MSK: Anatomy Flashcards
(238 cards)
1
Q
What are tubercles, tuberosities, and trochanters, condyles, and epicondyles?
A
Rounded projections of bone.
Condyles and epicondyles are at the articulating end.
2
Q
Name 6 types of synovial joints.
A
Pivot
Hinge
Saddle
Ball-and-socket
Condyloid
Plane
3
Q
What is the difference between the origin and insertion of a muscle?
A
The origin is the attachment site that doesn’t move during contraction, while the insertion is the attachment site that does move when the muscle contracts.
4
Q
What are the main branches of the main upper limb arteries?
A
Subclavian artery -> axillary -> brachial -> radial & ulna.
5
Q
What are the main branches of the main lower limb arteries?
A
Common iliac artery -> external iliac -> femoral -> popliteal -> tibial/fibula
6
Q
What type of joint is the glenohumeral joint, and what two bones form this joint?
A
Synovial ball and socket joint.
Scapula and humerus.
7
Q
What type of joint is the elbow?
A
Synovial hinge joint.
8
Q
What joint is formed by the articulation between the distal radius and two of the carpal bones? What type of joint is this?
A
Radiocarpal joint.
Synovial condyloid joint.
9
Q
What is protraction and retraction of the scapula?
A
Protraction = moving anteriorly e.g. reaching forwards
Retraction = moving posteriorly e.g. pulling shoulder back
10
Q
What articulation is found at the proximal/medial end of the clavicle?
A
Clavicle articulates with the manubrium of the sternum (sternocalvicular joint).
11
Q
What articulation is found at the distal/lateral end of the clavicle?
A
Clavicle articulates with the acromion of the scapula (acromiovlavicular joint).
12
Q
What ridge is palpable on the posterior surface of the scapula?
A
The spine
13
Q
What does the lateral end of the spine of the scapula expand to form?
A
The acromion
14
Q
What ‘beak-like’ projection of the scapula sits inferior to the acromion on the anterior surface of the scapula, and provides the site of attachment for several muscles?
A
Coracoid process (Greek: ‘raven-like’)
15
Q
What structures form the pectoral girdle?
A
Clavicle, scapula, and attached muscles.
16
Q
What part of the lateral aspect of the scapula does the head of the humerus articulate with at the glenohumeral joint?
A
Glenoid fossa
17
Q
What two small projections of bone superior and inferior to the glenoid fossa of the scapula are important sites for muscle attachments?
A
Supraglenoid and infraglenoid tubercles.
18
Q
What two projections of bone on the proximal humerus provide important sites for muscle attachment?
A
Greater and lesser tubercles.
19
Q
Why can fractures of the surgical neck of the humerus or shoulder dislocations cause numbness/weakness in the affected arm?
A
The axillary nerve runs medially to the surgical neck of the humerus. Anterior shoulder dislocation can put pressure on and potentially damage the axillary nerve.
20
Q
What slight protuberance of the upper lateral aspect of the humeral shaft is an important site of muscle attachment?
A
Deltoid tuberosity (attachment of deltoid muscle).
21
Q
Why can mid-shaft humeral fractures damage the radial nerve?
A
The radial (or spiral) groove runs along the posterior aspect of the humeral shaft and can be injured in mid-shaft humeral fractures.
22
Q
What important movement is the scapula capable of which allows the arm to be raised above the head?
A
Rotation.
23
Q
What large superficial muscle of the posterior pectoral girdle attach the scapula to the skull, cervical, and thoracic vertebrae?
What four movements does contraction of this muscle allow in the scapula?
A
Trapezius.
Rotation, elevation, retraction, depresses.
24
Q
What are the three smaller deeper muscles of the posterior pectoral girdle, that attach the scapula to the vertebral column?
A
Levator scapulae
Rhomboid major
Rhomboid minor
25
Contraction of what two small deep muscles of the posterior pectoral girdle, that attach the medial border of the scapula to the vertebral column, cause retraction of the scapula?
Rhomboid major (C7 and T1 origin)
Rhomboid minor (thoracic vertebrae origin)
26
What large superficial muscle of the posterior pectoral girdle, originates from the lower thoracic vertebrae and inserts onto the humerus, and causes extension, adduction, and internal rotation of the humerus?
Latissimus dorsi.
27
Most of the muscles of the posterior pectoral girdle are innervated by branches of the brachial plexus.
What nerve innervates the trapezius muscle?
Accessory nerve (CN VI) - NOT the brachial plexus!
28
What branch of the brachial plexus innervates the latissimus dorsi muscle of the posterior pectoral girdle?
Thoracodorsal nerve.
29
What six muscles attach the scapula to the humerus to move and stabilise the shoulder joint?
Deltoid
Supraspinatus
Infraspinatus
Subscapularis
Teres minor
Teres major
30
What four muscles have tendons which fuse with the fibrous capsule that surrounds the shoulder joint, working together to form the stabilising rotator cuff?
Supraspinatus
Infraspinatus
Teres minor
Subscapularis
("SITS")
31
What three bones does the deltoid muscle attach to?
Lateral part of the clavicle
Spine of the scapula
Humerus
32
What branch of the brachial plexus innervates the deltoid muscle?
Axillary nerve.
33
What muscle is a powerful abductor of the shoulder joint, but cannot initiate abduction?
Deltoid
34
What muscle initiates abduction of the shoulder?
Supraspinatus
35
The tendon of what muscle can be inflamed and pinched between the acromion and the humerus during shoulder movements (impingement)?
Supraspinatus
36
The axillary nerve travels through the quadrilateral space to enter the posterior scapula region.
What four structures form the boundaries of the quadrilateral space?
Teres minor (superior)
Teres major (inferior)
Long head of the triceps (medial)
Surgical neck of the humerus (lateral)
37
Other than the rotator cuff muscles, what three structures help stabilise the shoulder joint?
Glenoid labrum (rim of fibrocartilage around margin of glenoid fossa)
Ligaments
Tendon of biceps brachii
38
There are five groups of lymph nodes in the axilla that drain the upper limb, breast, chest wall, scapular region, and abdominal wall.
What lymph nodes in the apex of the axilla receive lymph from all these other lymph nodes?
Apical nodes
39
The subclavian artery travels over the first rib and under the clavicle into the axilla.
When does the subclavian artery become the axillary artery?
After it passes over the lateral border of the first rib.
40
When does the axillary artery become the brachial artery?
When it crosses the inferior border of teres major.
41
The brachail and basilic veins join to form the axillary vein, and the cephalic vein also joins in the axilla.
When does the axillary vein become the subclavian vein?
At the lateral border of the first rib.
42
What four bony prominences are found on the distal end of the humerus?
Medial and lateral epicondyles.
Trochlea
Capitellum
43
What does the trochlea, a bony prominence on the distal end of the humerus, articulate with?
The trochlear notch of the ulna.
44
What does the capitellum, a bony prominence on the distal end of the humerus, articulate with?
Head of the radius.
45
What separates the anterior and posterior compartments of the arm?
Intermuscular septa (which extend from the deep brachial fascia which surrounds the arm).
46
What three flexor muscles are found in the anterior compartment of the arm?
What nerve innervates them?
Biceps brachii
Brachialis
Coracobrachialis
Musculocutaneous nerve
47
What do the long and short head of the biceps brachii attach to both proximally and distally?
Proximally:
Long head - supraglenoid tubercle
Short head - coracoid process
Distally:
Converge to insert via a common tendon onto the radial tuberosity of the radius.
48
What movement can the biceps help with when the elbow is flexed?
Supination of the forearm.
49
What muscle attaches to the anterior aspect of the distal half of the humeral shaft, and inserts distally upon the ulna tuberosity to work as a powerful flexor of the elbow?
Brachialis
50
What are the three origin sites of the triceps brachii muscle in the posterior compartment of the arm?
Long head: infraglenoid tubercle of the scapula.
Lateral head: posterior humerus (proximal to radial groove).
Medial head: posterior humerus (distal to radial groove).
51
What is the most medial part of the triceps brachii?
Long head of the triceps.
52
The three muscle bellies of the triceps brachii converge via a common tendon onto a single insertion point. What is this insertion point?
Olecranon of the ulna.
53
What innervates all three parts of the triceps brachii?
Radial nerve.
54
What five spinal nerves are the roots of the brachial plexus, providing motor and sensory fibres to the upper limb?
C5, C6, C7, C8, T1
55
What two spinal nerve roots combine to form the superior trunk of the brachial plexus?
C5 and C6
56
What two spinal nerve roots combine to form the inferior trunk of the brachial plexus?
C8 and T1
57
What spinal nerve roots form the middle trunk of the brachial plexus?
C7
58
What happens to the three trunks of the brachial plexus under the clavicle?
Each trunk divides into an anterior and posterior division.
59
Posterior divisions of all the trunks of the brachial plexus combine to form what main cord?
The posterior cord.
60
What cord does the anterior division of the inferior trunk of the brachial plexus become?
The medial cord.
61
The anterior divisions of the superior and middle trunks of the brachial plexus combine to form what cord?
The lateral cord.
62
What are the five major terminal branches of the brachial plexus?
Axillary
Radial
Musculocutaneous
Ulnar
Median
63
What two branches of the brachial plexus are formed from the posterior cord?
Axillary and radial nerves
64
What branch of the brachial plexus is formed from a branch of the lateral cord and a branch of the medial cord?
Median nerve
65
What branch of the brachial plexus is formed from a branch of the lateral cord?
Musculocutaneous nerve
66
What branch of the brachial plexus is formed from a branch of the medial cord?
Ulnar nerve
67
What two muscles and areas of skin does the axillary nerve provide motor innervation to?
Deltoid and teres minor.
Also a small region of skin over the upper lateral arm.
68
What muscles and areas of skin does the radial nerve provide motor innervation to?
Triceps and all the muscles in the posterior compartment of the forearm.
Regions of skin over the arm, forearm, and hand.
69
What muscles and areas of skin does the musculocutneous nerve innervate?
The three muscles in the anterior compartment of the arm (biceps brachii, brachialis, coracobrachialis).
Skin over the lateral forearm.
70
What muscles and areas of skin does the median nerve innervate?
The small muscles of the thumb and most of the muscles of the anterior forearm.
Skin over lateral aspect of palm of the hand and the lateral digits.
71
Where is the median nerve most vulnerable to damage?
As it crosses the anterior aspect of the elbow - the anterior cubital fossa.
72
What muscles and areas of skin does the ulnar nerve innervate?
Most of the small muscles in the hand.
Skin over the medial aspect of the hand and medial digits.
73
Where is the ulnar nerve most vulnerable to damage?
Behind the medial epicondyle - easily palpable ("funny bone").
74
What connects the radius and ulna?
Interosseous membrane.
75
The trochlear notch of the ulna articulates with what part of the humerus?
The trochlear.
76
The radial head of the radius articulates with what part of the humerus?
The capitellum.
77
Is the olecranon part of the ulna or the humerus?
The ulna.
78
What is the anterior protrusion of the ulna called?
The coronoid process.
79
What are the distal protrusions of the radius and ulna called?
Styloid processes.
80
What type of joint are the proximal and distal radioulnar joints?
Synovial pivot joints.
81
What ligament of the radius wraps around the radial neck and attaches to the ulna to hold the radial head in place, and allows the radial head to rotate within it during pronation and supination?
The annular ligament.
82
How many carpal bones are there?
Eight.
83
What two carpal bones does the radius articulate with to form the radiocarpal joint?
Scaphoid and lunate.
84
What type of joint is the radiocarpal joint?
Condyloid synovial joint.
85
Name the eight carpal bones (first the proximal row, lateral to medial, then the distal row, lateral to medial).
Scaphoid Lunate Triquetrum Pisiform
Trapezium Trapeziod Capitate Hamate
"Some Lovers Try Positions
That They Can't Handle"
86
How many phalanges are in the thumb?
2 (fingers have 3)
87
The cubital fossa (antecubital fossa/ACF) is a triangular-shaped region - what forms its three borders?
Lateral border = brachioradialis
Medial border = pronator teres
Superior border = imaginary line drawn between the medial and lateral epicondyles of the humerus.
88
What two nerves can be found in the cubital fossa (ACF)?
Radial and median.
88
Where does the brachial artery bifurcate into the radial and ulnar arteries?
Deep in the cubital fossa.
89
How can the brachial artery be located?
It is medial to the biceps tendon in the cubital fossa (ACF).
90
What separates the superficial veins from deeper structures - the brachial artery and median nerve - in the cubital fossa (ACF)?
The bicipital aponeurosis (fascial extension of the biceps tendon).
91
What are the three main superficial veins in the cubital fossa (ACF)?
Cephalic, basilic, median cubital.
92
How many muscles are there in the anterior compartment of the forearm?
Eight.
93
The muscles of the anterior forearm are arranged in three layers: superficial, middle, and deep. What are the four muscles in the superficial layer of the anterior forearm, from lateral to medial?
Pronator teres.
Flexor carpi radialis.
Palmaris longus.
Flexor carpi ulnaris.
94
What function do most of the muscles of the anterior compartment of the forearm perform?
Flexors of the wrist, fingers, or thumb.
95
What nerve innervates most of the muscles of the anterior compartment of the forearm?
Median nerve.
96
What do the four superficial muscles of the anterior compartment of the forearm attach to proximally?
Medial epicondyle of the humerus (common flexor origin).
97
What is the muscle in the middle layer of the anterior compartment of the forearm, and how many tendons does it give rise to?
Flexor digitorum superficialis.
Gives rise to four tendons (that attach to digits 2-5).
98
What are the three muscles in the deep layer of the anterior compartment of the forearm?
Flexor digitorum profundus.
Flexor pollicis longus.
Pronator quadratus.
99
The flexor digitorum profundus give rise to four tendons, which attach to digits 2-5. What is significant about the innervation of the flexor digitorum profundus?
The lateral half, which gives rise to tendons attaching to the index and middle fingers, is innervated by the median nerve.
The medial half, which gives rise to tendons attaching to the ring and little fingers, is innervated by the ulnar nerve.
100
Which two muscles of the anterior compartment of the forearm are innervated by the ulnar nerve instead of the median nerve?
The flexor carpi ulnaris
101
What function do most of the muscles of the posterior compartment of the forearm perform?
Extensors of the wrist, digits, or thumb.
102
What nerve innervates ALL of the muscles of the posterior compartment of the forearm?
Radial nerve.
103
What do the majority of the muscles of the posterior compartment of the forearm attach to proximally?
The lateral epicondyle of the humerus (common extensor origin).
104
The muscles of the posterior compartment of the forearm are arranged in two layers, superficial and deep. What are the seven superficial muscles?
Brachioradialis.
Extensor carpi radialis longus.
Extensor carpi radialis brevis.
Extensor digitorum.
Extensor digiti minimi.
Extensor carpi ulnaris.
Anconeus.
105
Which superficial muscle of the posterior compartment of the forearm is located on the boundary between the posterior and anterior compartments and acts as a weak flexor of the elbow joint, hence functioning as an anterior compartment muscle?
Brachioradialis.
106
The extensor digitorum extends the digits via four long tendons inserting onto the dorsal aspects of the fingers. Why is it difficult to extend the middle and ring fingers independently?
The tendons of the extensor digitorum are connected by fibrous bands.
107
What band of tissue prevents the tendons from bowing when the wrist is extended?
The extensor retinaculum.
108
What are the five deep muscles of the posterior compartment of the forearm?
Supinator.
Abductor pollicis longus.
Extensor pollicis brevis.
Extensor pollicis longus.
Extensor indicis.
109
Where is the radial artery palpable?
Lateral to the tendon of flexor carpi radialis, at the level of the distal radius.
110
Why is the ulnar artery harder to palpate than the radial artery?
The ulnar artery lies deep to the tendon of flexor carpi ulnaris.
111
What happens after the radial and ulnar arteries enter the hand?
They anastamose to form palmar arches, to ensure the hand remains adequately perfused if one artery is occluded or injured.
112
What typically connects the cephalic and basilic veins in the cubital fossa (AFC)?
Median cubital vein.
113
The carpal tunnel is a narrow passageway at the wrist. What forms the carpal tunnel?
Floor and sides are formed by carpal bones, roof is formed by the flexor retinaculum.
114
The tendons of the anterior forearm muscles that insert onto the digits travel through the carpal tunnel. What other important structure also travels through the carpal tunnel?
The median nerve.
115
What type of joint is the first carpometacarpal joint, between the trapezium and the first metacarpal (thumb)?
Saddle joint.
116
What type of joints are the MCPJs (metacarpophalangeal joints - the knuckles)?
Condyloid synovial joints.
117
What type of joints are the IPJs (interphalangeal joints)?
Hinge synovial joints.
118
What is the term for movement of the thumb involving a combination of flexion, adduction, and internal rotation of the thumb metacarpal, that results in the thumb touching another finger - required for precision grip?
Opposition.
119
The tendon of the flexor digitorum superficialis (anterior forearm muscle) splits into two 'slips' which insert on either side of the middle phalanx of digits 2-5.
What joints of the digits are flexed by the flexor digitorum superificalis?
Flexes the MCPJs (metacarpophalangeal joints) and PIPJs (proximal interphalangeal joints) of digits 2-5.
120
The tendon of flexor digitorum profundus (anterior forearm muscle) passes through the gap in the flexor digitorum superficialis tendon to insert onto the palmar aspect of the distal phalanx of digits 2-5.
What joints of the digits are flexed by the flexor digitorum profundus?
Flexor digitorum profundus is the only muscle capable of flexing the DIPJ (distal interphalangeal joint). It also flexes the MCPJs (metacarpophalangeal joints) and PIPJs (proximal interphalangeal joints) of digits 2-5.
121
The tendon of the flexor pollicis longus inserts onto the distal phalanx of the thumb.
What is the key function of the flexor pollicis longus?
The flexor pollicis longus is the only muscle that flexes the interphalangeal joint of the thumb.
122
The long flexor tendons of the hand are enclosed in two sheaths, one to maintain the position of the flexor tendons in the midline, and one to reduce friction and allow the tendons to slide freely during flexion and extension. What are these two sheaths?
Fibrous tendon sheath - to maintain position in the midline.
Synovial sheath - to reduce friction.
123
What a strong thickening of the central part of the deep fascia of the palm protects the long flexor tendons, tendon sheaths, and vessels as they pass through the palm of the hand?
Palmar aponeurosis.
124
The hand has both extrinsic and intrinsic muscles. The extrinsic muscles originate in the forearm. The intrinsic muscles are within the hand itself.
What are the four groups of intrinsic muscles (named after their location) and the single muscle which does not belong in these groups?
Thenar eminence (3 muscles)
Hypothenar eminence (3 muscles)
Lumbricals (4 muscles)
Interossei (7 muscles)
Adductor pollicis is the single muscle not within the four groups.
125
What are the three muscles in the thenar eminence of the hand?
Flexor pollicis brevis.
Abductor pollicis brevis.
Opponens pollicis (deepest).
126
What nerve innervates the muscles in the thenar eminence of the hand?
Recurrent branch of the median nerve.
127
Why is the adductor pollicis muscle not included within the muscles of the thenar eminence of the hand?
The muscles of the thenar eminence are all innervated by the recurrent branch of the median nerve, where as the adductor pollicis muscle is innervated by the ulnar nerve.
Also, the adductor pollicis muscle is located deep in the palm, not in the thenar eminence (base of the thumb).
128
What function does the adductor pollicis muscle provide?
Pulls the thumb towards the palm.
129
What is similar between the muscles of the hypothenar eminence and the thenar eminence?
The muscles of the hypothenar eminence and the thenar eminence are mirrors of each other. The thenar eminence is at the base of the thumb, and the hypothenar eminence is on the medial side of the palm of the hand, proximal to the little finger.
130
What are the three muscles in the hypothenar eminence of the hand?
Flexor digiti minimi.
Abductor digiti minimi.
Opponens digiti minimi.
131
What nerve innervates the muscles in the hypothenar eminence of the hand?
Deep branch of the ulnar nerve.
132
There are four lumbrical muscles of the hand, one for each finger, inserting on the dorsal aspects of digits 2-5. What are the origins of the lumbricals?
The tendons of flexor digitorum profundus.
133
What nerve innervates the lumbricals?
The innervation of the lumbricals follows that of the flexor digitorum profundus tendons from which they arise:
Lateral two lumbricals (index & middle) = median nerve.
Medial two lumbricals (ring & little) = ulnar nerve.
134
Where are the interossei muscles of the hand?
Between the metacarpals (originate on metacarpals and insert onto the dorsal aspects of digits 2-5).
135
How many palmar and dorsal interossei muscles are there?
Palmar = 3
Dorsal = 4
136
What different movements do the palmar and dorsal interossei muscles perform?
Palmar = adduct.
Dorsal = abduct.
"PAD-DAB = Palmar ADduct, Dorsal ABduct"
137
What muscles of the hand can be seen on the dorsal aspect?
Only the four dorsal interossei muscles.
138
What veins do the dorsal venous network drain into laterally and medially?
Laterally = cephalic vein.
Medially = basilic vein.
139
What is the extensor hood/extensor expansion?
Fibrous structure located on the dorsal aspect of the digits, that helps keep tendons fixed in the midline and provides an attachment for muscles and tendons.
140
What are the medial and lateral boundaries of the anatomical snuffbox?
Medial = extensor pollicis longus.
Lateral = extensor pollicis brevis & abductor pollicis longus.
141
What vessels are found in the anatomical snuffbox?
Radial artery travels through it.
Cephalic vein travels across it.
142
What bone is found in the floor of the anatomical snuffbox?
Scaphoid.
143
What nerve travels over the anatomical snuffbox?
Superficial branch of the radial nerve.
144
What are the two palmar arches in the palm, and what artery mainly supplies each?
Superficial palmar arch = mainly ulnar artery.
Deep palmar arch = mainly radial artery.
145
Where in the hand does the ulnar nerve innervate?
Palmar and dorsal surfaces of the medial side of the hand, up to half of the ring finger.
146
Where in the hand does the radial nerve innervate?
Dorsal surface of the lateral side of the hand, up to the DIPJs of the thumb, index, middle, and halfway across the ring finger.
147
Where in the hand does the median nerve innervate?
Palmar surface of the hand between thumb and half of ring finger, and the dorsal aspect of the tips of the thumb, index, middle, and halfway across ring finger down to DIPJs.
148
What spinal nerves are tested when examining the dermatomes of the upper limb?
C5 - T1
149
How are the dermatomes of the upper limb tested?
C5 = upper lateral arm, over the deltoid muscle.
C6 = thumb.
C7 = middle finger.
C8 = little finger.
T1 = medial border of the arm, just proximal to the elbow.
150
What type of joint is the articulation between the acetabulum and the proximal femur (the hip joint)?
Synovial ball and socket joint.
151
What type of joint is the articulation between the distal ends of the tibia and fibula with the talus (ankle joint)?
Synovial hinge joint.
152
What three separate bones form each hip bone (innominate bone)?
Pubic, ilium, ischium.
153
Where do the three bones of the hip, the pubic, ilium, and ischium bones, fuse?
Acetabulum (socket of the hip joint).
154
Where do the left and right hip bones articulate with each other anteriorly?
The pubic symphysis.
155
What do the left and right hip bones articulate with posteriorly?
The sacrum - at the sacroiliac joints.
156
What is the obturator canal?
A small gap in the obturator membrane, that covers the obturator foramen, and the muscles that attach to the obturator membrane, which allows vessels and nerves to pass through it.
157
What is the obturator foramen?
Hole in between the superior and inferior pubic rami.
158
What is the uppermost part of the ilium?
Iliac crest.
159
What are the two key bony prominences of the ilium?
Anterior superior iliac spine (ASIS) (most anterior part of iliac crest)
Anterior inferior iliac spine (AIIS)
160
What are the two key bony prominences of the ischium?
Ischial spine
Ischial tuberosity
161
What ligament attaches to the ischial spine?
Sacrospinous ligament
162
What ligament attaches to the ischial tuberosity?
Sacrotuberous ligament (muscles of posterior thigh also attach to the ischial tuberosity).
163
What foramen is formed between the sacrotuberous and sacrospinous ligaments, and the greater sciatic notch?
The greater sciatic foramen.
164
What foramen is formed between the sacrotuberous and sacrospinous ligaments, and the lesser sciatic notch?
The lesser sciatic foramen.
165
Where are the greater and lesser trochanters of the femur?
Just distal to the neck of the femur.
166
Where is the intertrochanteric line on the femur?
Between the greater and lesser trochanters, on the anterior surface of the femur, just distal to the neck.
167
What is the linea aspera?
Bony vertical ridge on the posterior aspect of the femur shaft (site of muscle attachment).
168
Which parts of the femur articulate with the proximal tibia at the knee joint?
Medial and lateral femoral condyles.
169
Give features of the hip joint that make it a stable joint.
The acetabulum is deep.
There is a good fit between the acetabulum and the femoral head.
The acetabular labrum (rim of fibrocartilage) deepens the acetabulum further for even more stability.
170
Muscles of what region extend, abduct, and rotate the thigh at the hip joint?
The gluteal region.
170
What is another name for profunda femoris?
Deep femoral artery.
170
What arteries supply the hip?
Medial and lateral circumflex femoral arteries (arising from deep femoral artery/profunda femoris).
171
What three ligaments help stabilise the hip joint?
Iliofemoral
Pubofemoral
Ischiofemoral
172
How do the iliofemoral, pubofemoral, and ischiofemoral ligaments help to stabilise the hip joint?
When the hip is extended, these ligaments become taut and hold the femur more tightly.
173
Why is the knee most stable in extension?
The femur and tibia condyles fit together best in extension.
174
What are the most superior aspect of the tibial condyles called?
Tibial plateaus.
175
What happens to the femur when the knee reaches full extension? Why?
The femur rotates a very small amount to 'lock' the knee in place, so it becomes very stable.
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In full extension, the femur rotates a very small amount to 'lock' the knee in place. What small muscle is responsible for 'unlocking' the knee?
Popliteus muscle.
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What is the iliotibial tract?
The IT band! A thick band of connective tissue (lateral thickening of the fascia lata) that runs along the outer side of the thigh, attaching to the lateral aspect of the tibia and contributing to stability of the knee.
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What are the menisci?
C-shaped and wedge-shaped cartilages that sit on the tibial plateau.
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What is the main function of the menisci?
To deepen the tibial condyles for better articulation with the femoral condyles.
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Why is the medial meniscus more prone to injury than the lateral meniscus?
The medial meniscus attaches to the joint capsule (along its peripheral margin) and the medial collateral ligament. The lateral meniscus is not attached to the lateral collateral ligament, so it can move more freely.
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What force does the medial collateral ligament help resist?
Valgus force (pushing towards the midline).
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What force does the lateral collateral ligament help to resist?
Varus force (pushing outwards from the midline).
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What three ligaments connect the tibia to the femur?
Medial collateral ligament.
Anterior cruciate ligament.
Posterior cruciate ligament.
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Where does the ACL (anterior cruciate ligament) attach on the tibia and femur?
Tibia: anterior intercondylar area
Femur: medial aspect of lateral condyle
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Where does the PCL (posterior cruciate ligament) attach on the tibia and femur?
Tibia: posterior intercondylar area
Femur: lateral aspect of medial condyle
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What are the four superficial gluteal muscles?
Gluteus maximus
Gluteus medius
Gluteus minimus
Tensor fascia latae
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What three functions does the gluteus maximus provide?
Extensor of the hip
External rotator of the hip
Stabilises the knee (because it inserts onto the iliotibial tract)
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What do the majority of fibres from the gluteus maximus insert into distally?
Iliotibial band (IT band)
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What is the most superficial muscle of the gluteal region?
Gluteus maximus
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Gluteus medius and gluteus minimus have similar points of attachment to the posterior ilium and both insert onto the greater trochanter.
These similar bony attachments mean they both provide the same three functions - what are these?
Abduction of the hip
Internal rotation of the hip
Contract and hold the pelvis level when on one leg e.g. during walking/running, therefore provide an important role in normal gait.
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The tensor fascia latae (TFL) tenses the fascia lata and iliotibial band (IT band) to stabilise the extended knee. What is the fascia lata?
The fascia lata is a thick fascia that envelops the muscles of the thigh.
(the IT band is a lateral thickening of the fascia lata).
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What nerve innervates the gluteus maximus?
Inferior gluteal nerve
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What nerve innervates the gluteus medius, gluteus minimus, and tensor fascia latae?
Superior gluteal nerve
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What are the two main functions of the deep gluteal muscles?
External rotation of the hip
Stabilisation of the hip
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The deep gluteal muscles are small muscles that primarily stabilise and externally rotate the hip.
What are the five deep gluteal muscles?
Piriformis
Gemellus superior
Gemellus inferior
Obturator internus
Quadratus femoris
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The piriformis is one of the five deep gluteal muscles. What is the piriformis a landmark for?
The nerves of the sacral plexus are located on its surface in the pelvis.
The sciatic nerve emerges below its inferior border in the gluteal region.
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The anterior compartment of the thigh contains seven muscles, some of which act upon the hip joint - but what function do these muscles primarily provide?
Extension of the knee.
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The anterior compartment of the thigh contains seven muscles. What nerve innervates these muscles?
The femoral nerve (derived from spinal nerves L2-L4).
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What are the seven muscles of the anterior compartment of the thigh?
Quadriceps femoris (group of four muscles: rectus femoris, vastus lateralis, vastus medialis, vastus intermedius).
Satorius
Iliopsoas
Pectineus
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The quadriceps femoris is a group of four muscles (rectus femoris, vastus lateralis, vastus medialis, vastus intermedius). What do these four muscles converge onto?
The quadriceps tendon.
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Iliopsoas muscle is made of two muscles which converge via a common tendon onto the lesser trochanter of the femur, and is the primary flexor of the hip joint. What two muscles form the iliopsoas?
Psoas major and iliacus.
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The medial compartment of the thigh contains five muscles. What function do they primarily provide as a group?
Adduct the hip.
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The medial compartment of the thigh contains five muscles. What nerve innervates these muscles?
Obturator nerve (spinal nerves L2-L4).
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Why are the five muscles of the medial compartment of the thigh important for normal gait?
They adduct the hip, helping to draw the leg towards the midline during walking.
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What are the five muscles of the medial compartment of the thigh?
Adductor brevis
Adductor longus
Adductor magnus
Gracilis
Obturator externus
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What two muscles of the medial compartment of the thigh does the obturator nerve lie between?
Adductor brevis (deep) and adductor longus (superficial)
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The adductor magnus is a large muscle with an adductor part and a hamstring part. What two different nerves innervate each part?
Adductor = obturator
Hamstring = sciatic
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What function does the hamstring part of the adductor magnus provide?
Extension of the hip
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What do the femoral artery and vein travel through to enter the posterior thigh?
Adductor hiatus (gap formed between distal attachments of the two parts of the adductor magnus).
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What are the four muscles of the posterior compartment of the thigh?
Semimembranosus
Semitendinosus
Biceps femoris
Hamstring part of adductor magnus
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What three muscles extend the hip and flex the knee, and are often referred to as "the hamstrings"?
Semimembranosus, semitendinosus, and the long head of biceps femoris.
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What nerve innervates the semimembranosus, semitendinosus, and the long head of biceps femoris ("the hamstrings")?
Sciatic nerve (tibial part).
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What forms the lateral, medial, and superior borders of the femoral triangle?
Lateral = sartorius
Medial = adductor longus
Superior = inguinal ligament
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What vessels and nerves are found in the femoral triangle, from lateral to medial?
Femoral nerve, femoral artery, and femoral vein.
Lymphatics are found the most medially.
Remember "NAVaL" = nerve, artery, vein, lymphatics.
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What important superficial tributary enters the femoral vein in the femoral triangle?
Great saphenous vein.
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What artery do the superior and inferior gluteal arteries arise from?
Internal iliac artery.
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What artery does the femoral artery arise from?
Continuation of the external iliac artery.
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What does the femoral artery become after entering the distal part of the posterior thigh?
Popliteal artery.
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What arteries travel through small apertures in the adductor magnus to supply the hamstring muscles in the posterior compartment?
Perforating arteries (there are 3 or 4) which arise from the deep femoral artery (profunda femoris).
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What do the superior and inferior gluteal veins drain into?
Internal iliac vein.
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What is the femoral vein a continuation of?
Popliteal vein (after it leaves the popliteal fossa behind the knee).
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What is the external iliac vein a continuation of?
Femoral vein.
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What two nerves bound together form the large sciatic nerve, which is composed of fibres from L4-S3 spinal nerves?
Tibial nerve and common fibular nerve.
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Where does the patella ligament insert?
Tibial tuberosity (projection from the proximal anterior surface of the tibia).
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Which bone is the medial malleolus part of?
Tibia (lateral malleolus is fibula)
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What is the function of the longitudinal and transverse arches of the foot?
Shock absorption.
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Name the six tarsal bones.
Talus
Calcaneus
Navicular
Medial cuneiform
Intermediate cuneiform
Lateral cuneiform
Cuboid
"Tiger Cubs Need MILC"
227
What bones comprise the hindfoot?
Talus and calcaneus.
228
What bones comprise the midfoot?
Navicular, cuboid, and the cuneiforms (medial, intermediate, and lateral).
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What bones comprise the forefoot?
Metatarsals and phalanges.
230
What joint is between the proximal and distal phalanges in the great toe?
interphalangeal joint of the great toe (IPJ)
231
What type of joint is the ankle?
Synovial hinge.
232
What do the tibia and fibula articulate with to form the ankle joint?
The talus.
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What is the socket for the talus called that is formed of the tibia and fibula?
The ankle mortise.
234
Which joint performs eversion and inversion of the ankle?
The subtalar joint (articulation of the talus and calcaneus, with some articulation with the navicular).
