Quiz 1 Flashcards
(68 cards)
1
Q
Overview of Muscle Function
A
- muscles that attach to scapula with other attachment superior to scapula can elevate scapula
- muscles that attach to scapula with other attachment inferior to scapula can depress the scapula
- muscles that attach to the scapula with the other attachment medial to the scapula can retract (adduct) the scapula
- muscles that attach to the scapula with the other attachment lateral to the scapula can protract (abduct) the scapula
- always talking about glenoid in reference to what’s moving of the scapula as a whole i.e. if the glenoid elevates, the scapula is elevating
2
Q
Scapula Features
A
- triangle shaped flat bone
- medial, lateral, and superior borders
- inferior and superior angles
- 4 fossa: glenoid, supraspinous, infraspinous, subscapular
- 2 processes: acromion and coracoid
- suprascapular notch
3
Q
Thoracolumbar Fascia
A
- Dense irregular CT (aponeurosis)
- 3 layers: posterior to spinous processes, middle to transverse processes, anterior to transverse processes
- come together to form lateral raphe
- broad, flat, heavy duty, tendinous structure
- all in one lateral and as they come medially they split into layers
- one of his favorite
4
Q
Muscles Attach to TL Fascia
A
- latissimus dorsi
- internal oblique
- transverse abdominis
- all part of core
- important to know what muscles come off of here–>tighten these, tighten the TL fascia–>more support
5
Q
Glenohumeral Joint
A
- most flexible joint in the body
- 180 degrees of motion
- no scapula–>120 degrees
- no GH joint–>60 degrees
6
Q
Capsular Ligaments
A
- at bottom of GH joint
- allow extra space for when humeral head needs to move inferiorly like when the arm is raised completely
7
Q
Relative Distances of Muscles to Joints
A
- if really close to the joint it’s a good stabilizer
- if it’s really far it’s a good mover
8
Q
Subacromial Space
A
- there is a bursa in there and the tendons from the rotator cuff pass through
- tendons can get impinged in here and cause pain
9
Q
Glenoid Labrum
A
- made of fibrocartilage
- makes glenoid slightly deeper
10
Q
Innervated vs. Not Innervated Cartilage
A
- articular cartilage is not innervated
- muscles of disc and inner annular rings are not innervated but outer rings are
- fibrocartilage is, not very much, but it is innervated
11
Q
Breast/Mammary Glands
A
- Cooper’s ligaments-suspensory ligament of breast that hold up breast; come off clavicle and pectoral region and go all the way into the breast; attach to the skin, stretch over time
- gland lobules for milk production
- surrounded by fatty tissue
- nipple
- areola-pigmented area around nipple, which can vary from person to person
- lactiferous sinus: widened opening of ducts
- lactiferous ducts: tube from lobules to nipple
12
Q
Male Differences in the Breast
A
- have breast tissue that cannot produce milk directly behind nipple (can produce under very specific circumstances)
- small ducts
- do not develop lobules for milk production
- testosterone suppresses development
- can develop breast cancer (1%)
13
Q
Which muscles attach to coracoid process? Which ligaments?
A
- coracobrachialis
- short head of biceps
- pectoralis minor
- coracoacromial ligament: roof over GH joint
- coracoclavicular ligaments: conoid ligament and trapezoid ligament
14
Q
Sternoclavicular Joint
A
- proximal clavicle with manubrium
- divided by articular disc (very small, fibrocartilage, shock absorber)
- anterior and posterior sternoclavicular ligaments; anterior taut with retraction and posterior taut with protraction
- interclavicular ligament: clavicle, manubrium, clavicle; becomes taut with depression
- costoclavicular ligament: inferior medial clavicle to first rib; taut with elevation
- elevation/depression, protraction/retraction
- taut=primary restriction
- ligaments that go to and from same bone do not restrict movement but instead provide support or stability
15
Q
Apex of Axilla
A
- cervico-axillary Canal-passageway to neck
- first rib
- clavicle
- superior scapula
16
Q
Base of Axilla
A
- concave skin and fascia
- arm to thoracic wall to about 4th rib
- bounded by anterior and posterior axillary folds
17
Q
Borders of Axilla
A
- anterior: pectoralis major and pectoralis minor
- posterior: scapula, subscapularis, serratus anterior, teres major and latissimus dorsi
- medial wall: serratus anterior, ribs
- lateral wall: humerus, long head of triceps, coracobrachialis
18
Q
Contents of Axilla
A
- brachial plexus at cord level and nerve branches
- axillary artery
- axillary vein
- lymph nodes
- arteries and nerves are within a sheet of CT surrounding them (veins can sometimes be inside or outside) which helps with movement-lubricated sheet keeps them protected and allows sliding movements
19
Q
Cords and Nerves off Cords
A
- lateral cord: lateral pectoral nerve
- posterior cord: upper subscapular nerve, thoracodorsal nerve, lower subscapular nerve
- medial cord: medial pectoral nerve, medial cutaneous nerve of arm, medial cutaneous nerve of forearm
20
Q
Axillary Artery Branches
A
- begins at lateral border of first rib
- continuation of subclavian artery (becomes axillary when in armpit)
- passes posterior to pectoralis minor
- becomes brachial artery after inferior border of teres major
- divided into three parts
21
Q
Parts of Axillary Artery: Part 1
A
- lateral border of first rib and medial pectoralis minor
- has one major branch: superior thoracic artery-1st and 2nd intercostal spaces and serratus anterior
22
Q
Parts of Axillary Artery: Part 2
A
- posterior to pectoralis minor
- has 2 major branches
- thoracoacromial artery: pectoral, deltoid, acromial, clavicular branches
- lateral thoracic artery: lateral to pectoralis minor to breast (main blood supply to breast)
23
Q
Parts of Axillary Artery: Part 3
A
- lateral border of pectoralis minor to inferior border of teres major
- 3 major branches
- subscapular artery: into circumflex scapula and thoracodorsal
- anterior circumflex humeral artery
- posterior circumflex humeral artery: anastomosis with each other around surgical neck
- proximal humeral fracture disturbs this blood supply so humeral head dies and needs to be replaced
24
Q
Axillary Arteries
A
-run near surgical neck not anatomical neck
25
Axillary Vein
- extremely variable branches
- brachial vein: deep with brachial artery
- basilic vein: superficial from forearm and hand
- axillary vein becomes subclavian vein
- cephalic vein: superficial from lateral forearm and lateral arm and hand and runs between deltoid and pectoralis major into subclavian vein
- superficial veins drain into main venous system eventually
26
Axillary Lymph Nodes
- many in this area and are grouped
| - then go to subclavian lymphatic trunk-->lymphatic duct-->subclavian veins
27
Shoulder Joint Complex
- for every 3 degrees of movement 2 degrees come from the GH and 1 from thorax (120 from GH and 60 from scapula moving on thorax)
- GH joint
- acromioclavicular joint
- sternoclavicular joint
- scapulothoracic joint (not a true synovial joint)
28
Glenohumeral Joint
- glenoid fossa of scapula with humeral head
- joint capsule (always made of fibrous tissue and makes synovial fluid and surrounded by sheath)
- key ligaments: superior glenohumeral, middle glenohumeral, inferior glenohumeral (fingers on shoulder in three; all 3 interconnected and really just a thickening of the capsule), coracohumeral
29
Superior Glenohumeral Ligament
- stabilizes when doing nothing; tension/taut when at side
- stroke patients: weight of arm can dislocate shoulder because there is too much stress on this ligament as well as coracohumeral ligament
30
Middle Glenohumeral Ligament
- especially most important and most likely to be injured
| - provides anterior stability
31
Inferior Glenohumeral Ligament
-stops humeral head from sliding down too far
32
Coracohumeral Ligament
- base of coracoid right over top to anterior greater tubercle
- taut when arm hanging at side
33
Transverse Humeral Ligament
- holds long head of biceps and tendon in place
- doesn't limit joint movement but excessive tendon movement
- from greater tubercle to lesser tubercle
34
Glenoid Fossa
- shallow: deepened by glenoid labrum: fibrocartilage attached at periphery of glenoid
- joint capsule into rim of glenoid, labrum and anatomical neck of humerus
- long head of biceps into supraglenoid fossa and labrum into bone of fossa and labrum
- long head of triceps into infraglenoid fossa
- ligament=passive stabilizer
- tendon=dynamic stabilizer
35
Proximal Humerus
- head: spherical shape, articulates with glenoid fossa
- anatomical neck: just below head, attachment of GH joint capsule
- surgical neck: narrowing distal to head and tubercles, common site of fractures
- greater tubercle: lateral has 3 facets, attachment of supraspinatus on superior facet, infraspinatus on middle facet and teres minor on inferior facet
- lesser tubercle: medial, attachment of subscapularis
- crest of greater tubercle: attachment of pectoralis major
- crest of lesser tubercle attachment of teres minor
- intertubercular groove: attachment of latissimus dorsi, long head of biceps slides through, held down by transverse humeral ligament
- groove indicates anterior surface of humerus
36
Subdeltoid Bursa (Subacromial)
-between supraspinatus and acromion process
37
Acromioclavicular Joint
- distal clavicle with acromion process
- very stable joint with small amount of motion in 3 directions
- wedge shaped articular disc
- acromioclavicular ligament-superior, inferior
- coracoclavicular ligaments-conoid and trapezoid
38
Sternoclavicular Joint
- proximal clavicle with manubrium
- divided by articular disc
- anterior and posterior sternoclavicular ligaments
- interclavicular ligament-clavicle, manubrium, clavicle
- costoclavicular ligament-inferior medial clavicle to first rib
- elevation/depression, protraction/retraction
39
Scapulothoracic Joint
- not true joint
- scapula sliding on thorax
- muscles in between: subscapularis and serratus anterior (helps hold scapula against rib cage)
- protraction/retraction, elevation/depression, upward rotation/downward rotation (putting arm over head=upward rotation; getting up out of chair and pushing on arms of char=downward rotation)
- scapula winging and tipping: happens when scapula gets weak; medial border sticks out posteriorly-->weakness in serratus may happen because of damage to long thoracic nerve (has no sensory pattern)
40
Types of Tissues
- connective
- epithelial
- muscle
- nervous
41
Connective Tissue
- supports, connects, or separates
- cells: fibroblasts
- fiber: collagen, elastin
- extracellular matrix: fluid-ground substance containing GAGS and proteoglycans; GAGS are hydrophilic molecules, draw in water-->less gas, less mobile, less flexible, have fewer in old people
42
Types of Collagen
- 28 different
- type 1: most abundant, tensile forces, tendon, ligaments, skin, vascular bone
- type 2: tensile and compressive forces, high in GAGS, articular cartilage, fibrocartilage
- type 3: more extensible, skin, lung vascular tissue, granulation tissue, high in elastin
43
Epithelial Tissue
- lines cavities and surfaces through body
- forms glands: endocrine and exocrine
- secretion
- absorption
- some vascular, some avascular
44
Integumentary System
- protection
- containment
- prevent dehydration
- heat regulation
- sensation
- synthesis and storage of vitamin D
- epidermis: keratinized epithelium, avascular, outer layer, nutrition from dermis below, some sensory nerve endings
- dermis: dense layer of collagen and elastic fibers; contains hair follicles, smooth erector muscles, sebaceous glands, sweat glands, small capillaries, sensory nerve endings
- subcutaneous tissue: loose connective tissue, fat, sweat glands, blood vessels, lymphatic vessels, cutaneous nerves
- fat distribution varies greatly according to individual, location and gender
- skin ligaments-from deep fascia to dermis
45
Fascia
- connective tissue wrapping of structures of the body
- superficial and deep
- superficial=loose
- deep=dense and organized
- forms compartments around organs or muscles, groups of muscles (intermuscular septa)
46
Bursa
- closed sacs or envelopes with potential space that are usually flat
- inner lining has synovial membrane that produces synovial fluid
- found in areas of friction to help tissue glide
- synovial sheaths around tendons
- sac surrounding internal organs such as heart or lungs
47
Cartilage
- fibrocartilage-annulus fibrosis, symphysis pubis (type 1 and 2 collagen)
- articular cartilage (hyaline cartilage) semi rigid, shock absorbing, ends of bone, found in synovial joints, avascular, aneural (type 2 collagen)
48
Articular Cartilage
- chondrocytes: development, maintenance and repair
- four zones: superficial (diminshes shear), middle (compressive forces), deep (compressive forces), calcified (anchored to bone)
49
Bone
- periosteum: outer most layer, highly vascular and neural supply, attachment for ligaments and tendons (sharpey's fibers)
- compact bone: strength for weigh bearing
- spongy bone: softer bone
- medullary cavity: marrow
- types: long, short, flat, irregular, sesamoid
50
Bone Development
- intramembranous: direct ossification of mesenchyme in embryonic development
- endocondral: cartilage model of bone initially forms from mesenchyme and is replaced over time by bone
- primary ossification center: diaphysis (shaft of long bone)
- secondary ossification center: epiphysis (rounded end of long bone), metaphysis (wider portion near epiphyseal plate, site of growth in childhood), epiphyseal plate (hyaline cartilage plate in metaphyseal)
- epiphyseal line: remnant of plate in adult
51
Vascular and Nerve Supply of Bone
- nutrient arteries via nutrient foramina
- haversian system: canal system for blood supply
- periosteal nerves: outer layer of bone most innervated
52
Synovial Joints
- joint capsule, blood supply, nerve innervation, synovial membrane, joint cavity, synovial fluid, articular cartilage
- may also have capsular ligaments, fibrocartilage, plica
53
Fibrous Joints (Synarthrosis)
- bones united directly by fibrous tissue
- 3 types
- sutures
- syndesmosis (between long bones)
- gomphosis (teeth and maxilla or mandible)
54
Skeletal Muscle
- origin: proximal attachment
- insertion: distal attachment
- innervation: peripheral nerve
- action: when muscle contracts concentrically what muscle action occurs?
- contractile portion and non contractile portion
- types: flat, pennate (shaped like feather), fusiform (wider and cylindrically shaped in center and taper off at end), convergent (ex: pec major), quadrate, circular or sphincteral, multiheaded or multi-bellied
- noncontractile made of dense CT
- epimysium surrounds whole muscle
- perimysium surrounds bundles of muscle
- endomysium surrounds muscle fibers
55
Tendons and Ligaments
- dense regular CT: all fibers in one direction
- dense irregular CT: fibers in multiple directions
- tendon: muscle to bone; round, flat, aponeurosis
- ligaments: bone to bone; round, flat, aponeurosis
56
CNS
- brain and spinal cord
- membrane layers of CT (meninges)
- dura mater: dense, outermost layer, contains CSF
- arachnoid mater: intermediate layer, thicker, CSF flows through
- pia mater: delicate layer of CT closest to brain and spinal cord, contains CSF
57
Peripheral NS CT
- epineurium: outermost layer, tube of dense irregular CT surrounding nerve
- perineurium: surrounds fascicles of nerves
- endoneurium: innermost layer, tube of delicate CT surrounds myelin sheath and axon
58
Somatic NS
- parts of CNS and PNS providing sensory and motor innervation to all parts of the body
- sensory: touch, pain, temp, position
- muscle: to all skeletal muscle
59
ANS
- afferent and efferent to smooth muscle, cardiac muscle, regulate visceral function
- visceral pain
- sympathetic: thoracolumbar region, regulate blood flow
- parasympathetic: craniosacral region, head, internal organs, sexual function
60
Afferent and Efferent Nerves
- skin-->afferent nerve-->spinal cord-->efferent nerve-->muscle
- afferent: carry impulses to CNS; sensory nerve impulses to CNS from peripheral organs or sensors
- efferent nerves: carry impulses away from CNS; motor nerves, impulses from CNS to muscles or organs
- mixed nerves: contain both afferent and efferent components
61
Nerves
- cranial from cranium out (12)
- spinal nerves: from spinal cord through vertebral column, exit intervertebral foramen
- anterior or ventral root: efferent fibers
- posterior or dorsal root: afferent fibers
62
Dermatomes
-skin innervated by same nerve root
63
Myotome
- muscles innervated by same nerve root
| - must know when one nerve root is involved
64
Peripheral Nerves
- innervate a muscle or group of muscles
| - must know when one peripheral nerve is involved
65
Layers of Blood Vessels
- tunica externa: outermost layer, anchors blood vessels to organs or surrounding tissues
- tunica media: middle layer, contains smooth muscle and elastic fibers
- tunica intima: innermost layer of artery or vein
66
Arteries
- large arteries: smooth muscle and elastic fibers
- medium muscular
- small arteries to arterioles to capillaries
- anastomoses: communication of arteries
67
Veins
- large veins: contain smooth muscle
- medium veins: venous valves, especially in lower extremities
- venules: drain capillaries
68
Lymphoid System
- lymphatic plexuses: network of lymphatic capillaries, absorb interstitial fluid
- lymphatic vessels: carry lymph to lymph nodes or veins
- lymph: similar to blood plasma, contains WBC
- lymph nodes: oval shaped organs of immune system, acts as filter, contain WBC
