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first year osteopathy > Biomed 4 > Flashcards

Biomed 4 Flashcards

1
Q

Gluteal Muscles - Superficial group

A

Gluteus maximus, Gluteus medius, Gluteus minimus, Tensor of Fascia Lata

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2
Q

Gluteus Maximus - facts

A

largest most superficial gluteal muscle, fibres run on 45 degree angle inferiorly, distally attaches indirectly into the tibia (via ITB)

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3
Q

Gluteus Medius - facts

A

convergent (fan) shaped, deep to glut max, stabilising the pelvis while walking

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4
Q

Gluteus minimus - facts

A

deep to glute medius, smallest of the gluteal muscles, stabilising the pelvis while walking

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5
Q

Tensor Fascia Lata - facts

A

enclosed between two layers of fascia lata, gluteal muscle which is located quite anterior, aids stability of knee via iliotibial tract

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6
Q

Gluteal muscles - deep group

A

externally rotate & stabilise the hip joint
Piriformis, Obturator internus, superior gemellus, inferior gemellus, quadratus femoris

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7
Q

Piriformis - facts

A

‘pear’ shaped, exits pelvis via greater sciatic foramen, clinically relevant in sciatic neuralgia (piriformis syndrome)

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8
Q

Obturator Internus - facts

A

exits pelvic cavity through the lesser sciatic foramen

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9
Q

Superior Gemellus & Inferior Gemellus - facts

A

gemellus (singular), gemelli (plural), superior gemellus is superior to the obturator internus muscle, inferior gemellus is inferior to the obturator internus muscle, gemellus means ‘twin’

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10
Q

Quadratus femoris - facts

A

short, flat, quadrangular shaped muscle, quadratus = four sided

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11
Q

Anterior thigh muscles - facts (Location, main actions, N/S)

A

L - span a large area from anterior Lx to bones of leg, cross hip and knee joints, found anterior to femur
A - flex hip joint, extend knee joint
N/S - primarily femoral nerve

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12
Q

Anterior thigh muscles

A

Pectineus, Iliopsoas (Iliacus, Psoas major, Psoas minor), Sartorius, quadriceps femoris (four headed)

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13
Q

Sartorius - facts

A

‘tailors muscle’ (produces movements that result in cross legged position), longest muscle in the body

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14
Q

Quadriceps femoris - facts

A

rectus femoris, vastus lateralis, vastus medialis, vastus intermedius

not separate muscles, four heads

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15
Q

medial thigh muscles - Location, main action, N/S

A

L - from pubis and ischium to bones of the thigh and leg, found on medial side of femur
A - adduct hip joint
N/S - primarily innervated by obturator nerve

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16
Q

Medial thigh muscles

A

adductor longus, adductor brevis, adductor magnus, gracilis, obturator externus

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17
Q

Adductor Longus - facts

A

most anterior muscle of medial thigh group, helps form the borders of the femoral triangle and adductor canal

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18
Q

Adductor brevis - facts

A

lies deep to pectineus and adductor longus

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19
Q

Adductor magnus - facts

A

largest, most powerful medial thigh muscle, most posterior in adductor group, two parts (addcutor, hamstring), DA splits to form anatomical space (adductor hiatus)

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20
Q

Adductor Hiatus

A

opening between distal attachments of adductor magnus & femur, superior to adductor tubercle, allows for passage of femoral artery and vein

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21
Q

Gracilis - facts

A

most superficial and weakest adductor muscle, only adductor to cross the hip and knee joint

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22
Q

Obturator Externus - facts

A

passes under the head and neck of the femur, cannot be seen in medial thigh in the lab (too deep)

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23
Q

Posterior thigh muscles - Location, main actions, N/S

A

L - from pelvis to leg bones, found posterior to the femur
A - extend hip joint, flex knee joint
N/S - tibial or common fibular divisions of the sciatic nerve

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24
Q

Posterior thigh muscles

A

Semitendinosus, Semimembranosus, Biceps femoris

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25
Q

Semitendinosus

A

long cord-like tendon which begins about 2/3 of the way down the thigh

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26
Q

Semimembranosus

A

flat and membranous

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27
Q

Biceps femoris - facts

A

Two heads:
long head crosses hip & knee joints
short head only crosses knee joint

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28
Q

Regions of Lower Limb

A

Gluteal
Thigh
Knee region
Leg
Foot

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29
Q

The Pelvis - formed by and function

A

Bony pelvis formed by - sacrum, coccyx, two hip bones (innominate bones)

Function - protects pelvic organs, is a girdle for the lower limb muscles to attach to & act upon, transfers weight and force between the spine and femurs

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30
Q

Hip Bones - Child

A

three separate bones (ilium, ischium, pubis)
united by Y-shaped epiphysis at the acetabulum
fuse together by age 20-25

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31
Q

When you put your hands on your hips you are putting then on your …

A

ilia

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32
Q

when you sit down, you sit on your …

A

ischium

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33
Q

your pubic bones come together anteriorly at the …

A

pubic symphysis

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34
Q

Acetabulum

A

3 parts unite to form large cup-shaped socket
articular surface: femoral head articulates here to form the hip joint
Acetabular notch: incomplete are of the acetabulum inferiorly
Acetabular fossa: depression on the floor of the acetabulum

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35
Q

Sacrum - facts

A

wedge-shaped/triangular bone
base = superior, apex = inferior
formed by 5 fused sacral vertebrae
transmits weight of body to pelvic girdle

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36
Q

Femur facts

A

longest, strongest and heaviest bone in body
bone of thigh, transmitting weight from hip to tibia
articulates with innominate at hip
articulates with tibia & patella at knee joint
~ 1/4 of a persons height

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37
Q

Bursa of Gluteal region

A

Trochanteric bursa - between glute max fibres and greater trochanter
Ischial bursa - between inferior part of glut max and ischial tuberosity

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38
Q

deep fascia of the thigh

A

fascia lata

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39
Q

deep fascia of the leg

A

Crural fascia

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40
Q

thickened band of fibres on lateral aspect of fascia lata

A

iliotibial tract

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41
Q

Inguinal ligament

A

thickened fibrous band/retinaculum
from ASIS to pubic tubercle
formed by inferior margin of abdominal muscles
hip flexors & neurovascular structures pass beneath to enter/exit thigh

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42
Q

In what position does the gluteus maximus produce the greatest extension force?

A

from sitting to standing, climbing stairs, squats (on the way up)

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43
Q

Gluteus medius and minimus produce abduction at the hip joint which keeps the pelvis level when in single leg stance. What other movements can gluteus medius and minimus produce?

A

internal rotation of hip

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44
Q

Why is tensor fascia lata often hard for students to find on a cadaver? Hint it looks white

A

enclosed between two layers of fascia lata

45
Q

How does the quadratus/quadriceps femoris get its name? Why should we use the full name of each muscle instead of abbreviating them to ‘quad fem’?

A
  • Quadratus femoris – is a deep gluteal muscle with quadrangular shape
  • Quadriceps femoris – is an anterior thigh muscle. Quadriceps stands for 4-headed which describes the four heads (rectus femoris, vastus lateralis, vastus medialis, vastus intermedialis)
46
Q

Many people refer to the anterior thigh muscles as the ‘quads’. How many muscles are in the anterior thigh that are not part of quadriceps femoris? Name them.

A

sartorius, pectineus and Iliopsoas (Iliacus, Psoas min & maj)

47
Q

Which muscle/s pass under the inguinal ligament?

A

psoas major and iliacus

48
Q

What is the function of the inguinal ligament in regard to the anterior thigh muscles?

A

it holds down the muscles like a retinaculum

49
Q

Where would you expect to find adductor brevis in relation to the other adductor muscles?

A

Adductor brevis is deep to adductor longus &pectineus and adductor magnus lies deep to adductor brevis

50
Q

Which part of adductor magnus attaches proximal to the adductor hiatus? Which part attaches distal to the adductor hiatus?

A
  • proximal to the adductor hiatus = Adductor part
  • distal to the adductor hiatus = hamstring part
51
Q

Where does the tendon of obturator externus pass in relation to the femur so that it can attach to the trochanteric fossa?

A

passes under the head and neck of femur

52
Q

How do semitendinosus and semimembranosus get their names?

A
  • Semitendinosus has got a long cord-like tendon which begins about 2/3 of the way down the thigh
  • Semimembranosus is flat and membranous
53
Q

Which direction of knee rotation can each of the posterior thigh muscles produce?

A
  • internal rotation = semimembranosus, semitendinosus
  • external rotation = biceps femoris
54
Q

What does the term ‘pes anserine’ mean in Latin?

A

goose foot

55
Q

from anterior to posterior, which muscle tendons form the pes anserine?

A
  • Sartorius
  • Gracilis
  • Semitendinosus
56
Q

Upon which bone and where on this bone do the pes anserine tendons attach?

A

superior aspect of medial surface of tibia

57
Q

How is the hip bone formed in early life?

A

Y-shaped epiphysis at the acetabulum, fuses together by age 20-25

58
Q

Male pelvis

A

deeper, narrower, heavier, thicker

59
Q

female pelvis

A

shorter, wider, lighter, thinner
wider pelvis has flow on effect on hip and knee joint angles

60
Q

Joints of the pelvis

A

Lumbosacral joint (b/w L5 vertebra & sacrum)
Sacrococcygeal joint (b/w sacrum & coccyx)
Sacroiliac joint (SIJ) (b/w sacrum and ilium)
Pubis symphysis (b/w bilateral pubis bones)

61
Q

Why is there a limited range of motion of the joints of the pelvis?

A

It is limited by the interlocking joint surfaces and the strong surrounding ligaments
More designed for weight bearing

62
Q

Why is the fibrocartilaginous disc of the pubic symphysis wider in females than in males?

A

Pregnancy, Child-bearing – allows for more movement and stretch
Females pelvis is wider overall

63
Q

The posterior sacroiliac ligaments are angled in a way that they draw the ilium inwards towards the sacrum as weight pushes down on it. Why might this be so?

A

to provide stabilisation of SIJ during weight bearing/ when there is a force onto the Ilium

64
Q

Obturator foramen

A

formed by ilium and ischium
Enclosed by the obturator membrane, upon which the obturator internus and obturator externus attach proximally

65
Q

Nutation

A

Sacral base – tilts anterior & inferior
Apex of sacrum – tilts posterior & superior

66
Q

Counternutation

A

Sacral base – tilts posterior & superior
Apex of sacrum – tilts anterior & inferior

67
Q

Bones of the foot

A

Tarsals - Calcaneus, Talus, Cuboid, Navicular, 3 Cuneiforms
Metatarsals - 5 metatarsal bones
Phalanges - 14 phalanges

68
Q

What type of bone are tarsals?

A

short bones

69
Q

What type of bones are metatarsals and phalanges?

A

long bones

70
Q

Regions of the foot - name all three and which includes which bones.

A

Hindfoot - talus and calcaneus
Midfoot - navicular, cuboid and three cuneiforms
Forefoot - metatarsals & phalanges

71
Q

Talus - facts

A
  • only foot bone to articulate with leg bones (tibia, fibula)
  • articulates also with calcaneus and navicular
72
Q

Calcaneus - facts

A
  • transmits weight from talus to ground
  • forms heel
  • serves as attachment of achiles tendon
73
Q

Navicular - facts

A
  • boat shaped (means little ship)
  • articulates with anterior aspect of talus
  • medial side of foot
74
Q

Cuboid - facts

A
  • cuboidal
  • artiuclates with anterior aspect of calcaneus
  • lateral side of foot
75
Q

Cuneiforms - facts

A
  • 3 bones
    1. medial, 2. intermediate, 3. lateral
  • articulate with metatarsals of the same number
76
Q

Metatarsals - facts

A
  • named 1-5 from medial to lateral
  • each has base, shaft and head
  • fifth metatarsal has a prominence proximally called the tuberosity/styloid process
77
Q

Phalanges - facts

A
  • 14, each base, shaft, head
  • first digit (great toe, hallux) has two phalanges - proximal & distal
  • 2-5 have three phalanges - proximal, middle, distal
  • fifth referred as digiti minimi
78
Q

Sesamoid bones - foot

A
  • 2 sit inferior to head of 1st metatarsal
  • preventing crushing the tendon of flexor hallucis longus while standing & walking
79
Q

Patella - facts

A
  • provides biomechanical advantage to the quadriceps femoris when extending knee
  • rounded triangle shape
  • muscle attachments (base = DA quadriceps tendon, inferiorly = patellar tendon to tibial tuberosity)
  • articulates only with femur
80
Q

Tibia - facts

A
  • shin bone
  • medial, more anterior
  • second largest bone in body
  • weight-bearing
  • transfers weight from femur to talus of foot
81
Q

Fibula - facts

A
  • lateral, slightly posterior
  • no role in weight-bearing
  • many muscular attachments
  • helps form & stabilise ankle joint
82
Q

What are the tibia and fibula hold together by?

A

Strong interosseus membrane as well as superior & inferior tibiofibular joints

83
Q

Describe the role of fascia in the musculovenous pump

A
  • it assists the musculovenous pump to return the venous blood to the heart
  • creating compartmental pressure to return blood back to the heart
84
Q

Why is the musculovenous pump more important in the lower limb than the upper limb?

A

it has to work harder against gravity

85
Q

If a patient came in with compartment syndrome and their neurological and vascular structures within their leg were compressed, what type of symptoms or signs might they present with?

A

intense pain, tenderness, tightness or burning sensation, numbness/weakness, bruising from trauma, pulselessness, perishingly cold, pale

86
Q

Movements produced by muscles of leg

A

plantarflexion
dorsiflexion
eversion
inversion

87
Q

How many compartments are in the leg and what are they called?

A
  • 4 compartments
    Anterior compartment
    Lateral compartment
    Superficial posterior compartment
    Deep posterior compartment
88
Q

Anterior compartment - facts

A
89
Q

Anterior compartment - facts

A

main actions: dorsiflexor (extensor) compartment
Innervation: deep fibular nerve
Arteries & veins: anterior tibial artery and vein

90
Q

Which muscles are in the anterior compartment of the leg?

A

Tibialis anterior, Extensor digitorum longus, Extensor hallucis longus, Fibularis tertius

91
Q

Lateral compartments - facts

A

smallest leg compartment
main actions: evert subtalar joint, plantarflex ankle joint
Innervation: Superficial fibular nerve
Arteries & veins: none, supplied by branches of anterior tibial and fibular artery & vein which are located within other compartments

92
Q

Which muscles are in the lateral compartment of the leg and how can they also be referred as?

A

Fibularis (peroneus) longus, fibularis (peroneus) brevis

  • peroneus/peroneal muscles

Peroneus – the Latin term for fibularis. You will often see this used in texts and many osteopaths will refer to the ‘peroneal muscles’; peroneus longus & brevis instead of fibularis longus & brevis

93
Q

Posterior compartments - facts

A

divided into superficial & deep groups by transverse intermuscular septum
main actions: plantarflexion
Innervation: tibial nerve
Arteries & veins: Posterior tibial artery & vein, Fibular artery & vein

These vessels run deep to the transverse intermuscular septum

94
Q

Which muscles are in the superficial posterior compartment of the leg and what is their main actions?

A

Plantaris, Gastrocnemius (medial and lateral heads), Soleus

main action: Flex knee joint, Plantarflex ankle joint

95
Q

Tibialis

A

related to the tibia

Digitorum – related to the digits
Hallucis – related to the great toe (hallux, digit 1)

96
Q

Fibularis

A

related to the fibula

97
Q

Digitorum

A

related to the digits

98
Q

Hallucis

A

related to the great toe (hallux, digit 1)

99
Q

What are Retinacula?

A

thickened bands of deep fascia which hold tendons in place and prevent bow stringing

100
Q

Extensor retinacula

A

Two retinacula hold down anterior compartment tendons
- superior extensor retinaculum
- inferior extensor retinaculum

101
Q

Extensor retinacula - Mnemonic Anterior compartment

A

from medial to lateral:
Tall Housemates are never dull friends

Tibialis anterior, extensor Hallucis longus, anterior tibial Artery (& vein), deep fibular Nerve, extensor Digitorum longus, Fibularis tertius

102
Q

Fibular retinacula

A

two retinacula hold down the tendons of lateral compartment
- superior fibular retinaculum
inferior fibular retinaculum

103
Q

Flexor Retinaculum

A

deep posterior compartment

104
Q

Mnemonic Deep posterior compartment - flexor retinaculum

A

from anterior to posterior:
Tom Dick And Very Naughty Harry

Tibialis posterior, flexor Digitorum longus, posterior tibial Artery, posterior tibial Vein, tibial Nerve, flexor Hallucis longus

105
Q

Muscles of the great toe

A

Abductor hallucis, flexor hallucis brevis, adductor hallucis

106
Q

Muscles of the 5th digit

A

Abductor digiti minimi, Flexor digiti minimi brevis

107
Q

Muscles of Digits 2-5

A

Flexor digitorum brevis, Quadratus plantae, Lumbricals, Plantar interossei, Dorsal interossei

108
Q

Muscles on the dorsal surface of the foot

A

Extensor digitorum Brevis, Extensor Hallucis Brevis

first year osteopathy (8 decks)

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