MSK Flashcards
innervation of pec major and minor. Actions?
pec major - lat and med pectoral nerve. flexes, extends, adducts and medially rotates humerus
pec minor - med pec nerves. Stabilises scapula, draws it anterior and inferior
subclavius action and innervation
action - anchors and depresses clavicle
innervation - nerve to subclavius
function of clavicle
shock absorber, protects neurovascular bundle underneath
where do scapula and clavicle join
acromioclavicular joint
what are the types of bone and give eg
long (humerus), short (carpals), irregular (eg saccrum or coccyx), sesmoid (patella), flat (occipital)
what is an apophysis
normal developmental outgrowth of bones that fuses to bone later in development
what is a facet
flattened surface for joint or muscle attachment
types of joints and egs
cartilaginous - held by hyaline cartilage e.g. pubic symphysis
fibrous - fibrous CT e.g. sutures
synovial - articular cartilage with synovial capsule in between e.g. knee
state anterior forearm muscles and innervation
flexor carpi ulnaris, radialis, flexor pollicis longus, flexor digitorum P and S, pronator quadratus, pronator teres, palmaris longus
state posterior forearm muscles
3x3+3
extensor carpi radialis longus brevis, ulnaris
extensor digiti minimi, indices, digitorum
extensor pollicis longus, brevis, abductor pollicis longus
supinator, brachioradialis, anconeus
What are the origins of the brachial plexus nerves - median, musculocutaneous, ulnar, radial, axillary?
median - C5-T1 musculocutaneous - c5-7 radial - c5-t1 ulnar - c8-t1 axillary - C5-6
draw brachial plexus
see book
what does musculocutaenous innervate
ant muscles of arm - biceps, coracobrachialis and brachialis
what does axillary innervate
teres minor, deltoid, GH joint
how would you test ulnar, median, radial motor fucntion?
ulnar - test abduction of fingers
medial - test thumb opposition
radial - extend wrist with opposition
what innervates the interossei and what is their action
PADDAB
ulnar
what are the thenar muscles and their innervation
Abs FOr Ads abductor pollicis brevis flexor pollicis brevis opponens pollicis (median) Adductor pollicis brevis (ulnar)
hypothenar muscles?
Abs FO
no Ads
how test carpal tunnel syndrome. Symptoms?
tinels (tap on nerve and see if pins and needles)
smyptoms - pain and wrist, numbness, atrophy of thenar
what goes through carpal tunnel?
FDP, FDS, flexor pollicis, median nerve
what causes carpal tunnel?
MEDIAN TRAP
myxoedema, oedema premenstrually, diabetes, idiopathic, acromegaly, neoplasm, trauma, RA, pregnancy
what innervates lumbricals? action?
1+2 = median
3+4 = ulnar
bye bye muscle
what causes winged scapula? symptoms?
caused by dmg to long thoracic nerve or serratus anterior
symptoms - pain on flexion or abduction of shoulder, scapula border protrudes
what is hand of benediction caused by and action?
median damage. lose flexion digits 2 + 3 when trying to make a fist
what is the ulnar paradox
ulnar damage more proximal looks better even though worse
because proximal damage takes out half FDP and therefore there is no flexion at distal IP joint of digits 4+5
what is ulnar claw
extension at MCP and flexion at distal IP of digits 4+5 when trying to extend
if clavicle fractures, where does each part go
lateral displaced downward by weight of arm
medial upwards by pull of SCM
how test axillary nerve
abduction of deltoid
what does the radial groove contain
radial nerve, deep branch of brachial artery
how does supraepicondyle fracture of humerus happen? what is damaged
fall on flexed elbow
damage to brachial artery, median, ulnar, radial nerves
what is dislocation and subluxation
dislocation - articular surfaces of joint not in contact
subluxation - partial contact maintained
what is exaggerated primary curvature of spine called
kyphosis
where are the primary and secondary curvatures of spine found
primary - thoracic and sacral
secondary - cervical and lumbar
describe features of cervical vertebrae
bifid spinous process, transverse foramen, large vertebral foramen, smallest size
describe features of thoracic vertebrae
demi facets for ribs, small vertebral foramen, medium size
describe features of lumbar vertebrae
largest, small triangular vertebral foramen
what is scoliosis caused by
unbalanced muscle tonicity
what is the elbow joint ligaments
ulnar collateral, radial colateral, articular capsule, annular ligament
what is blood supply of elbow
anastamoses of brachial, radial, ulnar arteries
what is the type of joint between the radius and ulna
fibrous
how do you treat carpal tunnel syndroe
steroid injection, splinting, surgery
what is colles and smiths
colles - falling on outstretched hands
smiths - falling on flexed wrists
what is bennetts fracture
fracture of 1st base of metacarpal
what can cause erbs palsy
wound e.g. gunshot, pulling baby head frist
what is mallet finger
damage to extensor digitorum tendon while catching a ball
where does axillary artery start and end
start - lateral border of 1st rib from subclavius
end - inferior border of teres major
innervations of lat dorsi, trapezius, rhomboids, levator scapulae?
lat d - thoracodorsal nerve
trapezius - spinal accessory
rhomboids and levator - dorsal scapula nerve
innervation of subscapularis and teres major
subscapularis - upper and lower subscapular nerves
teres major - lower subscapular nerves
borders of anatomical snuffbox
medial - extensor pollicis longus
lateral - abductor pollicis longus, extensor pollicis brevis
floor - scaphoid
what does acetabular notch contain
ligament of head of femur with artery to head of femur
what is the blood supply to the acetabulum
medial and lateral circumflex femoral artery with artery to head of femur
what is slipped upper femoral epiphysis
fracture through femoral epiphyseal plate and femur rides upwards
what happens to the leg in a hip dislocation or fracture
dislocation - shortened and medially rotated
fracture - shortened and laterally rotated
what type of fracture is trochanteric and femoral neck fracture?
trochanteric - extra capsular
femoral neck - intracapsular
where does inguinal ligament attach
ASIS and pubic tubercle
name the bursitises of the hip and a cause
trochanteric - RA
ischogluteal - bike or horse riding
illiopsoas - swelling
give the superficial drainage of the lower limb
femoral vein from external iliac. great saphenous vein runs medially from femoral and becomes dorsal venous arch. small saphenous vein starts from popliteal vein and runs posteriorly
deep venous drainage of LL
femoral from external iliac. Profunda femoris splits from femoral (drains deep thigh). Femoral –> popliteal –> splits after knee into ant and post tibial vein and fibular vein
superficial venous drainage of UL
axillary vein –> basilic, brachial, cephalic. Median cubital connects basilic and cephalic. basilic and cephalic continue to distal arm and hand.
deep venous drainage UL
brachial from axillary. Profundia brachial vein splits to drain inner upper arm. brachial –> radial and ulnar/
action of fibularis and tibialis
fibularis - eversion
tibialis - inversion
innervation of anterior and lateral leg
anterior - deep fibular
lateral leg - superficial fibular
name the knee bursae and where found
suprapatellar - rectus femoris and femus
subpatellar - patella and skin
superficial infrapatellar - tibial tuberosity and skin
deep infrapatellar - patella tendon and tibia
what is housemaids knee
prepatella bursitis
what is the unhappy triad of symptoms and how does it occur
lateral blow to flexed knee
acl, mcl, and medial meniscus tear
diagnosis of OA on xray
osteophytes, sclerosis, loss of joint space, bony cysts
in what position is ankle stronger?
dorsiflexion
what are the ankle ligaments
medial - deltoid ligament (tibionavicular, tibiocalcaneal, tibiotalar)
lateral - talofibular (anterior and posterior), calcaneofibular
what side ankle ligaments are w4eaker
lateral
what is the syndesmosis of tibia and fibula made of
ant and post ligament of lateral malleolus and interosseus membrane
describe muscles used through the gait cycle
heel strike - glutes and dorsiflexors loading - quads stance - plantar flexors and abductors (stability) pressing - digit flexors and hip flexors swing - dorsiflexors and hip flexors
what are the dermatomes of the lower limb
see session 4 MSK
dermatomes of upper limb
see session 4 MSK
Name muscles of anterior thigh and action and innervation
all femoral quadriceps muscles - extend knee joint sartorius - flex, abduct, lateral rotate hip (cross legs) pectineus - adduction and flexion of hip illiopsoas - flexes hip
Name muscles of posterior thigh and action and innervation
all sciatic
all flex at knee and extend at hip
Name muscles of medial thigh and action and innervation
all obturator nerve
adductor magnus, longus, brevis, gracialis - adducts
nerve roots of femoral, obturator and sciatic
femoral and obturator - l2-l4
sciatic - l5-s2
muscles of superficial gluteus, innervation and action
maximus - inferior gluteal nerve. Extensor of thigh
medius and minimus - superior gluteal nerve. Abducts and medially rotates lower limb
muscles of deep gluteus, innervation and action
All laterally rotate and abduct Pretty Girls Often Grow Old Quickly Piriformis - piriformis nerve Gemelli superior - ob internus ob internus - ob internus nerve gemelli inferior - quadratus femoris nerve ob externus - ob externus nerve quadratus femoris - quadratus femoris nerve
muscles of lateral leg, innervation and action
fibularis longus and brevis
superficial fibular nerve
evert and plantarflex
muscles of anterior legm innervation and action
All deep fibular
tibialis anterior - dorsiflexion + inversion
extensor digitorum - extend 4 toes + dorsiflex
extensor hallucis longus - extend big toe + dorsiflex
muscles of posterior leg innervation and action
All tibial nerve
gastrocnemius, plantaris, soleus - plantarflex
popliteus - laterally rotates femur, pops knee out of locking
tibialis post - inverts + plantarflexes
flexor digitorum longus, flexor hallucis longus
Order of tendons, arteries and nerves at medial malleolus
Tom, Dick And Nervous Harry - anterior to posterior
tibialis posterior, flexor digitorum longus, posterior tibial artery, tibial nerve, flexor hallucis longus
