Musculoskeletal Final Flashcards
List some anatomical features of the clavicle, distal to medial:
Acromial End, Trapazoid line, Conoid tubercle, sublclavian groove, Sternal end
Name 4 fossae of the scapula.
Supraspinous
Infraspinous
Subscapular
Glenoid
Where is the acromion process of the scapula found in relation to the coracoid process?
Acromion is an extension of the Scapular Spine and the Coracoid is deep to it.
What notch/foramen is below the Acromion Process?
Spinoglenoid foramen
What process make the arch under which the supraspinatus tendon passes?
The acromion (3 types - flat, curved, and hooked)
Where does the deltoid attach to the humerus?
Halfway down
What is the name of the shoulder joint?
Gleno-humoral joint
What’s bigger - the anatomical or surgical neck of the humerus?
Surgical
anatomical just articulation
What is a main feature of the Sternoclavicular joint?
Articular disc!
What ligament connects the two clavicles?
Interclavicular ligament
Name 4 ligaments in the sternoclavicular joint.
Interclavicular
Ant. sternoclavicular joint
Post. sternoclavicular joint
Costo-clavicular
_______ is part of the acromioclavicular joint.
An articular disc
What are the two coracoclavicular ligaments?
Trapezoid
Conoid
What are the 3 Glenohumoral Ligaments?
Inferior, Middle, Superior
What is the most important glenohumoral ligament in terms of stability?
Inferior
What kind of disc is found in the glenoid labrum?
Fibrocartilage disc
T/F
There is one glenohumoral bursa
False.
The shoulder has many bursae
What is the primary Glenohumoral bursa?
What is its function?
Subacromial
Cushions rotator cuff
What two structures form an arch over the humoral head?
Coracoacromial ligament
Subacromial bursa
Is the scapulothoracic a true articulation?
No. lacks a ligament or bony connection.
Only has loose CT
With what frequency does pathology occur within the coracoclavicular joint and what population is it more common?
1-9%
Asians
What are the 4 anterior muscles of the axioappendicular muscles?
Pectoralis Major
Pectoralis Minor
Subclavius
Serratus Anterior
Origin, insertion, action, innervation for Pec Major:
medial 1/2 clavicle & sternum > bicipital groove
humeral/horizontal adduction
medial/lateral pectoral n.
What could shorten the pectoralis minor?
hunching over a computer all day
What is the origin/insertion of the pectoralis minor?
Upper ribs (3-5) > medial coracoid process
What muscle in the axioappendicular is innervated by a nerve of the same name?
Subclavius
Origin, insertion, innervation of the serratus anterior?
Upper 8 Ribs > Anterior Scapula
Long thoracic n.
Name the 6 posterior axioappendicular muscles.
Trapezius, Latissimus dorsi, levator scapulae, rhomboid major, rhomboid minor, omohyoid
Cervical and Thoracic spine > Scapular spine/clavicle
CN XI and C3/C4
Trapezius
Spinous processes lower 6 Thoracic + lower 3-4 ribs + iliac crest and thoracolumbar fascia > Floor of bicipital groove
Lat. Dorsi
What nerve innervates the Latissimus dorsi?
thoracodorsal n.
What is the function of the two Rhomboids (major and minor)?
Scapular retraction
What innervates the Omohyoid?
Ansa cervicalis n. (of the cervical plexus)
What are the 6 Scapulohumeral Muscles?
Deltoid Supraspinatus Infraspinatus Teres Minor Subscapularis Teres Major
What four muscles make up the rotator cuff?
Supraspinatus
Infraspinatus
Teres Minor
Subscapularis
Which rotator cuff muscle is injured the most?
Supraspinatus
Why are 4 separate muscles considered one rotator cuff?
Blends together around the humoral head with a conjoined tendon.
T/F
The Teres Major is part of the Rotator Cuff?
False
What innervate the Teres Major and Teres Minor?
Lower subscapular n.
Axillary n.
What are the 3 anterior muscles of the arm?
Biceps Brachii
Brachialis
Coracobrachialis
What are the 2 posterior muscles of the arm?
Triceps
Anconeus
What innervates the 3 muscles of the anterior compartment of the arm?
Musculocutaneous n.
What innervates the 2 muscles of the posterior compartment of the arm?
Radial n.
What are the 3 articulations in the elbow?
humero-radial
humero-ulnar
Proximal Radioulnar
What is the large rounded distal epicondyle of the humerus and with what does it articulate?
Capitellum
Radius
What is the humoral articular surface with the ulna?
Trochlea
name 2 anterior fossa of the distal humerus.
coronoid
radial
What is the name of the posterior fossa of the distal humerus?
Olecranon
The Ulna ______ in size distally, while the radius ______ in size distally.
Decreases
Increases
What separates the distal end of the ulna from the carpal bones?
TFCC
Triangular Fibrocartilage Complex
What inserts into the ulnar and radial tuberosities?
Biceps
What is the round articular surface on radius called where it articulates with the humerus?
Articular fovea
What is the function of the annular ligament?
Cups the head of the radius at radio-humeral joint.
Anatomically, the humeroradial is what type of joint?
Ball and socket
The humeroradial joint articulates what two surfaces?
Capitellum with the Articular Fovea
The humeroradial joint is better at absorbing _____ compression than ______ compression.
lateral
medial
T/F
The reason the humeroradial joint is resistant to lateral forces is because of the radial collateral ligament.
False
Most resistance is structural and comes from Capitellum
What type of joint is the humeroulnar?
True hinge joint
very stable
What results in carrying an angle at the elbow?
The asymmetrical nature of the Trochlea in the humerus
What makes up the Ulnar Medial (collateral) ligament?
Anterior, Posterior, and Transverse bands
What is the point of articulation in the proximal radioulnar joint?
Radial head > Radial notch of ulna
What type of joint is the radioulnar?
Ellipsoid
What degree of freedom does the radioulnar joint allow?
Supination and pronation
What ligament holds the radial head against the ulna?
Annular L.
What does the annular ligament both originate in and insert to?
The Coronoid Process
What ligament prevents traction in the proximal radio-ulnar joint?
Annular Ligament
What motions does the Annular Ligament allow?
Pronation and Supination
How many carpal bones in the hand?
8
2 rows of 4
Name 3 joints of the wrist.
Distal Radioulnar
Radiocarpal
Midcarpal
What is unique about the Pisiform carpal bone?
Lies anterior to the triquetrium and forms the Tunnel of Guyon with the Hamate
What is the Tunnel of Guyon?
Forms a passage between the Pisiform and Hamate that the Ulnar n. passes through
Some Lovers Try Positions That They Can’t Handle:
Scaphoid Lunate Triquetrium Pisiform Trapezium Trapezoid Capitate Hamate
What is the most commonly fractured carpal bone?
Scaphoid
What bone is palpable at the snuff box?
Scaphoid
How many Metacarpals are there?
5
How many phalanges are there?
14
How many metacarpal joints are there?
5
How many proximal interphalangeal joints are there?
4
How many distal interphalangeal joints are there?
4
How many Interphalangeal joints are there?
1 (thumb)
What are the three groups of the flexor compartment (Anterior) of the forearm muscles?
Superficial, Intermediate, and Deep
What innervates almost all of the flexor muscles of the forearm?
Median n.
What are the four muscles of the superficial group of the flexor forearm muscles?
Pronator teres
Flexor Carpi Radialis
Palmaris Longus
Flexor Carpi Ulnaris
What makes up the intermediate group of the flexor forearm?
Flexor Digitorum Superficialis
one muscle - don’t know why this is a “group”
What muscle of the deep forearm flexion group has 2 innervations?
Flexor Digitorum Profundis
Median n. 2 & 3
Ulnar n. 4 & 5
What nerve innervates all extensor muscles of the forearm?
Radial n.
What are the 4 groups of the extensor forearm muscles and how many per group?
Lateral, Medial, Outcropping, and Miscellaneous groups
3 muscles per group
Which group of the extensor forearm muscles makes the anatomical snuff box?
Outcropping Group
1 Soup Now
Extensor Indicis
Supinator
Anconeous
What are the functions of the Palmar Aponeurosis?
Grip, protection (it’s thick)
also - deep insertion into palmar ligaments
What is the thickening of the palmar fascia that contributes to flexion of the two ulnar fingers?
Dupuytren’s Contracture
(something also about males over 50)
What are the boundaries of the carpal tunnel?
Hook of Hamate and Pisiform (ulnar) to Scaphoid tubercle and Crest of Trapezium (radial)
+
Transverse carpal ligament (on palmar (volar) side)
How many structures does the Carpal Tunnel have?
10
What are the 10 structures of the Carpal Tunnel
9 tendons 1 nerve Flexor digitorum superficialis (4T) Flexor digitorum profundus (4T) Flexor pollicis longus (1T) Median n.
What is a characteristic of all carpal tendons?
Synovial sheaths
What is it called when a synovial sheath of the carpal tunnel swells?
Tenosynovitis
Carpal Tunnel Syndrome is an inflammation of what?
synovial sheaths
What nerve can suffer damage in carpal tunnel syndrome?
Median n.
Double Crush
Thoracic Outlet Syndrome
something about Proximal Compression
in carpal tunnel syndrome
What is Trigger Finger?
inflamed synovial lining + compression = stuck finger
Name the 4 muscles of the Thenar Eminence superficial to deep.
Abductor pollicis brevis
Flexor pollicis brevis
opponens pollicis
Adductor pollicis
What are the three branches of the Aorta and where do they go?
Brachiocephalic Trunk (right)
Subclavian a. (left)
Common Carotid a. (left)
Where does the axial a. to brachial a. division occur?
Teres Major
What are the first two branches to come off the Subclavian a. ?
Vertebral a.
Thyrocervical a.
What are 2 arteries that branch off the Thyrocervical Trunk?
Suprascapular a.
Transverse cervical a.
What two arteries come off the Transverse Cervical a. and what do they supply?
Superficial branch > Trapezius
Deep branch > Rhomboids
Trace the rhomboids blood supply back to the Aorta.
Rhomboids > Deep branch transverse cervical a. > Transverse cervical a. > Thyrocervical Trunk > Subclavian > Aorta
When does the subclavian change to the Axillary?
After passes the 1st rib
When does the Axillary artery change its name to Brachial?
After Teres Major
The Thoraco-Acromial artery comes from what division of the Axillary and supplies what?
2nd Division Axillary
Pectoral, Acromial, Clavicular, Deltoid
What are the boundaries of the brachial artery?
Inferior border of the Teres Major to the Cubital Fossa
What is the 1st branch of the brachial artery and where does it go?
Profunda Brachii (follows the Radial n. deep and to the Posterior side)
What happens to the vasculature at the elbow?
Anastomosis of:
Brachial a. and Ulnar a. around medial elbow.
&
w/ Profunda brachii/distal Radial a. on anterior/posterior lateral elbow
Where does vasculature go after the elbow anastomosis?
Interosseous space in forearm
then,
Ulnar and Radial aa. continue distally
Distal to the cubital fossa, what does the brachial a. divide into?
Radial a. and Ulnar a.
What are the three arches of hand vasculature?
Superficial palmar
Deep palmar
Dorsal carpal
What are the two divisions of digital arteries and which one is distal?
Common palmar
Proper palmar
What veins do not parallel the arteries?
Cutaneous
What are the two cutaneous veins in the arm?
Cephalic
Basilic
What are the borders of the Cubital Fossa?
Pronator Teres
Brachioradialis
Line between epicondyles (of humerus?)
T/F
The brachial plexus is formed by the dorsal ramii
False
What comprises the roots of the Brachial Plexus?
Ventral Rami
What will the brachial plexus mostly innervate?
Somatic muscle - motor and sensory
What would a nerve traveling through a chain ganglia and using the brachial plexus pathway innervate?
Somatic smooth muscle (glands, erector pili)
If a nerve innervates visceral smooth muscle, it goes through ______ ganglia
prevertebral (splanchnic)
What spinal nerves make up the brachial plexus?
C5 - T1
When are Trunks formed in the Brachial Plexus?
When the Roots come together
The posterior division is _______ to the anterior divisions of the brachial plexus.
In between
What are the three cords in the brachial plexus?
lateral
posterior
medial
What are the branches of cords in the brachial plexus?
Lateral: Musculocutaneous & Lateral half median n.
Medial: Medial half median n. & Ulnar n.
Posterior: Axillary & Radial
What is the musculocutaneous nerve called at its termination?
Lateral antebrachial cutaneous n.
Mnemonic for Drawing plexus
You Young Mermaids LineUp in front of Poseidon’s UTLRA Trident
Mnemonic for naming nerves
LSD SaLT MMMUMM
What does the axillary n. innervate?
Deltoid
Teres Minor
What spinal nerve contributions does the Ranial n. receive?
C5-T1
The radial nerve travels down the what part of the humerus and with what brachial artery?
Posterior humerus
deep brachial artery
Where does the radial nerve terminate?
What other nerves branch from it?
Dorsal Inerosseous n.
inferior lateral brachial cutaneous n.
posterior antebrachial cutaneous n.
How many muscles does the radial nerve innervate?
13
What does the Ulnar n. innervate?
medial hand / most muscles of hand
skin of hand
What does the Median n. innervate?
Flexor muscles in the forearm
and a few hand muscles
specific portion of cutaneous lateral hand
In the C5-T1 spinal nerves, what is the general pattern of innervation as move distally?
The more distal, the lower down the spine the innervation.
What nerve is affected in upper humeral/surgical neck breaks?
Axillary n.
A midshaft humeral break affects what nerve?
Radial n.
A distal humeral fracture affects?
Median n.
A medial epicondyle fracture affects?
Ulnar n.
A dermatome represents what level of innervation?
Root level
T/F
There are cutaneous nerves in the upper extremity that don’t come from the brachial plexus.
False
What can be determined using dermatome testing?
Whether problem is root level or cutaneous level.
