Module 5: Back and axilla

Question 1

The sacrum

Answer 1

Large bone located at terminal part of vertebral column

Question 2

What does the sacrum articulate with?

Answer 2

Articulates with ileum bilaterally and fifth lumbar vertebrae at its base

Question 3

Sacral canal

Answer 3

Continuation of vertebral canal terminating at sacral hiatus

Question 4

Sacral foramina

Answer 4

4 sacral foramina located lateral to the fused sacral bodies

Question 5

Sacral cornua

Answer 5

Two bony processes that palpated by clinicians as an anatomical landmark when administrating injections into sacral hiatus

Question 6

Promontory

Answer 6

Where upper border of base of sacrum articulates with L5

Question 7

The coccyx

Answer 7

Four fused coccygeal vertebrae that articulate with sacrum superiorly at sacrococcygeal joint

Question 8

Accessory ligaments of vertebral column

Answer 8

1. Ligamentum flavum
2. Anterior longitudinal ligament
3. Posterior longitudinal ligament

Question 9

Lumbar spinal stenosis

Answer 9

Narrowing of vertebral canal in lumbar region; caused by extra bone or tissue growth in the vertebral canal from calcification of ligamentum flavum or outgrowth of bone

Question 10

Symptoms of lumbar spinal stenosis

Answer 10

Numbness and weakness in lower limb, lower back pain, pain with walking and standing, pain relief when bending forward

Question 11

Extrinsic muscles of the back

Answer 11

Latissimus dorsi
Rhomboid major and minor
Trapezius
Levator scapulae

Question 12

Insertion of latissimus dorsi

Answer 12

Intertubercular sulcus of humerus (bicipital groove)

Question 13

Symptoms of latissimus dorsi strain

Answer 13

Lower back pain that radiates up to scapula, pain with lateral flexion or extension of back, adduction, rotation of arm

Question 14

What are the erector spinae muscles (lateral to medial)

Answer 14

Iliocostalis, longissiumus and spinalis

Question 15

Action of erector spinae muscles

Answer 15

Extend vertebral column

Question 16

Symptoms of illiocostalis muscle strain

Answer 16

Back pain, decreased ROM of spine, pain that worsens when sitting for long periods, standing or climbing stairs

Question 17

Common injured regions of iliocostalis muscle

Answer 17

1. Iliocostalis thoracis
2. Iliocostalis lumborum

Question 18

Iliocostalis thoracis region

Answer 18

Pain felt along medial border of scapula and posterior thorax

Question 19

Iliocostalis lumborum region

Answer 19

Pain felt in sacroiliac region

Question 20

How is the iliocostalis muscle strain different from a latissimus dorsi muscle strain?

Answer 20

Latissimus dorsi- superolateral pain
Iliocostalis strain- anterior and posterior thorax pain, pain that radiates to sacroiliac region

Question 21

Anterior wall of axilla

Answer 21

Pec major

Question 22

Posterior wall of axilla

Answer 22

Subscapularis, latissimus dorsi, teres major

Question 23

Medial wall of axilla

Answer 23

Serratus anterior

Question 24

Lateral wall of axilla

Answer 24

Inter-tubercular sulcus of humerus

Question 25

Apex of axilla

Answer 25

Base of neck

Question 26

Base of axilla

Answer 26

Skin of armpit

Question 27

What makes up the brachial plexus?

Answer 27

Roots Trunks Divisions Cords Branches

Question 28

What spinal nerve roots form the brachial plexus?

Answer 28

Ventral rami of spinal nerves C5-T1

Question 29

Trunks of brachial plexus

Answer 29

Superior: C5-C6 Middle: C7 Inferior: C8-T1

Question 30

Divisions of brachial plexus

Answer 30

3 anterior 3 posterior

Question 31

Cords of brachial plexus

Answer 31

Medial, lateral posterior Formed by combination of anterior and posterior divisions

Question 32

Branches of brachial plexus

Answer 32

1. Musculocutaneous nerve (lateral cord) 2. Axillary (posterior cord) 3. Median (medial and lateral cord) 4. Radial (posterior cord) 5. Ulnar (medial cord)

Question 33

Musculocutaneous nerve

Answer 33

C5-C7 Motor innervation to anterior compartment of arm

Question 34

Axillary nerve

Answer 34

C5, C6 Motor innervation to deltoid and teres minor

Question 35

Median nerve

Answer 35

C6-T1 Motor innervation to most of muscles of anterior compartment of forearm and five intrinsic muscles of hand

Question 36

Radial nerve

Answer 36

C5-T1 Motor innervation to posterior compartment of arm and forearm

Question 37

Ulnar nerve

Answer 37

C8-T1 Motor innervation to 2 muscles of anterior compartment of forearm and most of intrinsic muscles of hand

Question 38

Posterior cord damage (radial and axillary nerve)

Answer 38

Paralysis of deltoid muscle (abduction) and muscles of posterior compartment of arm (extension)

Question 39

What arteries supply the upper limb?

Answer 39

1. Subclavian 2. Axillary 3. Brachial 4. Radial and ulnar

Question 40

Axillary artery damage symptoms

Answer 40

Bruising, swelling/redness, elevated temp, weak radial pulse

Question 41

What veins drain the upper limb?

Answer 41

Radial Ulnar Cephalic Basilic Medial cubital Brachial Axillary

Question 42

Radial vein

Answer 42

Drains blood from deep structures of palm and lateral aspect of forearm

Question 43

Ulnar vein

Answer 43

Drains blood from deep structures of palm and medial aspect of forearm

Question 44

Cephalic vein

Answer 44

Drains into axillary vein Begins at dorsum of hand and travels up lateral side of anterior forearm

Question 45

Basilic vein

Answer 45

Becomes axillary vein Begins on dorsum of hand, travels up medial side of anterior forearm

Question 46

Medial cubital vein

Answer 46

Connects basilic and cephalic veins at cubital fossa Where blood is drawn

Question 47

Brachial vein

Answer 47

Drains into axillary vein Receives blood from radial and ulnar veins

Question 48

Axillary vein

Answer 48

Becomes subclavian vein