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MSK > 10. Upper Extremity Myology > Flashcards

10. Upper Extremity Myology Flashcards

1
Q

For the Pectoralis Major M.

What are the attachments?

A

O: Medial 1/2 of clavicle and anterior surface of stenum, costal cartilages 1-6

Lateral Edge of the Intertubercular Groove of Humerus

(covers the long head of Biceps Brachii M)

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2
Q

For the Pectoralis Major M.

What are the major actions?

A
  • Adduct and Medially Rotate Humerus
  • Protract and Depress Scapula
  • Flex Humerus
  • Return Humerus from flexed to neutral
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3
Q

For the Pectoralis Major M.

What is the innervation and artery?

A

Nerve: Lateral and Medial Pectoral Nerve

Artery: Pectoral Branch of the Thoracoacromial Trunk

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4
Q

For Pectoralis Minor M.

What are the attachments?

A
  • I: Upper Ribs (3-5)
  • O: Coracoid Process of the Scapula
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5
Q

For Pectoralis Minor M.

What is the action?

A

Stabilizes the Scapula by holding it to the Thoracic Wall.

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6
Q

For Pectoralis Minor M.

What is the innervation and artery?

A

Nerve: Medal Pectoral Nerve

(It gets pity innervated on the way to the Pectoralis Major M.)

Artery: Pectoral Branch of the Throacoacromial Trunk

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7
Q

For the Subclavius M.

What are the attachments?

A

First rib

to

Inferior aspect of the Clavicle at the subclavian groove

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8
Q

For the Subclavius M.

What is the Action?

A

Depresses the Clavicle

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9
Q

For the Subclavius M.

What is the innervation and artery?

A

Nerve: Nerve to the Subclavius M. (c5-c6)

Artery: Clavicular Branch of the Thoracoacromial Trunk

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10
Q

For the Serratus Anterior M.

What are the attachments?

A

Lateral Aspect of the Ribs

to

Deep surface of the medial border of the Scapula.

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11
Q

For the Serratus Anterior M.

What are the actions?

A

Protraction of the Scapula: Stabalizes the Scapula by pulling it to the Thoracic Wall

(Boxer’s Serratus Anterior Muscles are buff for this reason)

Superior Rotation of the Glenoid Cavity

(Pulls the medial border down towards the ribs - lateral end goes up)

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12
Q

For the Serratus Anterior M.

What is the innervation and artery?

A

Nerve: Long Thoracic Nerve

Artery: Lateral Thoracic Artery

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13
Q

What might damage to the Long Thoracic Nerve cause?

What motion does this prevent?

A

“Winging” of the Scapula

The Scapula is no longer Stabalized against the Thoracic Wall

Abduction of the Upper Extremity beyond the Horizontal Position

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14
Q

For the Deltoid M.

What are the Attachments?

A

Lateral 1/3 Clavicle, Acromion of the Scapula, and Deltoid Tubercle (on the spine) of the Scapula

to

Deltoid Tuberosity of the Humerus

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15
Q

For the Deltoid M.

What are the actions?

A

Anterior part: Flex and Internal Rotation of the Humerus

Middle Part / Whole Muscle: Abduction of the Humerus

Posterior Part: Extension of the Shoulder and External Rotation of the Humerus

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16
Q

For the Deltoid M.

What is the innervation and artery?

A

Nerve: Axillary Nerve

Artery: Posterior Circumflex Humeral Artery

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17
Q

For the Subscapularis M.

What are the attachments?

A

Medial Aspect of its Subscapular Fossa

to

Lesser Tubercle of the Humerus

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18
Q

For the Subscapularis M.

What are its actions?

A

Medial Rotation of the Humerus

Adduction of the Humerus

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19
Q

For the Subscapularis M.

What is the innervation and artery?

A

Nerve: Upper and Lower Subscapular Nerve

Artery: Subscapular Artery

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20
Q

For the Supraspinatus M.

What are the attachments?

A

Supraspinous Fossa of the Scapula

to

Greater Humeral Tubercle (running over the superior-most part of the Humerus)

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21
Q

For the Supraspinatus M.

What is the action?

A
  • Abduction of the Humerus with deltoid M., holds the humeral head in the glenoid cavity
  • lateral rotation
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22
Q

For the Supraspinatus M.

What is the innervation and artery?

A

Nerve: Suprascapular Nerve

Artery: Suprascapular Artery

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23
Q

For the Infraspinatus M.

What are the attachments?

A

Medial border of its Infraspinous Fossa

Greater Tubercle of the Humerus

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24
Q

For the Infraspinatus M.

What is its action?

A

Lateral rotation of Humerus, holds the humeral head in glenoid cavity

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25
Q

For the Infraspinatus M.

What is the innervation and artery?

A

Nerve: Suprascapular Nerve

Artery: Suprascapular Artery and Circumflex Scapular Artery

(The Circumflex Scapular Artery comes around the lateral border of the scapula and heads superiorly and medially)

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26
Q

For the Teres Major M.

What are the attachments?

A

Posterior aspect of the Inferior Angle of the Scapula

to

Intertubercular groove

(Front of the Humerus)

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27
Q

For the Teres Major M.

What are the actions?

A
  • Medially rotate the humerus
  • Adduction of the Humerus
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28
Q

For the Teres Major M.

What is the innervation and artery?

A

Nerve: Lower Subscapular Nerve

Artery: Subscapular Artery and Circumflex Scapular Artery

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29
Q

Teres Minor:

A

O: Middle part of lateral border of scapula

I: greater tubercle of humerus

A: laterally rotate the humerus and holds humeral head in the glenoid cavity

N: Axillary Nerve

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30
Q

What are the four rotator cuff muscles?

A

Supraspinatus M.

Infraspinatus M.

Teres Minor M.

Subscapularis M.

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31
Q

For the Triangular Space

What Muscles make up the border?

What can be found within?

A

Borders: Teres Major, Teres Minor, Long Head of Triceps Brachii M.

Contains: Circumflex Scapular Artery and Vein

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32
Q

For the Quadrangular Space

What Muscles make up the four borders?

What can be found within?

A

Borders: Long and Lateral Head of the Triceps Brachii M., Teres Major M. Teres Minor M.

Contains: Axillary Artery, Posterior Circumflex Humeral Artery, Posterior Circumflex Humeral Vein

(Contents are headed to the Deltoid Muscle, so if you remember the Deltoid M.’s nerve and artery, there you go)

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33
Q

For the Triangular Interval

What Muscles make up its three borders?

What does it contain?

A

Borders: Long and Lateral Head of the Triceps Brachii, Teres Major M.

Contains: Deep Brachial Artery and Vein, Radial Nerve

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34
Q

What part of the Biceps Brachii M. covers the Pronator Teres M.?

What is this?

A
  • The Bicipital Aponeurosis
  • Part of the bicep tendon inserts here , and blends w the antibracial fascia to make the biceptal aponerousis
  • it protects gooey stuff in cubodial fosa that we dont want to stick a needle into
  • it isnt an attachment point
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35
Q

For the Biceps Brachii M.

What are the attachments?

A
  • Long Head to the Supraglenoid Tubercle
  • Short Head to the Coracoid Process

Both insert on the Radial Tuberosity

The Biceps Brachii skips the Humerus entirely

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36
Q

For the Biceps Brachii M.

What are the Actions?

A

Flexes Shoulder and Elbow

Supinates forearm

Remember that these Muscles Flex / Extend the Joints they cross

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37
Q

For Biceps Brachii M.

What is the innervation and blood supply?

A
  • Musculocutaneous Nerve
  • Brachial artery
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38
Q

For the Coracobrachialis Muscle

What are the attachments?

A
  • Coracoid Process
  • Medial Aspect of the Humeral Body
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39
Q

For the Coracobrachialis Muscle

What are the actions?

A

Flexion and adduction of the Shoulder

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40
Q

For the Coracobrachialis Muscle

What is the innervation?

A

Musculocutaneous N.

Brachial Artery

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41
Q

For the Brachialis Muscle

What are the attachments?

A

Distal half of the Humerus

Ulnar Tuberosity / Coranoid Process

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42
Q

For the Brachialis Muscle

What is the action?

A

Flexion of the Elbow

The Bicep cannot flex a pronated Elbow. The Brachialis does that.

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43
Q

For the Brachialis Muscle

What is the innervation?

A

Musculocutaneous N.

Brachial A.

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44
Q

For the Triceps Brachii M.

Where are the attachments?

A
  1. Long Head to the Infraglenoid Tubercle
  2. Lateral and Medial Head come from the Humerus (and do not cross the shoulder joint)
  3. All insert into the Olecranon of the Ulna
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45
Q

For the Triceps Brachii M.

What is the action?

A

Extending the Forearm, long head resist dislocation of ths shoulder

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46
Q

For Triceps Brachii Muscle

What is the innervation?

A
  • Radial Nerve
  • Deep brachial artery
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47
Q

For the Anconeus Muscle

What are the attachments?

A

Lateral Humeral Epicondyle

Olecranon

(Even though it attaches to the Lateral Humeral Epicondyle like an extensor and exists entirely in the forearm, it’s considered a posterior compartment Brachial Muscle for this class. This may be because some people consider it to be a continuation of Triceps Brachii M.)

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48
Q

For the Anconius Muscle

What is the action?

A

Extends the Elbow (with triceps brachii M.) and stabalizes the elbow joint

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49
Q

For the Anconius Muscle

What is the innervation?

A

Radial Nerve

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50
Q

For the Pronator Teres M.

What are the attachements?

A
  • Superfical layer of flexor 1
  • Humeral Head to the Medial Epicondyle of the Humerus
  • Ulnar Head to the Coranoid Process of the Ulna
  • Both insert into the lateral aspect of the Radius
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51
Q

For the Pronator Teres M.

What is the action?

A

Pronation of the Elbow (drag radius into pronation)

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52
Q

For the Pronator Teres M.

What is the innervation?

A

Median Nerve

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53
Q

For the Flexor Carpi Radialis M.

What are the attachments?

A
  • Superfical layer of flexor 2
  • Medial Humeral Epicondyle
  • Metacarpal of the Second Digit
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54
Q

For the Flexor Carpi Radialis M.

What are the actions?

A
  • Flex the Elbow and Wrist
  • Abduct the Wrist
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55
Q

For the Flexor Carpi Radialis M.

What is the innervation?

A

Median Nerve

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56
Q

For the Palmaris Longus Muscle

What are the attachments?

A
  • Superfical layer of flexor 3
  • Medial Humeral Epicondyle
  • Palmar Aponeurosis
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57
Q

For the Palmaris Longus Muscle

What is the action (if present)?

A

Flexes the Elbow and Wrist and tense the palmar aponerosis

-sometimes people dont have this

58
Q

For the Palmaris Longus Muscle

What is the innervation?

A

Median Nerve

59
Q

For the Flexor Carpi Ulnaris Muscle

What are the attachements?

A
  • Superfical layer of flexor 4
  • Medial Humeral Epicondyle
  • Pisiform Bone, Hook of the Hamate, 5th Metacarpal
  • (Inserts everywhere in the medial Wrist)
60
Q

For the Flexor Carpi Ulnaris Muscle

What are the actions?

A
  • Flexion of the Elbow and Wrist
  • Adduction of the Wrist
61
Q

For the Flexor Carpi Ulnaris Muscle

What is the innervation?

A

Ulnar Nerve

62
Q

For the Flexor Digitorum Superficialis Muscle

What are the attachements?

A

Only intermediate layer of flexors

Medial Humeral Epicondyle, Coronoid Process of the Ulna, superior portion of the Radius

Inserts in the intermediate Phalanges of digits 2-5 in a forked tendon

-sends tendons through the carpal tunnel

63
Q

For the Flexor Digitorum Superficialis Muscle

What are the actions?

A

Flexion of the joints it crosses: Proximal Interphalangeal, Metacarpophalangeal, Carpometacarpal, Wrist, Elbow

64
Q

For the Flexor Digitorum Superficialis Muscle

What is the innervation?

A

Median Nerve

65
Q

For the Flexor Digitorum Profundus Muscle

What are the attachments?

A
  • Deep layer of flexors
  • Proximal Ulna and Interosseous Membrane
  • Distal Phalanges of Digits 2-5
    • Tendons run through the tendons split from the flexor digitorium superficialis M.
66
Q

For the Flexor Digitorum Profundus Muscle

What are the actions?

A
  • flex hand at wrist and flex all phalanges of digits 2-5 at the metacarpophalangeal, proximal and distal interphalangeal joints
67
Q

For the Flexor Digitorum Profundus Muscle

What is the innervation?

A

Medial Portion: Ulnar Nerve

Lateral portion: Anterior Interosseous N. (Median Nerve)

Its medial portion is directly underneath the ulnar nerve, so it kind of gets accidentally innervated.

68
Q

For the Flexor Pollicis Longus Muscle

What are the attachments?

A
  • Deep layer of flexors
  • Radius and Interosseous Membrane
  • Distal Phalanx of the Thumb
69
Q

For the Flexor Pollicis Longus Muscle

What is the action?

A
  • flexes the hand
  • abduct first metacarpal at the caropmetacarpal joint
  • flexes poth phalanges of the pollux at the intercapal joint
70
Q

For the Flexor Pollicus Longus Muscle

What is the innervation?

A

Anterior Interosseous Nerve

(branch of the Median Nerve)

71
Q

For the Pronator Quadratus Muscle

What are the attachments?

A

Deep flexor

Distal Ulna to Distal Radius

72
Q

For the Pronator Quadratus Muscle

What is the action?

A

Pronation of forearm

Holds the Ulna and Radius together

73
Q

For the Pronator Quadratus Muscle

What is the innervation?

A

Anterior Interosseous Nerve

74
Q

What two Antebrachial Extensors are innervated by the Radial Nerve when it is named as such? (before it changes names)

A

Brachioradialis M.

Extensor Carpi Radialis Longus M.

75
Q

What two Antebrachial Extensors are innervated by the “Deep” Radial Nerve?

A

Extensor Carpi Radialis Brevis M.

Supinator M.

76
Q

What three Antibrachial Extensors are innervated by the Posterior Interosseous Nerve?

A

Extensor Digitorum M.

Extensor Digiti Minimi M.

Extensor Carpi Ulnaris M.

77
Q

For the Brachioradialis Muscle

What are the attachments?

A

Superfical layer of extensors

Lateral Supracondylar Ridge

Radius

78
Q

For the Brachioradialis Muscle

What is the action?

A

Flexes the Elbow when the Arm is “Mid-Pronated”

(When the thumb is facing up)

79
Q

For the Brachioradialis Muscle

What is the innervation?

A

Radial Nerve

80
Q

For the Extensor Carpi Radialis Longus M.

What are the attachments?

A

Superfical Layer of extensors

Lateral Humeral Supracondylar Ridge

Metacarpal of the 2nd Digit

81
Q

For the Extensor Carpi Radialis Longus M.

What is the action?

A

Extension and ABduction of the Wrist

(active during fist clenching)

82
Q

For the Extensor Carpi Radialis Longus M.

What is the innervation?

A

Radial Nerve

83
Q

For Extensor Carpi Radialis Brevis M.

What are the attachments?

A

Lateral Epicondyle of the Humerus

Base of the 3rd Metacarpal

84
Q

For Extensor Carpi Radialis Brevis M.

What are the actions?

A

Extension and ABduction of the Wrist

85
Q

For Extensor Carpi Radialis Brevis M.

What is the innervation?

A

Deep Radial Nerve

86
Q

For the Extensor Digitorum M.

What are the attachments?

A

Superfical layer of extensor

Lateral Humeral Epicondyle

Extensor Hood

87
Q

For the Extensor Digitorum M.

What is the action?

A

Extension of the 2nd-5th Phalanges at every joint:

  • metacarpophalangeal, proxiamal and distal interphalangeal joints
88
Q

For the Extensor Digitorum M.

What is the innervation?

A

Posterior Interossious Nerve

(comes from the Radial Nerve)

89
Q

When does the Deep Radial Nerve become the Posterior Interosseous Nerve?

A

After it ducks under the Supinator and emerges again.

90
Q

For the Extensor Digiti Minimi M.

What are the attachments?

A

Superfical layer of extensors

Lateral Epicondyle of the Humerus

Extensor Hood of 5th Digit

91
Q

For the Extensor Digiti Minimi M.

What is the action?

A

Extends the 5th Digit at metacarphophalangeal, proximal, and distal interphalangeal joints

92
Q

For the Extensor Digiti Minimi M.

What is the innervation?

A

Posterior Interosseous Nerve

93
Q

For the Extensor Carpi Ulnaris M.

What are the attachements?

A

superfical layer of extension

Lateral Humeral Epicondyle

Dorasl aspect of the base of the 5th metacarpal

94
Q

For the Extensor Carpi Ulnaris M.

What is the action?

A

Extend and ADduct the Wrist (active during fist clenching)

95
Q

For the Extensor Carpi Ulnaris M.

What is the innervation?

A

Posterior Interosseous Nerve

(a branch of the Radial Nerve)

This is tough because it has Ulnar in the name, but remember that exception is only true on the Flexor side. ALL of the Extensors of the arm are innervated by the Radial Nerve, or a branch thereof.

96
Q

For the Supinator Muscle

What are the Attachments?

A

Deep extensor

Lateral Humeral Epicondyle, Lateral Collateral Ligament of the Elbow, and Supinator Crest of the Ulna.

Proximal Radius

97
Q

For the Supinator Muscle

What is the innervation?

A

Deep Radial Nerve

98
Q

For the Supinator Muscle

What is the action?

A

Supinate forearm

99
Q

For the Extensor Indicis M.

What are the attachments?

A

Distal Ulna and interosseous membrane to the extensor exapnsion of digit 2

100
Q

For the Extensor Indicis M.

What is the action?

A

Extension of the 2nd Digit (Index Finger)

-extend hand at wrist

101
Q

For the Extensor Indicis M.

What is the innervation?

A

Posterior Interosseous Nerve

102
Q

For Abductor Pollicis Longus M.

What are the attachements?

A

Outcropping muscles of the deep layer of extensors

O: posterior Ulna, Radius, Interosseous Membrane

I: Base of the 1st Digit’s Metacarpal

103
Q

For Abductor Pollicis Longus M.

What is the action?

A
  • abduct hand at wrist
  • abduct hand and abduct the thumb at the carpometacarpal joint
104
Q

For Abductor Pollicis Longus M.

What is the innervation?

A

Posterior Interosseous Nerve

(This is an outcropping muscle, but they are innervated like the extensors)

105
Q

For Extensor Pollicis Longus M.

What are the attachments?

What is interesting about the Tendon for this Muscle?

A

Ulna and Interosseous Membrane

Base of the Distal Phalanx of the thumb. (dorsal aspect)

Extensor Pollicis Longus M. goes to the Distal Phalanx, Extensor Pollicis Brevis M. goes to the Proximal Phalanx

The Tendon wraps around the Dorsal Radial Tubercle and uses it as a pulley.

106
Q

For Extensor Pollicis Longus M.

What is the action?

A

Extension of the Thumb, Abduction of the Wrist

-will extend the first metacarpal, proximal and distal phalanges of the polux at the carpometacarpal, metacarophalageal and interphalangeal joints

107
Q

For Extensor Pollicis Longus M.

What is the innervation?

A

Posterior Interosseous Nerve

108
Q

For Extensor Pollicis Brevis M.

What are the attachments?

A

Radius and Interosseous Membrane

Dorsal aspect of base of the Proximal Phalanx of the Thumb

109
Q

For Extensor Pollicis Brevis M.

What are the actions?

A
  • Extends first metacarpal and proximal phalanges of the pollux at the carpometacarpal and metacarpophalangeal joints
  • Abducts the Wrist
110
Q

For Extensor Pollicis Brevis M.

What is the innervation?

A

Posterior Interosseous Nerve

111
Q

What are the borders for the Anatomical Snuff Box?

A

Lateral: (anterior) Extensor Pollicis Brevis Tendon (and Abductor Pollicis Longus, sort of)

Medial: Extensor Pollicis Longus Tendon

  • The shorter Muscle has to be closer to the Thumb (lateral side)*
  • -radial artery and superfical radial nerve runs across the box*
112
Q

For the Abductor Pollicis Brevis M.

What are the attachments?

A

(part of thenar emeinice)

Carpals (scaphoid and trapezium bones) and Flexor Retinaculum

Base of the Proximal Phalanx of the 1st Digit

113
Q

For the Abductor Pollicis Brevis M.

What is the action?

A

Abducts the Thumb

-aids in opposition

114
Q

For the Abductor Pollicis Brevis M.

What is the innervation?

A

Recurrant Branch of the Median Nerve

This is the A in “1/2 LOAF 1/2”

115
Q

For the Flexor Pollicis Brevis M.

What are the attachments?

A

(part of thenar emience: has a deep head and superfical head)

Carpals (tubercles of scaphoid and trapezium) and flexor retincalulum

-latearal aspect of the bse of the proximal phalamix of the thumb

116
Q

For the Flexor Pollicis Brevis M.

What is the action?

A

Flexes the Metacarpal and the Proximal Phalanx of the Thumb

-flexes at carpometacarpal and metacarpophalangeal joints

117
Q

For the Flexor Pollicis Brevis M.

What is the innervation?

A

Superficial Head: Recurrent Branch of the Median Nerve

Deep Head: Deep Ulnar Nerve

118
Q

For Opponens Pollicis M.

What are the attachments?

A
  • part of thenar emience
  • Tubercles of scaphoid and trepezium bones and Flexor Retinaculum
  • (lateral aspect) Metacarpal of the 1st Digit
119
Q

For Opponens Pollicis M.

What is the action?

A

Opposition of the Thumb

120
Q

For Opponens Pollicis M.

What is the innervation?

A

Recurrent Branch of the Median Nerve

121
Q

For Adductor Pollicis M.

What are the attachments?

A
  • Oblique Head: slender
    • capitate, Base of the Third Metacarpal to the Base of the Proximal Phalanx
  • Transverse Head: fatty
    • anterior aspect Body of the Third Metacarpal to the Base of the Proximal Phalanx
122
Q

For Adductor Pollicis M.

What is the action?

A

Adduction of the Pollux

123
Q

For Adductor Pollicis M.

What is the innervation?

A

Deep Ulnar Nerve

124
Q

A superficial injury to the Thenar Eminence can damage what nerve?

What does this impede?

A

Recurrant Branch of the Median Nerve

Many of the Thumb Muscles

125
Q

For the Abductor Digiti Minimi M.

What are the attachments?

A

Part of hypothenar emience:

Pisiform Bone

Base of the Proximal Phalanx of the 5th Digit

126
Q

For the Abductor Digiti Minimi M.

What is the action?

A

Abduction of the 5th Digit

127
Q

For the Abductor Digiti Minimi M.

What is the innervation?

A

Deep Ulnar Nerve

128
Q

For the Flexor Digiti Minimi M.

What are the attachments?

A
  • part of hypothenar eminence
  • Hook of the Hamate and Flexor Retinaculum
  • Base of the Proximal Phalanx of the 5th Digit
129
Q

For the Flexor Digiti Minimi Brevis M.

What is the action?

A

Flexes the 5th Digit proximal phalynx

130
Q

For the Flexor Digiti Minimi M.

What is the innervation?

A

Deep Ulnar Nerve

131
Q

For the Opponens Digiti Minimi M.

What is the attachment?

A

Hook of the Hamate and Flexor Retinaculum

Middle of the 5th Metacarpal

132
Q

For the Opponens Digiti Minimi M.

What is the action?

A

Opposition of the 5th Digit

133
Q

For the Opponens Digiti Minimi M.

What is the innervation

A

Deep Ulnar Nerve

134
Q

For the Lumbrical Muscles

What are their attachments?

A

Originate at the Flexor Digitorum Profundus Tendon

Insert at the Extensor Expansion

He made a big deal about these originating at a tendon in class

135
Q

For the Lumbrical Muscles

What is their action?

A

Pinching with extended Interphalangial Joints, but flexed Metacarpophalangeal Joints

136
Q

For the Lumbrical Muscles

What are their innervations?

A

1st and 2nd: Recurrant Branch of the Median Nerve

3rd and 4th: Deep Ulnar Nerve

This is the 1/2 L, in 1/2 LOAF 1/2

137
Q

For the Dorsal Interosseous Muscles

Where do the attach?

How many of these do we have?

A

Go between a given digit, and the digit closer to the middle finger.

Eg. 1st Digit to 2nd Digit, but 5th Digit to 4th Digit

Four. The 2nd and 4th have one. The 3rd Digit abducts both ways and has two.

The thumb and pinky have their own abductors

138
Q

For the Dorsal Interosseous Muscles

What is their action?

A

Abduction of the fingers, except 1st and 5th

DAB Dorsals ABduct

139
Q

For the Dorsal Interosseous Muscles

What is the innervation?

A

Deep Ulnar Nerve

140
Q

For the Palmar Interosseous Muscles

What digits have these Muscles?

A

The First, Fourth, and Fifth Digits.

The Thumb has its own Adductors Pollicis, and the Third Digit doesn’t adduct, it can only abduct in either direction.

141
Q
A
142
Q
A

MSK (19 decks)

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