Study Guide Flashcards
1
Q
common palmar digital arteries
A
parent: superficial palmer arch
2
Q
pronation
A
C7, C8
3
Q
Lower plexus injury (klumpke’s palsy)
A
- arm forcibly abducted and pulled
- stretches lower trunk and or c8/t1 spinal nerves
- symptoms: paralysis of intrinsic hand muscles (complete claw hand); sensory loss over the medial arm, forearm, and hand
- median nerve is effected
4
Q
Anterior humeral circumflex
A
parent: axillary artery
5
Q
C5, C6, C7, C8, T1
A
radial, median, and lateral + medial pectoral
6
Q
flexor carpi radialis
A
attachments:
- Medial epicondyle of humerus
- Base of 2nd and 3rd metacarpals
innervation:
- median nerve
Action:
Flexion and abduction of hand
7
Q
The general scheme then is that the shoulder muscles are C5 and C6 (except the pectoralis major brings in C7 and latissimus dorsi brings in C7 and C8). The flexor arm is C5 and C6 while extensor arm is C7 and C8. As we get into the forearm, C5 goes away and C8 is added. Finally, the intrinsic hand muscles are all C8 and T1 (mostly T1).
A
The general scheme then is that the shoulder muscles are C5 and C6 (except the pectoralis major brings in C7 and latissimus dorsi brings in C7 and C8). The flexor arm is C5 and C6 while extensor arm is C7 and C8. As we get into the forearm, C5 goes away and C8 is added. Finally, the intrinsic hand muscles are all C8 and T1 (mostly T1).
8
Q
gluteal region nerves
A
gluteal region nerves
9
Q
Metacarpals and phalanges
A
- Metacarpals form the palm
- Phalanges: proximal (to metacarpals), middle, and distal
10
Q
median
A
origin: medial and lateral cords
spinal segments: c5 to c7 via lateral cord; c8, t1 via medial cord
motor: all muscles in the anterior compartment of the forearm (except flexor carpi ulnaris and medial half of flexor digitorum profundus), three thenar muscles of the thumb and two lateral lumbrical muscles
cutaneous: palmer surface of the lateral three and one-half digits and over the lateral side of the palm and middle of the wrist
11
Q
flexor digitorum profundus
A
attachments:
- Ulna and interosseous membrane
- Four tendons → distal phalanges of digits 2-5
innervation:
- Lateral half – median nerve (anterior interosseous)
- Medial half – ulnar nerve
Action: Flexion of MP and distal IP joints, wrist
12
Q
radial nerve innervations
A
BEST:
Brachioradialis
Extensors
Supinator
Triceps
13
Q
wrist extension
A
C6
14
Q
Extensor carpi radialis brevis
A
attachments:
- Lateral epicondyle of humerus
- Base of 2nd and 3rd metacarpals
innervation:
-Radial nerve
action:
Extension and abduction of hand
15
Q
pectoralis minor
A
attachments:
- Ribs and costal cartilages 3-5
- Coracoid process of scapula
innervation:
- Medial and lateral pectoral nerves
Action:
-Depression and protraction of the scapula
16
Q
semimembranosus
A
attachments:
- Ischial tuberosity
- Medial tibia
innervation:
- Tibial division of the sciatic nerve
action:
-Flexion of the leg and extension of the thigh
17
Q
cephalic vein
A
- superficial
- radial side
- pathway up through forearm/arm
18
Q
radioulnar joint injury
A
- common in children
- head of radius can slip through
19
Q
Extensor digiti minimi
A
attachments:
- Lateral epicondyle of humerus
- Extensor hood of the digit 5
innervation:
-Radial nerve
action:
Extension of the little finger
20
Q
Upper plexus injury (erb’s palsy)
A
- Forcibly increased angle between neck and shoulder
- common injury during delivery
- stretches upper trunk and/or C5/C6 spinal nerves
- symptoms: adducted and medially rotated arm; extended elbow, flexed wrist, sensory loss on lateral arm, forearm and hand (waiter’s tip posture going backwards)
21
Q
pectoral nerves
A
“Lateral is less, medial is more”
Lateral pectoral nerve goes through pectoralis major, while medial pectoral nerve goes though both pectoralis major and minor.
22
Q
Carpals
A
Straight Line To Pinky, Here Comes The Thumb -proximal to wrist scaphoid lunate triquetrum pisiform -distal to wrist hamate capitate trapezoid trapezium
23
Q
Superficial palmer arch
A
parent: ulnar artery
24
Q
dorsal venous arch of the hand
A
- superficial
- runs across one side of the hand to the other
25
brachialis
attachments:
- Anterior humerus
- Coronoid process of ulna
innervation:
-Musculocutaneous nerve
Action:
-Flexion of forearm
26
Supraclavicular branches
Supraclavicular branches
27
Extensor pollicis brevis
attachments:
- Radius and interosseous membrane
- Proximal phalanx of the thumb
innervation:
-Radial nerve
action:
Extension of the thumb
28
Intrinsic muscles of the hand
Intrinsic muscles of the hand
29
Unicorn
ulnar: c8, t1
30
lateral thoracic
parent: axillary artery
31
Abductor digiti minimi
attachments:
- Pisiform
- Proximal phalanx of digit 5
innervation:
-Deep branch of ulnar nerve
action: Abducts digit 5
32
Lateral Cord Branches mnemonic
LLM "Lucy Loves Me" - the lateral pectoral, lateral root of the median nerve, musculocutaneous
33
quadratus femoris
attachments:
- Ischial tuberosity
- Greater trochanter of the femur
innervation:
- Nerve to quadratus femoris
action:
-Lateral rotation of the thigh
34
rhomboid major
attachments:
- T2-T5 vertebrae
- Medial border of scapula
innervation:
- Dorsal scapular nerve
Action:
-Elevation and retraction the scapula
35
which branches of brachial plexus are purely muscular?
answer
36
medial cutaneous of arm
origin:
spinal segments: t1
cutaneous: medical side of distal one-third of arm
37
synovial sheaths
- minimizes friction where long tendons contact other structures (think carpal tunnel)
- Ulnar bursa: ulnar/medial portion of metacarpals down to digit V; follows FDS and FDP as the crowd the wrist
- radial bursa: radial portion; follows flexor policies longus
- separate finger sheaths for phalanges for digits II-IV
38
Colle's fracture
- a break of the distal radius
- fall on outreached hand
- dinner folk deformity, hand cups upward
39
Muscles inserting into humerus
“A lady between two majors”
Pectoralis major attaches to lateral lip of bicipital groove, the teres major attaches to medial lip of bicipital groove, and the latissimus dorsi attaches to the floor of bicipital groove. The “lati” is between two “majors”
40
Spinal level of Radial
C5, C6, C7, C8, T1
41
Rotator cuff muscles
Rotator cuff muscles
42
lacteral pectoral
origin:
spinal segments: c5 to c7
motor: pectoralis major, pectoralis minor
43
palmaris longus
attachments:
- Medial epicondyle of humerus
- Palmar aponeurosis of hand
innervation:
-median nerve
Action:
- Flexion of hand
- Tenses palmar aponeurosis when gripping
44
inability to turn right palm upward against resistance (supination); limited ability to flex his elbow. which nerve is most likely injured?
- musculocutaneous nerve: innervates biceps which flex elbow and does supination
- in pronation, radial bone flips over
45
branches of brachial plexus
Branches of brachial plexus
46
acromioclavicular ligament
- between the distal end of clavicle and acromion processes of the scapula
- strengthens the acromioclaviscular joint superiorly
- dislocation = shoulder separation
47
Median Nerve
- Muscular and cutaneous components
- goes through carpal tunnel
- Palmer branch: branches off before carpal tunnel so should not be affected by any carpal tunnel injuries
- Common digital branches go from thumb to the radial side of the ring finger
- recurrent branch serves the thenar muscles
48
Coracoclavicular ligament
- trapezoid ligament and conoid ligament
- anchors the clavicle to the coracoid process
- tear of ligament = separation of coracoid and clavicle
49
medial antebrachial cutaneous nerve
medial forearm from elbow to wrist
50
gluteus medius
attachments:
- Ilium
- Greater trochanter
innervation:
-Superior gluteal nerve
action:
- Abduction and medial rotation of the thigh
- prevents pelvic drop when leg is raised
51
Thoracodorsal
parent: subscapular
52
teres minor
attachments:
- Lateral border of the scapula
- Greater tubercle of the humerus
innervation:
-Axillary nerve
Action:
-Lateral rotation of arm
53
gluteus maximus
attachments:
- IIium, sacrum and sacrotuberous ligament
- Iliotibial tract of fascia lata and gluteal tuberosity
innervation:
-Inferior gluteal nerve
action:
-Extension and lateral rotation of the thigh
54
shoulder extension
C6, C7, C8
55
shoulder flexion
C5
56
motor and sensory deficits consistent with an axillary nerve injury; which motor defects will be most evident?
- axillary nerve innervates the teres minor (lateral rotation) and deltoid muscle (abduction)
- leads to diminished abduction and lateral rotation of the arm
57
levator scapulae
attachments:
- C1-C4 vertebrae
- Superior angle of the scapula
innervation:
- Dorsal scapular nerve
Action:
-Elevation of the scapula
58
posterior interosseous
parent: common interosseous
59
Infraspinatus
attachments:
- Infraspinous fossa of the scapula
- Greater tubercle of the humerus
innervation:
- Suprascapular nerve
Action:
-Lateral rotation of arm
60
Extensor carpi ulnaris
attachments:
- Lateral epicondyle of humerus and ulna
- Base of 5th metacarpal
innervation:
-Radial nerve
action:
Extension and adduction of wrist
61
shoulder abduction
C5
62
Spinal level of Long thoracic
C5, C6, C7
63
supraspinatus
attachments:
- Supra-spinous fossa of the scapula
- Greater tubercle of the humerus
innervation:
-Suprascapular nerve
Action:
-Initiation of abduction of arm to 15°
64
coracobrachialis
attachments:
- Coracoid process
- Mid-shaft of humerus
innervation:
-Musculocutaneous nerve
Action:
-Flexion of arm
65
radial nerve
- from posterior cord
- C5-T1
- serves the posterior (extensor) compartment of the arm and forearm
- runs along radial groove of humerus
- supplies triceps, anconeus, brachioradialis, extensor carpi radialis longus, extensor carpi radialis brevis, extensor carpi ulnaris, extensor digitorum, extensor digiti minimi, extensor indicts, abductor pollicis longus, extensor pollicis longus, extensor pollicis brevis, and supinator
- superficial branch is cutaneous only
- deep branch = posterior interosseous nerve is muscular only
- extensive cutaneous field in the posterior arm, forearm, and hand
66
Shoulder joint
Shoulder joint:
67
nerve fields and injuries
-deficits that overlap several dermatomes then the problem is probably ij the lower plexus or in a particular nerve branch
68
medial brachial nerve
medial upper/axillary arm
69
common interosseous
parent: ulnar artery
70
long thoracic
origin: c5 to c7 central rami
spinal segments: c5 to c7
motor: serrates anterior
71
Transverse scapular ligament
```
Army over (bridge)
Navy under (bridge)
```
Artery goes over and Nerve goes under the ligament
72
branches from the medial cord
branches from the medial cord
73
Medial Cord Branches mnemonic
MMMUM "Most Medical Men Use Morphine" - medial pectoral, medial cutaneous nerve of arm, medial cutaneous nerve of forearm, ulnar, the medial root of the median nerve
74
Arm muscles
Arm muscles
75
Lonely Three Musketeers
long thoracic: c5, c6, c7
musculocutaneous: c5, c6, c7
76
Other shoulder muscles:
Other shoulder muscles:
77
latissimus dorsi (thoracolumbar fascia
attachments:
- Thoracolumbar fascia to lower thoracic vertebra and iliac crest
- Intertubercular sulcus of the humerus
innervation:
-Thoracodorsal nerve
Action:
-Adduction, medial rotation, and extension of the arm
78
finger abduction/adduction
T1
79
Brachioradialis
attachments:
- Supracondylar ridge of humerus
- Distal radius
innervation:
-Radial nerve
action: Flexion of forearm when forearm is mid-pronated
80
baby hand is pulled while existing the womb; nerve deficient does not improve w/age. Describe muscle findings:
- elevation of scapula: normal
- abduction of arm: normal
- flexion of the forearm: normal
the above three are innervated by muscular cutaneous nerve
- opposition of thumb= decreased
- abduction of fingers= decreased
81
musculocutaneous nerve
- from lateral cord
- C5, C6, and C7
- serves the flexor compartment of the arm
- supplies: biceps brachii, coracobrachialis, and brachialis
- ends as the cutaneous nerve of the forearm
82
Abductor pollicis longus
attachments:
- Ulna, radius and interosseous membrane
- Base of 1st metacarpal
innervation:
-Radial nerve
action:
Abduction and extension of the thumb
83
deltoid
attachments:
- Spine and acromion of the scapula; lateral clavicle
- Deltoid tuberosity of humerus
innervation:
- Axillary nerve
Action:
- Abduction of arm (from 15° to 90°)
- Flexion of arm (anterior fibers)
- Extension of arm (posterior fibers)
84
thoracodorsal
origin:
spinal segments: c6 to c8
motor: latissimus dorsi
85
Abductor pollicis brevis
attachments:
- Carpals and flexor retinaculum
- Proximal phalanx and extensor hood of thumb
innervation:
-Recurrent branch of median nerve
action: Abduction of thumb
86
anular ligament
- attached to the radial notch of the ulna
| - loops around the head and neck of the radius
87
rotator cuff injury; prevents pitching in baseball; rotator cuff surgery; which plexus structures must be anesthetized in this procedure?
-c5 and c6 ventral rami/ lower trunk
88
thoracoacromial
parent: axillary artery
89
axillary artery branches
“Save The Lions And Protect Species”
```
Supreme/Superior Thoracic Artery
Thoracoacromial Artery
Lateral Thoracic
Anterior Circumflex Humeral
Posterior Circumflex Humeral
Subscapular (Thoracodorsal and Circumflex scapular)
```
90
protraction of scapula/ winged scapula. What muscle holds scapula against body?
serrates anterior and long thoracic nerve
91
Extensor digitorum
attachments:
- Lateral epicondyle of humerus
- Four tendons → extensor hoods of digits 2-5
innervation:
-Radial nerve
action:
Extension of the fingers and wrist
92
axillary
origin:
spinal segments: c5, c6
motor: deltoid, teres major
cutaneous: upper lateral part of arm
93
Extensor pollicis longus
attachments:
- Ulna and interosseous membrane
- Distal phalanx of thumb
innervation:
-Radial nerve
action:
Extension of the thumb
94
trapezius
attachments:
- Posterior skull; C7 to T12 vertebrae
- Spine and acromion of the scapula; lateral clavicle
innervation:
- Motor - accessory nerve (CN XI)
- Proprioception - ventral rami of C3 and C4
Action:
- Elevation (upper fibers), depression (lower fibers) and retraction (middle fibers) of the scapula.
- Lateral rotation of the scapula (points glenoid cavity up)
95
elbow joint
elbow joint
96
flexor pollicis longus
attachments:
- Radius and interosseous membrane
- Distal phalanx of thumb
innervation:
-median nerve
Action: Flexes MP and IP joint of the thumb
97
Cannot flex the 4th and 5th digits of left hand. Which nerve is most likely damaged?
Ulnar
98
inferior gemellus
attachments:
- Ischial tuberosity
- Greater trochanter of the femur
innervation:
- Nerve to quadratus femoris
action:
-Abduction and lateral rotation of the thigh
99
supination
C6
100
Nerves of the hand
Nerves of the hand
101
rotator cuff injury; prevents pitching in baseball; which muscles are involved in this injury?
SITS
| -infraspinatus, supraspinatus, teres minor, and subscapularis
102
thumb opposition
C8, T1
103
arteries of gluteal region
arteries of gluteal region
104
pronator teres
attachments:
- Medial epicondyle of humerus and ulna
- Mid-shaft of radius
innervation:
-Median nerve
Action:
-pronation of forearm
105
Adductor pollicis
attachments:
- Metacarpals and capitate
- Proximal phalanx and extensor hood of thumb
innervation:
-Deep branch of ulnar nerve
action: Adduction of thumb
106
tingling and numbness over thumb, index, and middle finger. Occasional pain over her wrist. Pain when making.a fist, but grip muscle strength is normal.
treatment w/ corticosteroid into her carpal tunnel. The goal is to reduce the inflammation of the synovial sheaths surrounding which tendons?
- flexor digitorum tendons
- flexor digitorum profundus
- flexor pollicis longus
107
posterior humeral circumflex in the quadrangular space
parent: axillary artery
108
obturator internus
attachments:
- Obturator membrane and surrounding bone
- Greater trochanter of the femur
innervation:
- Nerve to obturator internus
action:
-Abduction and lateral rotation of the thigh
109
finger flexion
C8
110
Nerve to cubclavius
origin: superior trunk
spinal segments: c5, c6
motor: subclavius
111
baby hand is pulled while exiting the womb; which brachial plexus is most likely injured?
lower plexus inferior trunk of brachial plexus; median nerve affected
112
posterior humeral circumflex
parent: axillary artery
113
pronator quadratus
attachments:
- Distal anterior ulna
- Distal anterior radius
innervation:
-median nerve
Action: pronation of the forearm
114
Ulnar Nerve
- Muscular and cutaneous components
- deep part supplies hypthenar muscles
- superficial part gives rise to branches that go to the little finger and ulnar side of ring finger
- innervates all interossei muscles in hand, adductor pollicis, and lumbricals 3 & 4
115
Palmar interossei (three muscles)
attachments:
- Metacarpals
- Extensor hoods of digits 2,3 and 5
innervation:
-Deep branch of ulnar nerve
action: Adduction of digits 2,3 and 5
116
upper (superior) subscapular
spinal segments: c5, c6
motor: subscapularis
117
radial
origin:
spinal segments: c5 to t1
motor: all muscles in the posterior compartments
cutaneous: posterior aspects of the arm and forearm, the lower lateral surface of the arm, and the dorsal lateral surface of the hand
118
Posterior Cord Branches mnemonic
- STAR - subscapular (upper and lower), thoracodorsal, axillary, radial
- ULTRA - upper subscapular, lower subscapular, thoracodorsal, radial, axillary
119
basilic vein
- superficial
- ulnar side
- pathway up through forearm/arm
120
Posterior thigh
Posterior thigh
121
weakness of left hand and wrist; left hand and fingers are noticeably flexed; low thumb abduction, wrist extension, and supination. What nerve is affected?
radial nerve affected
122
gluteus minimus
attachments:
- Ilium
- Greater trochanter
innervation:
-Superior gluteal nerve
action:
- Abduction and medial rotation of the thigh
- prevents pelvic drop when leg is raised
123
Erector spine:
extends the vertebral column during bilateral contraction and laterally flexes it during unilateral contraction. These muscles do not rotate the vertebral column.
124
wrist flexion
C7
125
Flexor pollicis brevis
attachments:
- Trapezium and flexor retinaculum
- Proximal phalanx of the thumb
innervation:
-Recurrent branch of median nerve
action: Flexion of thumb at MP joint
126
Palmaris brevis
attachments:
- Palmar aponeurosis and flexor retinaculum
- Skin on the medial hand
innervation:
- Superficial ulnar nerve
action: Improves grip
127
Supinator
attachments:
- Lateral epicondyle of humerus and ulna
- Lateral radius
innervation:
-Radial nerve
action:
Supination of forearm
128
carpal tunnel
contains:
- flexor digitorum superficialis tendons (4x)
- flexor digitorum superficialis tendons (4x)
- flexor pollicis longus tendon
- median nerve
129
Branches from the lateral cord
branches from the lateral cord
130
Suprascapular
origin: superior trunk
spinal segments: C5, C6
motor: supraspinatus, infraspinatus
131
Branches from the posterior cord
Branches from the posterior cord
132
Opponens digiti minimi
attachments:
- Hamate and flexor retinaculum
- 5th
innervation:
-Deep branch of ulnar nerve
action: Laterally rotates 5th metacarpal
133
pectoralis major,
attachments:
-Clavicular head: medial half of clavicle
Sternocostal head: sternum; first six costal cartilages
- Intertubercular sulcus of the humerus
innervation:
- Medial and lateral pectoral nerves
Action:
-Adduction and medial rotation of arm
Clavicular head: flexion of extended arm
Sternocostal head: extension of flexed arm
134
triceps brachii (long, lateral and medial heads)
attachments:
-Long head: infraglenoid tubercle of scapula
Medial and lateral heads: posterior humerus
- Olecranon of the ulna
innervation:
-Radial nerve
Action:
-Extension of forearm at the elbow joint.
135
dorsal scapular
origin: C5 ventral ramus
spinal segment: C5
motor: rhomboid major, rhomboid minor, levator scapulae
136
Cannot flex the 4th and 5th digits of left hand. cutaneous sensory loss would include skin overlying?
hamate
137
dorsal scapular
parent: Subclavian artery
138
protraction of scapula/ winged scapula. where most likely to experience cutaneous numbness or paresthesia?
there will be no cutaneous sensory deficit
139
Profunda brachii (deep brachial)
parent: brachial artery
140
elbow extension
C7, C8
141
Rotator cuff muscles (3 greater tubercle; 1 lesser tubercle)
SITS:
Superspinatus
Infraspinatus
Teres minor
Subscapularis
142
axillary nerve
- passes through the quadrangular space to gain access to the posterior shoulder.
- innervates the deltoid and trees minor muscles
- has a cutaneous field on the shoulder
143
not able to flex or abduct fingers. Thumb flexion and extension is weak and cannot oppose this thumb. Injury is at what level?
C8
144
rhomboid minor
attachments:
- C7 and T1 vertebrae
- Medial border of scapula
innervation:
- Dorsal scapular nerve
Action:
-Elevation and retraction the scapula
145
Flexor digiti minimi
```
attachments:
- Hamate and flexor retinaculum
- Proximal phalanx of digit 5
innervation:
-Deep branch of ulnar nerve
```
action:Flexes digit 4
146
Spinal level of Musculocutaneous
C5, C6, C7
147
Extensor indicis
attachments:
- Ulna and interosseous membrane
- Extensor hood of index finger
innervation:
-Radial nerve
action:Extension of index finger
148
Axillary artery
parent: Subclavian artery
149
flexor digitorum superficialis
attachments:
- Medial epicondyle of humerus, ulna and radius
- Four tendons → middle phalanges of digits 2-5
innervation:
-median nerve
Action: Flexion of MP, and proximal IP joints and wrist
150
Radial artery
parent: Brachial artery
151
dermatomes and injuries
-deficits that stays contained to particular dermatome, problem is high up such as a spinal cord, nerve, of upper plexus problem.
152
upper extremity mnemonics
upper extremity mnemonics
153
Thenar group
- Abductor pollicis brevis
- Flexor pollicis brevis
- Opponens pollici brevis
- radial artery
154
Identify the Triceps hiatus (triangular interval ):
between the two heads of the triceps muscle, and inferior to the teres major.
155
elbow flexion
C5, C6
156
thumb adduction
T1
157
Subscapular
parent: axillary artery
158
lower (inferior) subscapular
origin:
spinal segments: c5 , c6
motor: subscapularis, teres major
159
tingling and numbness over thumb, index, and middle finger. Occasional pain over her wrist. Pain when making.a fist, but grip muscle strength is normal. Which is the likely site of nerve compression?
-median nerve deep to the flexor retinaculum
| carpal tunnel syndrome
160
ulnar nerve
- from medial cord
- C8 and T1
- posterior to the medial epicondyle
- serves the flexor compartment of the forearm and intrinsic muscles of the hand
- supplies: flexor carpi ulnaris, flexor digitorum profundus, flexor digiti minimi, abductor digiti minimi, opponens digiti minimi, adductor pollicis, lumbricals 3 and 4, all interossei, and palmaris brevis
- cutaneous on the medial hand
161
Deep palmer arch
parent: Radial Artery
162
Quadrangular space (hand):
superiorly by the teres minor, inferiorly the teres major, medially by the long head of the triceps and laterally the surgical neck of the humerus
163
Hand
“PAD”: Palmar (hand) muscles ADduct
“DAB”: Dorsal (hand) muscles ABduct
```
Abductor digiti minimi
Flexor digiti minimi
Opponens digiti minimi
Adductor policis
Opponens pollicis
Flexor pollicis brevis
Abductor pollicis brevis
```
164
radioulnar joint injury
- common in children
- head of radius can slip through the anular ligament
- pulled elbox
165
semitendinosus
attachments:
- Ischial tuberosity
- Medial tibia
innervation:
- Tibial division of the sciatic nerve
action:
-Flexion of the leg and extension of the thigh
166
scaphoid fractures
-blood supply in hand usually goes to distal end so break can vascularly isolate the proximal end. Avascular necrosis can result
167
Spinal level of Thoracordosal
C6, C7, C8
168
Spinal level of Axially
C5, C6
169
Supper Assassin
Suprascapular: c5, c6
Axillary: C5, c6
170
Veins of hand
Veins of hand
171
lateral antebrachial cutaneous nerve
Lateral forearm from elbow to wrist
172
hand in prone position. Attempts to supine causes moderate pain. Pulled girl by hand = cause of injury. Which structures is most likely injured? (pulled elbow/ common in kids)
annular ligament
173
glenoid labrum
-cartilaginous rim around the circumference of the glenoid fossa deepens the fossa to stabilize the joint
174
hypothenar group
- abductor digiti minimi
- flexor digiti minimi
- opponens digiti minimi
- ulnar artery
175
Spinal level of Upper and lower subscapular
C5, C6
176
Dorsal interossei (four muscles)
attachments:
- Metacarpals
- Extensor hood of digits 2-4
innervation:
-Deep branch of ulnar nerve
action:Abduction of digits 2-4
177
Median nerve innervations
2 loaf:
Lateral 2 Lumbricals
Opponens pollicis
Abductor pollicis brevis
Flexor pollicis brevis
178
protraction of scapula/ winged scapula. what does long thoracic nerve innervate?
ventral rami of C5, C6, and C7
179
median
origin: medial and lateral cords
spinal segments: c5 to c7 via lateral cord; c8, t1 via medial cord
motor: all muscles in the anterior compartment of the forearm (except flexor carpi ulnaris and medial half of flexor digitorum profundus), three thenar muscles of the thumb and two lateral lumbrical muscles
cutaneous: palmer surface of the lateral three and one-half digits and over the lateral side of the palm and middle of the wrist
180
Transverse cervical artery
parent: thyrocervical trunk of Subclavian artery
181
musculocutaneous
origin:
spinal segments: c5 to c7
motor: all muscles in the anterior compartment of the arm
cutaneous: lateral side of forearm
182
muscles of posterior forearm
muscles of posterior forearm
183
Lumbricals (four muscles)
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attachments:
- Tendons of flexor digitorum profundus
- Extensor hoods of digits 2-5
innervation:
-Medial two by the deep ulnar nerve; lateral two by the median nerve
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action: Flex MP joints while extending IP joints
184
dermatomes of upper extremities
c3: lower neck, above clavicle
c4: clavicle area
c5: upper shoulder, laterally to just below elbow
c6: runs parallel to c5 but runs medially and then extends to thumb area
c7: middle hand and 3 middle finger regions
c8: hand and pinky finger
t1: medial forearm
t2: medial upper arm
185
Spinal level of Suprascapular
C5, C6
186
finger extension
C7
187
shoulder adduction
C6, C7
188
biceps brachi
attachments:
-Long head: supraglenoid tubercle of scapula
Short head: coracoid process
- Tuberosity of radius
innervation:
-Musculocutaneous nerve
Action:
-Flexion and supination of forearm
Accessory flexor of the arm
189
Spinal level of Median
C5, C6, C7, C8, T1
190
Gluteal region
Gluteal region
191
thoracoacromial artery branches
“CAlifornia Police Department”
Clavicular
Acromial
Pectoral
Deltoid
192
median nerve
- from lateral and medial cord
- C5 - T1
- supplies pronator teres, flexor carpi radialis, palmares longus, flexor digitorum superficialis, flexor digitorum profundus, flexor pollicis longus, pronator quadratus, flexor pollicis brevis, abductor pollicis brevis, opponens pollicis, and lumbricals 1 and 2
- passes through carpel tunnel to get access to hand
- cutaneous field is the lateral hand
193
superior gemellus
attachments:
- Ischial spine
- Greater trochanter of the femur
innervation:
- Nerve to obturator internus
action:
-Abduction and lateral rotation of the thigh
194
circumflex scapular
parent: subscapular
195
Ulnar artery
parent: Brachial artery
196
ulnar
origin:
spinal segments: (c7), C8, t1
motor: all intrinsic muscles of the hand (except three thenar muscles and two lateral lumbricals); also flexor carpi ulnaris and the medial half of flexor digitorum profundus in the forearm
cutaneous: palmer surface of the medial one and one-half digits and associated pal and wrist, and dorsal surface of the medial one and one-half digits
197
Opponens pollicis
attachments:
- Carpals
- 1st metacarpal
innervation:
-Recurrent branch of median nerve
action: Medial rotation and adduction of the thumb
198
Upper Extremity Joints
Upper Extremity Joints
199
medial pectoral
origin:
spinal segments: c8, t1
motor: pectoralis major, pectoralis minor
200
Extensor carpi radialis longus
attachments:
- Supracondylar ridge of humerus
- Base of 2nd metacarpal
innervation:
-Radial nerve
action: Extension and abduction of hand
201
patient asked to make fist; only 4th and 5th digits are able to flex, which muscles in his forearm still have normal function? which nerve?
flexor carpi ulnaris; ulnar nerve is intact
median nerve affected in other fingers
202
Spinal level of Lateral + medial pectoral
C5, C6, C7 + C8, T1
203
proper palmar digital arteries
parent: common palmar digital arteries
204
biceps femoris (long and short heads)
attachments:
- Ischial tuberosity (long head)
Linea aspera (short head)
- Head of fibula
innervation:
- Tibial division of the sciatic nerve (long head)
- Common fibular division of the sciatic nerve (short head)
action:
-Flexion of the leg and extension of the thigh
205
piriformis
attachments:
- Anterior sacrum
- Greater trochanter of the femur
innervation:
- Branches from S1 and S2
action:
-Lateral rotation and abduction of the thigh
206
flexor carpi ulnaris
attachments:
- Medial epicondyle of humerus and ulna
- Carpals and 5th metacarpal
innervation:
-ulnar nerve
Action:
-flexion and adduction of hand
207
Brachial artery
parent: axillary artery
208
suprascapular
parent: thyrocervical trunk of Subclavian artery
209
teres major
attachments:
- Inferior angle of the scapula
- Intertubercular sulcus of the humerus
innervation:
- Lower subscapular nerve
Action:
-Medial rotation and extension of arm
210
subscapularis
attachments:
- Subscapular fossa
- Lesser tubercle of humerus
innervation:
- Upper and lower subscapular nerves
Action:
-Medial rotation and adduction of arm
211
fall on outstretched hand' pain between tendons of the long abductor and extensor muscles of thumb. Which bone is likely broken?
- scaphoid in anatomical sub-box
212
anterior interosseous
parent: common interosseous
213
shoulder elevation
CN XI
214
Spinal level of Ulnar
C8, T1
215
superficial back
Superficial back
216
medial cutaneous of forearm
origin:
spinal segments: c8, t1
cutaneous: medial side of forearm
