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Where can u palpitate the following arteries
Femoral artery
Popliteal artery
Dorsalis pedis artery
posterior tibial artery
Femoral artery - groin
Popliteal artery - back of knee
Dorsalis pedis artery (dorsum of foot)
Medial ankle = posterior tibial artery
Skin direction is what
Skin is anisotropic, which means that it stretches more in one direction than other directions.
In skin The lines in which skin stretches the least (tension lines) are known as
Langer’s lines (cleavage lines).
Borders of Snuff Box
formed by the tendons of the extensor pollicis brevis and abductor pollicis longus (lateral) and the extensor pollicis longus (medial)
In terms of hip placement how does posterior vs anterior hip dislocation present
Posterior:
Internally R hip and shortened
Anterior
Externally R hip and abducted (lengthened, or appear as normal)
What nerve and artery are at greatest risk during anterior dislocation of humerus
Quadrangular space
so Axillary nerve and Posterior Circumflex Humeral Artery
As the Quadrangular space is formed by the Teres minor
Types of joints and examples for each
Synovial:
- Plane: Vertebrocostal joints
-Hinge: Knee
-Pivot: Radioulnar Joint
-Condyloid: Metacarpophalangeal
-Saddle: Radiocarpal joints
- Ball and socket: Shoulder
Cartilaginous: NO Synovial
- Synchondrosis: Epiphyseal plate
-Symphysis: Pubis symphysis
Fibrous:
- Suture: Coronal suture
- Syndesmosis: Distal tibiofibular joint
- Interosseous Membrane: Between Tibia and fibula
how to draw the lines for each section for axiliary artery
Each section is numbered to how many bracnhes they have so section 1 = superior thoracic
Section 2 = thoracioacriomal and lateral
Section 3 = thoracodorsal, Anterior and posterior humeral artery
Differences between LCL and MCL other than location
The MCL blends in with the underlying joint capsule and attaches to the Medial Meniscus, making it less mobile than the Lateral Meniscus.Whereas, the LCL does not attach onto the lateral meniscus and is discrete from the joint capsule
The MCL prevents the knee from going into valgus alignment, whereas the LCL prevents the knee from going into varus alignment
Identify the structures passing posterior to the medial malleolus. In what order do they run (anterior to posterior)?
- tibialis posterior tendon
-flexor digitorum tendon
- posterior tibial artery
-posterior tibial vein
- tibial nerve
- flexor hallucis tendon
Which nerve supplies sensation to the medial dorsal aspect of the great toe? What is this a branch of?
Medial Plantar Nerve. Branch of the tibial nerve
Where would you locate the Tibialis Posterior tendon and how would you test its integrity?
It is just posterior to the medial malleolus, between it and the posterior tibial artery where apulse can be felt. The test would be trying to invert the foot, and if the foot cannot do this but is dorsiflexed, TA is working but TP is not, and as both need to work to invert the foot then you know that TP is not working.
What direction must a force be directed to damage MCL? LCL? ACL? PCL?
MCL - force applied to the latearl side
LCL - force applies to the medial side
ACL - force applied posterior tiabia
PCL - Force appleid anterior tibia
As ACL prevents forward movement so needs force from behind knee to overstrech the ACL in prevnting foward motion.
What are the postential causes of a foot drop (inability to dorsiflex at the ankle)?
Deep peroneal nerve damage - anywhere along the sciatic nerve or common peroneal nerve
Damage to the dorsiflexor muscles - tibalis anterior, EDL EHL and peroneus tertius
Damage to the L4/5 nerve roots
CNS problem
Spinal cord injury at L3 or above
injury of the extensor muscles (anterior compartment) of the leg which includes the tibialis anterior, extensor digitorum longus, extensor hallucis longus and peroneus tertius.
injury or trauma to the nerve that innervates the muscles of the anterior compartment of the leg which is the deep peroneal nerve or the common peroneal branch causes footdrop.
anterior tibial artery that supplies blood to the anterior compartment of the leg.
Cervical vertebrae can be distinguished from thoracic and lumbar vertebrae by the presence of
One foramen in each transverse process
what are the two definitive features that make Thoracic vertebrae distinguishable from vertebra in other regions of the column
presence of costal facets on the vertebral bodies and transverse processes for rib articulation
heart-shaped vertebral body.
Oblique angle of superior articular processes
Stretch reflex process
c. Stretch of a muscle.
(This is the initial stimulus that activates muscle spindles.)
b. Action potentials are transmitted through ‘Ia’ afferents.
(Sensory information from the spindle is sent to the spinal cord.)
e. Action potentials are transmitted through axons of alpha motoneurones.
(Motor neurons in the spinal cord are activated.)
a. Acetylcholine (ACh) released from pre-synaptic terminals of the alpha motoneurone evokes an ‘end plate potential’ (EPP) in the muscle fiber.
(Neurotransmitter release leads to muscle fiber activation.)
d. Contraction of extrafusal muscle fibres.
(The final motor response.)
Steps of reverse myotactic
b. Activation of Golgi tendon organs.
(This detects increased tension in the muscle.)
d. Action potentials are transmitted through ‘Ib’ afferents.
(The signal is sent to the spinal cord.)
a. Excitatory neurotransmitter (glutamate) released from pre-synaptic terminals of ‘Ib’ afferents evokes an EPSP in ‘Ib’ inhibitory interneurone.
(This activates inhibitory interneurons.)
e. Inhibitory neurotransmitter is released from inhibitory (Ib) interneurones evokes an IPSP in the cell body of alpha motoneurone.
(This inhibits the motor neuron.)
c. Relaxation of extrafusal muscle fibres.
(The muscle relaxes to reduce tension.)
events involved in the ‘flexion (withdrawal) reflex’
Activation of nociceptors.
Action potentials are transmitted by type III and IV afferent fibres.
Excitation of interneurones in multiple spinal segments.
Action potentials are transmitted through axons of alpha motoneurones
Contraction of muscles (flexors).
What XRAY view for patella fracture
Skyline
What spinal nerve does the
Sciatic
Femoral
Obturator nerves stem from
Femoral L2-L4
Obturator nerve L2 - L4
Sciatic (L4 - S3)
How does each nerve enter from the spine to the compartment they need to get to and what do they branch into
Femoral
Sciatic
Obturator
Femoral Nerve:
Enters through pelvis and enters thigh under
inguinal ligament.
- Split immediately into anterior cutaneous nerves to supply the anterior thigh nerve sensation
- Saphenous nerve at/just below knee joint which supplies the medial LEG and skins the medial aspect of foot (BUT NO TOES) ALSO runs with great saphenous vein
- Obturator nerve
Travels around the pelvis to enter thigh under
through the obturator foramen. - Supplies muscular branches to medial compartment muscles thigh muscles
- Also innervates small area of skin on medial thigh via cutaneous branch
**sitting on adductor brevis
Sciatic Nerve
- Exits from pelvis via greater sciatic foramen and Lies on posterior Adductor magnus
-Emerges under the lower border of piriformis
- Divides in the posterior
thigh into its two terminal branches, the Tibial
nerve and the Common Peroneal nerve
What does the peroneal nerve split into
AND
what does each branch supply in the foot
Superficial and Deep
- Superifical enters the lateral compartment and supplies both muscles (Perneous longus and brevis)
- This nerve then continues as a cutaneous nerve, supplying the skin of the anterior leg and most of the dorsum of the foot
2.
Tibial nerve passes between two heads of?
Gastrocnemious
