Random Cards Flashcards
Where can u palpitate the following arteries
Femoral artery
Popliteal artery
Dorsalis pedis artery
posterior tibial artery
Femoral artery - groin
Popliteal artery - back of knee
Dorsalis pedis artery (dorsum of foot)
Medial ankle = posterior tibial artery
Skin direction is what
Skin is anisotropic, which means that it stretches more in one direction than other directions.
In skin The lines in which skin stretches the least (tension lines) are known as
Langer’s lines (cleavage lines).
Borders of Snuff Box
formed by the tendons of the extensor pollicis brevis and abductor pollicis longus (lateral) and the extensor pollicis longus (medial)
In terms of hip placement how does posterior vs anterior hip dislocation present
Posterior:
Internally R hip and shortened
Anterior
Externally R hip and abducted (lengthened, or appear as normal)
What nerve and artery are at greatest risk during anterior dislocation of humerus
Quadrangular space
so Axillary nerve and Posterior Circumflex Humeral Artery
As the Quadrangular space is formed by the Teres minor
Types of joints and examples for each
Synovial:
- Plane: Vertebrocostal joints
-Hinge: Knee
-Pivot: Radioulnar Joint
-Condyloid: Metacarpophalangeal
-Saddle: Radiocarpal joints
- Ball and socket: Shoulder
Cartilaginous: NO Synovial
- Synchondrosis: Epiphyseal plate
-Symphysis: Pubis symphysis
Fibrous:
- Suture: Coronal suture
- Syndesmosis: Distal tibiofibular joint
- Interosseous Membrane: Between Tibia and fibula
how to draw the lines for each section for axiliary artery
Each section is numbered to how many bracnhes they have so section 1 = superior thoracic
Section 2 = thoracioacriomal and lateral
Section 3 = thoracodorsal, Anterior and posterior humeral artery
Differences between LCL and MCL other than location
The MCL blends in with the underlying joint capsule and attaches to the Medial Meniscus, making it less mobile than the Lateral Meniscus.Whereas, the LCL does not attach onto the lateral meniscus and is discrete from the joint capsule
The MCL prevents the knee from going into valgus alignment, whereas the LCL prevents the knee from going into varus alignment
Identify the structures passing posterior to the medial malleolus. In what order do they run (anterior to posterior)?
- tibialis posterior tendon
-flexor digitorum tendon
- posterior tibial artery
-posterior tibial vein
- tibial nerve
- flexor hallucis tendon
Which nerve supplies sensation to the medial dorsal aspect of the great toe? What is this a branch of?
Medial Plantar Nerve. Branch of the tibial nerve
Where would you locate the Tibialis Posterior tendon and how would you test its integrity?
It is just posterior to the medial malleolus, between it and the posterior tibial artery where apulse can be felt. The test would be trying to invert the foot, and if the foot cannot do this but is dorsiflexed, TA is working but TP is not, and as both need to work to invert the foot then you know that TP is not working.
What direction must a force be directed to damage MCL? LCL? ACL? PCL?
MCL - force applied to the latearl side
LCL - force applies to the medial side
ACL - force applied posterior tiabia
PCL - Force appleid anterior tibia
As ACL prevents forward movement so needs force from behind knee to overstrech the ACL in prevnting foward motion.
What are the postential causes of a foot drop (inability to dorsiflex at the ankle)?
Deep peroneal nerve damage - anywhere along the sciatic nerve or common peroneal nerve
Damage to the dorsiflexor muscles - tibalis anterior, EDL EHL and peroneus tertius
Damage to the L4/5 nerve roots
CNS problem
Spinal cord injury at L3 or above
injury of the extensor muscles (anterior compartment) of the leg which includes the tibialis anterior, extensor digitorum longus, extensor hallucis longus and peroneus tertius.
injury or trauma to the nerve that innervates the muscles of the anterior compartment of the leg which is the deep peroneal nerve or the common peroneal branch causes footdrop.
anterior tibial artery that supplies blood to the anterior compartment of the leg.
Cervical vertebrae can be distinguished from thoracic and lumbar vertebrae by the presence of
One foramen in each transverse process
what are the two definitive features that make Thoracic vertebrae distinguishable from vertebra in other regions of the column
presence of costal facets on the vertebral bodies and transverse processes for rib articulation
heart-shaped vertebral body.
Stretch reflex process
c. Stretch of a muscle.
(This is the initial stimulus that activates muscle spindles.)
b. Action potentials are transmitted through ‘Ia’ afferents.
(Sensory information from the spindle is sent to the spinal cord.)
e. Action potentials are transmitted through axons of alpha motoneurones.
(Motor neurons in the spinal cord are activated.)
a. Acetylcholine (ACh) released from pre-synaptic terminals of the alpha motoneurone evokes an ‘end plate potential’ (EPP) in the muscle fiber.
(Neurotransmitter release leads to muscle fiber activation.)
d. Contraction of extrafusal muscle fibres.
(The final motor response.)
Steps of reverse myotactic
b. Activation of Golgi tendon organs.
(This detects increased tension in the muscle.)
d. Action potentials are transmitted through ‘Ib’ afferents.
(The signal is sent to the spinal cord.)
a. Excitatory neurotransmitter (glutamate) released from pre-synaptic terminals of ‘Ib’ afferents evokes an EPSP in ‘Ib’ inhibitory interneurone.
(This activates inhibitory interneurons.)
e. Inhibitory neurotransmitter is released from inhibitory (Ib) interneurones evokes an IPSP in the cell body of alpha motoneurone.
(This inhibits the motor neuron.)
c. Relaxation of extrafusal muscle fibres.
(The muscle relaxes to reduce tension.)
events involved in the ‘flexion (withdrawal) reflex’
Activation of nociceptors.
Action potentials are transmitted by type III and IV afferent fibres.
Excitation of interneurones in multiple spinal segments.
Action potentials are transmitted through axons of alpha motoneurones
Contraction of muscles (flexors).
What XRAY view for patella fracture
Skyline
What spinal nerve does the
Sciatic
Femoral
Obturator nerves stem from
Femoral L2-L4
Obturator nerve L2 - L4
Sciatic (L4 - S3)
How does each nerve enter from the spine to the compartment they need to get to and what do they branch into
Femoral
Sciatic
Obturator
Femoral Nerve:
Enters through pelvis and enters thigh under
inguinal ligament.
- Split immediately into anterior cutaneous nerves to supply the anterior thigh nerve sensation
- Saphenous nerve at/just below knee joint which supplies the medial LEG and skins the medial aspect of foot (BUT NO TOES) ALSO runs with great saphenous vein
- Obturator nerve
Travels around the pelvis to enter thigh under
through the obturator foramen. - Supplies muscular branches to medial compartment muscles thigh muscles
- Also innervates small area of skin on medial thigh via cutaneous branch
**sitting on adductor brevis
Sciatic Nerve
- Exits from pelvis via greater sciatic foramen and Lies on posterior Adductor magnus
-Emerges under the lower border of piriformis
- Divides in the posterior
thigh into its two terminal branches, the Tibial
nerve and the Common Peroneal nerve
What does the peroneal nerve split into
AND
what does each branch supply in the foot
Superficial and Deep
- Superifical enters the lateral compartment and supplies both muscles (Perneous longus and brevis)
- This nerve then continues as a cutaneous nerve, supplying the skin of the anterior leg and most of the dorsum of the foot
2.
Tibial nerve passes between two heads of?
Gastrocnemious
What does Sural nerve supply
skin to the lateral and
posterior sides of the inferior leg and heel.
Draw the cutaneous feelings on the foot
Desktop picture
Colourful foot
The larger Medial Plantar nerve supplies skin to most of the sole of the foot (think of as median nerve which supplies the medial 3.5 toes)
The smaller Lateral Plantar nerve innervates a strip of skin on the lateral border of the sole and lateral 1½ toes (think of as ulnar nerve)
What is specific to the 1 and 2 Metatarsals
- blood and nerve supply
Blood: Dorsalis Pedis
Nerve: Deep peroneal nerve
Label the cross section anatomy of the thigh
Answer and Test folder NAMED REVISION
Where does Tibialis A and P attach to?
Attach on the base 1st MT and medial cuneiform
Describe the anastomose’s of the femoral head creating blood flow
The profunda femoris creates a medial and lateral circumflex vessels which wrap around the femur head (lateral = anteriorly and medial = posteriorly) this forms a LATERAL ANASTOMOSIS
- also anastomose with gluteal vessel anastomses
Worst type of femur fracture type
Subcapital as this will disrupt the reticular vessels
Where does gluteal arteries arise from
Internal iliac arteries
Leave through superior and inferior sciatic foramen
Why is the gluteal region great for injections
and where should u give injection and WHY
provides a large muscular
area for venous absorption.
Lateral upper side to AVOID SCIATIC NERVE
What can hamstring injuries cause
Avulsion of ischial tuberosity
What position is the hip when posteriorly dislocated
hip flexed, adducted and
internally rotated
When is an oblique view of hand best?
When is ball catcher view the best
Clinical cause for types of views
Oblique:
Better view of metacarpals, particualry 4 and 5 MC
-Suspected fractures
Ball catcher view
Good for PIP and DIP
-Suspected RA
Female vs male hips on XRAY
Middle is more circle shape in ffemale and the ilium is more wide and open and is pubic symphysis
For each of the main upper limb nerves that pass through the forearm, describe the
best way to test if sensory information from the hand is still functioning. Include the
name of the specific sensory nerve that is tested.
- Median Nerve
Best test location: Tip of the index finger (palmar side)
Specific sensory nerve: Palmar digital branches of the median nerve
Why: This area is reliably innervated by the median nerve and not overlapped by other nerves.
- Ulnar Nerve
Best test location: Tip of the little finger (palmar side)
Specific sensory nerve: Palmar digital branches of the ulnar nerve
Why: This spot is exclusively supplied by the ulnar nerve, making it ideal for testing.
- Radial Nerve
Best test location: Dorsum of the first web space (between thumb and index finger)
Specific sensory nerve: Superficial branch of the radial nerve
Why: This area is solely innervated by the radial nerve, avoiding overlap with median or ulnar nerves.
What is boxers fracture
Fracture of 5th MC
You suspect the some of the muscles that attach to the dorsal digital expansion hood (DDEH)
of the 4th digit are damaged. In order to test the extent of the damage, list the muscles that
attach to the 4th DDEH and for each muscle provide its primary action on the digit.
- do for lumbricals, dorsal and palmar interossei
4th Lumbrical
Flexes MCP, extends PIP and DIP
3rd
Dorsal interosseous
Abducts 4th digit; assists MCP flexion & PIP/DIP extension
Palmar interosseous (if present) Adducts 4th digit; assists MCP flexion & PIP/DIP extension
Which nerves and arteries (total 4) are at the greatest risk from the comminuted fractures of
the forearm bones?
Median nerve
Ulnar Nerve
Radial A
Ulnar A
Radial Nerve is more superifical (less close to bone) so at LESS RISK
What does the epiphyseal line represent?
It marks the point where the epiphysis (the end of the bone) meets the metaphysis (the growth area) and indicates the bone has stopped growing in length. While the epiphyseal plate is responsible for longitudinal bone growth,
In which directions is the disc herniation most likely to occur?
Posterior-lateral
Why is back pain so hard to localise?
- Segmented Nerves (sinuvertebral is the meningeal branches of the spinal nerve) have up to 3 levels of overlap
- Non-segmented (sympathetic chain) is a sensory pathway from lower discs to upper discs.
Spinal nerve orgins of the main nerves:
Sciatic
Femoral
Obturator
Saphenous
tibial
Common peroneal
Inferior Gluteal
Superior gluteal
Sciatic: L4-S3
Femoral: L2-L4
Obturator: L2-L4
Saphenous: L3-L4
tibial L5-S2
Common peroneal N. L4-S2
Inferior Gluteal: L5-S2
Superior gluteal L4-S1
OA vs RA
OA:
not a wear tear disease, active
slow chronic inflammatory condition, so with repetitive use of the joints over the years
- Degeneration of articular cartiliage
RA:
Swollen, inflammed synovial membrane
