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Acem Primary > upper and lower limb > Flashcards

upper and lower limb Flashcards

1
Q

what type of joint is the wrist?

A

an ellipsoid type biaxial synovial joint
movement allowed; flexion extension, adduction, abduction
no active rotation takes place

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2
Q

what bones are involved in the wrist joint?

A

Distally; proximal row of carpal bones except pisiform
Proximaly; distal end of radius, articular disc (fibrocartilginous ligament which lies between the ulna and the wrist joint

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3
Q

where does the dorsal scapular nerve come off

A

C5

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4
Q

what is serratus anterior supplied by

A

C5 C6 C7 long thoracic nerve

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5
Q

What does the median nerve supply?

A

Pronator teres, Felxor carpi radialia, palmaris longus
Flexor digitorum superficialis
Flexor digitorum profundus (lateral), Flexor pollicis longus, Pronator quadratus
1st and 2nd lumbricals, Opponens pollicis, Abductor pollicis brevis, Flexor pollicis brevis

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6
Q

Describe the annular ligament

A

attached to the margins of the radial notch
clasps the head and neck of the radius
is intracapsular
radius have no attachment to the annular

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7
Q

Contents of the Quadrangular space

A

Axillary nerve
Posterior circumflec artery and vein

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7
Q

Contents of triangular space

A

Circumflex scapular artery

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8
Q

Contents of triangular interval

A

radial nerve, profundi brachii artery

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9
Q

boundaries of the adductor canal (Hunters canal)

A

Anteriorly - sartorius
Postermedially - adductor longus and adductor magnus
laterally - vastus medialis

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10
Q

Describe the long head of biceps

A

is intracapsular, arise from the supraglenoid tubercle
the tendon of the long head passes through the shoulder joint and intertubecular groove of the humerus to meet the short head
At the level of the humeral shaft, the two heads combine to form the muscle belly

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11
Q

Boundaries of the anatomical snuff box

A

Medial/ulnar side = extensor pollicis longus
lateral/radial side = extensor pollicis brevis, abductor pollicis longus
proximal = styloid process of the radius
floor = trapezium and scaphoid

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12
Q

Describe the injury to the medial cord of the brachial plexus

A

Nerves involved; ulnar, medial root of median
Muscles paralysed; ulnar nerve supplied muscles, 5 muscles of the hand supplied by the median nerve
Claw hand
sensory loss to the ulnar side of the forearm and hand

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13
Q

In abduction of the arm what happens to the clavicle and the scapula?

A

medial end of the clavicle moves downwards
scapula moves laterally on the chest wall
Scapula movement at first slower than the humerus

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14
Q

what is the proximal row of the carpals of the wrist?

A

scaphoid lunate triquetrium pisiform

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15
Q

what carpal bones articulate with the radius

A

scaphoid and lunate

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16
Q

Extensor part of the wrist has 6 compartments; compartment 1 contains

A

Extensor pollicis brevis
Abductor pollicis longus

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17
Q

Extensor part of the wrist has 6 compartments; compartment 2 contains

A

Extensor carpi radialis brevis
Extensor carpir radialis longus

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18
Q

Extensor part of the wrist has 6 compartments; compartment 3 contains

A

Extensor pollicis longus

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19
Q

Extensor part of the wrist has 6 compartments; compartment 4 contains

A

Extensor digitorum
Extensor indicis

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20
Q

Extensor part of the wrist has 6 compartments; compartment 5 contains

A

Extensor digiti minimi

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21
Q

Extensor part of the wrist has 6 compartments; compartment 6 contains

A

extensor carpi ulnaris

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22
Q

origin, insertion, artery, nerve and action of palmaris longus

A

O; medial epicondyle of humerus
I; palmer aponeurosis
A; ulnar artery
N; median nerve
action; wrist flexor

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22
Q

Origin, insertion, artery, nerve and action of Extensor Pollicis Longus

A

O; middle third of posterior urface of ulna, interosseus membrane
I; thumb distal phalanx
A; posterior interoseus artery
N; Posterior interosseous nerve, branching from the radial nerve
Action; Extension of the thumb MCP and IP

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23
Q

Origin, insertion, artery, nerve and action of Flexor carpi radialis

A

O; medial epicondyle of humerus, common flexor tendon
I; bases of second and third metacarpal bones through the flexor retinaculum
A; radial artery
N; Median nerve
Action; flexion and abduction at the wrist

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24
Q

Describe the sternoclavicular joint

A

a saddle type of synovial joint but functions as a ball and socket
divided into two compartments by an articular disc
the disc is attached to the anterior and posterior sternoclavicular ligaments and interclavicular ligament

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25
Q

Ligaments of the sternoclavicular joint

A

Anterior and posterior sternoclavicular ligaments reinforce the joint capsule
Interclavicular ligament strengthens the capsule superiorly
the costoclavicular ligament anchors the inferior surface of the sternal end of the clavicle to the 1st rib

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26
Q

Origin, insertion, action, innervation of Abductor Pollicis Brevis

A

O; flexor retinaculum and tubercles of scaphoid and trapezium
I; lateral side of base of the proximal phalanx of the thumb
A; palmer abduction
N; recurrent branch of median nerve

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27
Q

Origin, Insertion, Action, Innervation of Opponens Pollicis

A

O; flexor retinaculum and tubercle of trapezium
I; lateral side of first metacarpal bone
A; rotates thumb, pinch with index finger
N; recurrent branch of median nerve

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28
Q

Origin, insertion, action and innervation of Flexor Pollicis Brevis

A

O; flexor retinaculum and tubercle of trapezium
I; medial side of base proximal phalanx of the thumb
Action; flexes and stabilizes the MPJ
N; recurrent branch of median nerve

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29
Q

Describe the course of the ulnar nerve

A

located in the grooved surface of middle band of the medial collateral ligament
lies in contact with the sublime tubercle
enters the forearm between 2 heads of FCU
runs between FCU and FDP
passes below the ulnar head of pronator teres

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30
Q

Describe the course of the Cephalic vein

A

Arises from the lateral side of the dorsal venous network
Communicates with the basilic vein via the median cubital vein at the elbow
located in the superficial fascia along the anterolateral surface of the biceps brachii muscle
Passes between the deltoid and pectoralis major muscles
Through the deltopectoral triangle
empties into the axillary vein

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31
Q

what is the largest branch of the brachial plexes

A

Radial nerve

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32
Q

how much larger is the humeral head compared to the glenoid fossa

A

4x larger

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33
Q

loss of the greater tuberosity leads to loss of what direction of movement?

A

abduction and lateral rotation

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34
Q

Branches of the axillary artery

A

First part - Superior thoracic artery
Second part - thoraco-acrominal artery, lateral thoracic artery
Third part - subscapular artery, anterior and posterior humeral circumflex arteries

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35
Q

what nerve supplies the shoulder joint

A

axillary, suprascapular, lateral pectoral nerves C5, C6
injury will cause upper brachial plexus injury, erbs palsy

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36
Q

Origin, Insertion, atery, nerve, action of Subscapularis

A

O; subscapular fossa
I; Lesser tubercle of humerus
Artery; Subscapular artery
N; upper subscapular nerve, lower subscapular nerve
actions; internally (medially) rotates humerus stabilizes shoulder
covered by dense fascia

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37
Q

origin, insertion, artery, nerve and action of palmer interossei

A

O; sides of metacarpals facing midline
I; bases of proximal phalanges, extensor expansions
artery; palmar metacarapal artery of deep palmer arch
N; deep branch of ulnar nerve
Action; adduction, flexion and extension of fingers

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38
Q

Origin, Insertion, Artery, Nerve and action of Dorsal interossei

A

O; metacarpals
I; proximal phalanges and extensor expansions
Artery; dorsal and palmer metacarpal artery
N; deep branch of ulnar nerve
Action; abduct fingers

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39
Q

In the palmer aspect of the wrist where does the median nerve lie?

A

Between FDS and FPL

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40
Q

at the wrist where does the ulnar nerve lie

A

the Guyon canal, which is above the flexor retinaculum

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41
Q

where does the brachial artery divide

A

at the level of the radial neck

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42
Q

origin, insertion, artery, nerve and action of Flexor Pollicis longus

A

O: the middle 2/4 of the volar surface of the radius and the adjacent interosseus membrane
I; base of the distal phalanx of the thumb
Artery; anterior interosseus artery
N; anterior interosseous nerve, branch of median nerve
Action; Flexion of the thumb

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43
Q

When static the Glenohumeral Joint is stabilised by ?

A

the firmness of the superior capsule and suprahumeral ligament
the adhesive and cohesive forces of synovial fluid and negative joint pressure
the deepening of the fossa by the Glenoid labrum via the rotator cuff

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44
Q

whilst dynamic the Glenohumeral joint is stabilised by?

A

the Rotator Cuff
the Deltoid
the long head of biceps

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45
Q

what artery mostly supplies the humerus shaft

A

brachial artery

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46
Q

Origin, insertion, artery, nerve and action of Opponens pollicis

A

O; trapezium and transverse carpal ligament
I; radial side of metacarpal bone of thumb
Artery; superficial palmer arch
N; recurrent branch of median nerve
Action; flexion of thumb at CMCJ/trapezoimoetacarpal joint

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47
Q

what is the groove of the first rib related to?

A

subclavian artery

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48
Q

what are the 3 branches of the axillary artery

A

subscapular artery
anterior humeral circumflex artery
posterior humeral circumflex artery

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49
Q

how does the brachial plexus relate to the axillary artery

A

the brachial plexus cords surround 2nd part of the artery
cords named in relation to the artery
branches surround the 3rd part

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50
Q

when does the axillary artery become the brachial artery?

A

at the inferior border of teres major

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51
Q

route of the radial artery at the wrist

A

disappears beneath the tendons of APL and EPB at the wrist

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52
Q

branches of the radial artery in the forearm

A

radial recurrent artery
palmer carpal branch of radial artery
superficial palmer branch of radial artery

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53
Q

branches of the radial artery at the wrist

A

dorsal carpal branch of radial artery
first dorsal metacarpal artery

54
Q

branches of the radial artery in the hand

A

princeps pollicis artery
radial indicis
deep palmer arch

55
Q

attachment of the flexor retinaculum

A

scaphoid trapezium hamate pisiform

56
Q

what nerve is unaffected in compression of the median nerve in carpal tunnel syndrome

A

Palmer branch of the median nerve

57
Q

how do the tendons of FDP and FDS travel in the flexor sheath

A

invested by a single synovial sheath

58
Q

what happens when the palmer and dorsal interossei contract together

A

flexion of the MCPJ

59
Q

regarding the cubital fossa where does the posterior interosseous nerve exit

A

between the 2 heads of supinator

60
Q

Injury to the lateral cord causes damage to what

A

Nerves; musculocutaneous, lateral root of the median nerve
Muscles; biceps, coracobrachialis, all muscles supplied by the median nerve
loss of flexion of the forearm and wrist, sensory loss on the radial side of the forearm

61
Q

number of ossification centres in the scapula

A

7

62
Q

Describe digital nerves

A

are only sensory
lie anterior to digital artery

63
Q

innervation of radial nerve proximally to distally

A

brachioradialis
extensor carpi radialis longus
supinator
extensor carpi radialis brevis
extensor digitorum
extensor carpi ulnaris
extensor digiti minimi
abductor pollicis longus
extensor pollicis longus
extensor pollicis brevis
extensor indicis

64
Q

what is the largest branch of the brachial plexus

A

radial nerve

65
Q

where do lumbricals arise from ?

A

flexor digitorum profundus tendons

66
Q

where does the dorsal scapula nerve come from

A

C5

67
Q

origin, insertion, artery, nerve and action of flexor carpi radialis

A

O; medial epicondyle of humerus
I; bases of second and third metacarpal bones
A; radial artery
N; median nerve
action; flexion and abduction at wrist

68
Q

deep peroneal nerve travels with which artery in the leg

A

anterior tibial

69
Q

Injury to L5 will cause what clinical signs

A

inability to;
extend hip
flex knee
foot eversion
dorsiflex big toe
loss of sensation to ;
lateral part of the leg, dorsum of the foot and medial sole

70
Q

where does the plantar aponeurosis arise

A

from the medial process of calcaneous and fans out over the sole

71
Q

what does the ACL do for the knee?

A

limits posterior rolling of the femoral condyles on the tibial plateau during flexion
prevents hyperextension of the knee
prevents posterior displacement of the femur on the tibia

72
Q

what does the PCL do for the knee?

A

limits anterior rolling of the femur on the tibial plateau during extension
helps prevents hyperflexion of the knee
prevents anterior displacement of the femur on the tibia

73
Q

what are the extracapsular ligaments of the knee? (5)

A

patellar ligament
fibular collateral ligament
tibial collateral ligament
oblique popliteal
arcuate popliteal

74
Q

of the extra-capsular ligaments which is stronger out of the tibial collateral or fibular collateral

A

Fibular collateral ligament

75
Q

Describe the position of the Arcuate popliteal ligament

A

arises from the posterior aspect of the fibular head
passes superomedially over the tendon of popliteus
spreads over the posterior surface of the knee joint

76
Q

blood supply of the sciatic nerve

A

sciatic artery
branch of inferior gluteal artery

77
Q

what muscles form the hamstrings

A

semitendinosus
semimembranosus
long head of biceps femoral
hamstring part of adductor magnus

78
Q

what nerve supplies the long head and the short head of biceps femoris

A

tibial division of sciatic nerve = long head
fibular division of sciatic nerve = short head

79
Q

Course of the sciatic nerve

A

most lateral nerve entering the greater sciatic foramen inferior to piriformis
runs inferolaterally under gluteus maximus, midway between the greater trochanter and ischial tuberosity
rests on the ischium
passes posterior to obturator internus, quadratis femoris and adductor muscles
descends in the posterior thigh deep to biceps femoris
bifurcates into tibial and common fibular nerve at apex of popliteal artery

80
Q

what is the main nerve of the lateral compartment of the leg

A

superficial fibular nerve

81
Q

what is the function of the lumbricals in the foot

A

flex proximal phalanges
extend middle and distal phalanges of the lateral four toes

82
Q

Describe the course of the deep veins of the leg

A

the three deep veins into the popliteal vein, into the femoral vein in thigh, passes deep to inguinal ligament to become external iliac vein

82
Q

what does the DP artery come from

A

anterior tibial artery

83
Q

how does DP travel into the foot

A

begins midway between the malleoli
runs anteriomedially
deep to inferior extensor retinaculum
between extensor hallucis longus and extensor digitorum longus

84
Q

what structure of the foot does the DP artery form part of

A

deep plantar arch

85
Q

what is most important in stabilising the patella

A

the lowest fibres of the vastus medialis

86
Q

which knee bursa is likely to cause septic arthritis

A

suprapatellar

87
Q

what nerve supplies sensation to the dorsum of the foot between 1st and 2nd toes

A

deep fibular nerve

88
Q

what sensation does the saphenous nerve supply

A

medial aspect of the foot and lower leg

89
Q

what myotome is responsible for plantar flexion of ankle

A

S1 - S2

90
Q

Damage to what nerve can cause a Trendelenburg gait

A

superior gluteal nerve

91
Q

what structures attach to AIIS

A

rectus femoris
iliofemoral ligament

92
Q

where are femoral hernias in relation to pubic tubercle

A

inferior and lateral

93
Q

what are the lateral and medial boundaries of a femoral hernia

A

femoral vein laterally
lacunar ligament medially

94
Q

injury to what artery in NOF can cause avascular necrosis

A

Medial circumflex artery

95
Q

what movement occurs at the subtalar joint

A

inversion and eversion

96
Q

what are the 3 divisions of the internal iliac artery

A

Iliolumbar
lateral sacral (superior and inferior)
superior gluteal

97
Q

what does the iliolumbar artery supply

A

psoas major
iliacus
quadratus lumborum
cauda equina in vertebral canal

98
Q

damage to what muscle causes shin splints

A

tibialis anterior

99
Q

action of tibialis anterior

A

dorsiflexion of ankle
inversion of foot
maintains medial longitudinal arch

100
Q

bony components of the medial longitudinal arch of the foot

A

calcaneus
heads of 3 metatarsal bones

101
Q

what runs in the adductor canal

A

sapenous nerve
nerve to vastus medialis

102
Q

what is the origin of the femoral nerve

A

posterior division of the anterior rami of lumbar nerves 2,3,4

103
Q

how does the femoral nerve enter the thigh

A

deep to the inguinal ligament
lateral to the artery
OUTSIDE the femoral sheath

104
Q

origin of tibialis posterior

A

interosseus membrane and adjoining surfaces of tibia and fibula

105
Q

action of tibialis posterior

A

plantarflex ankle
invert and adduct forefoot
contributes to maintaining the longitudinal arch of the foot

106
Q

what forms the transverse arch of the foot

A

cuboid
cuneiforms
bases of metatarsals

107
Q

what tendons help maintain the curvature of the transverse arch

A

fibularis longus
tibialis posterior

108
Q

first layer of the foot

A

flexor digitorum brevis
abductor hallucis
abductor digiti minimi

109
Q

second layer of the foot

A

tendon of flexor hallucis longus
tendon of flexor digitorum longus
quadratus plantae
lumbricals

110
Q

third layer of the foot

A

flexor hallucis brevis
adductor hallucis
flexor digiti minimi brevis

111
Q

4th layer of the foot

A

interosseous muscles
tendon of peroneus longus
tendon of tibialis posterior

112
Q

where does gluteus maximus insert

A

deep lower 1/4 in gluteal tuberosity of femur
3/4 in iliotibial tract

113
Q

At all levels of the thigh where does the femoral artery lie

A

between saphenous nerve and femoral vein

114
Q

contents of the adductor canal

A

femoral artery
femoral vein
saphenous nerve
nerve to vastus medialis

115
Q

bones of the medial longitudinal arch

A

calcaneus
talus
navicular
3 cuneiforms
3 metatarsals

116
Q

what passes through the lesser sciatic foramen

A

tendon to obturator internus
internal pudendal artery and veins
pudendal nerve
nerve to obturator internus

117
Q

structures in the femoral triangle lateral to medial

A

femoral nerve
femoral sheath
femoral artery
femoral vein (it receives from great saphenous and deep femoral vein)
femoral canal containing deep inguinal lymph nodes and associated lymph

118
Q

what makes up the longitudinal arch of the foot

A

calcaneus
cuboid
lateral two metatarsals

119
Q

what nerve supplies the skin over the femoral triangle

A

genito-femoral

120
Q

what ligaments of the knee are extra capsular

A

Patellar ligament
Oblique popliteal ligament
Tibial collateral ligament
fibular collateral ligament
arcuate popliteal ligament

121
Q

what structures pass deep to the superior extensor retinaculum

A

Tibialis anterior
extensor Hallucis longus
tibial anterior Artery
tibial anterior Vein
deep fibular Nerve
extensor Digitorium longus
peroneus Tertius

Tim Has A Very Nasty Diseased Toe

121
Q

what nerve supplies the lateral leg

A

superficial peroneal nerve L5 S1 S2

122
Q

origin of popliteus

A

lateral surface of lateral condyle of femur and lateral meniscus

123
Q

Innervation and action of popliteus

A

Tibial nerve L4 L5 S1
unlocks the knee

124
Q

how is the femoral artery separated from the hip joint

A

psoas major

125
Q

action of gluteas maximus

A

laterally rotates and extends the hip

125
Q

what landmark is the femoral artery at

A

mid inguinal point

126
Q

what is the nerve supply of gluteus maximus

A

L5 S1 S2

127
Q

what is the weakest ligament in the hip

A

ischiofemoral ligament

128
Q

what limits the hip in full extension

A

iliofemoral ligament

129
Q

what is the infero medial border of popliteal fossa

A

gastrocnemius

130
Q

what is the sural nerve a branch of

A

tibial nerve
common peroneal nerve

131
Q

where does tibialis anterior insert

A

inserts into the medial cuneiform and adjacent first metatrsal

Acem Primary (5 decks)

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