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139 Cards in this Set
- Front
- Back
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Bony landmarks on the Clavicle |
Sternal end Acromial end Shaft |
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Bony landmarks on Scapula |
glenoid cavity spine acromion coracoid process medial (vertebral) border superior border superior angle inferior angle |
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Bony landmarks on the humerus |
head- articulates w/ glenoid cavity greater tubercle- lateral, proximal projection surgical neck anatomical neck intertubercular sulcus (bicipital groove)- tendon of long head of biceps brachii goes through shaft deltoid tuberosity-distal attachment for deltoid m. medial epicondyle- flexor m. of forearm attach lateral epicondyle- extensor m. of forearm attach |
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Bony landmarks on the ulna |
1. olecranon- proximal, moves into olecranon fossa of humerus during extension 2. posterior border of ulna 3. head- distal 4. shaft of the ulna 5. ulnar styloid process- distal, posterior projection |
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Bony landmarks on the radius |
1. Head- proximal 2. neck 3. radial tuberosity- distal insertion for long head of biceps brachii 4. shaft of radius 5. radial styloid process |
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Bony landmarks on the hands |
1. Carpus- proximal and distal rows of bones 2. 1st-5th metacarpal bones- thumb=1st -base -shaft -head 3. Phalanges- distal, middle, proximal (1st only distal, proximal) -base -shaft -head "the distal phalanx of the third digit of the right hand" |
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General subdivisions of the upper limb |
1. Shoulder 2. Arm 3. Elbow 4. Forewarm 5. Wrist 6. Hand |
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Surface Anatomy of Upper Limb: Palpate Clavicle, jugular notch, sternoclavicular joint, spine and acromion of scapula, acromioclavicular joint, anterior and posterior axillary folds |
x |
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Surface Anatomy of Upper Limb: Palpate infraclavicular fossa |
inferior to clavicle bw/n pec major and deltoid mm. |
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Surface Anatomy of Upper Limb:Palpate greater tubercle of humerus |
? |
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Surface Anatomy of Upper Limb:Palpate pectoralis major m. |
boob |
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Surface Anatomy of Upper Limb:Palpate digitations of serratus anterior m. |
inferior to axilla |
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Surface Anatomy of Upper Limb:Palpate Deltoid m. |
lateral, rounded shoulder m. |
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Surface Anatomy of Upper Limb:Palpate Clavopectoral triangle |
indentation bw/n pec major and deltoid -location of cephalic v.--> common placement for pacemaker leads |
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Surface Anatomy of Upper Limb:Palpate trapezius m. |
bw/n its attachment to skull and acromion |
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Surface Anatomy of Upper Limb:Palpate axillary fossa of the axilla |
-armpit -axillary vessels, lymph nodes, parts of brachial plexus |
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Surface Anatomy of Anterior and Medial Arm: Palpate deltoid m. |
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Surface Anatomy of Anterior and Medial Arm: Palpate biceps brachii m. |
bicep |
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Surface Anatomy of Anterior and Medial Arm: Palpate medial epicondyle of the humerus |
-medial bump at elbow -origin of common flexor tendon |
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Surface Anatomy of Anterior and Medial Arm: Palpate lateral epicondyle of the humerus |
-lateral elbow bump? -origin of common extensor tendon |
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Surface Anatomy of Posterior Arm: Palpate triceps m. |
-lateral posterior arm |
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Surface Anatomy of Posterior Arm: Palpate triceps tendon |
-superior to elbow |
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Surface Anatomy of Posterior Arm: Palpate olecranon |
-elbow |
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Surface Anatomy at cubital fossa: Palpate biceps m. and tendon |
-superior to cubital fossa (triangle at anterior elbow) |
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Surface Anatomy at cubital fossa: Palpate median cubital vein |
-connects cephalic and basilic vv. -crosses through cubital fossa- lateral inferiorly, medial superiorly |
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Surface Anatomy at cubital fossa: Palpate cephalic vein |
-begins at radial extremity of arch, moves along lateral forearm |
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Surface Anatomy at cubital fossa: Palpate Basilic vein |
-begins at ulnar extremity of arch, moves along medial forearm |
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Superficial veins of upper limb |
-basilic vain -cephalic vein -median cubital vein within superficial fascia |
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Surface Anatomy of Forearm: Palpate posterior border of ulna |
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Surface Anatomy of Forearm: Palpate flexor-pronator group of muscles |
attahch to medial epicondyle via common flexor tendon -thumb side of forearm |
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Surface Anatomy of Forearm: Palpate extensor-supinator groups of mm. |
-attach to lateral epicondyle via common extensor tendon -majority of posterior forearm, pinky side |
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Surface Anatomy of Forearm: Palpate head of the ulna |
bump superior to wrist, pinky side |
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Surface Anatomy of Forearm: Palpate styloid process of ulna |
pinky side, beneath head of ulna? |
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Surface Anatomy of Forearm: Palpate styloid process of radius |
superior to wrist thumb side |
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Surface Anatomy of Forearm: Palpate cephalic vein |
thumb side |
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Surface Anatomy of Anterior Wrist and hand: Distal wrist crease |
-horizontal wrist crease at proximal end of thenar and hypothenar eminences -transition area bw/n forearm bones and carpal bones of wrist |
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Surface Anatomy of Anterior Wrist and hand: proximal transverse palmar crease |
-begins at radial border of plam -above head of 2nd metacarpal -extends medially across palm superficial to bodies of 3rd-5th metacarpals |
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Surface Anatomy of Anterior Wrist and hand: distal transverse palmar crease |
-horizontal crease at level of metacarpophalangeal (MP) joints of digits 2-5 |
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Surface Anatomy of Anterior Wrist and hand: proximal digital crease |
root of finger |
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Surface Anatomy of Anterior Wrist and hand: middle digital crease |
horizontal crease at level of proximal interphalangeal (PIP) joints of digits 2-5 |
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Surface Anatomy of Anterior Wrist and hand: distal digital crease |
horizontal crease at level of distal interphalangeal (DIP) joints of digits 2-5 |
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Anatomical Snuff Box |
superior to thumb, between two tendons -location of radial artery |
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thenar eminence |
muscles on palm superior to thumb |
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hypothenar eminence |
muscles of palm superior to pinky |
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dorsal veinous network |
superficial veins on posterior surface of hand |
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heads of metacarpals |
big knuckles |
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brachial artery pulse point |
upper half of medial intermuscular septum of the arm (between anterior and posterior compartments) |
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vessels in upper limb most commonly used for arterial pulse |
bracial artery radial artery ulnar artery |
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radial artery pulse point |
-anterior surface of distal radius -anatomical snuff box
*most common vessel (for arterial pulse?) |
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ulnar artery pulse point |
anterior surface of distal ulna |
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venous channels of upper limb: most commonly used to removed blood and infuse liquids |
median cubital vein basilic or cephalic vein in forearm |
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palpable lymph nodes of upper limb |
-axillary nodes (5 in armpit area) -cubital nodes: in superficial fascia near basilic and/or cephalic veins, proximal to median cubital vein |
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upper limb dermatomes: C6, C8 |
C6: lateral shoulder, arm, forearm, hand (thumb) C8: medial arm, forearm, hand (pinky and 4th digit) |
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hand dermatomes: C6, C7, C8 |
C6: lateral- thenar eminence and thumb C7: skin covering metacarpals and phalanges 2-3, sometimes 4 C8: metacarpals and phalanges 4-5, sometimes medial 1/2 or entire 3 |
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subdivisions of lower limb |
1. hip 2. thigh 3. knee 4. leg 5. ankle 6. foot |
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bony pelvis (pelvic girdle) |
1. two coxal bones 2. sacrum 3. coccyx |
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bony landmarks of Coxal bone (hip bone, pelvic bone) |
1. iliac crest 2. ASIS 3. pubic tubercle 4. tubercle of the iliac crest 5. ischial tuberosity- sitz bones 6. pubic crest 7. obturator foramen 8. acetabulum- fusion of illium, ischium and pubis, articulates with femur |
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bony landmarks of femur |
1. head of the femur 2. neck of the femur- common fracture site 3. shaft of the femur 4. greater trochanter- lateral base of neck 5. lesser trochanter- medial base of neck 6. lateral femoral condyle- origin of lateral head of gastrocnemius m. 7. medial femoral condyle- origin of medial head of gastrocnemius m. 8. lateral epicondyle 9. medial epicondyle 10. patellar surface- distal, anterior depression |
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examine patella and orientation to femur and tibia |
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bony landmarks of tibia |
1. tibial tuberosity-anterior projection, proximal, patellar ligament attachment 2. anterior border- shard, vertical ridge on anterior surface 3. medial malleolus 4. lateral condyle of the tibia- proximal 5. medial condyle of the tibia-proximal |
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bony landmarks of fibula |
1. head 2. lateral malleolus |
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bony landmarks of foot: tarsus bones (7) |
1. talus-superior 2. calcaneus-posterior 3. navicular- bw/n talus and cuneiforms 4. cuboid- lateral, cube 5. 1st cuneiform- medial 6. 2nd cuneiform 7. 3rd cuneiform |
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bony landmarks of foot: calcaneal tuberosity |
-attachment for calcaneal tendon -posterior, superior calcaneus |
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bony landmarks of foot: metatarsals |
1-5 1st= big toe base shaft head |
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bony landmarks of foot: tuberosity of 5th metatarsal |
lateral protrusion |
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bony landmarks of foot: phalanges |
1st: proximal, distal 2-5: proximal, middle, distal base shaft head |
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bony landmarks of foot: sesamoid bones |
bone embedded in tendon or muscle pair inferior to head of first metatarsal |
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gluteal area |
-iliac crest to gluteal fold (inderior butt cheek) -four quadrants: vertical line through highest point of iliac crest, horizontal lines through mid sacrum and through ischial tuberosity 1. upper lateral- injection site 2. upper medial 3. lower lateral 4. lower medial |
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Surface anatomy of posterior gluteal surface and posterior thigh |
1. ischial tuberosity 2. level of iliac crests- L4/L5 intervertebral disc 3. greater trochanter of femur- lateral bulge, trace gluteus medius m. inferior from lateral edge of iliac crest to termination at greater trochanter 4. intergluteal cleft 5. sacrum- triangle superior to cleft 6. coccyx 7. PSIS 8. gluteal sulcus- line beneath butt cheek |
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popliteal fossa |
posterior to knee |
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hamsting mm. |
-biceps femoris m.: lateral posterior thigh, tendon inserts on head of fibula -semitendinosus and semimembranosus mm.: medial, tendon inserts on tibia? |
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quadriceps femoris muscle group |
palpate upper, middle and lower ends of group of mm. |
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patellar ligament |
patella to tibial tuberosity |
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femoral triangle |
1. femoral n. -lateral 2. femoral artery- oulse point!, intermediate 3. femoral v. - medial |
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Fracture of the Clavicle |
-frequent, mainly children (greenstick) -causes: --indirect F during fall= outstretched hand --> bones of forearm-->arm-->shoulder --direct fall on shoulder -weakest at junction of middle and lateral thirds -sternocledomastoid m. pulls medial portion superior--> visible through skin/palpable -lateral portion falls inferiorly-->shoulder drops -lateral portion may be pulled medially-->overriding of bone fragments |
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Fractures of the Humerus |
1. fractures of the surgical neck 2. impacted fractures 3. avulsion fracture of the greater tubercle of the humerus: 4. transverse fracture of the shaft of the humerus: direct blow to arm 5. spiral fracture of the humeral shaft 6. intercondylar fracture of the humerus: severe fall on flexed elbow |
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Greenstick Fracture |
-incomplete fracture -one side of bone is broken, other side is bent (clavicular fractures in younger children) -tree branch |
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Impacted Fracture |
-one fragment driven into spongy bone of other fragment -fall on hand -most humeral fractures result in this |
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Avulsion Fracture |
-small part of tubercle avulsed (torn away), Cause: -fall on acromion (middle, older), -fall on hand with arm abducted (younger), -mm. pull limb into medial rotation |
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Fracture of the surgical neck |
-elderly -osteoporosis |
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Bicipital myotatic reflex (biceps reflex) |
-relaxed limb pronated and partially extended at elbow
-thumb firmly placed on biceps tendon -hammer taps base of thumb nail bed -Positive: involuntary contraction of biceps=flexion of elbow --musculocutaneous n., C5 and C6 spinal cord segments -excessive, diminished or prolonged response: CNS, PNS or metabolic disorders |
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Fracture of humeral shaft |
1. midhumeral fracture: -radial n. injusred in radial groove --> triceps not paralyzed 2. supra-epicondylar fracture: -distal fragment pulled over proximal --> limb shortening --> damage to nn. or brachial vessels |
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Venipuncture in the cubital fossa |
-usually median cubital vein --crosses bicipital aponeurosis (grace Deux tendon)= separated from brachial a. and median n. -tourniquet removed once vein is punctured -also used for: --intro of cardiac catheters --coronary angiography |
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coxa vara |
angle of inclination between long axis of femoral neck and femoral shaft is decreased -results in mild shortening of lower limb, limits passive hip abduction |
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Coxa Valga |
angle of inclination between long axis of femoral neck and femoral shaft is increased |
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Femoral Fractures |
1. fracture of neck- most common a. transcervical b. intertrochanteric 2. intracapsular fractures 3. fractures of greater trochanter 4. fractures of femoral shaft a. spiral fracture of femoral shaft 5. inferior/distal femur |
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Tibial Fractures |
-junction of medial and inferior third= weakest 1. compound fracture- tibial shaft 2. transverse march (stress) fracture 3. diagonal fracture 4. boot top fracture |
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Fibular fractures |
fracture dislocations of ankle joint= fracture of lateral and medial malleoli -inversion: fibular fracture=lateral malleolus -eversion: fibular and tibial fracture= medial and lateral malleolus -soccer and bball players |
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Transcervical femoral fracture |
-middle of neck -cause: --indirect trauma (stumbling, stepping down hard) -unstable--> impaction results= limb shortened |
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intertrochanteric femoral fracture |
-between trochanters -cause: --indirect trauma (stumbling, stepping down hard)-unstable--> impaction results= limb shortened |
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intracapsular femoral fracture |
-w/n hip joint capsule -may cause degeneration of femoral head b/c of vascular trauma |
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spiral femoral fracture |
-cause: direct trauma -results in: a. foreshortening b. comminuted (several pieces) |
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transverse stress fracture of tibia |
-inferior third -long hikes w/o conditioning -foot fixed w/ bone turning during a fall |
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fracture of olecranon |
-"fractured elbow" -fall on elbow while contracting triceps brachii -olecranon pulled away--> avulsion Fx |
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measuring pulse rate |
-common place: radial artery lies on anterior surface of distal end of radius, lateral to tendon for FCR -aberrant radial artery may make it hard to palpate on one side, but can feel on other -can feel radial a in snuff box also |
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transverse patellar fractures |
-cause: --direct blow to knee --sudden contraction of quad -proximal fragment pulled superiorly by quad tendon |
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patellar tendon reflex |
-sit w/ legs dangling -strike ligament -extension of leg from quad contraction -femoral n. and L2-L4 spinal cord segments -diminution: any lesion that interrupts quad innervation |
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palpation, compression, cannulation of femoral artery |
-femoral pulse: midway between ASIS and pubic symphysis -palpation: pinky on ASIS, thumb on pubic tubercle, pulse felt on midpalm (inferior to midinguinal ligament) -compression: press posteriorly w/ hand as above against superior pubic ramus, psoas major, femoral head --> reduced blood flow -cannulation: inferior to midinguinal ligament --left cardiac angiography --coronary arteriography -blood taken here for blood gas analysis |
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popliteal pulse |
-popliteal artery deep=hard to feel -prone position, knee flexed -feel inferior where a. is related to tibia -weakening=femoral a. obstructon |
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calcaneal tendon reflex |
-ankle jerk reflex -legs dangling -strike tendon just proximal to calcaneus -plantarflexion of ankle joint -S1 and S2 nerve roots |
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posterior tibial pulse |
-between posterior medial malleolus and medial border of calcaneal tendon -foot must be inverted -examine both simultaneously=equality of F -absent in 60 + yo = peripheral arterual disease |
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plantar reflex |
-L4-S2 nerve roots -stroke lateral sole of footw/ blunt object -begin at heel and cross to base of big toe -flexion of toes abnormal: fanning of lateral four toes and dorsiflexion of great toe= Babinski sign =brain injury/cerebral disease (unless younger than 4) |
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palpation of dorsalis pedis pulse |
-feet slighlty dorsiflexed -just extensor retinaculum to lateral to extensor hallucis longus tendon -absent: arterial disease (5 Ps of acute arterial occlusion) -congenitally nonpalpable dorsalis pedis pulses |
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Surface Anatomy: Patella |
-anterior sesamoid bone of knee joint -in quadriceps femoris tendon |
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Surface Anatomy: tendon of quadriceps femoris m. |
extends to patella |
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Surface Anatomy: patellar ligament and tibial tuberosity |
-patella to tibial tuberosity -knee jerk reflex |
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Surface Anatomy: lateral and medial femoral epicondyles |
-palpable on either side of patella -immobile during flexion and extension of knee |
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Surface Anatomy: anterior tibial border, medial surface of shaft of tibia |
-anterior ridge -medial surface to ridge |
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Surface Anatomy: tendons of anterior compartment musculature |
-dorsum of foot -tendons from: 1. tibialis anterior 2. extensor hallucis longus 3. extensor hallucis brevis 4. extensor digitorum longus 5. fibularis brevis 6. fibularis tertius |
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Surface Anatomy: head of fibula |
superior, lateral |
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Surface Anatomy: tendon of biceps femoris |
lateral, posterior to knee |
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Surface Anatomy: popliteal fossa |
bound by: Superiorly: hamstring tendons inferiorly: heads of gastrocnemius -contains: 1. popliteal vessels 2. tibial n. 3. common fibular n. |
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Surface Anatomy: medial and lateral heads of gastrocnemius m. |
palpate at popliteal fossa, trace inferiorly until form calcaneal tendon |
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Surface Anatomy: calcaneal (Achilles) tendon |
-combo of gastrocnemius and soleus mm. -terminates at calcaneal tuberosity |
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Surface Anatomy: medial and lateral malleolus |
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superior surface of foot |
dorsum |
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inferior surface of foot |
plantar (volar) surface |
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Surface Anatomy: sesmoid bones |
on head of 1st metatarsal |
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Surface Anatomy: heads of metatarsal bones |
big toe knuckles |
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Surface Anatomy: tuberosity of 5th metatarsal |
base of 5th |
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Surface Anatomy: shafts of metatarsals and phalanges |
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Palpable arterial pulses of lower limb |
- femoral -posterior tibial -dorsalis pedis |
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femoral a. pulse |
inferior to inguinal ligament at midinguinal line |
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posterior tibial a. pulse |
compress area below and posterior to medial malleolus |
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dorsalis pedis a. pulse |
compress area bw/n bases of first two metatarsals |
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palpable superficial lymph nodes of lower limb |
superficial inguinal nodes: 1. superior superficial inguinal nodes- extend horizontally below medial inguinal ligament 2. inferior superficial inguinal nodes- extend medially, medial to great saphenous vein *medial to femoral vein drain: superficial lower limb, penile/scrotal OR vulvar/lower vaginal areas |
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outline anterior area of the L1 dermatome |
below and parallel to inguinal ligament |
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outline L5 dermatome |
lateral thigh and leg, central dorsum of foot -cutaneous area is painful if herniate L4-5 disc |
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outline S1 dermatome |
posterolateral thigh, leg, foot L5-S1 disc herniation |
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anterior lower limb dermatomes |
rotate medially as move distally |
