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(PA school) Gross Anatomy > Lecture 14: UE pt 4 > Flashcards

Lecture 14: UE pt 4 Flashcards

1
Q

1) How many muscles are in the arm (brachium)?
2) How many flexor muscles in anterior compartment? List them
3) What nerve innervates these flexors?

A

1) 4 arm muscles
2) Three: Biceps brachii (2 heads), Brachialis,& Coracobrachialis mm.
3) Musculocutaneous nerve

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2
Q

What 2 groups make up the 4 arm (brachium) muscles?

A

1) 3 flexor muscles: in anterior compartment
2) Triceps brachii: the one tri-headed extensor muscle in posterior compartment

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3
Q

What nerve and muscle are related to the triceps brachii m?

A

Radial n. and Anconeus m.

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4
Q

1) What compartment is the biceps brachii m. in?
2) What joint(s) does it cross?
3) What nerve innervates it?

A

1) Anterior compartment of arm
2) Shoulder and elbow joints
3) Musculocutaneous n.
(aka lateral cutaneous n. of the forearm)

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5
Q

List the 2 parts of the biceps brachii and where each is located. Where do both distally insert?

A

1) Long head: run in the intertubercular groove to proximal insertion at supraglenoid tubercle/labrum
2) Short head: proximal insertion at coracoid process
-Both distally insert at radial tuberosity

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6
Q

List the 3 actions of the biceps brachii

A

1) Flexes elbow (shoulder fixed)
2) Supinates forearm (elbow ~ 90 degrees and pronated forearm)
3) Forward flex shoulder

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7
Q

1) Define biceps tendonitis
2) List 2 common symptoms and what 2 things can often relieve them
3) What may be needed in severe cases?

A

1) An inflammation or irritation of the upperbicepstendon
2) Pain in the front of the shoulder and weakness; rest and medication.
3) Surgery may be needed to repair the tendon.

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8
Q

1) What type of injury is a ruptured biceps tendon?
2) What two things are related to it?

A

1) Rip cord injury
2)
-Sequelae of chronic bicipital tendonitis (MAC)
-Avulsion from glenoid tubercle or tears mid tendon (tendinosis)

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9
Q

1) Brachialis & coracobrachialis muscles are in what compartment of the arm?
2) What nerve innervates them?

A

1) Anterior compartment of arm cont.
2) Musculocutaneous n. innervates both

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10
Q

Name a muscle that is only a pure elbow flexor (only crosses elbow joint) and what its action is.

A

Brachialis; flexes elbow in all positions
NO ACTION on SHOULDER

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11
Q

1) What muscle helps flex and aDduct the shoulder? What else does it do?
2) Where does it run?
3) Does it act on the elbow?

A

1) Coracobrachialis m.
2) Superomedial arm to coracoid process
3) NO ACTION on ELBOW

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12
Q

1) What muscle crosses both shoulder and elbow?
2) What joint(s) does Brachialis cross?
3) What about Coracobrachialis?

A

1) Biceps
2) Crosses elbow
3) Crosses shoulder

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13
Q

1) What compartment of the arm is the triceps brachii m in?
2) What does it do and what assists it?
3) What nerve innervates it?

A

1) Posterior compartment
2) Chief extensor of elbow; Anconeus assists
3) Radial nerve

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14
Q

List the 3 heads of the triceps and specify which extends over GH joint

A

1) Long head – extends over GH joint
2) Lateral head
3) Medial head

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15
Q

1) What is a feature of the olecranon [of the elbow]?
2) What may the Anconeus m do to the ulna?

A

1) Olecranon bursa
2) May act on ulna during pronation

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16
Q

1) What does the axillary artery give off most proximally?
2) What two things does it branch into? List the larger branch first.
3) What arteries does this turn into in the forearm?

A

1) Post & Ant circumflex humeral aa.
2) Brachial artery
-Profunda brachii a. in radial groove along with radial nerve
3) Radial and ulnar

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17
Q

What are the two groups of veins of the arm?

A

Superficial and deep

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18
Q

1) What do the 2 superficial v of arm have in common?
2) What are they and which is lateral/ medial?
3) What joins them? Where?
4) Do they anastomose w deep veins?

A

1) Both arise from dorsal vein network
2) Cephalic v. (lateral); Basilic v. (medial)
3) Median cubital vein at cubital fossa
4) Yes; multiple anastomoses

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19
Q

Deep veins of the arm:
1) Brachial veins = ____________ and _________ veins
2) Brachial veins + Basilic vein form +______________ vein.

A

1) radial; ulnar
2) axillary

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20
Q

List the 5 nerves of the UE and what part of the cord they come from

A

1) Axillary.: posterior
2) Radial: posterior cord
3) Musculocutaneous: lateral cord
4) Median: lateral + medial cord
5) Ulnar: medial cord

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21
Q

List the 2 nerves that innervate the anterior forearm; specify what side each innervates

A

1) Median: Radial side [of flexors]
2) Ulnar: Ulnar side [of flexors]

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22
Q

Median nerve:
1) What parts of the cord does it come from?
2) Where does it run in relation to medial epicondyle?
3) What vessel does it run w distally to the forearm?

A

1) Medial & lateral
2) Anterior
3) Brachial a.

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23
Q

Median nerve:
1) In the cubital fossa, where is it in relation to the brachial artery? What abt to the median cubital vein?
2) Does it have branches to the arm?
3) Does it have branches to the elbow?

A

1) Medial; deep
1) No branches to arm
3) Articular br. To elbow

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24
Q

1) What nerve comes from the medial cord and passes posterior to the medial epicondyle (“funny bone”) to forearm?
2) Does this nerve have branches to the arm? What abt to the elbow?
3) What pathology can occur w this nerve? Where?

A

1) Ulnar n.
2) No branches to arm.
-Articular br. to elbow.
3) Ulnar n. entrapment @ elbow (cubital tunnel)
“Funny bone”

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25
Q

1) The musculocutaneous nerve (lateral cord) innervates all 3 muscles of what compartment? List these 3 muscles.
2) What nerve does it become?

A

1) All 3 muscles of anterior compartment of ARM
-Biceps brachii m. (both heads)
-Brachialis m. (elbow flexor)
-Coracobrachialis m (shoulder forward flexor)
2) Lateral cutaneous n. of the forearm

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26
Q

Biceps tendon DTR (deep tendon reflex) tests what nerve? What spinal levels is this?

A

Musculocutaneous nerve; C 5-6

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27
Q

1) What pt of the cord does the radial nerve come from?
2) It descends with profunda brachii a. in radial groove, then courses ___________ to lateral epicondyle and into ___________.
3) Then it divides into what two branches?
4) What compartment does the radial nerve supply? What overlying skin does it supply?

A

1) Posterior cord
2) anterior; cubital fossa,
3) Superficial and deep br.
4) Supplies posterior compartment m. in both arm and forearm & overlying skin of arm and hand

28
Q

1) Triceps reflex tests what tendon?
2) What nerve is this? What spinal levels?

A

1) Triceps tendon
2) Radial nerve; C6-7

29
Q

What nerve comes off posterior cord & goes to deltoid + skin over that area?

A

Axillary nerve

30
Q

1) Where is the forearm?
2) What are the two bones? What connects them?
3) What are the two jobs of the forearm?

A

1) Elbow to wrist
2) Radius and ulna; Interosseous membrane
3) Assist shoulder in application of force
-Placement of hand in space

31
Q

1) What types of muscles are in the anterior compartment of the forearm?
-What innervates them?
2) What types are in the posterior compartment of the forearm?
-What innervates them?

A

1) Flexors and pronators
-Median & ulnar nerves
2) Extensors and supinators
-Radial n. (all)

32
Q

1) What group of muscles have a common proximal attachment at medial epicondyle of humerus/ at “flexor wad”?
(inf. to 2nd digit/ pointer finger)
2) What do these do?

A

1) Flexors from medial epicondyle of humerus
2) Act on wrist and hand

33
Q

List the 4 members of the superficial layer of the anterior forearm (Flexor-pronator group).

A
  1. Pronator teres*
  2. Flexor carpi radialis (FCR)*
  3. Palmaris longus*
  4. Flexor carpi ulnaris (FCU)*, **
34
Q

[Flexor-pronator group/superficial layer of ant. forearm]:
1) Which members have a common flexor origin at medial epicondyle (flexor “wad”)?
2) Which are/is innervated by ulnar nerve?
3) True or false: all 4 members of this group do not act directly on digits

A

1) All 4 (PT, FCR, PL, FCU)
2) FCU (Flexor carpi ulnaris)
3) True; not directly on digits

35
Q

1) What muscle is the exception and is functionally an elbow flexor, but is in the posterior arm compartment?
2) What innervates it?

A

1) Brachioradialis
2) Radial nerve

36
Q

What does the flexor-pronator group’s intermediate layer (FDS) insert on?

A

Digits

37
Q

What 3 things do the flexor digitorum superficialis (FDS)* flex? Where does it flex each?

*(aka superficial digital flexors, aka intermediate layer of flexor pronator group/ ant. forearm)

A

1) Wrist at C-MC joints
2) Proximal phalanges 2-5 @ MC-P
3) Digits 2-5 @ PIP joints

38
Q

1) What nerve controls the FDS of the intermediate layer of anterior forearm?
2) What is their proximal attachment?
3) What is their [distal] insertion? (will be on test)

A

1) Median nerve
2) Medial epicondyle (short story)*
3) Middle phalanx of digits 2-5

39
Q

1) Define medial epicondylitis.
2) Where is the pain typically located?
3) What test is there for it?

A

1) Inflammation of the proximal attachments of flexor group
2) At or just below medial epicondyle
3) Resisted flexion at wrist reproduces pain at medial epicondyle/ proximal insertion of flexor “wad”

40
Q

1) Does the deep layer of the flexor-pronator group/deep layer cross elbow joint?
2) What are its 3 members?
3) What does FDP insert on?
4) What are FDP’s actions?

A

1) No
2) -Flexor digitorum profundus (FDP)/ deep digital flexors.
-Flexor pollicis longus (FPL).
-Pronator quadratus.
3) Insert into distal phalanges 2-5
4) Flexes C-MC & DIP digits 2-5
-Assists in flexion of wrist

41
Q

Describe the mixed innervation of the FDP (of the deep layer of the forearm’s flexor/ pronator group)

A

1) Median n. to lateral part: Digits 2-3
2) Ulnar n. to medial part: Digits 4-5

42
Q

1) What are the actions of the FPL (of the deep layer of the forearm’s flexor/ pronator group)?
2) What nerve innervates it?

A

1) Flexes MCP and IP joints of thumb
-Assists with wrist and CMC
3) Median n.

43
Q

What 3 things does Pronator quadratus do?

A

1) Pronates forearm
2) Bind radius and ulna
3) Helps during FOOSH injury

44
Q

What tendons “slip through” FDS (superficial) tendons prior to insertion @ P3?

A

FDP (deep) tendons

45
Q

Describe the FDS muscle test

A

With wrist supinated, push 3 lateral fingers toward dorsal surface while pt moves their middle finger towards palmar surface

46
Q

Describe the FDP muscle test

A

W wrist supinated, pinch joint b/t 2nd and 3rd phalanx.

47
Q

1) All of which forearm compartment is innervated by the radial nerve?
2) How many groups?

A

1) Posterior compartment (Extensor-supinator)
2) 3 groups

48
Q

List the 3 groups of the posterior compartment extensor-supinators and list their members

A

1) 3 muscles that extend and ulnar/radial deviate the wrist:
-Extensor carpi radialis longus (ECRL), ECRB, ECU.
2) 3 muscles that extend digits 2-5:
-Extensor digitorum, extensor indicis, extensor digiti minimi
3) 3 muscles that manipulate the thumb:
-Abductor pollicis longus (APL), extensor pollicis brevis (EPB), extensor pollicis longus (EPL)

49
Q

1) Where do the 4 superficial extensors of the forearm have a common proximal tendon attachment?
2) List these 4 superfic. extensors and their distal attachments

A

1) Lateral epicondyle
2) ECRL/ECRB: MC
-Extensor indicus et. digitorum: digits 2-5
-EDM: digit 5
-ECU: 5th MC

50
Q

Extensor group superficial layer:
List what’s found at the lateral epicondyle [of humerus] from medial to lateral. Incl. the distal attachment for each.

A

Med to lat:
1) ECU: 5th MC
2) EDM: digit 5
3) Ext digitorum and Ext indicus: digits 2-5
4) EPL
5+6) ECRL and ECRB: MC
7+8) Abductor PL & ext pollicis brevis

51
Q

Lateral epicondylitis is also called what? What group does it involve?

A

“Tennis elbow”; 4 superficial extensors

52
Q

1) Extensor digitorum tendons expand on distal ends of what? What is this called?
2) What 2 things does this divide into? Where does each go?

A

1) MCs; extensor expansion or “dorsal hoods:
2) Dorsal hood divides:
a) Median band
-Passes to base of P2
b) 2 lateral bands
-Passes to base of P3

53
Q

Tendons of what two things join lateral bands of dorsal hood?

A

Interosseous and lumbricals

54
Q

What is the name of the following painful condition that affects the tendons in your wrist?: It occurs when the 2 tendons around the base of your thumb become swollen, and the swelling causes the sheaths (casings) covering the tendons to become inflamed. This puts pressure on nearby nerves, causing pain and numbness.

A

De Quervain’s tenosynovitis

55
Q

Finkelstein test [w. lateral arm facing upward, make fist and move wrist downard] tests for what?

A

De Quervain’s tenosynovitis

56
Q

1) What makes up the snuff box dorsally?
2) What makes up its ventral side?
3) What abt proximally? Distally?
4) What 2 bones are involved?
5) What artery is here?

A

1) EPL
2) EPB and Abductor PL (APL tendon)
3) Radial styloid; Base of 1st MC
4) Scaphoid & trapezium (@ base of 1st MC)
5) Radial a.

57
Q

1) Name a nerve and artery in ulnar canal of Guyon.
2) What nerve is in the carpal tunnel?

A

1) Ulnar n. and artery
2) Median n. in carpal tunnel

58
Q

1) Brachial a. as it leaves cubital fossa is where?
2) What artery enters the hand via canal of Guyon? Where do you palpate the pulse?

A

1) In forearm
2) Ulnar a.; lateral side of FCU tendon

59
Q

1) Radial a. winds around lateral aspect of wrist to cross _______________ and enter hand posteriorly via the __________________ web space.
2) Where do you palpate the radial artery’s pulse? (2 places)

A

1) anatomical snuff box; thumb&2nd MC [web space]
2) B/t FCR and APL/EPB tendons & in the snuff box

60
Q

True or false: the hand includes the wrist, carpals, metacarpals, and phalanges

A

True

61
Q

Where are the thenar and hypothenar groups of the palmer aspect of the hand?

A

1) Thenar: at base of thumb
2) Hypothenar: over 5th MC

62
Q

True or false: thumb just has a proximal and distal phalange, and an IP and an MP joint

A

True

63
Q

What is a usefulmnemonicto help remember thecarpal bones?

A

Some – Scaphoid.
Lovers – Lunate.
Try – Triquetrum.
Positions – Pisiform.
That – Trapezium.
They – Trapezoid.
Can’t – Capitate.
Handle – Hamate.

64
Q

What are the two fascia of palm (palmer aspect)?

A

1) Palmar aponeurosis
2) Fibrous digital sheaths

65
Q

1) What is Dupuytren’s contracture of palmer fascia and aponeurosis?
2) What is the treatment?

A

1) Fibrosis of longitudinal bands on medial side of hand pulls digits 4, 5 into partial flexion
2) Surgical

(PA school) Gross Anatomy (52 decks)

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