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118 Cards in this Set
- Front
- Back
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Trapezius
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Spinal Accessory Nerve CN XI
Nuchal ligament, skull, C7-T12--> lateral third of clavicle, spine of scapula, acromion Elevate, retract, depress scapula |
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Latissimus Dorsi
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Thoracodorsal nerve (C6,7,8)
T7-sacrum, iliac crest, lower 3-4 ribs--> intertubercular groove (Lady between two majors) extend, adduct, medially rotate arm |
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Rhomboid Major
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Dorsal Scapular Nerve (C5)
T2-T5--> medial border scapula from spine to inferior angle Retract scapula, rotate to depress glenoid cavity |
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Rhomboid Minor
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Dorsal Scapular Nerve (C5)
Nuchal ligament, C7-T1--> medial end of scapular spine Retract scapula, rotate to depress glenoid cavity |
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Deltoid
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Axillary Nerve (C5-6)
Lateral third clavicle, acromion, spine of scapula--> deltoid tuberosity of humerus clavicular: flex/medially rotate arm, acromial: abducts arm, spinal: extend/laterally rotate arm |
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Supraspinatus
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Suprascapular Nerve (C4-6)
Supraspinous fossa--> superior greater tubercle of humerus Abduct arm first 90, rotator cuff |
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Infraspinatus
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Suprascapular Nerve (C5-6)
Infraspinous fossa--> middle greater tubercle of humerus Laterally rotates arm, rotator cuff |
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Teres Minor
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Axillary Nerve (C5-6)
upper lateral border of scapula--> interior facet of greater tubercle of humerus laterally rotates arm, rotator cuff |
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Teres Major
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Lower Subscapular Nerve (C5-6)
inferior angle of scapula--> medial lip of intertubercular groove of humerus (Lady between two majors) adducts and medially rotates arm |
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Subscapularis
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Upper and Lower Subscapular Nerve (C5-7)
subscapular fossa-->lesser tubercle of humerus medially rotates arm, rotator cuff |
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Levator Scapulae
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Dorsal Scapular Nerve (C5), Cervical Nerve (C3-4)
C1-C4-->medial border of the scapula, superior angle to the spine elevates scapula, rotates glenoid cavity inferiorly |
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Biceps Brachii
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Musculocutaneous (C5,C6)
short head: coracoid process, long head: supraglenoid tubercle of scapula--> radial tuberosity flexes elbow, long head flexes arm, strong supinator when arm is flexed Long head runs through bicipital groove-->can be used to locate rotator cuff |
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Pectoralis Major
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Medial (C8-T1) and Lateral Pectoral Nerves (C5-C7)
medial 1/2 clavicle, sternum, ribs 2-6--> lateral intertubercular groove of humerus (Lady between two majors) Flexes, adducts, medially rotates arm |
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Pectoralis Minor
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Medial Pectoral Nerve (C8-T1)
ribs 3-5-->coracoid process Draws scapula forward, medially, downward |
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Coracobrachialis
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Musculocutaneous Nerve (C5-6)
coracoid process-->mid shaft of humerus flexes shoulder and adducts arm resists shoulder dislocation |
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Brachialis
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Musculocutaneous Nerve (C5-6)
mid shaft humerus-->ulnar tuberosity flexes elbow |
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Triceps
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Radial Nerve (C5-T1)
Long head: infraaglenoid tubercle, lateral head: superior radial groove, medial head: inferior radial groove--> olecranon of ulna extends forearm (long head extends/adducts arm) |
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Pronator Teres
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Median Nerve (C5-T1)
Medial epicondyle-->middle of lateral radius pronates forearm |
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Flexor Carpi Radialis
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Median Nerve (C5-T1)
Medial epicondyle-->base of 2 and 3 metacarpal flexes forearm, flexes and abducts hand |
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Palmaris Longus
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Median Nerve (C5-T1)
Medial epicondyle of humerus-->flexor retinaculum, palmar aponeurosis (2, 3, 4 metacarpals) flexes forearm and hand losing: needed for hanging on trees |
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Flexor Carpi Ulnaris
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Ulnar (C7-T1)
Medial epicondyle of humerus--> pisiform, hook of hamate, metacarpal 5 flexes forearm, adducts hand |
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Flexor Digitorum Superficialis (FDS)
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Median Nerve (C5-T1)
Medial epicondyle-->middle phalanges of fingers Flexes proximal phalanges joints, flexes hand and forearm |
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Flexor Digitorum Profundus (FDP)
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Ulnar (C7-T1) and Median Nerves (C5-T1)
Anteromedial ulna-->base of distal phalanges flexes hand and only distal interphalangeal joints |
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Flexor Pollicis Longus
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Median Nerve (C5-T1)
Anterior radius-->base of distal phalanx of thumb flexes thumb |
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Pronator Quadratus
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Median Nerve (C5-T1)
Anterior distal ulna-->anterior distal radius weak pronator (unloaded hand) |
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Subclavian Artery
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Aorta-->first rib
Branches: Suprascapular, Internal Thoracic, Transverse cervical |
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Axillary Artery
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First rib to inferior Teres Minor, runs with brachial plexus
Branches: Screw The Lawyer, Save A Patient 1st stage: Superior Thoracic 2nd stage: Thoracoacromial trunk, Lateral Thoracic artery 3rd stage: Subscapular, Anterior and Posterior Circumflex Humeral |
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Brachial Artery
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Inferior Teres Major-->Radial/Ulnar bifurcation
Branches: Profunda brachial artery, muscular/collateral branches around elbow |
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Suprascapular
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From Subclavian
Course: Runs over Superior Transverse Scapular Ligament in Scapular Notch (army over, navy under) Anastomoses: Dorsal Scapular, Circumflex Scapular Supplies: Supraspinatus, Infraspinatus, Glenohumeral and Acromioclavicular joints |
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Superior Thoracic Artery
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From 1st stage Axillary
Course: Intercostal spaces Supplies: 1st and 2nd intercostal spaces, Serratus Anterior |
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Serratus Anterior
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Long Thoracic Nerve (C5-7)
Upper 8 ribs--> medial border of scapula Rotates scapula upward, abducts arm, elevates arm above horizontal C567 wing your way to heaven: prevents wing scapula |
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Transverse Cervical Artery
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From Subclavian
Course: Medial border of scapula, gives rise to Dorsal Scapular->collateral circulation of scapula Supplies: Trapezius, Levator Scapulae, Rhomboids, Serratus Anterior |
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Thoracoacromial Trunk
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From 2nd stage Axillary
Course: Pierces clavipectoral fascia Supplies: ABCD: Acromial, (Breast) Pectoral, Clavicular, Deltoid branches |
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Lateral Thoracic Artery
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From: 2nd stage Axillary
Course: lateral border Pec Minor Supplies: Pec Major, Pec Minor, Serratus Anterior, Lateral Mammary arteries |
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Subscapular Artery
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From 3rd stage Axillary
Course: Axillary border of scapula Supplies: Branches into Thoracodorsal and Circumflex Scapular arteries |
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Anterior and Posterior Circumflex Humeral Arteries
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From: 3rd stage Axillary
Course: surround surgical neck of humerus, posterior through Quadrangular Space Supplies: Deltoid, Arm muscles at shoulder joint-> collateral circulation |
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Thoracodorsal Artery
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From Subscapular Artery
Course: Lateral border of scapula, follows thoracodorsal nerve Supplies: Latissimus Dorsi |
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Circumflex Scapular Artery
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From Subscapular Artery
Course: Posteriorly through triangular/unnamed space Supplies: Infraspinous fossa, collateral circulation of scapular Anastomoses with Dorsal Scapular and Suprascapular |
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Profunda brachii artery
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From Brachial Artery
Course: Posteriorly through Triangular Interval and Radial Groove with Radial Nerve Supplies: Extensors |
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Superior and Inferior Ulnar Collateral Arteries
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From Brachial Artery
Supplies: collateral circulation of elbow joint, Medial arm muscles I Am Pretty Smart: Inferior collateral goes with Anterior recurrent, Posterior recurrent goes with Superior collateral |
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Axillary Lymph nodes
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Big dipper shape, distal to proximal: Humeral, Subscapular, Pectoral, Central, Apical
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Internal Thoracic Artery
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From Subclavian
Course: descends medially to breast Supplies: breast |
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Lymphatic Drainage of Breast
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Lateral: Pectoral to Central to Apical to Clavicular
Medial: Parasternal to Subdiaphragmatic |
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Musculocutaneous Nerve
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C5-C7, lateral cord
Biceps Brachii Coracobrachialis (pierces here) Brachialis |
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Radial Nerve
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C5-T1, posterior cord
BEAST Superficial: Brachioradialis, ECRL, sensory dorsal hand Deep: Extensors, Abductor Pollicus Longus, Supinator(penetrates) Upper: Triceps Triangular interval with profunda brachial artery |
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Axillary Nerve
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C5-C6, posterior cord
Teres Minor, Deltoid, Superolateral Arm Quadrangular space with circumflex humeral artery |
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Extensor Carpi Radialis Brevis (ECRB)
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Deep Radial Nerve (C7)
Common extensor origin (lateral epicondyle)--> base of 3rd metacarpal Extension of wrist, abduction, against FCR |
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Extensor Carpi Radialis Longus (ECRL)
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Radial Nerve (C6-C7)
Common extensor origin (lateral epicondyle)--> base of 2nd metacarpal Extension of wrist, abduction, against FCR |
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Extensor Carpi Ulnaris (ECU)
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Deep Radial Nerve (C7)
Common extensor origin (lateral epicondyle)--> base of 5th metacarpal Extension of wrist, abduction |
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Brachioradialis
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Superficial Radial Nerve (C6)
Brachium of humerus-->styloid of radius Flexion of elbow when in partially pronated position |
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Thoracodorsal Nerve
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C7-C8, posterior cord
latissimus dorsi |
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Subscapular Nerve (Upper and Lower)
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C5-C6, posterior cord
Upper: Subscapularis Lower: Subscapularis, Teres Major |
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Lateral Pectoral Nerve
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C5-C7, lateral cord
Pectoralis Major |
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Ulnar Nerve
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C8-T1, medial cord
FCU, FDP (ulnar half), abductor digiti minimi m., flexor digiti minimi brevis m., opponens digiti minimi m., ulnar 2 lumbrical mm., palmar and dorsal interosseous mm Posterior to medial epicondyle-->funny bone! |
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Medial Pectoral Nerve
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C8-T1, medial cord
Pectoralis Major and Minor |
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Medial Cutaneous Nerves (Brachial and Antebrachial)
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C8-T1, medial cord
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Median Nerve
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C6-T1, medial and lateral cords
pronator teres m., flexor carpi radialis m., palmaris longus m., FDS, FDP (radial half), flexor pollicis longus m., pronator quadratus m., abductor pollicis brevis m., flexor pollicis brevis m., opponens pollicis m., lateral 2 lumbrical mm. runs with brachial artery, branches in forearm can be trapped between two heads of pronator teres in bodybuilders |
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Long Thoracic Nerve
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C5, 6, 7
Serratus Anterior |
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Suprascapular Nerve
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C5, 6 (upper trunk)
Supraspinatus, Infraspinatus Passes through suprascapular notch-->becomes ossified-->dip shoulder to abduct |
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Dorsal Scapular Nerve
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C5 (root)
Rhomboids, Levator Scapulae |
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Reflex Tendons
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Biceps (C6, musculocutaneous)
Triceps (C7, C8, radial) Brachioradialis (C6, superficial radial) |
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Cutaneous Nerves of arm
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Axillary:deltoid
Lateral cutaneous n. of forearm (musculocutaneous) Radial Median Ulnar Medial cutaneous n. of forearm Medial cutaneous n. or arm |
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Shoulder Dystocia
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Vaginal Delivery
Upper fibers of brachial plexus-->proximal weakness |
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Erb's Palsy
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Injury to Upper Trunk (C5/C6)
Causes:breech birth, violent displacement of head from shoulder Effects:Proximal weakness of arm-->loss of abduction, flexion, and lateral rotation-->waiter's tip hand (arm in medial rotation, loss of lateral rotator function) |
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Carpal Bones
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Some Lovers Try Positions That They Can't Handle
Thumb to pinkie: Proximal: Scaphoid, Lunate, Triquetrum, Pisiform Distal: Trapezium, Trapezoid, Capitate, Hamate |
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Colle's fracture
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Land on hand, support with wrist-->fracture of styloid of radius-->distal end of radius tilted dorsally
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Dupuytren Contracture
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Connective tissue contracts and scars, palmar aponeurosis becomes hyperplastic-->pulls ring and little fingers down
requires surgery to fix, smokers/diabetics more at risk |
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PTS (Pronator Teres Syndrome)
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Entrapment of median nerve between two heads of pronator teres-->similar symptoms to carpal tunnel
Often found in bodybuilders due to steroids |
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Carpal Tunnel
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Superficial to Deep:
Flexor Retinaculum=transverse carpal ligament Median Nerve (superficial palmar arises proximally-->no effect on palmar sensation) and FCR tendon Metacarpals 2-5 and tendons of FDP, FPL- all within synovial cavity Cause: Inflammation, anterior dislocation of lunate Effects: pares/hypoes/anesthesia of lateral 3.5 digits (Tinel's sign), weakness in thumb (APB and opponens pollicis), atrophy of thenar muscles, Phalen's sign Treatment: surgical division of flexor retinaculum to reduce compression |
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Tennis Elbow
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overuse of ECRL and ECRB, lateral epicondylitis
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Golfer's Elbow
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overuse of flexors, medial epicondylitis
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Anconeous
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Radial Nerve (C5-T1)
lateral epicondyle-->olecranon and upper 1/4 of ulna bloodless, nerveless-->easy to reach radius in surgery extends forearm |
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Extensor Digitorum (Communis, ED)
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Lateral epicondyle--> Extensor expansion of proximal 4 digits before PIP
Extends fingers and hand (not past metacarpal joint) |
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Ganglion Cyst
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Bump on wrist full of fluid
Usually on dorsal side (ECRB on 3rd metacarpal) Flexion enlarges-->pain Anterior side: Can press on wrist to cause Carpal Tunnel |
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Extensor Digiti Minimi (EDM)
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Deep Radial Nerve (C7)
Lateral epicondyle and interosseus membrane-->extensor expansion, base of middle and distal phalanges of 5th digit Extends little finger, adducts |
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Cubital Fossa
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TAN: tendon, artery, nerve
biceps tendon, ulnar artery (where it splits off brachial), median nerve Floor: Brachialis and musculocutaneous nerve, Supinator Borders: Brachioradialis and radial nerve (medial), pronator teres (lateral) Medial cubital vein often used for venipuncture (btwn cephalic (lateral) and basilic (medial)) Artery underneath bicipital aponeurosis-->Grace a Deux |
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Wrist drop
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Sign of radial nerve injury--> can't extend wrist/fingers
High lesion: curled up triceps as well (supinator dead but can supinate with bicep) Low lesion: Policeman's tip |
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Quadrangular Space
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surgical neck of humerus, long head triceps, teres minor, teres major
Contains axillary nerve and posterior circumflex humeral artery |
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triangular space
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teres major, teres minor, long head triceps
contains circumflex scapular artery |
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Triangular Interval
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teres major, long head of triceps, mid-shaft humerus
contains radial nerve and profunda brachii artery |
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Anatomical Snuffbox
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Tendons of EPL (medial) and EPB/APL (lateral)
styloid of radius (proximal) scaphoid and trapezium (floor) contains radial artery-->pulse Check here for fractured Scaphoid |
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Bicipetal aponeurosis
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Grace a Dieu: Bicipetal aponeurosis in cubital fossa protects median nerve/brachial artery in venipuncture/bloodletting
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Extensor Indicis (EI)
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Posterior Interosseous Nerve (Deep Radial, C7)
Distal third of ulna and interosseous membrane-->extensor expansion of 2nd digit Extends 2nd digit independently, helps extend wrist |
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Supinator
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Deep Radial Nerve (C8)
Lateral epicondyle/radial collateral, annular ligaments-->proximal third of radius Supinates forearm, rotates forearm when elbow is flexed |
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Abductor Pollicis Longus (APL)
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Posterior Interosseous Nerve (Deep Radial, C8)
Posterior proximal ulna, radius, interosseous membrane-->Base of 1st metacarpal Abduct/extend thumb at CM joint |
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Extensor Pollicis Longus (EPL)
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Posterior Interosseous Nerve (Deep Radial, C8)
Posterior middle 1/3 ulna and interosseous membrane-->Base and distal phalanx of thumb Extends thumb at IP, MP, and CM joints |
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Extensor Pollicis Brevis (EPB)
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Posterior Interosseous Nerve (Deep Radial, C8)
Posterior distal third radius and interosseous membrane-->proximal phalanx of thumb Extends thumb at MP and CM joints |
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BLBLBLI
DMU |
Brachioradialis
ECRL ECRB APL EPB EPL Superficial: Anconeus, Brachioradialis, ECRL, ECRB, ED, EDM, ECU Deep: Sup, APL, EPB, EPL, EI |
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Extensor Retinaculum
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Prevents extensor tendons bowing out
Covers dorsal wrist joint |
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Common Wrist Injuries
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Fracture: Scaphoid, Triquetrum
Dislocation: Lunate |
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Smith's Fracture
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Reverse Colle's Fracture-->distal radius tilts anteriorly
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Fracture of Clavicle
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Upward displacement of proximal portion by sternocleidomastoid muscle and displacement of coracoclavicular ligament, downward displacement of distal by deltoid/gravity
Causes: breeched birth, pressing against pubis symphysis Effects: injury to brachial plexus, hemorrhage of subclavian vein, thrombosis of subclavian vein-->pulmonary embolism |
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Klumpke's Paralysis
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Lower Trunk injury (C8-T1, Ulnar Nerve)
Causes: breech delivery (birth palsy/obstetric paralysis), cervical rib, abnormal insertion or spasm of scalene muscles Effects: Claw Hand |
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Ape Hand
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Injury to median nerve (C5-7)
Causes: supracondylar fracture or compression of carpal tunnel Effects: lose pronation, thumb opposition, lateral two IPs, impair two medial IPs. Flattening of thenar muscles |
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Glenoid Labrum Tears
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Fibrocartilage
Causes: Common in athletes throwing football/baseball: Shoulder instability, subluxation-->tear in glenoid labrum Effects: pain while throwing, esp during acceleration; popping or snapping during abduction/lateral rotation |
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Popeye sign
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Cause: ruptured bicep tendon and bicipital aponeurosis, usually due to degeneration or injury (sudden forceful load in flexion, ie weight-lifting, throwing sports)
Effects: retracted muscle bunches up and bulges out |
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Impingement Syndrome
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Inflammation of rotator cuff tendons and/or surrounding bursa
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Anterior dislocation of the Lunate
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Cause: fall on dorsi-flexed wrist
Effects: carpal tunnel, avascular necrosis of lunate |
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Arthrodesis
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Degenerative joint disease of the wrist
Treatment: Surgical fusion of carpal bones |
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Skier's Thumb (Gamekeeper's thumb)
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Cause: Hyperabduction of Thumb
Effect: Tear UCL of thumb MP joint-->separates from thumb--> Stener lesion- UCL lodged superficial and proximal to Adductor Aponeurosis, Severe case--> avulsion fracture of metacarpal |
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Mallet Finger
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Cause: Sudden severe tension on extensor tendon-->avulse attachment to phalanx
Effect: DIP joint is hyperflexed |
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Boutonniere Deformity
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'Button Hole'
Injury of central slip base of middle phalanx, lateral slips separate--> slips through extensor expansion tendon-->pulls DIP into hyperextension PIP hyperflexion with DIP hyperextension |
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Opponens Pollicis
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Recurrent Median Nerve (C8)
Thenar Muscle Flexor retinaculum--> lateral MC of thumb Opposes thumb |
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Abductor pollicis brevis
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Recurrent Median Nerve (C8)
Thenar Muscle Flexor retinaculum-->lateral base of PP of thumb Abducts and helps oppose thumb |
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Flexor pollicis brevis
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Recurrent Median Nerve (C8)
Thenar Muscle Flexor reticulum--> lateral base of PP of thumb Helps with positioning, secondary to flexor pollicis longus Flexes and adducts thumb |
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Adductor Pollicis
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Deep branch of Ulnar Nerve (T1)
Thenar Muscle Bases of 2+3 MC-->Medial base of PP of thumb Adducts thumb toward lateral border of palm |
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Abductor digiti minimi
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Deep branch of Ulnar Nerve (T1)
Hypothenar Muscle Pisiform-->medial base of PP of 5th digit Abducts 5th digit, assists in flexion |
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Flexor digiti minimi brevis
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Deep branch of Ulnar Nerve (T1)
Hypothenar Muscle Hook of Hamate and Flexor retinaculum-->medial base of PP of 5th digit Flexes PP of 5th digit |
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Opponens digiti
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Deep branch of Ulnar Nerve (T1)
Hypothenar Muscle Hook of Hamate and Flexor retinculum--> Oppose 5th digit with thumb |
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Lumbricals
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1+2- Median (T1), 3+4 Deep Ulnar (T1)
FDP tendons-->Thumb side of digits 2-5 Flex MC, extend IP joints of digits 2-5 (bye-bye muscles) |
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Dorsal Interossei
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Deep Ulnar (T1)
Adjacent MC--> bases of PP digits 2-5 and extensor hood DAB: Abduct fingers from axis, aid lumbricals in bye-bye |
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Palmar Interossei
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Deep Ulnar (T1)
Palmar, long finger sides of MC 2,4,5--> bases of PP 2,4,5 and extensor hood PAD: Adducts fingers to axis, aid lumbricals in bye bye, extension of 2-4 |
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Medial Mid-palmar Space
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Central compartment of hand btwn synovial tendon sheath 3-5 and common flexor sheath
Easily infected-->swells on dorsal side w/o aponeurosis-->extensor tendons bulge |
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Thenar Space
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Thenar compartment of hand btwn synovial tendon sheath 2 and common flexor sheath
Easily infected-->swells |
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Dermatomes of Hand
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C6-Thumb
C7- Middle C8- Pinkie |
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Cutaneous Innervation of Hand
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Median: Palm and nail beds 1-3,
Radial: Dorsal 1-3 and anatomical snuffbox Ulnar: 4-5 |
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RUM
WCTU |
Radial Nerve Injury: Wrist Drop
Ulnar Nerve Injury: Claw Hand Median Nerve Injury: Thenar Atrophy, Ulnar Deviation |
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Arterial Supply of Hand
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Ulnar Artery-->superficial and deep branches, medial side, main supplier of superficial palmar arch--> common and proper palmar digitals
Radial artery: Main supplier of deep palmar branch-->princeps pollicis and radius indicis Anastomose to form superficial palmar, deep palmar, and dorsal carpal arches Vincular arteries-->synovial sheath |
