Anatomy Lab - Upper Extremity

Question 1

Shoulder girdle

Answer 1

Clavicle and scapula
Axial skeleton is sternoclavicular joint

Question 2

Where is the trapezoid line on the clavicle?

Answer 2

• Trapezoid line: extending laterally from conoid tubercle toward acromial articular surface.
• Attachment of trapezoid ligament- part of
coracoclavicular ligament

Question 3

What is another name for clavicle? What does the clavicle allow passage of?

Answer 3

• Aka collar bone
• Allows for passage of neurovascular bundle to/from upper extremity

Question 4

What is the shape of the clavicle?

Answer 4

• Sternal end: enlarged, triangular
• Acromial end: flatter, tapered, articulates with
acromion of scapula at acromioclavicular (AC) joint

Question 5

Where is the confidence tubercle?

Answer 5

• Conoid tubercle: inferior distal surface near
acromial end.
• Attachment of conoid ligament- part of the
coracoclavicular ligament

Question 6

What are the borders of the scapula?

Answer 6

• medial (vertebral)
• lateral (axillary)
• superior

Question 7

What are the angles of the scapula?

Answer 7

• inferior: union of lateral and medial
• lateral (bearing the glenoid fossa): union of lateral and superior borders
• superior: union of medial and superior
borders

Question 8

Where are all the landmarks on the scapula?
Subscapular, Spine, Acromion Process, Infraspinous Fossa, Supraspinous Fossa, Coracoid process, Scapular Notch, Glenoid Fossa/Cavity, Supraglenoid Tubercle, Infraglenoid Tubercle

Answer 8

• Subscapular Fossa: slightly concave anterior surface
• Spine: a ridge of bone on the dorsal surface
• Acromion Process: lateral, freely projecting process of the spine, articulated with distal clavicle forming acromioclavicular (AC) joint
• Infraspinous Fossa: dorsal surface inferior to the spine
• Supraspinous Fossa: dorsal surface superior to the spine
• Coracoid Process: thick, curved process attached to the superior border
projecting anterolaterally
• Scapular Notch: superior border, medial to the coracoid process
• Glenoid Fossa/Cavity: slightly concave surface of the lateral angle;
articulates with the head of the humerus
• Supraglenoid Tubercle: immediately superior to the glenoid fossa
• Infraglenoid Tubercle: immediately inferior to the glenoid fossa

Question 9

Where are all the landmarks on the Humerus?

Head, Anatomical Neck, Lesser tubercle, Greater tublercle, Intertubercular sulcus/Bicipital groove, Surgical Neck, Deltoid Tuberosity, Spiral groove/Sulcus of Radial Nerve, Trochlea, Radial fossa, Coronoid fossa, Olecranon fossa, Medial Epicondyle, Sulcus of Ulnar Nerve, Lateral Epicondyle

Answer 9

• Head: articulates with the glenoid fossa
• Anatomical Neck: indistinct area immediately distal to the head
• Lesser Tubercle: anteriorly, inferior to the head; the ridge of bone extending down from the tubercle is the crest of the lesser tubercle
• Greater Tubercle: large projection lateral to the head
• Intertubercular Sulcus/Bicipital Groove: groove between the tubercles
• Surgical Neck: indefinite area inferior to the tubercles where the bone narrows (fractures are
fairly common here)
• Deltoid Tuberosity: on the anterolateral surface, just superior to midshaft. Insertion of deltoid
• Spiral Groove/Sulcus of the Radial Nerve: shallow groove on the superior posterior surface passing inferiorly from medial to lateral. Immediately distal to deltoid tuberosity
• Capitulum: round, anterolateral articulating surface; articulates with the head of the radius
• Trochlea: pulley-like medial articulating surface; articulates with the trochlear notch of the ulna
• Radial Fossa: slight depression immediately proximal to the capitulum, on the anterior surface; receives the head of the radius in forearm flexion
• Coronoid Fossa: depression immediately proximal to the trochlea on the anterior surface;
receives the coronoid process of the ulna in forearm flexion
• Olecranon Fossa: large depression immediately proximal to the trochlea on the posterior surface; receives the olecranon process in forearm extension
• Medial Epicondyle: projection medial to the trochlea
• Sulcus of the Ulnar Nerve; on posterior, inferior surface of the medial epicondyle
• Lateral Epicondyle: projection lateral to the capitulum

Question 10

Where are all the landmarks on the Radius?

Head, Neck, Radial Tuberosity, Styloid Process

Answer 10

• Lateral bone of forearm
• Head: disk-like proximal end which articulates with the capitulum on its proximal aspect and with the radial notch of the ulna on its medial aspect
• Neck: narrowed region immediately distal to the head
• Radial Tuberosity: on anterior surface, distal to the neck; an insertion site for biceps brachii
• Styloid Process: bluntly pointed projection on the lateral, distal surface E. Ulnar Notch: depression on the medial, distal surface for articulation with the head of the ulna

Question 11

Where are all the landmarks on the Ulna?

Trocholear Notch/Semilunar Notch, Olecranon Process, Coronoid Process, Radial Notch, Ulnar Tuberosity, Styloid Process

Answer 11

• Medial bone of forearm
• Trochlear Notch/Semilunar Notch: large, anterior proximal indentation; articulates with the trochlea
• Olecranon Process: large posterior proximal projection
• Coronoid Process: anterior lip of the trochlear notch
• Radial Notch: indentation on the proximal lateral surface for articulation with the head of the radius
• Ulnar Tuberosity: at the base of the coronoid process
• Head: distal end
• Styloid Process: dorsal medial projection off the head

Question 12

What are the ligaments of the elbow?

Answer 12

1. Ulnar collateral ligament
2. Radial collateral ligament
3. Annular ligament

Question 13

What are the carpal bones proximal row, lateral to medial? Distal row, lateral to medial?

Answer 13

• Proximal row, lateral to medial
• Scaphoid: cashew- shaped, boat
• Lunate: crescent moon shaped
• Palpate at midline of wrist at distal radioulnar articulation
• Triquetral (triquetrum): 3-cornered
• Pisiform: pea shaped, arises in tendon of
flexor carpi ulnaris. A sesamoid bone

• Distal row, lateral to medial
• Trapezium: table or saddle- shaped, note
• Trapezoid: plug-shaped
• Capitate: domed, largest of carpals, forms
dorsal border of carpal tunnel with lunate
• Hamate: hook and wedge-shaped body,

Question 14

What are the ligaments of the wrist?

Answer 14

Scapholunate ligament
- Scaphoid to lunate
- MC wrist ligamentous sprain

Triangular Fibrocartilage Complex
- Between ulna and carpals
- Creates smooth surface
- Also often injured in falls

Question 15

Latissimus dorsi

O:
I:
A:
N:
V:
P:

Answer 15

• Broad muscle of back, “lats”
• O: SP of T7-T12, thoracolumbar fascia, iliac crest, ribs (9) 10-12
• I: floor of bicipital (intertubercular) groove
• A: extends, adducts, medially rotates
then move limb in opposite direction while compressing muscles
• * While treating psoas major, the lat can be
stretched by placing ipsilateral hand behind head thereby stretching thoracolumbar fascia
humerus, pulls body to arms while climbing. Important for global movements of thorax: unilateral lateral flexion, rotation and(bilateral contraction for extension of thorax
• N: Thoracodorsal nerve C6, 7, 8
• V: Thoracodorsal a
• P: side-lying, combine actions of muscle

Question 16

Trapezius

O:
I:
A:
N:
V:
P:

Answer 16

• O: EOP, medial 1/3 of superior nuchal line, nuchal ligament, SPs of C7-T12
• I: Lateral 1/3 of clavicle, acromion, spine of scapula
• A:
• Upper/superior/descending fibers: elevates scapula
• Middle fibers: retract scapula (along with all parts)
• Lower/inferior/ascending fibers: depresses scapula
• Upper and lower fibers contract to laterally
(externally) rotate scapula
• With scapulae fixed, extends and laterally rotates head

• N:
• Motor: Cranial Nerve XI (spinal accessory)
• Sensory (pain/proprioception) C3 & C4 spinal
nerves

• V: from transverse cervical or superficial cervical aa
• P: Differentiate palpation of upper trap from levator
scapulae and posterior scalene

Question 17

Rhomboid major & minor

O:
I:
A:
N:
V:
P:

Answer 17

• O:
• Minor: Nuchal ligament, SP of C7 & T1
• Major: SP
of T2-T5

• I:
• Minor: medial border of scapula above
scapular spine (note difference to
levator scapulae)
• Major: Medial border of scapula from
spine to inferior angle

• A: retract and inferiorly (medially)
rotate scapula
• N: Dorsal scapular n (C5) • V: Dorsal scapular a
• P: Deep to trapezius. Feel for
differences during scapular retraction

Question 18

Levator Scapule
O:
I:
A:
N:
V:
P:

Answer 18

• O: Posterior tubercles of TPs of C1-4
• I: Superior angle of scapula (medial
border of scapula superior to root of spine of scapula)
• A: elevates and inferiorly (medially)
rotates scapula
• N: Dorsal scapular nerve, (C5) and C3, C4 nerves
• V: Dorsal scapular a
• P: With head slightly extended and rotated away from contact, elevate shoulder while pressing into epimysial
groove between trapezius and posterior scalene

Question 19

Deltoid
O:
I:
A:
N:
V:
P:

Answer 19

• O: Lateral 1/3 of clavicle, acromion, spine of scapula
• I: deltoid tuberosity
• A:
• Anterior (clavicular) part: flexes and
medially rotates arm, horizontal
flexion/horizontal adduction
• Middle (acromial) part: abducts are
• Posterior (spinal) part: extends and laterally rotates arm , horizontal
abduction/lateral extension
• N: Axillary N (C5, 6)
• V: Posterior humeral circumflex a
• P: Feel for insertion and radial groove just distal and posterior to tuberosity

Question 20

Supraspinatus
O:
I:
A:
N:
V:
P:

Answer 20

• O: supraspinous fossa of scapula
• I: superior facet of greater tubercle of
humerus
• A: assists deltoid, first 30 degrees of
abduction of arm, stabilizes
glenohumeral joint
• N: Suprascapular n (C5)
• V: Suprascapular a
• P: Deep to trapezius and tendon passing under acromion

Question 21

What is the most commonly injured muscle of the rotator cuff?

Answer 21

Supraspinatus

Question 22

Infraspinatus
O:
I:
A:
N:
V:
P:

Answer 22

• O: infraspinous fossa of scapula
• I: middle facet of greater tubercle of
humerus
• A: laterally rotates, stabilizes glenohumeral joint, some extension
of a flexed arm
• N: Suprascapular (C5)
• V: Suprascapular & circumflex
scapular aa
• P: Deep to trapezius, inferior to spine of scapula. Differentiate between infraspinatus and teres minor

Question 23

Teres Major
O:
I:
A:
N:
V:
P:

Answer 23

• O: posterior surface of inferior angle of scapula
• I: medial lip of intertubercular groove of humerus
• A: adducts and medially rotates humerus
• N: Lower subscapular nerve (C6)
• V: Circumflex scapular
• P: Differentiate between major and minor by having “patient” internally and externally rotate arm
• * acts with Latissimus dorsi

Question 24

Teres minor
O:
I:
A:
N:
V:
P:

Answer 24

• O: Middle part of lateral border of scapula
• I: inferior facet of greater tubercle of
humerus
• A: laterally rotates arm, stabilizes
glenohumeral joint, lateral extension of
a laterally flexed arm
• N: Axillary N 9C5,6)
• V: Circumflex scapular a
• P: After differentiating between teres minor and major, follow toward
humerus to feel long head of triceps brachii splitting the two teres muscles
• * To differentiate between infraspinatus and teres minor, remove infraspinatus fascia and follow towards head of humerus until separation is evident

Question 25

Subscapularis O: I: A: N: V: P:

Answer 25

• O: Subscapular fossa • I: lesser tubercle of humerus • A: medially rotates humerus, stabilizes glenohumeral joint, aids in adduction of abducted humerus • N: Lower and Upper Subscapular nerves (C5-7) • V: • P: supine, with arm externally rotated and abducted, press firmly deep accounting for fat, fascia, vessels, nerves running between scapula and thorax

Question 26

Serratus anterior O: I: A: N: V: P:

Answer 26

• O: External, lateral surfaces of ribs 1-8(9) • I: anterior medial border of scapula • A: protracts and externally (upward) rotates scapula (inferior part), aids in depression of scapula (inferior part) • N: Long thoracic (C5-7, 8) • V: lateral thoracic and thoracodorsal aa • P: Side-lying, differentiate between lats and serratus anterior

Question 27

Serratus posterior superior O: I: A: N:

Answer 27

• Deep to rhomboids • O: ligamentum nuchae, SP C7-T2 • I: upper border of ribs 2-5 • A: elevates ribs 2-5 (inspiration) • N: Intercostal nn 2-5

Question 28

Serratus posterior inferior O: I: A: N:

Answer 28

• Deep to latissimus dorsi • O: SP of T11-L2 • I: inferior border of ribs 9-12 • A: depresses ribs 9-12 (expiration), assists in rotation and extension of spine • N: intercostal nn 9-12 (subcostal) • * likely implicated in side aches

Question 29

Pectoralis major O: I: A: N: V: P:

Answer 29

• O: • Clavicular head: anterior surface of medial half of clavicle • Sternal (sternocostal) head: anterior sternum, costal cartilages of ribs 1-6, aponeurosis of external oblique • I: lateral lip of intertubercular sulcus of humerus • A: adducts, medially rotates humerus, draws scapula anterior and inferior • Acting in isolation, clavicular head flexes humerus and sternal head extends a flexed humerus • N: Lateral and medial pectoral nerves • Clavicular head: C5-6 • Sternal head: C7-8 • V: pectoral branch of thoracoacromial trunk • P: differentiate between pectoralis major and pectoralis minor • * Follow the cephalic vein to where it dives between anterior deltoid and pectoralis major to locate borders of muscles. Slide hemostat under muscle near insertion to reflect medially.Reflect most of muscle attachment at clavicle to view subclavius m

Question 30

Pectoralis minor O: I: A: N: V: P:

Answer 30

• O: Ribs 3-5(6) near costal cartilages • I: coracoid process • A: stabilizes scapula- draws it inferiorly and anteriorly (anterior tilt) • N: Medial pectoral nerve (C8-T1) • V: pectoral branch of thoracoacromial trunk • P: deep to pectoralis major • * Slide a hemostat under pec minor and cut into the hemostat reflecting pec minor laterally. The brachial plexus will pass just deep to pec minor.

Question 31

Subclavius O: I: A: N: V: P:

Answer 31

• O: junction of rib 1 and costal cartilage • I: Inferior surface of middle 1/3 of clavicle • A: anchors and depresses clavicle, prevents dislocation of SC joint during pulling • N: Nerve to subclavius (C5) • V: clavicular branch of thoracoacromial trunk • P: deep to costal head of pectoralis major • * a small muscle, the pec major clavicular head must be adequately reflected to view subclavius

Question 32

Damage to long thoracic causes scapular winging to which muscle?

Answer 32

Serratus anterior

Question 33

Due to the muscle’s position and action, what muscles may be involved in some cases of thoracic outlet syndrome?

Answer 33

Subclavius

Question 34

External intercostals O: I: A: N: V: P:

Answer 34

• Intercostales externi exist from the neck of the rib to roughly the costal cartilage • O: Lower border of ribs 1-11 • I: upper border of ribs below (2-12) • A: elevates ribs during inspiration • N: intercostal nerves • V: intercostal aa • P: during deep inspiration • * very thin. Be careful when dissecting to see deeper layer

Question 35

Internal intercostals O: I: A: N: V: P:

Answer 35

• O: Superior border of ribs 2-12 • I: inferior boarder of ribs above (1-11) • A: depresses ribs during forced between internal intercostal muscles and pleura (or innermost intercostals, when present) expiration • N: intercostal nn • V: intercostal aa • P: during forced expiration • The intercostal nerve, artery, vein run

Question 36

Innermost intercostals O: I: A: N: V: P:

Answer 36

• * not dissected in lab • O: usually found in lower thoracic region- internal surface • I: internal surface of ribs 2-3 intervals below origin near angle of rib • A: elevates rib to aid in inspiration • N: intercostal nn • V: intercostal aa • Fibers run the same direction as internal intercostals

Question 37

Triceps brachii O: I: A: N: V: P:

Answer 37

• Long, lateral, medial heads • O: • Long head: infraglenoid tubercle of scapula • Lateral head: posterior surface of humerus superior to radial groove • Medial head: posterior humerus inferior to radial groove • I: olecranon process and fascia of forearm • A: Extends elbow, long head also extends and adducts at shoulder, stabilizes (resists dislocation) of humerus • N: • Long head: Axillary n (C5-6) • Lateral and medial heads: Radial n (C7-8) • V: Profunda brachii a • P: diffreetiate between heads of triceps • * Look for (but don’t cut) the radial nerve and axillary nerves as they pass through the triangular interval and quadrangular space, respectively.

Question 38

Anconeus O: I: A: N: V: P:

Answer 38

• O: Lateral epicondyle of humerus • I: lateral olecranon process and proximal posterior ulna • A: aids in extension of elbow, stabilizes elbow, maybe adducts ulna during pronation • N: Radial n (C7-T1) • V: Profunda brachii, recurrent interosseous a • P: Best isolated when attempting to hyperextend elbow

Question 39

Brachioradialis O: I: A: N: V: P:

Answer 39

• Most superficial of the posterior forearm muscles. Does NOT cross wrist. • O: Proximal 2/3 of lateral supra-epicondylar ridge of humerus • I: lateral surface of distal radius near styloid process • A: flexion at elbow with forearm in midpoint position, especially high repetitions • N: radial N (C5-7) • V: Recurrent radial a • P: Differentiate between brachioradialis, brachialis, extensor carpi radialis longus • * Superficial branch of radial nerve

Question 40

Extensor carpi radialis longus O: I: A: N: V: P:

Answer 40

• O: lateral supra-epicondylar ridge of humerus • I: dorsal base of 2nd metacarpal • A: extend and abduct (radial deviation), synergist of wrist flexors • N:Radial N (C6-7) • V: • P: Differentiate between minor action differences and insertions of ECR longus and ECR brevis

Question 41

Extensor carpi radialis brevis O: I: A: N: V: P:

Answer 41

• O: Lateral condyle of humerus (via common extensor tendon) • I: dorsal base of 3rd metacarpal • A: extend and abduct wrist, synergist during wrist flexion • N: Deep radial n (C7, C8) • V: Radial a • P: differentiate between ECRL and ECR

Question 42

Extensor digitorum O: I: A: N: V: P:

Answer 42

• O: Lateral condyle of humerus (via common extensor tendon) • I: extensor expansion of medial (ulnar) 4 digits • A: extends medial (ulnar) 4 digits at MCP joint, aids at PIP joint, aids in extension of wrist • N: Deep radial n (C7-8) • V: Posterior interosseous a • P: Palpate as tendons pass under extensor retinaculum up to lateral condyle

Question 43

Extensor digiti minimi O: I: A: N: V:

Answer 43

• O: lateral condyle of humerus (via common extensor tendon) • I: extensor expansion of 5th digit • A: extends 5th digit at MCP joint, aids at IP joints • N: Deep radial N (C7-8) • V: • * In dissection, this looks like it’s part of ED… but follow the small tendon!

Question 44

Extensor carpi ulnaris O: I: A: N: V:

Answer 44

• O: Lateral epicondyle of humerus, posterior ulna via shared aponeurosis • I: dorsal base of 5th metacarpal • A: extends and adducts (ulnar deviation), synergist of wrist flexors • N: Deep radial n (C7-8) • V: Ulnar a

Question 45

Extensor indices O: I: A: N: V:

Answer 45

• O: posterior distal 1/3 of ulna, IOM • I: extensor expansion of 2nd digit • A: Extends 2nd digit, aids in wrist extension • N: Deep radial N (C7-8) via posterior interosseous n • V: posterior interosseous a • * Separate muscle by following tendon of EI which is deep to tendon of ED

Question 46

Supinator O: I: A: N: V: P:

Answer 46

• O: lateral epicondyle of humerus, radial collateral & annular ligaments, supinator fossa, crest of ulna • I: lateral posterior and anterior surfaces of proximal 1/3 of radius • A: Supinates radius • N: Deep radial n (C7-8) • V: Recurrent radial a • P: Deepest of muscles in this area • * Look for deep radial nerve passing under supinator- a common entrapment site!

Question 47

Abductor pollicis longus O: I: A: N: V: P:

Answer 47

• O: posterior proximal half of ulna & radius & IOM • I: Base of 1st metacarpal • A: Abducts thumb and extends at carpometacarpal (CMC) joint • N: Deep radial n (C7,8) (via posterior interosseous n) • V: posterior interosseous n • P: along with EPB, forms the border of the anatomical snuffbox • * Looks as though it’s the same as EPB… but it’s not!

Question 48

Extensor pollicis brevis O: I: A: N: V:

Answer 48

• O: posterior distal 1/3 of radius, IOM • I: dorsal base of proximal phalanx of thumb • A: extends proximal phalanx at MCP & CMC joints, aids in abduction (radial deviation) of wrist • N: Deep radial n (C7,8) (via posterior interosseous n) • V: posterior interosseous n • Forms border of anatomical snuffbox

Question 49

Extensor pollicis brevis O: I: A: N: V:

Answer 49

• O: Posterior middle 1/3 of ulna & IOM • I: Dorsal base of distal phalanx of thumb • A: extends distal phalanx of thumb at IP joint, aids to extend thumb at MCP and CMC joints • N: Deep radial n (C7,8) (via posterior interosseous n) • V: Posterior interosseous a • Forms the border of the anatomical snuff box)

Question 50

Biceps brachii O: I: A: N: V: P:

Answer 50

• O: • Long head: supraglenoid tubercle of scapula (and probably labrum) • Short head: coracoid process • I: (mostly on radius) radial tuberosity and fascia of bicipital aponeurosis • A: flexion of elbow (especially when supinated), supination of forearm, aids in shoulder flexion • SH: resists shoulder dislocation • N: musculocutaneous n (C5-6) • V: Brachial a • P: differentiate between lateral and medial heads of biceps brachii • * The tendon of the long head of biceps brachii lies in the bicipital (intertubercular) groove and is held in place by the transverse humeral ligament

Question 51

Coracobrachialis O: I: A: N: V: P:

Answer 51

• O: coracoid process • I: middle 1/3 of medial shaft of humerus • A: helps flex and adduct arm, resists dislocation of shoulder • N: Musculocutaneous n (C5-6) • V: brachial a • P: Differentiate among the 3 muscles that attach at the coracobrachialis • * musculocutaneous nerve usually pierces muscle belly. Median nerve and/or brachial artery may pass deep to muscle- a potential entrapment site!

Question 52

Brachialis O: I: A: N: V: P:

Answer 52

• O: distal ½ of anterior humerus • I: coronoid process and ulnar tuberosity (of ulna) • A: (strongest) flexor of elbow in all positions • N: Musculocutaneous n (C5-6) AND radial n (C5-7) • V: • P: Deep to biceps brachii • * Be sure to dissect borders of muscle to differentiate between this muscle and biceps brachii, triceps brachii, brachioradialis

Question 53

Pronator teres O: I: A: N: V:

Answer 53

• O: • Ulnar head: coronoid process • Humeral head: medial epicondyle of humerus (common flexor origin) • I: lateral surface of radius • A: pronates and flexes forearm (at elbow) • N: Median n (C6-7) • V: ulnar and radial aa • * Cut through both heads to see deeper structures

Question 54

Flexor carpi radialis O: I: A: N: V: P:

Answer 54

• O: medial condyle of humerus (common flexor origin) • I: base of 2nd metacarpal • A: flexes and abducts (radial deviation) wrist • N: Median N (C7-8) • V: Ulnar a • P: Differentiate between FCR and other flexors of forearm

Question 55

Palmaris longus O: I: A: N: V: P:

Answer 55

• Inconsistent muscle. Tendon frequently harvested for surgical repair of elbow, shoulder, wrist. • O: medial epicondyle of humerus (common flexor origin) • I: distal flexor retinaculum, palmar aponeurosis • A: flexes wrist and tenses palmar aponeurosis • N: Median N (C7-8) • V: Ulnar a • P: Tendon is visible superficial to flexor retinaculum • * Removal of the distal attachment is common during removal of skin of hand and wrist.

Question 56

Flexor carpi ulnaris O: I: A: N: V: P:

Answer 56

• O: • Humeral head: medial epicondyle of humerus (common flexor origin) • Ulnar head: olecranon and posterior border of ulna • I: pisiform, hook of hamate, 5th metacarpal • A: Flexes and adducts (ulnar deviation) at wrist • N: Ulnar n (C7, C8) • V: Ulnar a • P: Palpate through to pisiform and hamate • * Pisiform develops within the tendon of FCU as it serves to incrase the contractile force of FCU

Question 57

Flexor digitorum superficialis O: I: A: N: V: P:

Answer 57

• O: • Humero-ulnar head: medial epicodyle (common flexor origin), coronoid process • Radial head: radius below radial tuberosity • I: sides of shafts of middle phalanges of medial 4 digits • A: flexes at PIP joint, more strongly flexes at MCP joint • N: Median N (C7-T1) • V: Ulnar artery • P: Deep to layer 1 • * Carpal tunnel dissection

Question 58

Flexor digitorum profundus O: I: A: N: V: P:

Answer 58

• O: Proximal ¾ of medial and anterior surfaces of ulna & IOM • I: • Medial (ulnar) part: bases of distal 4th and 5th digit phalanges • Lateral (radial) part: bases of distal 2nd and 3rd digit phalanges • A: Flexes at DIP • N: • Medial (ulnar) part: Ulnar n (C8, T1) • Lateral (radial) part: Median n (C8-T1)- via interior interosseous n (a branch of median nerve) • V: Ulnar and anterior interosseous aa • P: Deep to FDS • * Liberate from carpal tunne

Question 59

Flexor pollicis longus O: I: A: N: V: P:

Answer 59

• O: Anterior surface of radius, IOM • I: Base of distal phalanx of thumb • A: Flexes phalanges of digit 1 • N: Median n (C8-T1) via anterior interosseous n • V: Anterior interosseous a • P: Palpate through carpal tunnel and at groove in scaphoid • * deep and lateral tendon traveling through carpal tunnel

Question 60

Pronator quadratus O: I: A: N: V: P:

Answer 60

• O: Distal ¼ of anterior ulna • I: Distal ¼ of anterior radius • A: pronates forearm, deep fibers bind radius and ulna • N: Median N (C8, T1) via anterior interosseous n • V: anterior interosseous a • P: Difficult, deepest of forearm anterior compartment • * Anterior interosseous a & N travel deep to muscle • Lats to pronator quadratus UE dissection review

Question 61

What are the abdominal walls?

Answer 61

• External oblique • Superficial layer • Fibers go down and in- same direction as external intercostals • Reflect a portion to view internal intercostals deep to it • Internal oblique • Fibers running up and in • Transversus abdominis* • Not dissected • Rectus abdominis • Reflect rectus sheath to expose fibers of muscle • Pyramidalis* • Tenses linea alba • Not present in everyone • Triangular shaped muscle above pubic symphysis

Question 62

What is structural classification of the sternoclavicular joint?

Answer 62

Gliding

Question 63

What ligament limits movement of clavicular head A-P, P-A?

Answer 63

Sternoclavicular ligament

Question 64

What ligament limits inferior glide of clavicle?

Answer 64

Interclavicular ligament

Question 65

What ligament limits limits elevation of clavicle?

Answer 65

Costoclavicular ligament

Question 66

What ligament is between acromion and clavicle?

Answer 66

Acromioclavicular ligament

Question 67

What ligament attaches at conoid tubercle of clavicle?

Answer 67

Conoid portion of Coracoclavicular ligament

Question 68

What ligament attaches at trapezoid line of clavicle?

Answer 68

Trapezoid portion of Coracoclavicular ligament

Question 69

What ligament is connects acromion and coracoid process? What does it protect? What may be impinged because of it?

Answer 69

Coracoacromial ligament • Protects head of humerus • May impinge supraspinatus muscle or tendon

Question 70

What ligament encloses suprascapular notch to form suprascapular foramen/canal? What nerve is transmitted through that canal?

Answer 70

Transverse scapular ligament Supraspinatus and infraspinatus

Question 71

What glenohumeral joint is classified as? What movement does is allow for?

Answer 71

• Ball and socket (spheroid), diarthrodial • Allows for flexion, extension, abduction, adduction, internal and external rotation, circumduction

Question 72

What do the glenohumeral ligaments do?

Answer 72

• Superior, middle, inferior portions • Reinforce the articular capsule

Question 73

What motion does the elbow (humeroradial + humeroulnar) joint do?

Answer 73

• Diarthrodial, Hinge • Flexion, extension • *this is distinct from the radioulnar joint*

Question 74

What motion does the Radioulnar joint do?

Answer 74

• Diarthrodial, pivot • Rotation (supination + pronation)

Question 75

What is a common injury of the ulnar collateral ligament?

Answer 75

• Often injured in throwing motions • Tommy John surgery

Question 76

What motions do the condyloid joint?

Answer 76

All movements except rotation

Question 77

What type of joint is the thumb carpometacarpal joint? What motions does it do?

Answer 77

• Saddle (Sellar) • Flexion, extension, adduction, abduction • Opposition, reposition

Question 78

What motions does metacarpophalangeal joints do?

Answer 78

• Diarthrodial • Condyloid • Flexion, extension, abduction, adduction, circumduction

Question 79

What motions does interphalangeal joints do?

Answer 79

• Diarthrodial • Hinge (ginglymus) • Flexion, extension