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Anatomy (MPAS) > Lecture 12: MSK 3 > Flashcards

Lecture 12: MSK 3 Flashcards

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1
Q

General function of lower extremity

A

Responsible for stability (posture) and locomotion

Concentric and Eccentric (muscles shorten and lengthen)

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2
Q

Three regions of lower extremity

A

Pelvic region: between iliac crest and gluteal fold

Thigh: between hip and knee

Lower leg: below the knee

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3
Q

How are bones arranged in pelvic girdle?

A

Bones form a complete ring: basin

See figure

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4
Q

Role of pelvic girdle

A

Weight bearing

Bipedal movement (upright walking)

Protects reproductive organs

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5
Q

What is the hip bone composed of?

A

aka innominate bone

Three bones that fuse together (Y shape in acetabulum)

Ilium

Ischium

Pubis

See figure

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6
Q

Ilium (shape, location, role)

A

Large fan shape

Makes up proximal portion of innominate bone

Protects lower abdominal contents

Provides surface area for attachment of large powerful muscles

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7
Q

Ischium location

A

Posterior and inferior aspect of innominate bone

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8
Q

Pubis location

A

Anterior/inferior aspect of the innominate bone

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9
Q

Where is the sacroiliac joint?

A

Between the auricular surface of the ilium and the auricular surface of the sacrum

See figure

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10
Q

Sacroiliac joint type

A

Partly synovial (anterior)

Partly fibrous (posterior)

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11
Q

Movement allowed by sacroiliac joint

A

Some flexion/extension

Important in walking and full forward flexion

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12
Q

How is the sacroiliac joint supported?

A

Very strong ligaments

  1. Sacroiliac ligaments (ant/post)
  2. Sacrospinous ligament
  3. Sacrotuberous ligament
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13
Q

Where is the symphysis pubis?

A

Point where the two pubic bodies join anteriorly

See figure

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14
Q

How are the pubic bones joined?

A

Two very strong ligaments superiorly and inferiorly

Dense fibrocartilagenous disc in between which allows minimal movement

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15
Q

What does pregnancy do to the pubic symphysis?

A

Softens and loosens the pubic symphysis

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16
Q

Hip joint type

A

Ball and socket

Synovial and multi-axial

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17
Q

What bones articulate in the hip joint?

A

head of the femur and the acetabulum of the innominate bone

It is one of the most secure, yet very mobile joints

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18
Q

What is the acetabulum?

A

Incomplete ring on the lateral surface of the innominate bone

See figure

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19
Q

What closes the acetabulum?

A

transverse acetabular ligament

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20
Q

What is the acetabular fossa?

A

Deepest part of the acetabulum

Does not articulate with the femur

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21
Q

What is the lunate surface of the acetabulum?

A

Horseshoe shaped articular
(hyaline) cartilage

Articulates with the head of the femur

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22
Q

Parts of femur (proximal end) and functions

A

Neck: joins the head to the shaft of the long bone

Greater and lesser trochater: prominences for muscle attachments

Intertrochanteric line: joint and ligaments attach here

See figure

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23
Q

Characteristics of hip joint and capsule

A

Tight, strong, extensive

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24
Q

Where doe the hip joint capsule extend from? What is it reinforced by?

A

Extends from just beyond the outer edge of the acetabulum over femur to attach to level area around intertrochanteric line.

Reinforced by 3 strong thick ligaments which all resist excessive abduction: Ilio-femoral, Ischio-femoral, Pubo-femoral

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25
What bones form the knee joint?
Femur, patella, tibia Fibula is not part of knee joint See figure
26
What is the largest and most complex joint in the human body?
Knee joint
27
Knee joint type?
Synovial Modified hinge
28
Stability of knee joint
Lacks bony stability Stability is dependent on soft tissue structures (muscles, tendons and ligaments)
29
What bones form the patellofemoral joint (PFJ)?
Articulation between the trochlea of the femur and the posterior surface of the patella.
30
What is the centerpiece of the extensor mechanism?
PFJ
31
Knee movements
Modified Hinge Joint: “Screw Home Mechanism”: rotates when it comes into full extension Primary: Flexion / Extension (approx. 135 degrees) Secondary: Medial / Lateral Rotation when flexed (Approx. 45 degrees when knee flexed to 90 degrees)
32
Ligamentous support of the knee
Medial collateral ligament (MCL) Lateral collateral ligament (LCL) Anterior cruciate ligament (ACL) Posterior cruciate ligament (PCL) Meniscus
33
Shape of MCL
Fan shaped
34
What does the MCL attach to?
medial femoral epicondyle proximally and medial surface of the tibia distally Also attached to the medial meniscus
35
Role of MCL
Resists valgus force See figure
36
Shape of lateral collateral ligament (LCL)
Cord like Easily palpated
37
What is LCL attached to?
From lateral epicondyle of the femur to fibular head
38
Role of LCL
Resists varus force
39
Where are cruciate ligaments of knee found?
Contained in thin, vascularized envelope formed by synovial lining
40
Blood supply of cruciate ligaments
Poor blood supply Inadequate ability to heal
41
Function cruciate ligaments
1° restraint: Tibial translation (TT) 2 ° restraint: Int / Ext rotation and Varus / Valgus angulation
42
Location/attachments of ACL
APEX Attaches to the Anterior portion of the intercondylar eminence. Runs in a Posterior / Superior direction Runs towards the External aspect of the joint Note: medial surface of the lateral femoral condyle
43
Location/attachment of PCL
PAIN Attaches to the Posterior aspect of the intercondylar eminence Runs in and Anterior direction toward the front of the knee joint Runs inward towards the Internal aspect of the Note: lateral surface of the medial femoral condyle
44
Medial meniscus (shape, attachments)
C shaped disc like structure with a high outer edge attached to joint capsule and medial collateral ligament (MCL)
45
Lateral meniscus (shape, attachments)
O shaped disc like structure with a high outer edge connected to popliteus muscle
46
Function of meniscus
1 .Deepen the tibial surface to increase joint stability. 2. Spreads out the load bearing force on the joint. 3. Helps in the control of rotational and gliding motion at the tibio-femoral joint. 4. Helps circulate the synovial fluid thru the joint.
47
Tibia and fibula
See figure
48
Bones of foot vs bones of hand
Analogous to the bones of the hand but modified for weight bearing and locomotion.
49
What are the bones of the foot?
7 tarsals (talus, calcaneous, cuboid, navicular, lateral cuneiform, intermediate cuneiform, medial cuneiform) 5 metatarsals 14 phalanges See figure
50
Ankle joint type? Composition?
Synovial joint Comprised of 2 joints (Talocrural and subtalar)
51
Stability of ankle joint
Stable in dorsi flexion Unstable in planter flexion Strong ligaments Weak muscles
52
Which ankle joint is the true ankle joint?
Talocrural
53
Bones that form talocrural joint
Between the distal end of the tibia & fibula and the talus Referred to as a brick and mortar joint because of its bony configuration The tibia and fibula form a mortise in which the dome of the talus fits. See figure
54
Stability of talocrural joint
More stable in eversion then inversion
55
Bones that form subtler joint
The joint between the superior aspect of the calcaneus and the inferior aspect of the talus.
56
Ankle joint movements
Talocrural: dorsiflexion, plantar flexion Subtalar: inversion, eversion See figure
57
What are the lateral ligaments of the ankle?
1. Anterior Talofibular 2. Calcaneofibular 3. Posterior Talofibular See figure
58
Where are the medial ligaments of the ankle?
Extends from the medial malleolus of the tibia and attaches on the talus, calcaneus, & navicular bones
59
What are the gluteal region muscles?
Gluteus Maximus Gluteus Medius Gluteus Minimus Piriformis See figure
60
What is the largest muscle of the gluteal region?
Gluteus maximus
61
Actions of gluteus maximus
Extension of the hip Lateral rotation of the extended hip Composite motion: push-off in skating
62
Innervation of gluteus maximus
Inferior gluteal nerve
63
Role of gluteus medius and minimus
Critical stabilizer of pelvis during single leg support such as walking & running Maintains horizontal pelvic alignment during single leg stance phase Inability to stabilize results in “waddling” or Trendenlenburg gait pattern.
64
Actions of gluteus medius and minimus
Internal Hip Rotation Abduction of Hip
65
Innervation of gluteus medium and minimus
Superior Gluteal Nerve
66
What is the trendelenburg sign?
When gluteus medius and minimus are inactive, they cannot provide support The pelvis falls on the side of the raised limb
67
Where is the piriformis in relation to the gluteal muslces? Where does it arise from?
Deep to the gluteal muscles Exits the pelvis to the gluteal region via the greater sciatic foramen
68
Where is the sciatic nerve in reference to the piriformis?
Sciatic nerve is just inferior to piriformis
69
Action of piriformis
Lateral rotation of hip
70
Innervation of piriformis
Nerve to piriformis
71
Composition of the ilio-psoas?
2 separate muscles at the proximal end (poas major and iliacus) join distally and have common attachment on femur
72
Actions of ilio-psoas
Flexion of thigh / hip joint
73
Innervation of ilio-psoas
Psoas: Ventral rami L1–L3 • Iliacus: Femoral nerve
74
Sartorius location, shape, attachments
Superficial, Strap like Runs from lateral hip to medial knee Longest muscle in body
75
Action of sartorial
Knee & Hip Flexion NB: when need both at same time
76
Innervation of sartorial
Femoral nerve
77
Other name for sartorius
“TAILOR SIT MUSCLE” FABER FLEXION, ABDUCTION, EXTERNAL, ROTATION OF HIP, FLEXION OF KNEE
78
Which muscles allow hip extension?
*Gluteus Maximus Hamstrings Adductor Magnus
79
Which muscles allow hip flexion?
* Ilio Psoas * Rectus Femoris TFL Pectineus Adductor longus & brevis
80
Which muscles allow hip abduction?
* Gluteus Medius * Gluteus Minimus Tensor Fascia Lata (TFL) Ilio-Tibial Band (ITB)
81
Which muscles allow hip adduction?
* Pectineus * Adductor Magnus * Gracilis * Adductor longus & brevis
82
Which muscles allow internal rotation of hip?
* Gluteus medius | * Gluteus minimus
83
Which muscles allow external rotation of hip?
* Glut Maximus * Piriformis Obturator Internus & Externus Superior & Inferiorm Gemelli Quadratus Femoris
84
What joint do the medial thigh muscles cross?
Hip joint Only one crosses the knee (gracilus)
85
Common action of medial thigh muscles
Hip adduction
86
Innervation of medial thigh muscles
Obturator nerve
87
What are the medial thigh muslces?
1. Adductor Brevis 2. Adductor Longus 3. Adductor Magnus 4. Pectineus 5. Gracilis
88
Function of anterior thigh muscles
Large, powerful, anti-gravity Essential for activities of daily living
89
Innervation of anterior thigh muscles
Femoral nerve
90
Blood supply of anterior thigh muscles
Femoral artery and vein
91
Quadriceps femoris muscle group
Rectus femoris Vasti medialis Vasti intermedius Vasti lateralis
92
Rectus femoris (joints crossed, movement)
Rectus Femoris: Straight superficial portion that crosses both hip and knee joints Power hip flexion / knee extension
93
Vasti components of quadriceps femurs group (location, movement)
Surround the shaft of femur and wrap around thigh from back. Knee extension
94
Where do the quadriceps femoris muscles insert?
Tibial tuberosity via the quadriceps tendon - patella - patellar tendon/ligament
95
Innervation of quadriceps femurs group
Femoral nerve
96
Hamstring muscles
Biceps femoris Semi-membranosus Semi-tendinosis
97
Joints crossed by hamstrings, origin
Hip and knee origin: ischial tuberosity (innominate bone)
98
Movement of hamstrings
Rotation of flexed knee Modified hinge joint
99
Innervation of hamstrings
Sciatic nerve
100
What muscles are attached to the illiotibial band?
Tensor fascia latae Gluteus maximus See figure
101
Muscles of anterior compartment of lower leg, innervation
1. Tibialis anterior 2. Extensor Hallucis longus 3. Extensor Digitorum longus 4. Peroneus tertius All innervated by Deep peroneal nerve
102
Muscles of lateral compartment of lower leg? Innervation? what do they wrap around?
1. Peroneus Longus 2. Peroneus Brevis All innervated by Superficial peroneal nerve (L5-S2) All wrap around lateral malleolus
103
Muscles of superficial posterior compartment of lower leg? Innervation? attachment?
1. Gastrocnemius 2. Soleus 3. Plantaris All innervated by Tibial Nerve Common distal attachment: Achilles tendon
104
Muscles of deep posterior compartment of lower leg? Innervation? attachment?
1. Tibialis Posterior 2. Flexor Digitorum Longus 3. Flesor Hallicus Longus All innervated Tibial nerve Arise from posterior fibula & tibia All wrap around medial malleolus
105
Borders of femoral triangle
Inguinal ligament Sartorius Adductor longus
106
Floor of femoral triangle
Iliopsoas Pectineus Adductor longus
107
Contents of femoral triangle (medial to lateral)
Femoral Vein Femoral Artery Femoral Nerve
108
Blood supply to the lower extremity
See figure
109
Innervation of the lower extremity
See figure

Anatomy (MPAS) (22 decks)

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