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Flashcards in Anatomy Deck (53):
1

3 windows of ilioinguinal approach

Medial window

medial to external iliac artery & vein

Middle window

between external iliac vessels and the iliopsosas 

Lateral window

lateral to iliopsoas (iliopectineal fascia)

 

2

T1 dermatome/myotome

Finger abduction (interossei - ulnar n)

Sensory: medial elbow

3

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

Median nerve proper

Superficial group:

PT

FCR

PL

Intermediate group:

FDS

 

AIN

Deep Group

FPL

FDP (radial 2)

PQ

4

Name the structures attached to the 3 arrows

Top: Gluteus minimus

Middle: Piriformis

Bottom: Sacrotuberous ligament

5

Name the following strucutres

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

6

pediatric femoral shaft fracture reduction criteria

<10 degrees varus/valgus

<20 degrees AP

<2cm shortening

<10 degrees rotational alignment

7

Roots contributing to the femoral nerve

L2-L4

8

Describe course of obturator internus

origin

Path

Insertion

Origin: ischiopubic ramus & obturator membrane

Path:

THrough lesser sciatic notch

makes a 90 degree turn

Insertion: Medial aspect of GT

9

NAME THE ANATOMICAL STRUCTURES

10

Course of the radial nerve, hitting salient points

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

11

Internervous plane of Smith-Peterson approach to hip

Anterior approach:

Femoral nerve & Superior gluteal nerve

Superficial:

Sartorius (femoral)

TFL (superior gluteal)

Deep:

Rectus femoris (femoral)

Gluteus medius (superior gluteal)

12

Roots contributing to LFCN?

L2-3

13

Name the structures

14

 

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

 

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.

15

Roots contributing to Sciatic nerve

L4-S3

16

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

Foley to decompress bladder

17

Stoppa approach: 4 dangers

Bladder

Corona mortis

External iliac vessels

Obturator nerve & vessels

18

name the structures

1. Cephalic vein

2. FCR

3. FDS

4. ulnar artery

5. ulnar nerve

5. 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

19

Reduction criteria for paediatric radial neck fractures

<30 degrees angulated

<3-4mm translated

>45 degrees pro-supination

20

Course of the ulnar nerve

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

21

What is the corona mortis and where is it located?

Anastomosis between:

external iliac system or deep inferior epigastric artery

&

obturator system

Lives in the latearl 1/3 of the pubc ramus

22

C5 myotome & dermatome

Shoulder abduction (deltoid)

Elbow flexion (palm up) (biceps)

Sensory: lateral arm below deltoid

23

Reduction criteria for paediatric proximal humerus fracture

>50% apposition

<45 degrees angulated

No head split

Neer-Horwitz 1 or 2

24

C8 myo/dermatome

Finger flexion (FDS)

Sensory: 5th finger

25

Name the structures

1. anterior compartment

2. EDL

3. EHL

4: TA

5> deep peroneal nerve and tib ant vessels

6. lateral compartment

7. superficial peroneal nerve

8. peroneus longus (lateral to brevis - protects it)

9. peroneus brevis

10. deep posterior copmartment

11. Tib post

12. FHL

13. FDL

14. peroneal vessels

15. tibial nerve and posterio tibial vessels

16. long saphenous vein

17. superficial posterior compartment

18. Soleus

19. Achilles tendon

20. Sural nerve & lesser saphenous vein

21. Fibula

22. tibia

26

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

Medial sural cutaneous nerve

27

C7 myo/dermatome

Elbow extension (Triceps)

wrist flexion (FCR)

Sensory: Fingers 2,3,4

28

Course of median nerve

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

L2, 3 dermatome/myotome

Hip flexion (iliopsoas)

Hip adduction (hip adductors)

Knee extension (quad)

Sensory: anterior and inner thigh

30

Acceptable reduction criteria: tibial shaft

5 degrees varus/valgus

10 deg AP

50% cortical apposition

<1cm shortening

<10 degres rotational

(5, 50, 1, 10, 10)

31

name the structures

32

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

ascending branch of lateral femoral circumflex artery

33

L4 myo/dermatome

Knee extension (quad)

Ankle dorsiflexion (TA)

 

Sensory: lateral thigh, anterior knee and medial leg

 

Patellar reflex

34

S3,4 derm/myotome

Bladder & bowel function

"S2-3-4 keep the shit off the floor"

Sensation perianal

35

name the structures

1. intermedial dorsal cutaneous branch of SPN

2. medial dorsal cutaneous branch of SPN

3. peroneus tertius

4 EDL

5. EHL

6. deep peroneal nerve

7. tib ant

8. great saphenous vein

9 tibia

10. tib post

11. FDL

12. tibial nerve and posterior tibial vessels

13. FHL

14. achilles tendon

15. sural nerve and lesser saph vein

16. peroneus brevis

17. peroneus longus

18. fibula

36

Name the branhces of the axillary artery

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

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

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

C6 myotome & dermatome

Elbow flexion (thumb up) (brachioradialis)

Wrist extension (ECRL)

Sensory: thumb & radial hand

39

S2 derm/myotome

Toe plantar flexion (FHL, FDL)

Sensation: plantar foot

40

L5 derma/myotome

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

Humeral shaft (adult) reduction criteria

<20 AP

30 varus/valgus

<3cm shortening

42

Name the structures

43

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

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

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

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

2 distinct and major complications from extended iliofemoral approach:

permanent abductor weakness

Highest rate of HO

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

46

L1 dermatome

iliac crest & Groin

47

Medial approach to hip:

What is the danger when you're releasing iliopsoas?

Medial femoral circumflex artery

Must directly visualize

48

S1 derm/myotome

Foot plantar flexion (gastroc-soleus)

Foot eversion (Peroneals)

 

Sensation: posterior leg

 

Reflex: Achilles

49

Boundaries of the greater sciatic notch?

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

 

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

 

4 distinct phases:

1) ligament

2) fibrocartilage

3) mineralized fibrocartilage

4) bone

 

(Indirect attachment is Ligament --> Periosteum)

51

Medial femoral circumflex artery travels anterior to all SERs except:

Obturator externus

52

Signs of sacral dysmorphism

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

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

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