Arthrology, Myology- Part 1

Shoulder, arm, elbow, gluteal, pelvis, thigh and knee regions

Is the medial meniscus frequently injured?

Yes

Under the patella. Can be injured by blunt force e.g falling on your knees. Made out of fibrocartilage. There is a medial and lateral meniscus.

Does the atlas articulate with the occipital bone by means of a round flat facet?

No

The atlas articulates with the Atlanto occipital joint

Does the atlas move with the occipital bone on rotation of the head

Yes

Does the ulnar nerve have any branches in the arm?

No

Does the circumflex scapular artery anastomose with the suprascapular artery?

Yes

Anastomose: where two channels (vessels) meet. On the dorsal surface, joins the dorsal scapular artery

Does the supraspinatous muscle use the fascia spanning the area from the spine to the superior border of the scapula?

Yes

Are the muscles on the thigh subdivided into anterior, posterior and lateral groups?

No

No lateral (where the iliotibial tract), replaced with medial

What are the intervertebral discs composed of?

Fibrocartilage

Is the axillary vein:
A- Single
B- Paired
C- Plexiform vein

A- Single

Deep veins are usually pained, axillary vein is an exception

Which joint allows the least amount of movement?

Suture

Found in the skull

Which joint allows the most movement?

Ball and socket

Found in the shoulder and hip

Which of the following a hinge joint:
A- Hip
B- Knee
C- Neck
D Knuckle

B- Knee and D- Knuckle

A hinge joint can only move what direction?

Up and down

A saddle joint helps us to do what?

Pick up tiny objects

(Carpo metacarpal joint in the thumb)

A pivot joint is located where?

At the top of the spinal column (aka the neck)

A gliding joint is located where?

In between the vertebrae (Aka the spine)

Which is not a type of a joint in our skeleton:
A- Hinge
B- Ball and socket
C- Pivot
D- Swinging

Swinging (laugh out loud what is a swinging joint)

Which two joints move the same way in our skeleton?

Knee joints and Elbow joints

They’re both hinge joints

Give an example of an immovable joint?

Skull

Suture joint

Where is the ball-and-socket joint located?

Shoulder

And hip

Which of these body parts uses a pivot joint?
A- Spine
B- Neck
C- Finger
D- Shoulder

B- Neck (Top of the spinal column)

Where might you find a gliding joint?

Spine (In between the vertebrae)

What connects bones to each other at the joints?

Ligaments

Which type of joint allows the most movement?

Ball and Socket

What protects bones from being worn down?

Cartilage

Firm protective connective tissue

If the head of a femur is dislocated postero-medially, compression of which nerve is likely to result?

Sciatic Nerve

most posterior

Action of pectoralis major:
A- Flexion of humerus
B- Medial Rotation of humerus
C- Adduction of humerus
D- All of the above
E- only A and B

D- All of the above
(flexion, medial rotation and adduction of humerus)

Pectoralis major attaches to the intertubercular sulcus

The humerus may be rotated laterally by:

The Deltoid muscle

The muscle pair which assists in elevating the arm above the head is the:

Trapezius and Serratus anterior

The nerve trunk most intimately related to the capsule of the shoulder joint is:

Axillary (nerve)

To avoid the sciatic nerve, an injection into the buttock is best given into:

Upper and outer quadrant

Which of the following is a muscle from the anterior group of thigh muscles:
A- Gluteus maximus
B- Sartorius
C- Pectineus
D- Gracilils
E- Iliacus

B- Sartorius

Gluteus maximus (posterior)
Pectineus (anterior and medial)
Gracilils (medial- adductor compartment)
Iliacus (hip compartment)

The cephalic:
A- passes between the deltoid and pectoralis major muscles in its proximal part
B- superiorly passes through the deltopectoral triangle, where it empties into the subclavian vein
C- ends by joining the brachial vein
D- is medial to the biceps muscle in the upper arm
E- has no valves

A- passes between the deltoid and pectoralis major muscles in its proximal part

The posterior group of muscles of the arm is innervated by:

N.radialis

An open arterial anastomosis in the shoulder occurs between the suprascapular artery and which other artery?

Circumflex scapular

The nerve which passes through the quadrangular space of the posterior shoulder innervates which muscle?

Deltoid
(Axiallary nerve)

Two that leave axillary nerve posterior circumflex humeral artery

In the axilla the pectoralis minor is a landmark, being closely related to all of the following structures except:
A- Cephalic vein
B- Infraspinatus
C- Subscapularis
D- Supraspinatous
E- teres major

A- Cephalic Vein

The axillary nerve arises directly from which part of the brachial plexus?

Prosterior Cord

Which of the following is not a direct branch of the axillary artery?
A- anterior circumflex humeral
B- posterior circumflex humeral
C- thoracoacromial
D- thoracodorsal
E- subscapular

Thoracodorsal (teradactyl)

Axiallary artery- superior thoracic artery - thoracoacromial artery (has 4 branches) - lateral thoracic artery - subscapular artery- anterior circumflex humeral artery- posterior circumflex humeral artery

If the second part of the axillary artery was interrupted, collateral blood flow could pass from branches of the thyrocervical trunk into which artery?

Circumflex Scapular

In a fracture of the SURGICAL NECK of the humerus, which artery may be injured?

Posterior Humeral circumflex

While riding a bike, a patient fell against a tree (lame) and fractured the shaft of the humerus at mid length. What nerve may be injured because of its close proximity to the injury?

Radial Nerve
(Curves around the shaft of the humerus)

In a fracture of the MID SHAFT of the humerus, which artery is mostly likely to be injured?

Deep Brachial Artery

Which muscle is the strongest medial rotator of the arm?

Subscapularis

The rotator cuff is composed of all the following muscles except:
A- infraspinatus
B- subscapularis
C- supra spinatus
D- teres major
E- teres minor

D- Teres Major

-has more movement related to the latissimus dorsi

The patient was unable to retract his scapula because of paralysis of the trapezius and…?

Rhomboids

Retracts and rotates scapula

The team doctor tells a football player that he has “a pulled hamstring” muscle. This results from a tearing of the origin of a hamstring muscle from the:

(Where does the hamstring muscle originate?)

Ischial tuberosity

What muscle passes through the lesser sciatic foramen?

Obturator internus

How many perforating arteries do you find in the thigh?

3

What does the femoral canal contain:

Deep inguinal lymph node(s)

Which movement would fail in case of paralysis of the quadriceps femoris muscle?

Extension at the knee

Which structure does NOT enter or leave the inguinal region by passing deep to the inguinal ligament?
A- femoral artery
B- femoral nerve
C- femoral vein
D- psoas major muscle
E- round ligament of the uterus

E- Round Ligament of the Uterus

When walking, the action of the iliopsoas muscle results in what motion at the hip joint?

Flexion

Iliacus and psoas major becomes a unit and are responsible for hip flexion

The pulse of the femoral artery is best felt at which superficial reference point?

Femoral triangle

At which site could one expect to enter the femoral vein with a simple percutaneous (through the skin) introduction of an instrument?

Medial to the femoral arterial pulse

What anterior thigh muscle must be retracted to expose the adductor canal and it’s contents?

Sartorius

An obturator hernia that compresses the obturator nerve in the obturator canal may affect the function of all of the following EXCEPT?
A- adductor brevis
B- adductor longus
C- gracilis
D- obturator externus
E- pectineus

E- Pectineus

(Not innervated by the obturator nerve, it is only innervated by the femoral nerve)

Which of the following is NOT located within the adductor canal?
A-Saphenous nerve
B- femoral artery
C- nerve to vastus medialis
D- femoral vein
E- deep femoral artery

E- deep femoral artery

Inability to extend the knee and loss of cutaneous sensation over the anterior surface of the thigh would indicate a lesion or compression of the…?

Femoral Nerve

Which statement is true?
A- The femoral artery lies medial to the femoral vein
B- The femoral vein lies medial to the femoral artery
C- The external iliac veins join to form the inferior vena cava
D-The inferior vena cava cannot be imaged radiographically
E- A and C

B- The femoral vein lies medial to the femoral artery.

The femoral artery enters the popliteal fossa (becoming the popliteal artery) by passing through the:

Adductor hiatus

When the femur is fractured, the broken distal end often turns posteriorly to enter the popliteal fossa due to muscle traction. Because of its position deepest in the fossa, which structure is most vulnerable to laceration?

Popliteal artery

because it is the deepest structure in the femur

The deep femoral artery is the principle blood source for the muscles in which compartment of the thigh?

Posterior (hamstrings)

A fracture of the ischial tuberosity might be expected to most directly affect the muscles that produce which lower limb movement?

Flexion at the knee.

An elderly patient complains of difficulty in walking up stairs. Tests by her doctor reveal weakness in extension at her hip, but no change in hip flexion, or flexion or extension of the knee. Based upon these results, what muscle is most likely not functioning properly.

Gluteus maximus

Important for powerfully extending the thigh

Weakness in climbing stairs or jumping would indicate a lesion of which nerve?

Inferior gluteal nerve.

Inferior = gluteus maximus
Superior = medius and minimus

The lateral antebrachial cutaneous nerve comes from the…?

Musculocutaneous Nerve

In withdrawing a blood sample from the median cubical vein the needle passes slightly deep and medial; which nerve might possible be injured?

Medial antebrachial cutaneous

The vein of choice for withdrawing blood is the:
A- Basilic
B- Cephalic
C- Median antebrachial
D- Median Cubital

D- Median Cubital

Which of the following statements for the knee joint is true?
A- is synovial joint
B- Can do flexion and extension
C- the knee cap (patella) takes part in this joint
D- possesses synovial pockets called bursae
E- Medial meniscus gets 10 times more frequently injured

A- Is synovial joint
C- the knee cap takes part in this joint
D- Possesses synovial pockets called bursae
E- Medial meniscus gets 10 times more frequently injured

Which of the following nerves are directly related to the humerus?
A- radial nerve
B- median nerve
C- ulnar nerve
D- axillary (circumflex) nerve
E- musculocutaneous nerve

A, C, D (radial, ulnar, axillary (circumflex) nerves)

Which is/are true for the Shaft of the Humerus?
A- has lateral head of the triceps muscle attached to its upper posterior part
B- has a nutrient foramen directed downwards
C- has the radial nerve posterior to it
D- has the brachialis muscle attached to its anterior surface
E- in the adult contains red bone marrow

A- Has the lateral head (an median head) of the triceps muscle attached to its upper posterior part
B- has a nutrient foramen directed downwards
C- has the radial nerve posterior to it
D- has the brachial is muscle attached to it’s anterior surface

Which is/are true for the Basilic Vein?
A- begins on the medial side of the back of the wrist
B- becomes deep about the middle of the upper arms
C- ends by joining the subclavian vein
D- is medial to the biceps muscle in the upper arm
E- ends after piercing the clavipectoral fascia

A- begins on the medial side of the back of the wrist,
B- becomes deep about the middle of the upper arms
D- is medial to the biceps muscle in the upper arm

Which is/are true for the Upper End of the Humerus?
A- has the subscapularis muscle attached to the greater tuberosity
B- has the teres major muscle attached to the floor of the intertubercular sulcus (bicipital groove)
C- Has three epiphyses which fuse separately with the shaft
D- has the capsular ligament of the Glenn humeral attached to the whole of the anatomical neck
E- is the growing end of the humerus

E- is the growing end of the humerus

Because of the epiphyseal plate

Which is/are true for the Cephalic Vein?
A- begins in the region of the anatomical snuff box
B- at the elbow is deep to the lateral cutaneous nerve of the forearm
C- ends by joining the brachial vein
D- is medial to the biceps muscle in the upper arm
E- has no valves

A- begins in the region of the anatomical snuff box

Which is/are true for the Medial Cord of the Brachial Plexus?
A- gives a branch to the pectoralis major muscle
B- gives origin to the ulnar nerve
c_ forms part of the median nerve
D- Contains fibres of the fifth cervical spinal nerve
E- lies medial to the axillary artery

A- gives a branch to the pectoralis major muscle
B- gives origin the the ulnar nerve
C- forms part of the median nerve
E- lies medial to the axillary artery

Which is/are true for the Axillary Nerve?
A- has no cutaneous branches
B- supplies the deltoid and teres minor muscles
C- passes backwards inferior to the teres major muscle
D- contains fibres from the fifth and sixth cervical spinal nerves
E- is medial to the long head of the triceps muscle

B- supplies the deltoid and teres minor muscles
D- contains fibres from the fifth and sixth cervical spinal nerves

Which is/are true for the Pectoralis Major Muscle?
A- is attached to the floor of the intertubercular sulcus
(bicipital groove)
B- is supplied by branches of the three cords of the brachial
plexus
C- is a lateral rotator of the upper arm at the glenohumeral joint
D- is involved in flexion of the upper arm at the glenohumeral joint
E- is used in climbing a rope by means of the upper limbs.

D- is involved in felcion of the upper arm at the glenohumeral joint
E- is used in climbing a rope by means of the upper limbs

Which is/are true for the Posterior Cord of the Brachial Plexus?
A- contains fibres from only the seventh and eighth cervical
spinal nerves
B- gives off a branch which joins the median nerve
C- is posterior to the axillary artery
D- gives off branches which supply the subscapularis, teres
major and latissimus dorsi muscles
E- contains fibres which supply the muscles on the back of
the forearm.

C- is posterior to the axillary artery
D- gives off branches which supply the subscapularis, teres
major and latissimus dorsi muscles
E- contains fibres which supply the muscles on the back of
the forearm.

Which is/are true- The deltoid muscle (or part of it) can be used in:
A- medial rotation of the upper arm at the glenohumeral
(shoulder) joint
B- abduction of the upper arm at the glenohumeral joint
C- lateral rotation of the upper arm at the glenohumeral joint
D- adduction of the upper arm at the glenohumeral joint
E- flexion of the upper arm at the glenohumeral joint.

A, B, C, E: medial, lateral rotation, flexion and abduction of the upper arm at the glenohumeral joint

Pectoralis major adducts

Which is/are true for The lower end of the Humerus?
A- has part of the supinator muscle attached to it
B- has the ulnar nerve running posterior to its lateral part
C- usually has its four separate epiphyses by 12 years.
D- fuses with the shaft before the upper end fuses with the
shaft
E- has part of the pronator teres muscle attached to it.

A- has part of the supinator muscle attached to it
C- usually has its four separate epiphyses by 12 years.
D- fuses with the shaft before the upper end fuses with the
shaft
E- has part of the pronator teres muscle attached to it.

Which is/are true for the Flexion of the upper limb at the shoulder through 180° from the anatomical position?
A- requires the contraction of the sternocostal head of the
pectoralis major muscle
B- involves the contraction of the anterior part of the deltoid muscle
C- involves a muscle supplied by the musculocutaneous nerve
D- involves the contraction of the serratus anterior muscle
E- involves muscles supplied mainly by the eighth cervical
spinal nerve.

B- involves the contraction of the anterior part of the deltoid muscle
C- involves a muscle supplied by the musculocutaneous nerve
D- involves the contraction of the serratus anterior muscle

Which is/are true: In the cubital (antecubital) fossa
A- the ulnar nerve is on the medial side
B- the radial nerve is on the lateral side
C- the median nerve passes downwards on the lateral side of the brachial artery
D- all the superficial veins are deep to the cutaneous nerves
E- the brachial artery is lateral to the tendon of the biceps
muscle.

B- the radial nerve is on the lateral side

Which is/are true for the Deltoid Muscle:
A- is supplied solely by the axillary (circumflex) nerve
B- is supplied solely by the sixth and seventh cervical spinal
nerves
C- is associated with contraction of the supraspinatus
muscle in abduction of the upper arm at the glenohumeral
(shoulder) joint
D- is attached to the posterior surface of the clavicle
E- is attached to the humerus just distal to the lesser
tuberosity.

A- is supplied solely by the axillary (circumflex) nerve
C- is associated with contraction of the supraspinatus
muscle in abduction of the upper arm at the glenohumeral
(shoulder) joint

Which is/are true for the Femoral Vein in the Femoral Triangle
A- is medial to the femoral artery
B- is lateral to the femoral canal
C- directly receives the greater (long) saphenous vein
D- directly receives the superficial epigastric vein
E- directly receives the profunda femoris vein.

A- is medial to the femoral artery
B- is lateral to the femoral canal
C- directly receives the greater (long) saphenous vein
E- directly receives the profunda femoris vein

Which is/are true: These muscles are inserted into the greater trochanter of the femur exept:
A- gluteus maximus
B- gluteus medius
C- gluteus minimus
D- piriformis
E- obturator externus

A- gluteus maximus

Which is/are true for The Adductor (subsartorial) Canal?
A- is bounded laterally by the vastus lateralis muscle
B- contains the profunda femoris vessels
C- contains a large arterial branch which takes part in the
anastomosis round the knee joint
D- contains the nerve to the vastus medialis muscle
E- contains the saphenous nerve.

C- contains a large arterial branch which takes part in the
anastomosis round the knee joint
D- contains the nerve to the vastus medialis muscle
E- contains the saphenous nerve

Which is/are true for the Femoral Canal?
A- is the lateral compartment of the femoral sheath
B- contains some lymph vessels
C- at its proximal end is posterior to the inguinal ligament
D- at the proximal end is medial to the femoral vein
E- contains the femoral branch of the genitofemoral nerve

B- contains some lymph vessels
C- at its proximal end is posterior to the inguinal ligament
D- at the proximal end is medial to the femoral vein

Which is/are true for the Obturator Nerve?
A- has an anterior branch which is anterior to the adductor
longs muscle
B- supplies both the hip and knee joints
C- has no cutaneous branches
D- has a posterior branch which supplies the obturator
externus muscle
E- is lateral to the ureter in the pelvis

B- supplies both the hip and knee joints
D- has a posterior branch which supplies the obturator
externus muscle
E- is lateral to the ureter in the pelvis

Which is/are true for the piriformis muscle?
A- is attached to the greater trochanter
B- emerges from the pelvis through the greater sciatic foramen
C- Is a lateral rotator of the thigh at the hip
D- is inferior to the gluteus medius in the buttock
E- has the sciatic nerve emerging inferior to its lower border

(Everything)

A- is attached to the greater trochanter
B- emerges from the pelvis through the greater sciatic foramen
C- Is a lateral rotator of the thigh at the hip
D- is inferior to the gluteus medius in the buttock
E- has the sciatic nerve emerging inferior to its lower border

Which is/are true for the Femoral nerve?
A- continues as a cutaneous branch which runs along the
lateral border of the foot
B- supplies the iliacus muscle
C- supplies the pectineus muscle
D- supplies the obturator externus muscle
E- lies within the femoral sheath.

B- supplies the iliacus muscle
C- supplies the pectineus muscle

Which is/are true for the Deep Fascia of the thigh?
A- is attached to the inguinal ligament
B- is deep to the great (long) saphenous vein
C- transmits only veins
D- receives the insertion of the whole of the tensor fasciae
late muscle
E- contains the saphenous opening which is situated 3 cm
below and medial to the pubic tubercle.

A- is attached to the inguinal ligament
B- is deep to the great (long) saphenous vein
D- receives the insertion of the whole of the tensor fasciae
late muscle

Which is/are true for the Biceps Femoris muscle?
A- has a common origin with the semitendinosus muscle from the ischial tuberosity
B- has a short head which is attached to the femur medial to the attachment of the adductor magnus muscle
C- is entirely innervated by the common peroneal (lateral
popliteal) nerve
D- is superficial to the common peroneal nerve
E- is a lateral rotator of the leg on the thigh when the leg is
fullv extended at the knee joint.

A- has a common origin with the semitendinosus muscle from the ischial tuberosity
D- is superficial to the common peroneal nerve

Which is/are true with regard to the Quadriceps Femoris Muscle?
A- the rectus femoris has one attachment to the hip bone
B- the vastus intermedius is attached to the medial surface of the femur
C- the vastus lateralis has fleshy fibres extending more
distally than those of the vastus medialis
D- the lowermost fibres of the vastus medialis are vertically
arranged
E- its nerve supply comes from the lumbar and sacra spinal nerves

All false

Which is/are true for the Gluteus Maximus Muscle?
A- is attached to the intertrochanteric line of the femur
B- is attached to the iliotibial tract
C- is an extensor of the trunk on the lower limb
D- contracts during normal walking on flat ground
E- contracts during normal walking upstairs.

B- is attached to the iliotibial tract
C- is an extensor of the trunk on the lower limb
D- contracts during normal walking on flat ground
E- contracts during normal walking upstairs.

Which of the following is/are true for the Femoral Nerve?
A- gives directly or indirectly branches to the hip and knee
joints
B- gives branches to the quadriceps femoris muscle
C- gives off the lateral femoral cutaneous nerve
D- originates from the second, third and fourth lumbar spinal nerves
E- lies between the psoas and iliacus muscles external to the fascia iliaca.

A- gives directly or indirectly branches to the hip and knee
joints
B- gives branches to the quadriceps femoris muscle
D- originates from the second, third and fourth lumbar spinal nerves
E- lies between the psoas and iliacus muscles external to the fascia iliaca.

Which is/are true for the p popliteal artery
A- is anterior to the popliteal vein
B- is anterior to the tibial (medial popliteal) nerve
C- is anterior to the popliteus muscle
D- divides into the anterior and posterior tibial arteries at the lower border of the popliteus muscle
E- is lateral to the semimembranosus muscle.

A- is anterior to the popliteal vein
B- is anterior to the tibial (medial popliteal) nerve
D- divides into the anterior and posterior tibial arteries at the lower border of the popliteus muscle
E- is lateral to the semimembranosus muscle.

Which is/are true for the Psoas Major Muscle
A- is innervated by the anterior primary rami of the first three lumbar spinal nerves
B- is attached to the lesser trochanter
C- is an extensor of the thigh at the hip
D- is lateral to the femoral nerve
E- in its upper part is posteromedial to the ureter.

A- is innervated by the anterior primary rami of the first three lumbar spinal nerves
B- is attached to the lesser trochanter
E- in its upper part is posteromedial to the ureter.

Which is/are true for the femoral triangle?
A- is bounded below and medically by the adductor brevis muscle
B- has a floor formed by the iliacus muscle, the psoas major tendon, the pectineus mucle and the adductor longus muscle
C- Contains the femoral vessels with the femoral nerve medial to them
D- is roofed over by the fascia Latae of the thigh
E- contains the obturator nerve

B- has a floor formed by the iliacus muscle, the psoas major tendon, the pectineus muscle and the adductor longus muscle.
D- is roofed over by the fascia lata of the thigh

Which is/are true for the Right Gluteus Medius Muscle
A- is attatched to the lateral side of the greater torachanter
B- is innervated by the inferior gluteal nerve
C- is essential for normal walking on flat ground
D- is an abductor of the thigh at the hip
E- is usually contracted when standing on the right lower limb

A- is attatched to the lateral side of the greater trochanter
C- is essential for normal walking on flat ground
D- is an abductor of the thigh at the hip
E- is usually contracted when standing on the right lower limb