Long Answer Flashcards
(160 cards)
1
Q
Where does the muscle that attaches to the medial 1/3 of the superior nuchal line
attach distally/peripherally?
A
O: as above and ligamentum nuchae of spinous process C7-T12
Insert:Lateral 1⁄3 of clavicle, acromion and spine of scapula
2
Q
What muscle(s) attaches to the lateral 1/3 of the superior nuchal line and mastoid process deep to sternocleidomastoid?
A
Splenius capitis
3
Q
What is the caudal attachment of the superficial muscle the attaches to the lateral 1/3 of the superior nuchal line and the mastoid process?
A
C7-T3, lower half of nuchal ligament
4
Q
What is the innervation of semispinalis capitis?
A
Greater occipital nerve C2/3
5
Q
List the muscles that attach on or near the superior nuchal line in order from most medial to lateral:
A
Trapezius, Semispinalis Capitis, Splenius Capitis, Sternocleidomastoid
6
Q
What muscles that attach to the superior nuchal line of the skull share a similar innervation?
A
Trapezius and Sternocleidomastoid: Spinal accessory nerve XI
7
Q
What sensitive structures are associated with the insertion of trapezius on the skull?
A
Suboccipital triangle including sub occipital nerve, vertebral artery, greater/lesser occipital nerve
8
Q
What are the sensitive structures associated with the insertion of sternocleidomastoid on the skull:
A
Post jugular vein, lesser occipital neve, greater auricle nerve
9
Q
What innervates lateral pterygoid?
A
Lateral pterygoid nerve from mandibular branch ( from trigeminal CN V)
10
Q
What are the sensitive structures surrounding the temporomandibular joint?
A
Facial nerve, Parotid gland, superficial temporal artery, ,mandibular nerve, TMJ
disc
11
Q
What are the sensitive structures associated with the insertion of masseter onto the ramus and angle of the mandible?
A
Facial artery/vein, Facial nerve, parotid gland.
12
Q
Given the multiple innervations associated with the trigeminal nucleus what other cervical nerve roots might be affected with trigeminal nerve dysfunction or could contribute to it?
A
Facial nerve
13
Q
At the C5-7 level list the muscles in order of most superficial to deepest
A
● 1. UFT
● 2. Serratus posterior
● 3. Splenius capitis
● 4. Levator scapula
● 5. Semispinalis capitis
● 6. Spinalis colli
● 7. Semispinalis colli
● 8. Interspinalis colli
● 9. Multifidis
● 10. Rotatores
● 11. External intercostals
14
Q
Due to risk what muscles would not be needled at the C5-7 level?
A
External intercostals
15
Q
Where does the vertebral artery typically enter the transverse foramen of the cervical spine?
A
C6
16
Q
What is the innervation of Splenius Capitis?
A
Spinal nerves post ramus C2-3
17
Q
What is the innervation of multifidus in the cervical spine?
A
Medial branch dorsal rami of cervical nerves at adjacent level.
18
Q
What sensitive structures are associated with the C5-7 cervical segmental levels?
A
Brachial plexus, vertebral artery and subclavian artery and vein, carotid artery
19
Q
What muscles of the thorax would not be needled due to risk?
A
● 1. Diaphragm
● 2. Subcostals
● 3. Intercostals
● 4. Pec major over lungs
● 5. Ta
● 6. Subscapularis
● 7. Serratus anterior
20
Q
- What spinal condition in the thorax would be cause for the therapist to proceed with caution when needling the thorax and why?
A
● Scoliosis: due to change in orientation. Severe Osteoporosis with wedge
fractures-Muscle spasm may be protecting further flexion. Cancer that has
spread to bones-contraindication.
21
Q
List the muscles present at the T4 level from most superficial to deepest.
A
Trapezius
● 2. Rhomboid Major
● 3. Splenius Capitis
● 4. Splenius Cervicis
● 5. Semispinalis Capitis
● 6. Spinalis
● 7. Longissimus
● 8. Iliocostalis
● 9. Semispinalis
● 10. Multifidi
● 11. Rotators
22
Q
What is the innervation of the transversospinalis muscle group? ●
A
Dorsal rami of spinal nerves of adjacent segments
23
Q
What are the sensitive structures associated with thoracic spine points?
A
Lungs, pleural cavity, heart, pericardium,
24
Q
What are the attachments of multifidus in the lumbar spine and pelvis?
A
TVP and sacrum to SP of 2-4 segments above
25
Which muscle lies directly adjacent laterally to longissimus at the L3 level?
Iliocostalis
26
What organ lies lateral and deep to the L2 and L3 transverse processes?
kidneys
27
What is the innervation of longissimus lumborum/thoracis?
Dorsal rami of thoracic and lumbar roots
28
What sensitive structures would be associated specifically with quadratus lumborum?
Kidneys and lumbar plexus
29
What are the attachments of quadratus lumborum?
Post iliac crest to TVP of L1-4 and rib 12
30
What is the innervation of quadratus lumborum?
lumbar plexus T12-L4
31
What sensitive structures would be associated with needle points around the sacrum?
Sacral plexus, sciatic nerve, superior/inferior gluteal artery, pudental nerve and a post
cutaneus nerve of the thigh
32
What sensitive structures are associated with the lumbar spine from the L3-L5 levels?
Lumbar plexus, kidneys, cauda equina
33
What are the proximal and distal attachments of gluteus maximus?
Prox: sacrum and coccyx distal: itb and glut tuberosity of femur
34
What is the nerve and segments that innervate of gluteus maximus?
Inf gluteal nerve l5-s2
35
What muscles lie deep to gluteus maximus in the posterior hip?
Superior/inferior Gemelli, Obturator Internus and Externus, Piriformis, Glut med, Glute
Min, Quadratus Femoris
36
List the deep rotators of the hip in order starting from piriformis and moving caudally
1. Piriformis
● 2. Superior gemelli
● 3. Obturator internus
● 4. Inferior gemelli
● 5. Quad fem
● 6. Obturator exturnus
37
What are the attachments of piriformis?
Anterior Aspect of Sacrum (S2/3/4 and superior border of greater sciatic notch into
Greater Trochanter
38
What is the nerve and segments that innervate piriformis?
Nerve to piriformis sacral plexus L5-S2
39
What sensitive structures must be considered when treating piriformis?
Sciatic nerve and inferior gluteal artery and nerve
40
List the muscles that attach to medial surface of the greater trochanter above the trochanteric fossa :
Piriformis, Sup/Inf Gemelli, Obturator Internus- aspects of Glut med and glut min
41
What is the nerve and segments that innervate obturator externus?
Obturator L3-4
42
What are the sensitive structures you would need to consider when treating the deep rotators of the hip?
Sciatic n and inferior gluteal artery and nerve
43
Gluteus medius, minimus and tensor fasciae latae are innervated by what nerve and segments?
Superior gluteal nerve L4-S1
44
What muscles in the posterior hip include L5 in their segmental innervation?.
Gluteus maximus, medius, minimus
Tensor fasciae latae
Quadratus femoris
Obturator internus
Superior and inferior gemelli
45
Inferior Gemellus and quadratus femoris are innervated by what nerve and segments?
Nerve to Quadratus Femoris, L4/5/S1
46
What nerve root or myotome does resisted hip abduction test?
L5
47
What are the attachments of Tensor Fasciae Latae?
Ant surface of iliac crest and tubercle of asis to the it band
48
What are the attachments of rectus femoris?
Aiis and ilium to tibial tubercle via patellar tendon
49
What sensitive structures would you need to consider when treating Sartorius?
Femoral artery nerve and vein, circumflex iliac artery, lat femoral cutaneus nerve
50
What muscle lies directly medial/adjacent to vastus medialis?
sartorius
51
What reflex is associated with the quadriceps?
l3/4
52
What sensitive structure would you need to consider when treating vastus medialis?
Saphenous vein, femoral van
53
What nerve and segments innervate vastus lateralis, rectus femoris, vastus intermedius and vastus medialis?
Femoral nerve L2-4
54
What myotome(s) is/are associated with resisted testing of the quadriceps?
L3
55
What muscle lies deep to rectus femoris?
Vastus intermedius
56
What is the nerve and its segments that innervate pectineus?
Femoral n L2-4
57
What are the attachments of adductor brevis?
Inferior ramus of pubis to pectineal line and medial lip of linea aspera
58
What muscle(s) lie(s) medial and posterior to adductor longus?
Adductor brevis and magnus
59
What sensitive structures would you need to consider when treating the proximal portions of the adductor muscles of the medial thigh?
1. Obturator n, greater saphenous vein, saphenous n, femoral van
60
What nerve and segments innervate adductor brevis, adductor longus and gracilis exclusively?
Obturator (L2-4)
61
List the muscles in order of most superficial to deep on the medial side of the posterior thigh with the patient lying in prone:
Pectineus, Adductor Longus, Adductor Brevis, Add Magnus, Gracilis
62
What are the attachments of adductor magnus?
O: Inferior ramus of pubis, ramus of ischium and ischial tuberosity. I: medial lip of
linea aspera and adductor tubercle
63
What is the nerve and its segments that innervate adductor magnus?
Obturator L2-L4 and tibial n from sciatic L4
64
What is the nerve and its segments that innervate semimembranosus, semitendinosus and the long head of biceps femoris?
1. Tibia nerve (L4-S3)
65
What are the attachments of semimembranosus?
Isch tuberosity to groove on post aspect of medial tibial condyle
66
What sensitive structures would you need to consider when treating biceps femoris?
Sciatic nerve
67
What muscles of the posterior thigh have S1 as part of their segmental innervation?
Semimembranosus, Semitendinosus, Biceps Femoris long and short head
68
What myotome is associated with resisted knee flexion?
S2
69
What are the attachments of biceps femoris?
Long head Isch tuberosity short head post inferior shaft of femur, distally to head of
fibula
70
What is the nerve and its segments that innervates soleus, gastrocnemius and plantaris?
Tibial n s1-2
71
What are the attachments of tibialis posterior?
Prox: post surface of tibia, fibula and Interosseous membrane distally
to all tarsal bones except talus
72
What sensitive structures must you consider when treating popliteus and plantaris?
Tibial n peroneal n, posterior tibial a, popliteal v and a
73
What are the attachments of flexor hallucis longus?
Prox lower posterior surface of shaft of fibula and io membrane, distally to base of
distal phalanx of 1st toe
74
On the medial side of the middle 1/3 of the posterior lower leg list the muscles
in order of most superficial to deep with the patient in prone
1. Gastroc
● 2. Plantaris
● 3. Soleus
● 4. FDL
● 5. FHL
● 6. Tib post
75
What muscles of the posterior lower leg attach above the soleal line?
Gastoc soleus popliteus
76
What myotome is associated with resisted testing of inversion?
L4
77
What muscles of the lower leg have S2 as part of their segmental innervation?
Gastroc, Soleus, Popliteus, Flexor Digitorum Longus, Flexor Hallucis Longus and
possibly plantaris
78
What myotome is associated with resisted plantar flexion?
S1
79
What myotome is associated with resisted eversion?
S1
80
On the lateral side of the middle 1/3 of the posterior lower leg list the muscles in order of most superficial to deep with the patient in prone
Lateral head of gastroc, soleus, fibularis longus, FHL
81
What are the sensitive structures you must consider when treating soleus?
Sural n, tibial n, posterior tibial a and v
82
What nerve innervates all of the muscles of the superficial and deep posterior compartment of the lower leg and what are its segments?
Tibial nerve L4-S3
83
What are the attachments of peroneus longus?
Head and shaft of the fibula to base of 1st metatarsal and med cuneiform
84
What is the nerve and its segments that innervate peroneus brevis?
Superficial peroneal n L5-s2
85
What are the sensitive structures you must consider when treating the peroneals?
Common peroneal nerve
86
What muscle lies adjacent and lateral to tibialis anterior?
Extensor digitorum longus
87
What are the attachments of extensor digitorum longus?
Lateral tibial condyle, prox 3⁄4 of fibula and IO membrane to base and of middle and
distal phalange of the lateral 4 toes
88
What are the sensitive structures you must consider when treating muscles of the anterior compartment of the lower leg?
Lat sural cutaneous n, common peroneal n and deep peroneal n, ant tibial a and v
89
What muscles of the lower leg have L5 as part of their innervation?
Peroneus longus/brevis/tertius, gastrocnemius, soleus, plantaris, popliteus, FHL, tibialis
posterior, FDL, tibialis anterior, EHL, EDL
90
What muscle lies adjacent and lateral to extensor digitorum longus?
Peroneus longus
91
What muscle(s) lies distal on the fibula in relation to extensor digitorum longus?
Peroneus longus, brevis, tertius
92
What is the nerve and its segments that innervates all of the muscles of the anterior compartment of the lower leg?
Deep peroneal nerve L4-S2
93
What is the nerve and its segments that innervate extensor hallucis brevis?
Deep peroneal nerve L4-S2
94
What are the attachments of the dorsal interossei?
Adjacent surfaces of all metarsals to distal dorsal expansion
95
What is the nerve and its segments that innervate plantar interossei?
Lat plantar n S1/2
96
What sensitive structures must be considered when treating the interossei?
Plantar digital nerve, cutaneous/muscular branch of peroneal nerve
97
What nerve and segments innervate abductor hallucis, flexor digitorum brevis and the first lumbrical?
Medial plantar n L45
98
What are the sensitive structures you would need to consider when treating the plantar surface of the foot?
Medial dorsal cut n, deep muscular branch of fib nerve, intermediate
dorsal cutaneous n
99
What muscles lie deep to the tendons of flexor digitorum brevis in the distal 1/3 of the plantar surface of the foot (in order most superficial to deepest)
FDL, lumbricals, adductor hallucis, plantar interossei
100
What is the nerve and its segments that innervates all the muscles of the
plantar surface of the foot except abductor hallucis, flexor digitorum brevis and the first lumbrical?
Lat plantar n S1-2
101
What are the attachments of the long head of biceps brachii?
Supraglenoid tubercle to radial tub and biceps aponeurosis
102
What sensitive structures would need to be considered when treating the proximal attachments of coracobrachialis and the short head of biceps brachii?
Cephalic vein, thoracoacromial vein and artery, axillary artery, portions of brachial
plexus, musculocutaneous nerve
103
What are the attachments of anterior deltoid?
Lat third of acromion to deltoid tuberosity
104
What is the nerve and segments that innervate of lateral deltoid?
Axillary n c5/6
105
What muscles of the upper arm have C6 as part of their innervation?
Deltoid, corachobrachialis, biceps brachii, brachialis, triceps brachii
106
What myotome is associated with resisted elbow flexion in a supinated position of the forearm?
C6
107
What myotome is associated with resisted shoulder abduction?
C5
108
What nerve and segments innervate bices brachii, brachialis and coracobrachialis?
Musculocutaneous c5/6
109
What nerve and segments innervate triceps brachii?
Radial nerve C5/6
110
What sensitive structures must be considered when treating triceps?
Axillary nerve, posterior cutaneous nerve of the arm, deep brachial artery/vein
111
What myotome is associated with resisted elbow extension?
C7
112
What muscles of the posterior shoulder have C5 as part of their segmental innervation?
Deltoid, supraspinatus, infraspinatus, teres minor, teres major
113
What are the attachments of latissimus dorsi?
iliac crest, thoracolumbar fascia, spinous process of T6-L5 to intertubercular
groove
114
List the muscles from proximal to distal that attach along the medial border of the scapula:
Supraspinatus, infraspinatus, teres major, subscapularis, serratus anterior
115
What sensitive structures must be considered when treating supraspinatus?
Suprascapular n,a,and v, lungs
116
What nerve and segments innervate supraspinatus and infraspinatus?
Suprascapular n c5/6
117
What nerve and segments innervate deltoid and teres minor?
Axillary nerve C5/6
117
What are the sensitive structures that must be considered when muscles of the axilla and scapula anteriorly?
Suprascapular n a and v and axillary n, circumflex scapular vein and artery
117
What are the attachments of levator scapula?
Transverse process C1-4 to superior angle of scap, medial border of scap and spine of
scap
118
The tendons of what muscle(s) lie deep to the fibers of deltoid?
All rotator cuff, infraspinatus supraspinatus, teres minor, subscapularis. As well as
biceps and triceps
119
What are the attachments of infraspinatus?
Infraspinatus fossa to middle facet of greater tubercle of humerus
119
What nerve and segments innervate supraspinatus and infraspinatus?
Suprascapular n c5/6
119
What sensitive structures must be considered when treating the levator scapula and upper trapezius?
Lungs, supraclavicular n
119
What nerve and segments innervate deltoid and teres minor?
Axillary n c5/6
119
What nerve and segments innervate subscapularis and teres major?
Lower subscapular n c5/6
120
What are the attachments of pectoralis major?
Anterior surface of medial clavicle, ant surface of sternum and upper 6 costal cartilage,
aponeurosis of external oblique to lateral intertubercular groove
121
What is the innervation of pectoralis major?
Medial and lat pectoral nerves c8/t1
122
What muscles lies adjacent and lateral to brachioradialis?
ECRL, ECRB, Extensor digitorum
123
List the muscles of the deep posterior forearm that attach to the ulna from proximal to distal:
Anconeus, extensor digiti minimi, extensor carpi radialis brevis, supinator
124
What is the nerve and segments that innervates brachioradialis, extensor carpi radialis longus and anconeus?
Radial n c7/8
125
What myotome associated with resisted wrist extension?
C6
126
What muscle lies adjacent and lateral to extensor digitorum?
Extensor carpi radialis longus
127
What muscle lies deep to extensor digitorum?
Extensor indicis
128
What sensitive structures must be considered when treating the deep posterior compartment of the forearm?
Accessory cephalic vein, posterior antebrachial n.,
129
What is the nerve and segments that innervates extensor digitorum, extensor carpi ulnaris, extensor digiti minimi, extensor pollicis brevis, extensor pollicis longus, abductor pollicis longus and extensor indicis?
Post interosseous n c7/8
130
What myotome is associated with resisted distal interphalangeal joint extension of the thumb?
C8
131
What are the attachments of extensor digitorum?
Lat epicondyle of humerus to extensor expansion of medial 4 fingers
132
What nerve and segments innervates supinator and extensor carpi radialis brevis?
Deep branch of radial c7/8
133
What reflex is associated with brachioradialis?
C5/6
134
What nerve and segments innervates pronator teres, flexor carpi radialis, flexor digitorum superficialis, and palmaris longus?
Median C5/6
135
What muscle lies adjacent and medial to the insertion of flexor digitorum superficialis on the common flexor tendon?
FCR
136
What muscle lies deep the radial insertion of pronator teres?
FDS
137
What myotome is associated with resisted wrist flexion?
C7
138
What sensitive structures must be considered when treating the structures around the medial epicondyle?
Ulnar nerve, basilic v and superior ulnar collateral a
139
What muscles of the flexor compartment of the forearm have C8 as part of their segmental innervation?
Palmaris longus, flexor carpi ulnaris
140
What are the attachments of flexor digitorum profundus?
Post half of anterior border of radius and medial epicondyle and coronoid process to
middle phalanges of four medial fingers
141
What are the attachments of flexor digitorum superficialis?
Prox 3⁄4 of anterior and medial surfaces of ulna and IO membrane to base of distal
phalenges of medial 4 fingers
142
What nerve and segments innervate pronator quadratus and flexor pollicis longus?
Anterior interosseous n c8/t1
143
What are the attachments of flexor digitorum profundus?
Posterior half of anterior border of radius and medial epicondyle/coronoid process to
middle phalanges of four medial fingers
144
What is the innervation of flexor digitorum profundus?
Ulnar n c8/t1 and anterior interosseous n c8/t1
145
What is the nerve and segments that innervates the superficial head of flexor pollicis brevis, abductor pollicis brevis and opponens pollicis?
Recurrent branch of median n c8 t1
146
What myotome is associated with resisted finger adduction?
T1
147
What sensitive structures must be considered when treating the thenar
aspect of the hand?
Recurrent branch of the median nerve (motor supply to thenar muscles — very superficial)
Superficial branches of the radial artery
Cutaneous branches of the median nerve
148
What muscle lies deep to abductor pollicis and flexor pollicis brevis?
Opponens pollicis
149
What sensitive structures must be considered when treating the hypothenar aspect of the hand?
Superficial branch of the ulnar nerve
Superficial palmar arch (from ulnar artery)
Palmar cutaneous branch of the ulnar nerve
150
What are the attachments of flexor digiti minimi?
Proximal (origin): Hook of the hamate and flexor retinaculum
Distal (insertion): Base of the proximal phalanx of the 5th digit (little finger)
151
What nerve and segments innervate the flexor digiti minimi, opponens digiti minimi, and abductor digiti minimi?
Nerve: Deep branch of the ulnar nerve
Segments: C8-T1
152
What are the attachments of adductor pollicis?
Oblique head origin: Bases of 2nd and 3rd metacarpals and capitate
Transverse head origin: Shaft of 3rd metacarpal
Insertion: Medial side of the base of the proximal phalanx of the thumb
153
What is the nerve and its segments that innervates all of the deep muscles of the hand except the first 2 lumbricales?
Nerve: Deep branch of the ulnar nerve
Segments: C8-T1
154
What sensitive structures must be considered when treating the deep portions of the hand and wrist?
Ulnar nerve and artery (Guyon’s canal)
Median nerve (carpal tunnel)
Radial artery (in anatomical snuffbox and deep palmar arch)
Flexor tendons (especially FDS, FDP, FPL) within carpal tunnel
