Wvsom Msk - 9/9/14 - Upper Limb Development

Front 1

This is responsible for establishing the cranial-caudal organization of limb development.

Back 1

Hox genes

Front 2

Limbs begin development during what time period?

Back 2

4-8 Weeks

Front 3

These are an outpocketing on the ventrolateral body:

Back 3

limb buds

Front 4

The limb buds are composed of:

Back 4

mesenchymal cells with an ectodermal covering

Front 5

Limbs develop in which direction?

Back 5

proximodistal

Front 6

The Apical Ectodermal Ridge does what?

Back 6

influences mesenchyme core to stay undifferentiated

Front 7

At what time frame do the terminal portions of limb buds flatten out to form hand & foot plates

Back 7

6 weeks

Front 8

These separate the limb into 3 segments:

Back 8

circular constrictions

Front 9

This process separates the digits in the hands/feet:

Back 9

areas of cell death (apoptosis)

Front 10

The core of the limb bud is made up of this cell type:

Back 10

Mesenchyme

Front 11

The limb bud core mesenchyme differentiate into:

Back 11

chondrocytes

Front 12

Define diaphysis

Back 12

shaft

Front 13

Define epiphyses

Back 13

ends

Front 14

Define epiphyseal plate

Back 14

The growth plate / metaphysis that remains to allow for growth

Front 15

This develops into the secondary ossification center

Back 15

epiphyses

Front 16

Describe the stages of endochondral ossification:

Back 16

Stage #1: development of the primary center

Stage #2: development of the secondary centers of ossification

Step 1: chondrocyte differentiation

Step 2: Formation of hyaline cartilage models

Step 3: Blood vessels invade, bringing with them osteoblasts

Step 4: Secondary ossification centers at ends of bone (epiphysis) develop post-birth. Cartilage (growth) plate remains, allowing for continued bone growth

Front 17

The interzone is:

Back 17

the area between developing bones

Front 18

The mesenchyme in the interzones develop into:

Back 18

dense fibrous tissue

Front 19

The dense fibrous tissue in the interzone develops into:

Back 19

articular cartilage

menisci

ligaments

etc

Front 20

Irregular bones usually has several:

Back 20

primary & secondary ossification centers

Front 21

The upper extremities contain what dermatomes?

Back 21

C4-T2

Front 22

The lower extremities contain what dermatomes?

Back 22

L2-S2

Front 23

What rami supplies the limbs?

Back 23

Anterior primary rami

Front 24

This division innervates the embryonic ventral mass muscles:

Back 24

Anterior

Front 25

This division of the rami innervates the embryonic dorsal mass muscles:

Back 25

Posterior

Front 26

What is the embryonic origin of the limb buds?

Back 26

lateral plate mesoderm

Front 27

What are the two divisions of the axial line?

Back 27

Preaxial - cranial - towards head

Postaxial - caudal - towards tail/hind parts

Front 28

The upper limbs rotate which direction during development?

Back 28

90 degrees lateral so that the thumb is lateral

Front 29

The lower limbs rotate which direction during development?

Back 29

90 degrees medial so that the big toe is medial

Front 30

BUE: ventral mass muscles are where and do what?

Back 30

Flexors, aDDuctors, pronators

on the anterior side

Front 31

BUE: dorsal mass muscles are where and do what?

Back 31

extensors, ABductors, supinators

on the posterior side

Front 32

BLE: ventral mass muscles are where and do what?

Back 32

Flexors, aDDuctors, pronators

on the posterior side

Front 33

BUE: dorsal mass muscles are where and do what?

Back 33

extensors, ABductors, supinators

on the anterior side

Front 34

Describe the sequencing of Dermatomes on the upper limbs

Back 34

Front 35

What are the compartments of the shoulder girdle?

Back 35

Posterior Axioappendicular

Anterior Axioappendicular

Scapulohumeral

Axillary region

Front 36

Describe the muscles and nerves in the posterior axioappendicular region:

Back 36

Muscles: Trapezius, Latissimus dorsi, levator scapulae, rhomboids

Innervations: anterior rami (brachial plexus)

Front 37

Describe the muscles & nerves in the anterior axioappendicular region:

Back 37

Muscles: Pectoralis major/minor, subclavius, serratus anterior

Innervations: branches off the brachial plexus

Front 38

Describe the muscles & nerves in the scapulohumeral region:

Back 38

Muscles: Deltoid, supraspinatus, infraspinatus, teres major, teres minor, subscapularis

Innervations: posterior cord of brachial plexus

exception: *spinatus muscles are innervated by a branch off the superior trunk

Front 39

Describe the Axillary region borders:

Back 39

pyramidal shape with an apex, base, & 4 walls:

Anterior: pectoral muscles

Posterior: subscapularis

Lateral: intertubercular sulcus

Medial: serratus anterior

Apex: cervico-axillary canal

** ignore: Base: axillary fossa (fascia/skin)

Front 40

Describe the contents of the axillary region:

Back 40

axillary sheath surrounds:

axillary artery & vein and the brachial plexus

Front 41

Describe the components of the Arm:

Back 41

Humerus!

Front 42

Describe the Arm's posterior compartment:

Back 42

Muscles include Extensors such as triceps brachii and the brachioradialis.

Vessels include deep brachial artery that travels with the radial nerve.

Innervations include only the radial nerve.

Front 43

Describe the Arm's anterior compartment:

Back 43

Muscles include Flexors such as biceps brachii, brachialis, coracobrachialis, brachial artery.

Vessels include deep brachial artery.

Innervations include only the musculo-cutaneous nerve

Front 44

Describe the Cubital fossa

Back 44

A triangular depression anterior to the elbow b/w the forearm flexor and extensor muscles. The boundaries include protator teres (medially), brachioradialis (laterally) and a line drawn between medial & lateral epicondyles.

Contents: biceps brachii tendon, brachial artery, median nerve, and the median cubital vein that communicates b/w cephalic & basilic veins.

Front 45

Describe the components of the Forearm: [bones]

Back 45

radius & ulna!!

Front 46

Describe the Forearm's posterior compartment:

Back 46

Muscles: extensors, supinator.

Vessels: Posterior interosseus artery.

Innervated: radial nerve [& branches].

Front 47

Describe the Forearm's anterior compartment:

Back 47

Muscles: flexors & pronators.

Vessels: Radial & Ulnar artery.

Innervated by median & ulnar nerves.

Front 48

Describe the boundaries of the carpal tunnel:

Back 48

Floor & walls include the carpal bones.

Roof includes the flexor retinaculum.

Front 49

Describe the contents of the carpal tunnel:

Back 49

Tendons: Flexor digitorum profundus & superficialis, Flexor pollicis longus

Nerves: Median nerve

Front 50

List the compartments of the hand:

Back 50

Thenar, hypothenar, central, interosseous, adductor

Front 51

Describe the Thenar compartment of the hands:

Back 51

Muscles include the abductor pollicis brevis, flexor pollicis brevis, and opponens pollicis.

It is innervated by the median nerve (C6)

Front 52

Describe the Hypothenar compartment of the hands:

Back 52

Muscles include the abductor digit minimi, flexor digit minimi, and opponens digit minimi.

It is innervated by the deep branch of the ulnar nerve.

Front 53

Describe the Central compartment of the hands:

Back 53

Muscles include the lumbricals (acts on medial phalange).

Tendons include the the FDS & FDP.

They are innervated by the ulnar nerve except for 1/2 LOAF.

Front 54

Describe 1/2 LOAF mnemonic

Back 54

1 & 2 Lumbrical.

Opponens pollicis.

ABductor pollicis brevis.

Flexor pollicis brevis.

Front 55

Describe the Interosseous compartment of the hands:

Back 55

Muscles include the palmar interossei (3) and dorsal interossei (4).

It is innervated by the deep branch of the ulnar nerve.

Front 56

Describe the Adductor compartment of the hands:

Back 56

Muscles include the adductor pollicis and it is innervated by the deep branch of the ulnar nerve.

Front 57

Describe the snuff box:

Back 57

Boundaries include the tendon of extensor pollicis longus for the medial border and the tendon of extensor pollicis brevis & abductor pollicis longus.

The contents include the radial artery and is a location for s/sx of a fractured scaphoid bone.

Front 58

Describe how the sheaths and spaces in the hand can be involved in infection.

Back 58

The potential spaces in the hand include the thenar and midpalmar which are spaces usually filled with connective tissue that provide access into the tendon sheaths. This provides access points for infection to travel directly to the forearm.

- Midpalmar space > carpal tunnel > forearm

- 5th digit synovial sheath > common flexor sheath > carpal tunnel > forearm

- flexor pollicis longus sheath > carpal tunnel > forearm