Channels
ACh released across NMJ
ACh bind to AChrR and releases Na
depolarosation down T-tubules = activation of DHP-Rs
DHP-Rs activate RYR = release of Ca from SR
Ca binds to Troponin C
releases tropomysion and exposes actin active sites
what is the function of the erector spinale?
bilateral contraction = back ext
back lateral flexion = unilateral contraction
maintenance of posture
what is the function of the medial compartment of the thigh?
lat rotation
- obturator ext
hip flexion
- pectineus
hip add
-pectineus
-add brev, long and mag
-gracilis
med rotation
- add brev, long and mag
knee flexion
-gracilis
what is the action and innervation of the infrahyoids?
depresses the hyoid bone
anterior rami C1-C3 through anse cervicalis
what is innervated by the inferior gluteal nerve?
gluteus maximus
what is innervated by the superior gluteal nerve?
tensor faciate
glutesi med and mini
what is the motor and sensory supply of the medial plantar nerve?
medial sole
what is the motor and sensory supply of the lateral plantar nerve?
lat sole of foot
little toe and half 4th toe
what does the obturator nerve supply?
medial compartment of the thigh
what does the lumbosacral trunk supply?
sciatic nerve
superior gluteal
inf gluteal
pudenal
nerve to quadratus feoris
nerve to obturator internus
what are the muscles of the intermediate and deep region of the anterior compartment of the forearm?
Super, Pissed, Polly longs, (to) Quit
FDS
FDP
FPL
PQ
what are the muscles of the superficial posterior compartment of the forearm?
Brachioradialis
ECRL
ECRB
ED
EDM
ECU
what are the muscles of the deep posterior compartment of the forearm?
supinator
abd pollis longus
ext pollis long
ext pollis brevis
ext incidis
what are the muscle tendons that make up the snuffbox?
abd pollis longus
ext pollis bervis
ext pollis longus
what are the muscles that make up the thenar group?
The Best (thenar Brevis)
Abductor Pollis Brevis
flexor pollis brevis
Opponens pollis
what are the muscle groups that make up the hypothenar group?
Abd DM
Flexor DM
Opponens DM
What are the muscle groups that make up the hand?
Thenar
Hypothenar
Lumbricals
Interessoi
Abductor Pollis
(The Hand lacks interesting Abstract problems)
what are the pulses of the head?
Temporal, carotid and facial
anatomically describe how you would find the temporal pulse?
superficial
-anteriorly to the ear and immediately posterior too the position of temporomandibular joint
ant branch
- posterior to zygomatic process if frontal bone as is passes lateral to the temporal fascia
Describe, anatomically, how to find the fascial artery
palpate where crosses inferior border of mandible, adj to anterior margin of masseter muscle
describe, anatomcally how you would find the common and external carotid pulse
common
posteriolateral to larynx
external
immediately lateral to the pharynx. midway between the superior margin of the thyroid cartilage and the greater hyoid bone.
what pulses are palpable in the upper limb?
- radial pulse (wrist ditsal forearm and anatomical snuffbox)
- ulnar pulse (wrist)
- brachial pulse (cubital fossa and midarm)
- axillary pulse
Expalin in anatomical terms how you would find the axillary pulse
Found in the axilla, lateral to the apex of skin covering floor of axilla
Explain in anatomical terms how you would find the brachial pulses.
midarm
-on anterior arm
-in the cleft of biceps brachii and triceps brachii tendon
cubital fossa
-on anterior arm
-medial and superior to the biecps brachii tendon
explain in anatomical terms how you would find the ulnar pulse
immediately inferior to the lateral margin of the FCU tendon and proximal to the pisiform
-on the anterior arm
explain in anatomical terms how you would find the radial pulses
anatomical snuffbox
-on the lateral, posterior compartment
-lateral to the EPL, but medial to Abd Pl and EPB tendon
distal forearm:
- ant comparment
radial artery immediately lateral to the tendon of the flexor carpi radialis
muscle.
what pulses are palpable in the LL?
Foot
Posteior tibial artery
Dorsalis pedis
LL
femoral pulse
popliteal pulse
Explain in anatomical terms how you would find the posterior tibial artery pulse
halfway between the calcenous and medial malleolus
explain in anatomical terms how you would find the dorsalis pedis pulse?
dorsal side of foot, just lateral to the EHL tendon
explain in anatomical terms how you would find the femoral pulse.
inferior to the inguinal ligament and midway
between the anterior superior iliac spine and the pubic
explain in anatomical terms how you find the popliteal pulse.
deep in the popliteal fossa near the midline;
name the borders of the Anterior and posterior triangle of the neck.
Anterior
lat= ant margin of SCM
sup= inf margin of mandible
med= midline of neck
pos
ant= post margin of SCM
pos= ant margin of trapezius
inferiorly= middle 1/3 clavicle
outline the borders of the axilla
Ant wall: pec major, pec minor and subclavis
medial wall: serratus ant and thoracic wall
lat wall: pec major, lat dorsi and teres major (lady between 2 majors)
post= subscapularis, lat dorsi, teres major and long head of triceps brachii
floor= skin and fasci from arm
Borders of the cubital fossa
sup= linebetween medial and lat epicondyles
med= lat margin of pronator teres
lat= med margin of brachioradialis
floor= brachialis and supinator
roof= biciotial aponeursosis
borders of the carpal tunnel
roof= flexor retinaculum
floor= carpal bones
lat= med surface of trapezium
med= lateral surface of hamate
borders of the femoral triangle
sup = ingunial ligament
med= adductor longus
lat= satorius
floor = iliopsoas (lat) and pectineus (medially)
boundaries of the popliteal fossa
superomedial = Semimembranous and tendonous
superolateral = biecs femoris
inferomedial= medial head of gastrocnemius
inferolateral = lateral head of gastrocnemius
