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Orthopedic Surgery Ultimate > Anatomy > Flashcards

Anatomy Flashcards

1
Q

3 windows of ilioinguinal approach

A

Medial window

medial to external iliac artery & vein

Middle window

between external iliac vessels and the iliopsosas

Lateral window

lateral to iliopsoas (iliopectineal fascia)

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2
Q

T1 dermatome/myotome

A

Finger abduction (interossei - ulnar n)

Sensory: medial elbow

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3
Q

What do the AIN & median nerve proper innervate in the forearm?

A

Median nerve proper

Superficial group:

PT

FCR

PL

Intermediate group:

FDS

AIN

Deep Group

FPL

FDP (radial 2)

PQ

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4
Q

Name the structures attached to the 3 arrows

A

Top: Gluteus minimus

Middle: Piriformis

Bottom: Sacrotuberous ligament

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5
Q

Name the following strucutres

A

1: anterior compartment
2: tib ant
3: tibia
4: EDL
5: deep peroneal & tibial vessels
6: lateral compartment
7: peroneus longus
8: superficial peroneal nerve
9: fibula
10: tib post
11: FDL (comes off tibia)
12: FHL (comes off fibula)
13: peroneal vessels
14: tibial nerve and posterior tibial vessels
15: deep posterior compartment
16: soleus
17: long saphenous vein
18: superficial posterior compartment
19: Lateral head of gastrocnemius
20: medial head of gastroc
21: sural nerve and lesser saphenous vein

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6
Q

pediatric femoral shaft fracture reduction criteria

A

<10 degrees varus/valgus

<20 degrees AP

<2cm shortening

<10 degrees rotational alignment

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7
Q

Roots contributing to the femoral nerve

A

L2-L4

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8
Q

Describe course of obturator internus

origin

Path

Insertion

A

Origin: ischiopubic ramus & obturator membrane

Path:

THrough lesser sciatic notch

makes a 90 degree turn

Insertion: Medial aspect of GT

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9
Q

NAME THE ANATOMICAL STRUCTURES

A
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10
Q

Course of the radial nerve, hitting salient points

A

From posterior cord

Travels in poseterior aspect of axilla

Through triangular interval with profunda brachii artery

In the spiral groove 14-15cm proximal to lateral epicondyle

Exit the lateral intermuscular septum never less than 7.5cm from distal articular surface

Travels between brachialis & brachioradialis anterior to lateral epicondyle

Divides into SRN and PIN at level of radiocapitellar joint

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11
Q

Internervous plane of Smith-Peterson approach to hip

A

Anterior approach:

Femoral nerve & Superior gluteal nerve

Superficial:

Sartorius (femoral)

TFL (superior gluteal)

Deep:

Rectus femoris (femoral)

Gluteus medius (superior gluteal)

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12
Q

Roots contributing to LFCN?

A

L2-3

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13
Q

Name the structures

A
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14
Q

Explain the relation of the zone of calcification to physeal fractures.

A

The zone of Hypertrophic zone is divided into three layers, and the zone of calcification is the firsthest away from the resting zone.

This is where apoptosis happens - making it relatively weak and pre-disposes to injury.

Most fractures are through the zone fo calcification, which is good because it is far from the reserve zone which is protective against growth arrests.

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15
Q

Roots contributing to Sciatic nerve

A

L4-S3

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16
Q

In pelvic surgery, what adjunct do you need before cutting?

A

Foley to decompress bladder

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17
Q

Stoppa approach: 4 dangers

A

Bladder

Corona mortis

External iliac vessels

Obturator nerve & vessels

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18
Q

name the structures

A
  1. Cephalic vein
  2. FCR
  3. FDS
  4. ulnar artery
  5. ulnar nerve
  6. FCU
  7. FDP
  8. basilic vein
  9. ulnar shaft
  10. APL
  11. PIN
  12. ECU
  13. EDM
  14. Supinator
  15. FPL
  16. Radial shaft
  17. deep branch of radial nerve
  18. EDC
  19. ECRB
  20. ECRL
  21. BR
  22. Superficial radial nerve
  23. PT
  24. radial artery
  25. median nerve
  26. volar (flexors)
  27. Dorsal (extensors)
  28. mobile wad
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19
Q

Reduction criteria for paediatric radial neck fractures

A

<30 degrees angulated

<3-4mm translated

>45 degrees pro-supination

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20
Q

Course of the ulnar nerve

A

From medial cord

Runs in anterior compartment of arm, posteromedial to brachial artery

Pierces medial intermuscular septum at arcade of struthers ~8cm from the medial epicondyle, lying medial to triceps

Run behind medial epicondyle with superior ulnar collateral artery

Entes cubital tunnel

Enters forearm between 2 heads of FCU

Runs between FCU & FDP

In the wrist & had via Guyon’s canal

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21
Q

What is the corona mortis and where is it located?

A

Anastomosis between:

external iliac system or deep inferior epigastric artery

&

obturator system

Lives in the latearl 1/3 of the pubc ramus

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22
Q

C5 myotome & dermatome

A

Shoulder abduction (deltoid)

Elbow flexion (palm up) (biceps)

Sensory: lateral arm below deltoid

23
Q

Reduction criteria for paediatric proximal humerus fracture

A

>50% apposition

<45 degrees angulated

No head split

Neer-Horwitz 1 or 2

24
Q

C8 myo/dermatome

A

Finger flexion (FDS)

Sensory: 5th finger

25
Q

Name the structures

A
  1. anterior compartment
  2. EDL
  3. EHL
    4: TA

5> deep peroneal nerve and tib ant vessels

  1. lateral compartment
  2. superficial peroneal nerve
  3. peroneus longus (lateral to brevis - protects it)
  4. peroneus brevis
  5. deep posterior copmartment
  6. Tib post
  7. FHL
  8. FDL
  9. peroneal vessels
  10. tibial nerve and posterio tibial vessels
  11. long saphenous vein
  12. superficial posterior compartment
  13. Soleus
  14. Achilles tendon
  15. Sural nerve & lesser saphenous vein
  16. Fibula
  17. tibia
26
Q

What leads you to the popliteal fossa during a posterior approach to the knee?

A

Medial sural cutaneous nerve

27
Q

C7 myo/dermatome

A

Elbow extension (Triceps)

wrist flexion (FCR)

Sensory: Fingers 2,3,4

28
Q

Course of median nerve

A

From medial & lateral cords

Travels in anterior compartment of arm with brachial artery, lateral to it in the arm, medial to it at the elbow

No branches in arm

Enters forearm between PT and biceps

Travels beween FDS and FDP

Emerges between FDS and FPL

Enters hand via carpal tunnel

29
Q

L2, 3 dermatome/myotome

A

Hip flexion (iliopsoas)

Hip adduction (hip adductors)

Knee extension (quad)

Sensory: anterior and inner thigh

30
Q

Acceptable reduction criteria: tibial shaft

A

5 degrees varus/valgus

10 deg AP

50% cortical apposition

<1cm shortening

<10 degres rotational

(5, 50, 1, 10, 10)

31
Q

name the structures

A
32
Q

What vessel must you ligate to prevent bleeding in anterior approach to the hip?

A

ascending branch of lateral femoral circumflex artery

33
Q

L4 myo/dermatome

A

Knee extension (quad)

Ankle dorsiflexion (TA)

Sensory: lateral thigh, anterior knee and medial leg

Patellar reflex

34
Q

S3,4 derm/myotome

A

Bladder & bowel function

“S2-3-4 keep the shit off the floor”

Sensation perianal

35
Q

name the structures

A
  1. intermedial dorsal cutaneous branch of SPN
  2. medial dorsal cutaneous branch of SPN
  3. peroneus tertius

4 EDL

  1. EHL
  2. deep peroneal nerve
  3. tib ant
  4. great saphenous vein

9 tibia

  1. tib post
  2. FDL
  3. tibial nerve and posterior tibial vessels
  4. FHL
  5. achilles tendon
  6. sural nerve and lesser saph vein
  7. peroneus brevis
  8. peroneus longus
  9. fibula
36
Q

Name the branhces of the axillary artery

A

Sixties Teens Love Sex And Pot

Supreme Thoracic

Thoracoacromial trunk

Lateral thoracic artery (beside ribs)

Subscapular artery (gives of thoracodorsal & circumflex scapular)

Anterior humeral circumflex artery (will have branches ascending proximally)

Posterior humeral circumflex artery (the big one)

37
Q

Where does the ulnar nerve lie in Guyon’s canal?

A

Ulnar to hook of hamate

radial to pisiform

(b/c its between these two inside the canal)

Ulnar to ulnar artery

(goes nerve, artery, palmaris, ulnar –> radial)

38
Q

C6 myotome & dermatome

A

Elbow flexion (thumb up) (brachioradialis)

Wrist extension (ECRL)

Sensory: thumb & radial hand

39
Q

S2 derm/myotome

A

Toe plantar flexion (FHL, FDL)

Sensation: plantar foot

40
Q

L5 derma/myotome

A

Ankle dorsiflexion (also L4)

Foot inversion (TP)

Great toe dorsiflexion (EHL)

Hip extension (hamstrings, glut max)

Hip abduction (glut medius)

Sesory: lateral leg and dorsal foot

41
Q

Humeral shaft (adult) reduction criteria

A

<20 AP

30 varus/valgus

<3cm shortening

42
Q

Name the structures

A
43
Q

What structures exit through the lesser sciatic notch? (4)

A

The following structures pass through the lesser sciatic nothc:

  1. Tendon of obturator internus
  2. Nerve to obturator internus
  3. Pudendal nerve (goes through both greater & lesser))
  4. Internal pudendal artery (goes through both greater & lesser)
44
Q

What structures exit through the greater sciatic notch? (8)

A

The following structures pass through the greater sciatic notch:

Piriformis

Superior gluteal vessels and nerves

Inferior gluteal vessels and nerves

Sciatic nerve

Posterior femoral cutaneous nerve

Internal pudendal vessels

Pudendal nerve

Neve to obturator internus

Nerve to quadratus femoris

45
Q

2 distinct and major complications from extended iliofemoral approach:

A

permanent abductor weakness

Highest rate of HO

(both b/c you strip off the entire musculature from the outer table)

46
Q

L1 dermatome

A

iliac crest & Groin

47
Q

Medial approach to hip:

What is the danger when you’re releasing iliopsoas?

A

Medial femoral circumflex artery

Must directly visualize

48
Q

S1 derm/myotome

A

Foot plantar flexion (gastroc-soleus)

Foot eversion (Peroneals)

Sensation: posterior leg

Reflex: Achilles

49
Q

Boundaries of the greater sciatic notch?

A

anterolaterally by the greater sciatic notch of the ilium

posteromedially by the sacrotuberous ligament

inferiorly by the sacrospinous ligament and the ischial spine

superiorly by the anterior sacroilliac ligament

50
Q

What are the four phases of a direct insertion of a tendon onto bone?

A

4 distinct phases:

1) ligament
2) fibrocartilage
3) mineralized fibrocartilage
4) bone

(Indirect attachment is Ligament –> Periosteum)

51
Q

Medial femoral circumflex artery travels anterior to all SERs except:

A

Obturator externus

52
Q

Signs of sacral dysmorphism

A

Lumbarization of S1

Sacralization of L5

Mammilary bodies

Unfused intervertebral discs

Tongue in groove sign

Recessed sacral ala

Irregular neural foramen

Increased sacral height: should normally be below level of iliac brim

Acute alar slope

53
Q

What must you do before doing a psoas tendon release from the medial approach?

A

Isolate and protect the MFCA that runs directly on top of psoas

Orthopedic Surgery Ultimate (88 decks)

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