MSK areas

Question 1

draw the brachial plexus and label

Answer 1

Question 2

borders of the femoral triangle

Answer 2

medial: the medial border of adductor longus
lateral: medial border of sartorius
superior: inguinal ligament

Question 3

contents of the femoral triangle

Answer 3

N femoral nerve

A femoral artery

V femoral vein

E empty space

L lymph nodes

Question 4

femoral canal borders

Answer 4

medial: lacunar ligament
lateral: femoral vein
anterior: inguinal ligament
posterior: pectineus

Question 5

contents of the femoral canal

Answer 5

lymphatic vessels, deep lymph nodes, empty space, loose connective tissue

empty vein allows for distension of the femoral vein

Question 6

borders of the adductor canal

Answer 6

Anteromedial: Sartorius.

Lateral: Vastus medialis.

Posterior: Adductor longus and adductor magnus.

Question 7

content of the adductor canal

Answer 7

femoral artery

femoral vein

nerve to vastus medialis

saphenous nerve

Question 8

popliteal fossa

Answer 8

Superomedial border – semimembranosus.

Superolateral border – biceps femoris.

Inferomedial border – medial head of the gastrocnemius.

Inferolateral border – lateral head of the gastrocnemius and plantaris.

Question 9

popliteal fossa contents

Answer 9

(medial to lateral):

Popliteal artery

Popliteal vein

Tibial nerve

Common fibular nerve (common peroneal nerve)

Question 10

axilla borders

Answer 10

Apex – also known as the axillary inlet, it is formed by lateral border of the first rib, superior border of scapula, and the posterior border of the clavicle.

Lateral wall – formed by intertubercular groove of the humerus.

Medial wall – consists of the serratus anterior and the thoracic wall (ribs and intercostal muscles).

Anterior wall – contains the pectoralis major and the underlying pectoralis minor and the subclavius muscles.

Posterior wall – formed by the subscapularis, teres major and latissimus dorsi.

Question 11

axilla contents

Answer 11

Axillary artery (and branches) – the main artery supplying the upper limb. It is commonly referred as having three parts; one medial to the pectoralis minor, one posterior to pectoralis minor, and one lateral to pectoralis minor. The medial and posterior parts travel in the axilla.

Axillary vein (and tributaries) – the main vein draining the upper limb, its two largest tributaries are the cephalic and basilic veins.

Brachial plexus (and branches) – a collection of spinal nerves that form the peripheral nerves of the upper limb.

Axillary lymph nodes – they filter lymphatic fluid that has drained from the upper limb and pectoral region. Axillary lymph node enlargement is a non-specific indicator of breast cancer.

Biceps brachii (short head) and coracobrachialis – these muscle tendons move through the axilla, where they attach to the coracoid process of the scapula.

Question 12

Borders of the cubital fossa

Answer 12

The cubital fossa is triangular in shape and consists of three borders, a roof, and a floor:

Lateral border – medial border of the brachioradialis muscle.

Medial border – lateral border of the pronator teres muscle.

Superior border – horizontal line drawn between the epicondyles of the humerus.

Roof – bicipital aponeurosis, fascia, subcutaneous fat and skin.

Floor – brachialis (proximally) and supinator (distally).

Question 13

contents of the cubital fossa

Answer 13

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radial nerve

biceps tendon

brachial artery

median nerve

Question 14

carpal tunnel borders

Answer 14

The carpal tunnel is formed by two layers: a deep carpal arch and a superficial flexor retinaculum. The deep carpal arch forms a concave surface, which is converted into a tunnel by the overlying flexor retinaculum (transverse carpal ligament).

Question 15

Carpal Arch

Answer 15

Concave on the palmar side, forming the base and sides of the carpal tunnel.

Formed laterally by the scaphoid and trapezium tubercles

Formed medially by the hook of the hamate and the pisiform

Question 16

Flexor Retinaculum

Answer 16

Thick connective tissue which forms the roof of the carpal tunnel.

Turns the carpal arch into the carpal tunnel by bridging the space between the medial and lateral parts of the arch.

Spans between the hook of hamate and pisiform (medially) to the scaphoid and trapezium (laterally).

Question 17

hand bones

Answer 17

Some – Scaphoid.

Lovers – Lunate.

Try – Triquetrum.

Positions – Pisiform.

That – Trapezium.

They – Trapezoid.

Can’t – Capitate.

Handle – Hamate.

Question 18

hand joints

Answer 18

Question 19

contents of the carpal tunnel

Answer 19

The carpal tunnel contains a total of 9 tendons, surrounded by synovial sheaths, and the median nerve.

Question 20

tendons of the carpal tunnel

Answer 20

The tendon of flexor pollicis longus

Four tendons of flexor digitorum profundus

Four tendons of flexor digitorum superficialis

The 8 tendons of the flexor digitorum profundus and flexor digitorum superficialis are surrounded by a single synovial sheath. The tendon of flexor pollicis longus is surrounded by its own synovial sheath. These sheaths allow free movement of the tendons.

Question 21

Median Nerve

Answer 21

Once it passes through the carpal tunnel, the median nerve divides into 2 sensory branches:

1. Palmar cutaneous- thenar muscle group
2. Digital cutaneous- palmar skina nd dorsal nail beds of the lateral three and a half digits

Question 22

other nervous supply to the hand

Answer 22

ulnar

radius

Question 23

borders of the anatomical snuffbox

Answer 23

As the snuffbox is triangularly shaped, it has three borders, a floor, and a roof:

Ulnar (medial) border: Tendon of the extensor pollicis longus.

Radial (lateral) border: Tendons of the extensor pollicis brevis and abductor pollicis longus.

Proximal border: Styloid process of the radius.

Floor: Carpal bones; scaphoid and trapezium.

Roof: Skin.

Question 24

anatomical snuffbox content

Answer 24

cephalic vein, radial artery and superficial radial nerve branch

Question 25

inguinal ligament basic structure

Answer 25

direct hernia- through the superficial ring (medial to the inferior epigastric vessel) --\> older patients= weakness in abdominal wall indirect hernia- through the deep ring (lateral to the inferior epigastric vessel) --\> younger patients- congenital (male\>female)

Question 26

Mid-inguinal point –

Answer 26

halfway between the pubic symphysis and the anterior superior iliac spine. The femoral pulse can be palpated here.

Question 27

Midpoint of the inguinal ligament

Answer 27

– halfway between the pubic tubercle and the anterior superior iliac spine (the two attachments of the inguinal ligament). The opening to the inguinal canal is located just above this point.

Question 28

borders of the inguinal ligament

Answer 28

Anterior wall – aponeurosis of the external oblique, reinforced by the internal oblique muscle laterally. Posterior wall – transversalis fascia. Roof – transversalis fascia, internal oblique, and transversus abdominis. Floor – inguinal ligament (a ‘rolled up’ portion of the external oblique aponeurosis), thickened medially by the lacunar ligament.

Question 29

Contents of the inguinal canal

Answer 29

The contents of the inguinal canal include: Spermatic cord (biological males only) – contains neurovascular and reproductive structures that supply and drain the testes. See here for more information. Round ligament (biological females only) – originates from the uterine horn and travels through the inguinal canal to attach at the labia majora. Ilioinguinal nerve – contributes towards the sensory innervation of the genitalia Note: only travels through part of the inguinal canal, exiting via the superficial inguinal ring (it does not pass through the deep inguinal ring) This is the nerve most at risk of damage during an inguinal hernia repair. Genital branch of the genitofemoral nerve – supplies the cremaster muscle and anterior scrotal skin in males, and the skin of the mons pubis and labia majora in females.

Question 30

anterior

Answer 30

medial- imaginary midline lateral- anterior border of SCM superir- lower border of mandible

Question 31

posterior

Answer 31

inferior- 1/3 of clavicle anterior- posterior border of SCM posterior- anteiror border of trapezius

Question 32

carotid triangle

Answer 32

Superior – posterior belly of the digastric muscle. Lateral – medial border of the sternocleidomastoid muscle. Inferior – superior belly of the omohyoid muscle.