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KCUMB Anatomy - Erin > EXAM III 2015 > Flashcards

EXAM III 2015 Flashcards

(107 cards)

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1
Q

Define Extrinsic muscle, which CN innervates?

A

Hypaxial, Superficial back muscles; move shoulder and upper extremity

CN XI (Accessory) or branches of brachial plexus (ventral rami of spinal nerves)

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2
Q

Define Intrinsic muscles, purpose, what CN innervates?

A

Epaxial Deep back muscles

Support upright position and allow movements of the vertebral column

Proprioception

Dorsal rami of spinal nerves

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3
Q

Actions of the trapezius?

A

Elevates, depresses, and retracts scapula

Rotates glenoid fossa superiorly

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4
Q

What are the motor and sensory innervations of the trapezius?

A

Motor: Accessory Nerve

Sensory: Ventral rami of C3 & C4

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5
Q

Actions of the Latissimus dorsi and Innervation

A

Extends, adducts, & medially rotates humerus, raises torso towards arms during climbing

Innervation: thoracodorsal nerve

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6
Q

Action and Innervation of Rhomboid major and minor

A

Actions

Both retract, elevate, and rotate scapula downward and fix scapula to thoracic wall

Innervation

Both innervated by dorsal scapular nerve

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7
Q

Actions and Innervation of Levator Scapulae

A

Elevates scapula and tilts glenoid fossa inferiorly by rotating scapula (downward rotation)

Innervates: dorsal scapular nerve and ventral rami of cervical spinal nerves

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8
Q

Actions and Innervation of Serratus posterior superior

A

Elevates Ribs

Innervation: T2-T5 intercostal nerves (ventral rami)

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9
Q

Actions and Innervations of Serratus posterior inferior

A

Depresses ribs

Innervation: Intercostal nerves and subcostal nerve (ventral rami)

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10
Q

What are the major groups of epaxial back muscles?

A

Splenius (most superficial)

Splenius capitis, splenius cervicis

Erector Spinae Group

Iliocostalis, Longissimus, Spinalis

Transversospinalis Group

Rotatores, Multifidus, Semispinalis

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11
Q

Actions and Innervation of splenius cervicis and capitis

A

Bilaterally - extend head and neck

Unilaterally - laterally flex neck and rotate head to side of contracting muscle (epsilateral rotation)

Innervation: dorsal rami of spinal nerves

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12
Q

What are the muscles of the superficial layer of the erector spinae group?

A

Iliocostalis

Longissimus

Spinalis

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13
Q

What are the actions and innervations of the erector spinae group?

A

Bilaterally - extend vertebral column and head

Unilaterally - laterally flex vertebral column

Innervation - dorsal rami of spinal nerves

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14
Q

What are the 3 regional parts of the Spinalis? What is the origin of thoracis?

A

Thoracis: O - spinous processes & insert on spinous processes superior to them

Cervicis

Capitis

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15
Q

What are the deep layer intrinsic muscles of the back? What do they innervate?

A

Transversospinalis group

Semispinalis

Rotatores

Multifidus

Innveration: dorsal rami of spinal nerves

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16
Q

Cervicis, Capitis, Thoracis and Action

A

Action: extend head, thoracic & cervical regions; rotates them contralaterally (opposite side of muscle)

Cervicis: cervical transverse processes to spinous processes of 2nd cervical v.

Capitis: (deep to splenus capitis) superficial to cervicis, t.p. of T1-6 to nuchal line

Thoracis: transverse to spinous processes in thoracic region

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17
Q

Origin, Insertion, and Action of Multifidus

A

O: transverse processes from sacrum to 2nd cervical vertebra

I: spinous processes

Action: stabilizes vertebrae during localized movements of vertebral column

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18
Q

Rotatores brevis and longus and action

A

Action: extend head, thoracic & cervical regions; rotates them contralaterally

Brevis: t.p. of one vertebra to base of s.p. of next vertebra above (spans one intervertebral joint)

Longus: t.p. of one vertebra to s.p. of 2nd vertebra above (spans 2 intervertebral joints)

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19
Q

What are the intrinsic segmental muscles of the back and what do they innervate?

A

Interspinales - dorsal rami of spinal nerves

Intertransversari - dorsal & ventral rami of s.nerves

Levator Costarum - dorsal rami of C8-T11 s.nerves

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20
Q

What are the osteological structures of the suboccipital triangle?

A

Atlas (C1)

Axis (C2)

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21
Q

What are the muscles of the suboccipital triangle? (4)

A

Rectus capitis posterior major

Rectus capitis posterior minor

Obliquus capitis superior (superior oblique capitis)

Obliquus capitis inferior (inferior oblique capitis)

Mainly postural muscles, aid in extension/rotation at atlantoaxial joint

**ALL innervated by suboccipital nerve (dorsal rami of C1)

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22
Q

What are the nerves & vessels of the suboccipital region? (4)

A

Vertebral artery

Suboccipital nerve - dorsal ramus of C1, b/w skull & atlas = motor to all triangle muscles

Greater occipital nerve - dorsal ramus of C2, b/w atlas & axis, only sensory fibers

Posterior atlanto-occipital membrane - continuous w/ ligamentum flava

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23
Q

List the ribs and types of them

A

12 Total

1-7 True ribs

8-10 “false ribs”

11-12 “floating ribs”

Ribs 1 and 2, 11 and 12 are “atypical”

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24
Q

What are the general features of typical ribs?

A

Vertebral End

Head, Neck, Tubercle, Angle

Middle

body/shaft

Sternal End

Articulates directly w/ sternum, costal cartilages, or sits on fascia

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25
What does the breast rest on?
**Pectorial fascia** Superficial to the pectoralis major
26
What is retromammary space?
Potential space between the **breast** and **pectoral fascia**
27
Cooper's ligaments of the breast
Attaches the breast to the dermis of overlying skin via these ligaments = **Suspensory ligaments** Mammary gland lobules converge at nipple surrounded by pigmented areola
28
What are the arteries that supply the breast?
**Subclavian artery -** branches off into **internal thoracic** and **medial mammary branches** **Axillary artery -** branches off into **lateral thoracic** and **lateral mammary branches**
29
What is the venous drainage of breast tissue?
_Mainly_ medial and lateral mammary branches to lateral thoracic to **axillary vein** Some via internal thoracic vein via anterior intercostal veins
30
Explain Lymphatic drainage of breast tissue; what are the levels?
**Level I** (most lateral) Nipple, areola, lactiferous lobules = **Subareolar L.N.** **Level II** (medial) \>75% lymph via breast; **Allixary L.N.** (pectoral, central, apical) **Level III** (internal) Remaining lymph = parasternal & abdominal l.n.
31
Explain innervation of breast tissue
Mainly from **anterior and lateral branches of 4th-6th intercostal nerves** Also some via **supraclavicular nerve branches & branches from intercostal nerves**
32
Define Polymastia & Polythelia
Supernumerary breasts or nipples
33
What are the superficial fascia of the pectoral region? (3)
**Platysma** **Supraclavicular nerves** **Anterior & lateral branches of intercostal nerves**
34
What are the fascias of the pectoral region? (2)
**Superficial fascia** **Clavipectoral fascia**
35
What does the deltopectoral/clavipectoral triangle of the pectoral region consist of? What makes up the borders? vein? lymph nodes? arteries?
Bordered by: **deltoid. pectoralis major, middle 1/3 of clavicle** ## Footnote **Deltopectoral lymph nodes** **Cephalic vein** **Deltoid branch of thoracoacromial artery via axillary artery**
36
What's involved with the clavipectoral fascia? What does it attach to and what vessels are involved?
**Subclavius & pectoralis minor** Attaches to clavical and anterior thoracic wall Pierced by the cephalic vein, thoracoacromial artery, & lateral pectoral nerves Becomes susepensory ligament of axilla
37
What rami innervate the pectoral muscles?
Ventral
38
What muscles are composed of the pectoral region? (4)
Pectoralis major and minor Serratus anterior Subclavius
39
What are the actions of the pectoralis major and blood supply and innervations?
**Adduction & medial rotation of humerus** **Draws scapular anteriorly & inferiorly via clavicle** **Clavicular part flexes humerus in addition to extending humerus from sternal part** Blood supply: pectoral branches of thoracoacromial arterial trunk Innervation: **Lateral & medial pectoral nerve** (medial & lateral cord of the brachial plexus)
40
What are the actions, blood supply, and innervations of pectoralis minor?
_Actions_: **Stabilizes scapula; pulls it anteriorly and inferiorly against posterior thoracic wall** _Blood Supply_: **pectoral branches of thoracoacromial arterial trunk** _Innervation_: **Medial pectoral nerve** (C8,T1)
41
What are the actions, blood supply, and innervations of the subclavius muscle?
_Actions_: **Anchors & depresses clavicle** _Blood Supply_: **clavicular branches of thoracoacromial arterial trunk** _Innervation:_ **"nervce to subclavius"** (C5, C6)
42
What are the actions, blood supply, and innervation of the serratus anterior muscle?
_Actions:_ **Protracts and rotates scapula and holds scapular against thorax** _Blood supply_: **Lateral thoracic artery** _Innervation:_ **Long thoracic nerve** (C5,C6,C7)
43
What are the 3 divisions of the subclavian artery that are in relation to the anterior scalene muscle?
Part 1 = **medial** to anterior scalene muscle Part 2 = **posterior** to anterior scalene muscle Part 3 = **lateral** to anterior scalene muscle Subclavian artery arises posterior to sternoclavicular joint
44
What 2 large named arteries have tributaries that provide blood to the pectoral shoulder and axillary regions?
**Subclavian artery** - runs underneath clavicle where it becomes axillary **Axillary artery** - starts underneath clavicle & runs underneath pectoralis minor
45
What are the branches of the medial portion of the subclavian artery? In respect to the anterior scalene muscle
**1. Vertebral artery** **2. Internal thoracic artery (internal mammary)** **3. Thyrocervical arterial trunk**
46
What anterior arteries branch off the thryocervical arterial trunk? (4)
**Suprascapular artery** **Transverse cervical --\>** deep branch, superficial branch **Ascending cervical artery** **Inferior thyroid artery**
47
What posterior branches arise from the subclavian artery? (2)
**Supreme intercostal artery** **Deep cervical artery** **via the costocervical arterial trunk**
48
What could potentially arise on the lateral portion of the subclavian artery, what can *potentially* arise?
_Potentially_: **dorsal scapular artery** (can also arise from the transverse cervical artery) _Always Laterally_: **Axillary artery**
49
What's involved in the apex of the axilla boundaries? (3)
**Clavicle** - anteriorly **Scapula** - medially **1st rib** - posteriorly
50
What contributes to the base of the boundaries of the axilla? (4)
**Skin & Superficial fascia** **Anterior axillary fold; pectoralis major** **Posterior axillary fold; latissimus dorsi, tere major** **Chest wall; serratus anterior**
51
What are the components of the anterior wall of the bondaries of the axilla? (4)
**Clavicle** **Subclavius** **Pectoralis major** **Pectoralis minor**
52
What are the components of the posterior wall of the boundaries of the axilla? (4)
**Scapula** **Subcapularis** **Latissimus dorsi** **Teres major**
53
What are the lateral components of the boundaries of the axilla? (3)
**Bicipital groove** (interrubercular sulcus) **Tendon of long head of biceps** **Coracobrachialis tendon** All humerus
54
Where do the nerves of the brachial plexus originate from?
**Ventral rami** of cervical and thoracic spinal nerves C5-T1
55
What is a result of injury to the superior trunk (C5 & C6 spinal nerve roots), sensory and motor deficits?
"Erb's" Palsy; via excessive, forceful increase in angle b/w neck and shoulder Sensory deficits: **Lateral aspect of upper limb** Motor deficits: **Loss of arm abductionm, elbow flexion & forearm supination, weakness of wrist extension** "Waiter's tip" position
56
What is a result of injury to the inferior trunk (C8 & T1 spinal nerve roots), sensory and motor deficits?
"Klumpke's" Palsy Sensory: **Medial aspect of upper limb (except axilla)** Motor: **Loss of precision finger movements, weakness in forearm pronation, wrist & finger extension, and wrist & finger flexion** "claw-hand", attempted extension but 4th & 5th digits stay flexed
57
What is a result of injury to the radial nerve (C5-T1 spinal nerve roots)?
Mid-shaft fractures of humerus or axilla compression (crutches) "wrist drop" "Saturday night palsy" **Extensors compartments affected**
58
What is a result of injury to the axillary nerve (C5 & C6 spinal nerve roots)?
Via fractures to surgical neck of humerus or glenohumeral joint dislocation; improper use of backpack (Quadrangular space syndrome); impaired or lost function of deltoid & teres minor Paresthesia and/or pain w/ along course of nerve Patient cannot fully abduct arm, possible inability to laterally rotate arm
59
What is a result of injury to the long thoracic nerve (C5,C6,C7 spinal nerve roots), sensory and motor deficits?
Damaged nerve during surgical removal of lymph nodes or other tissues in axillary region; penetrating trauma to axillary region **serratus anterior affected** "winged scapula"; inability to raise arms past 90 degrees
60
What is a result of injury to the ulnar nerve (C8, T1, often C7 spinal nerve roots), sensory and motor deficits?
Via fracture of medial epicondyle of humerus; fracture of proximal ulna; slashed wrist ## Footnote **Damage can involved wrist and digit flexors, intrinsic hand muscles** **Radial deviation at wrist join, loss of ab- adduction of fingers, weak wrist flexion, some loss of digit flexion**
61
What is a result of injury to the median nerve (C6-T1 spinal nerve roots), sensory and motor deficits?
Via fracture of humerus above condyles; slashing of wrist, inflammation or irritation in carpal tunnel; **Carpal Tunnel Syndrome** Flexors of wrist and digits affected, & intrinsic hand muscles (usually thumb; digit 1) "Pope's Blessing"; **attempted flexion where 2nd & 3rd digits are left extended;**"Ape Hand"
62
Which muscle extend the head?
**Longissimus** **Splenius capitis & cervicis** **Spinalis capitis & cervicis** **Semispinalis** **Rotatores** **Muscles of the Suboccipital Triangle**
63
What muscles elevate the scapulae?
**Trapezius** **Rhomboids major & minor** **Levator scapulae**
64
What muscles retract the scapulae?
**Trapezius** **Rhomboid major & minor**
65
What muscles rotate the scapulae?
**Trapezius** **Rhomboids major & minor**
66
What muscles medially rotate the body of the humerus/shaft?
**Latissimus Dorsi**
67
What muscles retract the scapulae?
**Rhomboid major & minor**
68
What muscles extend the neck?
**Iliocostalis Cervicis** **Splenius capitis & cervicis** **Longissimus Cervicis**
69
What muscles extend the spine?
**Iliocostalis Thoracis & Lumborum** **Longissimus Thoracis** **Spinalis Thoracis**
70
What muscles laterally bend the neck?
**Iliocostalis Cervicis** **Longissimus Cervicis** **Semispinalus Cervicis**
71
What muscles laterally bend the spine?
**Iliocostalis Thoracis & Lumborum** **Longissimus Thoracis** **Semispinalis Thoracis** **Multifidus**
72
What muscles are involved in the dynamic support of the arch of the foot?
APHLI **A**nal **P**lay **H**as **L**ong **I**nteractions **Tibialis Anterior** **Tibialis Posterior** **Flexor Hallicus Longus** **Fibularis Longus** **Intrinsic plantar muscles**
73
What structures are involved in Passive Support of the Dynamic Arch of the foot?
PSLP **P**.**S. L**et's **P**lay **Plantar aponeurosis** **Short plantar ligament** **Long plantar ligament** **Plantar calcaneonavicular ligament**
74
What is a unique characteristic of the gastrocnemius?
**Lateral head may contain a sesamoid bone close to its proximal attachment** **Fabella** (3-5% people) May possibly assit as a leverage; during knee replacement, can become cracked and cause pain in individuals
75
What is the function of the gastrocnemius?
**Plantar flexion** **Flexes leg at knee joint** Most superficial posterior compartment muscle of the lower leg
76
What is the function of the soleus muscle? Characteristics?
**Plantarflexion** Broad, flat multipennate muscle Lies deep to gastrocnemius **Forms a tripartite muscle w/ gastrocnemius = "triceps surae" = forms calf prominence**
77
What does the "triceps surae" of the lower leg consists of and what does it form?
**Forms the calf prominence** **Soleus muscle joining with the gastrocnemius = tripartite muscle**
78
What is the function of the plantaris muscle?
**Weak plantarflexion and leg flexion**
79
What is the function of the popliteus muscle? Characteristics?
**Unlocks extended leg by laterally rotating femus on a stationary tibia** **Weakly extends the leg** Thin, flat triangular muscle **Forms the inferior border of popliteal fossa** **Deep to plantaris**
80
What is the function and characteristics of the flexor hallicus longus muscle?
**Flexes great toe** **Plantarflexes foot at ankle joint** Lies deep to soleus; largest deep posterior muscle **Passes inferiorly deep to flexor retinaculum**
81
What is the largest deep posterior muscle? What is its function?
**Flexor Hallucis Longus** **Flexes great toe; Plantarflex foot at ankle joint**
82
What is the function of the flexor digitorum longus muscle?
**Flexes lateral four digits** **Plantarflex foot at ankle joint**
83
What is the function of the tibialis posterior?
**Inversion** **Plantarflexion**
84
List the 5 components that run past the ankle laterally
**T**om, **D**ick, **a.n. H**arry ## Footnote **Tibialis posterior** **Flexor digitorum longus** **Posterior tibial artery** **Tibial nerve** **Flexor Hallucis longus**
85
What nerve innervates the posterior leg muscles?
**Tibial Nerve branch of sciatic nerve** Deep to soleus
86
Explain how the posterior tibial artery is related to clinical anatomy
Can be palpated if patient has cold feet or is losing sensation Palpated between posterior surface of medial malleolus and medial border of calcaneal tendon Deep to flexor retinaculum
87
What are the crural/leg fascias? (3)
**Fascia lata** **Crural fascia** **Extensor retinaculum**
88
What is the function of the tibialis anterior muscle?
**Dorsiflexion** **Inversion of foot**
89
What is the function of the extensor digitorum longus muscle?
**Extends lateral four digits** **Dorsiflexion**
90
What is the function of the fibularis tertius muscle?
**Dorsiflexion** **Eversion of the foot**
91
What is the function of the extensor hallucis longus?
**Extends hallux** **Dorsiflex ankle**
92
What nerve(s) supplies the anterior compartment muscles?
**Deep fibular nerve** **One of the two terminal branches of the _common fibular nerve_** (begins b/w fibula and fibularis longus muscle) Runs inferomedially w/ anterior tibial vessels b/w tibialis anterior and extensor hallucis longus
93
What does the deep fibular nerve innervate other than the anterior compartment muscles?
**Ankle joint and metacarpel phalangeal joints** **Dorsal intrinsic foot muscles** **Skin b/w 1st and 2nd digits** (only cutaneous innervation of foot)
94
What artery supplies the anterior compartment of the leg?
**Anterior tibial artery via popliteal artery**
95
What is the function of the fibularis longus muscle?
**Eversion** **Plantarflexion**
96
What is the function of the fibularis brevis muscle?
**Eversion** **Plantarflexion** Runs deep to fibularis longus muscle
97
What nerve supplies the lateral leg compartments?
**Superficial Fibular Nerve**
98
What occurs with damage to the common fibular nerve?
**Paralysis of all anterior and lateral crural muscles** **Footdrop = loss of dorsiflexion and eversion**
99
What causes shin splints?
**Repetitive microtrauma to tibialis anterior** inducing small tears to periosteum over tibia
100
What muscles are involved with layer 1 of the plantar aspect of the foot? (3)
**Abductor digiti minimi** **Flexor digitorum brevis** **Abductor Hallucis**
101
List the 3 fascia of the foot on the dorsum, sole, and plantar
Dorsum = **continuous w/ extensor retinaculum** Sole = **Plantar fascia** thickens to become **plantar aponeurosis** = Plantar
102
What are the roles of the foot muscles located on the sole?
**Help maintain foot arches** **Standing on uneven ground**
103
What muscles are involved in the 2 layer of the foot? (2) What are their functions?
**Quadratus plantae** Assists flexor digitorum longus in flexing lateral four digits, if absent, toes will be pulled laterally; keeps toes straight when flexed; corrects the line of pull of the flexor **Lumbricals** Flex mp joint Extend pip and dip joints
104
What nerves supply the sole of the foot?
**Medial and Lateral Plantar Nerve** **Supplies Plantar skin** **Appears in second foot layer**
105
What muscles of the foot do the medial plantar nerve innervate?
**Larger of the two terminal branches of the tibial nerve** **Abductor Hallucis** **Flexor digitorum brevis** **Medial 1 lumbrical** **Flexor hallucis brevis** All others are innervated by lateral plantar nerve
106
What nerve is derived to form the blood supply of the sole of the foot?
**Posterior tibial artery** **Divides deep to abductor hallucis to form medial and lateral plantar arteries**
107
What bones form the foot arch? What is the function and what are the two foot arches?
**Tarsal and Metatarsal bones** **Absorbs shock during weightbearing** **Makes foot adaptable to surface and weight changes** Longitudinal (medial & lateral parts) and Transverse Arch (runs b/w medial & lateral longitudinal arches)

KCUMB Anatomy - Erin (11 decks)

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