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Clinical anatomy module 6 > module 6: lower extremity > Flashcards

module 6: lower extremity Flashcards

1
Q

clinical examples of surface anatomy

A

venous blood draw cubital fossa
radial artery – ABG test
carpal tunnel injection

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2
Q

bones of the distal UP of the humerus

A 
trochlea (T)
capitulum (C)
lateral vs medial epicondyle (LE/ME)
supracondylar ridge (SCR)
olecranon fossa (OF)
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3
Q

proximal end of the ulna contains what landmarks?

A 
olecranon (O)
trochlear notch (TN)
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4
Q

distal end fo ulna contains what landmarks

A

head of ulna (H)

styloid process of ulna (SPU)

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5
Q

distal end fo ulna contains what landmarks

A

head of ulna (H)

styloid process of ulna (SPU)

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6
Q

identify the proximal and distal landmarks of radius

A

proximal radius: head and neck

distal radius: styloid process of radius (SPR)

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7
Q

carpal bones in the proximal row

A

scaphoid (S)
lunate (L)
triquetrium (TQ)
pisiform (P)

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8
Q

carpal bones in the distal row

A 
trapezium (TM)
trapezoid (TD)
capitate (C)
hamate (H)
hook of hamate (HH)
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9
Q

carpal bones in the distal row

A 
trapezium (TM)
trapezoid (TD)
capitate (C)
hamate (H)
hook of hamate (HH)
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10
Q

elbow joint provides what kind of movements?

A

flexion and extension

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11
Q

what muscles are flexing the elbow joint?

A

biceps brachii, brachialis and brachioradialis

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12
Q

what muscle is extending the elbow joint

A

triceps

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13
Q

elbow joint articulations

A

humero-ulnar articulation and humero-radial articulation

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14
Q

elbow joint ligaments

A

ulnar collateral ligament - medial elbow
radial collateral ligament - lateral elbow
annular ligament - “loops” around radial head “anchored” to ulna

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15
Q

elbow joint ligaments

A

ulnar collateral ligament - medial elbow
radial collateral ligament - lateral elbow
annular ligament - “loops” around radial head “anchored” to ulna

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16
Q

clinical application for elbow joint

A
  • ulnar collateral ligament rupture (or becomes sprain/stretched)
  • “Tommy John surgery” - surgery reconstructs the ligament
  • grafts – palmaris longus tendon, gracilis tendon, hamstring, great toe extensor tendon, donor grafts (allograft)
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17
Q

cubital tunnel syndrome

A

ulnar nerve gets entrapped as it passes posterior to elbow and enters the forearm in cubital tunnel

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18
Q

elbow joint: radial head dislocation

A

radial head gets “pulled” out of annular ligament “socket”

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19
Q

olecranon bursitis

A

chronic pressure on elbow creates inflammation/swelling of olecranon bursa

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20
Q

forearm movements

A

supination and pronation

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21
Q

what muscles provide supination for the forearm

A
  • supinator muscle, biceps brachii

- rotate palm up

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22
Q

what muscles provide pronation for the forearm?

A
  • rotate palm down

- pronator teres, pronator quadratus

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23
Q

what muscles provide pronation for the forearm?

A
  • rotate palm down

- pronator teres, pronator quadratus

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24
Q

interosessous membrane of the forearm

A

“tough” connective tissue that serves as the floor of the forearm

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25
Q

sacciform recess of the forearm

A

continuation of joint capsule that extends under annular ligament

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26
Q

PRUJ (proximal radioulnar joint) of the forearm

A

head of radius articulates with ulna

radius “rotates” within annular ligament

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27
Q

DRUJ (distal radioulnar joint) of the forearm

A

head of ulna articulates with radius

TFCC “unites” distal radius and head of ulna

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28
Q

TFCC (triangular fibrocartilage complex)

A
  • attachments on styloid process of ulna and distal radius
  • provides stability and mobility
  • allows radius to “pivot” around the ulna during pronation/supination of the forearm
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29
Q

TFCC tear

A
  • rupture of TFCC often from FOOSH (fall on outstretched hand) injury
  • “pain and instability” of ulnar side of wrist
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30
Q

wrist provides what movements?

A

flexion
extension
ulnar deviation
radial deviation

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31
Q

collateral ligaments of wrist

A

ulnar collateral ligament (UCL)

radial collateral ligament (RCL)

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32
Q

radiocarpal ligaments of the wrist

A

dorsal radiocarpal ligament (DRCL)

palmer radiocarpal ligament (PRCL)

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33
Q

wrist provides what joint?

A

radiocarpal joint

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34
Q

hand provides what joints?

A 
MCP joints (metacarpophalangeal)
PIP joints (proximal interphalangeal)
DIP joints (distal interphalangeal)
IP joint of thumb (interphalangeal)
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35
Q

movements of the fingers

A

abduction/adduction of digits

flexion and extension of MCP, PIP and DIP joints

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35
Q

movements of the fingers

A

abduction/adduction of digits

flexion and extension of MCP, PIP and DIP joints

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36
Q

movements of the thumb

A

adduction/abduction
flexion/extension
opposition

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37
Q

muscles located in superficial layer of the anterior forearm

A

Pronator teres
Flexor carpi radialis
Palmaris longus
Flexor carpi ulnaris

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38
Q

muscles located in intermediate layer of the anterior forearm

A

Flexor digitorum superficialis (FDS

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39
Q

muscles located in deep layer of the anterior forearm

A

Flexor digitorum profunda
Flexor pollicis longus
Pronator quadratus

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40
Q

attachment/innervation/action of the pronator teres

A

attachments on med epicondyle and mid-radius
innervated by median nerve
action: pronate forearm with elbow in extension

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41
Q

attachment/innervation/action of the flexor carpi radials (FCR)

A

attachments on med epicondyle and 2nd metacarpal
innervated by median nerve
action: flex & radial deviate wrist

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42
Q

attachment/innervation/action of the palmaris longus (PL)

A

attachment on med epicondyle and then distal attachment blends with palmer carpal ligament & palmer aponeurosis

innervated by median nerve

action: flex wrist/hand

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43
Q

attachment/innervation/action of the FLEXOR CARPI ULNARIS (FCU)

A

attachments on med epicondyle and 5th metacarpal

innervated by ulnar nerve

action: flex & ulnar deviate wrist

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44
Q

attachment/innervation/action of the flexor digitorum superficialis (FDS)

A

proximal attachment on med epicondyle and distal attachment on middle phalanges

innervated by median nerve

action: flex PIP joints of fingers

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45
Q

attachment/innervation/action of the flexor digitorum superficialis (FDS)

A

prox attachment on med epicondyle
distal attachment on middle phalanges

innervated by median nerve

action: flex PIP joints of fingers

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46
Q

flexor digitorum profunda (FDP)

A

attachments on ulna/interosseous membrane and distal phalanges

innervated by two nerves
lateral ½ supplied by AIN
medial ½ supplied by ulnar nerve

action: flex DIP joints of fingers

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47
Q

attachment/innervation/action of the flexor digitorum profunda (FDP)

A

attachments on ulna/interosseous membrane and distal phalanges

innervated by two nerves
lateral ½ supplied by AIN
medial ½ supplied by ulnar nerve

action: flex DIP joints of fingers

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48
Q

attachment/innervation/action of the flexor pollicis longus (FPL)

A

attachments on radius/interosseous membrane and distal phalange of thumb

innervated by AIN

action: flex IP joint of thumb

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49
Q

attachment/innervation/action of the pronator quadrates (PQ)

A

attachments on distal radius and ulna

innervated by AIN

Action: pronate forearm

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50
Q

what are the “wrist flexors”

A

FCR and FCU (and PL)

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51
Q

what are the “long finger flexors”

A

FDS, FDP and FPL

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52
Q

what are the “pronators”

A

PT and PQ

53
Q

what does the median nerve supply?

A

supplies all muscles of superficial and intermediate layers EXCEPT the FCU

54
Q

what does the AIN of median nerve supply?

A

supplies all muscles of the deep layer EXCEPT ½ of the FDP

55
Q

what does the ulnar nerve supply ?

A

only supplies FCU and ½ FDP

56
Q

what does the ulnar nerve supply ?

A

only supplies FCU and ½ FDP

57
Q

where is the palmer carpal ligament located? what does it contain?
what is it a continuation of?

A

location: anterior wrist
Contains: all flexor tendons crossing the wrist
continuation of extensor retinaculum (ER) from the dorsal surface of the wrist

58
Q

posterior forearm “layers”

A

superficial and deep layer

59
Q

muscles located in superficial layer of the posterior forearm

A 
Brachioradialis
Extensor carpi radialis longus
Extensor carpi radialis brevis
Extensor digitorum
Extensor digiti minimi
Extensor carpi ulnaris
60
Q

muscles located in superficial layer of the posterior forearm

A 
Brachioradialis
Extensor carpi radialis longus
Extensor carpi radialis brevis
Extensor digitorum
Extensor digiti minimi
Extensor carpi ulnaris
61
Q

Muscles located in deep layer of the posterior forearm

A 
Extensor indices
Outcropping muscles
Extensor pollicis longus
Extensor pollicis brevis
Abductor pollicis longus
Supinator
62
Q

Muscles located in deep layer of the posterior forearm

A 
Extensor indices
Outcropping muscles
Extensor pollicis longus
Extensor pollicis brevis
Abductor pollicis longus
Supinator
63
Q

attachment/innervation/action of the brachioradialis

A

attachments on supracondylar ridge and distal radius
innervated by radial nerve
action: elbow flexion

63
Q

attachment/innervation/action of the brachioradialis

A

attachments on supracondylar ridge and distal radius
innervated by radial nerve
action: elbow flexion

64
Q

brachioradialis is deep tendon reflex for which C?

A

6

65
Q

attachment/innervation/action of the extensor carpi radials longus (ECRL)

A

attachments on supracondylar ridge and 2nd metacarpal
innervated by radial nerve
action: extend & radial deviate wrist

66
Q

attachment/innervation/action of the extensor carpi radialis brevis (ECRB)

A

attachments on lat epicondyle and 3rd metacarpal

innervated by deep branch of radial nerve

action: extend & radial deviate wrist

67
Q

attachment/innervation/action of the extensor digitorum (ED)

A

attachments on lat epicondyle and digits 2-4 (extensor expansion hood)

innervated by PIN

action: extend wrist

68
Q

innervation of the extensor digiti minimi (EDM)

A

innervated by PIN

69
Q

attachment/innervation/action of extensor carpi ulnaris (ECU)

A

attachments on lat epicondyle and 5th metacarpal
innervated by PIN
action: extend and ulnar deviate wrist

70
Q

attachment/innervation/action of the supinator

A

attaches to the lat epicondyle/ulna and then inserts into proximal radius
“wraps around the radius”

innervated by deep branch of radial nerve

action: supinate forearm

71
Q

innervation of the extensor indices (EI)

A

extensor indices (EI)

72
Q

attachment and innervation of the extensor policis longus (EPL)

A

distal attachment distal phalange of thumb

innervated by PIN

73
Q

attachment and innervation of the extensor policies brevis

A

distal attachment proximal phalange of thumb

innervated by PIN

74
Q

attachment and innervation of the abductor pollicis longus (APL)

A

distal attachment base 1st metacarpal

Innervated by PIN

75
Q

“wrist extensors” of the posterior forearm

A

ECRL, ECRB, ECU

76
Q

“finger extensors” of the posterior forearm

A

ED, EDM, EI

77
Q

“thumb extensors/abductors” of the posterior forearm

A

Outcropping muscles (EPL, APL, EPB)

78
Q

extensor retinaculum (ER)

A
  • located on posterior wrist
  • contains all extensor tendons
  • “continuation” of palmer carpal ligament from the palmer surface of the wrist
79
Q

attachment and innervation of the thenar muscles

A

attachments- the thenar group emerges from the flexor retinaculum and attaches to the thumb

innervation - median nerve

80
Q

attachment and innervation of the hypothenar muscles

A

attachments - the hypothenar group emerges from the flexor retinaculum and attach to the little finger

Innervation - ulnar nerve

81
Q

action and innervation of adductor pollicis (AP)

A

action - adduct thumb

innervation - ulnar nerve

82
Q

Action and innervation of the lumbricals (L)

A

action - flex MCP jt and extend PIP/DIP joint

innervation:
1 and 2 – median nerve
3 and 4 – ulnar nerve

83
Q

Action and innervation of the palmer interossei (PL)

A

action
“PAD” - adduction digits

innervation - ulnar nerve

84
Q

Action and innervation of the palmer interossei (PL)

A

action
“PAD” - adduction digits

innervation - ulnar nerve

85
Q

action and innervation of the dorsal interossei

A

action
“DAB” - Abduct digits

innervation
ulnar nerve

86
Q

action and innervation of the dorsal interossei

A

action
“DAB” - Abduct digits

innervation
ulnar nerve

87
Q 
flexor retinaculum (transverse carpal ligament)
what does it attach?
A

“roof” of the carpal tunnel

attaches “across” carpal bones
attaches from scaphoid/trapezium across carpal tunnel to hamate/pisiform

88
Q

median nerve in distal upper extremity

pathway

A

Descends through carpal tunnel to supply thenar and 1st two lumbricals in the hand

88
Q

median nerve in distal upper extremity

pathway

A

Descends through carpal tunnel to supply thenar and 1st two lumbricals in the hand

89
Q

motor supply of median nerve for the forearm

A

pronator teres, PL, FCR

FDS

90
Q

motor supply of median nerve of hand

A

thenar group and 1st two lumbricals

91
Q

motor supply of AIN branch from median nerve

A

½ of FDP, FPL, pronator quadratus

92
Q

motor supply of AIN branch from median nerve

A

½ of FDP, FPL, pronator quadratus

93
Q

sensory supply of median nerve

A

thenar side of the palmer surface of the hand

94
Q

ulnar nerve in distal upper extremity

A

Continues on to supply a majority of the intrinsic muscles of the hand

95
Q

motor supply of ulnar nerve

forearm

A

Flexor carpi ulnaris
½ Flexor digitorum profundus
the portion that supplies 4th and 5th digits

96
Q

motor supply of ulnar nerve hand

A

all intrinsic muscles of hand EXCEPT thenar and first two lumbricals

97
Q

motor supply of ulnar nerve hand

A

all intrinsic muscles of hand EXCEPT thenar and first two lumbricals

98
Q

sensory supply of ulnar nerve

A

palmer and dorsal surface of hypothenar area and 5th digit

99
Q

sensory supply of ulnar nerve

A

palmer and dorsal surface of hypothenar area and 5th digit

100
Q

radial nerve in distal upper extremity

A

After “passing through” supinator the deep branch is renamed the PIN (posterior interosseous nerve)

101
Q

motor supply of radial nerve and it’s branches in distal extremity

A

brachioradialis, ECRL, supinator, ECRB, ED, EDM, EI, ECU, EPL, APL, EPB

102
Q

supply of radial nerve in distal extremity

A

posterior web space of the hand

103
Q

major arteries of the distal UE

A 
Brachial artery (B)
Radial artery (R)
Ulnar artery (U)
104
Q

anastomosis of the elbow

deep artery of arm becomes

A

radial collateral

105
Q

brachial artery becomes the

A

superior and inferior ulna collateral branches

106
Q

ulna artery becomes the

A

ulna recurrent artery

107
Q

the radial artery becomes the

A

radial recurrent artery

108
Q

radial artery (R)

A
  • descends to wrist to form anastomosis with ulna artery

- travels posterior to the thumb to form deep palmer arch

109
Q

ulnar artery (U)

A

common interosseous artery (CIA) branches off from ulna artery and then gives off two branches
(anterior interosseous artery (AIA) and
posterior interosseous artery (PIA) )

ulna artery descends to the wrist to form anastomosis with radial artery

109
Q

ulnar artery (U)

A

common interosseous artery (CIA) branches off from ulna artery and then gives off two branches
(anterior interosseous artery (AIA) and
posterior interosseous artery (PIA) )

ulna artery descends to the wrist to form anastomosis with radial artery

110
Q

anastomosis of the hand

A

superficial palmer arch (SPA)

111
Q

deep palmer arch (DPA)

A

passes posterior to thumb

located on floor of palm

112
Q

deep venous pathway

A

deep veins “follow” arterial pathways

radial, ulnar, brachial, axillary and subclavian veins

113
Q

superficial venous pathway

A

Basilic vein (B)
Cephalic vein (C)
Median antebrachial vein (MAB)
Median cubital vein (MC)

114
Q

superficial venous pathway

A

Basilic vein (B)
Cephalic vein (C)
Median antebrachial vein (MAB)
Median cubital vein (MC)

115
Q

borders and content of the cubital tunnel

A

borders

  • Imaginary line between lateral and medial epicondyles
  • pronator teres
  • brachioradialis

content

  • median nerve
  • brachial artery as it divides into radial and ulna arteries
115
Q

borders and content of the cubital tunnel

A

borders

  • Imaginary line between lateral and medial epicondyles
  • pronator teres
  • brachioradialis

content

  • median nerve
  • brachial artery as it divides into radial and ulna arteries
116
Q

where is the cubital tunnel located

A
  • medial aspect of posterior elbow
  • entrance to the tunnel is formed by two heads of flexor carpi ulnaris
  • Ulnar nerve
117
Q

cubital tunnel syndrome

A
  • ulnar nerve becomes entrapped in cubital tunnel as it descends deep to
  • the flexor carpi ulnaris
  • pain and paresthesia on ulnar side of the hand
  • weakness of muscles in the hand
118
Q

Anatomical Snuff Box (border and content)

A

borders: EPL, EPB and APL
content: radial artery and superficial branch of radial nerve

119
Q

Anatomical Snuff Box (border and content)

A

borders: EPL, EPB and APL
content: radial artery and superficial branch of radial nerve

120
Q

Carpal Tunnel

borders and structures

A

borders

floor: carpal bones
roof: flexor retinaculum (FR)

structures
median nerve
tendons of “long finger flexors”
FDS, FDP and FPL

121
Q

Carpal Tunnel

borders and structures

A

borders

floor: carpal bones
roof: flexor retinaculum (FR)

structures
median nerve
tendons of “long finger flexors”
FDS, FDP and FPL

122
Q

carpal tunnel syndrome

A

median nerve becomes entrapped in the carpal tunnel
atrophy & weakness of thenar muscles
pain & paresthesia along palmer side of thumb/1st digit

122
Q

carpal tunnel syndrome

A

median nerve becomes entrapped in the carpal tunnel
atrophy & weakness of thenar muscles
pain & paresthesia along palmer side of thumb/1st digit

123
Q

Guyon’s Canal

borders and content

A

borders: pisiform and hook of hamate
content: Ulnar nerve

124
Q

Guyon’s Canal

borders and content

A

borders: pisiform and hook of hamate
content: Ulnar nerve

125
Q

Guyon’s canal syndrome

A
  • Ulnar nerve becomes entrapped in Guyon’s canal
  • muscle weakness of intrinsic hand muscles
  • test strength adductor pollicis to screen
  • atrophy of hypothenar, interossei and adductor pollicis (web space)
  • pain and paresthesia of ulnar side of the hand

Clinical anatomy module 6 (1 decks)

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