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What side of the phalanges does the EDB link with EDL?
What side do dorsal interossei attach?
What side do plantar interossei attach?
What digits are connected to plantar interossei?
What muscle makes up majority of wing tendon on phalanges?
Where does the central band of the extensor expansion insert?
Base of middle phalanx
Where do the lateral bands of the extensor expansion insert?
Base of distal phalanx
What joint does the extensor sling surround?
At what joint does the FDB pass deep to the FDL?
nerve of lateral compartment
Nerve of Posterior compartment
Nerve of Anterior compartment
Artery of lateral compartment
brs. of AT and Fibular
Artery of Posterior compartment
Patellar reflex spinal nerve
Achille reflex spinal nerve
how many compartments found at medial malleolus?
- **4 (Tom Dick AN Harry)
- 1) TP
- 2) FDL
- 3) PTA, TN
- 4) FHL
How many dorsal interossei insert on 2nd phalanx?
2 (medial and lateral)
Medial plantar nerve innervation
- Abd. Hallucis
- FDB, FHB
- 1st lumbrical
All but Abd.H, EDB, EHB and 1st lumbrical
What are the small tendons that hold larger tendons to bone and house small blood vessels?
What Nerve innervates EDB & EHB?
Deep fibular N
T/F Saphenous nerve is posterior to medial malleolus?
F, it is anterior
What Nerves innervate nail beds?
Proper plantar digital nerves
In the foot, what are the two principal brs. of the SFN?
Medial and intermediate dorsal cutaneous
What N innervates the interspace b/t digits 1 and 2 (proper dorsal digital nerves 2 & 3)?
What two brs. commonly make up the Sural N?
- Medial sural cutaneous N (off of Tibial N)
- Lateral sural cutaneous N (off of CFN)
T/F Sural N passes posterior to lateral Malleolus?
B/T what layers can you find the MPN?
1 & 2
B/T what layers can you find the LPN?
3 & 4
How many medial and lateral tarsal arteries branch off of dorsalis pedis?
- Medial tarsal: 2 brs.
- Lateral tarsal: 1 br
How many dorsal metatarsal Arteries off of the arcuate artery?
What is terminal arborization
Digital anastomosis from plantar aspect of digits to dorsal
What strata is found in thick but not thin skin?
What glands exist in thin and thick skin?
- Thin: appocrine, eccrine, sebaceous, hair
- Thick: eccrine
What are the two substances that make up ECM?
Fibers and Ground substance
What makes up ECM fibers?
Collagen and elastic fibers
What makes up ECM ground substance?
Proteoglycans and adhesive glycoproteins
What is an aggrecan?
Large collection of PGs
T/F PGs are covalently linked to HA?
F, non-covalently linked via proteins
Role of Fibroblasts and ECM?
They produce ECM
4 components of innate immune system?
- Mast cells
2 components of Acquire immunity?
- T-cells (CMI)
- B-cells (humoral) = plasma cells = antibodies
4 structures that are alymphatic?
Hyaline cartilage DiRCT of LE?
- Joint capsules
- Dermis (reticular layer)
What are the stem cells of the perichondrium?
Type of growth of Perichondrium?
Type of growth of Cartilage?
Interstitial (isogenous groups with chondrocytes in lacunae)
T/F fibrocartilage does not have perichondrium?
- Articular disks
- IVD, symphysis type
What is an Osteon?
Basic functional unit of bone
What are canaliculi?
Junctions b/t lacunae in bone for communication
What type of collagen is bone ECM?
What is osteogenesis imperfecta?
Inadequate and dysfunctional Type I collagen so bone does not form and cannot remodel
What diseases are caused by Vit D deficiency in adults and children?
- Adults: OM
- Children: rickets
Where do osteoclasts arise?
Effects of PTH and Calcitonin on Ostoclast activity?
- PTH: increase bone resorption
- Calcitonin: decrease bone resorption
Where do PTH and Calcitonin arise?
- PTH : Parathyroid glands
- Calcitonin: Parafollicular cells
Name the three requirements for successful fracture healing?
- 1) Approximation
- 2) Limited movement
- 3) Intact periosteum and endosteum (for stem cell osteoblasts)
Which requires more Oxygen, fibroblasts or osteoblasts?
- ** Fibroblasts require the least
What cells first arrive on scene after a fracture? What do they form?
Fibrocartilage to form hyaline cartilage
4 stem cells of ossification?
What cells participate in intramembranouse ossification?
At what embryonic week does vasculature start to arise in bone ossification?
At what embryonic week does the primary center of ossification begin?
comparison of growth b/t hyaline cartilage and bone?
- hyaline: interstitial (mitotic chondroblasts becoming chondrocytes and resting in isogenous groups)
- Bone: appositional
In what day does LE embryonic development start?
What spinal levels contribute to LE embryo development?
What somites participate in LE muscle growth?
At what embryo week deos LE rotation start?
wk 6 (ends at wk 8)
What does the LE look like @ wk 7?
Apoptosis of digits starts and rotation continues
What is the embry origin of the nucleus propulsus?
Name the three layers of paraxial mesoderm?
When does endochondral ossification begin?
What are the two cell types in Synovial fluid and what do they produce?
- Type A: macrophage
- Type B: synovial fluid producers
Where does the Conus medullaris end?
L1-L2 IVD space
At what vertebral level do you perform a lumbar puncture?
L4, high point iliac crest
What type of joint is the sup/inf articular processes of vertebral bodies?
What is affected by a lumbar stenosis?
- 4 IV foramen causing difficulty with lumbar puncture
- ** might have to use sacral canal/hiatus for puncture
What is the general rule for nerve compression?
Nerve compression will cause pain in area of nerve that lies underneath (L4 will cause L5 pain)
At what vertebral level can you find the high point of iliac crest and PSIS?
What are the two components of the sacroiliac joint?
- Ant: synovial (hyaline)
- Post: fibrous
What is the X-ray method for viewing the lesser trochanter?
What is the strongest capsular ligament around the hip?
What three structures protect from lateral disloaction of the patella?
- high lateral condyle
- vastus medialis
- patellar ligament
What does the MCL attach to?
What does the LCL attach to?
What does Popliteus attach to?
What muscles areas are formed from Epimere & Hypomere?
- Epimere: true back muscles
- Hypomere: limb muscles
T/F muscles are formed from more than one myotome and are innervated by only one primary ramus?
F, they are formed from multiple myotomes but the innervation is multiple as well
What is another name for dorsal mm mass and what are their functions?
- function: extend and abduct
What is another name for ventral mm mass and what are their functions?
- function: flex and adduct
What is the LE border b/t preaxial and postaxial?
- Preaxial:Tibia and hallucis
- Postaxial: fibular and 5th digit
Embryonic origin for Schwann cells and PRG cells?
embryonically, what do the anterior and posterior branches of the anterior primary rami innervate?
- Anterior = preaxial, ventral
- Posterior = postaxial, dorsal
Lumbar & Sacral plexus are Anterior & Posterior Divisions of what anterior primary rami?
What are the 5 Anterior nerves of the LE?
- Posterior femoral cutaneous
- medial plantar
- lateral plantar
What are the 7 Posterior nerves of the LE?
- Superior gluteal
- Inferior gluteal
- Femoral nerve
- Lateral femoral cutaneous
- Common fibular
- Superficial fibular
- Deep fibular
What is the most powerful hip flexor and where does it insert?
Iliopsoas, inserts on lesser trochanter of femur
Innervation of gluteus maximus and medius/minimus?
- Maximus= inf gluteal
- Medius/minimus = sup gluteal
Obturator internus exits via lesser sciatic foramen, what two ligaments form the foramen?
Sacrospinous and Sacrotuberous ligaments
IT band innervation?
Sup gluteal N
What two mm form floor of femoral triangle?
Iliopsoas and Pectineus
4 hamstring characteristics
- Tibial nerve innnervation
- Origin @ ischial tuberosity
- flex knee
- extend hip
At what level does the meningeal sac end?
How many peripheral nerves can one anterior primary rami supply?
What nerve can be impinged at PSIS and inguinal ligament?
Lateral femoral cutaneous
Superficial and Deep inguinal lymph nodes drain to what nodes?
Vertebral level of IVC bifurcation?
Vertebral level of Aortic bifurcation?
Diff b/t direct and indirect inguinal hernia?
- direct: pierces inguinal canal
- indirect: passes within inguinal canal
What four Arteries make up the cruciate anastomoses of the femoral head/neck?
- Descending br. of inferior gluteal A
- Medial circumflex A
- Lateral circumflex A
- 1st perforating A off of Deep femoral A