Exam 4: Not From Muscle Tables Flashcards by Dylan Weaver

Act as walls to separate breast into 15-20 lobes, each lobe containing milk glands.

Suspensory ligaments (cooper’s ligaments

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Fractures of the distal phalanx. Treated by splinting and caring for associated soft tissue injuries

Tuft fracture

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Features include:
Soft tissue swelling
Increased coracoclavicular distance (5mm more than the normal side)
Widening of AC join (2-4mm asymmetry
Superior displacement of the distal clavicle

AC joint separation

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Arteries of the mammary gland

Internal thoracic artery (medially)
Thoracocromial artery
Lateral thoracic artery

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Results from damage to the long thoracic nerve. ______ no longer holds the scapula to thoracic wall. (Two answers)

Winged scapula

No longer holds serratus anterior muscle

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Layer of loose connective tissue separating breast from deep fascia. Potential space allows for movement of breasts over underlying structures. Tumors can sometimes invade the deep fascia and pectoralis major leading to fixation of breast to thoracic wall

Retromammary space

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“Ulnar artery territory”

Medial 3.5 digits

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Drains the lateral breast. About 75% of lymph from breast

Pectoral nodes

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Amount of AC joint assymetry indicative of an AC joint separation?

2-4mm

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What age group / activity is most commonly associated w clavicle fracture

Children and adolescents

Athletic activities

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Severance of the radial nerve due to fracture of the humerus leads to

Wrist drop (unable to extend wrist)

[DOES NOT AFFECT TRICEPS bc lets off branches before it gets to the radial groove]

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Most common injury to the shoulder

Fracture of the clavicle

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View that prevens the overlap of the humeral head over the glenoid.
Considered the true AP view of shouder

Grashey View

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Relatively rare deformity which is the result of a fall on outstretched, hyperextended hand. Occurs when lunate maintains normal position w respect to the distal radius while all other carpal bones are dislocated posteriorly

Almost always associated w a scaphoid fracture
Lunate appears triangular in shape on frontal view

Perilunate dislocation

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3 ligaments that make up the glenohumeral joint

Coracohumeral
Transverse humeral
Glenohumeral

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What are the two openings in the capsule of the glenohumeral joint

Opening for the subscapular bursa

Opening for the tendon of long head of biceps brachii

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Most commonly fx’d carpal
Mech of injury usually falling on outstretchd hand resulting in hyper-extension of wrist
Radiographs indicated if there is post-traumatic wrist pain w/ anatomical snuff box tenderness
If fx missed, avascular necrosis of prox pole of bone may occur

Scaphoid fracture

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The lactiferous duct empties at the __

Nipple

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Transverse fracture of the 5th metacarpal.
Most common type of metacarpal fx.
Usually a result of a direct blow w a clenched fist against a solid surface

Boxer’s Fracture

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Amount of coracoclavicular asymmetry indicative of an AC joint separation?

5mm

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What tendons have sesamoid bones in them in the thumb ?

One sesamoid bone in tendons of flexor pollicis brevis and abductor pollicis brevis.

One sesamoid bone w/in tendon of adductor pollicis

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Action of the superficial layer of muscles of the back

Move upper extremity

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Modified sweat gland located in superficial fascia.

Mammary gland

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Contents of clavipectoral (deltopectoral) trianlge

Cephalic vein

Tip of coracoid process of scapula

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Ligament that can stay intact during dislocation of AC joint

Coracoacromial ligament

Lobectomy

Removal of 1 of 15-20 lobes

Responsible for abduction of arm in 15* to 20* range

Deltoid

This is normal on elbow x-rays unless it has the appearance of a sail

Anterior fat pad

Most common type of shoulder dislocation/

Borders of clavipectoral (deltopectoral) triangle

Deltoid, pectoralis major, clavicle

Initiates the first 15* of abduction of the arm

Supraspinatous

Gradual degeneration with wear and tear or other inflammatory disorders such as RA

Attrition

Joint between head of ulna and ulnar notch of radius

Distal radioulnar joint

Most commonly torn tendon of rotator cuff

Supraspinatous tendon

Deep branch of ulnar nerve innervates? (4)

All interosseous muscles Lateral 2 lumbricals Hypothenar muscles Adductor pollicis

Most common shoulder injury in middlee age individuals?

Shoulder dislocations and AC joint separations

C5 C6 nerve damage causing motor deficits which includes medial rotation of arm and pronation of the forearm

Erb-Duchenne Palsy

Most frequently broken bone in body

Clavicle

Most common shoulder injury in elderly individuals

Proximal humerus fractures

Insertion of superficial group of back muscles

Scapula, clavicle, hmerus

Drains the lateral side of the superficial aspect of upper limb. Enters deltopectoral triangle, and pierces clavipectoral fascia to join the axillary vein

Cephalic vein

GROUP of back muscles that act to extend trunk when acting bilaterally, are located dorsal to the vertebral column and are innervated by dorsal primary rami of spinal nervees

Deep group

Suggests an occult fracture and indicates the presence of elbow joint effusion

Posterior fat pad sign Or Positive sail sign

Type of indirect force to the arm which will cause an anterior shoulder dislocation?

Abduction, extension, and external rotation

The axillary tail of the mammary gland which extends into the armpit (is removed in modified radical or radical mastectomy)

Tail of Spencee

Major Nerve that enters the palm of hand by passing through the carpal tunnel

Median nerve

A branch of the lateral cord of the brachial plexus

Lateral pectoral nerve

Physical exam finding that is characteristic of Klumpke Palsy

Claw Hand (fingers hyperextended at MP joints and flexed at PIP and DIP joints)

Drains milk ducts to the nipple

Lactiferous duct

Fx of the distal 1/3 of the radius assoc w subluxation of the head of the ulna at the wrist. Commonly occurs w FOOSH injury (Aka reverse monteggia fracture)

Galeazzi Fracture

Boundaries of the triangle of auscultation (good place to listen to lung sounds)

Inferior: lattisumus dorsi Superior: trapezius Lateral: Rhomboid Major

Weakened abduction of the arm (15-120 degrees) and loss of cutaneous innervation to upper lateral arm

Axillary nerve damage

Function of deep layer of muscles of the back

Move trunk and back; support body weight

What three ligaments are involved in the metacarpophalangeal joints?

Deep transverse metacarpal ligament Palmar ligament Collateral ligaments

What three muscles make up the thenar eminence

Abductor pollicis brevis Flexor pollicis brevis Opponens pollicis

Physical exam finding where the arm is medially rotated and in pronation

Waiter’s tip

Superficial branch of ulnar nerve innervates ? (3)

Skin of medial 1.5 digits Palmaris brevis Skin of distal medial 1/3 of palm

Fx of the proximal 1/3 of ulna and anterior dislocation of the head of the radius at the elbow. May result from a direst blow to the posterior ulna or a FOOSH injury Most commonly physical exam reveals radial head displacement into the cubital fossa w elbow pain and tenderness

Monteggia fracture

The rupture of the side slips of the extensor expansion that insert into the distal phalanx. Due to the hyperflexion of the. DIP joint

Baseball finger (mallet finger)

In posterior elbow dislocation, what nerve might be damaged?

Ulnar nerve

FOOSH

Fall on an out stretched hand

Synovial sac filled w fluid between the supraspinatous muscle and acromion and deltoid muscle If inflammed causes painful arc syndrome

Subacromial bursa

Structures that pierce the clavipectoral fascia

Cephalic vein Thoracoacromial artery Lateral pectoral nerve

What vertebra lies underneath the decussating fibers of the thoracolumbnar fascia?

Results in loss of function of deltoid muscle and loss of sensory innervation to upper lateral arm

Injury to axillary nerve

Does coracoacromial ligament maintain AC joint?

Most severe of carpal instabilities Caused by high energy trauma resulting in loading of a dorsiflexed wrist. Involves disruption of most major carpal ligaments Produces volar dislocation and forward rotation of -___ Triangular appear of ___ on frontal projection

Lunate dislocation

Action of intermediate layer of muscles of the back

Respiratory muscles (insert to ribs)

Drains the medial breast

Parasternal nodes

Origin of superficial group of back muscles

Vertebrae ...

Responsible for abduction of arm past 90 degrees of rotation

Trapezius, serratus anterior

Due to inflamation of subacromial bursa, causes painful movement of arm from 70 - 120 degrees

Painful arc syndrome

‘Pulled elbow’

Dislocation of the proximal radioulnar joint

‘Piece of a pie’ sign

Lunate dislocation

What nerve innervates the muscles of the thenar eminence?

Recurrent branch of median nerve

Sensory innervation by the median nerve of the hand | 2

Lateral 3.5 digits (palmar) and the dorsal nail beds. Lateral 2/3 of the palm

Painful arc syndrome

Inflammation of the subacromial bursa

Causes clavicle to be elevated due to the upward pull of trapezius and the shoulder droops from weight of upper limb

Dislocation of acromioclavicular joint

innervation of the muscles of the thenar eminence

Recurrent branch of the median nerve

The rupture of the central slip of. The extensor expansion that inserts into the middle phalanx. Results from flexion of PIP joint and simultaneous extension of DIP joint from trauma to end of dorsum of finger

Boutenniere deformity

Pertaining to the palm or the sole

Volar

Medial rotation of the first metacarpal so that the thumb touches the other digits

Opposition

_______, unlike the median nerve, does not pass through the flexor retinaculum to. Enter the hand

Ulnar nerve

Most common elbow fx in adults | FOOSH injury common.

Radial head fracture

Innervation of all deep muscles of the back

The dorsal rami of spinal nerves

Acromioclavicular and coracoclavicular ligaments torn causes

Separated shoulder Dislocation of acromioclavicular joint

Physical exam finding common of Erb-Duchenne Palsy

Waiter’s tip (medial rotation of arm and pronation of forearm )

Results from hyperabduction of the arm as when a person grabs something to prevent a fall or when newborn’s arm is pulled during pregnancy. Also results from the presence of cervicle rib placing traction on the lower trunk.

Klumpke Palsy (T1 spinal nerve torn [also sometimes C8])

Motor innervation by the median nerve in the hand (4)

``` Lateral 2 lumbricals Opponens pollicis Flexor pollicis brevis Abductor pollicis brevis (Note last 3 are thenar eminence) ```

What muscle’s heads does the ulnar nerve pass between?

The flexor carpi ulnaris. In between the ulnar head at the olecranon and the humeral head at the medial humeral epicondyle

What two heads does the median nerve pass through and is also the point at which the anterior interosseous branch of the nerve splits off?

The pronator teres. One head at the coronoid process and the other at the medial humeral epicondyle

Inflammation around synovial sheath causing difficulty extending phalanges at the IP joints

Trigger finger

Type of joint in which the joint capsule surrounds the joint cavity

Synovial plane joint

What type of joint is the acromioclavicular joint?

Synovial plane joint

A very strong bipartite accessory ligament which goes from the coracoid process to the clavicle and suspends the weight of the scapula and upper extremity from the clavicle

Coracoclavicular joint

What type of joint is the shoulder (glenohumeral) joint?

Synovial ball and socket joint

Two openings of the capsule of the shoulder joint?

Between tubercles of humerus for passage of tendon of long head biceps and anteriorly for comm w bsubscapular bursa

Deepens the shallow glenoid cavity. Fibrocartilage rim

Glenoid labrum

Thickenings of the anterior part of the glenohumeral joint capsule

Superior, middle and inferior glenohumeral ligaments

An accessory ligament extending from greater to lesser tubercles of the humerus. Forms a bridge over thee bicipital groove that holds tendon of long head of biceps against humerus

Transverse humeral ligament

Strong ligament that extends from the coracoid process of scapula to greater tuberosity of humerus and strengthens the superior part of the joint capsul

Coracohumeral ligament

What type of joint is the elbow joint

Synovial hinge joint, permitting flexion etension movements

What type of joint is the proximal radio-ulnar joint?

Synovial joint permitting supination and pronation of forearm in jonjuction w the distal radioulnar joint

‘pulled elbow’

Dislocation of the proximal radioulnar joit from tears in annular ligament

What type of joint is the middle radio-ulnar joint

Syndesmosis

What type of joint is the distal radio-ulnar joint

Synovial picot type joint permitting supination and pronation of forearm.

Articular disk of the distal radioulnar joint extends where

From the lower border of ulnar notch of radius to base of styloid process of ulnar

What type of joint is the wrist ( radiocarpal joint )

Ellipsoidal synovial joint , | Permits movements of abduction-adduction, flexion-extension, and cicrumduction

Ligament In the wrist that strengthens anterior and posterior surfaces of the capsule

Dorsal and palmar ligaments

Ligaments of the wrist that exten from styloid processes of radius and ulna to carpal bones , respectively. Somewhat limit abduction-adduction movements

Radial and ulna collateral ligametns

Fx of the distal end of the radius and ulna Most common fx in persons over 50 years of age. More freq in women. FOOSH injury Distal fragment of radius often displaced posteriorly from shaft resulting in “dinner fork” deformity

Colles’ fracturee

The carpometacarpal joint of the thumb is a

Synovial saddle shaped joint that permits flexion-extension and adduction-abduction

Metacarpophalangeal joints are

Synovial condyloid joints which permit movements of flexion-exteension and abduction-adduction

Interphalangeal joints are

Synovial hinge articulators Permit only flexion-extension movements Similar structurally to metacapalphalangeal joints

Means “lack of sensation

Anasthesia

Means diminished sensation

Hypothesia

Pins and needles or burning pain

Paresthesia

Myotome for abduction of arm at the glenohumeral joint

Myotome for flexion of the forearm at the elbow

Myotome for extension of the forearm at the elbow

Myotome for flexion of the fingers

Myotome for adduction and abduction of the fingers

C5 dermatome

Lateral arm, lateral forearm and shoulder

C6 dermatome

Thumb

C7 dermatome

Middle finger

C8 dermatome

Little finger

T1 dermatome

Medial arm

Thick basement membrane (hair)

Glassy membrane

Downgrowth of. Epidermis

External root sheath

Surrounds the beginning of the hair shaft at the hair bulb. Ends at the level of the sebaceous gland

Internal root sheath

Matrix that gives rise to the shaft of the hair. Site of stem cell division and differentiation into cells of the shaft and internal root sheath (Increase length of hair shaft) Has keratinocytes and melanocytes

Hair bulb

Loose connective tissue containing blood vessel | Brings essential nutrients to the hair follicle, location of division, growth, cornification, and hair formation

Hair papilla

Part of hair shaft. | Layer of overlapping dead squamous cells

Cuticle

Layer of hair shaft Cuboidal cells, keratinized portion of the hair shaft Contains melanosomes

Cortex

Part of hair shaft. Found only in thick hair. | Large vacuolated cells

Medulla