MSK Nuggets Flashcards
(167 cards)
1
Q
What are the trunks of the brachial plexus?
A
Superior
Middle
Inferior
2
Q
What are the cords of the brachial plexus?
A
Lateral
Posterior
Medial
3
Q
What important nerve is formed by the lateral cord?
A
Musculocutaneous
Others include:
Lateral pectoral
Lateral root of median nerve
4
Q
What important nerves are formed by the posterior cord?
A
Axillary
Radial
(others include thoracodorsal nerve, upper and lower subscapular nerve
5
Q
What important nerve is formed by the medial cord?
A
Ulnar nerve
Others include: Medial pectoral, median root of median nerve, median curaneous nerve of arm, median cutaneous nerve of forearm
6
Q
What nerve is formed by the combination of the lateral and medial cords?
A
Median nerve
7
Q
At what anotomical landpoint does the axillary artery begin?
A
The lateral border of the first rib
8
Q
When does the axillary artery become the brachial artery?
A
Lower border of teres major
9
Q
What trunk is affected in erbs palsy?
A
Upper trunk
10
Q
What are the features of erbs palsy?
A
Waiter’s tip appearance
Nerves affected = musculocutaneous, radial and axillary
Musculocuteneous = affects biceps, brachialis and coracobrachialis
Brachoradialis (radial nerve)
Deltoid through axillary nerve
11
Q
What is damage to the lower trunk called?
A
Klumpkes palsy
12
Q
What are the features of klumpkes palsy?
A
Muscles affected = intrinsic muscles of the hand and ulnar felxors of the wrist and fingers
Cause of injury = undue abduntion of the arm
13
Q
What are the branches of the brachial artery?
A
Superior ulnar collateral artery
Radial artery (this then gives of the ulnar artery)
Deep brachial
14
Q
Which veins arise from the dorsal venous arch?
A
Basilic cephalic
15
Q
Where does the median cubital vein allow shunting or blood?
A
Allows the shunting of blood from the cephalic vein to the basillic vein
16
Q
What are the 5 groups of axillary lymph nodes?
A
Anterior
Posterior
Apical
Central
Lateral
17
Q
To which group of lymph nodes do the following conditions spread?
A
Infection on the little finger = axillary
Boil in the scapular region = axillary
Medial part of the breast = internal thoracic
Lateral part of the breast = axillary
Infection around the umbilicus = Parasternal lymph nodes drain deep structures of the anterior abdominal wall above the level of the umbilicus. Below the level of umbilicus is supplie by the superficial inguinal nodes.
18
Q
What is the function of the conoid ligament?
A
It binds the clavicle to the coracoid process of the scapula
19
Q
Where is the clavicle most likely to break?
A
The junction between the medial two thirds and the lateral third.
20
Q
Which muscles are responsible for elevation of the scapula?
A
Upper fibres of trapezius
Levator scapulae
Rhomboids
21
Q
What are the muscles responsible for depression of the scapula?
A
Latissimus dorsi
Gravity
22
Q
What muscles are resonsible for protraction of the scapula?
A
Serratus anterior
Pectoralis major
23
Q
Which muscles are responsible for retraction of the scapula?
A
Trapezius (middle fibres)
Rhomboids
24
Q
Which muscles are repsonsible for lateral rotation?
A
Serratus anterior
Upper fibres of trapezius
Lower fibres of trapezius
25
What muscles are responsible for medial rotation: depressing the glenoid cavity
Gravity
Levator scapulae and the rhomboids
26
What is this ligament?
Trapezoid ligament
27
What is this ligament?
Acromioclavicular
28
What is this ligament?
Transverse humeral ligament
29
What is this ligament?
Coracohumeral ligament
30
What is this ligament?
Conoid ligament
31
What is this ligament?
Superior transverse scapular ligament
32
What ligament prevents superior dislocation of the humeral head?
Coracoacromial ligament
33
Which part of the shouler capsule is the weakest?
Inferior portion
34
Which bursa communicates with the joint cavity?
Subscapular
35
Which bursa articulates with the joint cavity
Subscapular
36
What is the role of the subacromial bursa?
Decreases friction and allows free motion of the rotator cuff relative to the coracoacromial arch and deltoid muscle
37
What common sporting injury damages the subacromial bursa?
Throwing
38
What are the actions of the subscapularis?
Internal rotation and extension of the arm
39
What are the actions of the supraspinatous?
Abduction of the arm
40
What are the actions of the infraspinatous?
External rotation of the arm
41
What are the actions of teres minor?
External rotation and adduction of the arm
42
What movements of the glenohumeral joint are generated by the rotator cuff?
Abduction and adduction
Internal and external rotation
Their main function is to maintain joint stability
43
What are the movements of the deltoid?
Anterior fibres = flexion and internal rotation
Middle fibres = abduction
Posterior fibres = extension and external rotation
44
What nerve supplies the deltoid?
Axillary nerve
45
What injury results in trapping and damage of the axillary nerve?
Fracture of the surgical neck of the humerus
46
What are the actions of the pec muscles on the shoulder?
Internal rotation
adduction
47
What is the nerve supply of seratus anterior?
Long thoracic nerve
48
What clinical sign is seen when this nerve is injured?
Winged scapula
49
During what procedure is the long thoracic nerve commonly injured?
Removal of axillary lymph nodes
50
What are the actions the trapezius has on the scapula?
Superior fibres = elevating the sacpula
Middle fibres = retracting the scapula
Inferior fibres = depressing the scapula
51
Which nerve supplies the trapezius muscle?
Accessory nerve (cranial nerve)
52
What are the actions of teres major on the shoulder?
Internal rotation
Extension
Adduction
(These are also the actions of latissimus dorsi on the shoulder joint)
53
What muscles are responsible for flexion of the shoulder?
Anterior deltoid
Upper part of pectoralis major
Coracobrachialis
54
What muscles are responsible for extension of the shoulder?
Posterior deltoid
Latissiums dorsi
Teres major
55
What muscles are responsible for adduction of the shoulder?
Lower part of pec major
Lat dorsi
Teres major
56
Which muscles are responsible for abduction of the shoulder?
Middle part of the deltoid
Supraspinatous
57
What muscles are responsible for medial or itnernal rotation?
Subscapularis
Latissimus dorsi
Teres major
Pectoralis major
58
What are the muscles responsible for lateral or external rotation?
Teres minor and infraspinatous
Posteroir deltoid
59
What muscles attach to the greater tubercule and the lesser tubercule o the humerus?
Greater tubercule = teres minor, infraspinatous, supraspinatous
Lesser tubercule = subscapularis
60
What is the highlighted part of the bone?
Trochlea
61
What is the highlighted part of the bone?
Capitulum
62
What is the highlighted part of the bone?
Coronoid fossa
63
What is the highlighted part of the bone?
Radial fossa
64
What is the highlighted part of the bone?
Olecranon fossa
65
What is the highlighted part of the bone?
Groove for radial nerve
66
What is the highlighted part of the bone?
Lesser tubercule of humerus
67
What is the highlighted part of the bone?
Greater tubercule
68
What is the highlighted part of the bone?
Surgical neck of humerus
69
What is the highlighted part of the bone?
Anotomical neck of humerus
70
What is the origin of the short head of the bicep?
Coracoid process
71
What is the origin of the long head of the bicep?
Supragleoid tubercule
72
Where is the insertion of the biceps tendon?
Radial tuberosity
73
What is the action of the biceps on the radioulnar joint?
Suppination
74
What is the nerve supply to the biceps?
Musculocutaneous nerve
75
Which cervical segments are mainly responsible for innervating the biceps brachii muscle?
C-5,6,7
76
Which cord of the brachial plexus does the musculocuteneous nerve arise from?
Lateral cord
77
What is the origin and insertion of the coracobrachialis?
Origin = coracoid process
Insertion = upper one third of frontal humerus
78
What are the actions of the coracobrachialis?
Flexion, adduction and internal rotation
79
What is the nerve supply of the coracobrachialis?
Musculocutaneous
80
What is the origin and insertion of the brachialis?
Origin = distal half of the shaft of the humerus
Insertion = coronoid process of ulna
81
Which nerve supplies the brachialis muscle?
Musculocutaneous nerve
82
How does the musculocutaneous nerve enter the arm?
Enters the arm by penetrating the coracobrachialis
83
What does the musculocutaneous nerve continue as?
Lateral cutaneous nerve of the forearm
84
Segmental root value for musculocutaneous nerve
c5,c6,c7
85
Which artery gives of the profunda brachii?
Brachial artery
86
How is the median nerve formed?
Formed by two roots
One by the medial cord
One from the lateral cord
87
What does the medial nerve supply?
Medial nerve supplies flexor muscles of the forearm as well as skin of the radial half of the palm and lateral digits
88
What muscles does the median nerve supply?
Superficial layer = pronator teres, flexor carpi radialis and palmaris longus
Intermediate layer = flexor digitorum superficialis
89
Which cord of the brachial plexus does the ulnar neve arise from?
It arises from the medial cord
90
What does the ulnar nerve supply?
Ulnar nerve supplies the flexor carpi ulnaris
Flexor digitorum profundus (medial half)
Supplies the skin of the medial wrist hands and digits
91
Which fracture of the humerus can cause damage to the :
1. radial nerve
2. ulnar nerve
3. axillary nerve
1. radial groove
2. medial epicondyle
3. surgical neck
92
What are the borders of the cubital fossa?
Medial border = lateral border of pronator teres
Lateral border = medial border of brachoradialis
93
What are the insertions of the triceps heads?
Long head of triceps originates at the infraglenoid tubercule
Lateral head of the triceps originates at posterolateral humerus
They insert at the olecranon process of the ulna
94
What is the action of the anconeus muscle?
Extension
95
What is the nerve supply to the anconeus and triceps?
Radial nerve
96
Wihch artery does the radial artery travel with?
Profunda brachii
97
What is the root value of the radial nerve?
C5 - T1
98
What is the characteristic sign of radial nerve damage?
Wrist drop, patient cannot extend elbow
99
What is the ligament
annular ligament
100
What is the ligament?
Radial collateral ligament of elbow joint
101
What is the ligament?
Ulnar colalteral ligament of elbow joint
102
What muscles are involved in supination?
Biceps brachii
Supinator
103
What muscles are responsible for pronation?
Pronator teres
Pronator quadratus
104
What are other muscles that assist during supination?
Extensor pollicis longus and extensor carpi radialis longus
105
What other muscles are also associated with pronation
Flexor carpi radialis
Palmaris longus
Brachioradialis
106
The subacromial bursa is closely related to which muscle?
Supraspinatous
107
What are the muscles of the superficial group of the anterior forearm?
Pronator teres, flexor carpi radialis, palmaris longus and flexor carpi ulnaris
108
What is the origin of the muscles of the anterior compartment of the arm (superficial group)?
Common flexor tendon attaches to the medial epicondyle
109
What is the innnervation of the superficial group of muscles in the anterior compartment?
pronator teres, flexor carpi radialis and palmaris longus are supplied by the median nerve
The flexor carpi ulnaris is supplied by the ulnar nerve
110
What muscle is associated with adduction of the wrist?
flexor carpi ulnaris
111
What muscle is associated with abduction of the wrist?
Flexor carpi radialis
112
What is the action of the brachioradialis?
The brachioradialis is a muscle of the forearm that flexes the forearm at the elbow. It is also capable of both pronation and supination, depending on the position of the forearm.
113
Which nerve innervates the brachioradialis?
The radial nerve
114
What are the insertions of the flexor digitorum superficialis?
They insert on the middle phalanx of the 2nd-5th digits. They cannot act on the distal interphalngeal joint because that is where the flexor digitorum profundus acts
115
What nerve innervates the flexor digitorum superficialis?
Median nerve
116
What is the nerve supply of the flexor digitorum profundus?
Medial half = ulnar nerve
Lateral half = median nerve
117
Which bone is the flexor pollicis longus closely related to?
Radius
118
What is the nerve supply of the flexor pollicis longus?
Median nerve
119
What is the action and neve supply of pronator quadratus?
Pronation, median nerve
120
Which muscles in the anterior forearm are not supplied by the median nerve?
Flexor carpi ulnaris (ulnar nerve)
Medial half of FDP
The brachioradialis is also suppluied by the radial nerve but I think this is in the extensor compartment (even though it is itself a flexor)
121
What structure does the median nerve pass underneath to enter the hand?
It enters the hand by passing underneath the flexor retinaculum
122
The ulnar nerve is .............. to the ulnar artery?
Medial
123
Can you feal the ulnar artery pulse?
No - it ies underneath te flexor carpi ulnaris
124
What are the two terminal branches of the brachial artery?
Ulnar artery
Radial artery
125
Which part of the radius is assocaited with the division of the brachial artery?
Neck of the radius
126
What are the contents of the carpal tunnel?
Median nerve
4 tendons of flexro digitorum profundus
4 tendons of flexor digitorum superficialis
1 tendon of flexor pollicis longus
127
What are the three muscles that make up the thenar eminence?
Abductor pollicis brevis
Flexor pollicis brevis
Opponens pollicis
128
Which nerve innervates the muscles of the thenar eminence?
Median nerve
129
Which segmental levels of the brachial plexus are responsible for innervating the median nerve?
C6 - T1 (contains some fibres from C5 in some individuals)
130
What muscles make up the hypothenar eminence?
Abductor digiti minimi
Flexor digiti minimi
Opponenes digiti minimi
131
Which nerve innervates the hypothenar eminence?
Ulnar nerve
132
What muscles are the adductor pollicis muscles?
Adductor pollicis transverse
Adductor pollicis oblique
133
What nerve supplies the adductor muscles?
Ulnar nerve
134
What is the action of the adductor pollicis muscles?
Adduction of the carpometacarpal joints
Flexion of the metacarophalyngeal joints
135
From which long flexor tendons do these lumbricals originate?
Tendon of flexor digitorum profundus
136
What is the nerve supply of the lumbricals?
Medial two lumbricals are supplied by ulnar nerve
Lateral two are supplied by the median nerve
137
What is the action of the lumbricals?
flex the metacarpophalangeal joints while extending both interphalangeal joints of the 2nd - 5th digit
138
How many interossei are there?
4 dorsal
3 palmar
139
What is the action of the interossei?
DAB
PAD
Dorsal = abduct the fingers
Palmar = adduct the fingers
140
Which nerve supplies the interossei muscles?
The ulnar nerve
141
Lesion of which trunk causes affects the interossei of the hand?
Inferior trunk
142
Which arteries are the main contributors for the palmar arches?
Superficial palmar arch = ulnar artery
Deep palmar arch = radial artery
143
Which muscles of the hand are supplied by the median nerve?
All the muscles in the hand are supplied by the ulnar nerve apart from the thenar muscles and the 1st and 2nd lumbricals which are supplied by the median nerve.
144
Dermatomes of the hand
145
What type of joint is the wrist?
It is described as a synovial condyloid joint or ellipsoid
146
What makes up the proximal part of the wrist joint?
Radius and articualr disk
147
Which carpal bones make up the distal part of the wrist?
Scaphoid, lunate and triquetral
148
What movements are possible at the wrist joint?
Flexion
Extension
Circumduction
Abduction
Adduction
149
What is the action of the extensor carpi radialis longus and brevis on the wrist joint?
150
Which muscles are responsible for extending the wrist as well as adducting/abducting it?
Extensors = Extensor carpi radialis (longus and brevis) - these are also abductors
Extensor carpi ulnaris - this is an extensor as well as an ulnar deviator (adduction)
151
What are the muscles that extend the medial four digits
Extensor digitorum
Extensor indicis
Extensor digiti minimi
152
What structure does the extensor digitorum pass underneath?
The extensor retinaculum
153
What are the muscles that extend or abduct the thumb?
Abductor pollicis longus
Extensor pollicis brevis
Extensor pollicis longus
154
Which nerve innervates all the muscles of the posterior compartment of the forearm
Radial nerve
155
What is the nerve supply of the supinator?
Radial nerve
156
The radial nerve splits into the superficial and deep branches in the cubital fossa. What is the deep branch of the radial nerve called? and what does the superficial branch supply?
Deep branch is called the posterior interosseous nerve. The superficial branch is sensory and is distributed to the dorsum of the hand.
157
Which fracture of the distal radius resembles a dinner fork?
Colles fracture
158
What are the tendons responsible for forming the anotomical snuffbox?
Laterally = tendon abductor pollicis longus and extensor pollicis brevis
Medially = Extensor pollicis longus
159
Which two bones can you feel in the anotomical snuffbox
Scaphoid and trapezium
160
Which artery lies on the floor of the snuffbox?
Radial artery
(Cephalic vein
Radial nerve)
161
162
163
What is the nerve that supplies the APL, EPL, EPB?
Radial nerve
164
What are the main actions of the EPL, EPB and the APL?
Extensor pollicis longus = extension of the caropmetacarpal joint, extension of the metacarpophalyngeal joint extension of the interphalyngeal joint
Extensor pollicis brevis = extension of the caropmetacarpal joint, extension of the metacarpophalyngeal joint
Abductor pollicis longus = abduction of the radiocarpal joint and carpometacarpal joint of the first digit
165
Which two muscles attach to the extensor expansion?
Interossei and lumbricals
166
What is the action of the lumbricals?
Flexion at the MP joint and extension at IP joint
167
