L18 - Concept of muscular compartments; WIP

Question 1

What is fascia?

Answer 1

• The body’s CT matric
• All-encompassing and interwoven system of fibrous CT found throughout the body
• Band or sheet of CT, primarily collagen beneath the skin that attaches, stabilises, encloses and separates muscles and other internal organs

Question 2

What is necrotising fasciitis?

Answer 2

• Flesh eating disease
• Bacterium feeds on fascia (infection)
• Damage is spread along fascial planes
• Able to consume an entire person in space of few hours
• Sudden onset that spreads rapidly

Question 3

Why is fascia important?

Answer 3

Provides a framework that organises, supports and protects muscle groups, organs and tissue units of the body

Question 4

Where are fascial spaces most exaggerated in the body?

Answer 4

1. Head region
2. Neck region
3. Limb regions

Question 5

What is the generic tissue layers enveloping any surface of the body

Answer 5

Outside –> inwards

1. Superficial fascia
   - Binds skin to rest of tissues of body
2. Deep fascia
   - Investing layer
   - Int layer of deep fascia
3. Muscles
4. Deepest layer of deep fascia

Question 6

What is the function of deep fascia?

Answer 6

• Encloses organs
• Support and protect muscles and other soft tissue structures
• Divides muscles into compartment

Question 7

What are the 2 main classes of fascia in the neck?

Answer 7

1. Superficial cervical fascia

2. Deep cervical fascia

Question 8

What does the deep cervical fascia consist of?

Answer 8

1. Investing fascia
2. Pretracheal fascia
3. Prevertebral fascia
4. Carotid sheaths
   - Alar fascia

Question 9

What are the tissue layers of the thigh?

Answer 9

1. The skin
2. Superficial fascia
3. Deep fascia (fascia lata)
4. Muscles (and membrane coverings)
5. Femur (covered in periosteum and endosteum)
6. Lateral intermuscular septum
7. Neurovascular bundle
8. Lymph nodes

Question 10

What is the lateral intermuscular septum of the thigh?

Answer 10

• A fold of deep fascia in the thigh
• Between the vastus lateralis and biceps femoris
• Separates the anterior compartment from the posterior compartment of the thigh

Question 11

What is the medial intermuscular septum of the thigh?

Answer 11

• A fold of deep fascia in the thigh
• Between the vastus medialis and the adductors and pectineus
• Separates the anterior compartment from the medial compartment of the thigh

Question 12

What is the posterior intermuscular septum of the thigh?

Answer 12

• A fold of deep fascia in the thigh

- Separates the lateral compartment of the thigh

Question 13

What are the 3 fascial compartments of the thigh (aka muscular compartments)?

Answer 13

1. Ant compartment
2. Lateral compartment
3. Posterior compartment

Question 14

What do the 3 fascial compartments of the thigh have in common?

Answer 14

Common blood supply from profunda femoris

Question 15

What do the 3 fascial compartments differ in?

Answer 15

1. Own general actions
2. Own muscles
3. Own nerve supply

Question 16

What is the function of the anterior compartment of the thigh?

Answer 16

• Knee extensors

- Quadriceps

Question 17

What is the function of the posterior compartment of the thigh?

Answer 17

• Knee flexors
• Hip extensors
• Hamstrings

Question 18

What is the function of the medial compartment of the thigh?

Answer 18

• Hip adductors

- Muscles collectively known as hip adductors

Question 19

Which is the primary nerve supplying the medial compartment of the thigh?

Answer 19

Obturator nerve

• Arises from lumbar plexus
• L2-L4

Question 20

Which is the primary nerve supplying the posterior compartment of the thigh?

Answer 20

Sciatic nerve

• Tibial (medial part)
• L4, L5
• S1-3

Question 21

Which is the primary nerve supplying the anterior compartment of the thigh?

Answer 21

Femoral nerve (L2-L4)

Question 22

Which artery supplies the anterior compartment of the thigh?

Answer 22

Femoral artery

Question 23

Which artery supplies the medial compartment of the thigh?

Answer 23

Obturator artery

Question 24

Which artery supplies the posterior compartment of the thigh?

Answer 24

Perforating branches of profunda femoris (a branch of femoral artery)

Question 25

How many muscle groups make up the posterior compartment of the leg and what are they called?

Answer 25

1. Superficial group 2. Deep group - These 2 form the calf muscles of the leg

Question 26

What are the muscles found in the superficial posterior compartment of the leg (calf muscles)?

Answer 26

1. Gastrocnemius 2. Soleus 3. Plantaris - They share a common tendon of insertion

Question 27

What is the triceps surae?

Answer 27

- Three headed muscle at the dorsal lower leg - Lies within superficial posterior compartment - Made up of soleus and gastrocnemius

Question 28

What is the innervation for the triceps surae?

Answer 28

Tibial nerve

Question 29

What is the name of the tendon that the 3 muscles of the superficial posterior compartment of the leg insert to? - Where does it insert to?

Answer 29

The tendo calcaneous - Achilles tendon - Strongest tendon in the body

Question 30

What is the main action of the tendo calcaneous (achilles tendon)?

Answer 30

Plantar flex

Question 31

Where does the tendo calcaneous (achilles tendon) insert into?

Answer 31

Inserts into the calcaneous of the foot (hell bone) | - The calcaneous connects with the talus and cuboid bones

Question 32

What are the muscles that make up the deep posterior compartment of the leg?

Answer 32

1. Popliteus 2. Flexor halucis longus 3. Tibialis posterior 4. Flexor digitorum longus

Question 33

Which muscles of the deep posterior compartment of the leg act on the knee joint?

Answer 33

Popliteus

Question 34

Which muscles of the deep posterior compartment of the leg act on the ankle and foot joints?

Answer 34

- Tibialis posterior - Flexor halucis longus - Flexor digitorum longus

Question 35

What are the different regions of the upper limb?

Answer 35

1. Arm 2. Forearm 3. Hand

Question 36

What are the different compartments that make up the hand?

Answer 36

1. Dorsal interossei (4) 2. Palmar interossei (3) 3. Thenar 4. Hypothenar 5. Adductor pollicis

Question 37

What are the symptoms of compartment syndrome?

Answer 37

``` P - Pain P - Pale skin tone (pallor) P - Paresthesia P - Pulselessness (faint pulse) P - Paralysis (weakness with movements) ```

Question 38

What are the causes of compartment syndrome?

Answer 38

1. Dec compartment size (fluid introduced into fixed vol) 2. Inc fluid content (bleeding or swelling after injury) - Burns - Intra-arterial injection - Infiltrated infusion - Haemorrhage - Envenomation (process by which venom in injected by bite or sting) 3. Extraneous constriction

Question 39

What is compartment syndrome?

Answer 39

- Occurs when perfusion pressure fall below tissue pressure in a closed anatomical compartment (build up of pressure in anatomical comp) - Can develop wherever an anatomical compartment is present

Question 40

What would happen in compartment syndrome was to be left untreated?

Answer 40

High pressure in compartment syndrome impedes the flow of blood to and from the affected tissue --> necrosis and death - Inc press --> dec tissue perfusion until no O2 available for cellular metabolism