anatomy exam 2 dow

contents of submandibular triangle

-Submandibular gland -lymph nodes -facial artery + vein

flexor pollicis longus innervation

Median nerve

brachialis innervation

musculocutaneous nerve

ulnar nerve palsy (claw hand)

results in atrophy of interossei and hypothenar muscles

median + ulnar palsy (simian hand)

results in atrophy of thenar and hypothenar muscles

median nerve palsy (gun hand)

results in atrophy of thenar membrane

radial nerve palsy

results in wrist drop

Fascias of the neck

superficial, middle (pretracheal), and deep (prevertebral)

what route does blood draining from facial vein take to return to systemic circulation?

blood from facial vein drains into internal jugular vein

digastric muscle innervation

branch of mandibular + facial nerves

cause + consequences of colle's fracture

cause: slip + fall with extended arm/hand consequences: radial fracture + possible ulnar fracture of styloid process

hypothyroidism

causes slow speech, somnolence, impaired memory, and decreased mental capacity

infrahyoid muscles are innervated by

cervical ansa C1-C3

stylohyoid muscle innervation

cervical branch of facial nerve

temporalis innervation

deep temporal branches of the mandibular nerve

6th compartment of extensor retinaculum

extensor carpi ulnaris

5th compartment of extensor retinaculum

extensor digiti minimi

4th compartment of extensor retinaculum

extensor digitorum + extensor indicis

3rd compartment of extensor retinaculum

extensor pollicis longus

2nd tendon compartment of extensor retinaculum

extensors carpi radialis longus + brevis

middle (pre tracheal) fascia of neck

fascia of the neck that contains infra hyoid muscles + is connected to carotid sheath

deep (pre vertebral) fascia of neck

fascia of the neck that covers the vertebral column + deep vertebral muscles

superficial fascia of neck

fascia of the neck that lies beneath the platysma muscle and contains all other neck structures

discontinuous (diarthrosis) joints

freely moving joints

what nerves are anesthetized during an intra oral approach to a mandibular nerve block?

inferior alveolar + linguinal nerves are anesthetized

amphiarthroses joints

joints that allow slight movement between bones

Continuous (synarthroses) joints

joints where movement is not possible

larynx muscles are innervated by

laryngeal nerve

lateral pterygoid innervation

lateral pterygoid branch of mandibular nerve

masseter innervation

masseteric branch of mandibular nerve

Content of foramen rotundum

maxillary nerve

medial pterygoid innervation

medial pterygoid branch of mandibular nerve

flexor digitorum profundus innervation

median + ulnar nerves

flexor carpi radialis innervation

median nerve

flexor digitorum superficialis innervation

median nerve

palmaris longus innervation

median nerve

pronator quadratus innervation

median nerve

pronator teres innervation

median nerve

carpal bone fractures clinical point

-18% hand fractures (proximal row) -scaphoid is most commonly broken -lunate most commonly dislocated -disability results if diagnosis/displacement fracture isn't recognized

roots/locations of cervical plexus nerves

-C1-C4 nerves -phrenic nerve (C3-C5) originates from cervical plexus -C5 root originates from brachial plexus

carpal tunnel syndrome clinical point

-CTS: pathologic condition of anterior wrist region (pain/hand weakness) caused by median nerve compression in carpal tunnel -causes: repetitive wrist movement, pregnancy, hypothyroidism, rheumatoid arthritis + amyloidosis

causes/signs of median nerve compression above elbow

-arm muscles not affected by nerve injury -wrist flexors are paralyzed -thumb flexors + muscles o thenar side are paralyzed but not adductor (ape hand) -flexsion at metacarpophalangeal joints maybe possible but fingers can't be flexed at interphalangeal joints -lumbricals 1+2 lose function (can't fully flex index + middle fingers) -compromised pronation of forearm + sensory loss of median nerve in hand

characteristics of shoulder joint

-behind humerus head + glenoid cavity -ball + socket joint -multiaxial + flex, extend, add/abduct, lateral + medial rotation, and circumduction -supported by ligaments -tendon of biceps brachii long head passes through

what arteries/veins are at danger during a tracheostomy?

-brachiocephalic artery + vein -aortic arch -carotid artery

winged scapula

-condition where the shoulder blade protrudes from the back in abnormal position -can't lift arm above 90 degrees -long thoracic nerve paralyzed -serratus anterior can't hold scapula to thoracic cage

larynx muscles

-cricothyroid -cricoarytenoid lateralis -cricoarytenoid posterior -transverse + oblique arytenoid -vocalis -thyroarytenoid -thyroepiglottis -aryepiglottis

suprahyoid muscles

-digastric -stylohyoid -mylohyoid -geniohyoid

causes/signs of ulnar nerve injury at wrist

-fingers hyperextended at metacarpophalangeal joints -fingers flexed at interphalangeal joints -"claw hand" = paralysis of interossi muscles + 2 medial lumbricals -tendons of flexor digitorum profundus are paralyzed so flexion of ring + pinky not possible at distal phalangeal joints -flexsion at metacarpophalangeal joint possible due to intact flexor digitorum superficialis -small pinky muscles paralyzed -abd/adduction of fingers are impaired (interossei paralysis) -sensory loss of hand in ulnar nerve territory over ulnar nerve area

Contents of foramen ovale

-mandibular nerve -venous plexus

Contents of foramen spinosum

-middle meningeal artery -meningeal branch of mandibular nerve

actions of thyroid hormone

-necessary for adult stature (bone formation + maturation) - increases BMR in many tissues (heat/temp regulation) -mature the CNS during perinatal period (deficiency = severe mental retard) -treats hyperthyroidism -increases heart rate + stroke volume -increased cardiac output + ventilation rate

facial nerve innervates the superficial facial muscles

-occipitofrontalis -orbicularis oculi -procerus -corrugator supercili -nasalis -levator labii superioris alaque nasi -levator labii superioris -zygomaticus minor + major -orbicularis oris -risorius

infrahyoid muscles

-omohyoid -sternohyoid -sternothyroid -thyrohyoid

causes/signs of ulnar nerve injury at elbow

-paralysis of flexor carpi ulnaris + medial part of flexor digitorum profundus -ulnar deviation of wrist is weakened + hand is abducted + extended

lymph nodes in the axillary region

-pectoral nodes -lateral nodes -apical nodes -subscapular nodes -central nodes

pathway of lymph node drainage

-pectoral= drains into mammary gland -some breast lymphatics drain into central group -central group drains into apical group -apical= drains into subclavian lymphatic trunk then into veins at venous angle

rotator cuff clinical Q+A

-rotator cuff muscles: SITS -injuries include tendinopathy of supraspinatus, calcification, pain, tendon rupture + avulsion of greater tubercle

causes/signs of median nerve compression at wrist joint

-short muscles of thumb may be paralyzed but not adductor -flexor pollicis longs is functioning -thenar muscle atrophy (ape hand) -sensory loss over median nerve area -percussion on nerve in wrist area can lead to heightened paraesthesia in CTS

lower (C8-T1) brachial plexus lesion

-sudden upward pull of shoulder + injury to roots following forced abduction of shoulder at birth (Klumpke's) -leads to paralysis of intrinsic muscle of hand -not as common as upper lesions -signs: -atrophic paralysis of forearm + hand muscles -sympathetic palsy (Horner's if T1 root)

contents of superior orbital fissure

-superior ophthalmic vein -lacrimal nerve -frontal nerve -trochlear nerve -abducent nerve -oculomotor nerve -nasociliary nerve

6 branches of axillary artery

-superior thoracic artery -thoracoacromial artery -lateral thoracic artery -subscapular artery -anterior + posterior circumflex humeral arteries

branches of external carotid arteries

-superior thyroidal -ascending pharyngeal -lingual -facial -occipital -posterior articular -maxillary -superficial temporal arteries

mastication muscles

-temporalis -masseter -lateral pterygoid -medial pterygoid

Upper (C5-C6) brachial plexus lesion

-traction on the arm at birth or falling on the shoulder may damage the upper part of the plexus (roots may be pulled out of spinal cord) -Signs: -paralysis of deltoid + supraspinatus (no arm abduction) -Infraspinatus paralysis (medial rotation of the arm) -Biceps and Brachialis paralysis (no elbow flexion) -loss of biceps and weak supination -shoulder adductors mildly affected (pectorals major + latissimus dorsi)

contents of foramen magnum

-vertbral artery -anterior spinal artery -accessory nerve -posterior spinal artery -spinal vein

sentinel lymph node

1st lymph node/group of lymph nodes that drain cancer tumor

Geniohyoid muscle innervation

C1 via hypoglossal nerve

nerves that make up cervical plexus

C1-C4 nerves -hypoglossal nerve -ansacervicalis nerve -greater auricular nerve -transverse cervical nerve -supraclavicular nerve -phrenic nerve

mylohyoid muscle innervation

Mylohyoid nerve (CN V3)

1st tendon compartment of extensor retinaculum

abductor pollicis longus + extensor pollicis brevis

deltoid (acromial part)

action: abduction innervation: axillary nerve

supraspinatus

action: abduction innervation: suprascapular nerve

pectorals major (sternal part)

action: adduction innervation: medial + lateral pectoral nerves

triceps brachii longhead

action: extension/adduction innervation: radial nerve

latissimus dorsi

action: extension/adduction/medial rotation innervation: thoracodorsal nerve

teres major

action: extension/adduction/medial rotation innervation: lower sub scapular nerve

deltoid (spinal part)

action: extension/lateral rotation innervation: axillary nerve

pectorals major (clavicle part)

action: flexion innervation: lateral pectoral nerve

Coracobrachialis

action: flexion innervation: musculocutaneous nerve

biceps brachii shorthead

action: flexion innervation: musculocutaneous nerve

deltoid (clavicle part)

action: flexion/medial rotation innervation: axillary nerve

teres minor

action: lateral rotation innervation: axillary nerve

infraspinatus

action: lateral rotation innervation: suprascapular nerve

pectoralis major

action: medial rotation innervation: medial + lateral pectoral nerves

subscapularis

action: medial rotation innervation: upper + lower sub scapular nerve

pulled elbow

aka "radial head subluxation" when ligament that wraps around radial head slips off when extended arm is pulled

tracheostomy procedure

procedure creating an opening in neck to place tube into windpipe below vocal cords to allow air in

brachioradialis innervation

radial nerve

extensor carpi radialis longus innervation

radial nerve

Extensor Indicis innervation

radial nerve (deep branch)

abductor pollicis longus innervation

radial nerve (deep branch)

extensor carpi lunaris innervation

radial nerve (deep branch)

extensor carpi radialis brevis innervation

radial nerve (deep branch)

extensor digiti minimi innervation

radial nerve (deep branch)

extensor digitorum innervation

radial nerve (deep branch)

extensor pollicis longus innervation

radial nerve (deep branch)

supinator innervation

radial nerve (deep branch)

metacarpophalangeal joint

type of joint found between carpals

saddle joint

type of joint found between carpo-metacarpal joints

Primary cartilaginous joint

type of joint found between epiphysis and diaphysis

interphalangeal joint

type of joint found between phalanges

synovial pivot joint

type of joint found between radioulnar joints

flexor carpi lunaris innervation

ulnar nerve

2 brachial plexus syndromes

upper (C5-C6) and lower (C8-T1)