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Musculoskeletal > TBL 15 > Flashcards

TBL 15 Flashcards

1
Q

What forms the hip bone?

A

fusion of the ilum, pubis, and ischium

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2
Q

What forms the hip joint?

A

acetabulum articulates with the head of the femur

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3
Q

Body and superior ramus of the pubis

A

know it

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4
Q

Body, ischial spine, ischial tuberosity, and ischiopubic ramus of the ischium

A

know it

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5
Q

Iliac fossa, iliac crest, anterior superior and anterior inferior iliac spines of the ilium

A

know it

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6
Q

Obturator foramen

A

know it

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7
Q

The capsule of the hip joint is reinforced by what ligmanents?

A

iliofemoral, pubofemoral, and ischiofemoral ligaments that pass in a spiral fashion from the hip bone to the femur

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8
Q

What results in hip dislocations and in what anatomical direction?

A

weakness of the ischiofemoral ligmament, most commonly in a posterior direction

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9
Q

What does extension of the femur do to the hip ligaments and what is the result?

A

which increases joint stability but restricts extension to 10-20 degrees beyond the vertical position

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10
Q

What does flexion of the femur do to the hip ligaments and what is the result?

A

unwinds the ligaments, which increases joint mobility and allows flexion to greater than 90 degrees beyond the vertical

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11
Q

What are avulsion fractures of the hip bone?

A

a small bone with a piece of a tendon or ligmanet attached is avulsed; occurs at apophyses (bony projections that lack secondary ossifcation centers) where muscle attach -> anterior superior and inferior iliac spines, ischial tuberosities, and ischiopubic rami

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12
Q

Cartliagenous replicas at future elbows and knee joints bend in what direction? What happens next?

A

anteriorly with the elbow and knee directed laterally; upper and lower limbs undergo 90 degree torsions around their long axes (i.e., the thumb and big toe assume their lateral and medial positions)

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13
Q

Head, neck, greater and less trochanters, lateral and medial epicondyles and condyles, linea aspera of the femur

A

know it

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14
Q

Tuberosity, medial and lateral condyles, medial malleolus of the tibia

A

know it

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15
Q

Head, neck, and lateral malleolus of the fibula

A

know it

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16
Q

Lateral and medial menisci

A

incomplete rings of dense connective tissue that partially cover the articular surface of the tibial condyles at the knee joint

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17
Q

Lateral/fibular collateral ligament (LCL)

A

attaches the lateral epicondyle of the femur to the head of the fibula

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18
Q

The LCL and lateral meniscus are separated by what?

A

tendon of the popliteus muscle

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19
Q

Medial/tibial collateral ligament (MCL)

A

strong, flat; attaches the medial epicondyle of the femur to the superomedial tibia

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20
Q

Difference between LCL and MCL

A

MCL is stronger and is attached to its meniscus

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21
Q

Anterior and posterior cruciate ligaments (ACL and PCL) positioning

A

cross obliquely in the center of the knee joint

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22
Q

PCL attachments

A

attaches the posterior intercondylar area of the tibia to the anterior aspect of the femoral medial condyle

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23
Q

PCL function

A

prevents anterior displacement of the femur on the tibia and hyperflexion of the leg

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24
Q

ACL attachments

A

anterior intercondylar area of the tibia to the posterior aspect of the femoral lateral condyle

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25
Q

ACL function

A

ACL prevents posterior displacement of the femur on the tibia and hyperextension of the leg

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26
Q

Which is stronger, ACL or PCL

A

PCL

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27
Q

Articular cartilage

A

(i.e., hyaline cartilage lacking a perichondrium) forms the sliding area of all joints

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28
Q

Menisci function

A

provide shock absorption and load distribution at the knee joint

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29
Q

What forms the synovial membrane that lines all joint capsules and produces synovial fluid to lubricate the articular surfaces

A

simple cuboidal epithelium

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30
Q

How can twisting of the flexed knee create the unhappy triad injury?

A

caused by blow to the lateral side of the extended knee or excessive lateral twisting of the flexed knee that disrupts the TCL and concomitantly tears and/or detaches the medial meniscus; ACL is taut during flexion and can also tear -> “unhappy triad”

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31
Q

What are the anterior and posterior drawer signs?

A

anterior = free tibia slides anteriorly under the fixed femur; posterior = free tibia to slide posteriorly under the fixed femur

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32
Q

How is the upper body weight transmitted?

A

centrally through the vertebral column, bilaterally to the sacrum, and via the sacroiliac joints to the thick portions of the ilia

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33
Q

Pubic symphysis

A

union of the pubic rami; stabilizes the weight-bearing sacrum and ilia

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34
Q

Ilia transfer the weight to?

A

the femurs at the hip joints (i.e., when standing, the weight of the upper body is transmitted to the heads and necks of the femurs)

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35
Q

Femoral obliquity

A

places the knee joint inferior to the sacrum and the verticality of the tibia returns the center of gravity to the vertical axes of the supporting legs and feet

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36
Q

Angle of inclination (of the femur) becomes more acute with?

A

aging and increased strain on the femoral neck makes its fracture more common in the elderly

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37
Q

Deep fascia of the thigh (aka fascia lata)

A

thickened laterally as the iliotibial tract and continues as the deep fascia of the leg

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38
Q

Dorsal vein of the big toe joins the dorsal venous arch of the foot to form?

A

great saphenous vein

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39
Q

Great saphenous vein, superior path?

A

courses anterior to medial malleolus of the tibia and posterior to the medial condyle of the femur before terminating in the femoral vein

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40
Q

Dorsal vein of the little toes join the dorsal venous arch to form?

A

small saphenous vein

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41
Q

Small saphenous vein, superior path?

A

courses posterior to the lateral malleolus of the fibula and along the lateral edge of the calcaneal tendon before terminating in the popliteal vein.

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42
Q

Superficial lymphatic vessels that accompany what and drain into what?

A

the great and small saphenous veins drain into the superficial inguinal and popliteal lymph nodes

43
Q

Iliopsoas attachements

A

formed by the psoas major in the abdomen and the iliacus in the pelvis -> attaches to the lesser trochanter of the femur distally

44
Q

Iliopsoas function

A

strongest flexor of the thigh and lifts the lower extremity when walking

45
Q

Quadriceps femoris (4 muscles)

A

powerfully extends the knee when rising from squatting or accelerating for running or jumping (i.e. actions that lift or move the entire body weight)

46
Q

Quadriceps tendon continues as?

A

the patellar ligament that attaches to the tibial tuberosity distally

47
Q

Vastus lateralis, vastus intermedius, and vastus medialis with their respective positions

A

know it

48
Q

Rectus femoris attachments

A

attaches to the anterior inferior iliac spine proximally

49
Q

Rectus femoris function

A

assists flexion of the thigh; extension of the leg when the thigh is extended and the leg is flexed (e.g., kicking a soccer ball)

50
Q

Patella

A

sesamoid bone within the patellar ligament, can withstand compression placed on the quadriceps tendon during movements at the knee joint

51
Q

Suprapatellar bursa

A

continuous with the synovial cavity of the joint and extends between the femur and quadriceps tendon, cushions the tendon when it pulls lengthwise across the knee joint to extend the leg

52
Q

What causes Osgood-Schlatter disease and what are its symptoms?

A

disruption of the epiphysial plate at the tibial tuberosity -> cause inflammation of the tuberosity and chronic recurring pain during adolescence

53
Q

Sartorius attachments

A

attaches to the ASIS proximally and medial to the tibial tuberoslty distally

54
Q

Sartorius function

A

synergizes with the psoas during flexion of the thigh and with stronger muscles (to be studied later) during flexion of the leg

55
Q

Abduction and adduction of the lower extremity at the hip joint

A

know it

56
Q

Adductor longus

A

attach to the body of the pubis proximally and the linea aspera distally

57
Q

Adductor brevis

A

attach to the body of the pubis and the linea aspera distally

58
Q

Adductor magnus

A

attach to the body of the pubis and ischiopubic ramus proximally and the linea aspera distally

59
Q

Gracilis attachments

A

attaches to the ischiopubic ramus proximally and medial to the tibial tuberosity distally

60
Q

Gracilis function

A

synergizes with the adductor muscles, and with stronger muscles (to be studied later) during flexion of the leg

61
Q

Where is the gracilis muscle used for transplantation and why is lower limb function not noticeably compromised?

A

it is a relatively weak member of the adductor group of muscles so it can be removed without noticeable loss of its actions on the leg

62
Q

What forms the superior boundary of the femoral triangle?

A

inguinal ligament -> extends between the ASIS and body of the pubis

63
Q

What forms the lateral boundary of the femoral triangle?

A

sartorius

64
Q

What forms the medial boundary of the femoral triangle?

A

adductor longus

65
Q

Femoral nerve originates from what spinal cord segments

A

L2-L4

66
Q

Femoral artery path

A

enters the lateral aspect of the femoral triangle to innervate the muscles of the anterior thigh before terminating as the cutaneous saphenous nerve

67
Q

What lesions might cause diminution or loss of the patellar tendon reflex?

A

results from any lesion that interrupts the innervation of the quadriceps

68
Q

Obturator nerve originates from what spinal segments

A

L2-L4

69
Q

Obturator nerve path

A

originates from spinal segments L2-L4, exits the abdominopelvic cavity via the obturator foramen to innervate the muscles of the medial thigh

70
Q

Femoral sheath extends from where?

A

extends from the deep fascia covering the iliopsoas under the inguinal ligament to surround the femoral artery and vein

71
Q

Femoral sheath function

A

allows the femoral artery and vein to glide under the inguinal ligament

72
Q

Femoral artery

A

supplies the anterior thigh

73
Q

Obturator artery

A

follows the course of the obturator nerve to supply the medial thigh

74
Q

Deep artery of the thigh (profunda femoris)

A

branches from the femoral artery to supply the posterior and lateral thigh

75
Q

Medial circumflex femoral artery

A

branch of the deep artery of the thigh, supplies the head and neck of the femur

76
Q

Why can aseptic vascular necrosis of the displaced femoral head occur after femoral neck fractures?

A

femoral neck fractures often disrupt the blood supply of the head of the femur -> artery to the ligament of the femoral head is only source of blood but it is inadequate

77
Q

Femoral canal

A

formed from the femoral sheath; contains efferent lymphatic vessels from the inguinal lymph nodes that pass through the oval femoral ring at the base of the canal to enter the abdomen

78
Q

Anterior compartments of the leg enclosed by deep fascia and positioned?

A

anteriorly; tibialis anterior, extensor digitorum longus, extensor hallucis longus

79
Q

Lateral compartments of the leg enclosed by deep fascia and positioned?

A

laterally; fibularis longus, fibularis brevis

80
Q

What are compartment syndromes and how are prolonged symptoms relieved?

A

fascial compartments of the lower limbs are generally closed spaces; trauma can produce hemorrhage, edema, and inflammation of the muscles -> increased intracompartmental pressure that compresses structures like small vessels, leading to ischemia and viability of tissue within; prolonged symptoms are relieved by a fasciotomy (incision) to relieve the pressure in the compartment

81
Q

Inversion vs eversion of the foot

A

inversion - medial goes up; eversion - lateral side goes up

82
Q

Dorsiflexion and plantarflexion of the foot

A

dorsiflexion - up; plantarflexion - down

83
Q

Tibialis anterior attachment

A

attaches to the tibia proximally and to the medial surface of the medial cuneiform bone and the 1st metatarsal bone

84
Q

Tibialis anterior function

A

dorsiflexes and inverts the foot

85
Q

Extensor digitorum attachment

A

attach to the tibia and fibula proximally and to the dorsum of the toes distally

86
Q

Extensor digitorum function

A

dorsiflex the foot and extend the toes

87
Q

Extensor hallucis longus attachment

A

attach to the tibia and fibula proximally and to the dorsum of the toes distally

88
Q

Extensor hallucis longus function

A

dorsiflex the foot and extend the toes

89
Q

Fibularis longus attachment

A

attaches to the fibula proximally and to the plantar surface of the foot distally

90
Q

Fibularis brevis attachment

A

attaches to the fibula proximally and to the lateral side of the foot distally

91
Q

Fibularis longus and fibularis brevis function

A

synergistically evert the foot

92
Q

Common peroneal nerve path

A

originates in the posterior thigh and passes around the neck of the fibula into the anterolateral leg where it terminally bifurcates into the superficial and deep peroneal nerves

93
Q

Deep peroneal nerve

A

innervates the muscles of the anterior compartment

94
Q

Superficial peroneal nerve

A

innervates the muscles of the lateral compartment

95
Q

The femoral artery continues into the popliteal fossa as?

A

popliteal artery

96
Q

Popliteal artery

A

bifurcates into the anterior and posterior tibial arteries

97
Q

Anterior tibial arteries

A

supplies the anterior and lateral compartments of the leg and continues onto the dorsum of the foot as the dorsal pedis artery

98
Q

Saphenous nerve

A

provides sensory fibers to the anteromedial leg and medial side of the ankle

99
Q

Common peroneal nerve

A

convey sensations from the inferolateral leg

100
Q

Superficial peroneal nerve

A

convey sensations to the lateral side of the ankle

101
Q

Why is the common peroneal nerve frequently injured and what are the symptoms after its injury?

A

because of its superficial position as it winds subcutaneously around the fibular neck, leaving it vulnerable to direct trauma; severance results in flaccid paralysis of all muscles in the anterior and lateral compartments of the leg (dorsiflexors of ankle and evertors of the foot) -> makes the limb “too long” so the toe do not clear the ground during the swing phase of walking

102
Q

Where is the dorsal pedis pulse palpated and what is the most common cause of its diminution or absence?

A

palpated with the feet slightly dorsiflexed, just lateral of the EHL tendons; most common cause of its diminution or absence is vascular insufficiency resulting from arterial disease

103
Q

When is a saphenous cutdown required and where can sensory loss occur after the procedure?

A

in trauma or hypovolemic shock patients when peripheral cannulation is impossible; saphenous nerve can be cut -> pain or numbness along the medial border of the foot

Musculoskeletal (11 decks)

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