Quickfire anatomy Flashcards
1
Q
What are the 4 rotator cuff muscles?
A
Supraspinatus, Infraspinatus, Subscapularis and Teres Minor
2
Q
What does the axillary nerve supply?
A
Motor: Deltoid, teres minor
Sensory: Regimental badge
3
Q
What is the spinal nerve innervation of axillary nerve?
A
C5, C6
4
Q
What does the radial nerve supply?
A
Posterior arm and posterior forearm
5
Q
What is the spinal nerve innervation of radial nerve?
A
C5 - T1
6
Q
What does the posterior interosseous nerve supply?
A
Motor to posterior forearm
7
Q
What does the superficial radial nerve supply?
A
Cutaneous only to dorsum of hand
8
Q
What does musculocutaneous nerve supply?
A
Anterior compartment of the arm
9
Q
What is the spinal nerve innervation of musculocutaneous nerve?
A
C5 - C7
10
Q
What does the lateral cutaneous nerve of the forearm supply?
A
cutaneous only to anterolateral surface of forearm
11
Q
What does the median nerve supply?
A
Forearm: all anterior compartment except 1.5 (FCU and 1/2 FDP)
Hand:
-sensory to lateral aspect of palm and and lateral three and a half fingers on palmar surface
-motor to thenar eminence and lumbricals 1 & 2
12
Q
What is the spinal nerve innervation of the median nerve?
A
C5 - T1
13
Q
What does the ulnar nerve supply?
A
Forearm: FCU and 1/2 FDP
Hand: All intrinsic muscles except thenar eminence and lumbricals 1 & 2
14
Q
What is the spinal nerve innervation of ulnar nerve?
A
C8 and T1
15
Q
What are some symptoms of ulnar nerve lesion?
A
Guttering of hand, unusual limb position, Klumpke’s paralysis
16
Q
What are the muscles in the most superficial layer of anterior compartment of the forearm?
A
Pronator teres, flexor carpi radialis, palmaris longus, flexor carpi ulnaris
17
Q
What muscle is in the intermediate layer of the anterior compartment of the forearm?
A
Flexor digitorum superficialis
18
Q
What muscles are in the deepest layer of the anterior compartment of the forearm?
A
Flexor digitorum profundus, flexor pollicis longus, pronator quadratus
19
Q
What are the muscles in the superficial layer of posterior compartment of forearm?
A
Brachioradialis, extensor carpi radialis longus, extensor carpi radialis brevis, extensor digitorum, extensor digiti minimi, extensor carpi ulnaris, anconeus
20
Q
What are the muscles in the deep layer of posterior compartment of forearm?
A
Supinator, abductor pollicis longus, extensor pollicis brevis, extensor pollicis longus, extensor indicis
21
Q
Draw out the brachial plexus
A
…
22
Q
What is the golden rule of anterior forearm innervation?
A
Everything is median nerve supplied EXCEPT 1.5 muscles:
-Flexor carpi ulnaris (FCU)
-Ulnar half of Flexor digitorum profundus (FDP) to fingers 4 & 5
23
Q
What are the borders of the anatomical snuffbox?
A
Lateral border: abductor pollicis longus tendon and extensor pollicis brevis tendon
Medial border: extensor pollicis longus tendon
24
Q
What passes through the anatomical snuffbox?
A
cephalic vein, radial artery, cutaneous branch of radial nerve
25
What passes through extensor tendon compartment 1 of the wrist?
- Abductor pollicis longus
| - Extensor pollicis brevis
26
What passes through extensor tendon compartment 2 of the wrist?
- Extensor carpi radialis longus
| - Extensor carpi radialis brevis
27
What passes through extensor tendon compartment 3 of the wrist?
-Extensor pollicis longus
28
What passes through extensor tendon compartment 4 of the wrist?
- Extensor digitorum
| - Extensor indicis
29
What passes through extensor tendon compartment 5 of the wrist?
-Extensor digit minimi
30
What passes through extensor tendon compartment 6 of the wrist?
-Extensor carpi ulnaris
31
What problem can happen with extensor wrist compartment 1?
Repetitive movements --> De Quervains tenosynovitis
| "Mommy's thumb"
32
What problem can happen with extensor wrist compartment 3?
EPL can wear on the dorsal radial tubercle and rupture
33
What problem can happen with extensor wrist compartment 6?
ECU can wear on the ulnar styloid process and rupture
34
What are the muscles of the anterior arm compartment?
BBC
Biceps brachii
Brachialis
Coracobrachialis
35
Where is the biceps brachii, what does it do and what is it's innervation?
Anterior arm
Flexes shoulder and elbow, supinates forearm
Musculocutaneous nerve
36
Where is coracobrachialis, what does it do and what is its innervation?
Anterior arm
Adducts arm
Musculocutaneous nerve
37
Where is brachialis, what does it do and what is its innervation?
Anterior arm
Flexes elbow
Musculocutaneous n. & radial n.
38
Where is triceps brachii, what does it do and what is its innervation?
Posterior arm
Shoulder and elbow extension
Radial nerve
39
What muscles cause pronation of the hand?
Pronator teres and pronator quadratus
40
What muscles cause supination of the hand?
Supinator and biceps brachii
41
What can a fracture to the neck of the radius damage?
Posterior interosseous nerve
42
What are the borders of the anconeus triangle?
- Radial head
- Lateral epicondyle
- Olecranon
43
What nerve controls pronation?
Median nerve
44
What nerve controls supination?
Musculocutaneous n. and radial n.
45
What are the borders of the cubital fossa?
lateral border - brachioradialis
superior border - interepicondylar line
medial border - pronator teres
46
What covers the roof of the cubital fossa and what is the purpose of this?
Bicipital aponeurosis
| Protects median nerve and brachial artery
47
What is found in the cubital fossa?
```
From lateral to medial = ‘TAN’
(Tendon, Artery, Nerve)
Biceps Tendon
Brachial Artery
Median Nerve
```
48
What are the muscles of anterior compartment of the thigh?
QUADRICEPS
1) Rectus femoris
2) Vastus intermedius - lies under rectus femoris
3) Vastus lateralis
4) Vastus medialis
5) Sartorius
49
What is the innervation of the anterior compartment of the thigh?
Femoral nerve (L2, 3, 4)
50
What is the function of Sartorius?
Thigh abductor and lateral rotator. (Sartorius runs infero-medially)
51
What are the muscles of the medial compartment of the thigh?
ADDUCTORS
1) Pectineus (Femoral nerve)
2) Adductor longus
3) Adductor magnus
4) Adductor brevis
5) Gracilis
52
What is the innervation of the medial compartment of the thigh?
```
Obturator nerve (L2, 3, 4)
Except pectineus which is innervated by femoral nerve (L2, 3, 4)
```
53
What are the muscles of the posterior compartment of the thigh?
HAMSTRINGS
1) Semimembranosus
2) Semitendinosus
3) Biceps femoris
54
What is the innervation of the posterior compartment of the thigh?
Tibial part of the sciatic nerve (L5, S1, S2)
55
What innervates the short head of biceps femoris?
Common fibular part of sciatic nerve
56
What is the blood supply to the anterior thigh compartment?
femoral artery
57
What is the blood supply to the medial thigh compartment?
obturator artery
58
What is the blood supply to the posterior thigh compartment?
Branches of deep femoral artery (profounda femoris)
59
What are the lateral rotator muscles?
1) Piriformis
2) Superior gemelli
3) Inferior gemelli
4) Obturator internus
5) Quadratus femoris
60
What is the innervation of the lateral rotator muscles?
L4 - S2
61
What is the function of the lateral rotator muscles?
Support and laterally rotate (externally rotate) the hip.
| Help keep hip joint surfaces together.
62
How can a psoas abscess occur and how can it present?
Can track down the fibrous sheath covering psoas producing a femoral triangle swelling that can mimic a femoral hernia
63
What is the function of iliopsoas?
Powerful flexor of the hip
| Note psoas major's attachment to lumbar vertebrae - hip flexion can exacerbate back pain
64
What is the innervation of iliopsoas?
L1, 2, 3
65
Where does the iliopsoas tendon attach and what can happen to it?
Iliacus attaches to lesser trochanter.
Can be subject to avulsion fracture.
Iliopsoas tendon inflammation can cause groin pain.
66
What can happen if the lateral cutaneous nerve of the thigh (LCNT) gets compressed?
Meralgia Paraesthetica
67
What does the femoral triangle contain?
(from lateral to medial) femoral nerve, femoral artery, femoral vein, lymph vessel
68
Where does the femoral artery enter the femoral triangle?
At the midinguinal point +/- 1.5cm
69
Where is the midinguinal point?
Halfway between ASIS and the pubic symphysis
70
How do the femoral vessels and the saphenous nerve pass from the anterior thigh to the popliteal fossa?
The femoral vessels and saphenous nerve enter the subsartorial/adductor canal and then pass into the popliteal fossa
71
Where is the adductor (subsartorial) canal and what does it contain?
Runs deep to sartorius in the middle 1/3rd of the medial thigh to the adductor hiatus.
Contains superficial femoral artery, femoral vein & saphenous nerve.
72
What is the adductor hiatus?
Hole in adductor magnus through which the femoral artery and vein pass to reach the popliteal fossa
73
What does the saphenous nerve innervate?
Innervates knee & skin of medial leg and foot
74
Where does the horizontal group of superficial lymph nodes sit?
Sit below inguinal ligament
75
Where does the vertical group of superficial lymph nodes sit?
Follow proximal part of great saphenous vein
76
What do the inguinal lymph nodes drain?
```
Lower limb
Perineal region
Penis
Lower anal canal
Lower vagina
Anterior labia majora / scrotal skin
```
77
What passes anteriorly to the medial malleolus?
Long saphenous vein and saphenous nerve
78
What passes posteriorly to the lateral malleolus?
Short saphenous vein and sural nerve
79
What can happen following excess inversion of the foot?
Avulsion fracture of the lateral malleolus
| Damage to the lateral collateral ligaments
80
Where can you find the knee joint line?
Knee joint line is palpable anteriorly and sits ~2cm distal to the skin crease behind the joint
81
What is the shape of the femoral condyles?
J-shaped condyles
82
What are the 3 separate articulations of the knee joint?
x2 femero-tibial, x1 femero-patellar
83
What does the popliteus do?
Unlocks a fully extended knee by laterally rotating the femur on the tibia
84
What is the innervation of the popliteus?
Tibial nerve L5, S1
85
What muscles cause ankle dorsiflexion?
Tibialis anterior, Extensor Hallucis Longus and Extensor Digitorum Longus
86
What muscles cause ankle plantarflexion?
Gastrocnemius
Soleus
Flexor Digitorum Longus & Flexor Hallucis Longus
Fibularis Longus & Fibularis Brevis
87
What are the muscles of the anterior leg compartment?
Tibialis anterior L4
Extensor digitorum longus L5
Extensor hallucis longus L5
88
What can happen with a loss of function of the anterior leg compartment?
inability to point toes at ceiling and foot drop. Collapse of arches of the foot.
89
What is the function of the anterior leg compartment?
Foot and digit dorsiflexion
| Foot inversion
90
What is the innervation of the anterior leg compartment?
Deep fibular nerve (L4, 5, S1)
91
What is the innervation of the lateral leg compartment?
Superficial fibular nerve (L5, S1)
92
What are the muscles of the lateral leg compartment?
Fibularis longus, Fibularis brevis
93
What is the function of the lateral leg compartment?
Weak plantarflexion.
Foot eversion.
Resists excess foot inversion
Protects lateral collateral ligament from excess stress during inversion of the foot.
Help balance body on foot during stance phase and help guide placement during gait.
94
What is the innervation of the posterior leg compartment?
Tibial nerve
95
What is the function of the posterior leg compartment?
Foot + digit plantarflexion
Foot inversion
Supports the arches of the foot
96
What are the muscles of the posterior leg compartment?
1) gastrocnemius S1, S2
2) Plantaris S1, S2
3) Soleus S1, S2
4) Popliteus
5) Tibialis posterior L4, L5
6) Flexor digitorum longus S1, S2
7) Flexor hallucis longus S1, S2
97
Where does the sciatic nerve normally divide into the tibial and common fibular nerves?
Proximal to knee joint line
98
What can a supracondylar fracture of the femur damage?
The neurovascular bundle in the popliteal fossa
99
What are the structure in the popliteal fossa?
popliteal artery (deep), popliteal vein, tibial nerve (superficial)
100
What nerve passes close to the fibula head?
Common fibular nerve
101
What are the borders of the popliteal fossa?
Semimembranosus and semitendinosus
Biceps femoris
Gastrocnemius medial head
Gastrocnemius lateral head
102
Draw out the lumbar plexus
.
103
Where is the saphenous opening?
1-4cm lateral and 0-3cm inferior to the pubic tubercle
104
Where can the posterior tibial artery pulsation be palpated?
Pulsation is palpated ~1/3rd of the way back along a line passing between the medial malleolus & the top of the calcaneus
105
What is found in the tarsal tunnel?
```
Tibialis posterior
Flexor digitorum
Posterior tibial artery
Vein
Tibial nerve
Flexor hallucis longus
```
106
What bones meet at the ankle joint?
talus, tibia and fibula
107
How many distinct bands of ligamentous fibres make up the medial collateral ligament of the ankle?
4
108
How many distinct bands of ligamentous fibres make up the lateral collateral ligament of the ankle?
3
109
What is the most commonly injured ligament of the ankle and how is it injured?
Anterior talofibular ligament (ATFL)
| via excess inversion & plantarflexion
110
What are the Ottawa rules for ANKLE x-ray?
X-ray is only required if there is pain in malleolar zone AND
Bone tenderness at the posterior edge or tip of the medial malleolus
OR
Bone tenderness at the posterior edge or tip of the lateral malleolus
OR
An inability to bear weight both immediately and in the ED for 4 steps
111
What are the Ottawa rules for FOOT x-ray?
X-ray is only required if there is any pain in the midfoot zone AND
Bone tenderness at the base of the fifth metatarsal
OR
Bone tenderness at the navicular
OR
An inability to bear weight both immediately and in the ED for 4 steps
112
Where do the movements of foot inversion and eversion take place?
At the subtalar joint (plane synovial joint between talus and calcaneus) and at the talocalcaneonavicular joint (ball and socket between talus, calcaneus and navicular)
113
What is a Maisonneuve fracture caused by?
Forced external rotation of the foot
114
What is a Lisfranc fracture?
Lisfranc ligament is a tough band of tissue that joins tarsal and metatarsal bones. Lisfranc fracture can be a break in a bone in the Lisfranc joint or an avulsion fracture.
115
What are the functions of the foot arches?
1) Allow the foot to support the weight of the body in the erect posture with the least weight
2) Allows foot to act as a spring, absorbing the shock produced during locomotion
116
What muscles support the medial foot arch?
Tibialis anterior + posterior, Fibularis longus, flexor digitorum longus, flexor hallucis and intrinsic foot muscles
117
What muscles support the lateral foot arch?
Fibularis longus, flexor digitorum longus and intrinsic foot muscles
118
What muscles support the transverse foot arch?
Fibularis longus and tibialis posterior
119
Which bones form the medial foot arch?
Metatarsal x3, cuneiform x3, navicular and talus
120
Which bones form the lateral foot arch?
4th and 5th metatarsals, cuboid and calcaneus
121
Which bones form the transverse foot arch?
Metatarsal bones x5, cuneiform bones x3 and cuboid
122
Define valgus
the distal part of the distal bone contributing to a joint is directed away from the midline
123
Define varus
the distal part of the distal bone contributing to a joint is directed toward the midline
124
How many compartments is the plantar foot separated into?
The plantar foot is separated into four compartments
125
What is the sensory innervation of the plantar foot?
```
Saphenous
Medial plantar
Lateral plantar
Sural
Tibial
```
126
What is the sensory innervation of the dorsal foot?
Sural
Superficial fibular
Saphenous
Deep fibular
127
Why does plantar fasciitis occur and what can exacerbate it?
Occurs due to overuse/trauma.
| Pain is exacerbated by passive digit dorsiflexion or pressure over medial calcaneal tubercle.
128
What is the innervation of the intrinsic muscles of the foot?
Medial & lateral plantar nerves S1,2 from tibial nerve
129
What is the function of the intrinsic muscles of the foot?
- Support the foot arches
- Act as ’dynamic ligaments’ (store and release energy)
- Support digits & great toe at push-off
130
What is the function of the flexor hallucis longus tendon?
Very strong flexor of big toe. Needed for toe-off during walking
131
What are the 4 phases of walking?
Heel strike, support, toe-off, swing/carry through
132
How many layers are the intrinsic muscles of the plantar foot separated into?
4 layers
133
What is Morton's neuroma?
Very painful growth on a digital nerve passing between digits 3 and 4 of the foot
134
What happens if lateral pectoral nerve is damage?
Loss of clavicular head of pectoralis major
135
What happens if suprascapular nerve is damaged?
Supraspinatus & infraspinatus; Damage limits lateral shoulder rotation & shoulder stability
136
What happens if dorsal scapula nerve is damaged?
Functioning of the rhomboids & levator scapulae is affected
137
What happens if you damage the long thoracic nerve?
The scapula ‘wings’ (axillary region surgery; incorrect thoracostomy/ thoracotomy incision)
138
What happens if the medial pectoral head is damaged?
Loss of sternal head of pec major & pec minor.
139
What does upper subscapular nerve innervate?
Subscapularis
140
What does thoracodorsal nerve innervate?
Latissimus dorsi
141
What does lower Subscapularis nerve innervate?
Subscapularis and teres major
142
Define dermatome
An area of skin innervated by a single spinal nerve
143
Define a cutaneous nerve area
Area of skin innervated by a named cutaneous nerve
144
What are the borders of the femoral triangle?
Inguinal ligament, sartorius, adductor longus
145
What is Hilton's law?
A mobile joint is innervated by the nerve innervating the muscle acting on the joint and also the nerve innervating the skin covering the joint – This can be a mechanism for pain referral
146
Where can ovarian cysts/ tumour/ovulation refer pain?
Can compress Obturator nerve and result in hip, medial thigh or knee pain
