Functional Anatomy

Question 0

Review the movements exhibited at each joint of the upper limb

Answer 0

Glenohumeral- elevation/depression, protraction/retraction, rotation
Radioulnar- flexion/extension, rotation
Radiocarpal: flexion/extension, aBduction/aDduction
Phalangeal: flexion/extension

Question 1

State a general principle with regard to the range of motion at each joint throughout the upper limb

Answer 1

Movement becomes restricted the further distal you move down the upper limb

Question 2

What 3 anatomical structures can be used to guide movement at any joint? Give example from upper limb for each.

Answer 2

Bones- ulnohumeral joint
Ligaments- radiocarpal joint
Muscles- glenohumeral joint

Question 3

How does insertion differ from origin with respect to muscle attachment?

Answer 3

Insertion- most moveable attachment

Origin- least moveable

Question 4

List 3 ways that muscles may be attached

Answer 4

Fleshy, aponeurotic, tendinous

Question 5

What is an aponeurosis?

Answer 5

Thin, flat, sheet-like tendon

Question 6

Identify a muscle that has a aponeurotic origin

Answer 6

Latissimus Dorsi

Question 7

What fascial structure prevents bowstringing of tendinous muscle attachment as they cross the joint?

Answer 7

Retinaculum

Question 8

How do muscles that are stabilizers differ from muscles that are mobilizers?

Answer 8

Stabilizers- attached at a distance from the joint crossed

Mobilize- attached close to the joint crossed

Question 9

Give example of a muscle that can reverse its origin and insertion

Answer 9

The brachioradialis makes your hands the least freely moveable part instead of most moveable … ??

Question 10

What constitutes a muscle sling?

Answer 10

All the muscles that cross any given joint

Question 11

What does “tendon action of a muscle” refer to?

Answer 11

Using the position of a joint to stretch/relax the tendon of a muscle crossing it. Best illustrated in paralyzed muscles that have become fibrous.

Question 12

List the 3 types of ligaments associated with the scapulothoracic joint complex and examples of each one

Answer 12

Extrascapular- coracoclavicular
Intrascapular- disc
Capsular- acromioclavicular

Question 13

List the muscles involved in the scapulothoracic sling and their general actions

Answer 13

Trapezius: retraction & superior rotation
Pectoralis minor: depression
Serratus anterior: protraction/aBduction, superior/inferior rotation
Levator scapulae: elevation
Rhomboids: retraction (aDduct) & inferiorly rotate

Question 14

List the muscles of the glenohumeral sling and their general actions

Answer 14

Deltoid: aBduction
Subscapularis: internal rotation
Supraspinatus, Infraspinatus, Teres Minor: external rotation
Teres major: aDduction & internal rotation
Coracobrachialis: aDduction & flexion
Pectoralis major: internal rotation
Latissimus dorsi: internal rotation, aDductor, extension

Question 15

List the muscles of the ulno-humeral sling and their general actions

Answer 15

Brachialis: flexion
Brachioradialis: flexion
Long head of triceps: extension
Pronator teres & pronator quadratus: pronation
Supinator: supination
Biceps brachii: supination & flexion

Question 16

Which muscles stabilize the ulno-humeral joint? which mobilize it?

Answer 16

Stabilize- brachioradialis

Mobilize- brachialis, long head of triceps

Question 17

List muscles involved in the muscle sling for the wrist concerned with flexion.

Answer 17

Flexor carpi ulnaris, flexor carpi radialis, palmaris longus

Question 18

List the muscles involved in the muscle sling for the wrist concerned with extension

Answer 18

Extensor carpi radialis longus
Extensor carpi radialis brevis
Extensor carpi ulnaris

Question 19

What is another term for ulnar deviation & radial deviation?

Answer 19

Ulnar deviation = aDduction

Radial deviation = aBduction

Question 20

What is an axiom concerning the origin/insertion of forearm muscles?

Answer 20

Deep muscles of the forearm insert more distally than superficial forearm muscles

Question 21

Which retinaculum of the wrist must be severed in carpal tunnel?

Answer 21

FLEXOR RETINACULUM :)

Question 22

What is the general function of retinaculae?

Answer 22

Prevent bowstringing of tendons during muscle contraction

Question 23

List the phalangeal joints proximal to distal.. what is the most stable position for these joints?

Answer 23

MP: metacarpo-phalangeal
PIP: proximal interphalangeal
DIP: distal interphalangeal
Flexed is most stable as the ligaments acting on these joings are stretched taut in this position

Question 24

Which muscles of the digital sling flex the DIP joint of digits 2-5?

Answer 24

The flexor digitorum profundus flexes DIP joints of digits 2-5

Question 25

Which muscles of the digital sling flex the DIP joint of the thumb?

Answer 25

Flexor pollicis longus

Question 26

Which muscles of the digital sling flex the PIP joints of digits 2-5

Answer 26

The flexor digitorum superificalis flexes PIP joints of 2-5

Question 27

Which muscles of the digital sling flex the MP joint of the thumb?

Answer 27

Flexor pollicis brevis flexes MP joint of the thumb

Question 28

Which muscles of the digital sling flex the MP joints of digits 2-5?

Answer 28

The lumbricals and interossei mm. flex MP joints of 2-5

Question 29

Which muscles of the digital sling extend the MP joints for digits 2-5?

Answer 29

Extensor digitorum extends MP joints 2-5

Question 30

Name the additional extensor muscle for the MP joint on digit 5

Answer 30

Extensor digiti minimi

Question 31

List the muscles that extend the thumb DIP

Answer 31

Extensor pollicis longus extends DIP thumb joint

Question 32

List the muscle that extends the thumb MP

Answer 32

Extensor pollicis brevis extends MP joint

Question 33

Name the additional extensor of MP joint of digit 2

Answer 33

Extensor indicis

Question 34

List muscles that extend PIP & DIP joints of digits 2-5

Answer 34

Interossei & lumbricals

Question 35

Which interossei aBduct which digits, which aDduct which digits?

Answer 35

Dorsal interossei 2-4 aBduct (DAB) | Palmar interosse 2-5 aDduct (PAD)

Question 36

Erb's Palsy

Answer 36

Upper lesion of plexus, aBductors & lateral rotators affected

Question 37

Klumpke's Palsy

Answer 37

lower lesion of plexus, paralyzes ulnar & median nerves so all intrinsic hand muscles paralyzed, claw hand.

Question 38

Flail extremity

Answer 38

Avulsion of all roots of brachial plexus, limb hangs at side, partial hemiparalyzed diaphragm and partial Horner's

Question 39

Why is Horner's syndrome a complication of lesions of the lower brachial plexus?

Answer 39

Due to involvement of T1 from the brachial plexus.. T1-T4 supply sympathetic innervation to head and neck.

Question 40

Lesion of long thoracic nerve

Answer 40

C5, C6, C7 | winged scapula, can not raise arm above head

Question 41

Lesion of axillary nerve

Answer 41

no aBduction of limb (deltoid)

Question 42

Lesion of musculocutaneous nerve

Answer 42

Loss of forearm flexion & supination

Question 43

Lesion of radial nerve in the axilla

Answer 43

unable to extend elbow joint, wrist joint, and finger (wrist drop)

Question 44

Lesion of radial nerve in the arm

Answer 44

wristdrop due to forearm extensors, inability to extend MP joints & extend/aBduct the thumb

Question 45

Lesion of ulnar nerve above the elbow

Answer 45

Loss of all intrinsic muscles of hand except thenar mm. and lumbricals 2 & 3 so claw hand, MC 4 & 5 can not extend

Question 46

Lesion to median nerve

Answer 46

Forearm supinated, weak wrist flexion and aDduction, MC 2 & 3 can not flex so hand of benediction At wrist- ape hand, no thumb abduction, thenar mm. affected

Question 47

How can you use the thumb as a test for integrity of radial, median, and ulnar nerves?

Answer 47

Radial: inability to extend thumb Median: inability to flex DIP joint Ulnar: no aDduction of MP joints with PIP & DIP joints extended

Question 48

What can be said about spinal nn. controlling upward/downward movement of joints of the upper limb, moving proximal to distal?

Answer 48

Most cranial nerves controlling a joint are responsible for its upward movement. most caudal nerves for its downward movement. the number of spinal nn needed for movement at a joint decrease as you go distally along the limb.