Exam 3 Flashcards
ligaments of the sternoclavicular joint
- intercalvicular
- ant/post sternoclavicular ligaments
- costoclavicular
ligaments of the acromioclavicular joint
- superior/inferioracromioclavicular-coracoclavicular (trapezoid and conoid)
- coracoacromial
roof of the shoulder
coracoacromial ligament
ligaments of glenohumeral joint
- inferior/middle/superior glenohumeral ligaments
- coracohumeral ligament
glenoid labrum
increases contact surface by 75%
primary bursa of the shoulder
subacromial bursa
-under coracoacromial ligament and above supraspinatus tendon and glenohumeral joint capsule
impingement syndrome
-decreased subacromial space
-microtrauma of supraspinatus tendon, subacromial bursa, or long head of biceps
pathologic involvement: subacromial bursa, superaspinatus tendon
spinal level of scapular spine
T3
spinal level of inferior scapular angle
T7
spinal level of last rib
T12
spinal level of iliac crest
L4
uncinate process
- c-spine
- located on superior/lateral edges of cervical bodies
- prevents posterior sliding movements of the vertebral bodies
- limits lateral flexion
weight bearing part of vertebra
body
protection part of vertebra
lamina and pedicle
movement part of vertebra
spinous process and transverse process
part of vertebra that obstructs movement
articulating processes
the posterior aspect of the anterior arch of C1 is
the fovea dentis
characteristics of cervical vertebra
- large triangular foramen
- uncinate processes
- bifid spinous processes
- transverse foramen
characteristics of thoracic vertebra
- long spinous processes angled downward
- smaller/circular vertebral foramen
- synovial joint articulations with the ribs
characteristics of lumbar vertebra
- large bodies
- triangular vertebral foramen
- articular facets in sagittal plane
- short stubby spinous processes
anterior antlanto-occipital/axial ligaments
o-prevents excessive lordosis
tectorial membrane
- covers dens and its ligaments
- overlies cruciform ligament
cruciform ligament
- prevent dens from dislocating into vertebral canal
- transverse and longitudinal portion
alar/apical ligaments
dens to foramen magnum
Anterior longitudinal ligament
- from axis to sacrum
- anterior and lateral vertebral bodies and anterior intervertebral disk
posterior longitudinal ilgament
-axis to sacrum on posterior vertebral bodies
ligamentum flavum
- connects lamina
- yelow from high elastin content
intertransverse ligament
-runs in frontal plane
interspinous ligament
-runs in sagittal plane
pattern of costal facets on t-spine
T1: full facet; 1 demifacet inferior
T10: 1 demifacet
T11: full costal facet
T12: full costal facet
Back muscle layers innervated by ventral rami
1
2
3
back muscle layers innervated by dorsal rami
4
5
6
7
nerve plexuses are only formed by
ventral rami
roots of dorsal scapular nerve
C5
nerve roots of suprascapular nerve
C5, C6
nerve roots of musculocutaneous
C5, C6, C7
nerve roots of nerve to subclavius
C5, C6
nerve roots of lower subscapular nerve
C5, C6
nerve roots of upper subscapular nerve
C5, C6
nerve roots of thoracodorsal nerve
C6, C7, C8
nerve roots of axillary nerve
C5, C6
nerve roots of radial nerve
C5, C6, C7, C8, T1
nerve roots of long thoracic nerve
C5, C6, C7
nerve roots of median nerve
C5, C6, C7, C8, T1
nerve roots of ulnar nerve
C8, T1
nerve root of medial pectoral nerve
C8, T1
nerve root of lateral pectoral nerve
C5, C6, C7
nerve root of medial antebrachial cutaneous
C8, T1
nerve root of medial brachial cutaneous
T1
nerves emerge ____ to the cervical vertebrae
superior
nerves emerge inferior to the ____ vertebrae
thoracic and lumbar
borders of the cubital fossa
superior: imaginary line between epicondyles
medial: pronator teres
lateral: brachioradialis
floor: brachialis and supinators
roof: deep fascia;bicipital aponeurosis; tissue;skin
contents of the cubital fossa
arteries: brachial and its branches
veins: basilic, cephalic, median cubital
muscle: biceps brachii
nerves: median, medial and lateral antebrachial cutaneous
mallet finger
- rupture of the extensor tendons on the base of the distal phalanx
- often causes avulsion
- from blow to tip of finger
swan neck deformity
- rupture of volar plate of the PIP
- lateral bands become lack allowing flexion of the DIP
- PIP is hyperextended while DIP is flexed
- seen in rheumatoid arthritis
Boutonniere deformity
- rupture of extensor tendon at its attachment to the base of th emiddle phalanx (central slip)
- lateral band pull PIP into flexion and DIP into extension
borders of carpal tunnel
radial border: scaphoid and trapezium
ulnar border: pisiform and hook of the hamate
roof: flexor retinaculum
structures in the carpal tunnel
- flexor digitorum superficialis
- flexor digitorum profundus
- flexor pollicis longus
- median nerve
Dupuyntren’s contracture
- thickening of palmar fascia
- contracture of ulnar 2 fingers
palmar aponeuroses
- main function is to anchor palmar skin to improve grip
- deep layer helps create carpal tunnels
- protection to underlying muscle, nerves, and vessels
what ligament carries the hand during pronation of forearm
dorsal radiocarpal ligament
-joins both collateral ligaments
ulnar medial collateral ligament
from ulna styloid process to triquetrum and pisiform
-resists radial deviation
radial lateral collateral ligament
from radial styloid process to scaphoid and trapezium
-resists ulnar deviation
TFCC
Triangular Fibrocartilage Complex *separates distal ulna from proximal carpal bones -dorsal and palmar radioulnar ligaments -triangular fibrocartilage -ulnotriquetral and ulnolunate ligament -ulnomeniscus homologue
triangular space contains
scapular circumflex artery
quadrangular space contains
- posterior humeral circumflex artery
- axillary nerve
possible nerve damage with surgical neck fracture
axillary nerve
possible nerve damage from midshaft humeral fracture
radial nerve
possible nerve damage from distal humerus fracture
median nerve
possible nerve damage from fracture of medial epicondyle
ulnar nerve
damage if upper extremity suddenly pulled superiorly (catching if falling/neonate delivery)
Klumpke’s Palsy
injury to inferior portion of brachial plexus:
C8/T1
increased angle beneath shoulder/neck (fall from height/neonate delivery)
- Erb-Duchenne palsy
- injury to superior portion of brachial plexus: C5/C6
- waiter’s tip position
basilic vein
- medial vein
- helps drain forearm and connects into brachial vein mid humerus
cephalic vein
runs up to connect to subclavian in shoulder region
subclavian vein is ____ to the anterior scalene muscle
anterior
main action of humero-radial joint
pronation/supination
-modified hinge joint
capitulum helps resist:
valgus forces
sits on the lateral side
elbow structure related to the carrying angle
trochlea since it is asymmetrical
radial notch
- on the ulna
- proximal radioulnar joint articulation
annular ligament
holds the radial head to the ulna
- origin/insertion both on coronoid process
- inner surface has hyaline cartilage
interosseous membrane
- third radioulnar articulation
- surface area for muscle attachment
- transmits forces from distal to proximal
- guides movement of radius during pronation/supination
stability of the elbow
- humeroulnar joint
- ligaments
- muscular support
elbow joint capsule is thicker
anteriorly than posteriorly
Ulnar collateral ligament (elbow)
- primary stabilizer against valgus stress
- 3 parts
most commonly injured elbow ligament
ulnar collateral ligament
anterior oblique band of UCL
- medial epicondyle to coronoid process
- primary restraint against extension
- restrains valgus throughout entire ROM
posterior band of UCL
- medial epicondyle to olecranon
- primary restraint against valgus from 65-140 degrees flexion
transverse band of UCL
coronoid process to olecranon
- reinforces medial joint capsule
- taut when other bands are taut
radial collateral ligament
- weak
- lateral epicondyle to annular ligament (not bone to bone)
- supports annular ligament
- resists varus force at elbow
lateral ulnar collateral ligament
- lateral epicondyle to lateral aspect of olecranon
- limited degree of support to capsule and varus forces
- sling to support radial head
- posterior lateral rotary instability if ruptured
what ligament acts as restraint to traction
- annular ligament
- distal segment
cephalic vein is between what muscles?
pectoralis major
deltoid
what vein is superficial to the brachial artery in the elbow?
median cubital vein
most medial structure in the cubital fossa
median nerve
prevalence of palmaris longus
absent in 10-20% of population
coracoacromial ligament
prevents superior dislocation of the humerus
what structures run deep to the arch of coracoacromial ligament and subacromial bursa?
- supraspinatus tendon
- long head of biceps brachii
long thoracic nerve pasly presents as
scapular winging
-serratus anterior not holding it anterior
what muscle stabilizes the glenohumeral joint?
supraspinatus
positions of zygapophyseal joints
cervical: 45 to horizontal
thoracic: 60 to horizontal
lumbar: vertical
what artery supplies teres minor?
scapular circumflex artery
blood supply to teres major?
thoracodorsal artery
blood supply to pectoralis major?
thoracoacromial a.
lateral thoracic a.
long head of triceps brachii passes…
between teres minor and teres major
- lateral border to triangular space
- medial border to quadrangular space
