Anatomy - Limbs Flashcards
1
Q
What are skeletal muscles attached to?
A
Attached to bones or skin
2
Q
Describe the cell shape and appearance of skeletal muscle.
A
Single, very long, cylindrical, multinucleated cells with obvious striations
3
Q
Describe the cell shape and appearance of cardiac muscle.
A
Branching chains of cells, uni or bi-nucleated and have some striations
4
Q
Describe the cell shape and appearance of smooth muscle.
A
Single, fusiform, uninucleated, no striations
5
Q
What is the only movement that a skeletal muscle can do? Explain how.
A
Shortening by moving the insertion closer to the origin
6
Q
What is the origin of a muscle?
A
Attachment point that is NOT moved during a contraction
7
Q
What is the insertion of a muscle?
A
Attachment point that is moved during a contraction
8
Q
What can you predict if you know the origin and insertion of a muscle?
A
Its action
9
Q
What is necessary for a muscle to be a able to move a joint?
A
It needs to cross it
10
Q
What is necessary for a muscle to be a able to move a bone?
A
It needs to be attached to it
11
Q
How are the limbs organized?
A
Muscle compartments separated by deep fascia/connective tissue that is stiff
12
Q
What do the muscles in one muscle compartment in a limb have in common?
A
They usually work together to produce similar actions and usually have a common innervation and vascularization
13
Q
What happens if the pressure increases within a muscle compartment of a limb? What is this called? What can this lead to?
A
Compression of nerve and blood supply of that compartment = compartment syndrome => tissue necrosis
14
Q
What kind of patients get compartment syndrome?
A
- Athletes2. Trauma
15
Q
Treatment of compartment syndrome?
A
Fasciotomy
16
Q
What are the 6 parts of upper limbs?
A
- Axilla2. Arm3. Elbow joint/cubital fossa4. Forearm5. Wrist joint6. Hand
17
Q
How many compartments in arm? List them.
A
- Anterior2. Posterior
18
Q
How many compartments in forearm? List them.
A
- Anterior deep2. Anterior superficial3. Posterior deep4. Posterior superficial
19
Q
What are the 7 parts of lower limbs?
A
- Gluteal region2. Hip joint3. Thigh4. Knee joint and popliteal fossa5. Leg6. Ankle7. Foot
20
Q
How many compartments in thigh? List them.
A
- Anterior 2. Posterior3. Medial
21
Q
How many compartments in leg? List them.
A
- Posterior superficial2. Posterior deep3. Lateral4. Anterior
22
Q
What are the 3 types of mesoderm (from closest to farthest from notochord)? Which 2 do limbs mainly come from?
A
- Paraxial2. Intermediate3. Lateral plate
23
Q
What does the paraxial mesoderm give rise to?
A
Somites
24
Q
What does the intermediate mesoderm give rise to?
A
Urogenital structures
25
What does the lateral plate give rise to?
1. Somatic mesoderm2. Splanchnic mesoderm
26
What does the somatic mesoderm give rise to?
1. Limb skeleton and connective tissues2. Parietal serous membranes
27
What does the splanchnic mesoderm give rise to?
1. Smooth muscle in internal organs2. CV system3. Visceral serous membrane
28
What does each somite form?
1. Dermatome2. Myotome3. Sclerotome
29
What are somites?
Bilaterally paired blocks of paraxial mesoderm that form along the neural tube of the developing embryo
30
What will the sclerotomes give rise to?
Vertebral column + skull
31
What will the dermatomes give rise to?
Dermis of skin in back
32
What will the myotomes give rise to?
Skeletal muscles of the body:1. Epimere2. Hypomere
33
What will the epimere give rise to?
Epaxial skeletal muscles = deep back skeletal muscles
34
What will the hypomere give rise to?
Hypaxial skeletal muscles = 1. Abdominal and thoracic wall skeletal muscles2. Superficial back muscles3. Limb skeletal muscles
35
Which layer of the skin is innervated?
Dermis
36
What are the epimere muscles innervated by?
Dorsal rami
37
What are the hypomere muscles innervated by?
Ventral rami
38
When do limbs start budding in embryologic development?
4 to 5 weeks
39
Which form first in an embryo: upper or lower limbs?
Upper limbs
40
Describe the budding of limbs in embryologic development.
1. Tissue from lateral plate mesoderm migrates and forms the blood vessels, bone, cartilage, and connective tissue of the limbs 2. Hypomere migrates from myotome and forms skeletal muscles on either side of the connective tissue and bones = compartment formation 3. Signaling factors form the proximal/distal, anterior/posterior, and medial/lateral axes of the limbs 4. Endochondral ossification: cartilaginous bones ossify 5. Limbs rotate: upper limbs do so laterally and lower limbs do so medially
41
What are teratogens?
Agents that cause defects in embryonic development
42
What is the relationship between muscles on opposite side of a bone?
Usually perform opposing actions
43
What used to be a very common embryological limb defect?
Thalidomide was being prescribed to pregnant women for nausea in first trimester in the 70s and caused the hand to develop from the proximal portion of the arm
44
What are the 3 types of back muscles?
1. Superficial2. Intermediate3. Deep
45
What is another name for deep back muscles?
Intrinsic back muscles
46
What is the common action of the superficial back muscles?
Movement of upper limbs and shoulders
47
What are superficial back muscles innervated by?
Anterior rami organized in brachial plexus, except for trapezius which is innervated by the accessory cranial nerve
48
What are the 2 deep back muscles? a. Locationb. Origin/Insertionc. Action
1. Erector spinae: a. Along spinal cord b. Origin: inferior end of spine, insertion: superior end of spinec. Extend spine and maintain upright posture 2. Transversospinales: a. Deep to erector spinae and runs in Xmas tree pattern run in between transverse process of spineb. ?c. Maintain upright posture
49
What is the common action of the deep back muscles?
Movement and support of trunk: extend spine, posture, some spine/head movements
50
What are the 4 superficial back muscles?
1. Trapezius2. Latissimus dorsi3. Rhomboid major 4. Rhomboid minor
51
Trapezius: 1. Origin?2. Insertion?3. Action?
1. Spinal column (upper half)2. Along scapula3. Elevation, retraction, and depression of the scapula aka shoulder
52
What is the scapula?
Shoulder blade bone
53
Latissimus dorsi: 1. Origin?2. Insertion?3. Action?
1. Spinal column (lower half)2. Front of humerus 3. Adduction, medial rotation and extension of the shoulder = swimming
54
What is the humerus?
Main arm bone
55
Rhomboids: 1. Origin?2. Insertion?3. Action?
1. Middle part of upper spinal column2. Medial border of scapula3. Retraction and elevation of scapula
56
Rhomboids' location compared to trapezius?
Deeper
57
Describe the composition of erector spinae.
3 groups of muscles arranged in vertical columns
58
Describe the composition of transversospinales.
3 groups of muscles arranged superficial to deep
59
What are the 2 muscles of the shoulder?
1. Rotator cuff muscles2. Deltoid
60
Deltoid: 1. Origin?2. Insertion?3. Action?
1. Scapula to clavicle2. Lateral side of the humerus 3. Arm abduction beyond 15 degrees
61
Can deltoid muscles initiate abduction from the most adducted position?
NOPE
62
Which muscle can initiate abduction from the most adducted position? What kind of muscle is it?
Supraspinatous muscle = rotator cuff muscle
63
Rotator cuff muscles: 1. Origin?2. Insertion?3. Action?
1. Scapula2. Humerus3. Rotation, abduction, and stabilization of shoulder
64
How many rotator cuff muscles?
4
65
What is the joint of the shoulder?
Glenohumeral joint
66
What is the axilla? Purpose?
ArmpitImportant area that passes structures from neck to upper limb
67
What are 4 contents of the axilla?
1. Axillary artery and vein2. Brachial plexus3. Lymphatics and lymph nodes4. Axillary tail of breast
68
Purpose of axillary artery?
Biggest blood supply for upper limbs
69
1 muscle of anterior arm?
Biceps brachii
70
Common action of muscles of anterior arm?
Flexion
71
Innervation of muscles of anterior arm?
Muculocutaneous nerve
72
1 muscle of posterior arm?
Triceps brachii
73
Action of muscle of posterior arm?
Extension
74
Innervation of muscle of posterior arm?
Radial nerve
75
Biceps brachii: 1. Origin?2. Insertion?3. Action?
1. 2 parts of the scapula2. Radius by biceps tendon3. Elbow load bearing flexor and forearm supinator (better when flexed)
76
Where does the name biceps come from?
The muscle has 2 heads aka 2 origins
77
What is the most superficial muscle of the arm?
Biceps brachii
78
What is the radius?
Lateral forearm bone
79
Which bone moves during supination and pronation of arm?
Radius
80
What is the ulna?
Medial forearm bone
81
Can the ulna pivot?
NOPE
82
What is the most common biceps tendon that ruptures? What is this called? Why?
Long head tendon between scapula and bicepsPopeye's sign because forms a bulge on the arm
83
How many tendons does the biceps have?
3
84
Triceps brachii: 1. Origin?2. Insertion?3. Action?
1. 3 heads from scapula and humerus 2. Posterior side of ulna at olecron process3. Elbow extension
85
Where does the name triceps come from?
The muscle has 3 heads aka 3 origins
86
What is the cubital fossa?
Depression anterior to the elbow joint
87
What are the 4 contents of the cubital fossa? List them from lateral to medial.
1. Tendon of biceps muscle2. Brachial artery 3. Median nerve4. Superficial veins used for venipuncture pass superficially (throughout the cubital fossa)
88
What is the brachial artery?
The second part of the axillary artery
89
Main action of forearm anterior muscles?
Flexion of wrist and digits
90
Main action of forearm posterior muscles?
Extension of wrist and digits
91
Innervation of posterior forearm muscles?
Radial nerve
92
Innervation of anterior forearm muscles?
1. Median nerve (mostly)2. Ulnar nerve (1.5 muscles)
93
4 muscles of the superficial anterior forearm? List from lateral to medial
1. Flexor carpi radialis2. Palmaris longus 3. Flexor carpi ulnaris4. Flexor digitorum superficialis (deeper than all first 3 muscles)
94
What does carpi mean?
Wrist
95
Where do the 4 muscles of the superficial anterior forearm originate?
Medial humerus
96
Action of flexor carpi ulnaris?
Flexes and adducts the wrist
97
Action of flexor carpi radialis?
Flexes and abducts the wrist
98
Action of flexor digitorum superficialis?
Flexes digits = Proximal Interphalangeal (PIP) Joint
99
Action of palmaris longus?
Grip
100
Why is the palmaris longus interesting?
Missing in 10-15% of the pop
101
Insertion of flexor digitorum superficialis?
Middle phalanges of digits (split tendon on each side), except thumb
102
Muscle of deep anterior forearm?
Flexor digitorium profundus
103
Action of flexor digitorium profundus?
Flexes digits except thumb = Proximal AND Distal Interphalangeal (PIP and DIP) joints
104
Insertion of flexor digitorum profundus?
Most distal bone of the fingers
105
Innervation of flexor digitorum profundus?
1/2 median nerve1/2 ulnar nerve
106
Innervation of the superficial anterior forearm?
1. Flexor carpi radialis: median2. Palmaris longus: median3. Flexor carpi ulnaris: ulnar4. Flexor digitorum superficialis: median
107
5 muscles of the superficial posterior forearm? List from lateral to medial
1. Brachioradialis2. Extensor carpi radialis brevis3. Extensor carpi radialis longus4. Extensor digitorum5. Extensor carpi ulnaris
108
Action of extensor carpi radialis longus and brevis?
Extensors and abductors of the wrist
109
Action of extensor carpi ulnaris?
Extensors and adductors of the wrist
110
Action of extensor digitorum?
Extensor of digits except the thumb
111
Action of brachioradialis?
Elbow flexor
112
Where is the brachioradialis muscle located?
Posterior superficial forearm but crosses over lateral elbow
113
Innervation of all 5 superficial posterior forearm muscles?
Radial nerve
114
What does radial deviation mean?
Wrist abduction
115
What does ulnar deviation mean?
Wrist adduction
116
2 muscles of deep posterior forearm? List from lateral to medial
1. Extensor pollicis brevis2. Extensor pollicis longus
117
What does pollicis mean?
Thumb
118
Function of extensor pollicis longus and brevis? What does this create?
Thumb extensionAnatomical snuffbox
119
What passes through the tendons of the extensor pollicis longus and brevis
Branch of radial artery
120
What can cause anatomical snuffbox injuries?
FOOSH injuries
121
What does FOOSH stand for?
Fall On an OutStretched Hand
122
What is the bone posterior to the anatomical snuffbox?
Scaphoid bone
123
What 3 bones are often fractured due to FOOSH injuries?
1. Scaphoid2. Distal radius (Colles' fracture)3. Clavicle
124
What is the carpal tunnel?
Narrow, tunnel-like structure in the wrist with median nerve and flexor tendons from anterior forearm in the center:- Dorsal and lateral sides of the tunnel formed by wrist bones- Ventral side of the tunnel covered by a strong band of connective tissue: flexor retinaculum
125
What is carpal tunnel syndrome (CTS) caused by? Symptoms?
Injury to the median nerve due to narrowing/inflammation of the carpal tunnelStarts with sensory symptoms and then severe carpal tunnel will cause impairement/Loss of innervation of muscles distal to the carpal tunnel: thenar muscles on bulge of thumb that allow it to oppose
126
What are the 2 types of muscles of the hand?
1. Extrinsic 2. Intrinsic
127
Innervation of extrinsic hand muscles?
1. Median2. Ulnar3. Radial
128
Action of extrinsic muscles of hand?
Power grip
129
Where are the extrinsic muscles of the hand located?
Forearm with tendons extending in the hand
130
Where are the intrinsic hand muscles?
In the hand
131
Action of intrinsic muscles of hand?
Precision grip
132
Innervation of intrinsic hand muscles?
1. Median (thenar eminance)2. Ulnar (all others)
133
Innervation of thenar eminence muscles?
Median nerve
134
Intrinsic hand muscles of the pinky?
Hypothenar eminance
135
Where is the gluteal region?
- Between iliac crest and inferior border of butt - Posterior and lateral to pelvic bone
136
What passes through the gluteal region?
Important nerves from pelvis
137
What are the 2 compartments of gluteal region?
1. Superficial2. Deep
138
What are the 3 muscles of the superficial gluteal region?
1. Gluteus maximus2. Gluteus medius3. Gluteus minimus
139
Gluteus maximus: 1. Origin?2. Insertion?3. Action?
1. Pelvic bone 2. Posterior side of femur and IT band (connective tissue on lateral side of thigh)3. Extension, lateral rotation, and abduction of thigh (getting up from flexed position)
140
Gluteus medius and minimus1. Origin?2. Insertion?3. Action?
1. Pelvic bone (top of crests)2. Top of femur3. Medial rotation and abduction of hip/thigh and secures its position when walking
141
Position of gluteus medius and minimus in relation to gluteus maximus?
Deep
142
Innervation of superficial gluteus region muscles?
Lumbosacral plexus
143
What happens when people lose the innervation to their gluteus medius and minimus muscles?
Their hips drop every time they step forward
144
Muscle of the deep gluteal region? What is special about it?
PiriformisMuscle of both the pelvic wall and the gluteal region and forms important landmarks (above and below) in gluteal region where blood vessels and nerves will exit pelvis to travel to gluteal region
145
Common action of muscles of the deep gluteal region?
Lateral rotation of the thigh/hip
146
Origin of piriformis? Insertion? Through what?
Pelvis and then comes out through the greater sciatic foramen to insert on the femur
147
What are the 2 nerves that pass below the piriformis? Describe location of each.
1. Sciatic nerve: passes below and travels to posterior thigh2. Pudendal nerve: passes below and enters perineum
148
Where do we do injections in the buttocks?
Superior lateral quadrant
149
Most vulnerable portion of buttocks where you should NOT do injections?
Lower medial quadrant
150
Most common procedure done on gluteal region?
Intramuscular injection
151
What are the 3 compartments of the thigh muscles?
1. Anterior2. Medial3. Posterior
152
Action of anterior thigh muscles?
Most extend knee (except for sartorius)
153
Action of posterior thigh muscles?
Flex knee (some also extend hip and rotate thigh)
154
Action of medial thigh muscles?
Adduct thigh
155
Innervation of anterior thigh muscles?
Femoral nerve
156
Innervation of posterior thigh muscles?
Sciatic nerve
157
Innervation of medial thigh muscles?
Obturator nerve
158
5 muscles of anterior thigh? List from lateral to medial
Quadriceps femoris group = quads:1. Vastus lateralis2. Rectus femoris3. Vastus medialis 4. Vastus intermedius (deep to rectus femoris)+5. Sartorius
159
Insertion of quads?
Common insertion on patella via quadriceps tendon all the way to the tibia
160
What is the patella?
Knee cap
161
Largest quadriceps?
Rectus femoris
162
Rectus femoris origin? Implication?
Pelvic boneCan move 2 joints: flex the hip and extend the knee
163
Location of sartorius muscle?
Diagonally in anterior thigh
164
Action of sartorius muscle?
Flexes knee and hip, external rotation and abduction of thigh = is there gum on my shoe muscle
165
4 muscles of medial thigh?
1. Gracilis2. Adductor longus3. Adductor brevis4. Adductor magnus
166
Gracilis:1. Shape2. Origin3. Insertion
1. Thin 2. Pelvic bone3. Tibia
167
3 muscles of posterior thigh? What are they called? List from lateral to medial (if looking at back of thigh)
Hamstring muscles:1. Biceps femoris2. Semitendinosus3. Semimembranosus
168
What 3 muscles insert on the medial side of the knee? From what compartment are they? Purpose? What is this called? What else is found here?
1. Gracilis (medial thigh)2. Semitendinosus (posterior thigh)3. Sartorius (anterior thigh)=> a muscle from each thigh compartment to stabilize knee on medial side = pes anserinusAlso IT band
169
What does pes anserinus mean?
Goose's foot
170
Where is the femoral triangle?
Top of anterior thigh near hip crease
171
4 contents of femoral triangle?
1. Femoral nerve2. Femoral artery3. Femoral vein4. Lymphatics
172
Biggest blood supply of lower limbs?
Femoral artery
173
Mnemonic to remember order of contents in femoral triangle?
Lateral to Medial: NAVeL
174
Passage of contents of femoral triangle?
Continue inferiorly to adductor canal into the popliteal fossa
175
4 contents of popliteal fossa? List from lateral to medial
1. Common fibular nerve2. Tibial nerve 3. Popliteal vein4. Popliteal artery
176
What are the popliteal artery/vein?
Continuations of femoral vessels
177
Common injury to lower leg? What is this called?
Rupture of common fibular nerve because it wraps around the tibia from the popliteal fossa to the front of tibia and is unprotected (car bumper) = foot drop because you cannot dorsiflex your foot
178
Innervation of posterior leg muscles?
Tibial nerve
179
Innervation of anterior leg muscles?
Common fibular nerve
180
Innervation of lateral leg muscles?
Common fibular nerve
181
Action of superficial posterior leg muscles?
Plantar flexion (especially when leg is extended)
182
Action of deep posterior leg muscles?
Toe flexion and foot inversion (suponation)
183
Action of anterior leg muscles?
Dorsiflexion, foot inversion (suponation), toe extension
184
Action of lateral leg muscles?
Foot eversion (pronation) and plantarflexion (weak)
185
Other name for common fibular nerve?
Common peroneal nerve
186
2 muscles of superficial posterior leg?
1. Gastrocnemius2. Soleus
187
Where do both muscles of the superficial posterior leg insert? What what tendon (2 names)?
Calcaneal tendon = Achilles tendon onto calcaneus bone
188
What is the calcaneus bone?
Heel bone
189
Where is the origin of gastrocnemius of the superficial posterior leg? What does this mean?
FemurCan also flex the knee
190
How many heads in gastrocnemius muscle?
2
191
Origin of soleus?
Top of tibia
192
Where does the name soleus come from?
Sole because it's really flat
193
3 muscles of deep posterior leg?
1. Tibialis posterior2. Flexor digitorum longus3. Flexor hallucis longus
194
2 muscles of foot inversion?
1. Tibilias posterior2. Tibialis anterior
195
Action of flexor digitorum longus and flexor hallucis longus?
Toe flexion:- Flexor digitorum longus: 4 toes- Hallucis longus: big toes
196
3 muscles of anterior leg?
1. Tibialis anterior2. Extensor digitorum longus3. Extensor hallucis longus
197
Where does the tibialis posterior insert?
Medial foot
198
Which muscle is responsible for shin splints?
Tibilias anterior
199
Action and insertion of tibialis anterior?
Action: foot dorsiflexion and inversionInsertion: medial foot
200
Actions of extensor digitorum longus and extensor hallucis longus?
Dorsiflexion and toe extension
201
2 muscles of lateral leg?
1. Fibularis longus2. Fibularis brevis
202
Insertion of lateral leg muscles?
Lateral foot and base of big toe
203
Which leg compartment is most important for walking?
Anterior leg
204
What causes a similar gait to the one with foot drop?
Impaired gluteus abductor (gluteus medius and minimus) muscles
205
2 types of foot muscles?
Intrinsic and extrinsic
206
2 nerves innervating the foot muscles? Mostly from which one?
1. Tibial nerve***2. Common fibular nerve
207
What is the tarsal tunnel?
Medial side of ankle and similar to carpal tunnel containing the posterior tibial artery and the tibial nerve
208
What does splanchnic mean? What is the opposite?
Relating to the visceraOpposite = parietal
209
Other name for hip bone?
Pelvic bone
210
What can be found between the triceps heads?
Radial nerve
211
What are the 3 boundaries of the femoral triangle?
1. Sartorius2. Adductor longus3. Inguinal ligament
