11/8 Flashcards
Pecs
- Pectoralis major-
O: Clavicular head: medial clavicle
Sternocostal head: costal cartilages of ribs 1-7
I: intertubercular (bicipital) groove
A: shoulder flexion, adduction, medial rotation
N: lateral and medial pectoral nerve
2. Pectoralis Minor- O: ribs 3-5 I: coracoid process of scapula A: protracts and depresses scapula N: medial pectoral nerve
Other anterior/lateral thorax muscles
1. Subclavius- O: 1st rib I: inferior clavicle A: depress clavicle N: subclavian nerve
2. Serratus anterior- O: lateral aspect of ribs 1-9 I: medial border of anterior scapula A: protracts scapula, holds scapula against thoracic wall N: long thoracic
Axilla Pyramid
Passage for vessels, nerves, and lymphatics
Disappears with arm abduction
- Lateral wall: intertubercular sulcus
- Posterior wall: teres major, latissimus dorsi, subscapularis, scapula
- Medial wall: serratus anterior, 4th rib
- Anterior wall: pectoralis major, pectoralis minor
Anterior Compartment of the Arm
Innervation: musculocutaneous nerve
Blood supply: brachial artery
- Coracobrachialis-
O: coracoid process
I: mid-medial humerus
A: flexes and adducts shoulder - Brachialis- small contribution from radial nerve to distal lateral portion
O: anterior humerus
I: tuberosity of ulna
A: powerful elbow flexor
Brachial plexus
- Root- anterior rami of C5-T1 (has C8), 2 branches (dorsal scapular and long thoracic)
- Trunks- superior, middle, and inferior, 2 branches(suprascapular and subclavian) for superior
- Divisions- anterior (superior, middle, and inferior) and posterior (3 of them)
- Cords-
Lateral: anterior division of superior/posterior, lateral pectoral
Medial: anterior division of inferior trunk, 3 branches
Posterior: posterior division of all 3 trunks
- Terminal branches-
Axillary: posterior cord, deltoid and teres minor
Musculocutaneous: lateral cord, anterior compartment, becomes lateral cutaneous nerve of forearm
Radial: posterior cord, posterior compartment of arm and forearm
Median: lateral and medial, innervates nothing in arm
Ulnar: medial, innervates nothing in arm
Axillary Artery
Has 3 sections
- Superior thoracic
- Thoracoacromial (4 branches) and lateral thoracic
- Subscapular (2 branches), anterior circumflex humeral, posterior circumflex humeral
Hip Injuries
- Posterior dislocation: most common, sports or hit dashboard
Hip is adducted and internally rotated
- Anterior dislocation: abducted and externally rotated
LE Injury Populations at Risk
Achilles Tendon: males 30-60
Quad and Patellar tendon rupture: males 40+, also pre-existing tendon degeneration
Ankle Injury: equally likely between girls and guys
Hip fracture: common for elderly
Meniscus tear: increases with age for degenerative (guys slightly more likely)
Patellar and Quadriceps Tendon Ruptures
Quad rupture: patella migrated distally since unopposed pull of patella tendon
Patella rupture: patella migrated proximally since unopposed pull of quad tendon
Do surgery, only not do if poor surgical candidate since neglected repair leads to chronic lack of knee extensor strength
ACL Injury
Quad contract or decreased relative hamstring strength
Axial compression
Knee abduction (valgus)
All work to increase tibial internal rotation and anterior translation
Patellar Dislocation
Lateral
Patella Alta: predisposes Risk since sit high up
Trochlear dysplasia: fails to develop trochlear groove so it’s flat and more susceptible to slide laterally
Medial patellofemoral ligament prevents lateral dislocation if the patella, needs to break for patellar dislocation
Patellar apprehension
Only do surgery of osteochondral injury or loose bodies, severe underlying anatomical abnormalities, or recurrent dislocations
