1
Q
Describe the unique features of the altas
A
- No body
- Lacks spinous process
- Widest cervical vertebrae
- Body fused with dens of axis
- Atlano-axial joint allows for rotation of head
- Atlanto-occipital joint allows for nodding of head
2
Q
What are the main features of the axis?
A
- Dens - prevents horizontal displacement of atlas
- Large spinous process
3
Q
What are the distinct features of the cervical vertebrae?
A
- Bifid spinous process
- Oval transverse foramen - vertebral arteries and veins
- Triangular vertebral foramen
4
Q
Label this diagram of a thoracic vertebrae.
A
5
Q
What are the features of the thoracic vertebrae?
A
- 2 demi-facets on each side
- 1 costal facet on each side
- Round vertebral foramen
6
Q
What are the features of lumbar vertebrae?
A
- No foramina of transverse processes
- No costal facets or demi-facets
- Vertebral foramina is small and triangular
7
Q
What is the remenant of the notocord?
A
Nucleus pulposus
8
Q
What are the parts of the intervertebral disc?
A
- Annulus fibrosus
- Nucleus pulposus
9
Q
Which artery is at risk of during fracture of head of humerus and mid-humeral fracture?
A
- Anterior/posterior circumflex humeral artery
- Profunda brachii
10
Q
What are the nerve roots for:
- Musculocutaneous
- Median
- Ulnar
- Axillary
- Radial
A
- Musculocutaneous - C5, C6, C7
- Median - C6, C7, C8, T1
- Ulnar - C8, T1
- Axillary - C5, C6
- Radial - C5, C6, C7, C8, T1
11
Q
What is the ulnar claw?
A
- Lesion of ulnar nerve at wrist
- Paralysis of medial 2 lumbricals - lumbricals flex MCP & extend IP joints
- Unopposed extension at MCP due to extendor digitorum
- Unopposed flexion at distal IP joint by flexor digitorum profundus
12
Q
What is the ulnar paradox?
A
- Lesion of ulnar nerve at elbow is a injury but looks better
- Flexor digitorum profundus (medial part) is paralysed so there’s no flexion at IP joint making ulnar claw much less obvious
13
Q
What are the muscles of pronation and supination?
A
- Supination - biceps brachii, supinator
- Pronation - pronator teres, pronator quadratus
14
Q
Which muscles are innervated by musculocutaneous nerve?
A
- Biceps brachii
- Brachialis
- Coracobrachialis
15
Q
Which muscles are innervated by radial nerve?
A
- Posterior compartment of arm - triceps brachii
- Posterior compartment of forearm
- x3 to wrist - ECRL, ECRB, ECU
- x3 to the fingers - ED, EDM, EI
- x3 to thumb - EPL, EPB, AbPL
- +3 - Brachioradialis, anconeus, supinator,
16
Q
What are the muscles innervated by the median nerve?
A
Forearm
- Superficial - Palmaris longus, flexor carpi radialis, pronator teres
- Intermediate - flexor digitorum superficialis
- Deep - Lateral half of flexor digitorum profundus, flexor pollicis longus, pronator quadratus
Hand
- Muscles of thenar eminence (LOAF) - Lumbricals 1 & 2, opponens pollicis, abductor pollicis brevis, flexor pollicis brevis
17
Q
What muscles are innervated by the ulnar nerve?
A
Forearm
- Superficial - Flexor carpi ulnaris
- Deep - Medial 1/2 of flexor digitorum profundus
Hand - everything except LOAF (median nerve)
- Muscles of hypothenar eminence:
- Opponens digiti minimi
- Abductor digiti minimi
- Flexor digiti minimi brevis
- Adductor pollicis
- Palmar/dorsal interosseui
18
Q
A
19
Q
What is the Hand of Benediction?
A
- Damage to median nerve
- Seen when patients asked to make a fist
- Paralysis of forearm flexors - apart from flexor carpi ulnaris and medial half of flexor digitorum profundus
- Paralysis of lateral 2 lumbricals
- Therefore unable to flex index and middle fingers as well as thumb
20
Q
What are the motor functions of:
- C5
- C6
- C7
- C8
- T1
A
- C5 - elbow flexors
- C6 - wrist extensors
- C7 - elbow extensors
- C8 - finger flexors
- T1 - finger abductors
21
Q
What are the motor functions of:
- L2
- L3
- L4
- L5
- S1
A
- L2 - hip flexors
- L3 - knee extensors
- L4 - ankle dorsiflexors
- L5 - long toe extensors
- S1 - ankle plantar flexors
22
Q
Briefly describe embrological development of limbs
A
- Limb buds appear on ventro-lateral body wall (somatic mesoderm with ectodermal cover)
- Apical ecotdermal ridge secretes signalling molecules (diffusion limited) preventing differenitation of mesochyme and encourage proliferation
- Proximal parts begins to differentiate due to lack of signalling molecules from AER
- AER marks boundary between dorsal/ventral parts & secretes dorsalising/ventralising influences over mesenchymal core
- Zone of polarising activity generates asymmetry in limbs
- Digial rays occur as AER regresses over areas between digits
- Mesoderm condenses, differentiates = cartilagous model then endochondrial ossification occurs
- Myogenic precursors are taken into limbs from somites - bring innovation with them
- Merge into common muscle masses around skeleton then split into individual muscles
23
Q
What are the borders of the axilla?
A
- Lateral wall - intertubecular groove of humerus
- Medial wall - serratus anterior and thoracic wall
- Anterior wall - pectoralis major and minor
- Posterior wall - scapularis, teres major, lastissimus dorsi
24
Q
What are the contents of the axilla?
A
- Long head of biceps brachii
- Corocobrachialis
- Brachial plexus
- Axillary artery
- Axillary vein
‘Big boobs can bring pleasure and arousal after viagra’
25
What are the borders of the cubital fossa?
* Superior - imaginary line between epicondyles
* Medial - lateral border of pronator teres
* Lateral - medial border of brachioradialis
26
What are the contents of the cubital fossa?
* Radial nerve
* Biceps tendon
* Brachial artery
* Median nerve
'Really need beer to be at my nicest'
27
What are the contents of the carpel tunnel?
* Median nerve
* Flexor pollicis longus
* Flexor digitorum superficialis
* Flexor digitorum profundus
28
What are the bones of the wrist?
* Scaphoid (lateral)
* Lunate
* Triquetrum
* Pisiform
* Trapezium (lateral)
* Trapezoid
* Cunate
* Hamate
'Some lovers try positions that they cannot handle'
29
Common causes of carpel tunnel syndrome
* T = trauma
* R = Rheumatoid arthritis
* A = acromegaly
* M = myxoedma - swelling of skin and underlying tissues (characteristic of hypothyroidism)
* P = pregnancy
30
What are the borders of the anatomical snuffbox?
* Medial border = Tendon of extensor pollicis longus
* Lateral border = Tendon of abductor pollicus longus and tendon of extensor pollicis brevis
* Proximal border = styloid process of radius
31
What causes pain in the anatomical snuffbox?
* Fracture of scaphoid
32
What is the innervation of serratus anterior? What sign is caused if this nerve is damaged?
* Long thoracic nerve
* Winged scapula
33
What is the innervation of latissimus dorsi?
Thoracodorsal nerve
34
What are the borders of the femoral triangle?
* Superior = inguinal ligament
* Lateral = medial border of sartorius
* Medial = lateral border of adductor longus
* Floor = pectineus, iliopsoas, adductor longus
35
What are the contents of the femoral triangle?
* Femoral Nerve
* Femoral Artery
* Femoral Vein
* Femoral Canal - Lymphatics
36
What is the difference between midinguinal point and midpoint of inguinal ligament? What can be found at these points?
* Mid-inguinal point = midway between pubic symphysis and ASIS - femoral artery
* Mid point of inguinal ligament - midway between pubic tubercle (start of inguinal ligament) to ASIS (end of inguinal ligament) - femoral nerve
37
What are the borders of the popliteal fossa?
* Superiomedial = Semimembranosus
* Superiolateral = Biceps femoris
* Inferiomedial = Medial head of gastrocnemius
* Inferiolateral = Lateral head of gastrocnemius
38
What are the contents of the popliteal fossa?
* Popliteal artery
* Popliteal vein
* Tibial nerve
* Common fibular nerve
39
What are the deep lateral rotators of the hip?
* Piriformis
* Obturator internus
* Obturator externus
* Quadratus femoris
* Gemellus superior
* Gemellus inferior
'Play golf or go on quests'
40
What are the muscles of anterior thigh?
* Sartorius
* Quadriceps femoris
* Rectus femoris
* Vastus medialis
* Vastus intermedius
* Vastus lateralis
* Iliopsoas
41
What are the nerve roots for the femoral nerve?
S2-S4
42
What are the muscles of the medial thigh?
* Pectineus
* Adductor brevis, longus and magnus
* Gracilis
43
What are the nerve roots for the obturator nerve? How does it enter the medial thigh?
* S2-S4
* Through obturator canal in obturator foramen
44
What are the muscles of the posterior thigh?
* Semimembranosus
* Semitendinosus
* Biceps femoris
45
What is the nerve roots of the sciatic nerve?
L4-S3
46
What are the muscles of the anterior compartment of the leg?
* Tibialis anterior
* Extensor digitorum longus
* Extensor hallucis longus
* Fibilaris tertius
47
What are the muscles of the lateral compartment of the leg?
* Fibularis longus
* Fibularis brevis
48
What are the muscles of the posterior compartment of the leg?
* Gastrosnemius
* Soleus
* Tibialis posterior
* Flexor digitorum longus
* Flexor halllucis longus
* Plantaris
* Popliteus
49
What is the difference between housemaid's knee and clergyman's knee?
* Housemaid's - inflammation of prepatellar bursa
* Clergyman's - inflammation of infrapatellar bursa
50
What is the unhappy triad?
* Force to lateral side of knee
* Damage to medial collateral ligament, medial meniscus, and anterior cruciate ligament
51
PPE Revision
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