Lecture 12 Flashcards

1
Q

synovial joint

A
  • 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
Q

what are the 6 features of the synovial joints?

A
  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)
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3
Q

picture of the 6 features

A
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4
Q

other features of synovial joints

A

fatty pads

articular discs (menisci)

bursae

tendon sheaths

  • protection for bones… we don’t want bones to hit bones
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5
Q

fatty pads

A

cusing between fibrous layer and synovial membrane or bone

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

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6
Q

articular discs (menisci)

A

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

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7
Q

bursae

A

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

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8
Q

tendon sheaths

A

elongated bursa wrapped completely around tendon subjected to frictions

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9
Q

arm and the synovial joint pic

A
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10
Q

knee and synovial joint pic

A
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11
Q

what are the six types of synovial joints

A
  1. plane
  2. hinge
  3. pivot
  4. condylar
  5. saddle
  6. ball and socket
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12
Q

plane joint

A
  • 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
Q

Hinge Joints

A
  • 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
Q

pivot joint

A
  • 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
Q

Condylar joint

A
  • 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
Q

saddle joint

A
  • 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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17
Q

Ball and Socket Joint

A
  • 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
Q

summary of joints

A
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19
Q

describe the lower limb

A

anchored to the axial skeletron by the acroiliac jont and ligaments

divided into: gluteal region, thigh, leg and foot

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20
Q

nerves

A
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21
Q

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

A
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22
Q

Ilio-inguinal

A

spinal segment: L1

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

sensory: skin over anteromedial thigh and adjacent perinum

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23
Q

genitofemoral nerve

A

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

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24
Q

femoral nerve

A

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

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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
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*
36
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
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
49
muscles the externally rotate the femur chart
50
gluteus chart
51
branches of the lumbosacral plexus associated with the lower limb part 1 chart
52
branches of the lumbosacral plexus associated with the lower limb part 2 chart
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
54
superior gluteal nerve
passes through greater sciatic foramen above piriformis travels between the gluteus medius and minimus **supplies gluteus medius and minimus**
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 fo**ot
56
ingerior gluteal nerve
passes through greater sciatic foramen below pififormis ## Footnote **innervates gluteus maximus**
57
Quadratus Femoris
passes through greater sciatic foramen below pififormis and deep to sciatic ## Footnote **innerverates quadrtus femoris and inferior gemellus**
58
obturator internus
passes through treater sciatic foramen below pififormis between post cutaneous and pudendal ## Footnote **innervates obstrurator internus and superior gemellus**
59
posterior cutaneous nerve of the thigh
passes through greater sciatic foramen below piriformis and medial to sciatic ## Footnote **innervates skin over gluteal fold, posterior thigh and parts of perineum**
60
pudendal nerve
passes through greater sciatic foramen below piriformsis and medial to sciatic somatic innervation of perineum **no gluteal innervation**
61
perforating cutaneous nerve
exits the pelvic cavity by piercing the sacrotuberous ligament ## Footnote **innervates skin over medial gluteus maximus**
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
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
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
65
veins
travel with the same named arteries (inferior gluteal veins and superior gluteal veins)
66
lymphatics
deep vessels accompany gluteal blood vessels into the pelvic cavity and drain into internal iliac nodes superficial drain into superficial inguinal nodes