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121 Cards in this Set
- Front
- Back
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Which ligament supports the lateral aspect of the ankle?
Which part of the ligament is likely to be torn? |
Lateral collateral ligament of the ankle joint.
Anterior talofibular component of the lateralcollateral ligament of the ankle joint |
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Name the tendons of the muscles which come in relation to the lateral malleolus. (2 marks)
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Fibularis Brevis and Longus
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A long distance runner complained of swelling and pain of his shin. Skin testing showed normal cutaneous sensation. Muscular strength tests, however, showed marked weakness of dorsiflexion and impaired dorsiflexion at the ankle joint. Which is the nerve involved? Name the muscles affected?
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Deep Fibular Nerve supplies muscular branches to the tibialis anterior, extensor digitorum longus, fibularis tertius, and extensor hallucis longus
In the ankle, deep fibular nerve innervates the extensor digitorum brevis and the extensor hallucis brevis |
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What are fibrous joints?
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Fibrous joints are connected by dense connective tissue, consisting mainly of collagen.
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Name the types of fibrous joints with examples of each.
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Sutures are found between bones of the skull.
Syndesmoses are found between long bones of the body, such as the radius and ulna in forearm Gomphosis is a joint between the root of a tooth and the sockets in the maxilla |
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What are cartilaginous joints
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Cartilaginous joints are connected entirely by cartilage (fibrocartilage or hyaline). Cartilaginous joints allow more movement between bones than a fibrous joint but less than the highly mobile synovial joint
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Types of cartilaginous joints
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Primary cartilaginous - Examples in humans are the "growth plates" between ossification centers in long bones.
Secondary Cartilaginous - Called "symphyses". Fibrocartilaginous and hyaline joints, usually occurring in the midline. Pubic syphyses. |
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What are synovial joints
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A synovial joint, also known as a diarthrosis, is the most common and most movable type of joint in the body
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Types of Synovial Joints
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Gliding - Carpals
Hinge - Elbow Ball and Socket - Glenohumeral Condyloid - Wrist Pivot - Disto/Proximal radioulnar Compound - Knee Saddle - Carpometacarpal |
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What are saddle joints? Name the movements that occur
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the opposing surfaces are reciprocally concave-convex.
carpometacarpal joint of the thumb as well as the sternoclavicular joint. |
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Condyloid Joint
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condyloid joint (also called condylar, ellipsoidal, or bicondylar[1]) an ovoid articular surface, or condyle, is received into an elliptical cavity. This permits movement in two planes, allowing flexion, extension, adduction, abduction, and circumduction.
metacarpophalangeal joints metatarsophalangeal joints |
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Name the arteries which supply the head of the femur?
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Medial and Lateral Circumflex Artieries (Profunda Femoris Branches) and also foveal artery.
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What is avascular necrosis of head of the femur?
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If blood supply from the medial and lateral circumflex arteries are disrupted (e. g. through fracture of the neck of the femur along their course then bone cells can die and also the joint surfaces of the hip joint.
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What is the anatomical basis for a better prognosis in intertrochanteric fractures of the femur?
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The intertrochanteic region contains large amounts of cancellous bone with a good blood supply, therefore typically heal well compared to femoral neck fractures
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Name the three important ligaments which support the hip joint.
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Ischiofemoral
Pubofemoral Illiofemoral |
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Which of the hip joint ligaments are stronger and why?
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The Y shaped Illiofemoral, In the upright position, it prevents the trunk from falling backward without the need for muscular activity.
The line of gravity passes behind the hip joint axis; therefore there is a tendency to fall back. This is prevented by the strong anterior ligaments. |
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Which movements around the hip joint tighten these ligaments?
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Closed packed position is extension of hip with slight abduction and medial rotation.
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What functions does the acetabular labrum subserve?
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It also increases the concavity of the acetabulum, which keeps the femoral head in place. pain and proprioceptive receptors are present, which protects the margins of the acetabulum.
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What is angle of femoral anteversion? What are the consequences of femoral anteversion on lower limb bones?
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Pathological increase in angle of torsion is called femoral anteversion
Femoral anteversion produces medial rotation of the femoral condyles and also the internal rotation of the tibia which leads to in-toeing. -Pathological implications of change in the angle of torsion,- a. Decrease in congruency of joint with increase in torsion. b. Alters the stability of the joint and the weight bearing capacity of the joint. c. Alters the internal modeling of the bone. d. Changes the muscle and joint mechanics of the lower limb |
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What is angle of torsion of the femur?
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The angle between the long axis of the femoral neck and a line touching the posterior borders of the femoral condyles in the axial plane. This angle varies between 10-15o
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What is pelvic diaphragm?
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The pelvic cavity is supported inferiorly by a musculofascial pelvic diaphragm which consists of levator ani and coccygeus muscle with the covering fascia superiorly and inferiorly.
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Function of pelvic diaphragm?
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Supports the abdominopelvic organs.
It maintains the urinary and fecal continence. Contracts actively when the intraabdominal pressure increases as in coughing, sneezing, lifting heavy objects. Supports the fetal head during child birth |
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What factors can cause pelvic floor weakness?
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- Hormonal changes during pregnancy/childbirth
- Postsurgical - Chronic disease like chronic cough, constipation. - Overweight - Inactivity - Ageing |
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Explain the locking and the unlocking mechanism of the knee.
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-Occurs in the last few degrees of extension
-Involves External rotation of tibia (Open chain) and internal rotation of femur (Closed chain) -Guided by cruiciate ligaments To move from full extension to flexion the knee must be first unlocked. Involves Internal rotation of the tibia and also popliteus muscle. |
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Name the ligamentous attachment of the lateral and the medial menisci? Which of these menisci are prone for injuries and Why?
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The open ends of the menisci are called as the anterior and the posterior horns. Anteriorly they are connected to each other by transverse ligament; they are directly or indirectly connected by patellomeniscal ligaments.
The peripheries of the menisci are attached to the tibial plateau by coronary ligaments. The medial meniscus is firmly attached to the medial collateral ligament hence relatively less mobile and more prone to injuries. |
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functions of the menisci.
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1. Stability
Deepen articular surface of tibia Improve congruity of joint, part of locking mechanism 2. Weight distribution Increase area for Weight bearing Equalize load over Weight bearing area Shock absorption 3. Lubrication Maintains a thin film of synovial fluid thus helps to decrease friction. |
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How do the menisci receive their nourishment? How is this different in early and later stages of life? How can the nutrition to the menisci be affected during prolonged immobilization?
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In the first year of life, whole of the meniscal body is supplied by blood vessels. Once weight bearing starts only the peripheral 25-30% is vascularised by the capillaries from the joint capsule and the synovial membrane. At ~ 50 years, only the peripheral portion of the menisci receive blood vessels, the central portion gets nutrition from the surrounding the synovial fluid.
The avascular nature of the central portions prolongs healing time after the injury. Hence movement is nessecary so central portion can recieve nutrition |
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What are the functions of the anterior and lateral abdominal wall muscles?
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The abdominal wall represents the boundaries of the abdominal cavity.
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What is the rectus sheath? Name the muscles and arteries lying within the rectus sheath.
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The rectus sheath is formed by the aponeuroses of the transversus abdominis and the external and internal oblique muscles. It contains the rectus abdominis
Subcostal and Inferior Epigastric |
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Discuss the structures (extrinsic and intrinsic bony and soft tissue structures) involved forming the longitudinal and transverse arches of the foot.
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The arches of the foot are formed by the tarsal and metatarsal bones and, strengthened by ligaments and tendons, allow the foot to support the weight of the body in the erect posture with the least weight.
Spring ligament - Longitutidinal Fib Longus - Transverse Arch |
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What type of the joint is the Sternoclavicular joint (S-C joint). Mention the bony parts forming the S-C joint .Write down the different types of movements occurring at this joint.
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The parts entering into its formation are the sternal end of the clavicle, the upper and lateral part of the manubrium and the cartilage of the first rib, visible from the outside as the suprasternal notch.
depression, protraction and retraction and rotation. |
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Which muscles will be affected if the greater tuberosity of the Humerus is fractured?
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Supraspinatus
Infraspinatus Teres Minor |
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A 34 years of age female was referred to you; she is pregnant and experiencing pain in her left sacroiliac joint.
Explain the factors associated with the stability of her sacro-iliac joints. |
The hormonal changes of menstruation, pregnancy, and lactation can affect the integrity of the ligament support around the SIJ, which is why women often find the days leading up to their period are when the pain is at its worst. During pregnancy, female hormones are released that allow the connective tissues in the body to relax. The relaxation is necessary so that during delivery, the female pelvis can stretch enough to allow birth.
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How do the bony structures of the talo-crural joint contribute to ankle stability?
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The lower end of the tibia and fibula form a rectangular concave articular surface for an almost rectangular trochlear surface of the talus. The shapes of these articulating surfaces resemble a mortise-and-tenon joint in carpentry.
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Describe the major ligaments contributing to talo-crural stability (include their role).
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The ankle joint is bound by the strong deltoid ligament and three lateral ligaments: the anterior talofibular ligament, the posterior talofibular ligament, and the calcaneofibular ligament.
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Do any muscles contribute to talo-crural stability? If so which one/s and when?
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a) Define the angle of inclination of the femur. B) Describe the pathological variations of this angle.
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This angulation occurs in the frontal plane between the longitudinal axis of the femoral shaft and the axis through the head and the neck of the femur. It ranges between 115-140o. This angle is more in infancy and childhood, decreasing gradually to normal in adults. In addition, in women this angle is smaller compared to men due to wider pelvis.
Pathological increase in the angle of inclination is coxa valga and the vice versa is coxa vara. |
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Which muscles make up the Rotator Cuff? Mention origin, insertion, action and nerve supply of each rotator cuff muscles.
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Subscapularis - Subscapular Fossa, Lesser Tubercle, Lower Subscapular nerve, Medially rotates humerus
Supraspinatus - Supraspinous fossa, greater tubercle, suprascapular nerve, Infraspinatus, greater tubercle, suprascapular nerve, Teres Minor, Axillary Nerve |
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b) Describe the role/s of the rotator cuff in movement of the gleno-humeral joint.
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Anteriorly- subscapularis
Superiorly - suprspinatus Posterioinferiorly - infraspinatus and teres minor |
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a) List the bones involved in the articulations of the tarsometarsal joints.
b) What is the basic function of these joints? |
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Define a (tarsametatarsal) ray? How does the motion differ between the first, third and fifth rays? Which ray is the least mobile?
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A TMT ray is a a functional unit formed by a metatarsal and its associated cuneiform bone. There are 4 TMT rays (4th ray consists of only metatarsal component). The second ray is the least mobile.
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Name the five articulations of the shoulder joint complex.
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Sternoclavicular
•Coracoacromial arch •Acromioclavicular joint •Scapulothoracic joint •Glenohumeral joint |
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Name the joint formed between the scapula and the clavicle .What are the movements possible at this joint?
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Acromioclavicular.
Early Elavation. Allows scapula movement |
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Discuss the mechanisms by which air is moved into and out of the lungs during (a) quiet respiration and (b) respiration after strenuous exercise.
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Quiet (primary muscles)Inspiration Thoraco-abdominal Diaphragm external intercostals
Expiration - elastic recoil of lung tissue surface tension gravity on ribs internal intercostals Forced Inhalation - sternocleidomastoideus scalenes pectoralis major pectoralis minor serratus anterior serratus posterior superior upper iliocostalis Expiration - abdominals external oblique internal oblique rectus abdominus |
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Enlist the intrinsic and extrinsic thoracic wall muscles.
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external layer -- external intercostal
internal layer -- internal intercostal innermost layer -- transversus thoracic (anterior), innermost (lateral) and subcostal (posterior) |
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What are bronchopulmonary segments?
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The part of the lung aerated by a single tertiary bronchus is known as bronchopulmonary segment. There are 10 bronchopulmonary segments in each lung
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What are the spinal nerve roots forming the brachial plexus?
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formed by the ventral rami of the lower four cervical and first thoracic nerve roots (C5-C8, T1).
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Name any three branches of the posterior and medial cords of the brachial plexus.
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Median
Ulnar Radial |
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Name the blood vessels entering and leaving the hila of the lungs. 3 marks
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Pulmonary Artery, veins, and lypmhatic vessels
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Name the different types of pleura.
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The parietal pleura is attached to the wall of the thoracic cavity and innervated by the intercostal nerves and phrenic nerve.
The visceral pleura is attached directly to the lungs, as opposed to the parietal pleura, which is attached to the opposing thoracic cavity. |
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How many fissures are there in the right lung?
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2, Horizontal and Oblique
1 in the left lung |
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Define bronchopulmonary segment??
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Part of the lung that is aerated by a single tertiary bronchus. 10 bronchopulmonary segments in each lung
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What are the bony landmarks bordering the inlet and outlet of the thoracic cavity.
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The superior thoracic aperture is bounded by: the first thoracic vertebra (T1) posteriorly, the first pair of ribs laterally (more specifically, the first ribs form lateral C-shaped curves posterior to anterior), the costal cartilage of the first rib and the superior border of the manubrium anteriorly.
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What is intrapleural pressure?
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Intrapleural pressure is the pressure in the space between the parietal and the visceral pleurae. This pressure is below atmospheric pressure, due to relationship between the lungs and the body wall.
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Pressure Gradient of air in lungs
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Air moves into lungs when pressure inside lungs is less than atmospheric pressure Air moves out of the lungs when pressure inside lungs is greater than atmospheric pressure
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Name two veins uniting to form the superior vena cava.
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Right and Left braciocephalic Veins
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What are the arteries supplying the heart?
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RIght and Left Coronary Arteries
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Name the valve guarding the left atrium and left ventricle.
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Left Atrium - Mitral Valve
Left Ventricle - Aortic Valve |
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Where do the pulmonary veins drain blood?
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The pulmonary veins are large blood vessels that carry oxygenated blood from the lungs to the left atrium of the heart. In humans there are four pulmonary veins, two from each lung.
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What is manubrio-sternal angle? Mention its three significance. 1+3 marks
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anterior angle formed by the junction of the manubrium and the body of the sternum
Boundary between the superior and inferior portion of the mediastinum Passage of the thoracic duct from right to left behind esophagus Aortic Arch Tracheal Bifurcation |
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Describe the function of papillary muscles.
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They attach to the cusps of the atrioventricular valves (a.k.a. the mitral and tricuspid valves) via the chordae tendinae and contract to prevent inversion or prolapse of these valves.
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Name the arteries which arise from the arch of the aorta.
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Right Brachiocephalic
Left Common Carotid Left Subclavian |
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What features of the nasal cavity facilitate the “conditioning” of inspired air?
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Nasal Conchae on the lateral surfaces.
Enchance air turbulance, warms and moistens, filters |
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Describe the articulations of the ribs with the thoracic vertebrae.
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Costovertabrea
Joining of ribs to the vertebrae occurs at two places, the head and the tubercle of the rib. Two convex facets from the head attach to two adjacent vertebrae. |
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What are vertebrosternal , vertebrochondral and floating (vertebral ) ribs?
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•upper 7 - “true ribs.” – vertebrosternal ribs connect to the sternum via costal cartilage.
• 7,8,9,10 costal cartilages - costal margin (vertebro-chondral ribs) •11th and 12thrib have no connection to sternum and : „floating ribs‟ or „vertebral ribs‟ |
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Name the muscles forming the pelvic floor diaphragm? Name three factors that can cause pelvic floor diaphragm weakness.
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Levator Ani and Coccygeus Muscles
Pregnancy Obesity Inconstitence - Urinary and Fecal Menopause |
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What is cartilaginous joint?
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Connected entirely by cartilage allow more movement than fibrous, but not more than synovial
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Which of the knee meniscus is prone to injury and Why?
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Medial
Firmly attached to tibia and less mobile. Thefore prone to injury |
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What is iliotibial band? Mention two muscles attached on that band.
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-Is the thickest lateral band of the deep fascia of the thigh (fascia lata),
-Lateral knee stabilizer -Gluteus maximus (superficial 2/3rd) and tensor fascia latae muscles insert on that band |
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The sacrum is capable of a small range of movement relative to the pelvis.
a) What are these movements called? 2 marks b) Briefly describe how they change the pelvic out let diameter |
Nutation is flexion and couternutation is extension of the sacrum relative to the pelvis that is superior aspect of the sacrum rotates around the sacroiliac joint. Nutation decreases the A-P diameter of the brim while increases the outlet diameter. Counternutation increase the AP diameter of the brim, while decreases the outlet diameter. There is also some amount of movement at the symphysis pubis.
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List the osseous components of the hind foot and the mid foot. Name the two functional articulations between hind foot and midfoot.
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Hindfoot - Talus & Calcaneal
Midfoot - navicular, cuboid and 3 cuneiforms -Talocalcaneal (Subtalar) –Transverse tarsal •Calcaneocuboid •Talonavicular |
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One day Arjun went to sleep with his right arm hanging over the back of the couch on Saturday night after having three bottles of beer. When he waked up in the morning he noticed a problem with his arm and wrist.
a. What nerve was likely to have been affected and where? b. What muscles are likely to be affected by this injury? c. What movements would Arjun not be able to do at his wrist? |
Radial Nervev in the spiral groove of the humerus.
All Extensor Compartment of the Arm Extend Wrist. Would have wrist drop |
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Name the three branches of the coeliac artery
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first major branch of the abdominal aorta.
Left Gastric Common Hepatic Splenic Artery |
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Give an account of the blood vessels entering and leaving the liver.
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The liver gets a dual blood supply from the hepatic portal vein and hepatic arteries.
Blood flows through the liver sinusoids and empties into the central vein of each lobule. |
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Peritoneum
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Within the abdominal cavity lies a continuous double-layered membrane, the peritoneum inside of which is the peritoneal cavity.
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Parietal and visceral peritoneum,
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parietal peritoneum, is attached to the abdominal wall.
is wrapped around the internal organs that are located inside the intraperitoneal space. |
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Lesser Omentum
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is the double layer of peritoneum that extends from the liver to the lesser curvature of the stomach and the start of the duodenum.
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Greater Omentum
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is a large fold of visceral peritoneum that hangs down from the stomach. It extends from the greater curvature of the stomach, passing in front of the small intestines and reflects on itself to ascend to the transverse colon before reaching to the posterior abdominal wall.
The functions of the greater omentum are: Fat deposition, Immune contribution Infection and wound isolation |
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mesentery
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the double layer of peritoneum that suspends the jejunum and ileum from the posterior wall of the abdomen.
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Name the major salivary glands and briefly describe their function.
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Parotid gland
Located inferior and anterior to the ears. Secretes saliva into the oral cavity via a parotid duct. Opens into the vestibule opposite second molar tooth. Submandibular gland Situated beneath the base of the tongue. Submandibular duct opens lateral to the lingual frenulum. Subligual gland Situated superior to the submandibular gland. Lesser sublingual ducts opens into the floor of the mouth. |
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Name the major cartilages of the larynx .
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Thyroid Cartilage
Cricoid Cartilage Arytenoid |
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How is voice produced?
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1.Air pressure from the lungs creates a steady flow of air through the trachea (windpipe), larynx (voice box) and pharynx (back of the throat).
2.The vocal folds in the larynx vibrate, creating fluctuations in air pressure that are known as sound waves. |
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What is a renal calculus and in which areas of the ureter is it most likely to be lodged?
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A kidney stone, also known as a renal calculus is a solid concretion or crystal aggregation formed in the kidneys from dietary minerals in the urine.
at the ureteric junction of renal pelvis; as the ureter passes over the iliac vessels; where the ureter enters into the urinary bladder |
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Identify the four segments of the oviduct. Where does fertilization takes place in most of the cases?
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leading from the ovaries of female mammals into the uterus, via the utero-tubal junction.
The egg is caught by the fimbriated end and travels to the ampulla where typically the sperm are met and fertilization occurs; |
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What is a nephron?
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Functional unit of kidney – Nephrons
Its chief function is to regulate the concentration of water and soluble substances like sodium salts by filtering the blood, reabsorbing what is needed and excreting the rest as urine. |
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What is renal hilum?
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renal vein, renal artery and ureter, respectively.
A useful mneumonic device for remembering this sequence is Virgins Are Unutilized. |
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What are intra peritoneal and extra peritoneal organs of the abdominal cavity, give two examples each.
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Some structures (e.g. kidneys, ascending and descending colons) are retroperitoneal organs, firmly attached to the posterior abdominal wall, and are relatively immobile.
Structures such as the stomach, ileum, jejunum, transverse and sigmoid colons are intraperitoneal organs, have peritoneal folds (mesentery) and able to move freely. |
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Name, and state the location of, the 3 extrinsic pairs of salivary glands. What are the primary functions of saliva?
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Parotid
Submandibular Subligual |
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What are the primary functions of saliva?
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•Wets bolus of food.
•Dissolves food. •Buffers food. •Starch digestion by salivary amylase. •Destroys bacteria by lyzozymes. •Protects oral cavity. |
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Briefly discuss the production, transportation, storage, and function of bile.
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Production occurs in the liver
Stored in the gall bladder aids the process of digestion of lipids in the small intestine Transport through bile duct and cystic duct |
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Which muscles are active during quiet inspiration?
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Diaphragm
external intercostals |
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Describe the pleurae, including details of function and innervations.
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The pleura is a serous membrane which folds back onto itself to form a two-layered, membrane structure. The thin space between the two pleural layers is known as the pleural cavity; it normally contains a small amount of pleural fluid. The outer pleura (parietal pleura) is attached to the chest wall. The inner pleura (visceral pleura) covers the lungs and adjoining structures, viz. blood vessels, bronchi and nerves.
The parietal pleural is innervated by somatic afferent fibers. |
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What is thoracocentesis?
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Thoracentesis or pleural tap is an invasive procedure to remove fluid or air from the pleural cavity for diagnostic or therapeutic purposes
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Briefly describe the various lobes of the left and right lungs and also the importance of anatomical knowledge of the lobes for chest physiotherapy.
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Right Lung - 3 Lobes
Left Lung - 2 Lobes Need to know lungs so that different positions can be applied if there is a need to loosen the airways which may become blocked due to mucus or foreign bodies |
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Describe the movement of the fibula during plantar- and dorsi-flexion of the ankle joint?
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Gliding and Rotation
Inferior glide with inversion/PF •Superior glide with eversion/DF |
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What is the “Q-angle” at the knee joint? How is it measured and what implications does it have for tibio-femoral or patello-femoral problems?
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Q angle is an angle formed between the two lines drawn from
a. anterior superior iliac spine (ASIS) to the midpoint of the patella and b. midpoint of patella to tibial tuberosity Increase in Q angle increases the lateral forces on the patella, leading to subluxation and dislocation of the patella on activation of the quadriceps on an extended |
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Describe the difference between the bucket handle actions of the ribs versus the pump handle action during inspiration.
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During breathing, the dimensions of the thorax change in vertical, lateral and anteroposterior directions. Elevation and depression of the diaphragm significantly alter the vertical dimensions of the thorax. Depression results when the muscle fibers of the diaphragm contract. Elevation occurs when the diaphragm relaxes. Changes in the anteroposterior and lateral dimensions result from elevation and depression of the ribs. The posterior ends of the ribs articulate with the vertebral column, whereas the anterior ends of most ribs articulate with the sternum or adjacent ribs. Because the anterior ends of the ribs are inferior to the posterior ends, when the ribs are elevated, they move the sternum upward and forward. Also, the angle between the body of the sternum and the manubrium may become slightly less acute. When the ribs are depressed, the sternum moves downward and backward. This “pump handle” movement changes the dimensions of the thorax in the anteroposterior direction. As well as the anterior ends of the ribs being lower than the posterior ends, the middles of the shafts tend to be lower that the two ends. When the shafts are elevated, the middles of the shafts move laterally. This “bucket handle” movement increases the lateral dimensions of the thorax.
•Pump handle – changes the AP dimension •Bucket handle – changes the transverse dimension |
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Describe the mechanism by which the plantar fascia contributes to the maintenance of the longitudinal arch of the foot.
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It runs from the tuberosity of the calcaneus (heel bone) forward to the heads of the metatarsal bones (the bone between each toe and the bones of the mid foot).
The plantar fascia contributes to support of arch of the foot by acting as a tie-rod, where it undergoes tension when the foot bears weight. |
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What is porta hepatis? What structures enter and exit the liver at the porta hepatis?
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transverse fissure of the liver is a short but deep fissure, about 5 cm long,
Common bile duct, hepatic portal vein, hepatic portal artery, lymphatic and nerves. |
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What is the function of chordate tendineae extending from the papillary muscles and valve cusps of the mitral and tricuspid valves?
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During ventricular contraction the valve cusp are forced upward with the flow of blood, however contraction of the papillary muscles attached to the cusp by chordae tendineae prevent the cusps from being everted into the atrium. In addition, these attachments prevent separation of the cusps during ventricular contraction.
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What is the innervation of parietal pleurae and to which dermatomes the pain is referred in the diaphragmatic pleural inflammation?
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The parietal pleural is innervated by somatic afferent fibers.
The diaphragmatic pleura and the mediastinal pleura are innervated mainly by the phrenic nerves (originating at spinal cord levels C3, C4 and C5). Pain from these areas would refer to the C3, C4 and C5 dermatomes (lateral neck and the supraclavicular region of the shoulder). |
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What is costodiaphragmatic recess?
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The largest and clinically important recesses, which occur in each peural cavity between the costal and diaphragmatic pleura. The costodiaphragmatic recesses are the regions between the inferior margin of the lungs and inferior margin of the pleural cavities. They are deepest after forced expiration and shallowest after forced inspiration.
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What is cough reflex?
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The cough reflex is a protective reflex to expel or remove foreign material from the respiratory tract before it reaches the lungs. The cough receptors are located throughout the respiratory tree especially the proximal parts of the respiratory tree. When these receptors are stimulated the impulses travel via branches of the Xth cranial nerve, to the medulla of the brain and to the cortex. The efferent neurons then send the signals from the cortex and medulla via the vagus to the glottis, external intercostals, diaphragm, and other major inspiratory and expiratory muscles. In a cough, the glottis is kept closed while the chest and the abdominal muscles contract compressing the lungs. When the glottis is opened suddenly, the resulting blast of air from the trachea ejects material that blocks the entrance to the glottis.
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What is the radial groove in the shaft of the humerus? What are consequences of radial nerve injury due to a mid-shaft fracture of the humerus?
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broad but shallow oblique depression for the radial nerve and deep brachial artery. It is located on the center of the lateral border of the humerus bone.
Extensor compartment of the arm affected |
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What are the consequences of entrapment of deep branch of the radial nerve in the arcade of Frohse?
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This branch passes under the supinator arch or arcade of Frosche and supplies all extensor muscle except anconeus, brachioradialis, ECRL .
Cant extend wrist |
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What are the consequences of ulnar nerve damage due to a fracture at the medial epicondyle?
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One common cause is cubital tunnel syndrome. In this syndrome, a tunnel on the medial side of the elbow traps the nerve.
Severe entrapment or complete severing of the ulnar nerve can present clinically as an ulnar claw, |
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Enlist the structures which pass through the carpal tunnel.
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9 Lonf flexor tendons
Median nerve compression |
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Carpal Tunnel Syndrome
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when any of the nine long flexor tendons passing through it swells or degenerates, the narrowing of the canal often results in the median nerve becoming entrapped or compressed
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What are the effects of damage to the ulnar nerve at the wrist level?
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loss of sensation over ulnar nerve distribution. Loss of muscle function of adductor pollicis, part of flexor pollicis brevis, all interossei, and medial two lumbricals (3rd and 4th)
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Which are the ligaments that keep the long flexor tendons of the hand in position?
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The cruciate ligaments, annular ligaments and the flexor retinaculum.
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Name the bones which participate in the formation of the carpometacarpal joint of the thumb. What are the movements that occur at the carpometacarpal joint?
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five joints in the wrist that articulate the distal row of carpal bones and the proximal bases of the five metacarpal bones.
flex ext abd add |
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What are ulnar negative and positive variances? What are the consequences of ulnar positive variance?
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Short ulna in comparison with the radius at their distal ends is referred to as ulnar negative variance while long ulna in comparison with the radius is called as ulnar positive variance. Both conditions alter the wrist and radiocarpal joint bioomechanics and the wrist stability.
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What is colles fracture?
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Fracture and posterior displacement of the distal end of the radius (sometimes referred to as a “dinner fork” deformity due to the shape of the resultant forearm.)
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tennis elbow?
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pain and inflammation on the lateral epicondyle and common extensor origin, also called as lateral epicondylitis
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golfers elbow
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It is a clinical condition associated with inflammation of the medial epicondyle and common flexor origin muscle tendons (mainly FCR and pronator teres tendons), also called as medial epicondylitis
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Which forearm muscles (anterior and posterior) produce ulnar and radial deviation at the wrist? Which of these movements has a greater range and why?
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Ulnar deviation is produced by flexor carpi ulnaris and extensor carpi ulnaris. Radial deviation is produced by extensor carpi radialis longus, extensor carpi radialis brevis and flexor carpi radialis. Ulnar deviation is ~20 – 45 o while radial deviation is ~15 – 20 o. This difference is because of the more distally projected radial styloid process.
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What is triangular fibrocartilage (TFC) inferior to the head of the ulna?
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It is an articular fibrocartilagenous disc present between inferior radioulnar joint and the wrist joint. It binds the distal ends of the radius and the ulna. Peripheries of the disc are thicker; the central portion of the disc is thinner.
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Describe scapulohumeral rhythm?
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Combination of glenohumeral and scapulothoracic movement to allow further range of movement. 180 deg elevation
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Gluteal muscles
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Glut Max - Gluteal Tuberosity, Inferior gluteal nerve, ext rotation and hip ext
Glut med and min - greater trochanter, sup gluteal nerve, hip abd |
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The structure of the glenohumeral joint
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Ball and Socket joint
Small glenoid cavity Reinforced by ligaments highly mobile |
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Describe the muscles that are responsible for internal and external rotation of the humerus.
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Internal Rotation - Subscapularis, Teres major, Pec major, lat dorsi, deltoid
External Rotation - Infraspinatus, Teres Minor, deltoid |
