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Clinical Morphology > Week 3 > Flashcards

Week 3 Flashcards

1
Q

main functions of lower limb

A

locomotion, supporting body weight, and maintaining balance.

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2
Q

gluteal region

A

area of lower limb attachment to axial skeleton; posterior to pelvic bones at proximal end of femur. bones include: pelvis and proximal end of femur (hip joint).

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3
Q

thigh

A

between hip and knee joint (femur)

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4
Q

leg

A

between the knee and ankle joints (tibia and fibula)

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5
Q

foot and digits (toes)

A

distal to ankle joint (tarsals, metatarsals, and phalanges)

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6
Q

Hip joint

A

between head of femur and cup-shaped acetabulum on lateral surface of pelvic bone. Multi-axial ball and socket joint designed for stability and weightbearing. flexion/extension, adduction/abduction, and external/internal rotation

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7
Q

ligaments that stabilize the hip joint

A

ligament of head of femur, iliofemoral ligament, pubofemoral ligament, ischiofemoral ligament

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8
Q

iliofemoral ligament

A

“y” shaped; continuous with anterior part of joint capsule; prevents hyperextension of the hip joint. It’s the strongest of hip ligments

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9
Q

pubofemoral ligament

A

triangular; continuous with anterior and inferior part of joint capsule; prevents excessive abduction and extension

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10
Q

ischiofemoral ligament

A

spiral shaped; continuous with posterior part of joint capsule; prevents hyperextension and helps hold head of femur in acetabulum

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11
Q

hip joint blood supply

A

primarily medial and lateral femoral circumflex arteries that anastamose around the neck of femur. medial provides majority of supply. damage to either can cause avascular necrosis of femoral head

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12
Q

knee joint

A

between condyles of distal femur and condyles of proximal tibia. allows for flexion and extension with a small degree of medial and lateral rotation

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13
Q

patellofemoral joint

A

between posterior aspect of patella with anterior aspect of distal femur

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14
Q

ligaments of knee

A

anterior/posterior cruciate ligaments, tibial (medial) and fibular (lateral) collateral ligaments

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15
Q

anterior cruciate ligament

A

attaches anterior aspect of tibia and posterior aspect of femur. Prevents anterior displacement of tibia on femur

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16
Q

posterior cruciate ligament

A

attaches posterior aspect of tibia and anterior aspect of femur. Prevents posterior displacement of tibia on femur

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17
Q

Tibial (medial) collateral ligament

A

Wide and flat on medial side of knee joint between medial epicondyles of femur and medial condyle of tibia

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18
Q

fibular (lateral) collateral ligament

A

thin and round on lateral side of knee joint between lateral epicondyle of femur and head of fibula

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19
Q

medial and lateral meniscus

A

c shaped fibrocartilaginous structures found in knee joint that deepen the articular surface of the tibia to increase stability of knee and function as shock absorbers

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20
Q

3 most commonly injured structures in knee

A

medial collateral ligament, medial meniscus, and anterior cruciate ligament. (Called “unhappy triad of O’Donohue” when injured together)

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21
Q

ankle joint

A

distal tibia and fibula with the talus of the foot. allows for dorsiflexion and planter flexion. Joint more stable when dorsiflexed than when plantar flexed

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22
Q

primary ligamentous support of ankle

A

broad deltoid ligament on medial side of ankle

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23
Q

3 ligaments on lateral side of ankle

A

anterior talofibular, posterior talofibular, and cancaneofibular

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24
Q

ankle sprains

A

normally occur via excessive inversion of a plantarflexed weight-bearing foot. Anterior talofibular ligament is most at risk of damage

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25
Q

subtalar joint

A

between inferior surface of talus and the superior surface of the calcaneous. allow for inversion and eversion of foot

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26
Q

muscles of gluteal region

A

abduct, extend, and externally rotate femur

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27
Q

superficial abductors and extensors of femur

A

gluteus maximus, gluteus medius, gluteus minimus and tensor fascia

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28
Q

gluteus maximus innervation

A

inferior gluteal nerve

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29
Q

gluteus medius innervation

A

superior gluteal nerve

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30
Q

gluteus minimus innervation

A

superior gluteal nerve

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31
Q

tensor fascia innervation

A

superior gluteal nerve

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32
Q

Deep external rotators of femur

A

external rotation and adduction. Piriformis, obturator internus, superior and inferior gamellus, and quadratus femoris

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33
Q

piriformis innervation

A

nerve to the piriformis

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34
Q

obturator internus innervation

A

nerve to the obturator internus

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35
Q

superior and inferior gamellus innervation

A

nerve to the obturator internus

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36
Q

quadratus femoris innervation

A

nerve to the quadratus femoris

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37
Q

blood supply of muscles in gluteal region

A

branches of inferior and superior gluteal arteries

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38
Q

compartments of thigh

A

anterior, posterior, and medial; separated by the intermuscular septa

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39
Q

anterior compartment of thigh

A

primarily extend the leg at the knee. Innervated by the femoral nerve and supplied by branches of the femoral and deep femoral arteries

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40
Q

medial compartment of thigh

A

primarily adduct the thigh at the hip. Innervated by the obturator nerve and supplied by branches of deep femoral and obturator arteries

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41
Q

posterior compartment of thigh

A

flex the leg at the knee and extend the thigh at the hip. Innervated by the sciatic nerve and supplied by the branches of the deep femoral artery

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42
Q

muscles of anterior compartment of the thigh

A

iliopsoas, sartorius, quadriceps

rectus femoris, vastus lateralis, vastus medialis, vastus intermedius

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43
Q

muscles of the medial compartment of the thigh

A

pectineus, adductor longus, adductor brevis, adductor magnus, gracilis, and obteratur externus

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44
Q

muscles of the posterior compartment of thigh

A

hamstrings

semitendinosus, semimebraneosus, biceps femoris

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45
Q

compartments of the leg

A

anterior, posterior, and lateral; separated by the intermuscular septa and bones

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46
Q

anterior compartment of leg

A

dorsiflex and invert the foot and extend the toes. innervated by the deep fibular nerve and supplied by branches of the anterior tibial artery

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47
Q

lateral compartment of leg

A

primarily plantar flex and evert the foot. innervated by superficial fibular nerve and supplied by branches of the fibular artery

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48
Q

posterior compartment of leg

A

plantarflex and invert the foot and flex the toes. innervated by the tibial nerve and supplied by branches of the posterior tibial artery

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49
Q

muscles of the anterior compartment of leg

A

tibialis anterior, extensor hallucis longus and extensor digitorum longus

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50
Q

muscles of the posterior compartment of leg

A

gastrocnemius, soleus, plantaris, popliteus, flexor haluucis longus, flexor digitorum longus, tibialis posterior

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51
Q

muscles of the lateral compartment of leg

A

fibularis longus and fibularis brevis

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52
Q

lumbar plexus

A

somatic plexus formed by anterior rami of spinal nerves L1-L4. Major nerves derived from lumbar plexus are lateral cutaneous nerve of thigh (L2, L3), femoral nerve (L2-L4) and obturator nerve (L2-L4)

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53
Q

Sacral plexus

A

somatic plexus formed by anterior rami of spinal nerves S1-S4. Major nerves are superior gluteal (L4-S1), inferior gluteal nerve (L5-S2), sciatic nerve (L4-S3), posterior femoral cutaneous (S1-S3), and the named branches to the small external rotators

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54
Q

femoral nerve lesion

A

deficits in flexion of thigh at the hip and extension of the knee. Loss of sensation on the anterior thigh and the medial knee, leg, and foot

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55
Q

obturator nerve lesion

A

deficits in adduction and external rotation of thigh at the hip. Loss of sensation in a defined area of the medial thigh above the knee

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56
Q

superior gluteal nerve lesion

A

deficits in abduction of the thigh at the hip (or lateral flexion of the trunk on a fixed limb). Hip drops when foot on the uninjured side is raised and patient shifts weight of trunk to injured side. N to maintain center of gravity (trendelenburg gait) O sensory deficits

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57
Q

tibial nerve lesion

A

deficits of inversion of the foot, plantarflexion of the ankle and flexion of the toes. Loss of sensation on the posterolateral leg to the lateral malleolus, the sole of the foot, and lateral side of the foot.

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58
Q

superficial fibular nerve

A

deficits in eversion and plantarflexion of the foot. Loss of sensation over the lateral leg and dorsum of the foot

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59
Q

Deep fibular nerve

A

deficits of inversion of the foot, dorsiflexion of the foot, and extension of the toes. Loss of sensation in a triangular area of skin between 1st and 2nd toes

60
Q

femoral artery

A

main artery of lower limb; a continuation of the external iliac artery starting as it crosses under the inguinal ligament and enters the femoral triange

61
Q

profunda femoris artery

A

arises off the posterolateral aspect of the femoral artery in the femoral triangle. It then travels poteriorly and distally; gives off 3 main branches

62
Q

3 branches of profunda femoris artery

A

perforating branches, lateral femoral circumflex artery, and medial femoral circumflex artery

63
Q

perforating branches of profunda femoris artery

A

3 or 4 arteries that perforate the adductor magnus and contribute to the supply of the muscles in the posterior and medial thigh

64
Q

lateral femoral circumflex artery

A

wraps around the anterior, lateral side of femur, supplying some muscles on the lateral aspect of thigh. It sends an important branch inferiorly to participate in the collateral circulation around the knee by anastamosing with the genicular arteries

65
Q

medial femoral circumflex artery

A

wraps around the posterior side of the femur, supplying its neck and head.

66
Q

adductor canal

A

a tunnel in the anterior superficial thigh, through which the femoral artery travels

67
Q

popliteal artery begins

A

femoral artery moves through the end of the adductor canal through an opening in the adductor magnus called the adductor hiatus and enters the posterior compartment of the thigh, proximal to the knee. This is where it becomes called the popliteal artery

68
Q

popliteal artery descends

A

down the posterior thigh, giving rise to genicular branches that supply knee joint. At lower border of popliteal fossa, the artery terminates by dividing into the anterior tibial and posterior tibial arteries

69
Q

posterior tibial aretery

A

a division of the popliteal artery; gives a small branch to the lateral part of the leg, called the fibular (peroneal) artery and continues to the sole of the foot behind the medial malleoulus

70
Q

anterior tibial artery

A

a division of the popliteal artery passes anteriorly between tibia and fibula through a gap in the interosseous membrane. Then it runs down the entire length of the leg into the foot, where it becomes the dorsalis pedis artery

71
Q

superior and inferior gluteal arteries

A

supply the gluteal region. They arise from the internal iliac artery and enter the gluteal region via the greater sciatic foramen

72
Q

2 major phases of the human gait cycle

A

stance phase (60%) and swing phase (40%)

73
Q

stance phase of gait cycle

A

heel strike, foot flat, mid stance, heel off

74
Q

swing phase of gait cycle

A

toe off, mid swing, heel strike

75
Q

muscle movements of stance phase

A

hip progresses from flexion to extension; knee progresses from extension to slight flexion; ankle progresses from dorsiflexion to plantarflexion

76
Q

muscle movements of the swing phase

A

hip progresses from extension to flexion; knee progress from flexion to extension; ankle progresses from plantarflexion to dorsiflexion

77
Q

compartment syndrome in the leg

A

common in leg because of the very tight crural fascia; essential clinical feature: conscious patients in severe pain out of proportion to the injury, aggravated by passive muscle stretch; treated most reliably with open fasciotomy by incision of the skin and fascia.

78
Q

what is compartment syndrome

A

occurs when pressure within an unyielding osteofascial compartment increases within that space. Irreversible muscle and nerve damage may occur within hours

79
Q

cause of compartment syndrome

A

trauma, revascularization procedures, burns, and over-exercise

80
Q

patellar apprehension test

A

positive test implies a preceding episode of patellar instability (subluxation or dislocation)

81
Q

patellofemoral grind test

A

Patellofemoral pathology

82
Q

Valgus stress test

A

MCL injury

83
Q

Varus stress test

A

LCL injury

84
Q

Lachman test

A

ACL injury

85
Q

Anterior Drawer Test

A

ACL injury

86
Q

Posterior drawer test

A

PCL injury

87
Q

Tests for Medial and lateral meniscus

A

most sensitive test is pain with full flexion; also check joint line tenderness

88
Q

Autonomic nervous system (ANS)

A

supplies internal organs and controls involuntary responses to changes in the internal and external environment. Divided into sympathetic division and the parasympathetic division

89
Q

origin of preganglionic neurons in sympathetic nervous system

A

spinal cord levels T1-L2

90
Q

preganglionic neuron length in sympathetic nervous system

A

short

91
Q

postganglionic neuron length in sympathetic nervous system

A

long

92
Q

location of ganglion in sympathetic nervous system

A

far from target organ; usually in sympathetic trunk

93
Q

preganglionic neurotransmitter in sympathetic nervous system

A

acetylcholin

94
Q

postganglionic neurotransmitter in sympathetic nervous system

A

norepinephrine

95
Q

origin of preganglionic neurons in parasympathetic nervous system

A

spinal cord levels S2-S4 and Cranial nerve III, VII, IX and X nuclei in the brain

96
Q

preglangionic neuron length in parasympathetic nervous system

A

long

97
Q

postganglionic neuron length in parasympathetic nervous system

A

short

98
Q

location of ganglion in parasympathetic nervous system

A

close to or in wall of target organ

99
Q

preganglionic neuotransmitter in parasympathetic nervous system

A

acetylcholine

100
Q

postganglionic neurotransmitter in parasympathetic nervous system

A

acetylcholine

101
Q

Effects of sympathetic nervous system in gastrointestinal system

A

decrease motility and secretion, contraction of sphincters

102
Q

Effects of sympathetic nervous system in bladder (urinary)

A

relaxation (inhibits voiding)

103
Q

Effects of sympathetic nervous system in eyes

A

dilate pupil

104
Q

Effects of sympathetic nervous system in skin

A

constricts blood vessels, stimulates sweat production; contraction of erector pili

105
Q

Effects of sympathetic nervous system in liver and gallbladder

A

stimulates glucose production and release by liver; stimulates glycogen breakdown

106
Q

Effects of parasympathetic nervous system in gastrointestinal system

A

increase motility and secretion, relaxation of sphincters

107
Q

Effects of parasympathetic nervous system in bladder (urinary)

A

contraction (promotes voiding)

108
Q

Effects of parasympathetic nervous system in eyes

A

constricts pupils

109
Q

Effects of parasympathetic nervous system in skin

A

no effect

110
Q

Effects of parasympathetic nervous system in liver and gallbladder

A

stimulates glycogen synthesis and storage; stimulates bile release from gallbladder

111
Q

Effects of parasympathetic nervous system in reproductive system

A

erection

112
Q

Effects of parasympathetic nervous system in respiratory system

A

bronchoconstriction and increased secretion

113
Q

Effects of parasympathetic nervous system in cardiovascular system

A

decrease heart rate and force of contraction

114
Q

Effects of parasympathetic nervous system in peripheral blood vessels

A

no effect

115
Q

Effects of sympathetic nervous system in reproductive system

A

ejaculation

116
Q

Effects of sympathetic nervous system in respiratory system

A

bronchodilation and reduced secretion

117
Q

Effects of sympathetic nervous system in cardiovascular system

A

increase heart rate and force of contraction

118
Q

Effects of sympathetic nervous system in peripheral blood vessels

A

vasoconstriction

119
Q

Intermediolateral (IML)

A

call column in spinal cord grey matter that contain sthe cell bodies of the preganglionic sympathetic neurons

120
Q

sympathetics to the skin of extremities and body wall

A

originate in the IML of spinal cord. Axons of preganglionic neurons exit the spinal cord via the ventral root of T1-L2 spinal nerves. (ie arterial blood vessels, errector pili muscles associated with hairs of skin and sweat glands)

121
Q

sypathetics to the head

A

originate in the IML of the spinal cords. Axons exit via ventral root of upper thoracic spinal nerves. (ie iris of eye, arterial blood vessels in head, erector pili in head)

122
Q

sympathetics tot he organs of the thorax

A

originate in IML of spinal cord. Axons exit via ventral root of T1-T5 spinal nerves. (heart, lungs, trachea, larynx, blood vessels)

123
Q

sympathetics to the organs of the abdomen and pelvis

A

originate in IML of spinal cord. Axons exit via ventral root of T5-L1 spinal nerves. They are splanchnic nerves, which synapse in peripheral ganglia located around abdominal aorta and ganglia in the pelvis

124
Q

Cranial outflow

A

parasympathetic nervous system. Cell bodies for cranial outflow are found in the brainstem nuclei of cranial nerves III, VII, IX, and X.

125
Q

Sacral outflow

A

parasympathetic nervous system. Cell bodies for sacral outflow are located in IML of sacral spinal cord (S2-S4). Axons exit the spinal cord via ventral root of S2-S4 and travel to target organs via pelvic splanchnic nerves

126
Q

Sympathetic system

A

Fight or flight

127
Q

Parasympathetic system

A

Rest and digest

128
Q

muscle contraction

A

energy from hydrolysis of ATP is transformed into mechanical energy during contraction

129
Q

Epimysium

A

dense connective tissue that surrounds the entire muscle and is synonymous with the deep fascia

130
Q

Perimysium

A

connective tissue that surrounds a group of fibers to form a fascicle. It conveys the large blood vessels and nerves into the muscle

131
Q

Type II skeletal muscle fibers

A

better for short bursts of speed; fatigue more quickly. Have hight ATPase activity. ATP is generated by anaerobic glycolysis and cells contain high levels of glycogen. Speed of contraction is high and there are small motor units in the muscle

132
Q

Type I skeletal muscle fibers

A

contain large amounts of myoglobin and mitochondria. Low ATPase activity (appear light in ATPase-stained section)
More efficient over long periods of time; used when sustained production of force is required; mainly for postural maintenance of endurance exercise.
ATP generated by oxidative phosphorylation, speed of contraction is low, and there are large motor units in the muscle

133
Q

Type II skeletal muscle fibers

A

better for short bursts of speed; fatigue more quickly. Have hight ATPase activity. ATP is generated by anerobic glycolysis and cells contain high levels of glycogen. Speed of contraction is high and there are small motor units in the muscle

134
Q

sarcolemma

A

plasma membrane of muscle cells

135
Q

sarcoplasmic reticulum

A

internal membrane network that has no connection with the extracellular space. Forms triads with T-tubules. It is where intracellular calcium is stored and release for muscle contraction

136
Q

myofibrils

A

take up about 80% of cytoplasm in muscle cells. They are composed of 2 major filaments formed by contractile proteins: thin actin filaments and thick myosin filaments

137
Q

desmin

A

intermediate filament protein found in muscle cytoplasm. Anchored inside sarcolemma and extends from one myofibril to another. helps organize cytoplasm and facilitates coordinated contraction of myofibrils

138
Q

sarcomeres

A

organized repeating contractile elements of myofibrils.

139
Q

z-line

A

defines boundary of sarcomere; contains actin binding protein, alpha actinin

140
Q

I-band

A

composed exclusively of actin thin filaments; width decreases in contraction

141
Q

A-band

A

composed of overlapping thick and thin filaments; width is constant in contraction

142
Q

M-line

A

middle of H-band; overlapping tails of thick filaments

143
Q

motor end plate

A

neuromuscular junction; each skeletal muscle fiber is innervated by an axon of a motor neuron. the axon interacts with the muscle fibers via the motor end plate

144
Q

contraction begins

A

with release of acetylcholine from synaptic vesicles in motor neuron end plate, which binds to sarcolemma and causes depolarization

145
Q

motor end plate

A

neuromuscular juntion; each skeletal muscle fiber is innervated by an axon of a motor neuron. the axon interacts with the muscle fibers via the motor end plate

146
Q

contraction begins

A

with release of acetylchonine from synaptic vesicles in motor neuron end plate, which binds to sarcolemma and causes depolarization

147
Q

muscle spindle

A

sensory organ in skeletal muscle.

Clinical Morphology (25 decks)

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