L5: Appendicular Pt. 2 Flashcards
(260 cards)
1
Q
What is the general structure of the female pelvis?
A
Light and thin
2
Q
What is the general structure of the male pelvis?
A
Heavy and thick
3
Q
What is the greater (false) pelvis like in females?
A
Shallow
4
Q
What is the greater (false) pelvis like in males?
A
Deep
5
Q
What is the shape of the pelvic inlet in females?
A
Wide and more oval
6
Q
What is the shape of the pelvic inlet in males?
A
Narrow and heart-shaped
7
Q
What is the size and orientation of the acetabulum in females?
A
Small and faces anteriorly
8
Q
What is the size and orientation of the acetabulum in males?
A
Large and faces laterally
9
Q
What is the shape of the obturator foramen in females?
A
Oval
10
Q
What is the shape of the obturator foramen in males?
A
Round
11
Q
What is the pubic arch angle in females?
A
Greater than 90° angle
12
Q
What is the pubic arch angle in males?
A
Less than 90° angle
13
Q
How is the iliac crest shaped in females?
A
Less curved
14
Q
How is the iliac crest shaped in males?
A
More curved
15
Q
How is the ilium oriented in females?
A
Less vertical
16
Q
How is the ilium oriented in males?
A
More vertical
17
Q
What is the greater sciatic notch like in females?
A
Wide (almost 90°)
18
Q
What is the greater sciatic notch like in males?
A
Narrow (about 70°; inverted V)
19
Q
How is the sacrum shaped in females?
A
Shorter, wider, and less curved anteriorly
20
Q
How is the sacrum shaped in males?
A
Longer, narrower, and more curved anteriorly
21
Q
What is the femur also known as?
A
Thigh bone
22
Q
What is the longest, heaviest, and strongest bone in the body?
A
Femur
23
Q
What does the proximal end of the femur articulate with?
A
Acetabulum of the hip bone
24
Q
What does the distal end of the femur articulate with?
A
Tibia and patella
25
Why are the knee joints closer to the midline than the hip joints?
Because the body of the femur angles medially
26
Why is the angle of convergence greater in females?
Because the female pelvis is broader
27
What is the rounded head of the femur's function?
It articulates with the acetabulum of the hip bone to form the hip joint
28
What is the small central depression in the head of the femur called?
Fovea for ligament of head of femur or fovea capitis
29
What does the ligament of the head of the femur connect?
The fovea of the femur to the acetabulum of the hip bone
30
What is the constricted region distal to the head of the femur called?
Neck of the femur
31
A broken hip is more often associated with a fracture in which part?
Neck of the femur
32
What are the greater trochanter and lesser trochanter?
Projections from the junction of the neck and body of the femur that serve as attachment points for tendons of thigh and buttock muscles
33
Where is the greater trochanter located?
Anterior to the hollow on the side of the hip
34
What is a common landmark for intramuscular injections into the lateral surface of the thigh?
Greater trochanter
35
Where is the lesser trochanter located?
Inferior and medial to the greater trochanter
36
What is the narrow line between the anterior surfaces of the trochanters called?
Intertrochanteric line
37
What is the ridge between the posterior surfaces of the trochanters called?
Intertrochanteric crest
38
What is the vertical ridge inferior to the intertrochanteric crest called?
Gluteal tuberosity
39
What is the vertical ridge that the gluteal tuberosity blends into called?
Linea aspera
40
What is the function of the gluteal tuberosity and linea aspera?
Attachment points for tendons of several thigh muscles
41
What are the expanded distal ends of the femur called?
Medial condyle and lateral condyle
42
What do the medial and lateral condyles of the femur articulate with?
Medial and lateral condyles of the tibia
43
What structures are superior to the condyles and attach ligaments of the knee joint?
Medial epicondyle and lateral epicondyle
44
What is the depressed area between the condyles on the posterior surface called?
Intercondylar fossa
45
Where is the patellar surface located?
Between the condyles on the anterior surface
46
What is the roughened projection just superior to the medial epicondyle?
Adductor tubercle
47
What muscle attaches to the adductor tubercle?
Adductor magnus muscle
48
What is the pelvic outlet of the female?
wider
49
What is the pelvic outlet of the male?
narrower
50
What is the ischial tuberosity of the female?
Shorter, farther apart, and more medially projecting.
51
What is the ischial tuberosity of the male?
Longer, closer together, and more laterally projecting.
52
What is the patella also known as?
Kneecap
53
What is the shape of the patella?
Small, triangular
54
Where is the patella located?
Anterior to the knee joint
55
What type of bone is the patella?
Sesamoid bone
56
In which muscle tendon does the patella develop?
Quadriceps femoris muscle
57
What is the broad proximal end of the patella called?
Base
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What is the pointed distal end of the patella called?
Apex
59
What does the posterior surface of the patella contain?
Two articular facets
60
What do the articular facets of the patella articulate with?
Medial condyle and lateral condyle of the femur
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What attaches the patella to the tibial tuberosity?
Patellar ligament
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What is the patellofemoral joint?
The joint between the posterior surface of the patella and the patellar surface of the femur
63
What is the intermediate component of the tibiofemoral (knee) joint?
Patellofemoral joint
64
What are the three functions of the patella?
Increases leverage of the tendon of the quadriceps femoris muscle, maintains tendon position when the knee is bent (flexed), and protects the knee joint
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What is patellofemoral stress syndrome also known as?
Runner’s knee
66
What is one of the most common problems runners experience?
Patellofemoral stress syndrome (runner’s knee)
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How does the patella normally track during flexion and extension of the knee?
Superiorly and inferiorly in the groove between the femoral condyles
68
What happens to patella tracking in patellofemoral stress syndrome?
The patella tracks laterally as well as superiorly and inferiorly
69
What does the increased pressure on the joint cause in patellofemoral stress syndrome?
Aching or tenderness around or under the patella
70
When does pain typically occur in patellofemoral stress syndrome?
After sitting for a while, especially after exercise
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What activities worsen the pain of patellofemoral stress syndrome?
Squatting or walking down stairs
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What is one cause of runner’s knee?
Constantly walking, running, or jogging on the same side of the road
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What are some predisposing factors for patellofemoral stress syndrome?
Muscle weakness, vigorous physical activities that stress the knee, running on hills, running long distances, and genu valgum (knock-knee)
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What is the anatomical deformity associated with patellofemoral stress syndrome?
Genu valgum (knock-knee)
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What are some treatment options for patellofemoral stress syndrome?
Decreasing activities that worsen the condition, ice, anti-inflammatory medications (such as ibuprofen), kinesiology tape or knee braces, custom orthotics, physical therapy, and arthroscopy
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articulate to form the hip joint
acetabulum of the hip bone and head of the femur
77
What is another name for the tibia?
Shin bone
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What is the larger, medial, weight-bearing bone of the leg?
Tibia
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What does the term tibia mean?
Flute
80
Why was the tibia called a flute?
Because the tibial bones of birds were used in ancient times to make musical instruments
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What bones does the tibia articulate with at its proximal end?
Femur and fibula
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What bones does the tibia articulate with at its distal end?
Fibula and talus bone of the ankle
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What connects the tibia and fibula, like the ulna and radius?
Interosseous membrane
84
What is the proximal end of the tibia expanded into?
Lateral condyle and medial condyle
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What do the lateral and medial condyles of the tibia articulate with?
Condyles of the femur
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What do the lateral and medial condyles of the tibia form?
Lateral and medial articular surfaces of the knee joints
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What does the inferior surface of the lateral condyle of the tibia articulate with?
Head of the fibula
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What is the upward projection that separates the slightly concave condyles?
Intercondylar eminence
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What is the tibial tuberosity?
A point of attachment for the patellar ligament
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What is the sharp ridge below the tibial tuberosity that can be felt under the skin?
Anterior border (crest) or shin
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What does the medial surface of the distal end of the tibia form?
Medial malleolus
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What does the medial malleolus articulate with?
Talus of the ankle
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What is the prominence that can be felt on the medial surface of the ankle region?
Medial malleolus
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What does the fibular notch articulate with?
Distal end of the fibula
95
What joint does the fibular notch help form?
Distal tibiofibular joint
96
Which long bone of the body is most frequently fractured?
Tibia
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What is the most frequent site of an open (compound) fracture?
Tibia
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What bone is parallel and lateral to the tibia?
Fibula
99
How does the size of the fibula compare to the tibia?
It is considerably smaller
100
Does the fibula articulate with the femur?
No
101
What does the fibula help stabilize?
Ankle joint
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What is the proximal end of the fibula called?
Head of the fibula
103
What does the head of the fibula articulate with?
Inferior surface of the lateral condyle of the tibia
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What joint does the head of the fibula help form?
Proximal tibiofibular joint
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What is the distal end of the fibula shaped like?
Arrowhead
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What is the projection on the distal end of the fibula called?
Lateral malleolus
107
What does the lateral malleolus articulate with?
Talus of the ankle
108
What does the lateral malleolus form on the ankle region?
The prominence on the lateral surface
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Where does the fibula articulate with the tibia to form the distal tibiofibular joint?
Fibular notch
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articulates with the lateral and medial condyles of the femur.
patella
111
articulates with the femur and fibula proximally, and with the fibula and talus distally.
tibia
112
MNEMONIC for location of tibia and fibula:
The fibuLA is LAteral.
113
What does bone grafting generally consist of?
Taking a piece of bone, along with its periosteum and nutrient artery, from one part of the body to replace missing bone in another part of the body
114
What does the transplanted bone restore?
The blood supply to the transplanted site
115
How does healing occur after bone grafting?
As in a fracture
116
What is a common source of bone for grafting?
Fibula
117
Why is the fibula commonly used for bone grafting?
Because even after a piece of the fibula has been removed, walking, running, and jumping can be normal
118
What is the weight-bearing bone of the leg?
Tibia
119
What is the proximal region of the foot called?
Tarsus (ankle)
120
How many tarsal bones are in the foot?
Seven
121
What are the two tarsal bones located in the posterior part of the foot?
Talus and calcaneus
122
What is the largest and strongest tarsal bone?
Calcaneus
123
What are the anterior tarsal bones?
Navicular, medial (first) cuneiform, intermediate (second) cuneiform, lateral (third) cuneiform, and cuboid
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What are the joints between tarsal bones called?
Intertarsal joints
125
What is the most superior tarsal bone?
Talus
126
What is the only bone of the foot that articulates with the fibula and tibia?
Talus
127
What are the two structures that articulate with the talus?
Medial malleolus of the tibia and lateral malleolus of the fibula
128
What joint is formed by the articulation of the talus with the tibia and fibula?
Ankle (talocrural) joint
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During walking, which bone transmits about half the weight of the body to the calcaneus?
Talus
130
What region of the foot is called the metatarsus?
The intermediate region of the foot
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How many metatarsal bones are in the foot?
Five
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How are the metatarsal bones numbered?
1–5 from medial to lateral
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What are the three parts of each metatarsal bone?
Proximal base, intermediate body, and distal head
134
What bones do the metatarsals articulate with proximally?
First, second, and third cuneiform bones and the cuboid
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What joints are formed between the metatarsals and the cuneiform/cuboid bones?
Tarsometatarsal joints
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What bones do the metatarsals articulate with distally?
Proximal row of phalanges
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What joints are formed between the metatarsals and phalanges?
Metatarsophalangeal joints
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Which metatarsal is thicker than the others because it bears more weight?
First metatarsal
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What is the distal component of the foot?
Phalanges
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How are the toes numbered?
1–5, beginning with the great toe from medial to lateral
141
What are the three parts of each phalanx?
Proximal base, intermediate body, and distal head
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What is another name for the great toe?
Hallux
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How many phalanges does the great toe have?
Two (proximal and distal phalanges)
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How many phalanges do toes 2–5 have?
Three (proximal, middle, and distal phalanges)
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What do the proximal phalanges of all toes articulate with?
Metatarsal bones
146
What do the middle phalanges of toes 2–5 articulate with?
Their distal phalanges
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What does the proximal phalanx of the great toe articulate with?
Its distal phalanx
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What are the joints between the phalanges of the foot called?
Interphalangeal joints
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When do fractures of the metatarsals occur?
When a heavy object falls onto or rolls over the foot
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Among whom are metatarsal fractures common?
Dancers, especially ballet dancers
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What happens if a ballet dancer is on the tip of her toes and loses her balance?
The full body weight is placed on the metatarsals, causing one or more of them to fracture
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How are the bones of the foot arranged?
In two arches that are held in position by ligaments and tendons
153
What do the arches of the foot enable?
They enable the foot to support the weight of the body, provide an ideal distribution of body weight over the soft and hard tissues of the foot, and provide leverage while walking
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How do the arches of the foot function when weight is applied and lifted?
They yield as weight is applied and spring back when the weight is lifted, storing energy for the next step and helping to absorb shocks
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By what age are the arches of the foot fully developed?
By age 12 or 13
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What are the two parts of the longitudinal arch?
The medial part and the lateral part
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Where does the medial part of the longitudinal arch originate?
At the calcaneus
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Through which bones does the medial part of the longitudinal arch rise and descend?
It rises to the talus and descends through the navicular, the three cuneiforms, and the heads of the three medial metatarsals
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Where does the lateral part of the longitudinal arch begin?
At the calcaneus
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How does the lateral part of the longitudinal arch rise and descend?
It rises at the cuboid and descends to the heads of the two lateral metatarsals
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Why does the medial portion of the longitudinal arch not touch the ground when walking on a hard surface?
Because the medial portion of the arch is so high
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Where is the transverse arch found?
Between the medial and lateral aspects of the foot
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Which bones form the transverse arch?
The navicular, three cuneiforms, and the bases of the five metatarsals
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What is one function of the arches?
To distribute body weight over the soft and hard tissues of the body
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How is body weight normally distributed between the ball of the foot and the heel?
The ball of the foot carries about 40% of the weight, and the heel carries about 60%
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What is the ball of the foot?
The padded portion of the sole superficial to the heads of the metatarsals
167
How does wearing high-heeled shoes change weight distribution?
The ball of the foot may carry up to 80% of the weight, while the heel carries only 20%
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What problems can result from wearing high-heeled shoes?
The fat pads at the ball of the foot are damaged, joint pain develops, and structural changes in bones may occur
169
The skeleton of the foot consists of the
proximal tarsals, the intermediate metatarsals, and the distal phalanges.
170
MNEMONIC for tarsals:
Tall Centers Never Take Shots From Corners. Talus Calcaneus Navicular Third cuneiform Second cuneiform First cuneiform Cuboid
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help the foot support and distribute the weight of the body and provide leverage during walking.
Arches
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What holds the bones composing the arches of the foot in position?
Ligaments and tendons
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What happens if the ligaments and tendons of the foot are weakened?
The height of the medial longitudinal arch may decrease or "fall"
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What is the result of a fallen medial longitudinal arch?
Flatfoot
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What are the causes of flatfoot?
Excessive weight, postural abnormalities, weakened supporting tissues, and genetic predisposition
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What conditions can fallen arches lead to?
Inflammation of the fascia of the sole (plantar fasciitis), Achilles tendinitis, shin splints, stress fractures, bunions, and calluses
177
What is often prescribed to treat flatfoot?
A custom-designed arch support
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What is clawfoot?
A condition in which the medial longitudinal arch is abnormally elevated
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What often causes clawfoot?
Muscle deformities
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In which individuals may muscle deformities leading to clawfoot occur?
Diabetics whose neurological lesions lead to atrophy of muscles of the foot
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What develops after the limb buds?
endochondral ossification of the limb bones begins by the end of the eighth embryonic week
182
What do most skeletal tissues arise from?
Mesenchymal cells
183
What are mesenchymal cells derived from?
Mesoderm
184
What part of the skeleton arises from ectoderm?
Much of the skeleton of the skull
185
What do mesenchymal cells condense and form?
Models of bones
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Where do bones form directly within mesenchyme?
Intramembranous ossification
187
Where do bones form within hyaline cartilage that develops from mesenchyme?
Endochondral ossification
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When does the skull begin development?
During the fourth week after fertilization
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From what does the skull develop?
Mesenchyme around the developing brain
190
What are the two major portions of the skull?
Neurocranium and viscerocranium
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What is the origin of the neurocranium?
Mesodermal
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What does the neurocranium form?
The cranial cavity bones
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What is the origin of the viscerocranium?
Ectodermal
194
What does the viscerocranium form?
Facial bones
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What are the two parts of the neurocranium?
Cartilaginous neurocranium and membranous neurocranium
196
What does the cartilaginous neurocranium consist of?
Hyaline cartilage developed from mesenchyme at the cranial base
197
What does the cartilaginous neurocranium later undergo?
Endochondral ossification
198
What does endochondral ossification form in the neurocranium?
Bones of the cranial base
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What does the membranous neurocranium consist of?
Mesenchyme
200
What does the membranous neurocranium later undergo?
Intramembranous ossification
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What does intramembranous ossification form in the neurocranium?
The flat bones that make up the roof and sides of the skull
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What are the membrane-filled spaces that separate the flat bones during fetal life and infancy?
Fontanels
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What are the two parts of the viscerocranium?
Cartilaginous viscerocranium and membranous viscerocranium
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From where is the cartilaginous viscerocranium derived?
The cartilage of the first two pharyngeal arches
205
What does endochondral ossification of the cartilaginous viscerocranium form?
Portions of the jaw bones, ear bones, and hyoid bone
206
From where is the membranous viscerocranium derived?
Mesenchyme in the first pharyngeal arch
207
What does intramembranous ossification of the membranous viscerocranium form?
Facial bones
208
From what are vertebrae and ribs derived?
Portions of cube-shaped masses of mesoderm called somites
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When do mesenchymal cells from somites surround the notochord?
About 4 weeks after fertilization
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What is the notochord?
A solid cylinder of mesodermal cells
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What does the notochord induce mesenchymal cells to form?
Vertebral bodies, costal (rib) centers, and vertebral arch centers
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What does the notochord induce mesenchymal cells between vertebral bodies to form?
The nucleus pulposus of an intervertebral disc
213
What do surrounding mesenchymal cells form in the intervertebral disc?
The annulus fibrosus
214
What happens if the vertebral arch does not develop properly?
A condition called spina bifida
215
From where do the ribs develop?
Processes from the vertebrae
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From where does the sternum develop?
Mesoderm in the anterior body wall
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From where is the skeleton of the girdles and limbs derived?
Mesoderm
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When do upper limb buds appear?
During the middle of the fourth week after fertilization
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When do lower limb buds appear?
About 2 days after the upper limb buds
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What do limb buds consist of?
Mesenchyme covered by ectoderm
221
What will some of the mesoderm surrounding the developing bones become?
Skeletal muscles of the limbs
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When do the limb buds develop a constriction around the middle portion?
By the sixth week
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What does the constriction in the upper limb bud produce?
Hand plates
224
What does the constriction in the lower limb bud produce?
Foot plates
225
What do hand plates and foot plates represent?
The beginnings of the hands and feet
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What type of skeleton is present in the limbs at this stage?
A cartilaginous skeleton formed from mesenchyme
227
When do the arm, forearm, and hand become evident in the upper limb bud?
By the seventh week
228
When do the thigh, leg, and foot appear in the lower limb bud?
By the seventh week
229
When do the shoulder, elbow, and wrist areas become apparent?
By the eighth week
230
What are the limb buds called by the eighth week?
The upper limb and the lower limb
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When does endochondral ossification of the limb bones begin?
By the end of the eighth week after fertilization
232
When are primary ossification centers present in most limb bones?
By the twelfth week
233
When do most secondary ossification centers appear?
After birth
234
What does the term hip fracture refer to?
A break in the proximal end of the femur (head, neck, and trochanteric regions)
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What bones may a hip fracture also involve?
The bones that form the acetabulum
236
In which age group do the majority of hip fractures occur?
Individuals older than 60
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How does the frequency of hip fractures change beyond age 60?
It increases even more
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What is the estimated incidence of hip fractures in the United States per year?
Between 300,000 to 500,000
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What is the most common cause of a hip fracture in the elderly?
A fall
240
What are causes of hip fractures in younger people?
Automobile accidents, falls from significant heights, or severe trauma
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What are complications of hip fractures?
Blood clots, pneumonia, muscle atrophy (decrease in muscle mass), postoperative infection, and bedsores
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What condition predisposes elderly people to hip fractures?
Decreases in bone mass due to osteoporosis
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In which group does osteoporosis occur more often?
Females
244
What are other contributing factors to hip fractures?
Lack of physical activity, low body weight, inadequate calcium and vitamin D intake, excessive alcohol consumption, cigarette smoking, vision problems, and dementia
245
What treatment do hip fractures often require?
Surgical treatment
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What is the goal of surgical treatment for hip fractures?
To repair and stabilize the fracture, increase mobility, and decrease pain
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How is the repair of a hip fracture sometimes accomplished?
By using surgical pins, screws, nails, and plates to secure the head of the femur
248
What may be replaced in severe hip fractures?
The femoral head or the acetabulum of the hip bone
249
What are the prostheses used to replace the femoral head or acetabulum called?
Artificial devices
250
What is hemiarthroplasty?
The procedure of replacing either the femoral head or the acetabulum
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What is the meaning of "hemiarthroplasty" based on its word parts?
Hemi- = one-half, -arthro- = joint, -plasty = molding
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What is total hip arthroplasty?
The replacement of both the femoral head and acetabulum
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What material is the acetabular prosthesis made of?
Plastic
254
What material is the femoral prosthesis made of?
Metal
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What are the prostheses designed to withstand?
A high degree of stress
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How are the prostheses attached to healthy portions of bone?
With acrylic cement and screws
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An inherited deformity in which the foot is twisted inferiorly and medially, and the angle of the arch is increased; occurs in 1 of every 1000 births. Treatment consists of manipulating the arch to a normal curvature by casts or adhesive tape, usually soon after birth. Corrective shoes or surgery may also be required.
Clubfoot or talipes equinovarus
258
A deformity in which the knees are abnormally close together and the space between the ankles is increased due to a lateral angu lation of the tibia in relation to the femur. Also called knock-knee.
Genu valgum
259
A deformity in which the knees are abnormally separated, there is a medial angulation of the tibia in relation to the femur, and the lower limbs are bowed laterally. Also called bowleg.
Genu varum
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Angulation of the great toe away from the midline of the body, typically caused by wearing tightly fitting shoes. When the great toe angles toward the next toe, there is a bony protrusion at the base of the great toe. Also called a bunion.
hallux valgus
