Anatomy Flashcards
Which bones make up the shoulder girdle?
1) clavicle
2) scapula
What is the name of the groove between the greater and lesser tubercles of the humerus?
intertubercular sulcus; bicipital groove
Why is the shoulder joint considered unstable?
only 1/2 of proximal humerus is spherical, yet the joint is a ball and socket joint
What is a frequent site of humeral fractures in adults?
surgical neck
Where does the smooth articular surface of the humerus meet the shaft?
anatomical neck
Which nerve is at risk of damage at the surgical neck?
axillary nerve
Which nerve is at risk of damage at the radial groove? (i.e., spiral fracture of humerus shaft)
radial nerve
Which nerve is at risk of damage at the distal humerus?
median nerve
Which nerve is at risk of damage at the medial epicondyle?
ulnar nerve
What is the function of the clavicle?
1) support the anterior shoulder
2) prevent excessive anterior displacement of scapula
Why is the clavicle susceptible to injury?
1) little protection
2) S-shaped
What are the fossas of the scapula?
1) supraspinatus fossa
2) infraspinatus fossa
3) subscapular fossa
4) glenoid fossa
What are the processes of the scapula?
1) acromion process
2) coracoid process
What are the borders of the scapula?
1) superior border
2) axillary border (lateral)
3) vertebral border (medial)
What are the angles of the scapula?
1) superior angle
2) inferior angle
What are the actions of the trapezius?
1) scapular retraction
2) scapular rotation
Where does the serratus anterior attach?
1) medial border of scapula
2) ribs
What is the action of the serratus anterior?
scapular protraction
Which nerve innervates the serratus anterior?
long thoracic nerve
What are the attachments of the deltoid muscle?
1) scapular spine
2) clavicle
3) deltoid tuberosity
What are the actions of the deltoid muscle?
1) abduction
2) [flexion, extension]
Which nerve innervates the deltoid muscle?
axillary nerve
Which muscles make up the rotator cuff muscles?
1) supraspinatus
2) infraspinatus
3) teres minor
4) subscapularis
What are the heads of the triceps brachii?
1) long head (crosses shoulder and elbow)
2) lateral head
3) medial head (deep to long and lateral)
Which vein runs along the medial border of the deltoid muscle?
cephalic vein
Which larger vein does the cephalic vein empty into?
axillary vein
What are the muscles of the anterior brachial region?
1) coracobrachialis (deep, proximal)
2) biceps brachii short head (medial)
3) biceps brachii long head (lateral)
4) brachialis (deep, distal)
Which nerve innervates the anterior compartment of the arm?
musculocutaneous nerve
BBC: biceps brachii, brachialis, coracobrachialis
Which nerve innervates the posterior compartment of the arm?
radial nerve; nerve of extension!
What are the boundaries of the antebrachial fossa?
SUP: line between lateral and medial epicondyles
LAT: brachioradialis
MED: pronator teres
What are the contents of the antecubital fossa?
1) radial nerve
2) biceps tendon
3) median nerve
4) brachial artery
“Really Need Booze To Be At My Nicest”
What are the superficial veins of the anterior brachial region?
1) cephalic vein (lateral)
2) basilic vein (medial)
Where do the superficial veins of the anterior brachial region originate?
dorsal venous arch
Where does the cephalic vein empty into?
axillary vein
Where does the basilic vein empty into?
brachial vein(s)
What is the cubital tunnel?
ulnar groove of the humerus; ulnar nerve passes through here
What is the structure which connects the radius and ulna along their internal surfaces and what is its function?
interosseous membrane
1) separates anterior and posterior compartments
2) allows pronation and supination
3) provides muscle attachment sites
Which nerve(s) innervate the anterior compartment of the forearm?
1) median nerve
2) ulnar nerve
Which nerve(s) innervate the posterior compartment of the forearm?
radial nerve
What are the muscles of the superficial group of the anterior compartment of the forearm?
1) pronator teres
2) flexor carpi radialis
3) palmaris longus
4) flexor carpi ulnaris
5) flexor digitorum superficialis
What causes golfer’s elbow?
medial epicondylitis
What are the muscles of the deep group of the anterior compartment of the forearm?
1) flexor digitorum profundus
2) flexor pollicis longus
3) pronator quadratus
What are the muscles of the superficial group of the posterior compartment of the forearm?
1) brachioradialis
2) extensor carpi radialis longus
3) extensor carpi radialis brevis
4) extensor digitorum
5) extensor digiti minimi
6) extensor carpi ulnaris
Which of the superficial muscles of the posterior compartment of the forearm do not originate from the common extensor tendon?
1) brachioradialis
2) extensor carpi radialis longus
* *both cross elbow and wrist**
What causes tennis elbow?
lateral epicondylitis
`What are the muscles of the deep group of the posterior compartment of the forearm?
1) supinator
2) abductor pollicus longus
3) extensor pollicis brevis
4) extensor pollicis longus
5) extensor indicis
The tendon of which muscle runs through the intertubercular sulcus?
biceps brachii long head
Which important structures pass through the suprascapular notch?
suprascapular artery
suprascapular nerve
Where does the latissimus dorsi insert and which muscles lie superior and deep to it here?
intertubercular sulcus
1) teres major (deep)
2) pectoralis major (superior)
Which nerve innervates the supraspinatus muscle?
suprascapular nerve
Which nerve innervates the infraspinatus muscle?
suprascapular nerve
Which nerve innervates the teres minor muscle?
posterior branch of the axillary nerve
Which nerve innervates the subscapularis muscle?
upper and lower subscapular nerves
Which muscle attaches to the radial tuberosity?
biceps brachii
Which muscle attaches to the ulnar tuberosity?
brachialis
Which muscle attached to the coracoid process?
1) biceps brachii short head
2) coracobrachialis
What are all the joints of the shoulder?
sternoclavicular
acromioclavicular
glenohumeral joint
What are the ligaments of the sternoclavicular joint?
ant. sternoclavicular ligament
post. sternoclavicular ligament
interclavicular ligament
articular disc locations and functions?
sternoclavicular joint
improve joint congruity
acts as shock absorber
resist medial displacement of clavicle
What are the ligaments of the acromioclavicular joint?
acromioclavicular ligament; not important in stability of joint
Which ligament stabilizes the acromioclavicular joint?
coracoclavicular ligament
- conoid (medial)
- trapezoid (anterio-lateral)
What is a step down deformity?
coracoclavicular ligament disrupted; AC joint dislocation
What are the ligaments of the glenohueral joint?
glenohumeral ligaments
- superior
- middle
- inferior** [hammock]
Which structure adds additional support to the glenohumeral joint?
glenoid labrum
Where does the joint capsule attach to the humerus in the glenohumeral joint?
anatomical neck of humerus
What is a way to assess the axillary nerve with a sensory test?
regimental patch distribution of axillary nerve (over deltoid muscle)
Which muscles comprise the scapulothoracic joint?
subscapularis
serratus anterior
rhomboids
**nonanatomic
What are the joints of the elbow?
humeroulnar
humeroradial
proximal radioulnar
What are the ligaments of the humeroulnar joint?
ulnar collateral (medial)
What are the ligaments of the humeroradial joint?
radial colalteral (lateral) anular (around radial head)
Which arm position do anular ligament dislocations more commonly occur?
proximal position
What are the joints of the wrist?
radiocarpal joint
distal radioulnar
midcarpal joint
What are the ligaments of the distal radioulnar joint?
triangular (articular disc)
Which bones articulate with the radius in the radiocarpal joint?
scaphoid and lunate bones
When the hand is adducted, what happens to the radiocarpal joint?
triquetrum articulates with articular disc
Which bones articulate in the midcarpal joint?
proximal row with distal row
What are the ligaments of the MP and IP joints?
metacarpal collateral
deep transverse metacarpal
palmar (prevent hyperextension)
What are the ligaments of the IP joints?
interpharangeal collateral
palmar (prevent hyperextension)
Which 3 tendons make up the anatomical snuffbox?
Abductor pollicus longus
Extensor pollicus brevis
Extensor pollicus longus
“A brevis between 2 longus”
What is the most commonly fractured carpal bone and how does it typically fracture?
scaphoid bone
FOOSH
What is return from opposition of the thumb?
reposition
What muscles are contained within the hypothenar eminence?
abductor digiti minimi
flexor digiti minimi
opponens digiti minimi
What muscles are a part of the thenar eminence?
abductor pollicus brevis
flexor pollicus brevis
opponens pollicus
Which muscle adduct thethumb?
adductor pollicus
Which muscles adduct digits 2, 3, 4?
palmar interosseous muscles (3)
Which muscles abduct digits 2, 3, 4?
dosral interosseous muscles (3)
Lumbricals are a part of which muscle?
flexor digitorum profundus tendons
What structure is the hood of the carpal tunnel?
flexor retinaculum
Which structures are contained within the carpal tunnel?
9 tendons and 1 nerve flexor digitorum profundus flexor digitorum superficialis flexor pollicus longus median nerve
Which tendon interacts with the carpal tunnel but is not contained within the actual tunnel?
flexor carpi radialis
Which structures of the hand are motor innervated by the median nerve?
thenar eminence
lateral 2 lumbricals
What are most of the structures of the hand motor innervated by?
all other intrinsic hand muscles are motor innervated by the ulnar nerve
What is the action of the supraspinatus?
abduction of the humerus (first 15 degrees before deltoid takes over)
What movement will be altered from a tear in the supraspinatus and how?
humerus will not abduct, but will instead elevate
What is the action of the subscapularis?
medial rotation
What is the action of the infraspinatus?
lateral rotation
What action is completed by the subscapularis and infrascapularis together?
create a compression force holding the humeral head against the glenoid fossa
What size gap should exist between the humeral head and the acromion and what does this gap prevent?
6mm
prevents supraspinatus from being pinched
What causes an acute tear in the rotator cuff muscles?
uncommon traumatic force
dislocation injury
What causes a chronic degeneration tear in the rotator cuff muscles?
impingement (usually supraspinatus), tendinitis/bursitis, partial thickness tear or full thickness tear
What are the 2 most common rotator cuff muscle tears?
1) supraspinatus
2) subscapularis
What are the contributing factors for a rotator cuff muscle tear?
1) age
2) vascularity
3) occupation/leisure activities
4) postural considerations
5) bony arhitecture
What is the presentation of symptoms for a rotator cuff tear?
pain
weakness
What are the most important findings on an X-ray to diagnose a shoulder joint injury?
sclerosis (increase bone density on the acromion where the humeral head would articulate
bone spurs
What is the gold standard of confirming a should joint injury?
MRI
What is the treatment for a shoulder joint injury?
1) avoid exacerbating activities
2) physical rehabilitation
3) NSAIDs
4) corticosteroid or lidocaine injections
5) surgical and post-op care
What is the initial phase of tennis elbow?
tendinitis with inflammation
What is tendinosis?
progressed phase of tendinitis which is degenerative and has poor blood flow
What are the physical findings of tennis elbow?
1) point tenderness
2) symptoms reproduced with passive wrist flexion
3) resisted active wrist extension
4) chair test`
What causes the symptoms of carpal tunnel syndrome?
compression of the median nerve
Specifically, what is the innervation of the thenar eminence?
recurrent branch of the median nerve
What is the Tinel’s sign?
special test to test carpal tunnel syndrome (tap for 30 sec)
What is the Phalen maneuver?
special test to test carpal tunnel syndrome (flex wrist)
Which study is done to rule in carpal tunnel syndrome?
nerve conduction studies
Which study is done to rule out carpal tunnel syndrome?
electomyography
What is occipital neuralgia?
neuropathic pain “disease or disorder involving the nerve itself”; impingement of greater occipital nerve
What are the scalenes, where do they originate, and what are their actions?
anterior (rib 1)
middle (rib 1)
posterior (rib 2)
lateral neck flexion and rib elevation
hrough which muscles does the brachial plexus break through?
scalene muscles
What are the five categories of structures which receive innervation in the back and can be sources of pain?
1) fibroskeletal structures
2) meninges
3) synovial joints
4) muscles
5) nervous tissue
What are the characteristics of pain from fibroskeletal structures?
sharp following a freacture of periostium; acute and localized with IV disc
What are the characteristics of pain from meninges?
this type of pain is rare
What does the recurrent meningeal branches of the spinal nerves innervate?
fibroskeletal structures
meninges
What are the causes of facet joint pain?
aging (OA)
disease (RA)
What do the posterior rami innervate and with which branches?
synovial joints (facet joints) back muscles (deep) --- anterior branches muscular branches
What is referred pain?
compression or irritation of spinal nerves or nerve roots
What are the boundaries of the suboccipiral triangle?
lateral: obliquus capitis superior
inferior: obliquus capitis inferior
medio-superior: rectus capitis posterior major
superior (outside triangle): rectus capitis posterior minor
What are the contents of the suboccipital tirangle?
vertebral artery
occipital artery
What is the sensory innervation of the top of the head?
CN V1 (Ophthalmic n.)
Which nerve innervates the suboccipital triangle motor and sensory?
motor: suboccipital n.
sensory: greater occipital n.
