PTM - 3 Flashcards
Which ribs are atypical
1, 2, 10, 11, 12
1- short and wide, single facet, scalene tubercle
2- thin, long, tuberosity for serratus anterior
10, single facet head
11, 12 single facet, no neck
Which ribs are atypical
1, 2, 10, 11, 12
1- short and wide, single facet, scalene tubercle
2- thin, long, tuberosity for serratus anterior
10, single facet head
11, 12 single facet, no neck
Lymph drainage of breast
Axillary
Parasternal
Posterior intercostal
Diaphragm origin and insertion
Origin: xiphoid, inner surface of lower 6 ribs
Insertion: Left crus on to L2, Right crus on to L3
Blood supply to spinal cord
Anterior spinal a (vertebral arteries)
Posterior spinal arteries (posterior inferior cerebellar arteries)
Anastamose at conus medullaris
Also segmental arterial supply from radicular arteries (Adamkiewicz)
Where does artery of Adamkiewicz originate from
T8 to L1 on the left of aorta
Could be damaged in AAA repair
Brown sequard cause
Result of hemisection of spinal cord ?direct trauma
Brown sequard syndrome sx
Ipsilaterall weakness, vibration and proprioception loss
Contralateral pain and temp
90% ambulatory by the end of recovery period
Central cord syndrome cause
hyperextension injury especially in elderly with background of degenerative changes such as osteophytes
Compression of spinal cord between lig flavum and intervertebral disc
Central cord syndrome sx
Upper limb weakness worse than lower limb as motor fibres run more centrally within the corticospinal tract
Good recovery
Anterior cord syndrome cause
interruption of blood supply to anterior spinal cord (anterior spinal artery)
How many vertebral bodies are there
33
7 C
12 T
5 L
5 fused sacral
3 fused cocygeal
Sx of anterior spinal cord syndrome
Loss of corticospinal and spinothalamic
Dorsal column unaffected
Lower limb worse than upper limb
10-20 % make recovery
How many vertebral bodies are there
33
7 C
12 T
5 L
5 fused sacral
3 fused cocygeal
Attachments of hip capsule
Proximally: acetabulum
Distally: anterior to intertrochanteric line, posterior 1cm above intertrochanteric crest
Ligaments of hip joint
Ileofemoral (strongest)
Pubofemoral
Ischiofemoral
Origin and insertion of ileofemoral ligament
Acetabulum to intertrochanteric line
Function of ileofemoral ligament
Resists hyperextension
Origin and insertion of psoas major
Deep part from transverse process of L1-4
Superficial head from lateral surface of T12-L4 + intervertebral discs
Inserts on lesser trochanter
Ileotibial band origin and insertion
Anterolateral tubercle of ilac crest on to lateral condyle of tibia
IT band muscles
Gluteus maximus and Tesnor fascia lata
Function of IT band
stabilises knee extension
Important in walking and running
Surface marking of sciatic nerve
Curved line
1- half way between posterior superior iliac spine and ischial tuberosity
2- half way between ischial tuberosity and greater trochanter
Variations of sciatic nerve passage
Most common: under the piriformis in greater sciatic foramen
Sometimes: passes through piriformis
Rarely: splits high with one division passing above and through piriformis
Which leg muscles attach to medial cuneiform bone
Tibialis anterior posterior
Peroneus longus
Origin and insertion of fibularis tetrius
Lower 1/3 of fibula to base of 5th metatarsal
Action of tibialis anterior and posterior
Anterior: dorsi +INVERSION
Posterior: plantar + INVERSION
At what joint does dorsiflexion/plantar flexion occur
tibiotalar
At what joint does inversion/eversion occur
Subtalar
How many arches does the foot have
3
Medial longitudinal
Lateral longitudinal
Transverse
Structures supporting the medial longitudinal arch
Bones: Calcenum, talus, navicular, cunieforms, media 3 metatarsals
Ligament: interosseus, spring lig
Muscles: flexor digitorum longus and brevis, flexor hallucis, tibialis anterior and posterior
Structures supporting lateral arch of foot
Bones: calceneum, cuboid, lateral 2 metatarsals
Lig: Long and short plantar ligaments
Muscle: peroneus longus, flexor digitorum longus and brevis
Structures supporting the transverse arche
Bones: all metatarsals
Ligaments: interosseus
Muscles: Peroneus longus
At what joint does inversion/eversion occur
Subtalar
Action of tibialis anterior and posterior
Anterior: dorsi +INVERSION
Posterior: plantar + INVERSION
Origin and insertion of fibularis tetrius
Lower 1/3 of fibula to base of 5th metatarsal
Surface marking of sciatic nerve
Curved line
1- half way between posterior superior iliac spine and ischial tuberosity
2- half way between ischial tuberosity and greater trochanter
Function of ileofemoral ligament
Resists hyperextension
