MSK: Anatomy Flashcards by Mary Kellam

What are tubercles, tuberosities, and trochanters, condyles, and epicondyles?

Rounded projections of bone.
Condyles and epicondyles are at the articulating end.

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Name 6 types of synovial joints.

Pivot
Hinge
Saddle
Ball-and-socket
Condyloid
Plane

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What is the difference between the origin and insertion of a muscle?

The origin is the attachment site that doesn’t move during contraction, while the insertion is the attachment site that does move when the muscle contracts.

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What are the main branches of the main upper limb arteries?

Subclavian artery -> axillary -> brachial -> radial & ulna.

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What are the main branches of the main lower limb arteries?

Common iliac artery -> external iliac -> femoral -> popliteal -> tibial/fibula

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What type of joint is the glenohumeral joint, and what two bones form this joint?

Synovial ball and socket joint.
Scapula and humerus.

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What type of joint is the elbow?

Synovial hinge joint.

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What joint is formed by the articulation between the distal radius and two of the carpal bones? What type of joint is this?

Radiocarpal joint.
Synovial condyloid joint.

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What is protraction and retraction of the scapula?

Protraction = moving anteriorly e.g. reaching forwards
Retraction = moving posteriorly e.g. pulling shoulder back

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What articulation is found at the proximal/medial end of the clavicle?

Clavicle articulates with the manubrium of the sternum (sternocalvicular joint).

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What articulation is found at the distal/lateral end of the clavicle?

Clavicle articulates with the acromion of the scapula (acromiovlavicular joint).

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What ridge is palpable on the posterior surface of the scapula?

The spine

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What does the lateral end of the spine of the scapula expand to form?

The acromion

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What ‘beak-like’ projection of the scapula sits inferior to the acromion on the anterior surface of the scapula, and provides the site of attachment for several muscles?

Coracoid process (Greek: ‘raven-like’)

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What structures form the pectoral girdle?

Clavicle, scapula, and attached muscles.

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What part of the lateral aspect of the scapula does the head of the humerus articulate with at the glenohumeral joint?

Glenoid fossa

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What two small projections of bone superior and inferior to the glenoid fossa of the scapula are important sites for muscle attachments?

Supraglenoid and infraglenoid tubercles.

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What two projections of bone on the proximal humerus provide important sites for muscle attachment?

Greater and lesser tubercles.

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Why can fractures of the surgical neck of the humerus or shoulder dislocations cause numbness/weakness in the affected arm?

The axillary nerve runs medially to the surgical neck of the humerus. Anterior shoulder dislocation can put pressure on and potentially damage the axillary nerve.

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What slight protuberance of the upper lateral aspect of the humeral shaft is an important site of muscle attachment?

Deltoid tuberosity (attachment of deltoid muscle).

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Why can mid-shaft humeral fractures damage the radial nerve?

The radial (or spiral) groove runs along the posterior aspect of the humeral shaft and can be injured in mid-shaft humeral fractures.

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What important movement is the scapula capable of which allows the arm to be raised above the head?

Rotation.

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What large superficial muscle of the posterior pectoral girdle attach the scapula to the skull, cervical, and thoracic vertebrae?
What four movements does contraction of this muscle allow in the scapula?

Trapezius.
Rotation, elevation, retraction, depresses.

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What are the three smaller deeper muscles of the posterior pectoral girdle, that attach the scapula to the vertebral column?

Levator scapulae
Rhomboid major
Rhomboid minor

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Contraction of what two small deep muscles of the posterior pectoral girdle, that attach the medial border of the scapula to the vertebral column, cause retraction of the scapula?

Rhomboid major (C7 and T1 origin) Rhomboid minor (thoracic vertebrae origin)

What large superficial muscle of the posterior pectoral girdle, originates from the lower thoracic vertebrae and inserts onto the humerus, and causes extension, adduction, and internal rotation of the humerus?

Latissimus dorsi.

Most of the muscles of the posterior pectoral girdle are innervated by branches of the brachial plexus. What nerve innervates the trapezius muscle?

Accessory nerve (CN VI) - NOT the brachial plexus!

What branch of the brachial plexus innervates the latissimus dorsi muscle of the posterior pectoral girdle?

Thoracodorsal nerve.

What six muscles attach the scapula to the humerus to move and stabilise the shoulder joint?

Deltoid Supraspinatus Infraspinatus Subscapularis Teres minor Teres major

What four muscles have tendons which fuse with the fibrous capsule that surrounds the shoulder joint, working together to form the stabilising rotator cuff?

Supraspinatus Infraspinatus Teres minor Subscapularis ("SITS")

What three bones does the deltoid muscle attach to?

Lateral part of the clavicle Spine of the scapula Humerus

What branch of the brachial plexus innervates the deltoid muscle?

Axillary nerve.

What muscle is a powerful abductor of the shoulder joint, but cannot initiate abduction?

Deltoid

What muscle initiates abduction of the shoulder?

Supraspinatus

The tendon of what muscle can be inflamed and pinched between the acromion and the humerus during shoulder movements (impingement)?

Supraspinatus

The axillary nerve travels through the quadrilateral space to enter the posterior scapula region. What four structures form the boundaries of the quadrilateral space?

Teres minor (superior) Teres major (inferior) Long head of the triceps (medial) Surgical neck of the humerus (lateral)

Other than the rotator cuff muscles, what three structures help stabilise the shoulder joint?

Glenoid labrum (rim of fibrocartilage around margin of glenoid fossa) Ligaments Tendon of biceps brachii

There are five groups of lymph nodes in the axilla that drain the upper limb, breast, chest wall, scapular region, and abdominal wall. What lymph nodes in the apex of the axilla receive lymph from all these other lymph nodes?

Apical nodes

The subclavian artery travels over the first rib and under the clavicle into the axilla. When does the subclavian artery become the axillary artery?

After it passes over the lateral border of the first rib.

When does the axillary artery become the brachial artery?

When it crosses the inferior border of teres major.

The brachail and basilic veins join to form the axillary vein, and the cephalic vein also joins in the axilla. When does the axillary vein become the subclavian vein?

At the lateral border of the first rib.

What four bony prominences are found on the distal end of the humerus?

Medial and lateral epicondyles. Trochlea Capitellum

What does the trochlea, a bony prominence on the distal end of the humerus, articulate with?

The trochlear notch of the ulna.

What does the capitellum, a bony prominence on the distal end of the humerus, articulate with?

Head of the radius.

What separates the anterior and posterior compartments of the arm?

Intermuscular septa (which extend from the deep brachial fascia which surrounds the arm).

What three flexor muscles are found in the anterior compartment of the arm? What nerve innervates them?

Biceps brachii Brachialis Coracobrachialis Musculocutaneous nerve

What do the long and short head of the biceps brachii attach to both proximally and distally?

Proximally: Long head - supraglenoid tubercle Short head - coracoid process Distally: Converge to insert via a common tendon onto the radial tuberosity of the radius.

What movement can the biceps help with when the elbow is flexed?

Supination of the forearm.

What muscle attaches to the anterior aspect of the distal half of the humeral shaft, and inserts distally upon the ulna tuberosity to work as a powerful flexor of the elbow?

Brachialis

What are the three origin sites of the triceps brachii muscle in the posterior compartment of the arm?

Long head: infraglenoid tubercle of the scapula. Lateral head: posterior humerus (proximal to radial groove). Medial head: posterior humerus (distal to radial groove).

What is the most medial part of the triceps brachii?

Long head of the triceps.

The three muscle bellies of the triceps brachii converge via a common tendon onto a single insertion point. What is this insertion point?

Olecranon of the ulna.

What innervates all three parts of the triceps brachii?

Radial nerve.

What five spinal nerves are the roots of the brachial plexus, providing motor and sensory fibres to the upper limb?

C5, C6, C7, C8, T1

What two spinal nerve roots combine to form the superior trunk of the brachial plexus?

C5 and C6

What two spinal nerve roots combine to form the inferior trunk of the brachial plexus?

C8 and T1

What spinal nerve roots form the middle trunk of the brachial plexus?

What happens to the three trunks of the brachial plexus under the clavicle?

Each trunk divides into an anterior and posterior division.

Posterior divisions of all the trunks of the brachial plexus combine to form what main cord?

The posterior cord.

What cord does the anterior division of the inferior trunk of the brachial plexus become?

The medial cord.

The anterior divisions of the superior and middle trunks of the brachial plexus combine to form what cord?

The lateral cord.

What are the five major terminal branches of the brachial plexus?

Axillary Radial Musculocutaneous Ulnar Median

What two branches of the brachial plexus are formed from the posterior cord?

Axillary and radial nerves

What branch of the brachial plexus is formed from a branch of the lateral cord and a branch of the medial cord?

Median nerve

What branch of the brachial plexus is formed from a branch of the lateral cord?

Musculocutaneous nerve

What branch of the brachial plexus is formed from a branch of the medial cord?

Ulnar nerve

What two muscles and areas of skin does the axillary nerve provide motor innervation to?

Deltoid and teres minor. Also a small region of skin over the upper lateral arm.

What muscles and areas of skin does the radial nerve provide motor innervation to?

Triceps and all the muscles in the posterior compartment of the forearm. Regions of skin over the arm, forearm, and hand.

What muscles and areas of skin does the musculocutneous nerve innervate?

The three muscles in the anterior compartment of the arm (biceps brachii, brachialis, coracobrachialis). Skin over the lateral forearm.

What muscles and areas of skin does the median nerve innervate?

The small muscles of the thumb and most of the muscles of the anterior forearm. Skin over lateral aspect of palm of the hand and the lateral digits.

Where is the median nerve most vulnerable to damage?

As it crosses the anterior aspect of the elbow - the anterior cubital fossa.

What muscles and areas of skin does the ulnar nerve innervate?

Most of the small muscles in the hand. Skin over the medial aspect of the hand and medial digits.

Where is the ulnar nerve most vulnerable to damage?

Behind the medial epicondyle - easily palpable ("funny bone").

What connects the radius and ulna?

Interosseous membrane.

The trochlear notch of the ulna articulates with what part of the humerus?

The trochlear.

The radial head of the radius articulates with what part of the humerus?

The capitellum.

Is the olecranon part of the ulna or the humerus?

The ulna.

What is the anterior protrusion of the ulna called?

The coronoid process.

What are the distal protrusions of the radius and ulna called?

Styloid processes.

What type of joint are the proximal and distal radioulnar joints?

Synovial pivot joints.

What ligament of the radius wraps around the radial neck and attaches to the ulna to hold the radial head in place, and allows the radial head to rotate within it during pronation and supination?

The annular ligament.

How many carpal bones are there?

Eight.

What two carpal bones does the radius articulate with to form the radiocarpal joint?

Scaphoid and lunate.

What type of joint is the radiocarpal joint?

Condyloid synovial joint.

Name the eight carpal bones (first the proximal row, lateral to medial, then the distal row, lateral to medial).

Scaphoid Lunate Triquetrum Pisiform Trapezium Trapeziod Capitate Hamate Some Loves Try Positions That They Can't Handle

How many phalanges are in the thumb?

2 (fingers have 3)

The cubital fossa (antecubital fossa/ACF) is a triangular-shaped region - what forms its three borders?

Lateral border = brachioradialis Medial border = pronator teres Superior border = imaginary line drawn between the medial and lateral epicondyles of the humerus.

What two nerves can be found in the cubital fossa (ACF)?

Radial and median.

Where does the brachial artery bifurcate into the radial and ulnar arteries?

Deep in the cubital fossa.

How can the brachial artery be located?

It is medial to the biceps tendon in the cubital fossa (ACF).

What separates the superficial veins from deeper structures - the brachial artery and median nerve - in the cubital fossa (ACF)?

The bicipital aponeurosis (fascial extension of the biceps tendon).

What are the three main superficial veins in the cubital fossa (ACF)?

Cephalic, basilic, median cubital.

How many muscles are there in the anterior compartment of the forearm?

Eight.

The muscles of the anterior forearm are arranged in three layers: superficial, middle, and deep. What are the four muscles in the superficial layer of the anterior forearm, from lateral to medial?

Pronator teres. Flexor carpi radialis. Palmaris longus. Flexor carpi ulnaris.

What function do most of the muscles of the anterior compartment of the forearm perform?

Flexors of the wrist, fingers, or thumb.

What nerve innervates most of the muscles of the anterior compartment of the forearm?

Median nerve.

What do the four superficial muscles of the anterior compartment of the forearm attach to proximally?

Medial epicondyle of the humerus (common flexor origin).

What is the muscle in the middle layer of the anterior compartment of the forearm, and how many tendons does it give rise to?

Flexor digitorum superficialis. Gives rise to four tendons (that attach to digits 2-5).

What are the three muscles in the deep layer of the anterior compartment of the forearm?

Flexor digitorum profundus. Flexor pollicis longus. Pronator quadratus.

The flexor digitorum profundus give rise to four tendons, which attach to digits 2-5. What is significant about the innervation of the flexor digitorum profundus?

The lateral half, which gives rise to tendons attaching to the index and middle fingers, is innervated by the median nerve. The medial half, which gives rise to tendons attaching to the ring and little fingers, is innervated by the ulnar nerve.

Which two muscles of the anterior compartment of the forearm are innervated by the ulnar nerve instead of the median nerve?

The flexor carpi ulnaris

What function do most of the muscles of the posterior compartment of the forearm perform?

Extensors of the wrist, digits, or thumb.

What nerve innervates ALL of the muscles of the posterior compartment of the forearm?

Radial nerve.

What do the majority of the muscles of the posterior compartment of the forearm attach to proximally?

The lateral epicondyle of the humerus (common extensor origin).

The muscles of the posterior compartment of the forearm are arranged in two layers, superficial and deep. What are the seven superficial muscles?

Brachioradialis. Extensor carpi radialis longus. Extensor carpi radialis brevis. Extensor digitorum. Extensor digiti minimi. Extensor carpi ulnaris. Anconeus.

Which superficial muscle of the posterior compartment of the forearm is located on the boundary between the posterior and anterior compartments and acts as a weak flexor of the elbow joint, hence functioning as an anterior compartment muscle?

Brachioradialis.

The extensor digitorum extends the digits via four long tendons inserting onto the dorsal aspects of the fingers. Why is it difficult to extend the middle and ring fingers independently?

The tendons of the extensor digitorum are connected by fibrous bands.

What band of tissue prevents the tendons from bowing when the wrist is extended?

The extensor retinaculum.

What are the five deep muscles of the posterior compartment of the forearm?

Supinator. Abductor pollicis longus. Extensor pollicis brevis. Extensor pollicis longus. Extensor indicis.

Where is the radial artery palpable?

Lateral to the tendon of flexor carpi radialis, at the level of the distal radius.

Why is the ulnar artery harder to palpate than the radial artery?

The ulnar artery lies deep to the tendon of flexor carpi ulnaris.

What happens after the radial and ulnar arteries enter the hand?

They anastamose to form palmar arches, to ensure the hand remains adequately perfused if one artery is occluded or injured.

What typically connects the cephalic and basilic veins in the cubital fossa (AFC)?

Median cubital vein.

The carpal tunnel is a narrow passageway at the wrist. What forms the carpal tunnel?

Floor and sides are formed by carpal bones, roof is formed by the flexor retinaculum.

The tendons of the anterior forearm muscles that insert onto the digits travel through the carpal tunnel. What other important structure also travels through the carpal tunnel?

The median nerve.