ANATOMY TEST QUESTIONS FOR UPPER AND LOWER LIMB - Copy.docx

NILL

1. MINISTRY OF HEALTH AND SANITATION
SCHOOL OF CLINICAL SCIENCES MAKAMBO, MAKENI
ANATOMY SECOND SEMESTER TEST SAQs 24/11/2022
ANSWER Any 6 QUESTIONS Marks 60%
TIME: 120 MINUTES
1. List the Hamstring Muscles with their blood supply and main nerve
innervating them?
2. The Hip is formed by ----- number of bones. List them. Name all the
Medial compartment muscles of the thigh.
3. Write short note on the Popliteal Fossa (Shape and location, borders,
roof and floor and give 2 contents).
4. List all the Rotator Cuff muscles. Give two (2) functions of this group
of muscles.
5. Name the All the Tarsal and Carpal bones according to their
positions.
6. Write short notes on Sciatic nerve (Name its root of origin, associated
foramen it passes through, it two branches and areas its innervates)
7. Write short note on the Brachial plexus(Listing the ROOTS,
TRUNK,DIVISIONS, CORDS and TERMINAL NERVES
8. Write short on the Carpal tunnel. (Boundaries, and structural contents
and syndrome).


GOOD LUCK

2. ANSWER TO ESSAY – ANATOMY
Qu 1. List the Hamstring Muscles with their blood supply and main nerve
innervating them?
Ans: The Hamstring Muscles are in the posterior compartment of the thigh.
They are three (3) three in number. All except the short head of the biceps femoris cross
both the hip and knee joints. As a group, the hamstring muscles flex the leg at the knee
joint and extend the thigh at the hip joint. They are also rotators at both joints.
1. The Biceps Femoris muscle is lateral in the posterior
compartment of the thigh and has two heads.
2. The Semitendinosus muscle is medial to the biceps femoris
muscle.
3. The Semimembranosus muscle lies deep to the
semitendinosus muscle in the posterior compartment of the
thigh

3. Blood supply to the Hamstring muscles.

The Femoral Artery is the main blood vessel supply of the thigh. It gives rise to the
Deep Artery of the Thigh (Profunda Femoris Artery) which is the largest branch of the
Femoral Artery. The PFA gives rise to three (3) Perforating Arteries and they (All
three) supplies the posterior compartment of the thigh.

4. Main Nerve innervating all Hamstring Muscles is the Sciatic Nerve L5, S1 & S2.

Qu 2. The Hip is formed by ----- number of bones. List them. Name all the
Medial compartment muscles of the thigh.
Ans. The hip joint is a synovial articulation between the head of the femur and the
acetabulum of the pelvic bones. The joint is a multiaxial ball and socket joint designed
for stability and weight-bearing at the expense of mobility.
The articular surfaces or bones of the hip joint are FOUR (4), they are:
a) the spherical head of the femur, and
b) the acetabulum of the pelvic bone .
Each pelvic bone is formed by three bones fused during childhood:
I. Ilium- is superior
II. Ischium – is posteroinferior
and
III. Pubis- is anteroinferior

6. Muscles of the Medial Compartment.
The medial compartment of the thigh consists of six (6) muscles that mainly adduct the
thigh at the hip joint except one, the Obturator externus which is a lateral rotator of the
thigh at the hip joint. The adductor muscles may also medially rotate the thigh.
The six (6) medial compartment muscles include:
1.Gracilis Muscle- is the most superficial
2.Pectineus Muscle - is a flat quadrangular muscle attached above to the pectineal line
of the pelvic bone

7. 3.Adductor longus Muscle - is a flat fan-shaped muscle that expands as it descends
posterolaterally and contributes to the floor of the femoral triangle,
4.Adductor brevis Muscle - lies posterior to the pectineus and adductor longus.
5.Adductor magnus Muscle - is the largest and deepest of the muscles in the medial
compartment of the thigh. The muscle forms the distal posterior wall of the adductor
canal and
6. Obturator externus) Muscle.
All except the pectineus, which is innervated by the femoral nerve, and part of the
adductor magnus, which is innervated by the sciatic nerve, are innervated by the
obturator nerve.


Qu 3. Write short note on the Popliteal Fossa (Shape and location, borders,
roof and floor and give 2 contents).
Ans: The popliteal fossa is an important area of transition between the thigh and leg
and is the major route by which structures pass from one region to the other.

8. The popliteal fossa is a diamond-shaped space behind the knee joint formed between
muscles in the posterior compartments of the thigh and leg.
The margins of the upper part of the diamond are formed:
Medially by the distal ends of the semitendinosus and semimembranosus muscles and
Laterally by the distal end of the biceps femoris muscle
The margins of the smaller lower part of the space are formed:
Medially by the medial head of the gastrocnemius muscle and
Laterally by the plantaris muscle and the lateral head of the gastrocnemius muscle.
The floor of the fossa is formed by the capsule of the knee joint and adjacent surfaces of
the femur and tibia, and, more inferiorly, by the popliteus muscle.
The roof is formed by deep fascia, which is continuous above with the fascia lata of the
thigh and below with deep fascia of the leg.
Contents of the Popliteal Fossa
The major contents of the popliteal fossa are:
the popliteal artery,
the popliteal vein, and
the tibial and common fibular nerves .
The most important structure in the superficial fascia is the small saphenous vein. This
vessel ascends vertically in the superficial fascia on the back of the leg and joins with the
popliteal vein.
The Posterior Cutaneous nerve of the thigh,

9. Qu 4. List all the Rotator Cuff muscles. Give two (2) functions of this group
of muscles.
There are four (4) muscles that group together forming the Rotator Cuff Muscles.
These include:
1. The Supraspinatus Muscle
2. Infraspinatus Muscle
3. Teres Minor Muscle and
4. Subscapularis Muscles
Tendons of the rotator cuff muscles (the supraspinatus,infraspinatus, teres minor, and
subscapularis muscles) blend with the joint capsule and form a musculotendinous collar
that surrounds the posterior, superior, and anterior aspects of the glenohumeral joint.
FUNCTION OF THE ROTATOR CUFF MUSCLE S
They stabilize and hold the head of the humerus in the glenoid cavity of the scapula
without compromising the arm's flexibility and range of motion.
They support other muscles in the Upper limb in performing their actions.

11. The tendon of the long head of the biceps brachii muscle passes superiorly through the joint and restricts upward movement
of the humeral head on the glenoid cavi
Qu 5. Name the All the Tarsal and Carpal bones according to their
positions.
Ans: There are seven (7) TARSAL BONES, which form the skeletal framework for the
ankle. These tarsal bones are arranged in a proximal group and a distal group with an
intermediate bone between the two groups on the medial side of the foot.
Proximal Group - consists of two large bones,
The Talus (Latin for "ankle") and
The Calcaneus (Latin for "heel").
Intermediate Group – Consist of one tarsal bone,
The Navicular (boat shaped)
Distal Group -- From lateral to medial, the distal group of tarsal bones consists of four
(4) bones:

12. The cuboid (Greek for "cube"), which articulates posteriorly with the calcaneus,
medially with the lateral cuneiform
Three cuneiforms (Latin for "wedge")

13. B. CARPAL BONES.
There are eight carpal bones which are the bones of the wrist.
They are arranged in two rows, a proximal and a distal row, each consisting of four
bones.
The Proximal Row - From lateral to medial and when viewed anteriorly, the proximal
row of bones consists of:
the Scaphoid – Boat-shaped,
the Lunate - Crescent shaped bone,
the three-sided Triquetrum bone, and
the Pisiform - Pea-shaped.
The Distal Row - From lateral to medial and when viewed anteriorly, the distal row of
carpal bones consists of:
the irregular four-sided trapezium bone,
the four-sided trapezoid,
the capitate, which is the largest of the carpal bones. It is like a head, and

14. the hamate, which has a hook.

15. Qu 6. Write short notes on Sciatic nerve (Name its root of origin, associated
foramen it passes through, it two branches and areas its innervates)
Ans: The Sciatic Nerve is a major nerve and the largest nerve in the body. It has a root
value of L4 to S3, originating from the Lumbosacral Plexus.
The Lumbosacral Plexus is a combination of the Lumba Trunk L4-L5 and the Sacral
Trunk S1-S4. (The anterior ramus of L4 and L5 from the Lumba Plexus combining
with the anterior rami of S 1 to S3 and part of S4 of the Sacral trunk).
The femoral nerve, and obturator nerve,are also major nerves originating from the
lumbosacral plexus together with the sciatic nerve
The Sciatic Nerve enters the gluteal region through the greater sciatic foramen inferior
to the piriformis muscle.
It descends in the plane between the superficial and deep group of gluteal region
muscles.
It lies just deep to the gluteus maximus at the midpoint between the ischial tuberosity
and the greater trochanter.
The sciatic nerve enters the posterior thigh at the lower margin of the quadratus
femoris muscle where it divides into its two major branches:
I. The Common Fibular Nerve - Posterior divisions of 14 to S2 and
II. The Tibial Nerve - Anterior divisions of 14 to S3

The sciatic nerve innervates:
A. All muscles in the posterior compartment of the thigh that flex the knee and
part of the adductor magnus originating from the ischium,
B. All muscles in the leg and foot, and
C. Skin on the lateral side of the leg and the lateral side and sole of the foot

20. Qu 7. Write short note on the Brachial plexus (Listing the ROOTS,
TRUNK, DIVISIONS, CORDS and TERMINAL NERVES

Ans: The brachial plexus is a somatic plexus formed by the anterior rami of C5 to C8,
and most of the anterior ramus of Tl. The plexus originates in the neck, passes laterally
and inferiorly over rib I, and enters the axilla.
The parts of the brachial plexus, from medial to lateral, are roots, trunks, divisions, and
cords.
All major nerves that innervate the upper limb originate from the brachial plexus,
mostly from the cords.
Proximal parts of the brachial plexus are posterior to the subclavian artery in the neck,
while more distal regions of the plexus surround the axillary artery.
The Roots - are the anterior rami of C5 to C8, and most of T l . The roots and trunks
enter the posterior triangle of the neck by passing between the anterior scalene and
middle scalene muscles and lie superior and posterior to the subclavian artery.
The Trunks – There are three trunks of the brachial plexus originating from the roots.
They pass laterally over rib I, and enter the axilla.
• The superior trunk is formed by the union of C5 and C6 roots.
• The middle trunk is a continuation of the C7 root.
• The inferior trunk is formed by the union of the C5 and Tl roots.
The Divisions
Each of the three trunks of the brachial plexus divides into an anterior and a posterior
division.

21. The three anterior divisions form parts of the brachial plexus that ultimately give rise to
peripheral nerves associated with the anterior compartments of the arm and forearm.

The three posterior divisions combine to form parts of the brachial plexus that give rise
to nerves associated with the posterior compartments.
No peripheral nerves originate directly from the divisions of the brachial plexus.
The Cords – There are three cords of the brachial plexus originating from the divisions
and are related to the second part of the axillary artery.

The lateral cord results from the union of the anterior divisions of the upper and middle
trunks and therefore has contributions from C5 to C 7-it is positioned lateral to the
second part of the axillary artery.

The medial cord is medial to the second part of the axillary artery and is the
continuation of the anterior division of the inferior trunk-it contains contributions from
C5 and Tl .

The posterior cord occurs posterior to the second part of the axillary artery and
originates as the union of all three posterior divisions-it contains contributions from all
roots of the brachial plexus (C5 to Tl).

Most of the major peripheral nerves of the upper limb originate from the cords of the
brachial plexus. Generally,
nerves associated with the anterior compartments of the upper limb arise from the
medial and lateral cords and
nerves associated with the posterior compartments originate from the posterior cord.

23. Qu 8. Write short on the Carpal tunnel. (Boundaries, and structural
contents and syndrome).
Ans: The carpal tunnel is formed anteriorly at the wrist by a deep arch formed by the
carpal bones and the flexor retinaculum.
The Base :- is formed medially by the pisiform and the hook of the hamate and laterally
by the tubercles of the scaphoid and trapezium.
The flexor retinaculum is a thick connective tissue ligament that bridges the space
between the medial and lateral sides of the base of the arch and converts the carpal arch
into the carpal tunnel.

The four tendons of the flexor digitorum profundus,
The four tendons of the flexor digitorum superficialis, and
The tendon of the flexor pollicis longus
pass through the carpal tunnel, as does the Median Nerve.

The flexor retinaculum holds the tendons to the bony plane at the wrist and prevents
them from "bowing. "
Free movement of the tendons in the carpal tunnel is facilitated by synovial sheaths,
which surround the tendons.
All the tendons of the flexor digitorum profundus and flexor digitorum superficialis are
surrounded by a single synovial sheath;
a separate sheath surrounds the tendon of the flexor pollicis longus.
The Median Nerve is anterior to the tendons in the carpal tunnel.
The tendon of the flexor carpi radialis is surrounded by a synovial sheath and passes

24. through a tubular compartment formed by the attachment of the lateral aspect of the
flexor retinaculum to the margins of a groove on the medial side of the tubercle of the
trapezium.

Note: The ulnar artery, ulnar nerve, and tendon of the palmaris longus pass into the
hand anterior to the flexor retinaculum and therefore do not pass through the carpal
tunnel.

The tendon of the palmaris longus is not surrounded by a synovial sheath.
The radial artery passes dorsally around the lateral side of the wrist and lies adjacent to
the external surface of the scaphoid.
The extensor tendons pass into the hand on the medial, lateral, and posterior surfaces of
the wrist in six compartments defined by an extensor retinaculum and lined by synovial
sheaths.

The tendons of the extensor digitorum and extensor indicis share a compartment and
synovial sheath on the posterior surface of the wrist.
The tendons of the extensor carpi ulnaris and extensor digiti rninimi have separate
compartments and sheaths on the medial side of the wrist.

The tendons of the abductor pollicis longus and extensor pollicis brevis muscles, the
extensor carpi radialis longus and extensor carpi radialis brevis muscles, and
the extensor pollicis longus muscle pass through three compartments on the lateral
surface of the wrist.