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Gross Anatomy > Gross Lecture Exam 2 > Flashcards

Gross Lecture Exam 2 Flashcards

1
Q

Three groups of shoulder muscles

A
  1. Originate from vertebral column or skull and insert on shoulder girdle or humerus
  2. Originate thoracic wall insert shoulder girdle or humerus
  3. originate scapula insert on humerus
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2
Q

Trapezius Origin (4)

A

EOP
Superior Nuchal line
Ligamentous Nuchae
Spines of thoracic vertebrae

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3
Q

Trapezius Insertion (2)

A

Clavicle

acromion process and spine of scapula

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4
Q

Trapezius Action (3)

A

Stabilize Scap
Elevates scapula
adducts scapula

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5
Q

Trapezius nerve supply (sensory and motor)

A

Sensory: C4 and C5
Motor: Spinal accessory nerve

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6
Q

Characteristics of Trapezius Palsy

A

deepening of shoulder on affected side

shoulder drops on affected side

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7
Q

Describe clinical test for XI cranial nerve

Spinal Accessory

A

Shrug shoulder against resistance. Test both sides at same time to check for weakness on one.

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8
Q

Rhomboid Major origin and insertion

A

Origin: Spine of upper thoracic vertebrae
Insertion: Vertebral border of scapula

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9
Q

Rhomboid Minor origin and insertion

A

Origin: Spines of lower cervicals and first thoracic
Insertion: Vertebral border of scapula

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10
Q

Levator Scapula Origin and Insertion

A

O: transverse processes of upper cervicals
I: superior angle of scap

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11
Q

Levator Scapula actions (3)

A

Elevate scapua
adduct scapula
stabilize scapula

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12
Q

Levator Scapula Nerve Supply and Nerve root

A

Dorsal scapular nerve (C5)

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13
Q

Describe affects of damage to C5 or levator scapula nerve

A

Complete adduct scapula difficulty

Scap is slightly further from midline on affected side

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14
Q

Latissimus Dorsi Origin (4)

A

Spines of lower thoracic and lumbar vertebrae
thoracodorsal fascia
crest of ilium
lower ribs

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15
Q

Latissimus Dorsi Insertion

A

Intertubercular groove (lesser tubercle) of humerus

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16
Q

Latissimus Dorsi Actions (2)

A

extends, adducts, and medially rotates humerus

forced expiration

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17
Q

Latissimus Dorsi nerve supply

A

Thoracodorsal (C6, C7, and C8)

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18
Q

Describe affect of weakness of Latissimus Dorsi

A

forward displacement of the shoulder

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19
Q

What makes up the lumbar triangle and what is its clinical significance?

A

Latissimus dorisi, crest of ilium, and external oblique musle.

hernia of posterior abdominal wall may develop here

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20
Q

What makes up the triangle of auscultation?

A

Latissimus dorsi, Trapezius, and Vertebral border of scap

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21
Q

Serratus anterior origin and insertion

A

O: Upper ribs
I: Vertebral border of Scapula

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22
Q

Serratus Anterior Actions (3) and Nerve Supply

A

Prime mover abduction of Scapula
Stabilizes Scap
Forced inspiration only when humerus is abducted

Long Thoracic (C5, C6, and C7)

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23
Q

Describe Long Thoracic Nerve Pulsy

A

Winging of the Scapula
Difficulty abducting scap and raising arm over head
may have pain around shoulder region

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24
Q

Causes of Long Thoracic Nerve Paulsy (3)

A

Trauma/Subluxation
Shoulder joint traction injuries
Recumbency for long period time

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25
Q

Two criteria of rotator cuff muscles

A

Tendon of insertion contributes to cuff formation around proximal humerus

Participate in lateral or medial rotation of humerus

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26
Q

Deltoid Origin (4) and insertion

A

O: Clavicle (anterior portion) Acromion process (middle) and Spine of scapula (posterior)

I: Deltoid tuberosity of humerus

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27
Q

Deltoid actions (3) and innervation

A

Anterior - Flexes and medially rotates humerus
Middle - Abducts humerus
Posterior - Extends and laterally rotates humerus

Axillary nerve (C5 and C6)

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28
Q

Name and causes for Atrophy of Deltoid

A

Crutch Paralysis

Fracture of surgical neck humerus
Dislocation of shoulder joint
Pressure of crutch in axilla

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29
Q

Deltoid atrophy problems

A

flattened shoulder appearance
loss of sensation (lateral brachial cutaneous branch of axillary nerve)
abduction of arm impaired

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30
Q

Which two bursae separate the acromion process and tendon of supraspinatous?

A

Subacromial and subdeltoid Bursae. This bursitis may be as common as tendonitis but hard to distinguish.

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31
Q

Supraspinatous Origin and Insertion

A

O: Supraspinous fossa
I: Greater tuberosity of humerus

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32
Q

Supraspinatous actions (3) and Innervation

A

Initiates abduction of humerus
laterally rotates humerus
stabilizes shoulder joint

Suprascapular (C5 and C6)

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33
Q

Describe Rotator Cuff Tendonitis

A

inflammation of the supraspinatous tendon
very common cause of shoulder pain
“shoulder impingement syndrome”
Sharp or aching anterior and or lateral aspect
weak shoulder movements
hard to sleep on that side
possible radiation

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34
Q

Causes of shoulder impingement syndrome

A

“rotator cuff tendonitis”

Genetic, born with hooked acromion
excess stress and repetition (athletes)
calcium deposits in tendon (old ppl)
Trauma

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35
Q

Clinical test for rotator cuff tear

A

Drop test - lower the fully abducted limb slowly…then it will DROP suddenly if tendon is torn.

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36
Q

Infraspinatous origin and insertion

A

O: infraspinous fossa
I: Greater tuberosiy of humerus

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37
Q

Infraspinatous actions (2) and innervation

A

Laterally rotates the humerus
Stabilizes shoulder joint

Suprascapular (C5 and C6)

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38
Q

Subscapularis O and I

A

O - Subscapular fossa

I - lesser tuberosity of humerus

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39
Q

Subscapularis Actions (2) and Innervation

A

Medially rotates humerus (ONLY rotator cuff muscle that does this)
Stabilizes shoulder joint

Upper and Lower subscapular nerve (C5 and C6)

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40
Q

Teres Minor O I A2 and N

A

O: axilarry border of scap
I: Greater tuberosity of humerus
A: laterally rotates humerus and stabalizes AC joint
N: axillary nerve (C5 and C6

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41
Q

Teres Major O I A2 and N

A

O - Inferior angle of scap
I - Medial lip of intertubercular grove
A - medially rotate humerus, stabalize ac joint
N - lower subscapular (C6)

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42
Q

Name the two divisions of the space between teres minor and major that is divided by the long head of triceps.

A

Quadrilateral space - lateral of two, axillary nerve and humeral circumflex vessels here

Triangular space - medial of two, circumflex scapular branch of subscapular artery here

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43
Q

What is the most stable joint of the upper extremity? What are its articulations?

A

Sternoclavicular joint

Sternal end of the clavicle

Clavicular notch and costal notches of the manubrium

Medial end of the first rib

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44
Q

The articular disc of the sternoclavicular joint is divided into two separate cavaties. What are their functions?

A

prevent clavicle from displacement with sternum

act as shock absorber for forces transmitted along clavicle

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45
Q

Sternocalvicular joint:

Classification
Capsular ligament characteristic

A

Plane gliding (kinda ball and socket a little)

very strong and completely surround joint

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46
Q

Extrinsic/extracapsular ligaments vs. intrinsic/intracapsular

A

Ex - superficial to capsular ligament

IN - deep to capsular ligament

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47
Q

What are the 4 ligaments of the sternoclavicular joint?

A

Anterior/Posterior Sternoclavicular

Interclavicular

Costoclavicular

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48
Q

Anterior/Posterior sternoclavicular characteristics

A

reinforce capsular ligament
prevents excessive protractions and retractions
Extrinsic acts like a wall

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49
Q

Interclavicular Characteristics

A

attached to both clavicles
prevent displacement when carrying heavy thing
extrinsic acts like a rope

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50
Q

Costoclavicular characteristics

A

strong attached to costal impression and rib 1
reinforces capsular ligament
limits elevation at medial end of clavicle
Extrinsic acts like a rope

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51
Q

Nerve supply and movement pf sternclavicular joint

A

Supraclavicular and nerve to subclavius

elevation,depression,pro/retraction and rotation passively when scap moves

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52
Q

Dislocation info for sternoclavicular

A

rarely happens cuz of strength
usually result of direct trauma to anterior aspect of sternal end clavicle. car crash or pile on football
mild sprain to complete dislocation
life threatening if compression of trachea or blood vessels in neck

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53
Q

Acromioclavicular joint

Articulations, Classification, Capsular lig. character

A

acromion process and lateral end of clavicle
plane gliding
think and week needs reinforce ligaments

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54
Q

What re the 3 ligaments of the A/C joint? Their nerve supply?

A

Superior/Inferior Acromioclavicular
Coracoclavicular
Suprascapular and axillary

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55
Q

Superior/Inferior Acromioclavicular ligament characteristics

A

Reinforce capsule
prevent clavicle from contact loss with acromion
extrinsic acts like a rope

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56
Q

Coracoclavicular ligament characteristics

A

Connects clavicle with coracoid process

divided into conoid and trapezoid portions which attach to respective clavicle locations

Suspends weight of scapula from clavicle

Extrinsic acts like a rope

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57
Q

Describe dislocation of the AcromioClavicular joint. (Shoulder Separation)

A

Often occur after severe blow to shoulder (Shoulder pointer)

when grade three, clavicle separates from scap

Lateral end of clavicle displaced and palpable

more prominent acromion

Subclavian artery may be compressed so diminished brachial pulse

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58
Q

Glenohumeral joint Articulation, classification, capsule character,

A

Head of humerus with glenoid cavity of scap
glenoid cavity much smaller so glenoid labrum

Ball and socket

thin and lax, opening inferior lateral part so long biceps passes out of cavity

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59
Q

Glenohumeral joint ligaments (5) and nerve supply

A 
Glenohumeral
Tranverse Humeral
Coracohumeral
Coracoacromial
Suprascapular

axillary and suprascapular n

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60
Q

Glenohumeral ligament character

A

inside joint cavity
helps prevent lateral rotation of humerus
intrinsic acts like a rope

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61
Q

Transverse Humeral ligament

A

spans intertubercular groove

keeps long head of biceps in place

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62
Q

Coracohumeral Lig

A

limits lateral rotation of huerus

extrinsic like a rope

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63
Q

Coracoacromial ligament

A

attaches coracoid and acromion
prevents upward displacement of humerus head
extrinsic acts like a wall

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64
Q

Suprascapular ligament

A

small ligament spans the scapular notch

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65
Q

Dislocation of the Glenohumeral joint describe

A

Most common is an Anterior Dislocation at the lateral aspect of the capsular ligament

Caused by excessive extension and lateral rotation of humerus which goes through anterior part of capsular ligament and ends up below coracoid. (subcoracoid dislocation)

possible loss of sensation along lateral arm and forearm cuz musculocutaneous and axilarry nerve damage

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66
Q

What are the three anterior arm muscles and which nerve supplies them

A

Biceps Brachii
Coracobrachialis
Brachialis

Musculocutaneous nerve

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67
Q

What is unique about the biceps brachii?

A

it has no attachment to the humerus and is known as a “three joint muscle” cuz it can cause movement at the shoulder, elbow, and superior radiulnar joints.

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68
Q

Biceps Brachii O I A and INN

A

Coracoid process and Supraglenoid tubercle
tuberosity of the radius and ulna shaft

Flexion of forearm at elbow joint
Supinator of forearm
Short adducts the humerus
long abducts the humerus

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69
Q

Describe Biceps Tendonitis

A

Long head moves back and forth in the intertubercular groove

usually activities with flexion at elbow joint resistance

some individuals have rougher/narrow groove that can irritate tendon and cause cracking sound (Crepitus)

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70
Q

Rupture of Long head Biceps tendon describe

A

usually torn at attachment of supraglenoid tubercle
audible pop or snap
rupture belly forms near center aspect of arm (popye deformity)
Chronic tendonitis and forceful flexion cause rupture

71
Q

Bicipital reflex describe

A

tap the biceps insertion to look for flexion at elbow

tests for segmental innervation at c5 and c6

72
Q

Coracobrachialis O I A

A

O - Coracoid process
I - shaft humerus
A - Flexion and weak adduction of humerus
Helps stabilize shoulder joint

73
Q

Brachialis O I A

A

O Shaft humerus
I coronoid process
A Flexion of forearm at elbow

74
Q

What is unique about triceps action

A

Only medial head works all the time, lateral and long head only for extra force!

75
Q

List the important branches of the Brachial artery and where they are located

A

Deep Brachial (brachial profundus)
First major branch, distal to teres major
Superior and inferior Ulnar Collateral arteries
off distal medial end of brachial and take part in arterial anastomosis around medial aspect of elbow joint

76
Q

Differences between Systolic and Diastolic pressure

A

As pressure in cuff is released blood flow resumes and you hear Systolic

Point when sound not heard any more is Diastolic

77
Q

What are the cutaneous veins of the upper extremity?

A

Dorsal Venous Arch
Cephalic Vein
Basilic Vein
Median Cubital Vein

78
Q

Characteristics of the Musculocutaneous nerve

A

rarely inured because beneath biceps

usually due to direct wound in axilla or dislocation of shoulder joint

79
Q

Effects if Musculocutaneous nerve is damaged

A

Anterior arm muscles will atrophy but weak flexion still possible due to pronator teres and brachioradialis

possible loss of sensation along lateral forearm cuz lateral antebrachial cutaneous nerve

80
Q

What are the three boundaries of the cubital fossa

A

Lateral - brachioradialis muscle
Medial - pronator teres muscle
Proximal - level of the epicondyles of humerus

81
Q

4 important structures in cubital fossa

A

Median nerve
Brachial artery (branches to ulnar and radial)
Tendon of biceps brachii
Median cubital vein

82
Q

Which two joints make up the elbow complex?

A

Elbow joint and proximal (superior) radioulnar joint

83
Q

Elbow Joint articulations, classification, capsular ligament character and innervation

A

Trochlea of the humerus with trochelar notch of ulna and capitulum of humerus with head of radius

hinge joint/ginglymus

loose anterior/posterior to permit maximum flexion and extension
strong colatteral to prevent movement
Capsule attaches to humerus and ulna but not radius

Musculocutaneous and Radial

84
Q

Elbow joint ligaments 3

A

Lateral or Radial Collateral
Medial or Ulnar Collateral
Annular Ligament

85
Q

Lateral/Radial Collateral ligament attachments and function

A

lateral epicondyle to annular ligament
prevents adduction at the joint
extrinsic acts like a rope

86
Q

Medial/Unlar Collateral attachment and function

A

medial epicondyle to proximal ulna
prevents abduction
Extrinsic acts like a rope

87
Q

Annular ligament attachment and function

A

margins of radial notch and encompasses but not attach to head and neck of radius
keeps head of radius in place
extrinsic acts like a wall

88
Q

Describe dislocation of elbow joint

A

Posterior are most common, olecranon process will dislocate from trochlea

caused by fractures, torn ligaments, or ulnar nerve injury

89
Q

Ulnar nerve damage causes

A

Stretched or lacerated during dislocation
entrapped in scar tissue after ligament healing
Entrapped in new bone formation

90
Q

Name for increased Carrying angle of elbow joint

A

Cubitus valgus

91
Q

Describe the Olecranon bursae

A

it sits between olecranon process and skin to dissipate pressure when leaning on elbow

repeated pressure cause friction type bursitis

injury or fall could cause bacterial infection of bursae

92
Q

Proximal (Superior) Radioulnar joint Articulation, Classification, Capsule characteristic

A

Head of radius with radial notch of ulna
pivot or trochoid joint (only rotational)
encloses the joint and continuous with elbow joint

93
Q

Ligaments of the Proximal Radioulnar Joint and describe them

A

Interosseous membrane (ligament) and Oblique chord

both limit supination

extrinsic and at like ropes

94
Q

What is the common name of a subluxation of the Head of the Radius? Describe it.

A

Pulled/Slipped elbow, Nursemaids Elbow

most common preschool injuries happens when child is suddenly jerked by hand or forearm

tear or pulls head of radius from under the annual ligament.

painful, extremity limp and forearm held flexed and pronated

supination hurts

95
Q

Does the ulna articulate with wrist joint?

A

No cuz the articular disc of the wrist is between it and the carpal bones

96
Q

Describe a Colles Fracture

A

fracture at distal end of radius, most common in adults esp 50+ women

individual falls on outstretched hand

distal fragment displaced posterior so radius shortens

97
Q

Typical sign of Colles fracture? does it heal well?

A

Dinner fork deformity - posterior angulation occurs in the forearm proximal to the wrist

heal well usually cuz good vascular supply

98
Q

Describe a Smith’s Fracture

A

fracture at distal end of radius

fall on back of hand, reverse colles fracture so displaced fragment anterior

99
Q

List the order of the ossification of the Carpal bones

A 
Capitate and Hamate
Triquetral
Lunate
Trapezium, Trapezoid, Scaphoid
Pisiform
100
Q

Around what age is the ossification of carpal bones complete? Does ossification start before or after birth?

A

14 to 16

Usually after

101
Q

What are Sesamoid bones? What are their functions?

A

bones embedded in some flexor tendons of the hand. usually over MP joints on digits 1 2 5 and IP1

protect and stabilize tendons

change the angle of the tendons (increase leverage)

102
Q

Describe a Scaphoid fracture

A

most common carpal fracture

fall on the palm of the hyperextended hand

twice as much force to break this as radius

appears as a sprained wrist, tenderness and swelling in snuffbox

103
Q

Describe a hammate fracture

A

may lead to a nonunion of fractured parts cuz pull of muscles attached to bone. Ulnar nerve is close to the hook of hamate andmay be inured

104
Q

Describe metacarpal fractures

A

held closely by ligaments so fractures tend to be stable and heal quickly cuz good blood supply

Boxers Fracture is that of the 5th metacarpal from a punch

105
Q

Describe Phalange fracture

A

usually crushing injuries (slam in door)

very painful! may result in hematomas

avulsion fractures with extensor tendons common

106
Q

Pronator Teres O I A Inn

A

Origin - medial epicondyle and coranoid process

Insertion - pronator ridge radius

Action - pronation and helps flexion

Innervation - median nerve

107
Q

What is pronator teres syndrome and what causes it?

A

Compression of median nerve at proximal forearm between head of muscle

Direct trauma or excessive pronation/supination

108
Q

Flexor carpi radialis OIAI

A

Medial epicondyle

Second metacarpal and little bit of 3rd

Flexion and abduction of hand

Median nerve

109
Q

Ulnar vs radial deviation

A

Know it?

110
Q

Flexor Carpi Ulnaris OIAI

A

Medial epicondyle and olecrandon process

Pisaform hammate and 5th metacarpal

Flexes andadducts hand

Ulnar nerve

111
Q

Flexor digatorum superficialias

A

medial epicondyle
middle phalanges of digits 2-5
flexes digit proximal IP joints, helps flexion hand
Median nerve

112
Q

Flexor digatorum profundus

A

Ulna shaft
distal phalanges 2-5
median and ulnar nerve
flexes dip joints and helps flex hand`

113
Q

Flexor pollicis longus

A

shaft of radius
distal phalanx of digit 1
flexes ip joint of thumb
median

114
Q

Pronator Quadratus

A

shaft of ulna
shaft or radius
pronates lower forearm, helps stabilize joint
median nerve

115
Q

Describe Carpal Tunnel Syndrome

A

Compression of the Median nerve at the distal radialulnar joint.

atrophy of the thenar muscles may occur “ape hand”

Sensory loss over lateral 2/3 palm

116
Q

What tests are done to identify carpal tunnel?

A

Make circle with thumb and pointer finger and doctor trys to pull first digit away

Also assess the sensivity of tip of digit 2

117
Q

Describe effects of Ulnar nerve damage

A

difficulty making a fist (Claw Hand)

118
Q

Guyon Tunnel or Canal Syndrome

A

comprimised ulnar nerve as it passes between hook of the hamate and the pisiform

sensation loss in medial one and half digits

119
Q

Cyclists or Handlebar Neuropathy

A

ppl who develop Guyon cannal due to biking a lot with a hyperextened grip

120
Q

Brachioradialis

A

Lateral supracondylar ridge

styloid process of the radius

Flexes forearm, pronates AND supinates depending

Radial nerve

121
Q

Extensor carpi radialis longus and brevis

A

Lateral Epicondyle
second and third metacarpals
Extends and abducts hand
Radial

122
Q

Extensor Digitorum

A

lateral epicondyle
middle and distal phalanges 2-5

extends digits, extends hand, abducts digits 2,4, and 5

Radial

123
Q

Extensor digiti minimi

A

Lateral epicondyle
proximal phalanx digit 5
extend digit 5

124
Q

Extensor Carpi Ulnaris

A

lateral epicondyle
fifth metacarpal
extends hand and adducts hand

125
Q

Describe Lateral Epicondylitis (Tennis Elbow)

A

painful due to excessive use of superficial posterior forearm muscles

pain at lateral epicondye run down their forearm laterally

any activity with full extension aggervates this

126
Q

Test for Tennis elbow

A

.stabilization of the patient’s forearm and having the patient make a fist and hyperextend their hand .applying pressure to the patient’s hand and attempting to force the patient’s hand into flexion, while the patient resists - pain if there

127
Q

Describe Mallet or Baseball finger

A

Sudden severe tension of one of the long extensor tendons may avulse at attachment to distal phalanx

result is poor extension at joint

128
Q

Supinator

A

Lateral epicondyle and supinator crest of ulna
Shaft of radius
supinates forearm
radial

129
Q

Abductor Pollicis Longus

A

shaft of ulna and radius
first metacarpal
adducts digit one at CM joint

130
Q

Extensor Pollicis Brevis

A

Shaft radius
Proximal phalanx thumb
Extends thumb

131
Q

Extensor Pollicis Longus

A

Shaft Ulna
Distal Phalanx digit one
extends digit

132
Q

What is in the floor of the Anatomical Snuffbox?

A

Styloid of radius, scaphoid and trapezium

133
Q

Describe DeQuervains Disease or Tenosynovitis Stenosans

A

Innflamation of tendons of abductor pollicis longus and extensor pollicis brevis within their common fibrous sheath

more common in old women menopause

134
Q

Extensor Indicis

A

Shaft of Ulna
Proximal phalanx digit two
extends digit two

135
Q

Describe damage to the radial nerve

A

most common cause is the fracture to humerus

triceps may be spared, but posterior forearm muscles and sensation affected

hand will drop to passive flexion Wrist Drop

136
Q

Differences between damages to superficial or deep branches of radial nerve

A

penetrating wounds will affect the deep branch and the patient will have difficulty carrying our extension of the hand and/or digits. Sensory loss is not seen, unless the superficial branch has been damaged
.damage to the superficial branch, always shows sensory loss but not motor loss

137
Q

What are the two major arteries of the forearm and their branches

A 
Radial Artery
     Recurrent artery
     Unnamed muscular branches
     superficial and deep palmar
Ulnar Artery
     Anterior and posterior recurrent
     Common Interosseous
          anterior and posterior interosseous
     Superficial and Deep Palmar

***Superfical and deep branches from both ulnar and radial form superficial and deep arches

138
Q

Distal or Inferior Radioulnar Joint

Articulation, Classicfication, and Capsule character Innervation

A

Head of ulna and ulnar notch of radius

pivot or trochoid

encloses but weak, may be deficient superiorly

Radial

139
Q

Distal or Inferior Radioulnar joint ligaments

A

Anterior and Posterior transverse ligaments - unite radius and ulna, strengthen capsule and prevent supination. Extrinsic acts like a rope

Articular disc (ligament) -small piece of fibrocartilage which attaches to the ulnar notch and the styloid process of the ulna. Chief uniting structure of joint

140
Q

Functions of the Interosseous Membrane

A

Provide strength and stability between radius and ulna

limit supination

increase surface area for muscle attachment

141
Q

What is more powerful pronation of forearm or supination?

Why easier to screwdrive with bend in elbow?

A

Supination

Biceps help

142
Q

Radiocarpal (Wrist) Joint

Articulation, Classification, Capsule, innervation

A

distal end of radius and articular disc with the Scaphoid, lunate and triquetral

condyloid

Rather thin and unremarkable

Median, Radial, and Ulnar

143
Q

Radiocarpal joint ligaments

A

Dorsal and Palmar radiocarpals
attach superiorly to radius and inferiorly to
scaphoid and lunate. Extrinsic Ropes

Palmar ulnocarpal
attach ulna to scaphoid/lunate Extrinsic Rope

Ulnar and Radial Collaterals
attach styloid process of ulna and radius to their respective sides carpal bones. Extrinsic Ropes

144
Q

Does medial and lateral rotation occur at the wrist joint?

A

NO!!!!!!! only flexion, extension, adduction and abdution

145
Q

LOOK AT CROSS SECTION DIAGRAMS!!!

A

LOOK AT CROSS SECTION DIAGRAMS!!!!

146
Q

The ability of our hands to manipulate objects in the environment

A

Manual dexterity

147
Q

What important structures are held within the carpal tunnel? outside of it?

A

median nerve and long flexor tendons to the digits

tendon of insertion of the palmaris longus and the cutaneous branches of ulnar nerve

148
Q

Carpal Tunnel Syndrome other name

A

Distal Median Nerve Neuropathy

149
Q

6 common causes of Carpal Tunnel

A

Edema caused by trauma, obesity, or pregnant

fractures, smiths fracture example

Tumors, ganglionic cyst for example

Oral Contraceptives

Repetitive flexion and extension of wrist

misalignment of bones

150
Q

Signs and Symptoms of Carpal Tunnel

A

paresthesia in median nerve cuteneous area

decreased skin moisture in nerve cutenaous area

pain awakening in the middle of night

atrophy of thenar muscles

symptoms intensified by activity flexion extension

151
Q

Carpal Tunnel Tests

Tinel’s Sign

Phalen’s Test

A

TS - sensation of “pins and needles” when doc taps over median nerve site at anterior wrist

PT - reproduce symptoms by having patient flex hands to maximum and hold for several minutes

152
Q

Main function of the extensor retinaculum

A

prevent “bowstringing” of extensor forearm tendons when hand is hyperextended.

153
Q

Structures NOT within the extensor retinaculum

A

Dorsal venous arch

Cephalic and Basilic Veins

Cutaneous branches of radial and ulnar nerve

154
Q

Two functions of Palmar Apenouriosis

A

Gives attachment to overlying skin to improve grip

protects underlying tendons

155
Q

Describe Dupuytren’s Contracture

A

shortening and hypertrophy of palmar aponeurosis

begins with one or more mild painful nodules involving the fascia at usually base of digit 4 5

causes contracture of muscles affeciting MP joints of digits 4 5 leading to flexion

genetic but no knowns cause

Common in men over 50

higher incidence in alocholics and epileptics

156
Q

What makes up the Thenar muscle?

A

Abductor pollicis brevis

Opponens pollicis

Flexor pollicis brevis

Adductor pollicis

157
Q

Abductor Pollicis Brevis OIAINN

A

Trapexium and Scaphoid

Proximal phalanx digit one

Abducts digit one at MP

median nerve

158
Q

Opponens Pollicis OIAN

A

Trapezium

First metacarpal

Medially rotates first metacarpal

median nerve

159
Q

Flexor Pollicis Brevis OIAN

A

Trapezium, trapezoid and capitate

proximal phalanx digit one

flexes digit one at MP joint

median and ulnar

160
Q

Adductor Pollicis OIAN

A

trapezoid, capitate, 2nd and 3rd metacarpals (oblique head 3rd metacarpal)

proximal phalanx digit one

Adducts digit one

Ulnar

161
Q

Hypothenar muscles list

A

Abductor digiti minimi

Flexor digiti minimi

opponens digiti minimi

162
Q

Abductor Digiti minimi OIAN

A

pisiform

proximal phalanx digit 5

abducts digit 5

ulnar

163
Q

Flexor digiti minimi

A

hamate

proximal phalanx digit 5

flexes digit 5 at MP joint

ulnar

164
Q

Opponens Digiti minimi

A

hamate

fifth metacarpal

laterally rotates 5th metacarpal

165
Q

Lumbricales OIAN

A

tendons of flexor digitorum profundus

tendons of extensor digitorum maximus

flexes MP joints and Extends IP joints

median and ulnar (first two and second two lumbricals)

166
Q

Dorsal Interossei OIAN

A

From adjacent metacarpals between them

proximal phalanx digits 2,3,4

Abducts 234, flexes MP, Extends IP

Ulnar nerve

167
Q

Palmaris Brevis OIAN

A

Flexor retinaculum

skin of hypothenar eminence

prevents skin of the palm from flattening during palmar grip

Ulnar

168
Q

Cutaneous supplied by Median nerve

A

lateral part of palmar surface of hand

169
Q

Cutaneous supplied by Ulnar

A

Medial aspect of hand both sides

170
Q

Cutaneous of radial nerve

A

lateral aspect of hand dorsum and dorsum portion of 1234 digits

171
Q

Two important carpal and metacarpal branches coming off the superci=fical and deep palmar arches

A

Princeps pollicis (to digit 1)

Radialis indicis artery

172
Q

Describe intermetacarpal joints

A

joints between bases of 2nd through fifth metacarpals…not between 1 and 2

173
Q

Skiers thumb (gamekeepers thumb) describe

A

rupture or laxity of collateral ligament at the MP joint of digit one

usually result of hyperabduction of MP joint

In severe injuries there may be avulsion fractures of head of first metacarpal

Gross Anatomy (4 decks)

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