locomotor anatomy yr 1 Flashcards
function of upper and lower limbs versus
upper= mobility, manipulation, dexterity lower= stability, weight bearing and locomotion
difference arm and forearm
arm is before the elbow and forearm below
skeleton of the upper limbs
humerus, radius ulna, carpal, metacarpals, phalanges
joints between carpals, metacarpals and phalanges 3
carpometacarpal joints
metacarpophalangeal joint
interphalangeal joints
what type of joints are the shoulder glenohumeral joint, elbow and wrist joint
ball and socket
hinge
ellipsoid
compartments of the arm draw
skin deep fascia anterior flexor component humerus and intermuscular septa posterior extensor component
comparments of the forearm draw
skin deep fascia anterior flexor component posterior extensor component intermuscular septa to radius interosseous membrane between ulna and radius
arteries of the upper limb
subclavian axillary brachial radial ulnar deep palmar arch superficial palmar arch
veins of the upper limb
subclavian axillary and cephalic venae comitantes of brachial artery venae comitantes of accompanying veins median cubital basilic off bracial dorsal venous arch
number of vertebrae and nerves for each spinal level
cervical 7 and 8 thoracic 12 and 12 lumbar 5 and 5 saccral 5 and 5 coocygeal 4 and 1
what is a plexus
complex recombination of axons as they rearrange themselves in passing from one area to another
three main plexus and spinal nerve levels
brachial = c5 to t1 lumbar= l1 to l4 sacral= l4 to s3
draw the brachial plexus
roots, trunks (upper mid low), divisions (lateral, post medial), terminal branches
musculocutaneous axillary median radial ulnar
what do the musculocutaneous, axillary, median radial and ulnar nerve supply
musculocutaneous= all muscles in anterior compartment axillary= shoulder median= most anterior flexors in the forearm and thenar muscles in the hand radial= all muscules in posterior compartment of arm and forearm ulnar= most intrinsic muscles in hand, felxor carpi ulnaris and half of flexor digitorum profundus in forearm
regions of lower limb
gluteal region femoral region knee region leg region foot region ankle talocural region
what type of joints are the hip, knee and ankle talocural joint
ball and socket and hinge and hinge
muscle compartment of the thigh
anterior compartment quadriceps
femur
posterior (hamstrings)
and a medial compartment (hip adductors)
muscle compartment of the leg
4 in anterior
2 in posterior
2 in lateral
anterior (tibalis anterior, extensor digitorum longus, extensor hallucis longus, fibularis tertius) posterior ( gastrocnemius and soleus deep too) lateral compartment ( fibularis longus and fibular brevis)
action of anterior and posterior compartment in thigh
anterior= flexes at hip and extends at knee posterior= extends at hip but flexes at knee (except sartorius flexes at both)
action of anterior and lateral compartment in leg
anterior= dorsiflexion foot lateral= plantarflexion foot
arteries of the leg
femur popliteal fibular/peroneal anterior and posterior tibial dorsalis pedis plantar arch
veins of lower limb
femoral
great saphenous (comes off femoral runs too foot)
popliteal
short saphenous
venae comitantes of posterior and anterior tibilar arteries
dorsal venous arch
nerves of lower limb
sciatic (sacral), femoral (lumbar), obturator nerve (lumbar), tibial nerve (branch of sciatic) and common fibular (branch of sciatic)
what type of joints are the elbow and knee
synovial hinge joints
what are the 2 joints in the elbow region
- the elbow joint (ie the whole part)
2. the proximal radioulnar joint (pivot joint of radius attached to the ulnar)
draw the distal end of the humerus anterior view
radial fossa coronoid fossa lateral epicondyle capitulum trochlea medial epicondyle
draw the distal end of the humerus posterior view
olecranon fossa
medial epicondyle
tochlea
lateral epicondyle
draw the proximal end of the ulnar anterior
olecranon tochlear notch radial notch coronoid process tuberosity of ulnar supinator crest
draw the proximal end of the radius
head
neck
radial tuberosity
what ligaments stabilise the elbow joint
medial collateral ligament
lateral collateral ligament
what movements does the proximal radioulnar joint have
pivot joint so rotational movement ie supination and pronation of the palm happens here
and sliding movement
what ligament holds the proximal radioulnar joint and where does it extend from
what function does it have
angular ligament
extends from ulnar to circle the radius
stops radius and ulna separating but allows radius to rotate
muscles that cause flexion and extension at elbow and nerves innervating
flexion= biceps brachii and brachialis deeper to biceps (mn) and brachioradialis (rn as posterior) extension= triceps (rn)
muscles action on radioulnar joint and nerve
pronators (2)
supinators (2)
pronators and supinators
pronator teres (superifical muscle with medial border of cubital fossa)
and pronator quadratus (median nerve)
Supinator (deep muscle posterior compartment, winds laterally around proximal part of radius and attached to anterior surface( radial nerve Biceps Brachii (very powerful supinator, inserts into radial tuberosity of radius) musculocutaneous nerve
number of bones in the hand
radius
8 carpals
5 metacarpals
14 phalanges
what is the wrist joint called
radiocarpal joint
what joints are in the hand 5
radiocarpal joint carpometacarpal joints metacarpophalangeal joints interphalangeal joints intercarpal joints
what are the 8 carpal joints in the hand and draw
SLTPTTCH SCAPHOID LUNNATE Triquetrum PISIFORM TRAPEZIUM TRAPEZOID CAPITATE HAMMATE
what are the 2 joints in the knee region
- knee joint
2. proximal tibiofibular joint
draw the distal end of the femur anterior and posterior
anterior: lateral epicodyle
patellar surface
medial epicondyle
posterior: intercondylar fossa
what is a sesamoid bone, and give an example
bone formed within a tendon
eg patella
what are the features of the patella
medial and lateral facets
apex
draw the proximal end of the tibia ant and post
tubercules of intercondylar eminence
lateral condyle
tibila tuberosity
medial condyle
posterior: articular facet for fibula
draw the proximal end of the fibular
facet for articulation with inferior surface of lateral condyle of tibia
head
neck
what type of joint is the knee joint and what actions does it have
synovial MODIFIED hinge joint
mainly flexion/ extension and slight rotation for “locking”
draw and name the 4 key features of the knee joint
synovial capsule
supratellar bursa
infrapatellar fat pad
articular surfaces
what 2 types of ligaments are there around the knee
- extracapsular ligaments
2. intracapsular ligaments
what are the 2 types of extracapsular ligaments and what is their function
- medial (tibial) collateral ligament: flat and part of joint
capsule - lateral fibular collateral ligament: cord-like and separate to capsule
-tighten in knee extension and loosen in flexion and re-inforce joint capsule
what are the 2 intracapsular ligaments and function
- anterior cruciate ligament: prevents anterior tibial translation - attaches anterior to posterior
- posterior cruciate ligament: prevents posterior tibial translation
what are the 2 fibrocartilaginous meniscus of the knee joint and what do they do
medial meniscus and lateral meniscus
sit between the femur medial/ lateral condyles and tibial tubercules of intercondylar eminence
process of knee moving locking and unlocking
locking knee ie sit to stand 1. move knee into extension 2. lateral surfaces stop moving before the medial 3. femur rotates medially- locks unlocking knee 1.active movement: popliteus muscle
what is the popliteus muscle function and anatomy
posterior surface of tibia, passes upwards and laterally to joint, lateral meniscus and lateral condyle
- acts to unlock by rotating femur laterally
what are the 4 quadriceps femoris muscles and draw and nerve supply
vastus medialis vastus intermedius (deep to others) vastus lateralis rectus femoris (middle) sartorius
femoral nerve
what are the 3 hamstrings and their nerve supply
sciatic nerve
- biceps femoris
- semimembranosus
- semitendinosus
muscles of the leg posterior and nerve supply
gastrocnemius and soleus
tibial nerve
nerve supply to popliteus muscle and function
unlock the leg (lateral rotation of femur on tibia)
tibial nerve as posterior
what are the bones of the foot
tarsals
metatarsals
phalanges
name the tarsals 5
calcneus talus cuboid navicular cuneiforms
where do inversion and eversion take place
in the tarsal bones
what type of joints are the shoulder and hip
shoulder (glenohumeral) ball and socket
what does the shoulder joint articulate with
the shallow glenoid fossa
what does the hip joint articulate with
the deep fossa (acetabulum)
draw the anterior scapula
superior angle medial border lateral border inferior border coracoid process glenoid cavity infraglenoid tubercle subscapular fossa
draw the posterior scapula
supraspinous fossa infraspinous fossa acromion coracoid process spine
draw the clavicle and describe articulations
lateral articulation with acromion
medial articulation with manubrium of sternum
conoid tubercle
trapezoid line
What movements can the scapula do 6
elevation and depression
protraction and retraction
lateral and medial rotation (arms up, arms down)
why can the scapula have so many movements
only articulates at the acromioclavicular joint otherwise no other articulations to the thorax
muscles that act on the scapula 2 and draw
what is their role
Levator scapulae
Rhomboids- major and minor
-act to lift scapula in elevation
-also in rotation and retraction
draw the proximal end of the humerus anterior
head lesser tubercle (anterior) part of the greater tubercle anatomical neck surgical neck inter-tubercular groove deltoid tuberosity
what other muscle acts on the scapula and where does it attach and what movements can it do
trapezius
- superifical muscle
- attaches to spine and acromion of scapula
- elevation retraction depression
Posterior of humerus anatomical features
head anatomical neck greater tubercle surgical neck deltoid tuberosity surgical groove for radial nerve
where does the joint capsule of the shoulder extend from and where to (2)
extends from margin of the glenoid fossa
- superior anatomical neck of humerus
- inferior surgical neck of humerus
label the capsule of the shoulder joint
acromium coracoacromial ligament coracoid process glenoid fossa glenoid labrum
out of the 3 factors from the lecture which ones affect stability of the shoulder joint
bony shape does not
capsule/ligamment does but less then the
muscle does the most
what are the 4 muscles in the rotator cuff group and draw
- subscapularis
- supraspinatus
- infraspinatus
- Teres minor
what is the function of the rotator cuff group
they attach the scapula to the proximal part of the humerus
stabilise the shoulder joint by holding the humeral head firmly in the glenoid fossa
where is the origin and insertion of the subscapularis and what action
origin =medial partof the costal surface of the scapula
insertion= lesser tubercle of humerus
medial rotation and adduction of shoulder
where is the origin and insertion of supraspinatus, action
origin= supraspinatous fossa of scapula
insertion= superior facet of greater tubercle of humerus
initiates abduction of shoulder
where is the origin and insertion of infraspinatus action
origin= infraspinatous fossa
insertion: middle facet of greater tubercle of humerus
action: lateral rotation at shoulder
origin and insertion of teres minor and action
origin: posterior surface of scapula
insertion: inferior facet of the greater tubercle of humerus
action: lateral rotation of shoulder
what is the deltoid muscle ie insertion and origins (3( and action 3
Insertion: deltoid tuberosity of humerus
origin: acromion, spine of scapula, lateral third of clavicle
multipennate muscle
posterior: lateral rotation and extension
medial = abduction
anterior= medial rotation and flexion
what is the pectoralis major ie actions and attachments
adduction and medial rotation
clavicular head and sternocostal head
order of deep to superficial muscles of scapula posterior
rotator cuffs: infra, supra, teres minor
alongside: rhomboids and levator scapula
superficial are the deltoid and the pectoralis major
what actions does the shoulder have and demonstrate
flexion and extension (bring in and out) horizontal
medial and lateral rotation (with bent elbow)
abduction and adduction in and out in vertical
circumduction
other name for hip joint
acetabulofemoral joint
bones of the hip bone 3
ilium
ischium
pubis
what bones act at hip joint 2
- femur
2. hip bone: ilium ischium pubis all unite at middle of acetabulum
anterior and posterior articulation of hip bone
- posteriorly articulates with axial skeleton at sacroiliac joint; anteriorly meets hip bone of opposite side a pubic smphysis to form bony pelvis
anatomical features of hip bone lateral
Iliac crest Iliac fossa Greater Sciatic notch Lesser sciatic notch upper part of ischial tuberosity Ramus of Ischium acetabulum acetabular notch Obturator foramen
anatomical features of the femur anterior and post
head neck greater trochanter lesser trochanter (post interochanteric crest)
anatomical features of the acetabulum
acetabular notch with transverse acetabular ligament and acetabular foramen
fibrocartilaginous rim
3 ligaments of the hip joint and draw
iliofemoral ligament anterior superior
pubofemoral ligament anterior/post inferior
ischiofemoral ligament posterior superior
how do the ligaments of the acetabulum capsule act in extension and flexion
extension wind spiral tightly draws femur to hip to increase stability ie tight when standing so can stand for longer as don’t have to rely on muscles
flexion loosens to increase mobility
3 factors affecting stability of the hip joint
mostly bony shape and ligaments
but also muscle
movements at the hip 3 types
flexion
abd and add (out to the side)
internal and external rotation ie turning foot placement in or out
the 4 flexors acting on the hip and compartment of thigh and draw
- iliopsoas (anterior)
- sartorius ant
- pectineus medial
- rectus femoris anterior
iliofemoral triangle mneomic
NAVEL
femoral nerve, artery, vein empty space lymphatics
sartorius, inguinal ligament, adductor longus, pectineus
the 4 extensors acting on the hip and draw
- biceps femoris laterally
- semitendinosus
- semimembranosus medially
- gluteus maximum
the 2 abductors of the hip
- gluteus medius
2. gluteus minimus
the 4 adductors of the hip and position
- adductor longus most lateral
- gracilis
- adductor brevis deep lateral to longus
- adductor magnus most medial
4 proximal and 4 distal carpal bones
proximal: sphenoid, lunnate, triquetrum, piriform
distal: trapezium, trapezoid, capitate, hammate
joints in the hand
intercarpal interphalangeal joints proximal and distal carpometacarpal joint metacarpophalangeal joints radiocarpal joint
3 types of phalanges
proximal middle and distal phalanx
what are the 2 types of muscles of the hand
extrinsic and intrinsic
what are the extrinsic muscles of the hand
action and origin and insertion
extrinsic muscles have their origin within the anterior or posterior compartment compartments of the forearm
-power grips as provide strength due too long tendons
pass through carpal tunnel
insert into the hand to move digits/ wrist
what are the intrinisc muscles of the hand origin and action
origin in the hand
responsible for precision grips
movements of the hand
abd and add
flex and ext
opposition and reposition
which extrinsic muscles have tendons that enter the hand and how many tendons do they have each (3)
and draw
anterior:
flexor digitorum superficialis (middle 2 heads)
flexor digitorum profundus (deep medial)
flexor pollicis longus (deep lateral)
4 from each
what is the carpal tunnel and what is the floor and the roof
fibro-osseous tunnel
formed by carpal arch( floor)
and flexor retinaculum (rooof)
how many structures pass through the carpal tunnel
10 structures 4 tendons from flexor digitorum superificialis 4 from flexor digitorum profundus 1 from flexor pollicis longus median nerve
what are the 3 main intrinsic muscle groups in the hand and draw
- palmaris brevis (ant lateral)
- thenar eminence (ant medial)
- palmar aponeurosis (ant middle
what are the 3 muscles of the thenar eminence and what nerve supplies them - draw
- abductor pollicis brevis (middle)
- flexor pollicis brevis (closest to fingers top)
- opponens pollicis (bottom and deep to)
recurrent branch of the median nerve
what are the 3 muscles of the hypothenar eminence and what nerve supplies them-draw
- abductor digiti minimi (deep lateral)
- flexor digit minimi brevis (deep medial)
- opponens digiti minimi (deep can only be seen medially to others)
ulnar nerve
all lateral deep to palmar brevis
where do the lumbricals originate and where do they attach and what action do they have and nerve control
orginate on tendons of FDP
attach to extensor expansion on radial side
-flex metacarpophalangeal joints and extend interphalangeal joints
lateral 2= median nerve
medial 2=ulnar nerve
what is the adductor pollicis and what nerve
deep to thenar eminence muscles
two heads- transverse and oblique
ulnar nerve
draw nerve innervation of the hand
anterior:
median= middle
ulnar=lateral till 1/2 of 4th finger
radial= medial 1/2 of thumb
posterior=
radial up to 1/2 of 4th finger and bottom 1/3 fingers
then medial above that and ulnar lateral
what are the2 inteossei muscles and what do they do and nerve innervation
palmar interossei= adduction
dorsal interossei= abduction
PAD DAB
on posterior of hand so ulnar innervation
2 arches of the hand and their blood supply
deep palmar arch supplied by radial artery
superficial palmar arch supplied by ulnar artery
venous drainage of the hand
dorsal venous network to basilic veins or cephalic veins to axillary vein
what does the median nerve supply in the hand
thenar eminence and lateral two lumbrical muscles
motor to lateral half of fdp
sensory to palm of hand and lateral 2 digits
what does the ulnar nerve supply in the hand
provides motor to hypothenar eminence medial two lumbricals, interossei and adductor pollicis muscle and palmar brevis
motor to medial half of fdp
sensory to medial digits
what is the borders of the anatomical snuff boxes and contents
posterior: extensor pollicis longus
anterior: abductor pollicis longus, extensor pollicis brevis
contents: radial artery, base of first metacarpal, scaphoid, trapezium, radial syloid process, cephalic vein
what are the 3 main conditions with the hand
- carpal tunnel syndrome
- ulnar claw
- hand of benediction
what is carpal tunnel syndrome
caused by compression of the median nerve causes inflammation
caused by repetitive movements ie occupational hazard, trauma, fluid retention
symptoms: tingling, paraesthesia in hand and loss of grip strength, atrophy of thenar eminence
what is ulnar claw
damage to ulnar nerve leads to permanent flexion of digits 4 and 5
remain hyperextended at the mcp joint and flexed at the IP joint due to paralysis of the medial two lumbricals
what is the hand of benediction
median nerve damage at the elbow
ask patient to clench fist
lateral two lumbricals are paralysed as well as lateral half of FDP
leaves inability to perform flexion at the mcp and ip joints of digit 2 and 3
