-
What side of the phalanges does the EDB link with EDL?
Lateral side
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What side do dorsal interossei attach?
Lateral (DAB)
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What side do plantar interossei attach?
Medial (PAD)
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What digits are connected to plantar interossei?
3,4,5
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What muscle makes up majority of wing tendon on phalanges?
lumbricals
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Where does the central band of the extensor expansion insert?
Base of middle phalanx
-
Where do the lateral bands of the extensor expansion insert?
Base of distal phalanx
-
What joint does the extensor sling surround?
MTPJ
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At what joint does the FDB pass deep to the FDL?
PIPJ
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nerve of lateral compartment
SFN
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Nerve of Posterior compartment
Tibial N
-
Nerve of Anterior compartment
DFN
-
Artery of lateral compartment
brs. of AT and Fibular
-
Artery of Posterior compartment
PT
-
Patellar reflex spinal nerve
L4
-
Achille reflex spinal nerve
S1
-
how many compartments found at medial malleolus?
- **4 (Tom Dick AN Harry)
- 1) TP
- 2) FDL
- 3) PTA, TN
- 4) FHL
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How many dorsal interossei insert on 2nd phalanx?
2 (medial and lateral)
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Medial plantar nerve innervation
- Abd. Hallucis
- FDB, FHB
- 1st lumbrical
-
LPN innervation
All but Abd.H, EDB, EHB and 1st lumbrical
-
What are the small tendons that hold larger tendons to bone and house small blood vessels?
Vincula
-
What Nerve innervates EDB & EHB?
Deep fibular N
-
T/F Saphenous nerve is posterior to medial malleolus?
F, it is anterior
-
What Nerves innervate nail beds?
Proper plantar digital nerves
-
In the foot, what are the two principal brs. of the SFN?
Medial and intermediate dorsal cutaneous
-
What N innervates the interspace b/t digits 1 and 2 (proper dorsal digital nerves 2 & 3)?
DFN
-
What two brs. commonly make up the Sural N?
- Medial sural cutaneous N (off of Tibial N)
- Lateral sural cutaneous N (off of CFN)
-
T/F Sural N passes posterior to lateral Malleolus?
T
-
B/T what layers can you find the MPN?
1 & 2
-
B/T what layers can you find the LPN?
3 & 4
-
How many medial and lateral tarsal arteries branch off of dorsalis pedis?
- Medial tarsal: 2 brs.
- Lateral tarsal: 1 br
-
How many dorsal metatarsal Arteries off of the arcuate artery?
4
-
What is terminal arborization
Digital anastomosis from plantar aspect of digits to dorsal
-
What strata is found in thick but not thin skin?
Strata Lucida
-
What glands exist in thin and thick skin?
- Thin: appocrine, eccrine, sebaceous, hair
- Thick: eccrine
-
What are the two substances that make up ECM?
Fibers and Ground substance
-
What makes up ECM fibers?
Collagen and elastic fibers
-
What makes up ECM ground substance?
Proteoglycans and adhesive glycoproteins
-
What is an aggrecan?
Large collection of PGs
-
T/F PGs are covalently linked to HA?
F, non-covalently linked via proteins
-
Role of Fibroblasts and ECM?
They produce ECM
-
4 components of innate immune system?
- Mast cells
- Complement
- Granulocytes
- Macrophages
-
2 components of Acquire immunity?
- T-cells (CMI)
- B-cells (humoral) = plasma cells = antibodies
-
4 structures that are alymphatic?
- Cornea
- CNS
- Cartilage
- Epidermis
-
Hyaline cartilage DiRCT of LE?
- Joint capsules
- Dermis (reticular layer)
- Perichondrium
- Periosteum
-
What are the stem cells of the perichondrium?
Chondroblasts
-
Type of growth of Perichondrium?
Appostitional
-
Type of growth of Cartilage?
Interstitial (isogenous groups with chondrocytes in lacunae)
-
T/F fibrocartilage does not have perichondrium?
T
-
Fibrocartilage structures?
- Articular disks
- labrum
- menisci
- IVD, symphysis type
-
What is an Osteon?
Basic functional unit of bone
-
What are canaliculi?
Junctions b/t lacunae in bone for communication
-
What type of collagen is bone ECM?
Type I
-
What is osteogenesis imperfecta?
Inadequate and dysfunctional Type I collagen so bone does not form and cannot remodel
-
What diseases are caused by Vit D deficiency in adults and children?
- Adults: OM
- Children: rickets
-
Where do osteoclasts arise?
Bone marrow
-
Effects of PTH and Calcitonin on Ostoclast activity?
- PTH: increase bone resorption
- Calcitonin: decrease bone resorption
-
Where do PTH and Calcitonin arise?
- PTH : Parathyroid glands
- Calcitonin: Parafollicular cells
-
Name the three requirements for successful fracture healing?
- 1) Approximation
- 2) Limited movement
- 3) Intact periosteum and endosteum (for stem cell osteoblasts)
-
Which requires more Oxygen, fibroblasts or osteoblasts?
- Osteoblasts
- ** Fibroblasts require the least
-
What cells first arrive on scene after a fracture? What do they form?
Fibrocartilage to form hyaline cartilage
-
4 stem cells of ossification?
- Periosteum
- Endosteum
- Mesenchyme
- Perichondrium
-
What cells participate in intramembranouse ossification?
Mesenchyme cells
-
At what embryonic week does vasculature start to arise in bone ossification?
wk 6
-
At what embryonic week does the primary center of ossification begin?
wk 8
-
comparison of growth b/t hyaline cartilage and bone?
- hyaline: interstitial (mitotic chondroblasts becoming chondrocytes and resting in isogenous groups)
- Bone: appositional
-
In what day does LE embryonic development start?
day 28
-
What spinal levels contribute to LE embryo development?
L3-L5
-
What somites participate in LE muscle growth?
Paraxial mesoderm
-
At what embryo week deos LE rotation start?
wk 6 (ends at wk 8)
-
What does the LE look like @ wk 7?
Apoptosis of digits starts and rotation continues
-
What is the embry origin of the nucleus propulsus?
Notochord
-
Name the three layers of paraxial mesoderm?
- Myotome:
- Dermatome:
- Sclerotome:
-
When does endochondral ossification begin?
8-12 weeks
-
What are the two cell types in Synovial fluid and what do they produce?
- Type A: macrophage
- Type B: synovial fluid producers
-
Where does the Conus medullaris end?
L1-L2 IVD space
-
At what vertebral level do you perform a lumbar puncture?
L4, high point iliac crest
-
What type of joint is the sup/inf articular processes of vertebral bodies?
Diarthrosis (synovial)
-
What is affected by a lumbar stenosis?
- 4 IV foramen causing difficulty with lumbar puncture
- ** might have to use sacral canal/hiatus for puncture
-
What is the general rule for nerve compression?
Nerve compression will cause pain in area of nerve that lies underneath (L4 will cause L5 pain)
-
At what vertebral level can you find the high point of iliac crest and PSIS?
-
What are the two components of the sacroiliac joint?
- Ant: synovial (hyaline)
- Post: fibrous
-
What is the X-ray method for viewing the lesser trochanter?
Bull-frog
-
What is the strongest capsular ligament around the hip?
1) iliofemoral
2) pubofemoral
3) Ischiofemoral
Iliofemoral
-
What three structures protect from lateral disloaction of the patella?
- high lateral condyle
- vastus medialis
- patellar ligament
-
What does the MCL attach to?
Medial meniscus
-
What does the LCL attach to?
Nothing
-
What does Popliteus attach to?
Lateral meniscus
-
What muscles areas are formed from Epimere & Hypomere?
- Epimere: true back muscles
- Hypomere: limb muscles
-
T/F muscles are formed from more than one myotome and are innervated by only one primary ramus?
F, they are formed from multiple myotomes but the innervation is multiple as well
-
What is another name for dorsal mm mass and what are their functions?
- Postaxial
- function: extend and abduct
-
What is another name for ventral mm mass and what are their functions?
- Preaxial
- function: flex and adduct
-
What is the LE border b/t preaxial and postaxial?
- Preaxial:Tibia and hallucis
- Postaxial: fibular and 5th digit
-
Embryonic origin for Schwann cells and PRG cells?
Neural crest
-
embryonically, what do the anterior and posterior branches of the anterior primary rami innervate?
- Anterior = preaxial, ventral
- Posterior = postaxial, dorsal
-
Lumbar & Sacral plexus are Anterior & Posterior Divisions of what anterior primary rami?
L1-S3
-
What are the 5 Anterior nerves of the LE?
- Obturator
- Tibial
- Posterior femoral cutaneous
- medial plantar
- lateral plantar
-
What are the 7 Posterior nerves of the LE?
- Superior gluteal
- Inferior gluteal
- Femoral nerve
- Lateral femoral cutaneous
- Common fibular
- Superficial fibular
- Deep fibular
-
What is the most powerful hip flexor and where does it insert?
Iliopsoas, inserts on lesser trochanter of femur
-
Innervation of gluteus maximus and medius/minimus?
- Maximus= inf gluteal
- Medius/minimus = sup gluteal
-
Obturator internus exits via lesser sciatic foramen, what two ligaments form the foramen?
Sacrospinous and Sacrotuberous ligaments
-
IT band innervation?
Sup gluteal N
-
What two mm form floor of femoral triangle?
Iliopsoas and Pectineus
-
4 hamstring characteristics
- Tibial nerve innnervation
- Origin @ ischial tuberosity
- flex knee
- extend hip
-
At what level does the meningeal sac end?
S2
-
How many peripheral nerves can one anterior primary rami supply?
Multiple
-
What nerve can be impinged at PSIS and inguinal ligament?
Lateral femoral cutaneous
-
Superficial and Deep inguinal lymph nodes drain to what nodes?
External iliac
-
Vertebral level of IVC bifurcation?
L5
-
Vertebral level of Aortic bifurcation?
L4
-
Diff b/t direct and indirect inguinal hernia?
- direct: pierces inguinal canal
- indirect: passes within inguinal canal
-
What four Arteries make up the cruciate anastomoses of the femoral head/neck?
- Descending br. of inferior gluteal A
- Medial circumflex A
- Lateral circumflex A
- 1st perforating A off of Deep femoral A
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