DIP Episode 151 - The Why’s of Anatomy For The USMLE Step 1 (Upper Limbs 3, Lower Limbs 1)

Welcome my name is Divine, I'm a resident this is episode 151 of the Divine Intervention Podcasts. In this podcast episode I'll be continuing my series that I titled the Wise of Anatomy for the USM list of one example. This will finish Opera Lymphs and then I'll also talk about lower limbs. Although to be honest for Opera Lymphs for the most part what I'm gonna be focusing on is like the Vascular Supply. For the lower limbs I'll also be talking about the Vascular Supply and talking about the big joints right like there's like high old things that shop on exams all the time relating to like the hip joint the knee joint and the ankle joint especially like those like weird and only gimme and talk about all those things. I decided to sort of like give you guys a breather today from like the nerves but the nerves will constitute the next like the next the wise of anatomy podcast and he'll be the nerves of the lower of the lower extremities although the nerves of the lower extremities to be honest they are not as complex as the nerves well depends on who you talk to but at least in my opinion they're not as you know annoying as the nerves of the upper extremities.

So the thing is right if you're looking about that to you so I'll just go ahead and jump right into it right so if you look at the upper extremity vessels right we know that essentially right you know we come up the ACE and any other we have like the right breakers we have the breakers of Alec Trunk the left common corroded on the left subclavian right so the subclavians ultimately supply your upper extremities.

The subclavian artery right ultimately changes need to become like the axillary artery and then so the axillary artery right it becomes it comes from the subclavian and again I think let me back up here for a second the thing is remember that I've kind of mentioned it already but I think it's worth repeating remember that the subclavian artery comes off the briculous cephalic trunk for the right the right subclavian comes off of the briculous cephalic trunk the left subclavian on the other hand comes directly off the of the euric arch so that's important to know right and remember that the subclavian changes need to axillary when you go past the lateral motor of the first trip and then the briculous the axillary changes need to break you at the bottom of the teres a major muscle is one of those weird things you want to commit to memory so like I said right again so clavian artery becomes axillary artery axillary artery becomes briculous artery and then the briculous artery by fricates into like the owner and the radial arteries the owner like and then they form like an anastomosis in the in the palm like there's this thing called the superficial pomegranate and the deep pomegranate arch for the most parts the superficial pomegranate comes from the owner artery the deep pomegranate comes from the from the real artery but again various by individual so it's very the they very really test that stuff because again there's a lot of variation in human beings and then the thing is one clinically relevant thing you want to know for the USM is is that you can actually have this the you can actually have this the real artery and use it for a cabbage right so like a coronary artery bypass graft you can also use the saffanas vein but actually the radial artery can actually be used you can actually last for pretty you know for a pretty long period of time so that's something high

you know and then the thing is though before you you know have this like the radial artery for example to use it for a cabbage right it would make sense that you want to make sure that you know the other honor artery actually works right because if you have this the presence radial and let's assume the honor artery is like bad then you have a huge problem on your hands right you have a huge problem on your hands because the presence of extremities will essentially at least they are they're like form and hand will like essentially die right so to figure that out because again you absolutely right you have like this anastomosis with those arches but again to to to figure out like make sure that like oh for example the honor artery is beaten because it's extremely rare to harvest the harvest the honor artery the thing you don't want to do is you want to do something called the Allen's test okay Allen's test essentially you include the honor artery right you you press on the honor of the radial arteries to the person squeeze a fist and then you notice that you know everything is like white and then if you release your hold over the honor artery the hand should think up if it doesn't think up then you absolutely should not have as that person's a radial artery for bypass or something because that person is a high risk for getting to a lot of trouble.

Classically on MBME exams they will test that in the context of a person that has like spluriderma or has some kind of renote phenomenon causing a condition and one of the high youth in I guess I'll mention with the others of the upper extremities remember I said that the chords of the bricchio plexus right like the lateral chord the medial chord and the posterior chord they are all named with reference to the positions like relative to the axillary artery so the thing is if a person actually has like an aneurysm of the axillary artery that can actually compress on those chords of the bricchio plexus and cause neurologic deficits and then you should also hopefully remember that the bricchio artery actually runs pretty closely to the with the median artery with the median nerve so if for example you have like remember it said last time at the last podcast that oh if you have a fracture of the if you have a super condyla fracture of the humerus that can mess up your median nerve believe it or not that can also mess up your your bricchio artery okay so that's something high you to me especially just before you buy forget to form the radial and the donor arteries now the last thing I think I want to talk about well maybe not the last thing but let's talk about the rotator cuff again it's very high you to know that's essentially how they test the shoulder joint on mbmi exams the thing is the glenohumero joint is very unstable right and again it makes sense that it should be unstable because you want that joint to you know have as much movement as possible right so the thing is to help with that inherent instability you need the rotator cuff to sort of like take one for the team right and the rotator cuff right it really really does help with stability of the shoulder joint and you absolutely want to know the four tendons right that contribute to forming the rotator cuff an

d there's this numonic right like the sits numonic every I'll show you for it somewhere the sits numonic right the S stands for superspineatus right and then the I stands for infraspineatus and then the T stands for subscapularis and then the S the other S stands for sorry the T stands for teris minor whoops and then the S stands for subscapularis and the thing is the superspineatus tendon protects the top of the shoulder joint the subscapularis protects the front of the shoulder joint and then the infraspineatus and teris minor actually protect the back so if you notice I didn't say anything I didn't say anything about something protecting the bottom right I didn't say anything about anything protecting the bottom right so you can already see that that can already you can hopefully already begin to decipher that you know what maybe that will not be the best thing in the world and you'll see why as I go along right so again nothing in the bottom and actually even the other tendons that sort of crossed the the shoulder joint at the inferior part of the joint they're very slim they are not very they're kind of slack they're not very like taught so the thing is whenever a person has a dislocation of the of the shoulder of the humor is essentially right it typically happens through that inferior part of the joint but you may see what divine in an early part of the in an early part of your podcast you said like in one of your earlier podcasts you said oh the most common kind of shoulder dislocation is anterior yes it is anterior but believe it or not when a shoulder dislocates the humor is actually moves downward first because again there's nothing protecting that part of the joint the humor is moves downward first and then he moves forward and then he moves upward and then we're like oh wow this person's humor has dislocated anterior yeah that's what has happened but I me

an I mean you you can say oh so because he dislocated anteriorly let me you know try to like push it right back all the way push it posteriorly and you I'll lock you back into the joint that's not gonna happen right that's why if you want to successfully reduce and anteriorly dislocate a shoulder you actually have to bend it down you have to like pull it pull it down and then move it back and then move it up okay because again it's just the reverse of what happens it dislocates downwards and then he moves anteriorly and then he moves superior okay very high you to know that for example and also for clinical practice so again most glenohumeral joint dislocations tend to be tend to be anterior okay and again I sort of explain the biomechanics behind that and again like I said and if you have a dislocation of your glenohumeral joint especially like an anterior dislocation you likely nook your axillary or your reoners right because again these are right below the shoulder joint and again don't forget right I talked about this in a prayer podcast fracture of the surgical neck of the humerus will cause an axillary nerve injury fracture of the a fracture of the the meat shaft of the humerus right will cause more radio nerve injury and so I guess that's all I'll say about the shoulder joint I'm gonna maybe talk about the wrist for a bit so the thing is right if you're looking at the wrist right with regards to bones right we have like I mean there are many bones and all that but the ones are probably really care the most about especially for example this and that's cafoid and the lunit bones right the thing is for the most part those bones actually connected directly to the radius if you actually look at like a radiograph or you look at like an atomic image of the wrist like the wrist joint there is very little that's actually connected to the owner bone most stuff is connect

ed to the radio to the radius right so the thing is usually whenever a person has like you know like a fall on an outstretched hand so the deal and for the most part the the hand bones that tend to be fractured especially if you're looking at the metal carpal bones tend to be the scafoid and the lunit although to be honest the scafoid is the one that most likely for whenever the scafoid like gets injured it's mostly usually a fracture the way I remember that is like San Francisco so like SF but usually the lunit for the most part tends to dislocate to be honest there is actually mechanisms behind why this is the case but involve a decent amount of like biomechanics and physics which I don't think people listening to this podcast we're very hot about so I'm gonna go ahead and I'm gonna go ahead and move on but the scafoid tends to fracture the the lunit tends to a dislocate right and the thing is whenever the lunit dislocated it actually tends to dislocate anteriorly into the carpal tunnel right again if you're looking at the anatomical position the lunit bone tends to dislocate anteriorly so you can already see that if a person has like a lunit dislocation that can mess up the that can mess up the median nerve right because the median nerve is the nerve that runs through the carpal tunnel and then the big thing I want to remember about the scafoid you're going oh the boy who cares if the scafoid fractures I promise you it's it's important to know why the scafoid fractures are because the thing is when the scafoid fractures blood the blood supply for this at least for the for the scafoid bone sort of runs from distal to proximal right so it's like if you're looking at the scafoid bone let's just let's just visualize it this way that there is like there is like an end of the scafoid bone that points towards your like your like your metacarpal like your like your phalang

eal bones right and then there's an end that points towards your ears the blood supply goes from that phalangeal bone side towards the radial bone side right so blood supplies from the distal end to the proximal end right so if you have a fracture of the scafoid bone you can disrupt that blood supply right so that's why the proximal head of the scafoid has the highest risk of a vasculine across it's right a vascular means blood supply is gone necrosis means dead tissue right because literally blood supply is gone so that's a high-ill thing to know so I guess really that's to be honest that's what I'm gonna talk to you with regards to the upper extremities and I think I've said I've talked about most of the high ill things I feel like I've talked about most of the high ill things I feel like with regards to the upper extremities I'm just gonna go ahead and go to the lower extremities right so for the lower extremities right so big things you want to know you want to know like the vascular stuff right and the vascular stuff again is not that hard I promise you it's not that hard the thing is there are just few high ill things they tend to test with these on the USMLE exams so what are those high ill things right the thing is we know that the big vessel right that runs through your belly is like your abdominal yoder right gives off all those fancy branches and then that abdominal yoder right it ultimately becomes the internal and external it by for kids to form the internal and external iliacs right for both sides of the lower for both our lower extremities so the thing is the external iliac right is the thing that ultimately you know sort of like goes after your lower extremities and the thing is your external iliac if you know keeps traveling when he goes below the inguinal ligament like I run like the midpoint of the inguinal ligament remember the inguinal ligament th

e two boundaries are like the ASIS the anterior superior x spine and the pubic tuber com right so like if you go below the midpoint of the inguinal ligament that's where you can actually pop it like you know the external iliac pulse and the beginning of the femoral pulse but basically once you go below was your traverse that below the inguinal ligament the external iliac changes into femoral artery okay and the thing with the femoral artery is the femoral artery because we say oh so that means the femoral artery must be you know the major blood supply of the thigh to be honest that's actually not true the femoral artery essentially doesn't do any real blood supply in the thigh the only the thing that have the vessel that gives of our blood supply to the thigh is actually the is actually the deep femoral artery the deep femoral artery is one branch of the femoral artery and it's giving off very approximately in the thigh like super super approximately in the thigh right so femoral artery gives off the deep femoral artery right and that's that deep femoral artery is essentially what gives a blood supply for the thigh but the femoral artery for the most part it just keeps traveling traveling traveling you sort of loops around to the back of the thigh and it goes through a hole that hole I like to call it the addoctor hiatus okay a.d.

doctor hiatus and once the femoral artery traverses that addoctor hiatus it changes into poplitella artery okay and then that poplitella artery you know gives off like the anterior the posterior tbl arteries the anterior tbl artery runs and tirline the leg posterior tbl artery runs posteriorly in the leg right that's a very those are very imaginative and means there and the thing is whenever a person has a peripheral arterial disease right again this is one way your friends at the inbemic intestines from the USMLA exams whenever a person has peripheral arterial disease right you know they tend to include the femoral you may think that oh because they've occluded the femoral they have a lot of pin in the thigh that's actually not true most of the pin whenever you see people have a peripheral arterial disease most of that pin tends to be in the in the legs right and again it should make sense because again the the femoral for the most part like I said earlier does not do squat in the thigh it's it's big branch it's giving super proximately the superficial I mean the deep femoral artery that does most of that blood supply and then remember I said that the poplitella artery you know sort of breaks up to form the anterior tbl and the posterior tbl the thing is the posterior tbl artery it sort of goes to the foot through the medium like posterior to the medium maleolus that's why if you palpite below if you palpite behind if you palpite behind the medium maleolus you feel the posterior tbl pulse to come make sense right posterior tbl posterior to the tbl I don't know if that helps you and then the anterior tbl artery it sort of goes over the door some of the foot and in fact when is the anterior tbl artery like literally like gets to the door some of the foot the name is changed to the orsialis pides right again all these things make a perfect sense the name becomes a orsia

lis pides artery so that's why if you you know palpite the door some of the foot you you'll feel the anterior tbl pulse which again is just a name change from anterior tbl to the orsialis pides so one of the high old I guess thing you want to know with regards to blood supply for the lower extremities the thing is the femur right the femur at least the femur has like three major parts right there's like the femur head there's a femur neck that comes right after and then after that you have the femur shaft right the thing is biomechanically ready for your transfer in weight because your femur right it essentially helps with like transfer in weight from like your upper body to your lower body right so the thing that happens is you know when weight is being transferred you know it goes through the head first and then the neck and then the shaft right but the thing is the femur neck tends to carry an artery that supplies the head of the femur that artery is called the MCFA it's called like the medial circumflex femur artery it supplies the femur head the thing is kind of going with that mantra I talked about with the scaffold again I like making parallels between things where I say that oh the scaffold blood supplies from distal to proximal sinthen happens with the femur right blood supply goes from the neck towards the head right and that blood supply is the medial circumflex a femur artery so the thing is you know if for example woman is put in a puzzle and she has lost bone marrow density because she has osteoporosis or let's say you have a person that has been on cortical steroids for a long while and they have osteoporosis or let's assume you have a person that has an oraxia nervosa if you ever see a person that has osteoporosis like super early in life think about like either using steroids or having like bad bad bad anorexia those people right the team to get osteo

porosis pretty early and they can lose bone mineral density along the like the femur neck right so they are pretty supposed to having like femur neck fractures right so when you have those femur neck fractures well too bad that can disrupt the medial circumflex femur artery and that can increase the presence risk of a evasculine accruciz of the femur head okay so evasculine accruciz of the femur head is also very high to knowing addition to evasculine accruciz of the of the proximal head of the of the scaffold so I think that's all I'm gonna say with regards to vascular things with regards to the lower extremities so let's sort of you know touch on these joints are one by one right so let's just go from proximal to this so let's talk about the femur right you know I think I've sort of said most of the big things I want with the femur let's go straight to the knee joint right so the knee joint the thing you'll probably want to establish in your mind is it's a very unstable joint right it's literally like two flat bones touching each other right and I mean yeah there is like some intervening articulate at major but really for the most part it's like you have like this straight bone femur going over the straight bone tibia the femur laugh for the most part does not really contribute to the does not really contribute to the knee joint so I guess I just think that what you will I mean it does contribute but you know it's not like the big particular whatever that's going on there so because the knee is a really unstable joint right you have a lot of support structures that really really help with that really help with trying to stabilize the joint but the thing is with all these support structures it kind of limits movement and it also increases the risk of like injury right and these support structures there's the menisky we'll talk about those there's the collateral ligam

ents we'll talk about those and then there's the crusher ligaments we'll talk about those as well so the thing is the menisky right the help actually by so I sort of think of it this way it's like you protect the knee joint from downward pressures from sideways pressures and from anterior posterior pressures right so the thing is the menisky right they help because they they present an almost like bald in surface like B8 WL that's what I preferring to not bald like an old guy with bald hair whatever but they present like a you know like a bald in surface so like the lateral and medium and it's like they present like these are bald in surfaces and that really helps with stabilizing the joints and then we also have like the ligaments right on the sides we have like the medial collateral ligament I remember I know that mean for the medial collateral ligament emission an mbm exam is something called the t-seal the the t-bl collateral ligament the mcl essentially mcl or t-seal but I'll keep referring to it as mcl the lcl location is called like the f-seal the fibula collateral ligament because the fibula is like lateral right and the t-b is medium so the medial collateral ligament the big thing is that it prevents excessive A Bduction of the knee joint right versus the lateral collateral ligament that prevents excessive A Bduction of the knee joint and one thing I want to see with these collateral ligaments is it's actually floridae high yield to know that the medial meniscus is actually fused to the medial collateral ligament right the reverse is actually not the case for the lateral collateral ligament okay so medial collateral ligament is fused to the medial meniscus lateral collateral ligament is not fused to the lateral meniscus so this actually makes the medial meniscus e-mobile but the lateral meniscus it makes it super mobile okay there is a very high yield implicati

on to this so let's talk about that high yield implication but I guess before we jump into that let me ask you a question how do these meniscus t-m?

the thing is first imagine the meniscus almost like the filling of a sandwich between like the femur and the t-b the femur and the t-b are like the two sides of the sandwich and then the meniscus have the filling the thing is the meniscus I tend to tear when you have like a rotational force applied to the femur when the leg is like firmly planted on the ground so the thing is so let's see again you have like you know leg firmly planted on the ground and then you have a rotational force the thing is when that rotational force happens right since the lateral meniscus is mobile right because it's not fused to the lateral collateral ligament it can move along with the rest of the femur when you have this rotational force but not so for the medium meniscus okay because the medium meniscus is immobile right so it's like you have an immobile structure it's firmly fixed and then it's undergoing like rotational motion it is very likely to tear on that those circumstances in fact this is why medium meniscus tears are a lot more common than lateral meniscus tears that's the first thing to understand so you can also even already begin to imagine that you know what since the medium meniscus is kind of fused to the medium collateral ligament for person has like injury like a tear of the medium collateral ligament that will also very likely tear the very likely tear the medium meniscus as well right so that's the big thing you want to keep in mind with those meniscus and then for the collateral ligaments right you may ask okay how do we enjoy the collateral ligaments well you can also injure them when you the legs are firmly planted on the ground right so remember this construct and it will make it very easy to remember like how these things are injured the thing is if the legs are firmly planted on the ground if you have a force that runs on the lateral side of the knee joints righ

t so remember if a force is running on the lateral side of the knee joint that will drive the that would drive the knee joint immediately right whenever you have like this you know like lottery lateral force that drives the knee joint immediately that will cause the leg to move outward right and that will ultimately tear the medial collateral ligament okay so again I'll repeat this a force that hits on the lateral side of the knee will drive the knee joint immediately and will drive the leg outward we can see drive the leg lottery okay so this is how you injure the MCL and another name I guess you can use for this lateral stress right sometimes on examples they call it a valgus stress remember the L in lateral for the L in valgus really the reverse is the case with how you get like a LCL injury right I mean sometimes they call that so if you have like a medial like a blow to the medial side of the knee that will drive the knee joint laterally right that's a virus VAR US that's a virus stress and that will cause lateral collateral ligament injury and again it should actually kind of make sense that MCL injuries MCL tears should be much more common than LCL tears are because think about it what side of the knee joint is exposed it's the lateral side right I mean the medial side of the knee joint is protected by the other by the other lower extremity right so you have like more occasions or more opportunities for like valgus as stressors that is why the MCL tends to be torn more frequently than the LCL and then let's I guess talk about the big bad a cruciate ligaments right the thing is again these people say oh divine they are so hard they're not just remember one rule okay remember one rule these cruciate ligaments like the ACL the anterior cruciate ligament under PCL posterior cruciate ligament they are named for they are named for their attachments to the to the TBA

okay they are named for the insertions on the TBA if you remember that everything it's all it's all downhill from there okay so again they're named for their attachment their insertions on the TBA not the femur okay so the anterior cruciate ligament inserts anteriorly on the TBA and vice versa so to repeat because again many people scrollers up on examples the ACL runs from the anterior TBA to the posterior femur okay so if you really think about it if you have like excessively directed force on the TBA so if you have like force that's directly anteriorly right so like so let's say like you hit the person from you know like the back of the TBA and you drive the TBA anteriorly or that will tear that that will tear the ACL at the same time rate if you look at it from the reverse case if you have excessive force that's directed that directs the femur posterior right so you push the femur posteriorly that will also tear the ACL right again it's very high you to know this thing I'm trying to describe here so so if for example you're doing a physical example an patient and you notice that oh crap this person's TBA is directed like like this person has excessive anterior displacement of the TBA relative to the femur that tells you that the person has an ACL tear okay and really all these statements have just me just reverse everything and you know what obtains for the PCL I'll just maybe tell you just remember the ACL what I've just explained that again you really didn't memorize this crap if you just understand what I just said right and then you just say okay I'll just reverse everything and I know I'm dealing with the with the PCL right and in general the ACL tends to tear more commonly than the PCL there are biomechanical and physics reasons behind this but again I suspect people listen to the spot cast probably don't really have time for that and it will take me a while

to explain so I think I'm gonna move on from I'm gonna go ahead and move on from that but an easy way to remember that the ACL tears more frequently than the PCL is just remember sports stars right I mean like remember like like I'm a Lakers fan so my heart was like broken heavy when I did Marcus cousin so the boogie man basically tore his AC Ls not gonna plead this season essentially or Clay Thumbson right also tore his ACL so just think of sports stars and think of them having ACL injuries and I'll hope you remember that the ACL the ACL is torn more frequently than the PCL right so kind of like to sort of summarize like which is torn more frequently I already said that the media minuscuses torn more commonly than the lateral miniscuss I explained the mechanism behind that I've explained that the media collateral ligament tends to be torn more frequently than the lateral collateral ligament explain the mechanism behind that and then I've explained that the ACL tends to be torn more frequently than the PCL right so you've probably heard of this fancy unhappy triad way for prison has like you know like like blow to the knee or whatever you can tear like the ACL the MCL and the media minuscuss on at the same time although there are some studies that cannot disperven that but that's again the classic thing that tends to be tested on exams so that's all I think I'm gonna say about the knee joint and then let's talk about the ankle the ankle joint is super easy really the only click on it I'm gonna talk about the ankle joints at a lateral and media collateral ligaments the thing is they're actually a ton more like there's a like if you're looking at the number of fibers or the number of like contributing ligaments there's a ton of like like ligament fibers for the media collateral ligament in comparison with the lateral collateral ligament so the thing is whenever a person

tears a ligament in the ankle it's almost always an LCL tear okay and usually the LCL the lateral collateral ligament of the ankle usually gets torn when you have excessive inversion so in version of the ankle and the thing is right so many people are like divine the lateral collateral ligament of the ankle has all these subunits the media collateral ligament of the ankle has all these subunits divine how do I remember all this subunits there's like eight different subunits and all that crap the truth is I've never tried to memorize those but let me tell you the trick I use right the trick I use is I just use one or remember that if you're looking at the bones of the lower extremities right the tibia is medial and the fibula is lateral so we never you see them describing an ankle ligament and you see the word tibio in the knee you're likely dealing with a derivative of the medial collateral ligament of the ankle on the flip side if you see the name like fibula in the name of the ligament then you likely to know that the derivative of the lateral collateral ligament of the ankle right so like taylo fibular ligament blah blah blah it's an LCL derivative so hopefully that rule helps you out and sort of minimize this your memorization so I think I'm gonna go ahead and stop here as I do at the end of every podcast again I do offer one or one to learn for a ton of exams right step one two CK two C.S.

step three med school preclinical exams 30th-ish collective shelf exams and then I do the stand I call longitudinal tutoring where again if you're a new first-year med student or a new second-year med student or new 30-year medical student I tutor you for all your like preclinical exams or your shelf exams but the thing is as I do that I also tutor you for your respective upcoming USML exam so let's say for example you're going through a microbiology block I'll tutor you for like microbiology but I'll also bring in the information that's tested on the USML is in the context of microbiology so most of these people have done this with they've been like super successful on their on their like their mainstream medical exams and then they've been like wildly successful on the USML exams so if that's something you're interested in feel free to reach out to me and I've done that with a ton of people and again everyone I've done that with has been very very successful on their exams it's something I've been doing over the last like year or two it's been super super successful for the people I've done it with and then if you're if you have a college buddy that needs to learn from like Gen Chem, O Chem Physics, Biochemistry, Physiology, Histology, Alpha Tutoring for all those things and then if you're a med student applying to residency so like an era's application or a college student applying to med school so like an Amcass application I do for like one or one advising or consulting for that I've done this with like tons like hundreds of people and again for like the med students have worked with that have you know applied for residency essentially all of them have much that their first choice yeah there's a few people here and there that's like second third choice but like 90% of people have worked with have much thing here have much thing their first choice I have a lot of

experience personal statements recliders editing applications, mocking interviews have a ton of experience with that so that's all I think I will see with this podcast again there will be a nod I'll keep making this wise of anatomy series my goal is really to help people that are preparing for the USMLA exams I'm also like med school anatomy exams I really do feel that most of the things I discuss in this podcast and like the high-value areas that will likely pop up on exams so I do hope you get something from this have a wonderful rest of your day God bless you I'll see you next time thank you

SITS (Supraspinatus, Infraspinatus, Teres Minor, Subscapularis).

The subscapularis tendon.

Valgus stress (a force applied to the lateral side of the knee) when the leg is firmly planted on the ground.

The Anterior Cruciate Ligament (ACL).

Look at the name: Tibio- suggests a derivative of the MCL/medial side; Fibular suggests a derivative of the LCL/lateral side.

The scaphoid bone (due to its distal-to-proximal blood supply).

Supraspinatus, Infraspinatus, Teres Minor, and Subscapularis.

The Medial Collateral Ligament (MCL) is fused to the medial meniscus.

Varus stress (a blow or force applied to the medial side of the knee).

Medial Circumflex Femoral Artery (MCFA).

It changes into the femoral artery.

The lunate bone (dislocates anteriorly into the carpal tunnel).

Supraspinatus, Infraspinatus, Teres Minor, and Subscapularis.

The Medial Collateral Ligament (MCL) is fused to the medial meniscus.

Varus stress (a blow or force applied to the medial side of the knee).

Medial Circumflex Femoral Artery (MCFA).

It changes into the femoral artery.

The lunate bone (dislocates anteriorly into the carpal tunnel).