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Musculoskeletal > Anatomy (upper) > Flashcards

Anatomy (upper) Flashcards

0
Q

Explain what a synovial joint is like

A

Has a joint capsule with an inner synovial membrane and an outer fibrous capsule

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1
Q

What is the most common joint?

A

Synovial

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2
Q

What are synovial joints made out of?

A

Hyaline cartilage. Some have articular disc. Typically very mobile

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3
Q

Name two types of solid joints

A

Fibrous (sutures) and cartilaginous

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4
Q

What are the three functional classifications of joints?

A

Synarthrosis (no movement), amphiarthrosis (little movement), diarthrosis (lots of movement i.e. synovial joints)

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5
Q

Possible movements at synovial joints

A

Non-axial, uniaxial, biaxial, multiaxial (3+)

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6
Q

What are the three superficial and lateral muscles in the forearm extensor compartment?

A

Brachioradialis, extensor carpi radialis longus, extensor carpi radialis brevis.

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7
Q

What muscles are the superficial layer of the forearm extensors besides the radialis group? (From lateral to medial)

A

Extensor digitorum, extensor digiti minimi, extensor carpi ulnaris.

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8
Q

What muscles are in the deep layer of the forearm extensor compartment? (Lateral to medial)

A

Supinator, abductor pollicis longus, extensor pollicis brevis, extensor pollicis longus, extensor indicis.

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9
Q

What are all nerves of the posterior forearm innervated by?

A

Radial nerve, can be via deep branch of the radial nerve or the posterior interosseous nerve.

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10
Q

What are the only two extensors innervated by the actual radial nerve?

A

Brachioradialis and extensor carpi radialis longus

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11
Q

What are the proximal and distal attachments of the brachioradialis?

A

Proximal 2/3 of supraepicondylar ridge of humerus. Distal radius proximal to styloid process

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12
Q

What is the blood supply and innervation to the brachioradialis?

A

BS: radial collateral, recurrent radial, and radial arteries.
Nerve: radial nerve (C5, 6, 7)

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13
Q

What are the attachments for the extensor carpi radialis longus? What is it’s action?

A

Prox: lateral supracondylar ridge of humerus.
Dist: dorsal aspect of base of 2nd metacarpal
Action: extend and abduct hand at the wrist

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14
Q

What is the blood supply and innervation to the extensor carpi radialis longus?

A

BS: radial collateral, radial recurrent, recurrent interosseous, posterior interosseous arteries.
Innervation: radial nerve (C6, 7)

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15
Q

What are the attachments of the extensor carpi radialis brevis? What is it’s action?

A

Prox: lateral epicondyle of humerus
Dist: dorsal aspect of base of 3rd metacarpal
Action: extend and abduct hand at the wrist

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16
Q

What is the blood supply and innervation to the extensor carpi radialis longus?

A

BS: radial collateral, radial recurrent, posterior interosseous, recurrent interosseous.
Innervation: deep branch of the radial nerve (C7, 8)

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17
Q

What are the attachments of the extensor digitorum? Action?

A

Prox: lateral epicondyle.
Dist: extensor expansions of medial 4 fingers
Actions: extends medial 4 fingers at metacarpophalangeal joints and somewhat at interphalangeal joints.

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18
Q

What is the blood supply and innervation to the extensor digitorum?

A

BS: posterior interosseous, recurrent interosseous, perforating branch of anterior interosseous artery.
Innervation: posterior interosseous nerve (C7, 8)

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19
Q

What nerve is the posterior interosseous nerve a continuation of?

A

Deep branch of the radial nerve

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20
Q

What are the attachments for extensor digiti minimi?

A

Prox: lateral epicondyle of humerus.
Dist: extensor expansion of 5th finger
Action: extends 5th finger at metacarpophalangeal joint and secondarily at interphalangeal joints.

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21
Q

What is the blood supply and innervation to the extensor digiti minimi?

A

BS: posterior interosseous, recurrent interosseous, and perforating branch of anterior interosseous arteries
Innervation: posterior interosseous nerve (C7, 8)

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22
Q

What is the extensor expansion and extensor hood mechanism?

A

As extensor digitorum contracts, pulls on extensor hood, which causes interphalangeal joints to extend. Lumbricals also attach here

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23
Q

What are the attachments for the extensor carpi ulnaris? Action?

A

Prox: lateral epicondyle
Dist: dorsal aspect of base of 5th metacarpal.
Action: extends and addicts hand at wrist

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24
Q

What is the blood supply and innervation to the extensor carpi ulnaris?

A

BS: radial collateral, radial recurrent, recurrent interosseous, posterior interosseous arteries.
Innvervation: posterior interosseous nerve (C7, 8)

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25
Q

What are the attachments for the supinator? Action?

A

Prox: lateral epicondyle of humerus, radial collateral and anular ligaments, ulnar crest
Distal: proximal 1/3 of radius (nearly all surfaces bc wraps around the bone)
Action: supinates forearm, bringing radius back to anatomical position

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26
Q

What are the 3 outcropping muscles of the deep layer of forearm extensors?

A

Abductor Pollicis Longus, Extensor pollicis longus, extensor pollicis brevis.

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27
Q

What are the 5 muscles of the deep layer of the forearm extensors? (lateral to medial)

A

Supinator, abductor pollicis longus, extensor pollicis brevis, extensor pollicis longus, extensor indicis

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28
Q

What is the blood supply and innervation to the supinator?

A

BS: radial artery, posterior interosseous, radial recurrent, recurrent interosseous, and middle collateral arteries.
Innervation: deep branch of the radial nerve (C7, 8)

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29
Q

What are the attachments and action of the abductor pollicis longus?

A

Prox: posterior surface of proximal 1/2 of ulna, and radius, interosseous membrane
Distal: base of 1st metacarpal
Action: abducts thumb and extends it at carpometacarpal joint.

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30
Q

What is the blood supply and innervation to the abductor pollicis longus?

A

BS: posterior interosseous artery
Innervation: posterior interosseous nerve

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31
Q

what are the attachments and action of the extensor pollicis longus?

A

Prox: posterior surface of middle 1/3 of ulna, interosseous membrane
Distal: dorsal aspect of base of distal phalanx of thumb.
Action: extend distal phalanx at the interphalangeal joint, and extends the metacarpophalangeal and carpometacarpal joint.

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32
Q

what is the blood supply and innervation to the extensor pollicis longus?

A

BS: posterior interosseous and perforating branch of anterior interosseous arteries
Innervation: posterior interosseous nerve (C7, 8)

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33
Q

what are the attachments and action of the extensor pollicis brevis?

A

prox: posterior surface of distal 1/3 of radius, interosseous membrane
distal: base of proximal phalanx of thumb
Action: extends proximal phalanx of thumb at metacarpophalangeal joint, also extends carpometacarpal joint

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34
Q

What is the blood supply and innervation of the extensor pollicis brevis?

A

BS: posterior interosseous and perforating branch of anterior interosseous arteries
Innervation: posterior interosseous nerve (C7, 8)

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35
Q

what are the attachments and action of the extensor indicis?

A

Prox: posterior surface of distal 1/3 of ulna and interosseous membrane
Distal: extensor expansion of 2nd finger
Action: independent extension of 2nd finger, also helps with extension of the wrist

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36
Q

What is the blood supply and innervation of the extensor indicis?

A

BS: posterior interosseous and perforating branch of anterior interosseous arteries
Innervation: posterior interosseous nerve (C7, 8)

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37
Q

Where does the blood supply come from for the posterior forearm?

A

the common interosseous artery comes through the top of the gap between the radius and ulna, then branches into the posterior and anterior interosseous arteries (anterior goes through interosseous membrane to flexor compartment). anterior interosseous branch then comes back through interosseous membrane to the posterior forearm, closer to the radius than ulna

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38
Q

What does the radial artery branch into in the hand?

A

deep palmar arch, dorsal carpal arch

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39
Q

What innervates the posterior forearm?

A

superficial branch of radial nerve (lateral, runs under brachioradialis), deep branch of radial nerve (posterior, becomes posterior interosseous nerve.

40
Q

What muscle does the deep branch of the radial nerve run through? What does it then become?

A

Runs through the supinator, becomes posterior interosseous nerve

41
Q

What happens in a radial nerve injury?

A

usually by a fracture of humeral shaft bc of its relationship to the spiral groove, will result in “wrist drop” ( paralysis of extensors, so flexors take over)

42
Q

What makes the borders of the anatomical snuff box?

A

abductor pollicis longus and extensor pollicis brevis (anterior border in anatomical position).
Extensor pollicis longus (posterior border in anatomical position).

43
Q

What is the floor, roof, and what runs in the anatomical snuff box?

A

Floor: scaphoid bone.
Roof: superficial radial nerve branches.
Runs in: radial artery.

44
Q

How many carpal bones? Metacarpals? Phalanges?

A

8 carpals (SLTPHCTT), 5 metacarpals, 14 phalanges (thumb only has 2).

45
Q

What are the joints of the hand?

A

carpometacarpal, metacarpophalangeal, interphalangeal.

46
Q

What muscle does strong flexion of MP and IP joints? (power grip)

A

flexor digitorum profundus

47
Q

What are the movements of the thumb?

A

abduction (forward, when in anatomical position), adduction (next to hand), extension (making L with thumb), flexion (across hand), opposition (touch w/ pinky), reposition (back to neutral)

48
Q

What are the bones that make up the radiocarpal joint?

A

radius, scaphoid, lunate.

49
Q

What’s the joint called between the distal and proximal carpal row?

A

midcarpal joint

50
Q

What percentages of flexion occurs at which joints of the wrist?

A

40% occurs at radiocarpal joint, 60% occurs at midcarpal joint

51
Q

What percentages of extension occurs at which joints of the wrist?

A

33% occurs at the midcarpal joint, 67% occurs at radiocarpal joint

52
Q

How much radial deviation (abduction) occurs at the wrist? Ulnar deviation?

A

15-25%, 30-45% (mostly occurs at midcarpal joint

53
Q

What tendon makes up the carpal tunnel?

A

Flexor retinaculum (transverse carpal ligament)

54
Q

What runs under the flexor retinaculum?

A

flexor digitorum superficialis, flexor digitorum profundus, median nerve, flexor pollicis longus, flexor carpi radialis

55
Q

When happens to the median nerve as it reaches the carpal tunnel?

A

moves from between f.d. superficialis and f.d. profundus to superficial to the f.d. superficialis.

56
Q

What is the ligament between the ulna and the pisiform/5th metacarpal?

A

ulnar collateral ligament

57
Q

Where is the articular disc of the wrist located?

A

between the carpals and the ulna & radius.

58
Q

What is the ligament between the radius and the scaphoid/trapezium/1st metacarpal?

A

radial collateral ligament

59
Q

Where is Guyon’s Canal and what is located there?

A

Ulnar side of wrist near the hypothenar eminence. Ulnar nerve and ulnar artery.

60
Q

What do the extensor tendons form? and where?

A

A movable hood over the MP and IP joints called the extensor expansion. Both extensor muscles and intrinsic hand muscles attach to dorsal digital expansion, enable uncoupling of flexion and extension.

61
Q

What does the extensor expansion of the hand allow us to do?

A

lets long extensor tendons to strongly extend the MP and allows extension of IP joints when MP are flexed by lumbricals.

62
Q

What cutaneously innervates the distal 1/3 of thumb and the palmar lateral 2.5 digits of the hand, along with the palm?

A

median nerve

63
Q

what nerve does the cutaneous innervation of the medial 1.5 fingers and hypothenar eminence, as well as the medial 1/2 of the dorsal aspect of the hand?

A

ulnar nerve

64
Q

what nerve cutaneously innervates the dorsal lateral 1/2 aspect of the hand and wrist?

A

radial nerve

65
Q

what nerve cutaneously innervates the lateral 1/2 of the wrist? medial 1/2?

A

lateral antebrachial cutaneous nerve, medial antebrachial cutaneous nerve.

66
Q

What is the median nerve deep to?

A

palmar aponeurosis

67
Q

What innervates the thenar eminence?

A

recurrent median nerve (easily injured)

68
Q

What nerve is irritated in carpal tunnel syndrome?

A

median nerve

69
Q

What gives blood supply to the anterior hand?

A

superficial palmar arch (ulnar artery), deep palmar artery (radial artery)

70
Q

What does the superficial arch give rise to?

A

common digital arteries

71
Q

what do common digital arteries give rise to?

A

proper palmar digital arteries

72
Q

what artery gives rise to the princeps pollicis artery?

A

radial artery

73
Q

what artery gives rise to the radialis indicis artery? where does the radialis indicis artery run?

A

princeps pollicis artery. runs on the lateral aspect of the 2nd digit.

74
Q

What makes up the distal carpal arch? Where does it run?

A

ulnar and radial arteries. runs on dorsal aspect of hand. gets contribution from anterior interosseous artery

75
Q

what three muscles form the thenar eminence?

A

abductor pollicis brevis, flexor pollicis brevis (deep and superficial head), opponens pollicis

76
Q

what three muscles form the hypothenar eminence?

A

abductor digiti minimi, flexor digiti minimi, opponens digiti minimi (palmaris brevis lies superficial)

77
Q

What is the PALMARIS BREVIS?**

A

muscle superficial to the hypothenar eminence**, connects to the transverse carpal ligament

78
Q

What is Dupuytren’s Contracture?

A

Progressive shortening and thickening of palmar fascia that pulls the 4th & 5th digits into partial flexion (hereditary)

79
Q

what is in the common flexor sheath (ulnar bursa) that’s beneath the flexor retinaculum? What’s it continuous with?

A

flexor digitorum superficialis, flexor digitorum profundus. Continuous with the synovial sheath for digit 5.

80
Q

What muscle has a synovial sheath separate from the ulnar bursa?

A

flexor pollicis longus

81
Q

What is tensosynovitis?

A

infection in digital synovial sheaths which can cause inflammation of the tendon and synovial sheath. In 5th digit the infectino can spread into the carpal tunnel and into forearm.

82
Q

What are the proximal and distal attachments of the opponens pollicis? What is it’s action, blood supply, and innervation?

A

Prox: flexor retinaculum and tubercles of scaphoid and trapezium.
Dist: lateral side of 1st metacarpal.
Action: oppose thumb, medially rotate 1st metacarpal
BS: radial artery
Innervation: recurrent branch of median nerve (C8, T1)
DEEPEST THENAR MUSCLE

83
Q

What muscles are affected in Duchenne’s limp? What nerve could be affected? Which side do they lean toward?

A

gluteus medius, gluteus minimus. Superior gluteal nerve. Lean towards the injured side

84
Q

What is Trendelenburg’s sign?

A

hip drop on the side opposite to the injured leg.

85
Q

What is the proximal and distal attachment of abductor pollicis brevis? What’s it’s action, blood supply and innervation?

A

prox: flexor retinaculum and tubercles of scaphoid and trapezium
distal: lateral side of base of proximal phalanx of thumb
Action: abduct thumb, aid in opposition
BS: radial artery
innervation: recurrent branch of the median nerve (C8, T1 for superficial head), deep branch of the ulnar nerve (C8, T1 for deep head)

86
Q

What are the attachments of the adductor pollicis? What is its action, blood supply, and innervation? Is it part of the thenar eminence?

A

Prox: bases of 2nd & 3rd metacarpals, capitate and adjacent carpals.
Distal: medial side of base of proximal phalanx of thumb.
Actions: adducts thumb toward lateral border of palm.
Blood supply: radial artery
Innervation: deep branch of the ulnar nerve (C8, T1)

87
Q

What are the attachments of abductor digiti minimi? What is its action, blood supply, and innervation?

A

Prox: pisiform
Distal: medial side of base of proximal phalanx of 5th digit
Actions: abducts 5th digit, aids in flexion of 5th proximal
BS: ulnar artery
Innervation: deep branch of the ulnar nerve (C8, T1)

88
Q

What are the attachments of flexor digiti minimi? What is its action, blood supply, and innervation?

A

Prox: hook of hamate and flexor retinaculum
Distal: medial side of base of proximal phalanx of 5th digit.
Action: flexes proximal phalanx of digit 5
BS: ulnar artery
Innervation: deep branch of the ulnar nerve (C8, T1)

89
Q

What are the roots of femoral nerve? What action does it innervate?

A

L2-L4. Primarily flexors of anterior leg.

90
Q

What are the attachments of opponens digiti minimi? What is its action, blood supply, and innervation?

A

Prox: hook of hamate and flexor retinaculum
Distal: medial border of 5th metacarpal
Action: Brings 5th metacarpal anterior and rotates it to bring it into opposition with thumb
BS: ulnar artery
Innervation: deep branch of ulnar nerve (C8, T1)

91
Q

What are the intrinsic (short) muscles of the hand?

A

Lumbricals, palmar interossei, dorsal interossei

92
Q

What are the attachments of the 1st and 2nd lumbricals? What are their innervation and blood supply?

A

attached to lateral two tendons of f.d. profundus.
BS: radialis indicis (radial a.), superficial palmar arch (ulnar a.)
Innervation: median nerve (C8, T1)

93
Q

What are the attachments of the 3rd and 4th lumbricals? What are their innervation and blood supply?

A

attached to medial 3 tendons of f.d. profundus.

BS: superficial palmar arch (ulnar a.) and dorsal carpal arch (ulnar a. and radial a.)

94
Q

Where do lumbricals insert? What is their action?

A

Insert: lateral sides of extensor expansions of digits 2-5.
Action: flex MP joints and extend IP joints (by extensor expansion and extensor hood) of digits 2-5.

95
Q

How many palmar interossei are there? What are their attachments?

A

3.
Prox: palmar surfaces of 2nd, 4th, 5th metacarpals
Distal: bases of proximal phalanges and extensor expansions of digits 2, 4, 5

96
Q

What are the actions of the palmar interossei? What is their blood supply and innervation?

A

Action: ADDuct 2nd, 4th, and 5th fingers toward axial line, also assist lumbricals.
BS: both radial a. and ulnar a. contributions
Innervation: Deep branch of ulnar nerve (C8, T1)

97
Q

How many dorsal interossei are there? What are their attachments?

A

4.
Attach to adjacent sides of 2 metacarpals.
Insert at bases of proximal phalanges and extensor expansions of digits 2-4.

98
Q

What are the actions of the dorsal interossei? What is their blood supply and innervation?

A

Action: ABduct 2nd and 4th fingers toward axial line; also assist lumbricals.
BS: mostly branches of radial a., but also some contribution from ulnar a. tributaries
Innervation: deep branch of ulnar nerve (C8, T1)

Musculoskeletal (10 decks)

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