Anatomy

Question 1

Bone types, shapes, divisions

Answer 1

Types:
- compact
- spongy (harder to break)

Shapes:
- long (humerus)
- short (carpals)
- flat (parietal)
- irregular (vertebrae)
- sesamoid (patella)

Skeletal divisions:
- axial (skull, spine, rib cage, sacrum, hyoid)
- appendicular (upper and lower extremities)

Question 2

Joint classes

Answer 2

Fibrous:
- sutures
- gomphosis
- syndesmosis

Cartilaginous:
- primary (in a bone)
- secondary (between bones)

Synovial: united by fibrous capsule, lines with synovial membrane, space filled with synovial fluid
- pivot
- plane
- hinge
- saddle
- ball and socket
- condyloid

Question 3

Muscular contraction and movement

Answer 3

Contraction:
- isotonic - muscle length changes, tension doesn’t
- isometric - muscle length stays the same, tension changes

Movement:
- prime mover - responsible for movement
- fixator - stabilizes proximal aspect
- synergist - works with prime mover
- antagonist - opposed the action

Question 4

Surface anatomy of the back

Answer 4

lordosis: curves in the anterior direction; cervical and lumbar

kyphosis: curves in the posterior direction; thoracic and sacral

Question 5

Scaphoid Fracture

Answer 5

Most common and often misdiagnosed
Occurs after a fall on an outstretched hand
Can lead to poor blood supply to the proximal part of the scaphoid.
Avascular necrosis may occur and produce degenerative joint disease of the wrist.

Question 6

Colle’s Fracture

Answer 6

Complete transverse fracture of distal 2cm of the radius
Common in adults over 50, especially women because osteoporosis weakens bones
Results from forced extension of hand which occurs when falling on an outstretched arm
The distal fragment of the radius is pulled dorsally and superiorly, resulting in dinner fork deformity
Because of the rich blood supply to the distal end of the radius, bony union is usually good

Question 7

Draw the brachial plexus

Answer 7

Question 8

Brachial plexus injuries

Answer 8

Commonly either upper or lower plexus
- Upper: C5 and C6
- Lower: C8 and T1

Question 9

Glenohumoral injury

Answer 9

Humoral head movement in relationship to glenoid cavity
Subluxation: contact persists
Dislocation: no contact

Question 10

Winged scapula

Answer 10

Injury to the long thoracic nerve or serratus anterior muscle results in a “winging scapula”.
- Originates from roots of C5-C7
- Descends along superficial surface of serratus anterior
- Exposed nature makes it more easily injured
Loss of function for the serratus anterior prevents the scapula from being held against the thoracic wall.
This is especially evident when the patient presses against a wall with outstretched arms.

Question 11

Humeral fracture

Answer 11

Fractures of the surgical neck of the humerus endangers the axillary n. and posterior circumflex humeral a. as they pass through quadrangular space.
Most common in elderly people with osteoporosis.
Axillary n. damage will weaken/ paralyze the deltoid leading to an inability to abduct the arm.

Question 12

Movements of the thumb

Answer 12

Question 13

Dupuyten’s contracture

Answer 13

Progressive thickening and shortening of the palmar aponeurosis on the medial side of the hand which pulls the 4th and 5th digits into partial flexion at MP and PIP joints
Treatment usually involves surgical excision of all fibrotic parts of the aponeurosis to free the fingers

Question 14

DeQuervain’s Tenosynovitis

Answer 14

Thickening of tendons and synovial sheaths of extensor pollicis brevis and abductor pollicis longus.
Idiopathic or related to overuse
Pain, swelling at base of thumb
Grip difficulty