Limb2: Overview of the limbs Flashcards
What bones are in the appendicular sksleton
Basically everything outside the skull, hyoid, vertebral column incl. sacrum and coccyx, ribs and sternum
Nervous supply to uppe rnad lower limb
Upper limb C5-T1
Lower limb L2-S3
Where are flexors and extensors located anteriorly and posteriorly
Upper: Flexors are anterior
Extensors are posterior
Lower: Extensors are anterior
Flexors are posterior
(flexion at the elbow involves bringing hand up toward shoulder, extesnion involves straightening arm )
(leg flexion is bending knee back so that the lower leg goes back, and extension brings it back to standing)
FLEXION: REDCE ANGLE BETWEEN TWO BODY PARTS
EXTENTION: INCREASE ANGEL BETWEEN 2 BODY PARTS
What is meant when said the lower limb rotates internally
The lower limb undergoes a permanent pronation resulting in a twisting of the dermatome fields during development
Why are the extensors and flexors the opposite way around in uppe rand lower limb
The lower limb internally rotates during its development meaning that, in the thigh and leg, the extensors are anterior and the flexors are posterior.
WHat do compartments share
Compartments tend to have a distinct function
Compartments tend to have the same nerve supply
Compartments tend to have the same blood supply
List the 7upper limb compartments
Pectoral (= chest) girdle muscles Intrinsic shoulder muscles Posterior arm muscles- extensor Anterior arm muscle-flexor Anterior forarm muscles,- flexor Posterior forearm muscles - extensors Intrinsic hand muscle (palmar anterior and dorsum)
Two movement types at the pectoral/shoulder girdle
Movements of the shoulder involve both movements of the arm relative to the scapula at the shoulder joint, and movements of the scapula relative to the chest wall.
Where do muslces acting on the shoulder attach
neck, anterior chest, back and arm.
List muscles in the pectoral or shoulder girdle
Deltoid, pec major, latissimus dorsi, rotator cuff muscles of shoulder and trapezius
Where does the brachialis mucle lie
deep to the bisceps… anterior to humerus. also involved in elbow flexion
What is the only true joint between the limb and the trunk
Sternoclavicular joint
What do the radius and ulna bones articular with
Proximal- humorus
Distally- carpals
Order of bones in hand, proximal to distal
Carpals, meta carpals, phalanges
Shoulder joint also known as
glenohumoral joint
Where do the hip abductors and extensors lie
In the gluteal region
State the compartments of the lower limb
Hip abductors (Gluteal)
Hip extensors (Gluteal)
Hip Flexors
Anterior thigh muscles – extensors
Medial thigh muscles – adductors
Posterior thigh muscles – flexors
Anterior leg muscles – extensors (dorsiflexors)
Lateral leg muscles – foot evertors
Posterior leg muscles – flexors (plantarflexors)
Intrinsic foot muscles – variety of functions
What is leg and what is thigh
Leg is knee down,
thigh is hip to knee
Which bone is medal and which lateral in the leg
tib medial
fib lateral
Where is the quadriceps, how many of them, what is the function
It in the anterior thigh. 4. Powerful EXTENSORS of the knee joint
and also flexors of the hip joint as they are attached to the iium
What are the upper and lwoer suraces of the foot known as
upper- dorsal
lower-plantar
What are hamstrings
posterior high muscles…….
Where does iliacus and psoas come from and what are their reevance to the lower limb
psoas from lumbar
iliacus from the blade of the ileus muslce…
join together and attach to inner side of the thigh
Flexors of the thigh
Where do nerves of the lower limb arise
Lumbo-sacral plexus L2-S3
Where are adductor muscles located in the thigh
medially
Outline the main arteries of the arm
Subclavian travels under the clavicle into the axillary region…. becomes
axillary artery
Then goes into arm and becomes brachail artery
At the elbow this divides into the ulnar and radial arteries
Then hand palmar arches and mectarcapl and digit arteries
Outline venous drainage of the limbs
Superficial and deep….
deep usually run with arteries
What modifications can the deep veins of the limb have
They can surround arteries (can be 2/3 veins which interlink)….
countercurrent heat exchange
pulsing of artery can help with venous return
State the superficial and deep venous drainage systems of the upper limb
Dorsal venous arch (sup.); Cephalic vein and basilic vein (sup.); Venae comitantes (deep); Axillary vein (deep); Subclavian vein; Superior vena cava
Outline the superficial venous drainage from te hand
dorsal venous arch –> basilic and cubital veins….
these then travel arond onto the anterior surface of teh arm… where the basilic vein is medial and the cubital vein is lateral
Which vein connects the basilic and cephalic vein
Median cubital vein
Outline arterial supply to lower limb
Aorta –>
common iliac –>
internal and external (external passes into limb) –>
femoral artery (pulse), change from external iliac to femoral artery occurs when it passes underneath the inguinal ligament –>
popliteal artery (when it passes behind knee) –>
posterior and anterior tibial artery, peroneal artery and dorsalis pedis
Outline the deep venous drainage of the lower leg
Same as the arterial supply
Outline the suoerficial venous drainage of lower limb
Venous arches on dorsum of foot…. go to:
great saphenous vein which passes the medial ankle, runs on medial side of the leg, round the back of the knee then back to the anterior surface of the leg and drains into teh inguinal region
The small saphenous vein drains at the back of the leg into the polpliteal vein at the knee
Where is the femoral triangle why is it important
The femoral triangle is the region of the groin where the femoral artery is accessed e.g. access to the cardiac vessels to carry out angiograms and angioplasty. A pulse can be felt in this area.
Underneath the iguinal canal
What do perforating veins do
Connect superficial and deep veins…. they contain a valve that only allows superficial to deep drainage
What happens if valves in perforating veins are compromised
blood is pushed from deep to superficial veins leading to varicose veins.
What is the use of surgical stockings
During recovery from operation you’re not moving so no muscles compressing veins so the venous return is sluggish (lack of the calf pump)…
Can lead to DVT
Elastic surgical socks compress the superficial veins promoting more vigorous deep venous return.
Outline which spinal nerves supply which areas
C1-4 : neck C5-T1 : upper limb T2-L1 : trunk L2-S3 : lower limb S2-C2 : perineum
Which nerve supplies anterior compartment of thigh
Which supplies medial compartment of thigh
Whcih nerve spplies the remaning parts of the thigh, leg and foot
Femoral n. supplies anterior compartment of thigh.
Obturator n. supplies medial (adductor) compartment of thigh.
Sciatic n. (or its terminal branches Tibial and Common Peroneal ns.) supply the remaining compartments (i.e. post. thigh, ant. and post. leg, foot)
T/F muscles are usually spplied by adjacent segments
T
T/F: Same action on joint = same nerve supply
T
T/f Opposing muscles 1-2 segments above or below
T
T/FMore proximal in limb = more caudal in spine
F More distal in limb = more caudal in spine
What is meant by segmental motor suppy to limbs
Groups of motor nerve cell bodies in the spinal cord C5-T1 = upper limb L2-S3 = lower limb Plexi for each limb Anterior divisions = flexor muscles Posterior divisions = extensor muscles
State the segmental motor supply to shoulder
abduction C5, adduction C678
external rotation C5, internal rotation C678
State the segmental motor supply elbow
flexion C56, extension C78
State the segmental motor supply to forearm
supination C6, pronation C78
State the segmental motor supply to wrist
flexion C67, extension C67
State the segmental motor supply to long tendons to hand
flexion C78, extension C78
State the segmental motor supply to intrinsic hand
T1
Outline the segmental supply to lower limb
Hip- flex L2/3
etend l4/5
Knee- extend l3/4
flex-l5/s1
Ankle- dorsiflex l4/5 plantarflex 21/s2
Differentiate segmental vs cutaneous sensory innveration
Segemntal: that particuar areas are supplid by single spinal nerve
Cutaneous: that those sensory nerves can get there by different nerves via plexu
What is eversion and inversion
Eversion- urning foot ou
Inversion turning soul of foot in
Which reflex mediates ankle jerk
S1
What is compartment syndrome and why can it occur
Muscle groups in confined compartments separated by firbous septa… increase in pressure in a compartment cannot spread out
Ischaemia caused by trauma-induced increased pressure in a confined limb compartment
What are common places for compartment syndrome to occur
Commonly the anterior, posterior and lateral compartments of the leg
What is the normal pressur ein the leg
25mmHg
What happens to vessels in compartment syndrome
Increase in preessure to just 50-60mmHg can collapse small vessels which leads to ischaemia but pulse is still presneet
What is acut 25mmHg
Trauma
What is chronic 25mmHg
Exercise induced
