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271 Cards in this Set
- Front
- Back
Appendicular skeleton
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Bones of upper and lower limb + supporting elements called girdles that connect limbs to trunk.
Provides control of external environment, changes in position and mobility |
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Pectoral girdle is made up of
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Clavicle (collar bone) + scapula (shoulder blade)
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Which bone provides the only direct connection between pectoral girdle and axial skeleton?
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Clavicle
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Scapula is supported and positioned by?
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Skeletal muscles; there is no direct bony or ligamentous connection between scapula and thoracic cage.
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Function of Pectoral Girdle
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Movements of clavicle and scapula
-position the shoulder joint -provide a base for arm movement -help maximize range of motion of the humerus |
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Where do muscles that move the arm originate?
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Pectoral girdle
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Clavicle (function)
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-Braces the shoulder
-transfers some of the weight of upper limb to axial skeleton |
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The clavicle originates in
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Manubrium of sternum
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What are the two ends of the clavicle
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Sternal end & acromial end
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Where do the ligaments of the shoulder attach on the clavicle?
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Conoid tubercle (acromial end) and Costal tuberosity (Sternal end)
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Tubercle
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A small rounded projection
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Tuberosity
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A rough projection
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Three sides of the scapular triangle
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superior border
medial border lateral border Muscles that position the scapula attach at these edges |
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Corners of the scapular triangle
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Superior angle (medial angle)
Inferior angle Lateral angle |
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Glenoid cavity
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Formed by lateral angle
Scapula articulates with humerus at glenoid cavity |
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Joint between humerus and scapula
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Glenohumeral or shoulder joint (Scapulohumerol joint )
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What is the fossa on the anterior surface of the scapula?
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subscapular fossa
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What are two large scapular processes?
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Coracoid process and acromion
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Coracoid process
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Smaller anterior process of scapula; projects anteriorly and slightly laterally and serves as attachment point for biceps brachii muscles
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Acromion
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Larger posterior process of scapula; projects anteriorly; located on lateral end of scapular spine.
Serves as attachment point for trapezium muscles of the back. |
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Joint between clavilce and scapula
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acromioclavicular joint (between acromion process of scapula and acromial end of clavicle)
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The two surface markings above and below the glenoid cavity
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Supraglenoid tubercle: attachment point for biceps brachii muscles
Infraglenoid tubercles: attachment point for triceps brachii muscles |
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Scapular spine
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Crosses the scapular body from acromion to end at medial border.
Serves as attachment point for deltoid and trapezius muscles. |
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What two regions does the scapular spine divide the posterior surface of scapula into?
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Supraspinous Fossa: an attachment for supraspinatus muscle
Infraspinous fossa: attachment for infraspinatus muscle. |
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What is indentation medial to the base of the coracoid process called?
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suprascapular notch
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Fossa
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A shallow depression
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Process
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Any projection or bump
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Bones of the upper limb
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Humerus, ulna, radius, carpal bones (wrist), metacarpals and phalanges of the hand.
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Where is the greater tubercle located and what muscles attach to it?
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Location: Proximal lateral margin of humerus.
Four scapular muscles attach to the greater tubercle: pectoralis major, supraspinatus muscle, infraspinatus muscle and teres minor muscle |
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Where is the lesser tubercle located and what muscles attach to it?
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Location: Anterior, medial surface on proximal end of humerus
The subscapularis, a scapular muscle attaches to it. |
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What is the groove between the lesser and greater tubercle on the humerus called? What runs through it?
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Intertuberculer sulcus or groove (Bicipital groove)
A tendon of the biceps brachii runs through it from its origin at the supraglenoid tubercle of the scapula. |
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Where do fractures often occur in the humerus?
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The surgical neck.
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What is the body of the humerus called?
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Shaft
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Location of deltoid tuberosity and what muscle attaches to it?
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Location: lateral border of shaft of humerus
Muscle: deltoid muscle |
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What is the distal articular surface of the humerus called and what are its two regions?
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Condyle.
The two regions are trochlea and capitulum. |
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Trochlea of the humerus articulates with what bone and runs between which two depressions?
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Trochlea articulates with ulna.
Runs from the anterior coronoid fossa to the posterior olecranon fossa. |
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The capitulum of the humerus articulates with what bone?
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Radius
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What are the three depressions on the distal end of the humerus and what projections do they accept?
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Coronoid fossa and olecranon fossa accept projections from ulna as the elbow flexes and extends.
Radial fossa accomadate small part of the radial head. |
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Radial groove location and what nerve runs through it?
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Location: runs along posterior margin of deltoid tuberosity.
The radial nerve runs through it. |
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Function of radial nerve
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Provides sensory information from back of hand and motor control over large muscles that extend (straighten) the elbow.
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What are epicondyles?
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Processes that develop proximal to an articulation and provide additional surface area for muscle attachment.
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What nerve crosses the medial epicondyle of the humerus?
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Ulnar nerve
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What location is called the funny bone?
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The humeral side of the elbow joint. Bumping it can strike the ulnar nerve which produced temporary numbness and paralysis of some muscles in the forearm.
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Relative position of ulna and radius to each other
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Ulna lies medial to radius in anatomical position.
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What forms the point of the elbow?
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Olecranon (olecranon process) of the ulna
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What feature of the ulna interlocks with the tochlea on the humerus?
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Trochlear notch
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What two markings for the superior and inferior border of the trochlear notch?
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Olecranon and Coronoid process.
Olecranon projects into the olecranon fossa when the elbox extends. The coronoid process projects into the coronoid fossa of humerus when elbow flexes. |
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What marking accommodates the head of the radius on the ulna?
What is the joint called. |
Radial notch
Proximal radioulnar joint |
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What shape is the shaft of the ulna?
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Triangle, with base on medial side and apex of triangle on lateral side.
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What fibrous sheet connects the ulna and radius? What is its function
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Interosseous membrane: provides additional surface area for muscle attachment.
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What are the two bone features at the distal end of the ulna?
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Ulnar head and styloid process. A cartilage attaches to the styloid process and separates ulnar head from wrist bones.
Ulnar head is part of distal radioulnar joint. |
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What two joints is the elbow joint made of?
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Humeroulnar joint and humeroradial joint.
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Where is the head of the ulna located?
Where is the head of the radius located? |
Distal end of ulna.
Proximal end of radius |
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Where does the biceps brachii muscle attach on the radius?
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Radial tuberosity. The muscle flexes the elbow.
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What is the distal end of the radius called?
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Distal extremity
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Do both the distal extremity and ulnar head participate in the wrist joint.
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No only the distal extremit does. Cartilage separates ulna from wrist.
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What feature of the radius articulates with the ulnar head?
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Ulnar notch of radius. This forms the distal radioulnar joint.
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Describe rotation of medial and lateral rotation at radioulnar joint.
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The proximal radioulnar joint permits medial or lateral rotation of ulnar head. When medial rotation occurs at the proximal radioulnar joint, the ulnar notch of the radius rolls across the rounded surface of the ulnar head. Medial rotation at the radioulnar joints in turn rotates the wrist and hand medially, from the anatomical position. The medial rotation is called pronation and the lateral rotation is called supination.
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What is the function of the styloid process of radius
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Stabilizes the wrist
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How many bones in the wrist?
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Eight. Four proximal carpal bone and four distal carpal bones.
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What is the phrase to help you remember the names of the carpal bones?
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Sam likes to push the toy card hard
Scaphoid Lunate Triquetrum Pisiform Trapezium Trapezoid Capitate Hamate |
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What two carpal bones articulate with the radius?
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Scaphoid and lunate
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What carpal bone articulates with the cartilage that separates the ulna from the wrist?
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Triquetrum
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What carpal bone extends further medially than any other carpal bone?
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Pisiform
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What distal carpal bones articulate with the scaphoid?
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Trapezium and trapezoid
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Which is the largest carpal bone?
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Capitate
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What are the palm bones called? How many are there and how are they numbered?
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Metacarpals; there are five metacarpal numbered I-V beginning with the lateral metacarpal.
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Three portions of the metacarpals
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Proximal base, small body and distal head
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What are the bones in the fingers called? How many are there?
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Phalanges; there are fourteen, two in the thumb or pollex and three in each finger.
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What carpal bone fractures most frequently?
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The scaphoid usually from falling onto an outstretched hand. It heals poorly in older people due to decreased blood supply.
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Why would a broken clavicle affect the mobility of the scapula?
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The clavicle attaches to the sternum and thus restricts the scapulas range of movement. If the clavicle is broken, the scapula will have a greater range of movement and will be less stable
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Which antebrachial bone is lateral in the anatomical position?
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Radius
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What is the function of the olecranon
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The olecranon is the point of the elbow. During the extension of the elbow the olecranon swings into the olecranon fossa on the posterior surface of the humerus to prevent overextension.
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Function of appendicular musculature
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To stabilize the pectoral and pelvic girdles and for moving the upper and lower limbs.
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What are the two groups of appendicular muscles?
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Muscles of the pectoral girdle and upper limbs.
Muscles of the pelvic girlde and lower limbs |
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How are muscular connections between pectoral girdle and axial skeleton different from muscular connections between pelvic girdle and axial skeleton?
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Muscular connections between pectoral girdle and the axial skeleton increase upper limb mobility since since skeletal elements are not locked in position relative to the axial skeleton. Emphasis on versatility.
In contrast the pelvic girdle has a strong skeletal connection to transfer weights from axial to appendicular skeleton. Emphasis on strength. |
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The action produced by a muscle at a joint depends on what?
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Structure of joint.
Location of insertion of muscle relative to the axis of movement at the joint. |
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What is the action line of the muscle?
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Imagine a string running from point of origin to point of insertion on the muscle. The string would follow the direction of the applied tension which is called the action line of the muscle.
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What rules can be applied to action lines to determine action of muscle produced at a joint?
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1. At joints that permit flexion and extension, muscles whose action lines cross the anterior aspect of a joint are the flexors of that joint and muscles who action lines cross the posterior aspect of a joint are extensors of that joint.
2. At joints that permit adduction and abduction, muscles whose action lines cross the medial aspect of a joint are adductors of that joint and muscles whose action lines cross the lateral aspect of a joint are abductors of that joint. 3. At joints that permit rotation, muscles whose action lines cross on the medial aspect of a joint may produce medial rotation at that joint, whereas muscles whose action lines pass on the lateral aspect of a joint produce lateral rotation at that joint. |
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Function of spurt and shunt muscles.
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Spurt muscles insert close to the joint and mainly produce movement at the joint.
Shunt muscles insert farther from the joint help stabilize the joint by pulling the articulating surfaces closer together in addition to producing motion at that joint. |
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Four groups of muscles of the pectoral girdle and upper limbs
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1. muscles that position the pectoral girdle
2. muscles that more the arm 3. muscles that move the forearm and hand 4. muscles that move the hand and fingers |
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List the muscles that position the pectoral girdle. What nerves innervate them?
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Seven total.
Trapezius Levator scapulae Rhomboid minor Rhomboid major Serratus anterior Subclavius muscle Pectoralis minor Nerves: cervical, dorsal scapular, medial pectoral, long thoracic, nerve to subclavius, accessory nerve |
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Levator scapulae (origin, insertion, action, innervation)
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Origin: cervical vertebrae
Insertion: Vertebral (medial) border of scapula near superior angle Action: elevates scapula Innervation: cervical nerves (C3 - C4) and dorsal scapular nerve (C5) |
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Pectoralis minor (origin, insertion, action, innervation)
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Origin: anterior and superior margins of ribs
Insertion: coracoid process Action: depresses and protracts shoulder; rotates scapula; elevates ribs if scapula is stationary Innervation: Medial pectoral nerve (C8, T1) |
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Rhomboid major (origin, insertion, action, innervation)
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Origin: vertebrae T2 to T5
Insertion: vertebral (medial) border of scapula from spine to the inferior angle Action: Adducts and performs downward motion of the scapula Innervation: Dorsal scapular nerve |
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Rhomboid minor (origin, insertion, action, innervation)
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Origin: Vertebrae C7-T1
Insertion: Vertebral (medial) border of scapula Action: Adducts and performs downward motion of the scapula Innervation: Dorsal scapular nerve |
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Serratus anterior (origin, insertion, action, innervation)
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Origin: Ribs (anterior and superior margins) 1-8, 1-9 or 1-10
Insertion: Anterior surface of vertebral border of scapula Action: protracts shoulder; rotates scapula so glenodi cavitry moves superiorly Innervation: Long thoracic nerve (C5-C7) |
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Subclavius (origin, insertion, action, innervation)
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Origin: First rib
Insertion: clavicle (inferior border of middle 1/3) Action: depresses and protracts border Innervation: Nerve to subclavius (C5-C6) |
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Trapezius (origin, insertion, action, innervation)
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Origin: occipital bone and thoracic vertebrae
Insertion: clavicle and scapula (acromion and scapular spine) Action: depends on active region and state of other muscles; may elevate, retract, depress or rotate scapula upward and/or clavicle; can also extend neck when the position of the shoulder is fixed Innervation: Accessory nerve (N XI) |
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Major abductor (muscle) of arm
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deltoid muscle
supraspinatus muscles assists at the start of the movement |
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What muscles rotate the arm medially?
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subscapularis and teres major muscle
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What muscles rotate the arm laterally?
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infrapinatus and teres minor muscle
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The scapular muscles that flexes and adducts the arm is?
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coracobrachialis and pectoralis major
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What muscles flex and extend the shoulder
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Pectoralis major (flex)
Latissimus dorsi (extends) |
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What muscles form the rotator cuff?
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supraspinatus, infraspinatus, subscapularis, teres minor merge with connective tissue of the shoulder joint capsule to form the rotator cuff
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Coracobrachialis (origin, insertion, action, innervation)
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Origin: Coracoid process
Insertion: medial margin of shaft of humerous Action: Adduction and flexion at shoulder Innervation: Musculocutaneous nerve |
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Deltoid (origin, insertion, action, innervation)
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Origin: Clavical and scapula (acromion and scapular spine)
Insertion: Deltoid tuberosity of humerus Action: abduction at shoulder (whole muscle); flexion and medial rotation of humerus (anterior part); extension and lateral rotation of shoulder (posterior part) Innervation: Axillary nerve |
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Supraspinatous (origin, insertion, action, innervation)
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Origin: Supraspinous fossa of scapula
Insertion: Greater tubercle of humerus Action: Abduction at shoulder Innervation: suprascapular nerve (C5) |
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Infraspinatous (origin, insertion, action, innervation)
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Origin: Infraspinous fossa of scapula
Insertion: Greater tubercle of humerus Action: Lateral rotation at shoulder Innervation: Suprascapular nerve (C5 - C6) |
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Subscapularis (origin, insertion, action, innervation)
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Origin: subscapular fossa of scapula
Insertion: Lesser tubercle of humerus Action: Medial rotation at shoulder Innervation: Subscapular nerve (C5 - C6) |
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Teres major (origin, insertion, action, innervation)
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Origin: Inferior angle of scapula
Insertion: Medial lip of intertuberculer sulcus of humerus Action: Extension and medial rotation at shoulder Innervation: Lower subscapular nerve (C5 - C6) |
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Teres minor (origin, insertion, action, innervation)
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Origin: Lateral Border of Scapula
Insertion: Greater Tubercle of humerus Action: Lateral rotation and adduction at shoulder Innervation: Axillary nerve (C5) |
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Latissimus dorsi (origin, insertion, action, innervation)
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Origin: Spinous processes of inferior thoracic and all lumbar and sacral vertebrae, ribs 8-12, and thoracolumbar fascia
Insertion: Floor of intertubercular sulcus of the humerus Action: Extension, adduction, and medial rotation at shoulder Innervation: Thoracodorsalnerve (C6-C8) |
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Pectoralis major (origin, insertion, action, innervation)
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Origin: Cartilage of ribs 2-6, body of sternum, and inferior and medial portion of clavicle
Insertion: Crest of greater tubercle and lateral lip of intertubercular sulcus of humerus Action: Flexion, adduction, and medial rotation of shoulder Innervation: pectoral nerve |
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What muscles move the arm?
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Coracobrachialis
Deltoid Supraspinatus Infraspinatus Subscapularis Teres major Teres minor Triceps brachii (long head) Biceps brachii Latissimus dorsi Pectoralis major |
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Pronation
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Moves the wrist and hand from palm-facing-front to palm-facing-back.
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Supination
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Moves the wrist and hand from palm-facing-back to palm -facing-forward.
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Where do most of the muscles that move the forearm and hand originate? What are the two exceptions
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Originate on the humerus and insert upon the forearm and wrist.
The two exceptions are the triceps brachii and biceps brachii which originate on the scapula. |
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In which position of the forearm (supinated or pronated) can the biceps brachii muscle NOT function properly?
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Pronated
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In general, where are the extensors and flexors of the forearm and wrist located?
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Extensors: posterior and lateral surfaces of the forearm
Flexors: anterior and medial surfaces of the forearm |
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What muscles (flexors) flex the elbow? What nerves innervate them?
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Biceps brachii
Brachialis Brachioradialis Nerves: musculocutaneous and radial |
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What muscles extend (extensors) the elbow? What nerves innervate them?
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Anconeus
Triceps brachii Nerves: radial |
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What muscles (pronators) pronate the forearm and wrist? What nerves innervate them?
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Pronator quadratus
Pronator teres Nerves: median nerve |
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What muscles (supinators) supinate the forearm and wrist? What nerves innervate them?
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Supinator
Nerves: deep radial |
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What muscles (flexors) flex the wrist? What nerves innervate them?
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Flexor carpi radialis
Flexor carpi ulnaris Palmaras longus Nerves: Median and ulnar |
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What muscles (extensors) extend the wrist? What nerves innervate them?
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Extensor carpi radialis longus
Extensor carpi radialus brevis Extensor carpi ulnaris Nerves: radial and deep radial |
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Biceps brachii (origin, insertion, action, innervation)
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Origin: Short head from the coracoid process; long head from the supraglenoid tubercle (both on scapula)
Insertion: Radial tuberosity Action: Flexion at the elbow and shoulder; supination Innervation: Musculocutaneous nerve (C5-C6) |
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Brachialis (origin, insertion, action, innervation)
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Origin: Distal half of the anterior surface of the humerus
Insertion: Ulnar tuberosity and cornoid process Action: flexion at the elbow Innervation: Musculocutaneous nerve (C5-C6) and radial nerve (C7-C8) |
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Brachioradialis (origin, insertion, action, innervation)
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Origin: Ridge superior to the lateral epicondyl of the humerus
Insertion: Lateral aspect of styloid process of radius Action: Flexion at elbow Innervation: Radial nerve (C6-C8) |
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Anconeus (origin, insertion, action, innervation)
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Origin: Posterior surface of lateral epicondyl of humerus
Insertion: Lateral margin of olecranon and ulnar shaft Action: Extension at elbow Innervation: Radial nerve (C6-C8) |
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Triceps brachii (origin, insertion, action, innervation)
lateral head long head medial head |
Origin: superior, lateral margin of humerus (lateral head); infraglenoid tubercle of scapula (long head); posterior surface of humerus, inferior to radial groove (medial head)
Insertion: olecranon of ulna (all) Action: Extension at elbow (all), extension and adduction at shoulder (long head) Innervation: radial nerve |
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Pronator quadratus (origin, insertion, action, innervation)
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Origin: Anterior and medial surface of distal ulna
Insertion: anterolateral surface of distal portion of radius Action: Pronates forearm and hand by medial rotation of radius at radioulnar joint Innervation: Median nerve (C8 - T1) |
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Pronator teres (origin, insertion, action, innervation)
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Origin: Medial epicondyl of humerus and cornoid process of ulna
Insertion: Middle of lateral surface of radius Action: rotates forearm and hand by medial rotation of radius at radioulnar joint, plus flexion at elbow Innervation: Median nerve (C6 - C7) |
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Supinator (origin, insertion, action, innervation)
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Origin: Lateral epicondyl of humerus and ridge near radial notch of ulna
Insertion: Anterolateral surface of radius distal to the radial tuberosity Action: Supinates forearm and hand by lateral rotation of radius at the radioulnar joint Innervation: deep radial nerve |
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Flexor carpi radialis (origin, insertion, action, innervation)
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Origin: medial epicondyle of humerus
Insertion: bases of second and third metacarpal bones Action: flexion and abduction at wrist Innervation: median nerve (C6-C7) |
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Flexor carpi ulnaris (origin, insertion, action, innervation)
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Origin: Medial epicondyle of humerus; adjacent medial surface of olecranon and anteromedial portion of ulna
Insertion: Pisiform, hamate, and base of fifth metacarpal bone Action: flexion and adduction at wrist Innervation: ulnar nerve (C8 - T1) |
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Palmaris longus (origin, insertion, action, innervation)
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Origin: Medial epicondyle of humerus
Insertion: palmar aponeurosis and flexor retinaculum Action: Flexion at wrist Innervation: Median nerve (C6-C7) |
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Extensor carpi radialis longus (origin, insertion, action, innervation)
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Origin: lateral suprcondylar ridge of humerus
Insertion: base of second metacarpal bone Action: extension and abduction at wrist Innervation: radial nerve (C6 - C7) |
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Extensor carpi radialis brevis (origin, insertion, action, innervation)
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Origin: Lateral epicondyl of humerus
Insertion: base of third metacarpal bone Action: extension and abduction at wrist Innervation: radial nerve (C6 - C7) |
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Extensor carpi ulnaris (origin, insertion, action, innervation)
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Origin: Lateral epicondyl of humerus; adjacent dorsal surface of ulna
Insertion: base of fifth metacarpal bone Action: extension and adduction at wrist Innervation: deep radial nerve (C6-C8) |
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What muscles provide strength and crude control of the hands and fingers?
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Extrinsic muscles of the hand
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Do extrinsic muscles cross the wrist joint?
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No, only their tendons cross the wrist joint.
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What prevents friction at the tendons that pass the dorsal and ventral surfaces of the wrist?
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Elongated bursae called synovial tendon sheaths.
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What holds the tendons of the extrinsic muscles of the hand in place at the wrist?
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Two wide bands of connective tissue called extensor retinaculum and flexor retinaculum.
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What causes carpal tunnel syndrome?
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Inflammation of the retinacula and tendon sheaths at the wrist which restricts movement and irritate the median nerve, a sensory and motor nerve that innervates the hand.
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What muscles provide fine control of the hand?
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Intrinsic muscles of the hand that originate on the carpal and metacarpal bones
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What is the function of the intrinsic muscles of the hand?
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1. flexion and extension of the fingers at the metacarpophalangeal joints
2. abduction and aduction fo the fingers at the metcarpophalangeal joints 3. opposition and reposition of the thumb |
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Do any muscles originate on the phalanges?
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No. And only tendons extend across the distal joints of the fingers.
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What is the opposition of the thumb?
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Starting from the anatomical position, the thumb is flexed and medially rotated at the carpometacarpal joint. This movement brings the tip of the thumb in contact with the tip of any other finger.
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What are the abductor extrinsic muscles of hand?
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Abductor pollicis longus
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What are the extensor extrinsic muscles of hand?
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Extensor digitorum
Extensor pollicis brevis Extensor pollicis longus Extensor indicis Extensor digiti minimi |
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What are the flexor extrinsic muscles of hand?
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Flexor digitorum superficialis
Flexor digitorum profundus Flexor pollicis longus |
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Adductor pollicis (origin, insertion, action and innervation)
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Origin: metacarpal and carpal bones
Insertion: proximal phalanx of thumb Action: Adduction of thumb Innervation: Ulnar nerve, deep branch (C8 - T1) |
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Opponens pollicis (origin, insertion, action and innervation)
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Origin: Trapezium and flexor retinaculum
Insertion: First metacarpal bone Action: Opposition of thumb Innervation: Median nerve (C6 - C7) |
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Palmaris brevis (origin, insertion, action and innervation)
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Origin: Palmar aponeurosis
Insertion: Skin of medial border of hand Action: Moves skin on medial border toward midline border toward midline of palm Innervation: Ulnar nerve, superficial branch (C8) |
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Abductor digiti minimi (origin, insertion, action and innervation)
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Origin: pisiform
Insertion: proximal phalanx of little finger Action: abduction of little finger and flexion at its metacarpophalangeal joint Innervation: ulnar nerve, deep branch (C8-T1) |
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Abductor pollicis brevis (origin, insertion, action and innervation)
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Origin: transverse carpal ligament, scaphoid and trapezium
Insertion: radial side of base of proximal phalanx of thumb Action: abduction of thumb Innervation: median nerve (C6 -C7) |
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Flexor pollicis brevis (origin, insertion, action and innervation)
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Origin: flexor retinaculum, trapezium, capitate, palmar ligaments of distal row of carpal bones and ulnar side of first metacarpal
Insertion: radial and ulnar sides of proximal phalanx of thumb Action: flexion and adduction of thumb Innervation: Branches of median and ulnar nerve |
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Flexor digiti minimi brevis (origin, insertion, action and innervation)
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Origin: hook of the hamate and flexor retinaculum
Insertion: proximal phalanx of little finger Action: flexion at fifth metacarpophalangeal joint Innervation: ulnar nerve, deep branch (C8-T1) |
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Opponens digiti minimi (origin, insertion, action and innervation)
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Origin: hook of the hamate and flexor retinaculum
Insertion: fifth metacarpal bone Action: flexion at metacarpophalangeal joint; brings digit into opposition with thumb Innervation: Ulnar nerve, deep branch (C8-T1) |
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Lumbirical (4) (origin, insertion, action and innervation)
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Origin: the four tendons of flexor digitorum profundus
Insertion: tendons of extensor digitorum to digits 2-5 Action: flexion at metacarpophalangeal joints; extension at proximal and distal interphalangeal joints Innervation: No 1 and 2 by median nerve; no. 3 and no. 4 by ulnar nerve, deep branch |
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Dorsal interosseous (4) (origin, insertion, action and innervation)
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Origin: each originates from oppsoing faces of two metacarpal bones (I and II, II and III, III and IV, IV and V)
Insertion: bases of proximal phalanges of digits 2-4 Action: abduction at metacarpophalangeal joints of digits 2-4; flexion at metacarpophalangeal joints; extension at interphalangeal joints Innervation: ulnar nerve, deep branch (C8-T1) |
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Palmar interosseous (4) (origin, insertion, action and innervation)
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Origin: sides of metacarpal bones II, IV and V
Insertion: bases of proximal phalanges of digits 2, 4 and 5 Action: adduction at metacarpophalangeal joints of digits 2, 4 and 5; flexion at metacarpophalangeal joints; extension at interphalangeal joints Innervation: ulnar nerve, deep branch (C8-T1) |
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How many and what are intrinsic muscles of the hand control the thumb?
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Four.
Adductor pollicis Opponens pollicis Abductor pollicis brevis Flexor pollicis brevis |
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Name three intrinsic hand muscles that control the small finger.
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Abductor digiti minimi
Flexor digiti minimi brevis Opponens digiti minimi |
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Major extendor of arm
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Latissimus dorsi
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Flexors of arm
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Pectoralis major and coracobrachialis
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What pectoral girdle and upper limb muscles does the musculocutaneous nerve innervate?
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Coracobrachialis, biceps brachii, brachialis
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What pectoral girdle and upper limb muscles does the axillary nerve innervate?
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Deltoid and teres minor
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What pectoral girdle and upper limb muscles does the subscapular and lower subscapular nerve innervate?
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subscapularis (subscapular) and Teres major (lower subscapular nerve)
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What pectoral girdle and upper limb muscles does the suprascapular nerve innervate?
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Supraspinatus and infraspinatus
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What pectoral girdle and upper limb muscles does the thoracodorsal nerve innervate?
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Latissimus dorsi
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What pectoral girdle and upper limb muscles does the pectoral and medial pectoral nerves innervate?
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Pectoralis major and pectoralis minor (medial nerve)
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What are the abductor extrinsic hand muscles?
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Abductor pollicis longus
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What are the Extensor extrinsic hand muscles?
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(hint: think all, thumb, index finger and small finger)
Extensor digitorum Extensor pollicis brevis Extensor pollicis longus Extensor indicis Extensor digiti minimu |
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What are the Flexor extrinsic hand muscles?
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(hint: think all and thumb)
Flexor digitorum superficialis Flexor digitorum profundus Flexor pollicis longus |
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What functions do the extrinsic hand muscles and intrinsic hand muscles perform for the thumb?
What nerves innervate these muscles? |
All thumb actions: abduction, adduction, extend, flex, opposition
Extrinsic: Abduct, extend, flex; deep radial and median nerves Intrinsic: Abduct, adduct, opposition, flex; median and ulnar nerves extend: only extrinsic opposition and adduct: only intrinsic hint: thumb flexors and extensors have brevis and longus; opponens, adduct and abduct do not. |
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What are the intrinsic hand muscles for thumb?
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Adductor pollicis
Flexor pollicis brevis Opponens pollicis Abductor pollicis |
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What intrinsic hand muscles control the little finger? What nerve innervate them?
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Abductor digiti minimu
Flexor digiti minimi brevis Opponens digiti minimi Nerve: Ulnar nerve |
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What intrinsic hand muscles control most fingers and what are their major functions? What nerves innervate them?
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Lumbiricals; flexion at metacarpophalangeal joints
Dorsal interosseus: abduction at metacarpophalnageal joints Palmar interosseus: adduction at metacarpophalangeal joints All of them cause extension at interphalangeal joints Nerves: median and ulnar nerves |
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Difference between Palmaris longus and palmaris brevis
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Palamris longus is a muscle that moves the hand. It flexes the wrist.
Palmaris brevis is an intrinsic hand muscle that moves skin on the medial border of hand to midline of palm. |
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What nerves innervate the extrinsic and intrinsic hand muscles?
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Extrinsic: Deep radial and median; one by ulnar nerve
Intrinsic: ulnar and median |
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Major adductors of arm
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Pectoralis major
Latissimus dorsi |
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General location where flexor muscles of wrist joint originate
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Medial epicondyl of humerus
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General location where extensor muscles of wrist joint originate
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Lateral epicondyl of humerus
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What are metatarsals?
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Five long bones that form the distal portion (metatarsus) of the foot.
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What are carpometacarpal joints?
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Five joints in the wrist that articulate the distal row of carpal bones and the proximal bases of the five metacarpal bones.
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Intercondylar fossa
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Depression between the medial and lateral condyles on distal end of femur, on the posterior surface.
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Spine
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A pointed process
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Epiphysis pg. 118
Diaphysis pg. 118 Metaphysis pg. 118 |
Epiphysis - ends of compact bone
Diaphysis - shaft/body of compact bone Metaphysis - narrow zone where diaphysis connects to epiphysis |
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Fibula
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Lateral bone of leg; lateral to tibia
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Entepicondylar foramen
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An opening in the distal (far) end of the humerus (upper arm bone) present in some mammals
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Lateral malleolus
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A process at distal end of Fibula that provides stability to the ankle joint
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Linea aspera
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A prominent elevation that run along the center of the posterior surface of the femoral shaft.
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What compartments does the deep fascia divide the arm and forearm into?
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Anterior and Posterior compartments. Most muscles within a compartment are innervated by the same nerve and supplied by the same vascular element.
Deep fascia envelopes the muscles and all deeper tissue and divides each region into well defined, physically separate spaces. |
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What are two other divisions of the upper extremity besides anterior and posterior compartments?
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Axilla (around armpit)
Cubital Fossa (in elbow area) |
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What nerves innervate the anterior (flexor) and posterior (extensor) compartments of the arm?
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Anterior: musculocutaneous nerve (a branch of brachial plexus)
Posterior: radial nerve (a branch of brachial plexus) |
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What nerves innervate the anterior (flexor) and posterior (extensor) compartments of the forearm?
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Anterior: median nerve (a branch of brachial plexus)
Posterior: radial nerve (a branch of brachial plexus) |
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What defines the anterior and posterior compartments of arm and forearm?
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Arm: Deep fascia + intermuscular septa (joins deep fascia to humerus)
Forearm: Deep fascia + intemuscular septa + interosseous membrane |
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What forms the floor and roof of the carpal tunnel passage way?
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floor: carpal bones
roof: flexor retinaculum Carpal tunnel connects anterior forearm compartment to palm. |
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1. What nerves innervate the skin and subcutaneous tissue of the upper extremity?
2. What are the surface areas innervated by these nerves called? |
1. Cutaneous branches of the nerves of the brachial plexus.
2. Dermatomes. Each ventral rami of the brachial plexus supplies a specific dermatome. |
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List arteries that supply upper extremity starting from aorta
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Right extremity: Aorta -> Brachiocephalic trunk -> Subclavian artery -> Axillary artery -> Brachial Artery -> Ulnar and Radial arteries (branch from brachial artery)
Left extremity: Aorta -> Subclavian artery -> Axillary artery -> Brachial Artery -> Ulnar and Radial arteries (branch from brachial artery) The difference between left and right upper extremity arteries is that the left subclavian artery arises directly from the aorta. |
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Discuss upper extremity veins
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-have both deep and superficial veins.
-deep veins accompany the arteries, sharing their names and relative distribution -one or two deep veins accompany artery but eventually there is a single axillary vein -Axillary vein -> Subclavian vein -> Brachiocephalic vein -superficial veins lie outside the deep facia of the compartments and are often visible through the skin |
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Discuss upper extremity lymphatics
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There are both deep and superficial lymphatics that evential drain into either the right lymphatic duct or the thoracic duct.
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Discuss upper extremity nerves
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-nerve supply from brachial plexus
-ventral rami of spinal nerves C5, C6, C7, C8 and T1 come together and divide, come together, divide again yielding branches of the brachial plexus. -Branches of brachial plexus: musculocutaneous, median, ulnar and radial nerves |
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What joint has the greatest range of motion of any joint in the body?
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Glenohumeral joint
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1. What four ligaments hold the clavicle in place?
2. What other features secure clavicle to sternum? |
1. interclavicular ligament
sternoclavicular ligament costoclavicular ligament acromioclavicular ligament 2. intracapsular disc and fibrocartilagenous disc. |
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Is trauma to clavicle more likely to result in fracture or disruption of ligaments?
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Fracture
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Two presentation of fracture of lateral aspect of clavicle?
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- inferomedial displacement of the shoulder secondary to the weight of the limb
-contraction of pectoralis major and latissimus dorsi |
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What kind of joint is the glenohumeral joint?
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Synovial, ball and socket joint
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1. What is the fibrcartilagenous ring attached along the outer margin of the glenoid fossa?
2. What happens to it in "throwers shoulder" or SLAP (Superior Labrum Anterior to Posterior) lesion injury? |
1. Glenoid labrum; serves to mitigate shallow nature of glenohumeral joint.
2. labrum tears away from glenoid |
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What forms the coracoacromial arch?
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Coracoid process and the acromion. The subacromial bursa lies with the arch superior to the supraspinatus.
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What provides the bulk of stability to the shoulder?
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Rotator cuff muscles and their common tendinous attachment.
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What is the significance of bone markings?
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Every marking provides a purpose such as muscle attachment or pathway for tendons, nerves or blood vessels.
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What muscles overlies all of the main muscles that control the arm muscles?
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Deltoid muscle. Is responsible for the outward smoothly contoured appearance of the shoulder.
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What is the function of the muscles passing from trunk to the scapula?
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Hold scapula in place and move it in relation to the trunk.
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What is the most superficial posterior trunk to scapula muscle?
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Trapezius
upper fibers elevate scapula middle fibers retract scapula lower fibers depress scapula |
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What three trunk to scapula muscles lie underneath the trapezius?
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Levator scapulae
Rhomboid major Rhomboid minor |
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What muscles define the axilla?
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latissimus dorsi, teres major and subscapularis (posteriorly), pectoralis major (anteriorly), serratus anterior (medially)
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What vein lies in the deltopectoral groove?
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cephalic vein (a major tributary of the axillary vein)
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What nerve can get damaged during dislocation of the glenohumeral joint?
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Axillary nerve; damage to nerve would lead to deltoid muscle atrophy.
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What is the axilla?
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The space between the root of the upper limb and the chest wall. Major nerves and vessels pass through the axilla as the extend distally from the next to the upper extremity.
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What is the axial bound by?
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clavicle, superior border of scapula and the first rib. The floor is bound by fascia passing between anterior and posterior walls.
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Where does part of the brachial plexus lie?
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Axilla; rest of brachial plexus lies proximal to axilla
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What are vanae comitantes?
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small, often paired veins lying alongside smaller arteries, particularly in extremities.
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What are the five nerve roots of the brachial plexus?
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C5 - C8 and T1
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How many lymph node groups in axilla?
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Three.
Pectoral group (drain lateral and anterior aspects of body wall) humeral group (drains most of upper extremity) Subscapular group (drains posterior aspects of body wall) |
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What are the three nerves in anterior compartment of arm?
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Median, ulnar and musculocutaneous.
Only musculocutaneous innervates the biceps brachii, brachialis and corocobrachialis. |
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Fundamental consideration of biomechanics
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-in order for a muscle to have effect over a joint, it must cross the joint
-the closer the joint to the proximal muscular attachment, the less leverage, and therefor, the less influence it can exert over the joint e.g. biceps brachii on glenohumeral joint. -the closer the joint to the distal muscular attachment, the greater the leverage and therefore, the greater the influence it can exert over the joint e.g. biceps brachii at elbow joint. |
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List the ligaments of the sternoclavicular joint
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Accessory ligaments:
anterior sternoclavicular ligament posterior sternoclavicular ligament Extracapsular ligaments -Interclavicular ligament -costoclavicular ligament |
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Interclavicular ligament (insertions + function)
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Insertions
-Interconnects the clavicles -firmly attached to the superior border of the manubrium. Functions: -reinforces superior portions of the adjacent articular capsules -prevents dislocation when shoulder is depressed |
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Costoclavicular ligament (insertions + function)
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Insertions
-costal tuberosity of clavicle -inferior margin of articular capsule -superior and medial portions of the first rib and the first costal cartilages Function: prevents dislocation of shoulder when shoulder is elevated. |
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Does the sternoclavicular joint have an articular disc?
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Yes. The articular disc divides the sternoclavicular joint and separates two synovial cavities.
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What joint permits the greatest range of motion of any joint in the body?
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The shoulder joint
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What is the most frequently dislocated joint?
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The shoulder joint
Note: strength and stability must be sacrificed to obtain mobility |
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What is the glenoid labrum? What is its function?
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Glenoid labrus is a ring of dense, irregular connective tissue that is attached to the margin of the glenoid cavity by fibrous cartilage.
Functions: -enlarges joint cavity -serves as attachment site for glenohumeral ligaments and the long head o biceps brachii muscle |
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Articular capsule of shoulder joint (insertion + weakness)
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Extends from the scapular neck to the humerus.
Weakest at its inferior surface. |
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What provides most of the stability at the shoulder joint?
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1. Ligaments
2. Surrounding skeletal muscles and their associated tendons. |
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What are the major ligaments of the shoulder joint?
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1. Glenohumeral ligaments
2. Coracohumeral ligament 3. Coracoacromial ligament 4. Acromioclavicular ligament 5. Coracoclavicular ligaments 6. Transverse ligaments |
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Glenohumeral ligaments (insertions and function)
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Insertions: shoulder joint capsule
Function: joint stabilization when humerus approaches or exceeds normal motion |
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Coracohumeral ligament (insertions and function)
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Insertions: coracoid process and head of humerus
Function: strengthens superior part of articular capsule and helps support weight of upper limb. |
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Coracoacromial ligament (insertions and function)
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Insertions: coracoid process and acromion, superior to joint capsule
Function: additional support to the superior surface of the capsule. |
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Acromioclavicular ligament (insertions and function)
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Insertions: acromion to the clavicle
Functions: restricts clavicular movement at acromial end. |
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Describe shoulder separation
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-A relatively common injury involving partial or complete dislocation of the acromioclavicular joint.
-Can result from a blow to the superior surface of the shoulder. -the acromion is forcibly depressed, bit the clavicle is held back by strong muscles. -can tear the inferior capsular wall and the glenoid labrum -the ligament involved is acromioclavicular ligament |
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Coracoclavicular ligaments (insertions and function)
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Insertions: clavicle to the coracoid process
Functions: limit the relative motion between the clavicle and scapula |
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Transverse humeral ligament (insertions and function)
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Insertion: extends between greater and lesser tubercles
Function: holds don tend of the long head of the biceps brachii in the intertubercular groove of the humerus. |
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Which contribute more to shoulder joint stability: ligaments and capsular fibers or muscles?
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Muscles. Do more to stabilize glenohumeral joint than ligaments and capsular fibers combined.
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Bursitis
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Painful inflammation of bursae that can restrict motion.
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Important bursae of the shoulder joint
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Subacromial and subcoracoid bursa: prevent contact between the acromion and coracoid process and the capsule.
Subdeltoid and subscapular bursa: lie between large muscles and the capsular wall. |
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How many joints if the elbow joint composed of?
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Composed of two joints between the
(1) humerus and ulna (humeroulnar joint) (2) the humerus and the radius (humeroradial joint) |
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What is the largest and strongest articulation of the elbow joint?
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Humeroulnar joint
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What contributes to stability at the elbow joint?
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1. the bony surfaces of the humerus and ulna interlock to prevent lateral motion
2. the articular capsule is very thick 3. the capsule is reinforced by strong ligaments |
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Ligaments of the shoulder joint
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1. Ulnar collateral ligament
2. Radial collateral ligament 3. Annular ligament |
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Ulnar collateral ligament (insertions and function)
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Insertions: medial epicondyle of the humerus to the coronoid process of the ulna and to olecranon
Function: stabilize medial surface of joint. |
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Radial collateral ligament (insertions and function)
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Insertions: between lateral epicondyle and annular ligament
Function: stabilizes lateral surface of the joint |
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Annular ligament
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Insertions: Annular ligament binds the proximal radial head to the ulna.
Function: holds head of radius in place. |
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What are the two radioulnar joints?
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1. Proximal radioulnar joint
2. Distal radioulnar joint |
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What is the largest muscle that causes movement a the radioulnar joints?
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Biceps brachii muscles. Contraction produces flexion at the elbow and supination of the forearm.
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What are the articulating surfaces of the radioulnar joints?
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1. Ulnar notch of radius
2. Radial notch of ulna 3. Articular disc (piece of hyaline cartilage) |
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What holds together the radioulnar joints?
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1. A series of radioulnar ligaments
2. Antebrachial interosseous membrane |
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What are the two joints that make up the elbow joint?
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Radiocarpal joint and intercarpal joint
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What bones are part of the radiocarpal joint?
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Distal articular surface of radius and three proximal carpal bones: scaphoid, lunate, triquetrum
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What major ligaments surround the wrist and stabilize the position of the individual carpal bones?
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-Palmar radiocarpal ligament: connect radius to anterior surface of scaphoid, lunate and triquetrum
-Dorsal radiocarpal ligament: connects radius to posterior surface of scaphoid, lunate and triquetrum -Ulnar collateral ligament: from styloid process of ulna to medial surface of triquetrum -Radial Collateral ligament: from styloid process of the radius to the lateral surface of the scaphoid. |
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What ligaments interconnect the carpal bones and connect the distal carpal bones to the metacarpal bones.
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Intercarpal ligaments and digitocarpal ligaments.
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1. What type of articulation is the carpometacarpal joint of the thumb?
2. What type of articulation are the other carpometacarpal joints? |
1. Saddle-type articulation.
2. Plane joints. |
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What are the articulations between the carpal bones called?
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Intercarpal joints
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1. What are the the articulations between the metacarpal bones and the proximal phalanges called?
2. What type of articulations are they? |
1. Metacarpophalangeal joints.
2. Condylar joints. |
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1. What are the the articulations between the phalanges called?
2. What type of articulations are they? |
1. Interphalangeal joints.
2. Hinge joints |
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Mary falls on the pals of her hand with her elbows slightly flexed. After the fall, she can't move her left arm at the elbow. If a fracture exists, what bone is most likely broken?
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Ulna
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Sternoclavicular (elements, type of articulation, movements)
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Elements: Sternum/clavicle
Type of articulation: Planar diarthrosis (a double "plane joint," with two joint cavities separated by an articular cartilage) Movements: Protraction/retraction, depression/elevation, slight rotation |
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Acromioclavicular (elements, type of articulation, movements)
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Elements: Scapula/clavicle
Type of articulation: Planar diarthrosis Movements: slight gliding movement |
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Glenohumeral/shoulder (elements, type of articulation, movements)
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Elements: Scapula/humerus
Type of articulation: Ball-and-socket diarthrosis Movements: Flexion/extension, adduction/abduction, circumduction, rotation |
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Elbow/humeroulnar and humeroradial (elements, type of articulation, movements)
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Elements: Humerus/ulna and humerus/radius
Type of articulation: Hinge diarthrosis Movements: Flexion/extension |
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Proximal radioulnar (elements, type of articulation, movements)
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Elements: radius/ulna
Type of articulation: pivot diarthrosis Movements: rotation |
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Distal radioulnar (elements, type of articulation, movements)
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Elements: radius/ulna
Type of articulation: pivot diarthrosis Movements: pronation/supination |
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Radiocarpal (elements, type of articulation, movements)
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Elements: radius/carpal bones
Type of articulation: condylar diarthrosis Movements: flexion/extension, adduction/abduction, circumduction, rotation |
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Intercarpal (elements, type of articulation, movements)
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Elements: Carpal bone/carpal bone
Type of articulation: planar diarthrosis Movements: slight gliding movement |
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Carpometacarpal of thumb (elements, type of articulation, movements)
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Elements: carpal bone/first metacarpal bone
Type of articulation: saddle diarthrosis Movements: flexion/extension, adduction/abduction, circumduction, opposition |
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Carpometacarpal (elements, type of articulation, movements)
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Elements: carpal bones/metacarpal bones II-V
Type of articulation: planar diarthrosis Movements: slight flexion/extension, adduction/abduction |
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Metacarpophalangeal (elements, type of articulation, movements)
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Elements: metacarpal bones/phalanges
Type of articulation: condylar diarthrosis Movements: flexion/extension, adduction/abduction, circumduction |
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Interphalangeal (elements, type of articulation, movements)
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Elements: phalanx/phalanx
Type of articulation: hinge diarthrosis Movements: flexion/extension |