Lecture 11: MSK 2 Flashcards

1
Q

What type of bone is the humerus?

A

Long bone

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2
Q

What are the distal articulations of the humerus?

A

Trochlea with the trochlear notch of the ulna (elbow joint)

Capitulum with the head of the radius

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3
Q

Indentations of humerus (anterior and posterior)

A

Anterior = Coronoid fossa (Ulna – Coronoid process)

Posterior = Olecranon fossa (Ulna - Olecranon process)

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4
Q

Where is the ulna on the forearm?

A

Medial

Little finger side

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5
Q

What bone is part of the “proper” elbow joint

A

Ulna

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6
Q

Distinguishing features of proximal head of ulna

A

Olecranon process

Trochlear notch

Coronoid process

Radial notch

See figure

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7
Q

Olecranon process

A

proximal end of ulna, shaped like wrench

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8
Q

Trochlear notch

A

Proximal end of ulna

Inner portion of wrench structure

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9
Q

Coronoid process

A

Proximal end of ulna

lower lip of wrench

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10
Q

Radial notch

A

Proximal end of ulna

faces laterally to accommodate radius

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11
Q

Distinguishing feature of distal end of ulna

A

Distal head = Styloid process

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12
Q

Which side of forearm is radius on?

A

Lateral

Thumb side

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13
Q

What does radius articulate with directly?

A

Carpal bones (wrist joint)

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14
Q

Proximal and distal ends of radius - features

A

Proximal: small rounded head

Distal: larger, ends as radial styloid process laterally

See figure

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15
Q

What do carpal bones allow?

A

Allow for mobility of the hand and opposition which is unique to the human species

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16
Q

Proximal row of carpals from lateral to medial

A

Scaphoid

Lunate

Triquetrum

Pisiform

See figure

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17
Q

Distal row of carpals from lateral to medial

A

Trapezium

Trapezoid

Capitate

Hamate

See figure

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18
Q

What do 5 metacarpals make up?

A

Palm of hand

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19
Q

Numbering of 5 metacarpals

A

Numbered 1 to 5 beginning with the thumb…the 5th metacarpal is on the ulnar side of the hand.

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20
Q

What type of bones are the metacarpals?

A

Long bones

Consist of a proximal base, shaft and distal head

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21
Q

What are the phalanges?

A

Fingers of the hand

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22
Q

How many phalanges per hand?

A

14

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23
Q

How many phalanges in thumb?

A

2

Proximal and distal

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24
Q

How many phalanges in each digit?

A

3

Proximal, middle and distal

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25
Q

How can you identify whether you are looking at anterior or posterior writs?

A

Anterior: can see hamate and pisoform

Posterior: do not see pisiform

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26
Q

What bones make up the elbow joint?

A

Humerus

Radius

Ulna

(mostly ulna and humerus)

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27
Q

What type of joint is the elbow joint?

A

Synovial joint

Hinge type

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28
Q

Movement of elbow joint

A

Flexion/Extension

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29
Q

What happens during elbow flexion

A

Trochlear notch of ulna articulates with the
trochlear surface of the humerus

Radial head glides on the capitulum of the
humerus.

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30
Q

What happens during elbow extension

A

Olecranon process of the ulna fits into the

olecranon fossa of the humerus (boney end-feel)

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31
Q

Carrying angle of forearm

A

Ulna naturally migrates laterally because trochlea is thicker medially

15 degree carrying angle (cubitus valgus) of forearm

Greater in females than males to accommodate for wider pelvic girdle

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32
Q

Where is the proximal radioulnar joint located?

A

Below elbow

Between proximal radius and ulna

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33
Q

Radioulnar joint type

A

Synovial joint

Pivot type

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34
Q

Movement of radioulnar joint

A

Pronation/Supination

Proximally radius and ulna are always side by side

Distally they cross each other when pronated

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35
Q

What is the wrist joint comprised of?

A

distal end of the radius and the proximal row of the carpal bones of the hand

Concave shape of the distal radius directly articulates with the convex shape of the scaphoid and lunate

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36
Q

How is the ulna separated from the carpals in the wrist joint?

A

fibro-cartilagenous disc

Ulna does not contribute to wrist joint

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37
Q

Wrist joint type

A

Synovial joint

Condyloid type

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38
Q

Movement of wrist

A

Flexion/Extension

Adduction/Abduction
(Ulnar/Radial Deviation)

See figure

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39
Q

What bones make up the Carp-metacarpal (CMC) joints

A

Distal row of the carpals & proximal base of the metacarpals

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40
Q

CMC joint type

A

Synovial joints

Condyloid type

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41
Q

Movements of CMC joints

A

Flexion/extension

Abduction/adduction
Ulnar/Radial deviation

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42
Q

Where is the 1st CMC joint

A

Thumb

Between the trapezium and the base of the first metacarpal.

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43
Q

1st CMC joint type

A

Saddle type

44
Q

What movement does 1st CMC joint allow?

A

Opposition (limited type of rotation)

Flexion/Extension

Abduction/adduction

See figure

45
Q

What is the corresponding anatomical structure of the metacarpal phalangeal (MCP) joints? What bones?

A

Knuckles of hand

Heads of metacarpels contact the
base of the 1st phalanges

46
Q

MCP joint type

A

Synovial joints

Condyloid type

47
Q

Movements of MCP joints

A

Flexion/extension

Abduction/adduction (Middle finger used as the point of reference to describe abduction and adduction)

48
Q

Where are the interphalangeal joints?

A

joints between the phalanges of the fingers

49
Q

Where are there proximal interphalangeal joints (PIP)?

A

Digits 1-5

50
Q

Where are there distal interphalangeal joints (DIP)?

A

Digits 2-5

51
Q

What type of joint are interphalangeal joints?

A

Synovial joints

Hinge type

52
Q

Movement of interphalangeal joints

A

Flexion / extension

in the sagittal plane

53
Q

Where is the biceps brachii located?

A

Superficial

Anterior arm

2 headed muscle

54
Q

Where do the heads of the biceps brachii attach?

A

Long head – attaches to glenoid fossa (thru bicipital groove)

Short head – attaches to the coracoid process of the scapula

55
Q

What joints does the biceps brachii cross?

A

Shoulder joint

Elbow joint

56
Q

Actions of biceps brachii

A

Elbow Flexion

Shoulder Flexion

Forearm Supination

57
Q

Innervation of biceps brachii

A

Musculocutaneous nerve

58
Q

Shape of brachialis

A

Flat, thin muscle

59
Q

Joints crossed by brachialis

A

Only crosses Elbow joint

Humerus to radius

60
Q

Actions of brachialis

A

Elbow Flexion

61
Q

Innervation of brachialis

A

Musculocutaneous nerve

62
Q

Where is coracobrachialis located?

A

Deep to pectorals major, pectorals minor and deltoid

63
Q

What joints does coracobrachialis cross?

A

Only shoulder

Humerus to coracoid process

64
Q

Actions of corachobrachialis

A

Shoulder Flexion

65
Q

Innervation of corachobrachialis

A

Musculocutaneous nerve

66
Q

Triceps brachii - How many heads? Location?

A

3 heads

Posterior arm (Brachium)

67
Q

Where do the heads of the triceps brachii insert?

A

All insert on the Olceranon process of the ulna

Long head – glenoid fossa of the scapula

Lateral head – posterior humerus

Medial head – posterior humerus

68
Q

Actions of triceps brachii

A

Elbow Extension

Shoulder Extension

69
Q

Innervation of triceps brachii

A

Radial nerve

70
Q

Compartments of the forearm

A

Anterior forearm

Posterior forearm

Each compartment contains a superficial and deep region

71
Q

Movement of forearm muscles

A

All forearm muscles are “extrinsic muscles” of the hand.

Involved in power movements of the wrist, thumb and fingers.

72
Q

Anterior forearm - muscle types?

A

Flexion (wrist and fingers)

Pronation

Ulnar deviation (adduction)

Radial deviation (abduction)

Thumb flexion

73
Q

Posterior forearm - muscle types, where do they arise?

A

Extension (wrist and fingers)

Supination

Ulnar deviation (adduction)

Radial deviation (abduction)

Thumb extension

74
Q

Where do muscles of anterior forearm arise?

A

Arise from the Medial Epicondyle

75
Q

Where do muscles of posterior forearm arise?

A

Arise from the Lateral Epicondyle

76
Q

5 muscles of anterior compartment, superficial layer, forearm

A
  1. Pronator Teres
  2. Flexor Carpi Radialis
  3. Plamaris Longus
  4. Flexor Carpi Ulnaris
  5. Flexor Digitorum Superficialis

See figure

77
Q

Innervation of muscles of anterior compartment of forearm, superficial layer

A

All innervated by median nerve

EXCEPT flexor carpi ulnaris, which is innervated by the ulnar nerve

78
Q

3 muscles of the anterior compartment, deep layer, forearm

A
  1. Flexor Digitorum Profundus
  2. Flexor Pollicus Longus
  3. Pronator Quadratus

See figure

79
Q

Innervation of 3 muscles of anterior compartment, deep layer, forearm

A

All innervated by median nerve

EXCEPT medial half of flexor digitorum profundus, innervated by ulnar nerve

80
Q

What is the flexor retinaculum? Role?

A

Creates Carpal Tunnel

Prevents the tendons from
bowstringing

Marginal Carpals; Cupping of Palm

81
Q

Where is the brachioradialis? What is it’s function?

A

At top of forearm (beer drinking muscle)

Flexes elbow in semi-pronation

Does not cross the wrist joint SO TECHNICALLY - not considered a member of either the flexor or extensor group of forearm muscles.

See figure

82
Q

Innervation of brachioradialis

A

Radial nerve

83
Q

5 muscles of posterior compartment of forearm, superficial layer

A
  1. Extensor Carpi Radialis Longus
  2. Extensor Carpi Radialis Brevis
  3. Extensor Digitorum
  4. Extensor Digiti Minimi
  5. Extensior Carpi Ulnaris

See figure

84
Q

Innervation of 5 muscles of posterior compartment of forearm, superficial layer

A

Radial nerve

85
Q

5 muscles of posterior compartment of forearm, deep layer

A
  1. Supinator
  2. Abductor Pollicis Longus
  3. Extensor Pollicus Longus
  4. Extensor Pollicis Brevis
  5. Extensor Indicis

See figure

86
Q

Innervation of 5 muscles of posterior compartment of forearm, deep layer

A

Radial nerve

87
Q

What does the palmar aponeurosis do?

A

Connects skin to underlying structures of the hand

See figure

88
Q

What are the three compartments of the intrinsic muscles of the hand?

A
  1. Thenar (3)
  2. Hypothenar (3)
  3. Central (3)
89
Q

Function of intrinsic muscles of hand

A

Precision movement

fine motor skills

90
Q

Anatomical position of thenar muscle group

A

Fleshy prominence on the radial side of the palm (thumb)

91
Q

Thenar group muscles

A
  1. Flexor pollicis brevis
  2. Abductor pollicis brevis
  3. Opponens pollicis

Act on thumb

92
Q

Innervation of thenar muscle group

A

Median nerve

93
Q

Anatomical position of hypothenar muscle group

A

Fleshy prominence on the ball of the little finger

94
Q

Hypothenar group muscles

A
  1. Flexor digiti minimi brevis
  2. Abductor digiti minimi
  3. Opponens digiti minimi

See figure

95
Q

Innervation of hypothenar muscle group

A

Ulnar nerve

96
Q

What are the central compartment muscles?

A

Muscles between hypo and thenar regions

More prominent on palmar surface

97
Q

3 muscle groups in central compartment

A
  1. Lumbricals (4) – flex MCP
  2. Interossei:
    PAD: 3 palmer / adduct MCP - toward midline

DAB: 4 dorsal / Abduct MCP - away from midline

  1. Adductor pollicis

See figure

98
Q

Innervation of central compartment

A

Ulnar nerve

99
Q

What are the 5 roots of the brachial plexus?

A

C5

C6

C7

C8

T1

100
Q

What are the branches of the brachial plexus?

A

Musculocutaneous nerve

Axillary nerve

Radial nerve

Median nerve

Ulnar nerve

101
Q

Why is there a C8 nerve but no C8 vertebrae?

A

In the cervical spine, the nerve roots are named after the vertebrae that lies below them.

Thoracic and lumbar nerve roots are named after the vertebrae above them

So, there is no C7, but since C8 lies above T1, it is called C8

102
Q

Nerves of upper arm

A

Axillary nerve - Deltoid & Teres minor

Musculocutaneous nerve - Anterior compartment muscles (Biceps brachii, Brachialis & Coracobrachialis)

Radial nerve - Posterior compartment muscle (Triceps brachii)

103
Q

Nerves of forearm and hand

A

Radial nerve - Posterior compartment
(Superficial & Deep), Brachioradialis

Ulnar nerve - Flexor carpi ulnaris, Medial 1⁄2 of Flexor digitorum profundus, Hypothenar muscle group, Central compartment muscles

Median nerve - Anterior compartment muscles
except those above, Thenar muscle group

104
Q

Sensory nerves of hand

A

Median nerve

Ulnar nerve

Radial nerve

See figure

105
Q

Main sections of blood supply of upper extremity

A
  1. Subclavian artery becomes the Axillary artery at the lateral border of the 1st rib.
  2. Axillary becomes Brachial artery at lower border of teres major muscle.
  3. Brachial divides into Radial & Ulnar artery in cubital fossa.
  4. Below wrist radial and ulnar arteries each divide and contribute to formation of Superficial and Deep Palmer Arches

See figure

106
Q

Blood supply in hand

A

Ulnar artery becomes superficial arch

Radial artery becomes deep arch

See figure