MSK 3 Flashcards
What is a bursa?
- usually in areas that are actively moving
- between tendons and bones or between bony prominence and the skin
- happens at acromion, elbow
What is bursitis?
- usually work related
- inflammation of bursa
- drainage of the bursa isn’t really done anymore
What are tendon sheaths?
- synovium found here
- like a bursa but it is wrapped around the tendon
- when tendon moves, bursa lubricates the movement
What is tendonitis and tendinosis?
- tendonitis is acute, tendinosis is chronic
- synovial sheaths are separated in the finger
- infection spreads usually from tendon sheath to the carpal tunnel then to the finger on the opposite side
Describe flexion vs extension and abduction vs adduction
Describe protraction and retraction
Describe circumduction
- circular movement
- requires 4 muscles that are organized around the joint
Describe abduction and adduction of the fingers
- based on the middle finger as the midline
- as you bring them back towards the middle finger and “add” them, it is adduction
Describe abduction, adduction, flexion, and extension of the thumb
- abduction occurs in plane of the nail bed (remain parallel)
- thumb is on there at an angle so in order to abduct it, it comes a bit foward to be in the plane of the nail bed (position how you would open a jar)
- flexion comes across the hand
- extension comes out
What is pronation and supination of the forearm?
- pronated position crosses the radius over the ulna
- supination the bones are parallel
Can pronation and supination happen with the lower limb?
- no, the two bones do not move with respect to one another
- they bear the weight of the body
- only movement that can occur is because the ankle has pliability so you can invert and evert
What is dorsiflexion versus plantarflexion
Describe the arteries of the upper limb
- begins as a branch off of the aorta called the subclavian
- at armpit level, axillary
- in arm, brachial
- in forearm, branches into radial and ulnar
- into the hand, radial and ulnar join together to form an anastomosis called the palmar arch (superficial and deep)
Describe the arteries of the lower limb
- external iliac goes underneath the inguinal ligament to go into the lower limb and instantly becomes the femoral artery
- at the back of the knee, called the popliteal
- divides into anterior and posterior tibial artery
- on the top of the foot, dorsal pedal artery
What are the arterial pulse points?
- subclavian, brachial, radial/ulnar, femoral, popliteal, dorsalis pedis
- evaluate the pulse from proximal to distal to see if there is a narrowing of the artery at some point
Where do veins return into the heart?
-superior and inferior vena cava
What are the principle veins in systemic circulation?
- deep set of veins that have the same names as the arteries
- superficial system of veins you can see underneath your skin
- cephalic vein drains into subclavian vein
- basilic vein drains into brachial vein
Where are all of the extensors located?
- behind the transverse processes of the vertebrae
- when these contract, body moves back
Where are the flexors located?
- in front of the transverse processes of the vertebrae
- bring body forward when they contract (flexion)
What are the muscles of the anterior body wall?
- external oblique (muscle fibres run down and medially)
- rectus abdominus (straight up and down)
- internal oblique under the external oblique
- third deepest layer; muscle fibres run horizontally across the abdomen in the transverse abdominus
What is the innervation of the anterior body wall?
- innervated segmentally by the ventral rami of the mixed spinal nerves
- motor to flexors of the spine
- sensory to skin on anterior surface (superficial sensory branches)
What are the extrinsic muscles of the back?
- superficial muscles if you just remove the skin
- they have their origin in the axial skeleton but insertion in the appendicular skeleton
- muscles have an action on the appendicular skeleton
- trapezius, rhomboids, and latissumus dorsi make up the larger areas covering the intrinsic back muscles
What are the intrinsic muscles of the back?
- have their origin and insertion in the back
- long superifical group coming from medial aspect of the vertebrae or the iliac crest- muscle fibres move upwards and laterally to attach onto transverse processes or the ribs/skull so they are called the spinotransverse system of muscles
- deep system arise from the transverse processes/ribs and go upwards and medially to attach to spinal processes so they are called the transverso-spinal system
What is the innervation to the intrinsic muscles of the back?
- segmentally innervated by the dorsal rami of the mixed spinal nerves
- motor to extensors of the spine
- sensory to skin on posterior surface
What are the curvatures of the spine?
-thoracic and sacrum retain the concave bending of the spinal cord
What are abnormal curvatures of the spine?
Scoliosis:
-can impact breathing because of its impacts in the thoracic region
Kyphosis:
- as you age, you lose bone from vertebral bodies so they get smaller
- exaggerates front curvatures especially in thoracic region
- increases kyphotic curvature in thoracic region
Lordosis:
- change centre of gravity by bearing a child can be compensated for by contracting intrinsic muscles of the back
- exaggerates curvature of the spine in lumbar region
What is the intervertebral disk?
- cartilage disk between bodies of vertebrae
- don’t move as much as synovial joint
- has gel material on the inside
What is the anterior longitudinal ligament?
-runs down the lengh of the vertebral column and wraps around most of the front of the bodies of the vertebrae
What is the posterior longitudinal ligament?
- located at front of vertebral canal where spinal cord would be located
- helps reinforce posterior aspects of the bodies of the vertebrae
What is the ligamentum flavum?
- as you bend spine forward, it stretches ligamentum flavum
- when you extend the spine, need elasticity to not crush the spine
- attached to periosteum of the bone and only located between adjacent lamina
What is facet joint capsule?
-connective tissue around the facet joint
What is the interspinous ligament?
- located between adjacent spinous processes
- intrinsic muscles of the back attach on this
What is the supraspinous ligament?
What is the intervertebral disc?
- shock absorber
- nucleus pulposus in the centre and allows for shock absorption
- kept in place by a ring of connective tissue called annulus fibrosis
- high water content in nucleus pulposus
- at night, water has infiltrated the nucleus but as you move during the day it will drive water out of the disc and decreases the space between adjacent vertebrae
What is spondylolysis?
- cracking of area of bone in vertebrae between superior and inferior articular processes
- holds back part of vertebrae to front part of vertebrae which is holding all of the weight
What is spondylolisthesis?
- slippage of L5 vertebrae onto the sacrum
- bodies of vertebrae slipping forward
- can cause back pain and symptoms in lower limb
