Anatomy Book Week 9-13

Question 1

What is carpal tunnel syndrome and what can cause it

Answer 1

The pressure on a median nerve in your wrist causes pain and numbness in your hand and fingers

More at risk if you are overweight, pregnant, do work where you repeatedly bend wrist or grip hard, have arthritis or diabetes

Question 2

Attachments of the biceps brachii muscle

Answer 2

Proximal attachment: short head tip of coracoid process of scapula
Long head: supraglenoid tubercle of scapula
Distal attachment: tuberosity of radius and fascia of forearm via bicipital aponeurosis

Question 3

How / where does rupture of the tendon of the long head of the biceps occur

Answer 3

Normally breaks at the supraglenoid tubercle of scapula

Detached muscle forms a ball near the elbow

Question 4

How does pronation / supination occur (detailing the roles of the biceps and anular ligament)

Answer 4

Supination: produced by supinator and the biceps brachi
Pronation: produced by pronator quadrants and pronator teres
Anular ligaments stabilise radial head within radial notch during pronation / supination

Question 5

Describe dislocation of the radial head

Answer 5

More common in girls
When they are jerked by the arm in the pronator position
Pulling detaches angular ligament from neck of radius, causing radial head to move more distally
Proximal part of anular ligament may become trapped between radial head and capitulum of humerus

Question 6

What is lateral epicondylitis (tennis elbow)

Answer 6

Pain around the outside of the elbow (overuse or repeated action of the forearm muscles, near elbow joint)

Question 7

What is medial epicondylalgia ( golfers elbow)

Answer 7

Pain where the tendons of your forearm muscles attach to the bony bump on the inside of your elbow (can spread to forearm and wrist)

Question 8

Describe dislocation of elbow joints

Answer 8

Occurs when any of the 3 bones in the elbow joint become separated or knocked out of their normal positions (not hugely common)

Question 9

What are the 8 carpal bones

Answer 9

1) hamate
2) capitate -round head
3) trapezoid - wedge shaped
4) trapezium - 4 sided
5) pisiform - pea shaped
6) triquetral
7) lunate
8) scaphoid

Some lovers try positions that they can’t handle

Question 10

Why is the fracture of the scaphoid bone a particular problem

Answer 10

The end of the radius bone may also break

Question 11

What is a colles fracture and how does it occur

Answer 11

A break in the radius close to the wrist (an inch below where the bone joins the wrist) usually occurs from a FOOSH or trauma accident

Question 12

Important surface landmarks to enable you to take a pulse in the arm

Answer 12

Easier to feel the pulse when the artery is near the surface of the skin and there is firm tissue (such as bone) beneath the artery

Question 13

How is blood pressure taken using a cuff and stethoscope

Answer 13

1) wrap the cuff around the upper arm
2) lightly press stethoscope bell over brachial artery just below cuffs edge
3) rapidly inflate cuff to 180 mmHg. Release air from the cuff at a moderate rate
4) listen with stethoscope. The first knocking sound is systolic when the sound disappears that is diastolic

Question 14

Function, innervation and general attachments of the serrated anterior

Answer 14

A muscle that originates on the surface of the 1st to 8th ribs at the side of the chest

Acts to pull the scapula forward around the thorax

Innervation: the long thoracic nerve (typically composed of cervical nerves C5, C6 and C7) is inserted along the medial border of the scapula between the superior and inferior angles
Along with being inserted along the thoracic vertebrae

Question 15

Why is the quadrangular space clinically important

Answer 15

It provides the anterior regions of the axilla passageway to the posterior regions. In this space, the axillary nerve and posterior circumflex humeral artery can be compressed or damaged due to space occupying lesions or disruptions due to trauma

Question 16

What are the boundaries of the quadrangular space

Answer 16

Superiorly: teres minor
Medially: long head of triceps
Inferiorly: teres major
Laterally: surgical neck of humerus

Question 17

What are the contents of the quadrangular space

Answer 17

Shaft of humerus, long head of triceps, teres minor and major

Question 18

Function and innervation of rotator cuff muscles (SITS)

Answer 18

Supraspinatus: abduction of arm. Innervated by suprascapular

Infraspinatus: lateral rotation of arm. Innervated by suprascapular

Teres minor: lateral rotation of arm. Innervated by axillary nerve

Subscapularis: medial rotation of arm. Innervated by subscapular nerve

Question 19

Why is the supraspinatus muscle the most commonly injured in the rotator cuff muscles

Answer 19

Is a relatively small muscle of the upper back that runs from the supraspinatus fossa
Superior portion of the scapula to the greater tubercle of the humerus

Tear can be caused by lifting something too heavy, falling on your arm or dislocating your shoulder

Question 20

Function and general attachments of the 3 heads of the triceps brachi

Answer 20

Function: helps in extension of elbow joint and also acts as an antagonist of the biceps and brachialis. Also helps to stabilise the shoulder joint by keeping head of humerus in correct place

Long head arises from infraglenoid tubercle of scapula, lateral head just superior to radial groove

Medial head: inferior to radial groove

Question 21

If the radial nerve is damaged in the radial groove, the triceps is weakened usually (not completely paralysed) why?

Answer 21

Because the medial and long head of triceps are attached close to the radial nerve

Question 22

Where does the radial nerve pass through the cubital fossa

Answer 22

Travels along the lateral border of the cubital fossa and divides into superficial and deep branches

Question 23

Where does the radial nerve go at the wrist and when it goes into the hand

Answer 23

Innervates muscles in the posterior compartment of the forearm and the extrinsic extensors of the wrist and hands
Provides cutaneous sensory innervation to most of the back of the hand

Question 24

What does nerve damage in the axilla result in

Answer 24

Deltoid and teres minor muscles are affected

Numbness in lateral shoulder region (loss of movement or sensation)
Chronic neuropathic pain

Question 25

What does nerve damage at the mid-shaft of the humerus (radial nerve) result in

Answer 25

Triceps are affected

Movement of triceps at the back of the upper arm and ability to bend wrist and fingers is impaired

Results in numbness or tingling

Question 26

What does nerve damage near the elbow result in

Answer 26

Flexor muscles of the forearm (flexor carpi ulnaris), flexor digitorum profundus

Can cause muscle wasting or atrophy
Numbness and tingling in fingers

Question 27

Where does the ulnar nerve cutaneously innervate the upper limb

Answer 27

Palmar branch: anterior skin and nails

Dorsal cutaneous branch: dorsal medial hand and the dorsum of the medial 1.5 fingers

Question 28

Where does the median nerve cutaneously innervate the upper limb

Answer 28

Skin of the palmar side of the index finger, thumb, middle finger, and half ring finger and nail bed

Palmar cutaneous branch of median nerve innervates the radial aspect of the palm

Question 29

Where does the musculcutaneous nerve cutaneously innervate the upper limb

Answer 29

Innervates the 3 muscles of the anterior compartment of the arm: coracobrachialis, biceps brachii and brachialis

Question 30

Where does the radial nerve cutaneously innervate the upper limb

Answer 30

Innervates the medial and lateral heads of the triceps brachii as well as all 12 muscles in the posterior osteofascial compartment of the forearm and the associated joints and overlying skin

Question 31

What muscles does the sciatic nerve innervate

Answer 31

Biceps femoral

Hamstring portion of adductor Magnus

Question 32

What muscles does the superior gluteal nerve innervate

Answer 32

Gluteus medius, gluteus minimus and tensor fasciae latae.

Question 33

Function and innervation of semitendinous, semimembranosus and biceps femoris

Answer 33

They are all hamstrings (innervated by tibial division of sciatic nerve)
Function: extension at hip joint and flexion at knee joint

Question 34

Function and innervation of the adductor Magnus

Answer 34

Pulls the hip towards the Body’s midline eg in walking and sprinting
Innervated by obturator nerve and sciatic nerve

Question 35

Function and innervation of the vastus lateralis

Answer 35

Longest and most powerful part of the quadriceps
Extends and stabilises knee
Innervated by the femoral nerve

Question 36

Attachments of the long and short heads of the biceps femoris

Answer 36

Long: ischium (lower and back part of the hip bone)
Short: femur bone

Question 37

Difference in functions of the long and short head of the biceps femoris

Answer 37

Long: flexes knee and extends hip
Short: flexes knee, laterally rotates lower leg

Question 38

Popliteus attachments

Answer 38

Proximal: lateral surface of lateral condyle

Distal: proximal posterior surface of tibia

Question 39

Function of the popliteus

Answer 39

Assists in knee flexion

‘Key’ to unlocking the knee as it begins knee flexion by laterally rotating the femur on the tibia

Question 40

What is the deepest structure in the popliteal fossa

Answer 40

Popliteal artery

Question 41

What is the triceps surae

Answer 41

The 2 heads of the gastrocnemius and the soleus

These 2 muscles both insert into the calcaneus, the bone of the heel and form the major part of the calf muscle

Question 42

Function and innervation of tibialis posterior

Answer 42

Supports the medial longitudinal arch during weight bearing

Innervated by tibial nerve

Question 43

Function and innervation of flexor hallucis longus

Answer 43

Powerful flexor of all the joints of the great toe

Innervated by tibial nerve

Question 44

What is tarsal tunnel syndrome

Answer 44

Entrapment and compression of the tibial nerve occurs when there is edema and tightness in the ankle involving the synovial sheaths of the tendons of muscles in the posterior compartment of the leg

Heel pain results from compression of the tibial nerve by the flexor retinaculum

Question 45

Where is the safe area for injection in the gluteal region

Why this region?

Answer 45

Superotaleral quadrant of gluteal region because muscles are so thick so allows for absorption of drugs

Question 46

Function of the fibula

Answer 46

Main function is to combine with the tibia and provide stability to the ankle joint

Distal end of fibula has several grooves for ligament attachments

Question 47

What is gastrocnemius strain

Answer 47

An injury to the calf muscle in the back of the leg occurs when the muscle is stretched too far

Question 48

What is the calcaneal tendon reflex

Answer 48

Occurs when the Achilles’ tendon is tapped while the foot is dorsiflexed
Positive result is jerking of the foot towards the plantar surface

Question 49

Consequences of damage to the superior gluteal nerve

Answer 49

Results in paralysis of the gluteus medius resulting in a characteristic gait on walking and standing

Question 50

Consequences of damage to the inferior gluteal nerve

Answer 50

Damage leads to gluteus maximum lurch

Loss of extension at hip and causes the buttock to waste

Question 51

Consequences of damage to the sciatic nerve

Answer 51

Sciatica occurs when sciatic nerve becomes pinched (usually by a herniated disc in spine or by overgrowth of bone on your vertebrae)
Occurs when one or more nerve roots from L4 to S3

Question 52

Consequences of damage to the tibial nerve

Answer 52

Commonly injured by fractures or other injury to the back of the knee or lower leg
Causes numbness, pain, tingling, and weakness of the knee or lower leg

Question 53

Consequences of damage to the common fibular nerve

Answer 53

Common fibular nerve wraps around the neck of the fibular so any fractures of fibular neck can cause nerve palsy
Patients with common fibular nerve damage will lose the ability to dorsiflex the foot at the ankle joint

Question 54

Consequences of damage to the sural nerve

Answer 54

Can result in burning pain and diminished sensation or numbness
The nerve passes down from the back of the knee along the outside of the lower leg