exam #3 Flashcards
what is the ankle joint called
the talocrural joint
what type of synovial joint is the talocrural joint
hinge joint
where is the talocrural joint located
between the distal parts of the tibia and fibula and the superior region of the talus
what is the malleolar mortise?
deep socket into which the pulley-shaped trochlea of the talus fits
-formed by distal ends of tibia and fibula (and inferior transverse part of posterior talofibular ligament)
what is the rounded superior articular part of the talus
trochlea
the tibia articulates with the talus in two places. what are these places
1) its inferior surface forms the roof of the malleolar mortise, transferring the body’s weight to the talus
2) its medial malleolus articualtes with the medial surface of the talus
the joint capsule of the talocrural joint is thin anteriorly and posteriorly but is supported by two strong collateral ligaments on each side
true or false?
true
anterior talofibular ligament
-flat, weak band that extends anteromedially from the lateral malleolus to the neck of the talus
posterior talofibular ligament
-thick, fairly strong band that runs horizontally medially and slightly posteriorly from the malleolar fossa of the fibula to the lateral tubercle of the talus
calcaneofibular ligament
-round cord that passes postero-inferiorly from the tip of the lateral malleolus to the lateral surface of the calcaneus
what is the name of the ligament that reinforces the medial side of the ankle joint?
medial ligament of the ankle (deltoid ligament)
what are the main movements of the ankle joint
dorsiflexion and plantarflexion
-during plantarflexion, some “wobble” (abduction, adduction, inversion, eversion) is possible
dorsiflexion is produced by muscles in the ______ compartment of the leg
anterior
plantarflexion is produced by muscles in the _______ compartment of the leg
posterior and lateral
which structures limit plantarflexion of the ankle joint
- ligaments: anterior talofibular, anterior part of medial ligament of the ankle (deltoid lig), anterior joint capsule
- contact of talus with tibia
- tension of dorsiflexors of ankle (anterior leg)
which structures limit dorsiflexion at the ankle joint?
- ligaments: deltoid ligament, calcaneofibular, posterior talofibular, posterior joint capsule
- contact of talus with tibia
- tension of plantarflexors of ankle
what are considered the “important” intertarsal joints? What are the main movements at these joints?
subtalar (talocalcaneal) joint and the transverse tarsal joint
-inversion and eversion are the main movements involving these joints
plantar calcaneonavicular (spring) ligament
- extends across and fills a wedge-shaped gap between the sustentaculum tali and the inferior margin of the posterior articular surface of the navicular
- supports the head of the talus
- plays important role in the transfer of weight from talus
- maintains longitudinal arch of foot
long plantar ligament
- passes from the plantar surface of the calcaneus to the groove on the cuboid (some fibers extend to base of metatarsals)
- forms tunnel for fibularis longus
- maintains longitudinal arch of foot
which structures limit inversion at the foot and toes?
- ligaments: lateral ligament of ankle, talocalcaneal ligament, lateral joint capsule
- tension of everter muscles
which structures limit eversion at the foot and toes?
- ligaments: medial ligament of ankle, medial talocalcaneal ligament, medial joint capsule
- tension of tibialis posterior, flexor hallucis longus, flexor digitorum longus
- contact of talus with calcaneus
which structures limit flexion at the foot and toes?
MTP: tension of posterior joint capsule, extensor muscles, and collateral ligaments
- PIP: soft tissue apposition, tension of collateral ligaments and posterior joint capsule
- DIP: tension in collateral and oblique retinacular ligaments and posterior joint capsule
which structures limit extension at the foot and toes?
- MTP: tension of plantar joint capsule, plantar ligaments, and flexor muscles
- PIP: tension in plantar joint capsule
- DIP: ligaments and plantar joint capsule
which structures limit abduction at the foot and toes?
- ligaments: collateral ligaments, medial joint capsule
- tension of adductor muscles
- skin between web space
which structures limit adduction at the foot and toes?
apposition of toes
what is the type, movements, articulating surfaces, joint capsule, and ligaments of the subtalar (talocalcaneal) joint?
type: plane synovial
movements: inversion and eversion
articulating surfaces: inferior surface of talus articulates with superior surface of calcaneus
joint capsule: attached to margins or articular surfaces
ligaments: medial, lateral, and posterior talocalcaneal ligaments and interosseus talocalcaneal ligaments
what is the type, movements, articulating surfaces, joint capsule, and ligaments of the talocalcaneonavicular joint?
type: synovial joint, talonavicular part is a ball-and-socket joint
movements: gliding and rotatory
articulating surfaces: head of talus articulates with calcaneus and navicular bones
joint capsule: incompletely encloses joint
ligaments: plantar calcaneonavicular (spring) ligament supports head of talus
what is the type, movements, articulating surfaces, joint capsule, and ligaments of the calcaneocuboid joint?
type: plane synovial
movements: inversion and eversion of foot; circumduction
articulating surfaces: anterior end of calcaneus articulates with posterior surface of cuboid
joint capsule: encloses joint
ligaments: dorsal and plantar calcaneocuboid and long plantar ligaments
what is the type, movements, articulating surfaces, joint capsule, and ligaments of the cuneonavicular joint?
type: plane synovial
movements: little movement
articulating surfaces: anterior end of navicular articulates with bases of cuneiform bones
joint capsule: common capsule encloses joints
ligaments: dorsal and plantar cuneonavicular ligaments
what is the type, movements, articulating surfaces, joint capsule, and ligaments of the tarsometatarsal joints?
type: plane synovial
movements: gliding or sliding
articulating surfaces: anterior ends of tarsal bones articulate with bases of metatarsal bones
joint capsule: separate joint capsules enclose with each joint
ligaments: dorsal, plantar, and interosseous tarsometatarsal ligaments
what is the type, movements, articulating surfaces, joint capsule, and ligaments of the intermetatarsal joints?
type: plane synovial
movements: little movement
articulating surfaces: bases of metatarsal bones articulate with each other
joint capsule: separate joint capsules enclose each joint
ligaments: dorsal, plantar, and interosseous tarsometatarsal ligaments
what is the type, movements, articulating surfaces, joint capsule, and ligaments of the metatarsophalangeal joints?
type: condyloid synovial
movements: flexion, extension, and some abduction, adduction, and circumduction
articulating surfaces: heads of metatarsal bones articulate with bases of proximal phalanges
joint capsule: separate joint capsule enclose each joint
ligaments: collateral and plantar ligaments
what is the type, movements, articulating surfaces, joint capsule, and ligaments of the interphalangeal joints?
type: hinge synovial
movements: flexion and extension
articulating surfaces: head of one phalanx articulates with bases of one distal to it
joint capsule: separate joint capsules enclose each joint
ligaments: collateral and plantar ligaments
what are the functions of the arches of the foot?
the arches distribute weight over the foot, acting not only as shock absorbers but also as spring boards for propelling it during walking, running, and jumping
longitudinal arch of the foot
- composed of media land lateral parts
- both parts act as a unit with the transverse arch spreading weight in all directions
medial longitudinal arch of the foot
- higher and more important than the lateral arch
- composed of the calcaneus, talus, navicular, three cuneiforms and three metatarsals
- ***talar head is the keystone of the medial arch
- tibialis anterior and posterior, and fibularis longus tendon help support this arch
lateral longitudinal arch of the foot
- much flatter than the medial longitudinal arch and rests on the ground during standing
- composed of calcaneus, cuboid, and lateral two metatarsals
transverse longitudinal arch of the foot
- runs from side to side
- formed by the cuboid, cuneiforms, and bases of the metatarsals
- medial and lateral parts of the longitudinal arches serve as pillars for transverse arch
- tendon of fibularis longus and tibialis posterior, crossing obliquely, help maintain the arch
the upper limb is characterized by what?
-its ability to grasp, strike, and perform fine motor skills (manipulation)
what are the 4 segments of the upper limb?
1) shoulder
2) arm
3) forearm
4) hand
shoulder region of the upper limb
includes deltoid, pectoral, scapular, an lateral part of lateral cervical regions
-pectoral girdle: bony ring, incomplete posteriorly formed by the scapular and clavicles and completed anteriorly by the manubrium of the sternum
arm region of the upper limb
(brachium)
- between the shoulder and the elbow
- centered around the humerus
- anterior and posterior regions of the arm
forearm region of the upper limb
(antebrachium)
- between the elbow and the wrist
- ulna and radius
- anterior and posterior regions
hand region of the upper limb
(manus)
- distal to the forearm
- contains carpus, metacarpus, and phalanges
- composed of the wrist, palm, dorsum of hand, and digits
- richly supplied with sensory endings for touch, pain, and temperature
the superior appendicular skeleton is formed by which structures?
pectoral girdle, bones of the free part of the upper limb
the superior appendicular skeleton articulates with the axial skeleton only at one place. Which is it?
sternoclavicular joint
what are the 3 functions of the clavicle
1) serves as a pivoting strut (rigid support) from which the scapula and free limb are suspended, keeping the free limb lateral to the thorax so that the arm has maximum freedom of motion
2) forms one of the boundaries of the cervico-axillary canal (passageway between neck and arm), affording protection to the nerovascular bundle supplying the upper limb
3) transmits shocks from the upper limb to the axial skeleton
what type of bone is the clavicle? What is different about this bone compared to others of the same kind?
- long bone
- does not produce bone marrow (has no medullary cavity)
what type of bone is the scapula?
flat bone
the scapula overlies the ___ through ___ ribs
2nd, 7th
which part of the scapula is the thickest?
the lateral border
which of the two long bones of the forearm does not articulate directly with the hand?
ulna (medial)
what is the anatomical name for the shoulder joint
glenohumeral joint
what is the largest bone in the upper limb
humerus
what is another name for intertubercular sulcus?
biccipital groove
what separates the lesser tubercle from the greater tubercle of the humerus?
biccipital groove (intertubercular sulcus)
what are the two prominent features of the humerus?
- deltoid tuberosity (lateral)
- radial groove (groove for radial nerve)
which features make up the condyle of the humerus?
- trochlea
- capitulum
- olecranon
- coronoid
- radial fossae
which is the stabilizing bone of the forearm?
ulna
which of the two bones of the forearm is the longest?
ulna
what are the two prominent processes at the proximal end of the ulna?
- olecranon (posteriorly)
- coronoid process (anteriorly)
proximally, the shaft of the ulna is ______, and distally, it is _____
thick, thinner
what separates the ulna from the carpal bones?
fibrocartilaginous articular disc
coronoid is to ______ as coracoid is to ______
humerus (ulna), scapula
the proximal end of the radius is _____ and the distal end is _____
thin, thicker
which styloid process is larger? radial or ulnar?
radial (it also extends further distally)
the ______ lies between the two shallow grooves for passage of the tendons of the forearm muscles and serves as a trochlea (pulley) for the tendon of the long extensor of the thumb
dorsal tubercle of the radius
scaphoid
- “boat”
- a boat shaped bone that has a prominent scaphoid tubercle
lunate
- “moon”
- a moon shaped none that is broader anteriorly than posteriorly
triquetrum
- “three-cornered”
- a pyramid bone on the medial aspect of the carpus
pisiform
- “pea”
- small, pea-shaped bone that lies on the palmar surface of the triquetrum
which bones make up the proximal row of carpals? (from lateral to medial)
- scaphoid
- lunate
- triquetrum
- pisiform
which bones make up the distal row of carpals? (from lateral to medial)
- trapezium
- trapezoid
- capitate
- hamate
trapezium
- “table”
- a four-sided bone on the lateral side of the carpus
trapezoid
-wedge-shaped bone
capitate
- “head”
- the head-shaped bone that is the largest bone in the carpus
hamate
- “little hook”
- a wedge-shaped bone, which has a hooked process that extends anteriorly
which metacarpal is the thickest and the shortest?
1st metacarpal (thumb)
what is the structure that holds the tendons of the hand in place?
flexor retinaculum
what is the proximal attachment, distal attachment, innervation, and action of pectoralis major?
- proximal: clavicular head: anterior surface of medial half of clavicle; sternocostal head: anterior surface of sternum, superior six costal cartilages, aponeurosis of external oblique muscle
- distal: lateral lip of intertubercualr sulcus (groove) of humerus)
- innervation: lateral and medial pectoral nerves
- action: adducts and medially rotates shoulder joint, draws scapula anteriorly and inferiorly
- acting alone, clavicular head flexes shoulder joint and sternocostal head extends it from the flexed position
what is the proximal attachment, distal attachment, innervation, and action of pectoralis minor?
- proximal: 3rd-5th ribs near their costal cartilages
- distal: medial border and superior surface of coracoid process of scapula
- innervation: medial pectoral nerve
- action: stabilizes scapula by drawing inferiorly and anteriorly against thoracic wall
what is the proximal attachment, distal attachment, innervation, and action of subclavius
- proximal: junction of 1st rib and its costal cartilage
- distal: inferior surface of middle third of clavicle
- innervation: subclavian nerve
- action: anchors and depresses clavicle
what is the proximal attachment, distal attachment, innervation, and action of serratus anterior
- proximal: external surfaces of lateral parts of 1st-8th ribs
- distal: anterior surface of medial border of scapula
- innervation: long thoracic nerve
- action: protracts scapula and holds against thoracic wall, rotate scapula
which muscles form the clavipectoral triangle?
- pectoralis major
- deltoid
- clavicle
muscle that is used to stabilize the scapula and is used when stretching the upper limb forward to touch an object that is just out of reach
pectoralis minor
which structures form the bridge where vessels and nerves pass to the arm
- coracoid process
- pectoralis minor
(this makes the pectoralis minor a useful anatomical landmark for structures of the axilla)
the _____ affords some protection to the subclavian vessels and the superior trunk of the brachial plexus if the clavicle fractures
subclavius
which muscle forms the medial wall of the axilla
serratus anterior
the _______ muscles attach the superior appendicular skeleton of the upper limb to the axial skeleton
posterior axio-appendicular (superficial and intermediate groups of extrinsic back muscles)
the posterior shoulder muscles are divided into three groups. What are these groups?
1) superficial posterior axio-appendicular (extrinsic shoulder) muscles: trapezius and latissimus dorsi
2) deep posterior axio-appendicular (extrinsic shoulder) muscles): levator scapulae and rhomboids
3) scapulohumeral (intrinsic shoulder) muscles: deltoid, teres major, and the 4 rotator cuff muscles (supraspinatus, infraspinatus, teres minor, and subscapularis)
the ______ provides a direct attachment of the pectoral girdle to the trunk. This large muscle covers the posterior aspect of the neck and the superior half of the trunk
trapezius
what are the 3 parts of the trapezium?
1) descending (superior) part: elevates the scapula
2) middle part: retracts the scapula (i.e. pulls it posteriorly)
3) ascending (inferior) part: depresses the scapula and lowers the shoulder
which two parts of the trapezius act together to assist in rotating the scapula in the thoracic wall?
ascending (inferior) and descending (superior)
the latissimus dorsi acts _____ on the glenohumeral joint and _____ on the pectoral girdle
directly, indirectly
what is the proximal attachment, distal attachment, innervation, and action of the trapezius?
- proximal: medial third of superior nuchal line, external occipital protuberance, nuchal ligament, spinous processes of C7-T12 vertebrae
- distal: lateral third of clavicle, acromion and spine of scapula
- innervation: spinal accessory nerve (cranial nerve 11)
- action: descending (superior) part elevates, ascending (inferior) part depresses, and middle part (or all parts together) retracts scapula; descending and ascending parts act together to rotate glenoid cavity superiorly
what is the proximal attachment, distal attachment, innervation, and action of latissimus dorsi?
- proximal: spinous processes of inferior six thoracic vertebrae, thoracolumbar fascia, iliac crest, and inferior three or four ribs
- distal: floor of intertubercular sulcus (groove) of humerus
- innervation: thoracodorsal nerve
- action: extends, adducts and medially rotates shoulder joint; raises body toward arms during climbing
what is the proximal attachment, distal attachment, innervation, and action of levator scapulae
- proximal: posterior tubercles of transverse processes of C1-C4
- distal: medial border of scapula superior to root of spine
- innervation: dorsal scapular and cervical spinal nerves
- action: elevates scapula and tilts its glenoid cavity inferiorly by rotating the scapula
what is the proximal attachment, distal attachment, innervation, and action of rhomboid minor
- proximal: nuchal ligament, spinous processes of C7 and T1
- distal: triangular area at medial end of scapular spine
- innervation: dorsal scapular nerve
- action: retract scapula and rotate it to depress glenoid cavity, fix scapula to thoracic wall
what is the proximal attachment, distal attachment, innervation, and action of rhomboid major?
- proximal: spinous processes of T2-T5 vertebrae
- distal: medial border of scapula from level of spine to inferior angle
- innervation: dorsal scapular nerve
- action: retracts scapula and rotate it to depress glenoid cavity, fix scapula to thoracic wall
what is the proximal attachment, distal attachment, innervation, and action of the deltoid?
- proximal: lateral third of clavicle, acromion and spine of scapula
- distal: deltoid tuberosity of humerus
- innervation: axillary nerve
- action: clavicular (anterior) part flexes and medially rotates shoulder, acromial (middle) part abducts shoulder, spinal (posterior) part extends and laterally rotates shoulder
what is the proximal attachment, distal attachment, innervation, and action of supraspinatus?
- proximal: supraspinous fossa of scapula
- distal: superior facet of greater tubercle of humerus
- innervation: suprascapular nerve
- action: initiates and assists deltoid in abduction of shoulder joint and acts with other rotator cuff muscles
what is the proximal attachment, distal attachment, innervation, and action of infraspinatus?
- proximal: infraspinous fossa of scapula
- distal: middle facet of greater tubercle of humerus
- innervation: suprascapular nerve
- action: laterally rotates shoulder joint, help hold humeral head into glenoid cavity of scapula
what is the proximal attachment, distal attachment, innervation, and action of teres minor
- proximal: middle part of lateral border of scapula
- distal: inferior facet of greater tubercle of humerus
- innervation: axillary nerve
- action: laterally rotates shoulder joint; help hold humeral head into glenoid cavity of scapula
what is the proximal attachment, distal attachment, innervation, and action of teres major
- proximal: inferior part of border of scapula and posterior surface of inferior angle of scapula
- distal: medial lip of intertubercular sulcus
- innervation: lower subscapular nerve
- action: adducts and medially rotates shoulder joint
what is the proximal attachment, distal attachment, innervation, and action of subscapularis?
- proximal: subscapular fossa (most of anterior surface of scapula)
- distal: lesser tubercle of humerus
- innervation: upper and lower subscapular nerves
- action: medially rotates and adducts shoulder joint; helps hold humeral head into glenoid cavity of humerus
which muscle acts as a shunt muscle, resisting inferior displacement of the head of the humerus from the glenoid cavity?
deltoid
the abduction of the shoulder joint is initiated by _______. The ______ is fully effective as an abductor after the initial ___degrees
supraspinatus, deltoid, 15
which muscles are the rotator cuff muscles? Why are these called rotator cuff muscles?
SITS
- supraspinatus
- infraspinatus
- teres minor
- subscapularis
-called rotator cuff because they form a musculotendinous rotator cuff around the glenohumeral joint
which of the rotator cuff muscles is not a rotator of the humerous
supraspinatus
which muscles are supplied by the dorsal scapular nerve?
-rhomboids, occasionally supplies levator scapulae
which muscles are supplied by the long thoracic nerve?
serratus anterior
which muscles are supplied by the suprascapular nerve?
supraspinatus and infraspinatus
which muscles are supplied by the subclavian nerve?
subclavius and sternoclavicular joint
which muscles are supplied by the lateral pectoral nerve?
-primarily pectoralis major, some lateral pectoral nerve fibers pass to pectoralis minor
which muscles are supplied by the musculocutaneous nerve?
muscles of anterior compartment of the arm (coracobrachialis, biceps brachii, and brachialis), skin of lateral aspect of forearm