Revision GEM Year 1 > Anatomy > Flashcards

Anatomy Flashcards

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1
Q 
Pectoral Girdle
Where is the following on the posterior view:
- suprascapular notch
- Acromion
- supraspinous fossa
- infraspinous fossa
- spine of scapula
A

Refer to pic

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2
Q

Pectoral Girdle
Where is the following on the clavicle?
- sternal end
- Acromial end

A

Refer to pic

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3
Q
  1. What are the two joints of the clavicle to surrounding bones?
  2. What type of joint are they?
  3. What is their innervation?
A

Acromioclavicular joint = synovial plane joint = C4

Sternoclavicular joint = synovial ball and socket joint = C6

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4
Q
  1. Which joint is more likely to dislocate, SC or AC?
  2. A clavicular structure on the lateral 1/3 of the clavicle will make which nerve vulnerable?
  3. What two things pass through the cervicoaxillary canal?
A
  1. AC joint
  2. Suprascapular nerve
  3. Brachial plexus and subclavian vessels
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5
Q
  1. What physiological joint does the scapula move over the thoracic cage on?
  2. Name the nerves responsible for the following moves of the scapula:
    - lateral rotation
    - protraction
    - retraction
    - elevation
A
  1. Scapulothoracic joint
  2. Lateral rotation: CN11 and C5-C7
    Protraction: C5-C7
    Retraction: CN11 and C3-C5
    Elevation: CN11 and C3-C4
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6
Q

Where is the following on the humerus (anterior view)?

  • articular head
  • greater and lesser tubercles
  • anatomical neck
  • surgical neck
  • shaft
  • supraepicondylar ridge
  • epicondyles
  • capitulum
  • trachea
A

Refer to pic

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7
Q

Where is the following on the humerus (posterior view)?

  • deltoid tuberosity
  • radial groove
  • olecranon fossa
A

Refer to pic

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8
Q

A fracture in the following parts of the humerus would affect with nerve:

  1. Neck of the numerus
  2. Midshaft humerus
  3. Supraepicondylar ridge
A
  1. Axillary nerve
  2. Radial nerve
  3. All nerves and arteries
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9
Q

Shoulder joint:

  1. What type of joint is the shoulder joint?
  2. What is the glenoid labrum?
  3. What does it do?
  4. What two things do the bursa in the joint do?
A
  1. Synovial ball and socket joint
  2. Fibrocartilage ring
  3. Deepens glenoid fossa and stabilises joint
  4. Bursa protect overlying tendons from erosion and also some communicate with joint cavity
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10
Q

Shoulder joint

  1. What around this joint prevents superior dislocation?
  2. What two things is it made out of?
  3. What is the innervation of the shoulder joint?
  4. Where is pain referred to?
A
  1. Coracoacromial arch
  2. Acromion and coracoacromial ligament
  3. C5-C6
  4. Into proximal, lateral arm
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11
Q

Shoulder joint capsule

  1. What two ligaments make up the joint capsule?
  2. Is dislocation usually anterior or posterior? How does it end up?
  3. Which nerve is vulnerable in dislocation?
A
  1. Coracohumeral ligament and glenohumeral ligament
  2. Usually anterior and ends up inferior
  3. Axillary nerve
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12
Q

Name the nerves responsible for the following movements of the shoulder joint:

  1. Flexion
  2. Extension
  3. Abduction
  4. Adduction
  5. Lateral rotation
  6. Medial rotation
A
  1. Flexion = C5-C6
  2. Extension = C7-C8
  3. Abduction = C5-C6
  4. Adduction = many + gravity
  5. Lateral rotation = C5-C6
  6. Medial rotation = C5-C8
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13
Q

Where are the following features on the elbow:

  • coronoid fossa
  • medial epicondyle
  • capitulum
  • trochlea
  • head of radius
  • radius
  • ulna
A

Refer to pic

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14
Q 
Elbow joint - Ulna (lateral view)
Where are the following features:
- olecranon
- trochlea notch
- radial notch
- coronoid fossa
A

Refer to pic

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15
Q

Elbow joint:

  1. What nerve is related to the neck of the radius?
  2. Which nerve and which artery passes into the forearm from the ulna?
  3. What 4 things are vulnerable in a fracture or dislocation of the elbow joint?
A
  1. Radial nerve
  2. Median nerve and brachial artery
  3. Brachial artery, ulnar nerve, median nerve and radial nerve.
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16
Q

Elbow joint capsule

  1. The elbow joint capsule is weaker in which two parts?
  2. What 3 ligaments make up the joint capsule? What is the test for two of these?
  3. What nerve are responsible for flexion?
  4. What nerves are responsible for extension?
A
  1. Anteriorly and posteriorly
  2. Lateral collateral ligament (varus test)
    Medial collateral ligament (valgus test)
    Anular ligament
  3. C5-C6
  4. C7-C8
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17
Q

Posterior pectoral girdle muscles

  1. What is the overall function of these muscles?
  2. What are the 5 muscles and what is their nerve supply?
A
  1. Attach girdle to axial skeleton
  2. Levator scapulae = dorsal scapular nerve, C4-C5
    Rhomboid minor = dorsal scapular nerve, C4-C5
    Rhomboid major = dorsal scapular nerve, C4-C5
    Trapezius = CN11
    Latissimus dorsi = thoracodorsal nerve, C6-C8
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18
Q
  1. What are the 3 anterior pectoral girdle muscles and what is their nerve supply?
  2. What is their overall function?
A
  1. Pectoralis major = C5-C8, T1
    Pectoralis minor = C8-T1
    Serratus anterior = long thoracic nerve, C5-C7
  2. Attach girdle to ventral thoracic wall
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19
Q 
Anterior pectoral girdle muscles
Pectoralis major
1. What are the two heads called?
2. What 3 things do both heads do?
3. Which head flexes from extension?
4. Which head extends from elevation?
5. Which head is innervated by the lateral pectoral nerve (C5-C7)?
6. Which head is innervated by the medial pectoral nerve (C8-T1)?
A
  1. Clavicular head and sternocostal head
  2. Adduct, medially rotate and accessory breathing muscles
  3. Clavicular head
  4. Sternocostal head
  5. Clavicular head
  6. Sternocostal head
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20
Q

Anterior pectoral girdle muscles
Pectoralis minor
1. What does this muscle do?
2. What is it innervated by?

A
  1. Depresses scapula

2. C8-T1

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21
Q

Anterior pectoral girdle muscles
Serratus anterior
1. What 2 things does this muscle want to do?
2. What nerve innervates this muscle?

A
  1. Protects scapula and holds it close to thoracic wall

2. Long thoracic nerve, C5-C7

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22
Q

Girdle to humerus muscles

  1. Humerus and girdle muscles include rotator cuff muscles and which other muscle?
  2. What nerves is it innervated by?
  3. What 3 things does this muscle do?
  4. What nerve is vulnerable in a shoulder dislocation or fracture of the neck of the humerus?
  5. Loss of deltoid would cause what kind of anaesthesia?
A
  1. Deltoid muscle
  2. Axillary nerve, C5-C6
  3. Flexion, extension and abduction
  4. Axillary nerve
  5. Regimental badge anaesthesia
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23
Q
  1. What are the 4 rotator cuff muscles?
  2. What is the innervation for all of them?
  3. What is their overall function?
  4. What is the additional muscle around here and what is its innervation?
A
  1. Supraspinatus, infraspinatus, teres minor and subscapular
  2. C5-C6
  3. Stabilise shoulder joint
  4. Teres major = lower subscapular nerve, C6
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24
Q

Rotator cuff muscles - posterior view (plus one anterior)
What is the innervation and function of each rotator cuff muscle:
1. Supraspinatus
2. Infraspinatus
3. Teres minor
4. Subscapularis

A
  1. Supraspinatus = suprascapular nerve = starts abduction
  2. Infraspinatus = suprascapular nerve and axillary nerve = lateral rotator
  3. Teres minor = suprascapular nerve and axillary nerve = lateral rotator
  4. Subscapularis = subscapular nerves = medial rotator
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25
1. Apart from the rotator cuff muscles, the other muscle in this area is called what? 2. What is it innervated by? 3. What are its two functions?
1. Teres major 2. Lower subscapular nerve, C6 3. Medial rotator and adductor
26
1. What are the 2 anterior arm muscles? 2. Which one has two heads? 3. What are they innervated by? 4. What is brachialis in particular innervated by? (C?) 5. What two things does biceps brachii do? What does the long head do? 6. What does brachialis do?
1. Biceps brachii and brachialis 2. Biceps brachii (long head and short head) 3. Musculocutaneous nerve 4. Brachialis = C5-C6 5. Flexes elbow and supinates forearm. Long head helps flex shoulder first 30 degrees 6. Flexes elbow
27
Anterior arm muscles: 1. What 2 things does the bicipital tendon and aponeurosis protect? 2. You can tap on the anterior elbow space for what reflex?
1. Median nerve and brachial artery | 2. C5-C6 reflex
28
Posterior arm muscles: 1. What is the posterior arm muscle? 2. How many heads does it have and what are they called? 3. What is it innervated by? 4. What space is formed? Which nerve and artery pass through it? 5. What interval is formed? Which nerve and artery pass through it? 6. Tapping on the posterior elbow space will show which reflex?
1. Triceps brachii 2. 3 heads: long head, lateral head and medial head 3. Radial nerve 4. Quadrangular space: axillary nerve and posterior circumflex artery 5. Triangular interval: radial nerve and profunda brachii artery 6. C7-C8 reflex
29
Posterior arm muscle: triceps brachii | What is its 2 functions?
1. Shoulder extension | 2. Elbow extension
30
1. What is the axilla a passage way into the upper limb for? | 2. What 6 groups are the axillary lymph nodes arranged into?
1. Neurovascular structures 2. Infraclavicular nodes Central nodes Humeral nodes Subscapular nodes Pectoral nodes Apical nodes
31
1. What are the 4 arteries going from scapula to end of humerus? 2. What are the 4 arteries throughout the scapula region?
1. Axillary, anterior + posterior circumflex, profunda brachii and brachial 2. Suorascapular, dorsal scapular, subscapular and thoracodorsal
32
``` Pectoral Girdle Where is the following on the anterior view: - Acromion - coracoid process - glenoid fossa - costal surface - subscapular fossa - medial (vertebral) border - lateral (axillary) border - inferior angle ```
Refer to pic
33
1. Give 2 benefits of having a plexus...
1. Better and finer control of muscles | Damage to a spinal nerve won't leave entire limb paralysed
34
Axilla: 1. What two things is it bordered by? 2. What runs through here? 3. What is it filled with? 4. What important thing does it contain?
1. Pectoral muscles and thoracic cage 2. Nerves and vessels of the upper limb 3. Fat 4. Important lymph node groups
35
Brachial plexus: 1. What are the 5 divisions in order from the neck to the upper limb? 2. What nerve roots are involved?
1. Roots, trunks, divisions, cords and branches | 2. C5-C8, T1
36
Brachial plexus: 1. What are the 3 sections of the trunks? 2. What are the 3 sections of the divisions? 3. What are the 3 sections of the cords? 4. What are the 3 anterior branches? 5. What is the posterior branch? What other nerve comes off this?
1. Upper, middle and lower 2. Anterior, posterior and anterior 3. Lateral, posterior and medial 4. Musculocutaneous, median and ulnar 5. Radial (axillary nerve comes off this)
37
Brachial plexus 1. Which area are the roots and trunks? 2. Where are the divisions? 3. Where are the cords and branches?
1. Neck 2. Cervicoaxillary canal 3. Axilla
38
Brachial plexus: musculocutaneous nerve 1. What is the root value of this nerve? 2. How can damage be caused to this? 3. What would be the consequence?
1. C5-C7 2. Direct damage is rare 3. Loss of anterior arm muscles
39
Brachial plexus: axillary nerve 1. What is the root value of this nerve? 2. How can damage be caused to this? (2 ways) 3. What would be the 2 consequences?
1. C5-C6 2. Dislocation of shoulder and fractured surgical neck of humerus 3. Loss of deltoid and teres minor
40
Brachial plexus: median nerve 1. What is the root value of this nerve? 2. How can damage be caused to this? 3. What would be the 3 consequences of this?
1. C5-T1 2. Stab to medial arm 3. Loss of most anterior forearm muscles Thenar muscles Lumbricals 1 and 2
41
Brachial plexus: radial nerve 1. What is the root value of this nerve? 2. How can damage be caused to this? (2 ways) 3. What would be the 2 consequences of this?
1. C5-T1 2. Fracture through humeral shaft and fracture/dislocation of head of radius 3. Loss of posterior arm muscles Loss of posterior forearm muscles
42
Brachial plexus: ulnar nerve 1. What is the root value of this nerve? 2. How can damage be caused to this? 3. What would be the 2 consequences of this?
1. C8-T1 2. Fracture of medial humeral epicondyle 3. Loss of hand muscles Loss of 2 anterior forearm muscles
43
Brachial plexus: | Damage to the long thoracic nerve would cause what?
Winging of the scapula
44
Brachial plexus 1. What are the 4 steps of the route of the brachial plexus? 2. The plexus is vulnerable in the neck because it is surrounded by what 2 things? 3. What part of the plexus is actually vulnerable there?
1. Behind clavicle, around axillary artery, lateral to axillary vein and runs towards humerus 2. Scalenus medius and scalenus anterior 3. C5 root and upper trunk
45
The radial nerve (C5-T1) innervates the posterior compartments. Name the roots that innervate the following things: 1. Triceps brachii 2. Brachioradialis 3. Radial wrist extensors 4. Posterolateral dermatomes 5. Digit extensors
1. Triceps brachii = C7-C8 2. Brachioradialis = C5-C6 3. Radial wrist extensors = C5-C6 4. Posterolateral dermatomes = C5-C6 5. Digit extensors = C7-C8
46
Erb's paralysis 1. What are the 2 ways you can get this? 2. How does the upper limb appear? 3. What 3 positions is the limb in?
1. Forced separation of neck from shoulder Stab wound to neck 2. "Waiters tip" 3. Limb is medially rotated, pronated and extended
47
Klumpke's paralysis 1. How does it happen? 2. Where is the damage? 3. How does the hand appear?
1. Stretching of arm 2. C8-T1 root and lower trunk damage 3. First two digits bent
48
Axillary artery: 1. What does it start as? 2. What does it continue as? 3. What does it anastomose with around the scapula? 4. What two branches come off it?
1. Subclavian 2. Brachial 3. Subclavian 4. Circumflex humeral and profunda brachii
49
``` Radius Where are the following features: 1. Head 2. Tuberosity 3. Shaft with 3 surfaces 4. Styloid ```
Refer to pic
50
``` Ulnar Where are the following features (anterior view): 1. Trochlear notch 2. Tuberosity 3. Shaft with 3 surfaces 4. Head 5. Styloid Where are the following features (lateral view): 1. Olecranon 2. Radial notch 3. Coronoid process ```
Refer to pic
51
A fracture or dislocation at the elbow makes what vulnerable?
All 3 main nerves
52
Radioulnar joints 1. Which nerve permits pronation? 2. Which 2 nerves permit supination? 3. What is the most proximal type of joint? (Elbow) 4. What is the membrane in the middle and what does it do? 5. What is the type of joint at the end? (Wrist)
1. Median nerve 2. Radial and musculocutaneous nerve 3. Synovial pivot joint 4. Interosseous membrane: transmits force to ulna 5. Synovial pivot joint
53
Radioulnar joints 1. What ligament is at the top near the head of the radius? 2. What is at the bottom near the head of the ulna? 3. What 2 things does it do?
1. Annular ligament 2. Triangular articular disc 3. Assists pivot action separates ulna from carpals
54
Hand osteology 1. What is the 1st digit of the hand? What is the 5th digit? 2. Where are the following structures: carpals, metacarpals and phalanges? 3. What two types of joints in the phalanges called? What type of joints are they? 4. What is the joint between the phalanges and the metacarpals called? What type of joints is it? 5. What type of joint is between the metacarpals and carpals? What are the types of joint it is?
1. 1st digit = thumb 5th digit = 4th finger 2. Refer to pic 3. Proximal interphalangeal joints and distal interphalangeal joints = hinge joints 4. Metacarpophalangeal joints = condyloid and saddle joints 5. Carpometacarpal joints = first joint is a saddle joint, the others are condyloid and plane
55
What 5 movements can the thumb do?
Abduction, adduction, flexion, extension and opposition
56
Hand bones 1. What is the mnemonic for carpal bones? 2. What order is the mnemonic in? 2. What are bones called?
1. Scared lovers try positions that they can't handle 2. Right hand: Bottom 4 right to left, top 4 right to left 3. Scaphoid Lunate Triquetral Pisiform Trapezium Trapezoid Capitate Hamate
57
1. What are the two ligaments of the wrist joint? Which two bones do they connect? 2. Which other strong ligaments are present? 3. A fractured scaphoid can cause what two consequences?
1. Medial collateral ligament = ulna to triquetrum Lateral collateral ligament = radius to scaphoid 2. Strong radiocarpal ligaments 3. Tenderness in anatomical snuffbox Avascular necrosis of proximal scaphoid
58
1. Define Colles fracture... 2. Define Smith's fracture... 3. What are 3 typical consequences of these?
1. Fracture of radius - backward displacement of hand 2. Fracture of radius - forward displacement of hand 3. Loss of wrist movement Loss of distal radioulnar joint movements Stiff mcp joints
59
Mid forearm 1. What nerve is the anterior compartment mainly supplied by? 2. Anterior compartment: what does the ulnar nerve supply? 3. What nerve is the posterior compartment supplied by? 4. What 2 things does the anterior compartment do? 5. What 2 things does the posterior compartment do?
1. Median nerve 2. FCU and medial 2 tendons of FDP 3. Radial nerve 4. Flexion and pronation 5. Extension and supination
60
Forearm muscles: anterior compartment 1. How many layers are there? 2. How many muscles are in the outer layer? 3. How many muscles are in the next layer? 4. How many muscles are in the innermost layer?
1. 3 layers 2. 4 muscles 3. 1 muscle 4. 3 muscles
61
Forearm muscles: anterior compartment Outermost layer 1. What is the acronym for the 4 muscles? 2. What are the 4 muscles? 3. What is their origin and what does overuse of these cause? 4. What are 3 of them supplied by? 5. What is the other muscle and what is it supplied by? 6. Innervation?
1. Pass fail pass fail 2. Pronator teres, flexor carpi radialis, palmaris longus and flexor carpi ulnaris 3. Origin is medial epicondyle - overuse causes golfer's elbow 4. Median nerve 5. Flexor carpi ulnaris = ulnar nerve 6. C7-C8
62
What 5 things do the anterior forearm muscles do?
1. Flexion of wrists and digits 2. Powergrip 3. Wrist stabilise 4. Wrist abduction and adduction 5. Pronation
63
``` Forearm muscles: anterior compartment Middle layer 1. What muscle is here? 2. What does it do? 3. Innervation? ```
1. Flexor digitorum superficialis 2. Flexes finger at PIP 3. Median nerve, C7-C8
64
Forearm muscles: anterior compartment Innermost layer 1. What is the acronym for these 3 muscles? 2. What are the muscles called? 3. Most are supplied by which nerve? 4. Except which digits of which muscle? What is this supplied by?
1. Pass Fail Fail 2. Pronator quadratus, flexor digitorum profundus and flexor pollicis longus 3. Median nerve C7-C8 4. FDP: digits 4 and 5 - Ulnar nerve (C8)
65
Muscles of posterior forearm 1. How many layers are there? 2. What are the layers called? 3. How many muscles are in each layer? 4. What is the overall function of each layer?
1. 2 layers 2. Superficial and deep 3. Superficial layer: 3 Deep layer: 5 4. Superficial layer: wrist and finger extensors Deep layer: supinator, muscles of thumb and extensor indicis
66
Posterior compartment of forearm SUPERFICIAL layer: 1. What is the way to remember the 3 muscles? 2. What are the names of the 3 muscles? 3. What is their origin? What does overuse of this cause? 4. Innervation? 5. What are the 3 overall functions of these muscles?
1. Extend digits, extend ulnar, extend radius 2. Extensors digitorum, extensor carpi ulnaris and extensor carpi radialis 3. Lateral epicondyle: overuse = tennis elbow 4. Deep branch of radial nerve, C6-C8 5. Extension of wrists and digits Stabilise wrist Wrist abduction/adduction
67
Posterior compartment of forearm DEEP layer: 1. What is the way to remember the 5 muscles? 2. What are the names of the 5 muscles? 3. Innervation? 4. What are the 3 overall functions of these muscles?
1. Supinate, abduct thumb, extend thumb short, extend thumb short and extend indices 2. Supinator, abductor pollicis longus, extensor pollicis longus, extensor pollicis brevis and extensor indicis 3. Deep branch of radial nerve, C7-C8 4. Supinates Abducts and extends thumb Extends index finger
68
``` Forearm muscles: posterior DEEP LAYER Radial nerve palsy 1. Radial nerve damage at the elbow would cause what 2 consequences? 2. Would there be any sensory loss? ```
1. Dropped wrist No extension of digits 2. No sensory loss
69
1. Brachioradialis is part of which forearm compartment: anterior or posterior? 2. What does it do? 3. What is it supplied by?
1. Posterior compartment 2. Elbow flexor in mid-pronation/supination 3. Radial nerve C5-C6
70
Cubital fossa 1. What 3 things run through this? 2. What are the 3 borders of it? 3. A nerve injury in the Cubital fossa will create what 3 consequences?
1. Median nerve, brachial artery and median cubital vein 2. Superior border between epicondyles, medial border of brachioradialis and lateral border of pronator teres 3. Hand of benediction on making a fist No pronation Weak wrist flexion, pulls to ulnar side
71
Anatomical snuffbox 1. Bordered by which muscles on each side? 2. What vein and artery is present here?
1. One side: extensor pollicis longus Other side: extensor pollicis brevis and abductor pollicis longus 2. Cephalic vein and radial artery
72
1. What is aponeurosis? 2. What does it do? 3. What does a hand in dupuytrens contracture look like?
1. Tough fibrous layer 2. Preventing movement of palmar skin 3. Pinky finger in constant flexion
73
Hand muscles: 1. What 3 things do the thenar muscles do? 2. What is it supplied by? 3. What 3 things do the hypothenar muscles do? 4. What is it supplied by?
1. Thumb flexion, abduction and opposition 2. Median nerve 3. 5th digit flexion, abduction and opposition 4. Ulnar nerve
74
Hand muscles 1. Between what do the interossei muscles sit? 2. What do palmar interossei muscles do? 3. What do dorsal interossei muscles do? 4. What are they all supplied by?
1. Metacarpals 2. Adduct 3. Abduct 4. Ulnar nerve, T1
75
Hand muscles Lumbrical muscles 1. What joint does it flex? 2. What joints does it extend? 3. What is the Innervation of the 2nd and 3rd digit? 4. What is the innervation of the 4th and 5th digit?
1. MCP joint 2. DIP and PIP joint 3. Median nerve 4. Ulnar nerve
76
Carpal tunnel 1. What two things form this tunnel? 2. What 4 bones in particular form the base? 3. Which nerve runs through here? 4. Compression of this nerve causes sensory loss where?
1. Flexor retinaculum and carpal bones 2. Pisiform, hamate, scaphoid and trapezium 3. Median nerve 4. Digits 1-3.5
77
1. Which nerve is vulnerable at the wrist? 2. What ligament does it pass under? 3. What is this canal called? 4. What artery is it medial to? 5. A lesion to this nerve will cause sensory loss where? 6. A lesion to this nerve will cause motor loss to what 4 things and what position does this produce?
1. Ulnar nerve 2. Pisohamate ligament 3. Guyon's canal 4. Ulnar artery 5. Pinky and half of ring 6. Hypothenar muscles Medial two lumbricals Interossei muscles Adductor pollicis brevis Causes "ulnar claw hand"
78
Where would you test the cutaneous sensation of the following nerves? 1. Ulnar 2. Median 3. Radial
1. Anterior hypothenar area 2. Anterior thenar space or 2nd digit fingertip 3. Posterior behind thenar area
79
Root damage to the following nerves would damage which movements? 1. C5 2. C6 3. C7 4. C8 5. T1
1. C5: shoulder abduction and lateral rotation 2. C6: elbow flexion and wrist extension 3. C7: elbow extension and wrist flexion 4. C8: thumb extension and wrist ulnar deviation 5. T1: finger abduction and adduction
80
How would you do a relfex test of the following: 1. C5-C6 2. C7-C8
1. C5-C6: biceps jerk | 2. C7-C8: triceps jerk
81
Forearm 1. What is the main artery and what does it branch off into? 2. The arteries form two ______ _________ in the palm 3. What 3 veins go into the arm?
1. Brachial into ulnar and radial 2. Palmar arches 3. Cephalic, basilic and median cubital
82
``` Lower limb Where are the following structures? Gluteal region Thigh Leg Foot ```
Refer to pic
83
Lower limb 1. What is the main nerve that goes down the lower limb? 2. Where is the dermatomal territory of the obturator nerve? 3. Where is the dermatomal territory of the femoral nerve? 4. Where is the dermatomal territory of the sciatic nerve and posterior cutaneous nerve of the thigh?
1. Sciatic nerve 2. Anterior inner thigh 3. Anterior outer thigh down to anterior inner calf 4. Posterior lower limb
84
1. Where are the following features: - hip x 2 - sacrum 2. What connects these two at the bottom? 3. What joint connects the hip to the sacrum?
1. Refer to pic 2. Pubic symphysis 3. Sacroiliac joints
85
1. The hip bone is formed from which 3 bones? 2. Which 2 bones is the greater sciatic notch between? 3. At what point do the bones fuse? 4. At what stage in a persons life do the bones fuse?
1. Ilium, ischium and pubis 2. Ilium and ischium 3. Acetabulum (fossa) 4. Late puberty
86
``` Hip bone Where are the following features of the hip bone: Ilium Ischium Pubis Acetabulum (fossa) Iliac crest PSIS ASIS Greater sciatic notch Ischial spine Ischium tuberosity Pubic tubercle ```
Refer to pic
87
Hip joint 1. What type of joint is it? 2. The acetabulum is firmly pressed onto what? 3. More stability or movement?
1. Synovial ball and socket 2. Head of femur 3. Stability
88
Hip bones 1. What is attached to the bony edge of the acetabulum? 2. What is it made of? 3. What 2 things does it do?
1. Acetabular labrum 2. Fibrocartilage 3. Makes the socket deeper Adds stability to joint
89
Hip bones 1. What are the 3 strong ligaments between the hip and the demor called? 2. Arteries pass through the fibres in this joint capsule to go to what? 3. What kind of fracture can disrupt this blood supply? 4. What can this result in?
1. Iliofemoral, ischiofemoral and pubofemoral 2. Head of the femur 3. Intracapsular femoral neck fracture 4. Avascular necrosis of femoral head
90
Deformity of hip joints 1. Define varus deformity... 2. Define valgus deformity...
1. Distal part of bone directed toward midline | 2. Distal part of bone directed away from midline
91
Fascia and compartments of lower limb 1. The thigh is covered in what fascia? 2. What is the faschial thickening on the lateral side called? 3. What 3 things does this thickening do? 4. Which vein runs superficial to this thickening?
1. Fascia lata 2. Iliotibial tract 3. Attachment point for muscles Helps in knee extension Stabilises hip over knee 4. Great saphenous vein
92
Thigh compartments 1. What does the anterior compartment contain (2 things)? Which nerve and artery is associated with it? 2. What does the posterior compartment contain (3 things)? Which nerve and artery is associated with it? 3. What does the medial compartment contain (1 thing)? Which nerve and artery is associated with it?
1. Anterior compartment: hip flexor and knee extensor Femoral nerve and femoral artery 2. Posterior compartment: hip extensor, knee flexor and rotators Sciatic nerve and branches of profunda femoris artery 3. Medial compartment: hip adductors Obturator nerve and obturator artery
93
Gluteal region 1. What are the 3 muscles of the gluteal region from outside to inside? 2. What 3 things do these muscles do? 3. Which two nerves are in this region and what is there root supply?
1. Gluteus maximus, gluteus medius and gluteus minimus 2. Hip extension, trunk extension and pelvic stabilisation 3. Superior gluteal nerve: L4-L5 Inferior gluteal nerve: L5-S1
94
Gluteal region 1. What do the gluteus medius and minimus do when walking? 2. When the gluteus medius is damaged or paralysed, what sign can be seen? 3. What does the gluteus maximus do when walking? 4. When the gluteus maximum is damaged or paralysed, what happens when the weaker limb is on the floor?
1. Prevent pelvis tilting towards unsupported side 2. Trendelenburg sign 3. Prevents trunk from tipping forwards 4. Person will lurch backwards
95
Hip 1. What are the 2 foramina called? 2. What 3 general things go through them? 3. What 2 ligaments have caused these foramina?
1. Greater sciatic foramen and lesser sciatic foramen 2. Nerves, arteries and some tendons 3. Sacrospinous ligament and sacrotuberous ligament
96
Hip 1. What are the 4 short lateral rotators called? 2. Where are they located? 3. What are they innervated by? 4. What are the 2 functions?
1. Piriformis, gemelli, obturator internus and quadratus femoris 2. Deep to gluteus medius 3. L4-S2 4. Laterally rotate hip joint Support hip joint
97
Lateral rotators of hip PIRIFORMIS 1. What does it pass through? 2. Which artery and nerve passes above this muscle? 3. Which artery and 2 nerves pass below this muscle? 4. These nerves are vulnerable to damage from which 4 things?
1. Greater sciatic foramen 2. Superior gluteal artery and nerve 3. Inferior gluteal artery and nerve, plus sciatic nerve 4. Compression, intramuscular injection, posterior dislocation and hip surgery
98
Intramuscular injection - gluteal region 1. Which muscle are you going into? 2. Give one method of finding the right region...
1. Gluteus medius 2. Vertical line through highest of iliac crest Horizontal line between ischial tuberosity and highest point of iliac crest
99
Hip flexors 1. Which muscle is a powerful hip flexor? 2. What is it innervated by? 3. What two muscles make up this big muscle? 4. Where is it inserted and what injury can that cause? 5. An abscess can track down the fascial sheath of psoas, producing a swelling in which area?
1. Iliopsoas muscle 2. L1-L2 3. Psoas major and iliacus 4. Lesser trochanter - can cause an avulsion fracture 5. Femoral triangle
100
Thigh: medial compartment 1. What do the muscles here do to the hip joint? 2. What is it innervated by and what is its nerve root? 3. Where is the origin for all of them? 4. Where is the insertion for all of them? 5. What are the 5 muscles called?
1. Adduction 2. Obturator nerve: L2-L4 3. Pubis 4. Femur 5. Gracilis, pectineus, adductor longus, adductor brevis and adductor magnus
101
Thigh: anterior compartment 1. What 2 things does this compartment do? 2. What is it supplied by and what is its root value? 3. What 4 muscles make up the quadriceps femoris? 4. What is the other muscle in this compartment? 5. What does loss of function lead to?
1. Knee extension and hip flexion 2. Femoral nerve: L3-L4 3. Vastus medialis, vastus lateralis, vastus intermedius and rectus femoris 4. Sartorius 5. Weak/absent knee extension
102
Thigh: posterior compartment 1. What are the 3 hamstring muscles? 2. What are the 2 things that it does? 3. What is it supplied by and what is its root value? 4. Where is its origin? 5. Where is it attached?
1. Semimembranosus, semitendinosus and biceps femoris 2. Extend the hip and flex the knee 3. Sciatic nerve: L5-S3 4. Ischial tuberosity 5. Tibia and fibula
103
Lumbar plexus 1. Which 2 compartments of the thigh does the plexus innervate? 2. What does it start off as?
1. Anterior and medial compartments | 2. Psoas major
104
Femoral triangle 1. What is this an access point for? 2. Which vein? 3. Which lymph nodes? 4. What would present as a swelling in the triangle? 5. What are its 3 borders?
1. Vascular structures 2. Great saphenous vein 3. Inguinal lymph nodes 4. Femoral hernia 5. Inguinal ligament, adductor longus and sartorius
105
Inguinal lymph nodes | 1. Give 4 regions that drain into these lymph nodes
1. Lower limb, perineum, penis and lower vagina
106
Lower limb arterial supply: 1. What does it start as? 2. What 2 branches come off it? And which is the larger branch? 3. What 3 branches come off this large branch?
1. Common iliac 2. Internal iliac and external iliac ( external iliac is larger) 3. Circumflex, deep femoral and femoral
107
Gait cycle 1. How many phases are there and what are they called? 2. There are several periods that can be grouped into what 2 groups?
1. 2 phases: stance and swing | 2. Support and swing
108
``` Leg bones Where are the following features: Lateral and medial epicondyle Fibula head and shaft Tibial tuberosity Tibia shaft Lateral malleolus Medial malleolus Interosseous membrane ```
Refer to pic
109
``` Foot bones Where are the following features: Phalanx Metatarsals Cuneiforms Cuboid Navicular Talus Calcaneus ```
Refer to pic
110
Leg compartments 1. What does the anterior compartment do? (3 things) what artery and nerve is associated with it? 2. What does the lateral compartment do? (1 thing) what artery and nerve is associated with it? 3. What does the posterior compartment do? (3 things) what artery and nerve is associated with it?
1. Dorsiflexion of foot, inversion of foot and extensors of digits Deep peroneal nerve and anterior tibial artery 2. Eversion of foot Superficial peroneal nerve and peroneal artery 3. Plantar flexion of foot, inversion of foot and flexors of digits Tibial nerve and posterior tibial artery
111
Knee 1. What type of joint is the knee joint? 2. Name 3 movements that the knee joint can do... 3. How many articulations are there? What are they? 4. What are menisci made of and where do they sit? 5. What are the 5 functions of the menisci?
1. Modified hinge joint 2. Flexion/extension, rotation and translocation 3. 3: 2 femoro-tibial and 1 femoral-patellar 4. Made of fibrocartilage and sit on tibial condyles 5. Increases contact area, weight bearing, shock absorbers, lubrication and participates in locking mechanism
112
Patella 1. What type of bone is it? 2. What does it articulate with? 3. What muscles are directly above it? 4. What are the 3 functions?
1. Sesamoid bone 2. Femoral condyles 3. Quadriceps 4. Reduces ligament and tendon wear Spreads forces to condyles Increases moment of quadriceps muscle
113
Cruciate ligaments 1. What do these ligaments resist? 2. What are the two types called and which tibial condyle do they attach to? 3. What is the acronym to remember this? 4. What movement does each one limit and when is it taut?
1. Anterior-posterior translation 2. Posterior cruciate ligament = medial condyle Anterior cruciate ligament = lateral condyle 3. LA-MP 4. ACL - limits anterior movement - taut in extension PCL - limits posterior movement - taut in flexion
114
Collateral ligaments 1. What are the two ligaments called? 2. What type of tibial movement does each prevent? 3. What type of blow is each one injured by?
1. Medial collateral ligament and lateral collateral ligament 2. MCL = prevents abduction (valgus) LCL = prevents adduction (varus) 3. MCL = lateral blow LCL = medial blow
115
Knee - arterial supply 1. Which 4 arteries form an anastomoses around here? 2. What does this mean for fractures here? 3. Which artery passes posterior to the knee joint?
1. Femoral, popliteal, tibial and circumflex femoral arteries 2. Won't result in avascular necrosis of bone 3. Popliteal artery
116
1. If bursa around the knee becomes inflamed, what does this cause? 2. What movement leads to the knee locking? 3. What direction does the femur rotate on the tibia before it locks? 4. Out of the ligaments and muscles, which are relaxed and which are tense? 5. Which muscle unlocks the knee?
1. Bursitis 2. Full extension 3. Medially 4. Ligaments tense and muscles relax 5. Popliteus
117
Leg: anterior compartment 1. Which 3 muscles are in this compartment and what is the nerve root for each? 2. Which nerve supplies these muscles? 3. Which nerve is subcutaneous at the head of the fibula and at risk of damage/compression? 4. Loss of function of these muscles will result in what consequence and during which phase of walking?
``` 1. Tibialis anterior = L4 Extensor digitorum = L5 Extensor hallucis = L5 2. Deep peroneal nerve 3. Common peroneal nerve 4. Foot drop during swing phase of walking ```
118
Leg: lateral compartment 1. What 2 muscles are here? 2. What nerve is it innervated by and what is the nerve root? 3. What is the main function?
1. Peroneus longus and peroneus brevis 2. Superficial peroneal nerve L5-S1 3. Evertors
119
Leg: posterior compartment 1. What are the 3 inner muscles? 2. What are the 2 outer muscles? 3. What nerve is it innervated by? 4. What are the 3 functions of this compartment? 5. Loss of function would lead to what when walking?
1. Tibialis posterior, flexor digitorum and flexor hallucis 2. Soleus and tendocalcaneus 3. Tibial nerve 4. Plantar flexion of foot, inversion of foot and flexion of digits 5. Weak push-off
120
Popliteal fossa 1. What are the 4 boundaries? 2. Which nerve, artery and vein are found in here? 3. What is the deepest structure and which bone is it closet to (making it vulnerable in a fracture)?
``` 1. Semimembranosus and semitendinosus Biceps femoris Gastrocnemius - medial head Gastrocnemius - lateral head 2. Tibial nerve, popliteal artery and popliteal vein 3. Popliteal artery close to femur ```
121
Leg and foot arteries | What are the 3 arteries?
Anterior tibial artery Peroneal artery Posterior tibial artery
122
Tarsal tunnel 1. What does it contain? 2. What area do these things supply? 3. Tendons can wear and rupture on which malleolus?
1. Sensory, motor and arterial supply 2. Plantar surface of foot 3. Medial malleolus
123
Leg and foot 1. The superficial drainage of the lower limb is by which vein? 2. Where does the long one pass in relation to the malleolus? 3. Where does the short one pass in relation to the malleolus?
1. Saphenous veins 2. Long saphenous vein passes anterior to malleolus 3. Short saphenous vein passes posterior to malleolus
124
Ankle 1. What type of joint is it? 2. What 3 bones form it? 3. What are the 2 types of collateral ligament? 4. How many components is each ligament made up of? 5. What movement does each ligament prevent on the tibia? And therefore what excessive foot movement does it prevent?
1. Synovial hinge joint 2. Talus, tibia and fibula 3. Medial collateral ligament and lateral collateral ligament 4. MCL = 4 components LCL = 3 components 5. MCL: prevents tibia moving laterally and prevents excessive foot eversion LCL: prevents tibia moving medially and prevents excessive foot inversion
125
Pott's fracture | What two things causes this?
Forced abduction and external rotation
126
Foot 1. What are the 3 arches of the foot? 2. What are the 3 functions of these arches? 3. What are the arches supported by, and what does absence of arch or support result in? 4. Which joint is effected in hallux valgus (bunion)?
1. Medial longitudinal arch, lateral longitudinal arch and transverse arch 2. Shock absorbance, weight distribution and stores forces to be released during walking 3. Soft tissue: absence would result in flat foot 4. Metatarso-phalangeal joint
127
Foot 1. Which arteries and nerves supply the plantar side of the foot? 2. Which artery supplies the dorsum of the foot?
1. Medial and lateral plantar arteries and nerves | 2. Dorsalis pedis
128
Peritoneal arrangements | 1. What are the 4 types of peritoneal arrangements and what does each one mean?
1. Intraperitoneal = inside 2. Retroperitoneal = behind (outside) 3. Mesentry = fold of peritoneum suspending organ from posterior abdominal wall 4. Secondary retroperitoneal = intraperitoneal which later becomes retroperitoneal
129
1. What is the major artery that supplies the gut? 2. Which branch of this artery supplies the foregut? 3. Which branch of this artery supplies the midgut? 4. Which branch of this artery supplies the hindgut?
1. Abdominal aorta 2. Celiac trunk 3. Superior mesenteric artery 4. Inferior mesenteric artery
130
1. What are the 2 parameters of the foregut? 2. What are the 2 parameters of the midgut? 3. What are the 2 parameters of the hindgut?
1. Lower oesophagus to duodenum (second part at major papilla) 2. Duodenum (second part at major papilla) to transverse colon (2/3 way across) 3. Transverse colon (2/3 way across) to upper anal canal
Revision GEM Year 1
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