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NPLEX I 2024 > MSK Anatomy > Flashcards

MSK Anatomy Flashcards

1
Q

rectus fibers run…

A

straight

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2
Q

transversus fibers run…

A

at right angles

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3
Q

oblique fibers run…

A

at angles to imaginary defined axis

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4
Q

what are the muscles of mastication

A

four pairs, all innervated by cranial nerve 10
- jaw closure: temporalis and masseter
- grinding: pterygoids
- chewing: buccinator

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5
Q

muscles promoting tongue movements

A

three extrinsic muscles anchor and move the tongue (all innervated by CN VII/hypoglossal)
- genioglossus
- hyoglossus
- styloglossus

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6
Q

what muscle divides the neck into two triangles (ant and post)

A

SCM

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7
Q

what are the anterior neck muscles

A

suprahyoid muscles
infrahyoid muscles

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8
Q

process of swallowing

A

tongue and buccinator muscles push food back toward pharynx, where muscles in post mouth and pharynx complete swallowing

epiglottis closes over larynx while muscles in walls of pharynx propel food foward to stomach

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9
Q

suprahyoid muscle group actions

A

four muscles involved in swallowing

  • form floor of oral cavity
  • anchor tongue
  • elevate hyoid bone
  • move larynx during swallowing
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10
Q

infrahyoid muscle group actions

A

four straplike muscles that depress the hyroid bone and larynx during swallowing and speaking

  • sternohyoid
  • sternothyroid
  • omohyroid
  • thyrohyoid
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11
Q

what muscles move the head

A

anterolateral neck muscles

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12
Q

what muscles extend the trunk/maintain posture

A

intrinsic muscles of the back

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13
Q

muscles of inspiration

A

diaphragm and external intercostals

  • contraction = enlarges rib cage
  • diaphragm divides thoracic and abdominal cavities
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14
Q

muscles of expiration

A

expiration brought on by relaxation of inspiratory muscles (dec rib cage size), as well as contraction of internal intercostals

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15
Q

action of anterior abdominal muscles

A
  • lateral flexion and rotation of trunk
  • compression of abdominal viscera
  • promote urination, defacation, childbirth, vomiting, coughing, screaming
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16
Q

anterior abdominal wall muscles

A

four paired muscles; their fasciae and aponeuroses form lateral and anterior abdominal wall
- rectus abdominis
- external obliques
- internal obliques
- transversus abdominis

all innervated by intercostal nerves

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16
Q

muscles of pelvic diaphragm

A

two paired muscles, both innervated by sacral nerves
- levator ani
- coccygeus

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17
Q

muscles of the urogenital diaphragm

A
  • anterior half of perineum, inf to pelvic floor
  • deep transverse perineal muscle
  • contains external urethral sphincter (voluntary)
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18
Q

muscles of superficial perineal space

A
  • ischiocavernosus + bulbospongiosus help maintain erection of penis/clitoris
  • superficial transverse perineal muscles
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19
Q

where do C1-C7 nerve roots come out in relation to their vertebrae?

A

ABOVE the vertebrae

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20
Q

where does C8 nerve root come out in relation to their vertebrae?

A

Above T1

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21
Q

where do T1- coccygeal nerve roots come out in relation to their vertebrae?

A

BELOW the vertebrae

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22
Q

where does the cervical cord nerve root come out in relation to their vertebrae?

A

1 above SP

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23
Q

where does the thoracic cord nerve roots come out in relation to their vertebrae?

A

2 above SP

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24
Q

where does the lumbar cord nerve root come out in relation to their vertebrae?

A

4 above SP

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25
Q

rootlets location

A

extend out from dorsal and ventral horns and converge into ROOTS

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26
Q

dorsal and ventral horns location

A

exit vertebral column and unite to form SPINAL NERVE

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27
Q

spinal nerve splits into…

A

RAMI

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28
Q

remi innervation

A
  • dorsal ramus innervates deep back muscles and overlying skin
  • ventral remus innervates remaining muscles, skin, etc
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29
Q

____ form the brachial plexus

A

ventral/ant rami

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30
Q

most nerves we encounter are…

A

ventral rami

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31
Q

at what joint does the upper extremity articulate with the axial skeleton?

A

sternoclavicular

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32
Q

what are the muscles called that support, propel, and stabilize the pectoral girdle?

A

axioappendicular muscles

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33
Q

what nerves make up the brachial plexus? where do they innervate?

A

C5 - shoulder
C6 - elbow
C7 - wrist
C8 - hand
T1 - hand

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34
Q

brachial plexus trunks

A

C5 + C6 > 1st trunk
C7 > 2nd
C8 + T1 > 3rd

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35
Q

from which nerve roots on the brachial plexus does the long thoracic nerve run from?

A

C5-C7

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36
Q

from which nerve roots on the brachial plexus does the dorsal scapular nerve run from?

A

C5

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37
Q

what are the end branches of the brachial plexus? where do they stem from?

A
  • musculocutaneous (C5-C7)
  • axillary
  • radial (C5-C8, T1)
  • median (C5-C8, T1)
  • ulnar (C8, T1)
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38
Q

where does the axillary nerve stem from?

A

off the radial nerve

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39
Q

what are the three trunks of the brachial plexus?

A

superior
middle
inferior

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40
Q

what is the order of splitting of the brachial plexus?

A

“Rugby Teams Don’t Cover Bruises”

  • 5 roots (C5-T1)
  • 3 trunks (sup, mid, inf)
  • 2 divisions (each trunk > ant + post)
  • 3 cords (lateral, medial, post)
  • 5 branches (musculocut, axil, median, radial, ulnar)
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41
Q

branches of the lateral cord of the brachial plexus

A

Rugby players are:
Long Legged Movers

  • lat pectoral n
  • lat root of medial n
  • musculocutaneous n
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42
Q

branches of the medial cord of the brachial plexus

A

Rugby Players:
Make Many Moves Using Muscles

  • medial brachial cutaneous n
  • medial antebrachial cutaneous n
  • medial pectoral n
  • ulnar n
  • medial root of median n
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43
Q

branches of the posterior cord of the brachial plexus

A

Rugby players are:
ULTRA competitive

  • upper subscapular n
  • lower subscapular n
  • thoracodorsal n
  • radial n
  • axillary n
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44
Q

what four joints make up the shoulder

A
  • glenohumoral
  • sternoclavicular
  • acromioclavicular
  • scapulothoracic
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45
Q

what is the glenohumoral joint?

A

ball and socket joint between the head of humerus and the glenoid fossa of the scapula

capsule is thin and loose; lies in folds when arm is adducted, and is taunt when arm is abducted

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46
Q

what part of the glenohumeral capsule is weakest? why?

A

inf part is weakest bc its not reinforced by rotato cuff mm

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47
Q

what runs through an aperature in the glenohumeral capsule?

A

long head of biceps

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48
Q

what are the capsular ligaments of the glenohumeral joint? what are their functions?

A
  • glenohumeral: thickening of ant capsule
  • coracohumeral: strengthens sup part of capsule
  • transverse humeral: holds down tendon
  • coracoacromial: limits superior movement
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49
Q

what strengthens the shoulder/AC joint superiorly?

A

acromioclavicular ligament

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50
Q

where does most of the strenght of the acromioclavicular joint come from?

A

coracoclavicular ligament
- trapezoid ligament (extends to trapezoid line on inf clavicle)
- conoid ligament (attached to root of coracoid process and conoid tubercle on inf clavicle)

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51
Q

arterial supply of acromioclavicular joint

A

suprascapular and thoracoacromial arteries

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52
Q

nerve supply of acromioclavicular joint

A

supraclavicular, lateral pectoral, axillary

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53
Q

main superficial vessels of upper limb

A

cephalic and basilic
- originate in subcutaneous tissue on dorsum of hand from dorsal venous network
- both lead to axillary v

B > A
C > MC > A

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54
Q

basilic vein path

A

basilic vein ascends on medial side, pierces brachial fascia, runs superiorly and parallel to brachial atery and drains into axillary v

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55
Q

cephalic vein path

A
  • ascents to ant elbow to communivate with median cubital vein
  • cephalic passes b/w deltoid and pec major muscles in deltopectoral groove and enters delto/clavipectoral triange and pierces the costocoracoid membrane to join the axillary v
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56
Q

what is the main vein used in blood draws

A

median cubital vein

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57
Q

pec major origin

A
  • medial clavicle
  • sternum
  • upper 6 costal cartilages (2 heads, clavicular and sternocostal)
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58
Q

pec major insertion

A

bicipital groove (humerus)

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59
Q

pec major nerve

A

medial and lateral pectoral nerves

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60
Q

pec major action

A

flex, adduct, medially rotate humerus

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61
Q

what forms the anterior axillary fold?

A

inferior border of pec major

62
Q

pec minor origin

A

ribs 3,4,5

63
Q

pec minor insertion

A

coracoid process of scapula (forms a bridge under which the neurovascular bundle travels)

63
Q

pec minor nerve

A

medial pectoral n

64
Q

pec minor action

A
  • protraction, depression, med rotation of scapula
  • stabilizes scapula, esp when stretching for something just out of reach
65
Q

subclavius origin

A

1st costal cartilage

66
Q

subclavius insertion

A

inf groove of clavicle

67
Q

subclavius nerve

A

n to subclavius

68
Q

subclavius action

A
  • depresses and stabilizes scapula
  • protects neurovascular bundle if clavicle breaks
69
Q

serratus anterior action

A
  • holds scapula to chest wall
  • protraction and sup rotation of scapula
70
Q

serratus anterior origin

A

external surfaces of ribs 1-8

70
Q

serratus anterior insertion

A

medial border of scapula

71
Q

trap origin

A
  • sup nuchal line
  • EOP
  • nuchal ligament
  • spines of C7-T12
72
Q

trap insertion

A
  • spine of scapula
  • acromion
  • lateral third of clavicle
73
Q

serratus anterior innervation

A

long thoracic nerve

74
Q

what forms the medial wall of the axilla?

A

serratus anterior

75
Q

trap innervation

A

CN XI (accessory)

76
Q

what is the posterior triangle

A
  • space between trap, clavicle, and SCM
  • brachial plexus and axillary artery pass between ant and middle scalene muscles
77
Q

accessory nerve location

A

descends from base of skull, out of post triangle of neck, down side of neck, and deep to trapezeius

78
Q

lat dorsi origin

A
  • spines of T6-L5
  • median crest of sacrum
  • iliac crest
79
Q

lat dorsi insertion

A

intertubercular groove of humerus

80
Q

lat dorsi actions

A

extend, adduct, medially rotate humerus

  • chin ups
81
Q

lat dorsi innervation

A

thoracodorsal nerve

82
Q

rhomboid minor origin and insertion

A
  • O: SPs of C7-T1
  • I: medial border of scapula, at level of spine
83
Q

rhomboid major origin and insertion

A
  • O: SPs of T2-T5
  • I: medial border of scapula, below level of spine
84
Q

levator scapulae origin, insertion, and relationship to SCM

A
  • deep to SCM
  • O: TPs of C1-4
  • I: medial border of scapula, above the spine
85
Q

levator scap, rhomboid major, rhomboid minor actions

A
  • ALL elevate, retract, and medially rotate the scapula
  • LEV SCAP ONLY - unilaterally flexes neck, B/L extends neck
86
Q

levator scap, rhomboid major, rhomboid minor innervation

A

dorsal scapular nerve

87
Q

nerves to muscles of the superficial back and what CN they come off of

A
  • dorsal scapular (CN5)
  • suprascapular (CN5,6)
  • accessory (CN XI)
  • axillary (CN
88
Q

muscles on the scapula that move the humerus

A
  • deltoid
  • supraspinatus
  • infraspinatus
  • subscapularis
  • teres major
  • teres minor
  • triceps
89
Q

deltoid origin

A

CLASPs

  • clavicle (lateral 1/3, ant deltoid)
  • acromion (intermediate deltoid)
  • SPine of scapula (post deltoid)
90
Q

deltoid insertion

A

deltoid tuberosity of humerus

91
Q

deltoid innervation

A

axillary

92
Q

deltoid actions

A

acts on humerus
- flex and extend
- abduct (all 3 parts together)
- medially and laterally rotate

93
Q

axillary nerve innervation, location, clinical importance

A
  • innervates deltoid and teres minor
  • passes through quadrangular space b/w teres and the long head of triceps and humerus

Clinical: quadrilateral space syndrome (QSS) = compression of axillary n and post humeral circumflex artery as they pass through this space

94
Q

what are the rotator cuff muscles?

A

SITS (clockwise from top)
- supraspinatus
- infraspinatus
- teres minor
- subscapularis

tendons of all these blend w glenohumeral joint capsule, reinforcing it

95
Q

supraspinatus origin and insertion

A

O: supraspinous fossa
I: greater tubercle

96
Q

supraspinatus action

A

abduct humerus (with deltoid)

97
Q

supraspinatus innervation

A

suprascapular n

98
Q

infraspinatous origin and insertion

A

O: infraspinous fossa
I: greater tubercle

99
Q

infraspinatous action

A

laterally rotates humerus

100
Q

infraspinatous innervation

A

suprascapular n

101
Q

teres minor origin and insertion

A

O: lat border scap
I: greater tubercle humerus

101
Q

teres minor action

A

laterally rotates humerus

102
Q

teres minor innervation

A

axillary nerve

103
Q

subscapularis origin and insertion

A

O: subscapular fossa
I: lesser tubercle

104
Q

subscapularis action

A

medially rotates humerus

105
Q

subscapularis innervation

A

upper and lower subscapular nerves

106
Q

suprascapular nerve pathway, innervation

A
  • originates from upper trunk of brachial plexus
  • passes thru suprascapular foramen > post scapular region
  • innervates supraspinatus
  • passes thru greater scap (spinoglenoid) notch
  • terminates in and innervates infraspinatus
107
Q

teres major origin and insertion

A

O: lateral border scap
I: medial intertubercular groove

108
Q

teres major action

A

adduct, medially rotate, and extend humerus

109
Q

teres major innervation

A

lower subscapular nerve (off axillary nerve)

110
Q

arteries of upper limb

A
  • subclavian: bw ant and middle scalenes
  • axillary: from lat 1st rib > lower teres major
  • brachial: from teres major > bifurcation of R + U arteries
  • radial
  • ulnar
  • deep and superficial palmar arches
  • digital arteries
111
Q

location of axillary artery

A

lateral border of first rib > inf border teres major

112
Q

axillary artery divisions

A

divided into three parts relative to pec minor

  • 1st: gives rise to sup thoracic artery and is enclosed in the axillary sheath
  • 2nd: post to pec minor and gives rise to thoracoacromial and lateral thoracic arteries which pass medial and lateral to the muscle respectively
  • 3rd: supscapular (largest branch), and anterior + posterior circumflex humeral arteries
113
Q

collateral circualtion around scapula

A

anastomoses from subclavian and axillary arteries
- dorsal scapular a (vertebral scap border)
- suprascap a (supra and infraspinous fossa)
- circumflex scapular a (medial triangular space)
- transverse cervical artery

114
Q

elbow joint ligaments, arterial supply, and innvervation

A
  • ulnar collateral
  • radial collateral
  • annular

arterial: anastomasis of arteries around elbow joint

innervation: musculocutaneous, radial, ulnar nerves

115
Q

ulnar collateral anatomy

A

triangular shaped, upper and lower bands (ulnar nerve passes bw bands post to medial epicondyle)

“funny bone”

116
Q

radial collateral ligament anatomy

A

attached to annular ligament

117
Q

annular ligament anatomy

A

sling around head of radius to form proximal radioulnar joint

118
Q

proximal radioulnar joint

joint type, ligaments

A

pivot type synovial joint

  • annular ligament (permits rotation of head of radius around ulna)
  • interosseous membrane (links bones together)
119
Q

muscles of the arms, innervation rules to live by

A
  • all extensors and supinators: radial n
  • all “pronator” names: median nerve
  • flexors: musculocutaneous

this means some have 2

120
Q

MAIN arm flexor

A

brachialis; the only PURE flexor, produces the most force

121
Q

brachialis origin and insertion

A

O: ant surface of distal half of humerus

I: coronoid process/ulnar tuberosity of ulna

122
Q

brachialis innervation

A

musculocutanous

(in some people it also includes radial)

123
Q

brachialis action

A

flexes forearm in slow and quick movements

steadies arm during extension by slow relaxation

124
Q

coracobrachialis origin and insertion

A

O: coracoid process
I: middle 1/3 humerus

125
Q

coracobrachialis action

A

flex and adduct arm
stabilizes glenohumeral joint

126
Q

coracobrachialis innervation

A

musculocutaneous (pierced by the nerve which then continued as lateral cutaneous nerve of forearm)

127
Q

triceps origin and insertion

A

O
- long head: infraglenoid tubercle
- lateral head: post humerus (sup/lat to radial groove)
- medial head: post humerus (inf/med to radial groove)

I: olecranon process of ulna

128
Q

triceps innervation

A

radial n

129
Q

triceps action

A

extends arm and forearm
stabilizes adducted glenohumeral joint

130
Q

what muscle helps the tricep extend the forearm and also abducts humerus during forearm pronation?

A

anconeus m

131
Q

what nerves would be affected by fractures at different points of the humerus?

A

ARM
- Axillary: head of humerus
- Radial: mid shaft
- Median: supracondylar

132
Q

cubital fossa boundaries

A
  • medial: pronator teres
  • lateral: brachioradialis
  • superior: imaginary line connecting medial and lateral epicondyles of humerus
  • floor: brachialis + supinator mm
  • roof: brachial and antebrachial fascia w/ bicipital aponeurosis
133
Q

structures in the cubital fossa

A

Really Need Beer To Be At My Nicest (lateral to medial)
- radial n
- biceps tendon
- brachial artery
- median nerve

134
Q

flexor digitorum superficialis anatomy, insertion, innervation, action

A

intermediate layer

inserts on middle phalanges of 4 fingers

median n

flexes fingers

135
Q

deep layer of lower arm muscles

A
  • flexor digitorum profundus
  • flexor pollicus longus
  • pronator quadratus
136
Q

flexor digitorum profundus insertion and innervation

A

inserts on distal phalanges

median n to radial half
ulnar n to ulnar half

137
Q

flexor pollicis longus insertion and innervation

A

inserts on distal phalanx of thumb

median n

138
Q

pronator quadratus location and innervation

A

extends from ulna to radius

prime mover for pronation, reinforces interosseus membrane (keeps radius and ulna together, esp in FOSH injury)

median n

139
Q

extensor muscles of the forearm (post)

A
  • mm that extend/abduct/adduct hand at the wrist (extensor carpi radialis longus, extensor carpi radialis brevis, extensor carpi ulnaris)
  • extend the medial four digits (extensor digitorum, extensor indicis, extensor digiti minimi)
  • extend/abduct thumb (abductor pollicis longus, extensor pollicis brevis, extensor pollicis longus)
140
Q

brachioradialis origin, insertion, innervation, and action

A

origin on lat humerus
inserts on radius
radial n
flexes elbow, maintains half pronated position “beer drinking muscle”

141
Q

extensors carpi radialis longus and brevis

insertion, innervation, action

A

insert on MC 2,3
radial n
extends and radially deviates wrist

142
Q

extensors digitorum and digiti minimi

insertion, innervation, action

A

insert into extensor expansions over middle and distal phalanges

radial n

extends fingers

143
Q

extensor carpi ulnaris

insertion, innervation, action

A

insert on MC 5

radial n

extends wrist and ulnar deviate

144
Q

posterior forearm muscles and innervation

A
  • supinator
  • abductor pollicis longus
  • extensor pollicis brevis
  • extensor pollicis longus
  • extensor indicis

radial n

145
Q

ulnar nerve location and innervation

A
  • passes post to medial epicondyle > enters forearm between heads of flexor carpi ulnaris > down ulnar side between this and FCU and FDP > becomes superficial at wrist

innervates
- flexor carpi ulnaris
- 1/2 of flexor digitorum profundus

146
Q

what artery is used to take BP

A

brachial

147
Q

superficial palmar arch anatomy

A
  • formed primarily by ulnar artery, as it enters palm through tunnel of guyon
  • anastomosis with radial artery
148
Q

structures in carpal tunnel

A
  • median n
  • flexors digitorum superficialis and profundus
  • flexor pollicis longus
149
Q

carpal tunnel syndrome results

A
  • cutaneous senosry loss on median n distribution (thumb, pointer, middle)
  • thenar wasting
  • weakness of lumbricals 1,2
150
Q

ulnar n innervation cutaneous

A

1.5 digits, ulnar side of palm, dorsum of hand

NPLEX I 2024 (23 decks)

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