Anatomy Flashcards
What are the three types of joint?
Fibrous
Cartilaginous
Synovial
List some examples of fibrous joints
Periodontal ligaments
Cranial sutures
Interosseus membranes
What type of cartilage is contained in primary cartilaginous joints?
Hyaline cartilage
What type of cartilage is contained in secondary cartilaginous joints?
Hyaline cartilage
Fibrocartilage
Give an example of a primary cartilaginous joint?
Synchondrosis in growing long bones
Give an example of a secondary cartilaginous joint?
Symphysis - intervertebral discs in spnes
List some common features of synovial joints?
Synovial cavity
Articular cartilage
Fibrous capsule
Synovial membrane
(May also contain articular discs, ligaments, bursae)
List some types of synovial joints?
Plane Condylar (ellipsoid) Hinge Saddle Pivot Ball and Socket
What are the features of a joint that help to give stability?
Shape of articulating surfaces
Capsule and ligaments
Muscles
What is contained in the superficial layer of articular (hyaline) cartilage?
Flattened chondrocytes that produce collagen and glycoproteins (eg lubricin)
What is contained in the transitional layer of articular (hyaline) cartilage?
Round chondrocytes that produce proteoglycans such as aggrecan
What are glycosaminoglycans (GAGs)?
Long unbranched polysaccharides, which are highly polar and thus attract water
Given that cartilage is avascular, aneural and alymphatic, how are nutrients and waste transported to and from?
Through synovial fluid produced by the synovial membrane
What type of cells produce synovium?
Type B Synoviocytes (and type A)
What is the function of type A synoviocytes?
Remove debris, and contribute to synovial fluid production
List some properties of synovial fluid?
- Viscous fluid
- Hyaluronic acid and lubricin
- Fluid component
What are the functions of synovial fluid?
Nutrition of cartilage
Removal of waste products
Lubrication (limit wear and tear)
What happens to synovial joints with ageing?
- Viscosity of synovial fluid increases (slower movements, reduced lubrication)
- Water content of cartilage decreases
- Increased risk of damage
What are the spinal nerves that supply the musculoskeletal nerve?
C5 - C7
What are the spinal nerves that supply the median nerve?
C6-C8, T1
What are the spinal nerves that supply the radial nerve?
C5-C8, T1
What are the spinal nerves that supply the ulnar nerve?
C7-C8, T1
What are the spinal nerves that supply the axillary nerve?
C5 and C6
What are the tributaries of the axillary vein?
Cephalic vein
Basilic vein
What type of joint is the acromioclavicular joint?
Synovial plane joint
What type of joint is the sternoclavicular joint?
Synovial saddle joint
What type of joint is the glenohumeral joint?
Synovial ball and socket joint
What are the movements of the scapula?
Elevation Depression Adduction (retraction) Abduction (protraction) Upward rotation Downward rotation
List some rotator cuff muscles?
Subscapularis
Supraspinatus
Infraspinatus
Teres minor
To abduct the arm 180 degrees, how much is the scapula rotated and how much is the humerus rotated at the shoulder joint?
60 degrees occurs by rotation of the scapula
120 degrees by rotation of the humerus at the shoulder joint
What movements are conducted by the biceps brachii?
Flex shoulder and elbow
Supinates the forearm
What movements are conducted by the brachialis?
Flexes elbow
What movements are conducted by the coracobrachialis?
Flex and adduct shoulder joint
What nerve controls movements of the anterior arm muscles?
Musculocutaenous (C5-C7)
What movements are conducted by the triceps?
Extension of elbow joint
Where on the forearm are the flexors of the wrist?
Anterior of arm
Where on the forearm are the extensors of the wrist?
Posterior of arm
What movement do palmar interossei have on the fingers of the hand?
Adduction
PalmarAD DorsalAB!
What movement do dorsal interossei have on the fingers of the hand?
Abduction
PalmarAD DorsalAB!
How many carpalmetacarpal joints (CMCJ) are there in the hand?
5
How many metacarpalphalangeal joints (MCPJ) are there in the hand?
5
How many Proximal Interphalangeal joints (PIPJ) are there in the hand?
4 (The thumb has no middle phalanx - so proximal and distal only in fingers)
How many Distal Interphalangeal joints (DIPJ) are there in the hand?
4 (The thumb has no middle phalanx - so proximal and distal only in fingers)
List the carpal bones of the hand
Scaphoid Lunate Triquetrum Pisiform Trapezium Trapezoid Capitate Hamate
(She looks too pretty; try to catch her)
What is important to consider about scaphoid blood supply?
Retrograde supply (From distal to proximal) Fractures are more difficult to heal - risk of Avascular Necrosis (AVN)
What are the boundaries of the anatomical snuffbox?
Medial - Extensor Pollicis Longus Tendon
Lateral - Extensor Policis Brevis Tendon and Abductor Pollicis Longus Tendon
What can be palpated in the anatomical snuffbox?
Radial artery
Radial styloid process
Scaphoid
Trapezium
List the superficial flexors of the forearm
Medially: Flexor Carpi Ulnaris Palmaris Longus Flexor Carpi Radialis Pronator Teres
What is the clinical relevance of Flexor Carpi Radialis?
Clinical landmark for approach to radius
What is the clinical relevance of Palmaris Longus?
Used in autograft tendon transfers
Can be tested for in patients by opposing thumb and little finger with wrist slightly flexed
What is the only tendon to act on distal interphalangeal joints (DIPJs)?
Flexor Difitorum Profundus (FDP)
To test - isolate DIPJ in that finger
Which two tendons act on proximal interphalangeal joints (PIPJs)?
Flexor Difitorum Superficialis (FDS)
and
Flexor Difitorum Profundus (FDP)
How to you clinically isolate Flexor Digitorum Superficialis? (FDS)
Holing other fingers out straight - FDS has individual muscle bellies in each finger, whereas FDP has a common muscle belly that can be stopped by straightening other fingers
What are the extensors at the wrist?
Extensor Pollicis Brevis and Abductor Pollicis Longus
Extensor Carpi Radialis Longus and Extensor Carpi Radialis Brevis
Extensor Pollicis Longus
Extensor Digitorum Communis and Extensor Indicis
Extensor Digiti Minimi
Extensor Carpi Ulnaris
What artery doe the superficial arch arise from in the hand?
Ulnar artery
What artery doe the deep arch arise from in the hand?
Radial artery
What test is conducted on the arteries at the wrist for intravascular access to radial artery?
Allens Test
Occlude both arteries at wrist. Open and release fist until blanched, release ulnar artery
What are the two main branches of the sciatic nerve?
Tibial nerve Common fibular (peroneal) nerve
What are the two main branches of the tibial nerve?
Medial plantar nerve
Lateral plantar nerve
What is the definition of a dermatome?
Sensory are of skin supplied by a single spinal nerve
What is the dermatome for the back of the heel?
S1
(STAND on S1
SLEEP on S2
SIT on S3
SH*T on S4)
What is Hilton’s Law?
The nerves crossing a joint supply the muscles acting on it and the joint itself
In relation to nerves, why may hip disease give rise to knee pain?
The nerves supplying the joints (and muscles) are the same (femoral, sciatic and obdurator)
What nerves supply the hip joint?
Obdurator nerve (predominately)
Femoral nerve
Lateral femoral cutaneous nerve
What is a myotome?
Group of muscles supplied by one segment of spinal cord
What are the names for the sequential divisions of the brachial plexus?
Roots Trunks Divisions Cords Branches
From which cord(s) does the radial nerve arise?
Posterior Cord
From which cord(s) does the median nerve arise?
Lateral Cord
Medial Cord
From which cord(s) does the ulnar nerve arise?
Medial Cord
Where does the radial nerve enter the forearm?
Passes between brachioradialis and brachialis
What is the median nerve closely associated with in the arm?
Brachial artery
Where does the medial nerve enter the forearm?
Passes between two heads of pronator teres
What ligament makes up the carpal tunnel?
Transverse carpal ligament
Where does the ulnar nerve enter the forearm?
Passes between two heads of flexor carpi ulnaris
What are the roots of the femoral nerve?
L2-L4
Which is the largest branch of the lumbar plexus?
Femoral nerve
List the contents of the femoral triangle, from medial to lateral
Femoral vein
Femoral artery
Femoral nerve
VAN
What does the femoral nerve supply?
Quadriceps muscles in thigh
What does the femoral nerve terminate in?
Saphenous nerve (supplies great toe)
What are the roots of the lateral femoral cutaneous nerve?
L2,3
What does the lateral femoral cutaneous nerve supply?
Sensory to lateral aspect of thigh
What are the roots of the sciatic nerve?
L4-S3
What does the sciatic nerve supply?
Hamstring muscles in thigh (posterior)
Part of abductor magnus
All lower leg and foot muscles via terminal branches (tibial and common fibular)
What are the roots of the common fibular nerve?
L4-S2
What muscle group is the myotome of C5?
Shoulder abduction
eg Deltoid
What muscle group is the myotome of C6?
Elbow flexion/Wrist flexors
eg Biceps
What muscle group is the myotome of C7?
Elbow Extensors
eg Triceps
What muscle group is the myotome of C8?
Finger Extensors
eg FDS/FDP
What muscle group is the myotome of T1?
Intrinsic Hand muscles - finger abductors
eg Interossei
What muscle group is the myotome of L2?
Hip flexors
eg Iliopsoas
What muscle group is the myotome of L3?
Knee extensors
eg Quadriceps
What muscle group is the myotome of L4?
Ankle dorsiflexors
eg Tibialis Anterior
What muscle group is the myotome of L5?
Long toe Extensors
eg EHL
What muscle group is the myotome of S1?
Ankle plantar flexors
eg gatrocnemius
What muscles are supplied by the musculocutaenous nerve?
Biceps brachii
Brachialis
What muscles are supplied by the axillary nerve?
Deltoid
Teres Minor
What muscles are supplied by the radial nerve?
Brachioradialis
Extensor Carpi Radialis Longus (ECRL)
Extensor Carpi Radialis Brevis (ECRB)
What nerves does the radial nerve divide into?
Posterior interossesous nerve (Motor)
Superficial radial nerve (Sensory)
What muscles are supplied by the medial nerve?
Flexors of forearm LOAF muscles (Lateral lumbricals (First, second), Opponens policis, Abductor pollicis brevis, Flexor policis brevis)
What muscles are supplied by the ulnar nerve?
Medial half of Flexor Digitorum Profundus (FDP),
Flexor Capri Ulnaris (FCU),
All Intrinsic hand muscles (Bar LOAF)
What nerves arise from the common fibular nerve?
Deep fibular nerve (Supplies anterior leg)
Superficial fibular nerve (Supplies lateral lag)