Clinical Anatomy Written Exam 1.

what movements are allowed at the ankle joint (talocrural)?

DF and PF, - less stable in PF

What are the two layers of the skin and what do they contain?

Epidermis - superficial tough outer layer, no vessels or lymphatics Dermis (deeper CT) - dense interconnected collogen and elastin fibers, (provides strength), superficial vessels and sensory nerve endings, (pain tempurature and touch)

T/F: all voluntary muscles attach directly to bones cartilage or ligaments

F, some have indirect attachments

T/F: each arch of the foot has a separate action and works independanlty

F: Function as unit, spread weight all directions

T/F: most bones are avascular

F: bones have a rich blood supply of BOTH vessels and nerves. sensory nerves carry pain fivers (nociceptors) to the periosteum) - sensation of tearing in periosteum is the cause of the acute pain of a fracture

T/F: the gasctocnemius is so strong that is can act on both the knee and ankle at the same time.

F: can't exert full power on both at same time, i.e. cant PF ankle if knee is fully flexed.

T/F: sensory neaurons and motor neaurons run as descrete structures via sensory and motor nerves

F: combine after exiting vertebral foramen to form spinal ganglion, later divide into posterior and anterior rami, each containing both sensory and motor neaurons.

T/F: any torsion or rotation of the femur is considered an unnatural bone deformity

F: femur naturally has some torsion/rotation due to the angle of the hip, femur runs medially to the knee joint. - female femur more oblique (wider pelvie)

T/F: the fibula is a non weight bearing bone and is therefore unimportant to LE machanics

F: important site for muscle attachments, contributes to ankle stability,

T/F: cartilage is only found on articulating surfaces of jounts

F: intercostal cartilage vs articulating (WB) cartilage

T/F: viens provide a predictable path of metastasis for some cancers?

F: lymphatic vessels do this

T/F: the ankle has a reletively thick joint capsule

F: most frequently injured joint. has collateral ligaments that provide mdial and lateral support.

T/F: an abnormal bursa would be collapsed, flat, and barely visable in a cadaver dissection.

F: normally collapsed, become enlarged and enflamed with abnormal pathology.

T/F: all veins carry deoxygenated blood?

F: pulmonary viens carry o2 rich blood from the lungs to the heart

What are the deep muscles of the posterior leg?

FHL, FDL, TP, and popliteus.

What are the four cutaneous nerves of the upper thigh>

Femoral nerve (anterior aspect), Obturaror nerve (follows medial path of adductor mm), Posterior cutaneous nerve of thigh, Latera cutaneous nerve of thigh.

What is the largest branch of the lumbar plexus?

Femoral nerve and branches, orginiates in the abdomen and passes deep to inguinal ligament. enters triagle lateral to vessels.

How many kids does dr. cleary have? how old are they? what are their names?

Grant - 17 Drew - 14 Violet - 11 Walker - 8

How old was your cadaver when he died? what did he do? what did he die of?

He was a colenal in the us armed forces, he died of metastatic prostate cancer at home of 04/21/2018, he was 87 years old

What are the major parts of the body from superior to inferior

Head > Neck > Thorax = Upper limb > Back = Abdomen > Pelvis/perineum > lower limb

what is calcaneal tendonitis and what are its causes?

Inflammation of tendon ìMicroscopic tears collagen fibersìPain with walking, especially with rigid soled shoesìCausesìRepetitive activities, running after prolonged inactivityìSudden increase in training intensityìPoor footwearìPoor training surfaces

What are the major body systems that are categorized in the systematic approach? (11 + one bonus system)

Integumentary, skeletal, articular, muscular, nervous, circulator, digestive, respitory, urinary, reproductive and endocrine Bonus: locomotive (Super system)

What is included in the articular system?

Joints and ligaments (arthrology), ligaments connect bony components, provides sites where some mm attach

What are the two major pumps of the circulatory system?

L heart: recieves oxygenated blood from the lungs, pumps though arteries out to body. often called the systemic pump R heart: receives deoxygenated blood from the body via viens and pumps to the lungs for O2, called pulmonary pump.

What primary nerve root innervates much of the skin covering the innominate bone laterall, the upper thigh anteriorly and the superior inguinal region anteriorly?

L1

What is the primary nerve root that innervates much of the superior lateral and anterior thigh and connects into the inguinal region to innervate parts of the anterior external genitalia?

L2

What primary nerve root innervates the majority of the medial thigh, anterior knee and inferior medial aspects of the inguinal region?

L3

What primary nerve root innervates teh cuteneous tissue of the lateral leg, dorsal foot, and medial digits one and two?

L5

What is the primary artery for the lateral compartment of the leg? What is the primary artery for the anterior compartment of the leg?

Lateral: perferating branches of the ant. tib. aa. and fibular aa. that penetrate the intramuscular septum. Anterior: Anterior tibial artery, branch of popliteal, transverses through the proximal hiatus of the IM, smaller than post. tib. aa. continues into ankle and becomes dorsallis pedis. (ant. tib vv becomes the dorsal venous network).

What are the classifications of bone shapes and give an example of each

Long: femur, tibia, fibula, etc. Short: cuboid, tarsels and metatarsals flat: protective functions (cranium) irregular: bones of the face sesemoid bones: develope in tendons. function is to redirect line of pull of muscles (mechanical advantage) or to provide protection for tendons from wear

Which type of vessel plays a major role in the bodies defense system?

Lymphatic vessels

what are the main functions of the plantar mm of the foot?

MAINTAIN ARCHES1 function as a group during stance. resist forces that reduce the longitudinal arches with loading response at heal -> transfer weight to ball fo foot and great toe. active during push off, stabilize foot for propulsion. refine efforts of long mm in pronation and supination to adjust to uneven ground.

What are the 2 major body segments in the regional approach?

Main body = head, neck and trunk Paired upper and lower limbs (subdivided into regions)

What is the difference between a marking and a formation on bone?

Marking: where tendons or ligaments attach, where arteries run formation: location where tendons pass to improve leverage or control type of movement

The medial circumflex vv feeds into what? the Lateral circumflex vv feeds into what?

Med > femoral vv Lat > deep femoral vv

What bones comprise the forefoot?

Metatarsals (also called the anterior or distal foot), - prox to dist: base, shaft, head, - plantar surface of 1st MT head has sesimoid bones embedded in tendons

Between arteries, viens and nerves, which vary the most and which vary the least?

Nerves vary less than arteries which vary less than viens

What does the plantar venous arch empty into? What does the dorsal nevous arch empty into?

P: lateral plantar vein and small saphenour D: great saphenous

What are the primary peripheral nerves for the three compartments of the leg?

Posterior: Tibial nn Lateral: superficial fibular Anterior: deep fibular

What are the three main approaches to studying anatomy?

Regional (body segments), Systematic (systems that function together) and clinical (practical applications)

the primary nerve root that innervates the skin on the lateral ankle and foot and digits 4 and 5 is the ___________________

S1

The primary nerve root that innervates most of the cuteneous buttox is the genitals is the

S3

How is weight transfered from the innominate bone to the feet?

SI joint > Pelvic Girdle > Hip Joint > Femur > Knee Joint > Tibia > Talus > Longitudinal arch (tarsels and MT)

spiral line of femur

Same as intertrochanteric line

What are the three cutaneous nerves of the proximal leg.

Saphenous (running medialy all the way to medial malleolus , large surface area), Medial Sural cutaneous nerve (small surface area, in region of small saphenous vien) and the lateral sural cutaneous nerve (extends above knee joint, ends midway down the leg)

What are the major segments of the upper limb?

Shoulder, arm (NOT UPPER ARM) , forearm, hand

What is included in the Muscular system? What is its purpose?

Skeletal, smooth and cardiac muscles (myology). contract to move or position bones at joints, smooth and cardiac control flow of fluids.

What are the body layers and tissue types ordered superficial to deep?

Skin > Subcutaneous Tissue > Deep Fascia > Muscles > Skeleton > Cavities (viscera)

What is included in the integumentary system?

Skin, nails, hair, sweat glands, and sebaceous glands (oil glands) as well as subcutaneous tissue/superficial fascia.

how is the femoral triangle formed?

Subfascial formation where iliopsoas and pactineus form the floor. botton corner formed between adductor longus and sartorius, medial corner formed by adductor longus and inguinal ligament and the superior lateral corner is formed by sartorius and the inguinal ligament.

What are the two most common types of fascia and what are their functions?

Superficial fascia (synonmous with subcutaneous tissue): wrapping, packing insulating meterial deep to skin that protects deep structures Deep Fascia: Dense layer of CT, - investing fascia is a type of deep fascia that has extensions that cover individual muscles and nearovascular bundles

What is the course of the superficial lymphatic system? What is the course of the deep lymphatic drainage system?

Superficial: run with great and small saphenous (great = end in superficial inguinal lymphnodes, small, end in popliteal lymph nodes) Deep: also enter popliteal lymph nodes, ascend through deep inguinal lymph nodes, run with the deep viens

What is the purpose of the spring ligament? what is its true name?

Supports head of talus thus forming part of the articular cavity where the talus is received. helps maintain the medial longitudinal arch of the foot. is a thick, broad fibrous band real name is the plantar calcaneonavicular ligament.

T/F: CT houses nerves and fibers and binds them into bundles

T

T/F: many paralell circuits of the body serve different organs and body regions

T

T/F: the anterior compartment of the foot is especially susceptible to compartment syndrome?

T

T/F: the hip region extends laterally to the greater trochanter and anteriorly to the ASIS

T

T/F: the regional approach to learning anatomy is most common in classes that include dissection

T

T/F: the skin has an endocrinological function in that it helps sythesize and store vit. D

T, it is also a good visible indicator of health status

T/F: vessels normally supply/drain all the structures they contact:

T:

T/F: one of the primary functions of the skeletal system is to store salts?

T: also location of BC production

T/F: the IM and all ligaments run inferiorly from tibia to fibula.

T: this way they can strongly resist the downward pull of muscles on fibula (thus preventing sepperation from tibia)

T/F: any torsion of the tibia is considered to be an abnormal bone deformity

T: tibia does not have natural torsion like the femur

What are the main contributing factors to knee injury?

The knee is a common fulcrum between two large levers - added torque, increased mobility decreased stability incongruent surfaces means the stability of the knee relies on ligaments, tendons and surrounding muscles tear to these supporting structures (especially the MCL and ACL) occur when foot is planted and a force is applied to the thigh or leg

Small Sephenous Veins

The small saphenous vein arises from the dorsel venous network and feeds into the popliteal vein.

What are the main bursa of the knee and why are they important?

There are atleast 12 tendond that cross the knee joint during movement, the bursa reduce friction and allow a more smooth glide of tendons during movement. 8 main bursa: suprapetellar, deep infrapetellar, subcuteneus infrapetellar, subcutaneus prepetellar, subtendinous prepetellar, gastrocnemius, semimembranosis and popliteus bursa

the superior gluteal nerve, inferior gluteal nerve, nerve to obturator internis and nerve to quadratus femoris all share what feature?

They are all branches of the sacral plaxus (L4-S4)

Which structures are often depicted as single structures in pictures but often run as duplicates with common anastamoses in real life?

V

Which type of vessel relies on a "musclular pump" to promote flow

V

What attaches to the pubic crest?

abdominal muscles

How does the inquinal ligament play a functional role in the femoral triangle?

acts as a flexor retinaculum, keeps structures in place, space deep to ligament allows for passage from pelvis to LE (important name change location)

Which mm of the anterior and medial thigh have two different layers with two different innervations

adductor magnus and pectineus

What three categories of description are considered to be an aspect of functional anatomy study?

anatomical planes, terms of relationships and comparisons, descriptors of mm movement.

what vessels supply the ankle

ant tibial, post tibial and fibular aa and vv, (deep) and great and small saphenous (cutaneus)

what nerves supply the knee joint?

ant: femoral n post: tibial n med: obturator nerve and saphenous (cutaneous) lat: common fibular n

Motor neurons arise from the _________ horns h of the spinal cord, sensory neurons arise from the ___________ horn.

anterior (ventral), posterior (dorsal) horn

superior to the talocrural joint are the ______________________________ligaments

anterior and posterior tibiofibular ligaments

Which is the largest compartment of the thigh? what are its two functional groups?

anterior compartment, hip flexors and knee extensors. rapid atrophy with disuse in this compartment pectineus is transitional muscle between anterior and medial compartments of the thigh.

Which rami (anterior or posterior) is larger? why?

anterior rami is larger. because is supplied more things, (anterior trunk, upper and lower limbs), the posterior rami supplied fewer things and is smaller (vert. collumn, deep back mm and skin)

What sepparates the compartments of the thigh?

anterior, medial and posterior compartments sepperated by fascia called an intermuscular septa

What is included in the integumentary system?

appanedages to the skin (Hair, nails, sweat glands) and subcutaneos tissue (superficial fascia). The skin is an extensive sensory organ that forms the bodys protective covering

What are the medial and lateral longitudinal arches? how are they formed? which is more important?

arches running the length of the foot, formed by bone shape, ligaments, pull of long tendons and pull of intrinsic muscles. The talar head is the keystone of both the medial and lateral longitudinal arches. medial arch more important

Great saphenous vein.

arises from dorsal venous network and feeds into the femoral vein as it enters the saphenous opening.

arcuate popliteal ligament

arises from posterior fibular head, strengthens posterio-lateral capsule

what is the external fiberous layer of the hip and what is its function?

attaches to acetabulum and femoral neck anteriorly at greater trochanter, and intertrochanteric line, fibers run spirally, some circular around fem neck, thick portions of capsule from ligaments of the hip

What does the deep fascia of the thigh attach to? What is its alternative name? As it extends distally, how does it change form?

attaches to inguinal ligament, pubis, iliac crest, sacrum, coccyx and IT band. Extends distally to exposed bone around knee, and deep fascia of leg inferior to knee

what is the ischiofemoral ligament and what is its function?

attaches to ischial part of acetabulum, spirals to femoral and base of greater trochanter - weakest of the three ligaments - tight during extension and internal rotation

What is the functional significance of the pubic tubercles?

attachment of inquinal ligamnets

What two features of the innominate bone articulate with the sacrum?

auricular surface and iliac tuberosity

Where would you find the tibial nerve near the ankle joint.

between FHL and FDL

what bony structures of the axial skeleton sepperate the CNS and PNS?

brain and spinal cord are the CNS, neurons become a part of the PNS as they exit the vertebral foremena and skull

What is a neurovascular bundle?

bundle of investing fascia containing nerve, artery and vien

What is the transitional zone between the trunk and LE?

buttox, inguinal cleft (ass crack?) sepparates right and left regions, gluteal fold marks the lower boundary

What two systems are included in the circulatory system?

cadiovascular and lymphatic systems

what cutaneous nerve innervates the heal of the foot?

calcaneal branches of the sural and tibal nerves

What is the most severe acute muscular problem of the leg?

calcaneal tendon rupture, more common in people who are poorly conditioned or ppl who have a history of calcaneal tendonitis

what are the three types of mm tissue?

cardiac, smooth skeletal, cardiac and smooth = involuntary skeletal and cardiac = striated

What is included in the circulatory system? What is its purpose?

cardiovascular and lymphatic systems (cardiology). heart and vessels conduct blood (deliver nutrients, remove waste). lymphatic vessles withdraw excess intersitial fluid, filters through nodes, returns fluid to blood stream.

What is th function of the plantar fascia?

central part = strong plantar aponeurosis functions like a ligament, holds parts of foot together, protection, supports long arches

what are tendons made from?

collogan fibers

Limb muscles that share actions usually share 1. ____________________ and 2. _____________________________

common fascial compartments and peripheral nerves

The sciatic nerve splits proximally to the knee into the tibial and ____________________, the later of which splits into the ________________________and _______________________ as it crosses over the anterior aspect of the fibula.

common fibular, superficial fibular, deep fibular.

what are the two types of bone

compact and spongy

What is the talocalcaneonavicular joint? what movements does it allow?

compound joint made of two articulations: the talonavicular and talocalcaneal (subtalar joint), considered a ball and socket joint, this joint allows some eversion and inversion of the foot

What causes sciatic nerve injury?

compression by piriformis muscle (pain in buttox), all or part of muscle can peirce muscle instead of tranvelling infioror to it. recovery of lesions is slow and usually incomplete. female athletes who are required to use glutes excessively at higher risk.

what is the transverse acetabular ligament?

continuation of labrum, runs over acatabular notch.

at the hip and thigh, the superficial fascia (subcutaneous tissue) is continuous with what structures?

continues with the inferior abdominal wall and gluteal feascia

what five bones comprise the midfoot?

cuboid, cuniforms (3), and navicular bones

what cutaneous nerve innervates the second digit of the foot?

deep fibular nerve

the dorsalis pedis becomes the ________________ as it continues into the foot.

deep plantar aa, joins deep plantar arch on plantar surface, forms anastamosis around the foot.

What are the medial ligaments of the ankle?

deltoid ligament - resists eversion, strong, fans out from the medial malleolus. portions: tibionavicular, tibiocalcaneal, anterior and posterior tibiotalar

What is the popliteal fossa, how is it formed?

diamond shaped depression when the knee is flexed. contains end of small saphenous vv, popliteal vv and aa, tibial nn, common fibular nn, sural nn, post cutaneous nn of thigh, popliteal lymph nodes and vessels, fat.

What veins empty into the femoral vein?

dorsal venous arch, anterior and posterior tibial, fibular, popliteal, deep femoral, lateral and medial circumflex (via the deep femoral), saphenous (via popliteal) and great saphenous (via the saphenous opening)

the anterior compartment of the foot is also know as the

dorsiflexor/extensor compartment

Where is the periformis located and why is it an important landmark?

exits pelvis through greater sciatic notch, attaches to apex of the greater trochanter. sepperates exit point of the superior and inferior bundles, pierced by sciatic nn in 12% of ppl.

Oblique popliteal ligament

expansion of semimembranosis tendon, reinforces posterior capsule

What muscle of the anterior compartment shares a synovial sheath with fibularis tertius?

extensor digitorum longus

each tendon of extensor digitorum forms ____________________ over the base of distal phalanges of digits 2-5

extensor expansion/dorsal aponeurosis

T/F: any anatomical variation between individuals is very rare and usually pathological

false, same architectual plan but all bodies diff. (variations related to gender, age, ethnicity, health status, and individual variability) Some structures vary more than others

What is the femoral sheath and what is its significance?

fascial tube deep to inguinal ligament. lines vascular compartment retro inguinal space.

What are the contents of the femoral sheeth?

femoral aa and vv (plus branches), great saphenous vv, deep lymph nodes.

what are the contents of the femoral triangle from lateral to medial?

femoral nerve (branches), femoral sheeth (artery and then vien). ** triangle bisected by artery and vein.

what nerves supply the hip?

femoral nerve, obturator nerve, n to quadratus femoris, superior gluteal nerve

what is the deep venous drainage of the LE?

femoral vein, popliteal vein, tibial vein, run deep to fascia and have like named arteries associated with them. their venous return is reliant on muscle contraction. they have valves which prevent back flow of blood. they have a variable course with frequent anastamosis.

what is the articularis genu?

few muscle slips that attack to anterior distal femur and synovial membrane. pull synovial membrane up during knee extension so it doesnt get pinched.

what are the three classes of joints (functional anatomy classification)?

fiberous, cartilaginous or synovial

what is a peripheral nerve?

fibers from diff. spinal nerve roots that have mixed to form a discrete branch. - cutaneous dist. as well as motor nerves that supply specific mm groups

medial and lateral maniscus

fibrocartilage, deepens articualr surface, improves shock absorbtion. thicker along external surfaces. attach into capsule. medial meniscus adheres to the MCL.

What are the two muscles in the lateral compartment of the leg?

fibularis longus, and fibularis brevis. they are the smallest and narrowis muscles in the leg. located between the calcaneus and the fibula. Their tendond share a common synovial sheath as they pass under the retinaculum and posteriorly to the lateral malleolus.

What is the purpose of the arches of the foot?

flexibility, shock absorbtion, spring board propulsion during walking, running and jumping.

what are the medial and lateral retinacula and how are they formed?

formed by distal tendinous attachements of the medial and lateral vasti, attach independantly to the patella, reinforce joint capsule, keep patella alligned

what is a motor unit?

functional unit of muscle, includes a motor neuron and and all the mm fibers it innervates. (therefore, all mm fibers that can contract simultaniously) 1-100 mm fibers per motor neuron depending on mm size and function

what mm compose the triceps surae?

gastroc (2 heads) and soleus, 93% of pf force. share calcaneal tendon which is teh most powerful tendon in the body.

What are the deep muscles of the hip?

gemellus superior, gemellus inferior, periformis, quadratus femoris obturator internis and obturator externis (fits in this group functionally but is deep to OI so not seen in prone pos.)

What is included in the reproductive system? What is its purpose?

glands, ducts, genitalia (gynocology = female reproductive system, andrology = male reproductive system)

What are the major segments of the lower limb?

gluteal, thigh, leg, foot

What muscles are in the superficial layer

gluteus maximus, medius and minimus, tensor fascia late

What is the superficial venous drainage of the LE?

great and small saphenous (most tributaries unnamed) and cutaneous veins. located in fascia separate from named arteries.

What is the great saphenous vein and where would you find it? Where does it terminate and into what stru

great saphenous vien runs the entire medial length of the LE, flowing distally to proximally, the saphenous vein terminates into the femoral vv as it enters the saphenous opening.

what is a myotome?

group of muscles that a single spinal nerve root innervates

in the leg, the flexor ___________________longus has a larger muscle belly than the flexor ____________________longus and runs between two seisamoid bones

hallucis digitorum

what is the strongest/most stable LE joint?

hip joint (btwn pelvic girdle and LE)

What are the intrinsic ligaments of the hip?

iliofemoral, ischiofemoral, and pubofemoral, these blend with the external fiberous layer of the hip joint capsule

which is the strongest hip flexor?

iliopsias, functional grouping of three other muscles (iliacus, psoas major and psoas minor) only muscle attaches to vertebral collumn, pelvis and femur, unique po. to stabilize

What are the three bones of the innominate and when do they fuse?

ilium, ischium and pubis, begin to fuse at end of teen years, rigidly fused in adults.

what is the pubofemoral ligament and what is its function?

inferior aspect, attaches to obturator crest of pubic bone, merges with capsule, blends with medial part of y-lig. - tightens during both extension and abduction - prevents over abduction of the hip

Where in the body would you find lymphatic node clusters?

inguinal, axial, and cervical regions

what the the three smallest articulations of the ankle?

intercuneiform, tarsometatarsal, and intermetatarsel. these joints are very small, are surrounded by tight ligaments and allow very little movement.

what is the adductor canal?

intermuscular passageway deep to sartorius, conveys major neurovascular bundle of the thigh: femoral aa and vv, prox. saphenous nn.

what are the main branches of the common iliac aa?

internal iliac and external iliac

what are the main ligiment of the subtalar joint?

interosseaous talocalcaneal ligament - strong ligament. binds talus to calcaneaus, lies in the tarsal sinus.

`what does ipsilateral mean? what does contralateral mean?

ipsi: same side of body (right hand and right foot) contra: opposite sides of body (right hand and left foot)

the ischium and pubis meat at a bony landmark called the

ischiopubic ramus

along with the ilium, what bone(s) contribute to the greater sciatic notch?

ischium

What is international anatomical terminology?

it is a component of medical terminology that uses proper terms to communicate with healthcare providers (i.e. "axillary" NOT "armpit" and "clavicle" NOT collerbone"). meant to be patient friendly and does not include medical jargon

How is TFL unique from the other superficial gluteal mm?

it's located anteriorly and is tightly enclosed in two layers of fascia

Tansverse Ligament of the knee

joins anterior edges of the menisci, crosses intercondylar area, tethers menisci together

What is included in the urinary system? What is its purpose?

kidneys, ureters, bladder and urethra (urology), filter blood, produce, transport, store and excrete liquid waste

what is the largest joint of the body?

knee joint, also most superficial - articulations are large incongruent shapes - lat and med femorotibial - femur and petella

What are the sources of strength for the hip joint?

labrum, adjacent muscles, strong capsule and capsular ligaments, high articular contact, deep socket vulnerable with aging due to... - angle of fem neck - close prox. to blood supply, damage = avascualr necrosis

What is teh obturator foramen and what is its function?

large oval, irregular triangular opening, - minimizes bony mass weight of pelvis - small passageway for obturator nerve and vessels - extensive surface area for fleshy mm attachment

How is gluteus maximus different from the other two gluteal muscles?

largest, heaviest and most corsely fibered mm in body, performs ER not IR, has sepperate invervation and vascularization (inferior gluteal bundle + superior gluteal bundle aa) from glute med, min and TLF (superior gluteal bundle)

The ________________ continues to become the deep platar arch

lateral plantar aa

the ___________malleolus extends one cm farther distally than the _______________malleoulus

lateral, medial

How is muscle length measured

length of both muscle belly and its tendon

Where would you find the arteries that supply the femoral head and neck?

ligamentum teres: branch of the obturator nerve that crosses the hip joint and enters the head of the femur at the fovea (within the synovial membrane), Medial and lateral circumflex arteries, both branch from the femoral aa.

what happens to the superficial fascia as it nears the knee?

losses much of its fat content and begins to blend with the deep fascia of the knee.

What does "pes anserinus" mean and what is its function in terms of the human body?

means "goose foot" attachment point of semi tendonosis, gracillis and sartorius. adds stability to medial knee in extension.

What primary nerve roots innervate the skin of the medial and lateral leg respectively?

med: L4 lat: L5

what blood vessels supply the hip?

medial and lateral circumplex arteries, and artery to head of femur (branch of obturator artery, transverses via ligamentum teres)

what are the two major branches of the posterior tibial aa as it nears the foot?

medial and lateral plantar aa.

What is included in the digestive system? What is its purpose?

mouth to rectum (gastroenterology). organs and glands for mastication, digestion, ingestion, swallowing, absorbtion and elimination of solid waste

how are the aa, nn, and vv ordered in the popliteal fossa?

nerves are most superficial, then viens, then arteries (which run along post surf. of femur).

what is hiltons law?

nn that supply mm that cross a joint also innervate the joint itself

What muscles compose the tricepts coxae?

obturator internis and the superior and inferior gemelli, these mm cannot act independantly. - OI leaves pelvis through lesser sciatic notch.

what is the adductor hiatus and what is its function?

opening in the distal adductor magnus (between adductor and hamstring part). superior to adductor tubercle. location where femoral aa moves posteriorly and becomes popliteal

what is the periosteum and what does it do?

outer layer of bone, can lay down more bone, contains meny sensory nerve endings

the medial depression (fovea) of the femur serves what purpose?

passage of ligamentum teres

what is the other name for fibularis tertius

peroneus tertius

What specific structures make up the lymphatic system?

plexuses, vessels, nodes, lymphocytes and some specific organs (thymus, spleen, etc)

all four genicular aa and vv feed into the _____________

popliteal aa and vv

knee flexion compresses which vessel?

popliteal artery and vv

the ____________ artery has a branch that travels anterior through the superior interosseous hiatus and becomes the _________________, as this artery nears the foot it supplied the ___________________ artery.

popliteal, anterior tibial, dorsalis pedis

coronary ligs

portions of the capsule btwn menisci margins and peripheral tibial condyles

On the dermatome map, the primary nerve root S2 appears to cover the same area as what cutaneous nerves>

posterior cutaneous nerve of thigh and the medial sural cutaneous nerve.

What does the Medial and Lateral Plantar vv feed into?

posterior tibial vv, small saphenous vv and the great saphenous vv.

ACL:

prevents anterior translation of tibia on femur, prevents hyperextension, poor blood supply, weaker than PCL`

PCL

prevents post. displacement of tib on fem. prevents hyperflexion (because tibia glides posteriorly on femur during flexion, picture not great for visualizing this)

What is the functional significance of the iliac crest?

protectice bumper, important site of aponeurotic attachment for thin sheet like mm and deep fascia (terminates in PSIS)

What is the functional significance of the anterior pubic bone?

prox. attachment for medial thigh muscles

Which bone of the innominate has a superior and inferior ramus?

pubis

What is cartilage, what is it made out of?

resilient, semi rigid CT, avascular, amount of cartilage degreeses with aging

petellar ligament

runs from petella to tibial tuberosity, - petellar allignment: medial and lateral retinacula from vastuc m and l attach here, continuous with joint capsule

What is the bifurcate ligament of the foot?

runs from the calcaneus to the cuboid and the calcaneus to the navicular

What are the common features of the hamstrings?

same peripheral nerve, same prox attachment on ischial tuberosity, all act on 2 joints. BF short head (4th mm in group) not fuctionally in this group, not technically a hamstring

What is the saphenous nerve and when does it join the great saphenous vv?

saphenous nerve is a branch of the femoral nerve (medial nerve of ant thigh), it joins the saphenous nerve in the leg after passing posteriorly through the adductor canal. - mult. branches to post leg - cutaneous branches in medial ankle and foot

what is the terminal branch of the femoral nn?

saphenous nerve, final cutaneus branch to anteriomedial leg. runs w/fem aa and vv through adductor canal, becomes superficial again, emerges between sartorius and gracillis. suplies anterio medial knee, leg and foot (skin and fascia)

which muscle is that tailors muscle?

sartorious, taylors worked cross legged. no strong actions, mainly a synergist.

what is the acetabulum and what is its function?

shallow cup/cavity on lateral aspect of innominate bone - all three bones contribute, - articulates w/femoral head - acatabular notch refers to the incomplete inferior margin - fossa, rough repression in floor

What is the purpose of the short plantar ligament? what is its true name?

short but wide band with great strength, assists in maintaining the longitudinal arches of foot. true name is the plantar calcaneocuboid ligament

What is included in the locomotor system? What is its purpose?

skeletal, muscular and articular systems produce movement, nervous system prompts movement

What movement occurs btwn the tibia and fibula?

slight movement during PF of ankle. sup articulation is a proper joint and inferior articualtion is a syndesmosis. interousseous membrane connects them.

What veins from the lower leg empty into the popliteal vein?

small saphenous, anterior and posterior tibial, and the fibular vien.

what are the ligaments of the lateral ankle?

smaller and weaker than medial ligaments anterior talofibular: flat, weak posterior talofibular: thick, strong, calcaneofibular: found cord

What is included in the endocrine system? What is its purpose?

specialized structures that secrete hormones (endocrinology), hormones carried to all parts of body, effect metabolism, broad influence on body like nervous system

What is a dermatome?

specific segment of skin supplied by a single spinal nerve

What is the acetabular labrum and what is it made from?

strong fibrocartilaginous ring around acetabular rim that increases articular area

What is the popliteal fascia and how is it formed?

strong sheet of deep fascia continuous with, fascia late (sup) and deep fascia of leg (inf). protective covering and flexor retinacula for hanstring tendons. often pierced by small saph.

what are the two bursa associated with the triceps surae and what are their functions?

subcutaneous calcaneal (superficial): allows skin to move over the taut tendon. retrocalcaneal (deep): allows tendon to glide over bone

what are the two most functional groups of the foot?

subtalar (talocalcaneal) and transverse tarsel

What cutanteous nerve innervates the remaining lateral leg (not inervated by the lateral sural cutaneous) and wraps around to innervate the big toe as well as digit 3 and half of digit four?

superficial fibular nerve

What is the main role of tibialis posterior?

supports/fixes medial longitudinal arch. static contraction throughout stance. works with tibialis anterior to invert foot in open chain position. also a weak PF

What nerve runs with the small saphenous?

sural nn

What does the stability of the knee depend on?

surrounding mm, ligaments connecting femur to tibia. - incongruent shape = relatively weak mechanics

What unique feature of the synovial membrane of the knee allows it to bend and stretch more redily?

synovial plicae, covers everything but articualar cartilage

T/F: muscles of the gluteal region share the same compartment.

t

what two bones comprise the hindfoot?

talus and calcaneus - only talus articulates w/leg. receives weight from tibia and transmits weight to calcaneous and forefoot (via ligaments)

What are the articulations of the ankle joint?

talus: trochlea part tibia: inferior WB surface and both malleoli - malleoli grip tightly during movement fibula: distal part from lateral malleolus

LCL fuction

taut in knee extension, slack in flexion, resist varus forces on the knee

MCL function

taut in knee extension, slack in flexion, weaker than lcl, resists valgus forces on the knee joint.

What makes the plantaris muscle unique to the gastroc and soleus?

tendon easily mistaken for a nerve (freshmans nn), vestigial (absent in 10-15% of pple), proprioceptive organ for larger PF muscles, can be removed for grafting purposes.

What are the "intermediate" muscles of the foot?

the dorsal interossei

which is the longest and heaviest bone?

the femur (Lenght = 1/4 persons height)

what vessels supply the knee joint?

the geniculars (4)

what is a spinal nerve?

the initial nerve that arises directly from the spinal cord (before it splits into an anterior and posterior ramus)

What structures compose the sciatic foramena?

the sacrospinous ligaments attachment to the innominate bone divide and partially for the greaterand lesser sciatic foramena.

What maintains the arches of the foot?

the shape of the bones, layers of fiberous support (aponerosis, ligaments), intrinsic foot muscles and long tendons of extrinsic foot muscles.

Why is swelling more pronounced in the foot than in other areas of the body?

the skin is especially thin and the subcutaneous tissue is very loose (dorsal surface). the WB surface is extremely thick and has lots of fiberous CT.

Which is the largest organ in the body?

the skin! provides protection including protection against dehydration, heat regulator, provides sensation through superficial nerves and sensory endings

What two structures are sepparated by the tarsel sinus?

the subtalar and talocalcaneonavicular joints

What are the two retinacula of the foot and what is their purpose?

the superior extensor retinaculum and the inferiori retinaculum, They are fascial thickenings that bind tendons before and after the ankle joint. purpose is to stabilize ankle joint, keep muscles in approximated with leg, also redirect some of the line of pull.

What cutaneous nerve inervates the lateral aspect of the distal leg, ankle and foot as well as digits 4 and 5?

the sural nerve

The Subtalar joint consists of ___________________ and its primary movements are _________________________.

the talus and calncaneous, inversion and eversion

What are the plantar ligaments of the foot? what is their main function?

they are critical to maintaining the longitudinal arches of the foot. Plantar Calcaneonavicular (spring ligament), the Plantar calcaneocuboid ligament (short plantar ligament), long plantar ligament (runs fron calcaneous to cubiod and bases of metetarsals 2-4.)

what do the superior and inferior gluteal vv empty into? what other vv empty here?

they empty into the internal iliav vv, the obturator vv also empties here

How is it that Glute med and min are internal rotators and glute max is an external rotator when they both attach to the greater tochanter?

they have a diff. angle of pull based on their specific attachment point.

what is the course of the superficial lymphatic drainage?

they run with the great and small saphenous veins and branches, great: end in superficial inguinal lymphnodes small: end in popliteal lymph noeds

how does the fascia late change as it moves laterally?

thickened and strengthened by longitudinal fibers of the IT band. becomes continues with the aponeurosis of the TFL and glute max.

What are the functional compartments of the thigh? What are the functional compartments of the leg?

thigh: anterior, posterior, medial leg: anterior, posterior and lateral

What is the second longest bone?

tibia,

what nerves supply the ankle?

tibial, deep fibular (branch of common fibular)

the gastrocnemius has primarily type __________ muscle fibers with are responsible for _____________________ movements while the soleus has primarily ___________________ fibers which are responsible for _________________________________movements.

type 2: fast twitch mm fibers rapid, powerful movements type 1: slow twitch mm fibers strong, slow, endurance based

What are intercalated disks and what type of cell would you find them in?

type of anastamosis that promotes simultaneous contraction of cardiac muscle cells

What does the medial circumflex artery get blood from? what about the lateral circumflex artery?

unlike in viens, the medial and lateral circumflex aa are supplied directly into the deep femoral aa. deep femoral aa also supplies perfurating branches.

Where do nerves usually enter a muscle belly?

usually enter fleshy mmm belly from deep aspect.

What is the fibular vein a branch of? what is the fibular artery a branch of?

vv: posterior tibial vv. aa: popliteal aa

what is the functional significance of the ischial tuberosity?

weight bearing bone during sitting, proximal attachment of many muscles

How does extension impact the capsular stability of the hip?

winds and tightens fibers, constricts capsule, draws femoral head tightly into acetabulum.

What is the iliofemoral ligament and what is its function?

y-ligament, located on the anterior superior aspect. - attaches to asis, acetabular rim, intertrochanteric line (spiral line). - strongest in the body - prevents hip extension during standing - tight with extension

What is the direction of the flow of arterial blood?

"A for away" flows proximal to distal.

what is the functional significance of the greater scietic notch?

"door" for vessels and nerves to leave pelvis and enter gluteal region. sciatic nerve also exit here

What are dermatome maps used for?

- indicates typical skin innervation pattern, used in the clinical study of nerve lesions. variability caused by double innervation from adjacent levels.

How are the superficial and deep compartments of the hip functionally different?

- superficial: proximal attachements to external surface of ilium, mainly hip ext, ABd, and IR - deep: smaller mm covered by glute max, distal attachments on/near intertrochanteric crest, hip ERs help stabilize hip/steady femoral head in acetabulum.

BTWN veins and arteries, which are: 1. Thicker and larger walls 2. under less pressure 3. contain 80% of bodies blood 4. have a larger diameter when profused with blood

1. A 2. V 3. V 4. V

The deep fascia is very strong and becomes continues with the 1.___________________. It invests the 2.________________ like an elastic stocking and prevents 3.______________________. The purpose of this is to make 4.____________________ more 5. _____________________ and to 6. ___________________

1. Periosteum, 2. LE/Limb, 3. outward expansion of contracting muscles 4. muscle contraction 5. efficient 6. compress vv to push blood to the heart.

What are the three functions of the popliteus muscle?

1. Standing with full knee ext: 5 degrees of external rotation of tibia on femur to initiate knee flexion. participation in skrew home mechanism. releases knee from close packed position. 2. standing with knee flexion: assists pcl (prevents posterior glide of tibia on femur) 3. foot off ground, knee flexed, assists med. hamstrings in IR, during flexion, pulls lateral meniscus posteriorly

The transverse tarsal joint is a 1._______________ joint and consists of the 2.___________________________________________joints. At this joint the 3.__________________ and 4._____________________ rotate on the 5._______________ along the 6._________________axis.

1. compound, 2. talonavicular and calcaneocuboid. 3. midfoot 4. forefoot 5. hindfoot 6. longitudinal

the dorsal venous network empties into the 1. _______________________while the plantar venous network empties into the _________________________ and __________________

1. great saphenous 2. small saphenous and lateral plantar

How many total phalanges are in one human foot ?

14

Between AA and VV, which have 1: greater capacity for expansion 2: under more pressure 3: valves to prevent backflow

1: V, 2: A, 3: V

what mm are in layers one and two of the plantar foot?

1: abductor digiti minimi, abductor hallucis and flexor digitorum brevis 2.lumbercle and quadratus plantae

what muscles are in layers 3 and 4 of the plantar foot?

3. flexor digiti minimi brevis, flexor hallucis brevis and adductor hallucis (transverse and oblique) 4. dorsal and plantar interossei

the deep muscles of the leg only produce ___% of the PF of the ankle

7%,

What is true of the clinical approach to learning anatomy? (select all that apply) A. it combines both regional and systematic approaches B. It only considers structures in terms of what would happen if they where impaired C. It applies anatomical knowledge to a clinical setting D. It is the primary approach for classes that involve dissection

A. T B. while the clinical approuch does consider impairments it can also take into account other aspects of clinical applications. C. T D. F: the primary approach used in dissection classes is the regional approach.

Which ligaments are considered internal knee ligaments?

ACL, PCL, med meniscus, lat meniscus, coronary ligs, transverse lig of the knee

Which rami form plexuses?

Anterior rami spinal nerves (sacral, lumbar, brachial and cervical plexuses) - give rise to named nerves moving distally. - intercostal nn?

what two extrinsic foot muscle cross at the ankle? what two tendons cross in the plantar foot.

At the ankle, the tendon of tibialis posterior crosses under that of flexor digitorum longus thus giving the "tom dick and harry" orietation of tendons near the medeal malleolus. in the plantar foot, flexor digitorum longus and flexor hallucis longus tendons cross one another.

What is included in the skeletal system? What is its purpose?

Bones and cartilage (osteology). Purpose is to provide basic shape and support for the body, mm syst. acts on skeletal syst. to produce movement. protects vital organs

What is the transverse arch of the foot?

Both longitudinal arches are pillars, intermediate cuneiform appears to be the keystone.

What is included in the nervous system? What is its purpose?

Central and Peripheral systems (neurology). CNS: brain and spinal cord. PNS: nerves as the exit through spinal foramen. Controls function, lets body respond to its environment