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THE BOARDS > MUSCULOSKELETAL ANATOMY PHYSIOLOGY PATHOLOGY > Flashcards

MUSCULOSKELETAL ANATOMY PHYSIOLOGY PATHOLOGY Flashcards

1
Q

External oblique

A

O: anterior iliac crest, pubic bone, abdominal aponeurosis

I: inferior border of R5-12

(BL) flexion (cc PPT)
(UL) IL lateral flexion (cc hip hike)
(UL) CL rotation
(BL) abdominal compression 
Depressed rib cage.
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2
Q

External oblique: palpation and MMT

A

Palpation: slight flexion with CL rotation. Palpate between iliac crest and lower ribs.

MMT: CL rotational sit up. Hold against gravity or apply force towards extension IL rotation

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3
Q

Internal obliques

A

O: inguinal ligament, iliac crest, thoracolumbar fascia

I: R10-12, abdominal aponeurosis

(BL) flexion (cc PPT)
(UL) lateral flexion (cc hip hike)
(UL) IL rotation
(BL) abdominal compression

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4
Q

Internal obliques: palpation and MMT

A

Palpation: slight flexion with IL rotation. Palpate between iliac crest and lower ribs.

MMT: IL rotational sit up. Hold against gravity or apply force towards extension CL rotation

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5
Q

Internal vs External Obliques: movement

A

Internal obliques IPSILATERAL rotation

External obliques CONTRALATERAL rotation

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6
Q

SCM

A

O: sternal head: anterosuperior manubrium; clavicular head: medal 1/3 clavicle

I: mastoid process

Cervical flexion
Capital extension
Lateral flexion
CL rotation

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7
Q

SCM: palpation and MMT

A

Palpation: supine. CL rotation, cervical flexion. Palpate away

MMT: same position. Stabilize sternum; apply pressure towards extension.

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8
Q

Glute Max

A

O: posterior iliac crest, posterolateral sacrum, coccyx, TLF, glute med fascia, sacrotuberous ligament

I: ITB, gluteal tuberosity of the femur

Hip extension, external rotation, upper 1/3 abduction, lower 2/3 adduction, PPT, knee extension via ITB

Inferior gluteal nerve (L5-S2)

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9
Q

Glute Max: palpation and MMT

A

Palpation: prone, knee flexed to 90º. Externally rotate, extend hip.

MMT (Vizniak): same position. Stabilize opposite PSIS. Apply pressure towards flexion.

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10
Q

Biceps Femoris

A

O: Long head: ischial tuberosity, sacrotuberous ligament
Short head: linea aspera, lateral supracondylar line of the femur

I: fibular head, lateral tibial condyle

Knee flexion, hip extension, lateral hip rotation, lateral knee rotation, adduction.

Sciatic nerve

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11
Q

Biceps Femoris: Palpation and MMT

A

Palpation: prone, knee flexed. Palpate from just distal-lateral to ischial tuberosity to fibular head. Extend knee to distinguish from vastus lateralis

MMT: prone, knee flexed 50-70º, externally rotated. Stabilize back of thigh, apply pressure towards knee extension, but not rotation.

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12
Q

Tibialis Anterior

A

O: Proximal 2/3 anterior tibia and interosseus membrane, lateral tibial condyle

I: first metatarsal and first cuneiform

Dorsiflexion, inversion

Deep fibular nerve

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13
Q

Tibialis Anterior: Palpation and MMT

A

Palpation: Seated or supine. Dorsiflexion plus inversion. Don’t extend toes.

MMT: Same position. Stabilize above ankle and apply pressure towards plantarflexion and eversion.

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14
Q

Pec Minor

A

O: Ribs 3-5
I: coracoid process

Scapular protraction, depression, downward rotation
Elevation of Ribs 3-5
*assists inspiration

Medial and lateral pectoral nerves

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15
Q

Pec Minor: Palpation and MMT

A

Palpation: Seated, hand behind back. Palpate just inferior to coracoid process. Lift hand from back.

MMT: supine, round shoulder forward (don’t press arm against table). Apply pressure toward table.

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16
Q

ECRB

A

Origin: lateral epicondyle of humerus (CET)

Insertion: posterior base of MC3

Wrist extension, radial deviation
Some elbow flexion

Radial nerve

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17
Q

ECRB: palpation and MMT

A

Palpation: Pinch wad of 3. Most posterior fingers will be on ECRB. Extend wrist and radially deviate

MMT: Seated, leaning forward so elbow flexed and shoulder extended. Stabilize elbow. Extend wrist and radially deviate. Apply pressure toward wrist flexion and ulnar deviation

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18
Q

Extensor Hallucis Brevis

A

O: dorsal surface of calcaneus

I: dorsal proximal phalanx #1

Extends big toe at MTP

Deep fibular nerve

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19
Q

EHB: Palpation and MMT

A

Palpation: place fingers 2-3 distal to lateral malleolus. Wiggle big toe. Differentiate from EDB by wiggling other toes (EDB will be lateral)

MMT: extend big toe. Stabilize at dorsum; apply pressure toward MTP flexion.

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20
Q

Rule of Three’s

A

For thoracic spine

T1-3, 10: SPs on same level as TVPs
T4-6, 11: SPs half a level below TVPs
T7-9, 12: SPs a full level below TVPs

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21
Q

Which SP is roughly at the same level as the superior angle of the scapula?

A

T2

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22
Q

Which SP is roughly at the same level as the inferior angle of the scapula?

A

T6/7

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23
Q

Which direction do the thoracic superior articular facets face?

A

Backwards
Upwards
Laterally

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24
Q

Freyette’s First Law

A

In lumbar and thoracic spines, when in neutral, lateral flexion and rotation will happen in opposite directions

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25
Q

Freyette’s Second Law

A

In flexion or extension, rotation and lateral flexion will occur in the same direction.

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26
Q

Anterior pillar

A

Functional division of the spinal column

Vertebral bodies and discs
Hydraulic, weight-bearing, shock absorbing portion of the spinal column.

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27
Q

Size of vertebral disc influences:

A

Amount of movement available between vertebrae

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28
Q

Posterior pillar

A

AKA vertebral arch

Articular processes and facet joints, TVPs, SPs.

Provide gliding mechanism for movement

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29
Q

Orientation of facets influence:

A

Direction of movement

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30
Q

Spinal unit

A

Two adjacent vertebrae and the joints in between.

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31
Q

Axis of movement for spinal unit

A

Nucleus pulposis of the IVD

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32
Q

Rectus Abdominis

A

O: pubic symphysis and crest
I: xiphoid process and cartilage of R5-7

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33
Q

Rectus Abdominis: Palpation and MMT

A

Palpation: supine, palpate during mini-crunch

MMT: Mini crunch. Hold against gravity, or stabilize thighs and apply pressure towards extension.

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34
Q

Transverse Abdominis

A

O: lateral 2/3 inguinal ligament, iliac crest, TLF, costal cartilage of R7-12

I: abdominal aponeurosis

Abdominopelvic compression

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35
Q

TVA: Palpation and MMT

A

Palpation: supine, knees pillowed in flexion, or 90º/90º hip/knee flexion. Palpate anterolaterally during forced exhalation.

MMT: Supine. 90º/90º hip/knee flexion with arms crossed over chest. Stabilize upper body (at elbows). Resist pressure applied to knees towards rotation.

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36
Q

Abdominal aponeurosis

A

AKA Rectus sheath

Composed of the aponeuroses of the obliques and TVA.

Envelops the rectus abdominis

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37
Q

Anterior triangle of the neck

A

Mandible/trachea/SCM

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38
Q

Posterior triangle of the neck

A

Upper traps/SCM/clavicle

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39
Q

Femoral triangle

A

Inguinal ligament
Sartorius
Adductor longus
floor: pectineus, iliopsoas

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40
Q

Anatomical snuff box

A

medial: Extensor pollicis longus
lateral: Adductor pollicis longus/Extensor pollicis brevis
proximal: styloid process of radius
floor: trapezium, scaphoid

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41
Q

Layer 1 of the plantar foot

A

Abductor hallucis
Abductor minimi pedis
Flexor digitorum brevis

All originate at the calcaneal tuberosity and insert in the toes.

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42
Q

Abductor hallucis

A

O: calcaneal tuberosity
I: medial dorsal surface of the proximal phalanx of the big toe

Abduction of the big toe
Weak MTP 1 flexion

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43
Q

Abductor hallucis: Palpation of MMT

A

Palpation: Palpate from calcaneal tuberosity to medial big toe, medial to plantar fascia, as person abducts big toe

MMT: Grip heel. Abduct big toe. Pressure applied toward adduction. If client can’t abduct big toe, have them attempt forefoot adduction against resistance.

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44
Q

Flexor Hallucis Brevis

A

O: cuboid and third cuneiform
I: medial and lateral aspect of plantar surface of the big toe (proximal phalanx)

Flexes toe at MTP #1

Even though layer #3, only deep to FHL tendon and plantar fascia

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45
Q

Flexor Hallucis Brevis: Palpation and MMT

A

Palpation: palpate medial sole of foot while flexing big toe. Medial to FHB, deep to plantar fascia

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46
Q

Fibularis Longus

A

O: Fibular head; proximal half of lateral fibula
I: First cuneiform and first MT (medial/plantar foot)

Eversion
Plantarflexion

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47
Q

Fibularis Longus: Palpation and MMT

A

Palpation: Start at fibular head and palpate downwards during eversion. Becomes difficult to palpate distal to lateral malleolus. Travels to base of 5th metatarsal then veers to plantar surface.

MMT: Sidelying or supine. Evert and plantarflex. Stabilize proximal to ankle. Apply pressure towards dorsiflexion and inversion

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48
Q

“Stirrup Muscles”

A

Fibularis Longus and Tibialis anterior OR Tibialis Posterior. Both the Fib Long and the Tib Ant insert into 1st cuneiform and MT1, and act to support the medial longitudinal arch of the foot.

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49
Q

Extensor Digitorum Longus

A

O: proximal 2/3 fibula, proximal 1/3 interosseus membrane, lateral tibial condyle

I: dorsal surfaces of toes 2-5

Extends toes 2-5 at MTP and IP joints
Dorsiflexion
Weak eversion

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50
Q

Extensor Digitorum Longus: Palpate and MMT

A

Palpation: Extend toes to identify tendons on dorsum of foot. Palpate proximally towards origin

MMT: Stabilize at big toe. Extend toes. Apply pressure towards flexion.

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51
Q

The fibularis tertius is actually believed to be part of what muscle?

A

Extensor digitorum longus

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52
Q

Flexor Digitorum Brevis

A

O: Calcaneal tuberosity, plantar fascia
I: medial and lateral sides of digits 2-5

PIP and MTP flexion of digits 2-5

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53
Q

Flexor Digitorum Brevis: Palpation and MMT

A

Palpation: Flex toes and feel through plantar fascia along midline of sole.

MMT. Stabilize proximal foot. Flex toes. Apply pressure towards PIP and MTP extension.

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54
Q

Gastrocnemius

A

O: medial and lateral femoral condyles

I: calcaneus via the Achilles tendon

Plantarflexion
Knee flexion
Inversion/supination

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55
Q

Gastrocnemius: Palpation and MMT

A

Palpation: duh

MMT: Supine. plantarflex. Apply pressure towards dorsiflexion

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56
Q

Soleus

A

O: soleal line of the tibia; fibular head and proximal 1/3 of fibula

I: calcaneus via the Achilles tendon

Plantarflexion
Weak inversion/supination

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57
Q

Soleus: Palpation/MMT

A

Palpation: prone, knee flexed to 90º. plantarflex. Palpate on either side ot belly of the gastrocnemius.

MMT. Prone. Stabilize shin. Knee flexed to 100º. Plantarflex. Apply pressure to heel towards dorsiflexion,

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58
Q

Pronation: talocrural/ subtalar/forefoot

A

dorsiflexion/eversion/abduction

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59
Q

Supination: talocrural/subtalar/forefoot

A

plantarflexion/inversion/adduction

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60
Q

Claw toe

A

MTP hyperextension
PIP/DIP flexion

Defective lumbricals, interossei

Associated with pes cavus, fallen metatarsal arch, spina bifida, neurological problems

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61
Q

Hammer toe

A

MTP extension contracture; PIP flexion contracture

Interossei lose ability to maintain proximal phalanx in neutral, so it gets pulled into extension

Heredity, footwear, muscle imbalance, hallux valgus

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62
Q

Mallet toe

A

Flexion deformity of the DIP

Bad shoes.

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63
Q

Layer 2 of the plantar foot

A

Quadratus Plantae

Lumbricals Pedis

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64
Q

Layer 3 of the plantar foot

A

Flexor hallucis brevis
Flexor digiti mini brevis
Adductor hallucis

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65
Q

Layer 4 of the foot

A

Plantar interossei

Dorsal interossei

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66
Q

Tibialis Posterior

A

O: Proximal 2/3 posterior tibia, fibula, interosseus membrane

I: navicular tuberosity, MT2-4, all of the tarsals except the talus.

Pronation
Inversion/supination

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67
Q

Tibialis Posterior: Palpation and MMT

A

Palpation: seated or supine. Identify tendon just posterior to medial malleolus (it will be most anterior of Tom, Dick & Harry; extend toes to exclude FDL and FHL). Palpate upwards. It will disappear under soleus

MMT: supine. Stabilize just above ankle. Lateral rotate leg, plantarflex and invert. Apply pressure towards dorsiflexion and eversion.

68
Q

Gluteus Medius

A

O: Just inferior to iliac crest; in between anterior and posterior gluteal lines

I: Greater trochanter (lateral)

All fibres: abduction, depress pelvis

Posterior fibres: extension, lateral rotation, posterior pelvic tilt, contralateral rotation

Anterior fibres: flexion, medial rotation, anterior pelvic tilt, weak ipsilateral rotation

69
Q

Gluteus Medius: Palpation and MMT

A

Palpation: Sidelying. Just inferior to middle of iliac crest. Abduct. Palpate towards trochanter; fibres go deep to TFL and Glute Max

MMT: Vizniak – supine; stabilize opposite ankle. Abduct; resist pressure towards adduction.
Kendall: sidelying; slight forward pelvic rotation. Stabilize pelvis; abduct; resist pressure toward adduction.

70
Q

Anterior fibres of the glute med run in the same direction as

A

TFL

71
Q

Posterior fibres of the glute med run in the same direction as

A

Piriformis

72
Q

TFL

A

O: ASIS and anterior iliac crest
I: ITB

Hip flexion
Abduction
Medial Rotation
Anterior pelvic tilt
Pelvic depression
Knee extension (via ITB)
73
Q

TFL: Palpation and MMT

A

Palpation: Supine. Place fingers just distal and lateral to ASIS. Hip flexion, medial rotation. Palpate toward ITB.

MMT: Supine. Stabilize opposite ankle. Flex hip to 45-60º; abduct 30º; medially rotate. Resist pressure towards opposite ankle (extension and adduction)

74
Q

Piriformis

A

O: Lateral aspect of anterior sacrum, sacrotuberous ligament
I: superomedial greater trochanter of the femur

Lateral hip rotation
Hip extension
Contralateral pelvic rotation

When hip flexed past 60º:
Medial hip rotation
Ipsilateral pelvic rotation

75
Q

Piriformis: Palpation and MMT

A

Palpation: Prone. Knee flexed to 90º. Palpate lateral to sacrum, between PSIS and apex. Laterally rotate hip. Palpate to insertion. Don’t apply to much resistance or glute max will fire.

MMT: Prone. Knee flexed to 90º. External hip rotation. Resist pressure towards medial rotation.

76
Q

Psoas Major

A

O: anterolateral bodies of T12-L5, with IVDs in between. Anteriorly on TVPs L1-5

I: lesser trochanter

Hip flexion
Posterior pelvic tilt
Lateral hip rotation
Ipsilateral hip hike
Trunk flexion
Anterior pelvic tilt
Contralateral rotation
Lateral flexion
77
Q

Psoas: Palpation and MMT

A

Palpation: supine, knees flexed. Find point halfway between ASIS and navel, lateral to rectus abdominis. Palpate gently downward on exhalation. Slight hip flexion.

MMT: Supine. Hip flexed to 60º, laterally rotated, abducted. Stabilize opposite hip. Apply pressure diagonally (medial to lateral) towards extension

78
Q

VMO

A

O: medial lip of linea aspera; intertrochanteric line; medial supracondylar line

I: Tibial tuberosity

Knee extension

79
Q

VMO: Palpation and MMT

A

Palpation: supine. Place hand medial and proximal to patella. Extend knee. Palpate toward origin.

MMT: Seated or supine. Knee flexed 10-20º, tibia externally rotated. Stabilize behind knee. Apply pressure toward knee flexion

80
Q

Sartorius

A

O: ASIS
I: Pes anserine

Hip flexion
Lateral hip rotation
Abduction
Medial tibial rotation
Anterior pelvic tilt
81
Q

Sartorius: Palpation and MMT

A

Palpation: Supine. Palpate distal and medial to ASIS. Hold thigh in hip flexion, lateral rotation. Palpate toward insertion. If can’t hold in that position, figure 4 with lateral rotation, flexion

MMT: Supine, knee bent. Patient may hold onto table for stability. Hip flexed, laterally rotated, abducted. Apply pressure toward extension, adduction, and medial rotation.

82
Q

Palpate greater trochanter

A

Locate middle of iliac crest
Slide fingertips inferiorly 4-6 inches along lateral thigh until you feel great big bump.

Dynamic: medial and lateral rotation

83
Q

Palpate gluteal tuberosity

A

Prone
Locate posterior surface of greater trochanter
Slide 1-2 inches distally along posterior femur until you feel tuberosity (may be flat, not bumpy)

Dynamic: hip extension

84
Q

Palpate femoral condyles

A

Mostly inaccessible.

Supine, knee entended.
Locate sides of patella.
Shift patella medially and slide off into the lateral condyle; shift laterally and slide off into the medial condyle

85
Q

Adductor pollicis

A

Oblique head -
O: anterior base of MC2-3, capitate
I: proximal phalanx 1, DDE

Transverse head:
O: distal base of MC 3
I: proximal phalanx 1

Adduction (CMC, MCP)
Thumb extension.

86
Q

Brachioradialis

A

O: lateral supracondylar ridge
I: styloid process of the radius

Elbow flexion
supination/pronation to neutral

87
Q

Brachioradialis: Palpation and MMT

A

Palpation: resist hammer curl. Palpate wad of three – most anterior

MMT: resist hammer curl

88
Q

Longus Capitis

A

O: TVP C3-5
I: Occiput (inferior – just anterior to foramen magnum)

Cervical flexion
Lateral flexion

89
Q

Longus Capitis: Palpate and MMT

A

Palpation: Supine. Feel medial to SCM, press posterior and medial. Flex against resistance for contraction

MMT: (general anterior neck flexor test). Supine. Stick ‘em up cactus arms. Tuck chin and flex neck. Resist pressure toward extension.

90
Q

Trapezius - upper

A

O: External occipital protuberance, medial 1/3 superior nuchal line, nuchal ligament, SP of C7

I: Lateral 1/3 clavicle, acromion process

Elevation of scapula
Retraction of scapula
Upward rotation of scapula

Cervical extension
CL rotation
Lateral flexion

91
Q

Trapezius – middle

A

O: SPs T1-5
I: acromion process and spine of scapula

Scapular retraction

92
Q

Trapezius – lower

A

O: SPs T6-12
I: Tubercle at the root of the spine of the scapula

Scapular depression
Scapular retraction
Upward rotation

93
Q

Trapezius: Palpation and MMT

A

Prone: palpation during scapular retraction (and active GH abduction?). Upper traps fire more with cervical extension.

MMT: Upper traps – seated. Shoulder elevated toward occiput, face turned away. Pressure towards shoulder depression and cervical anterolateral flexion

Middle traps: Prone. Arm out to the side – thumbs up Fonzie-style. Retract scapula. Pressure downward against forearm

Upper traps: Prone, arm out in 1/2 Y position, thumb up. Retract scapula. Pressure downward agains forearm

94
Q

Anterior Scalene

A

O: TVP C3-6
I: First rib

Cervical flexion
Lateral flexion
CL rotation
elevation of 1st rib (sniff)

95
Q

Anterior and middle Scalene: Palpation

A

Clavicle, just lateral to SCM. Slight CL rotation. Sniff. Middle scalene will also contract – anterior scalene is more medial.

96
Q

Middle Scalene

A

O: TVP C2-7
I: First Rib

Cervical flexion
Lateral flexion
elevation of 1st rib

97
Q

Posterior Scalene

A

O: TBP C5-7
I: Second rib

Lateral flexion
Elevation of 2nd rib

98
Q

Posterior Scalene: Palpation

A

Seated. Feel just above clavicle just medial to clavicular attachment of SCM. Sniff.
(Lateral flexion may help) . Middle scalenes will also contract (They’re more medial)

99
Q

Scalene: MMT

A

Test as anterolateral neck flexors. Supine. Stick ‘em up cactus arms. Rotate neck. Flex head. Pressure against temple toward taSplble

100
Q

Rhomboids

A

O: SP C7-T5
I: Medial border of the scapula

Retraction
Elevation
Downward rotation

101
Q

Rhomboids: Palpation and MMT

A

Palpation: Prone or seated. Hand in small of back. Feel between scapula and spine. Palpate and hand moved away from back

MMT: Prone. Arm out to side. Downward thumb. Pressure agains forearm toward floor.

102
Q

Splenius Capitus

A

O: Nuchal ligaments C3-6; SPs C7-T4
I: mastoid process

Cervical extension
Lateral flexon
IL rotation

103
Q

Splenius Capitus: Palpation and MMT

A

Palpation: Prone. Feel posterior triangle (between SCM and trapezius. Extend and IL rotate head

MMT: Prone, cervical IL rotation, lateral flexion. Slightly extend head. Stabilize upper T spine. Pressure on head towards flexion, opposite lateral flexion,

104
Q

Teres Major

A

O: Inferior angle and inferior lateral border of the scapula
I: medial lip of the bicipital groove

Internal rotation
Adduction
Extension

105
Q

Teres Major: Palpation and MMT

A

Palpation: prone. arm on table, foream dangling off. Feel lateral to inferior lateral border of scapula. Medially rotate arm to contract.

MMT: Prone. Arm behind back. Stabilize around other scapula. Pressure against arm (above elbow) toward abduction and GH flexion.

106
Q

Latissimus Dorsi

A

O: SP T7-L5, posterior sacrum, posterior iliac crest
I: medial lip of bicipital groove

Medial rotation
Adduction
Extension

107
Q

Latissimus Dorsi: Palpation and MMT

A

Palpation: standing, therapist to front and side. Client arm on therapist shoulder. Attempt adduction/extension while therapist palpates from axilla to insertion, and toward origin

MMT: Prone. Head CL rotated, arm semi-supinated (thumb pointing downward). Extend and adduct arm. Pressure against forearm toward abduction and flexion.

108
Q

Extensor Pollicis Longus

A

O: posterior ulna (middle 1/3, interosseus membrane)
I: Posterior surface of distal phalanx of the thumb

Extends thumb at CMC, MCP and IP joints.

Also laterally rotates and adduct CMC, extends and radially deviates at wrist, and supinates forearm.

109
Q

EPL: Palpation and MMT

A

Palpation: Seated. Neutral forearm (semi-supinated). Feel posterolateral wrist. Extend thumb. Distal tendon makes up ulnar-side border of snuffbox.

MMT: Sitting or supine. Neutral forearm. Stabilize by holding hand. Extend thumb. Pressure at dorsal IP towards flexion.

110
Q

Flexor Carpi Radialis

A

O: CFT
I: base of MC 2 and 3

Flexion, radial deviation
Pronation
Wrist flexion

111
Q

Flexor Pollicis Brevis

A

O: flexor retinaculum and trapezium
I: Proximal phalanx of the thumb

Flexion at CMC and MCP joints

112
Q

Coracobrachialis

A

O: coracoid process
I: medial shaft of humerus

flexion
adduction

113
Q

Hyoid Group

A

8 muscles (4 infrahyoid, 4 suprahyoid)

All move mandible (directly or indirectly) at TMJ, and stabilize hyoid during mandibular depression

114
Q

Suprahyoid Group

A 
Muscles above hyoid bone
Depress mandible (except styloid process)

Geniohyoid
Mylohyoid
Digastric
Stylohyoid

115
Q

Digastric

A

Suprahyoid

Posterior belly: mastoid notch –> hyoid
Anterior belly: mandible –> hyoid

Depresses mandible
Cervical flexion
Elevation of hyoid

116
Q

Mylohyoid

A

Suprahyoid

inner surface of mandible –> anterior hyoid

Depresses mandible
Cervical flexion
Elevates hyoid

117
Q

Geniohyoid

A

Suprahyoid

inferior mental spine of mandible –> anterior hyoid

Depresses mandible
Cervical flexion
Elevates hyoid

118
Q

Stylohyoid

A

Styloid process –> hyoid

Elevates hyoid
Extends head

119
Q

Which hyoid muscles are innervated by CN V

A

The Trigeminal nerve innervates:

Posterior belly of the digastric
Mylohyoid

120
Q

Which hyoid muscles are innervated by CN VII

A

The Facial nerve innervates:

Stylohyoid
Anterior belly of the digastric

121
Q

Why hyoid muscles are innervated by CN XII

A

The Hypoglossal nerve innervates:

Thyrohyoid
Geniohydoid

122
Q

Infrahyoids

A

Below hyoid
All depress hyoid and flex neck

Sternohyoid
Sternothyroid
Thyrohyoid
Omohyoid

123
Q

Sternohyoid

A

Infrahyoid

Posterior manubrium and clavicle
–> medial posterior hyoid

Depresses hyoid
Flexes neck

124
Q

Sternothyroid

A

Infrahyoid

Posterior manubrium and first costal cartilage –> lamina of thyroid cartilage

Depresses hyoid
Flexes neck

125
Q

Thyrohyoid

A

Infrahyoid

Thyroid cartilage (lamina) –> hyoid

Depresses hyoid
Flexes neck

126
Q

Omohyoid

A

Inferior belly: scapula –> clavicle
Superior belly: clavicle –> hyoid

Depresses hyoid
Flexes neck

127
Q

Infrahyoids: innervation

A

All ansa cervicalis, except thyrohyoid (CN XII)

128
Q

Q Angle

A

Quadriceps angle

Formed by a line drawn between ASIS and centre of the patella, and another line connected centre of patella and the tibial tubersity

Standing: normally 13-18º
Seated, quads relaxed: nada
Seated, quads engaged:

129
Q

If Q Angle is too large?

A

Over 13º – risk of patellar instability

Over 18º risk of patellar tracking dysfunction

130
Q

Medial collateral ligament

A

Medial epicondyle to medial shaft of tibia

Attached to meniscus

Taut with knee extension, abduction of tibia on femur, forward translation of tibia, external tibial rotation

131
Q

Patellofemoral ligament

A

Adductor tubercle –> medial patella

Can become irritated with PatFem tracking disorder.

132
Q

Lateral collateral ligament

A

Shorter, rounder than MCL

Lateral epicondyle –> fibular head

Superficial to popliteus tendon; runs between it and biceps femoris tendon
Doesn’t attach to meniscus

Taut with knee extension, adduction of tibia, external tibial rotation. Resists varus stress and hyperext ensign

133
Q

Anterior Cruciate ligament

A

Anterior intercondylar area of the tibia –(backwards upwards lateral) to lateral femoral condyle

Main function: prevent anterior movement of tibia and check lateral tibial rotation in flexion.

Also checks (hyper)extension of the knee.

134
Q

Posterior Cruciate ligament

A

Intercondylar area of the the tibia –(forward, medial, up) –> medial femoral condyle

Main functions: checking posterior translation of the tibia.

Also checks (hyper)extension.

135
Q

Fat pad, ACL and PCL are …

A

Intercapsular and extrasynovial

136
Q

Medial femoral condyle …

A

Extends further distally, creating a 10° valgus angle

137
Q

Lateral femoral condyle …

A

Extends more anteriorly, preventing lateral dislocation of the patella

138
Q

Which tibial condyle is larger?

A

Medial

139
Q

Medial meniscus

A

Horns attach by ACL and PCL attachments

Attached to capsule, MCL and coronary ligaments

Less mobile

140
Q

Lateral meniscus

A

Horns attach closely to each other

Attached to tibia, coronary ligaments, capsule, but not LCL

More mobile

141
Q

Fabella

A

The fabella (Latin for little bean) (or flabella) is a small sesamoid bone found in some mammals embedded in the tendon of the lateral head of the gastrocnemius muscle behind the lateral condyle of the femur.

Only about 10% population has one.

142
Q

Oblique popliteal ligament

A

Post-med tibial meniscus, tibial condyle –> blends with semimem tendon –> to lateral femoral condyle

Reinforced post-med capsule

Controls ant-med rotary instability

143
Q

Arcuate popliteal ligament

A

Y shaped Thickening of post-lat capsule

Fibula –> popliteal fascia / posterior horn of lateral meniscus and lateral femoral condyle

144
Q

Patellar Retinaculum

A

Medial and lateral extensions of the aponeuroses of the vastus lateralis and VMO

145
Q

What happens during knee extension?

A

Patella moves upward and laterally.

Fat pad fills patellar groove and covers trochlear groove.

Menisci glide anteriorly

MCL, LCL, and medial fibres of ACL and PCL tighten

Tibia externally rotates in last 15-20°
(Closed chain – femoral internal rotation )

146
Q

Primary rotary stabilizers of the knee

A

Cruciate ligaments

147
Q

Hallux ridigus

A

Limited extension/dorsiflexion of the big toe.

Often OA at MTP 1
Also extra long MT 1 bone, pronation, trauma.

More frequent in men

Acute (usually adolescent) or chronic.

148
Q

Transverse tarsal joint

A

Talonavicular and calcaneocuboidal (saddle/stellar) joints

Essentially ball and socket

Closed packed in supination

Supported by calcaneocuboid, bifurcated and long plantar ligaments.

Gliding, conjunction rotation

149
Q

Tarsometatarsal joints

A

Plane synovial

Closed packed in supination

Collectively referred to as Lisfranc joint

150
Q

Posterior tibiofibular ligament

A

Inferior tibfib joint

Prevents excess gapping and posterior glide

151
Q

Posterior talocalcaneal ligament

A

Subtalar joint

Connects lateral tubercle of talus to medial calcaneus

152
Q

Deltoid ligament

A

Talocrural joint (medial)

Triangular. Medial malleolus –> fans out to distal attachments
Collectively resists reversion, rotation, tilt and ant/post tarsal glide

Tibionavicular (anterior)
Anterior tibiotalar

Tibiocalcaneal

Posterior tibiotalar

153
Q

Tibionavicular ligament

A

Part of anterior deltoid ligament (superficial)

Medial malleolus –> blends with spring ligament/ navicular

Collectively resists reversion, rotation, tilt and ant/post tarsal glide

154
Q

Anterior tibiotalar

A

Part of anterior deltoid ligament (deep)

Resists rotation and lateral translation of talus

Medial malleolus –> deep anterior talus

155
Q

Posterior tibiotalar

A

Part of the deltoid ligament

Superficial
Medial malleolus –> medial talus

Collectively resists reversion, rotation, tilt and ant/post tarsal glide

156
Q

Tibiocalcaneal ligament

A

Part of the deltoid ligament (middle fibres)

Almost vertical orientation

Medial malleolus to sustenaculum tali

Collectively resists reversion, rotation, tilt and ant/post tarsal glide

157
Q

Posterior talofibular ligament

A

Fossa of lateral malleolus –> lateral tubercle of posterior talus

Checks excessive dorsiflexion.

158
Q

Short Plantar Ligament

A

AKA plantar calcaneocuboid ligament

Reinforces calcaneocuboid joint

159
Q

Long plantar ligament

A

Aka long calcaneocuboid ligament.

Reinforces calcaneal cuboid joint

160
Q

What muscles make up the erector spinae group?

A

Iliocostalis
Longissiumus
Spinalis

161
Q

Collectively what are the actions of the erector spinae?

A

Extension
Lateral flexibility
IL rotation
Anterior pelvic tilt

162
Q

Iliocostalis

A

Most lateral erector spinae

Lumbar, thoracic and cervical

O: Medial iliac crest, sacral crests, angles of R3-12

I: angles of R1-12, TVP of C4-7

Inferior attachment medial; superior attachment lateral

Extension
Lateral flexibility
IL rotation
APT

163
Q

Longissimus

A

Middle erector spinae muscle

Thoracis, cervicis, capitis

O: medial iliac crest, posterior sacrum, TVPs and SPs of L1-5 and TVPs of T1-5, articular processes C5-7.

I: TVPs T1-12, R4-12 (between tubercles and angles), TVPs of C2-6, mastoid process

Extension
Lateral flexion
IL rotation
APT

164
Q

Spinalis

A

Most medial erector spinae muscle

Thoracis, cervicis, capitis

O: SPs T11-L2 and C7, nuchal ligament

I: SPs T4-8, C2.

Extension
Lateral flexion

165
Q

Transversospinalis group

A

Multifidis

Rotatares

166
Q

Most commonly injured nerve in the shoulder

A

Axillary

Anterior dislocation or fracture of head of the humerus

167
Q

Lungs, GB, heart, diaphragm, spleen and elbows can all refer pain to …

A

The shoulder

THE BOARDS (5 decks)

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