Gross Test 2 Flashcards
are superficial or deep lymphatic vessels are the less numerous
deep
The pectoralis fascia leaves the lateral border of the pec major and becomes the ______ _______
axillary fascia
anterior axio-appendicular muscles
pectoralis major and minor, serratus anterior, subclavius
the pec major and adjacent deltoid form the ______ _______
deltopectorial groove
what makes up the claviopectoral triangle
deltoid, pec major and clavicle
what forms the “bridge” which vessels and nerves pass thru the arm?
coracoid process and pec minor
pec major
O: clavicular head- ant surface of medial half of clavicle
sternocostal head- ant surface of sternum, superior 6 costal cartilages, aponeurosis of external oblique muscles
I: lateral lip of intertubercular sulcus of humerus
Inn: lateral and medial pectoral nerves, clavicular head (C5, C6), sternocostal head (C7, C8, T1)
pec major action
adducts and medially rotates shoulder joint, draws scapula anterior and inferiorly. acting alone, clavicular head flexes shoulder joint and sternocostal head extends it from the flexed postition
why doesnt a fractured clavicle create a compound fracture?
the SCM pulls up on medial clavicle, but deltoid pulls down so it wont break the skin
pec minor
O: 3rd-5th ribs near costal cartilage
I: medial border and superior surface of coracoid process of scapula
Inn: medial pectoral nerve (C8, T1)
pec minor action
stabilizes scap by drawing it inferioly and anteriorly against thoracic wall
subclavius
O: junction of 1st rib and its costal cartilage
I: inferior surface of middle third of clavicle
Inn: subclavian nerve (C5, C6)
subclavius action
anchors and depresses clavicle
serratus anterior
O: external surfaces of lateral part of 1st-8th ribs
I: anterior surface of medial border of scapula
Inn: long thoracic nerve (C5, C6, C7)
serratus anterior action
protracts scapula and holds against thoracic wall; rotates scapula
deltoid
O: lateral third of clavicle, acromion and spine of scapula
I: deltoid tuberosity of humerus
Inn: axillary nerve (C5, C6)
deltoid action
clavicular part flexes and medially rotates shoulder joint. acromial part abducts shoulder joint, spinal part extends and medially rotates
what are the 4 muscles of the rotator cuff?
SITS (supraspinatous, infraspinatous, teres minor, suprascapularis)
supraspinatous
O: supraspinous fossa of scapula
I: superior facet of greater tubercle of humerus
Inn: suprascapular nerve (C4, C5, C6)
supraspinatous action
it initiate and assists in abduction with the deltoid and acts with other rotator cuff muscles
infraspinatous
O: infraspinous fossa of scapula
I: middle facet of greater tubercle of humerus
Inn: subscapular nerve (C5, C6)
infraspinatous action
laterally rotate shoulder joint, help keep head of humeral head in glenoid cavity of scapula
teres minor
O: middle part of lateral border of scapula
I: inferior facet of greater tubercle of humerus
Inn: axillary nerve C5, C6
teres minor action
laterally rotate shoulder joint, help keep humerol head in glenoid cavity of scapula
subscapularis
O: subscapular fossa (most anterior part) of scapula
I: lesser tubercle of humerus
Inn: upper and lower subscapular nerves (C5, C6, C7)
subscapularis action
medially rotates and adducts shoulder joint; help hold humeral head in glenoid cavity
teres major
O: inferior part of lateral border of scapula and posterior part of inferior angle of scapula
I: medial lip of intertubercular sulcus of humerus
Inn: lower subscapular nerve (C5, C6)
teres major action
adducts and medially rotates shoulder joint
omohyoid
O: superior border of scapula near suprascapular notch
I: inferior border of hyoid
Inn: none
Action: depresses, retracts and steadies hyoid
latissimus dorsi
O: last 3/4 ribs, inferior 6 thoracic spinous processes, thoracolumbar fascia, iliac crest
I: floor of intertubercular sulcus of humerus
Inn: thoracodorsal C6, C7, C8
Act: adduction, medial rotation, extension
trapezius
O: EOP, middle part of superior nuchal line, nuchal lig, spinous processes of C7-T12
I: acromion, spine of scapula, lateral third of clavicle
Inn: spinal accessory nerve (C3, C4)
Act: elevate, depress, retract, rotate glenoid cavity superiorly
levator scapulae
O: posterior tubercles of transverse processes of C1-C4
I: medial border of scapula superior to spin
Inn: dorsal scapular (C5), cervical (C3, C4)
Act: elevate scap, rotate glenoid inferiorly
biceps brachii
O: short head- tip of coracoid process of scapula. long head- supraglenoid tubercle of scapula
I: tuberosity of radius and fascia of the forearm via bicipital aponeurosis
Inn: musculocutaneous (C5, C6)
biceps brachii action
supinates forearm and when it is supinated, flexes the elbow. flexes shoulder joint; short head resists dislocation
brachialis
O: distal half of anterior surface of humerus
I: coronoid process and tuberosity of ulna
Inn: musculocutaneous nerve (C5, C6)
brachialis action
flexes elbow joint in all positions
coracobrachialis
O: tip of coracoid process of scapula
I: middle third of medial surface of humerus
Inn: musculocutaneous nerve (C5, C6, C7)
which three muscles help resist dislocation of the shoulder joint?
biceps brachii, corocobrachialis and triceps brachii
coracobrachialis actions
flex and adduct shoulder joint; resists dislocation of the shoulder
triceps brachii
O: long- infraglenoid tubercle of humerus. lateral- posterior surface of humerus, superior to radial groove. medial- posterior surface of humerus, inferior to radial groove
Inn: radial nerve (C6, C7, C8)
triceps brachii action
chief extensor of elbow joint; long head extends shoulder joint and resists dislocation of humerus (especially important during abduction)
brachioradialis
O: proximal 2/3 of lateral supraepicondylar ridge of humerus
I: lateral surface of distal end of radius proximal to styloid process
Inn: radial nerve (C5, C6, C7)
brachioradialis action
relatively weak elbow flexion of elbow, maximal when forearm is in midpronated position
extensor carpi radialis longus
O: lateral supraepicondylar ridge of humerus
I: dorsal aspect of base of second metacarpal
Inn: radial nerve (C6, C7)
Act: extend and abduct wrist joint
extensor carpi radialis brevis
O: lateral epicondyle of humerus
I: dorsal aspect of base of third metacarpal
Inn: deep branch of radial nerve (C7, C8)
Act: extend and abduct wrist joint, active during fist clenching
which nerves supply the base of the neck, extending laterally over the shoulder ?
C3 and C4
___ supplies the arm laterally
C5
at full adduction, abduction must be initiated by the ________ or by standing to the side
supraspinatus
the deltoid becomes fully effective as an abductor after the initial __ degrees of abduction
15
all except the _________ of the rotator cuff are rotators of the humerus
supraspinatus
____ _______ of the rotators holds the relatively large head of the humerus firmly against the small, shallow glenoid cavity during arm movements
tonic contractions
what is the apex of the axilla?
cervico-axillary canal (passageway between neck and axilla)
what is the cervioaxillary canal bounded by?
1st rib, clavicle and superior edge of scapula
these nerves pass anterior to the clavicle, deep to the platysma, and supply the skin over the clavicle and the superolateral aspect of the pec major
supraclavicular nerves (C3, C4)
posterior cutaneous nerve of the arm and forearm which supplies skin of posterior surface of the arm are branches of which nerve
radial
______ ______ form communications between the superficial and deep veins
perforating
cephalic and basilic veins arise from the _____ _____ _______
dorsal venous network
the vein that communicates between the cephalic and basilic veins that crosses thru the medical aspect of the elbow is the _____ _____ _____
median cubital vein
most vessels accompanying the cephalic vein cross the proximal part of the arm anterior aspect of the shoulder to enter the _____ ______ _____ ______
apical axillary lymph nodes
the deep lymphatic vessels terminate in the _______ ______ ______ ______
humeral axillary lymph nodes
the ____ _____ and adjacent _____ form the narrow deltopectorial groove
pect major and deltoid
which vein runs thru the deltopectorial groove?
cephalic
which muscle is primarily used when stretching the upper limb forward to grasp an object just out of reach
pec minor
each trunk of brachial plexus goes into an anterior and posterior divisions. anterior supplies ______, while posterior supplies ______
flexor, extensor
smallest nerve of brachial plexus is what?
medial cutaneous nerve of arm
Which is the stabilizing bone of the forearm ?
Ulna
The olecronon and coronoid process form the walls of the _____ ______
Trochlear notch
True or false. The ulna articulates directly with the carpal bones
False. Fibrocartilnigeous articular disks separate carpals and ulna
Which is the last of the epiphysis of long bones to fuse?
Sternal end of epiphysis of clavicle
A small triangular muscle on the posterior aspect of the elbow that covers the posterior aspect of the ulna proximally is called the
Anconeus
the main named branches of the brachial artery that arise from the medial aspect are the
profundi brachii artery and sup/inf collateral ulnar arteries
what vessels help form the periarticular arterial anastamoses of the elbow region?
inferior collateral ulnar arteries
do deep or superficial veins have more valves?
deep
true or false. the median and ulnar nerves supply no branches to the arm
true
what nerve continues as the lateral cutaneous nerve of the forearm?
musculocutaneous
while palpating at the medial bicipital groove, what artery is being felt?
brachial
boundaries of the cubital fossa are?
imaginary line connecting medial and lateral epicondyles, pronator teres, brachioradialis
floor of the cubital fosssa is
brachialis and supinator
the roof of the cubital fossa is formed by
continuity of brachial and antebrachial fascia , reinforced by bicipital aponeurosis , subcutaneous tissue and skin
contents of the cubital fossa are
terminal part of brachial artery, radial and ulnar artery beginnings, deep accompanying veins of artery, biceps brachii tendon, median nerve, radial nerve
this ligament encircles and holds the head of the radius in the radial notch of the ulna and permits supination and pronation
anular ligament
the radioulnar joint is which type?
synovial pivot
Which membrane does the cephalic vein pierce?
Costocoracoid
What fascia does the basilic vein pierce?
Brachial
Dermatomes shows
Segmental innervation
What three axes of movement occurs in glenohumeral joint ?
Sagittal, transverse, frontal
What type of stress does the radial collateral lig prevent?
Varus
What type of stress does the ulnar collateral lig prevent?
Valgus
What three types of collateral bands are there ?
Posterior, anterior, oblique
Only articulation between the upper limb and axial skeleton is
SC joint
Where does AC joint get its strength?
AC lig –> coracoclavicular lig
What does the coracoclavicular lig divide into?
Trapezoid and conoid lig
What arteries supplies the AC joint?
Suprascapular and thoracoacromial
What nerves innervates the AC joint?
Supraclavicular, lat pectorial and axillary
Supinator
O: lateral epicondyle of humerus, radial collateral and annular ligaments, supinator fossa, crest of ulna
I: anterior, posterior and lateral surfaces of proximal third of radius
Inn: deep branch of radial nerve C7 C8
Act: supinates forearm, rotates radius to turn palms anteriorly and superiorly
Abductor pollicis longus
O: posterior surface of proximal halves of ulna, radius and interosseous membrane
I: base of first metacarpal
Inn: posterior interosseous nerve C7 C8
Act:
pronator teres
O: ulnar head: coronoid process of ulna
humerol head: medial epicondyle of humerus
I: middle of convexity of lateral surface of radius
Inn: median nerve C6 C7
Act: pronates and flexes forearm
Flexor carpi radialis (FCR)
O: medial epicondyle of humerus
I: base of 2nd (3rd) metacarpal
Inn: median nerve C6 C7
Act: flex and abduct hand at wrist
palmaris longus
O: medial epicondyle of humerus
I: distal half of flexor retinaculum, palmar aponeurosis
Inn: median nerve C7 C8
Act: flexes hand at wrist and tenses palmar aponeurosis
flexor carpi ulnaris (humerol and ulnar head)
O: olecranon and posterior border of ulna
I: pisiform, hook of hamate, 5th metacarpal
Inn: ulnar nerve C7 C8
Act: flexes and adducts hand at wrist
flexor digitorum superficialis
O: humeroulnar head- medial epicondyle of humerus and coronoid process of ulna
radial head- oblique line of radius
I: shafts of middle phalages of medial four digits
Inn: median nerve C7 C8 T1
Act: flexes wrist joint, flexes interphalageal joints of middle four digits, acting more strongly, it also flexes proximal phalages at metacarpalphalageal joints
flexor digitorum profundum
O:proximal three quarters of medial and anterior surface of ulna and interosseus membrane
I: bases of distal phalanges of 2-3-4-5
Inn: digits 2-3 median nerve C8 T1, digits 4-5 ulnar nerve C8 T1
Act: flexes wrist joint, flexes interphalangeal joints of 2-3-4-5, assists with wrist flexion
flexor pollicis longus
O: ant surface of radius and adjacent inteross. membrane
I: base of distal phalanx of thumb
Inn: anterior inteross. nerve from median nerve C8 T1
Act: flexes wrist, flexes metacarphalangeal and interphalangeal joints of thumb
pronator quadratus
O: distal quarter of ant surface of ulna
I: distal quarter of ant surface o f radius
Inn: ant inteross. nerve from median nerve C8 T1
Act: pronates forearm, deep fibers bind radius and ulna together
what is the most superficial structure in the carpal tunnel?
median nerve
what passes through the carpal tunnel?
flexor digitorum superficialis (4 tendons), median nerve and flexor digitorum profundus (4 tendons), flexor pollicis longus
what causes the pain felt in carpal tunnel?
narrowing of the tunnel which irritates median nerve (bone inflammation etc)
what comprises the deep layer of ant. forearm muscles
flexor pollicis longus, flexor digitorum profundus, pronator quadratus
what position is best for wrist to prevent carpal tunnel pain?
neutral wrist
reduce pressure of tendons or the nerve to alleviate carpal tunnel pain?
nerve
what happens in carpal tunnel surgery?
release some of flexor retinaculum to create more room for the median nerve
the lateral cutaneous nerve of the forearm is an extension of which branch of the brachial plexus?
musculocutaneous
which three branches arise from the radial nerve?
1) posterior interosseus nerve
2) superficial branch of radial nerve
3) posterior cutaneous nerve of forearm
Median nerve has two branches in the forearm which are
anterior interosseus nerve, palmar cutaneous branch of median nerve
extensor digitorum
O: lateral epicondyle of humerus
I: extensor expansions of medial four fingers
Inn: posterior interosseus nerve (C7, C8)
Act: extend wrist joint, extend medial four fingers at primarily MC joint and secondarily at IP joint
extensor digiti minimi
O: lateral epicondyle of humerus
I: extension expansion of 5th metacarpal
Inn: posterior interosseus nerve C7 C8
Act: extend wrist, extend 5th metacarpal at MC joint and secondarily at IP joint
extensor carpi ulnaris
O: posterior border of ulna, lateral epicondyle of humerus
I: dorsal of base of 5th metacarpal
Inn: posterior interosseus nerve C7 C8
Act: extend wrist joint, adduct wrist joint
which part of the scapula is the thickest part of the bone?
lateral border
True of false. The glenoid cavity is considerably smaller than head of humerus
true
the inability to extend the wrist the the MCP joint due to radial nerve damage is called
wrist drop
the tendons of most flexor muscles pass across the anterior surface of the wrist and are held in place by the ________ ______ ______ and ________ ________, thickenings of the antebrachial fascia
palmar carpal lig, flexor retinaculum
what are the long flexors of the digits?
FDS and FDP
the intermediate layer of ant muscles in forearm is one muscle called
FDS (flexor digitorum superficialis)
deep layer of ant forearm muscles are
flexor digitorum profundus, flexor pollicis longus and pronator quadratus
does extending or flexing the wrist increase the operating distance of long flexor muscles?
extending
the FDS flexes the _____ ______
middle phalanges
the FDP flexes the ______ _______
distal phalanges
the FDP flexes the fingers in ___ action whereas the FDS flexes the fingers in ____ action
slow, fast
the pronator ____ is the prime mover for pronation and works with the pronator ______
quadratus, teres
muscles that extend and adduct/abduct are the
1) extensor carpi radialis longus
2) extensor carpi radialis brevis
#) extensor carpi ulnaris
extensors that extend the medial four fingers
1) extensor digitorum
2) extensor indicis
3) extensor digiti minimi
muscles that extend or abduct the thumb
1) extensor pollicis brevis
2) extensor pollicis longus
3) abductor pollicis longus
deep muscle of post. forearm
supinator
deep “outcropping” muscles of post. forearm are
APL, EPB, EPL, EI
lateral border of the anatomical snuff box
APL, EPB
tendon of the ___ bounds the anatomical snuff box medially
EPL
the floor of the snuff box
radial artery, schapoid, trapezium (between radial styloid process and 1st metacarpal)
this is when the a long extensor tendon is detaches from the phalanx and the IP joint is stuck in hyperflexion
mallet finger
tennis elbow is an overuse injury that stems from pain in the _____ ______
lateral epicondyle
where are synovial cysts most common on the wrist?
dorsum of the wrist
central concavity at palmar aspect of hand separates into two parts called
thenar and hypothenar eminences
what attaches to the tendons of the FDP?
lumbricals
what do the lumbricals do?
flex MCP, extend IP
lumbricals + extensor digitorm =
allow our fingers to go straight together at once
what type of muscles are dorsal interossei?
bipennate muscles
true or false. the dorsal interossei and stronger than the palmar interossei
true
palmar interossei act to
adduct
all interossei are supplied by the ____ nerve
ulnar
does an IV go in artery or vein?
vein (blood gas taken from an artery)
extensors of hand
extensor digitorum, ORL, interossei, lumbricals
what are intertendinous connections and what do they do?
restrict independent flexion of fingers. located on dorsum of hand and link adjacent tendon
