anatomy

Arterial Supply Upper Limb

Subclavian Artery

 

Origin

- on right arises from brachiocephalic trunk behind right sternoclavicular joint

- on left arises from the arch of the aorta

 

Ends

- outer border first rib as axillary artery

 

First part

- origin of artery to medial aspect scalenus anterior

- on right arches above the clavicle / lies on the pleura / RLN wraps about it

Arterial Supply Lower Limb

Femoral Artery

 

Enters thigh

- midway between ASIS and pubic symphysis

- in femoral triangle

- NAVY (nerve / artery / vein / Y fronts)

- in femoral sheath with femoral vein (transversalis fascia and psoas fascia)

- femoral nerve outside sheath / under the iliac fascia / lateral

 

Femoral triangle

 

Anatomy

- inguinal ligament superiorly

- medial border sartorius laterally

Background

Anatomy Lower Cervical Spine

 

Movement

- 50% of cervical rotation

- 60% of cervical flexion / extension

 

Uncovertebral joint

- lateral projections of body 

- medial to vertebral artery

 

Facet joints

- sagittal orientation 30 – 45o

 

Spinous processes

- bifid C3-5

- prominent C7

 

ATLS

 

Morton's Neuroma

Definition

 

Benign enlargement of the common digital branch

- usually 3rd webspace

 

Mortons Neuroma Common Site

 

Anatomy

 

Found at level of or just distal to MT heads

- deep to the deep transverse MT ligament

 

Epidemiology

 

Classically women between 40 and 60

Flexor Tendon Background

Anatomy

 

Fascicles of long, spiraling bundles

- tenocytes & Type I collagen

- synovial cells & fibroblasts present

 

Endotenon 

- surrounds the individual collagen bundles

 

Epitenon

- fine fibrous outer layer, highly cellular, continuous with endotenon

- contains most of the blood vessels & capillaries

 

Flexor Pulley Ruptures

Anatomy

 

5 Annular pulleys

3 Cruciate pulleys

 

Pathology

 

A1 and A5 expendable

 

Loss of other annular pulleys can lead to bowstringing

- A2 & A4 +/- A3

 

Aetiology

 

Rock climbers

- usually when slipping

 

May hear or feel a pop

 

Develop swelling / tenderness / pain

 

Bowstringing

Sinus Tarsi Syndrome

Anatomy

 

Osseous canal between talus and calcaneum

- interosseous talo-calcaneal ligament

- cervical ligament

- joint capsule

- nerve endings / arterial anastomoses

 

Sinus Tarsi

 

Aetiology

 

Flat foot / overpronation

Inversion / sprain

 

Pathology

 

Background

DefinitionHallux Valgus Severe

 

Bunion

- medial prominence of head of 1st MT

 

Hallux Valgus

- medial deviation 1st MT

- lateral deviation of great toe

 

Anatomy

 

Metatarsal head

- has 2 grooves separating ridge (cristae)