Wednesday Anatomy Lecture

Question 1

Angle of Inclination

Answer 1

Decreases with age (goes from 120 to 90 because of weight)

Consequently, hip fractures are more common in the elderly

Question 2

Femoral-Tibial Articulation

Answer 2

Largest and most superficial joint; primarily a hinge/synovial joint (allows minor gliding, rolling and rotation)

Question 3

Osteomyelitis

Answer 3

Serious infection of bone that can be extremely destructive

Question 4

What do the Iliofemoral-Ischiofemoral Ligaments do?

Answer 4

They tighten with hip extension and lock the femoral head tightly into the acetabulum when hip is extended

Question 5

What do the Gluteus Medius, Gluteus Minimus, and Tensor Fascia Lata muscle act in concert to do?

Answer 5

All three muscle act together in ambulation (innervated by the superior gluteal nerve)

Keep the pelvis level when the opposite foot is off the ground, allowing the lifted foot to clear the ground with each step (OPPOSITE SIDED muscles keep the pelvis level)

They also rotate the hip forward on the planted foot to help swing the lifted foot

Question 6

Anti-Gravity Muscles

Answer 6

Gluteus Maximus; Quadriceps Femoris

These are active when ascending stairs or rising from the sitting position (the soleus is also considered an anti-gravity muscle)

Question 7

Subtalar Joint

Answer 7

Where eversion and inversion occurs

Eversion is digging the medial side in, less concerned with pulling the lateral side up. Inversion is concerned with digging the lateral side in.

Question 8

Deep Component of the Posterior Compartment

Answer 8

Very dangerous because it contains a lot of vessels

Question 9

Tibialis Anterior action

Answer 9

A strong extensor of the ankle, but also an “inverter” of the foot because it is medial to the subtalar axis

Question 10

Fibularis Longus action when walking

Answer 10

Helps maintain the transverse arch (attaches to the first metatarsal): the “spring” when we walk

Question 11

What posterior superficial muscle is thought to be involved with proprioception?

Answer 11

Plantaris

Question 12

The “P’s” of Compartment Syndrome

Answer 12

Pressure
Persistent Pain (especially with Passive stretching)
Paresthesia (anasethesia)
Paresis/Paralysis

Irreversible damage

Question 13

What is normal interstitial pressure

Answer 13

0-9 mm Hg

Question 14

What to do if compartment syndrome is a possibility?

Answer 14

ALWAYS open the compartment (surgical decompression) rather than delay, especially before transferring a patient

Question 15

Ambulation and Standing at Ease

Answer 15

Read Moore pp542-544

Gastrocnemius & Soleus Effect “Push-Off” on the medial side

Fibularis Longus: Everts the foot to direct force to 1st and 2nd MC heads

The Intrinsics “grip” the surface

Question 16

Mortise-Tendon Configuration

Answer 16

Dorsiflexion and stability of the ankle joint

Question 17

Dorsiflexion and Plantar Flexion injury

Answer 17

Dorsiflexion: tightens the ankle (wedge shape of the talus)
Plantar flexion (toe-pointing): allows loose side-to-side movement

This can have implications for sorting out the MOI to the ankle

Question 18

Where does the Saphenous nerve exit on the lower leg?

Answer 18

Between the Gracilis and Sartorius

Question 19

What gives off the fibular artery

Answer 19

The posterior tibial artery, before it continues down the leg traveling with the tibial nerve and traversing the “tarsal tunnel” at the medial ankle

Question 20

Way to remember the posterior compartment’s organization

Answer 20

Tom, Dick, And a Very Nervous Henry

Tibialis Posterior, Flexor Digitorum Longus, Posterior Tibialis Artery, Posterior Tibial Vein, Tibial Nerve, Flexor Hallicus Longus