Exam 1 Flashcards
(217 cards)
1
Q
origin and insertion of trapezius
A
O: medial third of superior nuchal line, external occipital protuberance, nuchal ligament, C7-T12 spinous processes via nuchal ligament in cervical region
I: spine of scapula, acromion and lateral third of clavicle
2
Q
Action of the trapezius
A
elevate, retract and superiorly rotate scapula, neck extension slightly
3
Q
blood supply of trap
A
transverse cervical artery
4
Q
innervation of trapezius
A
spinal accessory nerve
5
Q
Latissimus Dorsi: origin and insertion
A
O: T7-L5 spinous processes thru thoracolumbar fascia, iliac crest and lower ribs
I: floor of intertubercular sulcus of humerus
6
Q
Latissimus Dorsi action
A
extend, adduct and medially rotate humerus
7
Q
innervation of Latissimus Dorsi
A
thoracodorsal nerver
8
Q
blood supply of latissimus dorsi
A
thoracodorsal artery
9
Q
Rhomboid Major: O and I
A
O: T2-T5 spinous processes
I: medial border of the scap
10
Q
Rhomboid major and minor blood supply
A
dorsal scapular artery
11
Q
Rhomboid major and minor action
A
elevate, retract and inferiorly rotate the scapula
12
Q
Rhomboid major and minor innervation
A
dorsal scapular nerve
13
Q
what muscles are supplied by the recurrent branch of the median nerve
A
abductor pollicis brevis, flexor pollicis brevis, and opponens pollicis
14
Q
what muscles are supplied by the deep branch of the ulnar nerve
A
adductor pollicis, abductor digit minimi, opponens digiti minimi, lumbricals 3 and 4, PADS and DABS
15
Q
lumbricals 1 and 2 are supplied by which nerve
A
median nerve
16
Q
lumbricals 3 and 4 are supplied by which nerve
A
deep branch of ulnar nerve
17
Q
which arteries primarily make up the superficial palmar arch
A
ulnar artery and superficial palmar branch of the radial artery
18
Q
what two structures run underneath the palmaris brevis
A
ulnar n and a
19
Q
innervation of pectoralis major
A
lateral pectoral nerve and medial pectoral nerve
20
Q
innervation of pectoralis minor
A
medial pectoral nerve
21
Q
innervation of subscapularis (upper)
A
upper subscapular nerve
22
Q
what muscles are innervated by the axillary nerve
A
deltoid and teres minor
23
Q
all the muscles innervated by the radial nerve
A
triceps brachii, acones, brachioradialis, extensor mm of forearm, skin of posterior arm forearm
24
Q
anterior forearm cutaneous nerves
A
medial cutaneous and medial antebrachial cutaneous nerves
25
where does the lateral cutaneous nerve branch from
median nerve
26
what veins join together to form subclavian vein
cephalic and axillary vein
27
what veins join together to form axillary vein
the basilic vein and brachial vein
28
what lies in the quadrangular space
axillary n and posterior circumflex humeral aa
29
what makes up the triangular interval
teres major
long head of triceps
shaft lateral head of triceps/humerus
30
action of the subclavius muscle
depress and pull the clavicle medially
31
which pollicis muscle is innervated by the deep ulnar n
adductor pollicis
32
where does the biceps tendon originate
glenohumeral labrum
33
function of the aconeus
pull on the joint capsule as joint extends, slight assistance with elbow extension
34
where does the Radial collateral ligament insert
the annular ligament (continuous with)
35
what two tendons make up the extensor hood
the dab interossei tendons and the extensor digitorum tendons
36
from what artery do the anterior and posterior interosseous arteries arise
the ulnar aa
37
Insertion of the flexor carpi ulnaris
pisiform
38
where does subscapularis insert
the lesser tubercle of the humerus
39
what makes up the triangle of auscultation
trapezius, medial border of scap and latissimus dorsi
40
what structures create the triangular space?
teres minor, teres major and the long head of the triceps
41
what structures create the triangular interval?
long head and lateral head of triceps and teres major
42
what structures create the quadrangular space?
surgical neck of humerus (roof) and joint capsule
teres minor, teres major, long head of the triceps and
43
what comes out of the triangular space?
circumflex scapular a
44
what comes out of the quadrangular space?
axillary n and posterior circumflex humeral a
45
what comes out of the triangular interval?
radial nerve and profunda brachii artery
46
what muscles are supplied by posterior circumflex humeral artery?
rotator cuff mm
47
the biceps short head originates where?
corocoid process
48
which part of the clavicle is most commonly fractured?
mid clavicle
49
in a mid clavicular break what pulls the mid clavicul cephalically?
the SCM
50
in a mid clavicular break what pulls the lateral clavicle inferiorly?
the trapezius
51
what ligament is at risk for injury with lateral clavicular fracture?
coracoclavicular ligament
52
what is the twisty ligament?
medial conoid portion of coracoclavicular ligament: posteriorly rotates clavicle to help with upper limb elevation
53
why do most humeral fractures happen and where
surgical neck of humerus due to osteoporosis in older adults
54
what structure can be affected by a mid humeral shaft fracture
radial nerve and profunda brachii, surgical edema can effect this also
55
complications of supracondylar fracture
median nerve and brachial artery
56
where does lateral thoracic artery travel
with long thoracic nerve
57
what artery supplied 1st 2 intercostal spaces
superior thoracic artery
58
common medical condition of axillary artery
thoracic outlet syndrome, clavicle and first rib are inflamed or not aligned correctly
59
biceps tendon rupture: who is more at risk and what muscle/tendon is more common
proximal long head tendon of biceps brachii, heard pop or snap when OLDER MEN are lifting something heavy
60
where does short head of biceps brachii insert
distal to radial head
61
which carpal bone can be fractured and become necrotic
scaphoid
62
where can you find the suprascapular notch
b/w coracoid process and the superior border
63
is the dorsal radial tubercle proximal or distal
distal
64
is the ulnar notch of the radius distal or proximal
distal
65
is the radial notch of the ulna distal or proximal
proximal
66
Deltoid O and I
O: lateral 1/3 of the clavicle, acromion process and lateral spine of the scapula
I: deltoid tuberosity of the poximal/mid humerus
67
median nerve injury at pronator teres results in
weak wrist flexion, hand deviated to ulnar side during wrist flexion, loss of DIP, PIP and MCP joints of middle and index finger and no opposition with flexion /abduction of the thumb weak, sensory loss of palmar/dorsal aspects of middle index and lateral 4th digit
68
median nerve injury in the carpal tunnel results in..
no opposition with flexion /abduction of the thumb weak, sensory loss of palmar/dorsal aspects of middle index and lateral 4th digit
69
radial nerve injury normally occurs from
incorrect fitting crutches or midshaft fracture of the humerus
70
radial nerve injury results in ...
wrist drop:
supination is weak, extension of MCP joints are lost and sensory to posterior aspect of distal arm, forearm and lateral dorsum of hand are lost
71
ulnar nerve injury at the elbow results in
radial deviation during wrist flexion ring and little finger flexion is lost
+ MCP flexion, PIP /DIP extension of ring and little finger are lost, adduction of the thumb is lost, sensory loss of ulnar path of hand
72
ulnar nerve injury at guyans canal results in
MCP flexion, PIP /DIP extension of ring and little finger are lost, adduction of the thumb is lost, sensory loss of ulnar path of hand
73
Anterior deltoid mm action:
flex and medially rotate the shoulder
74
Middle deltoid mm action:
shoulder abduction
75
Posterior deltoid mm action:
Extension and lateral rotation of the shoulder
76
Supraspinatus O and I:
O: supraspinous fossa of the scapula
I: superior facet on greater tubercle of humerus
77
supraspinatus action
initiates abduction of the shoulder, gives shoulder joint stability by reinforcing the joint capsule
78
supraspinatus innervation
suprascapular nerve (C4, C5, C6)
79
Infraspinatus O and I:
O: infraspinous fossa of the scapula
I: middle facet of the greater tubercle of humerus
80
Infraspinatus Action
lateral rotation of the shoulder, holds humeral head in the glenoid cavity of the scapula
81
infraspinatus innervation
suprascapular nerve (C4, C5, C6)
82
Teres minor O and I
O: middle part of the lateral scapular border
I: inferior facet of the greater tubercle of the humerus
83
Teres minor A:
lateral rotation of the shoulder, holds humeral head in the glenoid cavity of the scapula
84
Teres minor innervation
axillary nerve (C5 and C6)
85
Subscapularis O and I:
O: subscapular fossa
I: lesser tubercle of the humerus
86
subscapularis A:
Internal/medial rotation of the shoulder and shoulder adduction, helps hold humeral head in place
87
subscapularis innervation
upper and lower subscapular nerve
88
Teres major O and I:
O: Posterior surface of the inferior angle of the scapula
I: crest of the lesser tubercle (medial lip of bicipital groove)
89
Teres major A:
adduct and medially rotate shoulder joint, tries to be like the lat dorsi
90
Teres major innervation **
lower subscapular nerve (C6 and C7)
91
most common rotator cuff injury
rupture of the supraspinatus tendon
92
Levator Scapulae O and I:
O: posterior tubercles of transverse processes of C1-C4
I: superior part of medial border of scapula
93
Levator Scapulae Innervation
dorsal scapular nerve and C3-C4 spinal nerves
94
Levator scapulae action
elevate scapula and tilt its glenoid cavity inferiorly by rotating the scap
95
Rhomboid minor O and I:
O: inferior part of nuchal ligemant and spinous processes of C7 and T1
I: medial border of the scapula from level of spine to inferior angle
96
scapular elevation muscles
rhomboids, levator scap and upper trap
97
scapular depression muscles
lower trap and pectoralis minor, inferior part of SA
98
scapular retraction muscles
Latissimus dorsi, rhomboids and middle trap
99
scapular protraction muscles
SA and pectoralis minor
100
muscles producing scapular upward rotation
lower trap, upper trap and SA
101
muscles producing scapular downward rotation
latissimus dorsi, rhomboids, levator scap
102
Triceps Long head O and I:
O: infraglenoid tubercle
I: proximal end of olecranon of ulnar and fascia of forearm
103
Triceps lateral head O and I:
O: posterior surface of humerus , superior to radial groove
I: proximal end of olecranon of ulnar and fascia of forearm
104
Triceps Medial Head O and I:
O: posterior humerus, inferior to radial groove
I: proximal end of olecranon of ulnar and fascia of forearm
105
Triceps Action
elbow extension, assist with shoulder extension , long head steadies head of humerus with shoulder joint is abducted
106
triceps innervation
radial nerve (C6-C8)
107
Biceps short head O and I:
O: tip of coracoid process of the scapula
I: tuberosity of radius and fascia of forearm though bicipital aponeurosis
108
Biceps Long head O and I:
O: supraglenoid tubercle of scapula and the glenoid labrum
I: tuberosity of radius and fascia of forearm though bicipital aponeurosis
109
Biceps innervation
muscular branches of the musculocutaneous nerve (C5, C6, C7)
110
Biceps action
elbow flexion, supinates forearm, short head flexes shoulder, long head (with long head of triceps) stabilizes shoulder during abduction
111
Brachialis O and I:
O: distal half of anterior surface of the humerus
I: coronoid process and tuberosity of the ulna
112
Brachiais innervation
muscular branches of musculocutaneous nerve and radial ne4rve
113
Brachialis action
flex elbow in all positions
114
Coracobrachialis O and I:
O: tip of coracoid process of the scapula
I: proximal/medial humerus underneath long head
115
Coracobrachialis A:
assist with shoulder flexion and adduction
116
Coracobrachialis Innervation
musculocutaneous n
117
Anconeus muscle O and I:
O: lateral epicondyle of humerus
I: lateral surface of olecranon and superior part of posterior surface of the ulna
118
Anconeus Action
assist with elbow extension, pull joint capsule and abducts ulna during pronation `
119
Anconeus innervation
radial nerve (C7-T1)
120
Axillary nerve injury is common with ___
inferior dislocation of humeral head as head approaches quadrangular space
121
pectoralis major calvicular head O and I:
O: anterior medial surface of clavicle
I: crest of greater tubercle of intertubercular sulcus (lateral lip of bicipital groove
122
pectoralis major sternal head O and I:
O: anterior surface of the sternum, superior 6 costal cartilages
123
third origin of the pectoralis major=
aponeurosis of the external oblique muscles
124
Pectoralis major action:
adduct and medially rotate humerus, draw scapula anteriorly and inferiorly
clavicular head flexes shoulder joint and sternal head will extend shoulder when it is already flexed
125
pectoralis minor O and I
O: 3rd to 5th ribs near the cartilage
I: medial border and superior surface of coracoid process of scap
126
pectoralis minor A:
stabilize scapula by drawing it inferiorly and anteriorly against thoracic wall
127
subclavius O and I:
O: junction of the 1st rib and its costal cartilage
I: inferior surface of the middle third of clavicle
128
subclavius A:
anchors and depresses clavicle at SC joint
129
subclavius innervation
nerve to subclavius (C5 and C6)
130
what separates the suprascapular nerve and artery
superior transverse scapular ligament
131
Anterior forearm 1st layer
pronator teres, flexor carpi radialis, palmaris longus, flexor carpi ulnaris
132
anterior forearm 2nd layer
flexor digitorum superficialis
133
anterior forearm 3rd layer
flexor digitorum profundus, flexor pollicis longus
134
anterior forearm 4th later
pronator quadratus
135
anterior forearm muscles supplied by median nerve
pronator teres ,flexor carpi radialis, palmaris longus, flexor digitorum superficialis, lateral part of flexor digitorum profundus
136
anterior forearm muscles innervated by anterior interosseous
flexor pollicis longus and pronator quadratus
137
anterior forearm muscles supplied by ulnar nerve
flexor carpi ulnaris and medial part of flexor digitorum profundus
138
muscles that originate at common flexor origin (medial epicondyle of humerus)
one head of the pronator teres, flexor carpi radialis palmaris longus, one head of flexor carpi ulnaris
139
brachioradialis O and I:
O: lateral supracondylar ridge
I: basically the styloid process of the radius
140
brachioradialis A:
elbow flexion and forearm pronation
141
brachioradialis innervation
radial nerve from posterior cord
142
which MCs does the flexor carpi radialis insert on
base of 2nd and 3rd
143
what is the L muscle in the forearm/hand and where does it insert?
flexor pollicis longus, inserts on DIP of thumb
144
Pronator Teres Action:
pronation of forearm with elbow flexion
145
pronator teres action
wrist pronation
146
flexor carpi radialis action
abduction/flexion of wrist
147
flexor carpi ulnar action
adduction/flexion of the wrist
148
palmaris longus action
flex wrist and tighten the palmaris aponeurosis
149
which muscle attaches to the pisiform
flexor carpi ulnaris tendon
150
which tendon doe the lumbricals join with
flexor digitorum profundus
151
action of the lumbricals
flex the MCP joints and extend IP joints
152
what two tendons are covered/make up the flexor synovial tendon sheath
the FDS and FDP
153
synovial sheaths surround the ____
tendon
154
ulnar nerve injury will manifest as what?
claw hand
155
superficial layer of posterior forearm mm from proximal to distal
extensor carpi radialis longus, extensor carpi radialis brevis, extensor digitorum, extensor carpi ulnaris, extensor digiti minimi
156
deep layer of posterior forearm mm from proximal to distal
supinator, abductor pollicis longus, extensor pollicis longus, extensor indicis, extensor pollicis brevis
157
where does the cephalic vein pass proximally
in the deltopectoral triangle that separates the deltoid from the pectoralis major
158
one artery comes off of the first branch of the axillary artery
supreme thoracic artery
159
what arteries come off of the second branch of the axillary artery
Thoracoacromial artery
Lateral Thoracic Artery
160
What arteries come off of the third branch of the axillary artery
Thoracodorsal artery and circumflex scapular artery of the subscapular artery
Anterior humeral circumflex artery and posterior humeral circumflex artery
161
the subscapular artery gives off what two arteries
circumflex scapular artery and thoracodorsal artery
162
long thoracic nerve comes from where on the brachial plexus
C5-C7 ventral rami
163
dorsal scapular nerve comes from the ventral ramus of
C5
164
in the brachial plexus, the cords are named after what
their position relative to the axillary artery
165
C5 brachial plexus injury will effect which nerves and therefore which muscles
dorsal scap (no rhomboids and levator scap)
suprascapular nerve from C5 (weaker supraspinatus and infraspinatus)
weaker lateral pectoral innervation (pectoralis major)
weaker elbow flexors due to musculocutaneous nerve
166
C6 brachial plexus injury will effect which nerves and therefore which muscles
same as C5 with no involvement of rhomboids and levator scap so
suprascapular nerve from C5 (weaker supraspinatus and infraspinatus)
weaker lateral pectoral innervation (pectoralis major)
weaker elbow flexors due to musculocutaneous nerve
167
C7 brachial plexus injury will effect which nerves and therefore which muscles
weaker lateral pectoral nerve (pectoralis major)
weaker musculocutaneous nerve (Biceps, coracobrachialis and brachialis), weaker radial and axillary n) weaker USS, TD and LSS
168
C8/T1 brachial plexus injury will effect which nerves and therefore which muscles
medial pectoral nerve (pectoralis minor and major)
medial brachial cutaneous and medial antebrachial cutaneous, ulnar nerve (results in claw hand) and some involvement with thoracodorsal so weak latissimus dorsi
169
in regard to the bicipital aponeurosis what goes underneath
the median nerve
170
where does radial nerve emerge in the forearm
between brachialis and brachioradialis, continues as the superficial radial nerve in the forearm just deep to the brachioradialis mm
171
anterior wall of the axillary region
pectoralis major and minor
172
medial wall of the axilla
SA
173
lateral wall of the axilla
intertrubecular groove of the humerus
174
superior wall of the axilla
clavicle, scapula and first rib
175
posterior wall of the axilla
subscapularis, latissimus dorsi and teres major
176
brachial artery splits into
ulnar artery and radial ulnar in the forearm
177
the ulnar artery has proximal branches, what are they
common interosseous, anterior interosseous and posterior interosseous arteries
178
anterior interossesous nerve innervates
flexor pollicis longus, pronator quadratus and lateral 2 slips of the flexor digitorum profundus
179
what is the 1 and 1/2 exception of the forearm musculature
flexor carpi ulnaris and medial 2 slips of the FDP are innervated by the ulnar nerve
180
where does extensor carpi radialis brevis attach
3rd MCP
181
where does extensor carpi radialis longus attach
2nd MCP
182
radial nerve innervation in the forearm
brachioradialis and extensor carpi radialis longus
183
deep radial nerve innervation of the forearm
extensor carpi radialis brevis and supinator
184
Posterior interosseous innervation in the forearm
deeper musculature other than the extensor digitorum, extensor carpi ulnaris, abductor pollicis longus, extensor pollicis brevis, extensor pollicis longus and extensor indicis
185
median nerve innervation to the hand
lumbricals 1 and 2, AFO of thenar eminence through recurrent median nerve
186
deep ulnar nerve innervation in the hand
adductor pollicis, lumbricals 3 and 4, PADS and DABS, abductor DM, flexor DM and opponens DM
187
ulnar nerve innervation in the hand
abductor DM, flexor DM, opponens DM
188
which ligament of the UE anchors the clavicle to the scapula
coracoclavicular ligament
189
role of the coracoacromial ligament
acts as the superior support for the GH joint and preventing superior dislocations
190
what joint becomes taut when the GH joint is pulled inferiorly
coracohumeral ligament
191
how is the glenohumeral joint reinforced anteriorly
GH ligaments and the transverse humeral ligament alongside the long head of the biceps brachii as the tendon passes from the supraglenoid tubercle to the intertubercular groove
192
what supports the MP and IP joints medially and laterally
collateral ligaments (Metacrpophalengeal joint collateral ligament of proximal interphalangeal joint collateral ligament)
193
what ligament holds the metacarpophalangeal heads together
transverse metacarpal ligaments
194
what is the role of the palmar plates
deepen the MP and IP joints anteriorly and allow for tendons to run through
195
what attaches to the palmar plate
extensor hood
196
what lies in the 1st compartment of the extensor retinaculum
extensor pollicis brevis, abductor pollicis longus
197
what are the contents of the carpal tunnel
flexor digitorum profundus and superficialis tendon, portion of the median nerve
198
radial nerve innervation
brachioradialis, triceps brachi, extensor carpi radialis longus
199
Deep radial nerve innervation
supinator, extensor carpi radialis brevis
200
posterior interosseous innervation
abductor pollicis longus, extensor pollicis brevis, extensor pollicis longus, extensor digit minimi, extensor carpi ulnaris, extensor digitorum, extensor indicis
201
what is used to test the integrity of the musculocutaneous nerve (and spinal segments C5. C6)
biceps tendon relfec
202
musculocutaneous injury would result in
absent biceps reflex or decreased, loss of sensation along lateral forearm, weak arm flexion and supination, severe weakness in elbow flexion (would only have brachioradialis to assist which is innervated by radial nerve)
203
surgical neck fracture of the humerus can result in what
injury to axillary nerve or posterior circumflex humeral artery
204
midshaft humeral fracture can cause damage to the
radial n and profunda brachii artery
205
fracture of the medial epicondyle can cause damage to the
ulnar nerve
206
where does the stratum corneum lie
epidermis
207
the epidermis regenerates every __ to ___ days
14 to 21 days
208
what are the layers of the epidermis
stratum basale, spinosum, granulosum, lucidum and corneum
209
what attaches the stratum basale to the dermis
the basement membrane
210
what does the stratum basale contain
single row of keratinocytes
211
cutaneous branches of the radial nerve
inferior lateral cutaneous nerve of arm and posterior cutaneous of the forearm
they are sometimes branches of the same
212
superior border of the cubital fossa
imaginary line connecting the medial and lateral epicondyles
213
medial border of the cubital fossa
pronator teres
214
lateral border of the cubital fossa
the brachioradialis
215
contents of the cubital fossa
terminal part of brachial artery (radial and ulnar artery), accompanying veins of the arteries, biceps brachii tendon, median nerve and radial nerve dividing into superficial and deep branches
216
Contents of the axilla
fat, brachial plexus, axillary artery, veins and lymphatics
217
de quervain tenosynovitis
excessive friction of the APL and EPB tendons causing sheath fibrous thickening and stenosis of the osseofibrous tunnel
causes pain in the wrist that radiates proximally to the forearm and distally to the hand
