Anatomy

Question 1

Erb-Duchenne’s palsy?

Answer 1

Injury to upper trunk - C5, C6 (brachial plexus)
Causes waiter’s tip
(internally rotated arm with fingers pointed backwards)

Can be caused by clavicle fracture at birth

Question 1

Divisions of the brachial plexus?

Answer 1

READ THAT DAMN CADAVER BOOK

Roots (C5, C6, C7, C8, T1)
Trunks (sup, middle, inf)
Divisions (anterior or posterior)
Cords (lat, post, medial)
Branches (NERVES: musculocutaneous, axillary, median, radial, ulnar)

Question 2

Rotator cuff muscles (of shoulder)

Answer 2

SITS:

• Supraspinatus (supplied by suprascapular nerve)
  Abduction from 0-15 degrees
• Infraspinatus (supplied by suprascapular nerve)
  External rotation of shoulder
• Teres minor (supplied by axillary nerve)
  External rotation of shoulder + adduction
• Subscapularis (supplied by subscapular nerves)
  Internal rotation of shoulder + adduction

Question 3

Muscles responsible for shoulder abduction? (0-180 degrees)

Answer 3

• 0-15 degrees: supraspinatus
• 15-90: deltoid (supplied by axillary nerve)
• 90-180: trapezius + serratous anterior

Question 4

Effect of humerus fracture @ surgical neck

Answer 4

Axillary nerve injury
Loss of deltoid shoulder abduction 15-90 degrees = flat shoulder

Question 5

Effect of humerus fracture @ midshaft region

Answer 5

Wrist drop = loss of wrist extension

Question 6

Effect of humerus fracture @ supracondyle region (just above elbow joint)

Answer 6

Ulnar nerve injury
= claw hand

Question 7

Carpal bones of the hand?

Answer 7

Some - scaphoid
Lovers - lunate
Try - triquetrum
Positions - pisiform
That - trapezium
They - trapezoid
Can’t - capitate
Handle - hamate

Question 8

3 joints in hands?

Answer 8

DIP - distal interphalangeal joint
PIP - proximal interphalangeal joint
Metacarpophalangeal joint

Question 9

Components running through carpal tunnel?

Answer 9

Median nerve
- 9 tendons:
- tendon of flexor pollicis longus
- 4 tendons of flexor digitorium profundus
- 4 tendons of flexor digitorum superficialis

Question 10

Tests for carpal tunnel syndrome?

Answer 10

• (Tinel’s Sign)
  Tapping the nerve in the carpal tunnel to elicit pain in median nerve distribution

(Phalen’smanoeuvre)
- Holding the wrist in flexion for 60 seconds to elicit numbness/pain in median nerve distribution

Question 11

3 bones of each hip bone?

Answer 11

Pubic bone
Ilium
Ischium
=> fuse at the acetabulum

Question 12

Ligaments that stabilise the hip joint?

Answer 12

Iliofemoral ligament
Pubofemoral ligament
Ischiofemoral ligament

Question 13

Muscle that unlocks the knee for flexion?

Answer 13

A small muscle called popliteus is responsible for ‘unlocking’ the knee by rotating the femur back again to permit flexion.

Question 14

Ligaments of the knee?

Answer 14

1) COLLATERAL LIGAMENTS
- medial collateral => connects femur to tibia
- lateral collateral => connects femur to fibula

2) CRUCIATE LIGAMENTS
- anterior (ACL) ⇒ prevents tibia moving anteriorly relative to the femur.
- posterior (PCL) ⇒ prevents the tibia moving posteriorly relative to the femur.

Question 15

Tarsal bones? (foot)

Answer 15

(TIGER CUBS NEED MILC)

• talus
• calcaneus (heel bone)
• navicular
• three cuneiforms (medial, intermediate, and lateral).
• cuboid

Question 16

Metatarsal bones?

Answer 16

The metatarsals are numbered 1 – 5 from the medial (great toe) side to the lateral (little toe) side.

AFTER METATARSALS:
The bones of the digits (toes) are phalanges (singular = phalanx).

Question 17

Muscle innervated by ulnar nerve in upper limb?

Answer 17

• hand muscles (except thenar muscles + 2 lateral lumbricals)
• forearm muscles (flexor carpi ulnaris + medial half of flexor digitorum profundus)

Question 18

What muscles does the median nerve innervate in hand?

Answer 18

MEAT LOAF

MEAT = median nerve

L = 2 lateral lumbricals
OAF = thenar muscles (see individual names OAF)

• opponens pollicis
• abductor pollicis brevis
• flexor pollicis brevis

Question 19

Thenar muscles + roles

Answer 19

THUMB = POLLICIS
OAF
- opponens pollicis (opposes thumb)
- abductor pollicis brevis (abducts thumb)
- flexor pollicis brevis (flexes thumb)

Question 20

Hypothenar muscles + roles

Answer 20

PINKY = DIGITI MINIMI
OAF
- opponens digiti minimi
- abductor digiti minimi
- flexor digiti minimi

Question 21

Two types of interosseus muscles + roles?

Answer 21

• dorsal interossei (back of hand) - abduct
• palmar interossei (palm of hand) - adduct

PAD + DAB (palmar = adduct / dorsal = abduct)

Question 22

Connective tissue band around carpal tunnel (in wrist)?

Answer 22

Flexor retinaculum

Question 23

Arterial supply to pelvis?

Answer 23

Left and right INTERNAL ILIAC arteries.

Question 24

Key branches of the internal iliac arteries are the:

Answer 24

- **Vesical** arteries - supply the bladder in both sexes, and the prostate and seminal vesicles in males. - **Uterine and vaginal** arteries in females. - **Middle rectal** artery - supplies the rectum. - **Internal pudendal** artery - exits the pelvis to supply the perineum. - Superior and inferior **gluteal arteries** exit the pelvis to supply the **gluteal** region. - **Obturator** artery – exits the pelvis to supply the **lower limb**.

Question 25

Role of obturator artery?

Answer 25

Exits the pelvis to supply the lower limb. (branch of internal iliac artery)

Question 26

Role of internal pudendal artery?

Answer 26

Exits the pelvis to supply the perineum.

Question 27

Nerve innervating anterior thigh?

Answer 27

Femoral nerve

Question 28

Nerve innervating medial thigh?

Answer 28

Obturator nerve

Question 29

Nerve innervating posterior thigh?

Answer 29

Sciatic nerve (branches = tibial nerve + common fibular branch)

Question 30

Roles + muscles of anterior thigh?

Answer 30

Flexor of hip, extensor of knee/leg - Quadriceps femoris – a group of four large muscles. - Sartorius - Pectineus - Iliopsoas (psoas major + iliacus)

Question 31

Roles + muscles of medial thigh?

Answer 31

Adducts the thigh - Adductor brevis - Adductor longus - Adductor magnus ----------------------------- - Gracilis - Obturator externus

Question 32

Roles + muscles of posterior thigh?

Answer 32

Extensor of hip + flexor of the knee Three of these muscles (semimembranosus, semitendinosus, and the long head of biceps femoris) are referred to as the ‘hamstrings’ ------------------------------------ - Semimembranosus & semitendinosus (tibial nerve branch of sciatic nerve) - Biceps femoris (common fibular branch of sciatic nerve) - Hamstring part of adductor magnus (tibial nerve branch of sciatic nerve)

Question 33

Lumbosacral plexus - lumbar vs sacral plexus?

Answer 33

LUMBAR PLEXUS: - Pudendal nerve - Sciatic nerve (branches = tibial nerve + common fibular nerve) SACRAL PLEXUS: - Femoral nerve - Obtruator nerve

Question 34

Lumbar plexus?

Answer 34

- Obturator nerve - Femoral nerve (other nerves too, but not as important?) => thigh adduction + hip flexor + knee/leg extension

Question 35

Sacral plexus?

Answer 35

SP = S + P Sciatic nerve Pudendal nerve => gluteal region + posterior thigh + all of lower leg

Question 36

Arterial supply of the duodenum?

Answer 36

First half = coeliac trunk (gastroduodenal branches from the common hepatic artery) Second half = superior mesenteric artery

Question 36

What are the three main arteries supplying the gut?

Answer 36

FOREGUT = COELIAC TRUNK MIDGUT = superior mesenteric artery HINDGUT = inferior mesenteric artery

Question 37

What are the 3 branches of the coeliac trunk?

Answer 37

LEFT GASTRIC ARTERY SPLENIC ARTERY COMMON HEPATIC ARTERY

Question 38

What does the splenic artery supply?

Answer 38

Spleen Stomach (fungus - near spleen end) Pancreas

Question 39

What does the left gastric artery supply?

Answer 39

Distal oesophagus Stomach (lesser curvature)

Question 40

What does the common hepatic artery supply?

Answer 40

Gastroduodenal branch = stomach + duodenum Proper hepatic branch = liver

Question 41

What level of the spinal cord is the coeliac trunk?

Answer 41

L1

Question 42

What level of the spinal cord is the superior mesenteric artery?

Answer 42

L1

Question 43

What level of the spinal cord is the inferior mesenteric artery?

Answer 43

L3

Question 44

What level of the spinal cord does the abdominal aorta end?

Answer 44

L4 (where it splits into the R + L iliac arteries)

Question 45

What separates the frontal and parietal lobes?

Answer 45

Central sulcus

Question 46

What separates the frontal and temporal lobes?

Answer 46

Sylvian fissure

Question 47

What separates the parietal and occipital lobes?

Answer 47

Parieto-occipital sulcus

Question 48

Key areas and functions of the frontal lobe of the brain?

Answer 48

- Prefrontal cortex (decision making and emotion) - Motor cortex (primary motor cortex + - Broca's area - speech production (expressive aphasia)

Question 49

Key areas and functions of the parietal lobe of the brain?

Answer 49

- Primary somatosensory cortex (receives sensory information from all sensory receptors that provide information related to temperature, pain (spinothalamic pathway), vibration, proprioception and fine touch (dorsal column pathway)

Question 50

Key areas and functions of the occipital lobe of the brain?

Answer 50

- Primary visual cortex (visual perception) - Visual association cortex (interprets visual images) => color determination, facial recognition, depth perception, visuospatial processing and even plays a role in memory formation

Question 51

Key areas and functions of the temporal lobe of the brain?

Answer 51

- Hearing - Memory - Speech comprehension - Wernicke's area - receptive aphasia

Question 52

Key areas and functions of the insular lobe of the brain?

Answer 52

Deep within the lateral sulcus => taste sensation, visceral sensation, pain sensation, and vestibular function.