Exam 2 Flashcards
These nerves are from the cervical plexus, C3-4, and supply the skin over the clavicle and over the superior-lateral aspect of pectorals major.
Supraclavicular nerves
These nerves penetrate deep and superficial back muscles, and supply the skin on either side of midline of back.
Cutaneous branches of dorsal rami
The sternoclavicular joint articulates what bones?
Sternal end of clavicle; Articular notch on sternum; First costal cartilage
What is the structural type of the sternoclavicular joint?
Synovial (shallow, saddle; articular disc)
The articular disc in the sternoclavicular joint is made up of what? What does it attach to?
Fibrocartilage meniscus; Attaches to clavicle superiorly and manubrium and first costal cartilage inferiorly
What is the functional type of the sternoclavicular joint?
Diarthrotic (synovial); Triaxial
Name the 3 ligaments involved with the sternoclavicular joint.
1) Anterior/Posterior sternoclavicular ligaments
2) Costoclavicular ligament
3) Interclavicular ligament
What do the anterior/posterior sternoclavicular ligaments do?
Check anterior/posterior movements of clavicular head
What does the costoclavicular ligament do?
Axis for elevation and depression; Axis for protraction and retraction; Main check for elevation
What 2 bones are involved in the acromioclavicular joint?
Acromion process on scapula (concave facet) and the Lateral end of clavicle (convex facet)
What type of joint is the acromioclavicular structurally?
Synovial; Plane
What type of joint is the acromioclavicular functionally?
Triaxial; Diarthrotic; Scapula glides and rotates on clavicle
What are the movements involved in the acromioclavicular joint?
Scapular rotation; Winging of vertebral border of scapula; Tipping of inferior angle of scapula
Name the 2 ligaments involved in the acromiclavicular joint.
Acromiclavicular ligaments (Superior and inferior) Coracoclavicular ligament (consists of Trapezoid (lateral) and Conoid (medial))
What bones are involved with the glenohumeral joint?
Glenoid fossa on scapula and head of humerus
What is the structural type of the glenohumeral joint?
Synovial; Ball-and-socket
What is the functional type of the glenohumeral joint?
Triaxial; Diarthrotic; Flex/Extend; Abduct/Adduct; Circumduction; Lateral/medial rotation
Name the 3 ligaments involved with the glenohumeral joint.
Glenohumeral (Superior; Middle; Inferior)
Coracohumeral
Coracoacromial
What is the trapezium muscle innervated by?
CN XI and ventral rami of 3rd & 4th cervical nerves
What is the proximal attachment of the upper part of the trapezius?
External occipital protuberance, Superior nuchal line and ligamentum nuchae and spinous process of CV 7
What is the proximal attachment of the middle part of the trapezius?
Spinous processes of TV 1-6
What is the proximal attachment of the lower part of the trapezius?
Spinous process of TV 7-12
What is the distal attachment of the upper part of the trapezius?
Lateral third of clavicle
What is the distal attachment of the middle part of the trapezius?
Acromion and crest of scapular spine
What is the distal attachment of the lower part of the trapezius?
Tubercle of scapular spine
What action does the upper trapezius perform?
Elevates scapula (shrugs shoulder)
What action does the middle trapezius perform?
Adducts (retracts) scapula
What action does the lower trapezius perform?
Depresses scapula
What action do the upper and lower parts of the trapezius perform together?
Upward rotation of scapula
What supplies blood to the trapezius?
Dorsal scapular artery
What innervates the latissimus dorsi muscle?
Thoracodorsal nerve (C6-8)
What is the proximal attachment for the latissimus dorsi muscle?
Spines of TV 7-12 and lumbar and sacral vertebrae via thoracolumbar fascia; Posterior iliac crest and ribs 9-12
What is the distal attachment for the latissimus dorsi?
Floor of intertubercular (bicipital) groove
What actions does the latissimus dorsi perform?
Extends, adducts, and internally rotates the humerus
What supplies blood to the latissimus doris?
Thoracodorsal artery and a branch of the subscapular artery
What innervates the levator scapulae muscle?
Cervical nerves C3-5 and dorsal scapular nerve (C5)
What is the proximal attachment for the levator scapulae?
Transverse processes of CV 1-4
What is the distal attachment for the levator scapulae?
Medial border of scapula at level of and above the spine
What actions do the levator scapulae perform?
Elevates the scapula at the superior (medial) angle and assists in the downward rotation of the scapula
What supplies blood to the levator scapulae?
Dorsal scapular artery
Which muscle is the detached cranial edge of the serratus anterior?
Levator scapulae
What innervates the rhomboid muscles (minor and major)?
Dorsal scapular nerve
What is the proximal attachment of the rhomboid minor muscle?
Spines of CV 7 and TV 1 and lower end of ligaments nuchae
What is the proximal attachment of the rhomboid major muscle?
Spines of TV 2-4 (sometimes TV 5)
What is the distal attachment for the rhomboid muscles?
Medial border of scapula from level of spine inferiorly to the inferior angle (Rhomboid minor is superior to Rhomboid major)
What actions do the rhomboid muscles perform?
Adducts scapula; Rotates glenoid fossa downward; Fixes scapula to thoracic wall
What supplies blood to the rhomboid muscles?
Dorsal scapular artery
What is the origin (proximal attachment) of the subclavius muscle?
Junction of first rib and costal cartilage 1
What is the insertion (distal attachment) of the subclavius muscle?
Inferior surface of middle third of clavicle
What action does the sublcavius perform?
Anchors and depresses the clavicle
What innervates the sublcavius muscle?
Subclavian nerve (C5, C6 — branch from superior trunk)
What is the innervation for the pectoralis major?
Lateral and medial pectoral nerves; Clavicular head (C5, C6); Sternal head (C7, C8, T1)
What is the origin for the pectoralis major?
Anterior surface of the medial half of the clavicle (clavicular head); Anterior surface of the manubrium and body of the sternum (sternal head); Costal cartilages 2-6 (sternal head); Aponeurosis of the external oblique (sternal head)
What is the insertion for the pectoralis major?
Lateral lip of the intertubercular groove (bicipital groove) = crest of greater tubercle
What actions does the pectoralis major perform?
Adducts and medially rotates arm (humerus); Flexes arm (clavicular head); Extends arm (sternal head) from flexed position; Draws scapula anteriorly and inferiorly
What innervates the pectoralis minor?
Medial pectoral nerve (C8, T1)
What is the origin of the pectoralis minor?
Ribs 3-5 near costal cartilages
What is the insertion for the pectoralis minor?
Coracoid process
What is the action performed by the pectoralis minor?
Draws scapula inferiorly and anteriorly against thoracic wall (stabilizes scapula)
These muscles are considered the “scapulohumeral musculature” and attach the scapula to the humerus. They move the humerus at the shoulder joint and contribute to the stabilization of this joint. All innervated by brachial plexus.
Deltoid; Teres major; Serratus anterior; SITS (rotator cuff muscles) = Supraspinutus; Infraspinatus; Teres minor; Subscapularis
What innervates the serratus anterior muscle?
Long thoracic nerve (C5, C6, C7)
What is the proximal attachment for the serratus anterior?
External surface of lateral parts of ribs 1-8 (9)
What is the distal attachment of the serratus anterior?
Anterior surface of medial border of scapula
What actions does the serratus anterior perform?
Protracts scapula; Fixes scapula to thoracic wall; Rotates scapula
What is the blood supply to the serratus anterior?
Lateral thoracic artery
What innervates the deltoid muscle?
Axillary nerve (C5, C6)
What is the proximal attachment for the deltoid?
Lateral 1/3 of clavicle, acromion, and spine of scapula
What is the distal attachment for the deltoid?
Deltoid tuberosity of humerus
What actions does the deltoid perform?
Flexes, medially rotates, abducts, extends, and laterally rotates the humerus
What supplies blood to the deltoid?
Deltoid branch of thoracoacromial artery
The deltoid is sometimes divided into 3 sections, these 3 sections are called…
Spinodeltoid (posterior on spine of scapula)
Acromiodeltoid (middle on acromion)
Clavodeltoid (anterior on clavicle; also called cleidodeltoid)
What innervates the teres major muscle?
Lower subscapular nerve (C5, C6)
What is the proximal attachment for the teres major?
Posterior surface of inferior angle of scapula
What is the distal attachment for the teres major?
Medial lip of intertubercular (bicipital) groove of humerus
What actions does the teres major perform?
Adducts and medially rotates humerus
What supplies blood to the teres major?
Circumflex scapular artery
This “joint” is not a true anatomic joint, but it consists of the sliding of scapula on the thoracic cage.
Scapulothoracic joint
What is involved with the coracoacromial arch?
Acromion process; Coracoid process; Coracoacromial ligament (Arch prevents superior dislocation of the humeral head and protects head of humerus from a downward directed blow)
The “Quadrilateral Space” has what as its boundaries? What is contained within this space?
Inferior glenohumeral capsule; Teres major; Triceps longus; Surgical neck of humerus
Contents = Axillary nerve & Posterior circumflex humeral artery
What are the 4 muscles involved with the rotator cuff?
Supraspinatus; Infraspinaturs; Teres minor; Subscapularis (SITS)
What innervates the supraspinatus?
Suprascapular nerve (C4, C5, C6)
What is the proximal attachment for the supraspinatus?
Supraspinous fossa of scapula
What is the distal attachment for the supraspinatus?
Superior facet of greater tubercle of humerus
What action does the supraspinatus perform?
Works with deltoid in abduction of humerus; Acts with other rotator cuff muscles in stabilizing shoulder joint
What supplies blood the supraspinatus?
Suprascapular artery
What innervates the infraspinatus?
Suprascapular nerve (C5, C6)
What is the proximal attachment for the infraspinatus?
Infraspinous fossa of scapula
What is the distal attachment for the infraspinatus?
Middle facet of greater tubercle of humerus
What actions do the infraspinatus perform?
Laterally rotates the humerus; Helps hold humeral head in place; Stabilizes shoulder joint
What supplies blood to the infraspinatus?
Suprascapular artery
What innervates the teres minor?
Axillary nerve (C5, C6)
What is the proximal attachment for the teres minor?
Middle part of lateral border of scapula (Superior to teres major)
What is the distal attachment for the teres minor?
Inferior facet of greater tubercle of humerus
What actions does the teres minor perform?
Laterally rotates humerus; Helps hold humeral head in place; Stabilizes shoulder joint
What supplies blood to the teres minor?
Circumflex scapular artery
What innervates the subscapularis?
Upper and lower subscapular nerves (C5, C6, C7)
What is the proximal attachment for the subscapularis?
Subscapular fossa of scapula (anterior surface)
What is the distal attachment of the subscapularis?
Lesser tubercle of humerus
What actions does the subscapularis perform?
Medially rotates and adducts humerus; Helps hold humeral head in place; Stabilizes shoulder joint
What supplies blood to the subscapularis?
Suprascapular artery
Two parallel forces, equal in magnitude but opposite in direction, acting on different points of the body a distance apart from each other can be defined as a ______ _____.
Force couple
Give an example of a force couple.
Upper trapezius and lower trapezius working together to upwardly rotate the scapula
The glenohumeral joint has a glenoid labrum which consists of a _________ meniscus and it deepens the articulating surface of glenoid fossa.
Fibrocartilage
The glenohumeral joint capsule is very (TIGHT/LOOSE) and has up to a(n) (INCH/CM) of passive distraction (i.e., how far head of humerus can be pulled away from glenoid fossa)
LOOSE; INCH
In the scapulohumeral rhythm, it refers to the relatively uninterrupted movement of upper extremity from dependent position to full abduction. For full abduction, how many degrees of movement occur?
180 degrees
In scapulohumeral rhythm, how many degrees of movement are contributed by the glenohumeral joint and how many by the scapulothoracic movement?
120 degrees; 60 degrees
In the 60 degrees contributed by the scapulothoracic movement, 40 degrees is from the ________ joint and 20 degrees is from the _______ joint.
Sternoclavicular; Acromioclavicular
Put the following steps in arm abduction in order from first to last:
A. External rotation of humerus (infraspinatus)
B. Snubbing of head of humerus into glenoid fossa (Rotator cuff muscles)
C. Movement (searching) of scapula (serratus anterior clamps scapula to thoracic wall)
D. First few degrees of abduction (supraspinatus)
- C
- B
- D
- A
How can deltoid paralysis occur?
By damaging the axillary nerve
How can serratus anterior paralysis (winging of scapula) occur?
By damaging the long thoracic nerve
When there are tears in the rotator cuff, which muscle is most often torn?
Supraspinatus
What 3 arteries branch off of the aortic arch?
Left subclavian; Left common carotid; Brachiocephalic trunk (which turns into right subclavian & Right common carotid)
The right subclavian artery has 3 “divisions”. Part 1 is ____ the anterior scalene muscle, Part 2 is _____ to the anterior scalene muscle, and Part 3 is ______ to the anterior scalene muscle.
Medial; Posterior; Lateral
What are the anastomosing arterial branches involved with the scapula?
Suprascapular artery (from thyrocervical trunk)
Dorsal scapular artery (deep branch of transverse cervical a. from subclavian a.)
Posterior Intercostal arteries (from thoracic aorta)
Circumflex Scapular artery (division of subscapular artery from axillary artery)
Thoracodorsal artery (division of subscapular artery from axillary artery)
The artery that runs along the vertebral border of the scapula is always referred to as the ______ _____ artery.
Dorsal scapular
The cephalic vein runs along the (MEDIAL/LATERAL) side of the ante brachium in (SUPERFICIAL/DEEP) fascia, and dumps into the axillary vein.
Lateral; Superficial
The basilic vein runs along the (MEDIAL/LATERAL) side of the ante brachium in (SUPERFICIAL/DEEP) fascia.
Medial; Deep
What does the basilic vein join with to form the axillary vein?
Vena comitantes
The axillary vein is renamed to what after it passes under the clavicle?
Subclavian vein
There are ___ brachiocephalic vein(s) and ___ brachiocephalic artery(ies).
2; 1
The 2 brachiocephalic veins come together to form what?
Superior vena cava
These lymph nodes lie medial to the humerus near axillary artery and vein.
Brachial lymph nodes
These lymph nodes lie behind pectoralis minor with lateral thoracic artery and drain the mammary gland.
Pectoral lymph nodes
These lymph nodes lie along the lower border of scapula with subscapular artery and drain the back.
Subscapular lymph nodes
These lymph nodes are in axillary fat and receive lymph from the brachial, pectoral, and subscapular nodes. It drains to the apical nodes behind the clavicle.
Central lymph nodes
What are the muscles in the anterior brachial compartment?
Biceps brachii; Corachobrachialis; Brachialis
What action does the biceps brachii perform?
Flexes arm and forearm; Main supinator of forearm
What action does the coracobrachialis perform?
Flexes arm
What action does the brachialis perform?
Flexes forearm
What innervates the anterior brachial compartment?
Musculocutaneous nerve (C5-C6)
What nerves pass through the anterior brachial compartment but do not innervate anything within it?
Median nerve and ulnar nerve
What vascularizes the anterior brachial compartment?
Brachial artery; Basilic vein and venae comatantes
This is a two-joint muscle crossing both the glenohumeral and elbow joints.
Biceps brachii
What is the proximal attachment for the short head of the biceps brachii?
Tip of coracoid process
What is the proximal attachment for the long head of the biceps brachii?
Supraglenoid tubercle of scapula
What is the distal attachment for the biceps brachii?
Radial tuberosity
This is a single-joint muscle crossing only the glenohumeral joint.
Coracobrachialis
What nerve pierces the coracobrachialis?
Musculocutaneous nerve
What is the proximal attachment for the coracobrachialis?
Tip of coracoid process
What is the distal attachment for the coracobrachialis?
Middle third of medial border of humerus
This is a single-joint muscle crossing only the elbow joint.
Brachialis
What is the proximal attachment for the brachialis?
Distal half of anterior surface of humerus and intermuscular septum
What is the distal attachment for the brachialis?
Tuberosity of coronoid process
What muscles are within the posterior brachial compartment?
Triceps brachii and anconeus
What innervates the posterior brachial compartment?
Radial nerve (C7)
What is the blood supply for the posterior brachial compartment?
Deep brachial artery
The lateral and medial heads of this muscle are single-joint muscles that cross only the elbow joint.
Triceps brachii
The long head of this is muscle is a multijoint muscle crossing both the elbow and shoulder joints.
Triceps brachii
What is the proximal attachment for the long head of the triceps brachii?
Infraglenoid tubercle of scapula
What is the proximal attachment for the lateral head of the triceps brachii?
Posterior surface of humerus above the radial groove
What is the proximal attachment for the medial head of the triceps brachii?
Posterior surface of humerus below the radial groove
What is the distal attachment for the triceps brachii?
Olecranon process
What action does the triceps brachii perform? What extra action does the long head perform?
Forearm extension; Long head also extends arm
What innervates the triceps brachii?
Radial nerve (C6-8)
What is the proximal attachment for the anconeus muscle?
Posterior aspect of lateral epicondyle of humerus
What is the distal attachment for the anconeus muscle?
Lateral surface of olecranon and superior part of posterior surface of ulna
What action does the anconeus muscle perform?
Abducts ulna during pronation of forearm and assists triceps during forearm extension
What innervates the anconeus?
Radial nerve (C7-8, T1)
Which brachium cutaneous nerve is from the axillary nerve?
Superior lateral cutaneous nerve of arm
Which brachium cutaneous nerves are directly from the medial cord?
Medial brachial cutaneous nerve
Medial antebrachial cutaneous nerve
Which brachium cutaneous nerve is a termination of the musculocutaneous nerve?
Lateral antebrachial cutaneous nerve
Which brachium cutaneous nerves are from the radial nerve?
Posterior cutaneous nerve of arm
Posterior cutaneous nerve of forearm
This nerve supplies the flexor muscles on the radial side of the forearm but does NOT supply muscles in the arm.
Median nerve
The median nerve travels with the _______ artery. (Lateral to the artery in upper half of brachium, medial to artery in lower half of brachium)
Brachial
The median nerve crosses the _____ _____ superficially with the brachial artery, however it’s deep to the _______ ________.
Cubital fossa; Bicipital aponeurosis
Which nerve innervates the anterior arm?
Musculocutaneous nerve
This nerve supplies the flexor muscles on the ulnar side of the forearm. It starts in the anterior brachial compartment.
Ulnar nerve
This nerve supplies all the extensor muscles of the upper extremity plus the brachioradialis.
Radial nerve
This muscle thinks it’s an extensor due to its position, however it flexes the elbow.
Brachioradialis
This nerve descends posterior to the axillary artery, spirals around the posterior surface of the humerus in the radial groove accompanied by the deep brachial artery.
Radial nerve
Which nerve pierces the intermuscular septum laterally? Which one pierces medially?
Radial nerve; Ulnar nerve
Which nerve pierces the coracobrachialis in the upper half or third of brachium?
Musculocutaneous nerve
Any supinator/pronator muscle must attach to what bone?
Radius
This vein is a lateral continuation of the dorsal venous arch.
Cephalic vein
The cephalic vein is in (SUPERFICIAL/DEEP) fascia and passes through the deltopectoral triangle after piercing the fascia.
Superficial
This vein is a medial continuation of the dorsal venous arch.
Basilic vein
The basilic vein is in (SUPERFICIAL/DEEP) fascia then pierces the (SUPERFICIAL/DEEP) fascia and ascends in upper aspect of arm in this fascia.
Superficial; Deep
This vein connects the cephalic and basilic veins, it extends diagonally across the bicipital aponeurosis.
Median cubital vein
The median cubital vein receives blood from the _______ _______ vein and drains blood from the _______ hand.
Median antebrachial; Palmar
These are veins that run parallel to arteries, usually two per artery. Countercurrent heat exchange.
Venae comitantes
What are the contents of the cubital fossa?
TAN = Tendon (biceps tendon); Artery (brachial); Nerve (median)
What is the lateral border of the cubital fossa? Medial border?
Brachioradialis; Pronator teres
What is the superior base of the cubital fossa?
Line between two humeral epicondyles
What is the floor of the cubital fossa?
Supinator and brachialis muscles
What is the roof of the cubital fossa?
Skin; superficial fascia; deep fascia; bicipital aponeurosis
What are the muscles that are inserted by tendons in the grooves in the radius medially to laterally?
Extensor digitorum and extensor indicis
Extensor pollicis longus
Extensor carpi radialis brevis
Extensor carpi radialis longus
What is the common origin for the anterior compartment muscles of the forearm?
Medial epicondyle of the humerus
What is the common function of the anterior compartment muscles of the forearm?
Wrist and digit flexion
What innervates the muscles of the anterior compartment of the forearm?
Median and ulnar nerves
What are the 4 superficial muscles of the anterior compartment of the forearm?
Pronator teres
Flexor carpi radialis
Palmaris longus (sometimes absent)
Flexor carpi ulnaris
What is the intermediate muscle of the anterior compartment of the forearm?
Flexor digitorum superficialis
The (MEDIAN/ULNAR) nerve innervates the flexor digitorum superficialis.
Median nerve
What are the 3 deep muscles of the anterior compartment of the forearm?
Flexor digitorum profundus
Flexor pollicis longus
Pronator quadratus
This is the only muscle that can flex the distal IP joints of the fingers.
Flexor digitorum profundus
The flexor pollicis longus is innervated by the (MEDIAN/ULNAR) nerve.
Median nerve
What are the 6 superficial muscles of the posterior compartment of the forearm?
Brachioradialis Extensor carpi radialis longus Extensor carpi radialis brevis Extensor digitorum Extensor digiti minimi Extensor carpi ulnaris
What is the common function of the muscles of the posterior compartment of the forearm?
Wrist and hand extension
What is the common origin of the superficial muscles of the posterior compartment of the forearm?
Lateral epicondyle of humerus
ALL muscles of the posterior compartment of the forearm are innervated by what?
Deep branch of radial nerve OR posterior interosseous nerve
What are the 5 deep muscles of the posterior compartment of the forearm?
Supinator Extensor indicis Abductor pollicis longus Extensor pollicis longus Extensor pollicis brevis
What are the “outcropping muscles” of the posterior compartment?
Abductor pollicis longus
Extensor pollicis longus
Extensor pollicis brevis
Paresthesia over the shoulder and the proximal arm and weakness of arm abduction may be indicative of injury to which of the following nerves?
A. Musculocutaneous B. Radial C. Axillary D. Ulnar E. Median
C. Axillary
Nerve supply to the latissimus doors is through which of the following nerves?
A. Lateral pectoral nerve B. Medial pectoral nerve C. Long thoracic nerve D. Spinal accessory nerve E. Thoracodorsal nerve
E. Thoracodorsal nerve
Which of the following muscles is not part of the rotator cuff mechanism?
A. Teres major B. Subcapularis C. Teres minor D. Supraspinatus E. Infraspinatus
A. Teres major
Which of the following serves as the insertion site of the supraspinatus muscle?
A. Lesser tubercle
B. Inferior facet of the greater tubercle
C. Middle facet of the greater tubercle
D. Superior facet of the greater tubercle
E. Crest of the lesser tubercle
D. Superior facet of the greater tubercle
Which of the following muscles is most important in rotating the greater tubercle from under the acromion during full arm elevation?
A. Teres minor B. Infraspinatus C. Supraspinatus D. Subscapularis E. Pectoralis minor
B. Infraspinatus
Which of the following muscles is necessary for the first few degrees of arm elevation?
A. Infraspinatus B. Subscapularis C. Teres major D. Teres minor E. Supraspinatus
E. Supraspinatus
Which of the following muscles is primarily responsible for the prevention of “winging” of the scapula?
A. Pectoralis major B. Pectoralis minor C. Rhomboideus major D. Serratus anterior E. Serratus posterior superior
D. Serratus anterior
“Winging of the scapula” may be the result of injury to which of the following nerves?
A. Thoracodorsal B. Axillary C. Long thoracic D. Thoracoacromial E. Suprascapular
C. Long thoracic
Which of the following arterial branches does NOT come off the third part (distal part) of the axillary artery?
A. Subscapular artery
B. Posterior circumflex humeral
C. Anterior circumflex humeral
D. Superior (supreme) thoracic artery
D. Superior (supreme) thoracic artery
The circumflex scapular artery is a branch of which of the following?
A. Thyrocervical trunk B. Costocervical trunk C. Thoracoacromial trunk D. Subscapular artery E. None of the above
D. Subscapular artery
Which of the following nerves supplies the anterior brachium?
A. Ulnar nerve B. Median nerve C. Radial nerve D. Musculocutaneous nerve E. Axillary nerve
D. Musculocutaneous nerve
Which of the following muscles is a single-joint muscle and would not be involved in active/passive insufficiency?
A. Long head of the biceps B. Short head of the biceps C. Long head of the triceps D. Flexor digitorum superficialis E. Brachialis
E. Brachialis
Which of the following muscles attaches to the coracoid process?
A. Short head of the biceps brachii B. Triceps lateralis C. Pectoralis major D. Long head of the biceps brachii E. Subclavius
A. Short head of biceps brachii
Structures that are both medial to the biceps tendon and deep to the bicipital aponeurosis include which of the following?
A. Brachial artery only
B. Median nerve only
C. Median cubital vein only
D. Both the brachial artery and the median nerve
D. Both the brachial artery and the median nerve
In the arm, the posterior ulnar recurrent artery forms an anastomosis with which of the following?
A. Superior radial collateral B. Inferior radial collateral C. Deep brachial D. Superior ulnar collateral E. Inferior ulnar collateral
D. Superior ulnar collateral
Which of the following represents the medial boundary of the cubital fossa?
A. Brachioradialis muscle B. Pronator teres muscle C. Brachialis muscle D. Biceps tendon E. Pronator quadratus muscle
B. Pronator teres muscle
All of the deep extensor muscles of the forearm are innervated by the deep ______ nerve, or the posterior ________ nerve, which the continuation of the same nerve.
Radial; Interosseous
What is the proximal attachment for the brachioradialis?
Proximal 2/3 of supraepicondylar ridge of humerus
What is the distal attachment for the brachioradialis?
Distal radius (proximal to styloid process)
What actions does the brachioradialis perform?
Flexes forearm when pronated
What supplies blood to the brachioradialis?
Radial collateral – radial recurrent – radial artery
What innervates the brachioradialis?
Radial nerve
What is the proximal attachment for the extensor carpi radialis longus?
Lateral supracondylar ridge of humerus
What is the distal attachment for the extensor carpi radialis longus?
Dorsal aspect of base of 2nd metacarpal
What actions does the extensor carpi radialis longus perform?
Extends and abducts hand at wrist
What supplies blood to the extensor carpi radialis longus?
Radial collateral – radial recurrent – recurrent interosseous – posterior interosseous artery
What innervates the extensor carpi radialis longus?
Radial nerve
What is the proximal attachment for the extensor carpi radialis brevis?
Lateral epicondyle of humerus
What is the distal attachment for the extensor carpi radialis brevis?
Dorsal aspect of base of 3rd metacarpal
What actions does the extensor carpi radialis brevis perform?
Extends and abducts hand at wrist
What supplies blood to the extensor carpi radialis brevis?
Radial collateral – radial recurrent – recurrent interosseous – posterior interosseous artery
What innervates the extensor carpi radialis brevis?
Deep branch of radial nerve
What is the proximal attachment for the extensor digitorum?
Lateral epicondyle of humerus
What is the distal attachment for the extensor digitorum?
Extensor expansions of medial four fingers
What actions does the extensor digitorum perform?
Extends medial 4 fingers at metacarpophalangeal joints and somewhat at interphalangeal joints
What supplies blood to the extensor digitorum?
Recurrent interosseous – posterior interosseous artery – perforating branch of anterior interosseous artery
What innervates the extensor digitorum?
Posterior interosseous nerve
What is the proximal attachment for the extensor digiti minimi?
Lateral epicondyle of humerus
What is the distal attachment for the extensor digiti minimi?
Extensor expansion of 5th finger
What actions does the extensor digiti minimi perform?
Extends 5th finger at metacarpophalangeal joint and somewhat at interphalangeal joint
What supplies blood to the extensor digiti minimi?
Recurrent interosseous – posterior interosseous – perforating branch of anterior interosseous artery
What innervates the extensor digiti minimi?
Posterior interosseous nerve
What is the proximal attachment for the extensor carpi ulnaris?
Lateral epicondyle of humerus and posterior border of ulna
What is the distal attachment for the extensor carpi ulnaris?
Dorsal aspect of base of 5th metacarpal
What actions does the extensor carpi ulnaris perform?
Extends and adducts hand at wrist
What supplies blood to the extensor carpi ulnaris?
Radial collateral – recurrent interosseous – posterior interosseous artery
What innervates the extensor carpi ulnaris?
Posterior interosseous nerve
The deeps muscles of the forearm emerge from between extensor _____ _____ and the extensor ______ muscles.
Extensor carpi radialis
Extensor digitorum
The supinator muscle unwinds the ______.
Radius
What is the proximal attachment for the pronator quadratus?
Distal 3rd of ulna
What is the distal attachment for the pronator quadratus?
Distal 3rd of radius
What actions does the pronator quadratus perform?
Pronates forearm; Helps interosseous membrane hold radius and ulna together
What innervates the pronator quadratus?
Anterior interosseous branch of median nerve
What is the proximal attachment for the pronator teres?
Coronoid process of ulna
Medial epicondyle and supracondylar ridge of humerus
What is the distal attachment for the pronator teres?
Middle 3rd of lateral surface of radius
What actions does the pronator teres perform?
Pronates forearm
Flexes forearm
What innervates the pronator teres?
Median nerve
What is the proximal attachment for the supinator?
Lateral epicondyle of humerus
Radial collateral and ulnar ligaments
Ulnar crest
What is the distal attachment for the supinator?
Proximal 1/3 of radius (wraps around bone)
What actions does the supinator perform?
Supinates forearm (brings radius back to anatomical position)
What innervates the supinator?
Deep branch of radial nerve
The median gives off the (ANTERIOR/POSTERIOR) interosseous nerve.
Anterior
What is the functional neurological level of the median nerve?
C7
What nerve crosses anterior cubital fossa medial to the brachial artery?
Median nerve
What nerve passes between the two heads of the pronator teres and travels between the flexor digitorum superficialis and flexor digitorum profundus?
Median nerve
What nerve supplies the flexor carpi ulnaris and half of the flexor digitorum profundus? What is the rest of the anterior compartment of the forearm innervated by?
Ulnar nerve; Median nerve
What nerve travels from the posterior compartment of the arm through the sulcus in medial epicondyle and into the forearm between the two heads of flexor carpi ulnaris and extends between flexor carpi ulnaris and flexor digitorum profundus?
Ulnar nerve
What nerve runs in the arm in the radial groove and extends down the lateral side of the humerus then pierces the lateral inter muscular septum in the lower arm and enters the antebrachium between the brachioradialis and brachialis muscles and passes in front of lateral epicondyle and enters cubital fossa?
Radial nerve
The radial nerve divides into superficial and deep branches. The _____ branch wraps laterally around the neck of the radius between superficial and deep layers of the supinator and is renamed to posterior interosseous nerve and runs with the posterior interosseous artery.
Deep
The deep radial branch/posterior interosseous nerve innervates all extensor muscles of the forearm except extensor carpi radialis longus and anconeus, which are supplied by the _____ nerve before it branches.
Radial
The radial nerve accompanies which artery?
Radial artery
This nerve emerges from beneath brachioradialis in the distal forearm.
Radial nerve
This artery is the largest of the two terminal branches of the brachial artery.
Ulnar artery
What artery gives off the common interosseous near its origin?
Ulnar artery
In the middle 3rd of the forearm, the _____ artery is joined by the ulnar nerve and lies under the flexor carpi ulnaris. In the distal third of the forearm, it is superficial and lateral to the tendon of the flexor carpi ulnaris and adjacent to the ulnar nerve.
Ulnar
This artery proximally lies deep to the brachioradialis and distally becomes superficial between the brachioradialis and flexor carpi radialis. It winds dorsally through the anatomical snuff-box.
Radial artery
The ______ artery pierces the first dorsal interosseous muscle.
Radial artery
After the radial artery passes through the first dorsal interosseous muscle it gives off the _______ ______ artery to the thumb. Then its renamed the deep palmar arch, which gives off the palmar digital arteries.
Princeps pollicis artery
What artery forms a complete arch across the palm deep to the long extensor tendons?
Radial artery
The elbow is type of hinge joint, which (UNIAXIAL/TRIAXIAL).
Uniaxial
The function of the elbow joint is to…
Flex and extend forearm
Supinate and pronate forearm
The elbow joint contains 3 articulations, which are…
1) Humeroulnar
2) Humeroradial
3) Proximal radioulnar
The humeroulnar joint aids in flexion and extension of forearm, its made of the ________ notch to the ________.
Trochlear notch; Trochlea
The humeroradial joint aids in flexion, extension, pronation, and supination of the forearm. Its made of the fovea of head of _______ to the ________ of the humerus.
Radius; Capitulum
The elbow has 3 ligaments that are in a close-packed position, which helps with extension. These ligaments are…
1) Ulnar collateral ligament (Medial)
2) Radial collateral ligament (Lateral)
3) Annular ligament
The ulnar collateral ligament (of elbow) goes from the (MEDIAL/LATERAL) epicondyle to the coronoid process and olecranon process.
Medial
The radial collateral ligament (of elbow) goes from the (MEDIAL/LATERAL) epicondyle to the annular ligament and olecranon process.
Lateral
The annular ligament (of elbow) is attached to the ulna, and forms a sling around the neck of the ______.
Radius
Slack in the ulnar collateral ligament (of elbow) results in a (VALGUS/VARUS) deformity.
Valgus
Slack in the radial collateral ligament (of elbow) results in a (VALGUS/VARUS) deformity.
Varus
There is a carrying angle of the forearm in humans. It goes through the longitudinal axis of the humerus and long axis through the trochlea. This results in a lateral deviation of the forearm that is ____ degrees in men and ___-___ degrees in women.
5; 10-15
An increase in the carrying angle of the forearm is called cubitus (VALGUS/VARUS).
Valgus
A decrease in the carrying angle of the forearm is called cubitus (VALGUS/VARUS).
Varus
This carpal bone forms the floor of the anatomical snuff box.
Scaphoid
This carpal bone is the most commonly fractured wrist bone (fractures at the “waist”), and fractures may compromise the radial artery in the snuff box. It also articulates with the radius.
Scaphoid
In what order do the hand/wrist bones go?
A. Carpals – Phalanges – Metacarpals
B. Phalanges – Carpals – Metacarpals
C. Metacarpals – Carpals – Phalanges
D. Carpals – Metacarpals – Phalanges
D. Carpals – Metacarpals – Phalanges
The radiocarpal joint is a _________ (ellipsoidal) synovial joint.
Condyloid
The radiocarpal joint articulates with what surfaces?
Scaphoid (convex)
Lunate (convex)
Distal radius (Two concave fossa; lateral and medial)
The radiocarpal joint has 4 ligaments that help strengthen the capsule, which are…
1) Radial collateral ligament (lateral)
2) Ulnar collateral ligament (medial)
3) Dorsal radiocarpal ligament
4) Palmar radiocarpal ligament
What arteries supply the radiocarpal and midcarpal joints?
Arise from dorsal and palmar arches
What nerves innervate the radiocarpal and midcarpal joints?
Anterior interosseous branch of median nerve
Posterior interosseous branch of radial nerve
Dorsal and deep branches of ulnar nerve
The _______ joint is between proximal and distal rows of carpals and between carpals.
Midcarpal
What ligaments are involved in the midcarpal joint?
Dorsal ligaments
Palmar ligaments
Interosseous ligaments
What is the palmar structure sequence (radial to ulnar)?
Radius Radial artery Flexor carpi radialis tendon Median nerve (under palmaris longus tendon) Flexor digitorum superficialis tendon Ulnar artery Ulnar nerve Flexor carpi ulnaris tendon
List the 6 types of ligaments of the wrist, hand, and digits…
1) Collateral ligaments (Radial, Ulnar, Phalangeal)
2) Carpal ligaments
3) Metacarpal ligaments
4) Carpometacarpal ligaments
5) Palmar ligaments
6) Intermetacarpal ligaments
What are the 3 tendons of muscles that define the anatomical “snuff-box”?
Extensor pollicis longus (Dorsal and more medial)
Extensor pollicis brevis (Palmar border)
Abductor pollicis longus (Runs with ext. poll. brevis)
The snuff box is the site for the _______ pulse.
Radial
The _______ bone is in the floor of the snuff box, and branches of the superficial ______ nerve are in the roof.
Scaphoid; Radial
The _______ artery runs in the floor of the snuff box over the scaphoid bone.
Radial
The proximal attachment for the abductor pollicis longus is what?
Posterior surface of proximal half of ulna, radius and interosseous membrane
What is the distal attachment for the abductor pollicis longus?
Base of 1st metacarpal
What actions does the abductor pollicis longus perform?
Abducts thumb and extends it at the carpometacarpal joint
What supplies blood to the abductor pollicis longus?
Posterior interosseous artery
What innervates the abductor pollicis longus?
Posterior interosseous nerve
What is the proximal attachment for the extensor pollicis brevis?
Posterior surface of distal 1/3 of radius and interosseous membrane
What is the distal attachment for the extensor pollicis brevis?
Dorsum of proximal phalanx of thumb
What actions does the extensor pollicis brevis perform?
Extends proximal phalanx of thumb at its metacarpophalangeal joint, also extends carpometacarpal joint
What supplies blood to the extensor pollicis brevis?
Posterior interosseous artery
What innervates the extensor pollicis brevis?
Posterior interosseous nerve
What is the proximal attachment for the extensor pollicis longus?
Posterior surface of middle 1/3 of ulna and interosseous membrane
What is the distal attachment for the extensor pollicis longus?
Dorsal aspect of base of distal phalanx of thumb
What actions does the extensor pollicis longus perform?
Extends distal phalanx of thumb at its interphalangeal joint and extends the metacarpophalangeal and carpometacarpal joint
What supplies blood to the extensor pollicis longus?
Posterior interosseous artery
What innervates the extensor pollicis longus?
Posterior interosseous nerve