Gross anatomy exam 1 Flashcards by Alexis Bennett

Upper BP injury AKA…? and nerves?

(C5-C6) “Erb-Duchenne paralysis or palsy”

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Upper BP injury cause, symptoms, diagnosis, and treatment?

Cause: Commony occurs during childbirth when there is excess traction placed on the baby’s neck

Symptoms: weakness or paralysis in the shoulder and upper arm; difficulty elevating the arm; decreased grip strength; waivers tip hand postition

Diagnosis: Muscle strength and reflexes in the affected arm as identified by a neurological doctor

Treatment: PT or surgery

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Lower BP injury nerves, cause, symptoms, diagnosis, and treatment?

C8-T1

Cause: injury to BP nerves; forced overhead movements, sports, birth injuries, falls, moter accidents, or others

Symptoms: tingling, burning sensation, or mild weakness in the arm or hand

Diagnosis: Physical exam, muscle strength and relfexes in the affected arm as identified by a neurologiccal doctor

Treatment: Mild injuries may heal over time, surgery, casting, and splinting devices to stabilize the arm, pain medication, PT

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Axillary lymph nodes -
consequences of removal?

Consequences of removal -
Winged scapula - due to injury of long thoracic nerve which innervates the serratus anterior
Lymohdema - swelling of the body due to lymph vessel bloackage that results in the buildup of lymph fluid

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Biceps Brachii m.
origin, insertion, action, innervation, irrigation

Origin -
short head: coracoid process
long head: supraglenoid tubercle

insertion - radial tuberosity of the radius and the bicipital aponeurosis

action - flexion and supination of the arm at the elbow joint

inervation - mulsculocutaneous n. (C5-C6)

irrigation - Brachial artery

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Coracobrachialis m.
origin, insertion, action, innervation, irrigation

Origin - coracoid process

insertion - anteromedial surface of the humerus

action - flexion and adduction of the arm at the shoulder joint

innervation - Musculocutaneous n. (C5-C6)

irrigation - Brachial a.

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brachialis m.
origin, insertion, action, innervation, irrigation

origin - distal half of the anterior surface of the humerus

insertion - coronoid process of the ulna bone and tuberosity of the ulna bone

action - flexion of the forearm at the elbow joint

innervation - musculocutaneous n. (C5- C6) and Radial n. (C7)

irrigation - brachial a., radial recurrent a.

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Pectoralis major m.
origin, insertion, action, innervation, irrigation

Origin - Clavicle, sternum, and costal cartilages of upper ribs

insertion - lateral lip of the intertubercular groove of the humerus

Action - felxes, adducts, and rotates arm medially at the shoulder

Innervation - Lateral and medial perctoral n.

irrigation - pectoral branch of Thoraco-acromial a.

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Pectoralis minor m.
origin, insertion, action, innervation, irrigation

Origin - Anterior surface of costal cartilages of ribs 3-5

insertion - Medial borders and coracoid process of the scapula

Innervation - Medial pectoral n.

Irrigation - Thoracoacromial a., superior thoracic a., lateral Thoracic a.

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Serratus anterior m.
origin, insertion, action, innervation, irrigation

Origin - ribs 1-8/9, intercostal fascia

Insertion - Scapula (anterior surface of the superior angle, medial border, inferior angle)

Action - stabilizes/rotates/protracts scapula

innervation - Long Thoracic n. (C5-C7)

Irrigation - superior and lateral thoracic aa., thoracodorsal a.

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Humeral fractures and result in…?

Muscle, nerve, and vasculature injury

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How is Popeye Deformity caused

Rupture and tearing of the tendon of the long head of the bicpes brachii muscle casues downward movement of the muscle belly

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what does popeye deformity feel/sound and what is treatment?

Pop sound at elbow
Intense pain that quicklu subsides
Weakness in the shoulder and elbow
Cramping of the biceps brachii

Treatment - Rest, anti-inflamatory meds, PT or Surgery

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Causes and treatment of Subluxation and disloction of the radial head

Cause - child is lifted or jerked by limb while forearm is pronated

sudden pull of limb tears distal attachment of the anular ligament to head of radius

The radial head then moves distally, partially out of the “socket” formed by the anular ligament = pain

Treatment - Supination of the child’s forearm while elbow is flexed. tear in the anular ligament heals when the limb is placed in a sling for 2 weeks.

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Pronator Teres m.
superficial, intermediate, or deep?
origin, insertion, action, innervation, irrigation

superficial

Origin - Median supracondylar ridge (humerus), Coronoid process (ulna)

Insertion - Lateral surface of the radius

Action - Pronation of forearm at the proximal radioulnar joint; flexion of forearm at the elbow joint

Innervation - Medial n. (C6-C7)

Irrigation - Brachial a., Radial a., and Ulnar a.

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Flexor Carpi Radialis m.
superficial, intermediate, or deep?
origin, insertion, action, innervation

superficial

Origin - Medial Epicondyle of the humerus

Insertion - bases of metacarpal bones 2-3

Action - Flexion and ABduction of the wrist

Innervation - Medial n. (C6-C7)

Palmaris Longus m.
superficial, intermediate, or deep?
origin, insertion, action, innervation, irrigation

superficial

Origin - Medial epicondyle of humerus

Insertion - Flexor retinaculum and palmer aponeurosis

Action - Wrist flexion and tension of aplmar aponeurosis

Innervation - Median n. (C7-C8)

Irrigation - Anterior ulnar recurrant a. and median a.

Flexor Carpi Ulnaris m.
superficial, intermediate, or deep?
origin, insertion, action, innervation, irrigation

superficial

Origin - Medial epicondyle of the humerus, olecranon of the ulna bone

Insertion - Pisiform, hamate, base of metacarpal bone 5

Action - flexion and adduction of the wrist

innervation - Ulnar n. (C7-T1)

Irrigation - Posterior ulnar recurrents a., ulnar a.

Flexor digitorum superficialis m.
superficial, intermediate, or deep?
origin, insertion, action, innervation, irrigation

intermediate

Origin - Meidial epicondyle of the humerus, coronnoid process of the ulna, and the proximal half of the anterior border of the radius

Insertion - Phalanges of digits 2-5

Action - Flexion of digits 2-5

Innervation - Median n. (C8-T1)

Irrigation - Ulnar a., Radial a.

Flexior Digitorum Profundus m.
superficial, intermediate, or deep?
origin, insertion, action, innervation, irrigation

deep

Origin - Proximal half of the anterior surface of the ulna bone, interosseous membrane

Insertion - Palmar surfaces of distal phalanges of digits 2-5

Action - Flexion of digits 2-5

Innervation -
digits 2-3: Median n.
digits 4-5: Ulnar n.

Irrigation - Ulnar nad median aa. others…

Flexor Pollicis Longus m.
superficial, intermediate, or deep?
origin, insertion, action, innervation, irrigation

Deep

Origin - Anterior surface of the radius and interosseous membrane

Insertion - Palmar surface of distal phalanx of the thumb

Action - Flexion of the thumb

innervation - Median n. (C7-C8)

Irrigation -
Medial part: Anterior interosseous a. (ulnar a.)
Lateral part: Radial a.

Pronator quadratus m.
superficial, intermediate, or deep?
origin, insertion, action, innervation, irrigation

Deep

Origin - Distal anterior surface of the ulna

Insertion - Distal anterior surface of the radius

Action - Pronation of the forearm

Innervation - Median n. (C7-C8)

Irrigation - Anterior Interosseous a.

Colles’ Fracture
What is it and how is it caused

Complete transverse fracture of the distal end of the radius
Caused by forced dorsiflexion of the hand (breaking a fall - falling on the outstretched limb with forearm and hand pronated)

Bends outward

What is this known as?
- dorsal displacement of distal fragment of radius (often comminuted) making is shorter than the usually longer ulna

Smith’s fracture or “dinner fork deformity”

Bends inward

Abductor Pollicis brevis m. - Thenar, Hypothenar, Lumbricals, Palmar interossei muscles, Other - origin, insertion, action, innervation, irrigation

Thenar Origin - tubercles of scaphoid and the trapezium, flexor retinaculum Insertion - Lateral aspect of the base of proximal phlanx 1 Action - thumb ABduction Innervation - Recurrent branch of median n. (C8-T1) Irrigation - Superficial palmar branch of radial a.

Flexor Pollicis brevis m. - Thenar, Hypothenar, Lumbricals, Palmar interossei muscles, Other - origin, insertion, action, innervation, irrigation

Thenar Origin - Flexor retinaculum, tubercle of the trapezium, trapezoid, capitate Insertion - Lateral aspect of the base of proximal phlanx 1 Action - thumb flexion Innervation - Recurrent branch of median n. (C8-T1) Deep branch of Ulnar n. Irrigation - Superficial palmar a. radialis indicis a.

Opponenes pollicis m. - Thenar, Hypothenar, Lumbricals, Palmar interossei muscles, Other - origin, insertion, action, innervation, irrigation

Thenar Origin - Tubercle of trapezium, flexor retinaculum Insertion - radial border of metacarpal Bone 1 Action - thumb opposition Innervation - Recurrent branch of median n. (C8-T1) Irrigation - Superficial palmar branch of radial a.

Opponens digiti minimi m. - Thenar, Hypothenar, Lumbricals, Palmar interossei muscles, Other - origin, insertion, action, innervation, irrigation

Hypothenar Origin - Hook of Hamate, flexor retinaculum Insertion - Ulnar aspect of the metacarpal bone 5 Action - Flexion and lateral rotation of digit 5; opposition Innervation - deep branch of the ulnar n. (C8-T1) Irrigation - Deep plamar branch of the deep palmar arch

Abductor digiti minimi m. - Thenar, Hypothenar, Lumbricals, Palmar interossei muscles, Other - origin, insertion, action, innervation, irrigation

Hypothenar Origin - pisiform Insertion - Ulnar side of the base of the proximal phalanx 5 Action - ABduction and flexion of digit 5 Innervation - deep branch of the ulnar n. (C8-T1) Irrigation - Palmar branch of the ulnar a. Palmar digital a. superficial palmar arch

Flexor Digiti minimi brevis m. - Thenar, Hypothenar, Lumbricals, Palmar interossei muscles, Other - origin, insertion, action, innervation, irrigation

Hypothenar Origin - Hook of Hamate, flexor retinaculum Insertion - Base of the proximal phalanx of digit 5 Action - Flexion and lateral rotation of digit 5; opposition Innervation - deep branch of the ulnar n. (C8-T1) Irrigation - Deep plamar branch of the ulnar a.

Abductor digiti minimi m. - Thenar, Hypothenar, Lumbrical, Palmar interossei muscles, Other - origin, insertion, action, innervation, irrigation

Lumbrical Origin - Tendons of the flexor digitorum profundus m. Insertion - extensor expansion of the hand Action - finger flexion at the metacarpophalabgeal joints and finger extension at the interphalangeal joints Innervation - - Lumbrcals 1-2: Median n. (C8-T1) - Lumbricals 3-4): Ulnar n. (C8-T1) Irrigation - Dorsal carpal arch and superficial palmar arch

Palmar interossei - origin, insertion, action, innervation, irrigation

Origin - 1: Ulnar side of metacarpal bone 2 2 & 3: radial side of metacarpal bones 4 and 5 Insertion - 1: Ulnar base of proximal phalanx/extensor expansions of digits 4 and 5 2 & 3: Radial base of proximal phalanges/extenor expansion of digits 4 and 5 Action - finger ADDuction, flexion at the metacarpophlangeal joints Innervation - Deep branch of ulnar n. (C8-T1) Irrigation - Deep palmar a. Radialis inidicis a. Palmar mestaparpal a. Proximal and distal perforating a. common and proper palmar a.

Palmaris brevis m. - Thenar, Hypothenar, Lumbricals, Palmar interossei muscles, Other - origin, insertion, action, innervation, irrigation

Other Origin - Palmar aponeurosis, flexor retinaculum Insertion - Dermis of the skin of hypothenar region Action - tightens palmar aponeurosis, tightens grip Innervation - superficial branch of ulnar n. (C8-T1) Irrigation - superficial palmar arch

Adductor pollicis m. - Thenar, Hypothenar, Lumbricals, Palmar interossei muscles, Other - origin, insertion, action, innervation, irrigation

Other Origin - Palmar base of metacarpal bone 3, capitate, palmar bases of metacarpal bones 2 and 3 Insertion - Medialbase of proximal phalanx 1 Action - thumb ADDuction Innervation - Deep branch of ulnar n. (C8-T1) Irrigation - Deep palmar arch

Carpal tunnel borders and contents

Borders - . tubercles of Scaphoid and trapezoid lateral side . Pisiform and hook of hamate of medial side Contents - - 9 tendons ~ flexor pollicis longus tendon ~ 4 tendons of flexor digitorum profundus ~ 4 tendons of flexor digitorum superficialis -Median n. -Synovial Sheaths

Carpal tunnel syndrome Cause symptoms

- Results from a lesion the reduces the size of the carpal tunnel or increases size of some of the nine structures that pass through it. - Fluid retention, infection, and excessive exeercise of fingers may casue tendon swelling - paresthesia (tingling), hypoesthesia (loss of sensation), or anesthesia (absence of sensation) May occur in lateral 3 1/2 fingers due to sensory branch of median n. motor and recurrents branches of median n. may also cause muscle weakeness loss of coordination and strength in thumb (weakness of abductor pollicis brevis and opponens pollicis)

Carpal tunnel syndrome treatment

Carpal tunnel release - Partial of complete surgical division of the flexor retinaculum may be needded to alleviate the compression