WEEK 1 Flashcards
(74 cards)
1
Q
What is a (i) Dermatome (ii) Myotome?
A
(i) strip of skin supplied by one spinal nerve
(ii) muscles/group of muscles supplied by one spinal nerve
2
Q
What is the tip for remembering the lower limb dermatome sequence?
A
Stand on S1
Squat on S2
Sit on S3
3
Q
What is the role of deep fascia?
A
Forms a continuous sleeve (UL) or stocking (LL) around the muscles, but also sends septae between the muscles to separate them into compartments and often provide extra muscle attachment
4
Q
What is the importance of the space between superficial and deep fascia?
A
the intervening potential space allows movement
5
Q
What 2 things can deep fascia form?
A
Interosseous membranes (IO) - between bones Retinaculae - hold tendons in place
6
Q
Describe the deep fascia of the LL.
A
Forms a continuous stocking enclosing the thigh - Fascia Lata, and extends to the leg - Crural Fascia.
The fascia Lata thickens laterally as the Iliotibial Tract, and sends septae to divide the thigh into anterior, medial and posterior compartments.
7
Q
Where does the LL lumbo sacral plexus form? What ventral rami is it derived from?
A
Within psoas major on the posterior abdominal wall, and on the lateral wall of the pelvis.
L1 to L5 and S1 to S3
8
Q
What are the branches of the Lumbo-Sacral Plexus?
A
Femoral
Obturator
Sciatic
Tibial -> medial & lateral plantar
Common Fibular -> deep & superficial fibular
9
Q
Describe the passage of venous flow.
A
From superficial -> deep via perforators and then the muscle pump, arterial pulsation and negative intrathoracic pressure all help venous return to the heart, against gravity.
10
Q
Understand the lymph of the UL.
A
Axillary lymph nodes receive all lymph from UL and drain to subclavian trunk
Cubital lymph nodes are palpable
11
Q
List the lymph nodes of the LL.
A
Inguinal nodes - superficial (palpable) and deep Popliteal nodes (palpable)
12
Q
Explain some important features of the clavicle.
A
Lateral end - flat, articulates with acromion
Rounded, medial 1/3 - convex anteriorly
Medial end - quadrangular, articulates with manubrium of sternum
On inferior surface there is sites for ligament attachment
Space posterior to clavicle for NVB
13
Q
Describe the Sternoclavicular Joint and the Acromioclavicular Joint.
A
Sternoclavicular - synovial, bone-ends covered by fibrocartilage. Divided by a disc that attaches to the clavicle and manubrium, and the capsule, adding great strength => dislocation rare.
Acromioclavicular - less strong, allows small range gliding movement. Synovial with fibrocartilage over articular surfaces and a small disc => may become arthritic & cause shoulder pain.
14
Q
What are the ligaments which support the Sternoclavicular joint and the Acromioclavicular joint, respectively ?
A
SC - ligaments anteriorly & posteriorly, plus interclavicular & costoclavicular ligaments
AC- Conoid & Trapezoid parts of caracoclavicular ligament
15
Q
Describe the “space” within the shoulder, what surrounds it and what it is home to.
A
narrow “space” between the upper aspect of the shoulder joint and the overlying acromion, acromioclavicular joint and coraco-acromial ligament
home to the subacromial bursa and the tendon of supraspinatus muscle
16
Q
What does the pelvic girdle consist of?
A
Ilium, Ischium and Pubic bones, fused to form the Hip Bone, which attaches the Lower Limb to the Sacrum via the Sacro-iliac Joint
The Hip Bones attach to each other at the Pubic Symphysis
17
Q
Describe the Sacro-Iliac joint
A
Extremely limited movement, essentially for weight transference
Synovial anteriorly, supported by Anterior Sacro-iliac ligament
Fibrous posteriorly, linked by Interosseous Ligament
18
Q
What “safe” area of the buttock is used for intramuscular injections?
A
upper, outer quadrant
19
Q
Know the attachments for Serratus Anterior, what nerve supplies it, and what actions it accounts for.
A
thick, flat, very strong muscle, wraps around thorax from ribs 1 to 8, all the way to the MEDIAL border of the scapula
Long Thoracic Nerve
Protracts scapula and holds it against thoracic wall; laterally rotates scapula
20
Q
Know the attachments for Trapezius, what nerve supplies it, and what actions it accounts for.
A
skull, ligamentum nuchae and thoracic spines, passing to the lateral clavicle, acromion and spine of the scapula
Spinal Accessory Nerve (Cranial Nerve XI)
elevates the scapula as in shrugging the shoulders and retracts the scapula or braces the shoulders backwards
upper fibres, pull the glenoid upwards, while the lower fibres pull the medial spine downwards
21
Q
Know the key concepts of the LL.
A
- In standing upright, the hip is already extended
Think of hip extension as standing up from sitting, or climbing stairs, or walking and running - The muscles that abduct the hip are crucial in keeping the pelvis level when walking i.e. when body weight is supported on one leg
The neck of the femur is essential to the efficient function of these muscles - The femur rotates at the hip during walking
22
Q
What 3 things are cardiac muscle’s activity dependant upon?
A
Intrinsic properties
Hormones
Autonomic NS
23
Q
What are (i) intercalated discs (ii) gap junctions?
A
(i) Mechanical connection between adjacent cardiac muscle cells (structural). Electrical connection between adjacent cardiac muscle cells (functional).
(ii)Constructed from a hexagonal array of protein subunits – CONNEXINS
Sites of low electrical resistance between cells
Act as communicating channels – CONNEXON
24
Q
Give a summary of the events that occur at the motor end plate.
A
- Action potentials arriving at the axon terminal open voltage gated Ca2+ channels
- Inward diffusion of Ca2+
- Fusion of acetylcholine-containing vesicles (Ach) with the pre-synaptic membrane
- ACh diffusion across the 20nm synaptic cleft
- Nicotinic Ach receptors (nAChR) are chemically gated ion channels which permit monovalent cations to flow through
- Net entry of Na+ into end plate region causes depolarisation – end plate potential (epp)
- Action potential triggered in muscle fibres membrane
25
Outline the pathophysiology of myasthenia gravis
Muscle weakness that increases during periods of activity and improves after periods of rest
Eye and eyelid movement, facial expression, chewing, talking and swallowing are especially susceptible
Paralysis of the respiratory muscles
26
List the structures that make up the anterior, medial, lateral and posterior walls of the axilla.
1. ANTERIOR WALL:
PECTORALIS MAJOR
-Palpable as the ant axillary fold
-Action: movement of the humerus at the GH joint: adduction, medial rotation, flexion of the extended arm and extension of the flexed arm
PECTORALIS MINOR
-Attaches at Ribs 3-5 and to the Coracoid process of the scapula
-Action: stabilise the scapula on the thorax
-Supplied by lateral and medial pectoral nerves
CLAVIPECTORAL FASCIA
-Continuous with neck fascia
-Splits to enclose Pec minor and Subclavius
-Structures passing anteriorly must pierce the fascia
-Attaches to the skin of the armpit inferiorly
SUBCLAVIUS
-attaches at 1st rib CC and to the inf surface of clavicle
-Supplied by nerve to subclavius
-Draws clavicle inf
2. MEDIAL AND LATERAL WALLS
Medial wall is composed of:
-Ribs and intercostal spaces
-Serratus anterior: attaches at ribs 1-8 to medial border of scapula. Actions: protraction and lateral rotation of the scapula. Holds the scapula on the thoracic wall
The lateral wall is narrow; it is the bicipital groove.
-The proximal parts of Biceps and Coracobrachialis are sometimes included in the contents of the axilla.
-They are muscles of the anterior compartment of the arm
-Both attach to the coracoid process of the scapula
Coracobrachialis flexes the shoulder
Biceps flexes the shoulder and elbow
3. POSTERIOR WALL
-Subscapularis
-Latissimus dorsi
-Teres major
-Scapula
27
What are the 5 types of nerves in the brachial plexus?(from proximal to distal)
Roots, trunks, divisions, cords, terminal branches.
28
Describe the basic structure of the brachial plexus to illustrate the formation of its terminal branches.
1. ROOTS (5): C5, C6, C7, C8, T1.
- Ventral rami of spinal nerves
- Lie in the neck, close to the intervertebral foraminae
LONG THORACIC
- Passes inferiorly through the apex of the axilla, on the ribs to supply serratus anterior (MOTOR only)
DORSAL SCAPULAR
- Passes posteriorly to the back to supply levator scapulae and the rhomboids (MOTOR only)
2. TRUNKS (3): SUPERIOR, MIDDLE, INFERIOR
- Lie in the posterior triangle of the neck posterior to scalenus anterior and the subclavian artery
- Branches only arise from the upper trunk
SUPRASCAPULAR
- Passes posteriorly to the scapular region via suprascapular notch to supply supraspinatus, infraspinatus (MOTOR only)
NERVE TO SUBCLAVIUS
- Passes inferiorly to supply subclavius (MOTOR only)
3. DIVISIONS (6), EACH TRUNK GIVES RISE TO AN ANTERIOR AND POSTERIOR DIVISION
- Lie posterior to the clavicle. There are no branches from the divisions.
- Anterior divisions supply muscles of the anterior wall of the axilla, flexor muscles of the limb and skin that overlies those muscles
- Posterior divisions supply muscles of the posterior wall of the axilla, extensor muscles and skin that overlies those muscles
4. CORDS (3): LATERAL, POSTERIOR, MEDIAL
- Lie in the axilla, around the 2nd part of the axillary artery and are named according to their position in relation to the artery
LATERAL CORD (1 branch)
LATERAL PECTORAL NERVE
- Passes anteriorly to supply pectoralis major & minor (MOTOR only)
POSTERIOR CORD (3 branches)
UPPER SUBSCAPULAR NERVE
- Passes posteriorly to the scapular region to supply subscapularis (MOTOR only)
THORACODORSAL NERVE
- Passes inferiorly with its artery to supply latissimus dorsi (MOTOR only)
LOWER SUBSCAPULAR NERVE
- Passes posteriorly to the scapular region to supply subscapularis and teres major (MOTOR only)
MEDIAL CORD (3 BRANCHES)
MEDIAL PECTORAL NERVE
- Passes anteriorly, often pierces pectoralis minor and supplies both pectoralis major and minor (MOTOR only)
MEDIAL CUTANEOUS NERVE OF ARM
- Passes into the arm, supplies skin (SENSORY only)
MEDIAL CUTANEOUS NERVE OF FOREARM
- Passes into the arm, travels with the basilic vein, supplies skin (SENSORY only)
29
What are the root values of the terminal branches of the brachial plexus?
POSTERIOR CORD (2 BRANCHES)
1. RADIAL (C5, C6, C7, C8, T1)
- Passes posteriorly through the lower triangular space with profunda brachii artery
- Supplies all extensor muscles of arm and forearm and posterior skin of arm, forearm and hand (mixed MOTOR and SENSORY)
2. AXILLARY (C5, C6)
- Passes posteriorly through the quadrilateral space and lies on the surgical neck of the humerus with the posterior circumflex humeral artery
- Supplied the deltoid and teres minor and skin over the lower part of the deltoid (mixed MOTOR and SENSORY)
LATERAL CORD (2 BRANCHES)
3. MUSCULOCUTANEOUS (C5, C6, C7)
- Pierces coracobrachialis
- Supplies the flexor compartment of the arm (BBC) and becomes the lateral cutaneous nerve of the forearm (mixed MOTOR and SENSORY)
4i. LATERAL ROOT OF THE MEDIAN NERVE (C6, C7)
- Fibres join with the medial root to form the median nerve (mixed MOTOR and SENSORY)
MEDIAL CORD (2 BRANCHES)
4ii. MEDIAL ROOT OF MEDIAN NERVE (C8, T1)
- Fibres join with the lateral root to form the median nerve (mixed MOTOR and SENSORY)
4. MEDIAN (C6, C7, C8, T1)
- Travels with the brachial artery, is the most medial structure in the cubital fossa
- Supplies all flexor muscles of the forearm (except 1½) and has an important motor distribution in the hand (thumb muscles and lateral 2 lumbricals) and the skin over the lateral palm and later 3 ½ digits including nail beds (mixed MOTOR and SENSORY)
5. ULNAR (C7, C8, T1)
- Passes posteriorly to the elbow, supplies 1 ½ flexors of the forearms and supplies majority of the intrinsic muscles in the hand and the skin over the palm and medial 1 ½ digits (mixed MOTOR and SENSORY)
30
What is Erb-Duchenne Palsy/Erb's Paralysis? (causes, symptoms, presentation)
CAUSE - high energy trauma from motorcycle accidents or falling from a horse; could also occur during birth
SYMPTOMS - Paralysis of muscles in arms, loss of sensation to lateral forearm
PRESENTATION - (waiter’s tip position, hanging limb). Adducted shoulder, medial rotation of arm, elbow extended)
31
What is Klumpke's Palsy/Paralysis? (causes, symptoms, presentation)
CAUSES - occur during birth if limb is pulled excessively; could also occur when breaking a fall from height
SYMPTOMS - Paralysis of intrinsic hand muscles, flexor muscles of the wrist and fingers, forearm pronator. Loss of sensation to medial forearm, little finger
PRESENTATION - claw hand (wrist and fingers flexed, forearm supinated)
32
Describe the femoral nerve including its position and areas of major innervation, major branches and root values.
FEMORAL (L2, L3, L4)
- Largest branch of the lumbar plexus descending in the abdomen then travelling though the pelvis to the mid point of the inguinal ligament
- It then transverses behind the inguinal ligament into the thigh
- It passes through the femoral triangle and gives off articular branches to the hip and knee joints
- The terminal cutaneous branch of the femoral nerve is the saphenous nerve which continues with the femoral artery and vein, through the adductor canal to the leg.
- The femoral nerve is mixed MOTOR and SENSORY and supplies some of the anterior thigh muscles (hip flexors, knee extensors), and skin of anteromedial thigh and medial leg and foot (the latter via its terminal branch, the saphenous nerve)
33
Describe the sciatic nerve including its position and areas of major innervation, major branches and root values.
SCIATIC (L4, L5, S1, S2, S3)
- Enters gluteal region via the greater sciatic foramen (but supplies no structures in gluteal region) and runs deep to gluteus maximus, midway between the ischial tuberosity and the greater trochanter, behind the hip joint,
- The sciatic nerve usually emerges inferior to piriformis, passing over obturator internus, the gemelli and quadratus femoris and passing through the infero-medial quadrant of the buttock to descend in the posterior thigh on adductor magnus (to which it sends a supply in addition to the obturator nerve) deep to the biceps sandwiched between and supplying biceps femoris, and semitendinosus with semimembranosus (thigh extensors, leg flexors)
- The sciatic nerve is mixed MOTOR and SENSORY and supplies:
• Posterior thigh muscles
• All leg and foot muscles
• Skin to most of the leg and foot (via its two branches – tibial and common fibular)
SCIATIC NERVE – BRANCHES
- Usually branches at the apex of the popliteal fossa but in some cases can branch near the piriformis
1. TIBIAL (L4, L5, S1, S2, S3)
- The larger of the 2 branches
- Descends in to the popliteal fossa and posterior leg to the foot, passing post and inf to the medial malleolus sending out branches along the way (mixed MOTOR and SENSORY)
- Supplies posterior muscles in leg and knee joint; skin of posterolateral leg, sole of foot and lateral foot.
2. COMMON FIBULAR (Peroneal) (L4, L5, S1, S2)
- The smaller of the two branches
- Descends laterally in the popliteal fossa towards the lateral compartment of the leg, before branching (mixed SENSORY and MOTOR)
- Supplies short of biceps and muscles in anterior and lateral leg; skin of upper lateral leg, lower posterolateral leg, anterolateral leg and dorsum of foot.
34
Describe the fascia and muscles that form the boundaries, roof and floor of the femoral triangle.
The femoral triangle is bounded by the:
- Inguinal ligament (base)
- The sartorius muscle laterally (apex)
- And the adductor longus muscle medially
Within it, the femoral nerve (L2-L4) is the most lateral, femoral vein is the most medial and the femoral artery is in between.
- The muscular floor of the triangle consists of pectineus (medially) and iliopsoas (laterally)
- The roof of the triangle consists of fascia lata (deep fascia of the thigh), subcutaneous tissue and skin.
-The femoral sheath encloses the femoral artery and vein, NOT the nerve
35
Muscles are associated with extensive connective tissue coverings that support nerves and capillaries, name the three types of connective tissue and what their function is.
```
EPIMYSIUM
• Dense sheath on the surface
PERIMYSIUM
• Lies between fasiculi
ENDOMYSIUMS
• Separates the muscle fibres
```
36
Describe the roles of the main structural proteins located in the sarcomere. (HINT: there's 4)
Titin (connectin) – provides elasticity and stabilises myosin
Z-line protein (alpha-actinin) – provides anchoring point for actin and titin, creating structural integrity
M-line proteins (myomesin, M-protein)
Nebulin – helps align actin
37
What is (i) Sarcolemma (ii)Sarcoplasm?
(i) True cell membrane and encloses the muscle fibre
| (ii) Intracellular fluid that fills spaces between myofibrils
38
What are the various regions within a sarcomere?
A-BAND (an isotrophic)
- Primarily myosin filaments in the region of overlap
- Appears as quite a dark band when seen under a microscope
I-BAND (isotrophic)
- Actin filaments bisected by Z-line
H-ZONE
- Region of A-band which contains only myosin filaments
39
Upon muscle contraction, what happens to the length of the A-Band, I-Band and the H zone?
A-band will stay the same
I-band will decrease
H-zone will decrease
40
What are the intrinsic and extrinsic ligaments which hold the Glenohumeral joint in place?
```
Intrinsic:
Glenohumeral - weak
Transverse humeral - supports biceps tendon
Extrinsic:
Coracoacromial - strong
Coracohumeral - strong
```
41
What are bursae?
sac-like cavities near joints containing synovial fluid which also helps facilitate movement. The subscapularis bursa communicates with the joint cavity.
42
What is bursitis, and what can it lead to?
Inflammation of the bursae
May lead to degenerative changes in the associated tendons resulting in difficulty initiating certain movements (Example: supraspinatus tendon, inability to initiate abduction.)
43
What muscles attach the UL to the scapula? (scapulohumeral muscles)
Deltoid
Teres Major
(Triceps)
Rotator Cuff Muscles (SITS)
44
```
What muscle(s) are responsible for the following movements of the GH joint?
(i)Flexion (ii) Extension (iii) Lat rotation (iv) Med rotation (v) Abduction (vvi) Adduction.
```
(i) Pec major & Deltoid
(ii) Deltoid
(iii) Infraspinatus
(iv) Subscapularis
(v) Deltoid
(vi) Pec major & Lat dorsi
45
What are the 4 gateways to the scapular region? What do they contain?
```
SUPRASCAPULAR NOTCH
- Suprascapular nerve: supplies Supraspinatus and Infraspinatus
- Suprascapular artery: Branch of the subclavian artery. Forms anastomosis with circumflex scapular of the axillary artery
QUADRANGULAR SPACE
- Axillary nerve
- Posterior circumflex humeral artery
UPPER TRIANGULAR SPACE
- Circumflex scapular artery
LOWER TRIANGULAR SPACE
- Radial nerve
- Profunda brachii artery
```
46
What fuses within the femoral bone and at what age?
Epiphyses of the two trochanters and the femoral head are fused by 18/19 years
47
What are the 3 ligaments which reinforce the fibrous capsule?
ILIOFEMORAL (ant&sup) - strongest
Attaches from ant inf iliac spine to intertrochanteric line Prevents hyperextension of hip joint during standing
PUBOFEMORAL (ant&inf)
Blends with iliofemoral; attaches from obturator crest of pubic bone to merge with fibrous capsule
Prevents overabduction of hip joint; tightens during abduction and extension of hip
ISCHIOFEMORAL (post) - weakest
Attaches from acetabular rim (ischial) to medial part of greater trochanter
48
What is the neurovascular supply to the hip joint? Why is blood supply to the femoral head important?
Retinacular arteries - derived from circumflex femoral & the obturator arteries
Blood supply of femoral head is important as it may be affected by fracture of the femoral
neck.
49
What muscles are the flexors of the hip joint? (hint: there's 3) Where are they located?
Pectineus
Iliopsoas
Sartorius
**Located in the anterior thigh
50
What muscles are the adductors of the hip joint? (hint: there's 5) Where are they located?
```
Adductor longus
Adductor brevis
Adductor magnus
Gracilis
Obturator externus
**Located in the medial thigh
```
51
What muscles are the adductors of the hip joint? (hint: there's 3) Where are they located?
Biceps femoris
Semimembranosus
Semitendinosus
**Posterior thigh (also flex knee)
52
What muscles are the abductors & rotators of the thigh? (hint: there's 6) Where are they located?
```
Gluteus maximus, medius, minimus
Tensor fascia latae
Piriformis
Obturator internus
Superior & inferior gemelli
Quadratus femoris
```
53
Explain the role of the transverse tubules, and the terminal cisternae in skeletal muscle contraction.
Action potential is propagated from the end plate along the surface of the muscle fibre (sarcolemma)
AP is propagated into the fibre down the T-tubule membrane
Depolarisation of the T-tubule membrane is 'signalled' to the membrane of the terminal cisternae
54
Explain the role of the dihydropyridine and ryanodine receptor binding proteins.
```
DIHYDROPYRIDINES
- Voltage-gated Ca2+ channel blocking drugs
Nifedipine
Used to treat (smooth muscle)
- Hypertension
- Migraine
- Atherosclerosis
```
```
RYANODINE
- Spasmolytic drug acting as a skeletal muscle relaxant
Dantrolene
Used to treat (SR)
- Muscle spasm
Cerebral palsy
Malignant hyperthermia
```
55
Explain the role of 'junctional foot proteins'.
I. Membrane depolarisation opens the L-type Ca2+ channel
II. Mechanical coupling between the L-type Ca2+ channel and the Ca2+ -release channel causes the Ca2+- release channel to open
III. Ca2+ exits the SR via the Ca2+-release channel and activates troponin C, leading to muscle contraction
IV. Ca2+ entering the cell via L-type Ca2+ channels also can activate the Ca2+-release channels. However this pathway is not essential in skeletal muscle.
56
What does SERCA stand for? What is its role?
Sarcoplasmic Endoplasmic Reticulum Calcium ATPase
- The increase in intracellular calcium concentration activates a Ca2+ ATP-ase (calcium pump) in the SR membrane
- Active transport of calcium from the cytoplasm into the SR (2 Ca2+ ions per molecule ATP hydrolysed)
- [Ca2+] decreases from
57
What is the role of calsequestrin?
Stores calcium at high concentrations in the terminal cisternae to establish a concentration gradient from the SR to the cytoplasm
- calcium binding protein
- MW (molecular weight) 44000
- Binds 43 Ca2+ ions per molecule
58
What cells are used in cardiac contraction which are not involved in skeletal contraction? What is special about them?
PACEMAKER CELLS
- Specialised muscle cells
- Unstable resting potential
- Undergo automatic, rhythmical depolarisation
Pacemaker potentials ALWAYS depolarise to threshold
59
What are the 2 ways that calcium is obtained in cardiac muscle?
1. 25% enters through the DHPR L type calcium channel to induce CICR (ca induced ca release)
2. 75% through the calcium sensitive calcium release RYR protein in the SR
60
Describe how relaxation occurs in cardiac muscle.
- Requires a decrease in cytoplasmic Ca2+ concentration from:
>10-5M to
61
What facet of the patella is wider? Why is this the case?
Lateral facet
| to articulate with prominent lateral femoral condyle and prevent dislocation during knee extension (quadriceps)
62
What is the function of the anular ligament?
Holds the radial head in place, but allows its rotatory movement for supination and pronation
63
Describe the radial and ulnar collateral ligaments.
Radial Collateral Ligaments - from just inf. to Lat. Epicondyle, fanning to Anular Ligament (not radius)
Ulnar Collateral Ligaments - 2 strong bands and a weaker, posterior fan, from just inf. to Med. Epicondyle, to Olecranon and Coronoid Process of Ulna
64
What 3 things are all synovial joints dependant upon?
All synovial joints are dependent on 1. Adjacent Muscles, 2. Ligaments and 3. Bone Shape for their stability
65
Describe the contents of the fibrous capsule both anteriorly and posteriorly
Anteriorly: fibrous capsule replaced by the quadriceps tendon (patellar ligament) and patella (sesamoid bone), but also augmented by the iliotibial tract and by patellar retinacula from quadriceps.
Posteriorly: fibrous capsule is quite thin, but augmented by the oblique popliteal and arcuate ligaments, inferior to which is an opening in the capsule for the tendon of popliteus.
66
What are cruciate ligaments?
Named by their tibial attachment
They prevent antero-posterior displacement of the femur (in relation to the tibia) - and vice versa
act as a pivot for rotatory movements between the bones
67
What nerve(s) and spinal segment(s) does the biceps tendon jerk/reflex test?
Musculocutaneous nerve
| Particularly C5 and C6
68
What nerve(s) and spinal segment(s) does the knee jerk/reflex test?
Femoral nerve
| L3, L4
69
How many tarsal bones is there? Name them.
7 : talus calcaneus(heel), navicular, cuboid, cuneiforms 1-3
70
What type of joint is the (i) wrist and (ii) ankle joint?
(i) condyloid
| (ii) hinge
71
What are the names of the carpal bones in the hand?
```
Scaphoid
Lunate
Triquetrum
Pisiform
Trapezium
Trapezoid
Capitate
Hamate
```
72
Name the various joints of the hand and what movement(s) they result in.
```
Radiocarpal – Condyloid/Ellipsoid:
- Flexion and extension
- Abduction and adduction
Intercarpal - Plane joints:
-Sliding movements increase range of flexion and extension of wrist jt
IM & CMC - Plane joints (gliding)
- (Thumb – saddle: Flexion and extension, Abduction and adduction)
- 5th digit: flexion, rotation; 4th - some
Metacarpophalangeal - Condyloid joints:
- Flexion and extension
- Abduction and adduction
Interphalangeal - Hinge joints:
- Flexion and extension
```
73
Name the various joints of the foot and what movement(s) they result in.
```
Distal Tibiofibular – No movement:
- Helps to stabilise ankle and foot
Ankle – hinge joint:
- Plantar flexion and dorsiflexion
Intertarsal - Plane joints:
- Talocalcaneal/subtalar (inversion and eversion)
- Talocalcaneonavicular
- Calcaneocuboid
IM & TMT - Plane joints:
- Gliding movements
Metatarsophalangeal - Condyloid joints:
- Flexion, extension
- Abduction, adduction
IP - Hinge joints:
- Flexion and extension
```
74
What is club foot?
Congenital condition.
Talus bone deformity.
Shortened and tightened tendons in the leg.
Presentation: foot inversion, ankle plantar flexed, adduction of foot.
