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Questions pratiques de l'Université Montréal > Anatomie (m. sup/inf) > Flashcards

Anatomie (m. sup/inf) Flashcards

1
Q

Retaining ligaments of fingers and position

A

Grayson: Volar and transverse, palmar to neurovasc bundle (brevents bowstringing during flexion)

Cleland: dorsal, passes from junction of periosteum and flexor tendon sheath to skin

Transverse retinacular ligament: radial and ulnar to PIP, superficial to collateral ligaments, prevents dorsal displacement of lateral bands

Oblique retinacular ligament (Of Landsmeer): from volar P2 to dorsal P3, coordinates PIP and DIP joint motion

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2
Q

Deep fascial spaces of hand

A

Midpalmar space
Thenar space
Hypothenar space
Interdigital web space
Parona’s space (at wrist)

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3
Q

Extensor compart of wrist

A

1: APL, EPB
2: ECRL, ECRB
3: EPL
4: EDC and EIP
5: EDM
6: ECU

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4
Q

Position of EPL in at the level of the extensor retinaculum

A

Ulnar to Listers tubercule

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5
Q

Position of EIP and EDM relative to EDC

A

Both ulnar to EDC

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6
Q

Name of connections between EDC tendons

A

Juncturae tendinum

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7
Q

Extensor zones

A

1: DIP
2: P2
3: PIP
4: P1
5: MCP
6: MC
7: wrist
8: distal 1/3 forearm
9: proximal 2/3 forearm

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8
Q

Thumb extensor zones

A

1: over IP
2: over P1
3: over MCP
4: over MC
5: over carpal bones

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9
Q

Flexor tendon zones

A

Zone 1: distal to FDS insertion
Zone 2: distal to A1
Zone 3: distal to carpal tunnel
Zone 4: above carpal tunnel
Zone 5: proximal to carpal tunnel

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10
Q

Zones of thumb flexor tendon

A

Zone T1: Distal to IP joint
Zone T2: distal to A1 pulley
T3: Over thenar eminence
T4: Carpal tunnel
T5: Proximal to carpal tunnel

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11
Q

Thumb pulleys

A

A1 and A2 over MCP and IP
Oblique pulley is between both/P1 (most important to prevent bowstringing) run proximal ulnar to distal radial

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12
Q

Which is the most important pulley in the thumb

A

Oblique pulley

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13
Q

Name the two pathway of tendon healing and identify which one causes adhesions

A

Intrinsic pathway (proliferation of tenocytes)
Extrinsic pathway (invasion of cells from tendon sheath)(adhesions)

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14
Q

Anomalous interconnections in forearm

A

Martin-Gruber anastomosis
Riche Cannieu anastomosis

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15
Q

Describ Martin-Gruber anastomosis
Prevalence
Relevance clinically

A

Motor fiber connection between medial to ulnar nerve in forearm

Affects 10-25% population

Can cause preserved ulnar nerve motor function in the hand after high ulnar injury

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16
Q

Describ RicHe-Cannieu anastomosis

Relevance clinically

A

Motor fiber connection from ulnar to median nerve in Hand

Common

Can result in preserved thenar motor function after median nerve injury

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17
Q

Describe Marinacci anastomoses

A

Rare anomalous intercommunication from the ulnar nerve to the median nerve in the forearm

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18
Q

What are the dominant arteries for each finger

A

D1: UDA
D2: UDA
D3: UDA
D4: RDA
D5: RDA

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19
Q

Define Vincula

A

Fold of mesotenon in tendon sheath that anchors tendon to bone and contains receive direct blood supply from transverse digital arteries

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20
Q

Name and identify the location of the three volar communicating branch of the digital arteries and the associated vinculum

A

Proximal transverse palmar arch, proximal to PIP, gives vineculum longum profundus and vineculum brevis superficialis

Middle transverse palmar arch, proximal to DIP, gives vineculum brevis profondus

Distal transverse palmar arch at the level of the lanula

There is also a vinculum longus superficialis proximal P1 from direct branch of proper digital artery

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21
Q

Name a specialized neuromyoarterial receptor in fingertip and its clinical application

A

Glomus body

Functions to control blood pressure and thermoregulation

Can give rise to painful glomus body tumor

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22
Q

Structure comprise dans la perionychium (4)

A

Nail fold
Nail plate
Nail bed
Hyponychium

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23
Q

Define Hyponychium

A

Junction sterile matrix of nail bed and skin beneath distal nail margin

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24
Q

Define paronychium

A

skin on each side of the nail/lateral nail fold

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25
Q

Define eponychium

A

Skin proximal to nail that covers nail fold

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26
Q

Why is the lanula white

A

due to persistance of nail cell nuclei in the germinal matrix

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27
Q

Difference between germinal and sterile matrix and specific localisation of each

A

Germinal: proximal to lanula, distal to extensor tendon, reponsible for 90% of nail production

Sterile: nail bed distal to lanula, responsible for nail plate adherence, secondary site of nail production

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28
Q

3 location of nail growth

A

1) germinal matrix
2) sterile matrix
3) dorsal roof of nail fold

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29
Q

How/through which machanism does the germinal matrix produce the nail

A

gradient parakeratosis

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30
Q

Rate of nail growth and time to grow a complete nail

A

Rate: 3-4mm/month

100 days

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31
Q

4 conditions that increase speed of nail growth

A

Longer digit
Summer months
Young person
Nail bitters

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32
Q

2 components of nail fold

A

1) ventral floor: germinal matrix
2) dorsal roof: host cells that cause nail shine

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33
Q

quel % de la population a une arcade palmaire superficielle provenant seulement de l’artère ulnaire

A

39%

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34
Q

quel % de la population a une arcade palmaire superficielle parfaitement communicante radiale-ulnaire

A

35%

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35
Q

quel % de la population a une arcade palmaire superficielle provenant de l’artère ulnaire et artère médiane (pas de contribution radiale)

A

4%

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36
Q

quel % de la population a une arcade palmaire superficielle provenant de l’artère ulnaire + médiane + radiale

A

1%

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37
Q

quel % de la population n’a pas de communication entre art radiale et ulnaire au niveau de l’arcade palmaire superficielle (vascularisation des doigts séparément, PAS d’arcade proprement dite)

A

16%

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38
Q

quel % de la population a les 3 artères (R + U + M) qui vascularise les doigts séparément SANS communication en arcade palmaire superficielle

A

5%

39
Q

quel % de la population a:
-communication radio-ulnaire typique de l’arcade palmaire profonde

A

35%

40
Q

Comment on the muscle bellies of FDS and FDP

A

FDP: common muscle belly (except D2 which is separated)

FDS: individual muscle belly

41
Q

Arrangement of flexor tendons in carpal tunnel

A

FDS: D3 and D4 at superficial to D2 and D5
FDP is deep

42
Q

Innervation of FDP tendon

A

D2 and D3: AIN
D4 and D5: Ulnar nerve

43
Q

Configeration, origin, insertion, innervation and action of lumbricals

A

D1 and D2: unipennate, origin from radial side FDP, insert extensor expansion hood (radial lateral band), median nerve

D3 and D4: bipennate, origin from radial and ulnar side FDP, insert extensor expansion hood (radial lateral band), ulnar nerve

Action: main extensor of IP, weak flexor of MCP

44
Q

Name structure of extensor hood

A

Proximal: sagital bands, lateral bands

Central slip

Distal: oblique retinacular ligament, triangular ligament

45
Q

Accessory head of FPL name, origin and associated complication

A

Gantzer muscle

Origin: medial epicondyle and coronoid process of ulna

AIN compressive neuropathy

46
Q

Explain location or annular and cruciate pulleys

A

A1: MCP
A2: P1
C1: proximal to PIP
A3: PIP
C2: distal to PIP
A4: P2
C3: proximal to DIP
A5: DIP

47
Q

Most important pulleys and why

A

A2 and A4 pulleys

Prevents bowstringing the most

48
Q

What makes up the A0 pulley (2)

A

Transverse fibers of palmar aponeurosis

Vertical septa of Legeu and Juvara

49
Q

3 structure the makes a tendon

A

Endotenon (inner)
Epitenon (outer)
Paratenon (most outer)

50
Q

2 mechanism for tendon vascular supply, which is dominant

A

1: Direct vascular supply
2. Synovial diffusion (dominant)

51
Q

What are the 3 source of direct vascular supply to tendon, and localisation relative to the tendon

A

Myotendinous junction (proximal tendon)
Osteotendinous junction (distal tendon)
Connective tissues (mid tendon)

52
Q

3 connective tissue structures that vascularise the tendon

A

Paratenon
Mesotenon
Vincula

53
Q

% of population that does not have D5 FDS

A

7-20%

54
Q

Name and describe the variant connection between hand flexor tendons and its incidence

A

Linburg-Comstock variant

Between FPL muscle belly/tendon and FDP D2

8-35% of population

55
Q

Palmar interossei, # of units, bi vs unipennate, insertion, action, innervation

A

3 units
unipennate
Inserts on lateral bands
Adducts, flex MCP, extend IP
Ulnar nerve

56
Q

Dorsal interossei, # of units, bi vs unipennate, insertion, action, innervation

A

4 units
bipennate
Inserts on lateral bands
Abducts, flex MCP, extend IP
Ulnar nerve

57
Q

Sagital bands: origin and insertion and function (2)

A

Origin from intermetacarpal plate and insert on dorsal hood above MCP

Prevent lateral subluxation of extensor tendons, prevents MCP joint hyperextension

58
Q

Name 3 anomalous extensor muscle and their implication

A

Extensor carpi radialis intermedius (can be used in tendon transfer)

Extension medii proprius
Independent extensor of middle finger (can be used for sagital bands injuries)

Extensor digitorus, brevis manus, often between 2nd and 3rd metacarpal

59
Q

L’artère dorsalis pedis provient de quelle artère?

A

Tibiale antérieure

60
Q

3 actions motrices du nerf tibial

A

plantiflexion cheville
plantiflexion orteils
inversion du pied

61
Q

1 action motrice du nerf fibulaire superficiel

A

éversion du pied

62
Q

2 actions motrices du nerf fibulaire profond

A

dorsiflexion cheville
extension des orteils

63
Q

territoire sensitif du nerf fibulaire superficiel (2)

A

portion antéro-latérale de jambe distale
dorsum du pied (sauf 5e rayon et 1er webspace)

64
Q

territoire sensitif du nerf tibial

A

plante du pied (via nerf plantaire méd, lat et branche calcanéenne)

65
Q

territoire sensitif nerf fibulaire profond

A

1er espace interdigital dorsal

66
Q

Nommer les structures qui passent dans le tunnel tarsien (6)

A

Tibialis posterior
FDL
artère tibiale postérieure
veine tibiale postérieure
nerf tibial
FHL

67
Q

Combien de perforantes présente généralement l’artère profunda femoris?

A

4

68
Q

Nommer les 4 muscles du compartiments antérieur de la jambe

A

EDL
EHL
Tibialis anterior
Peroneus tertius

69
Q

Dans quel compartiment de la jambe se trouve l’artère tibiale antérieure?

A

antérieur

70
Q

Dans quel compartiment de la jambe se trouve le nerf fibulaire profond?

A

antérieur

71
Q

Nommer les 2 muscles du compartiment latérale de la jambe

A

Peroneus longus
Peroneus brevis

72
Q

Dans quel compartiment de la jambe se trouve le nerf fibulaire superficiel?

A

latéral

73
Q

Nommer les muscles du compartiments postérieur profond

A

FHL
FDL
Tibialis posterior
popliteus

74
Q

dans quel compartiment de la jambe se trouve le nerf tibial et l’artère tibiale postérieure

A

postérieur profond

75
Q

dans quel compartiment de la jambe se trouve l’artère fibulaire

A

postérieur profond

76
Q

4 os formants l’articulation de la cheville

A

malléole interne
malléole externe
talus
calcaneus

77
Q

nommer les trois os formant le pelvis

A

ilium
ischium
pubis

78
Q

Nommer les 8 muscles qui s’insère sur le grand trochanter du fémur

A

quadratus femoris
gluteus minimus
gluteus medius
obturateur interne et externe
piriforme
gemellus superior et inferior

79
Q

Nommer 2 muscles qui s’insère sur le petit trochanter du fémur

A

Muscle iliaque
Muscle grand psoas

80
Q

Nommer les 2 articulations qui forment le genou

A

Patello-fémorale
Tibio-fémorale

81
Q

De combien de % la patella augmente la force d’extension du genou?

A

30%

82
Q

Décrire la vascularisation du gluteus maximus

A

1/3 sup = art glutéale supérieure
2/3 inf = art glutéale inférieure

83
Q

Décrire la vascularisation du gluteus medius

A

art glutéale supérieure

84
Q

Décrire la vascularisation du gluteus minimus

A

art glutéale supérieure

85
Q

Décrire l’innervation des muscles glutéaux

A

nerf glutéal inférieur= maximus
nerf glutéal supérieur = medius + minimus

86
Q

Nommer les 6 muscles du compartiment antérieur de la cuisse

A

vaste médial, intermédiaire et latéral
rectus femoris
sartorius
articularis genu

87
Q

Nommer les 3 muscles du compartiment postérieur de la cuisse

A

Biceps femoris
Semi-tendineux
Semi-membraneux

88
Q

Nommer les muscles du compartiment médial de la cuisse

A

Adductor magnus, longus et brevis
Pectiné
Gracilis

89
Q

de quelles racines origines les nerfs suivants:
fémoral
obturateur
sciatique

A

fémoral = L2-L4
Obturateur = L2-L4
Sciatique = L4-S3

90
Q

décrire le trajet du nerf cutané fémoral latéral

A

-provient des racines lombaires postérieure L2-L3
-passe sous le ligament inguinal (ou parfois à travers) 3cm médial au ASIS
- longe antérieur au sartorius
- devient superficiel 10 cm sous le ASIS

91
Q

Structure of nerve from outside to inside (6)

A

Mesoneurium (loose areolar tissue)
Epineurium
Fascicles
Perineurium
Endoneurium
Axons

92
Q

Blood supply of nerves (3)

A

Vasa nervorum
Extrinsic vessels
Capillary plexus

93
Q

À quoi sert un nœud de Ranvier?

A
  • Gap junctions de Cellules de Schwann
  • Conduction saltatoire
  • Plus rapide
94
Q
A

Questions pratiques de l'Université Montréal (41 decks)

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