Upper Extremity Flashcards

1
Q

What is the anatomical position?

A

Face up, palms forward, feet flexed

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2
Q

Name the (3) planes the in which the body can be divided

A

Sagittal Plane
Transverse Plane
Coronal/Frontal Plane

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3
Q

What are the 4 types bones and give an example of each.

A

Long bone (humerus), short bone (talus), flat bone (sternum), irregular bone (vertebra)

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4
Q

What is an epiphysis?

A

End of a long bone, sponges bone

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5
Q

What covers the epiphysis?

A

Articular cartilage

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6
Q

What is a diaphysis?

A

The shaft of the bone, compact bone, encloses medullary cavity

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7
Q

What does an osteoclasts do?

A

Resorbs old bone tissue

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8
Q

What does an osteoblasts do?

A

Forms new bone cells

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9
Q

What are 3 types of cartilage?

A

Hyaline, Elastic, fibrocartilage

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10
Q

What is the most abundant cartilage in the body?

A

Hyaline cartilage

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11
Q

What type of cartilage can tolerate repeated bending?

A

Elastic cartilage (example ear)

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12
Q

What cartilage resists strong compression and tension?

A

Fibrocartilage (example inter-vertebral discs)

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13
Q

What are the three main types of joints?

A

Synovial Joint
Cartilaginous joint
Fibrous joint

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14
Q

What is the most mobile type of synovial joint?

A

Ball & socket

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15
Q

What are the two types of cartilaginous joints?

A

Synchondroses

Symphyses

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16
Q

What type of cartilage is in synchondroses joints?

A

Hylaine cartilage (not much movement)

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17
Q

What type of cartilage is in symphyses joints?

A

Fibrocartilage (good with impact, in vertebrae and pubic symphysis)

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18
Q

What are the three types of fibrous joints?

A

Suture
Syndesmosis
Gomphosis (don’t need to know this one)

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19
Q

How many pairs of spinal nerves are there?

A

31 pairs of spinal nerves

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20
Q

How many pairs of cranial nerves are there?

A

12 pairs of cranial nerves

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21
Q

How many vertebrae are there? How many per section?

A
33 total
7 cervical
12 thoracic
5 lumbar
5 segments of sacrum m (fused)
4 segments of coccyx
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22
Q

Where do the spinal nerves leave the spinal column?

A

In the intervertebral foramen

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23
Q

What type of nerve(s) are in the dorsal root?

A

Sensory axon and cell bodies

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24
Q

What type of nerve(s) are in the ventral root?

A

Motor neuron axons

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25
Q

What type of nerve(s) are in the dorsal ramus?

A

Both sensory and motor neurons

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26
Q

What type of nerve(s) are in the ventral ramus?

A

Both sensory and motor neurons

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27
Q

What is the difference between dermatomes and myotomes?

A
Derma= skin
Myo= muscle
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28
Q

How may (spinal) dermatomes are there in the body?

A

31 (# of spinal nerve pairs)

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29
Q

If somebody lost feeling in their thumb, what nerve was affected?

A

C6

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30
Q

What dermatome includes the pinky finger?

A

C8

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31
Q

What dermatome includes the middle finger?

A

C7

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32
Q

What dermatome includes the nipples?

A

T4

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33
Q

What dermatome includes the belly button?

A

T10

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34
Q

What nerves innervate the anterior lower extremity?

A

L1-L5

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35
Q

What nerves innervate the posterior lower extremity?

A

S1-S5

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36
Q

What nerves innervate the bottom of the foot?

A

L4 & L5

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37
Q

What type of muscle fibre directions provide the most force?

A

Multipennate

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38
Q

What is the direction of the fibres in pectoralis major?

A

Convergent

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39
Q

Between Parallel fibres and pinnate fibres which allow for a large range of motion and which allows maximal force?

A

Parallel: large range of motion
Pennate: maximal force

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40
Q

What is an isometric contraction?

A

Muscle remains the same length but the tension increases.

No movement but there is more tension. Think holding a glass and adding water.

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41
Q

What is an isotonic contraction?

A

Muscle changes in length and the tension stays the same.

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42
Q

What is the difference between concentric and eccentric isotonic contractions?

A

Concentric: muscle shortens
Eccentric: muscle lengthens

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43
Q

How are muscles attached to bones?

A

By tendons

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44
Q

What is the insertion/distal end?

A

The movable portion of the attachment

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45
Q

What is the origin/proximal end?

A

The less movable attachment

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46
Q

What is fascia?

A

Connective tissue that binds dustless to overlying skin or binds groups of muscles together.

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47
Q

What are the movements of the scapula? (3 opposing)

A

Elevation & Depression
Protraction & Retraction
Medial rotation (downward rotation) & Lateral rotation (upward rotation)

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48
Q

Trapezius origin(proximal)

A

External occipital protuberance (‘hole’ in base of skull)
Medial 1/3 of Superior Nuchal line (line along base of skull)
Ligamentum Nuchae (along spine)
Spinous processes & Supraspinous ligaments of C7-T12 vertebrae

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49
Q

Trapezius insertion(distal)

A

Lateral third of Clavicle

Acromion & Spine of Scapula

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50
Q

Trapezius actions

A

Retract, elevate & depress the scapula

Lateral rotation of the scapula during abduction of arm

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51
Q

Trapezius nerve supply

A

Spinal part of accessory nerve (Cranial nerve 11)

C3 & C4

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52
Q

What muscles are used for rotation of the scapula?

A

Trapezius (twist the spine of scapula) and serrated anterior (pulls of inferior angle)

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53
Q

Levator Scapulae origin(proximal)

A

Posterior tubercles of transverse processes of C1-C4 vertebrae

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54
Q

Levator Scapulae insertion(distal)

A

Medial border of scapula above the spine (next to superior angle)

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55
Q

Levator Scapulae actions

A

Elevates and medically rotates scapula

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56
Q

Levator Scapulae nerve supply

A

Dorsal scapular nerve

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57
Q

Rhomboid minor origin(proximal)

A

Nuchal ligament & spinous processes of C7-T1

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58
Q

Rhomboids minor insertion(distal)

A

Medial border of scapula at the root of the spine

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59
Q

Rhomboid minor actions

A

Retract & medially rotate scapula

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60
Q

Rhomboid minor nerve supply

A

Dorsal scapular nerve

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61
Q

Rhomboid major origin(proximal)

A

Spinous processes of T2-T5 vertebrae

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62
Q

Rhomboid major insertion(distal)

A

Medial border of scapula below the spine

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63
Q

Rhomboid major actions

A

Retract & medially rotate scapula

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64
Q

Rhomboid major nerve supply

A

Dorsal scapular nerve

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65
Q

Serratus anterior origin(proximal)

A

External surfaces of ribs 1-8

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66
Q

Serratus anterior insertion(distal)

A

Anterior surface of medial border of scapula

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67
Q

Serratus anterior actions

A

Protracts scapula
Rotates scapula
Holds the scapula against the thoracic wall

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68
Q

Serratus anterior nerve supply

A

Long thoracic nerve

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69
Q

What is winging of the scapula caused by?

A

Weakness or paralysis of the long thoracic nerve which supplies the Serratus anterior muscle.

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70
Q

Pectoralis major origin(proximal)

A

Medial half of clavicle
Sternum
First 6 costal cartilages
Aponeurosis of external oblique

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71
Q

Pectoralis major insertion(distal)

A

Lateral lip of intertubercular groove of humerus

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72
Q

Pectoralis major actions

A

Adducts arm
Flexes arm
Rotates arm medially

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73
Q

Pectoralis major nerve supply

A

Medial & lateral pectoral nerves

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74
Q

Pectoralis minor origin(proximal)

A

External surfaces of ribs 3, 4, 5

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75
Q

Pectoralis minor insertion(distal)

A

Coracoid process of the scapula

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76
Q

Pectoralis minor actions

A

Stabilizes the scapula, it is a fixator

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77
Q

Pectoralis minor nerve supply

A

Medial pectoral nerve

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78
Q

Latissimus Dorsi origin(proximal)

A

Spinous processes of T6-T12 vertebrae
Thoracolumbar fascia
Iliac crest
Inferior 3 or 4 ribs

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79
Q

Latissimus Dorsi insertion(distal)

A

Floor of intertubercular sulcus of humerus

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80
Q

Latissimus Dorsi actions

A

Extends, adducts and medially rotates arm

Accessory muscle of respiration

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81
Q

Latissimus Dorsi nerve supply

A

Thoracodosal nerve

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82
Q

What muscles help elevate the scapula? (4)

A

Trapezius
Levator scapulae
Rhomboid major
Rhomboid minor

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83
Q

What muscles help depress the scapula? (5)

A
Trapezius
Serratus anterior 
Pectoralis major
Pectoralis minor 
Latissimus dorsi
(And gravity)
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84
Q

What muscles help retract the scapula? (4)

A

Trapezius
Rhomboid major
Rhomboid minor
Latissimus dorsi

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85
Q

What muscles help protract the scapula? (3)

A

Serratus anterior
Pectoralis major
Pectoralis minor

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86
Q

What muscles help medially rotate (Downward rotation) the scapula? (6)

A
Levator scapulae
Rhomboid major
Rhomboid minor
Pectoralis major
Pectoralis minor
(And gravity)
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87
Q

What muscles help laterally rotate (upward rotation) the scapula? (2)

A

Trapezius

Serratus anterior

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88
Q

What are the (3) joints in the pectoral girdle?

A

Sternoclavicular joint
Acromioclavicular joint
Scapulohumeral joint

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89
Q

What is the only articulation between the upper extremity and axial skeleton?

A

The sternoclavicular joint

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90
Q

What type of cartilage is the intraarticular disc of the sternoclavicular joint?

A

Fibrocartilage

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91
Q

When the clavicle is fractured, what pulls on the separated parts that make it worse?

A

The sternocleidomastoid pulls up on medial end
Gravity pulls the arm down which pulls the lateral end down
The Pectoralis major pulls the humerus medially which pulls the lateral end of the clavicle medially which could cause overriding of the fractured ends of the clavicle

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92
Q

What way does the clavicle rotate when the arm is flexed or abducted?

A

Posterior rotation

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93
Q

What (3) ligaments are associated with the acromioclavicular joint?

A

Acromioclavicular ligament
Coraco-acromial ligament (connects two parts of the clavicle)
Coracoclavicular ligament - divides into trapezoid ligament and conoid ligament

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94
Q

What is the difference between shoulder separation and dislocation?

A

Separation: the dislocation of the acromioclavicular joint. The acromioclavicular ligament ruptures, this can be accompanied by rupture of the coracoclavicular ligament as well but not always

Shoulder dislocation: head of humerus displaced from the glenoid cavity

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95
Q

What is the glenoid labrum?

A

A fibrocartilaginous rim of the glenoid that helps to increase the depth of the glenoid.

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96
Q

What are the (4) muscles that form the rotator cuff?

A
Supraspinatus
Infraspinatus
Teres minor 
Subscapularis
(SITS muscles)
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97
Q

Subscapularis origin(proximal)

A

Subscapular fossa on anterior surface of scapula

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98
Q

Subscapularis insertion(distal)

A

Lesser tuberosity of the humerus

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99
Q

Subscapularis action

A

Medial rotation (of the arm?)

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100
Q

Subscapularis nerve supply

A

Upper and lower subscapular nerves

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101
Q

Supraspinatus origin(proximal)

A

Supraspinous fossa of scapula

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102
Q

Supraspinatus insertion(distal)

A

Upper part of the greater tuberosity of the humerus

Capsule of the shoulder joint

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103
Q

Supraspinatus action

A

Abduction of arm
Draws humerus toward the glenoid fossa (keeps it in place)
Weak lateral rotator and flexor

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104
Q

Supraspinatus nerve supply

A

Suprascapular nerve (C5)

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105
Q

Infraspinatus origin(proximal)

A

Infraspinous fossa of the scapula

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106
Q

Infraspinatus insertion(distal)

A

Middle facet of the greater tuberosity of the humerus

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107
Q

Infraspinatus actions

A

Laterally rotates the arm
Abducts arm
Adducts arm
Draws humerus toward the glenoid fossa (keeps it in place)

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108
Q

Infraspinatus nerve supply

A

Suprascapular nerve (C5, C6)

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109
Q

Teres minor origin(proximal)

A

Upper two-thirds of the dorsal surface of the axillary border of the scapula

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110
Q

Teres minor insertion(distal)

A

Laterally rotates arm
Weakly adducts arm
Draws humerus toward glenoid fossa (keeps in place)

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111
Q

Teres minor nerve supply

A

Axillary nerve (C5)

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112
Q

What are the (3) bursae around the shoulder joint?

A

Subacromial bursa
Tendon sheath (sleeve of bursa)
Subscapular bursa

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113
Q

What muscle does the first 15 degrees of abduction?

A

Supraspinatus

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114
Q

Which is more common, anterior or posterior shoulder dislocation?

A

Anterior shoulder dislocation is more common

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115
Q

Why is a shoulder dislocation always inferior and never superior?

A

The acromion blocks the humerus from dislocating superiorly

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116
Q

Teres Major origin(proximal)

A

Posterior surface of inferior angle of scapula

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117
Q

Teres Major insertion(distal)

A

Medial lip of intertubercular sulcus

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118
Q

Teres Major actions

A

Adducts and medially rotates arm

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119
Q

Teres Major nerve supply

A

Lower subscapular nerve

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120
Q

Deltoid origin(proximal)

A

Lateral third of clavicle
Acromion
Lower lip of spine of scapula

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121
Q

Deltoid insertion(distal)

A

Deltoid tuberosity of the humerus

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122
Q

Deltoid actions

A

Flexion & Extension
Medial & Lateral rotation
Abduction (15-90 degrees)

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123
Q

Deltoid nerve supply

A

Axillary nerve

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124
Q

What part of the Deltoid does flexion?

A

Clavicular (anterior) part of deltoid

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125
Q

What part of the Deltoid does abduction?

A

Middle part of deltoid

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126
Q

What part of the Deltoid does extension?

A

Spinal (posterior) part of deltoid

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127
Q

What needs to happen to abduct >90 degrees?

A

Lateral rotation of humerus is required

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128
Q

What muscles help flex the arm?

A

Deltoid

Pectoralis major

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129
Q

What muscles help extend the arm?

A

Deltoid

Latissimus Dorsi

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130
Q

What muscles help adduct the arm?

A
Infraspinatus
Teres Minor
Teres Major
Pectoralis major
Latissimus Dorsi
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131
Q

What muscles help abduct the arm?

A

Deltoid (15-90 degrees)

Supraspinatus (0-15 degrees)

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132
Q

What muscles help medially rotate the arm?

A
Deltoid
Subscapularis
Teres major
Pectoralis major
Latissimus Dorsi
133
Q

What muscles help laterally rotate the arm?

A

Deltoid
Infraspinatus
Teres Minor

134
Q

What is the only place that nerves and blood vessels can get into the upper limb?

A

Cervico-axillary canal

135
Q

What is the posterior limit of the axilla?

A

Scapula

136
Q

What is the anterior limit of the axilla?

A

Clavicle

137
Q

What is the medial limit of the axilla?

A

1st rib

138
Q

What are the (2) muscles that make up the anterior wall of axilla?

A

Pectoralis major

Pectoralis minor

139
Q

What are the (2) components that make up the medial wall of axilla?

A

Serratus anterior

4th rib

140
Q

What are the (4) components that make up the posterior wall of axilla?

A

Terres major
Latissius Dorsi
Subscapularis
Scapula

141
Q

What are the contents of the axilla?

A
Axillary artery 
Axillary vein
Brachial plexus
Axillary lymph nodes
Axillary fat
142
Q

What part of the cell makes up the grey matter?

A

Cell bodies

143
Q

What part of the cell makes up white matter?

A

Axons

144
Q

Where are Ganglion located?

A

Peripheral Nervous System (PNS)

145
Q

Where are (nerve) Nuclei found?

A

Central Nervous System (CNS)

146
Q

What type of neurons are found in the anterior horn?

A

Motor neurons

147
Q

What type of neurons are found in the posterior horn?

A

Sensory neurons

148
Q

Are motor neurons multipolar or pseudounipolar?

A

Motor = multipolar

149
Q

Are sensory neurons multipolar or pseudounipolar?

A

Sensory = pseudounipolar

150
Q

Are motor fibres afferent or efferent?

A

Motor = efferent

151
Q

Are sensory fibres afferent or efferent?

A

Sensory = afferent

152
Q

Order from most lateral to most medial: Spinal nerve
Dorsal and Ventral Roots
Dorsal and Ventral Rami

A

Dorsal and Ventral Rami
Spinal nerve
Dorsal and Ventral Roots

153
Q

How may cervical nerves and vertebrae are there?

A

8 nerves

7 vertebrae

154
Q

Is the C1 nerve located superior or inferior to the C1 vertebra?

A

C1 nerve is superior to the C1 vertebra

155
Q

Where is the C8 nerve located?

A

C8 nerve is inferior to the C7 vertebra and superior to the T1 vertebra

156
Q

Is the T1 nerve located superior or inferior to the T1 vertebra?

A

T1 nerve is inferior to the T1 vertebra

157
Q

What are the 5 major segments of the Brachial plexus?

A
Axillary nerve
Musculocutaneous nerve
Radial nerve
Median nerve
Ulnar nerve
158
Q

What are the divisions of the brachial plexus? (Vertically)

A
Roots
Trunks
Divisions
Cords
Branches (terminal/ peripheral nerves)
159
Q

What (3) nerves innervate the hand?

A

Radial, medial, ulnar

160
Q

What innervates all the muscles in the anterior arm?

A

Musculocutaneous nerve

161
Q

Coracobrachialis origin (proximal)

A

Coracoid process

162
Q

Coracobrachialis insertion(distal)

A

Middle third of the medial surface of humerus

163
Q

Coracobrachialis actions

A

Flexes arm

Weakly adducts arm

164
Q

Coracobrachialis nerve supply

A

Musculocutaneous nerve

165
Q

Biceps Brachii origin(proximal) long and short heads

A

Long head- supraglenoid tubercle of scapula

Short head- coracoid process of scapula

166
Q

Biceps Brachii insertion(distal)

A

Radial tuberosity

Bicipital aponeurosis into deep fascia on medial part of forearm

167
Q

Biceps Brachii actions

A

Flexes forearm
Supinates forearm
Weak flexor of arm (short head)
Stabilizes shoulder (long head)

168
Q

Biceps Brachii nerve supply

A

Musculocutaneous nerve

169
Q

Brachialis origin(proximal)

A

Anterior lower half of humerus

170
Q

Brachialis insertion(distal)

A

Ulna (proximal end)

171
Q

Brachialis actions

A

Flexes forearm

172
Q

Brachialis nerve supply

A

Musculocutaneous nerve

173
Q

Brachioradialis origin(proximal)

A

Lateral supracondylar ridge of humerus

174
Q

Brachioradialis insertion(distal)

A

Lateral distal end of radius and its styloid process

175
Q

Brachioradialis actions

A

Flexes forearm from mid-prone position (neutral, not supinated or pronated)
Pronate and supinate forearm

176
Q

Brachioradialis nerve supply

A

Radial nerve

177
Q

What innervates all muscles in the posterior arm and forearm?

A

Radial nerve

178
Q

Triceps brachii origin(proximal) long head, lateral head, and medial head

A

Long head- infraglenoid tubercle of scapula

Lateral and medial heads- posterior surface of the shaft of humerus

179
Q

Triceps brachii insertion(distal)

A

Olecranon process of ulna

180
Q

Triceps brachii actions

A
Extends forearm (all three heads)
Long head extends arm
181
Q

Triceps brachii nerve supply

A

Radial nerve

182
Q

What kind of joint is the middle radioulnar joint?

A

Syndesmosis joint, consists of the interosseous membrane

183
Q

Pronator teres origin(proximal)

A

Medial epicondyle of humerus

184
Q

Pronator teres insertion(distal)

A

Middle of lateral surface of the radius

185
Q

Pronator teres actions

A

Pronates and flexes forearm

186
Q

Pronator teres nerve supply

A

Median nerve

187
Q

What is the deepest muscle in the forearm?

A

Pronator quadratus

188
Q

Pronator quadratus origin(proximal)

A

Anterior surface of distal part of ulna

189
Q

Pronator quadratus insertion(distal)

A

Lower portion of anterior surface of radius

190
Q

Pronator quadratus actions

A

Pronates forearm and hand

191
Q

Pronator quadratus nerve supply

A

Median nerve

192
Q

Supinator origin(proximal)

A

Lateral epicondyle of humerus and proximal ulna

193
Q

Supinator insertion(distal)

A

Dorsal and lateral surfaces of upper third of radius

194
Q

Supinator actions

A

Supinates forearm and hand

195
Q

Supinator nerve supply

A

Radial nerve

196
Q

What are the (4) proximal carpal bones from medial to lateral?

A

Pisiform (anterior to Tq)
Triquetrum
Lunate
Scaphoid

197
Q

What are the (4) distal carpal bones from medial to lateral?

A

Hamate
Capitate
Trapezoid
Trapezium

198
Q

What articulates the radius to form the wrist joint? (Radiocarpal joint)

A

3 carpal bones: Scaphoid, lunate, and triquetrum

199
Q

What innervates all of the muscles in the posterior compartment of the forearm?

A

Radial nerve

200
Q

What innervates almost all of the muscles in the anterior compartment of the forearm?

A

Median nerve

201
Q

Flexor carpi radialis origin(proximal)

A

Medial epicondyle of humerus

202
Q

Flexor carpi radialis insertion(distal)

A

Anterior aspect of the bases of the second and third metacarpal bones

203
Q

Flexor carpi radialis actions

A

Flexes and abducts the hand at the wrist joint

204
Q

Flexor carpi radialis nerve supply

A

Median nerve

205
Q

Flexor carpi ulnaris origin(proximal)

A

Medial epicondyle of humerus

206
Q

Flexor carpi ulnaris insertion(distal)

A

Pisiform bone and base of the 5th metacarpal bone

207
Q

Flexor carpi ulnaris actions

A

Flexes and adducts the hand at the wrist joint

208
Q

Flexor carpi ulnaris nerve supply

A
Ulnar nerve
(This is the one exception to the anterior median nerve rule)
209
Q

Palmaris longus origin(proximal)

A

Medial epicondyle of humerus

210
Q

Palmaris longus insertion(distal)

A

Palmar aponeurosis

211
Q

Palmaris longus actions

A

Flexes the hand at the wrist

212
Q

Palmaris longus nerve supply

A

Median nerve

213
Q

Extensor carpi radialis longus origin(proximal)

A

Lateral supracondylar ridge of humerus

214
Q

Extensor carpi radialis longus insertion(distal)

A

Posterior surface of the second metacarpal bone

215
Q

Extensor carpi radialis longus actions

A

Extends and abducts hand at wrist joint

216
Q

Extensor carpi radialis longus nerve supply

A

Radial nerve

217
Q

Extensor carpi radialis brevis origin(proximal)

A

Lateral epicondyle of humerus

218
Q

Extensor carpi radialis brevis insertion(distal)

A

Posterior surface of the third metacarpal bone

219
Q

Extensor carpi radialis brevis actions

A

Extends and abducts hand at wrist

220
Q

Extensor carpi radialis brevis nerve supply

A

Radial nerve

221
Q

Extensor carpi ulnaris origin(proximal)

A

Lateral epicondyle of humerus

222
Q

Extensor carpi ulnaris insertion(distal)

A

Posterior surface of 5th metacarpal bone

223
Q

Extensor carpi ulnaris actions

A

Extends and adducts hand at wrist joint

224
Q

Extesor carpi ulnaris nerve supply

A

Radial nerve

225
Q

What nerve controls pronation?

A

Median nerve (pronator teres and pronator quadratus)

226
Q

What nerve(s) controls supination?

A

Musculocutaneous nerve (biceps brachii) and radial nerve (supinator)

227
Q

What (3) muscles flex the wrist?

A

Flexor carpi radialis
Flexor carpi ulnaris
Palmaris longus

228
Q

What (3) muscles extend the wrist?

A

Extensor carpi radialis longus
Extensor carpi radialis brevis
Extensor carpi ulnaris

229
Q

What (3) muscles radially/laterally deviate (abduct) the wrist?

A

Flexor carpi radialis
Extensor carpi radialis longus
Extensor carpi radialis brevis

230
Q

What (2) muscles ulnarly/medially deviate (adduct) the wrist?

A

Flexor carpi ulnaris

Extensor carpi ulnaris

231
Q

What muscles are used to circumduct the wrist?

A

All of the wrist muscles

FCR, FCU, ECRL, ECRB, ECU

232
Q

What nerves are injured in Erb’s palsy?

A

C5 & C6 nerve roots contribute to the median and radial nerves

233
Q

What nerves are injured in Klumpke’s palsy?

A

C8 & T1 nerve roots which contribute to the radial, median, and ulnar nerves

234
Q

What nerve is injured (or compressed) in Saturdal nigh palsy/ Crutch palsy / Wrist drop?

A

Radial nerve

Can happen from arm hanging over arm rest of a chair

235
Q

Where does the ulnar nerve and artery enter the hand?

A

Guyon’s tunnel, between the pisiform and hook of hamate.

236
Q

Which carpal bone is most likely to pop out of place? What problems can this cause?

A

Lunate because it is wider anteriorly than posteriorly (opposite from others).
Pops into the carpal tunnel, if the vascularity is impacted, it can cause avascular necrosis.

237
Q

Which carpal bone is essential for all thumb movements?

A

Trapezium and it’s saddle joint with the 1st metacarpal

238
Q

Which joint is most involved in radial deviation (wrist abduction)?

A

Midcarpal joint

239
Q

Which joint is most involved in ulnar deviation (wrist adduction)?

A

Radiocarpal joint

240
Q

Which joint is more involved in wrist flexion?

A

Midcarpal joint

241
Q

Which joint is more involved in wrist extension?

A

Radiocarpal joint

242
Q

Which actions partake at the radiocarpal joint?

A

Extension and Adduction

243
Q

What actions partake at the midcarpal joint?

A

Flexion and Abduction

244
Q

What is the shape of abduction and adduction of the thumb?

A

Abduction: Shake hand position
Adduction: high five/flat hand

245
Q

What is the positions for extension and flexion of the thumb?

A

Extension: ASL L shape
Flexion: ASL B shape

246
Q

What is thumb opposition?

A

Touching tips of fingers to thumb

ASL #6,7,8,9

247
Q

Flexor digitorum superficialis origin(proximal)

A

Medial epicondyle of humerus, proximal ulna and anterior shaft of radius

248
Q

Flexor digitorum superficialis insertion(distal)

A

Four tendons divide into two slips each and attach to the sides of the middle phalanges of the four fingers.

249
Q

Flexor digitorum superficialis actions

A

Flexes the four fingers at the PIP joints

250
Q

Flexor digitorum superficialis nerve supply

A

Median nerve

251
Q

Flexor digitorum profundus origin(proximal)

A

Anterior shaft of ulna and interosseous membrane

252
Q

Flexor digitorum profundus insertion(distal)

A

Four tendons attach to the anterior spect of the distal phalanges of the four fingers

253
Q

Flexor digitorum profundus actions

A

Flexes four fingers at the DIP joints

254
Q

Flexor digitorum profundus nerve supply

A
Median nerve (supplies index and middle finger)
Ulnar nerve (supplies ring and little finger)
255
Q

What are the 2 synovial sheaths for tendons and what do they do?

A

Common flexor sheath
Digital synovial sheath
They prevent friction between tendons

256
Q

What are the 2 types of fibrous digital sheaths? What do they do?

A

Annular (ring) and cruciform (cross)

They keep the tendons next to the bone

257
Q

Flexor pollicis longus insertion(distal)

A

Anterior aspect of the distal phalange of the thumb

258
Q

Flexor pollicis longus actions

A

Flexes thumb at IP joint

259
Q

Flexor pollicis longus nerve supply

A

Median nerve

260
Q

What nerve is impacted in carpal tunnel syndrome?

A

Median nerve is entrapped in the carpal tunnel

261
Q

What is the top of the carpal tunnel?

A

Flexor retinaculum tendon

262
Q

Extensor digitorum origin(proximal)

A

Lateral epicondyle of humerus

263
Q

Extensor digitorum insertion(distal)

A

Dorsal surfaces of all phalanges of the four fingers, through the extensor hood

264
Q

Extensor digitorum actions

A

Extends fingers and wrist

265
Q

Extensor digitorum nerve supply

A

Radial nerve

266
Q

Extensor indicis insertion(distal)

A

Posterior aspect of the index finger

267
Q

Extensor indicis actions

A

Extends index finger

268
Q

Extensor indicis nerve supply

A

Radial nerve

269
Q

Extensor digiti minimi origin(proximal)

A

Lateral epicondyle of humerus

270
Q

Extensor digiti minimi insertion(distal)

A

Posterior aspect of the little finger

271
Q

Extensor digiti minimi actions

A

Extends little finger

272
Q

Extensor digiti minimi nerve supply

A

Radial nerve

273
Q

Abductor pollicis longus origin(proximal)

A

Posterior aspect of the shaft of the radius, ulna, and interosseous membrane

274
Q

Abductor pollicis longus insertion(distal)

A

Posterior aspect of the 1st metacarpal bone

275
Q

Abductor pollicis longus actions

A

Abducts thumb

276
Q

Abductor pollicis longus nerve supply

A

Radial nerve

277
Q

Extensor pollicis longus origin(proximal)

A

Posterior surface of ulna and interosseous membrane

278
Q

Extensor pollicis longus insertion(distal)

A

Distal phalanx of thumb

279
Q

Extensor pollicis longus actions

A

Extends thumb

280
Q

Extensor pollicis longus nerve supply

A

Radial nerve

281
Q

Extensor pollicis brevis origin(proximal)

A

Posterior surface of radius and interosseous membrane

282
Q

Extensor pollicis brevis insertion(distal)

A

Proximal phalanx of thumb

283
Q

Extensor pollicis brevis actions

A

Extends thumb at metacarpophalangeal (MCP) joint

284
Q

Exensor pollicis brevis nerve supply

A

Radial nerve

285
Q

Which tendons pass through the first compartment on the dorsal wrist?

A

Abductor pollicis longus

Extensor pollicis brevis

286
Q

Which tendons pass through the second compartment on the dorsal wrist?

A

Extensor carpi radialis longus

Extensor carpi radialis brevis

287
Q

Which tendons pass through the third compartment on the dorsal wrist?

A

Extensor pollicis longus

288
Q

Which tendons pass through the fourth compartment on the dorsal wrist?

A

Tendons for the digitorum (4)

Extensor indicis

289
Q

Which tendons pass through the fifth compartment on the dorsal wrist?

A

Extensor digiti minimi

290
Q

Which tendons pass through the sixth compartment on the dorsal wrist?

A

Extensor carpi ulnaris

291
Q

What are the borders of the snuff box?

A

Extensor pollicis longus (lateral? side)

Extensor pollicis brevis and abductor pollicis longus (medial? side)

292
Q

What are the 3 thenar muscles?

A

Abductor pollicis brevis
Flexor pollicis brevis
Opponens pollicis

293
Q

What are the 3 hypothenar muscles?

A

Abductor digiti minimi
Flexor digiti minimi
Oppenens digiti minimi

294
Q

What nerve(s) innervate the thenar muscles?

A

Recurrent brach of median nerve

Flexor pollicis brevis deep head is innervated by the ulnar nerve

295
Q

What nerve(s) innervates the hypothenar muscles?

A

Ulnar nerve

296
Q

Abductor pollicis brevis action

A

Abducts the thumb

297
Q

Flexor pollicis brevis action

A

Flexes the thumb

298
Q

Opponens pollicis actions

A

Opposes the thumb and rates the first metacarpal medially

299
Q

Abductor digiti minimi actions

A

Abducts the 5th digit and assists in flexion of its proximal phalanx

300
Q

Flexor digiti minimi brevis action

A

Flexes proximal phalanx of 5th digit

301
Q

Opponens digiti minimi actions

A

Draws 5th metacarpal anterior and rotates it

Brings 5th digit into opposition with the thum

302
Q

1st & 2nd lumbricals origin(proximal)

A

Lateral 2 tendons of the flexor digitorum profundus (for index and middle fingers)

303
Q

3rd & 4th lumbricals origin(proximal)

A

Medial 3 tendons of the flexor digitorum profundus (for middle, ring, and pinky)

304
Q

Lumbricals insertions(distal)

A

Lateral sides of the extensor expansions of 2nd-5th digits

305
Q

1st & 2nd lumbricals nerve supply

A

Median nerve

306
Q

3rd & 4th lumbricals nerve supply

A

Ulnar nerve

307
Q

Lumbricals actions

A

Flex the metacarpophalangeal (MCP) joints

Help extend the interphalangeal joints of the fingers

308
Q

Which lumbericals are bipennate and which are unipennate?

A
Uni= 1 & 2 
Bi= 3 & 4
309
Q

Interossei nerve supply

A

Deep branch of the ulnar nerve

310
Q

Dorsal interossei actions

A

Abduct fingers

311
Q

Palmar interossei actions

A

Adduct fingers

312
Q

How many dorsal and palmar interossei are there?

A
Dorsal = 4
Palmar = 3
313
Q

Dorsal interossei origins(proximal)

A

Adjacent sides of two metacarpals

314
Q

Dorsal interossei insertions(distal)

A

Bases of proximal phalanges

Extensor expansions of 2nd-4th digits

315
Q

Palmar interossei origins(proximal)

A

Palmar surfaces of 2nd, 4th, and 5th metacarpals

316
Q

Palmar interossei insertions(distal)

A

Bases of proximal phalanges

Extensor expansions of 2nd, 4th, and 5th digits.

317
Q

Adductor pollicis origin(proximal)

A

Oblique head- anterior surfaces of 2nd and 3rd metacarpals

Transverse head- anterior surface of 3rd metacarpal

318
Q

Adductor pollicis insertion(distal)

A

Base of proximal phalanx of the thumb

319
Q

Adductor pollicis nerve supply

A

Ulnar nerve

320
Q

Adductor pollicis action

A

Adducts the thumb

321
Q

What does the median nerve innervate in the hand?

A

3 thenar muscles (not the deep head of flexor pollicis brevis)
1st & 2nd lumbricals
Cutaneous innervationn of radial 2/3 of the palm and the lateral 3 and 1/2 digits (only to PIP)

322
Q

What does the ulnar nerve innervate in the hand?

A
Hypothenar muscles
3rd & 4th lumbricals
Dorsal and palmar interossei
Adductor pollicis
Deep head of flexor pollicis brevis
Cutaneous ulner side of hand and medial 1 1/2 fingers
323
Q

All the muscles in the hand are innervated by nerves supplied from ____.

A

C8 and T1

324
Q

Which nerve and muscles are affected in Claw hand?

A

Ulnar nerve

3rd & 4th lumbricals

325
Q

What are the characteristics of Claw hand?

A

Pinky and ring finger are:
Hyper-extended MCP
Flexed PIP & DIP

326
Q

What are characteristics of Duputren’s contracture?

A

Pinky and ring figer are flexed at MCP and PIP, DIP is not as likely to be flexed.

327
Q

What does the median nerve innervate in the forearm, hand, and cutaneous?

A
Forearm: 
Pronator teres
Flexor carpi radialis
Palmar longus
Flexor digitorum superficialis
Flexor digitorum profundus (lateral half)
Flexor pollicis longus
Pronator quadratus
Hand:
Abductor pollicis brevis 
opponens pollicis
Superficial head of flexor pollicis brevis
Lumbricals 1 & 2

Cutaneous:
Radial 3 and 1/2 fingers

328
Q

What does the ulnar nerve innervate in the forearm and hand?

A

Forearm:
Flexor carpi ulnaris
Flexor digitorum profundus (medial half)

Hand:
Hypothenar muscles
Interossei
Lumbricals 3 & 4
Adductor pollicis