L.p.75-90 Study Merged

1. Which muscle crosses more than one joint? rectus femoris

2. The tendon of which muscle is most prominent at the posteromedial aspect of the knee? semitendinosus

3. Which set of muscles act as antagonists during knee extension? semitendinosus, biceps femoris

4. Which muscle does not converge on the proximal medial surface of the tibia to form the anserine? semimembranosus

5. Which thigh muscle does not attach to the tibia? biceps femoris

6. Which action is common to the three hamstring muscles? knee flexion

7. Structurally, the proximal and distal tibiofibular joints are classified as a combination of which types of joints? synovial plane and fibrous syndesmosis

8. Which ligament provides lateral stability to the knee? fibular collateral

9. Which ligament prevents knee hyperextension and posterior displacement of the femur on the tibia? anterior cruciate

10. Which knee bursa may become inflamed due to repetitive falls on the knee? subcutaneous infrapatellar

11. Which knee bursa is between the patella and the skin? subcutaneous prepatellar

12. Which bony landmark is located on the tibia? medial malleolus

13. Which compartment of the leg contains only three muscles? superficial posterior

14. Which septum separates the superficial and deep compartments of the posterior leg? transverse intermuscular

15. Which muscle is found in the anterior compartment of the leg? fibularis tertius

16. The tendon of which anterior compartment muscle is the most medial on the anterior aspect of the ankle? tibialis anterior

17. Which active resisted movements enhance palpation of the fibularis longus muscle? plantar flexion and eversion

18. What are the attachments of the fibularis longus muscle? head of fibula; first metatarsal, medial cuneiform

19. The flexor digitorum longus plantarflexes and inverts the foot. What is its stretched position? dorsiflexion and eversion

20. What are the attachments of the tibialis anterior muscle? lateral tibial condyle; medial cuneiform, first metatarsal bone

21. Which position describes the location of the cuboid bone? anterior to the calcaneus

22. Which joint enables inversion and eversion of the foot? subtalar

23. Which is a commonly sprained ligament? anterior talofibular

24. Which joint is not classified as plane synovial? metatarsophalangeal

25. Which statement best describes the muscle location in both the forearm and the leg? Forearm flexors are located in the anterior compartment, while leg flexors are located in the posterior compartment

26. Which muscles dorsiflex the ankle? tibialis anterior, extensor digitorum longus, extensor hallucis longus

27. Which bone is on the medial aspect of the foot? navicular

28. Which part of the foot includes the navicular, cuboid, and cuneiforms? midfoot

29. Which muscle is most active during the terminal stance portion of the stance phase of gait? soleus

30. Which muscle is the primary active muscle during the mid-swing portion of the swing phase of gait? tibialis anterior

31. Which is an agonist-antagonist pair of muscles? iliopsoas - gluteus maximus

32. Which muscle originates on the anterior surface of the sacrum? piriformis

33. In which pair do both muscles laterally rotate the thigh? piriformis / gluteus maximus

34. Which statement about the quadriceps femoris is true? The four heads insert on the patella

& tibial tuberosity

35. Which thigh muscle flexes, abducts and laterally rotates the thigh? sartorius

36. Which bony landmark is a common insertion for the adductor magnus, longus and brevis? linea aspera

37. Which thigh muscle is intermediate to the iliotibial band and the semimembranosus? biceps femoris

39. Which pubic landmark links the paired pubic bones? symphysis

40. Which bony landmark is on the distal aspect of the femur? adductor tubercle

41. Which bony landmarks are on the tibia? medial malleolus, tibial crest, soleal line

42. Which one of the following is considered a muscle of mastication? temporalis

43. Which muscle extends the neck? splenius

44. Which scapular landmark articulates with the lateral aspect of the clavicle? Acromion

45. Which muscle is located in the extrinsic-superficial layer of the back? levator scapula

46. Which muscle assists the diaphragm as a primary respiratory muscle? external intercostals

47. Which muscle abducts the arm? middle deltoid

48. Which muscle is a superficial anterior forearm muscle? palmaris longus

49. Which one of the following is a hypothenar muscle? abductor digiti minimi

50. Which abdominal muscle contralaterally rotates the trunk?

1. Which statement about the hamstring muscles is false? All insert on the medial condyle of the tibia.

2. Which muscle does not attach to the linea aspera? semitendinosus

3. What single resisted action is required for the contraction of both heads of the biceps femoris muscle? knee flexion

4. In order to stretch the semitendinosus muscle, what actions would you perform? hip flexion/knee extension

5. Structurally, the knee is a combination of which types of joints? synovial bicondylar modified hinge

6. What is not classified as an intrinsic knee ligament? lateral collateral

7. Which knee bursa is between the femur and the quadriceps tendon? suprapatellar

8. Which knee ligament attaches to a meniscus? medial collateral

9. Which bony landmark is located on the distal aspect of the tibia? medial malleolus

10. Which bursa is between the calcaneus and the Achilles tendon? retrocalcaneal

11. Which muscle attaches to the base of the fifth metatarsal? fibularis tertius

12. Which set of active resisted movements enhances palpation of the tibialis anterior muscle? dorsiflexion and inversion

13. What are the attachments of the tibialis anterior muscle? lateral tibial condyle, medial cuneiform & base of 1st metatarsal

14. Which movement does a therapist resist to engage the muscles of the lateral compartment of the leg? plantar flexion and eversion of the ankle

15. Which bony landmark is palpable on the fibula? lateral malleolus

16. Which set lists the posterior leg muscles from superficial to deep? gastrocnemius - plantaris - soleus

17. Which one of the following is not a superficial leg muscle? popliteus

18. Which muscle can act as a synergist during knee flexion? gastrocnemius

19. Which tendon is palpated most anteriorly on the medial side of the ankle? tibialis posterior

20. Where is the sustentaculum tali located? medial aspect of the calcaneus

21. Which movement occurs at tarsometatarsal joints? gliding

22. What are the attachments of the spring (plantar calcaneonavicular) ligament? sustentaculum tali / navicular

23. What type of synovial joint are the metatarsophalanageal joints? condyloid

24. Which statement about the carpus and tarsus is true? The scaphoid is the most lateral bone of the proximal carpals.

25. Which ligament is the major supporter of the medial longitudinal arch? spring ligament

26. Which bony landmarks are the proximal and distal ends of the medial longitudinal arch of the foot? calcaneal tubercle, head of the first metatarsal

27. What is the common action of the muscles in the first layer of the foot? support of arches of the foot

28. How many dorsal interossei muscles are there in the foot? 4

29. Which bony landmark is on the lateral side of the foot, just distal to the cuboid bone? styloid of the 5th metatarsal

30. Which ligament binds the intermetatarsal bones? interosseous

31. Which part of the foot includes the metatarsals and phalanges? forefoot

32. Which muscle is most active during the leading response portion of the stance phase of gait? tibialis anterior

33. Which muscle is most active during the terminal swing portion of the swing phase of gait? hamstrings

34. Which is an agonist-antagonist pair of muscles? iliopsoas - gluteus maximus

35. Which statement about the quadriceps femoris is false? The rectus femoris flexes the knee & extends the hip.

36. Which hamstring muscle has an attachment on the linea aspera of the femur? biceps femoris * (short head)

37. What is not a medial thigh muscle? vastus medialis

38. Which hip adductor is most medial? gracilis

39. Which bony landmark is on the proximal aspect of the humerus? anatomical neck

40. Which bony landmark is located on the superior aspect of the sacrum? base

41. Which bony landmarks are on the femur? linea aspera, adductor tubercle, patellar surface

42. Which muscle raises the eyebrows? frontalis

43. Which muscle does not flex the neck? splenius

44. Which muscle elevates the hyoid bone? digastric

45. Which muscle is located in the superficial-intrinsic layer of the back? splenius capitis

46. Which muscle elevates the ribs? external intercostals

47. Which muscle flexes the elbow? biceps brachii

48. Which muscle is a superficial posterior forearm muscle? extensor carpi radialis longus

49. Which muscle abducts the fingers? dorsal interosse

50. Which abdominal muscle only compresses and supports the abdominal viscera? transverse abdominis

L.P 75

With what other fascia is the superficial fascia of the thigh continuous? abdominal wall & buttock

What are the attachments of the deep fascia of the thigh? inguinal ligament and pubis iliac crest ischial tuberosity, sacrum, coccyx and sacrotuberous ligament, bones around knee

What else is the deep fascia of the thigh called? fasica lata

What are the attachments of the iliotibial band? iliac tubercle lateral condyle of tibia (Gerdy's tubercle)

What muscles attach into the I.T.B? T.F.L & gluteus maximus

What are compartments of the thigh are there? anterior posterior, medial

What is the longest muscle in the body? sartorius

What muscles insert into the pes anserine? gracilis, sartorius, semitendinosus

Which quadriceps muscle crosses the hip? rectus femoris

What functions does the patella perform? provides the quadriceps muscle with greater mechanical advantage, protects the knee

L.P 77

What are the common attachments of many of the hip adductor muscles? Pubis, linea aspera of femur

Which hip adductor extends the hip? adductor magnus

What is the opening in the adductor magnus that allows passage of the femoral vessels?

Adductor hiatus

List the boundaries of the femoral triangle.

superior: inguinal ligament medial: adductor longus lateral: sartorius

What passes through the adductor canal? femoral vessels, saphenous nerve

L.P 79

What is the common origin of the hamstrings? ischial tuberosity

Which hamstring inserts on the fibular head? biceps femoris

What are the boundaries of the popliteal fossa?

superomedial: semimembranosus & semitendinosus superolateral: biceps femoris inferomedial: medial head of gastrocnemius inferolateral: lateral head of gastrocnemius

What happens to the popliteal fossa when the surrounding muscles contract? they become taut, providing more protection for structures within the fossa

L.P 80

Which muscle group is most important in stabilizing the knee? quadriceps

List the ligaments that support the knee. Indicate which are intrinsic/extrinsic. cadence number of gait cycles within a minute centre of gravity place in body where weight is evenly dispersed lateral pelvic shift side-to-side movement of pelvis during walking step length distance between the right heel and the left heel stride length distance between right heel and same point on right heel in the next gait cycle vertical pelvic shift vertical movement of pelvis during walking Functions of the 3 types of muscles.

Table summary: Anatomy and kinesiology of the knee and leg. Knee ligaments are categorized as intrinsic, including the lateral collateral, medial collateral, arcuate popliteal, and oblique popliteal, and extrinsic, including the anterior and posterior cruciate ligaments. Specific knee facts note that the LCL splits the biceps femoris tendon, the MCL attaches to a meniscus, and the ACL is more prone to damage. The medial meniscus is described as C-shaped, and communicating bursae are those that connect with the synovial cavity. Leg anatomy details include the superior and inferior extensor retinacula, which hold extensor tendons in place, and three fascial compartments: anterior, posterior, and lateral. Muscle actions include dorsiflexion in the anterior compartment and eversion and plantarflexion in the lateral compartment. The triceps surae consists of the gastrocnemius and soleus muscles inserting into the Achilles tendon. The gastrocnemius requires the knee to be extended for stretching because it crosses the knee, unlike the soleus. Other notes indicate that 5 to 10 percent of the population lacks the plantaris muscle, and muscles in the deep posterior compartment provide about 7 percent of plantarflexion. The popliteus unlocks the knee by laterally rotating the femur on the tibia. Finally, the proximal tibiofibular joint is a plane synovial joint that moves during ankle dorsiflexion and plantarflexion, while the distal tibiofibular joint is a syndesmosis.

Table summary: Anatomy and biomechanics of the ankle, foot, and gait. The talocrural joint is a hinge joint, and the ankle's stability is supported by tendons, ligaments, bone shape, and the position of the trochlea of talus. Key ligaments include the medial deltoid ligament and the lateral group comprising the anterior talofibular, posterior talofibular, and calcaneofibular ligaments. Joint types include plane joints for the calcaneocuboid, subtalar, intermetatarsal, and tarsometatarsal joints, a ball-and-socket for the talocalcaneonavicular joint, hinge joints for the talocrural and interphalangeal joints, and a condyloid joint for the metatarsophalangeal joint. Foot regions are categorized as hindfoot for the calcaneus and talus, midfoot for the cuboid, cuneiforms, and navicular, and forefoot for the metatarsals and phalanges. The foot contains three arches: the medial longitudinal, lateral longitudinal, and transverse, with the medial being the highest. The medial longitudinal arch is supported by the tibialis anterior, tibialis posterior, and fibularis longus tendons. Additionally, the plantar aponeurosis attaches to the calcaneus and digital tendons. Gait is described by five stance phase sub-phases, from initial contact to pre-swing, and three swing phase sub-phases, from initial swing to terminal swing, with base width defined as the distance between the two feet.

smooth muscle: movement of substances cardiac muscle: blood circulation skeletal muscle: movement, maintaining posture, stabilizing joints, generating heat

4 characteristics of muscle? Excitability, contractility, extensibility, elasticity

Difference between extensibility and elasticity?

extensibility: the ability to stretch without tearing elasticity: the ability to return to resting length after being stretched

Identify the types of muscle by their description:

found in walls of hollow organs: smooth involuntary: cardiac, smooth long, cylindrical cells: skeletal move body parts and maintain posture: skeletal short, branched cells: cardiac spindle-shaped cells: smooth voluntary: skeletal

What is the area of a muscle between the tendons called? muscle belly

To what percentage can skeletal muscle cells shorten when they contract? 70%

Which muscle fibre arrangement shortens the most? parallel

What are the prime movers of an action called? agonists

What are the muscles that oppose prime movers called? antagonists

What are muscles that help with a movement called? synergists

What are muscles that hold structures in place while a movement is happening called? fixators

What kind of synovial joint is the acromioclavicular joint? plane synovial joint

What is the main function of the A.C joint? allow the scapula more range of rotation on the thorax

What are the 2 main ligaments of the A.C joint? Acromioclavicular, coracoclavicular, conoid & trapezoid parts

What type of synovial joint is the sternoclavicular joint? saddle synovial joint

What ligaments support the S.C joint? anterior S.C ligament, posterior S.C ligament, interclavicular ligament (costoclavicular)

What type of synovial joint is the glenohumeral joint? ball-and-socket synovial joint

What structure deepens the glenoid fossa to allow a better fit b/t the scapula & the head of the humerus? glenoid labrum

With what movement does the joint capsule of the G.H tighten? shoulder abduction

What structures make up the coracoacromial arch? coracoid process, coracoacromial ligament, acromion process

What bursa is located b/t the deltoid mm, the supraspinatus tendon & the G.H joint capsule?

For every 1 degree of movement of the scapula during glenohumeral movement, how many degrees does the humerus move? 2 degrees

List the 4 rotator cuff muscles. What is their common action? Supraspinatus, infraspinatus, teres minor

Subscapularis. They all support the head of the humerus in the glenoid fossa.

What muscles form the anterior and posterior folds of the axilla?

anterior: pectoralis major posterior: latissimus dorsi and teres major

The Body - A Layered Structure

What is the general function of connective tissue? Connective tissues support, protect structures, and envelop tissues of the body

How are body structures arranged? body structures are layered

What are the 3 visible layers called? epidermis (superficial), dermis (intermediate), subcutaneous (deep)

What is an example of C.T sheaths? muscle tissue wrappings

What do the superficial, intermediate and deep layers wrap?

superficial: covers muscle belly intermediate: wraps fascicles deep: wraps individual cells

What covers muscle? layers of muscle are covered by their own C.T sheath continuous with one another

Where do C.T wrappings extend and converge at? What do they form at the ends? C.T wrappings extend the length of the muscle & converge at the ends, forming tendons

What are structures in the body named according to? named according to the structure that they envelop ex: epi-mysium (muscle)/endo-neurium (nerve)

What does the movement of body parts require the interaction of? movement of body parts requires interaction b/w: bones, joints, nerve fibre, muscles, C.T wrappings

How many layers of C.T encase muscle? muscle is encased in 3 layers of C.T

What do tendons connect to? tendons connect to the periosteum (C.T sheaths that wrap bones)

What happens to C.T when muscle contracts? when muscle contracts, it pulls on the C.T sheaths, which in turn transmits the force to the bone to be moved

What is periosteum continuous with? What does it allow?

periosteum is continuous with ligamentous. Structures comprising the joints so movement is made possible through the connection of various C.T structures

Spinal Movements & Effect on Other Structures

What does the movement of the C/S (Cervical Spine) affect? neck (C/S) movements affect C.T coverings of the spinal cord

What happens to the C.T with C/S flexion? C/S extension? head flexion stretches C.T wrapping around the spinal cord & exerts pressure on the nerves exiting the spinal column head extension lessens the pull on the C.T wrappings, so they slacken, reducing tension on the C.T releases the pressure on nerves exiting the spinal column

What defines fascia? C.T is the medium of "inter-connectedness", collectively referred to as fascia

Clinical Relevance

What do injuries sustained by the body develop? injuries often leave scars during tissue repair

What can scar tissue do to the body? scars can: bind tissues that are normally freely moveable, syndromes & other chronic musculoskeletal conditions

Different types of fxnal classifications of joints

Functional classifications based on amount of movement possible at a joint:

- Synarthroses: immoveable

- Amphiarthroses: slightly moveable

- Diarthroses: freely moveable

structural classifications of joints

Structural classification based on type of tissue that holds joint together:

- fibrous: composed of fibrous tissue that holds bone ends together

- Cartilaginous: composed of cartilage that holds articulating bones together

- Synovial: articulating bones separated by a joint cavity that is filled w/synovial fluid

what is a joint Articulation between 2 or more bones fxnally, type of joint depends of its movement what is the structural classification of joint depends on tissue that holds joint together joints are not strongest unstable joints: gh, hip what makes the mechanical advantage: when the effort is farther than the load from the fulcrum, the lever operates at a mechanical advantage (power lever)

1st 2nd 3rd class levers effort, load, fulcrum what parts of the body

• joints are the fulcrums

• bones are the levers

• muscle contraction provides the effort

- the load is the bone itself, overlying tissues & anything trying to be moved by that lever

what are synovial joints classified as fxnally diarrhoses, freely moveable what is intracapsular/extracapsular ligaments of joints

- ☐ extracapsular: outside the capsule

- intracapsular: inside the capsule

Different features of synovial joints what makes them synovial ☐ 1. articular cartilage

○ 2. joint cavity (synovial cavity)

3. fibrous joint capsule (articular capsule)

4. synovial membrane

○ 5. synovial fluid

○ 6. reinforcing ligaments

what type of joint atlanto-odontoid joint synovial pivot where is the odontoid process atlanto-axial joint what type of joint is considered immovable synarthroses elasticity, excitability, extensibility, contractibility

○ Excitability ability to receive & respond to stimuli causes muscle contraction

Contractility ability to shorten forcibly when adequately stimulated

Extensibility ability to be stretched beyond normal resting length

Elasticity ability to resume normal resting length after being stretched

characteristic and fxn of smooth, cardiac and skeletal muscles

- skeletal-striated/stripe like

- o long

- cylindrical

○ voluntary

- contract along their long axis

• cardiac - striated/stripe like

○ short

- branched

○ involuntary

- ☐ contraction in various directions

- smooth -

- spindle shaped

○ short

○ involuntary

- o contraction constricts lumen

which of the 3 are branched cardiac where would you find them heart what is the fxn of long/short parallel fascicles parallel mm produce large degree of contraction

- definition of agonist, antagonist, synergist, fixator

- agonists: prime movers muscles that provide the major force for a specific movement

- ☐ antagonists: muscles that oppose, or reverse specific movement

- o synergists: 'work together' with agonists; promote the same movement, or reduce unnecessary/undesirable movements

- fixators: "holding" synergists that immobilize a bone or a muscle's origin

• what can/can't be assessed by palpation

- o Shape - tone

- colour-q16

• hyoid bone c2-c3

- characteristics of vertebrae why is it shaped

• features of I.V.D and what are not - label

- strongest attachment b/w vertebrae

- ☐ major site of weight bearing

- o have different shapes & sizes, depends on spinal region

structure consist of two parts:

annulus fibrosus (outer): concentric layers of fibrocartilage, at right angles to each other nucleus pulposus (inner): semi-gelatinous mass, highly elastic d/t ↑ water content, acts as a shock absorber during spinal movements, avascular.

- zygapophyseal joint another name facet joint

• ligaments of spine

- fxn of P.L.L and All

- All: prevents hyperextension of spine (tightens when spine column is extended)

○ P.L.L: prevents hyperflexion of spine, prevents posterior protrusion of nucleus pulposus

craniovertebral ligament

apical connects the tip of the dens and the occiput, resists long axis traction forces alar: connects lateral aspects of the apex of dens to the lateral aspect of the foramen magnum, limit lateral flexion of occiput on atlas atlanto occipital joint where is atlanto-odontoid and which ligament holds it in placec0-c1 atlanto-occipital membrane: extends from anterior & posterior arches of C.1 to the anterior and posterior margins of the foramen magnum what is a conceptual joint scapula and thorax do not form a true joint: known as conceptual scapulothoracic joint

• O.I.A of pec minor

o: costal cartilages 3 to 5 (anteromedial surface)

i: medial & superior aspect of coracoid process of scapula

a: protracts & stabilizes scapula 2 degrees: w/ scapula fixed, draws rib cage up

serratus anterior

- o: external surface of ribs 1 to 8 (or 9)

- i: anterior surface of medial border of scapula

- a:1°: protracts the scapula & holds it against the thoracic wall

- 2°: rotates scapula superiorly

○ subclavius

- o:junction of 1st rib & its costal cartilage

- i:inferior middle 1/3 of clavicle

- a: stabilizes & depresses clavicle

- upper traps

- o: medial 1/3 superior nuchal line, inion, ligamentum nuchae

- i: lateral 1/3 clavicle, acromion, spine of scapula

- a: elevates scapula, superior rotation of scapula

- 2°: bilateral: with scapula fixed, extends the head unilateral: lateral flexion of neck

- origin of deltoids common attachment with another muscle - traps

• shape / feature clavicle convex - concave - anteriorly/posteriorly

• features of the A.C joint

- coracoacromial arch strong, triangular ligament

- attachments:

- base: lateral border of coracoid process

- apex: edge of acromion

- supraspinatus

- o: supraspinous fossa

- i: superior facet of greater tubercle of humerus

- a: initial 15 degrees of abduction of the humerus

○ sub scap

- o: subscapular fossa

- i: lesser tubercle of the humerus

- a: adducts & medially / internally rotates humerus

- deltoid

- G.H joint

- o: insertion of traps lateral 1/3 of clavicle, acromion, spine of scapula

- i: deltoid tuberosity of humerus

- a: anterior part: flexes & medially rotates humerus

- middle part: abducts humerus

- posterior part: extends & laterally rotates humerus

- 2°: stabilize G.H jt

○ features

○ what does it lack and have

- I.O.A of

○ infraspinatus

○ teres minor

- o teres major

○ lev scap

• borders of axilla

- apex: glenohumeral joint

- base: skin & fascia covering the axilla

- anterior: pectoralis major

- posterior: latissimus dorsi

- o medial: ribs & intercostal muscles

- lateral: humerus (medial aspect)

- posture protracted shoulders

what muscles of weak or tight pec major and minor, rhomboid major/minor winging of scapula serratus anterior, rhomboid major/minor

Bones of pectoral girdle

o clavicles

○ scapula

AcromioClavicular joint

SternoClavicular joint

○ GlenoHumeral joint

o CoracoAcromial arch

Why Does G.H Joint Have More R.O.M

structure: size of humeral head compared to glenoid cavity, laxity of joint capsule what muscles attach to greater and lesser tubercle

- greater tubercle

- supraspinatus - superior facet

- infraspinatus - middle facet

- teres minor - inferior facet

- o lesser tubercle

- subscapularis

G.H movement does pectoralis major mm Not perform External Rotation ligament does not support acromioclavicular joint Sternoclavicular.

which term describes vertebral mm fibre direction rectus

Type of joint may have bursa associated synovial

Weak ligament helps prevent hyperflexion of spine. posterior longitudinal mm attaches to the scapula Serratus anterior zygapophyseal (facet) joints is false The general orientation of facet joints in each region of the spine is the same.

Rotator cuff mm is False They all rotate the humerus.

Type of synovial joint only allows rotation pivot synovial

Muscle fibre arrangement does pectoralis major mm have convergent

What is primary movement at the atlanto axial joint rotation

Primary function of fascia encase & compartmentalize body structure

Not function of skeletal mms. function as levers for movement

Scapular landmark does Not serve as an attachment for mm Glenoid fossa

Suture joints The edges of the bones interlock

Joint is the only bony articulation b/w the upper limb & axial skeleton sternoclavicular fulcrum is b/w the effort & the load 1 Class levers F/E/L load is b/w the effort & the fulcrum 2 Class levers L/E/F

Effort is applied b/w the load & fulcrum 3 Class levers F/L/E

Characteristic can't be assessed by palpation colour

erector M.M Spinalis, iliocostalis, longissimus

Not Erector mm Semispinalis.

level of vertebral Carotid tubercle palpated. C.6

Term is functional classification joints. Synarthrosis.

Strong fibrous ligament that joins the S.P of adjacent vertebrae Supraspinous ligament

Skeletal mm cell long cylindrical & voluntary

Insertion of infraspinatus mm greater tubercle of the humerus

Craniovertebral joint is False. Atlanta joint allows primary for flexion & extension.

Axillary boundary & structures that form it posterior latissimus dorsi

Anterior intervertebral joints are classified as symphyses

Palpate laterally & posteriorly to the first cricoid ring carotid tubercle

Which mm protracts scapula Serratus anterior

Edges of bones interlock Suture plate of hyaline cartilage synchronosis interosseous membrane syndesmosis level does Thyroid cartilage sit C.4 & C.5

Explain difference b/w extensibility & elasticity:

Extensibility ability to be stretched beyond normal resting length

Elasticity-ability to resume normal resting length after being stretched

Anterior boundary of axilla pectoralis major

Bony landmarks articulate w scapula clavicle & head of the humerus fascicle arrangement makes mm most powerful bipennate intervertebral disc The annulus fibrosus is made of concentric layers of fibrocartilage

Intertransverse ligaments is False They form strong broad elastic bands

Type of fascicle arrangement makes a mm able to shorten the most parallel

Joint = fulcrum

Conoid & trapezoid ligaments together form ligament Coracoclavicular

Speed levers The force exerted by mm be greater than the load

Hinge joint: Knee

T.T.2

Structure prevents soft tissue from Rubbing directly against bone bursa

Interosseus membrane It is a sheet of fibrous tissue linking 2 bones

Axial movement can the condyloid joint perform? Biaxial

Structural Classification of J.T.S It's Type of tissue binding the joint together

Functional Example of synarthrotic joint Suture.

Type of level Effort b/w fulcrum & the load 3 class lever E/w F/L

Type of level always strength but sacrifice R.O.M & speed 2nd class

Classification describes Synovial J.T Diarthrosis ligaments that are thickenings of the fibrous J.T capsule are known as intrinsic

Pivot type synovial joint atlanto axial

Example hinge J.T Knee

Synovial Jt permits greatest amount of movement ball & socket

It is slightly moveable amphiarthrodial

Orbicularis indicates a circular mm

Not fnc of mm blood cell production

Extensibility is the ability to be stretched features characterize cardiac mm cell short, branched, & involuntary mm fibre arrangements allows for greatest degree of movement parallel fnx grouping mm is false Antagonists contract w agonists to promote the movement ligament weak & links adjacent spinous processes interspinous ligament prevents hyperextension of spine. anterior longitudinal part of ligments thickens in the cervical S to form ligamentum nuchae Supraspinous &

interspinous ligaments.

ligament reinforces Transverse light of atlanto-axial Cruciate

Vertebra has no body, no S.P & no I.V.D C.1

Landmark is a feature of the atlas anterior arch

Jt classified as bicondylar atlanto-occipital

Predominant movement atlanto axial Jt rotation ligament does not connect the axis to the occiput transverse

2 type of synovial Jt the scapula form w other bones plane & ball socket

Fascia is false restrictions in the back do not cause restrictions in the upper limbs

I: infraspinatus mm middle facet of the greater tubercle of humerus

Palpation protocol Spine of scapula palpate inferomedially & posteriorly from the acromion

Not Clavicle fnx attaches the lower limb to the axial skeleton

Clavicle fnx provides side mm attachments, transmits compressive forces from upper limbs to axial skeleton / braces the scapula away from axial skeleton

Type Jt acromioclavicular plane

Jt saddle type of synovial Jt sternoclavicular

Role of costoclavicular ligament It limits elevation of medial end of the clavicle

Structure Not part of the coracoacromial arch acromioclavicular lig

Ligament 2 attachments are both on the same bone. Transverse humeral

Type of G.H Jt ball & socket

Rotator cuff mm is false they all rotate the humerus

Rotator cuff helps stabilize the glenohumeral Jt / 3 millimeters onto greater G.H movement does pectoralis major mm Not perform External Rotation ligament does not support acromioclavicular joint Sternoclavicular.

which term describes vertebral mm fibre direction rectus

Type of joint may have bursa associated synovial

Weak ligament helps prevent hyperflexion of spine. posterior longitudinal mm attaches to the scapula Serratus anterior zygapophyseal (facet) joints is false The general orientation of facet joints in each region of the spine is the same.

Rotator cuff mm is False They all rotate the humerus.

Type of synovial joint only allows rotation pivot synovial

Muscle fibre arrangement does pectoralis major mm have convergent

What is primary movement at the atlanto axial joint rotation

Primary function of fascia encase & compartmentalize body structure

Not function of skeletal mms. function as levers for movement

Scapular landmark does Not serve as an attachment for mm Glenoid fossa

Suture joints The edges of the bones interlock

Joint is the only bony articulation b/w the upper limb & axial skeleton sternoclavicular fulcrum is b/w the effort & the load 1 Class levers F/E/L load is b/w the effort & the fulcrum 2 Class levers L/E/F

Effort is applied b/w the load & fulcrum 3 Class levers F/L/E

Characteristic can't be assessed by palpation colour

erector M.M Spinalis, iliocostalis, longissimus

Not Erector mm Semispinalis.

level of vertebral Carotid tubercle palpated. C.6

Term is functional classification joints. Synarthrosis.

Strong fibrous ligament that joins the S.P of adjacent vertebrae Supraspinous ligament

Skeletal mm cell long cylindrical & voluntary

Insertion of infraspinatus mm greater tubercle of the humerus

Craniovertebral joint is False. Atlanta joint allows primary for flexion & extension.

Axillary boundary & structures that form it posterior latissimus dorsi

Anterior intervertebral joints are classified as symphyses

Palpate laterally & posteriorly to the first cricoid ring carotid tubercle

Which mm protracts scapula Serratus anterior

Edges of bones interlock Suture plate of hyaline cartilage synchondrosis interosseous membrane syndesmosis level does Thyroid cartilage sit C.4 & C.5

Explain difference b/w extensibility & elasticity:

Extensibility ability to be stretched beyond normal resting length

Elasticity-ability to resume normal resting length after being stretched

Anterior boundary of axilla pectoralis major

Bony landmarks articulate w scapula clavicle & head of the humerus fascicle arrangement makes mm most powerful bipennate intervertebral disc The annulus fibrosus is made of concentric layers of fibrocartilage

Intertransverse ligaments is False They form strong broad elastic bands

Type of fascicle arrangement makes a mm able to shorten the most parallel

Joint = fulcrum

Conoid & trapezoid ligaments together form ligament Coracoclavicular

Speed levers The force exerted by mm be greater than the load

Hinge joint: Knee

T.T.2

Structure prevents soft tissue from Rubbing directly against bone bursa

Interosseus membrane It is a sheet of fibrous tissue linking 2 bones

Axial movement can the condyloid joint perform? Biaxial

Structural Classification of J.T.S It's Type of tissue binding the joint together

Functional Example of synarthrotic joint Suture.

Type of level Effort b/w fulcrum & the load 3 class lever E/w F/L

Type of level always strength but sacrifice R.O.M & speed 2nd class

Classification describes Synovial J.T Diarthrosis ligaments that are thickenings of the fibrous J.T capsule are known as intrinsic

Pivot type synovial joint atlanto axial

Example hinge J.T Knee

Synovial Jt permits greatest amount of movement ball & socket

It is slightly moveable amphiarthrodial

Orbicularis indicates a circular mm

Not fnc of mm blood cell production

Extensibility is the ability to be stretched features characterize cardiac mm cell short, branched, & involuntary mm fibre arrangements allows for greatest degree of movement parallel fnx grouping mm is false Antagonists contract w agonists to promote the movement ligament weak & links adjacent spinous processes interspinous ligament prevents hyperextension of spine. anterior longitudinal part of ligments thickens in the cervical S to form ligamentum nuchae Supraspinous &

interspinous ligaments.

ligament reinforces Transverse light of atlanto-axial Cruciate

Vertebra has no body, no S.P & no I.V.D C.1

Landmark is a feature of the atlas anterior arch

Jt classified as bicondylar atlanto-occipital

Predominant movement atlanto axial Jt rotation ligament does not connect the axis to the occiput transverse

2 type of synovial Jt the scapula form w other bones plane & ball socket

Fascia is false restrictions in the back do not cause restrictions in the upper limbs

I: infraspinatus mm middle facet of the greater tubercle of humerus

Palpation protocol Spine of scapula palpate inferomedially & posteriorly from the acromion

Not Clavicle fnx attaches the lower limb to the axial skeleton

Clavicle fnx provides side mm attachments, transmits compressive forces from upper limbs to axial skeleton / braces the scapula away from axial skeleton

Type Jt acromioclavicular plane

Jt saddle type of synovial Jt sternoclavicular

Role of costoclavicular ligament It limits elevation of medial end of the clavicle

Structure Not part of the coracoacromial arch acromioclavicular lig

Ligament 2 attachments are both on the same bone. Transverse humeral

Type of G.H Jt ball & socket

Rotator cuff mm is false they all rotate the humerus

Rotator cuff helps stabilize the glenohumeral Jt / 3 millimeters onto greater 1. Which structure is a boundary of the thoracic outlet? body of T.1 vertebra

2. Which statement about the intercostal spaces is false? They house vital structures, such as the heart and lungs.

3. The highest point along the iliac crest usually lies at the level of which vertebral segment? L.4

4. Which thoracic joint primarily uses elastic recoil to assist with respiration? costochondral.

5. sternocostal joints is true? They link cartilage at the end of the rib to the sternum.

6. The predominant movement of the lower 4 ribs is described as bucket handle

7. Which statement about the muscles of the thorax is false? All originate on the thoracic vertebrae.

8. Whether a rib demonstrates bucket handle or pump handle movement depends on the angle of the line (axis) connecting the costovertebral joint and the costotransverse joint.

9. Which abdominal fascial layer is most superficial? Camper's.

10. Which statement about the diaphragm is false? During inspiration the muscle moves superiorly.

11. Which anatomical reference point is at the level of the intervertebral disc between L.3 and L.4? umbilicus

12. The inguinal ligament is formed by a thickening of the aponeurosis of which muscle? external oblique

13. What is not a muscle of the posterior abdominal wall? transversus abdominis

14. Which landmark is not an attachment of the quadratus lumborum? S.P of the lumbar spine

15. Which muscle is only present in about half the population? psoas minor

16. Which muscle has an inferoanterior fiber direction? external intercostal

17. The superficial ring of the inguinal canal is associated with which muscle? external oblique

18. What are the actions of the external oblique muscle? contralateral rotation, flexion.

19. The posterior superior iliac spines are located at the level of which vertebral segment? S.2

20. Which bony landmark is not a boundary of the greater pelvis? pubic body.

21. Which bony landmark is found within the boundaries of the true pelvis? pubic body

22. Which joint has three articulations? lumbosacral

23. pelvis is false? The male pelvis overall is broader and more flexible

24. sacrum is true? It articulates with the pelvis, forming the S.I joints

25. sacrum is false? The vertebral canal does not extend to the sacrum.

26. Which ligament supports the lumbosacral joints? iliolumbar

27. Which pelvic joint does not have an articular disc? sacroiliac

28. Which statement about the sacroiliac joint is true? It is classified as a syndesmosis and a synovial joint.

29. The iliopsoas is not a pelvic floor muscle.

30. Which statement about the pelvic diaphragm is false? It consists of four groups of large muscles assisting in respiration.

31. What is the medial attachment of the inguinal ligament? pubic tubercle.

32. Which attachment is common to both the piriformis and gluteus maximus muscles? sacrum

33. Which pair of muscles shares a common insertion? gluteus maximus / tensor fasciae latae.

34. Which muscles medially rotate and abduct the thigh? gluteus medius and gluteus minimis

35. The gluteus medius O: on the ilium between which landmarks? anterior and posterior gluteal lines

36. Which muscle travels through the lesser sciatic foramen? obturator internus

37. Which statement about the clinical significance of the piriformis muscle is false? The sciatic nerve usually passes superior to the piriformis.

45. What is the role of the iliofemoral ligament? prevents hyperextension of the hip joint

46. Which type of movement is possible at the hip? multiaxial

47. Which statement comparing the shoulder and hip is true? The hip joint has greater stability than the shoulder.

48. The trochanteric bursa is located between which structures? gluteus maximus and the greater trochanter

49. Which bony landmark is on the distal aspect of the femur? supracondylar lines

50. Which hip movement does the tensor fascia lata muscle not perform? extension

2. Which statement about the intercostal spaces is true? They house intercostal muscles and neurovascular bundles.

3. Which set of joints allows for range of motion movements? costotransverse, costovertebral

4. Which feature allows the costal cartilage to assist with exhalation? elasticity

5. Which joint links the head of the rib to demifacets of adjacent vertebrae? costovertebral

6. Which statement about sternocostal joints is true? They link cartilage at the end of the rib to the sternum.

7. Which statement about the muscles of the thorax is false? All originate on the thoracic vertebrae.

8. Which mm attaches to the ribs and the spinous processes of C.7-T.3? serratus posterior superior

9. The predominant movement of the lower 4 ribs is described as bucket handle

10. Which muscle originates on the spinous processes of the T.11 to L.2? serratus posterior inferior

11. Which statement about the diaphragm is false? During inspiration the muscle moves superiorly.

13. Which reference tool is generally used to describe the location of abdominal pain? quadrants

14. The inguinal ligament is formed by a thickening of the aponeurosis of which muscle? external oblique

16. Which muscle originates on the T.V.P's of the lumbar vertebrae and bodies & I.V.D's of T.12 - L.5? psoas major

17. external intercostal Which landmark is not an attachment of the quadratus lumborum? lumbar S.P's

18. Which structure is an attachment of the rectus abdominis muscle? xiphoid process

19. Which muscle forms part of the posterior abdominal wall? quadratus lumborum

20. Which muscle does not flex the trunk? transversus abdominis

22. Contraction of which muscle rotates the trunk contralaterally? external oblique

23. Which muscle is not part of the anterior abdominal wall? psoas major

26. The bones of the pelvis are classified as which type of bone? irregular

27. The greater pelvis is synonymous with which term? false pelvis

28. Which bony landmark is not found on the ilium? sacral promontory

29. Which bone is not part of the pelvic girdle? coccvx

30. Which ligament is an anterior thickening of the capsule of the sacroiliac joint? anterior sacroiliac

31. Which statement about the pelvis is true? The female pelvis is adapted for childbearing.

32. The sacrotuberous ligament connects the ilium, sacrum and coccyx to the ischial tuberosity and helps restrict nutation.

33. The sacroiliac joints are classified as which types of joints? plane synovial and syndes

34. pelvic floor is false? It attaches to the pelvic brim and sacral ala.

35. What is the insertion of the gluteus maximus? the iliotibial band and gluteal tub

36. The greater trochanter is not an attachment of the gluteus maximus.

37. Which landmarks make up the origin of the gluteus medius? between the anterior and posterior gluteal lines

38. Which muscle medially rotates the thigh? gluteus medius

39. The gluteus medius and minimus muscles perform which thigh movements? abduction / medial rotation

40. Which external hip rotator originates on the anterior sacrum? piriformis

41. Which statement about the clinical significance of the piriformis muscle is true? Blood vessels are named according to their relationship with this muscle.

42. Which muscle does not rotate the hip internally? obturator internus

43. Which ligament prevents hyperabduction of the thigh? pubofemoral

44. What is the role of the iliofemoral ligament? prevents hyperextension of the hip joint

45. Which type of movement is possible at the hip? multiaxial

46. Which feature does not contribute to the stability of the hip? strong tendon sheaths

47. The acetabulum is concave and the head of the femur is convex

48. Which statement comparing the shoulder and hip is true? The hip joint has greater stability than the shoulder.

49. The trochanteric bursa is located between which structures? gluteus maximus and the greater trochanter

50. Which landmark is intermediate to the greater and lesser trochanters on the anterior aspect of the femur? intertrochanteric line

2. Which one of the following sets of joints allows for physiological range of motion movements? costotransverse, costovertebral

3. Which one of the following thoracic joints primarily uses elastic recoil to assist with respiration? costochondral

4. Which one of the following statements regarding the levator costarum is false? Have an important respiratory function.

6. Which one of the following fascia lines the pelvic cavity? parietal

7. Which one of the following is a posterior abdominal wall muscle? psoas major

8. Which one of the following statements regarding the sacrum is false? Articulates with the innominate forming the sacroiliac joints.

9. Which one of the following statements regarding a comparison of the female pelvis to the male one is true? Is shorter with wider ischial tuberosities.

10. Which one of the following joints is classified as a plane synovial joint? sacroiliac

11. Which one of the following muscles can be palpated directly superior to the belly of the piriformis? gemellus superior

12. Which one of the following pairs of muscles shares a common insertion? gluteus maximus/tensor fasciae latae

13. Which one of the following muscles is likely injured in a client who cannot elevate the right leg and foot during the swing phase of walking? right gluteus medius

14. Which one of the following statements regarding the clinical significance of the piriformis muscle is true? Can be the cause of low back pain and sciatica.

15. Which one of the following groups of external rotators shares the following common actions: hip stabilization, external rotation, and abduction of the flexed thigh? piriformis, gemellus superior, obturator internus, gemellus inferior

16. Which one of the following statements regarding the hip joint is true? Has one intracapsular ligament and several intrinsic ligaments.

17. Which one of the following statements regarding the hip is true? The neck of the femur is oriented 125 anterior to the coronal plane.

18. Which one of the following bony landmarks is not visible from both the posterior and anterior view of the femur? gluteal tuberosity

19. Which one of the following statements regarding the fascia lata is false? Forms the superficial fascial layer of the thigh.

20. Which one of the following thigh muscles does not O: on any aspect of the pelvis? iliopsoas

21. Which one of the following sets of muscles flexes the hip? tensor fascia lata/ iliopsoas

22. Which one of the following statements regarding the pectineus muscle is true?

Iliacus

O: Superior 2/3 Iliac fossa, sacra ala, anterior sacroiliac ligament

I: lesser trochanter of the humerus

N: Femoral

A: Hip Flexion, Stabilizes hip, lateral rotation of hip joint.

Quadratus Lumborum

O: Medial lip of the iliac crest, iliolumbar ligament

I: (last Rib & T.P of L1-L.4) tips f the lumbar T.V.P's, medial 1 over 2 of the inferior aspect of 12 th rib

N: Lumbar plexus

A: Lumbar extension & L Flexion

Stretch: contralaterally laterally flex trunk: stretch ipsilateral upper limb over the head and drop ipsilateral lower limb behind the individual

Gluteus Maximus

O: Dorsal Surface of ilium post to posterior gluteal line, Dorsal sacrum & coccyx, sacrotuberous & sacroiliac lig

I: iliotibial band & Gluteal tuberosity

N: Inferior gluteal

A: Ext. L.R. Abdu. Add the hip Stretch: hip flexion with medial hip rotation

Gluteus Medius

O: Ext surface of ilium b/w ant & postero gluteal lines

I: L aspect of greater trochanter

N: Superior gluteal

A: Flex, Ext, Abd M.R & L.R of the hip Stretch: hip adduction with lateral hip rotation

Tensor Fascia lata

O:A.S.I.S; anterior iliac crest,

I: Iliotibial band

N: Superior Gluteal

A: M.R & abd the hip. (2 flex the hip; tightens facia lata and I.T.B; stabilizes knee)

Stretch: hip adduction with lateral hip rotation

piriformis

O: Anterior Surface of Sacrum, sacrotuberous ligament

I: Superior aspect of greater trochanter of the femur

N: Piriformis

A: L.R & Abd the hip when hip is Flex. Stretch: internal rotation of hip: figure 4, and draw bent lower limb towards trunk or vise versa

Sartorius

O: A.S.I.S

I: Proximal medial Shaft of the tibia via pes anserinus tendon

N: Femoral

A: Flex, L.R, Abd the hip & Flex & M.R of knee

Stretch: hip extension, adduction and medial rotation

Rectus Femoris

O: A.I.I.I.S I: Tibia Tuberosity via patellar lig

N: Femoral

A: Ext Knee & Flex the hip. Stretch: knee flexion with hip extension

Vastus Medialis

O: Medial lip of linea aspera

I: Tibial Tuberosity via the patella & Patellar ligament

N: Femoral

A: Ext Knee.

Vastus Lateralis

O: Lateral lip of linea aspera, Gluteal Tuberosity & greater trochanter

I: Tibia tuberosity via the patella & patellar lig.

N: Femoral A: Ext Knee. Stretch: knee flexion

Gracilis

O: anterior body & inferior ramus of pubis

I: proximal anteriormedial aspect of tibia (pes anserine)

N: obturator

A: adduction & flex of hip; flexion & M.R of knee.

Stretch: hip abduction with knee extension & lateral rotation

Adductor-Longus

O: body of pubis, inferior ramus of pubis

I: meddle 1/3 of the linea aspera of femur

N: obturator A: adduction & flex of hip; L.R of hip.

Adductor-Brevis

O: anterior surface of pubis

I: pectineal line & proxima 1/3 of the linea aspera of femur

N: obturator A: adduction & flex of hip; L.R of hip. Stretch: hip abduction

Adductor Magnus

O: adductor part: inferior ramus of pubis; ramus of ischium hamstring part: ischial tuberosity

I: adductor part: gluteal tuberosity, linea aspera & medial supracondylar line hamstring part: adductor tubercle

N: Obturator

A: Adduct, M.R, Ext the hip Assist to flex of the hip. Stretch: hip abduction

O: Long H: Ischial tuberosity

Short H: Lateral lip of linea aspera & lateral Supracondylar linea of the Femur

I: lateral aspect of fibular head

A: Knee Flex, Hip Ext & lateral R of Leg when Knee is flexed.

N: Sciatic

semitendinosus O: Ischial Tuberosity

I: Proximal, medial Shaft of the tibia at pes anserinus tendon

N: Sciatic

A: Hip Ext & Knee Flexion.

Semimembranosus

O: Ischial tuberosity

I: Posterior aspect of medial condyle of Tibia

A: Knee Flexion H.R E.X.T hip

N: Sciatic.

Brachioradialis

O: lateral Supracondylar ridge at the distal end of Humerus

I: Styloid process of radius

N: Radial

A: Forearm Flex, Stabilizi Elbow durin flexion & Exten.

Pronator Teres

O: medial epicondyle & coronoid process of the ulna

I: middle of L surface of the radius

N: Median

A: Prenoto the forearm, Stretch: extended elbow sup

A: Pronate the forearm Stretch: extended elbow supinate

Flexor Carpi Radialis

O: Medial Epicondyle of the humerus & ulnar non process

I: posterior surface of the ulna & Base of 2nd & 3rd metacarpals.

N: Median

A: Flex wrist & radial deviation. Stretch: with elbow extended, extend and adduct wrist

Flexor Carpi Ulnaris

O: Medial Epicondyle of the Humerus Olecranon process & posterior surface of the ulna

I: Pisiform, hamate & base of 5 metacarpal

N: Ulnar

A: Flex. Add wrist assist to flex elbow. Stretch with elbow straight.

A: Flex, Add wrist assist to flex elbow. Stretch: with elbow straight, extend and radially deviate wrist

Palmaris Longus

O: common flexor tendon at the medial epicondyle of the humerus

I: palmar aponeurosis (fascia of the palm)

A: tenses fascia of palm secondary wrist flexor

N: median nerve Stretch: spread palm elbow extended extend wrist

Extensor Carpi Radialis Longus

O: lat supracondylar ridge of the humerus

I: Base of 2nd metacarpal.

A: Ext & Abd wrist

N: Radial

Extensor Carpi Radialis Brevis

Extension Carpi Radiatis Brevis

O: L epicondyle of humerus

I: Metarpal 3 base.

A: Ext wrist, radial deviation N: Radial

Extensor Carpi Ulnaris

O: L epicondyle of humerus

I: Base of 5 metacarpal

N: Radial

A: Exten wrist, ulna deviation.

Extensor Digitorum

O: L. Epicondyle of humerus

I: Bases of middle & distal phalanges of 2 to 5 fingers

N: Radial A: Ext 2 to 5 fingers & assist to Ext the wrist.

M.C.L (Medial Collateral Ligament) - wrist

Attachments: runs b/w ulnar styloid process & pisiform/triquetrum

Fxns: reinforce medial side of wrist

L.C.L (Lateral Collateral Ligament) - Wrist

Attachments: runs b/w radial styloid process & scaphoid/trapezium

Fxns: reinforce lateral side of wrist

L.C.L (Lateral Collateral Ligament) - knee

Attachments: Proximal: lateral femoral condyle Distal: lateral surface of fibular head

Fxns: prevents lateral rotation during knee extension, Provides lateral stability to the knee

M.C.L (Medial Collateral Ligament)-knee

Attachments: Proximal: medial femoral epicondyle Distal: medial tibial condyle

Fxns: stabilizes knee medially, Attaches to medial meniscus

- a tear in the M.C.L can lead to damage of meniscus

Superficial Fascia

located deep to skin, blends w/ the dermis & continuous with abdominal wall & buttock contents: nerves, blood vessels, lymphatics, lymph nodes, adipose tissue.

Deep Layer (Fascia Lata) located b/w superficial fascia & muscles

Proximal attachments:

Anterior: inguinal ligament; inferior pubis

Scarpa fascial of inferior abdominal wall also attaches to fascia lata just inferior to inguinal ligament Posterior & lateral: iliac crest

Posterior & medial: ischial tuberosity; sacrum; coccyx; sacrotuberous ligament

Distal attachment:

– exposed parts of bones around knee

– continuous w/the deep fascia of the leg (crural fascia)

thick & strong, forms the iliotibial band (I.T.B)

Opening: just inferior to inguinal ligament, “saphenous opening” passageway for great saphenous vein

Functions: increases power of thigh muscles: forms fibrous “sleeve”, assists venous return

Image summary: An anatomical drawing of a human leg and hip from a side profile, labeling muscles and fascia. Key labeled structures include the Crest of the ilium, Gluteus maximus muscle, Tensor fasciae latae muscle, and the Deep fascia of the thigh (fascia lata). At the lower part of the thigh, just above the knee, a red circular highlight marks the Iliotibial band or ligament, labeled as the Area of Pain.

The Iliotibial Band (I.T.B) lateral thickening of fascia lata

Attachments: proximal: iliac tubercle (ilium) distal: lateral condyle of tibia (Gerdy's tubercle)

functions: attachment for Gluteus maximus & tensor fascia lata muscles, provides stability for hip & lateral aspect of knee.

Compartments of the Thigh 3 compartments: anterior, medial, posterior separation b/t compartments: intermuscular septa - fascial walls arising from fascia lata; attach to the linea aspera of femur organization: according to muscle action and nerve supply

Thigh: Anterior Compartment

muscles of anterior compartment: Pectineus: hip adductor, Iliopsoas: iliacus and psoas major – hip flexors (post. abdominal wall), Sartorius, Quadriceps femoris group

Image summary: An anatomical diagram of the leg and hip muscles, using color-coding to identify seven specific muscles. The psoas major is teal, the iliacus is green, the rectus femoris is yellow, the vastus medialis is red, the vastus lateralis is blue, the sartorius is purple, and the pectineus is orange.

Sartorius long, narrow strap-like muscle, longest muscle in body,most superficial muscle in anterior thigh attachments:

origin: A.S.I.S,

Insertion: medial tibial condyle (pes anserinus),

Action (faber) to (flexion, abduction & external rotation of the thigh); knee flexion; medially rotates knee when knee is flexed

Innervation: femoral nerve stretch: hip extension, adduction and medial rotation

Pes anserinus pes anserinus (pes anserine) refers to 3 tendons that insert on anteromedial surface of proximal tibia anterior to posterior: sartorius, gracilis (hip adductor), semitendinosus (hamstring)

pes anserinus means “goose foot”: derived from 3 pronged look of the tendons at the insertion Quadriceps femoris composed of 5 muscles united by a common tendon (quadriceps tendon)

Rectus femoris, Vastus medialis (long band (vastus = large located on anteromedial side of thigh),

Vastus lateralis (long band, large located on anterolateral side of femur), Vastus intermedius (large muscle located intermediate b/w Vastus medialis & Vastus lateralis), Tensor vastus intermedius common insertion: tibial tuberosity via patellar tendon common action: leg extension at knee (primary extensors of leg)

Image summary: An anatomical diagram from the Cleveland Clinic illustrating the muscles of the thigh and the patella. The superficial muscles are labeled as the Rectus femoris, Vastus lateralis, and Vastus medialis. The deep muscles are identified as the Tensor of the vastus intermedius and the Vastus intermedius, with the latter located beneath the superficial layers. The patella (kneecap) is labeled at the bottom of the leg structure.

Rectus femoris bipennate, straight (rectus), located along midline on anterior Femur, crosses 2 joints: hip & knee. Only quadriceps muscle to cross hip Rectus femoris

attachments:

origin: A.I.S & ilium superior to acetabulum insertion: tibial tuberosity via patellar tendon actions: leg extension, hip flexion innervation: femoral nerve stretch: knee flexion with hip extension youtube dot com U.R.L

Vastus Medialis long band (vastus equals large) located on anteromedial side of thigh

Attachments:

origin: medial lip of linea aspera, intertrochanteric line insertion: tibial tuberosity via patellar tendon action: leg extension innervation: femoral nerve stretch: knee flexion

Vastus Lateralis

long band, large, located on anterolateral side of femur attachments:

origin: lateral lip of the linea aspera, greater trochanter insertion: tibial tuberosity via patellar tendon action: leg extension innervation: femoral nerve stretch: knee flexion

Vastus Intermedius

large muscle located intermediate b/w Vastus medialis & Vastus lateralis

Attachments:

origin: anterior & lateral surfaces of femoral shaft insertion: tibial tuberosity via patellar tendon action: leg extension innervation: femoral nerve stretch: knee flexion

Tensor Vastus Intermedius newly discovered muscle, published in PubMed January, 2016 lies: between vastus lateralis & vastus intermedius. Anterior to vastus intermedius, deep to rectus femoris

attachments:

origin: anterior aspect of greater trochanter insertion: tibial tuberosity via the patellar tendon action: tenses aponeurosis of vastus intermedius. Medializes (move more medial) the action of the vastus intermedius

Innervation: femoral nerve

The Patella triangular shaped sesamoid bone embedded in patellar tendon base = superior aspect apex = inferior aspect posterior aspect covered w/ hyaline cartilage articular surface has many facets that articulate w/ femur (patellofemoral joint)

advantage: patella provides more leverage for quads by placing tendon more anteriorly, farther from joint's axis (position of greater mechanical advantage), protection of knee joint

1.5 characteristics that stabilize the hip joint?

The hip is a highly stable ball-and-socket joint. Its stability comes from:

1. Deep Acetabulum: The deep socket of the hip bone wraps tightly around the femoral head.

2. Acetabular Labrum: A fibrocartilaginous lip that deepens the socket even further.

3. Strong Intrinsic Ligaments: The iliofemoral (Y-ligament of Bigelow, the strongest), pubofemoral, and ischiofemoral ligaments.

4. Strong Fibrous Capsule: Encloses the joint and tightens during extension.

5. Surrounding Musculature: Heavy, powerful muscles (like the gluteals and deep rotators) pull the femoral head into the acetabulum.

2. Deep fascial layers of the thigh

Fasci lata: The dense, investment layer of deep fascia that encloses the entire thigh like a tight stocking.

Iliotibial (I.T) band / tract: A lateral thickening of the fascia lata.

Intermuscular septa (Lateral, Medial, and Posterior): Extensions that project inward from the fasci lata to the femur, separating the thigh into its three compartments.

3.3 compartments of the thigh

- Anterior compartment (Extensor)

- Medial compartment (Adductor)

- Posterior compartment (Flexor / Hamstring)

4.6 muscles of the anterior thigh

1. Rectus femoris

2. Vastus lateralis

3. Vastus medialis

4. Vastus intermedius

5. Sartorius

6. Iliopsoas (often counted here as it enters the anterior thigh, or Pectineus, which transitions between anterior and medial).

5.2 posterior abdominal wall muscles that are also considered anterior thigh muscles

- Psoas major

- lliacus

(Note: Together, these fuse in the thigh to form the Iliopsoas).

6.4 heads of the quadriceps femoris

- Rectus femoris

- Vastus lateralis

- Vastus medialis

- Vastus intermedius

7. The common insertion of the quads

They unite into the quadriceps tendon, which inserts onto the patella (and continues via the patellar ligament to insert onto the tibial tuberosity).

8. The common action of the quads

Extension of the leg at the knee joint.

9. The quadriceps muscle that also flexes the hip

Rectus femoris (because it is the only head of the quadriceps that crosses both the hip and knee joints, originating at the anterior inferior iliac spine).

Pelvis & Thigh

Bony Pelvis Palpate: A.S.I.S, A.I.I.S, iliac tubercle, iliac crest, ischial tuberosity, pubic tubercle, P.S.I.S Gluteal Muscles

Palpate muscles: Gluteus maximus, Gluteus medius, Gluteus minimus, Tensor fascial lata, Piriformis, Quadratus femoris

Inguinal Ligament A.S.I.S to pubic tubercle

Iliacus

Origin: iliac crest, iliac fossa, sacral ala, sacroiliac ligaments, insertion: lesser trochanter of femur (with psoas major tendon) stretch: hip extension: lunge or leg hanging off a bed

Rectus Femoris

origin: A.I.I.I.S, ilium superior to acetabulum insertion: tibial tuberosity stretch: knee flexion with hip extension

Vastus Medialis

origin: medial lip of linea aspera, intertrochanteric line insertion: tibial tuberosity stretch: knee flexion

Vastus Lateralis

origin: lateral lip of linea aspera, greater trochanter insertion: tibial tuberosity stretch: knee flexion

Sartorius

origin: A.S.I.S insertion: medial tibial condyle (pes anserinus)

stretch: hip extension, adduction and medial rotation

Medial Thigh Muscles

5 muscles: Pectineus, Adductor longus, Adductor brevis, Adductor magnus, Gracilis

Characteristics most extend from pubic bone to medial aspect of femur exception: Gracilis extends to proximal tibia common action: adduct & flex hip exception: posterior fibres of Adductor magnus extend the hip common origin: pubis Pectineus short, flat, quadrangular muscle, located superficial to Adductor brevis & superior to Adductor longus origin: superior ramus of pubis insertion: pectineal line of femur, just inferior to lesser trochanter innervation: femoral nerve actions: hip adduction, hip flexion stretch: hip abduction with hip extension and lateral rotation

Adductor Brevis short, triangular muscle, deep to Pectineus & Adductor longus attachments:

origin: body & inferior ramus of pubis insertion: pectineal line & proximal linea aspera of femur actions: hip adduction, 2 weak hip flexion innervation: obturator nerve stretch: hip abduction

Adductor longus large, broad triangular muscle, located on medial thigh superficial to Adductor brevis &

Adductor magnus. It is primarily responsible for pulling the thigh inward (adduction)

Origin body of the pubis, inferior to the pubic crest

Insertion: Middle third of the linea aspera on the posterior shaft of the femur (the thigh bone)

Action: Primary: Adducts the thigh (brings the leg toward the midline of the body). Secondary: Assists in flexing the extended thigh, and helps to laterally/medially rotate the hip joint

Nerve Innervation: Anterior division of the obturator nerve (derived from lumbar spinal roots L 2, L 3, L 4)

Adductor Magnus large, triangular muscle, largest of the medial thigh mm has 2 heads: adductor, hamstring located deep to Pectineus, Adductor brevis & Adductor longus attachments:

origins: adductor part: inferior ramus of pubis; ramus of ischium hamstring part: ischial tuberosity insertion: adductor part: gluteal tuberosity, linea aspera & medial supracondylar line hamstring part: adductor tubercle actions: adductor part: hip adduction hamstring part: hip extension innervation: adductor part: obturator nerve hamstring part: sciatic nerve stretch: hip abduction opening in aponeurosis of tendon is called adductor hiatus (passage of femoral artery & vein)

Gracilis long, strap-like muscle, most superficial medial thigh muscle, crosses hip & knee attachments:

origin: body & inferior ramus of pubis - insertion: proximal anteromedial aspect of tibia (pes anserine)

- actions: hip adduction, 2 knee flexion; medial rotation of knee

- innervation: obturator nerve

- stretch: hip abduction with knee extension & lateral rotation

Femoral Triangle triangular fascial space in inguinal region

fascia associated w/ femoral triangle is continuous w/ fascia of abdomen (surrounds femoral blood vessels, blood vessels pass through femoral triangle & enter adductor canal

adductor canal: located deep to middle 1 over 3 of Sartorius, runs from femoral triangle to adductor

hiatus allows for passage of: femoral artery & vein, saphenous nerve

Femoral triangle boundaries:

- superior: inguinal ligament

- medial: Adductor longus

- lateral: Sartorius

- floor: Iliopsoas & Pectineus

- roof: fascia lata & skin

Used to identify: Iliopsoas, femoral artery & vein, femoral nerve, inguinal lymph nodes

Correct Matches

1. gluteus medius: abduction Why: The gluteus medius is the primary abductor of the hip.

2. piriformis greater sciatic foramen Why: The piriformis travels through and almost completely fills the greater sciatic foramen.

3. quadratus femoris tibial tuberosity.

4. sartorius longest m. Why: The sartorius is the longest muscle in the human body.

5. T.F.L (Tensor Fasciae Latae) I.T.B Why: The T.F.L inserts directly into the Iliotibial Band (I.T.B).

6. vastus lateralis knee extension Why: As part of the quadriceps femoris group, its primary action is extending the knee.

The Thigh

Pectineus

- origin: superior ramus of pubis

- insertion: pectineal line of femur, just inferior lesser trochanter

- stretch: hip abduction with hip extension and lateral rotation

Adductor Longus

- origin: body of pubis, inferior to pubic crest

- insertion: middle 1/3 of linea aspera

- stretch: hip abduction

Adductor Brevis origin: body of pubis, inferior ramus of pubis insertion: pectineal line of femur, proximal linea aspera of femur stretch: hip abduction

Gracilis

origin: body & inferior ramus of pubis insertion: proximal anteromedial aspect of tibia (pes anserinus)

stretch: hip abduction with knee extension and lateral rotation

Adductor Magnus

Adductor Plagius origins:

adductor part: inferior ramus of pubis, ramus of ischium hamstring part: ischial tuberosity insertion:

adductor part: gluteal tuberosity, linea aspera & medial supracondylar line hamstring part: adductor tubercle stretch: place foot up on chair/block reach down toward the opposite toe

Hamstrings: Characteristics

common origin: ischial tuberosity exception: short head of biceps femoris cross both the hip & knee common action: hip extension, knee flexion common stretch: knee extension with hip flexion

Biceps Femoris fusiform muscle

has 2 heads: long, short. In inferior thigh, long head becomes tendinous and is joint by short head. Located on posterolateral thigh

attachments:

origin: long head: ischial tuberosity short head: lateral lip of linea aspera & lateral supracondylar line of femur insertion: lateral aspect of fibular head actions: knee flexion, hip extension, lateral rotation of the leg when knee is flexed innervation: L.H: tibial division of sciatic nerve S.H: fibular division of sciatic nerve

Semitendinosus long, tendinous muscle, medial to Biceps femoris, tendon is most prominent on posteromedial aspect of knee attachments:

origin: ischial tuberosity insertion: anteromedial proximal tibia at pes anserinus actions: knee flexion, hip extension, medially rotates the leg when knee is flexed innervation: sciatic nerve

Semimembranosus broad muscle; has flat aponeurosis resembling a membrane located on posteromedial thigh, deep to Semitendinosus attachments:

origin: ischial tuberosity insertion: posterior aspect of medial tibial condyle actions: knee flexion, thigh extension, medially rotates the leg when knee is flexed innervation: sciatic nerve

Popliteal Fossa diamond shaped region, posterior aspect of knee, mostly fat-filled clinical significance: nerves & blood vessels supplying leg pass through it, popliteal pulse boundaries: superomedial: Semimembranosus & Semitendinosus superolateral: Biceps femoris inferomedial: medial head of Gastrocnemius inferolateral: lateral head of Gastrocnemius roof: popliteal fascia floor: femur & Popliteus when mm forming boundaries contract, they become taut, further covering the fossa & providing more protection for structures within

Knee: knee is relatively weak mechanically d/t

Incongruence of articular surfaces, stability of knee joints depends on:

– strength & actions of surrounding muscles & their tendons

– ligaments that connect femur & tibia

Muscles & tendons are more important as supports, so many injuries are preventable through appropriate conditioning and training.

Most important muscle in stabilizing knee joint is quadriceps group, particularly inferior fibers of vastus medialis & vastus lateralis

Fibrous Capsule of the Knee very strong, reinforced by intrinsic ligaments, incomplete posterolaterally: allows tendon of Popliteus to pass out of joint to attach to tibia proximal attachment: superior to femoral condyles distal attachment: inferior to tibial plateau quadriceps tendon & patella replace fibrous layer anteriorly

6 ligaments support the knee: 4 intrinsic (thickening of fibrous capsule):

1. lateral (fibular) collateral (L.C.L)

2. medial (tibial) collateral (M.C.L)

3. arcuate popliteal

4. oblique popliteal

2 extrinsic intra-articular (intracapsular)

1. anterior cruciate (A.C.L)

2. posterior cruciate (P.C.L)

: Image summary: Two anatomical diagrams of the human knee joint identifying key ligaments and menisci. The top line drawing labels the anterior cruciate ligament, posterior cruciate ligament, lateral meniscus, medial meniscus, lateral collateral ligament, and medial collateral ligament. The bottom detailed illustration expands this list to include the arcuate popliteal ligament, oblique popliteal ligament, lateral patellofemoral ligament, and medial patellofemoral ligament.

Lateral Collateral Ligament (L.C.L) a.k.a. fibular collateral ligament, round, cord-like attachments:

proximal: lateral femoral condyle distal: lateral surface of fibular head functions: prevents lateral rotation during, knee extension, provides lateral stability to the knee splits tendon of Biceps femoris into 2 parts.

Medial Collateral Ligament (M.C.L) a.k.a. tibial collateral ligament, flat band attachments: proximal: medial femoral epicondyle distal: medial tibial condyle functions: stabilizes knee medially, attaches to medial meniscus (a tear in M.C.L can lead to damage of meniscus)

Oblique Popliteal Ligament short, broad

attachments: proximal: expansion of semimembranosus tendon distal: middle of posterior aspect of joint capsule function: helps reinforce capsule posteriorly

Arcuate Popliteal Ligament Y-shaped; fans out from fibula attachments: proximal: posterior surface of knee joint distal: posterior surface of fibular head function: reinforce capsule posterolaterally

Anterior Cruciate Ligament (A.C.L) w/ P.C.L, Forms an X

Attachments: proximal: posterior & medial side of lateral condyle of femur distal: anterior intercondylar area of tibia tibial to femoral attachment is superior, posterior & lateral functions: prevents hyperextension, prevents anterior displacement of tibia on femur by tightening when knee is extended, weaker then the P.C.L, so more prone to injury

Posterior Cruciate Ligament (P.C.L) w/ A.C.L, forms an X, stronger than A.C.L attachments: proximal: lateral surface of medial condyle of femur (anteriorly) distal: intercondylar area of tibia (posteriorly) to (tibial to femoral attachment is superior & anterior)

functions: helps prevent hyperflexion of knee, prevents posterior displacement of tibia on femur by tightening during flexion

Cruciate Ligaments during medial rotation of tibia on femur, cruciate ligaments wind around each other, limiting medial rotation to about 10 degrees ligaments become unwound during lateral rotation, so nearly 60 degrees of lateral rotation is possible when knee is flexed to about 90 degrees Anterolateral ligament (All) lateral aspect of knee, attached to lateral meniscus attachments: proximal: lateral femoral condyle, slightly anterior to attachment of the lateral collateral ligament distal: anterolateral aspect of proximal tibia function: stabilizes medial rotation of knee

Anterolateral Ligament (All)

L.F.E: lateral femoral epicondyle

P.O.P: popliteus tendon

G.T: Gerdy's tubercle

P.F.L: popliteofibular ligament

L.C.L: lateral collateral ligament

Menisci of Knee Joint crescent-shaped wedges of fibrocartilage, attached to medial & lateral tibial condyles b/w femur & tibia, thicker at periphery & taper to thin, unattached edges in interior of joint medial meniscus: C-shaped, broader posteriorly than anteriorly lateral meniscus: nearly circular, smaller, more freely moveable than medial meniscus functions: shock absorbers, improve alignment b/w articular surfaces of femur & tibia

Knee Bursae

at least 12 bursae around knee joint, 8 significant bursae surround the knee are:

4 are communicating (communicate with synovial cavity of knee joint):

1. suprapatellar

2. popliteus

3. gastrocnemius

4. anserine

4 are non-communicating:

1. Semimembranosus

2. subcutaneous prepatellar

3. subcutaneous infrapatellar

4.deep infrapatellar

clinically significant bursae:

suprapatellar: b/t quadriceps tendon & femur; infection of the bursa may spread to knee cavity subcutaneous prepatellar: b/t skin & anterior surface of patella; may become inflamed due to kneeling activities ex., housemaid's knee subcutaneous infrapatellar: b/t skin & tibial tuberosity; may become inflamed due to excessive friction, ex., falling on knee or occupational hazards

Lp# 82

Muscles of the Anterior & Lateral Compartments of the Leg

Fascia of the Leg: Superficial & Deep fascia of leg is continuous w/ fascia of_thigh superficial & deep fascia (lata) of thigh blend at knee, at the point where they blend, they form the deep (crural) fascia of the leg: located b/w subcutaneous tissue & muscles attachment: proximal: continuous w/fascia lata; thicker proximally than distally distal: continuous w/periosteum of tibia

2 thickenings of distal aspect of fascia: superior extensor retinaculum (fibula to tibia), inferior extensor retinaculum (Y-shaped: calcaneus to medial malleolus to plantar aponeurosis)

extensions: crural fascia divides into crural intermuscular septa functions of crural intermuscular fascia makes muscular contraction more efficient by preventing bulging of muscles, assists venous return, extensor retinacula (fascial thickenings) hold extensor tendons in place prevents bowing when muscles contract.

Leg Intermuscular Septa divides leg into 3 compartments:

1. anterior (extensor)

2. lateral (fibular)

3. posterior (flexor)

mm in posterior compartment are subdivided into superficial & deep parts by transverse intermuscular septum

Compartments of the Leg

Anterior compartment muscles:

- Tibialis anterior

- Extensor digitorum longus

- Extensor hallucis longus

- Fibularis tertius

Lateral compartment muscles:

- Fibularis longus

- Fibularis brevis

Posterior compartment muscles:

- Gastrocnemius

- Soleus

- Plantaris

- Tibialis posterior

- Flexor digitorum longus

- Flexor hallucis longus

- Popliteus

Anterior Compartment of the Leg anterior compartment tendons from medial to lateral:

- – Tibialis anterior

- – Extensor digitorum longus

- Extensor hallucis longus

- – Fibularis tertius

common action: ankle dorsiflexion

Tibialis Anterior large, long & slender muscle, superficial attachments:

origin: lateral condyle & superior 1/2 of the lateral surface of tibia, interosseous membrane insertion: medial & plantar surfaces of medial cuneiform, plantar surface of base of 1st metatarsal actions: dorsiflexion, ankle inversion innervation: deep fibular nerve stretch: ankle plantarflexion & eversion clinical significance: involved in conditions such as peripheral nerve lesions & anterior compartment syndrome ("shin splints")

Extensor Digitorum Longus unipennate muscle, tendons are intermediate to Fibularis tertius & Extensor

hallucis longus attachments:

origin: lateral tibial condyle, superior 3/4 of medial surface of fibula interosseous membrane insertion: dorsal aspect middle & distal phalanges of lateral 4 toes actions: dorsiflexion, toe extension innervation: deep fibular nerve stretch: ankle plantarflexion; toe flexion

Extensor Hallucis Longus thin muscle, b/w Tibialis anterior & Extensor digitorum longus attachments:

origin: middle of anterior surface of fibula, interosseous membrane insertion: dorsal base of distal phalanx of hallux action: dorsiflexion, hallux extension innervation: deep fibular nerve stretch: ankle plantarflexion and hallux flexion

Fibularis Tertius small, unipennate muscle most lateral of anterior muscle group blends w/ Extensor digitorum longus attachments:

origin: inferior 1/2 of anterior fibula, interosseous membrane insertion: dorsal base of 5th metatarsal action: dorsiflexion 2 degrees ankle eversion innervation: deep fibular nerve stretch: ankle plantarflexion and inversion

Fibularis Longus

long, larger of Fibularis muscles, tendon travels behind lateral malleolus to medial plantar surface of foot attachments:

origin: head of fibula, superior 2/3 of lateral surface of fibula insertion: plantar surface of base of 1st metatarsal, plantar surface medial cuneiform actions: ankle eversion, 2 degrees plantarflexion innervation: superficial fibular nerve stretch: ankle inversion & dorsiflexion

{Fibularis Brevis} short, fusiform muscle

located inferior to Fibularis longus & is partially covered by it. Tendon shares common synovial sheath w/ Fibularis longus as they wrap around lateral malleolus

attachments:

origin: inferior 2/3 of lateral surface of fibula insertion: dorsal surface of tuberosity lateral side of base of 5th metatarsal actions: ankle eversion, 2 degrees plantarflexion innervation: superficial fibular nerve stretch: ankle inversion & dorsiflexion

The Posterior Leg

Anterior & Lateral Compartments

1. What is the insertion of Tibialis anterior? medial and plantar surfaces of the medial cuneiform and base of the 1st metatarsal ^{*}

2. How is it different from the rest of the muscles in the anterior compartment? the other muscles (extensor digitorum longus, extensor hallucis longus, and fibularis tertius) insert on the dorsal aspect of the foot

3. What are the actions of the Tibialis anterior? dorsiflexion and inversion asterisk

4. Is there another anterior compartment muscle that inverts the foot? no-tibialis anterior is the only anterior compartment muscle inverting the foot

5. Where do the tendons of the lateral compartment travel? They travel behind (posterior) to the lateral malleolus

6. How does this affect the action of these muscles? The lateral malleolus acts as a pulley during contraction, which allows the foot to ever

7. When palpating the distal aspect (ankle) of the anterior compartment, what muscles do you cross from lateral to medial? Fibularis tertius, Extensor digitorum longus, Extensor hallucis longus, Tibialis anterior

8. When palpating the tendons of the Fibularis longus and brevis, which is located more anteriorly? the Fibularis brevis tendon is located anterior to the Fibularis longus tendon as they both travel posterior to the lateral malleolus

The Posterior Compartment

7 muscles are found in posterior compartment of leg

3 superficial mm:

- – Gastrocnemius

- Soleus

- – Plantaris

4 deep mm:

- – Tibialis posterior

- – Flexor digitorum longus

- – Flexor hallucis longus

- – Popliteus

superficial & deep compartments, separated by transverse intermuscular septum

Superficial Posterior Compartment

common insertion: calcaneus via calcaneal (Achilles) tendon comprises bulk of calf

- – Gastrocnemius & Soleus

- – together these muscles are also known as triceps suroe

Gastrocnemius fusiform muscle, has 2 heads, most superficial of posterior compartment, crosses both knee & ankle joints attachments origins:

medial head: superior aspect of medial femoral condyle lateral head: lateral aspect of lateral condyle of femur insertion (common): posterior surface of calcaneus via calcaneal tendon actions: plantarflexion when knee is extended, 2 degrees knee flexion innervation: tibial nerve stretch: ankle dorsiflexion with knee extended

Soleus broad, flat muscle; shape resembles a fish, located deep to Gastrocnemius attachments:

origin: posterior aspect of fibular head superior 1/4 of posterior surface of fibula. Soleal line of tibia.

Middle 1/3 of medial border of tibia insertion (common): posterior surface of calcaneus via calcaneal tendon actions: plantarflexion: primary plantarflexor when knee is flexed innervation: tibial nerve stretch: ankle dorsiflexion clinical significance:

postural muscle: maintains leg position on the foot, slow twitch muscle: high endurance

Plantaris short, thin, tendinous muscle, located b/w Gastrocnemius & Soleus, absent in 5% - 10% of people

attachments:

origin: inferior aspect of lateral supracondylar line of femur, oblique popliteal ligament insertion (common) posterior surface of calcaneus via calcaneal tendon actions: proprioception for larger plantarflexors. plantarflexion (weak)

innervation: tibial nerve

Associated Bursae

Retrocalcaneal bursa aka subtendinous calcaneal bursa, b/w calcaneus & Achilles tendon

Calcaneal bursa aka subcutaneous calcaneal bursa b/w skin & Achilles tendon

Deep Posterior Compartment

Characteristics: muscles are small compared to superficial compartment mm, plantarflexors in deep compartment produces only about 7% of total force of plantarflexion (most of this is lateral compartment mm, when Achilles tendon is ruptured, remaining plantarflexors cannot produce enough power to lift body's weight.

Tendons: cross ankle deep to flexor retinaculum, flexor retinaculum is continuous w/ deep crural fascia

Popliteus thin, triangular muscle, located deep to Plantaris; forms inferior part of floor of popliteal fossa attachments:

origin: lateral femoral condyle & lateral meniscus insertion: posterior surface of superior tibia, tendon passes b/t lateral meniscus and L.C.L of knee & through joint capsule of knee action: unlocks the knee, knee flexion (weak)

innervation: tibial nerve clinical significance: unlocks knee while walking/running femur rotates medially on fixed tibia to 'lock' the knee in extension popliteus laterally rotates femur on the tibia to then 'unlock' the knee and allow flexion when the femur is fixed, the popliteus medially rotates the tibia on the femur

youtu dot be U.R.L Flexor Digitorum Longus long, narrow muscle, medial to tibialis posterior; tendon passes superficial to flexor hallucis longus origin: medial posterior surface of tibia, inferior to soleal line insertion: plantar surface of bases of distal phalanges of lateral 4 toes actions: toe flexion, 2°: plantarflexion; supports longitudinal arches of foot innervation: tibial nerve stretch: toe extension and ankle dorsiflexion

Flexor Hallucis Longus bipennate muscle, lateral to tibialis posterior attachments:

origin: inferior 2/3 posterior surface of fibula, interosseous membrane insertion: plantar surface of base of distal phalanx of hallux action: hallux flexion (all joints) 2°: plantarflexion; supports medial longitudinal arch of foot significant role in movements requiring a powerful “push-off”, ex. running & jumping innervation: tibial nerve stretch: hallux extension and ankle dorsiflexion

Tibialis Posterior thick, flat muscle, deepest of the group, tendon crosses posterior aspect medial malleolus attachments:

origin: interosseous membrane, posterior surface of tibia inferior to soleal line, posterior surface of fibula attachments (cont'd):

insertion: navicular, cuboids, cuneiform, bases of metatarsals 2 through 4 under: plantar surface) asterisk action: foot inversion 2 degrees : plantarflexion innervation: tibial nerve stretch: ankle eversion & dorsiflexion

Drawing Muscles extensor digitorum longus, extensor hallucis longus, tibialis anterior fibularis longus fibularis brevis gastrocnemius soleus plantaris tibialis posterior flexor digitorum longus flexor hallucis longus

L.P 85 the Ankle

Proximal Tibiofibular Joint articulation b/w head of fibula & lateral condyle of tibia, plane-type synovial joint, articular capsule is surrounded by fibrous capsule

Supporting ligaments: Allows for slight movements, which occur during dorsiflexion & plantarflexion anterior ligament of fibular head posterior ligament of fibular head

Distal Tibiofibular Joint

a.k.a. tibiofibular syndesmosis, articulation b/w facets of distal fibula & tibia, fibrous joint (syndesmosis Supporting ligaments allows for slight movements, which occur to accommodate talus during dorsiflexion interosseous ligament (continuous with interosseous membrane)

anterior tibiofibular ligament posterior tibiofibular ligament inferior transverse (tibiofibular) ligament

Talocrural (Mortise) Joint

“The ankle”_hinge type synovial joint, located b/w distal tibia & fibula and the talus. tibia & fibula form a deep socket for trochlea (rounded projection of talus) articular capsule is thin anteriorly & posteriorly

Supported by collateral ligaments:

medial (deltoid) ligament lateral ligament

Movements:

primarily dorsiflexion & plantarflexion rotation adduction abduction

A mortise: adjoining pieces connect at an angle of 90 degrees. In its basic form it is both simple and strong.

Medial (Deltoid) Ligament

Strong triangular ligament, located at medial ankle attachments:

proximal: medial malleolus distal: talus, calcaneus, navicular functions:

stabilizes ankle during eversion prevents dislocation of the joint clinical significance: not typically involved in ankle sprains. With forcible eversion, deltoid may tear off part of medial malleolus (avulsion fracture)

Lateral Ligaments located at lateral ankle

- anterior talofibular

- posterior talofibular

- calcaneofibular

clinical significance

- weaker than deltoid lig.

- ankle most frequently sprained joint in body

- anterior talofibular ligament often injured (inversion sprain)

anterior talofibular ligament flat, weak band, runs anteromedially from fibula

attachments: lateral malleolus to neck of talus

posterior talofibular ligament thick, strong band, runs horizontally medially & slightly

posteriorly from fibula attachments: lateral malleolus to lateral tubercle of talus calcaneofibular ligament round cord, passes posteroinferiorly from fibula attachments: lateral malleolus to lateral aspect of calcaneus

Factors that affect ankle stability

1. Tendinous support: ankle crossed by several tendons bound by retinacula which increases support

2. Ligamentous support: strong medial & lateral ligaments

3. Shape of bones: distal ends of the tibia & fibula provides a deep socket for trochlea of talus to fit in: increases bone congruency

4. Position of the trochlea:

in dorsiflexion: forced posteriorly, spreading tibia & fibula apart. Greater congruency = stable joint in plantarflexion: trochlea moves anteriorly & malleoli come together. Reduces congruency = unstable joint

Subtalar Joint

plane-type synovial joint, located b/w talus & calcaneus, weak fibrous capsule

Supporting ligaments:

- medial talocalcaneal ligament

- lateral talocalcaneal ligament

- posterior talocalcaneal ligament

- interosseous talocalcaneal ligament

movements: inversion, eversion

Talocalcaneonavicular Joint

ball-and-socket synovial joint, located b/w head of talus, navicular & calcaneus fibrous capsule: incompletely closes joint

supporting ligament:

plantar calcaneonavicular (spring) ligament: attaches sustentaculum tali (calcaneus) to navicular bone movements: gliding, rotary

{Calcaneocuboid Joint} plane-type synovial joint, located b/w calcaneus & cuboid, enclosed by fibrous capsule

supporting ligaments:

dorsal calcaneocuboid ligament plantar calcaneocuboid ligament long plantar ligament

Movements: inversion, eversion, circumduction

Transverse Tarsal Joints

combination of talocalcaneonavicular & calcaneocuboid joints

functional unit, allows for:

inversion & adduction eversion & abduction

L.P 87 Tarsus, Metatarsus & Phalanges

1. 5th digit baby toe

The fifth digit of the foot is commonly referred to as the pinky or baby toe.

2. ball metatarsal heads

The "ball of the foot" is the padded area directly beneath the heads of the metatarsal bones.

3. dorsum top of the foot

In anatomical terms, the dorsum refers to the upper surface (top) of the foot.

4. great toe hallux

The medical and anatomical name for the big toe/great toe is the hallux.

5. plantar aspect sole

The plantar surface or aspect is the bottom or sole of the foot.

6. calcaneus heel

The calcaneus is the large bone that forms the foundation of the heel.

The Foot

The foot is divided into 3 parts:

hindfoot: talus and calcaneus midfoot: navicular, cuboid, and cuneiforms forefoot: metatarsals and phalanges

Tarsometatarsal Joints

plane-type, synovial joint, located b/w distal row of tarsal bones & metatarsal bases.

Enclosed by fibrous capsule supporting ligaments: dorsal, plantar, interosseous movements: gliding (sliding)

Intermetatarsal joints

plane-type, synovial joint, located b/w bases of adjacent metatarsals

Enclosed in same joint capsules as tarsometatarsal joints

Supporting ligaments: dorsal, plantar, interosseous;

movements: minimal: allow foot to conform to uneven surfaces

Metatarsophalangeal Joints condyloid synovial joint located b/w metatarsal heads & bases of proximal phalanges. Each joint enclosed in own fibrous capsule supporting ligaments: collateral, plantar movements:

flexion extension abduction adduction circumduction

Interphalangeal Joints hinge-type synovial joint, located b/w phalanges of each digit, fibrous capsule encloses each joint

Supporting ligaments: collateral, plantar

The Foot

feet bear body's weight when standing, walking, running, foot structure must accommodate the weight, the wear & tear, and adapt to varying surfaces

Foot is composed of several bones connected by ligaments, so has considerable flexibility allows it to deform with each ground contact & absorb much of the shock

Arches improve weight bearing capabilities & adaptability of the foot by also acting as springboards for propelling feet during walking, running, jumping

Arches of the foot: medial longitudinal, lateral longitudinal, transverse

Arches are maintained by: shape of bones, strength of plantar ligaments & aponeurosis, mm attaching to bones of arches functions of the foot: shock absorption (body weight), propel body during movement The Foot: Weight Transmission Tibia to Talus to Calcaneus to Heads of metatarsal bones 2 through 5 toSesamoid bones of 1st digit

Arches of the foot arches are maintained by shape of bones, strength of plantar ligaments & aponeurosis, strength of mm attaching to bones of arches

Medial Longitudinal Arch

composed of calcaneus, talus, navicular, 3 cuneiforms, medial 3 metatarsals higher than lateral longitudinal arch

Supported by tendons of:

Tibialis anterior

Tibialis posterior

Fibularis longus

Lateral Longitudinal Arch

composed of: calcaneus, cuboid, lateral 2 metatarsals

Flatter than medial longitudinal arch

Rests on the ground when standing

Transverse Arch

Composed of: cuboid, cuneiforms, bases of metatarsals

Traverses foot from side to side

Supported by:

Fibularis longus tendon

Tibialis posterior tendon medial & lateral longitudinal arches

Supporting Ligaments spring (plantar calcaneonavicular) ligament long plantar ligament short plantar (plantar calcaneocuboid) ligament

Based on the location of the spring, long plantar, and short plantar ligaments, what arches do they support? Spring ligament supports the medial longitudinal. Short and long plantar ligaments support the lateral longitudinal.

Sinus Tarsi Lateral mallelus Sinus tarsi

Spring (Plantar Calcaneonavicular) Ligament

attachments: sustentaculum tali of calcaneus, navicular

Deltoid Ligament

attachments: proximal: medial malleolus distal: talus, calcaneus, navicular

Lateral Ligaments of the Ankle

anterior talofibular ligament: lateral malleolus to neck of talus calcaneofibular ligament: lateral malleolus to lateral aspect of calcaneus posterior talofibular ligament: lateral malleolus to lateral tubercle of talus

Plantar Aponeurosis

Attachments:

Proximal: calcaneus

Distal: digital tendons via 5 slips

L.P 90 Integration of the Muscular System

Gait Cycle

sequence of motions occurring between 2 consecutive “initial contact” of the same foot describes what happens in one leg two phases: stance phase (60% - 65% of walking cycle). Swing phase (35% - 40% of walking cycle)

Stance Phase

foot is on ground & bearing weight; lower leg supports weight of body (acts as shock absorber while allowing body to advance over supporting limb)

5 sub-phases:

1. initial contact

2. load response

3. midstance

4. terminal stance

5. pre-swing

Initial contact (a. k. a. heel strike):

weight acceptance period of stance leg one foot is coming off ground other foot is accepting body weight & absorbing shock of initial contact both feet are on ground floor known as “double support” or “double-leg stance”

Load response (a. k. a. foot flat) & Midstance (a. k. a. single-leg stance):

“Single support” or “single-leg stance” one leg carries body weight other leg goes through its swing phase need lateral hip stability to maintain balance tibia of stance leg must advance over stationary foot

Terminal stance (a. k. a. heel off) & Pre-swing (a. k. a. toe off):

weight-unloading period" stance leg is unloading body weight to contralateral limb & preparing leg for swing phase both feet are in contact, so double support occurs for 2nd time during the gait cycle

Swing Phase

foot is not bearing weight & is moving forward allows toes of swing leg to clear the ground also allows swing leg to advance forward

3 sub-phases:

1. initial swing

2. mid-swing

3. terminal swing

Initial swing (a.k.a. acceleration): occurs when foot is lifted off floor, rapid knee flexion & ankle dorsiflexion allows swing limb to accelerate forward

Midswing:

swing leg is adjacent to weight bearing leg, which is in midstance

Terminal swing (a.k.a. deceleration):

swinging leg slows down in preparation for initial contact w/the ground

Quadriceps Hamstring actions are required: Quads control knee extension & Hamstrings control hip flexion.

Normal Gait Parameters

Base (step) width: distance b/w the two feet, about 5 - 10 centimeters

Step length (a.k.a. gait length): distance b/w the same point on opposite feet ex. the distance between the right heel and the left heel, about 72 centimeters, varies w/age, sex, height

Stride length: distance b/w same point on same foot ex. distance between right heel and same point on right heel in the next gait cycle, about 144 centimeters, varies from person to person

Lateral pelvic shift: side-to-side movement of pelvis during walking permits body weight to be centered over stance leg for balance, about 2.5 - 5 centimeters

Vertical pelvic shift: vertical movement of pelvis during walking high point is during midstance & low point is during initial contact center of gravity should not move up & down more than 5 centimeters during normal gait

Pelvic rotation: lessens angle of femur w/the floor, lengthening the femur, about 8 degrees of rotation, with 4 degrees forward on swing leg and 4 degrees posteriorly on stance leg to maintain balance, thorax rotates in opposite direction, when pelvis rotates clockwise, thorax rotates counter clockwise Centre of gravity: place in body where weight is evenly dispersed & all sides are in balance, standing, center of gravity is approximately 5 centimeters anterior to 2nd sacral vertebra (slightly higher in men than in women)

Vertical & horizontal displacements of center of gravity describe a figure-8, occupying a 5 centimeters square w/in pelvis during walking

Normal cadence: number of gait cycles w/in a minute 90 - 120 steps per minute. Cadence of women is usually 6 – 9 steps per minute higher than men, cadence typically decreases with age

Gait speed: about 1.4 m/second during gait assessment, get as many views as possible. Do not try to see everything at once:

look at feet as they walk back & forth then note knees as they walk back & forth then watch hips so, on up the body lastly, watch all areas working together look for asymmetry of movement in general then focus more closely on specific regions a compensatory impairment may be more obvious than the original causes/issue watch client walk back & forth 7, 8, or more times to ↑ amount of information you gather

L.P's 75 to 91

L.P 75

With what other fascia is the superficial fascia of the thigh continuous? abdominal wall & buttock

What are the attachments of the deep fascia of the thigh? inguinal ligament and pubis iliac crest ischial tuberosity, sacrum, coccyx and sacrotuberous ligament, bones around knee

What else is the deep fascia of the thigh called? fasica lata

What are the attachments of the iliotibial band? iliac tubercle lateral condyle of tibia (Gerdy's tubercle)

What muscles attach into the I.T.B? T.F.L & gluteus maximus

What are compartments of the thigh are there? anterior posterior, medial

What is the longest muscle in the body? sartorius

Wine

Which quadriceps muscle crosses the hip? rectus femoris

What functions does the patella perform? provides the quadriceps muscle with greater mechanical advantage, protects the knee

L.P 77

What are the common attachments of many of the hip adductor muscles? Pubis, linea aspera of femur

Which hip adductor extends the hip? adductor magnus

What is the opening in the adductor magnus that allows passage of the femoral vessels? Adductor hiatus List the boundaries of the femoral triangle.

superior: inguinal ligament medial: adductor longus lateral: sartorius

What passes through the adductor canal? femoral vessels, saphenous nerve

L.P 79

What is the common origin of the hamstrings? ischial tuberosity

Which hamstring inserts on the fibular head? biceps femoris

What are the boundaries of the popliteal fossa?

superomedial: semimembranosus & semitendinosus superolateral: biceps femoris inferomedial: medial head of gastrocnemius inferolateral: lateral head of gastrocnemius

What happens to the popliteal fossa when the surrounding muscles contract? they become taut, providing more protection for structures within the fossa

L.P 80

Which muscle group is most important in stabilizing the knee? quadriceps

List the ligaments that support the knee. Indicate which are intrinsic/extrinsic.

intrinsic:

lateral (fibular) collateral (L.C.L)

medial (tibial) collateral (M.C.L)

arcuate popliteal oblique popliteal extrinsic:

anterior cruciate (A.C.L)

posterior cruciate (P.C.L)

Which ligament of the knee splits the biceps femoris tendon? L.C.L

Which ligament of the knee attaches to a meniscus? M.C.L

Which cruciate ligament is more likely to be damaged? A.C.L

Which meniscus (medial or lateral) is “C”-shaped? medial

What is a “communicating” bursa? they communicate with the synovial cavity

Mix and match the bursae:

subcutaneous infrapatellar skin & anterior surface of patella subcutaneous prepatellar skin & tibial tuberosity suprapatellar quadriceps tendon & femur

L.P 82 What are the thickenings of the fascia of the leg called? superior and inferior extensor retinacula

What is their function? hold extensor tendons in place

What fascial compartments are in the leg? anterior, posterior, lateral

What is the common action of the muscles of the anterior compartment of the leg? dorsiflexion of ankle

What are the actions of the muscles of the lateral compartment of the leg? eversion and plantarflexion of the ankle

L.P 84

What muscles make up the “triceps surae”? What is their common insertion? gastrocnemius and soleus, Achilles tendon

To stretch the soleus you must perform dorsiflexion; to stretch the gastrocnemius you must perform dorsiflexion with the knee extended. Why the difference? gastrocnemius crosses the knee; soleus doesn't

About how many people lack the plantaris muscle? 5 to 10% of population

What percentage of plantarflexion is performed by muscles in the deep posterior compartment of the leg? only about 7%

How does the popliteus “unlock” the knee? when the knee is in a locked extended position, the femur is rotated medially on the tibia to allow flexion of the knee, the popliteus laterally rotates the femur on the tibia

L.P 85

What kind of synovial joint is the proximal tibiofibular joint? plane

During what movements does the proximal tibiofibular joint move? dorsiflexion/plantarflexion of ankle

What kind of joint is the distal tibiofibular joint? syndesmosis

What kind of joint is the talocrural joint? hinge

What is the medial ligament of the ankle called? deltoid ligament

What 3 ligaments make up the lateral ligaments of the ankle? anterior talofibular, posterior talofibular, calcaneofibular

List 4 factors that contribute to ankle stability. Tendons, ligaments, bone shape, position of trochlea of talus

Mix and match the joints and their types:

Calcaneocuboid plane subtalar plane talocalcaneonavicular ball-and-socket talocrural hinge

L.P 87

Identify the parts of the foot: bones region of foot calcaneus hindfoot cuboid midfoot cuneiforms midfoot metatarsals forefoot navicular midfoot phalanges forefoot talus hindfoot

Mix and match the joints and their types: intermetatarsal plane interphalangeal. hinge metatarsophalangeal condyloid tarsometatarsal plane

What are the 3 arches of the foot? medial longitudinal, lateral longitudinal, transverse

What maintains the arches of the foot? shape of the bones, plantar ligaments and aponeurosis, plantar muscles

Which longitudinal arch is higher? medial

What tendons support the medial longitudinal arch? tibialis anterior, tibialis posterior, fibularis longus

L.P 88

Where does the plantar aponeurosis attach? Calcaneus, digital tendons

L.P 90

L.P 90

What are the 5 sub-phases of the stance phase of gait? initial contact, load response, midstance terminal stance, pre-swing

What are the 3 sub-phases of the swing phase of gait? initial swing, mid-swing, terminal swing

Match the following terms with their definitions:

base width distance between the two feet cadence number of gait cycles within a minute centre of gravity place in body where weight is evenly dispersed lateral pelvic shift side-to-side movement of pelvis during walking step length distance between the right heel and the left heel stride length distance between right heel and same point on right heel in the next gait cycle vertical pelvic shift vertical movement of pelvis during walking 1. Which statement best describes the overall function of spinal cord? It carries sensory nerve impulses to the brain and motor ones from the brain.

2. What are the two main structural divisions of the nervous system? C.N.S and P.N.S

3. Lower motor neurons exit the spinal cord via which structure? ventral root

4. Which structure contains both motor and sensory fibres? ventral rami

5. Neurons that originate in the ventral aspect of the spinal cord transmit which type of signal? motor efferent

6. Which division of the nervous system facilitates cardiac contraction? autonomic

7. Which branch of the A.N.S is responsible for maintaining the body's rest and digestion functions? parasympathetic

8. Which statement best describes a nerve plexus? A network of nerves that supplies a specific region.

9. Which spinal segmental levels form the cervical plexus? C.1-C.4

10. Which muscle is innervated by a cranial nerve and ventral rami from the cervical plexus? trapezius

11. The brachial plexus arises from which spinal segments? C.5-T.1

12. Which cranial nerve provides motor supply to the sternocleidomastoid and trapezius? accessory

13. Which pair of muscles does the musculocutaneous nerve innervate? biceps brachii and brachialis

14. Which muscle does the radial nerve innervate? brachioradialis

15. Which muscle does the median nerve innervate? pronator teres

16. Which nerve passes along the medial aspect of the elbow? ulnar

17. From which spinal cord segment do intercostal nerves arise? T.1-T.11

18. Which statement about the branches of the lumbar and sacral plexuses is true? The tibial and common fibular nerves comprise the sciatic nerve.

19. Which nerve originates from spinal cord segments L.2-L.4? femoral

20. Which nerve does not come from the lumbar plexus? saphenous (Terminal branch of femoral nerve)

21. Which muscle does the obturator nerve not innervate? hamstring fibres of adductor magnus

22. Which nerve provides motor innervation to the hamstrings? sciatic

23. Which muscular structure does the tibial division of the sciatic nerve not innervate? short head of biceps femoris (Note: Marked "Dropped" on test)

24. Which nerve innervates the muscles that attach via the Achilles tendon? tibial

25. The inferior gluteal nerve innervates which muscle? gluteus maximus

26. Which spinal cord segments form the sacral plexus? L.4 - S.4

27. Which muscle does the deep fibular nerve innervate? tibialis anterior

28. Which nerve innervates the tibialis posterior muscle? tibial

29. Stimulation of which nerve leads to eversion of the foot? superficial fibular

30. In which pair are the nerve and muscle it innervates correctly matched? superior gluteal - gluteus minimus

31. Which muscle does the femoral nerve not innervate? adductor brevis

32. Which term is the fibres carrying sensory impulses from the periphery to the spinal cord? dorsal nerve root

33. A dermatome is an area of skin innervated by which type of nerve fibres arising from a single spinal nerve? sensory

34. Which statement about peripheral cutaneous patterns is true? Peripheral nerves originate from several spinal cord segmental levels.

35. Which of the following is correctly matched? endoneurium: covers individual axons

36. Which nerve may become compressed when the piriformis muscle is hypertonic? sciatic

37. Which ankle movement would be most affected if the deep fibular nerve were compressed? dorsiflexion

38. A lesion to the radial nerve will result in motor dysfunction of which group of muscles? posterior arm and forearm

39. Which statement about cranial nerves is false? All carry either motor or sensory nerve fibres. (False because several cranial nerves are mixed)

40. Which cranial nerve only carries special sense fibers? C.N I - olfactory

41. Which nerve innervates the muscles of the tongue? hypoglossal

42. Which statement about the vagus nerve is false? Damage to the nerve does not affect the function of the heart.

43. Which muscle is not innervated by the facial nerve (C.N 7)? masseter

44. The brachial plexus exits the neck by passing between the middle scalene and anterior scalene (Note: Marked "Dropped" on test)

45. Which nerve travels through the carpal tunnel? median

46. Which plexus is within the belly of psoas major? lumbar

47. Which nerve passes through the spiral groove of the humerus? radial

48. What is the most superficial meninx called? dura mater

49. What is not the name of one of the lobes of the brain? orbital

50. What is the extension of spinal nerves distal to the end of the spinal cord called? cauda equina

1. The spinal cord extends from the brain stem to which one of the following vertebral levels? L.2 (typically L1–L.2)

3. Which one of the following statements regarding spinal nerves is false? Exit the spinal canal through the foramen transversarium. (They exit through intervertebral foramina; foramen transversarium is for the vertebral artery in cervical vertebrae).

4. Which one of the following describes the type of signals conveyed by the autonomic nervous system? motor signals from the C.N.S to visceral structures.

5. How do axons of sympathetic neurons travel to the sweat glands in the skin of the thorax? within intercostal nerves

6. The nerves of which one of the following spinal cord segments does not form a major plexus? thoracic

7. Which one of the following cervical plexus nerves does not arise from the C.2 -C.3 spinal cord segments? phrenic (Phrenic nerve originates from C.3, C.4, C.5).

8. The deep posterior cervical muscles are innervated by which one of the following nerves?cervical dorsal rami

9. The brachial plexus exits the neck by passing between the middle scalene and anterior scalene. (Passing through the interscalene triangle).

10. Which one of the following nerves arises from branches of the C.5-C7 rami of the brachial plexus? long thoracic (Long thoracic nerve arises from roots C.5, C.6, C.7).

11. The lateral antebrachial cutaneous nerve is the sensory branch of which one of the following nerves? musculocutaneous

12. Which one of the following muscles does the radial nerve innervate? brachioradialis

13. Which one of the following nerves innervates the skin of the distal aspect of the second digit? median

14. Which one of the following nerves provides sensory innervation to the little finger (fifth digit)? ulnar

15. Which one of the following muscles do the intercostal nerves not innervate? erector spinae (Innervated by posterior/dorsal rami).

16. Which one of the following statements regarding sacral plexus nerves is true? The superior gluteal nerve runs superior to the piriformis.

17. Which one of the following branches of the lumbar plexus transmits sensory information from the skin of the anterior and inferomedial aspect of the thigh? femoral (via anterior cutaneous branches and saphenous nerve).

18. Which one of the following spinal cord segments forms the posterior femoral cutaneous nerve? S.1-S.3 (specifically S.1, S.2, S.3).

19. Which one of the following nerves supplies the skin of the lower abdomen and lower back? iliohypogastric

20. Which one of the following nerves provides motor innervation to the hamstrings? sciatic

21. Sensory innervation to the plantar aspect of the foot arises from which one of the following nerves? tibial (via medial and lateral plantar nerves).

22. Which one of the following nerves is palpable as it crosses the fibular neck? common fibular (common peroneal).

23. Which one of the following nerves innervates the gemellus superior muscle? nerve to obturator internus

24. Which one of the following groups of muscles does the superior gluteal innervate? gluteus medius, gluteus minimus, tensor fasciae latae

25. Which one of the following pairs of nerves arises from the L.2-L.4 spinal cord segment? femoral and obturator

26. Which one of the following muscles is not innervated by the sciatic nerve? vastus lateralis (Innervated by the femoral nerve).

27. Which one of the following nerves is located in the anterior compartment of the leg? deep fibular

28. Stimulation of which one of the following nerves leads to eversion of the foot? superficial fibular (Innervates fibularis longus and brevis).

29. Which one of the following statements regarding the nerve to the piriformis is true? Exits the pelvis via the greater sciatic foramen inferior to the piriformis.

30. In which one of the following pairs are the nerve and muscle it innervates correctly matched? sciatic - biceps femoris

31. Which one of the following medial thigh muscles does the femoral nerve innervate? pectineus

32. In which one of the following pairs are N.S components and their descriptions correctly matched? dorsal nerve root - fibres carrying sensory impulses from the periphery to the spinal cord

33. Which one of the following nerves may become compressed when the supinator muscle is hypertonic? deep branch of the radial nerve (also known as posterior interosseous nerve).

34. Which one of the following dermatomal patterns closely resembles the cutaneous pattern of the saphenous nerve? L.4

35. A client complains of tingling along the shoulder, lateral arm and forearm. What type of lesion does the client likely have? peripheral

36. Which one of the following statements regarding the organization of nerve fibres is false? Axon terminals synapse on association neurons outside the spinal cord.

37. Which one of the following ankle movements would be most affected if the deep fibular nerve were compressed? dorsi flexion

38. Complete severance of a peripheral nerve will most likely manifest with which one of the following sets of effects? loss of sensation, loss of muscle control, hyporeflexia

39. Which one of the following statements regarding cranial nerves is true? Most only serve the head and neck regions.

40. Which one of the following cranial nerves enables hearing and facilitates equilibrium? C.N 8 - vestibulocochlear

41. Stimulation from which one of the following cranial nerves constricts the pupil? C.N 3 - oculomotor

42. Anterior and posterior are the terms used to name which one of the following aspects of the brachial plexus? divisions (anterior and posterior divisions).

43. Which one of the following cranial nerves passes through the parotid gland? C.N 7 - facial

44. Which one of the following nerves supplies the majority of the parasympathetic innervation in the body? vagus

45. Which one of the following cranial nerves does not contain parasympathetic fibres? hypoglossal (Parasympathetic C.N's are 3, 7, 9, 10).

46. The spinal root of the accessory nerve innervates which one of the following muscles? trapezius 47. Which one of the following nerves passes through the tunnel of Guyon to enter the hand? ulnar

48. Assessing a client's ability to feel pain, hot & cold objects along the upper jaw-line, clinically tests which one of the following cranial nerves? trigeminal (V) (specifically V.2 maxillary division).

49. Which one of the following is the most superficial layer of the meninges? dura mater

50. Which one of the following terms describes "distal nerve roots extending from the spinal cord"? cauda equina

1. What is the best description of mixed spinal nerves? They are combined sensory and motor nerve fibres from which peripheral nerves arise.

2. Which statement about the brain is true? The brain stem is formed by the pons, medulla, and the midbrain.

3. Neurons that originate in the ventral aspect of the spinal cord transmit which type of signal? motor efferent

4. The parasympathetic division of the A.N.S is also known as craniosacral

5. Which statement about the autonomic nervous system is true? The sympathetic paravertebral ganglia are located close to the spine.

6. Which statement best describes a nerve plexus? It is a network of nerves that supply a particular body region.

7. Which nerve does not arise from the cervical plexus? long thoracic (it arises from the roots of C.5–C7 of the brachial plexus)

8. Which nerve innervates the diaphragm? phrenic

9. Which statement about the brachial plexus is true? It gives rise to nerves that innervate the shoulder, arm, forearm and hand.

10. Which compartment of the upper limb is innervated by more than one of the peripheral nerves of the brachial plexus? anterior antebrachium (innervated by both median and ulnar nerves)

11. Which pair of muscles does the musculocutaneous nerve innervate? biceps brachii and brachialis

12. Which nerve innervates the muscles of the posterior antebrachium? radial

13. Which muscle does the median nerve innervate? flexor digitorum superficialis

14. Which muscle is innervated by one peripheral nerve only? flexor carpi ulnaris (innervated solely by the ulnar nerve)

15. From which spinal cord segment do intercostal nerves arise? T.1–T.11

16. Which statement about sacral plexus nerves is false? The inferior gluteal nerve innervates the gluteal medius and minimus muscles.

17. Which branch of the lumbar plexus transmits sensory information from the skin of the anterior and inferomedial aspect of the thigh? obturator

18. Which nerve does the saphenous nerve branch from? femoral

19. Which muscle does the obturator nerve innervate? gracilis

20. Which statement about the sciatic nerve is true? It bifurcates superior to the popliteal fossa.

21. Which statement about the tibial nerve is false? It supplies motor innervation to all muscles in anterior/lateral leg compartments.

22. Which nerve innervates the fibularis longus muscle? superficial fibular

23. Which nerve innervates the extensor digitorum longus muscle? deep fibular

24. Which nerve innervates the abductor muscles of the hip? superior gluteal

25. Which spinal cord segments form the sacral plexus? L.4–S.4

26. Which muscle does the deep fibular nerve innervate? tibialis anterior

27. Which nerve innervates the tibialis posterior muscle? tibial

28. Which nerve provides motor innervation to the muscles of the lateral compartment of the leg? superficial fibular

29. Which dermatome is found along the lateral forearm and into the thumb? C.6

30. In which pair are the nerve and muscle it innervates correctly matched? superior gluteal – gluteus minimus

31. Which muscle does the femoral nerve not innervate? adductor brevis (innervated by the obturator n)

32. Which term is the fibres carrying sensory impulses from the periphery into the spinal cord? dorsal nerve root

33. Which statement describes a myotomal pattern of innervation? A group of muscles innervated by nerve fibres originating from a single spinal cord segment.

34. Which area is innervated by the L.5 dermatome? lateral leg (also dorsal surface of foot/great toe)

35. Which statement about peripheral cutaneous patterns is true? Peripheral nerves typically originate from several spinal cord segmental levels.

36. Which of the following is correctly matched? perineurium: covers fascicles of neuronal fibres

37. Which nerve would likely be affected if a client fractured the head of the fibula? common fibular

38. A lesion to the radial nerve will result in motor dysfunction of which muscles? posterior arm and forearm muscles

39. Which statement about cranial nerves is true? Most only serve the head and neck regions.

40. Which cranial nerve provides sensory innervation for smell? C.N 1 – olfactory

41. Stimulation from which cranial nerve constricts the pupil? C.N 3 – oculomotor

42. Which statement about the vagus nerve is false? Damage to the nerve does not affect the function of the heart.

43. Which cranial nerves supply sensory fibres for the sense of taste? facial (C.N 7); glossopharyngeal (C.N 9) (and C.N 10 vagus for epiglottis)

44. Which statement about the brachial plexus is false? It is located inferior to the clavicle at the medial aspect of the pectoralis muscles

45. Which nerve travels through the carpal tunnel? median

46. Which plexus is within the belly of psoas major? lumbar

47. What nerve roots does the cervical plexus arise from? C.1–C.4

48. What are the meninges from deep to superficial? pia --arachnoid --dura

49. What are the divisions of the cerebral hemispheres called? lobes

50. Through which passageway does the spinal cord exit the skull? foramen magnum

1. How many pairs of nerve roots arise from the spinal cord? 31

2. How many pairs of cervical nerve roots exit the spinal cord? 8

3. The sympathetic division of the A.N.S arises from which spinal cord segments? T.1-L.2

4. Which branch of the A.N.S is responsible for maintaining the body's rest and digestion functions? parasympathetic

5. Which branch of the nervous system is responsible for 'fight-or-flight' responses? sympathetic

6. Which branches of a plexus innervate the paraspinal muscles? dorsal rami

7. The phrenic nerve, which innervates the diaphragm, arises from which spinal cord segments? C.3-C.5

8. Which muscle is not innervated by the cervical plexus? supraspinatus

9. Anterior and posterior are the terms used to name which aspects of the brachial plexus? divisions

10. Which nerves provides motor innervation to the serratus anterior? long thoracic

11. The musculocutaneous nerve innervates which skin area(s)? anterolateral forearm

12. Which nerves supplies sensory innervation to: dorsum of the hand, proximal aspects of the lateral 31 over 2 digits, elbow, wrist radial

13. Which nerve travels deep to the flexor retinaculum? median

14. Which nerve provides sensory innervation to the 5th digit of the hand? ulnar

15. Which nerve provides sympathetic innervation to the stomach, liver, spleen and kidneys? greater splanchnic (T.5 - T.9)

16. Which set of spinal cord segments gives rise to the femoral nerve? L.2 - L.4

17. Which area is not innervated by the lumbosacral plexus? superior aspect of gluteal

18. The lumbar plexus innervates the muscles of which regions? anterior and medial thigh

19. Which spinal cord segments gives rise to the sciatic nerve? L.4-S3

20. Which muscle does the obturator nerve not innervate? hamstring fibres of adductor magnus

21. Which nerve does not exit the pelvis via the common pathway (through the greater sciatic foramen, inferior to the piriformis muscle)? superior gluteal

22. Which nerve is most superficial at the fibular neck? common fibular

23. The inferior gluteal nerve innervates which muscle? gluteus maximus

31. In which pair are the nerve and muscle it innervates correctly matched? sciatic - biceps femoris

32. Which statement comparing dermatomes and peripheral cutaneous innervation is false? Like dermatomes, peripheral cutaneous nerves arise from a single spinal cord segment.

33. Which of the following includes axons carrying sensory nerve impulses to the brain and motor impulses from the brain? spinal cord

34. A person has no sensation in the proximal medial thigh. Which structure has likely been damaged? obturator nerve

35. Which nerve innervates the skin of the lateral leg? common fibular nerve

36. Which ankle movement would be most affected if the deep fibular nerve were compressed? dorsiflexion

37. A lesion to the musculocutaneous nerve could result in motor dysfunction of which areas? anterior brachium

38. Which statement about cranial nerves is false? Cranial nerves are part of the C.N.S (They are part of the P.N.S)

39. Which cranial nerve only carries special sense fibers? C.N I - olfactory

40. Which cranial nerve does not innervate extrinsic muscles of the eye? C.N 2 - optic

41. Which statement about the trigeminal nerve (C.N 5) is true? It is the largest cranial nerve - fibres run from the face to the pons.

42. Which cranial nerve innervates the sternocleidomastoid and trapezius muscles? accessory (C.N 11)

43. Where does the brachial plexus end? axilla

44. Which nerve travels through the tunnel of Guyon? ulnar

45. The sciatic nerve usually exits the sciatic foramen inferior to the piriformis muscle.

46. Which of the following is correctly matched? epineurium: covers the nerve

47. Which area of the brain does not contain the blood-brain barrier? hypothalamus

48. What are the deep grooves in the gray matter of the cerebrum called? fissures

49. Which nerve passes through the spiral groove of the humerus? radial

50. What is the extension of spinal nerves distal to the end of the spinal cord called? cauda equina

1. Which statement about the circulatory system is true? It consists of the interlinked cardiovascular and lymphatic branches.

2. What receives blood from the left ventricle? systemic circulation

3. Which type of vessels always carries away from blood to the heart? arteries

4. Which best describes an anastomosis? merging of two or more blood vessels.

5. Which blood vessel delivers oxygenated blood from the lungs to the heart? pulmonary vein

6. Which blood vessel carries deoxygenated blood? pulmonary artery

7. What is not a feature of arteries? endothelial valves

8. Which blood vessel typically has the largest diameter? elastic arteries

9. Which statement best describes the tunica media of blood vessels? Circular arrangement of smooth muscle cells.

10. Which structure forms the outermost layer of a blood vessel? tunica externa

11. Which one of the following types of blood vessels allows for greatest exchange of fluid and substances? sinusoidal capillaries

12. Which statement about pre-capillary sphincters is true? Relaxation of the sphincters allows blood to flow through the capillaries.

13. Which statement about veins is true? Most have valves to assist in venous return.

erous fluid is found between which two layers of the heart? parietal and visceral pericardium

). What are the layers of the heart from deep to superficial? endocardium - myocardium - epicardium

17. Blood entering the left ventricle has just passed through which valve? mitral

18. Which structure anchors the cusps of the atrioventricular valves to the papillary muscles? chordae tendineae

19. The ay-or-tuh usually bifurcates at the L.4 vertebral level, forming the right and left common iliac arteries.

20. Which blood vessel branches directly off of the ascending ay-or-tuh? coronary arteries

21. Blood from the cardiac veins empties into the coronary sinus.

22. Which artery passes between the middle and anterior scalenes? subclavian

23. Which artery does not branch off of the aortic arch? right subclavian

24. Which branch of the subclavian arteries supplies blood to the brain? vertebral

25. Which artery ascends through the transverse foramen of the cervical vertebrae to the anterior aspect of the brainstem? vertebral

26. Which artery branches directly off the ay-or-tuh? left common carotid

27. Which artery arises from the internal carotid artery? anterior cerebral

28. Which artery supplies the majority of blood to the brain? internal carotid

29. Which artery carries oxygenated blood to the head? external carotid

30. Which statement about blood supply to the brain is true? The circle of Willis is a protective mechanism ensuring blood supply to the brain.

31. Which artery is palpable just anterior to the insertion of the masseter muscle? facial

32. Which arterial pulse can be palpated in the anatomical snuff box? radial

33. Which artery supplies the inferior surface of the diaphragm? inferior phrenic

34. Branches of which artery provide the major blood supply to the pectoral girdle? axillary

35. Which statement about arteries of the upper limb is false? The ulnar artery enters the anatomical snuffbox. (The radial artery enters it)

36. Which structure gives rise to the deep veins of the upper limb? palmar venous arch

37. Which artery supplies blood to the testes in males and ovaries in females? gonadal

38. The external iliac artery passes deep to which structure to become the femoral artery? inguinal ligament

39. Which artery passes anteriorly through the interosseous membrane of the leg? anterior tibial

40. Which vein do the dural sinuses drain into? internal jugular

41. What is not a deep vein in the upper limb? cephalic

42. Which vein converge forms the superior vena cava? brachiocephalic

43. Nutrient rich blood immediately passes to which organ upon leaving the intestinal tract? liver

44. What is the longest vein in the body? great saphenous

45. Which statement describes a mechanism enhancing the return of blood to the heart? Contraction of the diaphragm muscle enhances venous return.

46. Which statement about the lymphatic system is false? Lymph from ducts empties into trunks.

47. Which structure is not a part of malt (mucosal associated lymphoid tissues)? spleen

48. What are the largest lymphatic vessels called? ducts

49. Which body region does not drain into the right lymphatic duct? right lower limb

50. When swollen, which group of lymph nodes can be palpated along the anterior border of the upper trapezius? posterior cervical chain Questions 1 to 10

1. Which one of the following sets of circulatory system structures are controlled by the sympathetic division of the nervous system allowing for vasoconstriction? arteries and arterioles

2. Which one of the following structures receives blood from the left ventricle? systemic circulation

3. Which one of the following statements best describes an anastomosis? A merging, or coming together, of two or more blood vessels.

4. Which one of the following blood vessels delivers deoxygenated blood from the heart to the lungs? pulmonary arteries

5. Which one of the following features is not found in arteries? endothelial valves

6. Which one of the following statements best describes the tunica media of blood vessels? Circular arrangement of smooth muscle cells.

7. In which one of the following areas of the body are sinusoidal capillaries primarily found? liver and bone marrow

8. Which one of the following statements does not describe a characteristic of veins? High-pressure system that helps return blood to the heart.

9. The left atrium of the heart receives oxygenated blood from the lungs.

10. Which one of the following coverings of the heart is composed of dense connective tissue? fibrous pericardium

11. Which one of the following heart valves has only two cusps or flaps? left atrioventricular (mitral/bicuspid valve)

12. The abdominal ay-or-tuh bifurcates at which one of the following vertebral levels? L.4

13. The coronary arteries arise from which one of the following blood vessels? ascending ay-or-tuh

14. Which one of the following cardiac veins travels up the anterior interventricular groove and drains the left coronary artery? great

15. Which one of the following arteries is not a major branch of the subclavian artery? maxillary

16. The thyrocervical and costocervical trunks are responsible for supplying blood to which one of the following regions? neck and scapular region

17. Which one of the following arteries passes through the foramen transversarium in the cervical spine? vertebral

18. At which one of the following areas does the common carotid artery branch into the internal and external carotid arteries? at the level of the thyroid cartilage

19. Which one of the following arteries delivers blood to the Circle of Willis? internal carotid

20. Which one of the following branches of the external carotid artery supplies blood to the muscles of mastication? maxillary artery

21. Which one of the following arteries supplies the frontal lobe of the brain? anterior cerebral

22. Which one of the following pulses is palpable between the sternocleidomastoid and thyroid cartilage, at approximately the level of the C.6 vertebrae? common carotid

23. Which one of the following arteries is palpable medial to the brachioradialis at the wrist? radial

24. Which one of the following sets of structures outlines the boundaries where the femoral pulse can be palpated? (Femoral triangle) inguinal ligament, sartorius, adductor longus

25. Which one of the following statements regarding the intercostal arteries is true? The anterior and posterior intercostal arteries travel within intercostal spaces.

26. Branches of which one of the following arteries provide the major blood supply to the pectoral girdle? axillary

27. Which one of the following arteries is a branch of the axillary artery? thoracoacromial trunk

28. Which one of the following arteries passes between the medial and lateral heads of the triceps brachii? profunda brachii

29. Shortening or tightness of which one of the following structures may lead to compression of the ulnar artery? flexor digitorum superficialis

30. Venous return of superficial veins in the upper extremity arise from which one of the following venous arches in the hand? dorsal

31. Which one of the following arteries is unpaired? celiac trunk

32. Which one of the following arteries branches off the abdominal ay-or-tuh and supplies blood to the small intestines? superior mesenteric

33. Which one of the following arteries supplies blood to the adrenal glands? suprarenal

34. The abdominal ay-or-tuh extends from the aortic hiatus inferiorly to the level of the L.4 vertebrae where it bifurcates (splits) into the common iliac arteries.

35. Through which one of the following structures does the femoral artery not travel? obturator foramen

36. Which one of the following arteries supplies the extensor hallucis longus muscle? anterior tibial

37. Which one of the following veins drains the vertebrae, spinal cord, and deep cervical spine muscles? vertebral

38. Which one of the following blood vessels can be observed as it passes superficially over the sternocleidomastoid? external jugular vein

39. Which of the following veins merge to form the subclavian vein? axillary and external jugular (or internal/external jugular depending on anatomical textbook definitions; marked C/A on paper)

40. Which one of the following veins travels along the surface of the lateral side of the biceps brachii muscle? cephalic

41. De-oxygenated blood from the thorax empties into which one of the following blood vessels? superior vena cava (via the azygos system)

42. Nutrient rich blood immediately passes to which one of the following organs upon leaving the intestinal tract? liver

43. The popliteal vein is formed by the anastomosis of which one of the following sets of veins? anterior tibial / posterior tibial

44. Which one of the following mechanisms does not assist venous return from the lower body? gravity 45. Which one of the following statements regarding the lymphatic system is false? Lymph from ducts empties into trunks. (Trunks empty into ducts)

46. Which one of the following structures is not a part of M.A.L.T. (mucosal associated lymphoid tissues)? spleen

47. Which one of the following specialized features distinguishes lymphatic capillaries from veins? "blind-ended" vessels

48. Which one of the following trunks does not empty into the thoracic duct? right broncho-mediastinal

49. When swollen, which one of the following groups of lymph nodes can be palpated along the anterior border of the upper part of the trapezius? posterior cervical chain

50. Which one of the following groups of lymph nodes is located along the inferior aspect of the inguinal ligament? Horizontal

Page 1 (Questions 1 to 4)

1. What are the two main branches of the circulatory system? cardiovascular and lymphatic

2. Which one of the following types of vessels always carries blood to the heart? veins

3. Which one of the following statements best describes an anastomosis? A merging, or coming together, of two or more blood vessels.

4. Which one of the following blood vessels delivers deoxygenated blood from the heart to the lungs? pulmonary arteries

5. Which one of the following statements regarding veins and arteries is true? In general, arterial pathways are more consistent than venous ones.

6. Which one of the following structures forms the outermost layer of a blood vessel? tunica externa

7. Which one of the following statements regarding pre-capillary sphincters is true? Relaxation of the sphincters allows blood to flow through the capillaries.

8. Which one of the following statements does not describe a characteristic of veins? High-pressure system that helps return blood to the heart.

9. Through which one of the following chambers of the heart does deoxygenated blood to the lungs flow? right ventricle (or D if "right ventricle" is repeated, both options A and D state "right ventricle" in this test form).

10. The visceral layer of the serous pericardium covering the heart is also known as which one of the following? epicardium

11. Which one of the following structures anchors the cusps of the atrioventricular valves to the papillary muscles? chordae tendineae

12. Which one of the following bony landmarks is located at the same vertebral level as the bifurcation of the abdominal ay-or-tuh? iliac crest

13. Which one of the following arteries only serves the left side of the heart? circumflex

14. Which one of the following cardiac veins drains the area of the heart supplied by the left coronary artery and its branches? great

15. The subclavian artery extends laterally to the level of which one of the following structures? first rib

16. Which one of the following arteries supplies blood to the cervical region? costocervical

17. Which one of the following arteries ascends through the transverse foramen of the cervical vertebrae to the anterior aspect of the brainstem? vertebral

18. Which one of the following blood vessels does not arise directly from the aortic arch? right common carotid artery

19. How many arteries that serve the neck arise from the internal carotid artery? zero (The internal carotid artery gives off no branches in the neck).

20. Which one of the following arteries carries oxygenated blood to the head? external carotid (or D-brachiocephalic leads to the carotid, but A directly supplies the external head).

21. Which one of the following arteries supplies the frontal lobe of the brain? anterior cerebral

22. Which one of the following arteries does not have a palpable pulse? internal carotid

23. The radial artery pulse is palpated lateral to the flexor carpi radialis tendon.

24. The dorsalis pedis is continuous with which one of the following arteries? anterior tibial

25. Which one of the following arteries supplies the inferior surface of the diaphragm? inferior phrenic

26. From the inferior border of the teres major, the axillary artery continues distally and becomes which one of the following arteries? brachial

27. Which one of the following arteries is a branch of the axillary artery? anterior circumflex humeral

28. Which one of the following arteries enters the posterior brachium with the radial nerve through the spiral groove? profunda brachii

29. The radial artery supplies which one of the following groups of muscles? anterior antebrachial

30. Which one of the following structures gives rise to the deep veins of the upper limb? palmar venous arch

31. Which one of the following arteries gives off three branches to the liver, stomach, pancreas and spleen? celiac trunk

32. Which one of the following arteries branches off the abdominal ay-or-tuh and supplies blood to the small intestines? superior mesenteric

33. Which one of the following arteries supplies blood to the adrenal glands? suprarenal

34. Which one of the following arteries is not a branch of the internal iliac artery? median sacral

35. Which one of the following arteries exits the thigh through the adductor hiatus? femoral (It exits through the hiatus to become the popliteal artery).

36. The anterior tibial artery gives rise to the dorsalis pedis artery that supplies blood to the dorsal aspect of the foot.

37. Blood from the face drains into the cavernous sinus via which one of the following veins? ophthalmic vein

38. Which one of the following veins receives blood from the dural sinuses? internal jugular

39. Which one of the following veins does not drain the head and neck? axillary

40. In the proximal brachium, which one of the following veins follows the pathway of the nerves arising from the brachial plexus? brachial

41. Which one of the following veins converge to form the superior vena cava? brachiocephalic

42. At what vertebral level does the hemiazygos vein drain into the azygos vein? T.9 (typically between T.8 and T.9).

43. Which one of the following is the longest vein in the body? great saphenous

44. Nutrient rich blood from the liver passes through which one of the following veins to enter the inferior vena cava? hepatic

45. Which one of the following statements regarding the lymphatic system is false? Lymph from ducts empties into trunks. (In reality, trunks drain into ducts, not the other way around).

46. Which one of the following structures or cells is produced in the spleen? lymphocytes

47. Which one of the following specializations distinguishes lymphatic capillaries from veins?'close-ended' vessels

48. Which one of the following is not a major lymphatic trunk? brachiocephalic

49. When swollen, which one of the following groups of lymph nodes can be palpated along the anterior border of the upper part of the trapezius? posterior cervical chain

50. When inflamed, which one of the following lymph node groupings can be palpated along the lateral aspect of the adductor longus muscle? vertical inguinal

1. Which circulatory system structures are primarily responsible for vasoconstriction? arteries and arterioles

2. Which circulatory system structures can be directly and mechanically affected by massage techniques? lymphatic vessels

ch organ is the first to receive oxygenated blood after being pumped from the left ventricle? heart

ch type of vessels always carries blood to the heart? veins

emerging of two or more blood vessels is known as a(n) anastomosis

6. Which pathway shows blood flow through the pulmonary system? Right ventricle to pulmonary artery to lungs to pulmonary vein to left atrium

7. Which statement about veins and arteries is true? In general, arterial pathways are more consistent than venous ones.

8. Which of the following is a feature of arteries? relatively small lumen

9. Which statement best describes the tunica media of blood vessels? It is concentric rings of smooth muscle cells under sympathetic control.

10. Which capillary characteristically has large pores that allow for the passage of larger organic molecules to flow out into interstitial spaces? fenestrated

11. Which statement about pre-capillary sphincters is true? Relaxation of the sphincters allows blood to flow through the capillaries.

12. Which chamber of the heart receives deoxygenated blood from the body? right atrium

13. Which chamber of the heart has the thickest myocardium? left ventricle

14. Which statement does not describe a characteristic of veins? High-pressure system that helps return blood to the heart.

15. What are the layers of the heart from superficial to deep? epicardium - myocardium - endocardium

16. Serous fluid is found between which two layers of the heart? parietal and visceral pericardium

17. Which heart chamber does the bicuspid valve separate? left atrium and left ventricle

18. Blood entering the right ventricle has just passed through which valve? tricuspid

19. The ay-or-tuh usually bifurcates at the L.4 vertebral level, forming the right and left common iliac arteries.

20. Which statement about the ay-or-tuh is false? The ay-or-tuh is solely responsible for the blood supply to the structures of the thorax and abdomen.

21. The coronary arteries arise from which blood vessel? ascending ay-or-tuh

22. The subclavian artery passes between which muscles? Anterior scalene and middle scalene

23. Which artery ascends through the transverse foramen of the cervical vertebrae to the anterior aspect of the brainstem? vertebral

24. Blood from the cardiac veins empties into the coronary sinus

25. The subclavian artery becomes the axillary artery as it passes the lateral aspect of the first rib.

26. Which artery is formed by the anastomosis of the vertebral arteries? basilar

27. Which artery delivers blood to the Circle of Willis? internal carotid

28. Which artery carries oxygenated blood to the head? external carotid

29. In which area of the brain is the Circle of Willis? inferior aspect

30. The common carotid pulse is palpated between the S.C.M and the thyroid cartilage approximately at the level of the C.6 vertebrae

31. Which artery does not have a palpable pulse? internal carotid

32. The radial artery pulse is palpated lateral to the flexor carpi radialis tendon.

33. The posterior tibial artery pulse is palpated between the tendons of which muscles? flexor digitorum longus & flexor hallucis longus

34. At which area does the common carotid artery branch into the internal and external carotid arteries? at the level of the thyroid cartilage

35. Which statement about arteries of the upper limb is false? The ulnar artery enters the anatomical snuffbox.

36. Which structure gives rise to the superficial veins of the upper limb? dorsal venous arch

37. Which artery supplies blood to pelvic structures? internal iliac

38. Which vein has a corresponding artery with the same name? vertebral

39. Which vein do the dural sinuses drain into? internal jugular

40. What is not a deep vein in the upper limb? cephalic

41. Which veins join to form the superior vena cava? brachiocephalic

42. The femoral artery becomes the popliteal artery as it passes through which structure? adductor hiatus

43. What one of the following is the longest vein in the body? great saphenous

44. Which statement about venous drainage of the abdomen is true? Nutrient rich blood passes through the hepatic portal system.

45. What does not contribute to venous return? lymphatic flow

46. Which statement about the lymphatic system is false? Lymph from ducts empties into trunks.

47. Which statement about the thymus is false? Produces active B lymphocytes.

48. When swollen, which group of lymph nodes can be palpated just anterior to the upper trapezius? posterior cervical chain

49. Which duct collects lymph from the lower half (extremities) and left side of the body? thoracic

50. When inflamed, which lymph node grouping can be palpated along the lateral aspect of the adductor longus muscle? vertical inguinal

What is the basic function of the circulatory system? deliver oxygen & nutrients to the cells. Removal of tissue wastes

What are the two systems that make up the circulatory system? Cardiovascular, lymphatic

What is the broad function of the following blood vessels?

arteries: carry blood away from heart capillaries: site of gas, nutrient and waste exchange veins: carry blood toward heart

From where lymphatic vessels acquire their fluid (lymph)? interstitial space

What is excess interstitial fluid? edema

What are the 3 layers of blood vessel walls, from inner to outer? What kind of tissues are they comprised of?

tunica intima (interna); epithelium (endothelium)

tunica media; smooth muscle tunica adventitia (externa); C.T proper (collagen)

Arteries with their descriptions:

arterioles smallest arteries elastic arteries conducting arteries, largest arteries, carry blood away from heart.

muscular arteries distributing arteries, medium diameter

What are small veins known as? venues

How thick are the walls of blood capillaries? one cell thick

Which type of capillary are the least permeable? most permeable?

least: continuous most: sinusoidal

What is a large capillary network called? capillary bed

What are the arteriole and venule associated with capillary networks known as? terminal arteriole, postcapillary venue

What is the name of the vessel that connects the above two vessels (the vascular shunt)?

metarteriole

What is the function of the precapillary sphincters? restrict or allow blood to flow into the tissue as needed

When more than one blood vessel merges to serve or drain a region, what is that collection of vessels called? Are there more of these arrangements in the venous system or arterial system?

Anastomosis / more common in the venous system

What is the function of the pulmonary arteries? the pulmonary veins?

pulmonary arteries carry deoxygenated blood from the heart to the lungs pulmonary veins carry oxygenated blood from the lungs to the heart

About how much lymph is produced every day? 3 to 4 litres

What kind of cells are found in lymph nodes, to cleanse the lymph? white blood cells

What are the lymphatic vessels, from smaller to larger? Capillaries, vessels, trunks, ducts intermediate (muscle): myocardium inner: endocardium

: A series of anatomy and physiology questions and answers focused on the lymphatic system and heart. For the lymphatic system, it notes that capillaries collect proteins and cellular debris, vessels use valves for one-way flow, and the thoracic duct drains more lymph than the right lymphatic duct. It details lymphatic trunks such as the jugular, subclavian, bronchomediastinal, intestinal, and lumbar trunks. Key organs mentioned include the spleen for platelet storage and red blood cell breakdown, the thymus for T-cell maturation, and various tonsils and MALT locations. Regarding the heart, it identifies the upper atria, lower ventricles, the septum as the separating wall, and valves like the atrioventricular and semilunar valves that prevent backflow. It also notes the epicardium as the outer layer of the heart wall.

What is the primary characteristic of blood found on the right side of the heart? on the left?

right: deoxygenated left: oxygenated

How many pulmonary veins are there? 4 (2 from each lung)

What vessel carries all oxygenated blood out of the heart? ay-or-tuh

From which chamber does the above vessel exit? left ventricle

What are the two vessels that drain most of the deoxygenated blood from the body into the heart?

into what chamber do they flow?

superior and inferior venae cavae, into the right atrium

What is the dividing structure for blood into the above 2 vessels? diaphragm

What are the two main arteries that serve the heart? left and right coronary arteries

What are the main veins that drain the heart? Into what vessel do they drain? great, middle and small cardiac veins, they drain into the coronary sinus

What arteries branch directly off the ascending aortic and arch of the ay-or-tuh 5?

left & right coronary arteries brachiocephalic artery left common carotid artery left subclavian artery

Label the following diagram:

Image summary: An anatomical diagram of the aorta and its major branching arteries. Starting from the heart, the ascending aorta leads into the aortic arch, which gives rise to the brachiocephalic artery, the left common carotid artery, and the left subclavian artery. The vessel then continues as the descending thoracic aorta, passes through the diaphragm to become the abdominal aorta, and finally bifurcates into the right and left common iliac arteries.

The common carotid arteries branch into the external carotid and internal carotid arteries.

The subclavian arteries branch into the vertebral and axillary arteries.

At what point (landmark) does the thoracic ay-or-tuh become the abdominal ay-or-tuh? as it pierces the diaphragm At what vertebral level does the ay-or-tuh become the common iliac arteries? L.4

At what landmark do the common carotid arteries branch? thyroid cartilage

Name 2 branches of the external carotid artery that are palpable in the face? facial artery, superficial temporal artery

What 2 arteries supply about 80% of the brain, and from what artery do they branch? middle and anterior cerebral arteries, branch off the internal carotid artery

From what artery does the vertebral branch off? subclavian artery

Label the 2 items on the right of the following diagram:

Image summary: An anatomical diagram of the cervical spine and associated arteries. The diagram identifies vertebrae C1 through C7 and T1. The circulatory system is highlighted in red, labeling the Aorta at the bottom, branching into the Subclavian Arteries, which lead into the Vertebral Arteries ascending the spine. These merge at the top to form the Basilar Artery. The vertebral artery is divided into segments labeled V0 through V4, corresponding to different levels of the cervical vertebrae.

What type of structure is the circle of Willis? What vessels are the primary parts of it? arterial anastomosis, posterior, middle and anterior cerebral arteries

What artery does the subclavian artery become as it passes the 1st rib? axillary artery

L.p.111

Where does the axillary artery become the brachial artery? inferior border of teres major

What vessels does the brachial artery continue into in the forearm, and where does that occur?

radial and ulnar arteries in the cubital fossa

What do the radial and ulnar arteries become in the hand?

radial: palmar and dorsal arches ulnar: palmar arch

What do the iliac arteries branch into, and what regions to they supply?

external iliac arteries: lower limbs internal iliac arteries: pelvis

Describe the pathway of the arterial supply of the lower limb as it descends from the external iliac artery. external iliac artery leads to femoral artery leads to popliteal artery leads to anterior and posterior tibial arteries anterior tibial artery leads to dorsalis pedis artery posterior tibial artery leads to fibular artery and medial slash lateral plantar arteries

Lp 112

Where does the ay-or-tuh travel, relative to the heart? posterior

What is the general difference between parietal and visceral vessels that branch off the ay-or-tuh?

parietal: supply somatic structures visceral: supply visceral structures

What arteries serve the:

diaphragm: phrenic pericardium: pericardial lungs: bronchial esophagus: esophageal

What arteries serve the:

liver: hepatic stomach: gastric spleen: splenic intestines: mesenteric kidneys: renal ovaries/testes: gonadal

What are the largest veins in the body? inferior and superior venae cavae

What region do the azygos veins drain? thorax

Where does venous blood from the digestive organs go before it enters the inferior vena cava? the liver

Lp 113

What vessels drain blood into the subclavian veins? external jugular veins

What vessels drain blood into the brachiocephalic veins? vertebral veins, internal jugular veins

Which vessels drain most of the blood from the brain, head and neck? internal jugular veins

There are no jugular arteries. What arteries are the “mate” to the jugular veins? carotid

What vessels merge to form the superior vena cava? right and left brachiocephalic veins

What is a venous sinus? a venous channel located between the layers of the dura mater

What are the 2 primary superficial veins of the upper limb? Along which aspect of the upper limb do they travel?

cephalic vein: lateral basilic vein: medial

What are the 2 primary superficial veins of the lower limb? Along which aspect of the upper limb do they travel?

great saphenous vein: medial small saphenous vein: lateral

What is the great saphenous vein's claim to fame? longest vein in the body

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