Quiz 3 Flashcards
1
Q
Facial Nerve, CN VII
A
- muscles of facial expression
- taste to anterior part of tongue
- into face through auditory meatus (ear opening)
2
Q
Muscles of Facial Expression
A
- occipitofrontalis: front of forehead
- orbicularis oris: sphincter of mouth
- mentalis: raise and protrude lower lip
- buccinator: suck in cheeks
- orbicularis oculi: closes eyelids
- nasalis: pulls up skin of nose
- auricular superior, middle, inferior
- risorius: elevates angle of mouth, smile
- levator labii superioris: elevates upper lip
- depressor labii inferioris: pulls down lower lip
- platysma
3
Q
Trigeminal Nerve, CN V
A
- sensation to face; has 3 branches: ophthalmic, maxillary (upper jaw/nose), and mandibular (lower jaw)
- motor to muscles of mastication: masseter, temporalis, medial pterygoid, lateral pterygoid
- trigeminal neuralgia: face is in pain, usually unilateral, could be just one or all of the branches or combinations there of
4
Q
Lateral Pterygoid
A
- pulls head of mandible forward and shoves it down when you open your mouth really wide
- has a disc in this joint and it glides when mandible moves forward
- sometimes it audibly pops
5
Q
Temporomandibular Joint
A
- TMJ: synovial joint capsule, synovial lining
- temporal bone (upper jaw): mandibular fossa, articular eminence
- mandible (lower jaw): head, neck, body, coronoid process
- disc: retrodiscal ligaments, retrodiscal fat pad (often becomes inflamed)
- covered in articular cartilage to allow disc to slide forward; if disc comes past articular eminence jaw can get stuck and cause other issues or pain
- has capsular ligament and superior and inferior retrodiscal ligaments (look at picture to determine function)
6
Q
Musculature-Closing
A
- temporalis: closes, pulls mandible superiorly and retrusion
- masseter: closes, pulls mandible superiorly and retrusion
- medial pterygoid: pulls mandible posteriorly, lateral deviation
7
Q
Musculature-First Half of Opening
A
- infrahyoids: pull hyoid down and stabilizes
- suprahyoids: pulls mandible inferiorly
8
Q
Musculature-Second Half of Opening
A
-lateral pterygoid: pulls condyle and disc anteriorly as hyoids continue to pull mandible inferiorly
9
Q
Skull Bones
A
- focus on these
- frontal
- zygomatic
- parietal
- temporal
- mandible
- occipital
10
Q
Joints of Skull
A
- synostosis: two bones that begin as separate but eventually fuse as one
- cranial plates fuse together
- cranial sutures: held together by sharpe’s fibers
11
Q
Hemi-Pelvis or Pelvic Innominate
A
- ilium, ischium, pubis: fuse at end of teenage years
- acetabulum: hip joint socket; articulates with femoral head; has contributions from all three bones that make up pelvis
- all 3 bones contribute to acetabulum
12
Q
Ilium
A
- Ala or wing of ilium
- ASIS
- AIIS
- PSIS
- PIIS
- Iliac Crest: from ASIS to PSIS
- iliac fossa
- greater sciatic notch: becomes foramen when ligaments attach
- lesser sciatic notch: becomes foramen when ligaments attach
- gluteal line: posterior (maximus), anterior (medius), inferior (minimus)
13
Q
Ischium
A
- ischial tuberosity: can be fractured, also have bursa in here that you can get bursitis if you sit on hard surfaces for long periods of time
- ramus
- obturator foramen: obturator membrane, obturator nerve
- ischial spine: separates the greater from the lesser sciatic notch and therefore the greater and lesser foramen
14
Q
Pubis
A
- superior ramus
- inferior ramus
- pubic tubercle
- pubic symphysis: fibrous joint, similar to disc in back but without nucleus, has some shock absorbing properties
15
Q
Sacrum
A
- triangular shaped bone of 5 fused vertebra
- links spine to pelvis
- sacral canal: passageway for cauda equina
- sacral foramen: exit point for sacral nerve roots
- apex: inferior base: superior
- ala
16
Q
Coccyx
A
- 4 rudimentary vertebra
- base superior
- apex inferior
17
Q
Sacroiliac Joint
A
- part synovial, part fibrous joint
- contains articular cartilage and fibrocartilage
- very stable: little movement
- interlocking ridges and depressions on joint surfaces
- has nerve endings and can cause pain
18
Q
Sacroiliac Ligaments
A
- anterior SI
- posterior SI: thicker, more dominant, multidirectional tolerates forces from many directions
- sacrotuberous: sacrum to ischial tuberosity
- sacrospinous: sacrum to spine of ischium; separates greater from lesser sciatic foramen
- interosseous sacroiliac: within the joint
19
Q
Proximal Femur
A
- head
- neck
- greater trochanter
- lesser trochanter
- intertrochanteric crest
- intertrochanteric line
- gluteal tuberosity
- femur is anteverted natural twisting to the medial side, also bows out anteriorly
20
Q
Hip Joint Capsule
A
-from acetabulum to neck of the femur and intertrochanteric line
21
Q
Iliofemorial Ligament
A
- AIIS and acetabulum to intertrochanteric line anteriorly
- looks like inverted Y
- also known as the Y ligament of Bigalow
- taut in extension
22
Q
Ischiofemoral Ligament
A
- ischial part of acetabulum from posterior to anterior
- taut in hip extension
23
Q
Pubofemoral Ligament
A
- from pubic bone anterior to blend with iliofemoral ligament
- taut in hip extension
24
Q
Ligament to the Head of Femur
A
- from margins of acetabular notch to pit of femoral head
- fovea contains small artery
25
Q
Transverse Acetabular Ligament
A
-across acetabular notch
26
Q
Labrum of Hip
A
-fibrocartilaginous ring that attaches to rim of acetabulum and acetabular ligament
27
Q
Piriformis Syndrome
A
- compression of sciatic nerve that runs right underneath the muscle
- pain and paresthesia to leg
28
Q
What comes out of greater sciatic notch?
A
-superior and inferior gluteal nerves
29
Q
What comes out of lesser sciatic notch?
A
- pudendal nerve
- does rectal genital region
- comes off lower sacral nerve roots
30
Q
IT Band
A
- iliac crest to gerdy’s tubercle of tibia
- dense irregular connective tissue
- tensor fascia latae and gluteus maximus attach
- crosses greater trochanter and lateral knee
- covers greater trochanteric bursa
- covers gluteus medius
- runs across lateral epicondyle of knee-can cause pain for runners
31
Q
Posterior Compartment
A
- separated from anterior compartment by lateral and medial intramuscular septa
- hamstrings
- adductor muscles can also be included here
- intermuscular septa separate these; in between muscle groups is this heavy duty fascia
32
Q
Sciatic Nerve
A
- sole posterior deep nerve of thigh
- enters thigh by passing just lateral to ischial tuberosity and runs straight down middle of thigh
- branches into common peroneal (fibular) nerve and tibial nerve along popliteal fossa
- makes exit through greater sciatic foramen
- travels under piriformis and over top of deep external rotators of hip
- continues down posterior thigh and gives no branches in gluteal region
33
Q
Hamstring Blood Supply
A
- inferior gluteal artery (branch of internal iliac artery)
- obturator artery (branch of internal iliac artery)
- perforating branches of deep femoral artery (major branch of femoral artery) circumflex branches come off of deep femoral
- branches of popliteal artery (continuation of femoral artery)
34
Q
What are the four primary arteries that come of internal gluteal artery?
A
- superior gluteal
- inferior gluteal
- obturator
- pudendal
35
Q
Nervous Supply Gluteal Region
A
- sacral plexus supplies muscles of gluteal region
- forms sciatic nerve that runs through the gluteal region to supply the posterior muscles of the thigh and all the muscles below the knee
- passes through greater sciatic foramen
36
Q
Nerves of Gluteal Region
A
- most emerge through greater sciatic foramen, which is in close contact with piriformis
- only superior gluteal nerve passes superior to piriformis
- others typically first appear below piriformis
37
Q
Superior Gluteal Nerve
A
- emerges through greater sciatic foramen superior to piriformis muscle; no sensory
- runs between and supplies both gluteus medius and minimus
- continues beyond these muscles and eventually enters TFL
38
Q
Inferior Gluteal Nerve
A
- emerges through greater sciatic foramen inferior to piriformis
- no sensory
- supplies gluteus maximus
39
Q
Nerve to Obturator Internus
A
- emerges from greater sciatic foramen inferior to piriformis close to ischial spine
- also sends branch to superior gemellus
40
Q
Nerve to Quadratus Femoris
A
- runs deep to two gemelli and obturator internus
- also sens branch to inferior gemellus
41
Q
Glunial Nerves
A
-superior, middle, and inferior sensation to skin of buttock; not a branch of femoral nerve
42
Q
Posterior Cutaneous Nerve to Thigh
A
- travels through greater sciatic foramen and under gluteus maximus and medial to sciatic nerve
- not a branch of femoral nerve
- gives off branch to skin of lower gluteal
- continues to travel to posterior thigh
43
Q
Pudendal Nerve
A
- treavels through lesser sciatic foramen to perineal region (anus and external genitals)
- provides cutaneous sensation to genitalia
44
Q
PICTURES
A
-know schematics of which nerve does sensory to which portions of the lower limb
45
Q
Arteries of Gluteal Region-Superior Gluteal Artery
A
- all originate off internal iliac artery
- superior gluteal artery travels through greater sciatic foramen over the piriformis
- supplies gluteus medius, gluteus minimus, and TFL (same structures nerve did)
46
Q
Inferior Gluteal Artery
A
- travels through greater sciatic foramen, under the piriformis
- supplies gluteus maximus, obturator internus, quadratus femoris, and superior hamstrings
47
Q
Internal Pudendal Artery
A
- travels through greater sciatic foramen with nerve
- supplies genitalia
48
Q
Anterior Compartment of Thigh
A
- quadriceps
- sartorius
49
Q
VMO and Q Angle
A
- where tibia and femur come together
- fibers don’t run straight up and down in distal muscle, run at angle as they go to patella
- pulls patella more medially providing stabilization, good for people who have extra valgus at knee joint
- Q angle=quadriceps pull angle up to ASIS
- women have more of an angle means it wants to drift even more laterally but good VMO will pull patella more centrally again and would help it from becoming an issue
50
Q
Nerve Supply to Thigh-Lumbar Plexus
A
- collection of nerve roots and peripheral nerves in lumbar region
- formed by ventral divisions of L1-L4
- nerves of lumbar plexus pass in front of hip joint and mainly supply anterior part of thigh
- innervates muscles and skin on anterior and medial sides of thigh
- similarly, sacral plexus supplies posterior skin and muscles of thigh as well as muscles of gluteal region
- because lumbar and sacral plexuses are connected, and both innervate primarily lower limb they are often called lumbosacral plexus
51
Q
Lumbar Plexus Trail
A
- plexus formed lateral to intervertebral foramina and passes through psoas major
- leaves pelvis under inguinal ligament with exception of obturator nerve which exits pelvis through obturator foramen
52
Q
Femoral Nerve
A
- passes over iliopsoas and underneath inguinal ligament
- innervates all muscles in anterior compartment (sartorius, quadriceps, iliacus, pectineus)
- cutaneous branches include: anterior femoral cutaneous and spahenous nerves
53
Q
Adductor Canal
A
-under vastus medialis you have femoral artery, vein, and what’s left of femoral nerve which is mostly saphenous branch
54
Q
Geniotfemoral Nerve
A
- runs anteriorly over psoas major and through inguinal canal
- to the scrotum or labia majora and some of skin of upper anterior surface of thigh
55
Q
Ilioinguinal Nerve
A
-skin below inguinal ligament
56
Q
Femoral Artery
A
- distal continuation of external iliac artery
- passes underneath inguinal ligament to become femoral artery
- main branch supplies quadriceps
- then at leas one large branch, the deep artery (profunda femoris or deep femoral artery)
57
Q
Deep Profundus of Femoral Artery
A
- close to its origin, deep artery of thigh usually gives off two branches lateral and medial circumflex arteries
- these encircle femoral head to anastomosis
- deep artery of thigh runs distally and anterior to pectineus, adductor brevis, and adductor magnus and posterior to adductor longus
- gives off series of branches that go through adductors brevis and magnus close to femur and supply hamstrings
58
Q
Femoral Artery
A
- after giving off deep artery of thigh, it continues down anteromedial thigh between quads and adductors
- lays in adductor canal (artery is under vastus medialis and under that is adductor longus) these muscles make up canal
- then passes through adductor hiatus (opening in distal adductor magnus) in the insertion of adductor magnus and reaches posterior aspect of lower part of thigh
- known as popliteal artery here
59
Q
Veins of Thigh
A
- superficial: saphenous vein
- deep: femoral vein, deep femoral vein
- communicating branches between superficial and deep
60
Q
Femoral Triangle
A
- space in proximal part of anterior compartment of thigh
- borders: superior-inguinal ligament; lateral-sartorius; medial-adductor longus
- contents: femoral nerve, femoral artery, femoral vein, lymph nodes
- from lateral to medial=NAVL
61
Q
Femoral Sheath
A
- sleeve around proximal parts of femoral artery and vein
- extension of abdominal fascia
- can get femoral hernia here
62
Q
Inguinal Ligament
A
- pubic tubercle to ASIS
- same bone to same bone so even though its going over a joint, its not actually crossing it so you can’t tension it
- forms a kind of tunnel where lots of things go under
- blends with aponeurosis to external oblique
- pass deep to psoas major, iliacus, pectineus, femoral artery, nerve, vein, and lymphatics and lateral femoral cutaneous nerve
63
Q
Muscles Borders of Femoral Triangle
A
- sartorius: ASIS to pes anserine
- adductor muscles: pubic bone to medial femur
- iliopsoas: hip flexors from lumbar spine and anterior ilium to lesser trochanter
- pectineus: pubic bone to medial anterior femur
64
Q
Femoral Artery in Regards to Femoral Triangle
A
- comes from external iliac artery then branches into femoral and then has branches of femoral artery in femoral triangle: superior circumflex iliac artery, superior epigastric artery, external pudendal, collectively these supply groin and external genitalia
- profunda femoris: chief source of blood to hamstrings; branch of femoral: lateral and medial femoral circumflex arteries and genicular artery
65
Q
Saphenous Vein
A
- runs by itself
- branches off femoral vein
- usually where you get varicose and spider veins
66
Q
Adductor Hiatus
A
- opening adductor magnus for transmission of femoral artery and vein to pass behind the knee (popliteal region) and become popliteal artery and vein
- femoral artery and vein come through femoral triangle, canal, then hiatus then changes name to popliteal
- saphenous nerve at end of canal went superficial into skin of medial side of knee all the way to medial foot: strictly sensory, no motor
67
Q
Obturator Nerve
A
- through psoas major through obturator foramen into obturator canal
- innervates obturator externus, adductor longus, adductor brevis, adductor magnus (part), gracilis, pectineus (part), and skin over adductor region
68
Q
Obturator Artery and Vein
A
- branch of internal iliac artery
- through obturator foramen into obturator canal
69
Q
Blood Supply
A
- obturator is main blood supply to adductors but have some assistance from other arteries
- obturator externus and pectineus: obturator and medial circumflex arteries (comes off deep femoral)
- gracilis: obturator artery
- adductor longus and brevis: obturator and deep femoral arteries
- adductor magnus: obturator, deep femoral, and medial circumflex femoral arteries
70
Q
Common Iliac Artery
A
- off abdominal aorta
- splits into internal iliac artery and external iliac artery
- external iliac: under inguinal ligament to become femoral
- internal iliac: through obturator foramen to become obturator artery
