Functional Anatomy Flashcards
Review the movements exhibited at each joint of the upper limb
Glenohumeral- elevation/depression, protraction/retraction, rotation
Radioulnar- flexion/extension, rotation
Radiocarpal: flexion/extension, aBduction/aDduction
Phalangeal: flexion/extension
State a general principle with regard to the range of motion at each joint throughout the upper limb
Movement becomes restricted the further distal you move down the upper limb
What 3 anatomical structures can be used to guide movement at any joint? Give example from upper limb for each.
Bones- ulnohumeral joint
Ligaments- radiocarpal joint
Muscles- glenohumeral joint
How does insertion differ from origin with respect to muscle attachment?
Insertion- most moveable attachment
Origin- least moveable
List 3 ways that muscles may be attached
Fleshy, aponeurotic, tendinous
What is an aponeurosis?
Thin, flat, sheet-like tendon
Identify a muscle that has a aponeurotic origin
Latissimus Dorsi
What fascial structure prevents bowstringing of tendinous muscle attachment as they cross the joint?
Retinaculum
How do muscles that are stabilizers differ from muscles that are mobilizers?
Stabilizers- attached at a distance from the joint crossed
Mobilize- attached close to the joint crossed
Give example of a muscle that can reverse its origin and insertion
The brachioradialis makes your hands the least freely moveable part instead of most moveable … ??
What constitutes a muscle sling?
All the muscles that cross any given joint
What does “tendon action of a muscle” refer to?
Using the position of a joint to stretch/relax the tendon of a muscle crossing it. Best illustrated in paralyzed muscles that have become fibrous.
List the 3 types of ligaments associated with the scapulothoracic joint complex and examples of each one
Extrascapular- coracoclavicular
Intrascapular- disc
Capsular- acromioclavicular
List the muscles involved in the scapulothoracic sling and their general actions
Trapezius: retraction & superior rotation
Pectoralis minor: depression
Serratus anterior: protraction/aBduction, superior/inferior rotation
Levator scapulae: elevation
Rhomboids: retraction (aDduct) & inferiorly rotate
List the muscles of the glenohumeral sling and their general actions
Deltoid: aBduction
Subscapularis: internal rotation
Supraspinatus, Infraspinatus, Teres Minor: external rotation
Teres major: aDduction & internal rotation
Coracobrachialis: aDduction & flexion
Pectoralis major: internal rotation
Latissimus dorsi: internal rotation, aDductor, extension
List the muscles of the ulno-humeral sling and their general actions
Brachialis: flexion Brachioradialis: flexion Long head of triceps: extension Pronator teres & pronator quadratus: pronation Supinator: supination Biceps brachii: supination & flexion
Which muscles stabilize the ulno-humeral joint? which mobilize it?
Stabilize- brachioradialis
Mobilize- brachialis, long head of triceps
List muscles involved in the muscle sling for the wrist concerned with flexion.
Flexor carpi ulnaris, flexor carpi radialis, palmaris longus
List the muscles involved in the muscle sling for the wrist concerned with extension
Extensor carpi radialis longus
Extensor carpi radialis brevis
Extensor carpi ulnaris
What is another term for ulnar deviation & radial deviation?
Ulnar deviation = aDduction
Radial deviation = aBduction
What is an axiom concerning the origin/insertion of forearm muscles?
Deep muscles of the forearm insert more distally than superficial forearm muscles
Which retinaculum of the wrist must be severed in carpal tunnel?
FLEXOR RETINACULUM :)
What is the general function of retinaculae?
Prevent bowstringing of tendons during muscle contraction
List the phalangeal joints proximal to distal.. what is the most stable position for these joints?
MP: metacarpo-phalangeal
PIP: proximal interphalangeal
DIP: distal interphalangeal
Flexed is most stable as the ligaments acting on these joings are stretched taut in this position
Which muscles of the digital sling flex the DIP joint of digits 2-5?
The flexor digitorum profundus flexes DIP joints of digits 2-5
Which muscles of the digital sling flex the DIP joint of the thumb?
Flexor pollicis longus
Which muscles of the digital sling flex the PIP joints of digits 2-5
The flexor digitorum superificalis flexes PIP joints of 2-5
Which muscles of the digital sling flex the MP joint of the thumb?
Flexor pollicis brevis flexes MP joint of the thumb
Which muscles of the digital sling flex the MP joints of digits 2-5?
The lumbricals and interossei mm. flex MP joints of 2-5
Which muscles of the digital sling extend the MP joints for digits 2-5?
Extensor digitorum extends MP joints 2-5
Name the additional extensor muscle for the MP joint on digit 5
Extensor digiti minimi
List the muscles that extend the thumb DIP
Extensor pollicis longus extends DIP thumb joint
List the muscle that extends the thumb MP
Extensor pollicis brevis extends MP joint
Name the additional extensor of MP joint of digit 2
Extensor indicis
List muscles that extend PIP & DIP joints of digits 2-5
Interossei & lumbricals
Which interossei aBduct which digits, which aDduct which digits?
Dorsal interossei 2-4 aBduct (DAB)
Palmar interosse 2-5 aDduct (PAD)
Erb’s Palsy
Upper lesion of plexus, aBductors & lateral rotators affected
Klumpke’s Palsy
lower lesion of plexus, paralyzes ulnar & median nerves so all intrinsic hand muscles paralyzed, claw hand.
Flail extremity
Avulsion of all roots of brachial plexus, limb hangs at side, partial hemiparalyzed diaphragm and partial Horner’s
Why is Horner’s syndrome a complication of lesions of the lower brachial plexus?
Due to involvement of T1 from the brachial plexus.. T1-T4 supply sympathetic innervation to head and neck.
Lesion of long thoracic nerve
C5, C6, C7
winged scapula, can not raise arm above head
Lesion of axillary nerve
no aBduction of limb (deltoid)
Lesion of musculocutaneous nerve
Loss of forearm flexion & supination
Lesion of radial nerve in the axilla
unable to extend elbow joint, wrist joint, and finger (wrist drop)
Lesion of radial nerve in the arm
wristdrop due to forearm extensors, inability to extend MP joints & extend/aBduct the thumb
Lesion of ulnar nerve above the elbow
Loss of all intrinsic muscles of hand except thenar mm. and lumbricals 2 & 3 so claw hand, MC 4 & 5 can not extend
Lesion to median nerve
Forearm supinated, weak wrist flexion and aDduction, MC 2 & 3 can not flex so hand of benediction
At wrist- ape hand, no thumb abduction, thenar mm. affected
How can you use the thumb as a test for integrity of radial, median, and ulnar nerves?
Radial: inability to extend thumb
Median: inability to flex DIP joint
Ulnar: no aDduction of MP joints with PIP & DIP joints extended
What can be said about spinal nn. controlling upward/downward movement of joints of the upper limb, moving proximal to distal?
Most cranial nerves controlling a joint are responsible for its upward movement. most caudal nerves for its downward movement. the number of spinal nn needed for movement at a joint decrease as you go distally along the limb.
