Test 3 - Questions from Spencer & Zill Lectures Flashcards
Removal of a single lobe of the mammary gland in a procedure called
Lobectomy
Central lymph node drains into which node?
Apical node
Lymph node that drains the lateral breast and receives 75% of lymph from breast
Anterior/pectoral axillary node
This is the 3rd ligament found in the shoulder around the acromioclavicular joint, but it does NOT maintain the joint
Corocoacromial ligament
Blood supply to mammary gland is done by three artery branches, what are they?
- Internal thoracic/mammary artery (branch subclavian artery)2. Lateral thoracic artery (branch of axillary artery)3. Thoracoacromial artery (branch of axillary artery)Mnemonic: LIT arteries
Lymph node that drains the medial part of the breast, recives 25% of the lymph from the breast and sits next to the internal thoracic vessels
Parasternal node
Clavipectoral Fascia1. What muscles does it envelope?2. What is its main function?
1.Covers pectoralis minor and subclavius 2. Protects underlying nerves of brachial plexus and axillary vessels. 3. Attached to clavicle and axillary fascia
Space between breast (mammary glands) and pectoral fascia of pectoralis major that allows for movement of breast and can be invaded by rumors that may fix breast to thoracic wall
Retromammary Space
The three structures piercing the clavipectoral fascia are:
- Cephalic vein2. Thoracoacromial artery3. Lateral pectoral nerve
Name the Rotator cuff muscles supporting the shoulder joint
Supraspinatus, infraspinatus, teres minor and subscapularis
Removal of auxiliary tail of mammary gland in procedure called
Radical mastectomy
Palpitation of the tip of the coracoid process of the scapula is done in a region called? What else is in this area?
Deltopectoral TriangleCephalic vein
What three lymph nodes drain into the central lymph node
- Humeral (drains upper limbs)2. Posterior/subscapular (drains posterior wall of axilla)3. Anterior/pectoral (drains anterior wall of axilla and lateral side of breast)
Apical lymph node drains into which node?
Supraclavicular node
Supraclavicular lymph node drains into which node?
Right subclavian lymph trunk –> right lymphatic ductLeft subclavian lymph trunk –> thoracic lymphatic duct
Clinical presentation of posterior dislocation of elbow joint: 1. Occurs commonly in young children when they fall on outstretched hands2. Humerus is pushed through the weak/developing anterior capsule of joint3. Ulna and radius bones are pushed posteriorlyWhat nerve may be compromised in this injury?
Ulnar nerve, courses posteriorly around the ulna bone.
Clinical presentation of separated shoulder or dislocation of AC joint: two ligaments tear (name them), the clavicle is elevated due to trapezium muscle pulling and scapula falls away from weight of upper limb
Acromioclavicular and coracoclavicular ligaments
Clinical presentation (Winged scapula): medial border of scapula protrudes posteriorly when patient pushes hands agains wall. What nerve is damaged and what affected muscle does it innervate?
Nerve: long thoracic nerve or nerve to serratus anteriorMuscle: serratus anterior
The proximal radioulnar joint is between the head of the radius and the radial notch of the ulna bone.1. What type of joint? 2. What ligament holds this joint in place?3. What actions does the joint allow?4.
- Pivot joint2. Annular ligament3. Supination and pronation
Thoracodorsal nerve innervates which muscle
Latissimus dorsi
Glenohumeral joint is what type of joint?
Multiaxial ball and socket joint
The radiocarpal joint allows for what types of movement? (4)
Flexion, extension, adduction, abduction
The two cartilages associated with the glenoid fossa and their function are:
- Fibrous cartilage in glenoid labrum (deepens glenoid cavity)2. Hyaline cartilage in glenoid fossa (prevent/reduce wear and tear)
What is the name of the group of ligaments that support the elbow joint medially? Also the ligaments that are repaired in a procedure called Tommy John’s Surgery.
Ulnar collateral ligament
The elbow joint is what type of joint and what movements are allowed?
Synovial hinge jointFlexion and extension only.
The lateral ligaments of the elbow joint are ?
Radial collateral and annular ligament
Fascia on pectoralis major
Pectoral fascia
Clinical presentation: joint dislocation seen in younger children, presents as a bump on the skin from the displaced head of the radius. May be caused by excessive force on child’s arm that forces the radius superiorily (biceps also pulls on dislocated bone)What is the name of the joint that is affected?
Proximal radioulnar joint
Mammary Gland
Modified sweat gland located in superficial fascia: contains - suspensory ligament, - dividing breast into lobes, - with milk secreting glands, - via lactiferous duct
Inferior dislocation of glenohumeral joint can cause damage to which nerve?
Axillary nerve
Distal radioulnar joint is between ? Allows for what movements? And has an articulate disc that strong,y supports the joint and also seperates this joint from the wrist joint.
Head of Ulna and ulnar notch of radius, joint allows for supination and pronation.
Lateral pectoral nerve has ventral rami of spinal nerves?
C5, C6, C7
Middle radioulnar joint is a syndesmosis formed by what?
Interosseus membrane
When force is applied on the interosseous membrane between the radius and ulnar, it has two main functions namely?
- Dissipate force away from the small head of the radius2. Prevent fracture of the head of radius
The wrist joint/radio carpal joint is what type of joint?
Ellipsoidal joint
Below the radiocarpal joint lies three bones namely?
Scaphoid, lunate, triquetrum
What are the characteristics of the triangle of auscultation
Boundaries:1. Inferior - latissimus dorsi (T6-T12)2. Lateral - Rhomboid major (T2-T5)3. Superior - trapezius (C7, T1-T12)Triangle overlies the 6th intercostal space (makes sense based on where boundary muscles originate)
What are The 2 ligaments holding the bones of the synovial plane acromioclavicular joint together
- Acromioclavicular ligament2. Coracoclavicular ligament
Clinical presentation: in a radiocarpal fracture commonly seen in elderly women, the patient fell on their outstretched hand, resulting in avulsed ulnar styled process and displacement of the broken radius posteriorly. This fracture is also characterized by a “dinner-fork” deformity in the lateral view.What is the name of this fracture?
Colles’ fracture
Median part of median nerve has ventral rami of spinal nerves?
C8 & T1
Interphalangeal joints (DIP & PIP) are synovial hinge joints that allow for flexion and extension movements. They have two supporting ligaments namely?
Palmar and collateral ligaments
The only bony attachment to the skeleton in the upper extremity is via?
Clavicle
The most frequently broken bone in the body is?
Clavicle
Two nerve branches come directly from the ventral rami of the brachial plexus, what are their names?
Long thoracic nerve (C5-C7) and dorsal scapular nerve (C5)
Actions of the trapezius muscles are?
Mnemonic (DEER)1. Depresses the shoulder2. Elevated the shoulder3. Extends the head4. Retracts the scapula
Fascia that is one of the attachment points for the trapezius muscle is called
Ligamentum nuchae
Musculocutaneous nerve off the lateral cord has ventral rami of spinal nerves?
C5, C6, C7
Latissimus dorsi attaches to the fascia
Thorocolumbar fascia
Which intermediate back muscle has the same vertebrae origin as trapezius (T12 excluding). It’s action is to raise the ribs in inspiration and it is inner acted by the dorsal rami of the thoracic spinal nerves
Levatores costarum
What muscle does the musculocutaneous nerve pierce in the arm?
Coracobrachialis
Which rami of the spinal nerves sends sensory nerves to the skin of the back and posterior neck and motor neurons to deep muscles of the back and neck?
Dorsal primary ramus
Glenohumeral joint is made up of a fibrous capsule, three ligaments (name them) and two openings (name them)
- Glenohumeral, transverse humeral, and coracohumeral ligaments2. For the tendon of the long head of biceps brachii and opening for subscapular bursa
Radial nerve off the posterior cord has ventral rami of spinal nerves?
C5-C8 and T1
Which rami of the spinal nerve sends sensory nerves to the skin of extremities and anterior and lateral regions of the trunk, and motor nerves to the muscles of these same regions?
Ventral primary Ramos
Area innervated by a single spinal nerve of a sensory neuron is called?
Dermatome
Posterior division of brachial plexus supplies what part of the upper extremity?
Posterior compartment - extensors of arm and forearm
Axillary nerve off the posterior cord has ventral rami of spinal nerves?
C5 and C6 only
What muscles are innervates by the medial pectoral nerve
Pectoralis major and pectoralis minor
Which artery can be compressed mid-arm to control hemorrhage or to read blood pressure?
Brachial artery
Ulnar nerve has ventral rami of spinal nerves?
C8 and T1
Lower subscapular nerve innervates which muscles
Subscapularis and teres Major
Metacarpophalangeal joint is a synovial condyloid joint that is supported by three types of ligaments namely?What actions/movements are allowed at this joint?
1.Palmar (between bones), collateral (sides of bones), and deep transverse metacarpal ligaments2. Flexion, extension, adduction and abduction
Median nerve has ventral rami of spinal nerves?
C5-C8 and T1
What structures course through the radial grove created by the biceps muscle?
Radial nerve, deep brachial artery
All anterior divisions of the brachial plexus supply what compartment of the upper extremity?
The anterior compartment - Flexors of the arm and forearm
Upper subscapularis nerve innervates which muscle
Subscapularis
Medial cutaneous nerve of arm and medial cutaneous nerve of forearm (antebrachial nerve) have ventral rami of spinal nerves?
C8 and T1
What muscle is innervated by the lateral pectoral nerve
Pectoralis major
What muscles are innervated by the axillary nerve
Teres minor and deltoid
Lateral part of median nerve has ventral rami of spinal nerves?
C5-C7
What muscles does the dorsal scapular nerve innervate?
Levator scapulae, rhomboid major, rhomboid minor
What muscle does the long thoracic nerve innervate?
Serratus anterior
What two nerve branches come off directly from the upper trunk of the brachial plexus?
Suprascapular nerve and subclavius nerve both C5, C6
Clinical presentation: A patient arrives in the ER with a fracture to the midshaft of the humerus. The patient is unable to extend the hand (wrist-drop), what nerve is damaged and what muscle group is causing the wrist drop?
- Radial nerve in radial groove of humerus could be pinched.2. Deep branch of radial nerve innervates the extensors in the forearm that act on the hand.NOTE: This damage would not affect extension of arm at elbow joint because most of tricep brachii are innervated proximal to radial groove.
Suprascapular nerve innervates which muscles
Supraspinatus and infraspinatus
Subclavius nerve innervates which muscle?
Subclavius muscle
These two nerves travel through the arm along side the main artery vessel but do not branch or innervated muscles of the arm
Median nerve and ulnar nerve
What is the nerve that descends posteriorly to the medial epicondyle (funny bone)
Ulnar nerve
Musculocutaneous nerve becomes a sensory nerve past the elbow joint, what is the name of this nerve
Lateral cutaneous nerve of forearm
Radial nerve innervates (motor) which posterior muscle
Triceps brachi
Radial nerve sensory branches are:
- Lower lateral brachial cutaneous 2. Posterior brachial cutaneous3. Antebrachial cutaneous
Upper subscapular nerve, lower subscapular nerve and thoracodorsal/middle subscapular nerve have ventral rami of spinal nerves?
C5, C6, C7, C8, T1
