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S&F1 > Test 2 Memorizables > Flashcards

Test 2 Memorizables Flashcards

0
Q

Cutaneous Nerves:

Anterior Thigh

A

Branches from Femoral Nerve

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1
Q

Cutaneous Nerves:

Lateral Thigh

A

Lateral Femoral Cutaneous Nerve of Thigh

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2
Q

Cutaneous Nerves:

Medial Thigh

A

Branches from Obturator Nerve

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3
Q

Cutaneous Nerves:

Medial Leg

A

Saphenous Nerve

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4
Q

Cutaneous Nerves:

Lateral Leg

A

Lateral Sural Cutaneous Nerve

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5
Q

Cutaneous Nerves:

Posterior Leg

A

Sural Nerve

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6
Q

Cutaneous Nerves:

Dorsal Foot

A

Superficial Peroneal Nerve

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7
Q

Cutaneous Nerves:

Sole of Foot

A

Medial and Lateral Plantar Nerves (from Tibial Nerve)

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8
Q

Drains Lymph from Gluteal Region and Posterior Thigh

A

Horizontal Group (Superficial Inguinal Nodes)

Located below inguinal ligament

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9
Q

Drains Lymph from most of lower extremity

A

Vertical Group (Superficial Inguinal Node)

Located along terminations of Great Saphenous Veins

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10
Q

Drains lymph from vessels that accompany Small Saphenous Vein

A

Popliteal Nodes

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11
Q

Drain lymph from deep structures of leg through Femoral Canal

A

Deep Inguinal Nodes

Located Medial to Femoral Vein

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12
Q

Inguinal Ligament Dermatome

A

L1

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13
Q

Anterior Knee Dermatomes

A

L3, L4

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14
Q

Medial Side of Foot and Big Toe Dermatome

A

L4

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15
Q

Lateral Side of Foot, Little Toe Dermatome

A

S1

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16
Q

Posterior Side of Leg and Thigh Dermatome

A

S1, S2

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17
Q

Pes Anserinus

A

Convergence of Sartorius, Gracilis, and Semitendinosus at the Tibia

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18
Q

Hip Pointer

A

Contusion at Anterior superior iliac spine or over iliac crest

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19
Q

Pulled Groin

A

Tear or stretch of adductor muscles at Pubis

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20
Q

Borders of the Femoral Triangle

A

Superior: Inguinal ligament
Medial: Adductor Longus
Lateral: Sartorius
Floor: Adductor longus and pectineus

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21
Q

Course of arterial supply to Lower Extremity

A

LV, CIAs, EIA, FA (ant. then post.) –> PA, Ant.&Post. TAs

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22
Q

Attachments of the inguinal ligament

A

ant. sup. iliac spine

pubic tubercle

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23
Q

Cruciate anastomosis

A

sup: inferior gluteal artery
inf: first perforating artery
med: medial femoral circumflex
lat: lateral femoral circumflex

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24
Q

Positive Trendelenburg Sign

A

When lifting a leg, pelvis tilts on that (non-paralyzed) side

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25
Q

Muscle deep to superior gluteal artery and nerve

A

Gluteus minimus

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26
Q

Weaver’s Bottom

A

Ischial Bursitis

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27
Q

Site of Gluteal Region Intramuscular Injection

A

Upper lateral quadrant

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28
Q

Piriformis Syndrome

A

Early branching of sciatic nerve that penetrates the piriformis; compression becomes painful

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29
Q

Pulled Hamstring

A

Tear or avulse from part of origin of muscle from Ischial Tuberosity

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30
Q

Boundaries of the Popliteal Fossa

A

sup med: semimembranosus and semitendinosus
sup lat: biceps femoris
inf: gastrocnemius

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31
Q

Branch of the Tibial Nerve

A

Sural Nerve

accompanies small saphenous vein

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32
Q

Branch of the Common Peroneal Nerve

A

Lateral Sural Cutaneous Nerve

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33
Q

Damage to the common peroneal nerve can lead to

A

Foot Drop

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34
Q

Genicular Anastomosis:
SMG, SLG, IMG, ILG

What do they anastomose with?

A

SMG: Descending genicular artery
SLG: Descending branch of lateral femoral circumflex
IMG&ILG: Recurrent branch of Anterior tibial artery

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35
Q

Middle Genicular Artery:

Where does it arise from? What does it anastomose with?

A

Popliteal Artery

Sup. or Inf. lateral genicular arteries

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36
Q

Ligation point in femoral aneurysm

A

Femoral Artery–above knee, deep to sartorius in subsartorial canal

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37
Q

Sprained Ankle

A

Excessive Inversion

Anterior talofibular or calcaneofibular ligaments stretched or partially torn

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38
Q

Fabella

A

Sesamoid bone in lateral head of gastrocnemius

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39
Q

Achilles Tendon Tap Reflex Tests what nerves?

A

S1, S2

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40
Q

Orientation of deep muscle group bellies in the posterior compartment of the leg

A

Muscle bellies are backwards: flexor for great toe is lateral, flexor of other toes is medial

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41
Q

Where do the tibial nerve and posterior tibial artery lie in the posterior compartment of the leg?

A

Between superficial and deep groups

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42
Q

Sustentaculum tali

A

Projection from the calcaneus

Acts as pulley for flexor hallucis longus tendon

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43
Q

Tarsal Tunnel Syndrome

A

Swelling of synovial sheaths covering tendons of deep posterior leg muscles.

Symptoms: numbness of sole, and toes, weakened flexion of toes

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44
Q

Anterior leg syndrome leads to compression of what nerve? What condition can this lead to?

A

Deep peroneal nerve

Foot Drop

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45
Q

Muscles that end on the Extensor Expansions of the toes

A

Extensor Hallucis Longus

Extensor digitorum longus

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46
Q

Peroneus Tertius

A

Part of Extensor Digitorum Longus that ends on 5th metatarsal

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47
Q

Intermittent Claudication

A

Narrowing of the posterior tibial artery due to arteriosclerosis

Produces ischemia, painful cramps when walking, but subsides after rest

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48
Q

Blount’s Disease

A

Severe genu varum
Black children
Progressive

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49
Q

Rickets

A

Cause of genu varum

Lack of vit. D

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50
Q

Intrinsic Ligaments of the Hip Joint:

Attachments, function

A

Iliofemoral: ilium / intertrochanteric line
prevents overextension

Pubofemoral: superior ramus of pubis / lower part of intertrochanteric line
limits extension and abduction

Ischiofemoral: (spiral shaped) ischium / greater trochanter
limits extension

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51
Q

Function of the Ligament of the head of Femur

A

Transmit artery of ligament of head of femur (branch of obturator artery)

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52
Q

Common cause of hip dislocation

Presentation?

A

Congenital: upper lip of acetabulum fails to form

Leg rotated medially, appears shorter

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53
Q

Visible presentation of a fracture in the neck of the Femur

A

Leg rotated laterally

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54
Q

Bursae of the Knee

Locations?

A

Suprapatellar: posterior to quadriceps tendon

Prepatellar: between skin and patella

Superficial infrapatellar: between skin and patellar ligament

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55
Q

Housemaid’s Knee

A

Prepatellar bursitis

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56
Q

Clergyman’s Knee

A

Superficial infrapatellar bursitis

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57
Q

Attachments of the LCL

A

lateral condyle of femur / head of fibula

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58
Q

Attachments of the MCL

A

medial condyle of femur / medial side of tibia

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59
Q

ACL function

A

prevents movement of tibia anteriorly

60
Q

PCL function

A

prevents movement of tibia posteriorly

61
Q

Menisci of the knee attachments to collateral ligaments

A

Medial meniscus attached to MCL

Lateral meniscus NOT attached to LCL

62
Q

Terrible Triad of the Knee

A

MCL, ACL, Medial Meniscus

Caused by lateral blow to the flexed knee

63
Q

Medial ligament of the ankle:

Attachments? What motion does it limit?

A

Medial malleolus / Medial surface of talus and calcaneus

Limits eversion

64
Q

Anterior and Posterior talofibular ligaments

Attachments? Limits what motion?

A

lateral malleolus of fibula / talus

limit inversion

65
Q

Calcaneofibular ligament

Attachments? Limits what motion?

A

lateral malleolus of fibula / calcaneus

limit inversion

66
Q

Inversion/Eversion movements occur at what two foot joints?

A

Subtalar joint (talus / calcaneus)

Transverse tarsal joint (med: talus / navicular & lat: calcaneus / cuboid bones)

67
Q

Pott’s Fracture

What is damaged? (2)

A

Excessive Eversion

Medial malleolus is fractured,
Break in shaft of fibula

68
Q

Muscles involved in generating forces in the foot for walking and running (3)

A

Gastrocnemius
Soleus
Flexor Hallucis Longus

69
Q

Pes Planus:

Which ligament is affected?

A

Flat Feet

Stretching of the plantar calcaneonavicular ligament

70
Q

The axis of abduction/adduction for the toes is

A

The middle of the second toe

71
Q

Plantar Aponeurosis Functions (2)

A

Protects underlying structures

Helps support arch (lateral)

72
Q

Quadratus Plantae

A

Pulls flexor digitorum longus tendon laterally to straighten out toe flexion

73
Q

Function of the two sesamoid bones under head of the first metatarsal

A

Prevents weight of the body from resting on great toe tendon

74
Q

Adductor Hallucis Structure

A

Two heads of origin: oblique and transverse

One common tendon

75
Q

Layer 4 Deep Tendons (2)

A

Tendon of Peroneus Longus

Tendon of Tibialis Posterior

76
Q

Branches of Posterior Tibial Artery in the Foot

A

Lateral Plantar Artery

Medial Plantar Artery

77
Q

Lateral Plantar Artery gives rise to what?

A

Planter Arterial Arch

which gives rise to plantar digital arteries

78
Q

Which foot ligament is known as the ‘spring’ ligament?

A

Plantar calcaneonavicular ligament

*Also most important ligament in foot, apparently.

79
Q

What is the lateral arch of the foot supported by?

A

Long plantar ligament
Plantar aponeurosis
Peroneal tendons

80
Q

What is the transverse arch supported by?

A

Interosseus muscles

Peroneus longus tendon

81
Q

Growth Disturbance (varus)

A

Cause of genu varum

epiphyseal dysplasia

82
Q

Post-trauma (varus)

A

Cause of genu varum

Injury to growth plate near knee

83
Q

Foot muscles innervated by medial plantar nerve

A

flexor hallucis brevis
1st lumbrical
abductor hallucis
flexor digitorum brevis

84
Q

Which kinds of cartilage lack perichondrium?

A

Hyaline cartilage on articular surfaces of bone,

Fibrocartilage

85
Q

Which type of cartilage growth is associated with the formation of isogenous groups?

A

Interstitial growth

86
Q

Fibrocartilage features what kinds of collagen in a regular pattern?

A

Type 2 and Type 1

87
Q

Proton-ATPases are utilized by what type of bone cell?

A

Osteoclasts

88
Q

What resides in Howship’s Lacuna?

A

Osteoclasts

89
Q

What orientation do Volkmann’s canals have in relation to the long bone?

A

Transverse

90
Q

Osteopetrosis

A

Reduced osteoclast activity resulting in too much bone

91
Q

High Ankle Sprain

A

Tear or stretch of the anterior inferior tibio-fibular ligaments

92
Q

Pathway of Blood

A

RA - tricuspid valve - RV - pulmonary valve - pulmonary arteries - lungs - lung capillary beds - pulmonary veins - LA - mitral valve/bicuspid - LV - aortic valve - systemic arteries - systemic capillary beds - systemic veins - RA

93
Q

Layers of Arteries and Veins

A

Tunica Adventitia - outer connective tissue
Tunica Media - middle smooth muscle layer (controls arterial vasomotor tone)
Tunica Intima - inner lining - endothelial cells (diffusion)

93
Q

Features that distinguish veins from arteries

A

Veins….

  • thin walls
  • large luminal diameters
  • do not pulsate when cut
  • occur as multiple vessels in a common vascular sheath
  • valves
  • ability to expand (have 80% of blood volume)
94
Q

What are capillaries comprised of?

A

Simple endothelial cell tubes

94
Q

Capillary Beds

A

Networks of capillaries that connect arterioles and venules. Hydrostatic pressure at arteriole end forces fluid (o2) out of blood and osmotic pressure at the venule end allows waste and co2 into blood.

96
Q

At the arteriole end of capillary beds, what force pushes nutrient-rich fluid into the tissues?

A

Hydrostatic pressure

97
Q

The portal venous systems

A

Hepatic: drains blood from capillary beds of digestive tract to (eventually) the liver for metabolism and detox before hitting the heart

Hypophyseal: drains from capillary beds at base of hypothalamus to capillary plexus around anterior pituitary gland. Hypothalamic-anterior pituitary communication (neurosecretory hormones)

98
Q

At the venule end of capillary beds, what force allows waste products to enter the blood?

A

Osmotic pressure

100
Q

Locations without lymphatic capillaries

A

Teeth, Bone, Marrow, CNS

101
Q 
Regions supplied by each:
Subclavian Arteries
Common Carotid
Aortic Arch
Brachiocephalic Trunk
Pulmonary Veins
Pulmonary Trunk
Sup and Inf Vena Cava
A

Upper limb
Head and neck
From LV it descends to abdomen, pelvis, and lower limb
Branches to rt subclavian and rt carotid
LA from lungs
RV to lungs
RA from upper and lower body

102
Q 
Name of heart valves:
RV --> lungs
LA --> LV
LV --> systemic
RA --> RV
A

pulmonary valve

mitral valve

aortic valve

tricuspid valve

103
Q

What do lymphatic capillaries lack that allows the entry of material into the lymph?

A

Basement membrane

104
Q

What does the right lymphatic duct drain?

A

Upper right quadrant of the body

105
Q

What does the thoracic duct begin with?

A

Cisterna chyli (merger of the lymphatic trunks draining the lower half of the body)

106
Q

Where does the thoracic duct join the venous system?

A

Left venous angle

107
Q

Thrombus
Embolus
Embolism

A

Blood clot in place of origin
Blood clot that has moved
Obstructed vessel due to embolus

108
Q

Infarct

Stenosis

A

Necrosis due to total occlusion of an artery

Damage due to partial occlusion

109
Q

Varicose Veins

A

Abnormally swollen and dilated veins, usually occurring in the legs. Walls of veins lose their elasticity and damaged valves allow blood to pool in their veins instead of returning to the heart.

110
Q

Edema

A

Swelling of tissue due to excess amt of interstitial fluid

111
Q

Hypertension

A

High blood pressure because of abnormally high smooth muscle tonus

112
Q

Ateriovenous anastamoses

A

Where blood passes from arterial to venous circulation without passing through capillaries
Found in skin (esp. fingers) for thermal regulation

113
Q

A-delta mechanosensitive nociceptors are activated by what stimulus?

A

Noxious mechanical stimulation

114
Q

C fibers are activated by which stimuli?

A

Variety of chemical stimuli in addition to noxious mechanical and thermal stimulation

*polymodal nociceptors

115
Q

What is the difference between activators and sensitizers?

A

Activators directly activate nociceptors while sensitizers lower the threshold for nociceptor activation.

(Types of substances released into extracellular fluid compartment due to local tissue damage)

116
Q

Stepwise process of pain

A
  1. Lesion occurs
  2. Substance released into extracellular fluid from cells around lesion
  3. Free nerve endings respond to the stimuli present
  4. Orthodromic action takes signal toward DRG and spinal cord
117
Q

A-delta mechanothermal nociceptors are activated by which types of stimulation?

A

Noxious Mechanical and Thermal stimulation

118
Q

Chemical activators released in response to damage (4)

A

serotonin
bradykinin
potassium
histamine

119
Q

Chemical sensitizers released in response to injury

A

substance P

prostoglandins

120
Q

Which substance is both an activator and sensitizer in pain response?

A

serotonin

121
Q

Axon Reflex

A

Activation of one nociceptor ending initiates action potentials which conduct orthodromically towards CNS. These action potentials also propagate antidromically to invade nociceptor endings which were not activated by the noxious stimulus.

122
Q

Which pain response substance is released through axon reflex?

A

substance P (by C-fibers)

123
Q

Functions of Substance P in peripheral tissues

A

Sensitizer
Vasodilator
Induces histamine release from mast cells

124
Q

Source of potassium in pain response

A

Damaged cells

125
Q

Source of serotonin in pain response

A

Platelets

126
Q

Source of bradykinin in pain response

A

Plasma kininogen

126
Q

Source of Histamine in pain response

A

Mast cells

126
Q

Source of Prostaglandins in pain response

A

Damaged cells (arachidonic acid)

127
Q

Source of Substance P in pain response

A

Nociceptors

129
Q

Hyperalgesia

A

An exaggerated response to a noxious stimulus which signifies increased sensitivity of nociceptive afferent fibers

130
Q

Primary Hyperalgesia

A

Occurs in tissues surrounding the site of injury and is caused by the peripheral release of chemical activators and sensitizers during axon reflex.

*extent of this correlates with redness due to substance P induced vasodilation

131
Q

Secondary Hyperalgesia

A

Surrounds area of primary hyperlgesia and is mediated centrally through multiple processes. Results in lowered thresholds for nociceptors which innervate the surrounding area.

132
Q

Allodynia

A

Typically accompanies hyperalgesia and is pain sensation resulting from stimuli which are not capable of evoking pain.

134
Q

The excitatory influence by the ascending spinothalamics can be countered by what descending fibers? (2)

A
  1. Serotonergic
  2. Noradrenergic

*originate in medulla and pons of brainstem

135
Q

Gate Control Theory

A

Interneurons act as the gate keeper and are naturally inhibitory within the dorsal horns. C fibers “hold the gate open” by inhibiting the interneuron AND exciting the projection neuron (to spinothalamics). A-alpha or A-beta (non-nociceptive fibers) close the gate by exciting the interneuron to inhibit the projection neuron (to spinothalamics) thereby inducing analgesia.

136
Q

3 classes of endogenous opioid peptides

A
  1. Enkephalins
  2. Dynorphins
  3. Endorphins
137
Q

3 classes of opioid receptors

A
  1. MU (enkephalins and endorphins)
  2. Delta (enkephalins and endorphins)
  3. Kappa (only dynorphins)

*all metabotrophic (g-coupled!)

138
Q

What is the principal opioid and its receptor in the dorsal horn of the spinal cord?

A

enkephalin; mu receptors

139
Q

How do opioids work?

A

They exert powerful pre- and post-synaptic inhibition at the synapses between nociceptor afferents and projection neuron and also in the periaqueductal gray to regulate descending noradrenergic and sergonergic fibers.

140
Q

Postsynaptic Inhibition by opioids

A

Caused by the opening of K channels, hyperpolarizing the projection neurons and decreasing their ability to fire action potentials.

141
Q

Presynaptic inhibition by opioids

A

Reduces neurotransmitter release through a combination of effects:

  • opening K channels
  • inhibiting Ca channels
  • inhibiting adenylyl Cyclase and therefore reducing cAMP levels
142
Q

How can the periaqueductal gray be activated in pain modulation?

A

Exciting projection neuron by disinhibition by opioids: GABA inhibiting interneurons deactivated

Excitation from lateral spinothalamic tract collaterals (also stress, emotion)

143
Q

The PAG contains a high concentration of what? (3)

A

MU receptors, enkephalin producing neurons, and dynorphin producing neurons.

144
Q

Opiate drugs (like morphine - binds MU receptors) produce analgesia in what 2 ways?

A
  1. Excitation of PAG projection neurons which then activate the descending serotonergic and noradrenergic pathways from the brain stem.
  2. Inhibition of neurotransmission from nociceptors to dorsal horn projection neurons.
145
Q

Other Analgesics (5)

A
  1. Cyclo-oxygenase Inhibitors (aspirin) - inhibit formation of prostaglandins
  2. Capsaicin - induces long term desensitization to painful stimuli
  3. Antidepressants - inhibit reuptake of serotonin/norepinephrine; enhance effectiveness of descending pain control system
  4. NMDA receptor antagonist - ketamine
  5. Anticonvulsants - reduce abnormal excitability in pain system
146
Q

Neuropathic Pain

A

Chronic pain resulting from a disease or injury which affects neurons.

Many causes: diabetes, shingles, chronic trauma, tumors….may be idiopathic (no cause)

148
Q

Channelopathies

A

Chronic pain linked to a genetic mutation. Specific mutations in genes that code for the Na-v subunits expressed in periphery sensory neurons are implicated in some pain disorders.

Congenital insensitivity to pain due to issues with voltage gated sodium channel subunits.

149
Q

What ligament completes the cup of the acetabulum?

A

Transverse acetabular ligament

S&F1 (7 decks)

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