Anatomy Lab - Upper Extremity Flashcards
Shoulder girdle
Clavicle and scapula
Axial skeleton is sternoclavicular joint
Where is the trapezoid line on the clavicle?
• Trapezoid line: extending laterally from conoid tubercle toward acromial articular surface.
• Attachment of trapezoid ligament- part of
coracoclavicular ligament
What is another name for clavicle? What does the clavicle allow passage of?
• Aka collar bone
• Allows for passage of neurovascular bundle to/from upper extremity
What is the shape of the clavicle?
• Sternal end: enlarged, triangular
• Acromial end: flatter, tapered, articulates with
acromion of scapula at acromioclavicular (AC) joint
Where is the confidence tubercle?
• Conoid tubercle: inferior distal surface near
acromial end.
• Attachment of conoid ligament- part of the
coracoclavicular ligament
What are the borders of the scapula?
• medial (vertebral)
• lateral (axillary)
• superior
What are the angles of the scapula?
• inferior: union of lateral and medial
• lateral (bearing the glenoid fossa): union of lateral and superior borders
• superior: union of medial and superior
borders
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
• 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
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
• 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
Where are all the landmarks on the Radius?
Head, Neck, Radial Tuberosity, Styloid Process
• 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
Where are all the landmarks on the Ulna?
Trocholear Notch/Semilunar Notch, Olecranon Process, Coronoid Process, Radial Notch, Ulnar Tuberosity, Styloid Process
• 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
What are the ligaments of the elbow?
- Ulnar collateral ligament
- Radial collateral ligament
- Annular ligament
What are the carpal bones proximal row, lateral to medial? Distal row, lateral to medial?
• 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,
What are the ligaments of the wrist?
Scapholunate ligament
- Scaphoid to lunate
- MC wrist ligamentous sprain
Triangular Fibrocartilage Complex
- Between ulna and carpals
- Creates smooth surface
- Also often injured in falls
Latissimus dorsi
O:
I:
A:
N:
V:
P:
• 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
Trapezius
O:
I:
A:
N:
V:
P:
• 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
Rhomboid major & minor
O:
I:
A:
N:
V:
P:
• 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
Levator Scapule
O:
I:
A:
N:
V:
P:
• 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
Deltoid
O:
I:
A:
N:
V:
P:
• 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
Supraspinatus
O:
I:
A:
N:
V:
P:
• 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
What is the most commonly injured muscle of the rotator cuff?
Supraspinatus
Infraspinatus
O:
I:
A:
N:
V:
P:
• 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
Teres Major
O:
I:
A:
N:
V:
P:
• 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
Teres minor
O:
I:
A:
N:
V:
P:
• 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
Subscapularis
O:
I:
A:
N:
V:
P:
• 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
Serratus anterior
O:
I:
A:
N:
V:
P:
• 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
Serratus posterior superior
O:
I:
A:
N:
• 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
Serratus posterior inferior
O:
I:
A:
N:
• 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
Pectoralis major
O:
I:
A:
N:
V:
P:
• 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
Pectoralis minor
O:
I:
A:
N:
V:
P:
• 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.
Subclavius
O:
I:
A:
N:
V:
P:
• 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
Damage to long thoracic causes scapular winging to which muscle?
Serratus anterior
Due to the muscle’s position and action, what muscles may be involved in some cases of thoracic outlet syndrome?
Subclavius
External intercostals
O:
I:
A:
N:
V:
P:
• 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
Internal intercostals
O:
I:
A:
N:
V:
P:
• 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
Innermost intercostals
O:
I:
A:
N:
V:
P:
• * 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
Triceps brachii
O:
I:
A:
N:
V:
P:
• 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.
Anconeus
O:
I:
A:
N:
V:
P:
• 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
Brachioradialis
O:
I:
A:
N:
V:
P:
• 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
Extensor carpi radialis longus
O:
I:
A:
N:
V:
P:
• 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
Extensor carpi radialis brevis
O:
I:
A:
N:
V:
P:
• 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
Extensor digitorum
O:
I:
A:
N:
V:
P:
• 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
Extensor digiti minimi
O:
I:
A:
N:
V:
• 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!
Extensor carpi ulnaris
O:
I:
A:
N:
V:
• 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
Extensor indices
O:
I:
A:
N:
V:
• 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
Supinator
O:
I:
A:
N:
V:
P:
• 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!
Abductor pollicis longus
O:
I:
A:
N:
V:
P:
• 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!
Extensor pollicis brevis
O:
I:
A:
N:
V:
• 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
Extensor pollicis brevis
O:
I:
A:
N:
V:
• 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)
Biceps brachii
O:
I:
A:
N:
V:
P:
• 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
Coracobrachialis
O:
I:
A:
N:
V:
P:
• 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!
Brachialis
O:
I:
A:
N:
V:
P:
• 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
Pronator teres
O:
I:
A:
N:
V:
• 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
Flexor carpi radialis
O:
I:
A:
N:
V:
P:
• 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
Palmaris longus
O:
I:
A:
N:
V:
P:
• 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.
Flexor carpi ulnaris
O:
I:
A:
N:
V:
P:
• 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
Flexor digitorum superficialis
O:
I:
A:
N:
V:
P:
• 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
Flexor digitorum profundus
O:
I:
A:
N:
V:
P:
• 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
Flexor pollicis longus
O:
I:
A:
N:
V:
P:
• 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
Pronator quadratus
O:
I:
A:
N:
V:
P:
• 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
What are the abdominal walls?
• 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
What is structural classification of the sternoclavicular joint?
Gliding
What ligament limits movement of clavicular head A-P, P-A?
Sternoclavicular ligament
What ligament limits inferior glide of clavicle?
Interclavicular ligament
What ligament limits limits elevation of clavicle?
Costoclavicular ligament
What ligament is between acromion and clavicle?
Acromioclavicular ligament
What ligament attaches at conoid tubercle of clavicle?
Conoid portion of Coracoclavicular ligament
What ligament attaches at trapezoid line of clavicle?
Trapezoid portion of Coracoclavicular ligament
What ligament is connects acromion and coracoid process? What does it protect? What may be impinged because of it?
Coracoacromial ligament
• Protects head of humerus
• May impinge supraspinatus muscle or tendon
What ligament encloses suprascapular notch to form suprascapular foramen/canal? What nerve is transmitted through that canal?
Transverse scapular ligament
Supraspinatus and infraspinatus
What glenohumeral joint is classified as? What movement does is allow for?
• Ball and socket (spheroid), diarthrodial
• Allows for flexion, extension, abduction, adduction, internal and external rotation,
circumduction
What do the glenohumeral ligaments do?
• Superior, middle, inferior portions
• Reinforce the articular capsule
What motion does the elbow (humeroradial + humeroulnar) joint do?
• Diarthrodial, Hinge
• Flexion, extension
• this is distinct from the radioulnar joint
What motion does the Radioulnar joint do?
• Diarthrodial, pivot
• Rotation (supination + pronation)
What is a common injury of the ulnar collateral ligament?
• Often injured in throwing motions
• Tommy John surgery
What motions do the condyloid joint?
All movements except rotation
What type of joint is the thumb carpometacarpal joint? What motions does it do?
• Saddle (Sellar)
• Flexion, extension, adduction, abduction
• Opposition, reposition
What motions does metacarpophalangeal joints do?
• Diarthrodial • Condyloid
• Flexion, extension, abduction, adduction, circumduction
What motions does interphalangeal joints do?
• Diarthrodial • Hinge (ginglymus)
• Flexion, extension
