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1
Q

What is the superior border of the femoral triangle?

A

the inguinal ligament

2
Q

What is the lateral border of the femoral triangle?

A

the medial aspect of the sartorius muscle

3
Q

what is the medial border of the femoral triangle?

A

the lateral aspect of the adductor longus muscle

4
Q

what muscles make up the floor of the femoral triangle?

A

iliopsoas muscle laterally

pectineus muscle medially

5
Q

What 4 structures does the femoral triangle contain?

A

lateral –> medial

  • femoral nerve
  • femoral artery
  • femoral vein
  • femoral canal
6
Q

Where are the deep inguinal lymph nodes located?

A

femoral canal

7
Q

What are the femoral artery and vein enveloped in?

A

femoral sheath

8
Q

what fascia from the abdominal wall makes up the femoral sheath superiorly?

A

transversalis fascia and iliopsoas fascia

9
Q

What does the femoral sheath blend inferiorly with?

A

the adventita of the femoral artery and vein

10
Q

where is the femoral nerve in relation to the femoral sheath?

A

femoral nerve is lateral to the femoral sheath

11
Q

from what spinal nerves does the femoral nerve arise from?

A

L2, L3, L4

formed in the lumbar plexus

12
Q

what type of nerve is the saphenous nerve? (with regards to function)

A

sensory nerve

13
Q

what nerve does the saphenous nerve branch off of?

A

the femoral nerve

14
Q

When branching off the femoral nerve and leaving the adductor canal, what 2 muscles does the saphenous nerve pass between?

A

sartorius muscle

gracilis muscle

15
Q

What compartment of the thigh is the gracilis muscle in?

A

medial compartment

16
Q

What does the saphenous nerve supply?

A
  • fascia and skin of the anteromedial aspects of the knee and leg
  • fascia and skin of the medial aspect of the foot
17
Q

when the saphenous nerve makes its way down to the foot from the knee, what vein does it accompany?

A

the great saphenous vein

18
Q

What is a femoral hernia?

A

when peritoneum (with or without abdominal contents) herniates into the femoral canal through the femoral ring

19
Q

what does a femoral hernia usually present as?

A

a painful lump in the groin

20
Q

what does the femoral canal contain?

A

deep inguinal lymph nodes

adipose tissue

21
Q

how are the deep inguinal lymph nodes positioned in the femoral canal?

A

in a chain

22
Q

which artery do the medial and lateral circumflex femoral arteries emerge from?

A

profunda femoris artery

23
Q

what part of the body do the medial and lateral circumflex femoral arteries supply?

A

the majority of the head of the femur

24
Q

What is the inferior border of the external oblique aponeurosis?

A

inguinal ligament

25
Q

what is an aponeurosis?

A

flattened tendon

26
Q

From what 2 bony features does the inguinal ligament run between?

A

ASIS

pubic tubercle

27
Q

What does the medial half of the inguinal ligament contain?

A

inguinal canal

28
Q

What does the inguinal canal contain in males?

A

spermatic cord

29
Q

What does the inguinal canal contain in females?

A

the round ligament

30
Q

How do the femoral vessels, femoral nerve and the iliopsoas muscle/combined tendon enter or leave the lower limb?

A

by passing posterior to the inguinal ligament in the retroinguinal space then into the femoral triangle

31
Q

What is the name of the deep fascia of the thigh?

A

fascia lata

32
Q

Where is the origin of the iliopsoas? (ie attachment of the iliacus and attachment of the psoas major)

A

iliacus: iliac fossa

psoas major: lumbar transverse processes

33
Q

Where is the insertion of the iliopsoas? (ie the attachment of the iliacus and the attachment of the psoas major)

A

lesser trochanter of the femur (for both)

34
Q

what is the function of the iliopsoas muscle?

A

flexion at the hip

35
Q

what is the origin of the sartorius muscle?

A

ASIS

36
Q

what is the insertion of the sartorius muscle?

A

medial aspect of the proximal tibia

37
Q

what is the function of the sartorius muscle?

A

flexion at hip and knee

also externally rotates the hip

38
Q

what is the nerve supply to the sartorius muscle?

A

femoral nerve

39
Q

how many proximal attachments does the quadriceps femoris have?

A

4

40
Q

what is the origin of the quadriceps femoris- rectus femoris head?

A

ASIS

41
Q

what is the origin of the quadriceps femoris- vastus lateralis?

A

shaft of the femur

42
Q

what is the origin of the quadriceps femoris-vastus intermedius?

A

shaft of the femur

43
Q

what is the origin of the quadriceps femoris-vastus medius?

A

shaft of the femur

44
Q

what is the insertion of the quadriceps femoris?

A

patella then tibial tuberosity

45
Q

what is the function of the quadriceps femoris?

A

extension of the knee

46
Q

what nerve supplies the quadriceps femoris?

A

femoral nerve

47
Q

What ligament is hit with a tendon hammer during a ‘knee jerk’ test?

A

patellar ligament

48
Q

what does hitting the patellar ligament with a tendon hammer cause normally?

A

reflex contraction of the quadriceps and extension of the knee joint

49
Q

Where are the adductor muscle group in thigh located?

A

medial compartment

50
Q

what are the 5 adductor muscles in the thigh?

A
gracilis
adductor brevis
adductor longus
adductor magnus 
obturator externus
51
Q

what adductor muscle also has a hamstring part to it?

A

adductor magnus

52
Q

what adductor muscle in the thigh is the most medial?

A

gracilis

53
Q

what is the most posterior adductor muscle in the thigh?

A

adductor magnus

54
Q

where is adductor brevis in relation to adductor longus?

A

adductor brevis is superior and posterior to the adductor longus

55
Q

where are the origins of the adductor muscles in the thigh?

A

inferior pubic rami

ischial tuberosity for hamstring part of adductor magnus

56
Q

where are the insertions of the adductor muscles in the thigh?

A

the linea aspera of the femur
or
adductor tubercle of the tibia

57
Q

where is the linea aspera of the femur?

A

posterior surface

58
Q

what nerves supply the muscles of the medial compartment of the thigh?

A

all innervated by the obturator nerve (L2,3,4) except the hamstring part of the adductor magnus which is innervated by the tibial nerve

59
Q

through what foramen of the hip bone do the obturator nerve, artery and vein enter the medial compartment of the thigh?

A

obturator foramen

60
Q

where does the obturator nerve divide into anterior and posterior branches?

A

upper border of the adductor brevis

61
Q

what does the anterior cutaneous nerve of the thigh branch off of?

A

femoral nerve (L2,3,4)

62
Q

what does the lateral cutaneous nerve of the thigh branch off of?

A

lumbosacral plexus (L2,3)

63
Q

what supplies the medial cutaneous innervation of the thigh?

A

cutaneous branch of the obturator nerve (L2,3,4)

64
Q

what lymph nodes does lymph following the great saphenous vein drain into?

A

superficial inguinal lymph nodes

65
Q

where are superficial inguinal lymph nodes located?

A

in superficial fascia around the great saphenous vein

66
Q

where are the 2 places lymph from superficial inguinal lymph nodes can drain?

A

external iliac lymph nodes

deep inguinal lymph nodes

67
Q

what lymph nodes does lymph following the small saphenous vein drain into?

A

popliteal lymph nodes

68
Q

where are popliteal lymph nodes located?

A

popliteal fossa

69
Q

where does lymph from popliteal lymph nodes drain?

A

deep inguinal lymph nodes

70
Q

where does lymph from deep inguinal lymph nodes drain?

A

external iliac lymph nodes

71
Q

ultimately, where does all lymph from the lower limb drain?

A

external iliac nodes

72
Q

which head of the quadriceps femoris is most superficial?

A

rectus femoris

73
Q

what is the name of the opening in the distal tendon of the adductor magnus into the popliteal fossa?

A

adductor hiatus

74
Q

what happens to the femoral vein and artery as they pass through the adductor hiatus into the popliteal fossa?

A

renamed popliteal artery and vein

75
Q

What type of bone is the patella?

A

a sesamoid bone

embedded within the patella tendon

76
Q

what is a sesamoid bone?

A

a bone embedded within a tendon or a muscle

77
Q

what head of the quadriceps femoris is also involved in flexion at the hip- in addition to the usual function of extension at the knee?

A

rectus femoris

78
Q

why has the rectus femoris got an additional function (flexion of the hip)?

A

because unlike the other quadriceps, it also spans over the hip joint- not just the knee joint

79
Q

what combination of muscles makes up the iliopsoas muscle?

A

psoas major muscle

iliacus muscle

80
Q

what muscle is the most powerful hip flexor?

A

iliopsoas mucle

81
Q

What are the 6 regions of the lower limb?

A
gluteal
femoral
knee
leg
ankle
foot
82
Q

What region of the lower limb is the ‘odd-one out’ because it doesn’t have an anterior and posterior part?

A

gluteal

only found posteriorly, no anterior part

83
Q

What are the 2 distinct muscle groups of the gluteal region?

A

superficial muscle group

deep muscle group

84
Q

What are the 4 muscles in the superficial muscle group of the gluteal region?

A

gluteus maximus
gluteus medius
gluteus minimus
tensor fascia latae

85
Q

describe the positions of the gluteus maximus, medius and minimus relative to each other?

A

gluteus maximus is the most superficial
gluteus medius is in the middle
gluteus minimus is the most deep

86
Q

what are the functions of the superficial muscle group of the gluteal region?

A

extensors, abductors and medial rotators of the thigh

87
Q

what innervates the gluteus maximus?

A

inferior gluteal nerve

88
Q

what innervates the gluteus medius?

A

superior gluteal nerve

89
Q

what innervates the gluteus minimus?

A

superior gluteal nerve

90
Q

what innervates the tensor fascia latae?

A

superior gluteal nerve

91
Q

what muscles don’t contract properly when there is a problem with the inferior gluteal nerve? and what is this known as?

A

gluteus medius
gluteus minimus
tensor fascia latae

Trendelenburg’s Gait

92
Q

What are the 5 muscles of the deep muscle group of the gluteal region?

A
piriformis
obturator internus
superior gemelli
inferior gemelli
quadratus femoris
93
Q

the superior and inferior gemelli lie on either side of what muscle?

A

obturator internus

94
Q

when the skin and fascia has been removed, what are the 2 muscles which can be seen in the gluteal region?
(ie most superficial muscles of the gluteal region?)

A

tensor fascia latae

gluteus maximus

95
Q

what is the position of the tensor fascia latae in relation to the gluteus maximus?

A

tensor fascia latae is lateral to the gluteus maximus

96
Q

when the skin, fascia and the most superficial muscles of the gluteal region (tensor fascia latae and gluteus maximus) have been removed, what muscles can be seen in the gluteal region?
(name from superior to inferior)

A
gluteal medius
piriformis
superior gemelli
obturator inturnus
internal gemelli
quadratus femoris
97
Q

what is the function of the deep muscle group of the gluteal region?

A

lateral rotators of thigh

hip stabilisers

98
Q

what innervates all of the deep muscle group of the gluteal region?

A

sacral plexus

99
Q

what do nerves enter/exit the pelvis an perineum via?

A

greater and lesser sciatic foramen

100
Q

What 2 ligaments split the greater and lesser sciatic notches into greater and lesser sciatic foramen?

A

sacrotuberous ligament

sacrospinous ligament

101
Q

what does the sacrotuberous ligament run between?

A

sacrum and ischial tuberosity

102
Q

what does the sacrospinous ligament run between?

A

sacrum and ischial spine

103
Q

the gluteal region is divided into quadrants for injections, what region should be used for injections?

A

superolateral quadrant

104
Q

From what spinal nerves is the sciatic nerve made of?

A

L4-S3

105
Q

From what spinal nerves in the pudendal nerve made of?

A

S2,3,4

106
Q

What areas of the body does the pudendal nerve supply?

A

pernieum

107
Q

what muscles separate the pelvis from the perineum?

A

pelvic floor muscles

108
Q

From what spinal nerves in the posterior cutaneous nerve of the thigh made of?

A

S1,2,3

109
Q

What areas of the body does the posterior cutaneous nerve of the thigh supply?

A
skin of the:
posterior thigh,
popliteal
upper medial thigh
lateral perineum
110
Q

Where does the sciatic nerve exit the pelvis?

A

greater sciatic foramen

111
Q

what is the usually most lateral nerve to exit the greater sciatic foramen?

A

sciatic nerve

112
Q

The sciatic nerve exits the pelvis just inferior to what muscle?

A

piriformis

113
Q

what is the name of the artery which supplies blood to the sciatic nerve?

A

artery to the sciatic nerve

114
Q

What areas of the gluteal region does the sciatic nerve supply?

A

none

115
Q

The sciatic nerve bifurcates into what 2 nerves?

A
tibial nerve (greater section of divied)
common fibular
116
Q

Where usually does the sciatic nerve bifurcate into the tibial nerve and the common fibular nerve?

A

distal 1/3 thigh

but can occur anywhere from gluteals to popliteal fossa

117
Q

compare the tibial nerve to common fibular nerve in terms of size and relative position?

A

tibial nerve: larger and medial

common fibular: smaller and lateral

118
Q

what is the roof of the femoral triangle made of?

A

deep fasica

119
Q

What is the name of the condition where increased pressure in a body compartment affects the function of the muscles of nerves?

A

compartment syndrome

120
Q

What is the cause of the increased pressure in compartment syndrome?

A

swelling of tissue

increase in fluid (bleeding or oedema)

121
Q

what is used to relieve the pressure in emergency compartment syndrome?

A

fasciotomy

122
Q

What are the 3 muscle compartments in the lower limb?

A

anterior
posterior
lateral

123
Q

What are the 3 muscle compartments in the thigh?

A

anterior
posterior
medial

124
Q

What are the 4 muscles of the anterior compartment of the thigh?

A

pectineus
iliopsoas
sartorius
quadriceps femoris (rectus femoris; vastus lateralis, intermedius, medialis)

125
Q

what muscles of the anterior compartment of the thigh are flexors of the thigh? (hip flexors)

A

iliopsoas
pectineus
sartorius

126
Q

what muscles of the anterior compartment of the thigh are extensors of the leg?

A

quadriceps femoris

127
Q

what is the innervation of the iliopsoas muscle?

A

iliacus muscle- femoral nerve (L2,3,4)

psoas major- (L1,2,3)

128
Q

what is the innervation of the pectineus muscle?

A

femoral nerve (L2,3,4)

129
Q

what is the innervation of the sartorius muscle?

A

femoral nerve (L2,3,4)

130
Q

what is the innervation of the quadriceps femoris muscle?

A

femoral nerve (L2,3,4)

131
Q

what innervates the adductor longus?

A

obturator nerve (L2,3,4)

132
Q

what innervates the adductor magnus?

A
obturator nerve (L2,3,4)
hamstring part = tibial nerve
133
Q

what innervates te gracilis?

A

obturator nerve (L2,3,4)

134
Q

what innervates the adductor brevis?

A

obturator nerve (L2,3,4)

135
Q

what innervates the obrurator externus?

A

obturator nerve (L2,3,4)

136
Q

the obturator externus is an adductor muscle found in the medial compartment of the thigh, but unlike the other adductor muscles what is its main function?

A

lateral rotation of the thigh

137
Q

What are the 4 muscles in the posterior compartment of the thigh?

A

semimembranosus
semitendinous
biceps femoris (long head)
biceps femoris (short head)

138
Q

which muscle in the posterior compartment of the thigh is the most lateral?

A

biceps femoris (short head)

139
Q

what innervataes the semitendinosus?

A

tibial division of the sciatic nerve (L5, S1,2)

140
Q

what innervates the semimembranosus?

A

tibial division of the sciatic nerve (L5, S1,2)

141
Q

what innervates the biceps femoris?

A

tibial division of the scaitic nerve (L5, S1,2)

short head = common fibular division of hte sciatic nerve

142
Q

what are the muscles in the anterior compartment of the leg?

A

tibialis anterior
extensor hallicus longus
extensor digitorum longus
fibularis tertius

143
Q

what is the function of the muscles in the anterior compartment of the leg?

A

dorsiflexion of the ankle

extension of the toes

144
Q

what innervates the tibial anterior?

A

deep fibular nerve (L4,5)

145
Q

what innervates the extensor digitorum longus?

A

deep fibular nerve (L4,5)

146
Q

what innervates the extensor hallicus longus?

A

deep fibular nerve (L4,5)

147
Q

what innervates the fibularis tertius?

A

deep fibular nerve (L4,5)

148
Q

what are the muscles of the lateral compartment of the leg?

A

fibularis longus

fibularis brevis

149
Q

what is the function of the muscles in the lateral compartment of the leg?

A

eversion of the foot

weak plantarflex of the ankle

150
Q

what innervates the fibularis longus?

A

superficial fibular nerve (L5, S1,2)

151
Q

what innervates the fibularis brevis?

A

superficial fibular nerve (L5, S1,2)

152
Q

what does the common fibular nerve bifurcate into?

A

superficial fibular nerve

deep fibular nerve

153
Q

what are the 2 groups of muscles in the posterior compartment of the leg?

A

superficial group

deep group

154
Q

what is the function of the superficial group of the posterior compartment of the leg?

A

plantarflexion of the ankle

155
Q

what is the function of the deep group of the posterior compartment of the leg?

A

plantarflexion of the ankle

flexion of the toes

156
Q

what are the 4 muscles of the superficial group of the posterior compartment of the leg?

A

gastrocnemius
soleus
plantaris
popliteus

157
Q

what are the 3 muscles of the deep group of the posterior compartment of the leg?

A

tibialis posterior
flexor hallicus longus
flexoror digitorum longus

158
Q

what is the innervation of the soleus?

A

tibial division of the sciatic nerve (L5, S1,2)

159
Q

what is the innervation of the gastrocnemius?

A

tibial division of the sciatic nerve (L5, S1,2)

160
Q

what is the innervation of the plantaris?

A

tibial division of the sciatic nerve (L5, S1,2)

161
Q

what is the innervation of the popliteus?

A

tibial division of the sciatic nerve (L5, S1,2)

162
Q

what is the innervation of the flexor hallicus longus?

A

tibial division of the sciatic nerve (L5, S1,2)

163
Q

what is the innervation of the flexor digitorum longus?

A

tibial division of the sciatic nerve (L5, S1,2)

164
Q

what is the innervatio of the tibialis posterior?

A

tibial division of the sciatic nerve (L5, S1,2)

165
Q

what is the superolateral border of the popliteal fossa?

A

biceps femoris tendon

166
Q

what is the superomedial border of the popliteal fossa?

A

semimembranosus tendon

167
Q

what are the inferior borders of the popliteal fossa?

A

gastrocnemius

2 heads to form a diamond shape

168
Q

what are the contents of the popliteal fossa?

A
  • fat
  • terminal small saphenous vein
  • popliteal vessels
  • tibial and common fibular nerves
169
Q

what are the articulations of the hip joint?

A

head of femur and acetabulum of hip

170
Q

What are the 3 ligaments which spiral from the pelvis to the femur?

A

iliofemoral ligament
pubofemoral ligament
ischiofemoral ligament

171
Q

out of the 3 ligaments which spiral from the pelvis to the femur, which 2 are anterior?

A

iliofemoral ligament and pubofemoral ligament are anterior

ischiofemoral ligament is posterior

172
Q

What is the first main branch off of the femoral artery?

A

profunda femoris

deep femoral artery

173
Q

what are the first 2 branches off the profunda femoris?

A

medial circumflex artery

lateral circumflex artery

174
Q

what artery does the artery to the head of the femur branch off of?

A

obturator artery

175
Q

what do the medial and lateral circumflex arteries supply?

A

the hip joint

176
Q

in what ligament does the artery to the head of femur run?

A

in the ligamentum teres to the head of the femur

177
Q

what are the 3 articulations in the knee joint?

A

2 x femerotibial

1 x femeropatellar

178
Q

what muscle from the anterior compartment of the thigh stabilises the knee?

A

quadriceps femoris

179
Q

What are the main 2 extracapsular ligaments of the knee joint?

A

lateral (fibular) collateral ligament

medial (tibial) collateral ligament

180
Q

What are the 2 intra-articular ligaments of the knee joint?

A
anterior cruciate (ACL)
posterior cruciate (PCL)
181
Q

what are menisci of the knee joint made of?

A

crescent shaped fibrocartilage

182
Q

what sign do you get if the anterior cruciate (ACL) of the knee is damaged?

A

positive lachmans test

anterior sliding of the tibia under the femur

183
Q

what sign do you get if the posterior cruciate (PCL) of the knee is damaged?

A

posterior drawer sign

posteiror sliding of the tibia under the femur

184
Q

what is the calcaneal tendon more commonly known as?

A

achilles tendon

185
Q

what is the strongest ligament in the body?

A

iliofemoral ligament

186
Q

what is the strongest tendon in the body?

A

calcaneal tendon

187
Q

what 3 muscles tendon make up the calcaneal tendon?

A

gastrocnemius, soleus and plantaris

from superficial group of posterior leg compartment

188
Q

what is the normal result of an ankle jerk reflex test?

A

plantar flexion

189
Q

what spinal nerves roots does an ankle jerk reflex test?

A

S1, S2 nerve roots

190
Q

what is the most powerful extensor of the hip?

A

gluteus maximus

191
Q

what gluteal muscle, along with the superficial fascia overlying it, helps to define the gluteal fold?

A

gluteus maximus

192
Q

Where is the inferior gluteal neurovascular bundle located?

A

deep to the gluteal maximus

193
Q

where is the superior gluteal neurovascular bundle located?

A

deep to the gluteus medius

194
Q

what is the distal attachment of the deep muscles of the gluteal region?

A

greater trochanter of the femur

195
Q

What is the iliotibial tract?

A

a thickening of the deep fascia of the thigh

thickening of the fascia lata

196
Q

Where does the iliotibial tract run?

A

from the ASIS to the lateral aspect of the laterl tibial condyle- at the Gerdy tubercle

197
Q

what is the function of the iliotibial tract?

A

supports the knee joint

198
Q

What compartment of the thigh does the sciatic nerve enter?

A

posterior compartment

199
Q

What type of fibres does the posterior cutaneous nerve of the thigh contain?

A

sensory and sympathetic fibres

200
Q

at what level of the spine is a lumbar puncture taken?

A

L3,4

the plane between the iliac crests

201
Q

at what level does the spinal cord end?

A

L1/2

202
Q

during a lumbar puncture, samples of CSF are taken from what area surrounding the spinal cord?

A

subarachnoid space

203
Q

What is the conus medullaris?

A

the terminal part of the spinal cord

204
Q

What is the order of the muscles in the posterior thigh? (medially to laterally)

A

semimembranosus
semitendinosus
biceps femoris (long head)
biceps femoris (short head)

205
Q

which is more superficial- semimembranous or semitendinous?

A

semitendinosus

206
Q

What is the function of the muscles of the posterior thigh?

A

extend the hip

flex the knee

207
Q

What are the 3 reasons the biceps femoris (short head) is diffferent to the rest of the muscles of the posterior thigh?

A
  1. attaches to the linea aspera of the femur and not the ischial tuberosity
  2. it doesn’t cross the hip joint so doesn’t contribute to extension of the hip joint
  3. supplied by common fibular branch instead of tibial branch
208
Q

what increases the depth of the acetabulum?

A

the acetabular labrum

209
Q

what ligament attaches the femur to the depth of the acetabulum and also contains the artery to the head of the femur?

A

the ligament of the head of the femur

210
Q

what happens to the artery to the head of the femur in adulthood?

A

becomes obliterated

still remains within the ligament of the head of the femur

211
Q

what happens to the ligament of the head of the femur during hip dislocation?

A

ligament ruptures

212
Q

what type of joint is the hip joint?

A

synovial, ball and socket joint

213
Q

which is more stable- hip joint or shoulder joint?

A

hip joint

214
Q

what is the function of the ligaments around the hip joint?

A

reinforce stability of the joint

215
Q

Where is the intertrochanteric line of the femur?

A

a line in between the greater trochanter and the lesser trochanter of the femur
(anterior aspect)

216
Q

where does the fibrous capsure of the hip joint attach to the femur anteriorly?

A

intertrochanteric line of the femur

217
Q

What branches are given off the medial and lateral circumflex femoral branches and pass deep to the fibrous capsule into the head of the femur?

A

retinacular arteries

218
Q

What type of hip joint fracture will affect the retinacular arteries?

A

intercapsular hip fracture

occurs proximal to the intertrochanteric line

219
Q

what is the serious problem which can accompany intercapsular hip fracture?

A

damaged blood supply to the head of th femur causing avascular necrosis

220
Q

what fascia must the small saphenous vein pass through to end up in the popliteal fossa?

A

popliteal fascia

deep fascia

221
Q

from superficial to deep, names the components of the major neurovascular bundle that lies in the popliteal fossa?

A

tibial nerve
popliteal vein
popliteal artery

222
Q

what nerve gives rise to the medial sural cutaneous nerve?

A

tibial nerve

223
Q

what nerve gives rise to the lateral sural cutaneous nerve?

A

fibular nerve

224
Q

what nerve enables communication between the medial and lateral sural cuteneous nerves?

A

sural communicating branch

225
Q

what 2 nerves combine to form the sural nerve?

A

medial cutaneous sural nerve and branches from the sural communicating nerve

226
Q

what blood vessel does the sural nerve follow in the superficial fascia of the posterior aspect of the leg?

A

small saphenous vein

227
Q

what nerve gives branches to both the heads of gastrocnemius which in the popliteal fossa?

A

tibial nerve

228
Q

what muscle is deep to the lateral head of the gastocnemius?

A

plantaris muscle

229
Q

what muscle is deep to the plantaris muscle?

A

popliteus muscle

230
Q

what is the insertion of the plantaris

A

the calcaneus via the achilles tendon

231
Q

the tibial nerve courses through the posterior compartment of the leg deep to what muscle of the superficial compartment?

A

soleus

232
Q

what blood vessel does the tibial nerve follow through the posterior compartment of the leg?

A

posterior tibial artery

233
Q

From anterior to posterior, name the tendons of the muscles of the deep posterior compartment of the leg along with the tibial nerve and the posterior tibial artery?

A
tendon of Posterior Tibialis
tendon of Flexor Digitorum Longus
Posterior Tibial Artery
Tibial Nerve
tendon of Flexor Hallicus Longus
[Tom, Dick ANd, Harry]
234
Q

what is the insertion of the gastrocnemius

A

to the calcaneus via the Achilles tendon

235
Q

where does the medial head of the gastrocnemius attach proximally?

A

medial femoral condyle

236
Q

where does the lateral head of the gastrocnemius attach proximally?

A

lateral femoral condyle

237
Q

why does the gastrocnemius have a weak knee flexor function in addition to it’s powerful ankle plantar-flexor role?

A

it crosses the knee joint as well as the ankle joint

238
Q

where is the origin of the soleus?

A

to the neck of the fibula and the soleus line of the tibia

slopes inferiorly from lateral to medial

239
Q

where is the insertion of the soleus?

A

to the calcaneus via the achilles tendon?

240
Q

where does the popliteal artery divide into the anterior and posterior tibial arteries?

A

divides immediately distal to the popliteal fossa

241
Q

what artery is the fibular artery a branch of?

A

the posterior tibial artery

242
Q

What does the anterior tibial artery pierce in order to get to the anterior compartment of the leg?

A

interosseous membrane

243
Q

The posterior tibial artery leaves the posterior compartment by passing anterior or posterior to the medial malleolus?

A

posterior to the medial malleolus

244
Q

in the foot, the posteiror tibial artery terminates by dividing into what 2 arteries?

A

medial plantar artery

lateral plantar artery

245
Q

What are the 3 articulations of the knee joint?

A

2 between femur and tibia

1 between femur and patella

246
Q

What are the main movements of the knee?

A

flexion
extension
(at 90 degrees flexion also medial and lateral rotation)

247
Q

what muscles are involved in flexion of the knee?

A

mainly hamstrings and gastrocnemius

248
Q

what muscles are involved in extension of the knee?

A

mainly quadriceps

249
Q

what muscles are involved in the medial rotation of the knee?

A

hamstrings and gracilis

250
Q

what muscles are involved in the lateral rotation of the knee?

A

biceps femoris

251
Q

what are the main ligaments that help with stabilisation of the knee?

A
iliotibial tract
medial collateral ligament (MCL)
lateral collateral ligament (LCL)
anterior cruciate ligament (ACL)
posterior cruciate ligament (PCL)
252
Q

what are the medial and lateral menisci of the knee made of?

A

fibrocartilage

253
Q

what is the function of the medial and lateral menisci?

A

shock absorbers

assist with stabilisation of curved femoral condyles upon flatter tibial condyles

254
Q

what menisci is compromised in genu varum? and what occurs?

A

medial menisci

bowed legs

255
Q

what menisci is compromised in genu valgas? and what occurs?

A

lateral menisci

knock knees

256
Q

what 3 structures are torn in ‘unhappy triad’ knee injury?

A

medial collateral ligament
median menisci
anterior cruciate ligament

257
Q

what is the function of the anterior cruciate ligament?

A

prevents anterior displacement and excessive internal rotation of the tibia on the femur

258
Q

what femoral condyle does the anterior cruciate ligament attach to?

A

the lateral femoral condyle

259
Q

what is the function of the posterior cruciate ligament?

A

prevents posterior displacement of the tibia on the femur

260
Q

what femoral condyle does the posterior cruciate ligament attach to?

A

medial femoral condyle

261
Q

what test assesses the integrity of the ACL?

A

anterior drawer test

262
Q

what test assesses the intergrity of the PCL?

A

posterior drawer test

263
Q

what reduces friction on the quadriceps tendon during knee movements?

A

suprapatellar bursa

264
Q

where does the common fibular nerve bifurcate into the deep fibular nerve and the superficial nerve?

A

at the fibular neck

265
Q

what muscle compartment of the leg does the deep fibular nerve supply?

A

anterior compartment

266
Q

what muscle compartment of the leg does the superficial fibular nerve supply?

A

lateral compartment

267
Q

what muscles are involved in inversion of the foot?

A

tibialis anterior and tibialis posterior

268
Q

what muscles are involved in the eversion of the foot?

A

fibularis tertius
fibularis longus
fibularis brevs

269
Q

What separates the anterior and lateral compartment of the leg?

A

anterior intermuscular septum

270
Q

what nerve supplies the anterior compartment of the arm?

A

musculocutaneous nerve

271
Q

what nerve supplies the posterior compartment of the arm?

A

radial nerve

272
Q

what nerve supplies the anterior compartment of the forearm?

A

mainly median nerve (ulnar supplies flexor carpi ulnaris and the medial part of flexor digitorum profundis)

273
Q

what nerve supplies the posterior compartment of the forearm?

A

radial nerve

274
Q

what nerve supplies the hand?

A
ulnar nerve
(except LOAF = median)
275
Q

what nerve is damage in wrist drop? (ie can’t extend wrist)

A

radial nerve

276
Q

what are the 5 spinal nerve roots involves in the brahcial plexus?

A
anterior rami of
C5
C6
C7
C8
T1
277
Q

what spinal nerve roots form the upper trunk of the brachial plexus?

A

C5 and C6

278
Q

what spinal nerve roots form the middle trunk of the brachial plexus?

A

C7

279
Q

what spinal nerve roots form the lower trunk of the brachial plexus?

A

C8 and T1

280
Q

what divisions do each trunk of the brachial plexus divide into?

A

anterior division and posterior division

281
Q

what divisions of which trunks form the lateral cord of the brachial plexus?

A

anterior divisions of upper and middle trunks of the brachial plexus

282
Q

what divisions of which trunks form the posterior cord of the brachial plexus?

A

posterior divisions of the upper, middle and lower trunks of the brachial plexus

283
Q

what divisions of which trunks form the medial cord of the brachial plexus?

A

anterior division of lower trunk form of the brachial plexus

284
Q

what cords of the brachial plexus form the muscutaneous nerve?

A

lateral cord

285
Q

what cords of the brachial plexus form the median nerve?

A

lateral cord + medial cord

286
Q

what cords of the brachial plexus form the axillary nerve?

A

posterior cord

287
Q

what cords of the brachial plexus form the radial nerve?

A

posterior cord

288
Q

what cords of the brachial plexus form the ulnar nerve?

A

medial cord

289
Q

what are the cords of the brachial plexus named in relation to?

A

the axillary artery

290
Q

where are the trunks of the brachial plexus found?

A

neck region

291
Q

what 3 nerves of the brachial plexus form the letter M shape?

A

musculocutaneous
median
ulnar

292
Q

what spinal nerve roots are tested in the ankle reflex?

A

S1, S2

293
Q

what spinal nerve roots are tested in the knee reflex?

A

L3, L4

294
Q

what spinal nerve roots are tested in the biceps brachii tendon reflex?

A

C5, C6

295
Q

what spinal nerve roots are tested in the triceps brachii tendon reflex?

A

C7, C8

296
Q

what vein drains the lateral aspect of the forearm/arm?

A

cephalic vein

297
Q

what vein drains the medial aspect of the forearm/arm?

A

basilic vein

298
Q

what vein joins the cephalic vein to the basilic vein? (and where does it lie?

A

median cubital vein

in the cubital fossa

299
Q

what is the name of the 2 veins that accompany the brachial artery?

A

venae comitantes

300
Q

what are teh 3 types of joint?

A

fibrous
cartilaginous
synovial

301
Q

what type of joint is the interosseous membrane?

A

fibrous joint

302
Q

what are the 6 types of synovial joint?

A
  • synovial ball and socket joint
  • synovial hinge joint
  • synovial pivot joint
  • synovial plane joint
  • synovial ellipsoid joint
  • synovial saddle joint
303
Q

what type of joint is the shoulder joint?

A

synovial ball and socket joint

304
Q

what type of joint is the elbow joint?

A

hinge joint

305
Q

what type of joints are the interphalangeal joints of the hands?

A

hinge joints

306
Q

what type of movement to pivot joints allow?

A

rotational movement only

307
Q

what type of joints are the proximal radio-ulnar joints?

A

pivot joints

308
Q

what type of joints are the acromioclavicular joints?

A

plane joints

309
Q

what type of joints are the wrist joints?

A

ellipsoid joints

310
Q

what type of joints are the metacarple pharyngeal joints? (MCP)

A

ellipsoid joints

311
Q

what type of joints are the 1st carple metacarple joints?

A

saddle joints

312
Q

what is the main part of a synovial joint affected by trauma?

A

ligaments or capsule

313
Q

what is the main part of a synovial joint affected by osteoarthritis?

A

hyaline articular cartilage

314
Q

what is the main part of a synovial joint affected by rheumatoid arthritis?

A

synovial membrane

315
Q

what movement does a synovial plane joint allow?

A

movement in one plane - gliding

316
Q

where is the adductor canal?

A

anterior compartment of the thigh

posterior to the sartorius muscle

317
Q

what does the adductor canal contain?

A

femoral vein
femoral artery
branches of femoral nerve (eg saphenous nerve)

318
Q

what are the 5 joints of the foot?

A
  • subtalar joint
  • midtarsal joints
  • tarsometatarsal joints
  • metatarsophalangeal joints
  • interphalangeal joints
319
Q

what bones of the foot are involved in the subtalar joint?

A

talus and calcaneous

320
Q

how many midtarsal joints are there? and what are they?

A

2
calcaneocuboid joint
talocalcaneonavicular joint

321
Q

what bones of the foot are involved in the calcaneovuboid (midtarsal) joint?

A

calcaneous and cuboid

322
Q

what bones of the foot are involved in the talocalcaneonavicular (midtarsal) joint?

A

talus, calcaneous and navicular

323
Q

what type of joints are the midtarsal joints of the foot?

A

synovial joints

324
Q

what range of movement do the midtarsal joints of the foot have?

A

inversion and eversion

325
Q

what bones are involved in the tarsometatarsal joints?

A

cuneiforms/cuboid with the metatarsals

326
Q

what bones are involved in the metatarsophalangeal (MTP) joints?

A

metatarsals and phalanges

327
Q

what type of joints are the metatarsophalangeal joints?

A

synovial joints

328
Q

what range of movement do the metatartsophalangeal joints have?

A
flexion
extension
abduction
adduction
circumduction
329
Q

what joints are involved in the interphalangeal joints of the foot?

A

proximal to middle phalanges
middle to distal phalanges
proximal to distal 1st phalanx

330
Q

what type of joints are the interphalangeal joints of the foot?

A

synovial hinge joints

331
Q

what range of movement do the interphalngeal joints of the foot have?

A

flexion and extension

332
Q

what are the 3 arches of the foot?

A

medial longitudinal arch
lateral longitudinal arch
transverse arch

333
Q

what are the 3 main functions of the arches of the foot?

A
  • shock absorption
  • spring function
  • weight redistrubution to increased weight-bearing capacity
334
Q

what is the name of the thickened central area of the plantar fascia?

A

plantar aponeurosis

335
Q

what is the plantar fascia?

A

the deep fascia of the sole of the foot

336
Q

what supports the arches of the foot?

A

plantar aponeurosis and plantar ligaments

337
Q

what bones of the foot compose the medial longitudinal arch?

A

calcaneus, talus, navicular, 3 cuneiforms and metatarsals 1-3

338
Q

what muscles support the medial longitudinal arch of the foot?

A

flexor hallicus longus
attachments of the tibialis anterior
attachments of the fibularis longus

339
Q

where does the tibialis anterior attach to the foot?

A

to the junction between the medial cuneiform and the base of 1st metatarsal

340
Q

where does the fibularis longus attach to the foot?

A

tendon passes across the plantar aspect of the foot from lateral to medial to attach to the junction between the medial cuneiform and the base of the 1st metatarsal

341
Q

what bones of the foot compose the lateral longitudinal arch?

A

calcaneus, cuboid and metatarsals 4/5

342
Q

what bones of the foot compose the transverse arch?

A

cuboid, cuneiforms and metatarsals 1-5

343
Q

what muscles support the transverse arch of the foot?

A

fibularis longus

tibialis posterior

344
Q

what are the muscle compartments of the intrinsic muscles of the foot?

A

3 layers within the sole +
additional muscles between the metatarsals (interosseous muscles
2 on dorsum

345
Q

what movement do the intrinsic sole muscles of the foot perform?

A

flexion of the toes

346
Q

what movement do the interosseous muscles of the foot perform?

A

abduction/adducion of the toes

347
Q

what artery does the dorsalis pedis artery branch off of?

A

anterior tibial artery

348
Q

where is the pulse of the dorsalis pedis taken?

A

lateral to the extensor hallicus longus tendon

349
Q

what artery does the arcuate artery branch off of?

A

dorsalis pedis artery

350
Q

what arteries supply the dorsum of the foot?

A

dorsalis pedis

+ arcuate artery

351
Q

what artery do both the medial and lateral plantar arteries branch off of?

A

posterior tibial artery

352
Q

what arteries form the deep plantar arch?

A

medial and lateral plantar arteries

353
Q

what arteries do the metatarsal arteries arise from?

A

deep plantar arch and the arcuate artery

354
Q

what arteries do the digital arteries of the foot arise from?

A

metatarsal arteries

355
Q

how many digital arteries does each toe have?

A

4

356
Q

where do the great and small saphenous veins arise from?

A

dorsal venous arch

357
Q

what do the deep veins of the foot drain into?

A

anterior tibial vein, posterior tibial vein and fibular vein

all join to form popliteal vein

358
Q

how many dorsal foot muscles are there?

A

2

359
Q

what is the function of the dorsal foot muscle?

A

extension of the toes

360
Q

what is the motor nerve supply to the intrinsic muscles of the sole of the foot?

A

tibial nerve

361
Q

what is the motor nerve supply to the intrinsic muscles of the dorsum of the foot?

A

deep fibular nerve

362
Q

what is the sensory supply of the dorsum of the foot?

A

mainly superficial fibular nerve
deep fibular nerve supplies first interdigital cleft
sural nerve supplies proximal lateral border
saphenous nerve supplies proximal medial border

363
Q

what is the sensory supply of the plantar surface of the foot?

A

mainly tibial nerve to heel and majority of sole
sural nerve supplies proximal lateral border
saphenous nerve supplies proximal medial border

364
Q

what vessels do the lymphatic vessels of the foot follow?

A

the great and small saphenous veins

[in limbs, lymphatics follow veins]

365
Q

what forms the anterior wall of the axilla?

A

pectoralis major

366
Q

what are the main muscles of climbing?

A

pectoralis major and latissimus dorsi

367
Q

what vein is the axillary vein a continuation of?

A

brachial vein (a deep vein of the arm)

368
Q

when does the brachial vein become the axillary vein?

A

at the lower border of the teres major muscle

369
Q

where is the teres major in relation to the axilla?

A

the teres major contributes to the posterior wall of the axilla

(inferior border of teres major is the inferior extent of the axilla)

370
Q

where can pulsations of the subclavian artery be palpated?

A

where the artery crosses the first rib

371
Q

when does the subclavian artery become the axillary artery?

A

at the lateral border of the first rib

372
Q

what muscles do the roots and trunks of the brachial plexus lie between?

A

between anterior and middle scalene muscles

373
Q

where do the divisions of the brachial plexus lie?

A

immediately posterior to the subclavian vessels

deep to the clavicle

374
Q

where do the cords of the brachial plexus lie?

A

around the axillary artery, distal to the first rib

375
Q

what 3 muscles does the musculocutaneous nerve supply?

A

anterior compartment of the arm:
coracobrachialis
biceps brachii
brachialis

376
Q

which nerves of the brachial plexus pass into the posterior compartment of the arm?

A

axillary and radial nerve

377
Q

why is the axillary nerve vulnerable to injury in shoulder dislocation or fractured neck of humerus?

A

it wraps around the posterior aspect of the surgical neck of the humerus

378
Q

why is the radial nerve vulnerable to injury in a mid-shaft humeral fracture?

A

it wraps around the posterior aspect of the med-shaft of the humerus

379
Q

which is the most medial of the nerves of the brachial plexus?

A

ulnar nerve

380
Q

where is the ‘M-shaped’ configuration of the named nerves of the brachial plexus?

A

within the axilla

381
Q

what is the main muscle of the posterior wall of the axilla?

A

latissimus dorsi

382
Q

where does the subclavian vein drain into the internal jugular vein in relation to the sternoclavicular joint?

A

posterior to the sternoclavicular joint

383
Q

where is the subclavian artery in relation to the subclavian vein?

A

subclavian artery is immediately posterior to the subclavian vein

384
Q

where are the axillary lymph nodes located?

A

within the fascia of the axilla

385
Q

what cranial nerve supplies the trapezium?

A

the accessory nerve

386
Q

what type of nerves are the 5 named nerves of the brachial plexus?

A

somatomotor
somatosensory
sympathetic

387
Q

what is the path of the median nerve?

A

goes down the medial aspect of the arm and crosses the anterior aspect of the elbow (cubital fossa) and crosses the forearm through the wrist and into the hand through the carpal tunnel

388
Q

what is the path of the ulnar nerve

A

goes down the medial aspect of the arm and passes posteriorly to the medial epicondyle of the humerus, then into the anterior compartment of the forearm and into the hand

389
Q

what is the path of the axillary nerve?

A

emerges anteriorly and passes into the posterior compartment of the arm. It wraps around the surgical neck of the humerous and supplies the deltoid muscle

390
Q

what is the path of the radial nerve?

A

passes into the posterior compartment, passes anteriorly to the lateral epicondyle of the humerus and then into the posterior compartment of the forearm

391
Q

which nerve of the brachial plexus carries somatosensory nerve fibres to the medial 1.5 fingers of the hand? (anterior)

A

ulnar nerve

392
Q

which nerve of the brachial plexus carries somatosensory fibres to the lateral 3.5 fingers of the hand? (anterior)

A

median nerve

393
Q

which nerve of the brachial plexus carries somatosensory fibres to the lateral aspect of the dorsum of the hand?

A

radial nerve

394
Q

which nerve of the brachial plexus carries somatosensory fibres to the badge patche
of the lateral arm?

A

axillary nerve

395
Q

describe the 33 vertebrae organised in the sections of the spine?

A
7 cervical
12 thoracic
5 lumbar
5 sacral (fused)
4 coccgeal (fused)
396
Q

why do the cervical vertebrae have a really large central foramen?

A

large spinal cord

this thins as it gives out nerves roots

397
Q

why do the vertebral bodies get larger from the cervical vertebrae to the lumbar vertebrae?

A

because as you go down, you have to carry more weight

398
Q

where do the ribs attach to the vertebrae of the thoracic spine?

A

at the costal facets

2 superior costal facets, 2 inferior costal facets

399
Q

what are the posterior elements of the vertebrae?

A

the bony features of the vertebral arch

ie everything but the vertebral body

400
Q

compare the thoracic vertebra to the lumbar vertebra in terms of pedicles?

A

thoracic vertebra- small peedicles

lumbar vertebra- longer, wider pedicles

401
Q

compare the thoracic vertebra to the lumbar vertebra in terms of articular facet joints?

A

thoracic vertebra- more vertical facet joints

lumbar vertebra- more horizontal facet joints

402
Q

what type of joints are the superior and inferior articular facet joints of the vertebrae?

A

synovial joints

403
Q

in which joints does osteoarthritis of the spine occur?

A

in the facet joints

404
Q

what is the main peculiarity of the atlas vertebra?

A

it has no vertebral body

405
Q

what extra process does the axis have?

A
dens process
(odontoid peg)
406
Q

what is the function of the dens process of the axis vertebra?

A

articulates with the atlas and allows rotation of the head and atlas around the dens

407
Q

the atlas vertebra has big wide articular facets, where do these articulate superiorly?

A

to the occiput of the skull

408
Q

what is the function of the transverse foramen of the cervical vertebrae?

A

allow transmission of the vertebral artery, vein and nerve fibres

409
Q

compare the vertebral body of the cervical vertebrae to the ones of the thoracic vertebrae?

A

cervical vertebral body is smaller

410
Q

compare the lamina of the cervical vertebrae to the lamina of the thoracic vertebrae?

A

cervical lamina is much wider

411
Q

compare the transverse process of the cervical vertebrae to the transverse process of the thoracic vertebra?

A

cervical transverse process is much shorter

412
Q

what are the movements of the atlanto-occipital joint?

A

flexion
extension
lateral flexions

413
Q

what are the movements of the atlanto-dens joint?

A

rotation (with dens acting as pivot)

414
Q

what is the vertebra prominens?

A

the most prominent vertebra- C7

415
Q

why is there the greatest risk of spinal injury at cervico-thoracic or thoraco-lumbar junctions?

A

because there is greatest risk of injury at the junctions between mobile and fixed parts

416
Q

what are the 2 main parts of the intervertebral discs?

A

annular fibrosis

nucleus pulposus

417
Q

what is the annular fibrosis of the intervertebral disc?

A

ther peripheral tough fibrous structure, arranged in rings

418
Q

what is the nucleus polposus of the intervertebral disc?

A

the central gelatinous, semi-fluid substance

419
Q

where are the intervertebral discs most likely to rupture? and why?

A

posteriorly

annulus fibrosus is thinnest posteriorly

420
Q

why in old age does the spine lose height and return to the C shape of the newborn?

A

intervertebral discs lose fluidity and size causing shrinking

421
Q

what are the 5 main ligaments of the spine?

A
anterior longitudinal ligament
posterior longitudinal ligament
ligamentum flavum
supraspinous ligament
intraspinous ligament
422
Q

where is the anterior longitudinal ligament of the spine?

A

runs along the anterior surface of the vertebral body and discs

423
Q

where is the posterior longitudinal ligament of the spine?

A

runs along the posterior surface of the vertebral body and discs

424
Q

what does the ligamentum flavum of the spine link?

A

links vertebral laminae

425
Q

where is the supraspinous ligament of the spine?

A

runs along the peaks of the spinous processes

426
Q

what does the intraspinous ligament of the spine link?

A

links the spinous processes of the vertebrae

427
Q

compare the ligamentum flavum, supraspinous ligament and the intraspinous ligament in terms of strength?

A

ligamentum flavum and supraspinous ligament - tough

intraspinous ligament - relatively weak

428
Q

what are the 3 columns of Denis? (of the spine)

A

anterior column- anterior 2/3 of the vertebral body

middle column- posterior 1/3 of vertebral body

posterior column- posterior elements

429
Q

what happens to the stability of the spine when 1 column is injured?

A

spine is stable

430
Q

what happens to the stability of the spine when 2 columns are injured?

A

spine might be unstable

431
Q

what happens to the stability of the spine when 3 columns are injured?

A

spine is unstable

432
Q

what are the 3 classifications of muscles of the spine?

A
  • superficial (extrinsics)
  • intermediate
  • deep (intrinsics)
433
Q

what is the main function of the intermediate muscles of the spine?

A

respiratory function

434
Q

where is the origin of the intermediate muscles of the spine?

A

spinous processes

435
Q

where is the insertion of the intermediate muscles of the spine?

A

ribs

436
Q

what are the 3 intermediate muscles of the spine?

A
serratus posterior (x2)
serratus superior (x2)
serratus inferior (x2)
437
Q

what are the 4 main superficial (extrinsic) muscles of the spine?

A

trapezius (x2)
latissimus dorsi (x2)
rhomboid minor and major (x2)
levatus scapularis (x2)

438
Q

what is the function of the superficial (extrinsic) muscles of the spine?

A

movement of the shoulder and upper limb

not much to do with spinal movement

439
Q

where is the origin of the trapezius?

A

C1-T12 spinous processes

440
Q

where are the insertions of the trapezius?

A

occiput

spine of the scapula

441
Q

what is the function of the trapezius?

A

elevates + depresses scapula (ie shrugging shoulders)

retracts scapula

442
Q

where is the origin of the latissimus dorsi?

A

spinous processes and pelvis (brim of ilium)

443
Q

where is the insertion of the latissimus dorsi?

A

humerus

444
Q

what is the function of the latissimus dorsi?

A

adducts humerus
extends humerus
internally rotates humerus

445
Q

what is the innervation of the latissimus dorsi?

A

C6/7/8

446
Q

where are the rhomboid major and minor and the levatus scapularis in relation to the trapezium?

A

rhomboid major and minor and the levatus scapularis are just deep to the trapezium

447
Q

where are the origins of the rhomboid major and minor?

A

minor- spinous processes of C7/T1

major- spinous processes of T2-T5

448
Q

what are the insertions of the rhomboid major and minor?

A

medial border of the scapula

449
Q

what is the innervation of the rhomboid major and minor?

A

dorsal scapula nerve (C3/4)

450
Q

what is the function of the rhomboid major and minor?

A

keeps scapula against thoracic wall

retracts scapula

451
Q

where is the origin of levatus scapularis?

A

transverse processes of C1

452
Q

where are the insertions of levatus scapularis?

A

superior angle of scapula

453
Q

what is the innervation of the levatus scapularis?

A

branches of C4/5

454
Q

what is the function of the levatus scapularis?

A

elevates the scapula

455
Q

what are the 3 deep muscles of the spine? (intrinsics)

A

erector spinae muscles:
iliocostalis (x2)
longisimus thoracis (x2)
spinalis thoracis (x2)

456
Q

what happens to the lumbar lordosis in spinal trauma?

A

lordosis becomes flat

due to swelling

457
Q

describe the positions oft eh erector spinae muscles?

A

all parallel to the spine
iliocostalis (laterally)
longisimus thoracis (in between)
spinalis thoracis (medially)

458
Q

where is the origin of the erector spinae muscles?

A

occiput of the skull

459
Q

where is the insertion of the erector spinae muscles?

A

pelvis

multiple attachments alon thoracic wall

460
Q

what is the innervation of the erector spinae muscles?

A

posterior rami of the spinal nerves

461
Q

what is the spinal cord a continuation of?

A

the medulla oblongata

462
Q

where does the spinal cord exit the skull?

A

via the foramen magnum

463
Q

where does the spinal cord terminate?

A

in the cauda equina at L2

464
Q

what area of the body do nerves in the cervical spine govern?

A

arms

465
Q

what area of the body do nerves in the thoracic spine govern?

A

middle of the body

466
Q

what area of the body do nerves in the lumbar spine govern?

A

legs

467
Q

what area of the body do nerves in the sacral spine govern?

A

posterior aspects of legs

pelvis

468
Q

what are myotomes?

A

muscles controlled by the motor element of the nerve root from a specific level

469
Q

what are dermatomes?

A

skin sensation supplied by the sensory element of the nerve root from a specific level

470
Q

what type of mattern makes up the posterior and anterior horns in the spinal cord?

A

grey matter

471
Q

what lives in the white matter of the spinal cord?

A

ascending sensory tracts

descending motor tracts

472
Q

what are the 2 types of descending motor tracts?

A
  • crossed pyramidal tract (lateral cerebrospinal tract)

- uncrossed pyramidal tract (anterior cerebrospinal tract)

473
Q

compare the crossed pyramidal tract (lateral cerbrospinal) to the uncrossed pyramidal tract (anterior cerebrospinal)?

A

crossed- motor neurones crosse at medullary level and descend spine on the contralateral side of the cord

uncrossed- motor neurones descend spine on the ipsilateral side of the cord and crosse at the same level it will exit from

474
Q

what are the 6 types of ascending sensory tracts?

A
  • anterior spinothalmic tract
  • anterior spinocerebellar tract
  • lateral spinothalmic tract
  • posterior spinocerebellar tract
  • posterior column of Goli
  • posterior column of Burdach
475
Q

what is the pathway of the anterior spinocerebellar tract?

A

sensory neurones enter and ascend on ipsilateral side of cord
then enter cerebellum

476
Q

what is the pathway of the posterior spinocerebellar tract?

A

sensory neurones enter and ascend on the ipsilateral side of cord
then enter cerebellum

477
Q

what information do the anterior spinocerebellar tract and the posterior spinocerebellar tract carry?

A

proprioception

478
Q

what is the pathway of the anterior spinothalmic tract?

A

sensory neurones enter and ascend the spine on the ipsilateral side for a couple of levels. Then cross and ascend on the contralateral side.
Then enter thalmus

479
Q

what is the pathway of the lateral spinothalmic tract?

A

sensory neurones enter and ascend the spine on the ipsilateral side for a couple of levels. Then cross and ascend on the contralateral side.
Then enter thalmus

480
Q

what is the pathway of the posterior column of Goli?

A

sensory neurones enter and ascend the spine on the ipsilateral side of the cord

481
Q

what is the pathway of the posterior column of Burdach?

A

sensory neurones enter and ascend the spine on the ipsilateral side of the cord

482
Q

what information do the lateral spinothalmic tract and the anterior spinothalmic tract carry?

A

pain and temperature

483
Q

what information do the posterior columns of Goli and Burdach carry?

A

fine touch and proprioception

484
Q

what horn of the grey matter of the spinal cord do the descending motor tracts enter?

A

anterior horn

485
Q

what root are the descending motor tracts transmitted via from the anterior horn to the nerve root?

A

ventral root

486
Q

what root are the ascending sensory tracts transmitted via from the nerve root to the posterior horn?

A

dorsal root

487
Q

what horn of the grey matter of the spinal cord do the ascending sensory tracts enter?

A

posterior horn

488
Q

the dorsal root is for which type of nerve pathway?

A

sensory nerve function

489
Q

the ventral root is for which type of nerve pathway?

A

motor nerve function

490
Q

the anterior horn is for which type of nerve function?

A

motor nerve function

491
Q

the posterior horn is for which type of nerve function?

A

sensory nerve function

492
Q

what do the ventral and dorsal roots join to become?

A

nerve root

493
Q

what does the nerve root divide to become?

A

anterior and posterior rami

494
Q

what do the posterior rami form the nerve supply of?

A

the intrinsic muscles of the back

the strip of skin sensation in the centre of the back

495
Q

what do the anterior rami form the nerve supply of?

A

everything in the body/limbs apart from the intrinsic muscles of the back and the strip of skin sensation in the centre of the back

496
Q

where do the spinal nerve roots exit the spinal column? (ie what part of the spine)

A

the intervertebral foramina

497
Q

what are the 3 main risks to the nerve root leavng the intervertebral foramina

A

prolapsed disc
facet joint osteophytes
foraminal stenosis

498
Q

what nerve roots is the cauda equina made of?

A

L2-S5 and coocygeal nerve

499
Q

what do the nerves of the cauda equina supply?

A

pelvic organs and lower limbs

500
Q

at what level does the spinal cord terminate at?

A

L2

501
Q

what type of joints are sacroiliac joints?

A

synovial plane joints

502
Q

what is the treatment of sacroilitis?

A

non-surgical

NSAIDs, physiotherapy

503
Q

does sacroilitis radiate?

A

no- localised pain

504
Q

where do the anterior and posterior spinal arteries come from?

A

descend from the pia mater (innermost layer of the meninges)

reinforced by the cervical, intercostal and lumbar arteries at each level

505
Q

what is Batson’s venous plexus?

A

a network of valveless veins that connect the deep pelvic veins and the thoracic veins to the internal vertebral venous plexus

506
Q

why is the spine a common place for neoplastic metastases?

A

because of batson’s venous plexus linking deep pelvic veins (draining bladder and prostate) and the thoracic veins (draining breast) to the internal vertebral venous plexus

507
Q

what are the intrinsice muscles of the dorsal foot?

A

extensor hallicus brevis

extensor digitorum brevis

508
Q

what is the sensory nerve supply to the medial leg?

A

saphenous nerve

509
Q

what is the sensory nerve supply to the medial foot?

A

saphenous nerve

510
Q

what is the sensory nerve supply to the lateral leg?

A

superficial fibular nerve

511
Q

what is the sensory nerve supply to the majority dorsal foot?

A

superficial fibular nerve

512
Q

what is the sensory nerve supply to the sole of the foot and heel?

A

tibial nerve

513
Q

what is the sensory supply to the section of the dorsal foot between 1st/2nd toes?

A

deep fibular nerve

514
Q

what is the function of the MTP joints?

A

flexion, extension, abduction, adduction and circumduction of the toes

515
Q

what is the function of the subtalar and metatarsal joints?

A

eversion and inversion of the foot

516
Q

what is the function of the interphalangeal joints?

A

flexion and extension of the toes

517
Q

where does the hip capsule insert into the femur?

A

inter-trochanteric line

518
Q

what is the largest sesamoid bone in the body?

A

patella

519
Q

what mechanism is the patella encapsulated by?

A

extensor mechanism

520
Q

are people generally genu varum or genu valgum?

A

genu valgum

521
Q

what is the ankle joint proper?

A

the articulation between the talus and the tibia

522
Q

what movements are involved in the ankle joint proper?

A

flexion and extension

523
Q

what joints within the foot is involved in the inversion and eversion of the foot?

A

midtarsal (calcaneocuboid, talocalcaneonavicular)

524
Q

what is the ring-like cartilaginous structure which is an extension of the acetabulum?

A

acetabulum labrum

525
Q

what is the function of the acetabulum labrum?

A

to increase the stability of the femoral head

526
Q

what is a retrograde blood supply?

A

blood vessels journey past the area they supply then loop back

527
Q

what is the main supplier of blood to the femoral head?

A

mainly- lateral and medial circumflex arteries

also- intermedullary artery of shaft of femur
retrograde

528
Q

what ligament does the antegrade blood supply of the femoral head go through?

A

ligamentum teres

529
Q

which type of blood supply is more at risk of avascular necrosis after trauma? (antegrade or retrograde)

A

retrograde

530
Q

what bone in the hand has a retrograde blood supply so has a larger risk of avascular necrosis after trauma?

A

scaphoid

531
Q

what bone in the foot has a retrograde blood supply so has a larger risk of avascular necrosis after trauma?

A

talus

532
Q

what are the 2 main hip flexors?

A

iliacus and the psoas major (iliopsoas together)

533
Q

what are the 2 secondary hip flexors?

A

rectus femoris

sartorius

534
Q

what are the 3 main hip abductors?

A

gluteus medius
gluteus minimus
tensor fascia late

535
Q

what is the origin of the gluteus minimus/medius?

A

iliac wing

536
Q

what is the insertion of the gluteus minimus/medius

A

greater trochanter of femur

537
Q

what is the origin of the tensor fascia lata?

A

iliac crest

538
Q

what is the insertion of the tensor fascia lata?

A

lateral tibial via the iliotibial tract

539
Q

what are the muscles which stabilise you when you stand onone leg?

A

hip abductors

540
Q

what is the main function of the gluteus maximus?

A

hip extensor

541
Q

what is the origin of the gluteus maximus?

A

posterior aspect of the ilium/sacrum

542
Q

what is the insertion of the gluteus maximus?

A

iliotibial tract

543
Q

what is the origin of both short head and long head of the biceps femoris?

A

long head- ischial tuberosity

short head- linea aspera

544
Q

what is the insertion of the short and long head of the biceps femoris?

A

fibula head

545
Q

what is the origin of the semimembranosus?

A

ischial tuberosity

546
Q

what is the insertion of the semimembranosus?

A

posterior tibia

547
Q

what is the origin of the semitendinosus?

A

ischial tuberosity

548
Q

what is the insertion of the semitendinosus?

A

medial tibia

549
Q

what is the likely diagnosis of a middle-aged/old patient presenting with lateral hip pain and no tenderness of the groin?

A

trochanteric bursitis

550
Q

why is there always tenderness of the groin in a true inter-articular injury of the hip?

A

because the groin is right over the joint

551
Q

what are the 3 compartments of the knee?

A

lateral compartment
medial compartment
patellofemoral compartment

552
Q

what is the main function of the medial collateral ligaments of the knee?

A

resist valgus stresses

553
Q

what is the main function of the lateral collateral ligaments of the knee?

A

resist varum stresses

554
Q

what are the origins of the collateral ligaments of the knee?

A

lateral and medial condyles of the femur

555
Q

what direction does the anterior cruciate ligament of the knee go in?

A

inferomedially

556
Q

what direction does the posterior cruciate ligament of the knee go in?

A

inferolaterally

557
Q

what are the 2 main types of acute meniscal tears?

A

bucket handle tear

radial tear

558
Q

what are the 5 parts of the extensor mechanism?

A
quadriceps muscle
quadriceps tendon
patella
patella tendon
tibial tuberosity
559
Q

what nerve should you worry about in a fracture of the proximal fibula?

A

common fibular nerve

560
Q

what is the origin of the plantaris?

A

lateral femoral condyle

561
Q

where is the origin of the tibialis anterior?

A

lateral surface of the proximal tibia

562
Q

where is the insertion of the tibialis anterior?

A

medial cuneiform /base of the 1st metatarsal

563
Q

what is the medial ankle ligament?

A

deltoid ligament

564
Q

what is the lateral ankle ligament?

A

lateral ligament complex

565
Q

what forces does the deltoid ligament of the ankle resist?

A

eversion /valgising forces of the ankle

566
Q

what forces does the lateral ligament complex of the ankle resist?

A

inversion/ varising forces of the ankle

567
Q

what is the origin of the plantar fascia?

A

tuberosity of calcaneus

568
Q

what is the insertion of the plantar fascia?

A

heads of the metatarsals

569
Q

what are the 3 muscles in the anterior compartment of the arm?

A

biceps brachii
coracobrachialis
brachialis

570
Q

which is the most anterior muscle in the anterior compartment of the arm?

A

biceps brachii

571
Q

where do the short head and the long head of the biceps brachii attach?

A

short head- coracoid process of the scapula

long head- supraglenoid tubercle of the scapula

572
Q

what are the 3 muscles that attach to the coracoid process of the scapula?

A
  • pectoralis minor
  • coracobrachialis
  • short head of biceps brachii
573
Q

what groove does the tendon of the long head of the biceps brachii pass through?

A

intertubecular groove of the humeus

574
Q

what are the 2 distal attachments of the biceps brachii?

A
  • bicipital tuberosity of the radius via the biceps tendon

- medial side of proximal forearm via the bicipital aponeurosis

575
Q

describe the location of the corachobrachialis relative to the biceps brachii and brachialis?

A
  • deep to the biceps brachii

- medial to the brachialis

576
Q

what separates the coracobrachialis from the triceps?

A

medial intermuscular septae

577
Q

where is the distal attachment of the coracobrachialis?

A

humerus

578
Q

where is the distal attachment of the brachialis?

A

coranoid process of ulna

579
Q

where is the proximal attachment of the brachialis?

A

humerus

580
Q

what separates brachialis fromt he triceps?

A

lateral intermuscular septae

581
Q

what is the most powerful supinator of the forearm?

A

biceps brachii

582
Q

why can biceps brachii supinate the forearm?

A

because it spans the radioulnar joint

583
Q

what are the functions of the muscles of the anterior compartment of the forearm?

A
  • flexion, abduction + adduction of wrist
  • flexion of fingers + thumb
  • pronation of forearm
584
Q

what is the arrangement of the muscles of the anterior forearm?

A

layer 1, layer 2 and layer 3

suprficial to deep

585
Q

what are the 4 muscles of layer 1 of the anterior compartment of the forearm?

A
  • pronator teres
  • palmaris longus
  • flexor carpi radialis
  • flexor carpi ulnaris
586
Q

where do the muscles of layer 1 of the anterior compartment of the forearm attach proximally?

A

to the medial epicondyle of the humerus via the common flexor tendon

587
Q

where does the palmaris longus (layer 1) attach distally?

A

palmar aponeurosis

588
Q

where does the flexor carpi radialis attach distally?

A

to the metacarpals on the radial side (lateral)

589
Q

where does the flexor carpi ulnaris attach distally?

A

to the metacarpals on the ulnar side (medial)

590
Q

what muscles makes up layer 2 of the anterior forearm?

A

flexor digitorum superficialis

591
Q

how many muscle bellies/tendons are there in the flexor digitorum superficialis and what are these for?

A

4 muscle bellies/tendons for the medial four digits

592
Q

what are the 3 muscles of layer 3 of the anterior forearm?

A
  • flexor digitorum profundus
  • flexor pollicis longus
  • pronator quadratus
593
Q

how many muscle bellies/tendons are there in the flexor digitorum profunda and what are these for?

A

4 muscle bellies/tendons for the medial four digits

594
Q

what are the long tendons of the muscles of the anterior compartment held in place by as they pass into the wrist and hand?

A

palmar carpal ligament

flexor retinaculum

595
Q

what is golfers elbow?

A
medial epicondylitis
(tendonitis of the common flexor tendon)
596
Q

what makes the superior boundary of the cubital fossa?

A

transverse line between the epicondyles of the humerus

597
Q

what makes the inferomedial boundary of the cubital fossa?

A

pronator teres

598
Q

what makes the inferolateral boundary of the cubital fossa?

A

brachioradialis

599
Q

what are the 3 veins and the 2 tendons which form the superficial contents of the cubital fossa?

A
median cubital vein
cephalic vein
basilic vein
biceps tendon
bicipital aponeurosis
600
Q

what are the 2 nerves and the artery which form the deep contents of the cubital fossa?

A
median nerve (medially)
radial nerve (laterally)
brachial artery
601
Q

where does the brachial artery bifurcate into the radial and ulnar arteries?

A

at the apex of the cubital fossa triangle

602
Q

when does the radial nerve divide into its superficial and deep branches?

A

deep to the brachialis

just anterior to the lateral epicondyle

603
Q

what muscle does the radial nerve pierce in order to enter the posterior compartment of the forearm?

A

supinator muscle

604
Q

does the ulnar nerve cross the anterior or posterior surface of the medial epicondyle of the humerus?

A

posterior surface

605
Q

which nerve is involved in the ‘funny bone’ site?

A

ulnar nerve

606
Q

what muscle does the ulnar nerve pass through to reach the anterior compartment of the forearm? (and what tunnel does it do this in?)

A

through flexor carpi ulnaris (in the cibutal tunnel)

607
Q

what nerve supplying the hand is spared in carpal tunnel syndrome and why?

A

palmar cutenous branch of the median nerve

because it passes into the hand superficially to the flexor retinaculum

608
Q

what is the function of the brachialis?

A

flexion of the elbow

609
Q

what is the function of the coracobrachialis?

A

flexion of the shoulder

610
Q

what is the function of the biceps brachii?

A

(flexion of the shoulder)
flexion of the elbow
supination of the forearm

611
Q

what are the 3 parts of the deltoid muscle?

A
  • posterior (spinal) part
  • middle (acromion) part
  • anterior (clavicular) part
612
Q

what is the function of the posterior (spinal) part of the deltoid muscle?

A

extension of the shoulder

613
Q

what is the function of the middle (acromial) part of the deltoid muscle?

A

abduction of the shoulder

supraspinatus initiates and deltoid takes over at about 30 degrees

614
Q

what is the function of the anterior (clavicular) part of the deltoid muscle?

A

flexion at the shoulder

615
Q

what are the 3 parts of the trapezius?

A

ascending, middle and descending parts

616
Q

what is the function of the ascending part of the trapezius?

A

scapular depression

617
Q

what is the function of the middle part of the trapezius?

A

retraction of the scapulae

618
Q

what is the function of the descending part of the trapezius?

A

scapular elevation

619
Q

what do the ascending and descending trapezius parts contract together to produce?

A

superior rotation of glenoid fossa

620
Q

what is the function of the levator scapulae?

A

elevation of scapula and inferior rotation of glenoid fossa

621
Q

what is the function of the rhomboid major?

A

retraction of scapula and inferior rotation of glenoid fossa

622
Q

what is the function of rhomboid minor?

A

retraction of scapula and inferior rotation of glenoid fossa

623
Q

what are the 4 rotator cuff muscles?

A
  • supraspinatus
  • infraspinatus
  • teres minor
  • subscapularis
624
Q

what is the function of supraspinatus?

A

first 15 degrees of abduction

625
Q

what is the function of infraspinatus?

A

stabilises head of humerus in glenoid

external rotation of shoulder

626
Q

what is the function of teres minor?

A

stabilises head of humerus in glenoid

external rotation of shoulder

627
Q

what is the function of subscapularis?

A

stabilises head of humerus in glenoid

internal rotation of shoulder

628
Q

what is the function of tere major?

A

adduction and medial rotation of the shoulder

629
Q

what is the distal attachment of the supraspinatus?

A

greater tubercle of the humerus

630
Q

what is the distal attachment of the infraspinatus?

A

greater tubercle of the humerus

631
Q

what is the distal attachment of the subscapularis?

A

lesser tubercle of the humerus

632
Q

what is the distal attachment of the teres minor?

A

greater tubercle of the humerus

633
Q

what nerves innervate the rotator cuff muscles?

A

brachial plexus

634
Q

what nerve supplies the deltoid muscle?

A

axillary nerve

635
Q

what nerve supplies the teres minor?

A

axillary nerve

636
Q

where does the deltoid attach proximally?

A

lateral 1/3 of the calvicle and the inferior aspect of the scapular spine and acromion

637
Q

where does the deltoid attach distally?

A

to the deltoid tuberosity of the humerus

638
Q

where does the subacromion bursa lie?

A

between supraspinatus tendon and acromion process of scapula

639
Q

subacromial bursitis may give rise to shoulder pain, especially on what movement?

A

abduction

because inflamed bursa will irritate the supraspinatus tendon

640
Q

what spinal nerves supply sensory innervation to the posterior aspect of the arm?

A

medially: anterior rami of spinal nerves C8, T1 + T2
laterally: anterior rami of spinal nerves C5 + C6 (via axillary nerve)

641
Q

what is the only muscle of the posterior compartment of the arm?

A

triceps brachii

642
Q

what are the proximal attachments of the triceps brachi?

A

long head- infraglenoid tubercle of the scapula

lateral head- superior to the radial groove of the humerus

medial head- inferior to the radial groove of the humerus

643
Q

where is the distal attachment of the triceps brachii?

A

olecranon process of ulna (via the triceps tendon)

644
Q

what is the action of the triceps brachii?

A

extension of the forearm

weak extension of the arm

645
Q

what nerve supplies the triceps brachii?

A

radial nerve

646
Q

define the borders of the quadrangular space where the axillary nerve is found?

A

superiorly- teres minor
inferiorly- teres major
laterally- humerus
medially- long head of triceps

647
Q

what is the name of the area of skin on the lateral aspect of the arm that is supplied by the axillary nerve?

A

badge patch

648
Q

when patients have sustained an inferior dislocation of the shoulder, why is the badge patch tested?

A

to test for function of the axillary nerve

649
Q

what nerve does abduction of the shoulder beyond 15 degrees test?

A

axillary nerve

650
Q

what spinal nerves make up the axillay nerve?

A

C5 and C6

651
Q

what spinal nerves make up the radial nerve?

A

C5- T1

652
Q

what groove in the humerus is the radial nerve found in?

A

radial groove

653
Q

what nerve is particularly vulnerable to a spiral mid-shaft fracture of the humerus?

A

radial nerve

654
Q

what are the 4 main functions of groups of muscles in the posterior compartment of the wrist?

A

1- extension, abduction and adduction of wrist
2- extension of fingers
3- extension and abduction of thumb
4- supination of the forearm

655
Q

what 5 muscles of the posterior compartment of the wrist are known as the ‘superficial layer’?

A
brachioradialis
extensor carpi ulnaris
extensor carpi radialis
extensor digitorum
extensor digiti minim
656
Q

what 5 muscles of the posterior compartment are known as the ‘deep layer’?

A
supinator
extensor pollicis longus 
extensor pollicis brevis
abductor pollicis longus
extensor indicis
657
Q

where do the muscles of the superficial layer of the posterior arm attach proximally?

A

to lateral epicondyle of humerus via the common extensor tendon

658
Q

with the exception of the muscle group which supinate the forearm, where are the muscle bellies/tendons of the muscles of the posterior compartment of the arm?

A

muscle bellies within the posterior compartment

tendons pass to the wrist and fingers

659
Q

what holds the tendons of the muscles of the posterior compartment of the wrist in place as they cross the wrist?

A

extensor retinaculum

660
Q

what is the main action of brachioradialis? (a muscle of the posterior compartment of the forearm)

A

flexion of the semi-

pronated forearm

661
Q

what happens to the radial nerve as it passes through the supinator muscle back into the posterior compartment of the forearm?

A

becomes renamed the posterior interosseous nrve

662
Q

where is the medial head of the tricpes brachii in relation to the long head?

A

medial head is more deep and inferior to long head

663
Q

what artery is found in the radial groove?

A

profunda brachii artery

664
Q

what is tennis elbow?

A

lateral epicondylitis (tendonitis of the common extensor tendon)

665
Q

what is the function of the extensor carpi radialis?

A

extends wrist on radial side

666
Q

what is the function of the extensor carpi ulnaris?

A

extends wrist on ulnar side

667
Q

what is the function of the extensor digitorum?

A

extends fingers

668
Q

what is the funcion of the extensor pollicis longus?

A

extends thumb

669
Q

what is the function of the abductor pollicis longus?

A

abducts thumb

670
Q

what is the function of the extensor pollicis brevis?

A

extends thumb

671
Q

what is the function of the extensor indicis?

A

extends index finger

672
Q

what are the 2 parts of the elbow joint?

A

humero-ulnar joint

radiocapitellar joint

673
Q

what is the function of the humero-ulnar joint?

A

flexion/extension

674
Q

what is the function of the radio-capitellar joint?

A

supination/pronation

675
Q

what muscles supinate the forearm?

A

biceps brachi and supinator muscles

676
Q

what muscles pronate the forearm?

A

pronator teres

pronator quadratus

677
Q

what 9 tendons pass through the carpal tunnel?

A

4 flexor digitorum profundus
4 flexor digitorum superficialis
flexor pollicis longus

678
Q

what is the shoulder joint proper?

A

glenohumeral joint

679
Q

what part of the ulna articulates with the humerus?

A

olecranon process

680
Q

what is the origin of the supraspinatus?

A

supraspinous fossa

681
Q

what is the innervation of the supraspinatus?

A

suprascapular nerve

682
Q

what is the origin of the infraspinatus?

A

the infraspinous fossa

683
Q

what is the innervation of the infraspinatus?

A

suprascapular nerve

684
Q

what is the origin of the teres minor?

A

dorsal aspect of the lateral border of the scapula

685
Q

what is the origin of the subscapularis?

A

subscapular fossa

anterior wall of the scapula

686
Q

what is the insertion of the deltoid?

A

deltoid tuberosity on lateral aspect of the humerus

687
Q

what bone feature of the humerus articulates with the ulna?

A

trochlea

688
Q

what bony feature of the humerus articulates with the radial head?

A

capitulum

689
Q

why are supracondylar humeral fractures common inchildren?

A

because the supracondylar region of bone is very thin

690
Q

what 2 structures are susceptible to damage during supracondylar humeral fractures?

A

brachial artery

median nerve

691
Q

compare skin that is innervated to skin that is denervated when running under water for a long time?

A

innervated skin wrinkles

denervated skin doesn’t wrinkle

692
Q

what are the 3 main ligaments in the elbow?

A

the medial collateral ligament
the lateral collateral ligament
the annular ligament

693
Q

which ligament is much thinner- the medial or lateral collateral ligament of the elbow?

A

lateral collateral ligament is much thinner than the medial collateral ligament

694
Q

what is the function of the annular ligament of the elbow?

A

keeps the radial head in place

695
Q

what is the site of insertion for all the extensor muscles of the forearm? (posterior compartment)

A

common extensor origin on the lateral epiconyle of the humerus

696
Q

what is the site of insertion for all the flexor muscles of the forearm? (anterior compartment)

A

common flexor origin on the medial epicondyle of the humerus

697
Q

during supination/pronation of the forearm, which is the bone that actually does the movement?

A

radius

ulna remains in the same place

698
Q

what is the fracture which can present as a dinner fork deformity?

A

distal radius fracture

699
Q

what are the 2 groups of muscles of the hand?

A

extrinsic

intrinsic

700
Q

compare the intrinsic and extrinsic muscles of the hand in terms of where the muscle bellies are?

A

extrinsic- located in the anterior/posterior compartment of the forearm
intrinsic- located in the hand itself

701
Q

what is the thenar eminence?

A

the muscular part at the base of the thumb

702
Q

what are the 3 thenar muscles?

A

opponens pollicis
flexor pollicis brevis
abductor pollicis brevis

703
Q

what is the function of the thenar muscles?

A

move the thub

704
Q

what is the innervation of the thenar muscles?

A

median nerve

705
Q

are the thenar muscles intrinsic or extrinsic muscles of the hand?

A

intrinsic

706
Q

what is the function of the hypothenar muscles?

A

move the little finger

707
Q

what are the 2 hypothenar muscles?

A

flexor digiti minimi brevis

abductor digiti minimi

708
Q

what is the innervation of the hypothenar muscles?

A

ulnar nerve

709
Q

are the hypothenar muscles part of the intrinsic of extrinsic muscles of the hand?

A

intrinsic

710
Q

what is the function of the lumbricals muscles?

A

flex at the MCP joints

extend at the IP joints

711
Q

compare the dorsal interossei and palmar interossei muscles in terms of which abduct and which adduct the fingers?

A

dorsal interossei abduct the fingers

palmar interossei adduct the fingers

712
Q

are the interossei muscles intrinsic or extrinsic muscles of the hand?

A

intrinsic muscles

713
Q

how many lumbrical muscles of the hands are there?

A

4

714
Q

what is the innervation of the lumbrical muscles of the hand?

A

lateral 2 = median nerve

medial 2 = ulnar nerve

715
Q

are the lumbrical muscles intrinsic or extrinsic muscles of the hand?

A

intrinsic muscles

716
Q

what is the function of the flexor digitorum superficialis muscles of the hand?

A

flex fingers at PIP joints

717
Q

what nerve innervates the flexor digitorum superficialis muscles of the hand?

A

median nerve

718
Q

are the flexor digitorum superficialis muscles intrinsic or extrinsic muscles of the hand?

A

extrinsic

719
Q

what is the function of the flexor digitorum profundus muscles of the hand?

A

flex fingers at the DIP joints

720
Q

what nerve innervates the flexor digitorum profundus muscles of the hand?

A

lateral 2 = median nerve

medial 2 = ulnar nerve

721
Q

what are the functions of the annular and cruciate pulleys in the hands?

A

keep the flexor tendons down to the bones

722
Q

what are the 3 peripheral nerves of the hand?

A

median

ulnar radial

723
Q

compare the ulnar and median nerve muscular supply of the hand?

A

median nerve - LOAF
(lateral lumbrical + opponens pollicis + abductor pollicis brevis + flexor pollicis brevis)

ulnar nerve - all other intrinsic hand muscles

724
Q

compare cutaneous sensation nerve supply of the hand by the median, ulnar and radial nerves?

A

median nerve- radial 3.5 fingers
ulnar nerve- ulnar 1.5 fingers
radial enerve- variable portion of dorsum, particuarly 1st webspace dorsum

725
Q

how do you test the median nerve muscular supply within the hand?

A

test abductor pollicis brevis

726
Q

how do you test the median nerve cutaneous sensation within the hand?

A

touch tip of index finger and thenar eminsnce

727
Q

how do you test the ulnar nerve muscular supply within the hand?

A

test abductor indicis and adductor digiti minimi

728
Q

how do you test the ulnar nerve cutaneous sensation within the hand?

A

touch dorsum and volar aspects of little finger

729
Q

how do you test the radial cutaneous sensation within the hand?

A

touch dorsum of 1st webspace

730
Q

is the brachial plexus made of anterior or posterior rami?

A

anterior rami

731
Q

where does the ulnar nerve pass in relation to the medial epicondyle?

A

posterior to the medial epicondyle

732
Q

the superficial palmar arch is immediately deep to what tendon?

A

palmar aponeurosis

733
Q

the deep palmar arch runs across the anterior aspects of what?

A

the bases of the metacarpals

734
Q

each finger has 4 neurovascular bundles supplying it, what are these?

A

medial palmar
lateral palmar
medial dorsal
lateral dorsal

735
Q

what is ring block technique?

A

depositing local anaesthetic in a ring around the base of the finger to anaesthetise all 4 proper digital nerves

736
Q

what fascia is affected by dupuytren’s contractures?

A

palmar fascia

737
Q

what structure forms a secure tunnel through which the tendons of the FDS/FDP/FPL and their synovial sheaths can travel distally?

A

fibrous digital sheaths

738
Q

what does tenderness of the floor of the anatomical snuff box following trauma suggest?

A

scaphoid fracture

739
Q

which nerve supplies the lateral dorsum of the hand and proximal index and middle fingers?

A

radial nerve

740
Q

which nerve supplies the dorsal skin over the distal phalanges of the thumb, index finger, middle finger and lateral side of ring finger?

A

median nerve

741
Q

which nerve suplies the medial part of the dorsum of the hand and the dorsum of the little finger and the medial hald of the ring finger?

A

ulnar nerve

742
Q

what joints do the lumbricals of the hand span?

A

anterior MCPJs
posterior PIPs
of digits 2-5