313 Questions
What is the primary function of the corticopontocerebellar pathway?
Motor coordination and control
Which of the following is a common symptom of cerebellar lesions?
Dysmetria
What is the term for the inability to make rapidly alternating movements?
Dysdiadochokinesia
What is the primary output of the cerebellum that is affected in cerebellar lesions?
Corticospinal tract
What is the term for the inability to coordinate muscle activity during voluntary movement?
Ataxia
What is the primary region of the brain affected in cerebellar lesions?
Cerebellum
What is the primary function of the vestibulospinal tract?
Balance in response to head movements
Which part of the cerebellum is involved in regulating equilibrium?
Floculonodular lobe
What is the primary function of the dentate and interposed nuclei?
Influence on voluntary movements
What is the primary function of the fastigial nucleus?
Regulation of balance and coordination
What is the primary function of the superior cerebellar peduncle (SCP)?
Transmission of signals from the cerebellum to the cortex
What is the primary function of the vestibulocerebellum?
Coordination of eye movements
Which cranial nerves originate from specific locations outside the brainstem?
CN I and II
What type of fibers carry general sensation such as touch, pressure, and pain?
GSA
Which motor fibers are responsible for controlling involuntary muscles?
GVE
What is the term for motor fibers that control voluntary muscles that developed from branchial arches?
SVE
Which cranial nerve nucleus sends innervation to the contralateral muscle?
Trochlear nucleus
What is the term for the pathway from the cortex to the cranial nerves nuclei in the brainstem?
Corticonuclear pathway
What is one of the roles of the cerebellum mentioned in the text?
Fine tuning of skilled motor functions
Which function does the cerebellum NOT play a role in, as per the text?
Memory recall
Which of the following is NOT influenced by the cerebellum as mentioned in the text?
Muscle growth
What does the cerebellum compare in order to correct movements?
What joints/muscles really did and what the cortex said to do
What does the cerebellum allow you to do without overshooting?
Start and stop movements without overshooting
What does hypotonia refer to in terms of muscle tone?
Low muscle tone
Which term describes the lack of coordination between muscles or body parts normally working together?
Asynergia
What does asynergy lead to when severe?
Decomposition of movement
Which part of the nervous system is responsible for asynergia?
Central Nervous System
Which cranial nerve does not innervate the ipsilateral (same) side?
CN I
Which cranial nerve passes through the cranial foramen to reach peripheral targets in the face/neck?
CN V
What is the primary function of spinal reflexes?
To maintain homeostasis
What is the integrating center for spinal reflexes?
Gray matter of the spinal cord
What is the pathway followed by nerve impulses that produce a reflex?
Reflex arc
What type of reflex exhibits reciprocal innervation?
Somatic reflex
What is the function of the stretch reflex?
To control muscle length
What is the sequence of components in a reflex arc?
Receptor, sensory neuron, integrating center, motor neuron, effector
What is the primary function of the stretch reflex?
To maintain posture
What is the role of the Golgi tendon organs in the tendon reflex?
To activate interneurons
What is the purpose of the crossed extensor reflex?
To maintain balance
What is the term for the reflex that is a test for dysfunctional corticospinal tract?
Babinski's reflex or Extensor Plantar Reflex
What is the result of the flexor reflex on the affected limb?
Flexion of the joints
What is the type of reflex arc involved in the tendon reflex?
Polysynaptic
What is the normal response to stroking the outside sole from heel to toe with a pointed object?
Downward (flexor) movement of all toes
In which age group does the Babinski reflex cause an upward (extensor) movement of the big toe?
Infants under 1.5 years of age
What is the purpose of the Achilles Reflex test?
All of the above
What is the typical result of the Achilles Reflex test in disk herniation at the L5-S1 level?
The reflex is absent
What is the effect of peripheral neuropathy on the Achilles Reflex test?
The reflex is reduced
Where do the corticobulbar and corticospinal tracts originate from?
Cortex
What is the function of the corticospinal tract?
Voluntary motor control of skeletal muscles
Where do the lower motor neurons of cranial nerves have their cell bodies?
Motor nuclei of cranial nerves in the brainstem
What is the pathway of the corticospinal tract in the spinal cord?
Antero-lateral white columns
Where do the upper motor neurons terminate?
Cranial nerve nuclei in the brainstem
What is the function of the lower motor neurons?
Innervation of muscles
What is the primary function of the motor tracts of the spinal cord?
To relay motor instructions to the spinal cord
What are the two classifications of the motor tracts of the spinal cord?
Pyramidal and extrapyramidal tracts
What is the primary function of the corticospinal tract?
To coordinate, precise, and voluntary skeletal muscle movements
Where are the upper motor neurons (UMNs) of the pyramidal tracts located?
In the cerebral hemispheres' motor cortex
At what level do the majority of the corticospinal tract fibers cross?
Medulla and spinal cord
What is the function of the axons of the lower motor neurons (LMNs)?
To exit the spinal cord as the ventral root of the spinal nerve
What type of tracts regulate body movements that are subconscious or postural in nature?
Extrapyramidal tracts
Which part of the spinal cord contains the lateral corticospinal tract?
Lateral column
What is the characteristic of muscles in upper motor neuron lesions?
Increased muscle tone
What is the destination of the axons of the lower motor neurons (LMNs)?
Skeletal muscles
What inputs does the corticospinal tract receive?
From the sensory cortex, cerebellum, and others
What is the pathway of the descending fibers of the corticospinal tract?
Internal capsule, crus cerebri, pons, medulla
What is the primary function of the upper motor neuron?
Control of movement, determining which LMN will be active
What is the result of damage to the lower motor neuron?
Flaccid paralysis
What is the term for the increased muscle tone due to prolonged contraction?
Spasticity
Which type of paralysis occurs due to the loss of control from the upper motor neuron?
Spastic paralysis
What is the term for the muscle twitching seen in lower motor neuron lesions?
Fasciculations
What is the primary function of the corticospinal tracts?
Control of movement, determining which LMN will be active
What is the function of the pontine reticulospinal tract?
Enables extension of the legs to maintain postural support
What is the role of the spinomesencephalic tract in pain modulation?
It carries pain information from the dorsal horn to the periaqueductal gray region
What is the decussation pattern of the medullary reticulospinal tract?
It has both crossed and uncrossed fibers
Where do the reticulospinal tracts terminate?
The anterior grey horn of the spinal cord
What is the function of the periaqueductal gray region in pain modulation?
It sends impulses to the dorsal horn to block the release of Substance P
What is the role of the reticulospinal tracts in postural changes?
They enable extension of the legs to maintain postural support
What is the length of the spinal cord?
40-45 cm
Where does the spinal cord start from?
Medulla oblongata
What is the function of the cervical enlargement of the spinal cord?
Innervating the upper limbs
At what level does the spinal cord end in adults?
L1/L2 intervertebral disc
Why does the spinal cord extend as low as the level of the L3 vertebra in newborn infants?
Due to the growth of the vertebral column
What is the shape of the spinal cord when viewed externally?
Cylinder with two enlargements
What is the section of the spinal cord that gives rise to a pair of spinal nerves known as?
Segment
Where are the cell bodies of the sensory neurons associated with the dorsal root of a spinal nerve located?
Ganglion
What is the bundle of roots that includes the lumbar, sacral, and coccygeal spinal nerves called?
Cauda equina
What housing structure contains the dorsal root ganglion associated with the sensory neurons of the spinal nerves?
Cell body city
How many cervical segments are present in the spinal cord?
8
At which level does the spinal cord end in relation to vertebrae?
LI
Where are the cell bodies of the sympathetic neurons located in the spinal cord?
Lateral horns in T1 to L2 segments
Which part of the gray matter in the spinal cord contains the motor neurons cell bodies?
Ventral horns
In which column of the spinal cord's white matter are myelinated nerve fibers organized for postural movements?
Lateral column
Which segment of the spinal cord has a larger representation of parasympathetic neurons?
S2 to S4
What type of neurons are housed in the dorsal horns of the spinal cord?
Sensory neurons
The lateral horns of the spinal cord's T1 to L2 segments contain the cell bodies of neurons responsible for __________.
Regulation of fight or flight responses
What is the function of the Cranial Nerve VIII?
Special Somatic Afferent for hearing and balance
Which Cranial Nerve emerges from the brainstem in the lateral medulla and exits the posterior cranial fossa through the jugular foramen?
Cranial Nerve IX
What is the function of the chorda tympani branch of the facial nerve?
Carries taste perception from the anterior 2/3 of the tongue
What is the function of the GVE axons in the Glossopharyngeal Nerve?
Innervate the parotid gland for secretomotor function
Which of the following is NOT an extracranial branch of the facial nerve?
Greater petrosal nerve
What is the function of the SVA axons in the Glossopharyngeal Nerve?
Carry taste perception from the posterior 1/3 of the tongue
What is the function of the stapedius muscle?
Helps to dampen sounds
Which part of the cortex is responsible for processing taste information?
Insula
What is the function of the GVA axons in the Glossopharyngeal Nerve?
Carry general visceral afferent sensations from the carotid body
What is the function of the GSA axons in the Glossopharyngeal Nerve?
Carry general somatic afferent sensations from the skin and posterior 1/3 of the tongue
What is the function of the posterior auricular branch of the facial nerve?
Carries general sensory fibers to the skin behind the ear
Which of the following is a type of modality transmitted by the facial nerve?
All of the above
Which cranial nerve is responsible for the voluntary motor function of the tongue?
CN XII
What is the typical presentation of a patient with a CN XII injury?
Tongue deviation to the same side as the injury
Which muscle is innervated contralaterally by the cortex?
Genioglossus
What is the function of the spinal accessory nerve (CN XI)?
Voluntary motor function to the Sternocleidomastoid and Trapezius muscles
What is the typical response to a CN IX sensory problem?
No response
What is the pathway of the CN XI nerve?
Begins at the medulla and exits the cranium via the jugular foramen
What could be a potential cause of Bell's Palsy?
Injury to the facial nerve
Which type of nerve damage would likely result in dry eye or mouth in Bell's Palsy?
Damage to the GVE component of the nerve
What symptom would likely arise from damage to the SVE portion of the facial nerve?
Paralysis of facial muscles
In a Bell's Palsy patient, what might be the outcome of touching cotton gauze to the left eye only?
Only left eye blinks
Which area of the nerve being damaged could lead to impairment of taste in Bell's Palsy?
SVA component
What type of damage to the facial nerve would cause weakness, twitching, or paralysis of facial muscles in Bell's Palsy?
Damage to SVE component
What does the Vagus nerve innervate in the majority of the muscles of the pharynx, larynx, and soft palate?
Motor axons for moving food towards the esophagus during swallowing
What anatomical region is innervated by the GSA axons of the Vagus nerve?
Skin posterior to the ear
What senses does the SVA axons of the Vagus nerve carry from the taste regions?
Taste stimuli
What is the function of the GVE axons of the Vagus nerve related to the viscera?
Innervating thoracic and abdominal viscera
What nerves branch off from the Vagus nerve in case of injury, affecting the muscles of the larynx/voice box?
Motor axons
What is a common patient presentation of Vagus nerve injury related specifically to the nerves traveling posterior to the thyroid?
Difficulty producing speech
What is the primary function of the dorsal spinocerebellar tract?
Coordinating limb movements and maintaining posture
In which region of the brain does the medial lemniscus synapse with the third-order neuron?
Thalamus
What is the destination of the axon of the third-order neuron in the somatosensory pathway?
Somatosensory area of the cerebral cortex
Where does the axon of the first-order neuron synapse with the second-order neuron?
Nucleus gracilis and nucleus cuneatus
What is the function of the proprioceptive information transmitted by the dorsal spinocerebellar tract?
Regulating posture and coordinating limb movements
What is the characteristic of the pathway of the second-order neuron in the somatosensory pathway?
Contralateral and ascending
What is the main function of the dorsal spinocerebellar tract?
it transmits information from the spinal cord to the cerebellar cortex
Where do the axons of the second-order neurons form in the spinal cord?
in the lateral column
What is the role of the nucleus dorsalis in the dorsal spinocerebellar tract?
it is the site where the first-order neurons synapse with the second-order neurons
Which tract conveys unconscious proprioception from the upper limb to the cerebellum?
cuneocerebellar tract
What is the primary function of the anterolateral system?
it mediates conscious perception of nondiscriminative touch, pain, and temperature
What is the pathway of the axons originating from the posterior roots of the lower lumbar and sacral segments?
they ascend in the fasciculus gracilis and then enter the nucleus dorsalis
Where is the first-order neuron of the spinothalamic tract located?
Dorsal root ganglion of the spinal nerve
What is the neurotransmitter used at the synapse between the first- and second-order neurons of the spinothalamic tract?
Substance P
What is the function of the anterior spinothalamic tract?
Conveying non-discriminative touch
What is the result of the axon of the second-order neuron decussating in the spinothalamic tract?
It ascends through the lateral column of the spinal cord
What is the significance of the somatosensory map of the postcentral gyrus?
It represents the sensory receptors of the body
What is the concept behind the 'gate pain theory'?
The mind can control pain through willpower
What is the primary function of the spinoreticular tract?
To provide an afferent pathway for the reticular formation influencing levels of consciousness
Where do the axons of the second-order neurons in the spinoreticular tract ascend?
In the lateral white column of the spinal cord
What is the origin of the first-order neuron in the spinoreticular pathway?
Peripheral receptor
Where do the fibres of the spinoreticular tract terminate?
In the medulla oblongata, pons, and midbrain
What type of neurons are involved in the spinoreticular tract?
Sensory neurons
What is the function of the reticular formation in the spinoreticular tract?
To influence levels of consciousness
What is the role of the spino-olivary tract in the body?
Regulation of body movements and limbs
Where do the axons of the second-order neurons in the spino-olivary tract synapse?
In the inferior olivary nuclei in the medulla
What is the role of the PAG in relation to pain?
Activation of descending analgesia system
Where do the axons of the third-order neurons in the spino-olivary tract enter?
The cerebellum through the inferior cerebellar peduncle
What is the pathway of the spino-olivary tract in the spinal cord?
Antero-lateral white columns
What is the origin of the first-order neuron in the spino-olivary tract?
Peripheral receptor
What is the shape of the sacrum bone?
Wedge-shaped
What articulates with the 5th lumbar vertebra?
Upper border of the sacrum
What is the function of the posterior sacral foramina?
Passage for posterior rami of S1-S4 nerves
What is the name of the bony ridges on the posterior surface of the sacrum?
Sacral crests
How many pairs of posterior sacral foramina are present on the sacrum?
4
What is the name of the bulge on the anterior surface of the sacrum?
Sacral promontory
Which part of the femur is directed upward, medialward, and a little forward?
Head
What is the function of the fovea capitis femoris?
Attachment of the ligamentum teres femoris
What is the location of the intertrochanteric line?
On the anterior aspect of the proximal end of the femur
What is the shape of the greater trochanter?
Quadrilateral
What is the location of the quadrate tubercle?
About the middle of the intertrochanteric crest
What is the shape of the lesser trochanter?
Conical
What is the primary function of the Calcaneus?
To transmit the weight of the body to the ground
What is the name of the groove on the superior surface of the Calcaneus?
Sulcus calcaneus
What is the name of the surface on the head of the Talus that articulates with the medial malleolus?
Medial surface
What is the name of the canal formed by the sulcus tali and the similar groove on the upper surface of the Calcaneus?
Sinus tarsi
How many articular facets are present on the superior surface of the Calcaneus for the Talus?
Three
What is the direction of the neck of the Talus?
Forward and medially
What is the name of the joint connecting the thigh bone to the hip bone?
Hip joint
Which region of the lower limb contains the tarsal bones?
Pes (Foot)
How many phalanges are present in the foot for the big toe?
Two
Which bone articulates superiorly with the L5th vertebra?
Sacrum
The tarsometatarsal joint is located between which foot bones?
Metatarsus and tarsus
Which bone is NOT part of the regions and bones of the lower limb according to the text?
Parietal bone
What forms the inferior border (ischiopubic ramus) of the hip bone?
Ischium Ramus and inferior ramus of pubis
Which structure articulates with the body of the pubic bone at the pubic symphysis?
Pubic crest
Where does the superior ramus of Pubis join the ilium and ischium?
Iliopectineal eminence
What structure forms the upper boundary of the obturator foramen?
Iliopectineal eminence
What will turn into the obturator canal by attachment to the margins of the obturator foramen?
Obturator groove
Which structure carries the pectineal line (pubic pecten)?
Superior ramus of pubis
What is the insertion point of the tibialis posterior muscle?
Navicular, all three cuneiforms, cuboid, and calcaneus
What is the function of the flexor hallucis longus muscle?
Flexion of the big toe at the MTP and IP joints
Which muscle is responsible for plantar flexion of the foot at the ankle joint and flexion of the leg at the knee joint?
Plantaris
What is the origin of the flexor digitorum longus muscle?
Middle 1/3 of tibia
What is the function of the popliteus muscle?
Flexion of the leg at the knee joint and medial rotation of the leg
What is the insertion point of the calcaneus via the Achilles tendon?
Calcaneus
What is the function of the Gastrocnemius muscle?
Plantar flexion of the foot (ankle joint)
Which nerve is responsible for the function of plantar flexion and inversion of the foot?
Tibial Nerve
What is the origin of the Soleus muscle?
Soleal line of tibia and head of the fibula
What is the function of the Triceps Surae muscle group?
Plantar flexion of the foot and flexion of the leg
What is the role of the Gastrocnemius and Soleus muscles in venous blood return?
They act as a secondary heart
What is the insertion of the Gastrocnemius and Soleus muscles?
Calcaneus via calcaneal (Achilles) tendon
What is the function of the Tibialis anterior muscle?
Dorsiflexion of foot at ankle joint
Which muscle is responsible for extension of the big toe at MTP and IP joints?
Extensor hallucis longus
What is the origin of the Extensor digitorum longus muscle?
Proximal 2/3 of anterior surface of tibia and interosseous membrane
What is the function of the Popliteus muscle?
Unlocking the knee
What is the innervation of the Tibialis anterior muscle?
Deep fibular (peroneal) nerve
What is the insertion of the Extensor hallucis longus muscle?
Base of the distal phalanx of the big toe
What is the origin of the Fibularis (peroneus) tertius muscle?
Anterior surface of fibula and interosseous membrane
What is the primary function of the Fibularis (peroneus) longus muscle?
Eversion of the foot at the subtalar joint
Which compartment of the leg contains the Fibularis (peroneus) brevis muscle?
Superficial fibular (peroneal) compartment
What is the insertion of the Fibularis (peroneus) tertius muscle?
Base of the 5th metatarsal
Which nerve innervates the Fibularis (peroneus) longus muscle?
Superficial peroneal (fibular) nerve
What is the primary function of the Fibularis (peroneus) brevis muscle?
Eversion of the foot at the subtalar joint
What is the insertion point of the quadriceps femoris muscle?
Base of patella via the quadriceps tendon
What is the function of the articularis genus muscle?
Elevation of the capsule and the synovial membrane of the knee joint
Which nerve is responsible for the innervation of the pectineus muscle?
Femoral nerve
What is the origin of the adductor brevis muscle?
Body and inferior ramus of pubis
What is the function of the adductor longus muscle?
Adduction and flexion of the thigh at the hip joint
What is the insertion point of the adductor longus muscle?
Middle part of linea aspera
What is the origin of the Sartorius muscle?
Anterior superior iliac spine
Which quadriceps femoris muscle originates from the medial lip of the linea aspera?
Vastus medialis
What is the function of the Psoas Major muscle?
Flexion of the thigh
Which nerve innervates the Extensor muscles of the knee joint?
Femoral Nerve
What is the insertion of the Rectus femoris muscle?
Base of the patella via the quadriceps tendon
What is the function of the Vastus lateralis muscle?
Extension of the knee joint
What is the origin of the posterior head of the adductor magnus muscle?
Ischial tuberosity
What is the function of the anterior head of the adductor magnus muscle?
Adducts the thigh at the hip joint
What is the innervation of the adductor magnus muscle?
Tibial nerve and obturator nerve
What is the insertion of the gracilis muscle?
Proximal part of the medial surface of the shaft of the tibia
What is one of the functions of the gracilis muscle?
Flexes the leg at the knee joint
What is the term for the combined tendons of insertion of the Sarterious, Gracilis, and Semitendinosus muscles?
Pes Anserinus
What is the shape of the femoral canal in the upper femoral triangle?
Inverted cone
What is the term for the gait pattern seen in patients with cerebral palsy, associated with the adductor muscles?
Scissor's Gait
What is the role of the Gracilis muscle in surgical reconstruction?
Surgical reconstruction
What is the term for the contents of the femoral triangle, using the mnemonic 'NAVEL'?
Nerve, Artery, Vein, Empty Space, Lymph
What is the name of the muscle also known as the 4th hamstring?
Adductor Magnus
What muscle is responsible for flexing the thigh and lateral rotation of the thigh?
Psoas Major
Which nerve innervates the Adductor Muscles of the hip joint?
Obturator Nerve
Which muscle is considered part of the iliopsoas due to its distal attachment on the femur's lesser trochanter?
Iliacus
Which muscle is NOT part of the Extensor Muscles of the knee joint?
Adductor Longus
Which of the following functions is NOT performed by the Psoas Major muscle?
Abduction of the thigh
Which nerve innervates the Psoas Major muscle?
Femoral Nerve
What type of joint is the intercoccygeal joint classified as?
Synarthrosis
What is the function of the extensor digitorum brevis muscle?
To extend the toes
What is the type of joint that the pubic symphysis is classified as?
Cartilaginous symphysis
What is the origin of the extensor hallucis brevis muscle?
Dorsal surface of the calcaneus
What is the relationship between the motion of the SI joints and the symphysis pubis?
Motion at the SI joints must be accompanied by motion at the symphysis pubis
Which muscle is responsible for abducting the big toe?
Abductor hallucis
What is the name of the fascia that lies deep to the first layer of muscles in the sole of the foot?
Plantar fascia
How many muscles are present in the first layer of the sole of the foot?
4
Which muscle is also known as the flexor accessorius?
Quadratus plantae
How many dorsal interossei muscles are present in the fourth layer of the sole of the foot?
4
Which muscle has its origin at the medial process of the tuberosity of the calcaneus?
Flexor digitorum brevis
What is the insertion point of the flexor digiti minimi brevis muscle?
Base of the proximal phalanx of the 5th toe
Which muscle has its origin at the cuboid and 3rd (lateral) cuneiform?
Flexor hallucis brevis
What is the insertion point of the adductor hallucis muscle?
Base of the proximal phalanx of the great toe
Which muscle has its origin at the adjacent sides of metatarsal bones?
Dorsal interossei
What is the insertion point of the quadratus plantae muscle?
Tendon of the flexor digitorum longus
Which pelvic joint is often the site of low back pain following childbirth?
Sacroiliac joint
Which joint of the pelvis sustains more than three times the body weight with each step?
Hip joint
Which region of the body transmits large forces between the trunk and the ground?
Pelvic region
What type of joint is the sacroiliac joint classified as?
Gliding joint
Which joint in the pelvis transmits forces from the head, arms, and trunk to the lower extremities?
Lumbosacral joint
Which statement about the hip joints is accurate?
Hip joints are the most structurally stable, yet mobile, joints in the body.
What is the primary difference between the coverage of the sacral surface and the iliac surface in the sacroiliac (SI) joint?
Hyaline cartilage on the sacral surface versus fibrocartilage on the iliac surface
Which ligament fills the space between the sacrum and the inner side of the iliac tuberosity in the sacroiliac (SI) joint?
Interosseous ligament
What provides excellent leverage to hold the distal aspect of the sacrum in place against anterior weightbearing forces in the sacroiliac (SI) joint?
Sacrotuberous ligaments
Which ligaments run obliquely upward and outward from the sacrum in the sacroiliac (SI) joint, creating a self-locking mechanism?
Interosseous and posterior sacroiliac ligaments
How is the sacrococcygeal joint classified, depending on the subject's age?
Symphysis (secondary cartilaginous) synarthrosis joint
What creates the self-locking mechanism in the sacroiliac (SI) joint by compressing the sacrum between them?
Interosseous and posterior sacroiliac ligaments
Where does the arcuate popliteal ligament arise from?
The posterior aspect of the fibular head
What is the function of the collateral ligaments in the knee?
To provide transverse stability during extension
Where is the anterior cruciate ligament (ACL) attached to in the tibia?
The anterior intercondylar area
Which ligament runs from the lateral epicondyle of the femur to the head of the fibula?
Lateral collateral ligament
What happens to the collateral ligaments during flexion of the knee?
They become slackened
Where are the cruciate ligaments located in the knee joint?
In the center of the knee joint, within the intercondylar notch and fossa
What is the attachment point of the posterior cruciate ligament on the tibia?
Posterior intercondylar area
What is the shape of the medial meniscus?
C-shaped
What is the function of the cruciate ligaments in the knee joint?
To stabilize the joint in the antero-posterior direction
What is the attachment point of the horns of the menisci?
Tibial condyle
What is the ligament that links the two anterior horns of the menisci?
Transverse ligament of the knee
What is the location of the cruciate ligaments in relation to the synovial membrane?
Intracapsular and extrasynovial
What anatomical feature is present on the head for the attachment of the round ligament of the head?
Fovea
What is defined by the increase in the angle of anteversion of the femur?
Anteversion
In adults, what angle does the head of the femur form with the femoral plane?
10-30 degrees
What is the effect of a decrease in the angle of anteversion in the femur?
Out-toeing
What is the primary direction in which the acetabulum is oriented?
Laterally, inferiorly, and anteriorly
How is femoral anteversion usually affected with the growth and development of children?
Decreases
Which ligament limits lateral rotation and abduction of the hip?
Pubofemoral ligament
What is the function of the iliofemoral ligament?
Covers the hip joint anteriorly and superiorly
Which structure winds the fibers of the hip joint capsule and increases stability by pulling the femur tightly into the acetabulum?
Iliofemoral ligament
Which ligament covers the hip joint anteriorly and superiorly?
Ischiofemoral ligament
In what direction do the fibers of the fibrous layer of the hip joint capsule unwind during flexion?
Obliquely
Which ligament limits medial rotation of the hip joint?
Ischiofemoral ligament
What is the name of the structure that lodges the two intercondylar tubercles?
Intercondylar eminence
Which part of the tibial surface acts as a pivot to allow axial rotation?
Middle eminence
What reinforces the knee joint capsule, forming part of its complexity?
Ligaments
Where does the proximal tendon of the popliteus muscle attach?
Lateral femoral condyle
Which muscle forms part of the oblique popliteal ligament and gives off fibers to the MCL and its large bony attachment?
Semimembranosus muscle
What allows the tibia to rotate around and shorten the intercondylar eminence?
Intercondylar notch
What is the role of the iliotibial tract in the lower limb?
It forms a band that invests the tensor fascia lata muscle
Which muscle is situated on the outer surface of the pelvis?
Gluteus medius
What is the origin of the gluteus maximus muscle?
Posterior iliac crest, sacrum, and coccyx
What is the main function of the gluteus maximus muscle?
Knee stability and extension of the hip joint
What is the deep fascia of the thigh also known as?
Fascia lata
What is the relationship between the gluteus maximus and gluteus medius muscles?
The gluteus maximus muscle covers the posterior third of the gluteus medius muscle
Where does the Superior gemellus muscle originate?
Ischial spine
Which nerve innervates the Quadratus femoris muscle?
Nerve to quadratus femoris
What is the common function of the Deep Gluteal Muscles?
Hip joint extension
Where does the Gluteus minimus muscle insert?
Lateral surface of greater trochanter
What causes the Trendelenburg Sign & Gait?
Deep Gluteal Muscles weakness
Where does the Inferior gemellus muscle insert?
Medial surface of greater trochanter
Which nerve innervates the sartorius muscle despite it being located in the anterior compartment of the thigh?
Femoral nerve
Which nerve innervates most of the adductor muscles in the thigh except for the pectineus muscle?
Obturator nerve
Which nerve innervates the adductor magnus muscle in the thigh, providing dual innervation to this muscle?
Tibial nerve
Which nerve innervates the hamstring muscle known as the biceps femoris?
Sciatic nerve
Where does the hamstring muscle semitendinosus have its insertion point?
Proximal part of the medial surface of the tibia
Which hamstring muscle has its insertion on the posterior aspect of the medial condyle of the tibia?
Semimembranosus
Study Notes
Cerebellum
- Affects ipsilateral motor function, balance, and posture
- Fine-tunes skilled motor functions through feedback loops
- Initiates, terminates, coordinates, and times movements
- Plans motor movements, including motor learning
Cerebellum Anatomy
- Anterior and posterior lobes: provide subconscious movements
- Floculonodular lobe: regulates equilibrium
- Vermis: a "worm-like" part separating the two hemispheres
- Folia: gyri-like convolutions on the surface of the cerebellum
- Internal anatomy includes:
- White matter (arbor vitae)
- Gray matter (cortex) surrounding the arbor vitae
- Deep nuclei: dentate, interposed, fastigial
- Peduncles: superior, middle, and inferior
Functional Divisions of the Cerebellum
- Vestibulocerebellum (floculonodular lobe): coordinates balance, eye movements, and equilibrium
- Spinocerebellum: involved in motor coordination and learning
- Cerebrocerebellum: integrates cognitive and motor functions
Cerebellar Lesions
- Causes ataxia (loss of motor coordination)
- Symptoms include:
- Dysmetria (inability to judge distance)
- Dysdiadochokinesia (loss of alternating movement)
- Asynergia (lack of coordination between muscle groups)
- Intention tremor
Cranial Nerves
- 12 pairs, exiting the base of the brain and brainstem
- Pass through cranial foramina to reach peripheral targets in the face and neck
- Functions include:
- Motor control
- Sensory reception
- Special senses (taste, smell, vision, hearing, balance)
Motor Component of Cranial Nerves
- UMNs (upper motor neurons) in the cortex send bilateral innervation to cranial nerve nuclei
- LMNs (lower motor neurons) in the brainstem and spinal cord send ipsilateral innervation to muscles
- Exceptions: CN IV (trochlear nerve) innervates the contralateral superior oblique muscle
Reflexes and Reflex Arcs
- A reflex is a fast, involuntary response to a stimulus
- Reflex arcs include:
- Receptor
- Sensory neuron
- Integrating center
- Motor neuron
- Effector
- Types of reflexes:
- Somatic reflexes (spinal cord)
- Autonomic reflexes (visceral)
- Stretch reflex (muscle length control)
- Tendon reflex (muscle tension control)
- Flexor (withdrawal) reflex (pain withdrawal)
Spinal Cord
- Extends from the medulla oblongata to the level of L1/L2
- External features:
- Cylindrical shape with cervical and lumbar enlargements
- Ventral (anterior) median fissure and dorsal (posterior) median sulcus
- Ventral and dorsal rootlets forming the ventral and dorsal roots of spinal nerves
- Internal features:
- Gray matter (sutural horn, ventral horn, dorsal horn)
- White matter (tracts)
Motor Pathways
- Pyramidal tracts (corticospinal and corticobulbar)
- Extrapyramidal tracts (rubrospinal, tectospinal, vestibulospinal, reticulospinal)
- UMNs (cerebral cortex, brainstem) -> LMNs (brainstem, spinal cord) -> muscles### Internal Features of the Spinal Cord
- The spinal cord consists of gray matter and white matter
- Gray matter is shaped like an "H" with a ventral (anterior) horn and a dorsal (posterior) horn on each side
- The right and left halves of the gray matter are connected by a narrow strip called the gray commissure, which contains the central canal
- In some segments (T1 to L2 and S2 to S4), there is a third horn between the ventral and dorsal horns, known as the lateral horn
- Lateral horns of T1 to L2 segments contain cell bodies of sympathetic neurons
- Lateral horns of S2 to S4 segments contain cell bodies of parasympathetic neurons
- Ventral horns contain cell bodies of motor neurons
- Dorsal horns contain cell bodies of sensory neurons
White Matter of the Spinal Cord
- White matter surrounds the gray matter and is organized into ventral, lateral, and dorsal columns (funiculi) on each half of the spinal cord
- These columns contain bundles of myelinated nerve fibers (tracts) that travel along the length of the spinal cord
Cranial Nerves
Vagus Nerve (CN X)
- Has five modalities: BE/SVE, SVA, GVE, GVA, and GSA
- Fiber types:
- BE/SVE: innervates muscles of the pharynx, larynx, and soft palate
- SVA: carries taste perception from the root of the tongue and epiglottis region
- GVE: innervates thoracic and abdominal viscera up to the left colic flexure
- GVA: carries visceral sensation from the thoracic and abdominal viscera
- GSA: carries sensory information from skin posterior to the ear and dura in the posterior cranial fossa
- Injury to the vagus nerve can result in hoarse voice, vocal changes, and difficulty producing speech
Glossopharyngeal Nerve (CN IX)
- Has five modalities: BE/SVE, SVA, GVE, GVA, and GSA
- Fiber types:
- BE/SVE: innervates stylopharyngeus muscle
- SVA: carries taste perception from the posterior 1/3 of the tongue
- GVE: innervates the parotid gland
- GVA: carries visceral sensation from the carotid body
- GSA: carries sensory information from skin posterior to the ear and posterior 1/3 of the tongue
- Injury to the glossopharyngeal nerve can result in no response to stimulation
Facial Nerve (CN VII)
- Has five modalities: BE/SVE, SVA, GVE, GVA, and GSA
- Fiber types:
- BE/SVE: voluntary motor control to muscles of facial expression
- SVA: carries taste perception from the anterior 2/3 of the tongue
- GVE: innervates the submandibular and sublingual glands
- GVA: carries visceral sensation from the lacrimal gland
- GSA: carries sensory information from skin behind the ear
- Injury to the facial nerve can result in weakness or paralysis of facial muscles
Spinal Accessory Nerve (CN XI)
- Voluntary motor to sternocleidomastoid and trapezius muscles
- General Somatic Efferent (GSE)
Hypoglossal Nerve (CN XII)
- Voluntary motor to muscles of the tongue
- General Somatic Efferent (GSE)
- Injury to the hypoglossal nerve can result in tongue deviated to the same side as the injury
Reflexes
Corneal Reflex
- Protects the eyes from foreign bodies
- Sensory arc: CN V1 (touch to the surface of the cornea)
- Motor arc: CN VII (orbicularis oculi)
- Desired response: bilateral blinking regardless of input side
Pain Pathways
Spinothalamic Tract
- Conveys pain and temperature information to the thalamus
- First-order neuron: located in the dorsal root ganglion
- Second-order neuron: located in the dorsal horn of the spinal cord
- Third-order neuron: located in the thalamus
- Axons of the third-order neuron project to the somatosensory area of the cerebral cortex
Gate Pain Theory
- Serotonin and substance P play a role in pain modulation
- Enkephalins and endorphins are natural painkillers
Somatic Nerve Pathways
Dorsal Spinocerebellar Tract
- Conveys proprioceptive information from the trunk and lower limbs to the cerebellum
- First-order neuron: located in the dorsal root ganglion
- Second-order neuron: located in the dorsal horn of the spinal cord
- Axons of the second-order neuron form the dorsal spinocerebellar tract
- Terminates in the cerebellar cortex
Anterolateral System
- Conveys nondiscriminative touch, pain, and temperature information to the thalamus
- Divided into different tracts, including the spinothalamic tract
- First-order neuron: located in the dorsal root ganglion
- Second-order neuron: located in the dorsal horn of the spinal cord
- Third-order neuron: located in the thalamus
Bones
Hip Bone
- Composed of the ilium, ischium, and pubis
- Ilium: forms the superior and posterior part of the hip bone
- Ischium: forms the inferior and posterior part of the hip bone
- Pubis: forms the anterior and inferior part of the hip bone
Sacrum
- Composed of five fused vertebrae
- Forms the posterior wall of the pelvis
- Has five pairs of posterior sacral foramina
- Has four pairs of anterior sacral foramina
Femur
- Upper end: has a head, neck, and greater and lesser trochanters
- Body or shaft: strengthened by the linea aspera
- Lower end: has a medial and lateral condyleHere are the study notes for the provided text:
Superior Surface of the Talus
- Presents a smooth trochlear surface for articulation with the inferior surface of the distal end of the tibia
- Forms a canal (sinus tarsi) with the calcaneus, filled with the interosseous talocalcaneal ligament
Inferior Surface of the Talus
- Presents two articular areas: the posterior and middle calcaneal surfaces, separated by a deep groove (sulcus tali)
Neck of the Talus
- Directed forward and medially, located between the body and the head of the talus
Head of the Talus
- Looks forward and medially, with an anterior articular or navicular surface that is oval and convex
- Articulates with the medial malleolus
Calcaneus
- The largest of the tarsal bones
- Situated at the lower and back part of the foot, serving to transmit the weight of the body to the ground and forming a strong lever for the calf muscles
- Presents six surfaces
- Superior surface has three articular facets for the talus
- Sulcus (calcaneal sulcus) on the superior surface
Peroneal (Fibularis) Muscles
- Two muscles in the lateral compartment of the leg
- Innervated by the superficial peroneal (fibular) nerve
- Fibularis (peroneus) longus
- Origin: Head of fibula and interosseous membrane
- Insertion: Base of the 1st metatarsal and 1st cuneiform
- Function: (2) 1. Eversion of the foot at the subtalar joint, 2. Plantar flexion of the foot at the ankle joint
- Fibularis (peroneus) brevis
- Origin: Distal 1/2 of the lateral surface of the fibula
- Insertion: Tuberosity of the 5th metatarsal bone
- Function: (2) 1. Eversion of the foot at the subtalar joint, 2. Plantar flexion of the foot at the ankle joint
- Fibularis (peroneus) longus
Other Muscles
- Tibialis posterior
- Origin: Proximal 2/3 of the posterior surface of the tibia and fibula, and interosseous membrane
- Insertion: 2nd, 3rd, and 4th metatarsals, navicular, cuboid, and calcaneus
- Function: (2) 1. Plantar flexion of the foot at the ankle joint, 2. Inversion of the foot at the subtalar joint
- Popliteus
- Origin: Lateral surface of the lateral condyle of the femur
- Insertion: Above the soleal line on the posterior tibia
- Function: (2) 1. Flexion of the leg at the knee joint, 2. Medial rotation of the leg at the knee joint
- Gastrocnemius and soleus
- Form the triceps surae
- Function: (2) 1. Plantar flexion of the foot at the ankle joint, 2. Flexion of the leg at the knee joint
Anterior Compartment of the Leg
- Muscles innervated by the deep peroneal (fibular) nerve
- Tibialis anterior
- Origin: Lateral condyle and upper 2/3 of the lateral surface of the tibia, and interosseous membrane
- Insertion: 1st (medial) cuneiform and base of the 1st metatarsal
- Function: (2) 1. Dorsiflexion of the foot at the ankle joint, 2. Inversion of the foot at the subtalar joint
- Extensor hallucis longus
- Origin: Middle 1/3 of the anterior surface of the fibula and interosseous membrane
- Insertion: Base of the distal phalanx of the big toe
- Function: (3) 1. Extension of the big toe at the MTP and IP joints, 2. Dorsiflexion of the foot at the ankle joint, 3. Inversion of the foot at the subtalar joint
- Extensor digitorum longus
- Origin: Lateral condyle of the tibia, proximal 2/3 of the anterior surface of the fibula, and interosseous membrane
- Insertion: Middle and distal phalanges of toes 2-5
- Function: (3) 1. Extension of toes 2-5 at the MTP and IP joints, 2. Dorsiflexion of the foot at the ankle joint, 3. Eversion of the foot at the subtalar joint
- Tibialis anterior
Anatomical Structures Passing Behind the Medial Malleolus
- Mnemonics: Tom Dick Harry (or Tom Dick And Very Nervous Harry)
- Popliteal fossa
Muscles Moving the Ankle Joint, Foot, and Toes
- 4 muscles: Tibialis anterior, extensor hallucis longus, extensor digitorum longus, and fibularis (peroneus) tertius
Adductor Muscles of the Hip Joint
- Innervated by the obturator nerve
- Adductor longus
- Origin: Anterior surface of the pubis
- Insertion: Middle part of the linea aspera
- Function: (3) 1. Adduction of the thigh at the hip joint, 2. Flexion of the thigh at the hip joint, 3. Lateral rotation of the thigh at the hip joint
- Adductor brevis
- Origin: Body and inferior ramus of the pubis
- Insertion: Proximal 1/3 of the linea aspera
- Function: (3) 1. Adduction of the thigh at the hip joint, 2. Flexion of the thigh at the hip joint, 3. Lateral rotation of the thigh at the hip joint
- Adductor magnus
- Origin: Ischiopubic ramus and ischial tuberosity
- Insertion: Linea aspera and adductor tubercle
- Function: (3) 1. Adduction of the thigh at the hip joint, 2. Flexion of the thigh at the hip joint, 3. Extension of the thigh at the hip joint
- Adductor longus
Pelvic Region
- 7 joints: Lumbosacral, sacroiliac, sacrococcygeal, symphysis pubis, hip, and 2 intercoccygeal joints
- Hip joints are the most structurally stable and mobile joints in the body
- Sacroiliac joint can be a site of low back pain
- Pubic symphysis is a cartilaginous symphysis (amphiarthrosis) joint
Foot Muscles
- Dorsal surface of the foot: Extensor digitorum brevis and extensor hallucis brevis
- Sole of the foot: 4 layers of muscles
- 1st layer: Abductor hallucis, flexor digitorum brevis, abductor digiti minimi, and plantar fascia
- 2nd layer: Flexor hallucis longus tendon, flexor digitorum longus tendon, quadratus plantae, and lumbricals
- 3rd layer: Flexor hallucis brevis, adductor hallucis, flexor digiti minimi brevis, and plantar interossei
- 4th layer: Dorsal interossei
Test your knowledge on the neuroanatomy of the cerebellum and introduction to cranial nerves. This quiz covers topics like the effects on ipsilateral motor function, balance, posture, and fine-tuning of skilled motor functions through feedback mechanisms.
Make Your Own Quizzes and Flashcards
Convert your notes into interactive study material.
Get started for free
