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DPT 720 Gross Anatomy I > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

Lateral Cervical Muscles

A
  • sternocleidomastoid: two heads from sternum and clavicle then comes up at an angle to mastoid process
  • scalenes: anterior, middle, posterior
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2
Q

Thoracic Outlet

A
  • anterior scalene in front, middle scalene in back of triangle
  • first rib cuts across bottom which together with above makes a tight triangular shape where a whole bunch of nerves (esp nerve roots) come through this space
  • big scalenes means this space will be smaller which won’t allow enough space for nerves to come through which can lead to thoracic outlet syndrome
  • tested by having them take a deep breath and take pulse, if pulse disappears then they have it
  • stretch out scalenes and push down on first rib and symptoms of numbness and tingling in arm go away
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3
Q

Brachial Plexus

A
  • nerve complex of upper extremity
  • roots, trunks, divisions, cords, branches
  • paresthesia: any sensory other than normal
  • ischemia: lack of blood flow
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4
Q

Roots

A
  • C5, C6, C7, C8, T1
  • exit intervertebral foramen (hole in between vertebrae)
  • between anterior and middle scalene muscles
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5
Q

Trunks

A
  • superior C5, C6
  • middle C7
  • inferior C8, T1
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6
Q

Divisions

A
  • each trunk divides into anterior and posterior division
  • through cervicoaxillary canal
  • anterior divisions tend to go to anterior muscles (flexors)
  • posterior divisions tend to go to posterior muscles (extensors)
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7
Q

Cords

A
  • anterior divisions of superior and middle trunks to lateral cord
  • anterior division of inferior trunk becomes medial cord
  • posterior division of all three trunks form posterior cord
  • cords are named by position to axillary artery
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8
Q

Branches from Roots

A
  • dorsal scapular nerve C5 to rhomboids and occasionally levator scapula (no sensory component)
  • long thoracic C5, C6, C7 to serratus anterior (no sensory component)
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9
Q

Branches from Superior Trunk

A
  • suprascapular nerve C5, C6 to supraspinatus, infraspinatus GH joint capsule (no sensory component)
  • subclavian nerve C5, C6 to subclavius, SC joint
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10
Q

Branches from Lateral Cord

A
  • side branch from lateral cord: lateral pectoral nerve C5, C6, C7n to pectoralis major and some to pectoralis minor via branch to medial pectoral nerve
  • musculocutaneous nerve C5, C6, C7 to coracobrachialis,biceps brachii, brachialis, cutaneous to skin of lateral forearm to wrist
  • half of lateral cord turns into musculocutaneous and the other half into median nerve
  • lateral root to median nerve-merges with medial root to median nerve from medial cord to anterior forearm muscles
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11
Q

Side Branch of Posterior Cord

A
  • upper subscapular nerve C5 to superior subscapularis
  • thoracodorsal nerve (middle subscapular) C6, C7, C8 to latissimus dorsi
  • lower subscapular nerve C6 lower subscapularis and teres major
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12
Q

Branches from Posterior Cord

A
  • axillary nerve C5, C6 to deltoid, teres minor, GH joint capsule, skin of superior lateral arm (over deltoid) which runs through quadrangular space
  • radial nerve C5-T1 runs through triangular interval (anything on posterior surface of forearm)
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13
Q

Side Branches from Medial Cord

A
  • medial pectoral nerve C8, T1 to pectoralis minor and sternal part of pectoralis major
  • medial cutaneous nerve to arm C8, T1 cutaneous to medial side of arm to epicondyle of humerus
  • medial cutaneous nerve to forearm C8, T1 medial side of skin of forearm to distal wrist
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14
Q

Branches from Medial Cord

A
  • medial root to median nerve nerves with lateral root to median nerve
  • ulnar nerve C8, T1 (C7) to many muscles
  • ulnar has sensory in ulnar side of hand from pinky and half of 4th finger to wrist
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15
Q

Anterior Muscles of Upper Arm

A
  • coracobrachialis
  • brachialis
  • biceps brachii: tendon goes into joint capsule=intracapsular
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16
Q

Triceps Brachii

A

-what divides lateral and medial heads is where radial nerve sits (the “groove”) the radial nerve lies right on the bone splitting the heads

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17
Q

Quadrangular Space

A
  • above: subscapularis and teres minor
  • below: teres major
  • medially: triceps
  • laterally: shaft of humerus
  • passage of axillary nerve and posterior humeral circumflex artery
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18
Q

Triangular Interval

A
  • below quadrangular space
  • superior: teres major
  • medial: long head of triceps
  • lateral: lateral head of triceps and humerus
  • contents: radial nerve and deep brachial artery
  • fracture in midshaft of humerus would affect radial nerve
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19
Q

Vascular Supply Upper Arm

A
  • brachial artery: medial to humerus and biceps and brachialis along with median nerve
  • deep artery of arm (profunda)-of brachial artery and runs posterior to humerus with radial nerve along radial groove
  • humeral nutrient artery: off brachial artery and into humerus
  • superior and inferior ulnar collateral arteries-off ulnar side of brachial
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20
Q

Nerves in Upper Arm

A
  • musculocutaneous: off lateral cord, under pectoralis minor, pierces coracobrachialis to biceps, brachialis, then cutaneous to lateral forearm
  • radial nerve: off posterior cord, behind humerus, along radial groove, into triceps, anconeus, anterior to elbow on lateral side and all muscles in posterior forearm (posterior upper, anterior to joint, posterior again)
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21
Q

Distal Humerus

A
  • capitulum
  • trochlea, trochlea notch
  • medial condyle and epicondyle
  • lateral condyle and epicondyle
  • medial and lateral supracondylar ridges
  • coronoid f0ssa
  • olecranon fossa
  • groove for ulnar nerve
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22
Q

Proximal Ulna

A
  • coronoid process
  • ulna tuberosity (brachialis insertion)
  • olecranon process triceps insertion)
  • radial notch of ulna (articulation with radial head)
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23
Q

Proximal Radius

A
  • radial head
  • radial neck
  • radial tuberosity (biceps insertion)
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24
Q

Elbow Joint Complex

A
  • 3 joints in one joint capsule
  • humeral ulnar joint
  • humeral radial joint
  • radial ulnar joint
25
Q

Elbow Joint Capsule and Ligaments

A
  • capsule surrounds all 3 joints
  • anterior ligament: restricts hyperextension
  • medial collateral ligament: restricts valgus force
  • lateral collateral ligament: restricts varus force; lateral epicondyle to ulna and annular ligament
  • annular ligament: surrounds radial head but does not attach; ulna, around radial head and attaches back to ulna; just holds radius down; restricts radial head from separating from ulna
26
Q

Radial Notch of Ulna

A
  • for radial head

- concavity in proximal part of ulna because convex part of radial head sits in there

27
Q

Valgus vs. Varus Forces

A
  • valgus: the part of the body distal to the deformed part is deviated away from the body/midline (i.e. is more lateral) (ulnar collateral ligament tension)
  • varus:the part of the body distal to the deformed part is deviated toward the body/midline (i.e. is more medial) (radial collateral ligament tension)
28
Q

Anterior Forearm Muscles

A
  • flexors or pronators
  • most muscles are either wrist flexors, forearm pronators or both
  • exception is brachioradialis
29
Q

Posterior Forearm

A
  • extensors or supinators or both

- all muscles are radial nerve or branches of radial nerve innervated

30
Q

Forearm Bones

A
  • humerus
  • radius
  • ulna
  • interosseous membrane: superior radius inferior and medial to ulna; thick CT that doesn’t give much
  • oblique cord: from ulna inferior and lateral to radius
31
Q

Interosseus Membrane

A
  • fibers mostly run inferior and medial to radius or superior and lateral to ulna
  • helps to transfer forces to opposite sides (compression to bone to tension; tensile=pulling) through membrane to compression on the other bone again
32
Q

Forearm Motions

A
  • supination: palm up
  • pronation: palm down
  • occurs at proximal and distal radioulnar joints simultaneously (synovial joints, both must move simultaneously, if one doesn’t move the other can’t)
  • always radius moving on ulna
33
Q

Forearm Arteries

A
  • brachial splits into radial and ulnar arteries
  • common interosseous artery off ulnar artery
  • splits into anterior and posterior interosseous arteries that lie on interosseous membrane
  • IMPORTANT SLIDE
34
Q

Anterior Forearm Veins

A
  • superficial: basilic (medial vein of forearm, ulnar side, superficial, have no artery match), cephalic (radial side, superficial, have no artery match)
  • deep: radial vein and ulnar vein
35
Q

Anterior Forearm Nerves

A
  • median: anterior interosseous nerve
  • ulnar
  • medial antebrachial cutaneous nerve (cutaneous means sensory only; comes off medial cord directly as do medial pectoral and medial cutaneous of upper arm)
  • lateral antebrachial cutaneous nerve from musculocutaneous nerve
  • test question: will suggest that fingers 4 and 5 of superficialis are innervated by ulnar nerve–>they’re NOT it’s radial nerve
  • flexor carpi ulnaris and flexor digitorum profundus to fingers 4 and 5 are only muscles in anterior forearm that are ulnar nerve
  • only one is radial nerve–>brachialis
  • everything else is median nerve (covers fingers 1-3 and half of 4 in sensory palmar side as well as the tips of these fingers on the dorsal side)
36
Q

PICTURES

A
  • review pictures, especially innervation sensory schematics from notes
  • pay special attention to slide 17 on forearm, extensor surface powerpoint
37
Q

Superficial Posterior Forearm Muscles

A
  • extensor carpi radialis longus off lateral supracondylar ridge
  • all others off the lateral epicondyle of humerus
  • what muscle attaches anteriorly on the greater tubercle of humerus—>none
38
Q

Anatomical Snuffbox

A
  • extensor pollicis longus, extensor pollicis brevis, and abductor pollicis tendons make up borders
  • contents: scaphoid, trapezium, distal radius and base of first metacarpal are in base
  • radial artery also inside
  • sensory branch of radial nerve
39
Q

Distal Radius and Ulna

A
  • biconcave
  • articulates with scaphoid laterally and lunate medially
  • radial styloid on lateral side
  • covered by TFCC
  • distal ulna also has styloid on medial side
  • triquetrum would sit right over ulna, but TFCC is in the way
40
Q

TFCC

A
  • triangular fibrocartilaginous complex
  • ligament and central meniscus
  • holds ulna to radius
  • fibro part acts as shock absorber/cushion
  • attaches to lateral side of ulna styloid and ulna side of radius
  • also acts as a spacer
41
Q

Distal Radioulnar Joint

A
  • synovial
  • concave distal radius moves on convex distal ulna
  • held together by anterior and posterior distal radioulnar ligaments
  • further stabilized by interosseous membrane and TFCC
  • very hard to disrupt
42
Q

Ulnomeniscal Triquetral Joint

A
  • triangular fibrocartilaginous complex

- synovial joint

43
Q

Wrist

A
  • multiple joints in one joint complex
  • proximal row on radius
  • distal row on proximal row
  • flexion/extension
  • ulnar/radial deviation
44
Q

Wrist Ligaments

A
  • palmar complex: ligaments all over palmar side; taut with extension
  • dorsal complex: ligaments going all over dorsal side; taut with flexion
  • radial collateral taut with radial deviation
  • ulnar collateral taut with ulnar deviation
45
Q

Palmar Side Retinaculums

A
  • palmar carpal ligament

- flexor retinaculum

46
Q

Palmar Carpal Ligament

A

-superficial covering all the flexor tendons of wrist and hand, vascular supply and nerves on palmar side of wrist (superficial flexor tendons go under this except palmaris longus tendon)

47
Q

Flexor Retinaculum

A
  • thicker deeper ligament forming roof of carpal tunnel
  • much tighter and deeper anchored on both sides than palmar carpal ligament
  • anchored by pisiform, hook of hamate, scaphoid and trapezium
  • carpal bones are arch shaped
  • contents: tendons of flexor digitorum superficialis, flexor digitorum profundus, flexor pollicis longus, median nerve
  • note 2, 2, 4 configuration as these tendons go through tunnel; synovial sheath standard around FPL tendon but between other ones has 4 folds–>invagination (synovial invagination of the wrist)
48
Q

Synovial Sheaths at Wrist

A
  • two: radial and ulnar side sheaths (bursas)
  • radial surrounds flexor pollicis longus tendon
  • ulnar side folds around (invagination) flexor digitorum superficialis and flexor digitorum profundus tendons
49
Q

Tunnel of Guyon

A
  • ulnar nerve and artery goes through between pisiform and hook of hamate
  • roof is flexor carpal ligament that goes over top
50
Q

Extensor Compartments at Wrist

A
  • extensor tendons held in place in compartments by extensor retinaculum
  • each compartment surrounded by synovial sheath
  • 6 compartments numbered from radial to ulnar
51
Q

Extensor Compartment 1

A
  • abductor pollicis longus

- extensor pollicis brevis

52
Q

Extensor Compartment 2

A
  • extensor carpi radialis longus
  • extensor carpi radialis brevis
  • along radial side of lister’s tubercle
53
Q

Extensor Compartment 3

A
  • extensor pollicis longus

- crosses compartment 2 but is on ulnar side of lister’s tubercle

54
Q

Extensor Compartment 4

A
  • extensor digitorum (5 tendons)
  • extensor indicis
  • so 6 tendons in one sheath
55
Q

Extensor Compartment 5

A
  • extensor digiti minimi

- just to radial side of ulnar styloid

56
Q

Extensor Compartment 6

A
  • extensor carpi ulnaris

- just to ulnar side of ulnar styloid

57
Q

Bones of the Hand

A
  • sesamoid bones of hand
  • numbers vary by individual
  • most commonly found in tendons of adductor pollicis and flexor pollicis brevis
  • much smaller and inconsistent
58
Q

Ligaments of MCP and IP Joints

A
  • ulnar and radial collateral ligaments; on each side of joints (resist varus and valgus forces)
  • palmar ligaments: at all MCP (more lax because can abduct fingers) and IP joints, covered on palmar side by articular cartilage so flexor tendons can slide easily
59
Q

Volar Plate of MCP and IP

A
  • palmar ligaments that resist hyperextension
  • covered in articular cartilage that lets tendons slide
  • found in MCP and IP joints to reinforce capsules, enhances stability and limit hyperextension
  • most MCP and IP ligaments are primarily irregular type 1 collagen

DPT 720 Gross Anatomy I (8 decks)

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