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139 Cards in this Set

  • Front
  • Back

Bony landmarks on the Clavicle

Sternal end

Acromial end


Bony landmarks on Scapula

glenoid cavity



coracoid process

medial (vertebral) border

superior border

superior angle

inferior angle

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


deltoid tuberosity-distal attachment for deltoid m.

medial epicondyle- flexor m. of forearm attach

lateral epicondyle- extensor m. of forearm attach

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

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

Bony landmarks on the hands

1. Carpus- proximal and distal rows of bones

2. 1st-5th metacarpal bones- thumb=1st




3. Phalanges- distal, middle, proximal (1st only distal, proximal)




"the distal phalanx of the third digit of the right hand"

General subdivisions of the upper limb

1. Shoulder

2. Arm

3. Elbow

4. Forewarm

5. Wrist

6. Hand

Surface Anatomy of Upper Limb:

Palpate Clavicle, jugular notch, sternoclavicular joint, spine and acromion of scapula, acromioclavicular joint, anterior and posterior axillary folds


Surface Anatomy of Upper Limb:

Palpate infraclavicular fossa

inferior to clavicle bw/n pec major and deltoid mm.

Surface Anatomy of Upper Limb:Palpate greater tubercle of humerus


Surface Anatomy of Upper Limb:Palpate pectoralis major m.


Surface Anatomy of Upper Limb:Palpate digitations of serratus anterior m.

inferior to axilla

Surface Anatomy of Upper Limb:Palpate Deltoid m.

lateral, rounded shoulder m.

Surface Anatomy of Upper Limb:Palpate Clavopectoral triangle

indentation bw/n pec major and deltoid

-location of cephalic v.--> common placement for pacemaker leads

Surface Anatomy of Upper Limb:Palpate trapezius m.

bw/n its attachment to skull and acromion

Surface Anatomy of Upper Limb:Palpate axillary fossa of the axilla


-axillary vessels, lymph nodes, parts of brachial plexus

Surface Anatomy of Anterior and Medial Arm:

Palpate deltoid m.

Surface Anatomy of Anterior and Medial Arm: Palpate biceps brachii m.


Surface Anatomy of Anterior and Medial Arm: Palpate medial epicondyle of the humerus

-medial bump at elbow

-origin of common flexor tendon

Surface Anatomy of Anterior and Medial Arm: Palpate lateral epicondyle of the humerus

-lateral elbow bump?

-origin of common extensor tendon

Surface Anatomy of Posterior Arm: Palpate triceps m.

-lateral posterior arm

Surface Anatomy of Posterior Arm: Palpate triceps tendon

-superior to elbow

Surface Anatomy of Posterior Arm: Palpate olecranon


Surface Anatomy at cubital fossa: Palpate biceps m. and tendon

-superior to cubital fossa (triangle at anterior elbow)

Surface Anatomy at cubital fossa: Palpate median cubital vein

-connects cephalic and basilic vv.

-crosses through cubital fossa- lateral inferiorly, medial superiorly

Surface Anatomy at cubital fossa: Palpate cephalic vein

-begins at radial extremity of arch, moves along lateral forearm

Surface Anatomy at cubital fossa: Palpate Basilic vein

-begins at ulnar extremity of arch, moves along medial forearm

Superficial veins of upper limb

-basilic vain

-cephalic vein

-median cubital vein

within superficial fascia

Surface Anatomy of Forearm: Palpate posterior border of ulna

Surface Anatomy of Forearm: Palpate flexor-pronator group of muscles

attahch to medial epicondyle via common flexor tendon

-thumb side of forearm

Surface Anatomy of Forearm: Palpate extensor-supinator groups of mm.

-attach to lateral epicondyle via common extensor tendon

-majority of posterior forearm, pinky side

Surface Anatomy of Forearm: Palpate head of the ulna

bump superior to wrist, pinky side

Surface Anatomy of Forearm: Palpate styloid process of ulna

pinky side, beneath head of ulna?

Surface Anatomy of Forearm: Palpate styloid process of radius

superior to wrist thumb side

Surface Anatomy of Forearm: Palpate cephalic vein

thumb side

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

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

Surface Anatomy of Anterior Wrist and hand: distal transverse palmar crease

-horizontal crease at level of metacarpophalangeal (MP) joints of digits 2-5

Surface Anatomy of Anterior Wrist and hand: proximal digital crease

root of finger

Surface Anatomy of Anterior Wrist and hand: middle digital crease

horizontal crease at level of proximal interphalangeal (PIP) joints of digits 2-5

Surface Anatomy of Anterior Wrist and hand: distal digital crease

horizontal crease at level of distal interphalangeal (DIP) joints of digits 2-5

Anatomical Snuff Box

superior to thumb, between two tendons

-location of radial artery

thenar eminence

muscles on palm superior to thumb

hypothenar eminence

muscles of palm superior to pinky

dorsal veinous network

superficial veins on posterior surface of hand

heads of metacarpals

big knuckles

brachial artery pulse point

upper half of medial intermuscular septum of the arm (between anterior and posterior compartments)

vessels in upper limb most commonly used for arterial pulse

bracial artery

radial artery

ulnar artery

radial artery pulse point

-anterior surface of distal radius

-anatomical snuff box

*most common vessel (for arterial pulse?)

ulnar artery pulse point

anterior surface of distal ulna

venous channels of upper limb: most commonly used to removed blood and infuse liquids

median cubital vein

basilic or cephalic vein in forearm

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

upper limb dermatomes: C6, C8

C6: lateral shoulder, arm, forearm, hand (thumb)

C8: medial arm, forearm, hand (pinky and 4th digit)

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

subdivisions of lower limb

1. hip

2. thigh

3. knee

4. leg

5. ankle

6. foot

bony pelvis (pelvic girdle)

1. two coxal bones

2. sacrum

3. coccyx

bony landmarks of Coxal bone (hip bone, pelvic bone)

1. iliac crest


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

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

examine patella and orientation to femur and tibia

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

bony landmarks of fibula

1. head

2. lateral malleolus

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

bony landmarks of foot: calcaneal tuberosity

-attachment for calcaneal tendon

-posterior, superior calcaneus

bony landmarks of foot: metatarsals


1st= big toe




bony landmarks of foot: tuberosity of 5th metatarsal

lateral protrusion

bony landmarks of foot: phalanges

1st: proximal, distal

2-5: proximal, middle, distal




bony landmarks of foot: sesamoid bones

bone embedded in tendon or muscle

pair inferior to head of first metatarsal

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

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


8. gluteal sulcus- line beneath butt cheek

popliteal fossa

posterior to knee

hamsting mm.

-biceps femoris m.: lateral posterior thigh, tendon inserts on head of fibula

-semitendinosus and semimembranosus mm.: medial, tendon inserts on tibia?

quadriceps femoris muscle group

palpate upper, middle and lower ends of group of mm.

patellar ligament

patella to tibial tuberosity

femoral triangle

1. femoral n. -lateral

2. femoral artery- oulse point!, intermediate

3. femoral v. - medial

Fracture of the Clavicle

-frequent, mainly children (greenstick)


--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

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

Greenstick Fracture

-incomplete fracture

-one side of bone is broken, other side is bent

(clavicular fractures in younger children)

-tree branch

Impacted Fracture

-one fragment driven into spongy bone of other fragment

-fall on hand

-most humeral fractures result in this

Avulsion Fracture

-small part of tubercle avulsed (torn away),


-fall on acromion (middle, older),

-fall on hand with arm abducted (younger),

-mm. pull limb into medial rotation

Fracture of the surgical neck



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

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

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

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

Coxa Valga

angle of inclination between long axis of femoral neck and femoral shaft is increased

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

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

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

Transcervical femoral fracture

-middle of neck


--indirect trauma (stumbling, stepping down hard)

-unstable--> impaction results= limb shortened

intertrochanteric femoral fracture

-between trochanters

-cause: --indirect trauma (stumbling, stepping down hard)-unstable--> impaction results= limb shortened

intracapsular femoral fracture

-w/n hip joint capsule

-may cause degeneration of femoral head b/c of vascular trauma

spiral femoral fracture

-cause: direct trauma

-results in:

a. foreshortening

b. comminuted (several pieces)

transverse stress fracture of tibia

-inferior third

-long hikes w/o conditioning

-foot fixed w/ bone turning during a fall

fracture of olecranon

-"fractured elbow"

-fall on elbow while contracting triceps brachii

-olecranon pulled away--> avulsion Fx

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

transverse patellar fractures


--direct blow to knee

--sudden contraction of quad

-proximal fragment pulled superiorly by quad tendon

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

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

popliteal pulse

-popliteal artery deep=hard to feel

-prone position, knee flexed

-feel inferior where a. is related to tibia

-weakening=femoral a. obstructon

calcaneal tendon reflex

-ankle jerk reflex

-legs dangling

-strike tendon just proximal to calcaneus

-plantarflexion of ankle joint

-S1 and S2 nerve roots

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

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)

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

Surface Anatomy:


-anterior sesamoid bone of knee joint

-in quadriceps femoris tendon

Surface Anatomy: tendon of quadriceps femoris m.

extends to patella

Surface Anatomy: patellar ligament and tibial tuberosity

-patella to tibial tuberosity

-knee jerk reflex

Surface Anatomy: lateral and medial femoral epicondyles

-palpable on either side of patella

-immobile during flexion and extension of knee

Surface Anatomy: anterior tibial border, medial surface of shaft of tibia

-anterior ridge

-medial surface to ridge

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

Surface Anatomy: head of fibula

superior, lateral

Surface Anatomy: tendon of biceps femoris

lateral, posterior to knee

Surface Anatomy: popliteal fossa

bound by:

Superiorly: hamstring tendons

inferiorly: heads of gastrocnemius


1. popliteal vessels

2. tibial n.

3. common fibular n.

Surface Anatomy: medial and lateral heads of gastrocnemius m.

palpate at popliteal fossa, trace inferiorly until form calcaneal tendon

Surface Anatomy: calcaneal (Achilles) tendon

-combo of gastrocnemius and soleus mm.

-terminates at calcaneal tuberosity

Surface Anatomy: medial and lateral malleolus

superior surface of foot


inferior surface of foot

plantar (volar) surface

Surface Anatomy: sesmoid bones

on head of 1st metatarsal

Surface Anatomy: heads of metatarsal bones

big toe knuckles

Surface Anatomy: tuberosity of 5th metatarsal

base of 5th

Surface Anatomy: shafts of metatarsals and phalanges

Palpable arterial pulses of lower limb

- femoral

-posterior tibial

-dorsalis pedis

femoral a. pulse

inferior to inguinal ligament at midinguinal line

posterior tibial a. pulse

compress area below and posterior to medial malleolus

dorsalis pedis a. pulse

compress area bw/n bases of first two metatarsals

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

outline anterior area of the L1 dermatome

below and parallel to inguinal ligament

outline L5 dermatome

lateral thigh and leg, central dorsum of foot

-cutaneous area is painful if herniate L4-5 disc

outline S1 dermatome

posterolateral thigh, leg, foot

L5-S1 disc herniation

anterior lower limb dermatomes

rotate medially as move distally