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anatomy > Limbs overview > Flashcards

Limbs overview Flashcards

1
Q

Skeleton components

A

-made of axial skeleton (skull, vertebral column and thoracic cage) and appendicular skeleton (limbs)

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2
Q

Limb development

A

NERVE SUPPLY:

  • upper limbs supplied by C5-T1
  • lower limbs supplied by L2-S3

FLEXORS AND EXTENSORS:

  • in the upper limb, the flexors are anterior and the extensors are posterior
  • the lower limbs rotate internally so the extensors are anterior and the flexors are posterior
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3
Q

Internal rotation of the developing lower limb

A
  • lower limb undergoes permanent pronation (internally rotates) during development
  • results in twisting of the dermatome fields=twisted oblique fields as opposed to straighter fields in the upper limb
  • in the thigh and leg, the extensors are anterior and the flexors are posterior
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4
Q

Limb compartments

A
  • tend to have distinct function
  • tend to have same nerve supply
  • tend to have same blood supply
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5
Q

Compartments of the upper limb

A
  • pectoral girdle muscles (anterior and posterior)
  • intrinsic shoulder muscles
  • anterior arm muscles
  • posterior arm muscles
  • anterior forearm muscles
  • posterior forearm muscles
  • intrinsic hand muscles (palmar and dorsal surface)
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6
Q

Pectoral girdle

A
  • shoulder movement involves both arm movements relative to the scapula at the shoulder joint and scapula movements relative to the chest wall
  • muscles acting on shoulder joint have attachments in neck, anterior chest, back and arm
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7
Q

Compartments of the lower limb

A
  • hip abductors (gluteal)
  • hip extensors (gluteal)
  • hip flexors
  • anterior thigh muscles (extensors)
  • medial thigh muscles (adductors)
  • posterior thigh muscles (flexors)
  • anterior leg muscles (extensors)
  • lateral leg muscles (foot evertors)
  • posterior leg muscles (flexors)
  • intrinsic foot muscles
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8
Q

Muscles and nerves of the lower limb

A
  • arise in abdominal and pelvic cavities
  • muscles with attachments in abdomen and pelvis are flexors of hip (iliacus and psoas)
  • nerves supplying lower limb arise from lumbosacral plexus (L2-S3)=femoral nerve, sciatic nerve
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9
Q

Upper limb arterial supply

A

FROM HEART TO HAND

  • Aorta
  • Subclavian artery
  • Axillary artery
  • Brachial artery (pulse point) including deep brachial artery
  • Ulnar and radial arteries (pulse points)
  • Hand palmar arches (deep and superficial)
  • Metacarpal and digital arteries
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10
Q

Upper limb venous drainage (superficial and deep systems)

A

FROM HAND TO HEART

  • Dorsal venous arch (superficial)
  • Cephalic and basilic veins (superficial)
  • Venae comitantes (deep)
  • Axillary vein (deep)
  • Subclavian vein
  • Superior vena cava
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11
Q

Superficial veins in cubital fossa

A
  • superficial veins in cubital fossa region commonly used for phlebotomy or venous line insertion
  • median cubital vein (links cephalic and basilic veins) not always present
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12
Q

Lower limb arterial supply////////

A

FROM PELVIS TO FOOT

  • Aorta
  • Common iliac arteries (internal and external)
  • External iliac artery
  • Femoral artery (pulse point) to deep femoral
  • Popliteal artery (pulse points) to posterior tibial artery, anterior tibial artery, peroneal artery and dorsalis pedis artery
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13
Q

Lower limb venous drainage

A 
DEEP SYSTEM
-anterior and posterior tibial venae comitantes
-popliteal vein 
-femoral vein
-external iliac vein
SUPERFICIAL SYSTEM
-venous arches
-long (great) saphenous vein
-short (small) saphenous vein
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14
Q

Superficial veins of lower limb

A
  • great and small saphenous veins arise from venous network of dorsum of foot
  • great saphenous vein drains into femoral vein at groin
  • small saphenous vein drains into popliteal vein at popliteal fossa

-saphenous veins are consistent but other superficial veins are more variable

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15
Q

Femoral triangle

A
  • region of the grain where femoral artery can be accessed (cardiac vessel access to carry out angiograms and angioplasty)
  • pulse point of femoral artery
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16
Q

Varicose veins

A
  • perforating veins connect superficial and deep veins
  • perforating veins contain a valve that will allow flow only from superficial to deep
  • compromised valve means blood is pushed from deep to superficial veins, resulting in varicose veins
17
Q

Surgical socks

A
  • valves in veins allow flow only up towards heart
  • deep vessels in legs are sandwiched between calf muscle layers
  • during exercise (walking and running ), contraction of calf muscles squeezes thin-walled veins and pushes blood up the veins (CALF PUMP)
  • immobility (post-surgery) means less efficient venous return from foot and leg
  • sluggish deep venous return results in DVT
  • elastic surgical socks compress superficial veins to promote more vigorous deep venous return
18
Q

Spinal nerve anatomy

A
  • 8 cervical
  • 12 thoracic
  • 5 lumbar
  • 5 sacral
  • 1 or 2 coccygeal
19
Q

Spinal nerve organisation

A 
C1-4=neck
C5-T1=upper limb
T2-L1=trunk
L2-S3=lower limb
S2-C2=perineum
20
Q

Brachial plexus

A

/

21
Q

Lumbosacral plexus

A

Nerves supplying lower limb emerge from lumbosacral plexus

  • femoral nerve supplies anterior compartment of thigh
  • obturator nerve supplies medial compartment of thigh
  • sciatic nerve (or tibial and common peroneal nerves) supplies the remaining compartments
22
Q

Segmental motor supply

A

-groups of motor nerve cell bodies in the spinal cord

23
Q

Segmental supply principles

A
  • muscles supplied by 2 adjacent segments
  • same action on a joint means same nerve supply
  • opposing muscles have nerves 1-2 segments above or below each other
  • more distal muscles in limb=nerves originate more caudal in the spine (near tail)
24
Q

Upper limb segmental motor supply

A 
SHOULDER
-abduction=C5
-adduction-C6,C7,C8
-external rotation=C5
-internal rotation=C6,C7,C8
ELBOW
-flexion=C5,C6
-extension=C7,C8
FOREARM
-supination=C6
-pronation=C7,C8
WRIST
-flexion=C6,C7
-extension=C6,C7
LONG TENDONS TO HAND 
-flexion=C7,C8
-extension=C7,C8
INTRINSIC HAND
-T1
25
Q

Lower limb segmental motor supply

A 
HIP
-flexion=L2,L3
-extension=L4,L5
KNEE 
-extension=L3,L4
-flexion=L5,S1
ANKLE
-dorsiflexion=L4,L5
-plantarflexion=S1,S2
26
Q

Upper limb sensory segmental supply

A 
C4=infraclavicular region
C5=lateral arm
C6=lateral forearm and thumb
C7=middle finger
C8=medial side of hand, forearm and little finger
T1=medial arm
T2=axilla and trunk
T4=nipple
T10=umbilicus
T12=lower abdomen
27
Q

Lower limb sensory segmental supply

A

/

28
Q

Nerve function assessment

A

1) motor function
2) sensory function
3) reflex function
4) autonomic function

29
Q

Root injury (prolapsed intervertebral disc at L5/S1)

A

1) motor=loss of eversion
2) sensory=loss of sensation on outer border of foot
3) reflex=loss of ankle jerk (S1)
4) autonomic=minimal

30
Q

Lesion of common peroneal nerve at fibular neck

A

1) motor=foot drop
2) sensory=dorsum of foot at least
3) reflex=non
4) autonomic=minimal

31
Q

Compartment syndrome

A
  • muscle groups in confined compartments separated by fibrous septa
  • syndrome is ischaemia caused by trauma-induced increased pressure in a confined limb compartment
  • commonly affects anterior, posterior and lateral compartments of leg
  • normal pressure (25 mmHg), and only need 50-60 mmHg to collapse vessels and cause ischaemia=but pulse still present
  • acute compartment syndrome is trauma associated
  • chronic compartment syndrome is exercise-induced
  • emergency fasciotomy required to prevent muscle and tissue death in affected compartment
32
Q

Gluteal safe area

A
  • for intramuscular injections into gluteus medius
  • in the buttock, the muscles have a greater blood supply so drug uptake is often faster than subcutaneous and sub-dermal injections
  • intramuscular injections into buttock often contraindicated due to proximity to major vessels and nerves and the variation in adipose tissue over the muscles
33
Q

Venae comitantes

A

-pair of veins (or more) that closely accompany an artery in such manner that the artery pulsations aid venous return

anatomy (11 decks)

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