Practical 1 Flashcards
***Note: All of the bony parts are seen from an inferior aspect of the clavicle
How can you determine if you are examining the left or right clavicle?
- Acromial end is more rounded and blunt than the sternal end
- The sternal end is wider than the acromial end
- Once you determine the above two, check for the superior surface (which is smooth)
How can you determine if you are examining the left or right scapula?
- Locate the glenoid cavity which faces the lateral side
- Locate the spine of the scapula which faces the posterior surface
How can you determine if you are examining the left or right humerus?
- Identify the greater and lesser tubercles of the proximal humerus to help determine the posterior aspect of the humerus
- Locate the capitulum and trochlea to confirm the anterior and posterior aspect
- Identify the medial epicondyle of the distal humerus since it is larger and more prominent than the lateral epicondyle
What is the difference between the glenoid labrum and the glenoid cavity?
Glenoid cavity = shallow depression
Glenoid labrum = fibrocartilaginous rim attached around the margin of the glenoid cavity.
Classify the sternoclavicular joint?
Synovial saddle joint
Classify the acromioclavicular joint?
Synovial plane joint
Classify the glenohumeral joint?
Synovial ball-and-socket joint
Name the joint which is supported by each of the following ligaments?
Acromioclavicular = acromioclavicular joint
Costoclavicular = sternoclavicular joint
Glenohumeral = glenohumeral joint
Coracohumeral = glenohumeral
What features of the shoulder joint make it susceptible to dislocation?
Shallow glenoid cavity
Why is an anterior dislocation more likely than a posterior dislocation?
Majority of the muscles pull the shoulder forward anteriorly, making it more susceptible for anterior dislocations.
PECTORALIS MAJOR
O = Clavicular and sternocostal heads
I = Lateral lip of the bicipital groove
NS = Lateral pectoral nerve & Medial pectoral nerve
M = Adduction & medial rotation of the humerus
*Clavicular = flexes humerus
*Sternocostal = extends humerus
PECTORALIS MINOR
O = At ribs 3, 4 and 5
I = Coracoid process of the scapula
NS = Medial pectoral nerve
M = Stabilises the scapula & Accessory muscle of respiration when pectoral girdle is fixed
SUBCLAVIUS
O = The junction of the 1st rib and its costal cartilage
I = Subclavian groove of clavicle
NS = Subclavian nerve
M = Depresses the lateral clavicle
SERRATUS ANTERIOR
O = External surface of ribs 1-8
I = Anterior (costal) surface on the medial scapular border
NS = Long thoracic nerve
M = Protracts the scapula & holds it to the thoracic wall when punching or reaching objects anteriorly
TRAPEZIUS
O = Superior nuchal line & nuchal ligament spinous processes of C7-T12
I = Lateral ⅓ of the clavicle, acromion and spine of the scapula
NS = CN XI accessory nerve (motor fibres) & C3 and C4 nerve (sensory)
M = Elevates the scapula (descending fibres), retracts the scapula (middle fibres) & depresses the scapula (ascending fibres)
LATISSIMUS DORSI
O = Spinous processes of T7-T12, thoracolumbar fascia, iliac crest, lower 4 ribs
I = Bicipital groove
NS = Thoracodorsal nerve
M = Extension, adduction and medial rotation of the humerus & raises the body to the arms during climbing
LEVATOR SCAPULAE
O = Transverse process of C1-C4
I = Superior angle (or superior border) of the scapula
NS = Dorsal scapular nerve
M = Elevates the scapula
RHOMBOID MINOR
O = Spinous processes of the 7th cervical vertebrae & 1st thoracic vertebrae
I = Medial border of the scapula (level of the spine)
NS = Dorsal scapular nerve
M = Retracts the scapula & rotate the scapula to tilt the glenoid cavity inferiorly
RHOMBOID MAJOR
O = T2-T5 spinous processes
I = Medial border of the scapula (inferior to the spine)
NS = Dorsal scapular nerve
M = Retracts the scapula & rotate the scapula to tilt the glenoid cavity inferiorly
DELTOID
O = Lateral ⅓ of the clavicle, Acromion & spine of the scapula
I = Deltoid tuberosity of the humerus
NS = Axillary nerve
M = Anterior part flexes the arm, middle fibres abduction of the arm after 15 degrees and posterior fibres extend the arm.
TERES MAJOR
O = Inferior lateral border of the scapula
I = Medial lip of the bicipital groove of the humerus
NS = Lower subscapular nerve
M = Adduction & medial rotation at the shoulder joint
SUPRASPINATUS
O = Supraspinous fossa
I = Superior facet of the greater tubercle of the humerus
NS = Suprascapular nerve
M = Abducts arm to 15 degrees
INFRASPINATUS
O = Infraspinous fossa
I = Middle facet of the greater tubercle of the humerus
NS = Suprascapular nerve
M = Lateral rotators of the arm at the shoulder joint
TERES MINOR
O = Superior part of the lateral scapular border
I = Inferior facet of the greater tubercle of the humerus
NS = Axillary nerve
M = Lateral rotators of the arm at the shoulder joint
SUBSCAPULARIS
O = Subscapular fossa
I = Lesser tubercle of the humerus
NS = Upper subscapular nerve & lower subscapular nerve
M = Medial rotator & adductor of the arm at the shoulder joint
LONG HEAD OF BICEPS BRACHII
O = Supraglenoid tubercle of the scapula
I = Radial tuberosity
NS = Musculocutaneous nerve
M = Flexion and supination of the forearm
SHORT HEAD OF BICEPS BRACHII
O = Coracoid process of the scapula
I = Radial tuberosity
NS = Musculocutaneous nerve
M = Flexion and supination of the forearm
CORACOBRACHIALIS
O = Coracoid process of the scapula
I = Middle third of the humerus shaft (medial side)
NS = Musculocutaneous nerve
M = Adductor of the arm
BRACHIALIS
O = Distal two thirds of the anterior surface of the humerus
I = Ulnar tuberosity
NS = Musculocutaneous nerve
M = Chief flexor of the forearm
LONG HEAD OF TRICEPS BRACHII
O = Infraglenoid tubercle of the scapula
I = Olecranon process
NS = Radial nerve
M = Assists with the extension and adduction of the arm at the shoulder joint
MEDIAL HEAD OF TRICEPS BRACHII
O = Posterior surface of the humerus (inferior to the radial groove)
I = Olecranon process
NS = Radial nerve
M = Extension of the forearm
LATERAL HEAD OF TRICEPS BRACHII
O = Posterior surface of the humerus (superior to the radial groove)
I = Olecranon process
NS = Radial nerve
M = Assists with forearm extension at the elbow joint when the forearm is supinated or pronated
- Coracoacromial ligament
- Coracohumeral ligament
- Superior glenohumeral ligament
- Middle glenohumeral ligament
- Inferior glenohumeral ligament
- Trapezoid ligament
- Conoid ligament
- Transverse scapular ligament
- Acromioclavicular ligament
- Supraspinatus tendon
What are the muscles that join the scapula to the humerus?
Deltoid
Supraspinatus
Infraspinatus
Subscapularis
Teres major
Teres minor
What are the muscles that attach to the coracoid process of the scapula?
Pectoralis minor
Coracobrachialis
Short head of the biceps brachii
What are the muscles that move the scapula, but are NOT attached to the humerus?
Trapezius
Rhomboid major
Rhomboid minor
Levator scapulae
Serratus anterior
What are the muscles that attach to the greater tubercle of the humerus?
Supraspinatus
Infraspinatus
Teres major
What are the muscle that attaches to the lesser tubercle of the humerus?
Subscapularis
- Clavicle
- Acromial end of the clavicle
- Acromion
- Greater tubercle of the humerus
- Head of the humerus
- Lesser tubercle of the humerus
- Surgical neck of the humerus
- Coracoid process of the scapula
- Glenoid fossa
- Shoulder joint
- Lateral border of the scapula
- Lateral supracondylar ridge
- Medial supracondylar ridge
How can you determine if you are examining the left or right radius?
- The radial tuberosity is on the medial side
- The styloid process is on the lateral side
How can you determine if you are examining the left or right ulna?
- The olecranon sits in the posterior surface
- The radial notch is on the lateral side of the ulna
- The styloid process is on the medial side
What are the articular surfaces for the ulnohumeral (elbow) joint?
Trochlea notch of the ulna
Trochlea of the humerus
What are the articular surfaces for the proximal radio-ulnar joint?
Head of the radius
Radial notch of the ulna
Classify the ulnohumeral (elbow) joint?
Synovial hinge joint
Flexion and extension
Classify the proximal radio-ulnar joint?
Synovial pivot joint
Supination and pronation
What is the joint which is supported by the radial and ulnar collateral ligaments?
Ulnohumeral (elbow) joint
What is the joint which is supported by the annular ligament?
Proximal radio-ulnar joint
Name the muscles that join the arm to the forearm?
Anterior and posterior arm muscles (excluding coracobrachialis)
Name the muscles that attach to the medial epicondyle of the humerus?
Superficial and middle anterior forearm muscles (i.e. pronator teres, flexor carpi radialis, palmaris longus, flexor carpi ulnaris, flexor digitorum superficialis)
Name the muscles that attach to the lateral epicondyle of the humerus?
Extensor carpi radialis brevis
Extensor digitorum
Extensor digiti minimi
Extensor carpi ulnaris
PRONATOR TERES
O = Medial epicondyle of the humerus
I = Mid shaft of the radius
NS = Median nerve
M = Pronator of the forearm
FLEXOR CARPI RADIALIS
O = Medial epicondyle of the humerus
I = Base of the 2nd metacarpal bone
NS = Median nerve
M = Flexes and abducts the hand at the wrist
PALMARIS LONGUS
O = Medial epicondyle of the humerus
I = Palmar aponeurosis
NS = Median nerve
M = Flexes the hand at the wrist and tightens the palmar aponeurosis
FLEXOR CARPI ULNARIS
O = Medial epicondyle of the humerus
I = Pisiform, hook of hamate & 5th metacarpal bone
NS = Ulnar nerve
M = Flexes and adducts the hand at the wrist joint
FLEXOR DIGITORUM SUPERFICIALIS
O = Medial epicondyle of the humerus, coronoid process of the ulna & anterior border of the radius
I = Middle phalanges of the medial 4 digits
NS = Median nerve
M = Flexion of the middle phalanges at proximal interphalangeal joints & flexion of proximal phalanges at metacarpophalangeal joints
FLEXOR POLLICIS LONGUS
O = Anterior surface of the radius & interosseous membrane
I = Base of the distal phalanx of the thumb
NS = Median nerve
M = Flexes phalanges of the thumb
FLEXOR DIGITORUM PROFUNDUS
O = Proximal anterior surface of the ulna
I = Base of distal phalanges of medial four digits
NS = ulnar nerve (medial 1/2) & median nerve (lateral 1/2)
M = Flexes distal phalanges at distal interphalangeal joints, metacarpophalangeal joints & assists in flexion of hand
PRONATOR QUADRATUS
O = Medial, anterior surface of the ulna
I = Distal anterior surfaces of the radius and ulna
NS = Median nerve
M = Pronation of the radioulnar joint
- Supinator
- Abductor pollicis longus
- Extensor pollicis brevis
- Extensor pollicis longus
- Extensor indicis
- Brachioradialis
- Extensor carpi radialis longus
- Extensor carpi radialis brevis
- Extensor digitorum
- Anconeus
- Extensor carpi ulnaris
- Extensor digiti minimi
BRACHIORADIALIS
O = Lateral supracondylar ridge of the humerus
I = Just above the radial styloid process
NS = Radial nerve
M = Flexor of the forearm at the elbow
EXTENSOR CARPI RADIALIS LONGUS
O = Lateral supracondylar ridge of the humerus
I = Base of the second metacarpal
NS = Deep branch of the radial nerve
M = Extensors of the wrist
EXTENSOR CARPI RADIALIS BREVIS
O = Lateral epicondyle of the humerus
I = Base of the third metacarpal bone
NS = Deep branch of the radial nerve
M = Extensors of the wrist
EXTENSOR DIGITORUM
O = Lateral humeral epicondyle
I = Extensor expansion of medial 4 digits
NS = Deep branch of the radial nerve
M = Extends medial four digits at the metacarpophalangeal joints and interphalangeal joints
EXTENSOR DIGITI MINIMI
O = Lateral epicondyle of humerus
I = Extension of the 5th digit
NS = Deep branch of the radial nerve
M = Extends the 5th digit at the 5th metacarpophalangeal joint
EXTENSOR CARPI ULNARIS
O = Lateral epicondyle of the distal humerus
I = Base of the fifth metacarpal
NS = Deep branch of the radial nerve
M = Extensors of the wrist
ANCONEUS
O = Lateral epicondyle of the humerus
I = Lateral side of the olecranon and posterior surface of the ulna
NS = Radial nerve
M = Assists triceps brachii with extension of the elbow
SUPINATOR
O = Lateral epicondyle of the humerus, radial collateral ligament and supinator fossa
I = Proximal radius
NS = Deep branch of the radial nerve
M = Supination of the forearm when the elbow is extended
ABDUCTOR POLLICIS LONGUS
O = Posterior sides of the radius, ulna, and interosseous membrane
I = Base of the first metacarpal bone
NS = Posterior interosseus nerve (the continuation of the deep branch of radial nerve
M = Abducts and extends thumb at carpometacarpal joint
EXTENSOR POLLICIS BREVIS
O = Lower third of the posterior surface of the radius and the interosseous membrane
I = Proximal phalanx of the thumb
NS = Posterior interosseus nerve (the continuation of the deep
M = Extends proximal phalanx of thumb at carpometacarpal joint
EXTENSOR POLLICIS LONGUS
O = Middle third of the posterior surface of ulna
I = Distal phalanx of thumb
NS = Posterior interosseus nerve (the continuation of the deep
M = Extends distal phalanx of thumb at both metacarpophalangeal and interphalangeal joint
EXTENSOR INDICIS
O = Posterior two-thirds of the distal ulna
I = Tendon then inserts onto the extensor digitorum muscle that goes to the index finger
NS = Posterior interosseus nerve (the continuation of the deep
M = Extends the 2nd digit at the 2nd metacarpophalangeal and interphalangeal joints
What is the general function of the retinacula at the wrist?
Prevents ‘bowstringing’
What is the function of the flexor retinaculum?
Prevents the flexor (anterior) muscles from popping out during muscle contraction (flexion of the forearm at the wrist joint)
What is the function of the extensor retinaculum?
Prevents the extensor (posterior) muscles from popping out during muscle contraction (extension of the forearm at the wrist joint)
What is the 1 action that the FCR, ECRL and ECRB all have in common? Why?
Abduct the hand at the wrist joint
Because all the muscles and their tendons run along the radial side of the forearm
What is the 1 action that the ECU and FCU have in common? Why?
Adducts the hand at the wrist
Because all the muscles and their tendson run along the ulnar side of the forearm
- Shaft of the humerus
- Olecranon of the ulna
- Trochlear notch
- Radial head
- Radial neck
- Radial tuberosity
- Shaft of the ulna
- Lateral surface of the humerus
- Medial surface of the humerus
- Olecranon fossa of the humerus
- Medial epicondyle of the humerus
- Lateral epicondyle of the humerus
- Capitulum of the humerus
- Olecranon of the ulna
- Trochlear notch of the ulna
- Coronoid process of the ulna
- Proximal radio-ulnar joint
- Head of the radius
- Neck of the radius
- Radial tuberosity
- Shaft of the ulna
- Dorsal tubercle of the radius
- Ulnar notch of radius
- Articular disc of distal radioulnar joint
- Lunate
- Scaphoid
- Triquetrium
How can you determine if you are examining the left or right hand on a radiogram?
- Take note of the thumb to know the lateral side
- Try identifying the pisiform carpal bone (if you can see it, it is an anterior position)
How can you distinguish between the anterior and posterior surface of the hand on a radiogram?
- Try and see the curvature of the carpals, metacarpals and phalanges?
- Try identifying the pisiform carpal bone (if you can see it, it is an anterior, palmar position)
Name the bones and articular surfaces which contribute to each of the following joints:
Distal radio-ulnar joint
Wrist joint
Midcarpal joint
Distal radio-ulnar joint:
The head of the ulna and the ulnar notch of the radius
Wrist joint:
The distal end of the radius and the scaphoid and lunate carpal bones
Midcarpal joint:
Between the proximal row (scaphoid, lunate, and triquetrum) and the distal row (trapezium, trapezoid, capitate, and hamate)
Name the bones and articular surfaces which contribute to each of the following joints:
Carpometacarpal joint of the thumb
Carpometacarpal joint of digits 2-5
Metacarpophalangeal joints
Carpometacarpal joint of the thumb:
Trapezium and the base of the 1st metacarpal
Carpometacarpal joint of digit 2:
Trapezoid (primarily) with the base of the 2nd metacarpal
Carpometacarpal joint of digit 3:
Capitate (primarily) with the base of the 3rd metacarpal
Carpometacarpal joint of digit 4:
Capitate & hamate with the base of the 4th metacarpal
Carpometacarpal joint of digit 5:
Hook of hamate with the base of the 5th metacarpal
Metacarpophalangeal joints:
Heads of the proximal metacarpals with the bases of the proximal phalanges
Name the bones and articular surfaces which contribute to each of the following joints:
Proximal interphalangeal joints
Distal interphalangeal joints
Interphalangeal joint of the thumb
Proximal interphalangeal joints:
The heads of the proximal phalanges articulate with the bases of the middle phalanges
Distal interphalangeal joints:
The heads of the middle phalanges articulate with the bases of the distal phalanges
Interphalangeal joint of the thumb:
The head of the proximal phalanx of the thumb articulates with the base of the distal phalanx
Dorsal radiocarpal ligament is on the dorsal aspect of the hand (this image is from the palmar aspect)
Classify the joints and list the movements possible?
- Distal radioulnar joint
- Wrist (radiocarpal) joint
- Midcarpal joint
- Intercarpal joint
- Carpometacarpal joint of the thumb
- Carpometacarpal joint of digits 2-5
- Metacarpophalangeal joint of the thumb
- Metacarpophalangeal joint of digits 2-5
- Interphalangeal joints of digits 1-5
- Synovial pivot (supination and pronation)
- Synovial condyloid (flexion, extension, abduction, adduction, limited circumduction)
- Synovial plane (gliding movements & involved with extension and abduction for the wrist joint)
- Synovial plane (gliding movements & involved with extension and abduction for the wrist joint)
- Synovial saddle (flexion, extension, abduction, adduction)
- Synovial plane (gliding)
- Synovial hinge (flexion, extension)
- Synovial condyloid (flexion, extension, abduction, adduction)
- Synovial hinge (flexion, extension)
- Extensor hood
- Extensor digitorum tendons
- Extensor indicis tendon
- Extensor digiti minimi tendon (most medial)
- Extensor pollicis longus tendon
- Lumbricals
- Adductor pollicis
- Opponens pollicis
- Abductor digiti minimi
- Flexor digiti minimi brevis
- Opponens digiti minimi
- Flexor digitorum profundus tendons
- 1st dorsal interosseus
- Adductor pollicis
- Flexor pollicis brevis
- Abductor pollicis brevis
- Abductor digiti minimi
- Median nerve
- Abductor digiti minimi
- Flexor digiti minimi
- Abductor pollicis brevis
- Flexor pollicis brevis
- Transverse head of adductor pollicis
- Oblique head of adductor pollicis
- Lumbricals of digits 2 and 3
- Extensor pollicis brevis (tendon)
- Extensor pollicis longus (tendon)
- Extensor carpi radialis longus (tendon)
- Extensor carpi radialis brevis (tendon)
- Extensor digitorum of digits 3 and 4 (tendon)
- Combined extensor digitorum and extensor indicis (tendon)
- Dorsal interossei
- Abductor digiti minimi
ABDUCTOR POLLICIS BREVIS
NS = Median nerve
M = Abducts thumb at metacarpophalangeal joint of the thumb
FLEXOR POLLICIS BREVIS
NS = Median nerve
M = Flexes thumb at metacarpophalangeal joint of the thumb
OPPONENS POLLICIS
NS = Median nerve
M = Draws 1st metacarpal bone medially to oppose thumb and rotates it medially
ADDUCTOR POLLICIS
NS = Ulnar nerve
M = Adducts the thumb at the 1st metacarpophalangeal joint
ABDUCTOR DIGITI MINIMI
NS = Ulnar nerve
M = Abducts 5th digit at the metacarpophalangeal joint of the 5th digit
FLEXOR DIGITI MINIMI
NS = Ulnar nerve
M = Flexes the 5th digit at the metacarpophalangeal joint of the 5th digit
OPPONENS DIGITI MINIMI
NS = Ulnar nerve
M = Lateral rotation of the 5th digit
3?
LUMBRICALS
NS = Ulnar nerve (medial 2) and median nerve (lateral 2)
M = Flexes metacarpophalangeal joint of digits 2-5 while extending interphalangeal joints of digits 2-5
PALMAR INTEROSSEI (x3)
NS = Ulnar nerve
M = Adducts all the digits except the 3rd digit at the 3rd metacarpophalangeal joints
DORSAL INTEROSSEI (x4)
NS = Ulnar nerve
M = Abducts digits 2,3 and 4
PALMARIS BREVIS
NS = Ulnar nerve
M = Improves grip
- Palmar aponeurosis
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- C5 root
- C6 root
- C7 root
- C8 root
- T1 root
- C5 root
- C6 root
- C7 root
- Superior trunk
- Middle trunk
- Inferior trunk
- Posterior division
- Anterior division
- Lateral cord
- Posterior cord
- Medial cord
- Axillary nerve
- Musculocutaneous nerve
- Median nerve
- Radial nerve
- Ulnar nerve
- Musculocutaneous nerve
- Axillary nerve
- Radial nerve
- Median nerve
- Ulnar nerve
- Median nerve
- Ulnar nerve
- Radial nerve
- Musculocutaneous nerve
- Axillary nerve
- Axillary nerve
- Radial nerve
- Ulnar nerve
- Median nerve
- Axillary nerve
A. Brachial artery
B. Radial artery
C. Ulnar artery
- Trapezium
- Trapezoid
- Capitate
- Head of capitate
- Hamate
- Hook of hamate
- Scaphoid
- Lunate
- Pisiform
- Triquetrum
- Styloid process of the radius
- Head of the ulna
- Styloid process of the ulna
- Ulnar notch of the radius
- Distal radio-ulnar joint
- Radiocarpal (wrist) joint
- Carpometacarpal joint of digits 2-5
- Carpometacarpal joint of digit 1
- Midcarpal joint
- Distal phalanx of 2nd digit
- Middle phalanx of 2nd digit
- Proximal phalanx of 2nd digit
- Distal phalanx of 1st digit
- Proximal phalanx of 1st digit
- Sesamoid bone of the thumb
- Distal interphalangeal joint of 5th digit
- Proximal interphalangeal joint of 5th digit
- Metacarpophalangeal joint of 5th digit
- Carpometacarpal joint of digits 1-5 (combined 2 joints in this annotation)
- Trapezium
- Trapezoid
- Capitate
- Hamate
- Scaphoid
- Lunate
- Pisiform
- Triquetrum
- Styloid process of the radius
- Head of the ulna
- Right subclavian artery
- Right axillary artery
- Right brachial artery
- Radial artery
- Ulnar artery
- Palmar arch artery (likely the deep)
- Common palmar digital arteries
- Proper palmar digital arteries
- Axillary artery
- Thoracoacromial artery
- Pectoral branch of thoracoacromial artery
- Lateral thoracic artery
- Subscapular artery
- Circumflex scapular artery
- Thoracodorsal artery
- Anterior circumflex humeral artery
- Posterior circumflex humeral artery
- Brachial artery
- Acromion of scapula
- Superior angle of scapula
- Inferior angle of scapula
- Acromial end of clavicle
- Greater tubercle of humerus
- Lesser tubercle of humerus
- Shaft of humerus
- Coracoid process
- Insertion of extensor pollicis longus
- Insertion of extensor pollicis brevis
- Insertion of adbuctor pollicis longus
- Anatomical snuff box
- Median nerve
- Ulnar nerve
- Superficial branch of the radian nerve