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limbs u Flashcards

1
Q

what structures pass through carpel tunnel?

A

flexor digitorum profundus (4)
flexor digitorum superficialis (4)
flexor pollicis longus
median nerve

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2
Q

describe the attachments of pectoral is major

A

medial half of clavicle
superior 6 costal cartilages
aponeurosis of external oblique muscle
lateral lip of intertubercular sulcus

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3
Q

what actions can pectoralis major do? - how do you test these

A

adduction
flexion
medial rotation of humerus

with elbow flexed, against resistance, feel the muscle by placing hand on the chest

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4
Q

what other test is the same as pectoralis major function test except for the fact that you don’t need resistance?

A

glenohumeral joint test

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5
Q

what nerve innervates pectoralis major?

A

lateral & medial pectoral nerve

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6
Q

describe the attachments of pectoralis minor

A

ribs 3-5

coracoid process of scapula

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7
Q

what nerve innervates pectoralis minor?

A

medial pectoral nerve

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8
Q

what is the function of pectoralis minor?

A

stabilisation of scapula

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9
Q

describe the attachments of subclavius

A

1st costochondral joint

medial third of clavicle

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10
Q

what is the function of subclavius?

A

stabilisation & depression of clavicle

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11
Q

describe the attachments of seratus anterior

A

lateral end of ribs 1-8

medial border of scapula

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12
Q

what are the motions seratus anterior is able to do? - how do you test this

A

lateral rotation
protraction of scapula

put arm out and push against resistance, place hand on the posteriolateral aspect of the back

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13
Q

what nerve innervates seratus anterior?

A

long thoracic nerve

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14
Q

describe the attachments of latissumus dorsi

A 
(twists on itself)
intertubercular groove of humerus
T7-12
iliac crest
ribs 9-12
inferior border of scapula
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15
Q

what motions can latissimus dorsi do? - how do you test this

A

extension
adduction
medial rotation of humerus

adduct arm against resistance with elbow flexed, place hand on the back

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16
Q

what nerve innervates latissimus dorsi?

A

long scapular nerve

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17
Q

describe the attachments of trapezius

A 
occipital bone
nuchal ligament
spinous processes of C7-T12
clavicle
acromion
scapular spine
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18
Q

what motions can trapezius do? - how do you test this

A

elevation
depression
retraction
rotation of scapula

raise the shoulder against resistance

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19
Q

what nerve innervates trapezius?

A

accessory nerve

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20
Q

describe the attachments of levator scapulae and the nerve innervating

A

transverse processes of C1-4
medial border of scapula

dorsal scapular nerve

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21
Q

what motions can levator scapular do?

A

elevation of scapula

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22
Q

describe the attachments of rhomboid major and nerve innervating it

A

spinous processes of T2-5
medial border of scapula

dorsal scapular nerve

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23
Q

what motions can rhomboid major do?

A

retraction

medial rotation of scapula

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24
Q

describe the attachments of rhomboid minor and the nerve innervating it

A

spinous processes of C7-T1
medial border of scapula

dorsal scapular nerve

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25
what motions can rhomboid minor do?
retraction | medial rotation of scapula
26
describe the attachments of deltoid
acromion scapular spine lateral third of clavicle deltoid tuberosity of humerus
27
what motions can deltoid do? - how do you test this
abduction of humerus elbow flex, abduction, against resistance, feel for muscle at the shoulder
28
what nerve innervates deltoid?
axillary nerve
29
describe the attachments of teres major
lateral aspect of inferior angle of scapula | medial lip of intertubercular sulcus
30
what motions can teres major do?
adduction retraction medial rotation of humerus
31
what nerve innervates teres major?
lower subscapular nerve
32
what are the 4 rotator cuff muscles?
subscapularis supraspinatus infraspinatus teres minor
33
describe the attachments of subscapularis and nerve innervating it
``` subscapular fossa (anterior) lesser tubercle of humerus ``` upper and lower subscapular nerve
34
what motions can subscapularis do?
medial rotation of humerus
35
describe the attachments of supraspinatus and infraspinatus, and nerve innervating them
supraspinous or infraspinous fossa greater tubercle of humerus suprascapular nerve
36
what motions can supraspinatus do?
abduction for first 15 degrees of humerus
37
what motions can infraspinatus do?
lateral rotation of humerus
38
describe the attachments of teres minor and the nerve innervating it
lateral border of scapula greater tubercle of humerus axillary nerve
39
what motions can teres minor do?
lateral rotation of humerus
40
how do you test teres major and subscapularis?
medial rotation (+ adduction, retraction) put hands as far up the back as possible against resistance
41
how do you test supraspinatus, infraspinatus and teres minor?
lateral rotation and abduction put hands behind the neck against resistance
42
what are the muscles of anterior compartment of arm? | what nerve innervates them?
biceps brachii brachialis coracobrachialis musculocutaneous nerve
43
describe the attachments of biceps brachii
long head: supraglenoid tubercle of scapula -> through intertubercular groove short head: coracoid process of scapula (medial to long head) merge together and attach to radial tuberosity gives of aponeurosis which joins forearm fascia
44
what motions can biceps brachii do? - how do you test you test it
flexion and supination of forearm rest/stabilise the elbow joint, flexion or supination motion against resistance
45
describe the attachments of brachialis
middle of humerus shaft | ulnar tuberosity
46
what motion can brachialis do?
flexion of forearm
47
what is the relation of brachialis to cubical fossa?
is the floor of cubical fossa
48
describe the attachments of coracobracialis
coracoid process of scapula | middle of medial aspect of humerus
49
what motion can coracobrachialis do?
flexion | adduction of humerus
50
what nerve other than musculocutaneous nerve innervates brachialis?
radial nerve
51
describe the attachments of triceps brachii (posterior compartment of arm)
infraglenoid tubercle of scapula (long head) posterior surface of humerus inferior (medial head) and superior(lateral head) to radial groove olecranon of ulna
52
what motions can triceps brachii do? - how do you test it
extension of forearm extend forearm, against resistance, rest/stabilise elbow joint
53
what nerve innervates triceps brachii?
radial nerve triceps reflex
54
what are the superficial muscles of the anterior compartment of forearm?
pronator teres flexor carpi radialis palmaris longus flexor carpi ulnaris
55
describe the attachments of pronator teres
medial epicondyle of humerus coronoid process of ulna pronator tuberosity on lateral aspect of radius
56
what nerve innervates pronator teres?
median nerve
57
what motions can pronator teres do?
pronation of radius about ulna
58
describe the attachments of flexor carpi radialis
medial epicondyle of humerus | base of 2nd 3rd metacarpels
59
what motions do flexor carpi radialis do?
flexion | radial deviation of wrist
60
what nerve innervates flexor carpi radialis?
median nerve
61
describe the attachments of palmaris longus
medial epicondyle of humerus | flexor retinaculum & palmar aponeurosis
62
what motions can palmaris longus do?
assists flexion of wrist
63
what nerve innervates palmaris longus?
median nerve
64
describe the attachments of flexor carpi ulnaris
medial epicondyle of humerus (common flexor tendon) | pisiform, hamate, base of 5th metacarpal
65
what nerve innervates flexor carpi ulnaris?
ulnar nerve
66
what motions can flexor carpi ulnaris do?
flexion | ulnar deviation of wrist
67
how do you test the superficial flexors of anterior forearm?
flex elbow -> pronate -> flex wrist against resistance | rest/stabilise forearm
68
describe the attachments of flexor digitorum superficialis
common flexor tendon & ulna | intermediate phalanges
69
what motions can flexor digitorum superficialis do? - how do you test it
flexion of wrist, 4 metacarpophalangeal joint, 4 proximal interphalangeal joint stabilise proximal phalanx flex phalanx at proximal interphalangeal joint against resistance
70
what nerve innervates flexor digitorum superficialis?
median nerve
71
what are the deep anterior compartment muscles of forearm?
flexor pollicis longus flexor digitorum profundus pronator quadratus
72
describe the attachments of flexor pollicis longus
radius shaft | base of distal phalanx of thumb
73
what motions can flexor pollicis longus do?
flexion of thumb interphalangeal joint
74
what nerve innervates flexor pollicis longus?
median nerve
75
describe the attachments of flexor digitorum profundus
ulna | distal phalanges of 4 digits
76
what motions can flexor digitorum profundus do?
flexion of distal interphalangeal joint, metacarpophalangeal joint, wrist
77
what nerves innervate flexor digitorum profundus?
median nerve - middle & index finger | ulnar nerve - little & ring finger
78
describe the relationship between flexor digitorum profundus and flexor digitorum superficialis
profundus more deep than superficialis | but distally, crosses over = camper’s chias season
79
describe the attachments of pronator quadratus
distal ulnar shaft | adjacent side on radius shaft
80
what nerve innervates pronator quadratus?
median nerve
81
what motions can pronator quadratus do? - how do you test it
pronation of radius rest elbow, pronate against resistance
82
what are the superficial muscles of posterior compartment of forearm? nerve motion
``` brachioradialis - flexion of wrist extensor carpi radialis longus extensor carpi radialis brevis extensor digitorum extensor digiti minimi extensor carpi ulnaris anconeus - lateral epicondyle of humerus olecranon posterior ulna ``` radial nerve extension of wrist
83
what are the deep muscles of posterior compartment of forearm? nerve motion
``` supination - supination abductor pollicis longus extensor pollicis brevis extensor pollicis longus extensor indicis ``` radial nerve extension of fingers
84
how do you test muscles of posterior compartment of forearm?
flat hand & extend wrist against resistance | flat wrist & extend fingers against resistance p
85
what are the intrinsic muscles of the hand? | nerve
``` interossei - ulnar nerve lumbricals - index/middle median nerve, ring/little ulnar nerve thenar - median nerve hypothenar - ulnar nerve adductor pollicis - ulnar nerve ```
86
describe the attachments of interossei. motion how do you test it
between metacarpal bones palmar interossei: proximally in middle finger -> adduct digits in relation to middle line - paper in between and stop paper from pulling out dorsal interossei: distal end in middle finger -> abduct digits in relation to middle line - spread fingers against resistance
87
attachments of lumbricals motion what happens with ulnar neuropathy?
flex at metacarpophalangeal joint extend at interphalangeal joint paralysis of ring/little lumbricals -> hyperextension at metacarpophalangeal & hyperflexion at interphalangeal = ulnar claw
88
what are the muscles of thenar and hypothenar? | how do you test?
thenar: flexor pollicis brevis, abductor pollicis brevis, opponents pollicis hypothenar: abductor digiti minimi, flexor digiti minimi brevis, opponents digiti minimi little finger to thumb, try to break the connection
89
5 parts of brachial plexus (C5,6,7,8,T1)
``` roots trunks divisions cords branches ```
90
formation of branches
C5+6 = superior trunk, C7 = middle trunk, C8+T1 = inferior trunk posterior & anterior divisions superior & middle anterior = lateral cord, posterior cord, inferior anterior = medial cord 5 branches -> musculocutaneous, axillary, radial, median, ulnar nerve
91
musculocutaneous nerve
C5,6,7 lateral cord coracobrachialis, brachialis, biceps brachii flexion of forearm against resistance
92
axillary nerve
C5,6 posterior cord teres minor, deltoid muscle abduct arm against resistance
93
radial nerve
C5,6,7,8, T1 posterior cord posterior compartment of arm, posterolateral aspect of hand extension of forearm, wrist, metacarpophalangeal joint against resistance
94
median nerve
C6,7,8,T1 lateral and medial cords flexors of forearm, thenar, 2 lateral lumbricals flexion of wrist, wrist abduction, flexion of fingers at proximal interphalangeal joint against resistance
95
ulnar nerve
C8,T1 posterior cord flexor carpi ulnaris, flexor digitorum profundus, muscles of hand adduction or abduction of fingers, flexion and ulnar deviation of wrist
96
2 reflexes
biceps brachii tendon: within cubital fossa, thumb on tendon, flexion triceps brachii tendon: just superior to olecranon process, extension support arm and elbow
97
what artery can be damaged in case numeral fracture?
anterior and posterior numeral circumflex arteries from axillary artery wrap around surgical neck of humerus
98
what is Allen test?
determine whether it is safe to take blood clench fist for 30secs -> occlude both ulnar and radial artery and wrist -> open hand -> release ulnar artery -> measure time taken for hand to flush back to normal colour = determine blood flow of ulnar artery
99
what are the superficial veins
cephalic vein: through anatomical snuff box, radial side, joins axillary vein basilic vein: ulnar side, joins brachial vein two connected by median cubital vein at elbow
100
axilla
pectoralis major & minor thoracic wall, seratus anterior teres major, latissimus dorsi, subscapularis intertubercular sulcus axillary artery & vein, axillary lymph nodes brachial plexus tendon of short head of biceps brachii tendon of coracobrachialis
101
cubital fossa
``` brachioradialis pronator teres between epicondyle of humerus floor by brachialis roof by bicipital aponeurosis ``` lateral to medial: radial nerve, biceps tendon, brachial artery, median nerve
102
carpal tunnel
flexor retinaculum - scaphoid, pisiform, trapezium, hamate flexor digitorum profundus & superficialis, flexor pollicis longus, median nerve carpal tunnel syndrome: swelling of tendon -> compression on median nerve
103
anatomical snuffbox
extensor pollicis longus extensor pollicis brevis, abductor pollicis longus styloid process of radius scaphoid, trapezium radial nerve, radial artery, cephalic vein

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