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anatomy > 6c > Flashcards

6c Flashcards

1
Q

subunits of brachial plexus

A

Roots -> Trunks -> Divisions -> Cords -> Branches

Risk Takers Don’t Cautiously Behave

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2
Q

brachial plexus

A

Not the only plexus in the body have a cervical, lumbar and saccral ones

They give rise to nerves that innervate certain muscles.

This is how the nerves arise of the spinal cord in bundles

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3
Q

why have a brachial plexus

Why have plexus, why not have nerves straight of the spinal cord?

A

The reason is of the redundancy to the type of innervation

If there is damage to the plexus

We have multiple levels of input for a certain movement.

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4
Q

brachial plexus - M

A

Musculocutaneous Nerve
Medial Nerve
Ulnar Nerve

KNOW DIAGRAM - GO DO THAT NOW + CHECK NOTES TO SEE WHAT THEY ALL DO

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5
Q

radial nerve

A

is posterior and not a part of the M, goes to posterior arm and posterior forearm

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6
Q

subclavian artery + vein

A

In between radial nerve and the Median and Ulnar Nerve

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7
Q

median nerve

A

Anterior forearm from the spinal cord

It has multiple roots down to the spinal cord.

It thereby also has lots of innervation and it can go from C5 and C8

In between those two is partial innervation ( C5 and C8)

Multiple levels provide movement.

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8
Q

muscles of pectoral girdle

A

Anterior and posterior muscles
- Same region we have muscles that move the humerus as well.

Humerus

  • Axial muscles move the humerus
  • Muscles also orginate both anteriorily and posteriorily off the scapula
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9
Q

muscles that move shoulder

A

trapezius
rhomboids
levator scapulae

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10
Q

trapezius

A

Large muscle group labelled number 1 is a triangular shaped muscle.

Functional sense it has multiple functions with opposite functions

It can extend and flex depending on which fibers are contracted

And since the muscle is so large you can select the fibres that can do specific functions.

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11
Q

trapezius - contractions

A

When you contract the muscle it is not an all out contraction it is not maximal

It is delicate and not all the muscle groups are affected at once.

It is possible to maximally contract just not realistic.

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12
Q

trapezius - fibers

A

There are fibers in this muscle that run in different directions.

Inferior medially
Horizontal
Oblique

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13
Q

trapezius - attachments

A

All along the spinous processes.

Superior spinous ligament

In this region of the back where the trapezius goes down the spinuous process as many muscles attach to the superior spinous ligament or ligamentum nuchae.
- - >The trapezius orginates here.

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14
Q

trapezius - relation to scapula`

A

It attaches to the spine of the scapula

Abduction - scapula moves laterally
Adduction - scapula moves inwards

Scapula can downwardly rotate where the glenoid fossa moves down or upwardly rotate where the glenoid fossa moves up.

Superior fibres cause upwards rotation of the scapula

When the inferior fibres contract the press down and upwards rotate the scapula

Middle fibers are horizontal so it causes abduction of the scapula and innervation is via the accessory nerve.

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15
Q

rhomboids

A

Major and minor and functionally they do the same thing

Innervated by the dorsal scapular nerve

These elevate, adduct and downwardly rotate the scapula.

There are two muscles here collectively move the body.

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16
Q

levator scapulae

A

Elevates and downwards rotation of the scapula

Dorsal scapula nerve.

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17
Q

subclavius

A

Only muscle that attaches to the clavicle and attaches from the first rib to the underside of the clavicle.

Contract this muscle when we breathe or move our shoulder.

Innervation is via the subclavian nerve

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18
Q

pectoralis minor

A

Attaches from ribs 3 to 5 and attaches to the coracoid process on the scapula which is its insertion point.

It does two things:

  • Breathing as it attaches to the ribs, lifts up the ribs
  • It causes abduction of the scapula by contraction pulling it away from the midline.

Innervation through the muscle is via the pectoral nerve.

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19
Q

serratus anterior

A

originates at the ribs
- From the ribs it goes along the ribs around to the back and goes underneath the scapula and attaches to the medial border.

Innervation is in the long thoracic nerve.

It assists in breathing

This muscle is used to ensure the scapula stays flat against the back of the rib cage.
- No matter where we position our arm it stays in its position and moves slightly when it is rotating.

If you generate a lot of force the scapula would move laterally and the glenoid fossa would come anterior
- If the force was strong enough it would go to the clavicle and this is why we do not have this why the serratus anterior muscle.

If you ask people to push against a wall when they have a damage to the long thoracic nerve they get winging scapulae they would likely break their clavicle.

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20
Q

coracobrachialis

A

Anterior compartment of the arm and it is a deep muscle

It is not part of this muscle compartment with the subclavius, pectoralis minor and serratus anterior but is innervated by the musculocutaneous nerve.

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21
Q

pectoralis major muscle

A

Shoulder girdle majority comes off the sternum and the medial third of the clavicle

It attaches to the greater tubercle of the humerus.

It is a large muscle with multiple functions

When contracted you can have adduction of the humerus, flexion of the shoulder or bringing the humerus forwards and medial rotation.

Innervation by the pectoral nerves.

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22
Q

latissmuss dorsi muscle

A

Comes off the axial skeleton at the thoracolumbar fascia.

It runs underneath the armpit and attaches to the intertubercular cursis or the biccipital groove just medial to the attachment of the pectoralis major

It adducts the humerus and medially rotates the humerus as well.

It goes underneath the arm to medially rotate to attach to the anterior side of the proximal humerus.

It also causes extension of the shoulder since it arises from the back.

Innervation is from the thoracodorsal nerve.

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23
Q

deltoid

A

Moves the humerus and it can be either an anterior or posterior muscle

It has multiple fibre groups.

Deltoid starts by attaching to the lateral process of the clavicle along the acromion process and down the spine of the scapula.

Axillary nerve innervates this whole muscle.

On the humerus it attaches to the deltoid tuberosity just down from the shaft.

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24
Q

deltoid - groups of fibres

A

Anterior

  • Attach to the clavicle
  • Contract these you have flexion and medial rotation.

Middle

  • Acromion process
  • Contraction abduction lift up the humerus

Posterior

  • Spine of the scapula.
  • Fibres from here extension and lateral rotation of the shoulder joint.
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25
Q

muscles that move humerus

A

Four muscles
Originate off the scapula
These muscles are known as rotator cuff muscles
- The corocohumeral ligament is the only one that supports the joint along with these muscles

1) supraspinatus muscle
- attaches just above the spine of the scapula or the supraspinous fossa

2) Infraspinatus is below the spine in the fossa.

3) Teres minor
- Lateral border

4) subscapularis muscle
- subscapular fossa

All these muscles attach either to the greater or lesser tubercle they cuff around the shoulder joint and they rotate the shoulder joint

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26
Q

ROTATOR CUFF

A

look at rotator cuff vid + learn it that way

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27
Q

Teres major

A

The teres major is not a rotator cuff muscle.

It attaches to the proximal shaft of the humerus.

It abducts.

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28
Q

rotator cuff - relation to greater tubercle

A

The greater tubercle is where the supraspinatus attaches

The infraspinatus cuffs and attaches to the greater tubercle of the humerus

The teres minor also attaches to the greater tubercle.

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29
Q

arm

A

The arm runs from the shoulder to the elbow and is also called the brachium

In the arm there are two compartments and are separated by fascia.

  • Much thicker fascia bundle the muscles
    • —> Anterior
    • —-> Posterior
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30
Q

anterior + posterior arm

A

There are individual muscles in the anterior and posterior compartments separated by fascia

There is a series of vessels and nerves in these compartments.

They are grouped together and they run and feed these muscles in this compartment the blood and innervation that they need.

Anterior
- The functions are flexion of the shoulder and flexion of the elbow

Posterior
- Functions are extensions and hyperextension of the elbow.

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31
Q

anterior brachium

A

Powerful flexors of the elbow.

Has one muscle that supinates the forearm in the anterior arm.

Muscles that cross joints can influence them specifically the shoulder joint and the elbow joint.

It is the biceps muscle and is superficial and its name stems that it has two heads a short and long head.

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32
Q

anterior brachium - long + short head

A

Short head
- Attaches to the corocoid process.

Long head
- Lateral to the short head attaches to the supraglenoid tubercle.

Both heads cross the shoulder joint and influence it.

This muscle will cause flexion of the shoulder (both heads)

The long head has a long tendon
- It runs through the bicipital groove or the intertubercular groove.

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33
Q

long head + short head - coming together

anterior brachium

A

the two come together to form one muscle belly that runs distally to form the elbow joint.

This bicep muscle attaches to the radial or bicipital tuberosity.
- It is located on the radial bone.

Aponeurosis

  • It is a sheath tendon and is wide sheet.
  • The bicipital aponeurosis breeds off of the solid tendon
  • It covers the muscles of the forearm, the heads where they attach to the funny bone or medial epicondyle.
34
Q

anterior brachium - biceps

A

The bicep muscle functionally flexs the shoulder and elbow and it supinates the forearm.

  • The muscle pop ups.
  • If you pronate your hand and hammer curl it you relax your biceps

You do not use your biceps you are affecting a deeper muscle known as the brachalis the more powerful muscle in comparison to the biceps.

Musculocutaneous nerve

35
Q

coracobrachialis -= note

A

Corocobrachalis is not part of the shoulder girdle.

It runs from corocoid to the humerus.

Remember it should be included in the arm.

Also innervated by the musculocutaneous nerve because it is a muscle in this compartment.

36
Q

coracobrachialis

A

Attaches to the corocoid process to the shaft of the humerus

Does not influence the elbow joint but it does for the shoulder joint.

Anterior compartment of the arm.

37
Q

brachialis

A

strongest flexor of elbow

Inserts onto the ulnar tuberosity from the brachium

It is important as it flexes the elbow whether your arm is in the pronation and supination because it is attached to the ulna that does not move.

Strong and wider attachment and it is wider and is dedicated only to the elbow and not the shoulder.

If someone cant flex their elbow ask them to pronate the hand

  • This tells you the injury is as far as the brachalis
  • If supinated it could be the biceps muscle.

Musculocutaneous nerve

38
Q

posterior brachium

A

back half of upper arm - triceps
all radial nerve
extends elbow
common insertion on olecranon

Triceps - It means 3 heads

Long head
- Attaches to the infraglenoid tubercle.

Medial head
- Don’t cross the shoulder joint and is in reference to where it attaches to the humerus.

Lateral head
- Don’t cross the shoulder joint and it is in reference to where it attaches to the humerus.

These 3 heads one of them attaches to the scapula and only one crosses the shoulder joint

39
Q

forearm

A

antebrachium

40
Q

forearm (antebrachium) compartments

A

Two compartments in the forearm
- Oblique separation between posterior and anterior

Anterior compartment

  • They flex the wrist
  • They cross the elbow and will influence that joint and it is often called the flexor region and they flex your fingers as well including the thumb

Posterior
- Extensors and they cause extension of the wrist and the elbow.

41
Q

Abduction and adduction of the wrist

A

Anterior forearm and posterior muscles both do it (so but still check)

Abduction is the same as radial deviation

Ulna deviation or adduction means bringing towards the midline.

42
Q

pronator teres

A

(anterior)
- It pronates

Flexion usually means anterior and posterior usually means extension

This muscle in order to allow this movement it takes the radius and puts on top of the ulna
- It thereby must attach to the radius.

Proximally it has a shared attachment and all these muscles in the superficial forearm attach to the medial epicondyle.

It goes from the medial epicondyle to the proximal radius.

It flexes the elbow this is the primary function.

43
Q

flexor carpi radialis

A

It extends down to the carpals to attach to them

It specifically attaches to the metacarpals and carps and does not attach to the fingers

It flexes the carpals which means it flexes the wrist.

Causes abduction of the wrist.

Radialis refers to the side

  • It runs from the medial epicondyle to the radial side of the forearm.
  • It attaches to metacarpal two and 3 specifically.
44
Q

palmaris longus

A

Muscle that stems off the medial epicondyle and attaches to the palmar fascia which is on the palm.

Not everyone has this muscle

From evolution we are losing it over time and is a very weak flexor of the wrist.

45
Q

flexor carpi ulnaris

A

It causes adduction of the wrist beginng to the midline

It originates or stems off at the medial epicondyle and runs down the ulna side all the way to the carpals

And it attaches ot the metacarpals specifically the fifth one and also the hamate.

The tendon that embedds the pisiform and this is incorporated here before it attaches to the fifth metacarpal.

The flexor carpi ulnaris is innervated by the ulna nerve the rest of the muscles are innervated by the median nerve.

46
Q

muscles that flex digits

A

Other muscle is on top of the other, the first one is the superficialis.

The other is the flexor digitorum profundus.
- found in the deeper layer

47
Q

flexor digitorum superficilias

A

Innervated by the median nerve

Attaches to the medial epicondyle, ulna and radius along with the proximal phalanx.

Flexes the digits

Has multiple attachments from digits 2 to 5

Attaches proximally to the medial epicondyle, ulna and radius.

This muscle attaches to the digits so it has to get to them but does not make it all the way down to the tips of the fingers it has an odd split at the proximal phalanx and is bifurcated.

It attaches to the base of the proximal phalanx.

It will not flex the tips of the fingers as it does not reach that far.

48
Q

muscles in deep layer of forearm

A

Attach to only the ulna and radius

Profundus muscle keeps going and attaches to the base of the distal phalanx as it runs underneath.

49
Q

muscles in mid layer of forearm

A

Attaches to most of the muscles in the forearm and the distal attachment is how you identify them

50
Q

flexor pollicis longus

A

Deep layer

They have a common proximal attachment but the distal one tells you how the muscles will function.

Common attachments are the radius and ulna
- It attaches mostly to the radius

It attaches to the distal phalanx of the thumb to flex it.

It flexes the thumb

The shorter one is called the FIexor pollicis brevis.

51
Q

pollicis

A

thumb

52
Q

pronator quadratus

A

It pronates and it puts the radius on top of the ulna

It therefore must attach to the radius

that rectangular white thing

53
Q

distal forearm

A

Ulna does not move and distally it attaches from the ulna to the radius and it is a square shaped muscle with four sides to it.

54
Q

flexor digitorum profundis

A

Deep muscle

Common attachment is the radius and the ulna and this is a distal attachment

It carries down the forearm, wrist, metacarpals and all the way down to the base of the distal phalanx past the superficialis.

55
Q

anterior forearm innervation

A

re innervated by the median nerve

Except the supinator or the extensor carpi radialis longus.

Median nerve innervates jmost of the superficial nerves as well.

The ulna nerve innervates a portion of the flexor digitorum profundus and the other half is the median nerve.

The ulna nerve also the flexor carpi ulnaris.

The ulnar nerves innervates the muscle that extends to the tendon of digit 5 and half of digit 4.

56
Q

posterior forearm - origin

A

common origin

Lateral epicondyle

Known as the superficial muscles

57
Q

extensor digitorum

A

Extends the digits

Only have one of them per arm

The back of the hand the tendons go to distal phalanx on the posterior side and those are the tendons of the extensor digitorum

58
Q

extensor radialis longus + brevis

A

Similar function to extend the wrist and are both on the radial side.

Longus

  • Goes from the lateral epicondyle to the second metacarpal and importantly it does not extend as far as the digits.
  • Meaning it only extends the wrist.

Brevis
- The shorter one goes from the lateral epicondyle to metacarpal 3.

59
Q

extensor digiti minimi

A

Extends the small finger or the pinkie

Proximally attaches to the lateral epicondyle down posterior compartment but it does not attach to a bone but to the tendon of the extensor digitorum of the digit 5.

Small and is only in the pinkie.

60
Q

extensor carpi ulnaris

A

It is on the ulna side and medial on the posterior side form the lateral epicondyle to the fifth metacarpal.

61
Q

abductos pollicis longus

A

Common origin of these muscles is the radius and the ulna goes to the first metacarpal.

Radial nerve

It abducts the thumb

Extends the thumb and also abducts it as well.

You move the fingers away in a parallel function meaning you are extending the thumb but abducting the thumb is where you make an L away from the palm of the hand.

62
Q

extensor pollicis longus + brevis

A

Extend the thumb

Radial nerve

Radius and ulna origin

Longus
- Goes to distal phalanx.

Brevis
- Goes to the proximal phalanx of the thumb.

63
Q

extensor indicis

A

Does not go to thumb but attaches to the index finger.

Attaches to the distal phalanx.

Radius and ulna origin

Radial nerve

64
Q

supinator

A

It is an extensor muscle but is in the superficial region.

It attaches to the lateral epicondyle.

And it supinates when you move the radius and it attaches to the proximal radius

Radial nerve

If you here extensor in the upper limb you are thinking radial nerve.

65
Q

anatomical snuff box

A

triangular deepening on radial, dorsal aspect of hand
- when u raise thumb

surrounded by:
extensor pollicis longus
extensor pollicis brevis
abductor pollicis longus

+ radial artery is near it

66
Q

radial artery - snuff box

A

A pocket extends when you use the muscles of the posterior section

Extensor pollicis longus and brevis and the abductor pollicis longus

These all tighten and then it creates a little pocket where you can listen to a pulse

These muscles are on the surface when you abduct the thumb and the abductor pollicis longus is the only one that will move

Then the only tendon you can feel is the abductor pollicis longus as all the other ones are already extended.

67
Q

adduction + abduction - fingers eg

A

adduction -bring closer together
abduction - move farther apart

e.g. move fingers closed - adduction
move fingers apart - abduction

68
Q

in hand nerves

A

median and ulnar nerves only

69
Q

wrist region nerves

A

Median nerve is located (passes through the cubital fossa) which is medial to the brachialis tendon and passes through the two heads of the pronator teres.

The ulna nerve is embedded in the fat above the same ligament. This is anterior.

Radial nerve is posterior and this is within the fat just underneath the skin

70
Q

flexor recnaculum

A

Runs across the top and is like a ceiling and between it and the carpal bones is called the carpal tunnel.

When you move the tendons back and forth rapidly like playing a guitar or piano you cause friction and there is swelling but in this area you do not want swelling to occur as it pinches the median nerve.

Therefore you get carpal tunnel syndrome.

It does not influence the ulna nerve because they are in fat and have a lot room.

It occurs in pain muscles innervation by median nerve and thats how you see if they have carpal tunnel syndrome.

71
Q

wrist drop

A

problem with radial nerve because they are unable to extend the wrist

72
Q

claw hand

A

Injury with the ulna nerve and people tend to rely on the index or their thumb.

The individuals are not able to use their pinkie finger.

73
Q

thenar group muscles

A

Short flexors

Abductor pollicis

Brevis is a small muscle in the hand

Opponens

All innervated by the median nerve.

74
Q

hypothenar group muscles

A

Influence group and digit 5 there are many brevis muscles

They are all innervated by the ulna nerve.

75
Q

lumbricals

A

Has no body attachments

Attaches from the flexor digitorum profundus and wraps around the finger to attach to extensor digitorum longus tendon.

Its function is flexion of the phalanges

From carpals to the phalanges at the joint

Basically perpendicular at the knuckles its from tendon to tendon.

76
Q

palmar interossei adduct (PAD)

A

Look for interossei from the metacarpals to the base of the proximal phalanges.

The palmar one’s are the one’s you see from the palm view.

These muscles adduct the digits and bring the digits close together and bring the thumb towards the midline digits 2 to 5 to come closer to the middle finger.

77
Q

dorsal interossei abduct

A

Dorsum of the back of the hand theses are the dabs muscles.

They abduct take the digits to 2,4 ad 5 away from the middle finger.

78
Q

Why do so many muscles working the digits arise in the forearm not in the hand?

A

It is matter of strength

Maximal strength so you call upon the superficialis and longus to open the jar every time.

Intrinsic muscles are for many intrinsic muscles.

79
Q

axilliary nerve

A

Innervates the teres minor and the deltoid muscles

Branches off the radial nerve

80
Q

brachial plexus - looking for the M

A

(3 nerves)

Musculocutaneous nerve, median nerve and the ulna nerve
- You can see the m and then you know the 3 nerves there and what they are

Musculocutaneous
- Muscles of anterior arm

Median and ulnar
- Anterior forearm and flexor region

anatomy (9 decks)

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