Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Medicine year 2 semester 2 > Case 23- Anatomy 2 > Flashcards

Case 23- Anatomy 2 Flashcards

1
Q

Boundaries of the axilla

A

Its roughly pyramid shaped
• Lateral wall/border- Intertubercular sulcus
• Medial wall/border- Thoracic wall, serratus anterior
• Posterior wall/border- Subscapularis, teres major, latissimus dorsi, long head triceps brachii
• Anterior wall/border- Pectoralis major and minor, subclavius, fascia
• Base/floor (outlet)- skin of armpit, opening into the arm
• Apex (inlet)- bordered by the clavicle, 1st rib and superior scapula

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Posterior wall of the axilla

A

There are various openings in the posterior wall of the axilla for nerves and vessels:
• Quadrangular space- Axillary nerve, posterior circumflex humeral artery
• Triangular space- Circumflex scapular artery and vein
• Triangular interval- Radial nerve, profunda brachii (deep brachial) artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Contents of the axilla

A
  • Axillary artery and its 6 major branches
  • Axillary vein and its tributaries
  • Axillary process of the breast
  • Proximal parts of the biceps brachii and coracobrachialis
  • Brachial plexus
  • Axillary lymph node
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Contents of the axilla

A
  • Axillary artery and its 6 major branches
  • Axillary vein and its tributaries
  • Axillary process of the breast
  • Proximal parts of the biceps brachii and coracobrachialis
  • Brachial plexus
  • Axillary lymph node
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Regions of the upper limb

A
  • Shoulder
  • Arm- Brachium, between shoulder and elbow
  • Forearm- Antebrachium, between elbow and wrist
  • Hand
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Compartments of the upper limb

A

The upper limb is organised into compartments. The anterior compartment is composed of flexor muscles, the posterior compartment is composed of extensor muscles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Anterior arm- Flexors

A
  • 3 muscles= Biceps brachii (Flexes at shoulder and elbow), Coracobrachialis (Flexes at the shoulder), Brachialis (Flexor at elbow)
  • Flex the elbow
  • Flex the shoulder
  • Supinate the forearm
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Biceps brachii

A
  • The Biceps has two heads and is in the arm
  • Long head- Attaches to the Supraglenoid tubercle. Goes over the humerus and lies in the intertubercular groove. Held in place by the transverse tubercle ligament
  • Short head- Attaches to the Coracoid process. Thicker and denser, at lower risk of rupture
  • The two heads converge and form the belly of the muscle
  • Inserts- radial tuberosity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What happens when the long head of the bicep ruptures

A

‘Popeye’ deformity. The belly of the bicep is displaced distally. Bulge in the distall part of the arm as the long arm is no longer held upwards

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Working out muscle action- Bicep brachii

A
  • What compartment are we in? Anterior
  • What is the general rule for these muscles? Flexors
  • Where is the muscle attaching? Scapula, radius
  • What joints does the muscle cross? Shoulder, elbow
  • Flexor of the shoulder and the elbow
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Biceps brachii action

A
  • Flexor of the forearm at the elbow
  • Accessory flexor of the arm at the shoulder joint
  • Supinates forearm- pulling the radius back into parallel with the Ulna, turning your hand to be palm up
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Coracobrachialis

A
  • Originates from the Coracoid process (in the Scapula)
  • Attaches to the midshaft humerus
  • Action- flexor of arm at the shoulder
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Brachialis

A
  • Originates from the humerus
  • Attaches to the tuberosity of the ulna in the forearm
  • Action- flexor of forearm at the elbow
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Anterior arm (Flexors) innervation- Musculocutaneous nerve

A
  • From lateral cord brachial plexus
  • Pierces coracobrachialis
  • Continues in the plane between brachialis and biceps brachii
  • Continues as lateral antebrachial cutaneous nerve (sensory- to the lateral part of the forearm)
  • All 3 anterior arm muscles are supplied by the same nerve
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Posterior arm muscles

A

Extensors= 1 arm, the Tricep brachii
• Has 3 heads and is located in the arm
• Long head- infraglenoid tubercle
• Lateral and medial heads- above and below the radial groove on the posterior aspect of the humerous
• Inserts on the olecranon process of the Ulna
• Action- extends forearm at elbow, extends and adducts arm at the shoulder. Major extender at the elbow and accessory extender at the shoulder
• Innervation- radial nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Long head bicep and tricep attachment

A
  • Long head bicep- Supraglenoid tubercle

* Long head tricep- Infraglenoid tubercle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Long head bicep and tricep attachment

A
  • Long head bicep- Supraglenoid tubercle

* Long head tricep- Infraglenoid tubercle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Posterior arm muscles (extensors) innervation

A

Innervated by the radial nerve
• From posterior cord of the brachial plexus
• Through triangular interval
• Continues in radial groove
• Moves anteriorly to cross lateral epicondyle
• Gives rise to posterior antebrachial cutaneous neve (sensory)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Other nerves in the arm (Median and Ulnar)

A
  • Median nerve- lies close to the brachial artery on the lateral side throughout the arm
  • Ulnar nerve- lies close to the brachial artery. Midway through it pierces into the posterior compartment. It lies posterior to the medial epicondyle
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Elbow joint

A
  • 3 articulations- 3 different bones
  • Share a common synovial cavity- different to shoulder where each articulation has a different synovial cavity
  • Each articulation corresponds to a different movement
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

The three articulationd of the elbow joint

A

• Between the trochlear notch of the ulna and the trochlea of the humerus
• Between the head of the radius and the capitulum of the humerus
• Between the head of the radius and the radial notch of the ulna (Proximal radio-ulnar joint- the distal one is in the wrist)
Proximal radio-ulnar joint= Pronation and Supination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Movement of the elbow- Pronation and Supination:

A
  • Head of the radius rotates
  • Distal end of the radius moves over the ulna (pronated)
  • In the pronated position, the radius crosses over the ulna so the bones are no longer parallel, crossing of the forearm bones
  • The reverse occurs to return to supination with the bones parallel. The head of the radius move back
  • Allow you to flip your hand from palm down to palm up (posterior and anterior)
  • These movements occur at the proximal and distal radio-ulnar joint
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Movements of the elbow

A
  • Flexion and extension of the forearm at the elbow- Joint between the head of the radius and capitulum of the humerus. The joint between the trochlear notch of the ulna and the trochlea of the humerus
  • Pronation and Supination- joint between the head of the radius and the radial notch of the ulna
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Ligaments of the elbow

A
  • The joint capsule of the elbow is thickened to form ligaments
  • The ligaments help strengthen the joint capsule
  • Medial (ulnar) and Lateral (radial) collateral ligaments- support flexion and extension. These may also be referred to as the radial and ulnar collateral ligaments. Run from superior to inferior
  • Anular ligament of the radius= Cuff like ligament. Surrounds the head of the radius in the radial notch of the ulnar. Holds the radius in position during pronation and supination (rotational movemements)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Ligaments- pulled elbow

A
  • Subluxation = partial dislocation
  • The sudden pulling of the upper limb tears the distal attachment of the anular ligament, where it is loosely attached to the neck of the radius. The radial head then moves distally, partially out of the “socket” formed by the anular ligament
  • The source of pain is the pinched anular ligament. Treatment of the subluxation consists of supination of the child’s forearm while the elbow is flexed. The tear in the anular ligament heals when the limb is placed in a sling for 2 weeks.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Elbow- Fat pads

A
  • The synovial membrane is separated from the fibrous membrane of the joint capsule by pads of fat
  • When we flex the elbow the coronoid process of the Ulnar and the head of the radius sit in the fossae at the front of the humerus, when we flex the fat pads move out of the way
  • Fill the fossae of the humerus during extension
  • Fat pads overlie the coronoid fossa, the olecranon fossa, and the radial fossa.
  • Cushion the bony processes during movements of the elbow
26
Q

Fat pads sign

A

On an x-ray, the fat pads are usually concealed in the fossae. Swelling/effusion in the joint can cause the fat pads to become visible. Indication of a fracture.

27
Q

Elbow- Bursae

A

Several bursae but only the olecranon bursae are clinically relevant
Olecranon Bursae
• Subcutaneous olecranon bursa is vulnerable to injury during falls onto the elbow, and infection from abrasions of skin covering the olecranon
• Repeated excessive pressure and friction, as occurs in wrestling, for example, may cause this bursa to become inflamed (‘student’s elbow’)
• Causes Olecranon Bursitis- infection

28
Q

The Cubital fossa

A

The cubital fossa is a triangular depression on the anterior aspect of the elbow. Its borders are formed by the two forearm muscles and an imaginary line between the two epicondyles of the humerus.

29
Q

Borders of the cubital fossa

A
  • Floor – Brachialis muscle
  • Superior border - Line between epicondyles
  • Medial border – Pronator teres
  • Lateral border – Brachioradialis
  • Roof - superficial fascia and skin
30
Q

Structures in the Cubital fossa- from lateral to medial

A
  • The tendon of the biceps brachii muscle
  • The brachial artery - tends to bifurcate into the radial and ulnar arteries just distal to the fossa. You can feel a pulse in this artery by palpating medial to the biceps tendon.
  • The median nerve
  • The medial cubital vein (most commonly used in venepuncture)- passes diagonally through the roof of the cubital fossa connecting the lateral side with the basillic vein on the medial side
  • The radial nerve- lies just under the lip of the brachioradialis muscle, which forms the lateral margin of the fossa
31
Q

Movement at the shoulder

A

Can occur in two ways:
• Via the scapula (shoulder blade) gliding and rotating over the ribcage
• At the ball and socket joint between the glenoid fossa of the scapula and head of the humerus (glenohumeral joint)
• Most movements involve a combination of these

32
Q

Movement of the scapula

A

The scapula can glide forwards and backwards along the ribcage to allow protraction and retraction. It can also rotate to extend the range of abduction above 90 degrees

33
Q

Movements of the Glenohumeral joint

A

The glenohumeral joint is very mobile, permitting a wide range of flexion and extension, rotation, abduction and adduction. Combining all these movements creates circumduction.

34
Q

Arm- The anatomical position

A
  • We describe movements as occurring from the anatomical position
  • Hands by the sides, palms facing inwards
  • The little finger is considered medial and the thumb lateral
  • The ulnar side of the forearm is medial (little finger side), the thumb is lateral so on the radial side
35
Q

Movements at the wrist

A

Abduction of the wrist can be referred to as radial deviation, Adduction of the wrist may be referred to as ulnar deviation.
Pronation and Supination- occur at the distal and proximal radioulnar joints. During pronation, the radius crosses over the ulna. In supination the bones return to their parallel arrangement

36
Q

Movement of the wrist

A

The wrist can flex and extend and perform a small range of adduction and abduction. These movements are largely brought about by muscles in the forearm

37
Q

Movements of the digits

A
  • Movements of the fingers occur at the metacarpophalangeal joints (the joints between the digits and the hand) and at the joints within the fingers (the interphalangeal joints).
  • The thumb can perform flexion/extension and abduction/adduction as with the other digits. These movements occur in a plane perpendicular to that of the other digits.
  • The thumb can also rotate at the metacarpophalangeal joint to perform opposition, bringing the tip of the thumb to meet the other 4 digits. This is a movement unique to the thumb and is crucial in enabling us to grip objects and manipulate them precisely.
38
Q

Bones of the shoulder (3 bones)

A
  • The Clavicle (Collarbone)
  • The Scapula (shoulder blade)
  • The humerus (funny bone)
39
Q

Bones of the shoulder- 3 joints

A
  • Between the sternum and the clavicle
  • Between the clavicle and the scapula- This forms a structure known as the pectoral girdle or shoulder girdle. This is the line of attachment from the sternum going down the clavicle to the scapula. The pectoral girdle is the main attachment of the upper limb to the trunk
  • Between the proximal humeral (head) and the glenoid fossa of the scapula- this forms the glenohumeral joint
40
Q

Clavicle

A
  • Roughly ‘S’ shaped- projects anteriorly then posteriorly as it curves towards the upper limb
  • Articulates from the manubrium of the sternum (medially) and the scapula (laterally)
  • The only bony attachment between the trunk and the upper limb
41
Q

Scapula

A
  • Two surfaces- costal (anterior) and posterior
  • Triangle shaped
  • Three borders- superior, lateral and medial
  • Three angles- lateral (attached to the glenoid fossa), superior (middle and top) and inferior (at the bottom)
42
Q

Humerus

A

• Articulates with the scapula proximally and the forearm bones distally
• The proximal end is involved with the shoulder joint
The shaft and distal end of the humerus is in the arm
Landmarks- radial fossa, the radius articulates with the humerus here

43
Q

Forearm bones

A
  • Radius- lateral (near thumb). Smaller proximally and larger distally
  • Ulna- medial (near little finger). Larger proximally, smaller distally
  • They lie parallel to each other
  • At the elbow- articulates with each other and with the humerus
  • At wrist- articulates with each other and with the carpal bones
44
Q

Interosseous membrane

A
  • Thin fibrous sheet between which connects the radius and the ulna
  • Site of muscle attachment
  • Helps support the forearm and support the bone, provides a larger surface area for muscle attachment
  • There are gaps in the interosseous membrane- the Free upper border (proximal end) and the Aperture for vessels (distal end). Both the free upper margin and distal aperture allows the passage of vessels between the anterior and posterior compartments of the forearm
44
Q

Interosseous membrane

A
  • Thin fibrous sheet between which connects the radius and the ulna
  • Site of muscle attachment
  • Helps support the forearm and support the bone, provides a larger surface area for muscle attachment
  • There are gaps in the interosseous membrane- the Free upper border (proximal end) and the Aperture for vessels (distal end). Both the free upper margin and distal aperture allows the passage of vessels between the anterior and posterior compartments of the forearm
45
Q

3 groups of bones in the hand

A
  • 8 carpal bones (most proximal)
  • 5 metacarpals- Numbered with Roman numerals, I to V. The carpals and metacarpals of the 4 digits form the palm. Middle set of bones
  • The phalanges- 3 per finger, 2 in the thumb. Most distal in the digits
46
Q

Naming and numbering the digits

A
  • Thumb (pollux) (1)
  • Index finger (indices) (2)
  • Middle finger (3)
  • Ring finger (4)
  • Little finger (digiti minimi) (5)
47
Q

Carpal bones

A
  • They are arranged in two rows of four. 8 in total, form the palm with the metacarpal
  • Proximal row- Scaphoid, lunate, triquetrum, pisiform. From thumb to little finger. (Straight Line To Pinkie)
  • Distal row- Hamate, capitate, trapezoid, Trapezium. From little finger to thumb. (Here comes the thumb)
48
Q

Carpal arch

A
  • The carpal bones do not lie flat- they form an arch shape. The Pisiform sits on top of the Triquetrom
  • The flexor retinaculum is stretched over the top of the arch- between the pisiform and hamate. Helps hold the tendons which project from the forearm to the hand in position.
  • Creates a space that structures pass through to/from the forearm: the carpal tunnel, which structures run through
49
Q

Wrist joint

A

Distal end pf the radius and ulna connects with the proximal carpal bones

50
Q

Joints of the hand and finger- Carpometacarpal joints

A
  • Between distal carpal bones and metacarpals
  • CMC joints between metacarpals II to V = not particularly mobile
  • CMC between metacarpal I and trapezium = saddle joint. Its much more mobile, allows wider range of movement of the thumb
51
Q

Metacarpophalangeal joints (MCP’s)- what are the reinforced by

A

Between the metacarpals and proximal phalanges of the digits. Reinforced by:
• Palmar ligament
• Medial and lateral collateral ligaments- thickenings of the joint capsule, either side of the MCP joint
• 3 deep transverse metacarpal ligaments – restrict movement of metacarpals (except thumb = increased mobility). By linking the heads of the metacarpal bones together, they restrict the movement of these bones relative to each other. This forms a unified skeletal framework for the palm of the hand
• A deep transverse metacarpal ligament does not occur between the palmar ligament of the metacarpophalangeal joint of the thumb and the palmar ligament of the index finger. This also contributes to increased mobility of the thumb.

52
Q

Proximal and distal interphalangeal joints (PIPs and DIPs)

A
  • Between the phalanges
  • The thumb only has one interphalangeal joint but the other digits have a proximal and distal joint. Because the thumb only has two phalanges and the other digits have three
  • These are reinforced by medial and lateral collateral ligaments and palmar ligaments
53
Q

Types of joints

A
  • Solid joints- little/no mobility. No joint cavity- bones are joined by fibrocartilage or fibrous connective tissue
  • Synovial- highly mobile, bones are separated by an articular cavity
54
Q

Types of joints

A
  • Solid joints- little/no mobility. No joint cavity- bones are joined by fibrocartilage or fibrous connective tissue
  • Synovial- highly mobile, bones are separated by an articular cavity
55
Q

Types of solid joints

A
  • Fibrous- Sutures (i.e. skull). Gomphoses (teeth). Syndesmoses (i.e. interosseous membrane)
  • Cartilagenous- Syndochondroses (i.e. growth plates). Symphyses (i.e. pubic symphysis)
56
Q

Synovial joint

A
  • Joint capsule formed by an inner synovial membrane and an outer fibrous membrane). Articular cavity between the Hyaline cartilage on both bones.
  • Hyaline cartilage- covers the articulating surfaces of the bones
  • Articular cavity- contains synovial fluid (lubricant)
  • Fibrous membrane- dense connective tissue which stabilises the joint. May thicken to form the ligament
  • Synovial membrane- attaches at the interface between the cartilage and bone. Highly vascular, produces synovial fluid
57
Q

Extra features of the synovial joint

A
  • Bursa- closed sac of synovial membrane outside the joint. Its between structures i.e. between the tendon and the bone or the skin and the bone. The Bursa surrounds a tendon, it also reduces friction.
  • Articular disk- A Fibrocartilage disk which absorbs compression forces and increases range of movement
  • Fat pad- usually between the synovial and fibrous membrane. Mobile- moves in and out of spaces as the joint moves
58
Q

Synovial joint pathology

A
  • Cartilage- Osteoarthritis, inflammatory arthritis
  • Tendons- Tendonitis
  • Bursae - Bursitis
  • Synovial membrane- Synovitis, inflammation e.g. in arthritis
59
Q

Types of synovial joints- Hinge, Bicondylar, Condylar, Saddle

A
  • Hinge i.e. elbow- movement around 1 axis, flexion and extension
  • Bicondylar i.e. knee- movement around 1 axis (flexion and extension). Limited rotation around a 2nd axis. Its 2 convex surfaces (condyles) articulating with a concave or flat surface
  • Condylar i.e. wrist- movement around 2 axes at right angles to each other (flexion and extension, abduction and adduction)
  • Saddle i.e. thumb- saddle shaped articular surfaces. Allows movement around 2 axes at right angles to each other (flexion and extension, abduction and adduction)
60
Q

Types of synovial joints- Ball and socket, Plane, Pivot

A
  • Ball and socket i.e. hip, glenohumeral- allows movement around multiple axes. Flexion and extension, abduction and adduction, rotation
  • Plane i.e. acromioclavicular- allows sliding or gliding movements when one bone moves across the surface of another
  • Pivot i.e. atlanto-axial- permit rotation
61
Q

Cartilage, Ligament and Tendon

A

Cartilage- connective tissue, lots of different types. Articular cartilage covers the ends of bones in synovial joints. Covers the surface of joints acting as a shock absorber
Ligament- attaches bone to bone. Helps to stabilise joints. Can be thickenings of the joint capsule or attach outside of the joint capsule
Tendon- attaches muscle to bone

Medicine year 2 semester 2 (47 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions