ALL CONTENT P2 Flashcards
1
Q
Three parts of the pelvis and what do they consist of
A
Bowl: hip bones + sacrum
Joints: sacroilic and symphysis
Girdle: hip bones + some sacrum
2
Q
What are three functions of the pelvis
A
Support and protect viscera, provide muscle attatchment site, supports weight of upper body
3
Q
What are the two parts of the basin
A
Pelvic inlet and outlet
4
Q
What is superior to pelvic inlet
A
False or greater pelvis (IGF)
5
Q
What is inferior to pelvic inlet
A
True or lesser pelvis
6
Q
What makes up the pelvic inlet
A
Pubic crest, sacral promontory, pectineal line, arcuate line
7
Q
What makes up the pelvic outlet
A
Apex of coccyx, ischial tuberosities, pubic symphysis
8
Q
Classify pubic symphysis and sacroiliac joint
A
1) symphysis: fibrocartilage 2) sacroiliac: ant (synovial) and post (fibrous)
9
Q
Name the posterior pelvic ligaments
A
1) sacrotuberous 2) posterior sacroiliac ligament 3) sacrospinous
10
Q
Name the anterior pelvic ligaments
A
1) interosseous sacroiliac 2) anterior sacroiliac ligament 3) illiolumbar
11
Q
Weight transfer through pelvis four steps
A
Weight pushes sacrum inferiorly
Sacrum becomes ‘wedged’ in
Irregular joint surfaces interlock
Ligaments come under tension
12
Q
What causes the sacroiliac joint to move
A
External forces
13
Q
Overall movement of the sacroiliac
A
Slight gliding and rotation
14
Q
Define nutation
A
Anterior rotation of superior sacrum
15
Q
Define counter nutation
A
Anterior rotation of inferior sacrum
16
Q
Nutation is resisted by which ligaments
A
Sacrotuberous and sacrospinous
17
Q
Define form closure
A
How passive structures contribute to the stability of joints
18
Q
Define force closure
A
How active structures contribute to the stability of joints
19
Q
What structures does form closure consist of
A
Ligaments, gravity, rigid structures
20
Q
What structures does force closure consist of
A
Muscles and fascia
21
Q
Purpose of form closure
A
Create rigid interlocking surfaces
22
Q
Purpose of force closure
A
Enhances compression of joints
23
Q
What muscles produce pelvic drop around AP axis
A
Ipsilateral gluteus maximus, contralateral EO and IO, contralateral hip adductors
24
Q
What muscles produce anterior pelvic tilt around AP axis
A
Erector spinae, hip flexors
25
What muscles produce pelvic rotation to the R
Left EO, Right IO, Left hip lateral rotators, right hip medial rotators
26
What movement does the sacrotuberous and sacrospinous resist
Nutation
27
What is meant by true vs false pelvic
Anything above pelvic inlet is an accessory
28
What are three factors that contribte to form closure
Shape of joint surface, tension in ligaments, keystone like wedge shape of sacrum
29
What is contralateral vs ipsilateral
Controlateral: opposite
Ipsilateral: same
30
Is contralateral abduction or adduction in drop (acronym)
Contalateral: adduction (CODD contralateral, opposite, adduction, drop)
31
During lift and drop which side of the pelvic is adduction
Higher side: adduction (smaller angle)
32
What is the windlass effect
The plantar fascia supports the foot during weight bearing activities
33
What are the three sections of pelvic organs
1) Lower urinary tract 2) reproductive 3) lower GIT
34
What do the three sections of the pelvic organs consist of
1) Bladder & urethera 2) uterus & prostate 3) rectum & anal canal
35
Explain the pelvic floor
Dome shaped muscular sheet seperating the pelvic cavity and perineal region below
36
What is the pelvic floor made up of
Muscle and fascia
37
What are the four functions of pelvic floor
Supports pelvic viscera
Contributes to increase intra abdominal pressure
Acts as sphincters for the passageways through the pelvis
Assists in childbirth: forms a 'gutter'
38
What is the endopelvic fascia made up of
Webs of
1) loose connective tissue
2) adipose tissue
3) smooth muscle
39
What are the two functions of endopelvic fascia
Maintains organ placement, conduit for passageway of nerves and blood to organs
40
Explain the location of the perineum
Between pubic symphysis and coccyx
41
What is the perineum made up of
1) Perineal body
2) Skeletal muscle & fascia
3) Urogenital and anal triangle
41
What muscles make up the peroneal muscle categories
1) ischiocavernosus, bulbospongiosus, super and deep transverse perineal
2) external anal sphincter
41
List the two categories of peroneal muscles
1) Urogenital triangle 2) anal triangle
42
What are the three functions of peroneal muscles
1) Provid added closure to vagina & anus
2) support and fix perineal body
3) maintain erection of penis
43
What is the perineal body
Irregular fibromuscular mass
44
Where is the perineal body located
Midline between anus and vagina/penis
45
What is the perineal body a site of attatchment for
Bulbospongiosus
46
What are the muscles of the pelvic floor supplied by
Nerve to levator ani (slight input from pudenal nerve)
47
What are the muscles of the perineum supplied by
Pudinal nerve (slight input from nerve to levator ani)
48
In terms of blood supply what do arteries and viens have
1) Arteries (branches) 2) Viens (tributaries)
49
What are the three aortic branches
1) Arch of aorta
2) descending aorta
3) common iliac arteries
50
How do deep viens run
Run with arteries but in the opposite direction
51
What are vena commitantes
Two+ small viens that match with the artery
52
What is anastomose in terms of superficial viens
Communication
53
Two reasons of significance of having two sets of viens
1) Two ways to return blood to heart
2) Temperature control
54
Purpose of retinacula in lower leg
Hold the tendons in place and prevent bow stringing
55
Superior and inferior extensor retinaculum binds to which muscle's tendons
TA, EHL, EDL, FT (anterior muscle group)
56
Two types of peroneal retinacula
Superior and inferior peroneal retinaculum
57
The peroneal retinacula binds down which two muscles tendons
PL and PB (lateral muscle group)
58
What does the flexor retinaculum convert bony grooves into and why
Into canals for the TP, FHL, FDL (posterior deep muscle groups) tendons
58
Purpose of synovial sheaths
Facilitate sliding of the tendons
59
Origin and insertions of intrinsic vs extrinsic foot muscles
Intrinsic: both in foot
Extrinsic: origin leg and insertion foot
60
Three functions of plantar aponeurosis of the foot
Bind to skin, attatchment site for foot muscles, helps maintain arches of foot
60
What are the dorsal muscles of the foot
Extensor digitorum brevis, extensor hallicus brevis
61
Where is aponeurosis located in foot
Superificial immediately under the skin
62
Three foot functions
Weight bearing, propulsion, shock absorption
63
List five characteristics of step off
Foot is rigid
Mid tarsal joint locks
Plantarflex ankle and extend MTP joints
Tightens plantar aponeurosis
Raises medial longitudinal arch
64
List three characteristics of heel strike
Foot is flexible
Mid tarsal joint unlocks
Subtalar joint pronates
65
Five features of medial longitudinal arch
Calcaneus, talus, navicular, 3 cuneiforms, 1-3 metatarsals
66
Four features of lateral longitudinal arch
Calcaneus, talus, cuboid, 4-5 metatarsals
67
What plane does the transverse arch run in
Coronal plane
68
What is the proximal end of the transverse arch formed from
All three cuniform bones, metatarsal bases, cuboid
69
What is the distal end of the transverse arch formed from
Head of metatarsal
70
Two purposes of arches
Shock absorber and weight bearing
71
What is the bowstring of dynamic support
Pulls the end of the arch together
71
Ligamentous support (plantar aponeurosis explain)
Toe extension creates tension in aponeurosis which lifts up longitudinal arch creating a windlass effect
71
Static support factors that help arches
1) Shape
2) Ligaments: long and short plantar ligament, spring ligament, plantar aponeurosis, interossei
71
When is muscular (dynamic) support used & 2 types of support
Walking and running (support includes bowstring and sling)
72
Structures of medial longitunal arch (dynamic support)
Abductor hallicus,
FHL
FDL
tibialis posterior
tibialis anterior
72
What is the sling of dynamic support
Lifts the summit upwards
73
Structures of lateral longitunal arch (dynamic support)
Fibularis longus
fibularis brevis
fibularis tertius
tibialis posterior
abductor digiti minimi
74
Dorsal digital expansion allows the toes to do what
Extend simultaneously
74
Dorsal digital expansion is important for what
Digital sweep
74
What is digital sweep
Longest possible sweep of the tips of the digits
75
Are foot movements pure
No
76
How does digital sweep occur
Interplay between the extrinsic and intrinsic foot muscles
Flexion of MTP (IP maintained in extension) -> flexion of IP
77
Lumbricals prevent
Toe clawing
77
What consists of digital sweep
Intrinsic muscles (extend IP joints), interossei and lumbricals
78
Lumbricals flex and extend what
Flex: MTP joint Extend: IP joint
79
What is clawing of the toes
Long flexor and long extensor work unopposed
80
Clawing of the toes pulls what into flexion and extension
FDL: IP flexion | EDL: MTP extension
81
Clawing of the toes creates what rest
A new abnormal position
81
Two main phases of gait
Stance (foot in contact with ground) and swing (foot not in contact with ground)
82
What is cyclical
Repetitious sequence of limb motion to move body foward
82
Plane of hip, knee and ankle during gait
Sagittal
82
Define gait
Manner or style of walking
82
Gait is how many strides
One stride
83
Plane of pelvis during gait
Sagittal and coronal
84
Knee motion gait degree of flexion and extension
60 degrees + 0 degrees = 60 degrees
84
Hip motion gait degree of flexion and extension
30 degrees + 20 degrees = 50 degrees
85
Failure of this coronal plane is called what
Trendelenburg gait
85
Ankle motion gait degree of plantar and dorsiflexion
20 degrees + 5 degrees = 25 degrees
86
What weak muscles cause trendelenburg
Weak hip abductors of stance leg
86
Describe the phases of ankle motion during gait
Plantarflexion: loading response (reduces impact of heel contact)
Dorsiflexion: mid to terminal stance (facilitates body weight over foot)
Plantarflexion: prep for swing phase (transforming extended knee to freely flexing joint)
Dorsiflexion: swing (foot clearance)
87
Describe the coronal plane of pelvic motion during gait
Lift and drop around anteroposterior axis
88
Activation of what limits drop during stance phase
Activation of contralateral gluteus medius and minimus
89
Explain the motion trendelenburg
As patients drop the left foot during stance the contralateral hip drops
89
Describe the sagittal plane of pelvic motion during gait
Tilt around the transverse axis
90
L3 action
Hip flexion
Knee extension
90
L1 action
None
91
L2 action
Hip flexion
92
L4 action
Hip extension
Knee extension
Ankle dorsiflexion
93
L5 action
Hip extension
Knee flexion
Ankle dorsiflexion
Toe extension
94
Loading response ROM
15-25 flex
15-20 flex
0-5 plantar
94
S1 action
Knee flexion
Ankle plantarflexion
Toe extension + flexion
95
Initial contact ROM
30 flex
5 flex
0-5 dorsiflex
95
S2 action
Ankle plantarflexion
Toe flexion
96
Initial contact action
Extending
Flexing
Plantarflexing
96
Initial contact muscles
Extensor
Extensor
Dorsiflexor
96
Mid stance ROM
5-10 flex
5-10 flex
5-10 dorsiflex
96
Terminal stance ROM
5-10 extend
5-10 flex
5-10 dorsiflex
97
Loading response action
Extending
Flexing
Plantarflexing
98
Mid stance action
Extending
Extending
Dorsiflexing
98
Loading response muscles
Extensor
Extensor
Dorsiflexor
99
Terminal stance action
Extending
Flexing
Dorsiflexing
99
Terminal stance muscles
Flexor
Flexor
Plantarflexor
99
Mid stance muscles
Extensor
Extensor
Plantarflexor
100
Initial contact purpose
Pulls knee into extension
Shock absorb
Lower foot to ground
101
Loading response purpose
Pulls knee into extension
Prevent knee collapse
Lower foot to ground -> prevent slap
102
Mid stance purpose
Finishes pull of knee into extension
Pushes knee into extension
Slow foward shank motion
103
Terminal stance purpose
Controls hip extension
Bends knee for foot clearance
Continues to slow foward motion
104
Motor distribution femoral nerve
Pectineus, illiacus, sartorius, quad
105
Motor distribution saphenous nerve
None
106
Motor distribution obturator nerve
Pectineus
Gacilis
Add brevis
Add longus
1/2 add magnus
Obturator externus
106
Motor distribution lateral cutaneous nerve
None
106
Motor distribution muscular branches 1
Illiopsoas
106
Sensory distribution saphenous nerve
Skin of medial thigh -> great toe
107
Motor distribution genitofemoral nerve
None
108
Sensory distribution femoral nerve
Skin of anterior and medial thigh
109
Sensory distribution obturator nerve
Skin of medial thigh
110
Sensory distribution lateral cutaneous nerve
Skin of lateral thigh
111
Sensory distribution genitofemoral nerve
Skin of medial thigh + skin of genitalia
112
Sensory distribution muscular branches 1
Hip joint
113
Motor distribution posterior femoral cutaneous nerve
None
113
Motor distribution tibial nerve
All posterior lower leg muscles
114
Sensory distribution tibial nerve
Knee + ankle joint
114
Motor distribution muscular branches 2
External rotators except obturator externus
114
Motor distribution inferior gluteal
Gluteus maximus
114
Motor distribution superior gluteal
Gluteus medius
Gluteus minimus
Tensor fascia lata
115
Sensory distribution posterior femoral cutaneous nerve
Skin of posterior and lateral leg -> mid calf
116
Sensory distribution superior gluteal
Hip joint
116
Sensory distribution inferior gluteal
Hip joint
116
Motor distribution sural nerve
None
117
Sensory distribution muscular branches
Hip joint
117
Motor distribution medial plantar nerve
Abductor hallicus
FDL
FHL
Lumbrical 1
117
Motor distribution sciatic nerve
Hamstrings
1/2 adductor magnus
118
Motor distribution lateral plantar nerve
Adductor hallicus
Lumbrical 2-4
Interossei
FDMB
ABDM
FA
119
Motor distribution common peroneal
None
120
Motor distribution deep peroneal
All anterior lower leg muscles
120
Sensory distribution medial plantar nerve
Skin of medial 3 1/2 digits + corresponding sole
121
Motor distribution superficial peroneal
Fibularis longus
Fibularis brevis
122
Sensory distribution sciatic nerve
Hip + knee joint
123
Sensory distribution lateral plantar nerve
Skin of lateral 1 1/2 digits + corresponding sole
124
Sensory distribution sural nerve
Skin of lateral and posterior leg
125
Sensory distribution superficial peroneal nerve
Skin of lateral leg
126
Sensory distribution common peroneal nerve
Skin of ant, post, lat upper leg
126
Sensory distribution deep peroneal
Skin between digits 1-2
127
Dermatome of L1
Lower back, pelvis
128
Dermatome of L2
Lower back, upper anterior thigh
129
Dermatome of L5
Gluteal
Pelvis
Post + lateral thigh
Lateral leg
Dorsal of foot
Toe 1-3
129
Dermatome of L3
Lower back
Anterior thigh
Medial leg
130
Dermatome of S2
Gluteal
Medial and posterior thigh + leg
130
Dermatome of L4
Medial gluteal
Lateral thigh
Medial leg
Dorsal foot
Toe 1-3
131
Dermatome of S1
Gluteal
Lateral and posterior thigh + leg
132
Dermatome S3
Pelvis
Medial thigh
