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MSK > Thorax, Abdomen, Upper Limb > Flashcards

Thorax, Abdomen, Upper Limb Flashcards

1
Q

thoracic cage/skeleton of thoracic wall

A
  • thoracic wall = ribs + sternum component
  • functions:
    • protect organs ⇢ heart, lungs, spleen, liver, kidneys
    • role in breathing
      • expanded by respiratory muscles – creates a vacuum ⇢ draws air into lung
      • rhythmic movement
      • compressed to expel air
    • attachment points
      • anchoring attachments for upper limb
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2
Q

sternum

A
  • sternum = chest
    • most anterior
  • directly overlies mediastinal viscera
  • 3 parts (joined by symphyses usually):
    • manubrium - superior
    • body
    • xiphoid process - inferior
    • symphyses will turn into synostosis/bony joint in older individuals
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3
Q

sternum – notches/sternal angle

A
  • jugular (suprasternal) notch
    • palpable superior border of manubrium
  • clavicular notches
    • articulate with clavicles
      • sternoclavicular joints ⇢ synovial – allows movement of clavicles
  • sternal angle
    • between manubrium & body
    • 2nd rib attaches
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4
Q

ribs – true/false/floating

A
  • 12 pairs of ribs
  • true ribs: attach directly to sternum via (their own) costal cartilage
    • costal cartilage ⇢ hyaline cartilage strip - remnant of ossification process – ribs turned into bone but cartilage strip stayed (helps w elasticity)
    • 1st - 7th ribs
  • false ribs: indirect connection to sternum – not their own costal cartilage
    • cartilage connects to the superior cartilage
    • 8th - 10th (sometimes)
  • floating ribs: rudimentary cartilages do not connect to sternum
    • 10 (sometimes), 11th, & 12th
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5
Q

ribs – intercostal spaces/costal margin

A
  • intercostal spaces: separates ribs and costal cartilages
    • named according to rib forming superior border
      • ex: 4th intercostal space is between ribs 4 & 5
    • filled in during life with muscles
  • costal margin (arch)
    • cartilaginous
    • formed by shared cartilages of false ribs
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6
Q

ribs – head/tubercle

A
  • head of rib
    • articulate with vertebral bodies
  • tubercle of rib
    • articulate with thoracic transverse processes
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7
Q

1st rib

A
  • broadest, shortest, most sharply curved
  • attachment for anterior scalene muscle ⇢ deep muscle in neck
    • forms prominent bump/tubercle on this rib
  • much of this rib lies above the level of the clavicle
    • most superior rib
    • root of neck region
    • deep – not palpable
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8
Q

axio-appendicular muscles

A
  • extend from thoracic cage to bones of upper limb or pectoral girdle
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9
Q

intercostal muscles

A
  • keep thoracic cage stiff during respiration ⇢ keep it from collapsing
  • external intercostal muscles:
    • 11 pairs
    • action: most active during inspiration
  • internal intercostal muscles:
    • 11 pairs
    • action: most active during expiration – specifically forceful
  • innermost intercostal muscles
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10
Q

diaphragm

A
  • sepates thoracic and abdominal cavities
  • action: chief muscles of inspiration
    • contracts ⇢ flattens diaphragm – allows thoracic cage size to increase and expand
  • innervation: phrenic n.
    • “C3, 4, & 5, keep the diaphragm alive” ⇢ damage to these spinal nerves could have implications in terms of phrenic nerve
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11
Q

diaphragm openings

A
  • 3 openings:
    • caval opening:
      • inferior vena cava (IVC) ⇢ deoxygenated blood from lower limb/abdominal region traverse through to get to right atrium of heart
    • esophageal hiatus:
      • esophagus ⇢ traverse to get into abdominal cavity & get to stomach
      • vagus nerves (CN X) ⇢ parasympathetics with GI tracts
    • aortic hiatus:
      • descending aorta ⇢ descend to supply blood to portions inferior to diaphragm
      • thoracic duct – lymphatics
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12
Q

muscles of abdomen

A

no bones anteriorly

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13
Q

muscles of anterolateral abdominal wall

A
  • external oblique muscle: superficial
  • internal oblique muscle: intermediate
  • transverse abdominis muscle: deep
  • action:
    • supports & compresses abdominal viscera
      • protection – keep everything in place
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14
Q

rectus sheath

A
  • aponeurosis (wide tendon) of anterolateral abdominal muscles
  • encloses rectus abdominis muscle
  • linea alba
    • fibers
    • = white line
    • midline raphe – seam
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15
Q

rectus (“straight”) abdominis muscle

A

actions:

  • flexes waist – like in doing sit ups
  • compresses abdominal viscera ⇢ protecting deeper structures
  • tendinous intersections
    • 3-4 pairs
    • if hypertrophied – six-pack appearance
  • long ⇢ from costal margin region/xiphoid process down to pubic symphysis
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16
Q

upper limb

A
  • mobility ⇢ more mobility in upper limb than lower
  • ability to grasp & conduct fine motor skills
  • subdivided into 4 regions:
    • shoulder
    • arm (brachium)
    • forearm (antebrachium)
    • hand
17
Q

clavicle

A
  • “collarbone”
  • pectoral girdle = what’s linking axial skeleton to the arm
  • directly connected to thorax

sternal (medial) end: articulates with manubrium

  • sternoclavicular joint

acromial (lateral) end: articulates with acromion

  • acromioclavicular joint
18
Q

clinical connection: fracture of clavicle

A
  • one of the most frequently fractured
  • common in children (greenstick fracture)
  • often caused by indirect force transmitted from a fall with an outstretched hand ⇢ force moves up
  • weakest part:
    • junction of middle and lateral 3rds
  • fracture ⇢ try to immobilize
    • make sure any fractured ends don’t project too far posteriorly
      • important neurovasculature (subclavian vein/artery, nerves of brachial plexus)
19
Q

scapula – coracoid process

A
  • scapula = shoulder blade
    • sitting on back of ribs (~ ribs 2-7)
    • not full articulation with ribs – attachments with muscles ⇢ not true joints
  • coracoid process = like a crow’s beak
    • superior to glenoid cavity & projects anterolaterally
    • attachment site for pectoralis minor & short head of biceps brachii muscles
      • ligaments of AC joints
20
Q

scapula – spine/acromion

A
  • spine of scapula
    • posterior surface
    • palpable
  • acromion (process)
    • lateral continuation of spine
    • ‘point of shoulder’
    • articulates with lateral end of clavicle – acromioclavicular joint
21
Q

scapula – glenoid fossa

A
  • glenoid fossa
    • socket – ball & socket shoulder joint
      • glenohumeral joint
    • relatively shallow ⇢ bulbous head of humerus doesn’t fit well
      • fit of bones ⇢ so much mobility associated with shoulder joint ⇢ also why decreased stability
22
Q

humerus: proximal

A
  • head
    • smooth – covered by articular cartilage
    • ‘ball’ – ball and socket joint (shoulder)
      • glenohumeral joint
      • more mobility, less stability
  • anatomical neck
    • just distal to humeral head
  • surgical neck
    • constriction just distal to tubercles
    • common site of fracture – weaker area of bone
      • axillary n. endangered
        • innervate deltoid muscle ⇢ abduction of shoulder joint
23
Q

humerus: proximal p2

A
  • greater tubercle
    • lateral margin of proximal humerus
    • 3 of 4 rotator cuff muscles attach
  • lesser tubercle
    • anterior projection
    • 1 of 4 rotator cuff muscles attach
  • intertubercular sulcus
    • between the tubercles
    • long head of biceps tendon
    • latissimus dorsi (floor)
      • movement of shoulder joint
24
Q

humerus: distal

A
  • medial epicondyle
    • epicondyle = articulations w certain joints
    • same side as head
    • more prominent
    • flexors located on forearm attach here – proximal attachment (flexion)
    • ulnar nerve
  • lateral epicondyle
    • extensors located on forearm attach here (extension)
25
Q

humerus: distal (capitulum/trochlea)

A
  • capitulum
    • = little head
    • articulation of head of radius
  • trochlea
    • = pulley
    • articulation with trochlear notch of ulna
      • forming humero-ulnar joint (elbow)
26
Q

humerus: distal – olecranon fossa

A
  • posterior
  • accommodates olecranon during full extension of elbow joint
    • fits into fossa during extension
    • will move away from it during flexion
27
Q

ulna

A
  • longer, medial, stabilizing of the 2 forearm bones
    • radius will rotate around ulna during pronation/supination
  • olecranon process
    • posterior
    • ‘point of elbow’
    • triceps brachii muscle – distal attachment
  • coronoid process
    • anterior projection
    • brachialis muscle – flexion of elbow
  • trochlear notch
    • moving around trochlea
  • radial notch
    • divot
    • head of radius – articulation of ulna + radius
28
Q

radius

A
  • lateral & shorter
    • larger more distally ⇢ articulate with proximal row of carpal bones to form wrist joint
  • head
    • articulate with:
      • capitulum of humerus (top of head)
      • radial notch of ulna (side of head)
        *
28
Q

radius

A
  • lateral & shorter
    • larger more distally ⇢ articulate with proximal row of carpal bones to form wrist joint
  • head
    • articulate with:
      • capitulum of humerus (top of head)
      • radial notch of ulna (side of head)
  • radial tuberosity
    • medial projection distal to head
    • biceps brachii muscle – distally attach
29
Q

clinical connections: colles fracture

A
  • complete transverse fracture of distal 2 cm of radius
  • results from forced extension of hand
    • FOOSH (Falling On an Out-Stretched Hand)
  • typically, >50 years (osteoporosis) ⇢ higher incidence
30
Q

wrist (carpus)

A
  • two rows, each has 4 bones
    • proximal (L to M)
      • scaphoid, lunate, triquetrum, pisiform
        • pisiform doesn’t articulate with radius, rest do
        • pisiform: sesamoid bone – form within tendon (flexor carpi ulnaris tendon) ⇢ develop after birth with movement over time
    • distal (L to M)
      • trapezium, trapezoid, capitate, hamate
      • articulates with metacarpals
31
Q

clinical connections: scaphoid fracture

A
  • most frequently fractured carpal bone
  • often results from a fall on the palm
    • hand abducted
  • often misdiagnosed early ⇢ doesn’t show up on radiograph right after injury – with time (bc of poor blood supply) it’ll become more prominent
32
Q

carpal tunnel

A
  • anterior concave space formed by carpal bones
    • roof: transverse carpal ligament (flexor retinaculum)
  • what passes through the tunnel?
    • tendons (long) & tendon sheaths of flexor muscles
    • median nerve ⇢ one of the terminal branches of brachial plexus
33
Q

carpal tunnel syndrome

A
  • reduction of size of carpal tunnel or increasing of size of structure within the tunnel
    • often swelling of tendon or tendon sheaths
  • median nerve compression can cause:
    • paresthesia (tingling)
    • hypoesthesia/anesthesia
    • progressive loss of coordination and strength of thumb
      • median n. – provides motor innervations ⇢ movement of thumb
34
Q

metacarpals (5)

A
  • numbered 1-5 (lateral/thumb to medial)
  • carpometacarpal joints
    • articulation with distal row of carpal bones
  • metacarpophalangeal joints
    • articulation with proximal phalanges
35
Q

phalanges

A
  • proximal (5)
  • middle (4)
  • distal (5)
  • pollex = thumb
  • proximal interphalangeal joint (PIP)
  • distal interphalangeal joint (DIP)

MSK (6 decks)

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