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Anatomy Flashcards

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1
Q

Divisions of lower limb

A

Lower limb
Inguinal region/groin
Thigh
Knee/Popliteal fossa
Leg
Ankle
Foot

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2
Q

Functions of the lower limb

A

support body weight
locomotion
maintain balance

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3
Q

Superficial muscles, functions and innervations of gluteal region

A
  • gluteus maximus, gluteus medius, gluteus minimus, tensor fascia latae
  • extensors, abductors, medial rotators of thigh
  • gluteal nerves (GM=inferior gluteal, all others= glut med and min)
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4
Q

Deep muscles, functions and innervations of gluteal region

A
  • piriformis, obturator internus, gemelli and quadratus femoris
  • lateral rotators of thigh and hip stabilisers
  • nerves from sacral plexus
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5
Q

Entry and exit point of gluteal nerves

A

greater and lesser sciatic foramen
- formed by sacrotuberous and sacrospinous ligaments

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6
Q

Which nerves enter/exit the pelvis via gluteal region?

A
  • Sciatic (L4-S3)
  • Pudendal (S2-S4)
    - Principal nerve to perineum
  • Posterior cutaneous nerve of thigh (S1-S3)
    • innervates skin over posterior thigh, popliteal fossa, lateral perineum and upper medial thigh
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7
Q

Describe the sciatic nerve

A
  • largest in body
  • usually exits inferior to piriformis
  • supplies nothing in gluteal region
  • separates in distal thigh (tibial nerve and common fibular)
    • innervates post thigh, leg foot, skin
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8
Q

Contents of the femoral triangle

A

Femoral Nerve
Femoral Artery
Femoral Vein
Lymphatics

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9
Q

Boundaries of the femoral triangle

A

superior – inguinal ligament

medially – adductor longus

laterally – sartorius

floor – iliopsoas and pectineus

roof – deep fascia (fascia lata)

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10
Q

Deep fascia of thigh and leg?

A

Fascia lata - thigh
Crural fascia - leg

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11
Q

What is compartment syndrome?

A

increased pressure caused by swelling of tissue or increase in fluid
- affects functions of the muscles or nerves in the compartment
- fasciotomy to relieve pressure in emergency

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12
Q

3 compartments of the thigh

A

Anterior
Medial
Posterior

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13
Q

3 compartments of the leg

A

Anterior
Posterior
Lateral

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13
Q

Describe anterior thigh compartment

A

flexors of thigh
- pectineus, iliopsoas, sartorius

extensors of leg
- quadriceps femoris

all femoral nerve (L2, L3, L4)
- psoas major (L1,L2,L3)

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14
Q

Describe medial compartment of thigh

A

adductors of thigh
- adductor longus, adductor brevis, adductor magnus, gracilis, obturator externus

all obturator nerve (L2, L3, L4)
- hamstring part of adductor magnus (tibial nerve)

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15
Q

Describe posterior compartment of thigh

A

extensors of thigh & flexors of leg
- semitendinosus, semimembranosus & biceps femoris

all tibial division of sciatic nerve (L5, S1, S2)
- short head biceps femoris (common fibular division of sciatic

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16
Q

Describe anterior compartment of leg

A

dorsiflexors of ankle & extensors of toes
- tibialis anterior, extensor digitorum longus, extensor hallucis longus, fibularis tertius

all deep fibular nerve (L4, L5)

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17
Q

Describe lateral compartment of leg

A

evert foot & weakly plantarflex ankle
- fibularis longus, fibularis brevis

all superficial fibular nerve (L5, S1, S2)

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18
Q

Describe the hip joint

A

Ball and socket/synovial joint
Multiaxial
- flexion-extension
- abduction-adduction
- medial-lateral rotation
- circumduction

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19
Q

How are hip joint ligaments formed?

A

thick part of fibrous layer of joint capsule forms ligaments

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20
Q

3 ligaments of the hip joint

A

iliofemoral
pubofemoral
ischiofemoral

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21
Q

What is the ligament to head of femur?

A

Ligamentum teres

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22
Q

Arterial supply of hip joint

A

medial and lateral circumflex femoral arteries
- usually from deep femoral artery
- give off retinacular arteries

artery to head of femur
- branch of obturator
- travels in ligament to head of femur

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23
Q

Describe the knee joint

A

hinge joint, mostly flexion-extension
- 3 articulations
- 2 x femerotibial
- 1 x femeropatellar

synovial joint
- external fibrous layer
- internal membranous layer
- extensions as bursae

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24
Ligaments of the knee joint
extracapsular - patellar ligament - lateral (fibular) collateral ligament - medial (tibial) collateral ligament intra-articular - anterior cruciate (ACL) - posterior cruciate (PCL) joint integrity - anterior / posterior drawer signs menisci - fibrocartilage - medial and lateral
25
Boundaries of the popliteal fossa
superolaterally – biceps femoris superomedially – semimembranosus inferiorly – gastrocnemius roof – popliteal fascia
26
Contents of the popliteal fossa
lots of fat terminal small saphenous vein popliteal vessels tibial and common fibular nerves
27
Describe the calcaneal/Achilles tendon
- thickest and strongest in body - tendons of gastrocnemius and soleus together - attaches to calcaneal tuberosity - ‘ankle jerk’ reflex - tests S1, S2 nerve roots
28
Superficial lymphatics of the thigh
follow saphenous veins drain to superficial inguinal lymph nodes then external iliac lymph nodes
29
Deep lymphatics of the thigh
follow deep veins (popliteal lymph nodes) deep inguinal lymph nodes external iliac lymph nodes
30
Which lymphatics drain from external to common iliac?
Lumbar lymphatics
31
Gluteus maximus attachments
iliac crest, sacrum, sacrotuberous ligament and coccyx proximally distally onto the iliotibial tract
32
Gluteus medius/minimus attachments
both attach to the external/posterior/gluteal aspect of the ilium anterolateral aspect of the greater trochanter of the femur.
33
Function of gluteal muscles
Max - biggest extensor of thigh Med - abduct and medially (internally) rotate the thigh Min - ""
34
What does Trendelenberg's test ID?
Damage to the gluteal muscles or their nerve supply (superior gluteal nerve)
35
Inferior vs superior gluteal NV bundle?
Inferior - supplies max Superior - supples med and min
36
Describe piriformis
Deep to gluteal muscles Lateral rotator of hip, stabilise femur Small strips of muscle
37
Describe the iliotibial tract
AKA fascia lata Thickening of the deep fascia of the thigh Tensor fascia lata is the musc part
38
Describe sciatic nerve
Roots L4-S3 Can experience slipped disc
39
Describe pudendal nerve
Roots S2-S4 Pudendal nerve block in obs
40
Describe post. cutaneous nerve of thigh (PCNT)
Roots S1-S3 Supplies skin of post aspect of thigh
41
Describe lumbar puncture
Patient fully flexed, ID iliac crests at L3/4 (avoids end of cord at L1/2), use spinal pack to get CSF
42
3 muscles of the hamstring
(medially) semimembranosus, semitendinosus and (laterally) the long and short heads of biceps femoris.
43
Where does the sciatic nerve divide in the lower limb?
- anywhere between the gluteal region and the popliteal fossa - divides into tibial nerve and common fibular nerve
44
Why is the short head of the bicep not considered a hamstring?
1. It attaches proximally to the linea aspera of the femur, not to the ischial tuberosity. 2. It does not cross the hip joint and therefore does not contribute to the movement of the hip joint. 3. It supplied by the common fibular branch of the sciatic nerve rather than the tibial branch.
45
Why do semitendonosis and semimembranosis have their names?
semitendinosus - has a longer tendon than the other muscles semimembranosus - shiny membranous appearance
46
Function of acetabular labrum
increases the depth of the acetabulum
47
Divisions of spinal vertebrae
. cervical (7V) * thoracic (12V) * lumbar (5V) * sacral (5V fused) * coccyx (4V fused)
48
Natural curvatures of the vertebral column
Cervical - convex anteriorly Thoracic - concave anteriorly Lumbar - convex anteriorly Sacral - concave anteriorly
49
Examples of abnormal curvatures of vertebral column
Thoracic kyphosis AS Lumbar lordosis Scoliosis
50
Spondylolysis vs spondylolisthesis
-lyolysis = stress fracture -lolisthesis = displacement
51
Examples of superficial (ext) and deep (int) muscles of the back
Superficial - pec girdle/upper limb Deep - splenius/erector spinae/transversospinalis/gutter between transverse/spinous process
52
Ext muscles of back that move upper limb?
trapezius * levator scapulae * rhomboid major * rhomboid minor * latissimus dorsi
53
Two types of joints of the spine
IV joint Facet joint
54
When does ossification occur in utero?
Primary - 12w, long bones Secondary - 36w, distal femur
55
Describe Swanson's classification
Failure of formation Failure of separation Hypoplasia Overgrowth Duplication Constriction ring syndrome Skeletal dysplasia
56
Achondroplasia affects which bone site....
Proliferative site
57
Treatment of osteogenesis imperfecta
Bisphosphonates
58
How does Risser scale measure skeletal age?
Fusion of iliac apophysis to pelvis 1, 2, 3, 4 - middle stages, not yet mature 5 - full fusion, skeletal maturity
59
Describe SALTER-HARRIS classification
Straight -T1 Above - T2 Lower - T3 Through - T4 cRush - T5
60
What type of joint is the sacro-iliac joint?
Fibrous (posteriorly) and synovial (anteriorly)
61
What movements are possible at hip joint?
Abd/adduction Flex/extension Med/lat rotation = Circumduction
62
Cominuted fracture = ?
Multiple fractures/lots of separate bony fragments
63
Which features of hip joint preserve stability?
- Bony arch: Femoral head and acetabulum Synovial joint - Acetabular labrum - Ligaments
64
Posterior hip dislocation results in ....
Internally rotated and shortened lower limb
65
Describe deficits resulting from sciatic nerve injury
...
66
What does left gluteus medius pathology result in?
Right hip drop
67
What is Shenton's line?
Curved line drawn along inf border of superior pubic ramus and along inferomedial border of neck of femur
68
What does neck of femur fracture look like on lower limb?
Externally rotated and shortened
69
Complication assoc with neck of femur fracture?
Avascular necrosis (more likely to occur with fracture closer to head of femur)
70
Structures at risk of injury in femoral shaft fracture...
Sciatic nerve Popliteal and femoral artery
71
Varus vs vagus knee changes...
Varus - abducted Vagus - adducted
72
What movement do ACL and PCL prevent?
Anterior and posterior slide of tibia to femur
73
Which nerves are most likely to be injured in anterior shoulder dislocation?
Axillary and radial
74
What fracture commonly results from FOOSH?
Distal radial fracture (Colles fracture) - results in dinnerfork deformity
75
Differences in muscle wasting in carpal/cubital tunnel
Carpal - palmar Cubital - dorsal
76
Which muscle is responsible for knee felxion?
Popliteus

Musculoskeletal (8 decks)

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