exam #3 Flashcards
(288 cards)
1
Q
what is the ankle joint called
A
the talocrural joint
2
Q
what type of synovial joint is the talocrural joint
A
hinge joint
3
Q
where is the talocrural joint located
A
between the distal parts of the tibia and fibula and the superior region of the talus
4
Q
what is the malleolar mortise?
A
deep socket into which the pulley-shaped trochlea of the talus fits
-formed by distal ends of tibia and fibula (and inferior transverse part of posterior talofibular ligament)
5
Q
what is the rounded superior articular part of the talus
A
trochlea
6
Q
the tibia articulates with the talus in two places. what are these places
A
1) its inferior surface forms the roof of the malleolar mortise, transferring the body’s weight to the talus
2) its medial malleolus articualtes with the medial surface of the talus
7
Q
the joint capsule of the talocrural joint is thin anteriorly and posteriorly but is supported by two strong collateral ligaments on each side
true or false?
A
true
8
Q
anterior talofibular ligament
A
-flat, weak band that extends anteromedially from the lateral malleolus to the neck of the talus
9
Q
posterior talofibular ligament
A
-thick, fairly strong band that runs horizontally medially and slightly posteriorly from the malleolar fossa of the fibula to the lateral tubercle of the talus
10
Q
calcaneofibular ligament
A
-round cord that passes postero-inferiorly from the tip of the lateral malleolus to the lateral surface of the calcaneus
11
Q
what is the name of the ligament that reinforces the medial side of the ankle joint?
A
medial ligament of the ankle (deltoid ligament)
12
Q
what are the main movements of the ankle joint
A
dorsiflexion and plantarflexion
-during plantarflexion, some “wobble” (abduction, adduction, inversion, eversion) is possible
13
Q
dorsiflexion is produced by muscles in the ______ compartment of the leg
A
anterior
14
Q
plantarflexion is produced by muscles in the _______ compartment of the leg
A
posterior and lateral
15
Q
which structures limit plantarflexion of the ankle joint
A
- ligaments: anterior talofibular, anterior part of medial ligament of the ankle (deltoid lig), anterior joint capsule
- contact of talus with tibia
- tension of dorsiflexors of ankle (anterior leg)
16
Q
which structures limit dorsiflexion at the ankle joint?
A
- ligaments: deltoid ligament, calcaneofibular, posterior talofibular, posterior joint capsule
- contact of talus with tibia
- tension of plantarflexors of ankle
17
Q
what are considered the “important” intertarsal joints? What are the main movements at these joints?
A
subtalar (talocalcaneal) joint and the transverse tarsal joint
-inversion and eversion are the main movements involving these joints
18
Q
plantar calcaneonavicular (spring) ligament
A
- extends across and fills a wedge-shaped gap between the sustentaculum tali and the inferior margin of the posterior articular surface of the navicular
- supports the head of the talus
- plays important role in the transfer of weight from talus
- maintains longitudinal arch of foot
19
Q
long plantar ligament
A
- passes from the plantar surface of the calcaneus to the groove on the cuboid (some fibers extend to base of metatarsals)
- forms tunnel for fibularis longus
- maintains longitudinal arch of foot
20
Q
which structures limit inversion at the foot and toes?
A
- ligaments: lateral ligament of ankle, talocalcaneal ligament, lateral joint capsule
- tension of everter muscles
21
Q
which structures limit eversion at the foot and toes?
A
- ligaments: medial ligament of ankle, medial talocalcaneal ligament, medial joint capsule
- tension of tibialis posterior, flexor hallucis longus, flexor digitorum longus
- contact of talus with calcaneus
22
Q
which structures limit flexion at the foot and toes?
A
MTP: tension of posterior joint capsule, extensor muscles, and collateral ligaments
- PIP: soft tissue apposition, tension of collateral ligaments and posterior joint capsule
- DIP: tension in collateral and oblique retinacular ligaments and posterior joint capsule
23
Q
which structures limit extension at the foot and toes?
A
- MTP: tension of plantar joint capsule, plantar ligaments, and flexor muscles
- PIP: tension in plantar joint capsule
- DIP: ligaments and plantar joint capsule
24
Q
which structures limit abduction at the foot and toes?
A
- ligaments: collateral ligaments, medial joint capsule
- tension of adductor muscles
- skin between web space
25
which structures limit adduction at the foot and toes?
apposition of toes
26
what is the type, movements, articulating surfaces, joint capsule, and ligaments of the subtalar (talocalcaneal) joint?
type: plane synovial
movements: inversion and eversion
articulating surfaces: inferior surface of talus articulates with superior surface of calcaneus
joint capsule: attached to margins or articular surfaces
ligaments: medial, lateral, and posterior talocalcaneal ligaments and interosseus talocalcaneal ligaments
27
what is the type, movements, articulating surfaces, joint capsule, and ligaments of the talocalcaneonavicular joint?
type: synovial joint, talonavicular part is a ball-and-socket joint
movements: gliding and rotatory
articulating surfaces: head of talus articulates with calcaneus and navicular bones
joint capsule: incompletely encloses joint
ligaments: plantar calcaneonavicular (spring) ligament supports head of talus
28
what is the type, movements, articulating surfaces, joint capsule, and ligaments of the calcaneocuboid joint?
type: plane synovial
movements: inversion and eversion of foot; circumduction
articulating surfaces: anterior end of calcaneus articulates with posterior surface of cuboid
joint capsule: encloses joint
ligaments: dorsal and plantar calcaneocuboid and long plantar ligaments
29
what is the type, movements, articulating surfaces, joint capsule, and ligaments of the cuneonavicular joint?
type: plane synovial
movements: little movement
articulating surfaces: anterior end of navicular articulates with bases of cuneiform bones
joint capsule: common capsule encloses joints
ligaments: dorsal and plantar cuneonavicular ligaments
30
what is the type, movements, articulating surfaces, joint capsule, and ligaments of the tarsometatarsal joints?
type: plane synovial
movements: gliding or sliding
articulating surfaces: anterior ends of tarsal bones articulate with bases of metatarsal bones
joint capsule: separate joint capsules enclose with each joint
ligaments: dorsal, plantar, and interosseous tarsometatarsal ligaments
31
what is the type, movements, articulating surfaces, joint capsule, and ligaments of the intermetatarsal joints?
type: plane synovial
movements: little movement
articulating surfaces: bases of metatarsal bones articulate with each other
joint capsule: separate joint capsules enclose each joint
ligaments: dorsal, plantar, and interosseous tarsometatarsal ligaments
32
what is the type, movements, articulating surfaces, joint capsule, and ligaments of the metatarsophalangeal joints?
type: condyloid synovial
movements: flexion, extension, and some abduction, adduction, and circumduction
articulating surfaces: heads of metatarsal bones articulate with bases of proximal phalanges
joint capsule: separate joint capsule enclose each joint
ligaments: collateral and plantar ligaments
33
what is the type, movements, articulating surfaces, joint capsule, and ligaments of the interphalangeal joints?
type: hinge synovial
movements: flexion and extension
articulating surfaces: head of one phalanx articulates with bases of one distal to it
joint capsule: separate joint capsules enclose each joint
ligaments: collateral and plantar ligaments
34
what are the functions of the arches of the foot?
the arches distribute weight over the foot, acting not only as shock absorbers but also as spring boards for propelling it during walking, running, and jumping
35
longitudinal arch of the foot
- composed of media land lateral parts
| - both parts act as a unit with the transverse arch spreading weight in all directions
36
medial longitudinal arch of the foot
- higher and more important than the lateral arch
- composed of the calcaneus, talus, navicular, three cuneiforms and three metatarsals
- ***talar head is the keystone of the medial arch
- tibialis anterior and posterior, and fibularis longus tendon help support this arch
37
lateral longitudinal arch of the foot
- much flatter than the medial longitudinal arch and rests on the ground during standing
- composed of calcaneus, cuboid, and lateral two metatarsals
38
transverse longitudinal arch of the foot
- runs from side to side
- formed by the cuboid, cuneiforms, and bases of the metatarsals
- medial and lateral parts of the longitudinal arches serve as pillars for transverse arch
- tendon of fibularis longus and tibialis posterior, crossing obliquely, help maintain the arch
39
the upper limb is characterized by what?
-its ability to grasp, strike, and perform fine motor skills (manipulation)
40
what are the 4 segments of the upper limb?
1) shoulder
2) arm
3) forearm
4) hand
41
shoulder region of the upper limb
includes deltoid, pectoral, scapular, an lateral part of lateral cervical regions
-pectoral girdle: bony ring, incomplete posteriorly formed by the scapular and clavicles and completed anteriorly by the manubrium of the sternum
42
arm region of the upper limb
(brachium)
- between the shoulder and the elbow
- centered around the humerus
- anterior and posterior regions of the arm
43
forearm region of the upper limb
(antebrachium)
- between the elbow and the wrist
- ulna and radius
- anterior and posterior regions
44
hand region of the upper limb
(manus)
- distal to the forearm
- contains carpus, metacarpus, and phalanges
- composed of the wrist, palm, dorsum of hand, and digits
- richly supplied with sensory endings for touch, pain, and temperature
45
the superior appendicular skeleton is formed by which structures?
pectoral girdle, bones of the free part of the upper limb
46
the superior appendicular skeleton articulates with the axial skeleton only at one place. Which is it?
sternoclavicular joint
47
what are the 3 functions of the clavicle
1) serves as a pivoting strut (rigid support) from which the scapula and free limb are suspended, keeping the free limb lateral to the thorax so that the arm has maximum freedom of motion
2) forms one of the boundaries of the cervico-axillary canal (passageway between neck and arm), affording protection to the nerovascular bundle supplying the upper limb
3) transmits shocks from the upper limb to the axial skeleton
48
what type of bone is the clavicle? What is different about this bone compared to others of the same kind?
- long bone
| - does not produce bone marrow (has no medullary cavity)
49
what type of bone is the scapula?
flat bone
50
the scapula overlies the ___ through ___ ribs
2nd, 7th
51
which part of the scapula is the thickest?
the lateral border
52
which of the two long bones of the forearm does not articulate directly with the hand?
ulna (medial)
53
what is the anatomical name for the shoulder joint
glenohumeral joint
54
what is the largest bone in the upper limb
humerus
55
what is another name for intertubercular sulcus?
biccipital groove
56
what separates the lesser tubercle from the greater tubercle of the humerus?
biccipital groove (intertubercular sulcus)
57
what are the two prominent features of the humerus?
- deltoid tuberosity (lateral)
| - radial groove (groove for radial nerve)
58
which features make up the condyle of the humerus?
- trochlea
- capitulum
- olecranon
- coronoid
- radial fossae
59
which is the stabilizing bone of the forearm?
ulna
60
which of the two bones of the forearm is the longest?
ulna
61
what are the two prominent processes at the proximal end of the ulna?
- olecranon (posteriorly)
| - coronoid process (anteriorly)
62
proximally, the shaft of the ulna is ______, and distally, it is _____
thick, thinner
63
what separates the ulna from the carpal bones?
fibrocartilaginous articular disc
64
coronoid is to ______ as coracoid is to ______
humerus (ulna), scapula
65
the proximal end of the radius is _____ and the distal end is _____
thin, thicker
66
which styloid process is larger? radial or ulnar?
radial (it also extends further distally)
67
the ______ lies between the two shallow grooves for passage of the tendons of the forearm muscles and serves as a trochlea (pulley) for the tendon of the long extensor of the thumb
dorsal tubercle of the radius
68
scaphoid
- "boat"
| - a boat shaped bone that has a prominent scaphoid tubercle
69
lunate
- "moon"
| - a moon shaped none that is broader anteriorly than posteriorly
70
triquetrum
- "three-cornered"
| - a pyramid bone on the medial aspect of the carpus
71
pisiform
- "pea"
| - small, pea-shaped bone that lies on the palmar surface of the triquetrum
72
which bones make up the proximal row of carpals? (from lateral to medial)
- scaphoid
- lunate
- triquetrum
- pisiform
73
which bones make up the distal row of carpals? (from lateral to medial)
- trapezium
- trapezoid
- capitate
- hamate
74
trapezium
- "table"
| - a four-sided bone on the lateral side of the carpus
75
trapezoid
-wedge-shaped bone
76
capitate
- "head"
| - the head-shaped bone that is the largest bone in the carpus
77
hamate
- "little hook"
| - a wedge-shaped bone, which has a hooked process that extends anteriorly
78
which metacarpal is the thickest and the shortest?
1st metacarpal (thumb)
79
what is the structure that holds the tendons of the hand in place?
flexor retinaculum
80
what is the proximal attachment, distal attachment, innervation, and action of pectoralis major?
- proximal: clavicular head: anterior surface of medial half of clavicle; sternocostal head: anterior surface of sternum, superior six costal cartilages, aponeurosis of external oblique muscle
- distal: lateral lip of intertubercualr sulcus (groove) of humerus)
- innervation: lateral and medial pectoral nerves
- action: adducts and medially rotates shoulder joint, draws scapula anteriorly and inferiorly
- acting alone, clavicular head flexes shoulder joint and sternocostal head extends it from the flexed position
81
what is the proximal attachment, distal attachment, innervation, and action of pectoralis minor?
- proximal: 3rd-5th ribs near their costal cartilages
- distal: medial border and superior surface of coracoid process of scapula
- innervation: medial pectoral nerve
- action: stabilizes scapula by drawing inferiorly and anteriorly against thoracic wall
82
what is the proximal attachment, distal attachment, innervation, and action of subclavius
- proximal: junction of 1st rib and its costal cartilage
- distal: inferior surface of middle third of clavicle
- innervation: subclavian nerve
- action: anchors and depresses clavicle
83
what is the proximal attachment, distal attachment, innervation, and action of serratus anterior
- proximal: external surfaces of lateral parts of 1st-8th ribs
- distal: anterior surface of medial border of scapula
- innervation: long thoracic nerve
- action: protracts scapula and holds against thoracic wall, rotate scapula
84
which muscles form the clavipectoral triangle?
- pectoralis major
- deltoid
- clavicle
85
muscle that is used to stabilize the scapula and is used when stretching the upper limb forward to touch an object that is just out of reach
pectoralis minor
86
which structures form the bridge where vessels and nerves pass to the arm
- coracoid process
- pectoralis minor
(this makes the pectoralis minor a useful anatomical landmark for structures of the axilla)
87
the _____ affords some protection to the subclavian vessels and the superior trunk of the brachial plexus if the clavicle fractures
subclavius
88
which muscle forms the medial wall of the axilla
serratus anterior
89
the _______ muscles attach the superior appendicular skeleton of the upper limb to the axial skeleton
posterior axio-appendicular (superficial and intermediate groups of extrinsic back muscles)
90
the posterior shoulder muscles are divided into three groups. What are these groups?
1) superficial posterior axio-appendicular (extrinsic shoulder) muscles: trapezius and latissimus dorsi
2) deep posterior axio-appendicular (extrinsic shoulder) muscles): levator scapulae and rhomboids
3) scapulohumeral (intrinsic shoulder) muscles: deltoid, teres major, and the 4 rotator cuff muscles (supraspinatus, infraspinatus, teres minor, and subscapularis)
91
the ______ provides a direct attachment of the pectoral girdle to the trunk. This large muscle covers the posterior aspect of the neck and the superior half of the trunk
trapezius
92
what are the 3 parts of the trapezium?
1) descending (superior) part: elevates the scapula
2) middle part: retracts the scapula (i.e. pulls it posteriorly)
3) ascending (inferior) part: depresses the scapula and lowers the shoulder
93
which two parts of the trapezius act together to assist in rotating the scapula in the thoracic wall?
ascending (inferior) and descending (superior)
94
the latissimus dorsi acts _____ on the glenohumeral joint and _____ on the pectoral girdle
directly, indirectly
95
what is the proximal attachment, distal attachment, innervation, and action of the trapezius?
- proximal: medial third of superior nuchal line, external occipital protuberance, nuchal ligament, spinous processes of C7-T12 vertebrae
- distal: lateral third of clavicle, acromion and spine of scapula
- innervation: spinal accessory nerve (cranial nerve 11)
- action: descending (superior) part elevates, ascending (inferior) part depresses, and middle part (or all parts together) retracts scapula; descending and ascending parts act together to rotate glenoid cavity superiorly
96
what is the proximal attachment, distal attachment, innervation, and action of latissimus dorsi?
- proximal: spinous processes of inferior six thoracic vertebrae, thoracolumbar fascia, iliac crest, and inferior three or four ribs
- distal: floor of intertubercular sulcus (groove) of humerus
- innervation: thoracodorsal nerve
- action: extends, adducts and medially rotates shoulder joint; raises body toward arms during climbing
97
what is the proximal attachment, distal attachment, innervation, and action of levator scapulae
- proximal: posterior tubercles of transverse processes of C1-C4
- distal: medial border of scapula superior to root of spine
- innervation: dorsal scapular and cervical spinal nerves
- action: elevates scapula and tilts its glenoid cavity inferiorly by rotating the scapula
98
what is the proximal attachment, distal attachment, innervation, and action of rhomboid minor
- proximal: nuchal ligament, spinous processes of C7 and T1
- distal: triangular area at medial end of scapular spine
- innervation: dorsal scapular nerve
- action: retract scapula and rotate it to depress glenoid cavity, fix scapula to thoracic wall
99
what is the proximal attachment, distal attachment, innervation, and action of rhomboid major?
- proximal: spinous processes of T2-T5 vertebrae
- distal: medial border of scapula from level of spine to inferior angle
- innervation: dorsal scapular nerve
- action: retracts scapula and rotate it to depress glenoid cavity, fix scapula to thoracic wall
100
what is the proximal attachment, distal attachment, innervation, and action of the deltoid?
- proximal: lateral third of clavicle, acromion and spine of scapula
- distal: deltoid tuberosity of humerus
- innervation: axillary nerve
- action: clavicular (anterior) part flexes and medially rotates shoulder, acromial (middle) part abducts shoulder, spinal (posterior) part extends and laterally rotates shoulder
101
what is the proximal attachment, distal attachment, innervation, and action of supraspinatus?
- proximal: supraspinous fossa of scapula
- distal: superior facet of greater tubercle of humerus
- innervation: suprascapular nerve
- action: initiates and assists deltoid in abduction of shoulder joint and acts with other rotator cuff muscles
102
what is the proximal attachment, distal attachment, innervation, and action of infraspinatus?
- proximal: infraspinous fossa of scapula
- distal: middle facet of greater tubercle of humerus
- innervation: suprascapular nerve
- action: laterally rotates shoulder joint, help hold humeral head into glenoid cavity of scapula
103
what is the proximal attachment, distal attachment, innervation, and action of teres minor
- proximal: middle part of lateral border of scapula
- distal: inferior facet of greater tubercle of humerus
- innervation: axillary nerve
- action: laterally rotates shoulder joint; help hold humeral head into glenoid cavity of scapula
104
what is the proximal attachment, distal attachment, innervation, and action of teres major
- proximal: inferior part of border of scapula and posterior surface of inferior angle of scapula
- distal: medial lip of intertubercular sulcus
- innervation: lower subscapular nerve
- action: adducts and medially rotates shoulder joint
105
what is the proximal attachment, distal attachment, innervation, and action of subscapularis?
- proximal: subscapular fossa (most of anterior surface of scapula)
- distal: lesser tubercle of humerus
- innervation: upper and lower subscapular nerves
- action: medially rotates and adducts shoulder joint; helps hold humeral head into glenoid cavity of humerus
106
which muscle acts as a shunt muscle, resisting inferior displacement of the head of the humerus from the glenoid cavity?
deltoid
107
the abduction of the shoulder joint is initiated by _______. The ______ is fully effective as an abductor after the initial ___degrees
supraspinatus, deltoid, 15
108
which muscles are the rotator cuff muscles? Why are these called rotator cuff muscles?
SITS
- supraspinatus
- infraspinatus
- teres minor
- subscapularis
-called rotator cuff because they form a musculotendinous rotator cuff around the glenohumeral joint
109
which of the rotator cuff muscles is not a rotator of the humerous
supraspinatus
110
which muscles are supplied by the dorsal scapular nerve?
-rhomboids, occasionally supplies levator scapulae
111
which muscles are supplied by the long thoracic nerve?
serratus anterior
112
which muscles are supplied by the suprascapular nerve?
supraspinatus and infraspinatus
113
which muscles are supplied by the subclavian nerve?
subclavius and sternoclavicular joint
114
which muscles are supplied by the lateral pectoral nerve?
-primarily pectoralis major, some lateral pectoral nerve fibers pass to pectoralis minor
115
which muscles are supplied by the musculocutaneous nerve?
muscles of anterior compartment of the arm (coracobrachialis, biceps brachii, and brachialis), skin of lateral aspect of forearm
116
which muscles are supplied by the median nerve?
muscles of the anterior forearm compartment (except for the flexor carpi ulnaris and unlar half of flexor digitorum profundus), five intrinsic muscles in thenar half of palm and palmar skin
117
which muscles are supplied by the median pectoral nerve?
pectoralis minor and sternocostal part of pectoralis major
118
which muscles are supplied by the ulnar nerve?
flexor carpi unlaris and ulnar half of flexor digitorum profundus (forearm) ;most intrinsic muscles of hand; skin of hand medial to axial line
119
which muscles are supplied by the upper subscapular nerve?
superior portion of subscapularis
120
which muscles are supplied by the lower subscapular nerve?
inferior portion of subscapularis and teres major
121
which muscles are supplied by the thoracodorsal nerve?
latissimus dorsi
122
which muscles are supplied by the axillary nerve?
glenohumeral (shoulder) joint, teres minor and deltoid muscles
123
which muscles are supplied by the radial nerve?
all muscles of posterior compartments of arm and forearm, dorsum of hand lateral to axial line of digit 4
124
what are the 2 movements produced between the arm and the forearm at the elbow joint?
flexion-extension; pronation-supination
125
of the four arm muscles, ___ are flexors
3
126
which muscles of the arm are flexors?
- biceps brachii
- brachialis
- coracobrachialis
127
which muscle in the arm is an extensor?
-triceps brachii
128
the anterior compartment muscles of the arm are innervated by the _______ nerve
musculocutaneous
129
the posterior compartment of the arm is innervated by the _____ nerve
radial
130
what type of muscle is the brachialis
flattened fusiform
131
which muscle is pierced by the muscolucutaneous nerve?
coracobrachialis
132
what are the three heads that make up the triceps brachii
long, lateral, medial
133
which muscle is the chief extensor of the elbow
triceps brachii
134
where is the subtendinous olecranon bursae
between the triceps tendon and the olecranon
135
what sits in the radial groove?
radial artery
136
what is the proximal attachment, distal attachment, innervation, and action of biceps brachii
- proximal: short head: tip of coracoid process of scapula; long head: supraglenoid tubercle of scapula
- distal: tuberosity of radius and fascia of forearm via bicipital aponeurosis
- innervation: musculocutaneous nerve
- action: supinates forearm and, when it is supinated, flexes elbow joint; short head resists dislocation of shoulder
137
what is the proximal attachment, distal attachment, innervation, and action of brachialis
- proximal: distal half of anterior surface of humerus
- distal: coronoid process and tuberosity of ulna
- innervation: musculocutaneous nerve
- action: flexes elbow joint in all positions
138
what is the proximal attachment, distal attachment, innervation, and action of coracobrachialis
- proximal: top of coracoid process of scapula
- distal: middle third of medial surface of humerus
- innervation: musculocutaneous nerve
- action: helps flex and adduct shoulder joint; resists dislocation of shoulder
139
what is the proximal attachment, distal attachment, innervation, and action of triceps brachii
- proximal: long head: infraglenoid tubercle of scapula; lateral head: posterior surface of humerus, superior to radial groove; medial head: posterior surfaces of humerus, inferior to radial groove
- distal: proximal end of olecranon of ulna and fasica of forearm
- innervation: radial nerve
- action: chief extensor of the elbow joint; long head extends shoulder joint and resists dislocation of humerus (especially important during abduction)
140
what is the proximal attachment, distal attachment, innervation, and action of aconeus
- proximal: lateral epicondyle of humerus
- distal: lateral surface of olecranon and superior part of posterior surface of ulna
- innervation: radial nerve
- action: assists triceps in extending elbow joint, stabilizes elbow joint, abducts ulna during pronation
141
cubital fossa
shallow triangular depression on the anterior surface of the elbow
142
what are the boundaries of the cubital fossa
- superiorly, an imaginary line connecting the medial and lateral epicondyles
- medially, the pronator teres
- laterally, the brachioradialis
143
the floor of the cubital fossa is formed by the ______ and _____ muscles
brachialis, supinator
144
the roof of the cutibal fossa is formed by ______, reinforced by the _____, ______, and ______
continuity of brachial and antebrachial fascia, bicipital aponeurosis, subcutaneous tissue, skin
145
what are the contents of the cubital fossa
- biceps brachii tendon
- median nerve
- radial nerve, dividing into superficial and deep branches
146
what is the role of the forearm
assist the shoulder in the application of force and in controlling the placement of the hand in space
147
the flexors and pronators of the forearm are found in the ____ compartment and are supplied mainly by the _____ nerve
anterior, median (flex me) (the 1 1/2 exceptions are innervated by the ulnar nerve)
148
the extensors and supinators of the forearm are found in the ______ compartment and are all innervated by the ______ nerve
posterior, radial (it's rad to extend)
149
the flexor-pronator muscles of the forearm are divided into 3 groups. What are they?
1) a superficial layer of four muscles: pronator teres, flexor carpi radialis, palmaris longus, and flexor carpi ulnaris (FCU)
- these muscles are attached proximally by a common flexor tendon to the medial epicondyle of the humerus
2) an intermediate layer: one muscle: flexor digitorum superficialis (FDS)
3) a deep layer of three muscles: flexor digitorum profundus (FDP), flexor pollicis longus (FPL), and pronator quadratus
150
what is the proximal attachment, distal attachment, innervation, and action of pronator teres?
- proximal: ulnar head: coronoid process of ulna; humeral head: medial epicondyle of the humerus
- distal: muddle of convexity of lateral surface of radius
- innervation: median nerve
- action: pronates and flexes forearm
151
what is the proximal attachment, distal attachment, innervation, and action of flexor carpi radialis (FCR)?
- proximal: medial epicondyle of humerus
- distal: base of 2nd (3rd) metacarpal
- innervation: median nerve
- action: flexes and abducts hand at wrist
152
what is the proximal attachment, distal attachment, innervation, and action of palmaris longus
- proximal: medial epicondyle of humerus
- distal: distal half of flexor retinaculum, palmar aponeurosis
- innervation: median nerve
- action: flexes hand at wrist and tenses palmar aponeurosis
153
what is the proximal attachment, distal attachment, innervation, and action of flexor carpi ulnaris (FCU)? (humeral head and ulnar head)
- proximal: olecranon and posterior border of ulna (via aponeurosis)
- distal: pisiform, hook of hamate, 5th metacarpal
- innervation: ulnar nerve
- action: flexes and adducts hand at wrist
154
what is the proximal attachment, distal attachment, innervation, and action of flexor digitorum superficialis (FDS)
- proximal: humero-ulnar head: medial epicondyle of humerus and coronoid process of ulna; radial head: oblique line of radius
- distal: shafts of middle phalanges of medial 4 digits
- innervation: median nerve
- action: flexes wrist joint; flexes proximal interphalangeal joints of middle four digits, acting more strongly, it also flexes proximal phalanges at metacarpophalangeal joints
155
what is the proximal attachment, distal attachment, innervation, and action of flexor digitorum profundus (FDP)
- proximal: proximal three quarters of medial and anterior surfaces of ulna and interosseous membrane
- distal: bases of distal phalanges of 2nd-5th digits
- innervation: lateral part (to digits 2 and 3) median nerve; medial part (to digits 4 and 5) ulnar nerve
- action: flexes wrist joint; flexes distal interphalangeal joints of digits 2-5, assists with wrist flexion
156
what is the proximal attachment, distal attachment, innervation, and action of flexor pollicis longus (FPL)
- proximal: anterior surface of radius and adjacent interosseous membrane
- distal: base of distal phalanx of thumb
- innervation: anterior interosseous nerve (from median nerve)
- action: flexes wrist; flexes metacarphphalangeal and interphalangeal joints of thumb
157
what is the proximal attachment, distal attachment, innervation, and action of pronator quadratus
- proximal: distal quarter of anterior surface of ulna
- distal quarter of anterior surface of radius
- innervation: anterior interosseous nerve (from median nerve)
- action: pronates forearm deep fibers bind radius and ulna together
158
which muscles of the forearm cross the elbow?
- pronator teres
- palmaris longus
- brachioradialis
- flexor carpi radialis
- flexor carpi ulnaris
159
which is the only muscle of the forearm that does not have its tendon underneath the flexor retinaculum?
palmaris longus
160
which muscles of the forearm do not cross the elbow joint?
- flexor pollicis longus
- flexor digitorum profundus
- pronator quadratus
161
the extensor muscles of the forearm are divided into 3 functional groups. What are they?
1) muscles that extend and abduct the hand at the wrist joint: extensor carpi radialis longus (ECRL), extensor carpi radialis brevis (ECRB), and extensor carpi ulnaris (ECU)
2) muscles that extend the medial four digits: extensor digitorum, extensor indicis, and extensor digiti minimi (EDM)
3) muscles that extend or abduct the thumb: abductor pollocis longus (APL), extensor pollicis brevis (EPB), and extensor pollocis longus (EPL)
162
what are the 4 superficial extensors of the forearm that have a proximal attachment to a common extensor tendon to the lateral epicondyle?
- ECRB
- extensor digitorum
- EDM
- ECU
163
what are the 2 superficial extensor muscles that have a proximal attachment to the lateral supraepicondylar ridge of the humerus and the adjecent lateral intermuscular septum?
- brachioradialis
| - ECRL
164
what is the proximal attachment, distal attachment, innervation, and action of brachioradialis
- proximal: proximal 2/3 of lateral supra-epicondylar ridge or humerus
- distal: lateral surface of distal end of radius proximal to the styloid process
- innervation: radial nerve
- action: relatively weak flexion of the elbow joint, maximal when forearm is in midpronated position
165
what is the proximal attachment, distal attachment, innervation, and action of extensor carpi radialis longus (ECRL)
- proximal: lateral supra-epicondylar ridge of humerus
- distal: dorsal aspect of base of 2nd metacarpal
- innervation: radial nerve
- action: extend and abduct wrist joint
166
what is the proximal attachment, distal attachment, innervation, and action of extensor carpi radialis brevis (ECRB)
- proximal: lateral epicondyle of humerus (common extensor origin)
- distal: dorsal aspect of base of 3rd metacarpal
- innervation: deep branch of radial nerve
- action: extend and abduct wrist joint; active during wrist clenching
167
what is the proximal attachment, distal attachment, innervation, and action of extensor digitorum
- proximal: lateral epicondyle of humerus
- distal: extensor expansions of medial 4 fingers
- innervation: posterior interosseous nerve (continuation of deep branch of radial nerve)
- action:extend wrist joint; extend medial four fingers primarily at metacarpophalangeal joints; secondarily and interphalangeal joints
168
what is the proximal attachment, distal attachment, innervation, and action of extensor digiti minimi
- proximal: lateral epicondyle of humerus
- distal: extensor expansion of 5th finger
- innervation: posterior interosseous nerve (continuation of deep branch of radial nerve)
- action: extends wrist joint; extends 5th finger primarily at metacarpophalangeal joint and secondarily at interphalangeal joints
169
what is the proximal attachment, distal attachment, innervation, and action of extensor carpi ulnaris
- proximal: lateral expicondyle of humerus; posterior border of ulna via shared aponeurosis
- distal: dorsal aspect of base of 5th metacarpal
- innervation: posterior interosseous nerve (continuation of deep branch of radial nerve)
- action: extends and adducts wrist joint (also active during fist clenching)
170
what is the proximal attachment, distal attachment, innervation, and action of supinator
- proximal: lateral epicondyle of humerus; radial collateral and anular ligaments, supinator fossa, crest of ulna
- distal: lateral, posterior, and anterior surfaces of proximal third of radius
- innervation: deep branch of radial nerve
- action: supinates forearm; rotates radius to turn palm anteriorly or superiorly (if elbow is flexed)
171
what is the proximal attachment, distal attachment, innervation, and action of abductor pollicis longus
- proximal: posterior surface of proximal halves of ulna, radius, and interosseous membrane
- distal: base of 1st metatarsal
- innervation: posterior interosseous nerve
- action: extends wrist joint; abducts thumb and extends it at carpometacarpal joint
172
what is the proximal attachment, distal attachment, innervation, and action of extensor pollicis longus
- proximal: posterior surface of middle third of ulna and interosseous membrane
- distal: dorsal aspect of base of distal phalanx of thumb
- innvervation: posterior interosseous nerve
- action: extends wrist; extends distal phalanx of thumb at interphalangeal joint; extends metacarpophalangeal and carpometacarpal joints
173
what is the proximal attachment, distal attachment, innervation, and action of extensor pollicis brevis
- proximal: posterior surface of distal third of radius and interosseous membrane
- distal: dorsal aspect of base of proximal phalanx of thumb
- innervation: posterior interosseous nerve
- action: extends wrist joint; extends proximal phalanx of thumb at metacarpophalangeal joint; extends carpometacarpal joint
174
what is the proximal attachment, distal attachment, innervation, and action of extensor indicis
- proximal: posterior surface of distal third of ulna and interosseous membrane
- distal: extensor expansion of 2nd finger
- innervation: posterior interosseous nerve
- action: extends wrist; extends 2nd finger (enabling its independent extension); helps extend hand at wrist
175
which three tendons form the anatomical snuff box?
tendons of APL (abductor pollicis longus), and EPB (extensor pollicis brevis) (laterally)
tendon of EPL (extensor pollicis longus) (medially)
176
_______ lies on the floor of the snuff box
______ process can be palpated proximally, and the ______ can be palpated distally in the snuff box
______ and ______ can be felt in the floor of the snuff box between the radial styloid process and the 1 metacarpal
-radial artery, radial styloid process, 1st metacarpal, sqcaphoid, trapezium
177
the skeleton of the hand consists of:
-carpals, metacarpals, and phalanges
178
what are the 2 eminences of the palmar surface of the hand?
-thenar eminence and hypothenar eminence
179
the intrinsic muscles of the hand are located in 5 compartments. What are they?
1) thenar compartment: abductor pollicis brevis. flexor pollicis brevis, an dopponens pollicis
2) hypothenar compartment: abductor digiti minimi, flexor digiti minimi brevis, and opponens digiti minimi
3) adductor compartment
4) central compartment: lumbricals (and long flexor tendons)
5) interosseous compartment: interossei (between metacarpals)
180
what are the 5 movements of the thumb? (thenar muscles)
1) abduction: APL and abductor pollicis brevis (APB)
2) adduction: adductor pollicis (AD) and 1st dorsal interosseous
3) extension: EPL, EPB, APL
4) flexion: FPL and flexor pollicis brevis (FPB)
5) opposition: opponens pollicis
181
what is the proximal attachment, distal attachment, innervation, and action of opponens pollicis
- proximal: flexor retinaculum and tubercles of scaphoid and trapezium
- distal: lateral side of 1st metacarpal
- innervation: recurrent branch of median nerve
- action: to oppose thumb, it draws 1st metacarpal medially to center of palm and rotates it medially
182
what is the proximal attachment, distal attachment, innervation, and action of abductor pollicis brevis
- proximal: flexor retinaculum and tubercles of scaphoid and trapezium
- distal: lateral side of base of proximal phalanx of thumb
- innervation: recurrent branch of median nerve
- action: abducts thumb, helps oppose it
183
what is the proximal attachment, distal attachment, innervation, and action of flexor pollicis brevis (superficial and deep heads)
- proximal: flexor retinaculum and tubercles of scaphoid and trapezium
- distal: lateral side of base of proximal phalanx of thumb
- innervation: superficial head: recurrent branch of median nerve; deep head: deep branch of ulnar nerve
- action: flexes thumb
184
what is the proximal attachment, distal attachment, innervation, and action of adductor pollicis (oblique head and transverse head)
- proximal: oblique head: bases of 2nd and 3rd metacarpals, capitate, adjacent carpals; transverse head: anterior surface of shaft of 3rd metacarpal
- distal: medial side of base of proximal phalanx of thumb
- innervation: deep branch of ulnar nerve
- action: adducts thumb toward lateral border of palm
185
what is the proximal attachment, distal attachment, innervation, and action of abductor digiti minimi
- proximal: pisiform
- distal: medial side of base or proximal phalanx of 5th finger
- innervation: deep branch of ulnar nerve
- action: abducts 5th finger, assists in flexion of its proximal phalanx
186
what is the proximal attachment, distal attachment, innervation, and action of flexor digiti minimi brevis
- proximal: hook of hamate and flexor retinaculum
- distal: medial side of base of proximal phalanx of 5th finger
- innervation: deep branch of ulnar nerve
- action: flexes proximal phalanx of 5th finger
187
what is the proximal attachment, distal attachment, innervation, and action of opponens digiti minimi
- proximal: hook of hamate
- distal: medial border of 5th metacarpal
- innervation: deep branch of ulnar nerve
- action: draws 5th metacarpal anterior and rotates it, bringing the 5th finger into opposition with thumb
188
what is the proximal attachment, distal attachment, innervation, and action of lumbricals 1 and 2 of hand
- proximal: lateral two tendons of flexor digitorum profundus (as unipennat emuscles)
- distal: lateral sides of extensor expansions of 2nd-5th fingers
- innervation: median nerve
- action: flex metacarpophalangeal joints; extend interphalangeal joints of 2nd-5th fingers
189
what is the proximal attachment, distal attachment, innervation, and action of lumbrical 3 and 4 of hand
- proximal: medial three tendons of flexor digitorum profundus (as bipennate muscles)
- distal: lateral sides of extensor expansions of 2nd-5th fingers
- innervation: deep branch of ulnar nerve
- action: flex metacarpophalangeal joints; extend interphalangeal joints of 2nd-5th fingers
190
what is the proximal attachment, distal attachment, innervation, and action of dorsla interossei (1-4) of hand
- proximal: adjacent sides of two metacarpals (as bipennate muscles)
- distal: bases of proximal phalanges; extensor expansions of 2nd-4th fingers
- innervation: deep branch of ulnar nerve
- action: abduct 2nd-4th fingers from axial line; act with lumbricals in flexing metacarpophalangeal joints and extending interphalangeal joints
191
what is the proximal attachment, distal attachment, innervation, and action of palmar interossei (1-3) of hand
- proximal: palmar surfaces of 2nd, 4th and 5th metacarpals (as unipennate muscles)
- distal: bases of proximal phalanges; extensor expansions of 2nd, 4th, and 5th fingers
- innervation: deep branch of ulnar nerve
- action: adduct 2nd, 4th, and 5th fingers towards axial line; assist lumbricals in flexing metacarpophalangeal joints and extending interphalangeal joints
192
hypothenar muscles
- abductor digiti minimi, flexor digiti minimi brevis, and opponens digiti minimi
- medial side
193
short hand muscles
lumbricals and interossei
| -lumbricals= earthworm
194
acting together, the dorsal and palmar interossei muscle produce ______ at the metacrapophalangeal joints and ______ at the interphalangeal joints
flexion, extension
195
carpal tunnel
- passageway deep to the flexor retinaculum between the tubercles of the scaphoid and the trapezium on the lateral side of the pisiform and the hook of hamate on the medial side
- distal to the carpal tunnel, the median nerve supplied two and a half thenar muscles and the 1st and 2nd lumbricals
196
the ________ supplies cutaneous branches to the anterior surfaces of the medial one and a half fingers
superficial branch of the ulnar nerve
197
the ________ supplies the hypothenar muscles, the medial two lumbricals, the AD, the deep head of FBP, and all the interossei (also supplies several joints)
deep branch of ulnar nerve
198
which nerve is referred to as "the nerve of fine movements"? why?
the ulnar nerve
| -because it innervates muscles that are concerned with intricate hand movements
199
which muscles of the hand does the radial nerve supply?
the radial nerve supplies no hand muscles
200
sternoclavicular joint
- synovial saddle joint
- between the sternal end of the clavicle and the manubrium and first costal cartilage
- saddle joint but also functions as a ball and socket joint
- divided into two compartments by an articular disc
201
although the sternoclavicular joint is extremely strong, it has reduced mobility
true or false?
false, this joint is extremely strong and has a lot of mobility to allow movement of pectoral girdle and upper limb
-during full elevation, the clavicle is raised to approx. 60 degree angle, can also be moved anteriorly or posteriorly over a range of 25-30 degrees
202
acromioclavicular joint
- plane synovial joint
- located 2 to 3 cm from the "point" of the shoulder formed by the lateral part of the acromion of the scapula
- acromial end articulates with the acromion
- articular surface are separated by an incomplete wedge-shaped articular disc
203
glenohumeral joint
- ball and socket joint
| - permits wide range of movement, but relatively unstable
204
scapulo-humeral rhythm
- the scapula and humerus move in 1:2 ratio
- when the arm is abducted 180 degrees, 60 degrees occurs by rotation of scapula, 120 degrees by rotation of humerus at shoulder joint
205
the glenoid cavity is deepened slightly by what?
glenoid labrum
206
the glenoid cavity accepts a little more than ___ of the humeral head at its articulation
1/3
207
which structures limit flexion at the pectoral girdle?
- ligaments: posterior part of coracohumeral, trapezoid, and posterior part of joint capsule of gelnohumeral joint
- muscles: rhomboids, levator scapulae, extensor and external rotator muscles, rotator muscles of glenohumeral joint
208
which structures limit abduction at the pectoral girdle?
- ligaments: middle and inferior glenohumeral, trapezoid, and inferior part of joint capsule of glenohumeral joint
- muscles: rhomboids, levator scapulae, adductor muscles of glenohumeral joint
- bony: apposition between greater tubercle of humerus and superior part of glenoid cavity/labrum of lateral aspect of acromion
209
which structures limit extension at the pectoral girdle?
- ligaments: anterior part of coracohumeral and anterior part of joint capsule of glenohumeral joint
- muscles: clavicular head of pectoralis major
210
which structures limit medial rotation at the pectoral girdle?
- ligaments: posterior glenohumeral joint capsule
| - muscles: infraspinatus and teres minor
211
which structures limit lateral rotation at the pectoral girdle?
- ligaments: glenohumeral, coracohumeral, anterior glenohumeral joint capsule
- muscles: latissimus dorsi, teres major, pectoralis major, subscapularis
212
movements of the glenohumeral joint
this joint has more freedom than any other joint in the body
-this freedom results from the laxity of its joint capsule and the configuration of the spherical humeral head and shallow glenoid cavity
213
what type of joint is the elbow joint
hinge synovial
214
how many articulations are there at the elbow joint
two: humero-ulnar and humero-radial
215
collateral ligament of the elbow
strong angular bands that are medial and lateral thickenings of the fibrous layer of the joint capsule
216
radial collateral ligament
- lateral
- fan-like
- extends from the lateral epicondyle of the humerus and blends distally with the anular ligament of the radius
217
anular ligament of the radius
-encircles and holds the head of the radius in the radial notch of the ulna, forming the proximal radio ulnar joint and permitting pronation and supination of forearm
218
ulnar collateral ligament
-extends from the medial epicondyle of the humerus to the coronoid process and olecranon of the ulna
219
movements of the elbow joint
-flexion and extension - the long axis of the fully extended ulna makes an angle of approximately 170 degrees with the long axis of the humerus - this angle is called the carrying angle
220
the carrying angle is more pronounced in men
true or false?
false, it is more pronounced in women
221
proximal radio-ulnar joint
- pivot type synovial joint
| - allows movement of the head of the radius on the ulna
222
distal radio ulnar joint
- pivot type synovial joint
| - radius moves around the relatively fixed distal end of the ulna
223
which which structures limit extension at the humero-ulnar and humero-radial joints?
- muscles: flexor muscles of elbow
- joint capsule: anteriorly
- bony apposition: between the olecranon of the ulna and olecranon fossa of humerus
224
which structures limit flexion at the humero-ulnar and humero-radial joints?
- muscles: triceps brachii
- joint capsule: posteriorly
- soft tissue apposition beyween anterior forearm and arm
- bony apposition: between the head of radius and radial fossa of humerus
225
which structures limit pronation at the humero-radial, proximal radio-ulnar, distal radial-ulnar, and interosseous membrane?
- muscles: supinator, biceps brachii
- ligaments: dorsal inferior radio-ulnar, interosseous membrane
- bony apposition of the radius on ulna
226
which structures limit supination at the humeroradial, proximal radio-ulnar, and distal radio-ulnar joints?
- muscles: pronator teres, pronator quadratus
| - ligaments: anterior inferior radio-ulnar interosseous membrane
227
what type of joint is not a hinge synovial joint?
a) metacarpophalangeal joint
b) distal interphalangeal joint
c) proximal interphalanegeal joint
d) none of these answers are correct (they are all hinge synovial joints
a
228
what type of joint are the radiocarpal joints
condyloid synovial
229
what type of joints are the intercarpal joints
plane synovial
230
what type of joints are the carpometacarpal and intermetacarpal joints?
plane synovial joints, except the CMC joint of the thumb which is a saddle joint
231
which movements occur at the radiocarpal joints?
flexion-extension, abduction-adduction, circumduction
232
which movements occur at the intercarpal joints?
-small amounts of gliding, flexion and abduction of hand occur at midcarpal joint
233
which movements occur at the carpometacarpal and intermetacarpal joints?
flexion-extension and abduction-adduction of CMC joint of 1st digit; almost no movement at 2nd 3rd digits; 4th digit slightly mobile; 5th digit very mobile
234
which structures limit flexion at the wrist and carpal joints?
ligaments: posterior radiocarpal and posterior part of joint capsule
235
which structures limit extension at the wrist and carpal joints?
- ligaments: anterior radiocarpal and anterior part of joint capsule
- bony apposition: between radius and carpal bones
236
which structures limit abduction at the wrist and carpal joints?
- ligaments: ulnar collateral ligament and medial part of joint capsule
- bony apposition: between styloid process of radius and scaphoid
237
which movements occur at the metacarpophalangeal joints?
flexion-extension, abduction-adduction, and circumduction of 2nd-5th digits
-flexion of thumb occurs but abduction-adduction is limited
238
which movement occur at the interphalangeal joints?
flexion-extension
239
what is the superior attachment, inferior attachment, innervation, and action of the platysma muscle?
- superior: inferior border of mandible, skin, and subcutaneous tissues of lower face
- inferior: fascia covering superior parts of pectoralis major and deltoid muscles
- innervated by the cervical branch of fascial nerves (CN VII)
- action: draws corners of mouth inferiorly and widens it as in expressions of sadness and fright; draws skin of neck superiorly when teeth are clenched, indicating tension
240
what is the superior attachment, inferior attachment, innervation, and action of the sternocleidomastoid (SCM)?
- superior: lateral surface of mastoid process of temporal bone and lateral half of superior nuchal line
- inferior: sternal head: anterior surface of manubrium of sternum; clavicular head: superior surface of medial third of clavicle
- innervated by the spinal accessory nerve (CN XII) and C2 and C3 nerves
- action: unilateral contraction: tilts head to the same side (laterally flexes neck) and rotates it so face is turned superiorly toward opposite side; bilateral contraction: extends neck at atlanto-occipital joints, flexes cervical vertebrae so that chin approaches manubrium, extends superior cervical vertebrae while flexing inferior vertebrae so chin is thrust forward
- with cervical vertebrae fixed, may elevate manubrium and medial end of clavicles, assisting of pump handle action of deep respiration
241
Passmore told us to remember a list of bones in the skull was was this list in order?
```
ethmoid
frontal
inferior conchae
lacrimal
mandible
maxilla
nasal
parietal
sphenoid
temporal
vomer
zygomatic
```
242
what passes through the foramen magnum?
spinal cord/brain stem
243
which nerve goes through the cribriform plate?
olfactory nerves
244
what is dr Passmore's 2nd favourite bone?
sphenoid
245
what is the proximal attachment, distal attachment, innervation, and action of temporalis?
- proximal: triangular muscle with broad attachment to floor of temporal fossa and deep surface of temporalis fascia
- distal: narrow attachment to tip and medial surface of coronoid process and anterior border of ramus of mandible
- innervated by the anterior trunk of mandibular nerve via deep temporal nerve
- action: elevates mandible, closing jaws; posterior, more horizontal fibers are retractions of mandible
246
what is the proximal attachment, distal attachment, innervation, and action of masseter?
- proximal: quadrate muscle attaching to inferior border and medial surface of maxillary process of zygomatic bone and the zygomatic arch
- distal: angle and lateral surface of the ramus of the mandible
- innervated by anterior trunk of mandibular nerves via masseteric nerve
- action: elevates mandible, superficial fibers make limited contribution to protrusion of mandible
247
what is the proximal attachment, distal attachment, innervation, and action of lateral pterygoid?
- proximal: triangular two headed muscle from (1) infratemporal surface and crest of greater wing of sphenoid and (2) lateral surface of lateral pterygoid plate
- distal: superior head attaches primarily to joint capsule and articular disc of TMJ; inferior head attaches primarily to pterygoid fovea on anteromedial aspect of neck of condyloid process of mandible
- innervated by anterior trunk of mandibular nerve via nerves to lateral pterygoid
- action: acting bilaterally, protracts mandible and depresses chin; acting unilaterally, swings jaw toward contralateral side; alternate unilateral contraction produces larger chewing movements
248
what is the proximal attachment, distal attachment, innervation, and action of medial pterygoid
- proximal: quadrangular two headed muscle from (1) medial surface of lateral pterygoid plate and pyramidal process of palatine bone and (2) tuberosity of maxilla
- distal: medial surface of ramus of mandible, inferior to mandibular foramen; in essence, a mirror image of the ipsilateral masseter, the two muscle flanking the ramus
- innervated by the anterior trunk of mandibular nerve via nerve to medial pterygoid
- action: acts synergistically with masseter to elevate mandible; contributes to protrusion; alternate unilateral activity produces smaller grinding movements
249
what is the superior attachment, inferior attachment, innervation, and action of anterior scalene
- superior: anterior tubercles of transverse processes of C3-C6
- inferior: 1st rib
- innervated by cervical spinal nerves
- action: flexes neck laterally, elevates 1st rib during forced respiration
250
what is the superior attachment, inferior attachment, innervation, and action of levator scapulae
- superior: posterior tubercles of transverse processes of C1-C4
- inferior: superior part of medial border of scapula
- innervated by dorsal scapular nerve, cervical spinal nerve
- action: elevates scapula and tilts glenoid cavity inferiorly by rotating scapula
251
what is the superior attachment, inferior attachment, innervation, and action of middle scalene
- superior: posterior tubercles of transverse processes of C4-C7
- inferior: superior surface of 1st rib; posterior to groove for subclavian artery
- innervated by anterior rami of cervical spinal nerve
- action: flexes neck laterally; elevates 1st rib during forced inspiration
252
what is the superior attachment, inferior attachment, innervation, and action of posterior scalene
- superior: posterior tubercles of transcerse processes of C4-C6
- inferior: external border of 2nd rib
- innervated by anterior rami of cervical spinal nerve
- action: flexes neck laterally; elevates 2nd rib during forced inspiration
253
orbits of the eye
pyramidal, bony cavities in the facial skeleton that protect the eye
- bases (orbital openings) directly anterolaterally
- apices posteromedially
254
what does the orbit of the eye contain?
the eyeball and their muscles, nerves, and vessels together with lacrimal apparatus
-all space in the orbit not occupied by structures is filled with orbital fat (shock absorber for the eye)
255
____ bones contribute to the orbit of the eye
7
256
which 7 bones contribute to the orbit of the eye?
- ethmoid
- frontal
- lacrimal
- maxilla
- palatine
- sphenoid
- zygomatic
257
what is the origin, insertion, innervation, and action of the superior oblique (SO) muscle?
- origin: body of sphenoid bone
- insertion: tendon passes through trochlea to insert into sclera, deep to SR
- innervated by the trochlear nerve (CN IV)
- action: abducts, depresses, and rotates eyeball medially (intorsion)
258
what is the origin, insertion, innervation, and action of inferior oblique (IO)?
- origin: anterior part of the floor of the orbit
- insertion: sclera deep to lateral rectus muscle
- innervated by the oculomotor nerve (CN III)
- action: abducts, elevates, and rotates eyeball laterally (extorsion)
259
what is the origin, insertion, innervation, and action of superior rectus (SR)?
- origin: common tendinous ring
- insertion: sclera posterior to corneoscleral junction
- innvervated by the oculomotor nerve (CN III)
- action: elevates, adducts, and rotates eyeball medially
260
what is the origin, insertion, innervation, and action of inferior rectus (IR)?
- origin: common tendinous ring
- insertion: sclera just posterior to corneoscleral junction
- innervated by the oculomotor nerve (CN III)
- action: depresses, adducts, and rotates eyeball laterally (extorsion)
261
what is the origin, insertion, innervation, and action of medial rectus (MR)?
- origin: common tendinous ring
- insertion: sclera just posterior to corneoscleral junction
- innervated by the oculomotor nerve (CN III)
- action: adducts eyeball
262
what is the origin, insertion, innervation, and action of lateral rectus (LR)?
- origin: common tendinous ring
- insertion: sclera just posterior to corneoscleral junction
- innervated by the abducent nerve (CN VI)
- action: abducts eyeball
263
look at fig. 7.35
p. 531
264
which muscles contribute to elevation at the temporomandibular joint? (close mouth)
temporalis, masseter, and medial pterygoid
265
which muscle contribute to depression (opening mouth) at the temporomandibular joint?
lateral pterygoid
266
which muscles contribute to protrusion at the temporomandibular joint?
lateral pterygoid, masseter, and medial pterygoid
267
which muscles contribute to retrusion at the temporomandibular joint?
-temporalis, masseter
268
which muscles contribute to lateral movements (grinding and chewing) at the temporomandibular joint?
-temporalis of same side, pterygoids of opposite side, and masseter
269
what are the 3 divisions of the ear
external, middle, internal
270
the _____ and _____ parts of the ear are mainly concerned with the transference of sounds to the internal ear
external and middle
271
the ____ ear contains the organs of equilibrium and hearing
internal
272
the _______ separates the external ear from the middle ear
tympanic membrane
273
the ________ joins the middle ear to the nasopharynx
pharyngotympanic
274
which bones articulate with each other in the ear?
MIS
| -malleus articulates with incus, incus articulates with stapes
275
cranial nerves are part of which division of the nervous system?
peripheral nervous system
276
CN I
name: olfactory nerve
- sensory nerve
- smell
277
CN II
name: optic
- sensory
- vision
278
CN III
name: oculomotor
- motor: ciliary muscles, sphincter pupillae muscles, all extrinsic muscles of the eye except those listed for CN IV and CN VI
279
CN IV
name: trochlear
| - motor: superior oblique muscle of eye
280
CN V
name: trigeminal
sensory root: face, sinuses, teeth
-motor root: muscles of mastication
281
CN VI
name: abducent
| - motor: lateral rectus muscle of eye
282
CN VII
name: facial
- primary root: motor: muscles of facial expression
- intermediate nerve: motor: submandibular, sublingual, lacrimal glands; sensory: taste to anterior two thirds of tongue, soft palate
283
CN VIII
name: vestibulocochlear
- vestibular nerve, sensory: orientation, mood
- cochlear nerve, sensory: hearing
284
CN IX
name: glossopharyngeal
- motor
- sensory: taste: posterior third of tongue, general sensation: pharynx, tonsillar sinus, pharyngotympanic tube, middle ear cavity
285
CN X
name: vagus
- functions not that important
- essentually, nerve for top of palate
286
CN XI
name: spinal accessory
| - motor: sternocleidomastoid and trapezius
287
CN XII
name: hypoglossal
| - motor: all instrinsic and extrinsic muscle of tongue (excluding palatoglossus - a palatine muscle)
288
there are 2 nerves that contribute to taste, which one contributes to which part of the tongue?
- CN VII (facial nerve) = taste to anterior 2/3 of tongue
| - CN IX (glossopharyngeal nerve) = taste to posterior 1/3 of tongue
