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185 Cards in this Set
- Front
- Back
What are the different segments of the vertebral column?
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Cervical, thoracic, lumbar, sacral, and coccyx
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How does the curvature of the vertebral column change with development?
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At mid gestation there is a single anterior curve, at birth mostly straight with 1 posterior curve, and the adult has 2 anterior curves and 2 posterior curves
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Where are the posterior curves in the spine located?
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One in the cervical spine and one in the lumbar spine
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What are lordosis and kyphosis?
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Lordosis is the posterior curve found in the cervical spine and lumbar spine. Kyphosis is an anterior curvature found in the thoracic and sacral spine
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What is an abnormal thoracic kyphosis?
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Abnormal increase in the thoracic curvature
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What is an abnormal lumbar lordosis?
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Abnormal increase in the lumbar curvature
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What is scoliosis?
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Abnormal lateral curvature
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What makes up the intervertebral notch?
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The inferior vertebral notch of the superior vertebra and the uperior vertebral notch of the inferior vertebra
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What is the zygapophysial joint?
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A synovial joint between the superior articular process of one vertebra and the inferior articular process of the vertebra directly above it
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How can you tell the difference between the different vertebra?
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Cervical vertebrae have transverse foramen, thoracic vertebra have a spinous process that comes off at an acute angle and the lumbar vertebra are just big
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Where does the rib articulate with the vertebra?
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The head of the rib articulates with the body of the vertebra and the body of the rib articulates with the transverse process
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What are the primary ligaments that support the vertebral column?
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Strong ligaments - The anterior longitudinal ligament, the posterior longitudinal ligament, and the ligamentum flavum. Small ligaments – supraspinous ligament, nuchal ligament, and interspinous ligamnet
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Where is the anterior longitudinal ligament found?
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On the antero-lateral aspect of vertebral bodies and intervertebral discs. This is a very strong ligament
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Where is the posterior longitudinal ligament found?
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Within the vertebral canal along posterior aspect of vertebral bodies. Weaker than the anterior longitudinal ligament
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Where is the ligamnetum flavum found?
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Extending from lamina to lamina. It functions to resist separation of the vertebral lamina
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Where is the supraspinous ligament found?
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Connecting the apices of the spinous processes from C7 to the sacrum
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What is the nuchal ligament?
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A strong median band at the back of the neck in the same area as the supraspinous ligament
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What is the interspinous ligament?
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Weak bands of tissue connecting adjoining spinous processes
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What is the nucleus pulposus?
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The only remnant of the notochord
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At what levels do the meninges terminate?
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The pia mater terminates at about L4/L5 while the arachnoid and dura go down to about S3
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At what level does the spinal cord terminate?
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L1/L2
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What muscles make up the erector spinae?
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Spinalis, longissimus and iliocostalis
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What innervates the erector spinae?
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Branches of segmental Dorsal ventral primary rami
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What are the origin and insertion of the spinales?
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Originates from a tendon that attaches to the iliac crest and then the fibers run from spinous process to spinous process
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What are the origin and insertion of the longissimus?
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Originates from same tendon as the spinals and inserts on the transverse processes (ingeriorly) and mastoid process (superiorly)
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What are the origin and insertion of the iliocostalis?
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Originates from same tendon as spinales and longissimus and inserts onto the ribs
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What are other smaller muscles of the deep back?
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Semispinalis, multifidus, rotators, interspinales, intertransversarii, and levatores costarum. All of these are also innervated by segmental dorsal primary rami
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Where do the erector spinae muscles lie in relation to the thoracolumbar fascia?
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The erector spinae lie within the thoracolumbar fascia
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Which neck muscles cause flexion?
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Bilateral action of the longus coli, scalene and sternocleidomastoid
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Which neck muscle do extension?
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Semispinalis cericis and iliocostalis cervicis, splenius cervicis and levator scapulae, splenius capitis, multifidus, longissimus capitis, semispinalis capitis, and trapezius
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What muscles to lateral bending do the neck?
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Unilateral action of iliocostalis cervics, longissimus capitis and cervics, splenius capitis and cervicis, and intertransverse and scalene
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What is a dermatome?
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Sensory distribution from a specific area of skin that is related to a specific dorsal root of a spinal nerve
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What is cutaneous distribution?
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Sensory distribution from a specific area of skin that is related to a specific end nerve (such as the radial nerve, or mental branch of the trigeminal nerve)
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Do you have an ideal of which areas of the body are covered by each dermatome?
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Slide 31
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Which direction does the scapula move when it is protracted?
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Protraction is toward the front and retraction is toward the back
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How are rotational movements of the scapula defined?
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By the direction the acrominon process travels
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What must a muscle do in order to work?
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It must cross a joint (except muscles of facial expression). A muscle works at any joint it crosses
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What is the embryologic origin of the superficial muscles of the back and shoulder?
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Ventral somites they are innervated by ventral primary rami and are not true muscles of the back
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What does the trapezius do?
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Scapular elevation, retraction, superior rotation and depression
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What does the latissimus dorsi do?
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Humeral extension, adduction, and medial rotation (acts of the humerus)
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What does the rhomboid major do?
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Scapular elevation, retraction, and inferior rotation
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What does the rhomboid minor do?
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Scapular retraction, elevation, and inferior rotation
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What does the levator scapulae do?
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Scapular elevation, retraction, and inferior rotation
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What are the muscles of the rotator cuff?
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Remember SITS. Supraspinatus, Infraspinatus, Teres minor, and Subscapularis
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What is the action of the supraspinatus?
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Abduction of the humerus
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What does the infraspinatus do?
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Lateral rotation of the humerus
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What does the teres minor do?
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Lateral rotation of the humerus
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What doe sthe teres Major do?
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Humeral extension, adduction and medial rotation. Remember this is not a muscle of the rotator cuff and it follow the path of the latisimus dorsi
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What does the subscapularis do?
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Medial rotation of the humerus
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Where is the triangle of auscultation?
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Between the Trapezius, rhomboid magor and the latissimus dorsi
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What are the fascial spaces on the posterior shoulder?
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1. Triangular space 2. Quadrangular space 3. Triangular interval
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What are the borders of the triangular space?
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Teres minor superior, teres major inferior and the long head of the triceps brachii lateral
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What runs through the triangular space?
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Branch of circumflex scapular artery
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What are the borders of the quadrangular space?
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Teres minor superior, teres major inferior, long head of triceps brachii medial, and the lateral head of triceps brachii ( or shaft of the humerus) lateral
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What are the contents of the quadrangular space?
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Posterior humeral circumflex artery, axillary nerve
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What are the borders of the triangular interval ?
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Teres major superior, long head of triceps brachii medial, lateral head of triceps brachii (or shaft of the humerus) lateral
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What are the contents of the triangular interval?
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Profunda brachii artery, radial nerve
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Which nerve runs on the shaft of the humerus?
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The radial nerve which can be severe when the humerus breaks
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What are some anastomoses around the shoulder?
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The circumflex humeral artery posterior and anterior. the suprascapular artery with the deep branch of transverse cervical artery and the circumflex scapular artery
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What are the muscles of anterior shoulder?
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Deltoid, pectoralis major, pectoralis minor, serratus anterior, subscpularis
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What are the actions of the deltoid?
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Anterior fibers – flexion, adduction and medial rotation. Medial fibers – abduction. Posterior fibers – extension, adduction, and lateral rotation
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What are the actions of the serratus anterior?
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scapular protraction, superior rotation, and depression
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Where does the long thoracic nerve run in relation to the serratus anterior?
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on the surface of the muscle
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What are the actions of the pectoralis major at the shoulder?
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Flexion, adduction, medial rotation
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Where does the cephalic vein run?
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In a groove between the pectoralis major and the deltoid
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What actions does the pectoralis minor have on the scapula?
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Depression, inferior rotation and protrusion
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What ligaments directly hold the humerus in the glenoid fossa?
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Superior, middle, and inferior glenohumeral ligaments. This ligaments are very small and not very stable because of this it is really the muscles that hold the joint in place
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What causes dislocation of the glenohumeral joint?
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Lateral rotation and excessive extension
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What are two dislocations of the acromioclavicular joint?
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Dislocation without ligament rupture and dislocation of the acromioclavicular joint with rupture of the coracoclavicular ligament
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What are the 3 major accessory ligaments of the shoulder?
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acromioclavicular ligament, coracoacromial ligament, and coracoclavicular ligament (trapezoid ligament and conoid ligament)
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What innervates a joint capsule in general?
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Any nerve that runs around it
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In general what arteries supply blood to the joint capsule?
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Any artery that runs next to the joint
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What are the 5 contents of the axilla?
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Fat, Axillary Lymph Nodes, Axillary Veins and tributaries, Axillary Artery and its branches, Brachial Plexus and its branches.
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Where does the axillary artery begin?
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As the subclavian artery passes the 1st rib, it becomes the axillary artery.
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What are the borders of the axilla?
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Anterior: Pectoralis Major and minor, and the clavicle, Posterior: Scapula, subscapularis, latissimus dorsi, Medial: Thorax, serratus anterior, Lateral: Intertubercular sulcus of the the humerus.
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What are 4 main branches of the subclavian Artery?
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Vertebral, internal thoracic, Thyrocervical trunk, costocervical trunk.
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What are the 3 branches off the thyrocervical trunk?
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Inferior Thyroid artery, Transverse cervical, and Suprascapular artery
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Where does the costocervical trunk go?
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It branches to the the root of the neck and the 1st two intercostals spaces.
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What are the 6 branches of the axillary artery?
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The supreme thoracic artery, the Thoracoacromial trunk and branches, The lateral thoracic artery and its branches, the posterior humeral cirmumflex, and the anterior humeral circumflex artery (A / supreme threat/ To The/ Live That/ People Have Can/ Always Help Change Anything
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Where can the lateral thoracic artery be found?
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It travels adjacent to the long thoracic nerve on the surface of the serratus anterior.
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What are the 4 branches of the throacoacromial trunk?
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Acromial, Deltoid, Pectoral, and Clavicular
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What are the two branches of the subscapular artery?
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The circumflex scapular artery and the throacodorsal artery.
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What does the thoracodorsal artery supply?
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They latissimus dorsi.
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Where do the Cephalic and Basilic veins lie with respect to eachother?
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The cephalic vein lies lateral to the basilica vein.
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Where do the brachial, basilica, and cephalic veins drain to?
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The axillary vein.
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Where do the cephalic, axillary and external jugular veins drain to?
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The subclavian vein.
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Which two veins merge to form the brachiocephalic vein?
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The subclavian and internal jugular vein.
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Are the major veins generally superficial or deep to their corresponding arteries?
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They are usually superficial to the arteries.
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Where is the bicipital groove?
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Between the greater and lesser tubercles of the humerus…also called the intertubercular groove.
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Where is the anatomical neck located with respect to the surgical neck of the humerus?
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The anatomical neck is superior to the surgical neck.
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Where it the olecrenon?
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It is a proximal extension of the ulna that articulates with the olecrenon fossa of the humerus….forms the point of the elbow….
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What 3 muscles are in the anterior compartment of the arm and what innervates them?
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Biceps, Coracobrachialis, and the brachialis…all innervated by the musculocutaneous nerve
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Which is the largest muscle of the posterior compartment of the arm?
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The triceps
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What innervates the triceps and other muscles of the posterior arm?
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The radial nerve
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Which nerves of the upperlimb have cutaneous innervations?
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Almost all of them do, not just the musculocutaneous nerve.
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Why does the short head of the biceps look longer than the long head?
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The short head is visible all the way to its origin at the corocoid process, the long head originates on the superior scapula within the shoulder joint, much of the muscle isn’t seen because it is within the joint.
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Where do the short and long heads of the biceps lie with respect to each other?
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The short head is medial and the long head is lateral.
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Where does the musculocutaneous nerve run with respect to the coracobrachialis?
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It goes right through the coracobrachialis.
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Which muscle is considered to be the true flexor at the elbow?
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The brachialis.
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Which muscle is the primary extensor at the elbow?
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The triceps.
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Which small muscle can aid the triceps to extend at the elbow?
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The anconeus
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Where do the long, lateral, and medial heads of the triceps originate?
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The long head originates on the scapula, the lateral and medial heads originate on the humerus.
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What is unique about the brachioradialis?
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It starts on the posterior arm and is innervated by the radialis like the other posterior arm muscles, but it attaches to the anterior radius and so it can have the action of the anterior arm muscles if the musculocutaneous nerve were to be damaged.
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Where does the radial nerve run with respect to the triceps brachii?
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It runs on the surface of the medial head of the triceps, deep to the lateral head.
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What is the profunda brachii?
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Aka the deep brachial artery that runs between the lateral and medial heads of the triceps.
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What are the actions of the triceps muscles?
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Extension and adduction at the shoulder and extension at the elbow.
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What is the action of the brachioradialis?
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Flexion at the elbow.
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What are the actions of the biceps?
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At the shoulder: the long head does flexion and the short head does adduction, at the humero-ulnar joint: flexion, and at the radio-ulnar joint: supination.
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What actions does the coracobrachialis do?
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Flexion and adduction at the shoulder
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What actions does the brachialis do?
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Flexion at the humero-ulnar joint.
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What two branches does the brachial artery give off just inferior to the anterior cubital fossa?
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The ulnar and radial arteries.
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Where is the median cubital vein?
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It connects the cephalic vein and the basllic vein near the cubital fossa.
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Which vein is the deep vein in the arm?
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The brachial vein
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Which two veins are the main superficial veins of the arm?
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The basilica medially and the cephalic laterally.
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Which of the superficial veins of the arm might pose more problems for a phlebotomist?
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There are more crucial structures deep to the basilica vein that could cause problems in a misplaced IV, so the cephalic vein is the better target.
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What are the borders of the cubital fossa?
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Pronator teres, Brachioradialis, and the line between the humeral epicondyles.
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Where do the cephalic, basilica and median cubital veins run with respect to the muscles of the anterior arm and forearm?
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Superficial to all of these muscles.
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What structures run in the deep cubital fossa?
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Branchialulnar and radial arteries, the median nerve, the radial nervesuperficial and deep branches of the radial nerve.
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Do you know the bony landmarks of the humerus?
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Check them out on slide 24!
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What articulates with the trochlea of the humerus?
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The olecrenon process of the ulna.
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What holds the bones of the elbow in place?
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Ligaments…specifically the radial collateral ligament, the ulnar collateral ligament, and the anular ligament of the radius, and the joint capsule.
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What are the characteristics of the annular ligament of the radius?
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It runs in a horizontal direction, it is cone shaped in adults large superior to small inferior, but in kids the smaller bottom isn’t formed yet so you can pop the head of the radius out of joint if you swing them by their arms.
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Who is responsible in 99% of the dislocated elbow problems in kids?
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Dads. They are just too rough.
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How many of each of the different types of bones are there in the hand?
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8 carpals, 5 metacarpals and 14 phalanges
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How can you remember the different carpals?
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Some Lovers Try Positions That They Cannot Handle. Scaphoid Lunate Triquetrum Pisiform Trapezium Trapezoid Capitate Hamate
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Where does the Pisiform Sit with relation to the Triquetrum?
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On the ventral so you can only see 7 carpal from the dorsal
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What type of joints are between the carpals?
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Synovial joints
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What innervates the muscles of the posterior compartment of the forearm?
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The radial nerve
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What innervates the anterior compartment of the forearm?
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The median nerve. Exceptions ½ of the flexor digitorum profundus and the flexor carpi ulnaris that are innervated by the ulnar nerve
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What are the deep muscles of the Anterior forearm from lateral to medial (thumb to pinkie)?
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Pronator teres, Flexor Carpi radialis, Palmaris Longus, Flexor carpi ulnaris
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What does the pronator teres do?
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It originates on the medial epicondyle and medial side of coronid process of the ulna and inserts on the radius this allows it to pronate at the elbow joint
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What does the Flexor carpi radialis do?
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Originates on medial epicondyle and inserts on 2nd metacarpal the primary actions are flexion and abduction at the wrist
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What are the origin, insertion and primary action of the Palmaris longus?
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Originates on medial epicondyle, inserts in palmar aponeurosis of the hand, primary action is flexion at the wrist
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What are the origin, insertion and primary action of the flexor carpi ulnaris?
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Originates on medial epicondyle and olecranon, inserts on pisiform bone, primary actions are flexion and adduction at wrist
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Where is the pronator quadrates found?
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Originates on the ulna and inserts on the radius the primary action is pronation
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What are the primary flexors of the fingers?
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Flexor digitorum superficialis, flexor digitorum profundus, and flexor pollicis longus
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What are the origin, insertion and primary action of the flexor digitorum superficialis?
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Originates on medial epicondyle and proximal aspect of the radius, inserts on middle phalanx of each finger, primary action is flexion at proximal interphalangeal joints
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What are the origin, insertion and primary action of the flexor digitorum profundus?
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Originates on anterior aspect of ulna and interosseus membrane, inserts on distal phalanx of each finger, primary action is flexion at distal interphalangeal joint
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What are the origin, insertion and primary action of the flexor pollicis longus?
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Originates on proximal aspect of radius and interosseus membrane, inserts on distal phalanx of thumb, and the primary action is flexion at interphalangeal joint of thumb
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Where does the median nerve run in the forearm?
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Between the superficialis and the profundus but by the time it gets to the area of the wrist it becomes very superficial
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What is the most lateral muscle of the anterior arm?
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The brachioradialis which comes around from the posterior forearm and is innervated by the radial nerve
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What are the superficial muscles of the forearm from lateral to medial?
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Brachioradialis, flexor carpi radialis, Palmaris longus, and flexor carpi ulnaris
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What path does the tendon of the flexor digitorum profundus take?
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It runs on top of the tendon of the superficialis which splits and forms a tunnel through wich the flexor digitorum profundus runs to attach to the distal phalanx
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What is golfer’s elbow?
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Medial epicondylitis, tendon has inflammation and tiny tears
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What are the origin, insertion and primary action of the brachioradialis?
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Originates on distal end of humerus and inserts on the lateral surface of the distal aspect of the radius. Primary action is flexion at the elbow
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What are the origin, insertion and primary action of the anconeus?
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Originates on the lateral epicondyle and inserts on the ulna. The primary action is extension at the elbow
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What are the origin, insertion and primary action of the extensor carpi radialis longus?
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Originates on distal end of humerus and inserts on 2nd metacarpal. The primary action is extension at the wrist
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What are the origin, insertion and primary action of the Extensor carpi radialis brevis?
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Originates on the lateral epicondyle and inserts on 2nd and 3rd metacarpals. The primary action is extension at the wrist
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What are the origin, insertion and primary action of the extensor digitorum (communis)?
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Originates on lateral epicondyle and inserts via extensor hoods into dorsal aspect of middle and distal phalanges of the four fingers. The primary action is extension at the fingers
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What are the origin, insertion and primary action of the extensor carpi ulnaris?
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Originates on the lateral epicondyle and ulna inserts on the 5th metacarpal (pinkie side). The primary action is extension and adduction of the wrist
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What are 2 wrist abductors?
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Flexor carpi radialis innervated by the medial nerve and the extensor digitorum innervated by the radial nerve
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What are 2 adductors of the wrist?
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Extensor carpi ulnaris innervated by the radial nerve and the flexor carpi ulnaris innervated by the medial nerve
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What are the origin, insertion and primary action of the supinator?
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Originates on lateral epicondyle and ulna, inserts on lateral surface of radius. Primary action is supination at the radio-ulnar joint
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What are the origin, insertion and primary action of the abductor pollicis longus?
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Originates on ulna, radius, and interosseus membrane, inserts on base of 1st metacarpal. The primary action is abduction at the wrist
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What are the origin, insertion and primary action of the extensor pollicis brevis?
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Originates on radius and interosseus membrane inserts on proximal phalanx of the thumb. The primary action is extension of metacarpophalangeal and carpometacarpal joints of the thumb
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What are the origin, insertion and primary action of the extensor pollicis longus?
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Originates on ulna and interosseus membrane, inserts on distal phalanx of the thumb. Primary action is extension of interphalangeal joints of the thumb
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What are the origin, insertion and primary action of the extensor indicis?
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Originates on radius and interosseus membrane and inserts on extensor hood of index finger. Primary action is extension of index finger
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What runs through the anatomical snuff box?
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The radial artery
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What supplies blood to the scaphoid bone?
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A branch of the radial artery. If the scaphoid bone breaks there is a possibility that part of the scaphoid bone will lose its blood supply and undergo necrosis rendering the hand useless. This can be fixed with a prosthetic bone
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What tendons form the anatomical snuffbox?
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The extensor policis longus and the extensor policis brevis
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Where is the extensor hood?
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It is a ligament that wraps around the proximal end of the 2nd phalanx
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What is tennis elbow?
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Lateral epicondylitis
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What is tommy john surgery?
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Reconstruction of the ulnar ligament that keeps pitcher in the game.
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Where is borrowed tendon taken from in tommy john surgery?
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The Palmaris longus tendon
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What is a nerve plexus?
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When a group of fibers join together, merge and new groups of fibers (nerves) emerge from them
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What two structures does the brachial plexus pass between when it enters the posterior triangle of the neck?
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The middle scalene and the posterior scalene
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What are the 5 end nerves of the brachial plexus?
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Musculocutaneous nerve, Axillary nerve, radial nerve, median nerve, and ulnar nerve
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What runs in the middle trunk?
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C7 alone
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If a cutaneous nerve has antebrachial in its name where is it most likely to innervate?
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The forearm
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Where do the dermatomes of the upper limb cover?
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C5 is the deltoid, C6 is the thumb side, C7 is the middle finger, C8 is the pinkie side and T1 is the upper medial arm
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Where do fibers of the musculocutaneous nerve originate and what do they innervate?
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C5-C7. Brachialis, Biceps brachii, and Coracobrachialis
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Where do fibers of the Axillary nerve originate and what do they innervate?
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C5 and C6 Deltoid, and teres minor
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Where do fibers of the median nerve originate and what do they innervate?
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C5-T1. All muscles in anterior forearm and hand not innervated by the ulnar nerve
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Where do fibers of the radial nerve originate and what do they innervate?
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C5-T1. All muscles on posterior aspect of upper limb
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Where do fibers of the ulnar nerve originate and what do they innervate?
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C7-T1. Flexor carpi ulnaris, ½ of flexor digitorum profundus, muscles of 5th digit, medial two lumbricals, and all interossei
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Where do fibers of thelateral pectoral nerve originate and what do they innervate?
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C5-C7. Petoralis major
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Where do fibers of the medial pectoral nerve originate and what do they innervate?
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C8 and T1. Pectoralis major and pectoralis minor
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Where do fibers of the upper subscapular nerve originate and what do they innervate?
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C5 and C6. subscapularis
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Where do fibers of the lower subscapular nerve originate and what do they innervate?
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C5 and C6. Subscapularis and teres major
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Where do fibers of theThoracodorsal nerve originate and what do they innervate?
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C6-C8. Latissimus dorsi
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Where do fibers of the suprascapular nerve originate and what do they innervate?
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C5 and C6 supraspinatus and infraspinatus
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Where do fibers of the dorsal scapular nerve originate and what do they innervate?
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C5 levator scapulae, rhomboid major, and rhomboid minor
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Where do fibers of the long thoracic nerve originate and what do they innervate?
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C5-C7 serratus anterior
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What does the median nerve innervate in the hand?
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Lumbricals of index and middle fingers, opponens pollicis, flexor pollicis brevis, and abductor pollicis brevis
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What does the ulnar nerve innervate in the hand?
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All interossei, lumbricals of ring and pinky fingers, adductor pollicis, abductor digiti minimi, flexor digiti minimi, and opponens digiti minimi
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