Test 1: Upper Extremity Flashcards
(107 cards)
1
Q
Palpate:
Phalanges
A
.
2
Q
Palpate:
metacarpals (head, base, shaft)
A
.
3
Q
Palpate:
UCL of thumb
A
.
4
Q
Palpate:
Scaphoid
A
.
5
Q
Palpate:
lunate
A
.
6
Q
Palpate:
triquetrum
A
.
7
Q
Palpate:
pisiform
A
.
8
Q
Palpate:
trapezium
A
.
9
Q
Palpate:
trapezoid
A
.
10
Q
Palpate:
capitate
A
.
11
Q
Palpate:
hook of hamate
A
.
12
Q
Palpate:
hamate
A
.
13
Q
Palpate:
ulnar nerve at hand
A
through hook of hamate
14
Q
Palpate:
ulnar styloid process
A
.
15
Q
Palpate:
ulnar head
A
Head of ulna = distal. Pronate forearm, make a fist. Big bump.
16
Q
Palpate:
dorsal tubercle
A
Dorsal or Lister’s tubercle: pulley for extensor pollicis longus. On dorsal surface, vertical.
17
Q
Palpate:
radial styloid process
A
.
18
Q
Palpate: median nerve (wrist). How do you know when you are on it?
A
Median nerve
Sensation changes from lateral side of 4th digit across finger/palm of hand
19
Q
Palpate:
radial shaft
A
.
20
Q
Palpate:
radial pulse
A
.
21
Q
Palpate:
shaft of ulna
A
.
22
Q
Palpate:
radial head
A
.
23
Q
Palpate:
annular ligament
A
.
24
Q
Palpate:
radial tuberosity
A
anterior proximal radial surface
25
Palpate:
| medial epicondyle
.
26
Palpate:
| lateral epicondyle
.
27
Palpate:
| RCL (elbow)
Lateral epicondye to head of radius
Varus force
Feel with fingertips while cupping hand around ankle and applying force with palm
28
Palpate:
| UCL (elbow)
medial epicondyle to coronoid process/olecranon
29
Where is the coronoid process?
Anterior lip of olecranon fossa
30
Palpate:
| olecranon process
.
31
Palpate:
| olecranon bursa
can't really feel unless inflamed
32
Palpate:
| olecranon fossa
Can only feel with elbow flexed
33
Palpate & OIAN (origin, insertion, action, innervation):
brachioradialis
Drinking muscle
Thumbs up elbow flex
O: proximal ⅔ of the lateral supracondylar ridge of humerus I: styloid process of radius
A: elbow flex
N: radial nerve
How to differentiate from extensors: get person to ext wrist
34
Palpate & OIAN:
pronator teres
Oblique direction
O: CFO: medial epicondyle, coronoid process
I: middle of lateral surface of radius
A: pronates, weak elbow flexor
N: median nerve
How to find muscle: pronate against resistance contract and relax until you feel down the muscle
35
Palpate & OIAN:
flexor carpi radialis
```
O: CFO: medial epicondyle
I: base of second and third metacarpals
A: flexes wrist, RD, weak elbow flexor
N: median nerve
Flex wrist with fist - least prominent most lateral tendon
```
36
Palpate & OIAN:
palmaris longus
Closest to midline
O: CFO: medial epicondyle
I: flexor retinaculum and palmar aponeurosis
A: flex the wrist, weak elbow flexor
N: median nerve
Pinch fingers together, wrist flexion - tendon fans out
37
Palpate & OIAN:
flexor carpi ulnaris
O: CFO: medial epicondyle, posterior surface of proximal ⅔ of ulna
I: pisiform, hook of hamate and base of fifth metacarpal
A: flexes wrist, UD
N: ulnar nerve
Make sure you distinguish this between extensor carpi ulnaris by moving between flex and ext
38
Palpate & OIAN:
flexor digitorum superficialis
O: medial epicondyle, UCL
I: sides of middle phalanges of 2-5th fingers
A: flex 2-5 MCP and PIP joints, wrist flex
N: median nerve
Superficialis splits in two, to permit profundus to go right through
How to differentiate: flex at fingers
39
Palpate & OIAN:
flexor digitorum profundus
Does everything the same as superficialis but no elbow flexion and also flexes DIP
O: anterior and medial surfaces of proximal ¾ of ulna
I: Base of distal phalanges, palmar surface of 2-5th fingers
A: flex 2-5 fingers MCP and DIP.
N: Dual innervation:
Digits 2-3 medial nerve
Digits 4-5 ulnar nerve
40
What forms the cubital fossa?
**Don't need to palpate
On anterior aspect of elbow
Formed by imaginary line between epicondyles of humerus, pronator teres, and brachioradialis muscle
In it:
Median nerve
Brachial artery
biceps/brachialis tendon forms floor
At distal end of fossa, brachial artery splits into radial and ulnar artery
41
Palpate & OIAN:
pronator quadratus
O: medial/anterior surface of distal ulna
I: lateral/anterior surface of distal radius
A: pronate
N: median
42
Palpate & OIAN:
flexor pollicis longus
O: anterior surface of radius and interosseous membrane
I: base of distal phalanx of thumb
A: flex IP, MCP and CMC joints in thumb, assists with wrist flex
N: median
43
Palpate & OIAN:
extensor carpi radialis longus
O: distal ⅓ of lateral supracondylar ridge
I: base of second metacarpal
A: extends wrist, RD, weak elbow flex
N: radial
44
Palpate & OIAN:
extensor carpi radialis brevis
O: CEO lateral epicondyle
I: base of 3rd metacarpal
A: ext and abd wrist, weak elbow flex
N: radial
45
Palpate & OIAN:
extensor digitorum
O: CEO lateral epicondyle
I: bases of middle and distal phalanges of 2-5th fingers
A: ext 2-5 fingers MCP and IP joints
N: radial
46
Palpate & OIAN:
extensor carpi ulnaris
O: CEO lateral epicondyle
I: base of 5th metacarpal
A: ext and add wrist
N: radial
47
Palpate & OIAN:
extensor indicis
Deeper layer of forearm extensor muscles
O: post surface of distal shaft of ulna and interosseous membrane
I: tendon of ext digitorum at level of 2nd metacarpal
A: ext and add 2nd finger at MCP joint, weak wrist ext
N: radial
48
Palpate & OIAN:
supinator
Wraps around radius
Sits deep to wad of 3, difficult to palpate
O: lateral epicondyle, RCL, annular ligament, supinator crest of the ulna
I: anterior, lateral surface of proximal 1/3rd of radial shaft
A: supinate forearm
N: radial
49
Palpate & OIAN:
anconeus
O: lateral epicondyle of the humerus
I: olecranon process and posterior proximal surface of ulna
A: ext elbow
N: radial
50
Palpate & OIAN:
extensor pollicis longus
O: post surface of ulna and interosseous membrane
I: base of distal phalanx of thumb
A: ext thumb at IP and EPL joints, abduct the wrist
N: radial
Goes around ext tubercle medially
51
Palpate & OIAN:
extensor pollicis brevis
O: posterior surface of radius and interosseous membrane
I: base of proximal phalanx of thumb
A: ext thumb at MCP and CPC joints, abd wrist
N: radial
Doesn’t go around dorsal tubercle
Goes further distal than abductor pollicis longus
52
Palpate & OIAN:
abductor pollicis longus
O: post surface of radius and ulna, and interosseous membrane
I: base of 1st metacarpal
A: abd, ext thumb, abd wrist
N: radial
53
Palpate
| shaft of humerus
.
54
Palpate
| deltoid tuberosity
.
55
Palpate
| brachial pulse
.
56
Palpate
| head of humerus
.
57
Palpate
| lesser tubercle
Anterior when person is in anatomical position
| Can’t find this when not in anatomical position
58
Palpate
| greater tubercle
Less prominent bump off of lateral corner (off of acromion)
59
bicipital groove/intertubercular groove or sulcus
space in between greater and lesser tubercle
60
Palpate
| transverse humeral ligament
horizontal. Extends between lesser and greater tubercles
61
Palpate
coracoid process.
What attaches here?
move approx. 1 inch medially from lesser tubercle
3 muscles that attach here: Pec minor
Short head of biceps
Coracobrachialis
62
Palpate & OIAN:
biceps brachii long head
O: supraglenoid tubercle of scapula - cannot feel the long head past the head of the humerus
I: Tuberosity of radius and aponeurosis of the biceps brachii
A: flex the elbow, supinate the forearm, flex the shoulder
N: musculocutaneous
63
biceps brachii short head
O: coracoid process of scapula
I: tuberosity of radius and aponeurosis of the biceps brachii
A: flex the elbow, supinate the forearm, flex the shoulder
N: musculocutaneous
64
Palpate & OIAN:
brachialis
Palpate underneath biceps brachii before triceps
O: anterior surface of the distal ⅓ of the humerus
I: tuberosity and coronoid process
A: flex the elbow
N: musculocutaneous
65
Palpate & OIAN:
Triceps brachii lateral head
```
Superficial
O: posterior surface of proximal half of the humerus
I: olecranon process
A: elbow ext
N: radial
```
66
Palpate & OIAN:
Triceps brachii long head
```
Superficial
Medial to lateral head
O: Infraglenoid tubercle
I: olecranon process
A: elbow ext, shoulder ext and add
N: radial
```
67
Palpate & OIAN:
Triceps brachii medial head
```
Deep
O: Posterior surface of distal half of the humerus
I: olecranon process
A: ext elbow
N: radial
```
68
Palpate & OIAN:
Supraspinatus
O: supraspinous fossa
I: greater tubercle
A: scaption/abd shoulder, stabilize
N: suprascapular
69
Infraspinatus
O: infraspinus fossa
I: greater tubercle
A: ER, add shoulder, stabilize
N: subscapular
70
Teres minor
O: upper ⅔ of the lateral border of scapula
I: greater tubercle
A: ER, add shoulder, stabilize
N: Axilary
*** can’t differentiate between IS and teres minor other than location
Can differentiate between this and teres major because teres major is an IR
71
OIAN Subscapularis
```
*Don't need to palpate
O: subscapular fossa
I: lesser tubercle of the humerus
A: IR, stabilize
N: dual innervation - upper and lower subscapular nerve
```
72
Palpate:
| manubrium
.
73
Palpate:
| Sternum (body)
.
74
Palpate:
| Xiphoid process
.
75
Palpate:
| Clavicle
.
76
Palpate:
| Sternoclavicular joint
.
77
Palpate:
| Acromion process
.
78
Palpate:
| Acromioclavicular joint
.
79
Palpate:
| medial border of scapula
.
80
Palpate:
| lateral border of scapula
.
81
Palpate:
| spine of scapula
.
82
Palpate:
| superior angle of scapula
.
83
Palpate:
| inferior angle of scapula
.
84
Palpate & OIAN:
deltoid - anterior fibres
```
O:
CLASP
Lateral clavicle
Acromion
Spinous process
I: deltoid tuberosity
A: shoulder abd, flex IR, horizontal adduction
N: axillary nerve
```
85
Palpate & OIAN:
Deltoid - middle fibres
```
O:
CLASP
Lateral clavicle
Acromion
Spinous process
I: deltoid tuberosity
A: shoulder abd
```
86
Palpate & OIAN:
Deltoid - posterior fibres
```
O:
CLASP
Lateral clavicle
Acromion
Spinous process
I: deltoid tuberosity
A: shoulder abd, ext, ER, horizontal abd
N: axillary nerve
```
87
Palpate & OIAN:
Teres major
O: Inferior angle and lower ⅓ of lateral border of the scapula
I: medial lip of bicipital groove
May be easier side lying because it goes through axilla
A: shoulder ext, add, and IR
Known as lats’ little helper (same actions) - moving immediately lateral = latissimus dorsi
N: lower subscapular
88
Palpate:
| Subacromial bursa
passively extend arm. In between acromion and head of humerus
89
Palpate & OIAN:
Pectoralis major
O: Medial half of clavicle, sternum, and cartilage of ribs 1-6.
I: lateral lip of bicipital groove
A: shoulder add, IR, elevate thorax.
Upper fibres: flex shoulder, horizontal add
Lower fibres: extend the shoulder FROM FLEX
N: DUAL INNERVATION: upper - lateral pectoral. Lower - lateral and medial pectoral.
Palpate medial aspect and lateral aspect, skipping breast tissue
Get pt to make their own barrier
How to engage: horizontal adduction
90
Palpate & OIAN:
pectoralis minor
O: 3-5th ribs
I: medial surface of coracoid process
A: reverse action!!
If scapula fixed, elevates the thorax during inhalation
If scapula not fixed, depress, abduct, downward rotate scapula
N: medial pectoral
Deep to pec major
Generally try not to palpate through pec major
Palpate underneath pec major
Palpate as much of muscle as possible by palpating anterior ribs
Get them to push forward with their shoulder to get under
91
What are the 4 superficial forearm flexors?
- pronator teres
- flexor carpi radialis
- palmaris longus
- flexor carpi ulnaris
92
What forearm flexor is in the intermediate layer?
flexor digitorum superficialis
93
What are the 3 deep forearm flexors
- pronator quadratus
- flexor pollicis longus
- flexor digitorum profundus
94
Extensor carpi radialis brevis should be differentiated from which muscles?
- brachioradialis
- extensor carpi radialis longus
- abductor pollicis longus
- extensor digitorum
95
Extensor carpi ulnaris should be differentiated from which muscles?
- flexor carpi ulnaris
- extensor digiti minimi
- extensor digitorum
96
Flexor digitorum superficialis should be differentiated from which muscles?
- flexor digitorum profundus
| -
97
Extensor pollicis longus should be differentiated from which muscles?
- abductor pollicis longus
- extensor indicis
- extensor pollicis brevis
98
Flexor carpi radialis should be differentiated from which muscles?
- flexor digitorum superficialis
- flexor digitorum profundus
- pronator teres
- palmaris longus
99
What makes up the anatomical snuffbox?
- extensor pollicis longus
- extensor pollicis brevis
- abductor pollicis longus
100
How can you differentiate between the brachialis and biceps brachii short head?
- brachialis is underneath biceps brachii before triceps
| - biceps brachii supinates the forearm
101
How can you differentiate between triceps long and lateral heads?
long head also extends the shoulder
102
How can you differentiate between infraspinatus and teres minor?
Location. Otherwise difficult to differentiate
103
How can you differentiate between teres minor and teres major?
teres major IR, teres minor ER
104
Extensor digitorum tendon is ______ (medial/lateral) to the extensor indicis tendon.
lateral
105
Lady between 2 majors:
Latissimus dorsi inserts at the floor of bicipital groove
Teres major - medial lip of bicipital groove
Pectoralis major - lateral lip of bicipital groove
106
What are the muscles that have reverse action?
Pec minor: If scapula fixed, elevates the thorax during inhalation. If scapula not fixed, depress, abduct, downward rotate scapula
Serratus anterior:
with origin fixed - scapula abd, upward rotation, depress, hold medial border against rib cage
With scapula fixed - elevate thorax during forced inhalation
Scalenes:
elevates ribs during inhalation
Flex head and neck
107
Which muscles have dual innervation?
Flexor digitorum profundus: digits 2-3 median, 4-5 ulnar.
subscapularis: upper and lower subscapular nerve
Pec major: upper - lateral pectoral. Lower - lateral and medial pectoral
