Gross Exam 2 Flashcards
What m. is involved in a whiplash injury
Upper portion of the trapezius
What is the lumbar triangle
A depression found at the lower portion of the latissimus dorsi, and its borders are made up of the latissimus dorsi, crest of the ilium, and the external oblique.
What is the clinical significance of the lumbar triangle
A posterior hernia can develop here
What is the triangle of auscultation
A depression at the sup. border of the lats and medial to inf. angle of the scapula. Its borders are the latissimus dorsi, trapezius, and the vertebral border of the scapula
What is the clinical significance of the triangle of ascultation
The relatively thing layer of tissue allows lung sounds to be heard easier here. It can be enlarged by having the patient protract their scapula
What is winged scapula
Weakened serratus anterior m. due to long thoracic n. damage.
What m. make up the rotator cuff
The Supraspinatus, infraspinatus, subscapularis, and teres minor
What are the 2 criteria that make a m. a rotator cuff m.
The tendon of insertion mus contribute to forming a cuff, and they must help with either int. or ext. rot.
What is crutch paralysis
aka atrophy of the deltoid due to an inj. to the axillary n. causes include fx of surgical neck of humerus, dislocation of the shoulder, or pressure of crutch in axilla
What are symptoms of crutch paralysis
Loss of sensation may occur over the lat. aspect of the arm. Abd. greatly impaired
What separates the supraspinatus from the acromion process
The Subacromial and subdeltoid bursa
What is rotator cuff tendonitis
aka Shoulder impingement. irritation and inflamm of supraspinatus tendon with sharp or aching pain
Mechanisms for shoulder impingement syndrome
Genetic (born with hooked acromion process), Weakness around rotator cuff, excess & repetitive stress, trauma, or calcium deposits
Rotator cuff tears
Previous inj, usually near its insertion, complete tears come from a single traumatic inj, and the drop test is performed to test for a tear
Subacromial and Subdeltoid bursitis
May be more common than tendonitis, but difficult to distinguish from each other
The infraspinatus is sometimes fused with what other m.
The teres minor
What is the quadrilateral space
More lateral than the triangular space, and it contains the axillary n and humeral circumflex blood vessels
What is the triangular space
More medial that the quadrilateral space, and it contains the circumflex scapular branch of the subscapular artery
How are ligaments classified
Either extrinsic (extracapsular) or intrinsic (intracapsular), and they act as either a rope or a wall
What joint does the upper limb articulate with the axial skeleton through
The Sternoclavicular joint, and it is the most stable of the upper extremity
Because the SC joint’s articulating surfaces do not fit well together, what is found in the joint to overcome this
The articular disc
What are the functions of the articular disc
Prevent the clavicle from being displaced at its articulation, and act as a shock absorber for forces being transmitted along the clavicle
The SC joint is classified as what kind of joint
Plane gliding joint
What ligament surrounds the SC joint
The capsular ligament
What ligaments are associated with the SC joint
The Ant. and Post. SC, Interclavicular, and the Costoclavicular ligaments
Dislocation of the SC joint
Rarely dislocated because of the strength of the ligaments, but when they do occur, it is usually from direct trauma ex. hitting your chest on the steering wheel during a car accident. Can be life threatening because of compression of the trachea or blood vessels
Where is the AC joint located
Articulations of the Acromion process and the lateral (acromion) end of the clavicle
What kind of joint is the AC joint
It is a plane gliding joint
What is the weak ligament associated with the AC joint
The capsular ligament
What is the n. supply of the AC joint
Dorsal scapular, suprascapular, and axillary n.
What are the ligaments of the AC joint
Sup. and Inf. AC ligament, and the Coracoclavicular ligament
The Sup and Inf AC ligaments support the AC joint how
They are extrinsic and act like ropes to keep the them in contact
What are the two portions of the coracoclavicular ligament, and what are their functions
The conoid and trapezoid which are responsible for holding and suspending the weight of the scapula from the clavicle extrinsicly acting like ropes
What is a shoulder pointer
Severe blow to the shoulder can lead to bruising
A dislocation of the AC joint is aka…
A shoulder separation
What structure can sometimes be compromised, and is indicated by a diminished brachial and radial pulse
The subclavian artery
What are the articulations of the GH (shoulder) joint
The head of the humerus and the glenoid fossa of the scapula
To make the GH joint more stable, what is located in the glenoid fossa
The Glenoid labrum
What type of joint is the GH joint
A ball and socket
What is the n. supply to the GH joint
Axillary and Suprascapular
There is a hole in the capsular ligament for what purpose
To allow the long head of the biceps brachii to pass out of the joint cavity
What n. roots when compromised allow for easy disarticulation from the scapula
C5 and C6
What is unique about the capsular ligament
It surrounds the joint, thin and lax, and it allows a lot of freedom of movement
What does the GH ligament do
It strengthens the anterior aspect of the capsule and prevents ext. rot. of the humerus at the shoulder joint. intrinsic acts like a rope
What does the Transverse Humeral ligament do
Span the intertubercular groove, converting it into a canal, and helps keep the long head of the biceps in place
What does the Coracohumeral ligament do
Strengthen the capsule from above, limit ext. rot, and extrinsic acts like a rope
What does the Coracoacromial ligament do
Attaches to the coracoid and acromion processes, prevents upward displacement of the head of the humerus, and extrinsic acts like a wall
What does the Suprascapular ligament do
Small ligament which spans the scapular notch
What structures are the most important in preventing GH dislocations
The muscles
What kind of GH dislocation is the most common and take place at the inf. capsular ligament
Ant. dislocations
An Ant. dislocation at the GH joint is also called
A subcoracoid dislocation
Patients c/o numbness or other loss of sensation, may have sustained an inj. to what nerves as well in a GH dislocation
Musculocutaneous and axillary n.
Why is the biceps brachii known as a 3 joint m.
It can cause movements at the elbow, shoulder, and proximal radio-ulnar joints`
What is popeye deformity
When the long head of the biceps is torn or ruptured near its attachment on the supraglenoid tubercle and the belly forms a ball near the center of the ant. aspect of the arm
What is the segmental innervation that the bicipital tendon reflex tests
C5 and C6
What structure is always found passing through the coracobrachialis
The Musculocutaneous n.
How else can ext. be produced at the elbow joint if the triceps is atrophied
Gravity can extend the arm
What is the segmental innervation of the tricpes that is tested in reflex testing
C7 and C8
What m. can sometimes be found partially blended with the triceps
The anconeus
What structure is the continuation of the axillary artery, and at the cubital fossa branches into 2 terminal branches
The brachial artery
What 2 arteries does the brachial artery branch into at the cubital fossa
The unlar and radial arteries
What anatomical location is the brachial pulse taken at
The bicipital furrow
Where does the brachial profundus run
It begins just distal to the teres major and follows the radial n. to supply the posterior aspect of the arm
Why is the brachial artery used to take a blood pressure
It is approx. at the level of the heart and the m. mass of the arm can effectively trasmit the pressure of the cuff to the blood vessels
What is the prominent venous arch on the dorsum of the hand
The dorsal venous arch
What 2 branches make up the dorsal venous arch
The lateral Cephalic vein and the medial basilic vein
Where are most blood samples taken from
The Median cubital vein
If there is a loss of sensation along the lat. aspect of the forearm, what n. is involved
The lateral antebrachial cutaneous nerve
What are the borders of the cubital fossa
Lat: Brachioradialis Med. Pronator teres & Sup: levels of the epicondyles of the humerus
What structures are found in the cubital fossa
Median n, Brachial artery, tendon of the biceps, & Median cubital vein
What makes up the elbow complex and what kind of joint is it
The elbow joint and proximal radio-ulnar joint, and it is a hinge/ginglymus joint
What is the n. supply to the elbow joint
Musculocutaneous, radial, median, and ulnar
What are the ligaments of the elbow joint
Capsular, RCL, UCL, and annular ligaments
What kind of dislocation is most common at the elbow joint
Posterior dislocation
What may accompany dislocations at the elbow joint
Fx, Torn ligaments, or inj. to the ulnar n.
What can happen to the ulnar n. following an elbow dislocation
It can be stretched, lacerated, entrapted in scar tissue, or entrapted in new bone formation.
Who has a larger carrying angle, males or females
Females
An inc in the carrying angle larger than normal is aka
Cubitus valgus
Where is the bursa in the elbow located
The olecranon bursa is located between the olecranon process and the skin
What kind of joint is the superior radio-ulnar joint
A pivot/trochoid joint
The interosseous membrane and oblique cord do what
Limit supination beyond anatomical position
What is nursmaid’s elbow
A subluxatoin of the head of the radius`
What is found at the distal end of the ulna between the ulna and carpal bones
The articular disc of the wrist
Which forearm bone is the stabalizing bone
The ulna
The radius and ulna have 3 ossification centers, where are they
Primary in the shaft, and one at each end (distal and proximal)
What is a Colles fx
Fx to the distal end of the radius common in adults from falling on an outstretched hand. The fx happens posteriorly giving it the dinner fork deformity
What is a Smith’s fx
Distal end of the radius. from falling on the back of the hand and is sometimes called a reverse colles because of the ant. displacement
What is the function of the sesamoid bones of digit 1,2,5
Protect and stabilize tendons and change the angle of the tendons as they pass to their insertion
What is the most commonly fx carpal bone
The scaphoid
What structure can be compromised with hamate fx
The ulnar nerve
What is a Boxer’s fx
Fx to the 5th metacarpal
Median n. entrapment can happen at the sup or inf. radio-ulnar joint what are they called
Pronator teres syndrome (sup) and Carpal tunnel syndrome (inf)
What is ape hand
When median n. damage causes the thenar m. to atrophy
What is the motor test for median n. damge
The pt. makes a circle with thumb and 2nd digit and you try to pull them apart
What is the sensory test for median n. damage
Test cutaneous sensation of the tip of the second digit
Where is the most common area for ulnar n. compression
At the distal elbow joint
What is claw hand
Ulnar n. damage making it difficult to form a fist because they cannot fully flex digits four and five
What is Guyon tunnel sydrome
Compromise or damage to the ulnar n. where it passes between the pisiform and hook of the hamate
What is cyclists or handlebar neuropathy
Indivs who develop guyon tunnel sydrome from their hands being in hyperextened position against the grips
What is Dequervain’s (aka Tenosynovitis)
Inflammation of the tendons of the abd. pollicis longus and the extensor pollicis brevis within their common fibrous sheath
What is the clinical sign for damage to the radial n.
Wrist drop (passive flexion of the wrist)
Which branch of the radial artery runs proximally to the brachial profundus
The recurrent branch
What are the branches of the hand the radial artery makes
Superficial and deep palmar arches
What makes up the radiocarpal joint and what kind of joint is it
It is made up of the distal end of the radius, articular disc, scaphoid, lunate, and triquetral bones. it is a condyloid joint
T/F: medial and lateral rotation occur at the wrist joint
False
What is our chief tactile organ
Our hands
What structures are not contained by the flexor retinaculum
The tendon of the palmaris longus and the cutaneous branches of the ulnar n.
T/F: Supination is more important than pronation
True
What is Tinel’s sign
Pins and needles sensation when taped over the median n.
What is brachiation
Locomotion using the arms
What is Dupuytren’s contracture
Tightening of the palmar facia usually at digits 4 & 5
Skier’s (Gamekeeper’s) Thumb
Rupture or laxity of the collateral ligaments of the joint typically from hyperabd. of the MP joint of digit 1
