anatomy Flashcards
obturator nerve nerve roots
L2-4
femoral nerve nerve roots
L2-4
sciatic nerve nerve roots
L4-S3
LFCN nerve roots
L2-L3
ilioinguinal nerve roots
T12-L1
iliohypogastric nerve roots
T12-L1
genitofemoral nerve roots
L1-2
anatomy at suprascapular notch
superior transverse scapular ligament separates suprascapular artery superiorly and nerve inferiorly (army over navy - artery over nerve)
first bone to ossify
clavicle at 5 weeks
humeral head retroversion
30 degrees
humeral head height
5.6 cm above superior border of pec major tendon
what prevents AP displacement at the AC joint
AC ligaments
CC ligament locations relative to AC joint
conoid is more medial (45 mm from AC joint, stronger), trapezoid is more lateral (25 mm from AC joint)
borders of quadrangular space
superior - teres minor, inferior - teres major, medial - long head of triceps, lateral - humerus
contents of quadrangular space
axillary nerve, posterior humeral circumflex vessels
borders of triangular space
superior - teres minor, inferior - teres major, lateral - long head of triceps
contents of triangular space
circumflex scapular vessels
borders of triangular interval
superior - teres major, lateral - lateral head of triceps/humerus, medial - long head of triceps
contents of triangular interval
radial nerve and profunda brachii artery
trapezius innervation
cranial nerve XI (accessory nerve)
lat innervation
thoracodorsal nerve
rhomboids innervation
dorsal scapluar nerve
levator scapulae innervation
C3 and C4 nerves
pec major innervation
medial and lateral pectoral nerves
pec minor innervation
medial pectoral nerve
serratus anterior innervation
long thoracic nerve
deltoid innervation
axillary nerve
teres major innervation
lower subscapular nerve
subscap innervation
upper and lower subscapular nerves
supraspinatus innervation
suprascapular nerve
infraspinatus innervation
suprascapular nerve
teres minor innervation
axillary nerve
order of insertion at intertubercular groove
pec major most lateral, lat in the middle, teres major most medial
main blood supply to humeral head
anterolateral branch of anterior humeral circumflex artery
muscles innervated by radial nerve proper
triceps, anconeus, ECRL, ECRB, brachioradialis
muscles innervated by PIN
ED, supinator, EDM, ECU, APL, EPL, EPB, EIP
what nerve does posterior cutaneous nerve to the arm and forearm come from
radial nerve
which cord does the radial nerve originate from
posterior cord
where is the spiral groove safe zone in a posterior approach to the humerus
10 cm distal to lateral acromion, 10 cm proximal to lateral epicondyle
where does the radial nerve pierce the intermuscular septum?
never less than 7.5 cm above articular surface
primary static stabilizer to valgus stress at the elbow
medial/ulnar collateral ligament, anterior bundle most important
where does the LUCL attach distally
supinator crest
what is the ligament of struthers
attaches supracondylar process and medial epicondyle, site of compression for median nerve
biceps brachii insertion
ulnar margin of radial tuberosity, long head is proximal, short head is distal
first carpal bone to ossify
capitate at 1 year
when are anterior and posterior bands of UCL taut
0-60 = anterior, 60-120 = posterior
coracobrachialis innervation
musculocutaneous nerve
biceps brachii innervation
musculocutaneous nerve
brachialis innervation
musculocutaneous and radial
triceps innervation
radial nerve
pronator teres origin, insertion, innervation
origin medial epicondyle and coronoid, insertion midlateral radius, innervation median nerve
FCU origin, insertion, innervation
origin medial epicondyle and posterior ulna, insertion pisiform, innervation ulnar nerve
pronator quadratus innervation
AIN
brachioradialis origin, insertion, innervation
origin lateral supracondylar humerus, insertion lateral distal radius, innervation radial nerve
ECRL origin, insertion, innervation
origin lateral supracondylar humerus, insertion second metacarpal base, innervation radial nerve
ECRB origin, insertion, innervation
origin lateral epicondyle, insertion third metacarpal base, innervation radial nerve
anconeus origin, insertion, innervation
origin lateral epicondyle, insertion proximal dorsal ulna, innervation radial nerve
extensor digitorum origin, insertion, innervation
origin lateral epicondyle, insertion extensor aponeurosis, innervation PIN
EDM origin, insertion, innervation
origin common extensor tendon, insertion small finger extensor expansion over P1, innervation PIN
ECU origin, insertion, innervation
origin lateral epicondyle, insertion fifth metacarpal base, innervation PIN
what nerve does the lateral cutaneous nerve of the forearm come from?
musculocutaneous
terminal branches of upper trunk of brachial plexus
suprascapular nerve, nerve to subclavius
which hand intrinsics are innervated by the median nerve
1/2 LOAF 1/2 - half of the lumbricals, opponens pollicis, APB, 1/2 of FPB (superficial head)
origin and insertion of lumbricals
origin - FDP, insertion - radial lateral bands
terminal branches of lateral cord
musculocutaneous, lateral pectoral nerve, median
terminal branches of posterior cord
radial, axillary, upper and lower subscapular, thoracodorsal
terminal branches of medial cord
ulnar, medial pectoral, medial brachial cutaneous, medial antebrachial cutaneous, median
which cord does the musculocutaneous nerve come from
lateral
which cord does the radial nerve come from
posterior
which cord does the axillary nerve come from
posterior
which cord does the ulnar nerve come from
medial
which cord does the median nerve come from
medial and lateral
what is the only peripheral nerve originating from a root of the brachial plexus?
dorsal scapular (Rhomboids)
medial scapular winging
long thoracic nerve, serratus anterior
lateral scapular winging
spinal accessory nerve, trapezius
where does musculocutaneous enter the coracobrachialis
5-8 cm distal to coracoid
muscles innervated by musculocutaneous
coracobrachialis, brachialis, biceps
where does the anterior branch of the axillary nerve enter deltoid fascia
5-7 cm distal to acromion
where is the spiral groove relative to medial and lateral epicondyles
20cm from medial epicondyle, 14cm from lateral epicondyle
course of superficial sensory branch of radial nerve
emerges through antebrachial fascia 6-9cm proximal to styloid, runs between BR and ECRL
muscles innervated by AIN
FDP to first and second, FPL, PQ
muscles innervated by median nerve
pronator teres, FCR, PL, FDS, 1/2LOAF1/2 (radial lumbricals, opponens pollicis, APB, supinator head of FPB)
muscles innervated by ulnar nerve
FCU, FDP to 3 and 4, palmaris brevis, abductor and opponens digiti minimi, flexor digiti minimi, lumbricals 3 and 4, interossei, adductor pollicis, deep head of FPB
where does AIN run
branches 4cm distal to elbow then runs between FPL and FDP, terminates in PQ
where does palmar cutaneous branch start
branches off of median nerve 6 cm proximal to styloid
course of ulnar nerve
passes posterior to medial IM septum at Arcade of Struthers 8-10 cm from medial epicondyle, crosses elbow post to ME in cubital tunnel, enters forearm between 2 heads of FCU, runs between FCU and FDP
where does the dorsal cutaneous branch come off ulnar nerve
7 cm proximal to ulnar styloid
relationship of brachial artery to surrounding muscles in AC fossa
BR is lateral, PT is medial, brachialis and supinator are posterior
supply of palmar arches
radial artery becomes deep palmar arch, ulnar artery becomes superficial palmar arch
which palmar arch do the digital arteries arise from
superficial
structures separating greater and lesser sciatic notch/foramina
iliac spine and sacrospinous ligament
strongest hip capsular ligament
iliofemoral (Y ligament of Bigalow)
iliacus innervation
femoral
psoas innervation
femoral
pectineus innervation
femoral and obturator
rectus femoris innervation
femoral
sartorius innervation
femoral
hamstring muscles and innervations
biceps femoris long head, semitendinosus, semimembranosus - tibial. biceps femoris short head - peroneal
gracilis innervation
obturator
adductor muscles and innervations
brevis and longus - obturator, magnus obturator and tibial
glute muscles and innervations
minimus and medius - superior gluteal. maximus - inferior gluteal
TFL innervation
superior gluteal
bundle of ACL tested with pivot shift
posterolateral
what does the posterior oblique ligament do
resist internal rotation with knee in full extension
main components of posterolateral corner
LCL, popliteus tendon, popliteofibular ligament
primary blood supply to talar body
artery of the tarsal canal from posterior tibial artery
tib ant origin and insertion
origin lateral tibia, insertion medial cuneiform and first metatarsal
EHL origin and insertion
origin mid fibula, insertion distal phalanx of great toe
EDL origin and insertion
origin tibial condyle/fibula, insertion middle and distal phalanges of toes
peroneus tertius origin and insertion
origin fibula and EDL tendon, insertion fifth metatarsal,
peroneus longus origin and insertion
origin proximal fibula, insertion medial cuneiform and first metatarsal
peroneus brevis origin and insertion
origin distal fibula, insertion tuberosity of fifth metatarsal
FHL origin and insertion
origin fibula, insertion distal phalanx of great toe
FDL origin and insertion
origin tibia, insertion distal phalanges of second through fifth toes
tibialis posterior origin and insertion
origin tibia, fibula, IOM. insertion navicular and medial cuneiform
ligaments that make up syndesmosis
AITFL, PITFL, IOL, transverse fibular ligament
what ligament supports the head of the talus
plantar calcaneonavicular (spring)
lisfranc ligament
medial cuneiform to second metatarsal
spring ligament attachments
sustentaculum tali to navicular
nerves exiting below the piriformis
POPS IQ - pudendal, nerve to obturator internus, posterior femoral cutaneous, sciatic, inferior gluteal, nerve to quadratus femoris
where does femoral nerve run
between iliacus and psoas, enters thigh via femoral triangle under inguinal ligament
structures in femoral triangle (lateral to medial)
NAVeL - femoral Nerve, Artery, Vein, empty, Lymphatics
saphenous nerve nerve roots
L3-4
relationship between peroneal and tibial divisions of sciatic nerve
peroneal more lateral
structures exiting greater sciatic foramen
piriformis, superior and inferior gluteal nerves and vessels, sciatic nerve, pudendal nerve, internal pudendal vessels, posterior femoral cutaneous nerve, nerve to obturator internus and quadratus femoris
structures exiting lesser sciatic foramen
obturator internus, pudendal nerve, nerve to obturator internus, internal pudendal vessels
which posterior thigh muscle is not supplied by the tibial division of the sciatic nerve?
short head of biceps femoris is supplied by peroneal division of sciatic nerve
what nerve innervates all of the intrinsics of the foot except one?
tibial (via medial and lateral plantar nerves), EDB is innervated by DPN
what is baxter’s nerve
most proximal branch of lateral plantar nerve that supplies abductor digiti quinti
two terminal cutaneous branches of SPN
dorsal medial and dorsal intermediate cutaneous nerves
two terminal branches of tibial nerve
medial and lateral plantar (divide under flexor retinaculum)
corona mortis
anastomosis between inferior epigastric (external iliac) and obturator (internal iliac)
course of femoral artery from aorta
aorta bifurcates to common iliacs at L4, common iliacs divide to internal and external at S1, external iliac continues under inguinal ligament to become femoral artery
what motion occurs at occiput-C1
50% of flexion/extension
what motion occurs at C1-C2
50% of rotation
apex of lumbar lordosis
L3
C5 muscle
deltoid
C6 motion
wrist extension
C7 motion
wrist flexion
C8 motion
finger flexion
T1 motion
interossei
L4 muscle
tib ant
L5 motion
toe extensors
S1 muscles
peroneal
structures in carotid sheath
internal and common carotid arteries, internal jugular vein, vagus nerve (CN X)
where does piriformis originate
anterior sacrum
where is the sciatic nerve relative to the ischial tuberosity?
1.2 cm lateral
where is the radial nerve relative to the confluence of triceps aponeurosis and long/lateral head of triceps
4 cm proximal
where does radial nerve branch to PIN and superficial sensory
1-3 cm distal to lateral epicondyle
where does AIN branch from medial nerve
4cm distal to elbow, runs between FPL and FDP
what nerve is at risk with posterior ICBG and where does it branch
superior cluneal nerve, branches 8cm lateral to PSIS
what nerve lies on the anteromedial psoas muscle
genitofemoral
mnemonic for lumbar plexus
I (twice) get laid on fridays - iliohypogastric, ilioinguinal, genitofemoral, LFCN, obturator, femoral
which nerve emerges anterior to the psoas
genitofemoral
which nerve emerges medial to the psoas
obturator
which nerves emerge lateral to the psoas
iliohypogastric, ilioinguinal, LFCN, femoral