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3 - Musculoskeletal > Anatomy 1 > Flashcards

Anatomy 1 Flashcards

1
Q

3 types of joints

A

Fibrous (immobile)
Cartilaginous (a bit mobile)
Synovial (vey mobile)

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2
Q

Examples of fibrous joints

A 
Periodontal ligaments
Cranial sutures
Interosseous membranes (e.g. btw radius and ulna)
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3
Q

In fibrous joints, the bones are connected by…

A

Fibrous connective tissue - composed of collagen fibres

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4
Q

2 types of cartilaginous joints

A

Primary (synchondrosis) - hyaline cartilage only

Secondary (symphysis) - hyaline + fibrocartilage

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5
Q

Examples of primary cartilaginous joints (synchondrosis)

A

epiphysial growth plate in growing long bones

First sternocostal joint

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6
Q

Examples of a symphysis
(secondary cartilaginous)

+ its make up

A

IV disc
pubic symphysis

bone - hyaline - fibrocartilage - hyaline - bone

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7
Q

Layers of articular/ hyaline cartilage

A

Articular surface

Superficial/tangential layer
Transitional layer

Bone

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8
Q

Superficial/tangential layer of hyaline cartilage - histology + function

A

Darker purple
Flattened chondrocytes - produce collagen and glycoproteins (e.g. lubricin)
Collagen fibre orientation = horizontal

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9
Q

Transitional layer of hyaline cartilage - histology and function

A

Lighter purple
Round chondrocytes - produce proteoglycans (e.g. aggrecan*)
Collagen fibre orientation = vertical

*really good at binding to water - healthy, young cartilage is >75% water which makes it incompressible (protects tissue)

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10
Q

Proteins to which oligosaccharide chains are attached

More of a protein than a carb

A

Glycoproteins

e.g. lubricin

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11
Q

Proteins that are heavily glycosylated (a protein core with one or more GAGs attached)
Tend to be more carb that protein

A

Proteoglycans

e.g. aggrecan

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12
Q

Long unbranched polysaccharides which are highly polar and so attract water (help with lubrication)

A

Glycosaminoglycans (GAGs)

e.g. hyaluronic acid

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13
Q

Characteristics of the synovium

A

Composed of synoviocytes - produce fluid
Rich capillary network*
No epithelial lining

*O2, CO2 and metabolites are directly exchanged btw blood and synovial fluid

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14
Q

Types of synoviocytes

A

Type A:
look like macrophages
Remove debris
Contribute to synovial fluid production

Type B:
Fibroblast like
Main producer of synovial fluid

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15
Q

Characteristics of synovial fluid

A

Viscous like
contains hyaluronic acid and lubricin molecules
Fluid component is from blood plasma

exists in joints in small volumes (~0.5ml in knee)
Has a rapid turnover (~2hours)

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16
Q

Functions of synovial fluid

A

Nutrition of cartilage + removal of waste products (as cartilage is avascular, aneural + alymphatic)

Lubrication (–> less friction –> less wear)

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17
Q

3 types of lubrication

A

Boundary:
glycoproteins bind to receptors on articular surfaces to form a thin film

Hydrodynamic (like aquaplaning):
surfaces kept apart by liquid pressure

Weeping:
fluid in the cartilage is squeezed out to increase fluid volume

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18
Q

The co-efficient of friction of a synovial joint (range)

A

0.002 - 0.02

low number = little friction

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19
Q

The anterior wall of the axilla is formed by the…

A

Pectoralis major + minor

Subclavius muscles

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20
Q

The posterior wall of the axilla is formed by the…

A

Subscapularis
Teres major
Latissimus dorsi

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21
Q

The medial wall of the axilla is formed by the…

A

Thoracic wall

Serratus anterior

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22
Q

The lateral wall of the axilla is formed by the…

A

Intertubercular groove of the humerus

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23
Q

At what anatomical point does the subclavian artery become the axillary artery?

A

Lateral border of the 1st rib

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24
Q

At what anatomical point does the axillary artery become the brachial artery?

A

Lower border of the teres major muscle

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25
Q

Erb’s point location

A

On the upper trunk

2-3cm above the clavicle on the posterior border of the sternocleidomastoid

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26
Q

Injury to the upper trunk causes…

name, presentation + causes

A

Erb’s palsy

“Waiter’s tip” appearance of upper limb (medially rotated with wrist flexed)

Causes: fall on the shoulder, birth injury

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27
Q

Which 3 muscles are affected in Erb’s palsy?

A

Deltoid
Biceps
Brachialis

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28
Q

Injury to the lower trunk causes…

name + muscles affected

A

Klumpke’s palsy

muscles affected: intrinsic muscles of hand & ulnar flexors of the wrist and fingers

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29
Q

Function of the median cubital vein

A

A large communicating vein

Shunts blood from the cephalic vein to the basilic vein

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30
Q

The cephalic vein arises from…

A

The lateral end of the dorsal venous arch

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31
Q

The basilic vein arises from…

A

the medial end of the dorsal venous arch

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32
Q

All lymphatic vessels from the upper limb drain into…

A

Axillary lymph nodes (difficult to see in the dissected cadaver)

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33
Q

5 groups of axillary lymph nodes…

A 
Anterior/ pectoral group
Posterior/ subscapular group
Apical group
Central group
Lateral group
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34
Q

Enlargement of axillary nodes is frequent in infections/malignancies affecting…

A

Upper limb + shoulder
Upper back
Front of chest + breast
Upper anterolateral abdominal wall

35
Q

Shape of the clavicle

A

Looking at it anteriorly:
Medial 2/3rds = convex, Lateral 1/3rd = concave

The superior, subcutaneous surface is smoother

36
Q

Most common site of clavicle fractures

A

At the junction between the medial 2/3rds and lateral 1/3rd
Where the curvature changes from concave to convex = The weakest point

The clavicle is small but transmits large forces from the upper limb to the axial skeleton so a fall onto the shoulder/ outstretched arm is likely to break it.

37
Q

What type of joint is the acromioclavicular joint?

A

Synovial plane joint

38
Q

What type of joint is the sternoclavicular joint?

A

Synovial saddle joint

39
Q

The scapulo-humeral rhythm

A

Beyond about the first 30 degrees of shoulder abduction,
for every 3 degrees of abduction, 2 occur at the shoulder joint and 1 occurs at the scapula-thoracic joint
(2:1 ratio)

40
Q

The scapulothoracic joint

A

Not a true anatomical joint

The movement of the scapula on the thoracic wall

41
Q

The fibrocartilaginous rim around the margin of the glenoid cavity that deepens the glenoid cavity is called the…

A

Glenoid labrum

42
Q

The ligament between the acromion and coracoid processes is called…
Its function is to….

A

the coracoacromial ligament

strengthens the superior aspect of the joint capsule (prevents superior displacement of the humeral head)

43
Q

The coraco-acromial arch is formed by the…

A

Acromion process
Coracoacromial ligament
Coracoid process

44
Q

Which bursa communicates with the shoulder joint cavity?

A

The subscapular bursa

located under the coracoid process

45
Q

What is the role of the subacromial bursa?

A

Reduces friction beneath the deltoid - promoting free motion of the rotator cuff muscles

(the largest bursa)
(commonly injured in sports involving overhead motions e.g. swimming)

46
Q

Attachments of all rotator cuff muscles

A

All extend from the scapula to the humerus

47
Q

The most important role of the rotator cuff muscles

A

Pull the humeral head into the glenoid fossa giving extra stability
(also have a role in movement at the glenohumeral joint)

48
Q

Origin and insertion of the deltoid

A

Origin: spans from the lateral spine of the scapula, across the acromion to the lateral third of the clavicle

Insertion: The deltoid tuberosity on the lateral humerus

49
Q

The axillary nerve supplies sensory innervation to…

A

The skin over the inferior portion of the deltoid

“badge area”

50
Q

Origin and insertion of pectoralis major

A

Origin: medial third of the clavicle, sternum and ribs

Insertion: Humerus

51
Q

The triangular space below the clavicle, btw the deltoid and pectoralis major muscle is called the…

A

deltopectoral triangle

contains the cephalic vein, used for the placement of central lines

52
Q

Attachments of serratus anterior

+ location in relation to another muscle

A 
Lateral ribs (8-9) 
to the inferior angle of the scapula

located under latissimus dorsi

53
Q

attachments of pectoralis minor

A

Ribs to coracoid process (via tendon)

54
Q

What clinical sign is seen then the long thoracic nerve is injured?

+ when is it commonly injured?

A 
Scapular winging
(serratus anterior can no longer keep the scapula pulled against the thoracic cage)

Commonly injured during radical mastectomy as it runs on the superficial surface of the muscle

55
Q

Muscles of the anterior (flexor) compartment of the arm

A

Biceps brachii
Brachialis
Coracobrachialis

56
Q

The short head of the biceps brachii arises from…

A

the coracoid process

along with the coracobrachialis

57
Q

The long head of the biceps brachii arises from…

A

The supraglenoid tubercle

then runs in the bicipital (intertubercular) groove of the humerus

58
Q

Distal attachment of the biceps brachii

A

((Unite at the distal third of the upper arm
form a short tendon))

inserts into the tuberosity of the radius

59
Q

Origin and insertion of the coracobrachialis

A

Origin: tip of the coracoid process
Insertion: medial margin of the humerus (around the middle)

60
Q

Origin and insertion of brachialis

A

Origin: Distal half of the shaft of the humerus
Insertion: Coronoid process of the ulna

(lies partly under biceps brachii)

61
Q

Course of the musculocutaneous nerve

what does it become

A

Descends btw biceps and brachialis (supplying them both)

Continues as the lateral cutaneous nerve of the forearm

62
Q

the musculocutaneous nerve becomes the lateral cutaneous nerve of the forearm and supplies cutaneous sensation to the…

A

anterolateral aspect of the forearm

63
Q

Functions of the musculocutaneous nerve

A

sensory supply of the anterolateral aspect of the forearm

motor innervation of the anterior (flexor) compartment of the arm (biceps, brachialis, coracobrachialis)

64
Q

Course of the median nerve

A

Descends with the axillary/brachial artery
Crosses the cubital fossa

(gives no branches in the axilla or upper arm)

65
Q

Course of the ulnar nerve

A

Descends with brachial artery
Then enters the posterior compartment of the arm
–> the back of the medial epicondyle

66
Q

what injury commonly damages the axillary nerve

A

shoulder dislocation*
fractured neck of humerus

*so check for sensation in badge patch before and after replacing a dislocated shoulder

67
Q

The base of the cubital fossa is formed by…

A

an imaginary line drawn between the two epicondyles of the humerus

68
Q

The medial border of the cubital fossa is formed by…

A

the lateral border of pronator teres

69
Q

The lateral border of the cubital fossa is formed by…

A

the medial border of brachioradialis

70
Q

Contents of the cubital fossa

lateral to medial

A

Radial Nerve (very deep/not very identifiable) - lateral
Brachial Tendon
Brachial Artery
Medial Nerve - medial

(Really Need Beer To Be At My Nicest)

71
Q

Muscles in the posterior compartment of the arm

A

triceps (only)

72
Q

Origins and insertion of the triceps

A

long head: infraglenoid tubercle of the scapula
short lateral + medial heads: humerus

Insertion: olecranon process of the ulna

73
Q

Nerve supply to the triceps and anconeus muscle

A

radial nerve

74
Q

The radial nerve innervates

general

A

all the extensor muscles of the elbow and wrist joint

75
Q

Course of the radial nerve

A

descends in the radial (spiral) groove of the humerus

76
Q

Which deep branch of the brachial artery accompanies the radial nerve in the radial (spiral) groove?

A

profunda brachii

77
Q

characteristic sign of a radial nerve injury

A

wrist drop

78
Q

Both the proximal and distal radioulnar joints are which type of joint?

A

Uniaxial pivot
type synovial joints

(movements = pronation + supination)

79
Q

The radius and ulna are parallel when….

and crossed when…..

A

parallel when supinated

crossed when pronated

80
Q

Muscles attaching to the greater tuberosity of the humerus

A

Supraspinatus
Infraspinatus
Teres minor

SIT

(subscapularis attaches to the lesser tuberosity)

81
Q

Functions of the clavicle

A 
Supports the shoulder
Protects the brachial plexus and vessels
Attachments for muscles
 - trapezius
 - deltoid
 - pectoralis major
 - subclavius
 - SCM
 - sternohyoid
82
Q

The axillary nerve supplies motor innervation to…

A

Deltoid

Teres minor

83
Q

Common causes of radial nerve palsy

A

Nerve compressed (e.g. with arm over back of chair - Saturday night palsy)

Nerve trapped - e.g. due to midshaft humeral fracture

84
Q

The brachial artery bifurcates and becomes…

A

The ulnar artery (burrows deep)

The radial artery (superficial)

3 - Musculoskeletal (7 decks)

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