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Clinical anatomy module 6 > module 6: lower extremity > Flashcards

module 6: lower extremity Flashcards

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1
Q

clinical examples of surface anatomy

A

venous blood draw cubital fossa
radial artery – ABG test
carpal tunnel injection

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2
Q

bones of the distal UP of the humerus

A 
trochlea (T)
capitulum (C)
lateral vs medial epicondyle (LE/ME)
supracondylar ridge (SCR)
olecranon fossa (OF)
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3
Q

proximal end of the ulna contains what landmarks?

A 
olecranon (O)
trochlear notch (TN)
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4
Q

distal end fo ulna contains what landmarks

A

head of ulna (H)

styloid process of ulna (SPU)

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5
Q

distal end fo ulna contains what landmarks

A

head of ulna (H)

styloid process of ulna (SPU)

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6
Q

identify the proximal and distal landmarks of radius

A

proximal radius: head and neck

distal radius: styloid process of radius (SPR)

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7
Q

carpal bones in the proximal row

A

scaphoid (S)
lunate (L)
triquetrium (TQ)
pisiform (P)

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8
Q

carpal bones in the distal row

A 
trapezium (TM)
trapezoid (TD)
capitate (C)
hamate (H)
hook of hamate (HH)
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9
Q

carpal bones in the distal row

A 
trapezium (TM)
trapezoid (TD)
capitate (C)
hamate (H)
hook of hamate (HH)
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10
Q

elbow joint provides what kind of movements?

A

flexion and extension

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11
Q

what muscles are flexing the elbow joint?

A

biceps brachii, brachialis and brachioradialis

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12
Q

what muscle is extending the elbow joint

A

triceps

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13
Q

elbow joint articulations

A

humero-ulnar articulation and humero-radial articulation

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14
Q

elbow joint ligaments

A

ulnar collateral ligament - medial elbow
radial collateral ligament - lateral elbow
annular ligament - “loops” around radial head “anchored” to ulna

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15
Q

elbow joint ligaments

A

ulnar collateral ligament - medial elbow
radial collateral ligament - lateral elbow
annular ligament - “loops” around radial head “anchored” to ulna

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16
Q

clinical application for elbow joint

A
  • ulnar collateral ligament rupture (or becomes sprain/stretched)
  • “Tommy John surgery” - surgery reconstructs the ligament
  • grafts – palmaris longus tendon, gracilis tendon, hamstring, great toe extensor tendon, donor grafts (allograft)
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17
Q

cubital tunnel syndrome

A

ulnar nerve gets entrapped as it passes posterior to elbow and enters the forearm in cubital tunnel

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18
Q

elbow joint: radial head dislocation

A

radial head gets “pulled” out of annular ligament “socket”

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19
Q

olecranon bursitis

A

chronic pressure on elbow creates inflammation/swelling of olecranon bursa

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20
Q

forearm movements

A

supination and pronation

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21
Q

what muscles provide supination for the forearm

A
  • supinator muscle, biceps brachii

- rotate palm up

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22
Q

what muscles provide pronation for the forearm?

A
  • rotate palm down

- pronator teres, pronator quadratus

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23
Q

what muscles provide pronation for the forearm?

A
  • rotate palm down

- pronator teres, pronator quadratus

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24
Q

interosessous membrane of the forearm

A

“tough” connective tissue that serves as the floor of the forearm

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25
sacciform recess of the forearm
continuation of joint capsule that extends under annular ligament
26
PRUJ (proximal radioulnar joint) of the forearm
head of radius articulates with ulna | radius “rotates” within annular ligament
27
DRUJ (distal radioulnar joint) of the forearm
head of ulna articulates with radius | TFCC “unites” distal radius and head of ulna
28
TFCC (triangular fibrocartilage complex)
- attachments on styloid process of ulna and distal radius - provides stability and mobility - allows radius to “pivot” around the ulna during pronation/supination of the forearm
29
TFCC tear
- rupture of TFCC often from FOOSH (fall on outstretched hand) injury - “pain and instability” of ulnar side of wrist
30
wrist provides what movements?
flexion extension ulnar deviation radial deviation
31
collateral ligaments of wrist
ulnar collateral ligament (UCL) | radial collateral ligament (RCL)
32
radiocarpal ligaments of the wrist
dorsal radiocarpal ligament (DRCL) | palmer radiocarpal ligament (PRCL)
33
wrist provides what joint?
radiocarpal joint
34
hand provides what joints?
``` MCP joints (metacarpophalangeal) PIP joints (proximal interphalangeal) DIP joints (distal interphalangeal) IP joint of thumb (interphalangeal) ```
35
movements of the fingers
abduction/adduction of digits | flexion and extension of MCP, PIP and DIP joints
35
movements of the fingers
abduction/adduction of digits | flexion and extension of MCP, PIP and DIP joints
36
movements of the thumb
adduction/abduction flexion/extension opposition
37
muscles located in superficial layer of the anterior forearm
Pronator teres Flexor carpi radialis Palmaris longus Flexor carpi ulnaris
38
muscles located in intermediate layer of the anterior forearm
Flexor digitorum superficialis (FDS
39
muscles located in deep layer of the anterior forearm
Flexor digitorum profunda Flexor pollicis longus Pronator quadratus
40
attachment/innervation/action of the pronator teres
attachments on med epicondyle and mid-radius innervated by median nerve action: pronate forearm with elbow in extension
41
attachment/innervation/action of the flexor carpi radials (FCR)
attachments on med epicondyle and 2nd metacarpal innervated by median nerve action: flex & radial deviate wrist
42
attachment/innervation/action of the palmaris longus (PL)
attachment on med epicondyle and then distal attachment blends with palmer carpal ligament & palmer aponeurosis innervated by median nerve action: flex wrist/hand
43
attachment/innervation/action of the FLEXOR CARPI ULNARIS (FCU)
attachments on med epicondyle and 5th metacarpal innervated by ulnar nerve action: flex & ulnar deviate wrist
44
attachment/innervation/action of the flexor digitorum superficialis (FDS)
proximal attachment on med epicondyle and distal attachment on middle phalanges innervated by median nerve action: flex PIP joints of fingers
45
attachment/innervation/action of the flexor digitorum superficialis (FDS)
prox attachment on med epicondyle distal attachment on middle phalanges innervated by median nerve action: flex PIP joints of fingers
46
flexor digitorum profunda (FDP)
attachments on ulna/interosseous membrane and distal phalanges innervated by two nerves lateral ½ supplied by AIN medial ½ supplied by ulnar nerve action: flex DIP joints of fingers
47
attachment/innervation/action of the flexor digitorum profunda (FDP)
attachments on ulna/interosseous membrane and distal phalanges innervated by two nerves lateral ½ supplied by AIN medial ½ supplied by ulnar nerve action: flex DIP joints of fingers
48
attachment/innervation/action of the flexor pollicis longus (FPL)
attachments on radius/interosseous membrane and distal phalange of thumb innervated by AIN action: flex IP joint of thumb
49
attachment/innervation/action of the pronator quadrates (PQ)
attachments on distal radius and ulna innervated by AIN Action: pronate forearm
50
what are the “wrist flexors”
FCR and FCU (and PL)
51
what are the “long finger flexors”
FDS, FDP and FPL
52
what are the “pronators”
PT and PQ
53
what does the median nerve supply?
supplies all muscles of superficial and intermediate layers EXCEPT the FCU
54
what does the AIN of median nerve supply?
supplies all muscles of the deep layer EXCEPT ½ of the FDP
55
what does the ulnar nerve supply ?
only supplies FCU and ½ FDP
56
what does the ulnar nerve supply ?
only supplies FCU and ½ FDP
57
where is the palmer carpal ligament located? what does it contain? what is it a continuation of?
location: anterior wrist Contains: all flexor tendons crossing the wrist continuation of extensor retinaculum (ER) from the dorsal surface of the wrist
58
posterior forearm “layers”
superficial and deep layer
59
muscles located in superficial layer of the posterior forearm
``` Brachioradialis Extensor carpi radialis longus Extensor carpi radialis brevis Extensor digitorum Extensor digiti minimi Extensor carpi ulnaris ```
60
muscles located in superficial layer of the posterior forearm
``` Brachioradialis Extensor carpi radialis longus Extensor carpi radialis brevis Extensor digitorum Extensor digiti minimi Extensor carpi ulnaris ```
61
Muscles located in deep layer of the posterior forearm
``` Extensor indices Outcropping muscles Extensor pollicis longus Extensor pollicis brevis Abductor pollicis longus Supinator ```
62
Muscles located in deep layer of the posterior forearm
``` Extensor indices Outcropping muscles Extensor pollicis longus Extensor pollicis brevis Abductor pollicis longus Supinator ```
63
attachment/innervation/action of the brachioradialis
attachments on supracondylar ridge and distal radius innervated by radial nerve action: elbow flexion
63
attachment/innervation/action of the brachioradialis
attachments on supracondylar ridge and distal radius innervated by radial nerve action: elbow flexion
64
brachioradialis is deep tendon reflex for which C?
6
65
attachment/innervation/action of the extensor carpi radials longus (ECRL)
attachments on supracondylar ridge and 2nd metacarpal innervated by radial nerve action: extend & radial deviate wrist
66
attachment/innervation/action of the extensor carpi radialis brevis (ECRB)
attachments on lat epicondyle and 3rd metacarpal innervated by deep branch of radial nerve action: extend & radial deviate wrist
67
attachment/innervation/action of the extensor digitorum (ED)
attachments on lat epicondyle and digits 2-4 (extensor expansion hood) innervated by PIN action: extend wrist
68
innervation of the extensor digiti minimi (EDM)
innervated by PIN
69
attachment/innervation/action of extensor carpi ulnaris (ECU)
attachments on lat epicondyle and 5th metacarpal innervated by PIN action: extend and ulnar deviate wrist
70
attachment/innervation/action of the supinator
attaches to the lat epicondyle/ulna and then inserts into proximal radius “wraps around the radius” innervated by deep branch of radial nerve action: supinate forearm
71
innervation of the extensor indices (EI)
extensor indices (EI)
72
attachment and innervation of the extensor policis longus (EPL)
distal attachment distal phalange of thumb | innervated by PIN
73
attachment and innervation of the extensor policies brevis
distal attachment proximal phalange of thumb | innervated by PIN
74
attachment and innervation of the abductor pollicis longus (APL)
distal attachment base 1st metacarpal | Innervated by PIN
75
“wrist extensors” of the posterior forearm
ECRL, ECRB, ECU
76
“finger extensors” of the posterior forearm
ED, EDM, EI
77
“thumb extensors/abductors” of the posterior forearm
Outcropping muscles (EPL, APL, EPB)
78
extensor retinaculum (ER)
- located on posterior wrist - contains all extensor tendons - “continuation” of palmer carpal ligament from the palmer surface of the wrist
79
attachment and innervation of the thenar muscles
attachments- the thenar group emerges from the flexor retinaculum and attaches to the thumb innervation - median nerve
80
attachment and innervation of the hypothenar muscles
attachments - the hypothenar group emerges from the flexor retinaculum and attach to the little finger Innervation - ulnar nerve
81
action and innervation of adductor pollicis (AP)
action - adduct thumb | innervation - ulnar nerve
82
Action and innervation of the lumbricals (L)
action - flex MCP jt and extend PIP/DIP joint innervation: 1 and 2 – median nerve 3 and 4 – ulnar nerve
83
Action and innervation of the palmer interossei (PL)
action “PAD” - adduction digits innervation - ulnar nerve
84
Action and innervation of the palmer interossei (PL)
action “PAD” - adduction digits innervation - ulnar nerve
85
action and innervation of the dorsal interossei
action “DAB” - Abduct digits innervation ulnar nerve
86
action and innervation of the dorsal interossei
action “DAB” - Abduct digits innervation ulnar nerve
87
``` flexor retinaculum (transverse carpal ligament) what does it attach? ```
“roof” of the carpal tunnel attaches “across” carpal bones attaches from scaphoid/trapezium across carpal tunnel to hamate/pisiform
88
median nerve in distal upper extremity | pathway
Descends through carpal tunnel to supply thenar and 1st two lumbricals in the hand
88
median nerve in distal upper extremity | pathway
Descends through carpal tunnel to supply thenar and 1st two lumbricals in the hand
89
motor supply of median nerve for the forearm
pronator teres, PL, FCR | FDS
90
motor supply of median nerve of hand
thenar group and 1st two lumbricals
91
motor supply of AIN branch from median nerve
½ of FDP, FPL, pronator quadratus
92
motor supply of AIN branch from median nerve
½ of FDP, FPL, pronator quadratus
93
sensory supply of median nerve
thenar side of the palmer surface of the hand
94
ulnar nerve in distal upper extremity
Continues on to supply a majority of the intrinsic muscles of the hand
95
motor supply of ulnar nerve | forearm
Flexor carpi ulnaris ½ Flexor digitorum profundus the portion that supplies 4th and 5th digits
96
motor supply of ulnar nerve hand
all intrinsic muscles of hand EXCEPT thenar and first two lumbricals
97
motor supply of ulnar nerve hand
all intrinsic muscles of hand EXCEPT thenar and first two lumbricals
98
sensory supply of ulnar nerve
palmer and dorsal surface of hypothenar area and 5th digit
99
sensory supply of ulnar nerve
palmer and dorsal surface of hypothenar area and 5th digit
100
radial nerve in distal upper extremity
After “passing through” supinator the deep branch is renamed the PIN (posterior interosseous nerve)
101
motor supply of radial nerve and it’s branches in distal extremity
brachioradialis, ECRL, supinator, ECRB, ED, EDM, EI, ECU, EPL, APL, EPB
102
supply of radial nerve in distal extremity
posterior web space of the hand
103
major arteries of the distal UE
``` Brachial artery (B) Radial artery (R) Ulnar artery (U) ```
104
anastomosis of the elbow | deep artery of arm becomes
radial collateral
105
brachial artery becomes the
superior and inferior ulna collateral branches
106
ulna artery becomes the
ulna recurrent artery
107
the radial artery becomes the
radial recurrent artery
108
radial artery (R)
- descends to wrist to form anastomosis with ulna artery | - travels posterior to the thumb to form deep palmer arch
109
ulnar artery (U)
common interosseous artery (CIA) branches off from ulna artery and then gives off two branches (anterior interosseous artery (AIA) and posterior interosseous artery (PIA) ) ulna artery descends to the wrist to form anastomosis with radial artery
109
ulnar artery (U)
common interosseous artery (CIA) branches off from ulna artery and then gives off two branches (anterior interosseous artery (AIA) and posterior interosseous artery (PIA) ) ulna artery descends to the wrist to form anastomosis with radial artery
110
anastomosis of the hand
superficial palmer arch (SPA)
111
deep palmer arch (DPA)
passes posterior to thumb | located on floor of palm
112
deep venous pathway
deep veins “follow” arterial pathways | radial, ulnar, brachial, axillary and subclavian veins
113
superficial venous pathway
Basilic vein (B) Cephalic vein (C) Median antebrachial vein (MAB) Median cubital vein (MC)
114
superficial venous pathway
Basilic vein (B) Cephalic vein (C) Median antebrachial vein (MAB) Median cubital vein (MC)
115
borders and content of the cubital tunnel
borders - Imaginary line between lateral and medial epicondyles - pronator teres - brachioradialis content - median nerve - brachial artery as it divides into radial and ulna arteries
115
borders and content of the cubital tunnel
borders - Imaginary line between lateral and medial epicondyles - pronator teres - brachioradialis content - median nerve - brachial artery as it divides into radial and ulna arteries
116
where is the cubital tunnel located
- medial aspect of posterior elbow - entrance to the tunnel is formed by two heads of flexor carpi ulnaris - Ulnar nerve
117
cubital tunnel syndrome
- ulnar nerve becomes entrapped in cubital tunnel as it descends deep to - the flexor carpi ulnaris - pain and paresthesia on ulnar side of the hand - weakness of muscles in the hand
118
Anatomical Snuff Box (border and content)
borders: EPL, EPB and APL content: radial artery and superficial branch of radial nerve
119
Anatomical Snuff Box (border and content)
borders: EPL, EPB and APL content: radial artery and superficial branch of radial nerve
120
Carpal Tunnel | borders and structures
borders floor: carpal bones roof: flexor retinaculum (FR) structures median nerve tendons of “long finger flexors” FDS, FDP and FPL
121
Carpal Tunnel | borders and structures
borders floor: carpal bones roof: flexor retinaculum (FR) structures median nerve tendons of “long finger flexors” FDS, FDP and FPL
122
carpal tunnel syndrome
median nerve becomes entrapped in the carpal tunnel atrophy & weakness of thenar muscles pain & paresthesia along palmer side of thumb/1st digit
122
carpal tunnel syndrome
median nerve becomes entrapped in the carpal tunnel atrophy & weakness of thenar muscles pain & paresthesia along palmer side of thumb/1st digit
123
Guyon’s Canal | borders and content
borders: pisiform and hook of hamate content: Ulnar nerve
124
Guyon’s Canal | borders and content
borders: pisiform and hook of hamate content: Ulnar nerve
125
Guyon’s canal syndrome
- Ulnar nerve becomes entrapped in Guyon’s canal - muscle weakness of intrinsic hand muscles - test strength adductor pollicis to screen - atrophy of hypothenar, interossei and adductor pollicis (web space) - pain and paresthesia of ulnar side of the hand

Clinical anatomy module 6 (1 decks)

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