Lecture 12 Flashcards Preview

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Flashcards in Lecture 12 Deck (66):
1

synovial joint 

  • bones separated by fluid-filld joint cavity 
  • are diarthrotic 
  • synovial joints are very mobile so they have less stability.... so we need ligaments 

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2

what are the 6 features of the synovial joints?

  1. articular cartliage 
    • caps at the end of the bone... smooth cap to make smooth movement
  2. synovial caivty 
    • space between the two bone that make the join
  3. synovial fluid 
    • made by the synovial membrane 
  4. jont capsule 
    • fibrous layer (external) 
    • synovial membrane (inner, makes synovial fluid)
  5. reinforcing ligaments (extra ligments) 
  6. nerves and blood vessles (nevers ging throgh) 

3

picture of the 6 features 

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4

other features of synovial joints 

fatty pads 

articular discs (menisci) 

bursae 

tendon sheaths 

 

- protection for bones... we don't want bones to hit bones 

5

fatty pads 

cusing between fibrous layer and synovial membrane or bone 

 

sorrounding places where bone come into contact with each other....extra adipose for cushioning 

6

articular discs (menisci) 

fibrocartilage separates articular surface to improve "fit" of bone ends, stabilize joint and reduce wear and tear 

 

menisci only in knee joint for the femur to have nice snug fit....makes a nice cushion to reduce wear and tear 

7

bursae 

sace lined with synovial membrane (contain synovial fluid)...any place where we'll have some tension 

reduce friction where ligaments, muscles, skin, tendons, or bones rub together 

8

tendon sheaths 

elongated bursa wrapped completely around tendon subjected to frictions 

 

 

9

arm and the synovial joint pic 

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10

knee and synovial joint pic 

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11

what are the six types of synovial joints 

  1. plane 
  2. hinge 
  3. pivot 
  4. condylar 
  5. saddle 
  6. ball and socket 

12

plane joint 

  • 2 flat structures that slide across one another 
  • found in
    • intercarpals joints 
    • intertarsal joints 
    • joints between vertebral articular surfaces 
  • non axial so allows for micromovements 

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13

Hinge Joints 

  • like a door frame 
  • uniaxial== flexion and extension is the only movement 
  • Found in : 
    • elbow 
    • knee 
    • interphalangeal joint (joint within the finger itself) 

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14

pivot joint 

  • used for pivot motions 
  • found in 
    • proximal radioulna joints 
    • atlantoaxial joints (neck)
  • allows the radius to spin around the ulna 
  • uniaxial beacuse only moving in one place, spinning on the long axis of the bone 

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15

Condylar joint 

  • has concave and convex surface 
  • biaxial... move in both sagitall and coronal place... 
  • allows flexion and extension and abduct and adduction 
  • found in: 
    • metacarpophalangeal (knuckle) joints 
    • wrist joins 

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16

saddle joint 

  • only found in carpometacarpal joints of the thumbs 
  • concave and convex ... aloows for the same movement as the condyler ( flexion&extension and abduction&adduction)
  • Thumb attachment to wrist 
  •  

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Ball and Socket Joint 

  • most mobile and least stable..
  • found in 
    • head of humorous sit it socket by scapula (glenoid fossa) 
    • head of femur sit in socket by ilium and ishium (acetabelum) 
  • multiaxial..
    • flexion and tension 
    • adduction and abduction 
    • rotation 

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18

summary of joints 

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19

describe the lower limb 

anchored to the axial skeletron by the acroiliac jont and ligaments 

 

divided into: gluteal region, thigh, leg and foot 

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20

nerves 

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21

Branches of the lumbosacral plexus associated with the lower limb -- first 1 

 

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22

Ilio-inguinal 

spinal segment: L1 

Motor: none in the lower limb (innervates muscles of abdominal wall) 

sensory: skin over anteromedial thigh and adjacent perinum 

23

genitofemoral nerve 

spinal segment: L1 -:2 

motor: none in lower limb (genital branch innervates cremaster) 

sensory: skin on anterior central thigh, genital branch innervates skin on anterior perineum 

24

femoral nerve 

spinal segment: L2- L4 

motor: muscles in the anterior compartment of thigh, branches supply iliacus and pectineus

sensory: skin over anterior thing, anteromedial knee, medial leg and medial foot 

 

25

obturator nerve 

spinal segment: L2- L4 

motor: muscles in the medial compartment of thigh (except pectineus and part of adductor magnus), obturator externus 

sensory: skin over upper medial thigh 

26

branches of the lumbosacral plexus associated with the lower limb -- part 2 

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27

sciatic 

spinal segment: L4 -S3 

motor: muscle in posterial thigh, part of adductor magnus (ischium), muscles in the leg and foot 

sensory: skin over lateral leg and foot, sole and dorsal surface of foot 

28

superior gluteal 

 

 

spinal segment: L4- S1 

motor: gluteus medius, gluteus minimus, tensor fascia lata 

sensory: none 

29

inferior gluteal 

spinal segment: L5 -S2 

motor: gluteus maxims 

sensory: on 

30

lateral cutaneous nerve of the thigh 

spinal segment: L2- L3

motor: none 

sensory: parietal peritoneum in iliac fossa, skin over anterolateral thigh 

31

posterior cutaneous nerve of the thigh 

Spinal segment: S1-S3 

motor: none 

sensory: skin over upper medial aspect of thigh and adjacent perineum, post thigh and upper post leg 

32

nerve to quadratus femoris 

spinal segment: L4-S1 

motor: quadratus femoris and inferor gemellus 

sensory: none 

 

33

nerve to obturator internus 

spinal segment: L5- S2 

motor: obturator internus and superior gemellus 

sensory: none 

34

perforating cutaneous nerve 

spinal segment: S2- S3

motor: none 

sensory: skin over medial gluteal fold 

35

Muscles of the gluteal region 

superfical group of larger muscles which abducg and extend the hip 

gluteus maximus 

gluteus medius 

gluteus minimus 

tensor fascia latae 

gluteus minimus is the deepest, medius is the middle, tensor fascia latae

....insers into the IT band 

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37

IT band 

Ilotibia tract ... thick fascia along the later aspect of the thigh 

38

Gluteus minimus 

origin: posterior ilium btween anterior and inferior gluteal lines 

insertion: greater trochanter 

innervation: superior gluteal nerve 

action: abduct femur- stabiliaztion of pelvis during single leg stance 

39

gluteus medius 

origin: posterior ilum between anterior and posterior gluteal lines 

inserton: greater trochanter 

innervation: superior gluteal nerve 

action: abduct femur-stabilization of pelvis during single leg stance 

 

important for stabilization of pelvis... keep hip stable, and prevent hip from dropping every step 

40

gluteus maximus 

origin: fascia covering gluteus medius, posterior ilium, fascia or erector spinae, dorsal surface of sacrum, coccyx, sacrotuberous ligament (originates on the ileum and sacrus and to coccyx, fibers run diagonal)

Insertion: posterior ilotibila tract and gluteal tuberosity 

innervation: inferiro gluteal nerve 

action: extension, lateral rotaton, abduction of hip 

 

passes over the posterior aspect of hip and allows for extension of hip....diagonial nature of fiber allows it to pass over the lateral aspect of hip to cause abduction and a little rotation 

41

tensor fascia lata

origin: lateral cest of ilium between ASIS and tubercle of crest 

insertion: Iliotiila tract of fascia lata 

innervation: superior gluteal nerve 

action: stabilizes knee in extension 

42

what are the deep group of small muscle which externally rotate the femur?

piriformis 

obturator internus 

superior gemellus 

inferior gemellus 

quadratus femmoris 

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43

Piriformis 

origin: anterior surface of sacrum 

insertion: greater trochanter 

innervation: branches S1-S2 

action: laterally rotate extneded hip; abduct flexed femur 

44

obturator internus 

origin: anterolateral wall of true pelvis, obturator membrane 

insertion: greater trochanter 

innervation: nerve to obturator internus 

action: laterally rotate extended hip; abduct flexed femur 

45

superior gemellus 

origin: external surface of ischial spine 

innertion: superiro surface of obturator internus tendon and greater trochanter 

innervation: nerve to obturator internus 

action: laterally rotate extended hip, abduct flexed femus 

46

Inferior gemellus 

origin: upper aspect of ischial tuberosity 

insertion: inferior surface of obturator internus tendon and greater trochanter 

innervation: nerve to quadratus femoris 

action: laterally rotate extended hip, abduct flexed femus 

47

quadratus femoris 

origin: lateral aspect of ischium anterior to ischial tuberosity 

insertion: quadrate tubercule on intertrochanteric crest 

innervation: nerve to quadratus femoris 

action: laterally rotate femur 

48

picture 

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49

muscles the externally rotate the femur chart 

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50

gluteus chart 

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51

branches of the lumbosacral plexus associated with the lower limb part 1 chart 

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52

branches of the lumbosacral plexus associated with the lower limb

part 2 chart 

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53

Trendelenburg Sign 

happens in people with weak or paralyzed abductors....

when patient stand on leg, the pelvis drops on the lifted leg side ....seen in patients with superior gluteal nerve damage 

gait is abnormal... weakened abductor muscles allow pelvis to tilt, patient compensates by tiliting the trunk the other way to maintain levle of the trunk during gait 

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54

superior gluteal nerve 

passes through greater sciatic foramen above piriformis 

travels between the gluteus medius and minimus 

supplies gluteus medius and minimus 

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55

sciatic nerve 

 

passes through greater sciatic foramen below pififormis 

descends between superfical and deep gluteal muscles, enters posterior thigh

innervates all of the muscles of the posterior compartment of thigh and muscles that move ankle and foot 

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56

ingerior gluteal nerve 

passes through greater sciatic foramen below pififormis 

innervates gluteus maximus 

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57

Quadratus Femoris 

passes through greater sciatic foramen below pififormis and deep to sciatic 

innerverates quadrtus femoris and inferior gemellus 

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58

obturator internus 

passes through treater sciatic foramen below pififormis between post cutaneous and pudendal 

innervates obstrurator internus and superior gemellus 

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59

posterior cutaneous nerve of the thigh 

passes through greater sciatic foramen below piriformis and medial to sciatic 

innervates skin over gluteal fold, posterior thigh and parts of perineum 

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60

pudendal nerve 

passes through greater sciatic foramen below piriformsis and medial to sciatic 

somatic innervation of perineum 

no gluteal innervation 

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61

perforating cutaneous nerve 

exits the pelvic cavity by piercing the sacrotuberous ligament 

innervates skin over medial gluteus maximus 

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62

Intramuscular injections 

injection in the upper outer quadrant ... to avoid sciated nerve and superior gluteal vessels and nerve 

must be careful not to damage neurovascular structures 

inject into gluteus medius anterosupeiror to gluteus maximus 

 

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63

Inferor gluteal artery 

originates from anterior trunk of internal iliac artery

exits greater sciatic foramen below pififormis with nerve 

supplies surrounding muscles and descends into posterior thing where it anastomoses with branches of femoral artery 

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64

superior gluteal artery 

originates from posterior trunk of internal iliac artery

exits greater sciatic foramen above piriformis with nerve 

divides in gluteal region...

superifical branch==passes onto deep surface of gluteus maximsu 

deep branch== passes between gluteus medius and minimus 

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65

veins 

travel with the same named arteries 

(inferior gluteal veins and superior gluteal veins) 

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66

lymphatics 

deep vessels accompany gluteal blood vessels into the pelvic cavity and drain into internal iliac nodes 

 

superficial drain into superficial inguinal nodes 

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