Morphological Plan of the Upper Limb Flashcards
1
Q
Tuberosity vs Tubercle - What is the difference?
A
- Tuberosity - large roughened area half way down shaft
- Tubercle - sit near head of bone - small and round prominence where connective tissues attach
2
Q
When your palm or forearm faces up, it’s …
A
When your palm or forearm faces up, it’s supinated.
3
Q
Muscles of the upper limb - Anterior Attachment of Upper limb to Trunk
- Pectorialis Major/Minor and Serratus Anterior - all originate from … wall
- Pectoralis Major:
- Attachments: sternum, medial portion of clavicle and costal cartilages
- Insertion of both heads is into the … … of the humerus (sits between greater and lesser tubercle of humerus)
- Adductor, flexor, medial rotator of the arm at glenohumeral joint
- Pectorialis Minor:
- Originates from …
- Inserts into … process of scapula
- … shoulder (moves forward)
- Serratus anterior
- Originates - …
- Insert into medial edge of …
- … shoulder and stablises …
A
- Pectorialis Major/Minor and Serratus Anterior - all originate from thoracic wall
- Pectoralis Major:
- Attachments: sternum, medial portion of clavicle and costal cartilages
- Insertion of both heads is into the intertubercular sulcus of the humerus (Intertubercular sulcus - sits between greater and lesser tubercle of humerus)
- Adductor, flexor, medial rotator of the arm at glenohumeral joint
- Pectorialis Minor:
- Originates from ribs 3,4,5
- Inserts into coracoid process of scapula
- protracts shoulder (moves forward)
- Serratus anterior
- Originates - upper eight ribs
- Insert into medial edge of scapula
- protracts shoulder and stablises scapula
4
Q
Ligaments of Vertebral Column
- They reinforce and stabilize …
- Limit … of …
A
- They reinforce and stabilize joints
- Limit range of movement
5
Q
Skeleton of Upper Limb
- Label the diagram
A
- Pectoral girdle - scapula and clavicle
- Humerus
- Radius
- Ulna
- Carpal bones (8)
- Metacarpals (5)
- Phalanges (14)
6
Q
Elbow joint
- … joint
- … forearm, … forearm
- … and … of palm
A
- hinged joint
- Flex forearm, extend forearm
- Pronation and Supination
7
Q
Intervertebral joints and discs
- Sit between bodies of vertebre
- Intervertebral joints are important for … bearing and …
- They are secondary … joints - joint surfaces seperated by block of … (intervertebral … - important for shock absorption)
A
- Sit between bodies of vertebreIntervertebral joints are important for weight bearing and strength
- Secondary cartilaginous joints - joint surfaces seperated by block of fibrocartilage (intervertebral disc - important for shock absorption)
8
Q
Multifidus
- Thickest in the … region - extends along whole length up towards cervical region
- … in shape
- Extends from … process to … process
- Contracts - helps to extend and rotate but most importantly … vertebral column
A
- Thickest in the lumbar region - extends along whole length up towards cervical region
- Triangular in shape
- Extends from transverse process to spinous process
- Contracts - helps to extend and rotate but most importantly stablising the vertebral column (maintains posture)
9
Q
Thoracic curve (T2-T12) is … anteriorly and is called thoracic … curve
A
Thoracic curve (T2-T12) is concaves anteriorly and is called thoracic kyphotic curve
10
Q
The shoulder joint is called the … joint
A
Glenohumeral
11
Q
Muscle Groups of Upper Limb
- As you move down the upper limb - … muscle groups -> to … muscle groups
A
As you move down the upper limb - course muscle groups -> to fine muscle groups
12
Q
Abduction is a movement … from the …
A
Abduction is a movement away from the midline – just as abducting someone is to take them away. For example, abduction of the shoulder raises the arms out to the sides of the body.
13
Q
Superficial back muscles
- Label the two shown
A
- Levator scapulae and Rhomboids minor/major
14
Q
Cervical curve (C2-T2) concaves …; laterally viewed looks like a inward curve which is called cervical … curve
A
Cervical curve (C2-T2) is concaves posteriorly; laterally viewed looks like a inward curve which is called cervical lordotic curve
15
Q
Latissimus Dorsi
- Large … muscle
- Originates mainly from our … fascia
- Spirals through a region called the axilla - inserts right into your … groove
- Adducts/extends/medially rotates …
A
- Large flat muscle
- Originates mainly from our thorocolumbar fascia
- Spirals through a region called the axilla(armpit) - inserts right into your bicipital groove (intertubercular sulcus between greater and lesser tubercle of humerus)
- Adducts/extends/medially rotates arm
16
Q
Deep Back Muscles (Intrinsic)
- Important for posture and moving vertebral column
- 3 layers
- … - most superficial (in the neck)
- … Spinae (main group)
- … (very deep)
A
- Important Posture and moving vertebral column
- 3 layers
- Splenius - most superficial (in the neck)
- Erector Spinae (main group)
- Multifidus (very deep)
17
Q
Opposition and Reposition
- Define both
A
- Opposition brings the thumb and little finger together.
- Reposition is a movement that moves the thumb and the little finger away from each other, effectively reversing opposition.
18
Q
How many phalanges are there? (upper limb)
A
14
19
Q
The glenohumeral joint (Shoulder joint) is a type of … joint
A
ball and socket joint
20
Q
Clinical: Intervertebral disc
- Disc …
- You may get a tear in the annulus fibrosus which can cause the nucleus pulposus to … out and impinge on …
- These are often caused by what?
A
- Disc protrusion
- You may get a tear in the annulus fibrosus which can cause the nucleus pulposus to herniate out and impinge on nerves
- lifting heavy objects can cause this to happen
21
Q
What ligament of the vertebral column resists hyperextension?
A
Anterior longitudinal ligament
22
Q
Flexion/Extension
- Define both
A
- Flexion refers to a movement that decreases the angle between two body parts
- Extension refers to a movement that increases the angle between two body parts.
23
Q
Trapezius - Upper muscle fibres enable … of scapula
A
Upper fibres enable elevation of scapula
24
Q
Sacral curve (sacrovertebral articulation - coccyx) is … forward and is called sacral … curve
A
Sacral curve (sacrovertebral articulation - coccyx) is concave forward and is called sacral kyphotic curve
25
_Muscles of the upper limb - Forearm_
* Anterior, **...** compartment:
* **...** of wrist or digits
* Most come from **...** epicondyle
* Posterior, **...** compartment:
* **...** of wrist or digits
* Most come from **...** epicondyle
* Anterior**, Flexor** compartment:
* **Flexion** of wrist or digits
* Most come from **medial** epicondyle
* Posterior - **extensor** compartment:
* **Extension** of wrist or digits
* Most come from **lateral** epicondyle
26
How many carpal bones are there?
8
27
Ulnar tuberosity forms the muscular attachment of the ... muscle
ulnar tuberosity forms the muscular attachment of the **brachialis** muscle
28
_Anatomical evolution of the Upper Limb_
* Changes to the foot, hip, knee, vertebral column, skull
* Longer ...
* ..nation/..ination
* ... thumb
* These changes have enabled us to mechanically ... with our environment
* Changes to the foot, hip, knee, vertebral column, skull
* Longer **clavicles**
* **Pronation/Supination (palm down/palm up)**
* **Opposable** thumb (for gripping objects)
* These changes have enabled us to mechanically **interact** with our environment
29
_Muscles of the back_
* Extrinsic muscles (move upper limbs/ribs)
* These are ... and ...
* Intrinsic muscles (postural/move vertebral column)
* These are ...
* Extrinsic muscles (move upper limbs/ribs)
* **Superficial and intermediate**
* Intrinsic muscles (postural/move vertebral column)
* **Deep**
30
_Ligaments of the Vertebral Column_
* Name each ligament (red, purple, light blue, green, yellow)
* Which ones resist hyperextension, and which ones resist hyperflexion?
* red - anterior longitudinal ligament - resists hyperextension
* purple - posterior longitudinal ligament - resists hyperflexion
* light blue - ligamentum flava/flavum - resists hyperflexion
* green - intraspinous ligament - resists hyperflexion
* yellow - supraspinous ligament - resists hyperflexion
31
Whiplash can cause tearing of what ligament in the vertebral column?
* Clinical: Injury to **anterior longitudinal ligament** following whiplash
32
_Nerve Supply of Back Muscles_
* Anterior Primary Ramus
* Supplies all of ... muscles - mainly from cervical spinal nerves
* But ... muscle is supplied by 11th cranial nerve - accessory nerve
* Posterior Primary Ramus
* Supplies all of the ... muscles
_Nerve Supply of Back Muscles_
* Anterior Primary Ramus
* Supplies all of **extrinsic** muscles - mainly from cervical spinal nerves
* But **trapezius** muscle is supplied by 11th cranial nerve - accessory nerve
* Posterior Primary Ramus
* Supplies all of the **intrinsic** muscles
33
_Movements of the vertebral column_
* Flexion/extension
* Lateral flexion/lateral extension
* Rotation
34
_Muscles of the upper limb - Arm_
* **Flexors**:
* ... - comes from coracoid process - insert into proximal part of shaft of humerus - flex your arm at glenohumeral joint
* ... brachii - two heads (short from coracoid process, long head from just above glenoid fossa) Muscle bellies -\> insert into radial tuberocity - important flexor of the arm at glenohumeral joint and flexor of forearm at elbow joint
* ... - coming from anterior part of humerus (distal) inserts into ulna tuberosity - flexor of forearm at elbow joint
* **Extensors**:
* ... brachii - three heads - long - just below glenoid fossa - medial head - medial side of humerus lateral head - lateral side of humerus - 3 muscle bellies come together to insert into olecranon
* **Flexors**:
* **Coracobrachialis** - comes from coracoid process - insert into proximal part of shaft of humerus - flex your arm at glenohumeral joint
* **Biceps** Brachii - two heads (short from coracoid process, long head from just above glenoid fossa) Muscle bellies -\> insert into radial tuberocity - important flexor of the arm at glenohumeral joint and flexor of forearm at elbow joint
* **Brachialis** - coming from anterior part of humerus (distal) inserts into ulna tuberosity - flexor of forearm at elbow joint
* **Extensor**:
* **Triceps** brachii - three heads - long - just below glenoid fossa - medial head - medial side of humerus lateral head - lateral side of humerus - 3 muscle bellies come together to insert into olecranon
35
_Limb movements_
* Flexion/Extension
* Abduction/Adduction
* Lateral/Medial rotation
* Pronation/Spination
* Circumduction
* Opposition
36
... brings the thumb and little finger together.
**Opposition** brings the thumb and little finger together.
37
The glenoid fossa articulates at the head of the ...
humerus
38
_Pronation/Supination_
* Define both
* Supination and pronation are terms used to describe the up or down orientation of your hand, arm, or foot.
* When your palm or forearm faces up, it's supinated.
* When your palm or forearm faces down, it's pronated
39
_Trapezius muscle - Fibres_
* The trapezius is responsible for moving and rotating our ...
* Upper fibres enable elevation
* Lower fibres enable depression
* Middle fibres enable retraction
* The trapezius is responsible for moving and rotating our **scapula**
* Upper fibres enable **elevation**
* Lower fibres enable **depression**
* Middle fibres enable **retraction**
40
When your palm or forearm faces down, it's ...
When your palm or forearm faces down, it's **pronated**
41
_Ligaments - Anterior to body of Vertebral Column_
* Anterior ... ligament
* Limits amount of ... (resists hyper...)
* Anterior **longitudinal** ligament
* Limits amount of **extension** (resists **hyperextension**)
42
Lumbar facet joints are wrapped and allow for what movements? (and prevent what?)
Flexion/Extension, no rotation
43
_Ligaments of the Vertebral Column_
* Name each ligament (red, purple, light blue, green, yellow)
* Which ones resist hyperextension, and which ones resist hyperflexion?
* red - anterior longitudinal ligament - resists hyperextension
* purple - posterior longitudinal ligament - resists hyperflexion
* light blue - ligamentum flava/flavum - resists hyperflexion
* green - intraspinous ligament - resists hyperflexion
* yellow - supraspinous ligament - resists hyperflexion
44
_Parts of the Intervertebral Disc_
* The intervertebral disc is made up of two components: the Annulus Fibrosus and the Nucleus Pulposus.
* Which one is the Semi-fluid core of the disc? (Absorbs compression)
* Which one is the outer region made up of fibrocartilage? (strong)
* The intervertebral disc is made up of two components: the Annulus Fibrosus and the Nucleus Pulposus.
* Which one is the Semi-fluid core of the disc? (Absorbs compression) **- Nucleus Pulposus.**
* Which one is the outer region made up of fibrocartilage? (strong) **- Annulus Fibrosus**
45
What are the secondary curvatures of the vertebral column?
Secondary curvatures are the cervical and lumbar curvatures - they concave posteriorly and convex anteriorly, being referred to as lordoses (singular: lordosis).
46
Ligamentum ...: Connects the laminae of adjacent vertebra
Ligamentum **flavum**: Connects the laminae of adjacent vertebra
47
_Erector Spinae_
* Can be divided into three muscle blocks - all which originate from erector spinae ...
* Can be divided into three muscle blocks - all which originate from erector spinae **aponeurosis**
48
Extensor muscles of the forearm - anterior or posterior? medial or lateral epicondyle?
Extensor muscles of the forearm - anterior or **posterior**? medial or **lateral** epicondyle?
49
What is a Tuberosity?
Tuberosity - large roughened area half way down shaft
50
Lateral rotation is a rotating movement ... from the midline
Lateral rotation is a rotating movement away from the midline
51
Intervertebral disc thickness ... down the vertebral column
Intervertebral disc thickness **increases** down the vertebral column
52
Lumbar curve (T12 - sacrovertebral angle) concaves ... and is called lumbar ... curve
Lumbar curve (T12 - sacrovertebral angle) is concaves **posteriorly** and is called lumbar **lordotic** curve
53
_Erector Spinae_
* Can be divided into three muscle blocks - all which originate from erector spinae aponeurosis
* Most lateral - ... - inserts into ribs
* Intermediate - ... - inserts into transverse processes
* Medial - ... - inserts into spinous processes
* Can be divided into three muscle blocks - all which originate from erector spinae aponeurosis
* Most lateral - **Iliocostalis** - inserts into ribs
* Intermediate - **Longissimus** - inserts into transverse processes
* Medial - **Spinales** - inserts into spinous processes
54
_Curves of the vertebral column_
* How many curvatures?
* Which ones form first (primary) during fetal development? (what are they called?)
* Which ones form after (secondary) and help during childhood? (what are they called?)
* What are the curvatures important for? (3)
* **4 curvatures:**
* **Primary (Fetal) - Kyphoses - Thoracic and Sacral** (The thoracic spine and sacrum both curve outward referring to the term kyphosis) fetal adopts flexed posture
* **Secondary (Childhood) - Lordoses - Cervical and Lumbar** - enable a child to move from crawling to walking
* Important for:
* **Bipedalism**
* **Shock absorption**
* **Flexibility**
55
Intervertebral discs are ... absorbers
Intervertebral discs are **shock** absorbers
56
_Scapular and Humerus_
* Scapular:
* Has ... angle and an ... angle. Also has a ....
* 2 bony prominences - ... (continuous with ...) & ...
* ... fossa articulates at humerus (head of humerus)
* Humerus:
* 2 dotted lines represent the ... neck (top line) of humerus and ... neck (bottom line - more prone to injury than other neck)
* Between the two necks we have the ... tubercle and the ... tubercle (muscles attach onto these)
* Halfway down the shaft we have a deltoid ... - deltoid muscle attaches here
* Distal end of bone - ...
* 2 - called the ... ... and ... ...
* Scapular:
* Has **superior** angle and an **inferior** angle. Also has a **spine**.
* 2 bony prominences - **Acromion** (continuous with spine) & **Coracoid**
* **Glenoid** fossa articulates at humerus (head of humerus)
* Humerus:
* 2 dotted lines represent the **anatomical** neck (top line) of humerus and **surgical** neck (bottom line - more prone to injury than anatomical neck)
* Between the two necks we have the **greater** tubercle and the **lesser** tubercle (muscles attach onto these)
* Halfway down the shaft we have a deltoid **tuberosity** - deltoid muscle attaches here
* Distal end of bone - **epicondyles**
* 2 - **Lateral epicondyle and Medial epicondyle**
57
Flexion refers to a movement that ... the angle between two body parts.
Flexion refers to a movement that decreases the angle between two body parts.
58
Nucleus ... is the core - semi-fluid portion of intervertebral disc
Nucleus **pulposus** is the core - semi-fluid portion of intervertebral disc
59
What muscle is this?
Latissimus dorsi
60
Facet joints are what type of joint?
Synovial
61
_Muscles of the upper limb - Posterior Attachment of Upper limb to Trunk_
* Posteriorly, we have ... back muscles - originate from ... column
* Posteriorly, we have **superficial** back muscles - originate from **vertebral** column
62
The olecranon is a large bony prominence at the ... end of the ...
The olecranon is a large bony prominence at the **proximal** end of the **ulna**
63
_Shoulder Joint - (... joint)_
* The shoulder joint is formed by the articulation of the head of the ... with the ... cavity (or fossa) of the ...
* ... and ... joint
* Highly mobile: we can:
* F..
* E..
* A..
* A..
* all together = C...
* ... rotate
* ... rotate
* The shoulder joint is formed by the articulation of the head of the **humerus** with the **glenoid** cavity (or fossa) of the **scapula**
* **Ball and Socket joint**
* Highly mobile: we can:
* **Flex**
* **Extend**
* **Abduct**
* **Adduct**
* **all together = circumduct**
* **Laterally rotate**
* **Medially rotate**
64
Thoracic facet joints are near vertical and allow for what movements? (and prevent what?)
allow for rotation, permits flexion and extension
65
Degeneration of what joints can cause back pain?
facet joints
66
_Muscles of the back_
* ... muscles (move ... .../...)
* These are **Superficial and intermediate**
* ... muscles (postural/move ... ...)
* These are **Deep**
* Extrinsic muscles (move **upper limbs/ribs**)
* **Superficial and intermediate**
* Intrinsic muscles (**postural/move vertebral column**)
* **Deep**
67
Intervertebral discs are at their thickest where along the vertebral column?
the bottom - lumbar spine - more weight bearing here
68
_Wrist and Hand Joints_
* Wrist - ... joint
* Extend hand, flex hand, abduct, adduct (all - circumduct)
* ... joint (is present between the proximal and distal carpal bones of the wrist.)
* ... joint (form the articulation between the distal row of carpal bones and the bases of the five metacarpal bones)
* Thumb ... - ... Joint - (very mobile articulation between the trapezium and the base of the first metacarpal) - flex, extend, adduct, abduct, opposition, reposition
* ... joints - The metacarpophalangeal joints (MCP) are situated between the metacarpal bones and the proximal phalanges of the fingers (knuckles) - condyloid joint - flex, extend, adduct (bringing fingers together), abduct (spreading finger)
* ... joints - simple hinge joints - flex and extend - There are two sets in each finger (except in the thumb, which has only one joint)
* Wrist - **Radiocarpal** joint
* Extend hand, flex hand, abduct, adduct (all - circumduct)
* **Midcarpal** joint (is present between the proximal and distal carpal bones of the wrist.)
* **Carpometacarpal** joint (form the articulation between the distal row of carpal bones and the bases of the five metacarpal bones)
* Thumb **carpometacarpal** - **Saddle** Joint - (very mobile articulation between the trapezium and the base of the first metacarpal) - flex, extend, adduct, abduct, opposition, reposition
* **Metacarpophalangeal** joints - The metacarpophalangeal joints (MCP) are situated between the metacarpal bones and the proximal phalanges of the fingers (knuckles) - condyloid joint - flex, extend, adduct (bringing fingers together), abduct (spreading finger)
* **Interphalangeal** joints - simple hinge joints - flex and extend - There are two sets in each finger (except in the thumb, which has only one joint)
69
_Ligaments of the Vertebral Column_
* Name each ligament (red, purple, light blue, green, yellow)
* Which ones resist hyperextension, and which ones resist hyperflexion?
* red - anterior longitudinal ligament - resists hyperextension
* purple - posterior longitudinal ligament - resists hyperflexion
* light blue - ligamentum flava/flavum - resists hyperflexion
* green - intraspinous ligament - resists hyperflexion
* yellow - supraspinous ligament - resists hyperflexion
70
_Trapezius_
* Largest superficial back muscle - ... shaped
* Origin - from ... and ... spinous processes
* Inserts into spine of scapula, acromion and lateral portion of ...
* Divided into upper fibres, middle fibres, lower fibres
* Moves and rotates scapula (upper fibres enable ..., lower fibres enable ... of scapula, middle fibres enable ... of scapula)
* Largest superficial back muscle - **diamond** shaped
* Origin - from **cervical** and thoracic spinous processes
* Inserts into spine of scapula, acromion and lateral portion of **clavicle**
* Divided into upper fibres, middle fibres, lower fibres
* Moves and rotates scapula (upper fibres enable **elevation**, lower fibres enable **depression** of scapula, middle fibres enable **retraction** of scapula)
71
_Facet joints_
* Joints ... vertebral arches
* ... joints
* Movement of these depends upon joint angle:
* ... - slight slope (permits flexion/extension/rotation)
* ... - near vertical (permits rotation but prevents flexion/extension)
* ... - Wrapped (permits flexion/extension but prevents rotation)
* Clinically: Degeneration of facet joints can cause ... ...
* Joints **between** vertebral arches
* **Synovial** joints
* Movement of these depends upon joint angle:
* **Cervical** - slight slope (permits flexion/extension/rotation)
* **Thoracic** - near vertical (permits rotation but prevents flexion/extension)
* **Lumbar** - Wrapped (permits flexion/extension but prevents rotation)
* Clinically: Degeneration of facet joints can cause **back pain**
72
Label the Facet Joints (Thoracic/Cervical/Lumbar?)
* 1 = Cervical
* 2 = Thoracic
* 3 = Lumbar
73
Trapezius - Middle fibres enable ... of scapula
Middle fibres enable **retraction** of scapula
74
_Ligaments - Posterior to body of Vertebral Column_
* Posterior ... ligament
* Ligamentum ...
* Limits amount of ... - resists hyper...
* Posterior **longitudinal** ligament
* Ligamentum **flava**
* Limits amount of **flexion** - resists **hyperflexion**
75
_Abduction/Adduction_
* Define both
* Abduction is a movement away from the midline – just as abducting someone is to take them away. For example, abduction of the shoulder raises the arms out to the sides of the body.
* Adduction is a movement towards the midline. Adduction of the hip squeezes the legs together.
76
What are the primary curvatures of the vertebral column?
Primary curvatures are the thoracic and sacral (pelvic) curvatures - they concave anteriorly and are referred to as kyphoses (singular: kyphosis).
77
Most mammals are quadrapedal, but humans are ...
bipedal - free upper limb
78
Metacarpal D1 refers to the ... and D5 refers to the ...
Metacarpal D1 refers to the **thumb** and D5 refers to the **little finger**
79
The elbow joint is a ... joint
hinged joint
80
_Scapular and Humerus_
* Label the diagram
81
Flexor muscles of the forearm - anterior or posterior? medial or lateral epicondyle?
Flexor muscles of the forearm - **anterior** or posterior? **medial** or lateral epicondyle?
82
Extension refers to a movement that ... the angle between two body parts
Extension refers to a movement that increases the angle between two body parts
83
_Lateral/Medial Rotation_
* Define both
* Medial rotation is a rotational **movement towards** the midline. It is sometimes referred to as internal rotation. To understand this, we have two scenarios to imagine. Firstly, with a straight leg, rotate it to point the toes inward. This is medial rotation of the hip. Secondly, imagine you are carrying a tea tray in front of you, with elbow at 90 degrees. Now rotate the arm, bringing your hand towards your opposite hip (elbow still at 90 degrees). This is internal rotation of the shoulder.
* Lateral rotation is a rotating **movement** **away** from the midline. This is in the opposite direction to the movements described above.
84
Cervical facet joints have a slight slope and allow for what movements?
flexion/extension/rotation of neck region
85
What 2 superficial back muscles sit behind the trapezius?
Levator scapulae and Rhomboids (minor and major)
86
* The hypothenar muscles produce the hypothenar ... – a muscular protrusion on the medial side of the palm, at the base of the ... finger.
* These muscles are similar to the ... muscles in both name and organisation.
* The hypothenar muscles produce the hypothenar **eminence** – a muscular protrusion on the medial side of the palm, at the base of the **little** finger.
* These muscles are similar to the **thenar** muscles in both name and organisation.
87
What is the name for the membrane holding the radius and ulna together? (Forearm)
**interosseous** membrane
88
An intervertebral disc (or intervertebral fibrocartilage) lies between adjacent vertebrae in the vertebral column. Each disc forms a ... joint (a symphysis), to allow slight ... of the vertebrae, to act as a ligament to hold the vertebrae together, and to function as a ... absorber for the spine
An intervertebral disc (or intervertebral fibrocartilage) lies between adjacent vertebrae in the vertebral column. Each disc forms a **fibrocartilaginous** joint (a symphysis), to allow slight **movement** of the vertebrae, to act as a ligament to hold the vertebrae together, and to function as a **shock** absorber for the spine
89
Latissimus dorsi muscle .../.../... rotates the arm
Latissimus dorsi muscle **adducts/extends/medially** rotates the arm
90
_Brachioradialis_
* Origin - lateral side of ...
* Inserts into ... ... process
* ... your forearm at elbow joint when half ... (allows you to pick up a glass and move towards your mouth)
* Origin - lateral side of **humerus**
* Inserts into **Radial styloid** process
* **Flex** your forearm at elbow joint when half **pronated** (allows you to pick up a glass and move towards your mouth)
91
_Muscles of the upper limb - Hand_
* ... muscles - \> enable you to move your thumb (D...)
* ... muscles - \> enables you to move your little finger (D...)
* **Thenar** muscles - \> enable you to move your thumb **(D1)**
* **Hypothernar** muscles - \> enables you to move your little finger **(D5)**
92
How many metacarpals are there? (upper limb)
5
93
Curvatures of vertebral column are important for Bi..., ... absorption and f....
Curvatures of vertebral column are important for Bi**pedalism**, **shock** absorption and **flexibility**
94
At the Distal end of forearm, there are two processes (one of the radius, one of the ulna) what are they called?
Styloid Process of radius, Styloid Process of ulna
95
_Superficial back muscles_
* How many are there?
* What do the attach together?
* There are **4** superficial back muscles
* Attach **upper limb to trunk**
96
What ligaments of the vertebral column resists hyperflexion?
Posterior longitudinal ligament and ligamentum flava, also have Interspinous ligaments (Connects the spinous processes of adjacent vertebrae) and Supraspinous ligaments (Connects the tips of adjacent spinous processes)
97
_Circumduction_
* Define
Circumduction can be defined as a conical movement of a limb extending from the joint at which the movement is controlled.
98
The Intrinsic back muscles are deep - they do what?
postural/move vertebral column
99
thoracolumbar fascia separates what muscles?
Extrinsic and Intrinsic muscles of the back
100
_Arrangement of upper limb_
* Surface anatomy of the Upper limb - List in order (starting with shoulder - most proximal to most distal)
* As you move down the upper limb - ... muscle groups -\> to ... muscle groups
* Shoulder
* Arm
* Elbow
* Forearm
* Wrist
* Hand
* As you move down the upper limb - **course** muscle groups -\> to **fine** muscle groups
101
The Extrinsic muscles and Intrinsic muscles of the back are separated by what?
**thoracolumbar fascia**
102
_Functional Compartments - Muscles of Upper Limb_
* The (upper) arm muscles are a group of five muscles located in the region between the shoulder and elbow joints.
* They are divided into two distinct compartments of the arm. The anterior (...) compartment and the posterior (...) compartment.
* The (upper) arm muscles are a group of **five** muscles located in the region between the shoulder and elbow joints.
* They are divided into two distinct compartments of the arm. The anterior (**flexor**) compartment and the posterior (**extensor**) compartment.
103
What is a Tubercle?
Tubercle - sit near head of bone - small and round prominence where connective tissues attach
104
_Thenar Muscles_
* How many thenar muscles are there?
* They produce a bulge known as ...
* What are they responsible for?
* The thenar muscles are **three** short muscles located at the base of the thumb.
* The muscle bellies produce a bulge, known as the **thenar eminence**
* They are responsible for the **fine movements of the thumb.**
105
Main function of latissimus dorsi is ...
adduction of arm
106
_Muscles of the upper limb - Shoulder Joint_
* ... muscle - large, delta shaped muscle
* Origin - ... of scapula, a... and lateral part of ...
* Insertion - ... ... (halfway down humerus)
* It is a powerful ...
* Divided into anterior, middle, posterior - allow flexion of arm and extension of arm, medial and lateral rotation
* anterior part - allows flexion of arm and medial rotation
* posterior part - extension and lateral roation
* ... cuff muscles
* ... major - cylindrical - shape of muscle
* **Deltoid** muscle - large, delta shaped muscle
* Origin - **spine** of **scapula**, **a****cromion and lateral part of clavicle**
* Insertion - **Deltoid tuberosity** (halfway down humerus)
* Powerful **Abductor**
* Divided into anterior, middle, posterior - allow flexion of arm and extension of arm, medial and lateral rotation
* anterior part - allows flexion of arm and medial rotation
* posterior part - extension and lateral roation
* **Rotator** cuff muscles
* **Teres** major - cylindrical - shape of muscle
107
_Radius and Ulna (forearm)_
* In the anatomical position - Laterally is the **radius**, medially is the **ulna**
* Proximal part of forearm:
* At the proximal end of the ulna - bony point called the ...
* At the proximal end of the radius - ... radial ... articulates against the ulner
* 2 proximal ... on forearm - the radial ... (bicep muscle inserts here) and ulna ... (brachialis muscle inserts here)
* Between the radius and ulna - ... membrane - holds bones together
* Distal end of forearm:
* ... process of radius (brachioradialis muscle attaches here)
* ... process of the ulna.
* In the anatomical position - Laterally is the **radius**, medially is the **ulna**
* Proximal part of forearm:
* At the proximal end of the ulna - bony point called the **olecranon**
* At the proximal end of the radius - **rounded radial head** articulates against the ulner
* 2 proximal **tuberosity** on forearm - the radial **tuberosity** (bicep mulscle inserts here) and ulna **tuberosity** (brachialis muscle inserts here)
* Between the radius and ulna - **interosseous** membrane - holds bones together
* Distal end of forearm:
* **Styloid** process of radius (brachioradialis muscle attaches here)
* **Styloid** process of the ulna.
108
_Upper limb_
* How many bones?
* How many muscles?
* ... plexus
* Major vessels
* **32 bones**
* **57 muscles**
* **Brachial** plexus
* Major vessels
109
_Erector Spinae_
* Label the 3 muscle blocks
* Blue - most lateral - **iliocostalis** - inserts into ribs
* Green- intermediate - **longissimus** - inserts into transverse processes
* Red - most medial - **spinales** - inserts into spinous processes
110
The Extrinsic back muscles are superficial and intermediate - they move what?
upper limbs/ribs
111
The upper limb has ... bones and ... muscles
The upper limb has **32** bones and **57** muscles
112
... is a movement that moves the thumb and the little finger away from each other, effectively reversing opposition.
Reposition is a movement that moves the thumb and the little finger away from each other, effectively reversing opposition.
113
_Levator Scapulae_
* Sits behind ...
* ... scapula (like the upper fibre's of trapezius)
* Originates from the upper ... vertebrae
* Inserts into ... angle of the scapula
* Sits behind **trapezius**
* **Elevates** scapula (like the upper fibre's of trapezius)
* Originates from the upper **cervical** vertebrae
* Inserts into **superior** angle of the scapula
114
Medial rotation is a rotational movement ... the midline. It is sometimes referred to as ... rotation.
Medial rotation is a rotational movement **towards** the midline. It is sometimes referred to as **internal** rotation.
115
Just below the head and neck of the radius is the radial ..., which is an oval-shaped convexity upon which the ... ... inserts.
Just below the head and neck of the radius is the radial **tuberosity**, which is an oval-shaped convexity upon which the **biceps brachii** inserts.
116
Facet joints are joints between ...
vertebral arches
117
Trapezius - Lower fibres enable ... of scapula
Lower fibres enable **depression of scapula**
118
_Evolution of the upper limb_
* Most mammals are ... - This is important for: L... and C...
* Man has evolved - we are ... (which frees our upper limb)
* Most mammals are **Quadrapedal** - This is important for: **Locomotion and climbing**
* Man has evolved - we are **Bipedal** (which frees our upper limb)
119
How many muscles in the upper limb?
57 muscles
120
_Rhomboids (Minor and major)_
* Originate from lower cervical (C7) to ... thoracic spinous process
* Insert into ... border of our scapula
* ... the scapula (like the middle fibres of trapezius)
* Originate from lower cervical to **5th** thoracic spinous process
* Insert into **medial** border of our scapula
* **Retract** the scapula (like middle fibres of trapezius) unlike pec minor and serratus anterior which protract the scapula
121
Prominent ridge on the scapula is known as the ... of scapula
spine of scapula
122
_Ligaments of Vertebral Column_
* Label the ligaments
* Arrow on left = anterior longitudinal ligament
* Arrow on top right = posterior longitudinal ligament
* (Both Long ligaments that run the length of the vertebral column, covering the vertebral bodies and intervertebral discs)
* Arrow on bottom right = ligamentum flava (Connects the laminae of adjacent vertebrae)
123
_Superficial back muscles_
* Label the two shown
* Top is trapezius, bottom is latissimus dorsi
124
_Wrist and hand_
* There are ... carpal bones in two rows of ... (proximal and distal)
* Each bone has a different name
* ... metacarpals - D... is the Thumb, D... is the little finger
* There are **8** carpal bones in two rows of **4** (proximal and distal)
* Each bone has a different name
* **5** metacarpals - **D1** is the Thumb, **D5** is the little finger
125
How many bones in the upper limb?
32
126
Adduction is a movement ... the midline
Adduction is a movement **towards** the midline. Adduction of the hip squeezes the legs together.
127
Define proximal
proximal means closer to its origin
128
Define distal
distal means further away from it's origin
129
... Fibrosis is the outer, strong part of the intervertebral disc
**Annulus** Fibrosis is the outer, strong part of the intervertebral disc
130
Three flexor muscles are found in the anterior compartment of the arm. One of these muscles is a flexor at the shoulder joint (...), one a flexor at the elbow joint (...), and the third is a flexor at both the shoulder and elbow joint (... Brachii).
Three flexor muscles are found in the anterior compartment of the arm. One of these muscles is a flexor at the shoulder joint (**Coracobrachialis**), one a flexor at the elbow joint (**Brachialis**), and the third is a flexor at both the shoulder and elbow joint (**Biceps** Brachii).
131
_Biceps Brachii_
* This muscle, as its name suggests, has two heads.
* The long head has an origin from the ... tubercle of the scapula, and the short head from the ... process of the scapula.
* The two heads of biceps unite to form a large muscle that inserts by a flattened tendon into the tuberosity of the radius
* . An expansion of the tendon of biceps, the bicipital ..., crosses medially over the superficial flexors of the forearm and attaches to the posterior border of the ulna via the deep fascia.
* This muscle, as its name suggests, has two heads.
* The long head has an origin from the **supraglenoid** tubercle of the scapula, and the short head from the **coracoid** process of the scapula.
* The two heads of biceps unite to form a large muscle that inserts by a flattened tendon into the tuberosity of the radius
* An expansion of the tendon of biceps, the bicipital **aponeurosis**, crosses medially over the superficial flexors of the forearm and attaches to the posterior border of the ulna via the deep fascia.
132
_Biceps Brachii_
* This muscle, as its name suggests, has two heads.
* The long head has an origin from the supraglenoid ... of the scapula, and the short head from the coracoid process of the scapula.
* The two heads of biceps unite to form a large muscle that inserts by a flattened tendon into the tuberosity of the ...
* An expansion of the tendon of biceps, the bicipital aponeurosis, crosses medially over the superficial flexors of the forearm and attaches to the posterior border of the ... via the deep fascia.
* This muscle, as its name suggests, has two heads.
* The long head has an origin from the supraglenoid **tubercle** of the scapula, and the short head from the coracoid process of the scapula.
* The two heads of biceps unite to form a large muscle that inserts by a flattened tendon into the tuberosity of the **radius**
* An expansion of the tendon of biceps, the bicipital aponeurosis, crosses medially over the superficial flexors of the forearm and attaches to the posterior border of the **ulna** via the deep fascia.
133
_Coracobrachialis_
* Coracobrachialis is much ... than biceps.
* It has the same origin as the ... head of biceps; the ... process of the scapula. Thus the short head of biceps and the tendon of coracobrachialis have a common origin, which forms a conjoint tendon.
* The muscle inserts into the ... aspect of the humerus half way down the shaft.
* Coracobrachialis is much **smaller** than biceps.
* It has the same origin as the **short** head of biceps; the **coracoid** process of the scapula. Thus the short head of biceps and the tendon of coracobrachialis have a common origin, which forms a conjoint tendon.
* The muscle inserts into the **medial** aspect of the humerus half way down the shaft. Locate coracobrachialis which lies medial to biceps and follow it to its origin and insertion. Identify the coracoid process of the scapula.
134
_Coracobrachialis_
* Coracobrachialis is much smaller than biceps.
* It has the same origin as the short head of biceps; the coracoid process of the scapula. Thus the short head of biceps and the tendon of coracobrachialis have a common origin, which forms a conjoint tendon.
* The muscle inserts into the medial aspect of the humerus half way down the shaft.
* Coracobrachialis is much smaller than biceps.
* It has the same origin as the short head of biceps; the coracoid process of the scapula. Thus the short head of biceps and the tendon of coracobrachialis have a common origin, which forms a conjoint tendon.
* The muscle inserts into the medial aspect of the humerus half way down the shaft.
135
What is the function of the coracobrachialis muscle?
Flexion of the arm.
136
What are the functions of the biceps brachii muscle?
Flexion of the arm and forearm. It is also a powerful supinator of the forearm.
137
_Brachialis_
* Brachialis has an origin from the distal half of anterior surface of the ... and inserts into the .. process of the ulna.
* Brachialis has an origin from the distal half of anterior surface of the **humerus** and inserts into the **coronoid** process of the ulna. Locate brachialis which lies deep to biceps and follow it to its origin and insertion. Identify the coronoid process of the ulna.
138
_Brachialis_
* Brachialis has an origin from the distal half of anterior surface of humerus and inserts into the coronoid process of the ...
* Brachialis has an origin from the distal half of the anterior of the humerus and inserts into the coronoid process of the **ulna**.
139
What is the function of the brachialis muscle?
Flexion of the forearm.
140
_Triceps brachii_
* There is only one muscle in the ... compartment of the arm. This is the triceps brachii muscle which, as its name suggests, arises from three heads – the long head has an origin from the ... tubercle of the scapula, the lateral head from the posterior aspect of the ... above the spiral (or radial) groove of the humerus, and the medial head again from the posterior surface of the humerus but ... the spiral groove. The three heads unite to insert into the ... process of the ulna.
* There is only one muscle in the **posterior** compartment of the arm. This is the triceps brachii muscle which, as its name suggests, arises from three heads – the long head has an origin from the **infraglenoid** tubercle of the scapula, the lateral head from the posterior aspect of the **humerus** above the spiral (or radial) groove of the humerus, and the medial head again from the posterior surface of the humerus but **below** the spiral groove. The three heads unite to insert into the **olecranon** process of the ulna.
141
_Triceps brachii_
* There is only one muscle in the posterior compartment of the arm. This is the triceps brachii muscle which, as its name suggests, arises from three heads – the long head has an origin from the infraglenoid tubercle of the scapula, the lateral head from the posterior aspect of the humerus above the ... (or ...) groove of the humerus, and the medial head again from the posterior surface of the humerus but below the ... groove. The three heads unite to insert into the olecranon process of the ...
* There is only one muscle in the posterior compartment of the arm. This is the triceps brachii muscle which, as its name suggests, arises from three heads – the long head has an origin from the infraglenoid tubercle of the scapula, the lateral head from the posterior aspect of the humerus above the **spiral (or radial)** groove of the humerus, and the medial head again from the posterior surface of the humerus but below the **spiral** groove. The three heads unite to insert into the olecranon process of the **ulna**.
142
_Quadrangular space_
* Located in the ...
* Superior border: subscapularis muscle
* Inferior border: teres major muscle
* Lateral border: surgical neck of the humerus
* Medial border: long head of the triceps brachii muscle
* Content: ... nerve, ... circumflex artery
* Located in the **axilla**
* Superior border: subscapularis muscle
* Inferior border: teres major muscle
* Lateral border: surgical neck of the humerus
* Medial border: long head of the triceps brachii muscle
* Content: **axillary** nerve, **posterior** circumflex artery
143
_Quadrangular space_
* Located in the axilla
* Superior border: ... muscle
* Inferior border: teres ... muscle
* Lateral border: ... neck of the humerus
* Medial border: ... head of the triceps brachii muscle
* Content: axillary nerve, posterior ... artery
* Located in the axilla
* Superior border: **subscapularis** muscle
* Inferior border: teres **major** muscle
* Lateral border: **surgical** neck of the humerus
* Medial border: **long** head of the triceps brachii muscle
* Content: axillary nerve, posterior **circumflex** artery
144
What are the borders of the Quadrangular Space and what structures pass through it?
* Located in the axilla, the quadrangular space is bordered superiorly by **subscapularis muscle** (by teres minor muscle when viewed posteriorly), inferiorly by **teres major muscle**, laterally by the **surgical neck of the humerus** and medially by the **long head of triceps brachii muscle.**
* The **axillary nerve and the posterior circumflex humoral artery** (PCHA) travel posteriorly **through** the quadrangular space to gain access to the posterior division of the pectoral girdle where they both supply the deltoid.
145
* The muscles of the arm, forearm and hand are supplied by a network, or plexus, of nerves – the ... plexus – that normally arise from the anterior primary rami of C5, C6, C7, C8 and T1. The roots from these cervical and thoracic levels come together to form the superior (or upper), middle and inferior (or lower) trunks of the ... plexus, as shown in the figure below:
* After the trunks have formed, the nerves of the brachial plexus divide to give rise to the cords. These cords are named lateral, medial and posterior due to their relationship to the axillary artery (i.e. the cords lie lateral, medial or posterior to the artery).
* The muscles of the arm, forearm and hand are supplied by a network, or plexus, of nerves – the **brachial** plexus – that normally arise from the anterior primary rami of C5, C6, C7, C8 and T1. The roots from these cervical and thoracic levels come together to form the superior (or upper), middle and inferior (or lower) trunks of the brachial plexus, as shown in the figure below:
* After the trunks have formed, the nerves of the brachial plexus divide to give rise to the cords. These cords are named lateral, medial and posterior due to their relationship to the axillary artery (i.e. the cords lie lateral, medial or posterior to the artery).
146
* The muscles of the arm, forearm and hand are supplied by a network, or plexus, of nerves – the brachial plexus – that normally arise from the ... ... rami of C5, C6, C7, C8 and T1. The ... from these cervical and thoracic levels come together to form the superior (or upper), middle and inferior (or lower) trunks of the brachial plexus, as shown in the figure below:
* After the trunks have formed, the nerves of the brachial plexus divide to give rise to the cords. These cords are named lateral, medial and posterior due to their relationship to the axillary artery (i.e. the cords lie lateral, medial or posterior to the artery).
* The muscles of the arm, forearm and hand are supplied by a network, or plexus, of nerves – the brachial plexus – that normally arise from the **anterior primary** rami of C5, C6, C7, C8 and T1. The **roots** from these cervical and thoracic levels come together to form the superior (or upper), middle and inferior (or lower) trunks of the brachial plexus, as shown in the figure below:
* After the trunks have formed, the nerves of the brachial plexus divide to give rise to the cords. These cords are named lateral, medial and posterior due to their relationship to the axillary artery (i.e. the cords lie lateral, medial or posterior to the artery).
147
* The muscles of the arm, forearm and hand are supplied by a network, or plexus, of nerves – the brachial plexus – that normally arise from the anterior primary rami of **...(5)** The roots from these cervical and thoracic levels come together to form the superior (or upper), middle and inferior (or lower) ... of the brachial plexus, as shown in the figure below:
* After the ... have formed, the nerves of the brachial plexus divide to give rise to the .... These co...ds are named lateral, medial and posterior due to their relationship to the axillary artery
* The muscles of the arm, forearm and hand are supplied by a network, or plexus, of nerves – the brachial plexus – that normally arise from the **anterior primary** rami of **C5, C6, C7, C8 and T1.** The roots from these cervical and thoracic levels come together to form the superior (or upper), middle and inferior (or lower) **trunks** of the brachial plexus, as shown in the figure below:
* After the **trunks** have formed, the nerves of the brachial plexus divide to give rise to the **cords**. These **cords** are named lateral, medial and posterior due to their relationship to the axillary artery (i.e. the cords lie lateral, medial or posterior to the artery).
148
What are the functions of the deltoid muscle?
It abducts, flexes, extends, medially and laterally rotates arm
149
What are the functions of the triceps brachii muscle?
The long head extends the arm and forearm. The lateral and medial heads extend the forearm only
150
What are the function of the pectoralis minor muscle?
Protract the scapula.
151
Which area of skin in the hand does the median nerve supply?
It supplies the skin over digits 1, 2, 3 and half of digit 4.
152
Which area of skin in the hand does the ulnar nerve supply?
It supplies the skin over half of digit 4 and all of digit 5
153
Which area of skin in the hand does the radial nerve supply?
It supplies the dorsolateral aspect of the hand
154
Which area of skin does the axillary nerve supply?
It supplies a small area over the insertion of the deltoid, known as the ‘badge area’.
