Stuff

Which of the following is a CORRECT statement about the parasympathetic nervous system?

- Long preganglionic and short postganglionic - constrict pupils and rest/digest

Rupture of the transverse cervical ligament is a destabilizing injury that can occur in isolation or with atlantoaxial subluxation. This very important ligament is located on:

Transverse ligament Located on C1 on lateral masses and occipital condyles of the head Holds the dens of C2 (axis)

Ligation of the femoral artery at the adductor hiatus in the distal thigh, would not interrupt blood supply to the hamstring muscles because the ____________.

deep femoral artery supplies the posterior compartment of the thigh

Which of the following muscles is NOT part of the deep group of back muscles?

trapezius, rhomboids, latissimus dorsi, levtor scapula, serratus posterior inferior, serratus posterior superior

During a skiing lesson, a 15-year-old boy crashed into a tree and sustained a back injury that damaged the dorsal primary rami of several of his spinal nerves. Which of the following muscles is most likely to be affected in this injury?

All of the dorsal primary rami muscles are deep muscles

A 35-year-old female is diagnosed with a disc herniation at C3-C4. Which spinal nerve would most likely be affected?

C4 Cervical & lumbar nerves are affected on the lower number e.g. C3-C4 = C4 nerve or L2-L3 - L3

Your patient has a foot drop, as a result of nerve damage in the gluteal region. What would you expect to find if there was nerve damage in the gluteal region that you would not find if the damage was at the fibular head?

Damage to the sciatic nerve and therefore impaired function of the hamstrings and posterior compartment muscles

A 45-year-old male is treated at the hospital after he fell from his bicycle. Radiographic examination reveals fractures of the tibia and the fibula. On physical examination the patient displays "foot drop", but normal eversion. Which of the following nerves is most likely injured, and what other symptom is this patient most likely to experience?

Deep Fibular Nerve damage - can't dorsiflex, therefore pt displays foot drop

The transverse intermuscular septum of the leg:

Divides the posterior compartment of the leg into superficial and deep groups Superficial - gastroc, plantaris, soleus Deep - popliteus, flexor hallucis longus, flexor digitorum longus, tibilais posterior

A 25-year-old female is pushing some heavy weights while doing squats. Unfortunately, she drops the weight and immediately grabs at her upper thigh, writhing in pain. During physical examination, the female is diagnosed with a femoral hernia. Based on your knowledge of the subinguinal space, what reference structure would be found IMMEDIATELY lateral to the herniated structure?

Femoral vein

A 55-year-old female suffers a "Ballerina fracture", which is an avulsion fracture of the tuberosity of the 5th metatarsal. Which muscle would tend to pull the fragment away from the metatarsal base because of its attachment to the tuberosity?

Fibularis brevis - attaches to MT tuberosity Fibularis longus - attaches to the base of the 1st MT and cuboid

Muscles that belong to the pes anserinus

Gracilis sartorius semitendinosus

A 72-year-old female suffered a hip dislocation when she fell down the steps to her garage. Which of the following structures is most significant in resisting hyperextension of the hip joint?(greys #22)

Iliofemoral (Y-shaped) Bigelow Ligament - strongest ligament in the body

A 56-year-old male slips and falls fracturing the proximal shaft of the right femur. On arrival to the ER, the attending notices that the right quadriceps are weak on extension of the leg. It is most likely that there is . Which of the following symptoms would also be attributed to femoral nerve damage?

Loss of anterior/medial thigh sensation Loss of medial posterior leg and foot (through saphenous)

A 70-year-old female is referred to the clinic because of pain deep in her right femoral triangle, and a marked weakness in adduction of the right thigh. MRI shows a small hernia deep to the pectineus muscle. Which nerve was most likely compressed by the hernia?

Obturator nerve; supplies the adductors of the thigh

Which nerve is CORRECTLY matched with its component spinal nerve roots?

SIPPS Sacral Plexus (L4-S1) - Superior gluteal nerve, n to rectus femoris, inf. gemellae (L5-S2) - Inferior gluteal nerve, n to obturator internus, sup. gemellae (S1-S3) - Posterior femoral cut n (S2-S4) - Pudendal (L4-S3) - Sciatic

A positive sign of a common test (Trendelenberg gait) very simply demonstrates the inability of the body to keep the pelvis level as each foot is lifted off of the ground while walking. Those with a positive sign of this test will often walk with an exaggerated rolling of their hips, an attempt to prevent one foot from dragging along the ground. What structure is most likely damaged?

Superior gluteal nerve - gluteus medius and minimus

A 31-year-old female presents with Bell's palsy, which has resulted in paralysis of muscles on one side of her face. She is scheduled to receive a nerve graft from a cutaneous nerve from the lower limb to replace the defective facial nerve. Six months after surgery, there is an area of skin on the back of the leg laterally and also on the lateral side of the foot that has no sensation. What nerve was most likely used in the grafting procedure?

Sural nerve Medial sural = innervates skin on back of leg and lateral side of foot Lateral sural = innervates skin on posterolateral side of leg

A 10-year-old girl presents with an "S-shape" deformity of the spine, depicting scoliosis. Which region of the vertebral column is usually affected in scoliosis?

Thoracic

You elicit the ankle joint reflex in a patient by tapping the calcaneal tendon. Both afferent and efferent limbs of the reflex arc are carried in the ________________ nerve.

Tibial nerve

A 33-year-old woman had a direct blow to the patella during a car collision. The woman is admitted to the emergency department and radiographic examination reveals patellofemoral syndrome. The type of syndrome is characterized by lateral dislocation of the patella. Which of the following muscles needs to be strengthened to prevent future dislocation of the patella?

Vastus medialis (VMO)

A 65-year-old male presents with a severely painful rash and skin eruptions that are localized entirely on one side of his body. The rash closely follows the dermatome of C7. The man is diagnosed with herpes zoster virus. In what structure has the virus most likely proliferated to cause the man's current condition?

dorsal primary rami/dorsal root ganglia

If the piriformis, superior and inferior gemelli, and obturator internus muscles were not functioning, which hip action would be greatly diminished?

external rotation

A 22-year-old female sustains an avulsion fracture of the greater trochanter. Which of the following muscles would continue to function normally if such an injury occurred because it does not attach to this bony feature?

gluteus maximus --> attaches to the IT band and TFL, gluteal tuberosity

A 26-year-old female sustains a penetrating injury to the left gluteal region that damages the tibial nerve. Which of the following defects is most likely to result from this injury?

loss of posterior leg muscles

A 25-year-old male is admitted to the emergency department after a car collision. He complains of severe pain in his right hip and thigh. Radiographic examination reveals a fracture of the neck of the femur. An MRI examination reveals avascular necrosis of the femoral head. The most likely cause of avascular necrosis of the femoral head in this patient, is that the fracture included the ____________________, which is a branch of the _______________.

medial circumflex artery from the deep femoral artery

Pulsations of the posterior tibial artery can be felt _____________.

posterior to the medial malleolus

A 25-year-old male was shot in the suboccipital region damaging his suboccipital nerve. Which muscle does the suboccipital nerve innervate?

rectus capitis posterior major rectus capitis posterior minor obliquus capitis superior obliquus capitis inferior

A 27-year-old male had suffered a penetrating injury in the popliteal region by an object thrown from a riding lawnmower. After a midline incision was made in the skin of the popliteal fossa to remove the foreign object, a vein of moderate size was observed in the superficial fascia. Which vein would be expected at this location?

small saphenous vein - superficial vein in the popliteal fossa

A 19-year-old male football player presents with high fever, severe headache, nausea, and a stiff neck for 3 days. The attending physician suspects meningitis and obtains a sample of cerebrospinal fluid (CSF) from the lumbar cistern using a lumbar puncture. Which structures of the cauda equina are suspended in CSF and float away from the pressure of the needle?

spinal nerve roots bathed in CSF after the *lumbar cistern* L1