Exam Five

Question 1

Name the three bones that fuse to form the os coxa (hip bone)

Answer 1

ilium, ischium, pubis

Question 2

The three bones that make up the hip bone fuse at what structure?

Answer 2

acetabulum

Question 3

Name 6 important structures found on the ilium

Answer 3

arcuate line, PSIS, PIIS, ASIS, AIIS, iliac crest

Question 4

Name 2 important structures found on the ischium

Answer 4

ischial tuberosity, ischial spine

Question 5

Name 1 important structure found on the pubis (it serves as a major insertion for many muscles)

Answer 5

pectineal line

Question 6

What 3 bones/structures make up the bony pelvis?

Answer 6

sacrum, coccyx, hip bone

Question 7

Name the 3 divisions of the articulated pelvis

Answer 7

pelvic brim/inlet, greater/false pelvis, lesser/true pelvis

Question 8

Describe the structures that make up the pelvic brim/inlet

Answer 8

pectineal line of pubis, arcuate line of ilium, sacrum promontory

Question 9

Describe the location of the greater/false pelvis

Answer 9

lower part of abdominal cavity; superior to pelvic inlet

Question 10

Describe the location of the lesser/true pelvis

Answer 10

actual pelvis; inferior to pelvic inlet and superior to pelvic outlet (closed by pelvic diaphragm)

Question 11

Name the 4 main joints of the pelvis and tell me what kind of join they each are

Answer 11

1. sacroiliac - synovial; helps transition weight to lower limb
2. lumbosacral - secondary cartilaginous (fibrocartilaginous)
3. sacrococcygeal - secondary cartilaginous (fibrocartilaginous)
4. pubic symphysis - secondary cartilaginous (fibrocartilaginous)

Question 12

Name the 2 major ligaments of the pelvis

Answer 12

sacrotuberous, sacrospinous

Question 13

Name the two primary functions of the pelvic ligaments

Answer 13

1. help prevent anteroinferior displacement of superior sacrum and lateral flaring of the sacrum
2. convert greater and lesser sciatic notches into greater and lesser sciatic foramina (foramen found below the ligaments)

Question 14

Describe the location of each of the pelvic ligaments

Answer 14

1. sacrospinous - sacrum to ischial spine

2. sacrotuberous - sacrum to ischial tuberosity

Question 15

Contrast the pelvic inlet in a female to that in a male

Answer 15

females - rounded/oval

male - heart shape/more obstructed

Question 16

Contrast the pelvic canal in a female to that in a male

Answer 16

females - short with parallel walls

males - long and funnel shaped

Question 17

Contrast the ischial tuberosities and spine in a female to those in a male

Answer 17

females - everted

males - inverted (obstructs inlet)

Question 18

Contrast the greater sciatic notch in a female to that in a male

Answer 18

female - broader

male - narrower

Question 19

Contrast the pubic arch and subpubic angle in a female to that in a male

Answer 19

female - broader (usually greater than 90 degrees)

male - narrow (usually less than 70 degrees)

Question 20

Contrast the sacrum in a female to that in a male

Answer 20

female - short and broad

male - long and narrow, anteriorly tilted

Question 21

Describe the lateral muscular wall of the pelvis and name the muscle that makes it up

Answer 21

obturator internus

• arises within lesser pelvis (passes through lesser sciatic foramen) and attaches to femur’s greater trochanter
• obturator membrane: lines obturator internus muscle (membrane forms tendinous arch medially)

Question 22

Describe the posterior muscular wall of the pelvis and name the muscle that makes it up

Answer 22

piriformis

• attaches to sacrum within lesser pelvis (passes through greater sciatic foramen) and attaches to femur’s greater trochanter
• bed for sacral nerve plexus

Question 23

What major structure makes up the pelvic floor?

Answer 23

pelvic diaphragm

Question 24

What 2 muscles make up the pelvic diaphragm?

Answer 24

levator ani + coccygeus

Question 25

What is the function of the pelvic diaphragm?

Answer 25

functions to support viscera (particularly when increased intraabdominal pressure) and aids voluntary control of urination of feccal incontinence

Question 26

Name/describe the 3 major muscular parts of the levator ani (medial to lateral)

Answer 26

1. puborectalis - muscular sling arising from pubis; maintains fecal continence; This muscle is sometimes treated as part of the pubococcygeus 2. pubococcygeus - arises from pubis and tendinous arch, attaching to coccyx 3. iliococcygeus - arises from tendinous arch and ischial spine and blends with pubococcygeus

Question 27

Describe the attachments of the coccygeus (ischiococcygeus) muscle

Answer 27

ischial spine to coccygeus/sacrum

Question 28

Name the innervation of the urinary system

Answer 28

sympathetics T10 to L2, parasympathetics S2-4

Question 29

What is the primary purpose of the urinary system?

Answer 29

functions to transport urine from kidneys to bladder, store urine, and transfer urine to the outside world

Question 30

Are the kidneys considered organs of the pelvis?

Answer 30

no! kidneys are considered abdominal organs though they are embryologically pelvic

Question 31

What are the ureters and what are their purpose?

Answer 31

- retroperitoneal muscular tubes transporting urine from kidneys to posterosuperior bladder - enter bladder obliquely, forming flap valves so muscular contractions of bladder act as sphincters preventing urinary reflux into ureters

Question 32

Describe the difference of the male and female ureters

Answer 32

female - pass medial to uterine arteries' origins | male - ductus deferens rest between ureters and peritoneum

Question 33

Arterial supply to ureters

Answer 33

via nearby arteries (in the pelvis: females = uterine, male = inferior vesicular)

Question 34

Innervation to the ureters

Answer 34

via nearby autonomic plexuses (renal, aortic, superior and inferior hypogastric)

Question 35

What is the function of the bladder?

Answer 35

serve as a reservoir for urine

Question 36

Describe the position of the bladder in adults vs. children

Answer 36

adults - empty bladder rests in lesser pelvis; may extend to umbilicus children - empty bladder may rest in abdomen (Even when empty)

Question 37

Name/describe the 5 main parts of the bladder

Answer 37

1. apex - anterosuperior 2. fundus - posterior wall of bladder (near uterus) 3. body - area between apex and fundus 4. neck - constriction (internal urethral meatus/opening found here) 5. trigone - triangle between ureteric and urethral openings

Question 38

What is the uvula of the bladder?

Answer 38

projection of the trigone often visible in old men

Question 39

What muscle predominates in the bladder walls?

Answer 39

detrusor

Question 40

Differentiate the bladder of a female vs a male

Answer 40

female - muscle of bladders' neck continuous with urethra's muscle male - muscle of bladder's neck continuous with prostate's fibromuscular tissue; muscle fibers form involuntary internal urethral sphincter (prevents semen from entering the bladder)

Question 41

What is the urethra?

Answer 41

muscular tube conveying urine from bladder to the outside world

Question 42

Describe the female urethra (3)

Answer 42

- descends anterior to vagina (partly pelvic, partly perineal) - urine exists via external urethral orifice - glands exist adjacent to urethra (will discuss in perineum)

Question 43

Describe 3 main things to know about the male urethra

Answer 43

- much longer and more complex than females' - internal urethral sphincter in addition to the external one in females - 2 urethral curves in flaccid penis; 1 in erect penis

Question 44

Describe the voluntary vs involuntary control of the male urethra

Answer 44

- internal sphincter under involuntary control - prevents retrograde movement of sperm back into bladder - external sphincter under voluntary control

Question 45

Name/describe the 4 main parts of the male urethra

Answer 45

1. preprostatic - from neck of bladder to prostate 2. prostatic - within prostate; gently curves - near internal sphincter 3. intermediate/membranous - short, narrow, and least distensible; passes through external urethral sphincter (where stones lodge) 4. spongy - longest, ending at external urethral orifice of glans penis

Question 46

Which 2 parts of the male urethra are located in the perineum rather than the pelvis?

Answer 46

intermediate/membranous, spongy

Question 47

Name the 5 specializations of the prostatic urethra

Answer 47

1. urethral crest (median ridge) 2. seminal colliculus - rounded eminence (swelling) 3. prostatic utricle - cul de sac remnant of uterovaginal canal in seminal colliculus 4. openings of ejaculatory ducts - in seminal colliculus (inferior to prostatic utricle) - convey other contents of semen 5. openings of prostatic ducts - lateral to seminal colliculus (in sinuses on side) - convey material from prostate into urethra

Question 48

Name the 4 structures that make up the female reproductive system

Answer 48

ovaries, uterine tubes, uterus, vagina

Question 49

Name/describe the 4 parts of the uterine tubes

Answer 49

1. infundibulum - funnel shaped with fimbrae 2. ampulla - widest and longest 3. isthmus - entering uterine horns 4. uterine part - short segment in uterine wall

Question 50

What are the 2 major parts of the uterus?

Answer 50

body and cervix

Question 51

Describe the body of the uterus and its 3 main parts

Answer 51

upper 2/3 of uterus 1. fundus - superior to uterine tubes 2. uterine horns - entrance of uterine tubes 3. isthmus - constricted region superior to cervix

Question 52

Describe the cervix of the uterus and its 2 main parts

Answer 52

lower 1/3 (neck) 1. internal os - opening to uterus 2. external os - opening to vagina

Question 53

Name the 4 main supporting structures of the uterus

Answer 53

1. ovarian ligament - ovary to uterus (posteroinferior to uterotubal junction) 2. round ligament (ligamentum teres) - uterus (anteroinferior to uterutubal junction) to labia majora 3. broad ligament (mesentary of uterus, 4 parts) 4. pelvic diaphragm

Question 54

Name the 4 parts of the uterine mesentary/broad ligament

Answer 54

1. suspensory ligament - conveys ovarian vessels, lymphatics, and nerves 2. mesovarium - suspends ovary 3. mesosalpinx - suspends uterine tube 4. mesometrium - suspends most of the uterus

Question 55

Describe the position of the uterus

Answer 55

typically anteverted and anteflexed (maintained by round ligament)

Question 56

Describe the function, position, and composition of the vagina

Answer 56

- musculomembranous tube running from cervix to vestibule (party in pelvis, partly in perineum) - posterior to urethra and bladder, anterior to rectum - compressed via several muscles (external urethral sphincter and bulbospongiosus) - superiormost vagina surrounds cervix as anterior, posterior, and lateral fornices

Question 57

Describe the innervation to the vagina

Answer 57

- lower 1/4 = somatic (deep perineal branch of pudendal) | - upper 3/4 = autonomic

Question 58

Name the 7 main structures of the male reproductive system

Answer 58

ductus deferens, testes, epididymis, seminal vesciles, ejaculatory ducts, prostate, bulbourethral glands

Question 59

Ductus deferens

Answer 59

- continuation of duct of epididymis - ampulla = expansion of it - joins duct of seminal vesicle to form ejaculatory duct

Question 60

Seminal vesicles

Answer 60

paired glands secreting thick fluid into ejaculatory ducts

Question 61

ejaculatory ducts

Answer 61

2 ducts formed by joining of seminal vesicle duct and ductus deferens, converging upon the seminal colliculus of prostatic urethra, descends through posterior prostate

Question 62

Prostate (4)

Answer 62

- accessory gland - contains prostatic urethra - divided into 4 lobes - prostatic ducts = empty into prostatic sinuses on either side of seminal colliculus

Question 63

bulbourethral glands (3)

Answer 63

- small glands secreting semen during sexual arousal - posterolateral to intermediate/membranous urethra - ducts open into spongy urethra in bulb of penis

Question 64

What is semen?

Answer 64

mixture of secretions by the testes, seminal vesicles, prostate and bulbourethral glands (usually containing sperm)

Question 65

Name 2 possible clinical variants in the reproductive system of females and males

Answer 65

1. retroverted uterus | 2. bening prostatic hyperplasia and TURP (transurethral resection of the prostate)

Question 66

Describe the 2 components of pelvic fascia

Answer 66

continuation of endoabdominal fascia 1. parietal - lines walls and floor 2. visceral - lines pelvic surfaces

Question 67

Describe/name the 3 peritoneal reflections of the pelvis and what organs are in each

Answer 67

1. extraperitoneal or subperitoneal - technically outside or below the peritoneal cavity; includes most pelvic viscera 2. primarily retroperitoneal (PRP) - kidneys, ureters, rectum, anal canal; additionally the male prostate, seminal vesicles and vas deferens 3. intraperitoneal (IP) - uterus, ovaries, uterine tubes (uterus could be secondarily IP)

Question 68

Name/describe 5 main spaces/pouches of the pelvis

Answer 68

1. retropubic space (space of Retzius) - behind pubis, accommodates bladder distension 2. retrorectal space - behind rectum, accommodates rectal expansion 3. rectovesical pouch - in males, between bladder/prostate and rectum 4. vesicouterine pouch - in females, between bladder and uterus 5. rectouterine pouch (pouch of Douglas) - between uterus and rectum (accessed via posterior fornix)

Question 69

Name the 10 branches of the internial iliac artery (remember there is a posterior division [3] and an anterior division [7])

Answer 69

1. Iliolumbar - 1st branch, goes up and back 2. lateral sacral - lateral surface of sacrum, smaller 3. superior gluteal - between L4/5 and S1 (huge) 4. umbilical - one part obliterated, superior vesicular and artery to ductus deferens branches 5. internal pudendal - below pelvic diaphragm o perineum 6. middle rectal 7. (inferior) vesicular - inferior surface bladder 8. obturator - goes to obturator foramen (abberant if comes off external iliac) 9. uterine 10. inferior gluteal - biggest of anterior division, tends to run betwen S2/3

Question 70

Describe the course of the gonadal arteries (testicular or ovarian)

Answer 70

directly from the abdominal aorta

Question 71

Describe the 4 main components of the lymphatic system of the pelvis

Answer 71

1. inguinal nodes (superficial and deep) - receives lymph from lower limbs and lowest body wall (including external genitalia) 2. external and internal iliac nodes - receive lymph from pelvis and inguinal nodes 3. common iliac nodes - receive lymph mainly from external and internal iliac nodes 4. lumbar nodes - receive lymph from common iliac nodes

Question 72

Name the 2 branches of the lumbar plexus and the levels of each

Answer 72

lumbosacral trunk (L4/5), obturator (L2-4)

Question 73

Name the major nerve components of the pelvis (5)

Answer 73

lumbar plexus, accessory obturator (when present, L3/4), sacral plexus, coccygeal plexus, autonomics

Question 74

Name the 4 main divisions of the sacral plexus and give their levels

Answer 74

1. sciatic L4-S3 2. pudendal S2-4 3. superior gluteal L4-S1 4. inferior gluteal L5-S2

Question 75

Describe the sciatic division of the sacral plexus

Answer 75

- anterior and posterior division - exits pelvis via greater sciatic foramen - supplies lower limb

Question 76

Describe the pudendal division of the sacral plexus

Answer 76

- anterior division - exits pelvis via greater sciatic foramen, enters perineum via lesser sciatic foramen - supplies skin and muscles of perineum; main sensory nerve for external genitalia

Question 77

Describe the superior gluteal division of the sacral plexus

Answer 77

- posterior division - exits pelvis via greater sciatic foramen - supplies gluteus medius, minimus and tensor fascia latae

Question 78

Describe the inferior gluteal division of the sacral plexus

Answer 78

- posterior division - exits pelvis via greater sciatic foramen - supplies gluteus maximus

Question 79

Describe the coccygeal plexus of the pelvis

Answer 79

small plexus from ventral rami of S4/5 and coccygeal nerves

Question 80

Describe the sympathetic innervation to the pelvis

Answer 80

- usually 4 ganglia bilaterally on anterior sacrum, converge at ganglion impar (end of sympathetic trunk) 1. arise from T11-L2 spinal segments 2. pass through sympathetic chain 3. then through lumbar and sacral splanchnic nerves 4. synapse in inferior mesenteric ganglion 5. postsynaptics travel through superior hypogastric plexus, R/L hypogastric nerves, and/or inferior hypogastric (pelvic) plexus 6. follow pelvic arteries to target organs

Question 81

Describe the parasympathetic innervation

Answer 81

1. parasympathetics arise from S2-4 (pelvic splanchnics) 2. ascend mainly through inferior and superior hypogastric plexuses (no synapsing) 3. follow arteries to target organs 4. synapse in ganglia in organ/gut plexuses 5. reach targets via short postsynaptic fibers

Question 82

Tell me the general location of the perineum

Answer 82

inferior to the pelvis (diamond shape, made of 2 triangles when viewed with the thighs abducted)

Question 83

Tell me the 3 structures that bound the perineum

Answer 83

coccyx, ischial tuberosities, pubis

Question 84

Name/describe the 2 triangles of the perineum and name the organs found there

Answer 84

1. anal triangle = posterior, includes anal canal and paired ischioanal fossae 2. urogenital triangle = anterior triangle, structures different in males and females

Question 85

Name the 4 structures found in the male urogenital triangle and the 7 structures found in the female urogenital triangle

Answer 85

1. male - penis, scrotum, testis, epididymis | 2. female - vulva (ext. genitalia); mons pubis, labia majora, labia minora, vestibule, vaginal orifice, clitoris

Question 86

What is the anal canal?

Answer 86

terminal part of the large intestines, from pelvic diaphragm to anus, divided into upper/lower halves based upon the pectinate line

Question 87

Describe the derivation, cell type, structures, innervation, arteries, veins, and lymphatics for the upper half of the anal canal

Answer 87

1. derived from hindgut endoderm 2. lined by columnar epithelium 3. anal columns = vertical folds, indicating anorectal junction, semilunar folds (anal valves) - inferior aspect of columns indicates an irregular line - the pectinate line 4. innervation - autonomic (parasymp and symp) 5. arteries - superior rectal off IMA and middle rectal off internal iliac 6. veins - superior rectal (drains into IMV) 7. lymphatics - travel superiorly up to the inferior mesenteric nodes

Question 88

Describe the derivation, cell type, structures, innervation, arteries, veins, and lymphatics for the lower half of the anal canal

Answer 88

1. derived from ectoderm of proctodeum (future anal pit) 2. lined by stratified squamous epithelium 3. no anal columns 4. innervation - somatic (inferior rectal branch of pudendal nerve) 5. arteries - inferior rectal (internal pudendal) 6. veins - inferior rectal (draining into internal pudendal) 7. lymphatics - travel inferiorly to superficial inguinal nodes

Question 89

Name/describe the 2 anal sphincters

Answer 89

1. internal - smooth muscle; thickening of inner circular muscular coat at proximal anal canal; involuntary 2. external - skeletal muscle; voluntary, innervated by inferior rectal nerve

Question 90

Name the 6 structures that make up boundaries for the ischiorectal (ischioanal) fossa

Answer 90

skin, levator ani, obturator internus, sacrotuberous ligament, sacrospinous ligament, deep transverse perineal muscles

Question 91

Name the 2 primary contents of the ischiorectal fossa

Answer 91

fat and connective tissue, which permit distension of anal canal; as well as the pudendal canal

Question 92

What is the pudendal canal and what structures are found within it?

Answer 92

1. fascial canal on lateral wall of the ischiorectal fossa, found in the fascia of the obturator internus muscle 2. pudendal nerve (S2-4) - exits pelvis via greater sciatic foramen; enters perineum via lesser sciatic foramen; branches = inferior rectal, dorsal nerve of penis or clitoris, perineal nerves 3. internal pudendal artery (off internal iliac) - branches into inferior rectal and branches to penis or labia & clitoris 4. internal pudendal vein

Question 93

Name 2 common clinical conditions related to the anal triangle

Answer 93

hemorrhoids (internal or external with external more painful), isciorectal abscess

Question 94

Name the 3 primary fascial layers of the urogenital triangle

Answer 94

superficial fatty layer, superficial membranous layer (Colles fascia), deep fascia (investing fascia)

Question 95

Describe the fatty superficial fascial layer of the urogenital triangle (2 things and differentiate male/female)

Answer 95

- called camper's fascia in the abdomen - continuous with ischiorectal fat - in males: diminished amt of fat (disappears in scrotum and penis) replaced by dartos muscle in the skin of the scrotum - in females: makes up substance of fat in the mons pubis and labia majora

Question 96

Describe the membranous superficial layer of the urogenital triangle (2 things and one specific to males)

Answer 96

- called Scarpa's fascia in abdomen - forms tubular sheath around penis and clitoris (Colles fascia or superficial penile or clitoral fascia) - males: attached to the scrotum's Dartos muscle

Question 97

Describe the deep/investing fascia of the urogenital triangle (4)

Answer 97

- envelops the muscles of perineum (ischiocavernous, bulbospongiosus, superficial transverse perineal) - fused to suspensory ligament of penis or clitorus - in the abdomen it is continuous with the fascia of the external oblique and rectus sheath - continues as the deep penile fascia (Buck's fascia); holds penile corpora together

Question 98

Tell me what the male superficial perineal pouch is and name its 5 contents

Answer 98

- potential space between membranous/colles fascia and perineal membrane (thin inferior fascia of UG diaphragm) 1. root of penis (bulb and crura) 2. ischiocavernous muscle 3. bulbospongiosus muscle 4. superficial transverse perineal muscle 5. spongy urethra

Question 99

Tell me what the deep perineal pouch of the urogenital triangle is in a male, one important clinical fact about it, and name its 6 contents

Answer 99

- space between superior fascia of UG diaphragm and perineal membrane (inferior fascia of UG diaphragm) - filled by sphincter urethrae and transverse perineal muscles; this space is easily ruptured 1. membranous urethra 2. external urethral sphincter 3. bulbourethral (cowper's) gland 4. deep transverse perineal muscle 5. dorsal nerve of penis 6. internal pudendal arterial branches

Question 100

Describe what makes up the scrotum (5 things)

Answer 100

testes, epididymis, spermatic cord, membranous (colles) fascia, dartos muscle

Question 101

What is the function, composition, and innervation of the dartos muscle of the scrotum?

Answer 101

- smooth muscle the helps to elevate testes (assists the cremaster), but mainly wrinkles or expands the skin of the scrotum - changes surface area exposed for thermoregulation - innervated by genital branch of genitofemoral nerve

Question 102

Name the 9 components of the penis

Answer 102

1. tunica albuginea surrounds corpora cavernosa and corpus spongiosum (erectile bodies) 2. deep penile fascia (Buck's) to bind erectile bodies together 3. superficial penile fascia (Colles/membranous) surrounds penis externally underneath the skin 4. root of penis 5. body of penis 6. proximal spongy urethra that opens at external urethral meatus 7. muscles covering the bulb and crura 8. superficial transverse perineal muscles (2) 9. perineal body

Question 103

Describe the root of the penis

Answer 103

- attached part of the penis, located in superficial perineal pouch - 3 cylindrical erectile tissue (covered with muscles)

Question 104

Describe/name the 3 erectile tissues found at the root of the penis

Answer 104

1. bulb - corpus spongiosum; attached to the perineal membrane of UG diaphragm 2. right and left crura - corpus cavernosum; attached to ischiopubic rami

Question 105

Describe the body of the penis and the 3 cylinders of erectile tissue found there

Answer 105

- continuation of erectile tissues from the root of the penis 1. corpus spongiosum (1) - continuation of bulb; contains urethra (Spongy), expands at its terminal end to form glans penis 2. corpus cavernosa (2) - formed by right and left crus

Question 106

Name the 2 pairs of muscles that cover the bulb and crura of the penis

Answer 106

bulbospongiosus, ischiocavernosus

Question 107

Describe the bulbospongiosus muscles; attachment and 2 functions

Answer 107

- paired muscles, attached to each other at the median tendinous raphae - cover the bulb of the penis - compress bulb when contracted, which aids to empty the spongy urethra of residual urine/semen - erection; increases pressure on erectile tissue in the root and compressing venous return (i.e. deep dorsal vein of penis)

Question 108

Describe the attachment of the ischiocavernous muscles, as well as their functions

Answer 108

- paired muscles, covering the right and left crus muscles - compress each crus to aid in achieving and maintaining an erection via the compression of the crura (forcing blood distally) and by retarding venous return

Question 109

What are the superficial transverse perineal muscles and what is their function?

Answer 109

- small muscles arising from ischial tuberosity and inserting into perineal body - fix the perineal body

Question 110

Describe the perineal body and its function, as well as its innervation

Answer 110

- small fibrous mass in center of perineum - structures attaching to the perineal body include the external anal sphincter, bulbospongiosus, and superficial transverse perineal muscles - perineal branches of pudendal nerve supply perineal muscles and skin

Question 111

Name the 6 contents of the deep perineal pouch in the male

Answer 111

1. membranous urethra (smallest and most narrow part of urethra) 2. external sphincter urethra 3. bulbourethral (Cowper's) glands 4. deep transverse perineal muscle 5. dorsal nerve of the penis (from pudendal nerve) 6. internal pudendal artery provides branches to the penis

Question 112

Function of the dorsal nerve of the penis

Answer 112

supplies skin of penis and glans penis

Question 113

what is the external sphincter urethra?

Answer 113

- muscle surrounding membranous urethra | - voluntary muscle innervated by perineal branch of pudendal nerve

Question 114

What are the bulbourethral (Cowper's) glands and what is their function?

Answer 114

- ducts of the glands extend into superficial perineal pouch to enter spongy urethra - produces a few drops of fluid that cleanse the urethra and provide lubricating fluids for sexual activity

Question 115

What is the location and function of the deep transverse perineal muscle?

Answer 115

- posterior to sphincter urethrae | - extends from ischial rami to perineal body

Question 116

What is the internal pudendal artery and what is its function?

Answer 116

- provides branches to the penis - deep arteries of the penis (Fill corpora cavernosa with blood; aids in erection) - helicine branches - open into cavernous spaces, coiled arteries in flaccid penis

Question 117

What are the 2 main structures found in the female urogenital triangle?

Answer 117

clitoris and labia

Question 118

Name and describe the 2 divisions of the labia

Answer 118

1. labia majora - prominent folds of skin, providing protection; filled with fat, smooth muscle, and terminal part of round ligament 2. labia minora - delicate mucus membrane folds medial to labia majora; forms prepuce and frenulum

Question 119

What is the vestibule of the labia minora?

Answer 119

space between labia minora, containing the external meati of the urethra, vagina, and ducts of the greater and lesser vestibular glands

Question 120

Differentiate between the two parts of the clitoris and describe them

Answer 120

1. root - attached portion in superficial perineal pouch; 3 masses of erectile tissue covered with muscles 2. body - proximal detached portion of clitoris (glans is head), consists of corpora cavernosa

Question 121

Name/describe the 3 erectile tissues/muscles of the clitoris

Answer 121

1. bulb of vestibule - homologous with bulb of penis and corpus spongiosum; divided into 2 parts, surround vaginal and urethral orifice 2. right and left crura (corpora cavernosa) - attach to pubic arch

Question 122

Name the 7 contents of the superficial perineal pouch of the female

Answer 122

1. root of clitoris (bulb and crura) 2. muscles covering the bulb and crura; bulbospongiosus and ischiocavernosus 3. greater vestibular glands 4. lesser vestibular glands 5. superficial transverse perineal muscles 6. perineal body 7. perineal branches of pudendal nerve

Question 123

Name/describe the 2 muscles of the female superficial perineal pouch

Answer 123

1. bulbospongiosus - covers bulb of vestibule, compress deep dorsal vein of clitoris 2. ischiocavernosus - cover the crura of the clitoris (Assist in erection of clitoris)

Question 124

Describe the greater and lesser (paraurethral) vestibular glands of the female superficial perineal pouch

Answer 124

1. greater - open into vestibule, posterolateral to vaginal orifice, secrete lubricating mucus during sexual activity 2. lesser - correspond to male's prostate; open into vestibule, lateral to urethral orifice, secrete mucus into vestibule for distribution to labia & vestibule

Question 125

Name the 6 contents of the female deep perineal pouch

Answer 125

1. part of urethra 2. part of vagina 3. sphincter urethrae 4. deep transverse perineal muscles 5. internal pudendal vessels, arterial branches 6. dorsal nerves of clitoris (from pudendal nerve) - supplies clitoris

Question 126

Name 5 clinical conditions and variants of the urogenital triangle

Answer 126

1. male and female circumcision 2. phimosis - foreskin cannot be fully retracted 3. pudendal nerve block 4. perineal body in obstetrics 5. episiotomy - incision made in perineum between anus and vaginal opening during childbirth

Question 127

Describe the 3 components of the general plan of innervation to the perineal organs

Answer 127

1. external sphincters - tonically active 2. sympathetics - internal sphincters 3. parasympathetics - smooth muscle in organ walls

Question 128

Describe the 2 urethral sphincters

Answer 128

1. internal - only present in males; smooth muscle at neck of bladder; prevents retrograde ejaculation into the bladder; under sympathetic control 2. external - striated muscle (voluntary); permits holding urine past point at which bladder would empty as a reflex; prevents leakage with stress, strain, and in sleep

Question 129

What are 3 big actions of sexual function? (3 e's)

Answer 129

1. erection 2. emission 3. ejaculation

Question 130

Describe the innervation for erection and what happens during it (3)

Answer 130

parasympathetic - pelvic splanchnic nerves (s2-4) - dilate helicine arteries, filling cavernous tissues with blood - help from bulbospongiosus and ischiocavernosus muscles by compressing venous plexus and impeding venous return

Question 131

Describe the innervation and function of emission (4)

Answer 131

sympathetic L1-2 - movement of semen into prostatic urethra - peristalsis of ductus deferentes and seminal vesicles - prostatic contraction adds prostatic fluid - several glands involved: seminal vesicles, prostate, bulbourethral glands

Question 132

Describe the innervation and function of ejaculation (5)

Answer 132

somatic and autonomic - expulsion of secretions and spermatozoa - effected by rhythmic contractions of bulbospongiosus and ischiocavernosus muscles - pudendal nerve (S2-4) - autonomics: sympathetic close internal urethral sphincter, parasympathetic contract urethral muscle

Question 133

Describe the general development of the limbs in embryonic terms - which one is first?

Answer 133

- lower limb develops similar to the upper limb (week 4) but occurs a week later (week 5)

Question 134

At what segments of the trunk can you see the development of the lower limb? How about the upper limb?

Answer 134

L2-S2 lower limb, C5-T1 upper limb

Question 135

To what direction are the great toes/thumbs and soles/palms directed before development of the limbs is complete?

Answer 135

- great toes/thumbs located on superior aspect of buds | - soles/palms are directed medially

Question 136

What major event happens during development of the limbs that causes them to be oriented the way they are in adults?

Answer 136

- undergo torsion around their long axis but in the opposite direction during the 7th week - lower limbs rotate medially and upper limbs rotate laterally about 90 degrees around their long axis

Question 137

The rotation of the limbs during development is still in progress even after birth, what two things does this seem to explain as far as anatomically significance?

Answer 137

- explains how baby feet meet sole to sole | - barber-pole pattern of the cutaneous innervation (dermatome pattern)

Question 138

Name the 2 major foramen of the hip bones that are important for gluteal region muscle attachment

Answer 138

greater and lesser sciatic foramen

Question 139

What is the function of the greater sciatic foramen and how is it formed?

Answer 139

- passageway for all lower limb nerves and arteries to leave pelvis - formed by the greater sciatic notch and sacrospinous and sacrotuberous ligaments

Question 140

Name the 7 structures that traverse the greater sciatic foramen

Answer 140

1. piriformis muscle 2. superior and inferior gluteal vessels and nerves 3. internal pudendal vessels and nerve 4. sciatic nerve 5. posterior femoral cutaneous nerve 6. nerve to quadratus femoris and inferior gemellus 7. nerve to obturator internus and superior femellus

Question 141

How is the lesser sciatic foramen formed?

Answer 141

- formed by lesser sciatic notch and sacrospinous and sacrotuberous ligaments

Question 142

Name the 3 structures that traverse the lesser sciatic foramen

Answer 142

1. tendon of obturator internus 2. internal pudendal vessels and nerve 3. nerve to obturator internus

Question 143

What 3 muscles and 2 muscle groups make up the superficial layer of the gluteal muscles?

Answer 143

gluteus maximus, gluteus medius, gluteus minimus, extensors of thigh, abductors of thigh

Question 144

O, I, A, N, blood supply for gluteus maximus

Answer 144

1. origin - sacrotuberous ligament, ilium (posterior to posterior gluteal line), sacrum, coccyx 2. insertion - gluteal tuberosity and iliotibial tract (IT band) 3. action - extend and laterally rotate thigh, rising from sitting position, running, help stabilize knee joint via IT band insertion 4. nerve - inferior gluteal 5. blood- superior and inferior gluteal arteries

Question 145

O, I, A, N, blood supply for gluteus medius

Answer 145

1. origin - ilium between anterior and posterior gluteal line 2. insertion - greater trochanter 3. action - abduction and medial rotation of thigh, stops hip from sagging on unsupported side (with glut. min) 4. nerve - superior gluteal 5. blood - superior gluteal artery

Question 146

O, I, A, N, blood supply for gluteus minimus

Answer 146

1. origin - ilium between anterior and inferior gluteal lines 2. insertion - greater trochanter 3. action - abduction and medial rotation of thigh 4. nerve - superior gluteal 5. blood - superior gluteal artery

Question 147

What is the significance of a positive Trendelenburg sign?

Answer 147

damage to superior gluteal nerve; waddling gait, high steppage gait, swing out gate

Question 148

Name the 5 deep muscles of the gluteal region and tell me what kind of actions they permit for the hip and thigh

Answer 148

- stabilizers of hip joint and lateral rotators of the thigh 1. piriformis 2. obturator internus 3. superior gemellus 4. inferior gemellus 5. quadratus femoris

Question 149

O, I, A, N for piriformis (the keep deep muscle of the gluteal region)

Answer 149

1. origin - anterior surface of sacrum (inside the pelvis) 2. insertion - greater trochanter (located party in the pelvis and partly in the gluteal region) 3. nerve - S1, S2 4. action - lateral rotation of thigh

Question 150

O, I, A, N for obturator internus

Answer 150

1. origin - obturator membrane and surrounding bone 2. insertion - greater trochanter (leaves pelvis through the lesser sciatic foramen) 3. action -lateral rotation, extension, and abduction of the FLEXED thigh 4. nerve - nerve to obturator internus (L5, S1, S2)

Question 151

O, I, A, N for superior gemellus

Answer 151

1. origin - ischial spine 2. insertion - tendon of obturator internus 3. action - lateral rotation, extension, and abduction of the FLEXED thigh 4. nerve - nerve to obturator internus (L5, S1, S2)

Question 152

O, I, A, N for inferior gemellus

Answer 152

1. origin - ischial tuberosity 2. insertion - tendon of obturator internus 3. action - lateral rotation, extension, and abduction of the FLEXED thigh 4. nerve - nerve to quadratus femoris (L5, S1)

Question 153

O, I, A, N for quadratus femoris

Answer 153

1. origin - ischial tuberosity 2. insertion - intertrochanteric crest 3. action - laterally rotate thigh 4. nerve - nerve to quadratus femoris (L5, S1)

Question 154

What is the nerve plexus of the lower limbs? What is it formed from (branches)?

Answer 154

- sacral plexus - formed by ventral primary rami of Lumbosacral trunk (L4,5) and S1-S4 - each nerve contributing to the sacral plexus receives postganglionic sympathetic fibers from the lower end of the sympathetic chain

Question 155

Describe the passage of branches into and out of the sacral plexus

Answer 155

- all large branches pass through greater sciatic foramen to appear in the gluteal region - ventral primary rami of the nerves converge to exit through the greater sciatic foramen - S1-S4 nerves enter the pelvis through the sacral foramina

Question 156

are pelvic splanchnic nerves part of the sacral plexus?

Answer 156

no!

Question 157

2 important details about the location of the sacral plexus

Answer 157

1. plexus as a whole is covered by the branches of the internal iliac artery 2. the major part of the plexus lies on the anterior surface of the piriformis muscle

Question 158

the nerves of the sacral plexus supply teh muscle sand skin of what 4 things?

Answer 158

gluteal region, posterior thigh, entire leg, entire foot

Question 159

What is the significance of the L4-S4 roots in the sacral plexus as far as their innervation patterns?

Answer 159

split to give rise to anterior and posterior divisions

Question 160

Name the 5 nerves of the posterior division of the sacral plexus

Answer 160

1. common peroneal nerve 2. superior gluteal 3. inferior gluteal 4. posterior femoral cutaneous - partially 5. nerve to piriformis

Question 161

What is the triceps coxae?

Answer 161

the unit of the obturator internus, superior and inferior gemellus acting together

Question 162

Name the 5 nerves of the anterior division of the sacral plexus

Answer 162

1. tibial nerve 2. nerve to obturator internus 3. nerve to quadratus femoris 4. pudendal nerve 5. nerve to levator ani

Question 163

Superior gluteal nerve (L4-S1) - what happens if it's injured, where it exits

Answer 163

1. injury would affect the gluetus medius and minimus and tensor fascia latae muscles 2. exits through the greater sciatic foramen above the piriformis, whereas all other branches of sacral plexus leave below piriformis

Question 164

What does injury tot he inferior gluteal nerve (L5-S2) cause?

Answer 164

affects gluteus maximus

Question 165

Name the levels of the sacral nerve, the largest branch of the sacral plexus, as well as the two nerves that form it.

Answer 165

1. sciatic = L4-S3 2. tibial - anterior division (L4, L5, S1, S2, S3) 3. common peroneal - posterior division (L4, L5, S1, S2)

Question 166

What happens in the gluteal region if the sciatic nerve is injured?

Answer 166

nothing - doesn't affect any muscles in the gluteal region

Question 167

Levels of the posterior femoral cutaneous nerve

Answer 167

S1-S3

Question 168

levels of the quadratus femoris nerve

Answer 168

L4-S1

Question 169

levels of the obturator internus nerve

Answer 169

L5-S2

Question 170

levels of the pudendal nerve

Answer 170

S2-S4

Question 171

Describe the 3 nerves that allow cutaneous innervation of the gluteal region as far as which kind of rami they are

Answer 171

1. superior cluneal - dorsal primary rami 2. medial cluneal - dorsal primary rami 3. inferior cluneal - ventral primary rami

Question 172

Name the 3 major arteries of the gluteal region, what they supply, and where they come from

Answer 172

- originate directly or indirectly from internal iliac artery, enter the gluteal region through the greater sciatic foramen 1. superior gluteal artery - glut max, med, min and tensor fascia latae 2. inferior gluteal artery - glut max, short lateral rotators of thigh 3. internal pudendal artery - perineal region

Question 173

Name the 3 major veins of the gluteal region and where they come from

Answer 173

superior and inferior gluteal veins, internal pudendal vein all tributaries of internal iliac vein

Question 174

Name the 4 general structures that make up the lower limb

Answer 174

gluteal region, thigh, leg, foot

Question 175

Describe the general modes of injury to the lower limb

Answer 175

- lower limb is specialized for locomotion and weight bearing - connected to trunk via the bony pelvis - injuries to lower limb usually involves knee, leg and foot (hip only 3%)

Question 176

Name 8 fun facts about the femur

Answer 176

1. directed inferomedially 2. longest and heaviest bone 3. about 1/4 of a person's height 4. consist of a proximal and a distal epiphysis, a neck and a shaft - proximal has head that projects superomedially and slightly anteriorly 5. articulates with acetabulum 6. head connected to the shift through the neck at about 126 degree angle = angle of inclination 7. angle widest at birth (140) and decreases with age (110 in old age) 8. angle less in females than males because females have wider hips

Question 177

Describe the superficial fascia of the thigh (4)

Answer 177

- lies deep to skin - continuous with abdominal fascia - contains considerable amount of fat - contains cutaneous nerves and vessels

Question 178

Name 8 major structures found on the femur

Answer 178

1. greater and lesser trochanters 2. intertrochanteric line anteriorly 3. intertrochanteric crest posteriorly 4. linea aspera 5. medial and lateral epicondyles 6. medial and lateral condyles 7. intercondylar fossa 8. popliteal fossa

Question 179

Name the 6 main cutaneous nerves of the superficial fascia of the thigh

Answer 179

1. genital branches of genitofemoral nerve and ilioinguinal nerves 2. femoral branch of genitofemoral 3. medial cutaneous branch of femoral 4. intermediate cutaneous branch of femoral 5. lateral femoral cutaneous 6. posterior femoral cutaneous

Question 180

name the location, function, and levels of the genital branches of genitofemoral nerve and ilioinguinal nerves

Answer 180

- genitofemoral branch L1,2 and ilioinguinal branch L1 - emerge from superficial ring to supply the proximal medial thigh - most branches go to genital region

Question 181

name the function and levels of the femoral branch of the genitofemoral nerve

Answer 181

L1, 2 - supplies the skin over the femoral triangle (proximal part of anterior thigh)

Question 182

name the function of the medial cutaneous branch of the femoral nerve

Answer 182

supplies the skin of the medial thigh

Question 183

name the function of the intermediate cutaneous branch of the femoral nerve

Answer 183

supplies the skin of the distal anterior thigh

Question 184

name the levels and function of the lateral femoral cutaneous nerve

Answer 184

L2,3 - enters the thigh medial to the ASIS to supply the lateral thigh, lateral to the intermediate cutaneous branch of the femoral nerve

Question 185

Name the levels and function of the posterior femoral cutaneous nerve

Answer 185

S1, 2, 3 - supplies the posterior thigh and popliteal region, originates from the sacral plexus, courses inferiorly into the thigh from the gluteal region

Question 186

Name the 3 major arteries of the superficial fascia of the thigh

Answer 186

originate from the proximal part of the femoral artery 1. superifical epigastric 2. superficial circumflex iliac 3. external pudendal

Question 187

supply of the superficial epigastric artery

Answer 187

proceeds superiorly to provide the skin over the lower abdominal wall

Question 188

supply of the superficial circumflex iliac artery

Answer 188

proceeds laterally inferior to the inguinal ligament, parallels the course of the deep circumflex iliac artery

Question 189

Name the major vein of the superficial fascia of the thigh. Describe its path through the body, its function, and one important trait

Answer 189

- begins in the foot and ascends to its termination at the proximal part of the thigh (found in superficial fascia), enters the thigh by passing posterior to the medial condyle of the femur - traverses the saphenous opening in the fascia lata to empty into the femoral vein inferior to the inguinal ligament - receives numerous tributaries in the leg and thigh - has vales; more numerous in leg

Question 190

What is the function of the deep fascia (fascia lata) of the thigh? What exactly is it? What important structure doe sit contain?

Answer 190

- prevents bulging of muscles - dense layer of CT between the muscles of the thigh and the superficial fascia - strong along the anterior and lateral parts of thigh - IT band is a lateral thickening of this fascia

Question 191

Describe the superior (4) and inferior attachments of the deep fascia of the thigh

Answer 191

- inferior: continuous with crural fascia at the knee - superior: inguinal ligament, parts of the hip bone (pubic bone, iliac crest, ischial tuberosity), sacrum and coccyx, scarpa's fascia and sacrotuberous ligament

Question 192

Name the 3 intermuscular septa that are provided by the deep fascia to divide the thigh into an anterior, medial and posterior compartment. Where do they attach?

Answer 192

- attach at linea aspera - lateral intermuscular septa - medial intermuscular septa - posterior intermuscular septa

Question 193

Name the 9 muscles of the anterior compartment of the thigh, tell me their general functions, and which nerve innervates them all

Answer 193

- femoral nerve, flex the hip and extend the knee 1. sartorius 2. rectus femoris 3. vastus lateralis 4. vastus medialis 5. vastus intermedius 6. articularis genu 7. psoas major 8. iliacus 9. tensor fascia latae

Question 194

Sartorius O and I

Answer 194

anterior superior iliac spine - superior part of medial surface of tibia

Question 195

Rectus femoris O and I

Answer 195

AIIS - patella

Question 196

Vastus lateralis and vastus medialis O and I

Answer 196

linea aspera - patella

Question 197

vastus intermedius O and I

Answer 197

body of femur - patella

Question 198

articular genu O and I

Answer 198

anterior part of femur - synovial membrane of knee

Question 199

psoas major O and I

Answer 199

lumbar vertebrae - lesser trochanter of femur

Question 200

iliacus O and I

Answer 200

iliac crest and fossa - lesser trochanter of femur

Question 201

tensor fascia latae O and I

Answer 201

ASIS - IT band

Question 202

Name the 6 muscles of the medial compartment of the thigh, tell me their general function and the nerve that innervates them all

Answer 202

- adductors, innervated by obturator nerve 1. pectineus 2. adductor longs 3. adductor brevis 4. adductor magnus 5. gracilis 6. obturator externus

Question 203

pectineus O, I, nerve

Answer 203

superior ramus of pubis - pectineal line of femur; innervated by femoral and obturator nerves

Question 204

adductor longus O and I

Answer 204

body of pubic bone - linea aspera

Question 205

adductor brevis O and I

Answer 205

inferior ramus of pubic bone - linea aspera

Question 206

adductor magnus O and I for each part, as well as nerve

Answer 206

1. adductor part: ischiopubic ramus - linea aspera; innervated by obturator nerve 2. hamstring part: ischial tuberosity - adductor tubercle of femur; supplied by tibial nerve

Question 207

gracilis O and I

Answer 207

inferior ramus of pubis - superior part of medial surface of tibia

Question 208

obturator externus O and I

Answer 208

margins of obturator foramen and obturator membrane - trochanteric fossa of femur

Question 209

Name the 3 muscles of the posterior compartment of the thigh (with one exception), their general action, general origin (Except one part), and innervation

Answer 209

- hamstrings except short head of biceps femoris originate from ischial tuberosity - act on two joints: extend hip and flex knee - tibial nerve innervates them 1. biceps femoris (long/short) 2. semitendinosus 3. semimembranosus

Question 210

Biceps femoris O and I and nerve for each of the 2 heads

Answer 210

1. long head: ischial tuberosity - fibular head; innervated by tibial nerve 2. short head: linea aspera - fibular head; innervated by common peroneal nerve

Question 211

semitendinosus O and I

Answer 211

ischial tuberosity - medial surface of upper tibia

Question 212

semimembranosus O and I

Answer 212

ischial tuberosity - medial tibial condyle

Question 213

Name the boundaries of the femoral triangle, which is located in the proximal part of the anterior thigh

Answer 213

1. superior - inguinal ligament 2. medial - medial border adductor longus 3. lateral - med. border sartorius 4. base - inguinal ligament 5. apex - where sartorius crosses the adductor longus 6. roof - fascia lata 7. floor - iliopsoas and pectineus muscles

Question 214

Name the 5 major structures found in the femoral triangle

Answer 214

femoral artery/branches, femoral vein/branches, femoral nerve/branches, lymphatic vessels/nodes, femoral sheath

Question 215

Where do femoral hernias usually occur?

Answer 215

femoral triangle - originate at the femoral ring

Question 216

What is the femoral sheath and what makes it up?

Answer 216

funnel-shaped fascial tube in femoral triangle: lateral, intermediate and medial compartments (medial has femoral canal)

Question 217

Where is the Adductor canal? What are 2 other names for it? Tell me it's 3 boundaries and 3 major structures within it

Answer 217

- extends from apex of femoral triangle to adductor hiatus in adductor magnus muscle (15 cm long) - subsartorial canal/ Hunter's canal - boundaries: anteriomedial is sartorius, lateral is vastus medialis, posterior is adductor longus and magnus - contains femoral artery/vein, spahenous nerve, nerve to vastus medialis

Question 218

Name the levels of the femoral nerve, its general location, 3 important facts

Answer 218

- L2,3,4 - travels deep to inguinal ligament to enter the femoral triangle, lies lateral to the femoral artery - largest branch of lumbar plexus - not enclosed by femoral sheath - breaks into sensory and motor branches while still in the triangle

Question 219

Name the 3 sensory branches of the femoral nerve

Answer 219

1. medial femoral cutaneous nerve 2. intermediate femoral cutaneous nerve 3. saphenous nerve - travels to adductor canal, leaves the canal at its lower end to innervate the skin of the leg and foot

Question 220

The motor branches of the femoral nerve supply what 4 muscles?

Answer 220

1. sartorius 2. quadriceps femoris 3. articularis genu 4. pectineus - also gets a branch from obturator nerve

Question 221

Describe the 2 branches of the obturator nerve, which originate from the obturator foramen

Answer 221

1. anterior: located between adductor lognus and brevis; supplies adductor longus, gracilis, adductor brevis, and part of pectineus 2. posterior: located between adductor brevis and magnus; supplies obturator externus, adductor brevis, and adductor magnus

Question 222

The femoral artery is a continuation of the external iliac, and enters the thigh by passing below the inguinal ligament to the femoral vein - name its 6 branches in the thigh

Answer 222

1. superficial circumflex iliac 2. superficial epigastric 3. superficial and deep external pudendal 4. lateral femoral circumflex 5. medial femoral circumflex 6. profunda femoris

Question 223

The obturator artery of the thigh is a branch of what?

Answer 223

internal iliac

Question 224

What 4 arteries make up the cruciate anastomosis in the thigh?

Answer 224

1. first perforating artery 2. medial femoral circumflex artery 3. lateral circumflex artery 4. inferior gluteal artery

Question 225

What is the popliteal fossa? What are it's four major boundaries?

Answer 225

fat filled diamond space at the back of the knee 1. inferomedial/inferolateral = gastrocnemius 2. superolateral = biceps femoris 3. superomedial = semimembranosus tendon 4. floor = popliteal surface of femur and posterior knee ligaments

Question 226

Name the 5 main contents of the popliteal fossa

Answer 226

1. termination of small saphenous vein 2. popliteal vessels and branches 3. tibial and common peroneal nerves 4. posterior cutaneous nerve of thigh 5. popliteal lymph nodes and vessels

Question 227

Which artery gives off the most branches to the thigh the femoral artery or the profunda femoral artery?

Answer 227

profunda!

Question 228

What happens if you cut the femoral nerve?

Answer 228

cannot extend your knee

Question 229

What is the function of the tibia for the leg?

Answer 229

weight bearing

Question 230

Name and describe the location or function of 5 major structures of the tibia

Answer 230

1. condyles - articulate with the femoral condyles superiorly 2. soleal line - posterior side, attachment for soleus muscle 3. intercondylar eminence - attachment point for cruicate ligaments and menisci 4. medial malleolus - distal end that articulates with the talus 5. tibial tuberosity - attachment for patellar ligament

Question 231

What is the main function of the fibula for the leg? Name and describe the 3 major structures on it

Answer 231

- slender LATERAL bone of the leg that serves as a place for muscle attachments 1. head (proximal) 2. neck 3. lateral malleolus - distal end that articulates with tallus

Question 232

What is the interosseus membrane and what is its function?

Answer 232

fascia between the interosseus borders of the tibia and fibula that serves to connect them

Question 233

Describe the cutaneous innervation of the leg including some stuff on dermatomes and by naming the 3 main nerves there

Answer 233

1. dermatomes - cutaneous branches predominantly from lumbar and sacral plexuses (L1-S4) 2. saphenous nerve - supplies skin on medial side of leg 3. sural nerves - branches of tibial and common (4 branches) 4. superficial peroneal nerve - branch of common peroneal to supply skin of anterolateral leg and dorsum of foot

Question 234

Name the 4 branches of the sural nerves of the leg and tell me what it branches from

Answer 234

1. medial sural cutaneous - branch of tibial 2. lateral sural cutaneous - branch of common peroneal 3. sural communicating - branch of lateral sural cutaneous; joins with medial sural cutaneous 4. sural nerve - formed by junction of medial sural and communicating sural cutaneous nerves

Question 235

Name the 2 superficial veins of the leg and describe their path/supply

Answer 235

1. great saphenous - begins at foot and ascends along the medial side of the leg to drain into femoral vein; contains 10-12 valves 2. small saphenous - begins at lateral side of foot and ascends along the posterior medial leg, drains into popliteal vein posterior to the knee joint

Question 236

What is the crural fascia? Describe its location and function

Answer 236

- deep fascia of the leg; continuation of the fascia lata inferior to the knee - attached to the anterior and medial borders of the tibia (doesn't wrap all the way around) - gives rise to 6 different septa and retinacula

Question 237

Name the 6 major structures of the crural fascia

Answer 237

1. anterior intermuscular crural septum 2. posterior intermuscular crural septum 3. transverse intermuscular crural septum 4. superior extensor retinaculum 5. inferior extensor retinaculum 6. flexor retinaculum

Question 238

Name the 3 compartments of the leg and tell me how they are formed

Answer 238

anterior, lateral and posterior formed by the intermuscular septa attached to the fibula (aka the interosseous membrane)

Question 239

3 key facts describing the function and make up of the anterior compartment of the leg

Answer 239

- dorsiflexor (extensor compartment) - located anterior to IO membrane, between the anterior intermuscular septum and tibia - muscles pass anterior to the ankle joint

Question 240

Name the 4 muscles of the anterior leg and their primary actions as a group

Answer 240

- dorsiflexors of the ankle and extensors of the toes tibialis anterior, extensor hallucis longus, extensor digitorum longus, peroneus tertius

Question 241

attachments for tibialis anterior as well as injuries and actions (included with IO membrane)

Answer 241

medial cuneiform and 1st metatarsal -tibialis anterior strain, shin splints, strongest dorsiflexor

Question 242

extensor hallucis longus origin and insertion (and one fun fact)

Answer 242

fibula and IO membrane to distal phalange of big toe *deepest muscle in anterior compartment

Question 243

extensor digitorum longus

Answer 243

tibia, fibula and IO membrane to middle and distal phalanges 2-5

Question 244

peroneus tertius

Answer 244

fibula and IO membrane to 5th metatarsal base

Question 245

Which nerve serves the anterior compartment of the leg?

Answer 245

deep peroneal - off of common peroneal

Question 246

Which primary artery is found in the anterior compartment of the leg? Describes its path and name the 4 branches it gives off

Answer 246

* anterior tibial artery (branch of popliteal) - enters the compartment by passing through the superior part of the interosseus membrane 1. tibial recurrent 2. anterior medial malleolar 3. anterior lateral malleolar 4. dorsalis pedis (at ankle joint)

Question 247

Describe what happens in compartment syndrome

Answer 247

- caused by trauma to the muscles of the anterior compartment of the leg - bleeding leads to increased pressure in the compartment causing compression of other structures - ischemia and nerve damage

Question 248

What results from injury to the common peroneal nerve?

Answer 248

-paralysis of all the anterior and lateral compartment muscles of the leg --> can't dorsiflex --> drop foot

Question 249

Describe the main function of the lateral compartment of the leg and its boundaries

Answer 249

- everter compartment - smallest compartment - bounded by the fibula, anterior and posterior intermuscular septa and deep fascia

Question 250

Name the 2 muscles of the lateral compartment of the leg, as well as their attachments

Answer 250

1. peroneus longs - lateral fibula to base of the 1st metatarsal and medial cuneiform 2. peroneus brevis - lateral fibula to tuberostiy of the 5th metatarsal

Question 251

Name the nerve of the lateral compartment of the leg and the 2 arteries there

Answer 251

- superficial peroneal nerve - branches of peroneal artery (from posterior comp.) - branches of anterior tibial artery (from anterior comp.)

Question 252

4 important facts about the posterior compartment of the leg

Answer 252

- muscles produce plantar flexion and inversion of the foot - flexor compartment - largest of the 3 leg comp. - divided into a superficial and deep compartment by the transverse intermuscular septum

Question 253

Name the 8* muscles of the posterior compartment of the leg and the nerve that innervates them all

Answer 253

1. gastrocnemius 2. soleus 3. plantaris 4. triceps surae*** 5. popliteus 6. flexor hallucis longus 7. flexor digitorum longus 8. tibialis posterior

Question 254

attachments of gastrocnemius and 2 main functions

Answer 254

lateral and medial condyles of femur to calcaneus - flex leg at knee joint and plantar flex foot

Question 255

attachments of the soleus and 3 big facts

Answer 255

fibula, soleal line of tibia to the calcaneus - anti gravity muscle - no action on knee - fibers continuously active during standing - functions for most of push off during walking

Question 256

triceps surae

Answer 256

gastroc + soleus - generates 95% of plantar flexion force - large size human characteristic

Question 257

plantaris attachment and 3 main facts

Answer 257

lateral supracondylar line of femur to calcaneus - absent 5-10% - separate attachment - organ of proprioception

Question 258

popliteus attachments and function

Answer 258

- lateral condyle of femur to superior to soleal line of tibia - unlocks knee joint by laterally rotating femur 5 degrees

Question 259

flexor hallucis longus attachments

Answer 259

fibula and IO membrane to base of big toe

Question 260

flexor digitorum longus attachments

Answer 260

tibia inferior to soleal line to bases of distal toes 2-5

Question 261

tibialis posterior attachments

Answer 261

tibia, fibula and IO membrane to navicular, cuneiforms, cuboid, and bases of 2-4 metatarsals

Question 262

Name the nerve of the posterior compartment of the leg and its spinal levels

Answer 262

tibial nerve (L4-S3)

Question 263

Name the major artery of the posterior compartment of the leg and its 9 branches

Answer 263

posterior tibial artery 1. circumflex fibular 2. peroneal -- 4 off here 3. nutrient - largest nutrient artery in the body 4. muscular 5. posterior medial malleolar 6. communicating - joints post. tibial and peroneal 7. medial calcaneal (posterior) 8. medial plantar 9. lateral plantar

Question 264

Name the 4 branches off the peroneal artery off the posterior tibial artery in the posterior compartment of the leg

Answer 264

perforating branch of peroneal communicating artery posterior lateral malleolar posterior lateral calcaneal

Question 265

Describe venous return of the posterior compartment of the leg

Answer 265

activity of triceps surae --> calf pump superficial veins, perforating veins

Question 266

Name the 3 muscles of the deep part of the posterior compartment of the leg

Answer 266

flexor hallucis longus, flexor digitorum longus, tibialis posterior

Question 267

what is a varicosity of the leg?

Answer 267

painful, twisting and enlargement of veins that happens when valves in the leg veins are incompetent and blood gets pumped into superficial veins, pressure increases greatly there

Question 268

Name the 4 major groupings of bones in the foot

Answer 268

tarsals (7), metatarsals (5), phalanges (14), sesamoid bones

Question 269

What are the two major bones of the hind foot? The 3 major bones of the mid foot? And the major bone groups of the fore foot?

Answer 269

hind foot - calcaneous and talus mid foot - cuboid, navicular, cuneiforms fore foot - phalanges and metatarsals

Question 270

What makes up the ball of the foot?

Answer 270

sesamoid of the 1st metatarsal and head of the 2nd metatarsal

Question 271

How many phalanges does the big toe have?

Answer 271

2

Question 272

Describe the deep fascia of the dorsum of the foot

Answer 272

- continues with crural fascia and the plantar surface of the foot

Question 273

What is the inferior extensor retinaculum made of? Name and describe its 3 parts

Answer 273

- thickening of the deep fascia of the dorsal foot 1. stem (frondiform ligament) 2. superomedial limb - attaches at the anterior surface of medial malleolus 3. inferomedial limb - attaches by blending with the plantar fascia

Question 274

Name the 4 major cutaneous nerves of the dorsal foot and describe what they innervate

Answer 274

1. saphenous - medial site of foot as far as the 1st metatarsal 2. lateral dorsal cutaneous - continuation of the sural nerve into the foot 3. superficial peroneal nerve - medial and intermediate dorsal cutaneous nerves, supply middle part of the dorsum of the foot 4. deep peroneal nerve - supplies the skin between 1st and 2nd toes

Question 275

What gives the foot a deep concavity/arch at the bottom?

Answer 275

the cuneiform bones

Question 276

Describe 4 major tendons for muscles of the leg and foot

Answer 276

1. extendor digitorum longus - one tendon for each of the lateral four toes, dorsal expansion over the toes 2. extensor hallucis longus - to the 1st toe 3. extensor digitorum brevis - extends toes 2-4 4. extensor hallucis brevis - goes to 1st toe as part of extensor digitorum brevis

Question 277

purpose of the sesamoid bones

Answer 277

curves the tendon on the foot muscles so increases power of pull

Question 278

What is the only intrinsic muscle of the dorsum of the foot?

Answer 278

extensor digitorum brevis

Question 279

What is the primary artery to the dorsum of the foot? Name its 5 major branches

Answer 279

``` dorsalis pedis 1/2. lateral and medial tarsal 3. arcuate 4. deep plantar 5. first dorsal metatarsal ```

Question 280

Name the branches of the arcuate artery off the dorsalis pedis in the dorsum of the foot

Answer 280

1. three dorsal metatarsal arteries - each gives rise to two dorsal digital arteries - the first dorsal digital is a branch of the 1st dorsal metatarsal and the 10th dorsal digital is a branch of the 4th dorsal metatarsal 2. perforating arteries connect the dorsal metatarsal arteries with the deep plantar branch

Question 281

Describe the deep plantar artery's location and function

Answer 281

- one of the two terminal branches of the dorsalis pedis | - goes to plantar side and joins with the deep plantar arch of the lateral plantar artery

Question 282

Describe the first dorsal metatarsal artery's location and function

Answer 282

- second terminal branch of the dorsalis pedis | - gives rise to three dorsal digital arteries

Question 283

What is the bony boundary between the foot and leg?

Answer 283

malleolus

Question 284

Name the 5 veins of the dorsum of the foot

Answer 284

1. dorsal venous arch - dorsal metatarsal veins (4), dorsal digital veins 2. medial dorsal digital vein of the 1st toe and lateral dorsal digital vein of the 5th toe 3. medial and lateral marginal veins 4. great saphenous 5. small saphenous

Question 285

Name/describe the 5 nerves used for the cutaneous innervation of the plantar surface of the foot

Answer 285

1. saphenous nerve 2. lateral dorsal cutaneous nerve - continuation of the sural nerve 3. calcaneal branches of tibial nerve - supply the heel area 4. medial plantar nerve (similar to median nerve) - supplies medial 3 and 1/2 digits 5. lateral plantar nerve - supplies lateral 1 1/2 digits (similar to ulnar nerve of upper limb)

Question 286

3 big things about the deep fascia of the plantar surface of the foot

Answer 286

- thicker than dorsal surface - flexor retinaculum (thickening of plantar fascia) - plantar aponeurosis (central part of plantar fascia)

Question 287

Describe the function, composition, location, division of the plantar aponeurosis

Answer 287

1. thick and strong, central part of the plantar fascia, longitudinally arranged into fibers that extends from calcaneous to the toes 2. helps support longitudinal arches of the foot, prevents foot injury 3. divides into 5 slips - one for each toe that attaches to the fibrous digital sheaths

Question 288

What divides the plantar surface of the foot into 3 compartments? name them

Answer 288

- vertical septa from the plantar aponeurosis | - medial, lateral, and central

Question 289

Dorsalis pedis artery is a continuation of what?

Answer 289

anterior tibial artery

Question 290

How many layers of intrinsic muscles are found on the plantar surface of the foot and what is their overall function?

Answer 290

4 layers! | help to maintain balance and support the arches of the foot

Question 291

Name the 3 muscles of the first layer of muscles on the plantar surface of the foot, as well as their attachments

Answer 291

1. adductor hallucis - tuberosity of calcaneous to base of 1st proximal phalanx 2. flexor digitorum brevis - tuberosity of calcaneous to middle phalanx of lateral 4 toes 3. abductor digiti minimi - tuberosity of calcaneous to base of 5th proximal phalanx

Question 292

Name the 2 muscles and 2 tendons of the second layer of muscles of the plantar side of the foot

Answer 292

1. flexor digitorum longus tendon 2. flexor hallucis longus tendon 3. quadratus plantae - calcaneus to tendon of flexor digitorum longus 4. lumbrical muscles (4) - tendon of digitorum longus to flexor sheath of lateral 4 toes

Question 293

Name the 3 muscles of the third layer of muscles on the plantar surface of the foot and describe their attachment

Answer 293

1. flexor digiti minimi brevis - base of 5th metatarsal to 5th proximal phalanx 2. adductor hallucis - oblique head from base of met. 2 thru 4 to base of 1st proximal phalanx and transverse head from mP joint ligaments to base of 1st proximal phalanx 3. flexor hallucis brevis - cuboid to base 1st proximal phalanx

Question 294

Name the 2 tendons and 2 muscles of the fourth layer of muscles of the plantar surface of the foot

Answer 294

1. peroneus longus tendon 2. tibialis posterior tendon 3. plantar interossei muscles (3) - base of metatarsals 3 thru 5 to base of proximal phalanx of toes 3 to 5 4. dorsal interossei muscles (4) - adjacent sides 1 to 5 metatarsals to proximal phalanx of 2 to 4 toes

Question 295

What are the 3 primary nerves for the plantar surface of the foot? Name the 3 major branches the tibial provides

Answer 295

tibial nerve, sural, saphenous 1. medial calcaneal 2. medial plantar 3. lateral plantar

Question 296

What does the medial calcaneal nerve innervate?

Answer 296

sensory innervation to the heel on the plantar surface of the foot

Question 297

Describe the path of the medial plantar nerve, some comparisons to its counterpart (lateral) and which 4 things it provides motor branches to

Answer 297

- larger than lateral plantar - between 1st and 2nd layer of muscles, passes deep to abductor hallucis brevis - divides into three common plantar digital nerves which each give rise to two proper plantar digital nerves - supplies cutaneous branch to 3 1/2 digits - motor branches to abductor hallucis, flexor digitorum brevis, flexor hallucis brevis, and 1st lumbrical

Question 298

Describe function, path, and branching of the lateral plantar nerve

Answer 298

- passes deep to abductor hallucis - provides cutaneous branches to lateral 1 1/2 digits - provides one common plantar digital nerve - provides motor branches to the rest of the intrinsic muscles

Question 299

Sural nerve does what on the palmar surface of the foot?

Answer 299

sensory to lateral margin of the foot and lateral side of the 5th toe

Question 300

Describe the function of the saphenous nerve for the palmar surface of the foot

Answer 300

branch of femoral nerve, sensory to medial side of foot

Question 301

Describe the arteries of the sole of the foot

Answer 301

- from posterior tibial artery - medial and lateral plantar arteries - supply plantar muscles - anastomose with arteries on dorsum of foot

Question 302

Describe the medial plantar artery, as well as its location and what it supplies

Answer 302

1. smaller than lateral plantar artery 2. passes between abductor hallucis and flexor digitorum brevis 3. supplies medial side of great toe (first proper plantar digital artery)

Question 303

Describe the location of the lateral plantar artery, as well as what it supplies and its divisions

Answer 303

1. runs obliquely across the foot to the lateral side, at the base of the 5th metatarsal it passes to the medial side (to form the deep plantar arch) 2. on the medial side it joins with the deep plantar branch of the dorsalis pedis to complete the deep plantar arch which provides four plantar metatarsal arteries 3. each plantar metatarsal artery divides into 2 proper plantar digital arteries that supply adjacent sides of each toe 4. first proper plantar digital artery usually originates either from the first metatarsal or from the medial plantar artery 5. the 10th proper plantar digital is usually a terminal branch of the lateral plantar artery

Question 304

Which toe is the central toe?

Answer 304

second toe! (right next to big toe)

Question 305

Function of the plantar interossei muscles

Answer 305

adduct the toes

Question 306

Function of the dorsal interossei muscles

Answer 306

abduct the toes

Question 307

Name the 3 arches of the foot and tell me what forms them (in general) and what their function is

Answer 307

- medial longitudinal, lateral longitudinal, transverse - formed by the tarsal and metatarsal bones of the foot - add to weight bearing, resilience, shock absorption and propelling of the lower limb during walking

Question 308

Tell me what makes up the medial longitudinal arch, what supports it, and its comparison to the lateral longitudinal arch

Answer 308

- higher and more important than the lateral longitudinal ligament - consists of calcaneus, talus, navicular, 3 cuneiforms and 3 medial metatarsals - arch is supported by the spring (calcaneonavicular) ligament and the plantar aponeurosis

Question 309

Characteristics of the lateral longitudinal arch of the foot, what makes it up, and what supports it

Answer 309

- flatter than medial arch - rests on the ground during standing - consists of the calcaneus, cuboid, and lateral 2 metatarsals - arch supported by the long plantar ligament, short plantar ligament and plantar aponeurosis

Question 310

Describe the location of the transverse arch of the foot and tell me what makes it up

Answer 310

- runs side to side | - formed by the cuboid, three cuneiforms, and bases of all metatarsals

Question 311

Tell me which 3 bones make up the ankle (talocrural) joint, as well as what 2 ligaments make it up

Answer 311

- trochlea of talus, tibia, fibula | - articular capsule, deltoid ligament, lateral ligament

Question 312

What are the 7 joints of the foot?

Answer 312

1. ankle (talocrural) 2. subtalar (talocalcaneal) 3. other tarsal joints 4. tarsometatarsal 5. intermetatarsal 6. metatarsal phalangeal (MP) 7. interphalangeal (IP)

Question 313

What type of joint is the talocrural (ankle) joint? What are its 2 actions? Describe them

Answer 313

- ginglymus or hinge type of synovial joint 1. dorsiflexion - range up to 35 degrees; joint is very stable when dorsiflexed 2. plantar flexion - range up to 55 degrees; ankle joint is very UNstable when plantar flexed

Question 314

Describe the articular capsule of the ankle (talocrural) joint (3)

Answer 314

1. surrounds joint cavity 2. thin anteriorly and posteriorly 3. strong medially and laterally where it is strengthened by deltoid and lateral ligament

Question 315

Describe the deltoid ligament of the talocrural (ankle) joint

Answer 315

- located on medial side of the joint with 4 distinct bands | - very strong triangular band of ligaments

Question 316

Describe the lateral ligament of the ankle (Talocrural) joint

Answer 316

- three distinct bands - located on lateral side of ankle joint - weaker than deltoid ligament

Question 317

What type of joint is the subtalar (talocalcanea) joint? Where is it? What 2 actions does it permit?

Answer 317

1. plane type of synovial joint 2. between talus and calcaneus 3. permits inversion and eversion

Question 318

What type of joints are the other tarsal joints and what movements do they allow?

Answer 318

- plane, gliding type synovial joints | - inversion and eversion of foot

Question 319

What makes up the tarsometatarsal joints and what type of joints are they?

Answer 319

- plane type of synovial | - four anterior tarsal bones with the bases of the metatarsals

Question 320

What are the intermetatarsal joints and what type of movement do they allow?

Answer 320

- plane type of synovial joint - permits slight gliding movements - articulation between bases of metatarsals

Question 321

What type of joints are the metatarsal phalangeal (MP) joints and what type of movements do they permit?

Answer 321

- condyloid type of synovial - permit flexion, extension, abduction, adduction and rotation - articular between the heads of the metatarsals and the bases of the proximal phalanges

Question 322

What type of joints are the interphalangeal (IP) joints and what to 2 movements do they permit?

Answer 322

- hinge type synovial joint | - permit flexion and extension

Question 323

What are the 2 common ankle joint injuries?

Answer 323

ankle sprains, Potts fracture

Question 324

Ankle sprains (3)

Answer 324

- ankle joint is most frequently injured major joint - ankle sprains usually occur because of torn or damaged ligaments - usually an INVERSION injury causing damage to the lateral ligaments (anterior talofibular, posterior talofibular, calcaneofibular)

Question 325

Pott's fracture

Answer 325

- when foot is forcefully EVERTED - often results in fracture of lateral and medial malleoli and fibula - think football --> yikes it's bad

Question 326

Name the 4 bands of the deltoid ligament of the foot

Answer 326

anterior tibiotalar, posterior tibiotalar, tibonavicular, tibicalcaneal

Question 327

Name the 3 bands of the lateral ligament of the foot

Answer 327

anterior talofibular, posterior talofibular, calcaneofibular

Question 328

Transverse tarsal joints (2) and what type of joint they are

Answer 328

1. talocalcaneonavicular - ball and socket | 2. calcaneocuboid - plane

Question 329

Name the 6 important ligaments of the hip joint

Answer 329

1. iliofemoral ligament 2. pubofemoral ligament 3. ischiofemoral liagment 4. ligament capitis femoris 5. acetabular labrum 6. transverse acetabular ligament

Question 330

Key traits of the hip joint (5)

Answer 330

1. second most mobile major joint 2. adapt for supporting body, yet permits significant degree of movement 3. 1/2 head of femur fits into acetabulum (2/3 of a sphere) 4. head of femur completely covered with articular cartilage, except over fovea capitis femoris 5. ball and socket

Question 331

Describe 3 key traits of the acetabulum and its articulation with the femur

Answer 331

1. articular surface - lunate surface which is also covered with cartilage 2. acetabular notch - inferomedial part 3. floor of acetabulum - devoid of cartilage but contains fibroelastic mass

Question 332

Describe the articular capsule of the hip joint (5)

Answer 332

- strong, dense, fibrous - thicker along anterior and upper parts; thin posteriorly and inferiorly - fibers both circular and longitudinal - zona orbicularis consists of circular fibers along neck of femur - fibers blend with those of other ligaments

Question 333

Largest joint in the body

Answer 333

knee (also very unstable and bears most weight)

Question 334

Describe the shape, location, attachments, and function of the iliofemoral (iliotrochanteric) ligament of the hip joint

Answer 334

- largest, strongest, widest - triangular in shape (inverted Y) - lies in front of the joint - apex attached to AIIS, base attached to intertrochanteric line - checks hyperextension and external rotation** - helps to maintain erect posture

Question 335

Describe the shape, attachments and function of the pubofemoral (pubocapsular) ligament of the hip joint

Answer 335

- triangular in shape - apex blends with iliofemoral ligament, base attached to superior ramus of pubis and obturator crest - checks hyperextension, abduction and external rotation

Question 336

Describe the arrangement, location, attachments, and function of the ischiofemoral (ischiocapsular) ligament of the hip joint

Answer 336

- spiral arrangement - attached to body of ischium below and behind acetabulum - fibers go up and laterally to attach to the femoral neck below the greater trochanter - becomes tense during extension of femur - checks hyperextension and internal rotation

Question 337

Describe the shape, attachments, location, and function of the ligament capitis femoris in the hip joint

Answer 337

- about 4 cm long, can be absent - flat and triangular - attached to fovea capitis femoris and by its base to the transverse ligament - lies within the joint, covered by synovial membrane - becomes tense when flexed thigh is adducted - kind of usesless in adults but not kids

Question 338

What is the acetabular labrum?

Answer 338

fibrocartilaginous rim attached to the margin of acetabulum

Question 339

What is the transverse acetabular ligament?

Answer 339

- continuation of acetabular labrum across the acetabular notch - contains NO cartilage cells

Question 340

what is the biggest possible problem at the hip joint as far as motion goes?

Answer 340

hyperextension

Question 341

describe the synovial membrane of the hip joint

Answer 341

- lines the articular capsule and is attached to the margins of the acetabular surfaces - covers the portion of neck of femur located in the joint capsule

Question 342

The arteries of the hip joint are derived from what 6 primary arteries?

Answer 342

1. obturator 2. medial circumflex femoral (provide retinacular) 3. lateral circumflex femoral (provide retinacular) 4. inferior gluteal 5. superior gluteal 6. first perforating

Question 343

Avascular necrosis can occur at the head of the femur. Describe two fractures that can cause this

Answer 343

1. basal fracture - at base of neck; usually doesn't cause necrosis of head, but can 2. subcapital fracture - breaks vessels to the head of the femur- occurs below head of femur

Question 344

Name the 5 nerves of the hip joint

Answer 344

femoral, obturator, superior gluteal, inferior gluteal, sciatic

Question 345

Retinacular arteries are found where?

Answer 345

run along the neck of the femur in the hip joint

Question 346

Motions of the knee joint

Answer 346

- very unstable | - resembles a hinge joint structurally but allows rotation and gliding too

Question 347

Tell me the two types of joints found within the knee joint

Answer 347

- joint between tibia and femur is a synovial HINGE joint with some degree of rotation so technically it is a CONDYLOID joint - joint between patella and femur is a GLIDING SYNOVIAL joint

Question 348

Describe the articulation that occurs within the knee joint

Answer 348

- between rounded condyles of the femur, condyles of the tibia and in front between lower end of femur and patella - articular surfaces of femur, tibia and patella are covered by cartilage - mechanically weak joint and fairly unstable

Question 349

Which type of fracture is worse - subcapital or basal?

Answer 349

subcapital - damages retinacular arteries so necrosis occurs

Question 350

Name the 7 primary ligaments of the knee joint and tell me which tendon is also involved

Answer 350

1. quadriceps tendon 2. patellar ligament 3. fibular collateral ligament 4. tibial collateral ligament 5. oblique popliteal ligament 6. arcuate popliteal ligament 7. coronary ligament 8. intra-articular ligaments (5)

Question 351

Describe the attachment, location, make up, and function of the articular capsule of the knee joint (5)

Answer 351

- fairly strong in some areas - incomplete at places where it is replaced by tendons of surrounding muscles - attached to margins of articular surfaces - on lateral side, it allows the tendon of the popliteus muscle to go through - fibrous capsule strengthened by ligaments of the joint

Question 352

Describe the make up of the quadriceps tendon (3)

Answer 352

- medial and lateral patellar retinacula - encloses patella - bursa below the tendon

Question 353

Describe the patellar ligament

Answer 353

- from patella to tuberosity of tibia - 8 cm long - infrapatellar bursa

Question 354

Describe the structure, location and attachments of the fibular collateral ligament

Answer 354

- rounded, cord-like structure, about 5 cm long - covered by tendon of biceps femoris (divides to go on both sides) - extends from lateral epicondyle of the femur to the head of the fibula - NOT attached to lateral meniscus - tendon of poplitus muscle below it

Question 355

Describe the structure, and attachments of the tibial collateral ligament

Answer 355

- broad flat band about 10 cm long - crossed by tendons of gracillis, semitendinosus and sartorius - extends from medial epicondyle of femur (below the adductor tubercle) to medial surface of tibia - firmly attached to medial meniscus ***

Question 356

Function of the collateral ligaments of the knee

Answer 356

both become tight during extension and stabilize the knee joint

Question 357

Describe the function, location, and structure of the oblique popliteal ligament

Answer 357

- expansion of the tendon of the semimembranous muscle - strengthens posterior aspect of joint - broad fibrous band with great strength - fibers go from medial condyle of tibia to lateral condyle of femur - forms part of the floor of popliteal fossa and popliteal vessels rest on it

Question 358

Location of arcuate popliteal ligament

Answer 358

arches medially over tendon of popliteal muscle to attach to intercondylar area of tibia and to the fibular head

Question 359

describe the coronary ligament of the knee

Answer 359

deep fibers of the capsule attached to the menisci

Question 360

Name the 5 intra-articular ligaments of the knee

Answer 360

1. transverse 2. anterior and posterior meniscofemoral 3. anterior and posterior cruciates

Question 361

Describe the transverse ligament of the knee joint

Answer 361

- connects the two mensici anteriorly | - often absent

Question 362

Describe the anterior and posterior meniscofemoral ligaments

Answer 362

travel obliquely from the lateral menisci to the medial femoral condyle

Question 363

3 key facts about the cruciate ligaments of the knee

Answer 363

- very strong - cross each other - named according to their TIBIAL attachments

Question 364

ACL

Answer 364

- longer but weaker than posterior - from anterior interchondral fossa to lateral condyle of femur - stops hyperextension at the knee

Question 365

PCL

Answer 365

- shorter, stronger than anterior - from posterior interchondral fossa to the medial condyle of femur - stops hyperflexion at the knee

Question 366

Describe the function, structure, and location of the menisci of the knee joint

Answer 366

- C shaped lamellae of fibrocartilage that are interposed between femoral and tibial condyles - attached to tibial condyles - peripheral area is thick and attached to capsule via coronary ligament - inner surface is thin - function is to deepen the articular surfaces

Question 367

location and function of the synovial membrane of the knee

Answer 367

lines articular capsule, attached to margins of articular surfaces and to the peripheral edges of the menisci

Question 368

which cruciate ligament gets damaged more often?

Answer 368

ACL

Question 369

nerve supply to knee joint (4)

Answer 369

femoral, obturator, common peroneal, tibial

Question 370

2 key components of blood supply to the knee joint

Answer 370

- genicular anastomosis (5 of the arteries) | - middle genicular artery penetrates the capsule and supplies intercondylar structures

Question 371

describe the 2 PRIMARY movements of the knee joint (when standing)

Answer 371

1. flexion via hamstrings | 2. extension via quads

Question 372

Baker's cyst

Answer 372

synovial fluid escapes into popliteal fossa

Question 373

most common knee injury

Answer 373

ligament sprains

Question 374

unhappy triad

Answer 374

medial collateral ligament, medial meniscus, ACL

Question 375

Anterior and posterior drawer signs

Answer 375

1. anterior pull on knee - ACL tear - skiing accident (moves anteriorly more so than it should) 2. posterior push on knee - PCL tear - car accident (moves posteriorly more so than it should)

Question 376

genu varum

Answer 376

bow leg (knees out) - reduced Q angle

Question 377

genu valgum

Answer 377

knock knee (knees in) - increased Q angle

Question 378

bursitis of knee

Answer 378

12 bursae around the knee joint - 4 communicate with the knee joint