Anatomy Book Week 9-13 Flashcards
What is carpal tunnel syndrome and what can cause it
The pressure on a median nerve in your wrist causes pain and numbness in your hand and fingers
More at risk if you are overweight, pregnant, do work where you repeatedly bend wrist or grip hard, have arthritis or diabetes
Attachments of the biceps brachii muscle
Proximal attachment: short head tip of coracoid process of scapula
Long head: supraglenoid tubercle of scapula
Distal attachment: tuberosity of radius and fascia of forearm via bicipital aponeurosis
How / where does rupture of the tendon of the long head of the biceps occur
Normally breaks at the supraglenoid tubercle of scapula
Detached muscle forms a ball near the elbow
How does pronation / supination occur (detailing the roles of the biceps and anular ligament)
Supination: produced by supinator and the biceps brachi
Pronation: produced by pronator quadrants and pronator teres
Anular ligaments stabilise radial head within radial notch during pronation / supination
Describe dislocation of the radial head
More common in girls
When they are jerked by the arm in the pronator position
Pulling detaches angular ligament from neck of radius, causing radial head to move more distally
Proximal part of anular ligament may become trapped between radial head and capitulum of humerus
What is lateral epicondylitis (tennis elbow)
Pain around the outside of the elbow (overuse or repeated action of the forearm muscles, near elbow joint)
What is medial epicondylalgia ( golfers elbow)
Pain where the tendons of your forearm muscles attach to the bony bump on the inside of your elbow (can spread to forearm and wrist)
Describe dislocation of elbow joints
Occurs when any of the 3 bones in the elbow joint become separated or knocked out of their normal positions (not hugely common)
What are the 8 carpal bones
1) hamate
2) capitate -round head
3) trapezoid - wedge shaped
4) trapezium - 4 sided
5) pisiform - pea shaped
6) triquetral
7) lunate
8) scaphoid
Some lovers try positions that they can’t handle
Why is the fracture of the scaphoid bone a particular problem
The end of the radius bone may also break
What is a colles fracture and how does it occur
A break in the radius close to the wrist (an inch below where the bone joins the wrist) usually occurs from a FOOSH or trauma accident
Important surface landmarks to enable you to take a pulse in the arm
Easier to feel the pulse when the artery is near the surface of the skin and there is firm tissue (such as bone) beneath the artery
How is blood pressure taken using a cuff and stethoscope
1) wrap the cuff around the upper arm
2) lightly press stethoscope bell over brachial artery just below cuffs edge
3) rapidly inflate cuff to 180 mmHg. Release air from the cuff at a moderate rate
4) listen with stethoscope. The first knocking sound is systolic when the sound disappears that is diastolic
Function, innervation and general attachments of the serrated anterior
A muscle that originates on the surface of the 1st to 8th ribs at the side of the chest
Acts to pull the scapula forward around the thorax
Innervation: the long thoracic nerve (typically composed of cervical nerves C5, C6 and C7) is inserted along the medial border of the scapula between the superior and inferior angles
Along with being inserted along the thoracic vertebrae
Why is the quadrangular space clinically important
It provides the anterior regions of the axilla passageway to the posterior regions. In this space, the axillary nerve and posterior circumflex humeral artery can be compressed or damaged due to space occupying lesions or disruptions due to trauma
What are the boundaries of the quadrangular space
Superiorly: teres minor
Medially: long head of triceps
Inferiorly: teres major
Laterally: surgical neck of humerus
What are the contents of the quadrangular space
Shaft of humerus, long head of triceps, teres minor and major
Function and innervation of rotator cuff muscles (SITS)
Supraspinatus: abduction of arm. Innervated by suprascapular
Infraspinatus: lateral rotation of arm. Innervated by suprascapular
Teres minor: lateral rotation of arm. Innervated by axillary nerve
Subscapularis: medial rotation of arm. Innervated by subscapular nerve
Why is the supraspinatus muscle the most commonly injured in the rotator cuff muscles
Is a relatively small muscle of the upper back that runs from the supraspinatus fossa
Superior portion of the scapula to the greater tubercle of the humerus
Tear can be caused by lifting something too heavy, falling on your arm or dislocating your shoulder
Function and general attachments of the 3 heads of the triceps brachi
Function: helps in extension of elbow joint and also acts as an antagonist of the biceps and brachialis. Also helps to stabilise the shoulder joint by keeping head of humerus in correct place
Long head arises from infraglenoid tubercle of scapula, lateral head just superior to radial groove
Medial head: inferior to radial groove
If the radial nerve is damaged in the radial groove, the triceps is weakened usually (not completely paralysed) why?
Because the medial and long head of triceps are attached close to the radial nerve
Where does the radial nerve pass through the cubital fossa
Travels along the lateral border of the cubital fossa and divides into superficial and deep branches
Where does the radial nerve go at the wrist and when it goes into the hand
Innervates muscles in the posterior compartment of the forearm and the extrinsic extensors of the wrist and hands
Provides cutaneous sensory innervation to most of the back of the hand
What does nerve damage in the axilla result in
Deltoid and teres minor muscles are affected
Numbness in lateral shoulder region (loss of movement or sensation)
Chronic neuropathic pain
What does nerve damage at the mid-shaft of the humerus (radial nerve) result in
Triceps are affected
Movement of triceps at the back of the upper arm and ability to bend wrist and fingers is impaired
Results in numbness or tingling
What does nerve damage near the elbow result in
Flexor muscles of the forearm (flexor carpi ulnaris), flexor digitorum profundus
Can cause muscle wasting or atrophy
Numbness and tingling in fingers
Where does the ulnar nerve cutaneously innervate the upper limb
Palmar branch: anterior skin and nails
Dorsal cutaneous branch: dorsal medial hand and the dorsum of the medial 1.5 fingers
Where does the median nerve cutaneously innervate the upper limb
Skin of the palmar side of the index finger, thumb, middle finger, and half ring finger and nail bed
Palmar cutaneous branch of median nerve innervates the radial aspect of the palm
Where does the musculcutaneous nerve cutaneously innervate the upper limb
Innervates the 3 muscles of the anterior compartment of the arm: coracobrachialis, biceps brachii and brachialis
Where does the radial nerve cutaneously innervate the upper limb
Innervates the medial and lateral heads of the triceps brachii as well as all 12 muscles in the posterior osteofascial compartment of the forearm and the associated joints and overlying skin
What muscles does the sciatic nerve innervate
Biceps femoral
Hamstring portion of adductor Magnus
What muscles does the superior gluteal nerve innervate
Gluteus medius, gluteus minimus and tensor fasciae latae.
Function and innervation of semitendinous, semimembranosus and biceps femoris
They are all hamstrings (innervated by tibial division of sciatic nerve)
Function: extension at hip joint and flexion at knee joint
Function and innervation of the adductor Magnus
Pulls the hip towards the Body’s midline eg in walking and sprinting
Innervated by obturator nerve and sciatic nerve
Function and innervation of the vastus lateralis
Longest and most powerful part of the quadriceps
Extends and stabilises knee
Innervated by the femoral nerve
Attachments of the long and short heads of the biceps femoris
Long: ischium (lower and back part of the hip bone)
Short: femur bone
Difference in functions of the long and short head of the biceps femoris
Long: flexes knee and extends hip
Short: flexes knee, laterally rotates lower leg
Popliteus attachments
Proximal: lateral surface of lateral condyle
Distal: proximal posterior surface of tibia
Function of the popliteus
Assists in knee flexion
‘Key’ to unlocking the knee as it begins knee flexion by laterally rotating the femur on the tibia
What is the deepest structure in the popliteal fossa
Popliteal artery
What is the triceps surae
The 2 heads of the gastrocnemius and the soleus
These 2 muscles both insert into the calcaneus, the bone of the heel and form the major part of the calf muscle
Function and innervation of tibialis posterior
Supports the medial longitudinal arch during weight bearing
Innervated by tibial nerve
Function and innervation of flexor hallucis longus
Powerful flexor of all the joints of the great toe
Innervated by tibial nerve
What is tarsal tunnel syndrome
Entrapment and compression of the tibial nerve occurs when there is edema and tightness in the ankle involving the synovial sheaths of the tendons of muscles in the posterior compartment of the leg
Heel pain results from compression of the tibial nerve by the flexor retinaculum
Where is the safe area for injection in the gluteal region
Why this region?
Superotaleral quadrant of gluteal region because muscles are so thick so allows for absorption of drugs
Function of the fibula
Main function is to combine with the tibia and provide stability to the ankle joint
Distal end of fibula has several grooves for ligament attachments
What is gastrocnemius strain
An injury to the calf muscle in the back of the leg occurs when the muscle is stretched too far
What is the calcaneal tendon reflex
Occurs when the Achilles’ tendon is tapped while the foot is dorsiflexed
Positive result is jerking of the foot towards the plantar surface
Consequences of damage to the superior gluteal nerve
Results in paralysis of the gluteus medius resulting in a characteristic gait on walking and standing
Consequences of damage to the inferior gluteal nerve
Damage leads to gluteus maximum lurch
Loss of extension at hip and causes the buttock to waste
Consequences of damage to the sciatic nerve
Sciatica occurs when sciatic nerve becomes pinched (usually by a herniated disc in spine or by overgrowth of bone on your vertebrae)
Occurs when one or more nerve roots from L4 to S3
Consequences of damage to the tibial nerve
Commonly injured by fractures or other injury to the back of the knee or lower leg
Causes numbness, pain, tingling, and weakness of the knee or lower leg
Consequences of damage to the common fibular nerve
Common fibular nerve wraps around the neck of the fibular so any fractures of fibular neck can cause nerve palsy
Patients with common fibular nerve damage will lose the ability to dorsiflex the foot at the ankle joint
Consequences of damage to the sural nerve
Can result in burning pain and diminished sensation or numbness
The nerve passes down from the back of the knee along the outside of the lower leg
