Anki LL Anat 1 Flashcards
(82 cards)
1
Q
What are the important landmarks of hip bone?
A
Spines (ilium - AS, AI, PS, PI) Tubercles/tuberosity (pubic, ischial) Ramus (ischium, pubic, ischiopubic) Crest (ilium) Acetabulum Obturator foramen
2
Q
How is the hip joint so stable?
A
- ball & socket synovial joint 2. head of femur completely in acetabulum 3. cavity deepened by the acetabular labrum (fibrocartilaginous collar)
3
Q
Components of hip joint srufaces?
A
- Synovial membrane 2. Articular cartilage (hyaline cartilage) 3. Acetabular labrum
4
Q
Muscles involved in flexion of hip joint?
A
Iliopsoas (from spine & hip to femur) Rectus femoris (from hip to patellar) Sartorius (from hip to tibia)
5
Q
Muscles involved in extension of hip joint?
A
Gluteus maximus Semimembranosus Semitendinosus Biceps femoris
6
Q
Muscles involved in abduction of hip joint?
A
Gluteus medius Gluteus minimus Deep gluteals (piriformis, gemelli etc.) Tensor fascia lata
7
Q
Muscles involved in medial rotation of hip joint?
A
Gluteus medius Gluteus minimus
8
Q
What is the aterial supply to the femoral head?
A
- Obrurator artery -> artery to head of femur 2. Deep femoral -> Medial & Lateral circumflex artery (retrogade)
9
Q
What are the 3 main types of femur fractures & their clinical significance?
A
- Femoral neck fractures (subcapital & trascervical) Subcapital fractures can lead to avascular necrosis of femur head 2. Intertrochanteric fracture 3. Subtrochateric fracture
10
Q
What is the common dislocation of hip joint?
A
Posterior dislocation: shortened, medially rotated, sciatic nerve at risk of injury
11
Q
What are the 4 components of quadriceps femoris Origins: Insertions:
A
- Vastus lateralis 2. Rectus femoris 3. Vastuc medialis 4. Vastus intermedius (deep) Origins: all orignates from Femur except Rectus femoris which is the Hip Insertions: all inserts at quadriceps tendon which is the base of the patellar Note: Rectus femoris has action over 2 joints!
12
Q
What are the 4 extracapsular ligaments and 2 intracapsular ligaments at the knee joint?
A
- Patellar ligament 2. Lateral collateral ligament, LCL 3. Medial collateral ligament, MCL 4. Oblique poplitead ligament 5. Anterior cruciate ligament 6. Posterior cruciate ligament Note: MCL, ACL & Medial meniscus form the unhappy triad
13
Q
Why is the medial collateral ligament more prone to injury?
A
Unhappy triad: ACL, medial mensicus and medial collateral ligament are all attached. Any injury to one structure can implicate others. Note: lateral meniscus is not attached to any tendon
14
Q
Muscles involved in flexion of knee joint?
A
Biceps femoris (from hip to fibula) Semitendinosus (from hip to tibia) Semimembranosus (from hip to tibia)
15
Q
Muscles involved in extension of knee joint?
A
Quadriceps femoris (4 muscles) Note: Rectus femoris has action over hip joint as well
16
Q
Muscles involved in medial rotation of knee joint?
A
Semitendinosus
17
Q
Muscles involved in lateral rotation of knee joint?
A
Biceps femoris Note: attaches from hip (pubic) fibula
18
Q
What structures can be viewed in endoscopy of knee joint?
A
- Ligaments 2. Components of synovial joint (mensicus, synovial membrane, hyaline cartilage)
19
Q
Describe the articulation at ankle joint
A
The lower end of tibia and fibula is fitted into the upper part of the talus
20
Q
What are the ligaments of ankle joint?
A
Medial: Deltoid ligament Lateral ligaments: PTFL, ATFL, TFL
anterior talofibular ligament (ATFL), the calcaneofibular ligament (CFL), and the posterior talofibular ligament (PTFL
21
Q
What are the muscles involved in dorsiflexion of ankle joint?
A
Tibialis anterior Extensor hallucis longus Extensor digitorum longus Peroneus tertius
22
Q
What are the muscles involved in plantarflexion of ankle joint?
A
(Superficial Posterior) Gastrocnemius Plantaris Soleus (Deep Posterior) Flexor digitorum longus Flexor hallucis longus Tibialis posterior (Lateral) Peroneus longus Peroneus brevis
23
Q
What is the articulation of subtalar joint?
A
The subtalar joint is an articulation between the Talus & Calcaneus and functions as a plane synovial joint
24
Q
What is the articulation of the transverse talar joint?
A
Formed by the articulation of calcaneus-cuboid and talus-navicular bones
25
Muscles involved in eversion of foot at subtalar & transverse tarsal joint?
Peroneus longus & brevis
26
Muscles involved in inversion of foot at subtalar & transverse tarsal joint?
Tibialis anterior Extensor hallucis longus Tibialis posterior
27
Bones that form the medial longitudinal arch?
Calcaneus Talus Navicular Cuneiform bones (all 3) Medial 3 matetarsals
28
Bones that form the lateral longitudinal arch?
Calcaneus Cuboid Lateral 2 metatarsals
29
Bones that form the transverse arch?
Lies at the tarso-metatarsal joints Bases of metatarsals Cuboid Cuneiform bones (all 3)
30
Keystone & suspension from above for medial longitudinal arch?
Keystone: Head of Talus Suspension from above: Tibialis antrior and posterior
31
Keystone & suspension from above for lateral longitudinal arch?
Keystone: Cuboid Suspension: Peroneus longus & brevis
32
Keystone & suspension from above for transverse arch?
Keystone: Wedge shape formed by bones Suspension: Peroneus longus & brevis
33
Muscles involved in adduction of hip joint?
3+2 Adductor longus Adductor brevis Adductor magnus (has hamstring part) Pertineus (short, proximal) Gracillis (long, distal)
34
Which parts of the pelvis are palpable?
Anterior superior iliac spine Pubic tubercle
35
Which part of the femur is palpable?
Greater trochanter
36
What is the clinical significance of femur neck fractures (hip fracture)?
These fractures tear the retinacular arteries arising from the medial circumflex femoral artery and disrupt the main blood supply to the head of the femur. As the artery to the ligament of the femoral head tends to be inadequate in maintaining the femoral head, such a fracture tends to result in avascular necrosis Note: Not in children, who have adequate blood supply to the femoral head Note: Intertrochanteric fractures are of lesser consequence
37
Where are the attachments of patellar tendon?
Superior: Quadriceps femoris tendon Distal: Tibial tuberosity
38
What are the bones of the tarsal?
From proximal to distal:Calcaneus Talus Navicular (Medial), Cuboid (Lateral) Cuneiforms (Medial, Intermediate, Lateral)
39
What causes flat foot?
Collapse of longitudinal arch due to congenital reasons or fatigue of muscular support results in stretched ligaments and pain on walking
40
What are the nerve supply to the hips?
Femoral nerve L2, 3, 4 Obturator nerve L2, 3, 4 Nerve to quadratus femoris L4, 5 Sciatic nerve (superior gluteal nerve) L4, 5, S1, 2, 3
41
Which muscles lock & unlock the knee?
Lock: Medial rotation of femur about tibia Unlock: Popliteus muscle contracts, rotate femur laterally about tibia
42
What does the quadriceps tendon jerk test for?
Elicited by a firm strike on the patella ligament This tests the function of the femoral nerve and L2-L4 (especially L3) spinal nerves
43
Why is sartorius so cool?
It can flex, abduct, laterally rotate & medially rotate (combined actions produce a cross-legged sitting postion)
44
What is the significance of the adductor canal & adductor hiatus
It is the distal continuation of the femoral triangle It is the intramascular passgage for femoral artery, vein & branches of nerve These vessels then pass from the adductor canal to the popliteal fossa throught the adductor hiatus (hamstring attachment of adductor magnus)
45
What does the calcaneal tendon jerk test for?
Tests for damage to tibial nerve or S1 & S2 of spinal segments that supply the tibial nerve
46
Sciatic nerve Origin: Terminate: Tibial & Common fibular nerve Motor: Sensory: Clinical:
L4, L5 S1, S2, S3 Through sciatic foramen, below piriformis Posterior thigh, leg & foot
47
Popliteal fossa Borders: Contents (lateral to medial): Relations: Clinical:
NVA Relations: Femoral nerve divides into tibial & common fibular nerve here Small saphenous vein frains into popliteal vein here Clinical: Popliteal artery can give aneurysm here
48
Femoral triangle Borders: Structures: Relations: Clinical:
Structures: Everything is inside femoral sheath except nerve Relations: Great saphenous vein drains into femoral vein through saphenous opening in femoral triangle Clinical: Femoral artery & vein accessed at mid-inguinal (NOT THE SAME AS midpoint of inguinal ligament) which is between ASIS & pubic tubercle
49
Popliteal artery Origin: Course: Termination: Anterior & Posterior tibial arteries (lower border of popliteus), Anterior tibial artery then enters foot as Dorsalis pedis artery -> Deep plantar artery Branch:
50
The great saphenous vein Drains into: Landmarks: Location: Relations:
Femoral vein Medial malleolus Medial thigh to leg Saphenous nerve in leg
51
What is the main blood supply to the neck of femur
Medial circumflex artery
52
Innervation of posterior calf and its origin
53
What is the path of arteries in the leg (posterior medial, posterior lateral, anterior)
Popliteal Anterior: Anterior tibial (deep fibular nerve)-> Dorsal pedis Posterior: Posterior tibial (tibial nerve) & Fibular Anterior tibial artery descends together with the deep fibular nerve, a branch of the common fibular nerve, along the anterior aspect of the leg Fibular artery (lateral) Posterior tibial artery (medial)
54
Components involved in the knee jerk reflex?
L3-4 spinal segments Patellar tendon struck Rectus femoris stretched and then contracts Monosynaptic - interneurons not involved Singal sent through afferent sensory neurons into the dorsal horn of the spinal cord via the L3-L4 spinal segments. Thereafter, the afferent sensory neurons then synapse with the efferent motor neurons, and the signal continues to travel along the axons of the motor neurons out through the ventral horn of the spinal cord. The signal eventually returns back to the quadriceps femoris muscle via the femoral nerve, triggering the contraction of the muscle, and the extension of the leg at the knee joint.
55
What are the muscles of anterior compartment of leg and their general functions?
Tibialis anterior (inversion & dorsiflexion) - attaches to the medial part Extensor digitorum longus (extension of 4 toes) Extensor hallucis longus (extension of big toe) Fibularis tertius (eversion & dorsiflexion) - attached to lateral part Innervated by deep fibular nerve (L4-S1) Supplied by anterior tibial artery
56
What are the only 2 muscles in lateral leg and their actions?
Fibularis longus Fibularis brevis Eversion & plantarflexion (comes from the bottom) Innervated by superficial fibular nerve (L4-S1)
57
What is the piriformis syndome?
Lateral rotation (by piriformis) will further irritate sciatic nerve All branches of sciatic nerve affected - Tibial nerve (posterior leg & intrinsic foot) - Common fibular nerve (lateral & anterior leg - dorsi, extension of toes, invet & evert)
58
Across which joints do the posterior leg muscles (calf) attach?
Plantaris from femur to calcaneus - knee & ankle Gastrocnemius from femur to calcaneus - knee & ankle Soleus (deep) from tibia to calcaneus - ankle only Popliteus from femur to tibia - knee only
59
Which fracture likely to cause foot drop?
Injury to Common fibular nerve Fracture at neck of fibular
60
What is the pathology associated with neck of femur fracture?
Avascular necrosis of head of femur
61
List down the path and divisions of the common fibular nerve
Sciatic nerve bifurcates into tibial and common fibular nerves at popliteal fossa The common fibular nerve wraps around neck of fibular and then divides into superficial and deep fibular nerves
62
Injury to superior gluteal nerve causes?
Impairs gluteus medius and maximusClinical: Trendelenburg gait (hip drop contralateral to weak side)
63
Why is the adductor magnus so special?
The adductor magnus is dually innervated by the sciatic and obturator nerves, where the adductor part of the muscle is innervated by the obturator nerve and the hamstring part is innervated by the tibial division of the sciatic nerve
64
Innervation of the biceps femoris?
short head (lower attachment) by the fibular division long head (higher attachment) by the tibial division short head from femur, long head from hip to lateral portion of knee (fibular head, lateral tibia) Note: Action over 2 joints Note: Sciatic nerve is actually 2 individual nerves bundled together in the same connective tissue sheath, usually separate at the popliteal fossa
65
Which is the strongest resistor of hip hyperextension?
Iliofemoral ligament arises from the anterior inferior iliac spine and then bifurcates before inserting into the intertrochanteric line of the femur. It has a ‘Y’ shaped appearance, and prevents hyperextension of the hip joint. It is the strongest of all the ligaments.
66
Posterior thigh muscles that crosses joints?
Semitendinosus & Semimembranosus from hip (ischial tuberosity) to tibial (tuberosity) - hip & knee Biceps femoris from hip (ischial tuberosity) to tibia & fibular - hip & knee Adductor magnus only from hip to femur
67
Briefly describe the functions of the 3 hip ligaments
Iliofemoral: Y-shaped, strongest ligament in body and prevents hyperextension when standing Puberofemoral: from the obturator crest to prevent excessive abduction Ischiofemoral: weakest of 3, only one which is posterior Ligament of head: weak & useless... Note: Since muscles in the anterior are fewer and weaker, the 2 anterior ligaments are the strongest
68
Difference in medial and lateral longitudinal arch
Medial: navicle & 3 metatarsals (calc, talus, 3 cuneiforms) Lateral: cuboid & 2 metatarsals (calc, talus, 3 cuneiforms)
69
What kind of tissue is the meniscus?
Fibrocartilage (not dense connective tissue)
70
Which artery is the dorsalis pedis a continuation of?
anterior tibial artery
71
What are the nerves that innervate the foot?
Posterior compartment (innervated by the tibial nerve) - plantarflex and invert the foot Lateral compartment (innervated by the superficial fibular nerve) - evert the foot Anterior compartment (innervated by the deep fibular nerve) - dorsiflex and invert the foot
72
Which quadriceps muscle crosses 2 joints?
Rectus femoris from patellar to hip (knee & hip)
73
Where is lumbar puncture performed?
L4-L5
74
What muscles does the superior gluteal artery supply?
All 3 gluteal muscles
75
What ligament usually damaged in inversion sprain?
anterior & posterior talofibular (ATFL & PTFL) calcaneofibular (CFL)
76
Visualize the path of arteries vs nerves in the leg
Arteries:Femoral, Popliteal, Tibial (Anterior - Dorsalis pedis & Posterior), Fibular Nerve: Obturator Fermoral, Saphenous Sciatic, Tibial, Common fibular (Deep, Superficial)
77
Which nerve follows the anterior tibular artery
Deep fibular nerve
78
Where does the long saphenous vein drain into?
Superficial inguinal lymph nodes Small saphenous vein drains into popliteal lymph node and then superficial & deep inguinal nodes
79
What is inside and not inside the femoral sheath?
Femoral nerve NOT inside Femoral artery Femoral vein Deep inguinal lymph nodes Loose areolar tissue N(VA...)
80
What does fibularis tertius do?
Eversion, dorsiflexion
81
Which part of is most involved during the iliotibial band syndrome?
Rubbing against lateral epicondyle
82
Where can we palpate the dorsalis pedis artery?
The dorsalis pedis artery pulse can be palpated: lateral to the extensor hallucis longus tendon or medially to the extensor digitorum longus tendon) or distal to the dorsal most prominence of the navicular bone
