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Anatomy Exam 6 > Review > Flashcards

Review Flashcards

1
Q

Gluteus maximus. Innervation

A
  • Innervation: inferior gluteal (L5-S2)
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2
Q

Gluteus medius. Innervation

A
  • Innervation: superior gluteal (L4-S1)
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3
Q

Gluteus minimus. Innervation

A
  • Innervation: sup gluteal (L4-S1)
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4
Q

What is a positive Trendelenburg sign? What does this indicate?

A
  • During the stance phase, the opposite abductor muscles (gluteus medius and minimis) normally serve to prevent the pelvis from tilting down, both hips should be maintained at the same level.
  • Positive sign = weak abductor muscles of the hip supplied by the superior gluteal nerve or damage to the nerve
  • These individuals have waddling/hip steppage or swing out gait
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5
Q

Piriformis. Innervation

A
  • Innervation: S1, S2 (mnemonic = Piriformiss, 2 esses: S1, S2)
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6
Q

Obturator internus. Innervation

A
  • Innervation: obturator internus nerve (L5, S1, S2)
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7
Q

Superior gemellus. Innervation

A
  • Innervation: obturator internus nerve (L5, S1, S2)
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8
Q

Inferior gemellus. Innervation

A
  • Innervation: nerve to quadratus femoris (L4-S1)
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9
Q

Quadratus femoris. Innervation

A
  • Innervation: nerve to quadratus femoris (L4-S1)
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10
Q

What nerves form the sacral plexus?

A
  • L4/5 (from lumbosacral trunk) and S1-S4 (via sacral foramina)
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11
Q

True/False. The nerves of the sacral plexus supply the gluteal region, anterior/posterior thigh, entire leg and entire foot.

A
  • False. Does not supply the anterior thigh
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12
Q

Posterior division sacral plexus nerves

A
  • Common peroneal (L4-5, S1-2)* part of sciatic
  • Superior gluteal (L4-S1)
  • Inferior gluteal (L5-S2)
  • Posterior femoral cutaneous, partly (S1-S3)
  • Nerve to piriformis (S1, S2)
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13
Q

Anterior division sacral plexus nerves

A
  • Tibial nerve (L4-5, S1-3)* part of sciatic
  • Nerve to obturator internus (L5-S2)
  • Nerve to quadratus femoris (L4-S1)
  • Pudendal nerve (S2-4)
  • Nerve to levator ani
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14
Q

Sciatic nerve is composed of what nerves? From what spinal levels?

A
  • Tibial (anterior division) – L4-S3

- Common peroneal (posterior division) – L4-S2

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15
Q

65 yo female comes into your office with paralysis of her gluteal muscles. Do you suspect sciatic nerve involvement?

A
  • No. Injury to sciatic nerve does not affect muscles in the gluteal region. Innervation to those muscles are prior to formation of the sciatic nerve in the sacral plexus
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16
Q

Name of nerve that exit the pelvis above the piriformis muscle. Below?

A
  • Above = superior gluteal through greater sciatic foramen

- Below = all other branches of sacral plexus

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17
Q

What muscles are affected with injury to the superior gluteal nerve?

A
  • Gluteus medius and minimus
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18
Q

What muscles are affected with injury to the inferior gluteal nerve?

A
  • Gluteus maximus
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19
Q

Nerves that innervate the cutaneous gluteal region. From which rami does each originate?

A
  • Superior cluneal (dorsal rami)
  • Medial cluneal (dorsal rami)
  • Inferior cluneal (ventral rami)
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20
Q

Nerve supply to cutaneous proximal medial thigh

A
  • Genital branches of genitofemoral (L1, L2) and ilioinguinal nerves (L1)
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21
Q

Nerve supply to cutaneous femoral triangle/proximal anterior thigh

A
  • Femoral branch of genitofemoral (L1, L2)
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22
Q

Nerve supply to cutaneous medial thigh

A
  • Medial cutaneous branch of femoral (L2-4)
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23
Q

Nerve supply to anterior distal thigh

A
  • Intermediate cutaneous branch of femoral (L2-4)
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24
Q

Nerve supply to lateral thigh

A
  • Lateral femoral cutaneous nerve (L2, L3)
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25
Q

Nerve supply to posterior thigh

A
  • Posterior femoral cutaneous nerve (S1-3)
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26
Q

Nerve supply to popliteal region

A
  • Posterior femoral cutaneous nerve (S1-3)
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27
Q

What are the muscle compartments of the thigh? What are the muscles contained in each? What nerve supplies each compartment?

A

1.) Medial = adductor compartment
a.) innervation = obturator nerve (this nerve has two divisions, anterior and posterior, which are anterior and posterior in reference to adductor brevis)
b.) pectineus#, adductor longus, adductor brevis, adductor magnus*, gracilis, obturator externus
# also innervated femoral nerve
* hamstring part is innervated by tibial nerve, not obturator nerve

  1. ) Anterior = hip flexor, knee extensor compartment
    a. ) innervation = femoral nerve
    b. ) sartorius, rectus femoris, vastus lateralis, vastus medialis, vastus intermedius, articularis genu, psoas major, iliacus, tensor fascial latae

3.) Posterior = hip extensor, knee flexor compartment
a.) innervation = tibial nerve
b.) biceps femoris~, semitendinosus, semimembranosus
~ short head innervated by common peroneal nerve, not tibial nerve

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28
Q

What nerve supplies skin on the medial side of the leg?

A
  • Saphenous nerve (L3, 4), branch off femoral
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29
Q

Branches of the common peroneal nerves

A
  • Lateral sural cutaneous nerve, branch off this = sural communicating nerve, which joins with medial sural cutaneous nerve (from tibial)
  • Superficial peroneal nerve
  • Deep peroneal nerve
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30
Q

What nerve supplies skin of the anterolateral leg and dorsum of the foot?

A
  • Superficial peroneal nerve (branch off common peroneal, which is part of sciatic off of sacral plexus)
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31
Q

Branches of the tibial nerve in leg

A
  • Medial sural cutaneous nerve
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32
Q

What forms the sural nerve?

A
  • Junction of medial sural and communicating sural cutaneous nerve
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33
Q

3 compartments of the leg? Muscles of each compartment? Nerves?

A
  1. ) Anterior compartment:
    - Muscles: tibialis anterior, extensor hallucis longus, extensor digitorum longus, peroneus tertius
    - Nerve: deep peroneal nerve
  2. ) Lateral compartment:
    - Muscles: peroneus longus, peroneus brevis
    - Nerve: superficial peroneal nerve
  3. ) Posterior compartment:
    - Muscles: gastrocnemius + soleus = triceps surae, plantaris, popliteus, flexor hallucis longus, flexor digitorum longus, tibialis posterior
    - Nerve: tibial nerve (L4-S3)
34
Q

Injury to the common peroneal (fibular) nerve causes what paralysis?

A
  • Paralysis to anterior and lateral compartment muscles
  • Anterior is supplied by deep peroneal (fibular) nerve
  • Lateral is supplied by superficial peroneal (fibular) nerve
35
Q

What nerve supplies the cutaneous medial side of the foot as far as the 1st metatarsal?

A
  • Saphenous nerve (branch of femoral)
36
Q

What nerve supplies the cutaneous lateral side of the foot to the 5th toe?

A
  • Lateral dorsal cutaneous nerve (continuation of sural nerve from common peroneal)
37
Q

What nerve supplies the cutaneous middle part of the dorsum of the foot?

A
  • Superficial peroneal nerve branches = medial / intermediate dorsal cutaneous nerves
38
Q

What nerve supplies the skin between the 1st and 2nd toes?

A
  • Deep peroneal nerve (from common peroneal)
39
Q

What nerve innervates the cutaneous heel area?

A
  • Medial calcaneal (of tibial nerve) for the majority of the heel
  • Lateral aspect = lateral dorsal cutaneous (from sural from common peroneal)
40
Q

What nerve supplies the medial 3.5 digits on the plantar surface of the foot?

A
  • Medial plantar nerve (of tibial nerve) is larger than lateral
41
Q

What nerve supplies the lateral 1.5 digits on the plantar surface of the foot?

A
  • Lateral plantar nerve (of tibial nerve)
42
Q

What nerve supplies the medial side of foot (including arch) of the foot?

A
  • Saphenous nerve (from femoral)
43
Q

Innervation of the plantar foot muscles

A
  • Medial plantar nerve innervates: mnemonic = LAFF = 1st Lumbrical, Abductor hallucis, Flexor digitorum brevis, Flexor hallucis brevis
  • Lateral plantar nerve innervates all other plantar foot muscles
44
Q

What forms the arches of the foot? Function?

A
  • Tarsal and metatarsal bones

- Weight bearing, resilience, shock absorption, propelling limb in walking

45
Q

Arches of foot – what bones does each consist of?

A
  • Medial longitudinal arch: calcaneus, talus, navicular, three cuneiforms and three medial metatarsals
  • Lateral longitudinal arch: calcaneus, cuboid, two lateral metatarsals
  • Transverse arch: cuboid, three cuneiforms, bases of all metatarsals
46
Q

Medial longitudinal arch. Bones? Ligaments?

A
  • Bones: calcaneus, talus, navicular, three cuneiforms, three medial metatarsals
  • Ligament: calcaneonavicular ligament (aka spring ligament), plantar aponeurosis
47
Q

Lateral longitudinal arch. Bones? Ligaments?

A
  • Bones: calcaneus, cuboid, lateral two metatarsals

- Ligament: long plantar ligament, short plantar ligament (aka calcanavicular), plantar aponeurosis

48
Q

Transverse arch. Bones?

A
  • Bones: cuboid, three cuneiforms, bases of all metatarsals
49
Q

Joints of the foot. Bones that make up the joint? What type of joint is each? Motion?

A
  1. ) Ankle, aka talocrural joint:
    - Bones: trochlea of talus, tibia, fibula
    - Joint type: hinge (ginglymus) type of synovial
  2. ) Subtalar joint, aka talocalcaneal joint:
    - Bones: talus, calcaneus
    - Joint type: plane type of synovial
    - Motion: inversion, eversion
  3. ) Transverse tarsal joints: Motion here = inversion and eversion
    a. ) talocalcaneonavicular:
    - Bones: talus, calcaneus, navicular
    - Joint type: ball and socket
    b. ) calcaneocuboid:
    - Bones: calcaneus, cuboid
    - Joint type: plane
  4. ) Tarsometatarsal joints:
    - Bones: tarsals and metatarsals
    - Joint type: plane type of synovial
    - Motion: gliding
  5. ) Intermetarsal joints:
    - Bones: between bases of metatarsals
    - Joint type: plane type of synovial
    - Motion: slight gliding between bases
  6. ) Metatarsal phalangeal (MP) joints:
    - Bones: heads of metatarsals and bases of proximal phalanges
    - Joint type: condyloid type of synovial
    - Motion: flexion, extension, abduction, adduction and rotation
  7. ) Interphalangeal (IP) joints – proximal (PIP) and distal (DIP):
    - Bones: between phalanges
    - Joint type: hinge type of synovial
    - Motion: flexion and extension
50
Q

Talocrural joint (ankle joint). Bones of the joint, joint type, ligaments, actions?

A
  • Bones: trochlea of talus, tibia, fibula
  • Joint type: hinge (ginglymus) type of synovial
  • Ligaments:
    a. ) Articular capsule: surrounds joint cavity, surrounded by
    b. ) Deltoid ligament: medial side of joint with 4 bands (very strong): anterior tibiotalar, posterior tibiotalar, tibionavicular, tibiocalcaneal
    c. ) Lateral ligament: lateral side of joint with 3 bands (weaker than deltoid): anterior talofibular, posterior talofibular, calcaneofibular
  • Actions: dorsiflexion (stable in this position), plantar flexion (unstable)
51
Q

Ankle sprains are usually the result of what excessive motion at the joint?

A
  • Inversion, damaging lateral ligaments, which are weaker than the medial deltoid ligaments
52
Q

What is a Potts fracture?

A
  • Foot is forcefully everted, result is fracture of medial and lateral malleoli (or more proximal fibula)
53
Q

What type of joint is the hip joint?

A
  • Ball and socket type synovial joint
54
Q

What is the name of the surface of the acetabulum that forms the joint with the head of the femur?

A
  • Lunate surface surrounds the acetabular fossa
55
Q

What is the acetabular notch?

A
  • inferomedial aspect of the acetabulum
56
Q

Blood supply to the hip joint?

A
  • Obturator
  • Retinacular arteries from the medial and lateral circumflex femoral
  • Inferior and superior gluteal arteries
  • 1st perforating artery
57
Q

What type of fracture leads to necrosis of the head of the femure?

A
  • Subcapital (area of neck immediately adjacent to head) fracture as it breaks vessels to the head
  • Basal fracture (area at base of neck) usually doesn’t lead to necrosis of head
58
Q

Nerves to hip joint?

A
  • Femoral, obturator, superior/inferior gluteal, sciatic
59
Q

What are the ligaments of the hip joint? Location of each?

A
  • Articular capsule: surrounds joint and blends with other ligaments
  • Iliofemoral (iliotrochanteric) ligament: anterior of joint, attached to AIIS and intertrochanteric line
  • Pubofemoral (pubocapsular) ligament: superior ramus of pubis and obturator crest and blends with iliofemoral ligament
  • Ischiofemoral (ischiocapsular) ligament: body of ischium below and behind acetabulu and attach to femoral neck below greater trochanter
  • Ligament capitis femoris: fovea capitis to transverse ligament
  • Acetabular labrum: fibrocartilaginous rim attached to margin of acetabulum
  • Transverse acetabular ligament: acetabular labrum continuation across acetabular notch
60
Q

Function of iliofemoral ligament?

A
  • Checks hyperextension and external rotation, helps maintain erect posture
61
Q

Function of pubofemoral ligament?

A
  • Checks hyperextension, external rotation and abduction
62
Q

Function of ischiofemoral ligament?

A
  • Checks hyperextension, internal rotation
63
Q

Function of ligament capitis femoris?

A
  • Tenses when flexed thigh is adducted
64
Q

What is the largest strongest and widest ligament of the hip joint?

A
  • Iliofemoral ligament
65
Q

What type of joint is the knee joint?

A
  • Between tibia and femur = synovial hinge joint, better described as condyloid given its rotatory motion
  • Patella and femur = plane gliding synovial joint
66
Q

Nerve supply to the knee joint?

A
  • Femoral, obturator, common peroneal and tibial
67
Q

Blood supply to the knee joint?

A
  • Genicular arteries from the femoral artery anastomose
68
Q

Which genicular artery penetrates through the joint capsule to supply the intercondylar structures of the knee joint?

A
  • Middle genicular artery (from femoral artery)
69
Q

Ligament of the knee joint? Location of each?

A
  • Articular capsule: attached to margins of articular surfaces, incomplete where replaced by tendons
  • Quadriceps tendon: encloses patella
  • Patellar ligament: patella to tuberosity of tibia
  • Tibial (medial) collateral ligament: medial epicondyle of femure to medial surface of tibial, attached to medial meniscus
  • Fibular (lateral) collateral ligament: lateral epicondyle of femure to head of fibula, no attached to lateral meniscus
  • Oblique popliteal ligament: it is an expansion of tendon of semimembranosus muscle, fibers from medial condyle of tibia to lateral condyle of femur
  • Arcuate popliteal ligament: intercondylar area of tibia to fibular head
  • Coronary ligament: fibers surrounding capsule attached to menisci
  • Intra-articular ligaments: transverse, ant/post meniscofemoral, cruciate ligaments (ACL, PCL)
70
Q

Describe location of the intra-articular ligaments of the knee.

A
  1. ) Transverse ligament: connect menisci anteriorly
  2. ) Ant/posterior meniscofemoral ligament: obliquely from lateral menisci to medial femoral condyle
  3. ) Cruciate ligaments
    a. ACL: anterior interchondral fossa to lateral condyle of femur
    b. PCL: posterior interchondral fossa to medial condyle of femur
71
Q

Function of tibial (medial) collateral ligament? Fibular (lateral) collateral ligament?

A
  • Become tight during extension and stabilize the knee joint
72
Q

Function of cruciate ligaments of knee joint?

A
  • ACL: stops hyperextension of the knee

- PCL: stops hyperflexion of the knee

73
Q

Which of the cruciate ligaments of the knee joint are stronger?

A
  • PCL is shorter and stronger than the ACL
74
Q

Function of the menisci of the knee joint?

A
  • Deepen the articular surfaces
75
Q

What ligament of the knee joint attaches the menisci to the capsule?

A
  • Coronary ligament
76
Q

To what bone are the menisci of the knee joint attached?

A
  • Tibial condyles
77
Q

What is a Baker’s cyst?

A
  • Where synovial fluid escapes from the knee joint into the popliteal fossa
78
Q

What is the unhappy triad? Describe the mechanism of this injury?

A
  • Injury to knee involving MCL, medial meniscus and ACL

- Knee is hit on the lateral aspect

79
Q

Clinical examinations to test for ACL and PCL tears?

A
  • ACL tear: anterior drawer test

- PCL tear: posterior drawer test

80
Q

Name accidents that can cause ACL and PCL tears?

A
  • ACL: skiing

- PCL: car accident

81
Q

What is genu varum?

A
  • Decreased Q-angle = Bow leg
82
Q

What is genu valgum?

A
  • Increased Q-angle = Knock knee

Anatomy Exam 6 (2 decks)

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