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184 Cards in this Set

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What is the weakest point of the clavicle?
Inflection point
What bony landmark is used to locate the insertion point of a central line?
point of maximum anterior convexity (of clavicle)
What converts the suprascapular notch into a "foramen" for the suprascapular nerve?
superior transverse ligament
What is the function of the clavicle?
connects UL to axial skeleton, transmits forces
What is the function of the scapula?
articulates clavicle and humerus, sliding motion
What is the function of the humerus?
transmits forces, positions forearm
Which is a more common site of humerus fractures- surgical neck or anatomical neck?
surgical neck
What is contained within the intertubercular groove of the humerus?
long head of the biceps tendon
The lateral epicondyle is an attachment point for...
RCL, supinator and extensor muscles of forearm
The medial epicondyle is an attachment point for...
UCL, pronator teres and flexor muscles of forearm
The trochlea is on the ___________ side. The capitellum articulates with the ______________,
medial, radius
Fractures of the surgical neck of the humerus threaten which nerve?
Axillary
Fractures of the medial epicondyle threaten which nerve?
Ulnar
Fractures of the lateral epicondyle threaten which nerve?
Radial
What is the function of the ulna?
guides forearm flexion and extension, passive in supination/pronation
The olecranon process is a feature of what bone? The olecranon fossa is a feature of what bone?
Ulna, Humerus
The base of the ulna is (proximal/distal)
proximal
The ___________ ____________ is between the coronoid process and the olecranon process.
trochlear notch
What is the function of the radius?
Controls pronation and supination
What attaches to the radial tuberosity?
biceps tendon
The head of the radius is located (proximally/distally)
proximally
The proximal row of carpal bones articulates with the (radius/ulna)
Radius
The ulnar tunnel is formed by...
the pisiform bone, palmar carpal ligament, flexor retinaculum
Why is the scaphoid clinically significant?
Most frequently fractured carpal bone, has blood supply distally but not proximally.
What are the motions of the clavicle at the sternum?
elevation, depression, anterior & posterior rotation
The subclavian vein has what spatial relationship with the point of maximum anterior convexity of the clavicle?
SCV is posterior and superior to the clavicle at this point
What are the motions of the scapula at the clavicle?
anterior & posterior gliding
What are the motions of the scapula at the rib cage?
depression, elevation, upward rotation, downward rotation, retraction, protraction
The suprascapular artery and vein pass ____________ to the superior transverse ligament.
superior
The spine of the scapula on the medial border is at which level?
T3
What attaches to the coracoid process?
short head of the biceps, coracobrachialis, pec minor, conoid ligament, trapezoid ligament
What attaches to the supraglenoid tubercle?
long head of biceps
What attaches to the infraglenoid tubercle?
long head of triceps
What attaches to the greater tubercle of the humerus?
pec major, supraspinatus, infraspinatus, teres minor
The lesser tubercle is (anterior/posterior) to the greater tubercle.
anterior
What attaches to the lesser tubercle?
teres major, subscapularis
A fracture of the distal end of the humerus is threatening to the ____________ nerve.
Median
Where does the radial groove end?
near the deltoid tuberosity
What runs in the radial groove?
radial n, profunda radial a, accompanying vein
What attaches to the olecranon process?
Triceps brachii
What attaches at the ulnar tuberosity?
brachialis
What is the most common fracture of the forearm? To which bone does it occur? What is the MOI?
Colles fracture, distal 2cm of radius, FOOSH
Fractures in the ______ of the scaphoid are not easily discovered due to _______________________.
neck, lack of blood supply
Which is the most dislocated of the carpals?
lunate
The sternoclavicular joint is unlike other joints in that the articular cartilage is _________ _____________________.
mostly fibrocartilage
The SC joint is reinforced by...
anterior SC ligament, posterior SC ligament, interclavicular ligament, (and costoclavicular ligament weakly)
The AC ligament is an (intrinsic/extrinsic) stabilizer of the AC joint and is (strong/weak) reinforcement.
intrinsic, weak
What forms the extrinsic reinforcement of the AC joint?
Coracoclavicular ligament (conoid and trapezoid portions), costoclavicular ligament
What reinforces the GH joint?
superior, middle, and inferior GH ligaments, coracohumeral ligament (intrinsic), RC tendons (intrinsic), coracoacromial ligament (extrinsic)
The transverse humeral ligament prevents bowstringing of the _________________________ tendon during ______________.
long head of the biceps brachii, abduction
The subdeltoid (subacromial) bursa lies between what structures?
Acromion process and rotator cuff muscles
Which shoulder bursa communicates with the joint space?
subscapularis bursa
The subscapular bursa lies between what structures?
subscapularis tendon and the joint capsule
What structures prevent superior shoulder dislocations?
RC muscles and coracoacromial arch
Shoulder dislocations typically occur in the ________________________ direction.
Anterior/inferior
What reinforces the elbow joint?
UCL, RCL, annular lig
The innerosseous membrane is deficient by 2-3 cm (proximally/distally)
proximally
What reinforces the wrist joint?
UCL, RCL, palmar radiocarpal ligaments
What bones does the radius articulate with at the wrist?
Scaphoid, lunate, triquetrum
What does Hilton's law state?
That joints are innervated for pain and proprioception by all the nerves that supply motor innervation to the muscles that cross the joint.
What is the etiology of a "frozen shoulder"
the two redundant surfaces of the joint capsule fuse together, drastically limiting ROM
What two nerves should be checked (and how) prior to resetting a dislocated shoulder?
axillary n (by pinpricking the deltoid- if spasm, then intact) radial n (by muscle testing wrist extensors)
What is the etiology of "nursemaid's elbow"
Traction distally upon radiohumeral joint causes subluxation of the radius from the annular ligament.
The interosseous membrane openings are for the passage of what two vessels?
anterior & posterior interosseous arteries
The distal ulna is separated from the carpals by ______________.
triangular fibrocartilage complex
The midcarpal joints contribute to which motions of the wrist?
radial and ulnar deviation
How can you test for a median nerve neuropathy?
opposition of thumb to 5th finger tip
The hamate articulates with...
The capitate articulates with...
The trapezoid articulates with...
The trapezium articulates with...
4th & 5th metacarpals
2nd, 3rd, and 4th metacarpals
2nd metacarpal
1st and 2nd metacarpal
PIP flexion with DIP hyperextension is called...
PIP hyperextension with DIP flexion is called....
boutonniere deformity
swan neck deformity
The upper arm has a ___________ ____________ enveloping the entire musculature of the arm and the _____________________________ dividing the arm into anterior and posterior cavities.
brachial fascia, medial and lateral intermuscular septa
What muscles are within the anterior compartment of the arm?
biceps brachii, coracobrachialis, brachialis
What are the innervation and arterial supply to the anterior compartment of the arm?
musculocutaneous n, brachial a
What muscles are within the posterior compartment of the arm?
triceps brachii, anconeous
What are the innervation and arterial supply to the posterior compartment of the arm?
radial n, profunda brachial a
The antebrachial fascia, intermuscular septa, and interosseous membrane form what compartments in the forearm?
superficial & deep flexor compartments, superficial & deep extensor compartments
What muscles are contained within the anterior superficial compartment of the forearm?
PT, FCR, PL, FCU, FDS
What are the innervations and arterial supply to the anterior superficial compartment?
median & ulnar n, ulnar a
What muscles are contained within the anterior deep compartment of the forearm?
FPL, FDP, PQ
What are the innervation and vascular supply to the anterior deep compartment?
anterior interosseous n, anterior interosseous a
What muscles are contained within the posterior superficial compartment of the forearm?
BR, ECRL, ECRB, ED, EDM, ECU
What are the innervations of the posterior superficial compartment?
superficial radial n, posterior interosseous n (in fascial plane)
What muscles are contained within the deep posterior compartment?
Sup, APL, EPB, EPL, EI
What is the innervation of the deep posterior compartment?
posterior interosseous n
The central part of the palmar fascia is also known as...
palmar aponeurosis
The _________ nerve lies under the __________ ___________ ligament in ____________ canal.
ulnar, palmar carpal, Guyon's
The ulnar nerve runs between what two structures in the wrist?
palmar carpal ligament and flexor retinaculum
Depuytren's contracture is a disease of the ____________ fascia
palmar
The flexor retinaculum forms a roof over carpal tunnel containing which structures?
FDS tendons (4), FDP tendons (4), FPL tendon (1), median nerve
The extensor retinaculum makes ___ tunnels for tendons to pass.
6
What are the 3 palmar most compartments of the hand?
hypothenar compartment, thenar compartment, central compartment
The subclavian and brachial plexus are contained within the __________ sheath. This is an extension of the ________________ fascia.
axillary, prevertebral
What is contained within the axillary sheath?
Axillary vessels and branches, brachial plexus and branches, lymph nodes imbedded in fat
The clavopectoral fascia encloses what muscles?
(most of the)subclavius and pec minor
What innervates levator scapula?
Dorsal scapular n (C5)
What innervates rhomboids?
Dorsal scapular n (C5)
What innervates trapezius?
Accessory n (C2 C3)
What innervates serratus anterior?
Long thoracic n (C5-C7)
What innervates pectoralis minor?
Medial pectoral n (C8 T1)
What innervates subscapularis?
Upper and lower subscapular nn (C5 C6)
What innervates supraspinatus?
suprascapular n (C5 C6)
What innervates infraspinatus?
Suprascapular n (C5 C6)
What innervates teres minor?
Axillary n (C5 C6)
What innervates teres major?
lower subscapular n (C5-C7)
What innervates coracobrachialis?
musculocutaneous n (C5 C6)
What innervates deltoid?
axillary n (C5 C6)
What innervates biceps brachii?
musculocutaneous n (C5 C6)
What innervates triceps brachii?
Radial n (C7 C8)
What innervates pectoralis major?
Medial pectoral n (C8 T1)
Lateral pectoral n (C5-C7)
What innervates latissiumus dorsi?
Thoracodorsal n (C5-C7)
What innervates SCM?
Accessory n (C2 C3)
What innervates anconeus?
Radial n (C7 C8)
What innervates brachioradialis?
Radial n (C5 C6)
What innervates brachialis?
Musculocutaneous n (C5 C6)
What innervates pronator teres?
median n (C6 C7)
What innervates flexor carpi radialis?
median n (C7 C8)
What innervates palmaris longus?
median n (C6 C7)
What innervates flexor carpi ulnaris?
ulnar n (C8 T1)
What innervates flexor digitorum superficialis?
median n (C7 C8)
What innervates flexor digitorum profunda?
2nd & 3rd- Anterior interosseous
4th & 5th- Ulnar n
(C7-T1)
What innervates flexor pollicis longus?
Anterior interosseous n (C7 C8)
What innervates pronator quadratus?
Anterior Interosseous n (C7 C8)
What innervates brachioradialis?
Radial n (C5 C6)
What innervates extensor carpi radialis longus?
Radial n (C6 C7)
What innervates extensor digitorum?
Posterior interosseous n (C7 C8)
What innervates extensor digiti minimi?
Posterior interosseous n (C7 C8)
What innervates extensor carpi ulnaris?
Posterior interosseous n (C7 C8)
What innervates the supinator?
Deep radial n (C5 C6)
What innervates abductor pollicis longus?
Posterior interosseous (C7 C8)
What innervates extensor pollicis brevis?
Posterior interosseous n (C7 C8)
What innervates extensor pollicis longus?
Posterior interosseous n (C7 C8)
What innervates extensor indicis?
Posterior interosseous n (C8 T1)
What innervates abductor pollicis brevis?
recurrent branch of median n (C8 T1)
What innervates flexor pollicis brevis?
recurrent branch of median n (C8 T1)
deep branch of ulnar n (C8 T1)
What innervates opponens pollicis?
recurrent branch of median n (C8 T1)
What innervates palmaris brevis?
Ulnar n (C8 T1)
What innervates abductor digiti minimi?
Ulnar n (C8 T1)
What innervates flexor digiti minimi?
Ulnar n (C8 T1)
What innervates opponens digiti minimi?
Ulnar n (C8 T1)
What innervates the lumbricals?
2-3 Median n (C8 T1)
4-5 Ulnar n (C8 T1)
What innervates the interosseous mm?
deep branch of Ulnar n (C8 T1)
What innervates adductor pollicis?
Ulnar n (C8 T1)
What muscles act to move the scapula?
levator scapulae (elevation), rhomboids (retraction), trapezius (upward rotation), serratus anterior (protraction), pectoralis minor (downward rotation)
Which muscles move the humerus (relative to the scapula)?
subscapularis (adduction), supraspinatus (abduction), infraspinatus (ER), teres minor (ER), teres major (IR), coracobrachialis (flexion), deltoid (abduction)
What are the preplexus nerves? What do they innervate?
phrenic n (C5)
C5-C8 to longus colli, scalenes
dorsal scapular n (C5)- rhomboids and levator scapula
long thoracic n (C5-C7)- serratus anterior
Which roots make the upper trunk? The middle? The lower?
C5 & C6, C7, C8 & T1
The 3 posterior divisions merge to form the ___________ ______.
Posterior cord
The anterior divisions from _______ and ___________ trunks merge to form the lateral cord.
upper and middle
The anterior division of the lower trunk becomes...
medial cord
What nerves originate proximal to the cords?
Suprascapular n (motor to supraspinatus and infraspinatus, sensory to GH joint), nerve to subclavius
What nerves emerge from the lateral cord (prior to terminal branches)? What do they innervate?
lateral pectoral n (motor to superior pec major, sensory to GH joint)
What nerves emerge from the medial cord (prior to terminal branches)? What do they innervate?
medial pectoral n (motor to pic minor and inferior pec major), medial brachial (sensory to medial arm skin), medial antebrachial (sensory to medial forearm skin)
What nerves emerge from the posterior cord (prior to terminal branches)? What do they innervate?
upper subscapular (motor to subscapularis, sensory to GH joint), thoracodorsal n (motor to latissimus dorsi, sensory to GH joint), lower subscapular (motor to lower subscapularis, teres major, sensory to GH joint)
What are the terminal branches of the posterior cord?
Axillary n and Radial n
What does the axillary n innervate?
motor to teres minor, deltoid, sensory to lateral shoulder skin and GH joint
The axillary n has fibers from which roots?
C5 C6
What does the radial nerve innervate?
motor to all extensors and one supinator, sensory to dorsal skin of arm, forearm, and hand
What is a typical finding of radial neuropathy?
wrist drop
The radial n has fibers from which roots?
C5-T1
Describe the course of the radial n.
Passes between long and medial heads of triceps, runs in radial groove of posterior compartment. Pierces lateral intermuscular septum to reach anterior compartment, runs anterior to lateral epicondyle and branches.
What are the branches of the radial nerve? What do they supply?
superficial radial n (sensory only), deep radial n (motor to ECRB and supinator) dives into supinator and emerges as posterior interosseous n (ED, EDM, ECU, APL, EPB, EPL, EI)
When the deep radial n pierces the supinator it becomes...
posterior interosseous n
The posterior interosseous n innervates...
ED, EDM, ECU, APL, EPB, EPL, EI
What are the terminal branches of the medial cord?
Ulnar n (& median n)
The ulnar n contains fibers from which roots?
C8 T1
Describe the path of the ulnar n. to the wrist.
Descends in anterior compartment in medial intermuscular septum behind the brachial artery and gives no branches in the arm. Pierces medial septum midarm to enter posterior compartment, passes behind medial epicondyle in ulnar groove. Covered by aponeurosis of FCU, which it then pierces and enters anterior forearm to run between FCU and FDP where it provides motor innervation to FCU and 4th and 5th FDP
Describe the path of the ulnar n from the wrist down.
Found between ulnar artery and FCU tendon in the wrist, runs under palmar carpal ligament and over flexor retinaculum. Within the hand it splits to a deep branch, superficial branch, and muscular branches.
The ulnar n provides motor innervation to all the muscles of the hand except...
lateral 2 lumbricals and muscles of the thenar eminance
What does the superficial branch of the ulnar n innervate?
skin on medial and lateral side of 5th finger and medial side of 4th, also dorsal medial skin of hand
What are the terminal branches of the lateral cord?
Musculocutaneous n (& median n)
The musculocutaneous n contains fibers from which roots?
C5 C6
What does the musculocutaneous n supply?
motor to coracobrachialis, biceps brachii, brachialis, sensory to elbow joint and skin of lateral forearm
The median nerve contains fibers from which roots?
C6-T1
Describe the course of the median n to the wrist.
Runs entirely in anterior compartments of arm, forearm, and hand. Initially ant to brachial a, then lat to BA in medial intermuscular septum, just prox to elbow it is medial to BA, crosses cubital fossa deep to bicipital aponeurosis, b/t heads of pronator teres (gives ant. interosseous branch), b/t heads of FDS. Main median n descends b/t FDS and FDP.
The anterior interosseous n innervates...
FPL, lateral FDP, PQ, sensory to wrist
The median nerve innervates which muscles in the forearm?
PT, PL, FCR, FDS
Describe the course of the median nerve from the wrist down.
At the wrist it slips under the flexor retinaculum anterior and lateral to the muscle tendons. Then branches into recurrent branch and continuation divides into medial and lateral motor branches.
The recurrent branch of the median nerve innervates...
muscles of the thenar eminance (FPB APB OP)
The medial and lateral motor branches of the median n innervate...
motor to first and second lumbricals, sensory to m/l skin of 2nd finger, m/l skin of 3rd finger, radial side of 4th finger
List the pure dermatomes.
Pad of thumb- C6
Pad of 3rd finger- C7
Pad of 5th finger- C8
The skin of the lateral deltoid is innervated by...
Axillary n
The skin of the 1st-2nd dorsal webspace is innervated by...
Radial n
The skin of the pad of the index finger is innervated by...
Median n
The skin of the pad of the little finger is innervated by...
Ulnar n
The skin of the lateral forearm is innervated by...
Musculocutaneous n