review Flashcards
exam 1
what happened here?
avascular necrosis of femoral head
identify
A. pubic tubercle
B. lesser trochanter
C. Greater trochanter
D. Iliac Crest
E. interchonateric line
F. Obturator foramen
what happened here?
femoral neck fracture
what happened here?
hip dysplasia
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open book fracture
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what is abnormal?
ACL
What is abnormal?
torn PCL
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5th metatarsal tubercle—> broken
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posterior dislocation of the femur
which one is abnormal and why
the one on the right has a achille rupture. Notice the tendon seperated from the calcaneous
What happened here?
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normal or abnormal?
normal
normal or abnormal
abnormal- spondylitis
normal or abnormal
spondylolysis
normal or abnormal
abnormal- spondylolethesis
normal or abnormal
abnormal- spondylolethesis
Which of the following structures does not lie in the adductor canal?
a. superficial femoral artery
b. femoral vein
c. saphenous nerve
d. great saphenous vein
e. nerve to vastus medialis
d. great saphenous vein
A 20 year old patient cannot flex and medially rotate the thigh while running and climbing. Which of the following muscles is most likely damaged?
a. semimembranosus
b. sartorius
c. rectus femoris
d. vastus lateralis
e. tensor fascia lata
Answer: E. The tensor fascia lata is the main muscle responsible for medial rotation of the thigh. Sartorius contributes to lateral rotation, semimembranosus contributes to extension of the thigh, and the quadriceps muscles contribute to extension of the knee.
A patient experiences weakness when abducting and medially rotating the thigh after an accident. Which of the following muscles is most likely damaged?
a. piriformis
b. obturator internus
c. quadratus femoris
d. gluteus maximus
e. gluteus minimus
Answer: E. The gluteus minimus is one of the main abductors of the thigh. It also contributes to medial rotation.
A construction worker is hit on the leg with a concrete block and is subsequently unable to plantarflex and invert the foot. Which of the following muscles is most likely damaged?
a. extensor digitorum longus
b. tibialis anterior
c. tibialis posterior
d. peroneus longus
e. peroneus brevis
Answer: C. The tibialis posterior is serves to invert the foot, is a strong plantarflexor, and maintains the arch of the foot. The EDL extends the toes, and the peroneus longus and brevis serve to evert the foot.
A 12 year-old female slips and falls on the bathroom floor. As a result, she has a posterior dislocation of the hip joint and a fracture of the neck of the femur.
Rupture of the ligament of the head of the femur may lead to damage to a branch of which of the following arteries?
a. medial femoral circumflex
b. lateral femoral circumflex
c. obturator
d. superior gluteal
e. inferior gluteal
Answer: C. The obturator artery passes through the ligamentum capitus femoris (ligament of the head of the femur). The medial and lateral circumflex arteries directly provide blood supply to the head of the femur.
Which of the following is true of the anterior cruciate ligament?
a. It becomes tight during flexion of the leg
b. It resists posterior displacement of the femur on the tibia
c. It inserts into the medial femoral condyle
d. It helps prevent hyperflexion of the knee joint
e. It is lax when the knee is extended
Answer: B. The ACL serves to resist posterior displacement of the leg, it becomes tight during leg extension, limits hyperextension, and inserts into the medial tibial condyle.
Which of the following structures contains the cell bodies of voluntary motor neurons?
a. ventral horn of gray matter
b. dorsal horn of gray matter
c. intermediolateral cell columns of gray matter
d. dorsal root ganglia
e. paravertebral ganglia
Answer: A. Lower motor neuron cell bodies are found in the ventral horn of the gray matter of the spinal cord.
It is common for intervertebral disks to shrink in people older than 40 and it can result in spinal stenosis and herniation. At which locations are the spinal nerves most likely to be compressed?
a. between the denticulate ligaments
b. as they pass through the vertebral foramen
c. between the superior and inferior articular facets
d. between inferior and superior vertebral notches
e. between the superior and interior intercostovertebral jointsv
Answer: D. The spinal nerves exit the spinal column between the superior vertebral notch of one vertebra and the inferior vertebral notch of the superior vertebra. This space would be narrowed with the shrinkage of the IV disks.
An X-ray of a 58 year old patient reveals that the L3 vertebra has slipped anteriorly on the L4 vertebra. What is the proper name of this condition?
a. spondylolysis and spondylolisthesis
b. spondylolisthesis
c. Hangman’s fracture
d. intervertebral disk herniation
e. von Munchhausen fracture
Answer: B. Spondylolisthesis refers to the dislocation of vertebrae, which is described in this scenario.
A 25 year-old man suffers a gunshot wound to the lower part of his back and is unable to move his legs. A neurologic examination and an MRI scan reveal injury to the cauda equina. Which of the following is most likely damaged?
a. dorsal primary rami
b. ventral primary rami
c. dorsal roots of the thoracic spinal nerves
d. ventral roots of the sacral spinal nerves
e. lumbar spinal nerves
Answer: B. Inability to move the legs indicates damage to the ventral primary rami, those that control motor movement.
If a person’s spinal cord is crushed at the level of the 4th lumbar spinal segment, which of the following structures would most likely be spared from destruction?
a. dorsal horn
b. ventral horn
c. intermediolateral cell column
d. gray matter
e. pia mater
Answer: C. The intermediolateral cell column runs roughly from T1-L2 and carries neurons of the sympathetic nervous system.
The notochordal process lengthens by migration of cells from the
a. notochord
b. primitive streak
c. notochordal plate
d. primitive node
e. neural plate
Answer: D (and B).
During development the notochordal process:
a. fuses with the underlying endoderm then later detaches
b. serves as a basis for the axial skeleton
c. serves as a basis for the axial skeleton
d. induces the formation of the neural tube
e. all of the above
e. all of the above
gastrulation occurs in the weeks
3 and 4
dermomyotomes
muscles and skin
gastrulation establishes the body plan
cranial-caudal, dorsla-ventral adn left and right
bilaminar germ disc
combination of the epiblast and hypoblast
hypoblast becomes the
endoderm- lining of the GI tract
epiblast forms the
ectoderm
ectoderm gives rise to the
CNS and PNS
mesoderm gives rise to
CT, cartilage and bone as well as smooth muscle and skeletal muscle
axial mesoderm
notochord
paraxial mesoderm form
somitomeres and then somites
Segmentation
fundamental organizing principle for the vertebrate body
epithelial comite form
slcerotome, myotome and dermatome
sclerotome
vertebrae
sclerotome
splits from the upper half of the somite of the vertebrae in question and lower half of the superior somite
sclerotome in cervical is
different beucase of the extra cervical
notochord forms the
nucleous pulposus
epimere
borsal/back musculature
hypomere
ventral body wall and limb musculature
what does not split in gastrulation
myotome
neurulation
neural plate rolls up into neural tube
CNS forms from
neural tube
PNS forms from
Neural crest
Dorsal root ganglia is formed from
neural crest
failure of neural crest cells to migrate to the GI leading to a megacolon
Hirshung’s
lumbar-sacral plexus
femoral and obturator
bony landmarks of the fermoral triangle
ASIS and Pubic tubercle
femoral ring
femoral artery, vein and lymph
what type if pathology is involved with the femoral ring?
hernia
adductor canal borders
medial- v. medialis
adductor longus and sartorious
higher risk of developing for long sedentary life and obese
Deep vein thrombosis
Deep vein thrombosis can lead to
varicose veins
Tredenlenburg sign
hips sags on unsupported side opposite to side affected
anterior part of the glt. medius and minimus
medially rotate
tensor fascia lata action
medially rotates
safest area for a glut injection
superior-lateral quadrant
obturator internus travels through the
lesser sciatic foramen
piriforms travels through the
greater schiatic foramen
cruciate anastamosis
medial and lateral circumflex
1st perforating
inferiro artery
interchontrateric fracture worse than a femoral neck fracture?
Nope!!! does not endager the medial circumflex artery
drain skin and subcutaneous tissue below umbilicus
superficial inguinal lymph nodes
posterior displacment of the tibia
PCL
anteriror displacement of the femure
PCL
posterior displacement of the femur
ACL
anterior displacment of the tibia
ACL
MCL is attached to the
medial meniscus
stress on medial collateral ligmaners
genu valgum “knock Knees”
popliteus muscle to unlocks by
laterally rotating the femur and when foot is off the ground, the tibia rotates medially
jone’s fracture
avulsion of the 5th metatarsal
Shin- splints
compartment syndrome
dorsalis pedis is lateral to the
extensor hallucis longus
peripheral vascular disease
poor circulation
pudendal nerve
S2-S4
Sciatic nerve
L5- S3
resists anterior dislocation of the head of the femur
ilio-femoral ligament
pubofemoral ligmanet prevents
overabduction
which bone bears the wight in the lower limb
tibia
Pott’s fracture
forced eversion of the foot
deltoid avulse from medial mallelous
laterl malleolus is sheared
trimallelular fracture
involves the lateral malleolus, the medial malleolus, and the distal posterior aspect of the tibia, which can be termed the posterior malleolus
forced eversion sparins the
delotid ligament
high ankle sprain
anterior tibiofibular ligmanet and lesser extent the posterior tibifibular ligament
cell bodies of voluntary neurons are found in the
vnetral horn of gray matter
unipolar
dorsal root ganglia
lumbosacral plexus is formed from the
ventral rami
tranversispinalis
semispinalis
multifidus
rotatores
lumbar cistern contains
CSF and cauda equina
for a CSF tap what meninge layer would you not penetrate?
Pia
herniation of the nucleus pulposus of an IV disc usually occurs
posterolaterally
hyper-khyphosis occurs in whihc region of the spine
thoracic
denticulate ligmanets run from
cervical to T12
sclerotome
vertebral column
fracture of a vertebra at the
pars interarticularis spondyolysis
entrance of the scaral hiatus has a bony landmark called
cornua of sacral hiatus
injury to the cauda equina affects the
ventral roots of the sacral spinal
adamkiewicz which supplies the lower spinal cord
anterior segmental medullary artery
prostate metastatis
internal venous plexus (outside of the dura) make connections with the spinal veins
middle genicular artery comes from
the anterior side of the popliteal artery
what structures arise from the epimere
erector spinae