A&P I_Exam 5_Torso 1

Pectoralis Major Origin: clavicle, sternum, and costal cartilages of ribs ____ or _______ (sometimes _____-______) Insertion: intertubercular sulcus (AKA _________ ________) of humerus Action: _______ and _______ rotates humerus at the shoulder joint. Innervation: lateral and medial ______ nerves

-2-5 or 2-6 (sometimes 1-7) -intertubercular groove -adducts and medially

Pectoralis Minor: Origin: Ribs ________, _________, or _______ Insertion: ______ process of scapula Actions: ________ (protracts) scapula and rotates it _________; elevates ribs during forced __________ when scapula is fixed. Innervation: medial ________ nerve

-2-5, 3-5, or 2-4 -coracoid -abducts -downward -inspiration -pectoral

Levator Scapulae: Origin: superior ___ or _____ cervical vertebrae Insertion: _______ vertebral border of scapula Action: elevates ______ Innervation: ________ _______ nerve

-4 or 5 -superior -scapula -dorsal scapular

Teres Major Origin: ________ lateral border (angle) of scapula Insertion: intertubercular sulcus (AKA intertubercular _______) of humerus Action: ______, medially rotates, and extends arm (_________) at shoulder joint Innervation: lower ________ nerve

-inferior -groove -adducts -dorsally -subscapular

Quadrangular Space -A four-sided space associated with the posterior axilla Borders are: Superiorly: ______ border of teres minor Inferiorly: _______ border of teres major Medially: ________ head of triceps Laterally: ______ neck of humerus

-inferior -superior -long -surgical

Humerus--Proximal End -The ____________ sulcus (bicipital groove, also intertubercular groove) contains the long head of the biceps brachii muscle. -_________ neck is distal to the tubercles, where the humerus is frequently broken.

-intertubercular -surgical

Acromioclavicular Joint -Where the _________ (acromial) end of the clavicle articulates with the acromion process of the scapula. -Generally considered a joint of the upper limb -A small _________ joint -Site of shoulder separations -Stabilizing ligaments *____________ ligament *____________ ligament (includes trapezoid and conoid ligament)

-lateral -synovial -Acromioclavicular -Coracoclavicular

The scapular notch (suprascapular notch) is an indentation along the superior border through which the ___________ nerve passes.

suprascapular

The axillary artery begins at the lateral border of the ____ rib as the continuation of the ______ artery. It becomes the _______ artery when it passes the inferior border of the teres _____ (it generally reaches the humerus at that point)

-1st -subclavian -brachial -major

Latissimus Dorsi: Origin: spinous processes of inferior ____ thoracic vertebrae, lumbar vertebrae (T___-L____); crests of sacrum and ilium Insertion: intertubercular sulcus (AKA ________ ________) of humerus Action: extends, _________, and medially rotates humerus at shoulder joint, draws arm inferiorly and posterioly, raises body toward arms during climbing. Innervation: __________ nerve

-6 -T7-L5 -intertubercular groove -adducts -thoracodorsal

There are _______ carpal bones bound together by _______ that comprise the wrist. There are _______ metacarpal bones that are contained in the palm of each hand. Each hand contains _____ phalanges: 3 in each finger and 2 in each thumb.

-8 -5 -14

Serratus Anterior: Origin: superior ____ or ____ ribs Insertion: ______ border and ______ angle of scapula Action: _______ scapula and rotates it ______; elevates ribs when scapula is fixed. Termed "_________ muscle" because it is important in horizontal arm movements such as punching and pushing. Innervation: _______ _______ nerve

-8 or 9 -vertebral -inferior -abducts -upward -boxers -long thoracic

_________ __________ syndrome is a form of thoracic outlet syndrome, which is caused by compression of the brachial plexus and brachial vessels in the root of the neck, producing a mixture of nerve compression symptoms in the arm and shoulder including pain, pins and needles, numbeness, weakness, and circulation changes (sweating, blueness, blotchiness). This is a rare form of thoracic outlet syndrome wherein the brachial plexus and vessels are trapped between the anterior and middle ______ muscles.

-Anterior Scalene Syndrome (AKA scalenus anterior syndrome, scalene entrapment syndrome) -scalene

Suprascapular Neuritis: Clinical findings -Neuralgic pain often radiates to the C__-C__ dermatones (i.e. to the point of the shoulder and down to the outside aspect of the forearm) -In some cases the radiation of pain is _________ -Direct pressure over the nerve in the notch with the examining finger can reproduce the local and referred pain down the arm -Prolonged entrapment of the nerve leads to visible wasting of the supraspinatus and infraspinatus muscles

-C5-C6 -vague

Rhomboid Minor: Origin: spinous processes of C__-T___ vertebrae Insertion: medial (vertebral) border of scapula superior to the scapular spine Action: elevates and adducts (retracts) scapula; stabilizes scapula (fixes scapula to thoracic wall) Innervation: _______ ________ nerve

-C7-T1 -dorsal scapular

__________ __________ attach the bones of the upper limbs to the axial skeleton and are held in place by muscle attachments. The pectoral girdle is part of what division of the skeleton? The human body has two pectoral girdles, each comprising a ______ and ______.

-Pectoral girdles -appendicular skeleton -clavicle and scapula

Clavicle: -____-shaped bone with two ______. -Extends from sternum to _______ above the 1st rib. -Fracture site is junction of ________. -_______ attached to clavicle stabilize its position

-S -curves -Scapula -curves -ligaments

Components of the upper limb: _________: proximal segment of the limb that overlaps thorax and back of the trunk, plus lower lateral neck __________: first segment of the free upper limb ________: elbow to wrist _______: composed of wrist, palm, dorsum of hand, and fingers

-Shoulder -Arm -Forearm -Hand

Muscles of the back: __________ layers connect the upper limb to the vertebral column. The intermediate layer is composed of muscles that are involved in _________ (sometimes called _______ muscles of the upper limb) The ____________ layers are muscles that extend the head and vertebral column, and produce rotation and lateral bending of the head, neck, and back.

-Superficial -Respiration -Extrinsic -Deepest

Rhomboid Major: Origin: spinous processes of thoracic vertebrae T___-T___. Insertion: ________ (vertebral) border of scapula inferior to the scapular spine Action: elevates and _________ (retracts) scapula; stabilizes scapula (fixes scapula to thoracic wall) Innervation: _______ ______ nerve

-T2-T5 -medial -adducts -dorsal scapular

Superficial back muscles: Composed of what 4 muscles? -Act on the upper limb, even though they are located in the back. -Generally receive their nerve supply from _______ rami of cervical nerves, except the _______, which receives its motor fibers from CN XI.

-Trapezius -Latissimus dorsi -Levator scapulae -Rhomboids (major and minor) -ventral -trapezius

Clavicle: The two ends of the clavicle are the ________ extremity and the _______ extremity. The __________ tubercle is the site of attachment of the conoid portion of the coracoclavicular ligament, which is located between the clavicle and the _________ process of the scapula.

-acrominal -sternal -conoid -coracoid

Landmarks of the scapula: -The _________ is the lateral end of the spine, and is the high point of the shoulder. Tailors measure the length of the upper limb from this landmark. -The ________ _______ accepts the head of the humerus to form the glenohumeral joint.

-acromion -glenoid cavity

The coracoacromial ligament spans the coracoacromial _____, between the acromion and the coracoid process of the scapula, forming an arch that prevents the superior displacement of the head of the humerus from the glenoid cavity of the scapula.

-arch

Surface Anatomy of the back and pectoral Region (continued): The ______ is the site where the limb joins the trunk. The _______ ________ is the elbow is the insertion site for all three heads of the triceps. The _______ _______ vein is commonly used for normal venipuncture.

-axilla -olecranon process -lateral epicondyle -median cubital

Quadrangular space transmits (contains) the: _________ nerve Posterior ________ humeral artery Posterior circumflex ________ vein

-axillary -circumflex -humeral

Interosseous membrane of the forearm: -Is a ________, _______, fibrous connective tissue that joins the shafts of the radius and ulna. It also provides a site of attachment for some tendons of deep skeletal muscles of the forearm. Radioulnar articulations: -Articulation of the head of the radius with the ulna's radial notch is the _________ radioulnar joint. -The ulna articulates with the ulnar notch at the radius at the ______ radioulnar joint. The _______ tubercle of the radius is a small prominence on the dorsal aspect of the distal end of the radius, lateral to the groove for the _________ ________ __________ tendon. It serves as a trochlea (pulley) for the tendon. AKA Lister's tubercle.

-broad -flat -proximal -distal -dorsal -extensor pollicis longus

Humerus--Distal End -The rounded ________ is near the lateral epicondyle. -The ________, with its indentation is more medial in position. -Two anterior depression in the bone receive parts of the radium and the ulna when the forearm is _______ at the elbow. -The shallow ________ fossa lies above the capitulum, and contains part of the radius during flexion. -The deep _______ fossa located above the trochlea receives the ulnar coronoid process.

-capitulum -trochlea -flexed -radial -coronoid

Deltoid: Origin: acromial extremity of _______, acromion and spine of ________ Insertion: deltoid _______ of humerus Action: entire muscle ________ arm at shoulder joint, anterior fibers flex and medially rotate arm, posterior fibers extend and _______ rotate arm. Innervation: _______ nerve.

-clavicle -scapula -tuberosity -abducts -laterally -axillary

Surface Anatomy of the back and pectoral Region (Continued): The ________ muscle contributes to the rounded shape of the shoulder. The _____________ __________ is the site of articulation of the clavicle with the acromion of the scapula. The _______ _______ is the depression between the two sternal ends of the clavicles. The ________ _______ is the most superficial muscle of the anterior thoracic wall. It has a broad origin from the clavicle and sternum. The border forms the anterior axillary fold. The ________ _______ muscle is on the anterolateral side of the thorax.

-deltoid -acromioclavicular articulation -jugular notch -pectoralis major -serratus anterior

Humerus--Proximal End ___________ tuberosity in the middle of the shaft of the site of attachment of the deltoid muscle. -The distal end of the humerus is where projections of the humerus articulate with forearm bones to form the ________ joint.

-detoid -elbow

Radius: The proximal end of the radius has a _____-shaped head that articulates with both the capitulum of the humerus and the ______ notch of the ulna. Inferior to the head is the _______ neck. The radial ________ is a roughened area inferior to the neck that serves as a point of attachment for tendons of the bicepps brachii muscle. The radial ______ process is on the lateral side and can be felt proximal to the thumb. It provides attachment for the brachioradialis muscle in the vicinity, and the ________ collateral ligament to the wrist.

-disc -radial -constricted -tuberosity -styloid -radial

Ulna (continued): The head of the ulna is at the _______ end. A disc of fibrocartilage separates the wrist from the head of the ulna. A _______ process on the distal end is an attachment point for the ________ collateral ligament to the wrist.

-distal -styloid -ulnar

Articular capsule: -A loose _______ capsule surround the glenohumeral joint -It is attached to the margin of the ________ cavity, and to the anatomical neck of the _______. -There is an opening in the capsule between the ________ of the humerus for passage of the tendon of the _______ head of the biceps brachii.

-fibrous -glenoid -humerus -tubercles -long

Subclavius muscle: Origin: _____ rib Insertion: _______ Action: Depresses clavicle and moves it ________. Helps stabilize the pectoral girdle. Innervation: ________ nerve (AKA nerve to the subclavius)

-first -clavicle -anteriorly -subclavian

The clavicle or collar bone lies horizontally in the superior and anterior part of thorax superior to the _______ rib and articulates with the sternum and scapula. The clavicle, one of the most frequently broken bones in the body, transmits _______ force from the upper limb to the trunk.

-first -mechanical

Subscapularis Origin: subscapular ______ of scapula Insertion: ______ tubercle of humerus Action: ______ rotates arm at shoulder joint Innervation: _______ and ______ subscapular nerves

-fossa -lesser -medially -upper and lower

Infraspinatus: Origin: infraspinous ________ of scapula Insertion: greater _______ of humerus Action: ______ rotates arm at shoulder joint Innervation: ________ nerve

-fossa -tubercle -laterally -suprascapular

Supraspinatus: Origin: Supraspinous ______ of scapula Insertion: greater tubercle (AKA greater _________) of humerus Action: assists ______ with initial stages of abducting arm at shoulder joint, and continues to act throughout abduction Innervation: _________ nerve

-fossa -tuberosity -deltoid -suprascapular

Surface Anatomy of the back and pectoral Region: The vertebral borders of the scapulae lie lateral to the vertebral _________. The __________ is a large triangular shaped muscle of the upper and middle back. Another superficial muscle is the _________ _____, which is inferior to the trapezius. The posterior axillary fold is formed from the lateral border of this muscle as its fibers travel toward its insertion on the ____. Another muscle that contributes to the posterior axillary fold and also inserts is the _______ ________. It is located near the inferior angle of the scapula.

-furrow -trapezius -latissimus dorsi -arm -teres major

The axilla is the pyramidal space inferior to the _______ joint and superior to the axillary fascia at the junction of the arm and thorax. -The axilla provides passageway for vessels and nerves to reach the upper limb.

-glenohumeral

Rotator Cuff: -The cuff generally inserts on the ________ tuberosity of the humerus and the subscapularis inserts on the ________ tuberosity. -The rotator cuff helps to lift and rotate the arm, and to stabilize the ball of the shoulder within the joint. -All the muscles except the ______ are rotators of the humerus.

-greater -lesser -supraspinatus

Articulation of the glenohumeral joint: The large, round _________ head articulates with the relatively shallow _______ cavity of the scapula. The glenoid cavity accepts about ____ of the humeral head, which is held in the cavity by the ______ of the rotator cuff.

-humeral -glenoid -tonus

Bone of the Arm: The ________ is the longest and largest bone of the upper limb. It articulates ________ with the scapula and _______ at the elbow with both the radius and ulna. The head of the humerus articulates with the glenoid cavity of the scapula at the ________ or shoulder, joint. ___________ & _________ tubercles are sites of insertion for some of the muscles that move the humerus at the shoulder joint. The anatomical neck is located between the tubercles and the head, and is the site of attachment of the _________ capsule.

-humerus -proximally -distally -glenohumeral -greater & lesser -articular

Triangle of auscultation: A small triangular gap in the thick musculature of the back is a good place to examine posterior segments of the lungs using a stethoscope. Folding the arms across the chest enlarges the auscultatory triangle. This triangle of auscultation is formed by: -Superior horizontal border of ________ ______ -Medial border of _________ -Inferolateral border of the _________

-latissimus dorsi -scapula -trapezius

Functions of the upper limb: Designed for extensive motion: -__________ appendage -Operate devices -Frequently ______ because of its functions

-manipulative -injured

The axillary vein lies on the _____ side of the axillary artery. It is formed by the union of the _____ veins and the _______ vein at the inferior border of the teres ____.

-medial -brachial -basilic -major

Landmarks of the scapula continued: -The thin edge of the scapula closer to the vertebral column is the ________ border, AKA vertebral border -The thick edge closer to the arm is the _______ border, AKA axillary border -The medial and lateral borders join at the _______ border.

-medial border (green label on picture) -lateral border (purple label on picture) -inferior angle (red label on picture)

Teres Minor Origin: ________ lateral border of scapula Insertion: greater _______ of humerus Action: _______ rotates and ______ arm at shoulder joint Innervation: _______ nerve

-middle -tubercle -laterally -adducts -axillary

Ulna: The proximal end of the ulna contains the _______, which forms the prominence of the elbow. The ________ process is an anterior projection at the proximal end. Together, the olecranon and the coronoid process receive the trochlea of the humerus. They contribute to the formation of the ______ notch, which is a large curved area that forms part of the elbow joint. On the lateral side of the coronoid process is the _________ notch, which is a depression that receives the head of the radius. Just inferior to the coronoid process is the ________ tuberosity, to which the brachialis muscle attaches.

-olecranon -coronoid -trochlear -radial -ulnar

Humerus---Distal End -The _________ fossa is a large depression of the posterior humerus that receives the olecranon process of the ulna when the forearm is _______.

-olecranon -extended (straightened)

Sternoclavicular joint: -Articulation between sternal end of clavicle with manubrium of sternum and first costal cartilage -Synovial joint (it is a ________ joint) -The only true synovial joint that connects the _________ with the ________.

-saddle -pectoral girdle -ribcage

The ________ articulates with the clavicle and the humerus. The scapulae articulate with other bones ________ but are held in place _______ only by complex shoulder and back musculature.

-scapula -anteriorly -posteriorly

Long thoracic nerve injury: Injury to the long thoracic nerve results in paralysis of the ______ ______ muscle. When the arm is raised, the vertebral border and inferior angle of the scapula pull away from the thoracic wall and protrude outward, causing the medical border of the scapula to protrude. The arm can not be _______ beyond the horizontal position. This condition is called a ______ scapula.

-serratus anterior -abducted -winged

Bones of the forearm: Ulna: forms medial border of forearm and is the _________ forearm bone. Radius: forms lateral border of forearm and is ________ and the _________ forearm bone.

-stabilizing -shorter -moveable

Articulations of the pectoral girdle: -The clavicle articulates with the manubrium of the sternum at the _________ joint. -Scapula Articulates with the clavicle at the ____________ joint Articulate with the humerus at the _________ joint -Pectoral girdles DO NOT articulate with the _________ _______ but are held in place by muscle attachments.

-sternoclavicular -acromioclavicular -glenohumeral -vertebral column

The tendon of the supraspinatus is separated from the coracoacromial ligament, acromion, and deltoid by the ________ bursa. When this bursa is inflamed, abduction of the arm is extremely painful during the arc of ______ to _______ degrees. This is called ________ _______ syndrome.

-subacromial -50-130 -painful arc

The __________ fossa on the anterior surface is a surface of attachment for the subscapularis muscle. The __________ __________ scapular ligament transverses the scapular notch and converts it into a foramen. The __________ muscle originates near the scapular notch, and frequently also extends to the superior transverse scapular ligament. The ____________ nerve is the sensory to the shoulder joint, and motor to the infraspinatus and supraspinatus muscles. The suprascapular artery passes over the ligament. A Navy travels under a bridge, an Army travels over a bridge

-subscapular -superior transverse -omohyoid -suprascapular

Trapezius: Origin: external occipital protuberance, ________ _______ line of occipital bone, ligamentum nuchae, and spinous processes of C_____-T_______. Insertion: clavicle, acromion, and ______ of _____ Action: ________ fibers elevate scapula and extend head; ________ fibers adduct (retract) scapula; ________ fibers depress scapula. Innervation: CN _____

-superior nuchal -C7-T12 -spine of scapula -superior -middle -inferior -CN XI

Humerus--Distal End -On the anterior surface is the sharp lateral __________ ridge on the shaft of the bone that ends in the lateral epicondyle. -The larger ___________ epicondyle is the termination of the medial _________ ridge.

-supracondylar -medial -supracondylar

_____________ neuritis is a form of entrapment neuropathy commonly caused by compression of the suprascapular nerve at the back of the shoulder. The nerve is liable to injury as it travels through the suprascapular notch where it is spanned by the _________ ligament. Types of injuries include overuse of the arm and excessive traction.

-suprascapular -transverse

The __________ fossa is a surface for attachment of the supraspinatous muscle of the shoulder. The ____________ fossa is a surface for attachment of the infraspinatus muscle of the shoulder.

-supraspinous -infraspinous

Fractures of the Humerus: Most fractures of the proximal end of the humerus are fractures of the _______ neck. -_________ fractures: one fragment is driven into the spongy bone of the other fragment. Tend to be stable, Arm passively moveable with little pain. -_________ fractures: fractures to the body of the humerus frequently result from a direct blow to the arm. The pull of the deltoid muscles carries the proximal fragment of the fractured humerus laterally. -________ fractures: occurs when a ligament or tendon attached to a bone pulls away part of the bone (at any location--not just the humerus). When this type of fracture is located at the greater tubercle of the humerus, it causes the tubercle to be pulled away. These are relatively common, and usually result from a fall either onto the point of the shoulder (acromion) in middle aged and elderly, or the hand in younger people.

-surgical -Impact -Transverse -Avulsion

The Axillary nerve wraps around the ________ neck of the humerus. The posterior ________ humeral artery accompanies the axillary nerve at this location. The Radial nerve wraps around the _______ of the humerus. The _______ brachial artery accompanies the radial nerve at this location.

-surgical -circumflex -shaft -deep

Fractures of the humerus at different locations may be associated with damage to particular nerves because the humerus is in direct contact with specific nerves at those locations: -Fractures of humerus at: ______________= axillary nerve ________=radial nerve ________=median nerve _______ ___________= ulnar nerve

-surgical neck -shaft (radial groove) -Distal end -medial epicondyle

Stabilizing the Pectoral Girdle: ________ extends from skull & vertebrae to clavicle & scapula. ________ scapulae extends from cervical vertebrae to scapula. ________ extends from thoracic vertebrae to vertebral border of scapula.

-trapezius -levator -rhomboideus

The ________ does not participate in the wrist joint. The distal end of the ________ and the articular disc of the distal radioulnar joint articulate with the proximal row of carpal bones, except for the __________, this bone acts primarily as a a _________ bone, increasing the leverage of the flexor carpi ulnaris, and articulates with only the _________.

-ulna -radius -pisiform -sesamoid -triquetrum

Thoracoappendicular muscles are upper limb muscles that attach to the thoracic cage. Comprised of what 4 muscles anteriorly and what 1 muscle posteriorly?

Anteriorly: -Pectoralis major -Pectoralis minor -Serratus anterior -Subclavius Posteriorly: -latissimus dorsi

Movements of the shoulder joint: What are the 8 movements?

Flexion Extension Hyperflexion Abduction Adduction Circumduction (a combination of flexion, extension, abduction, and adduction) Lateral rotation (a circular movement around the long axis of the bone at the joint) Medial rotation (a circular movement around the long axis of the bone at the joint)

The shoulder consists of what 4 joints which provide movement in multiple planes? GASS The ball and socket joint of the shoulder is a mobile joint with a shallow _______ fossa, unlike the hip which is a stable joint having a deep ________ fossa.

Glenohumeral Acromioclavicular Sternoclavicular Scapulothoracic glenoid acetabular

The Mnemonic for the carpal bones (proximal row, lateral to medial) and (distal row, lateral to medial): Some Lovers Try Positions That They Can't Handle

Scaphoid Lunate Triquetrum Pisiform (proximal row, lateral to medial) Trapezium Trapezoid Capitate Hamate (distal row, lateral to medial)

Scapulohumeral muscles: The scapulohumeral muscles are the intrinsic shoulder muscles, they include what 6 muscles? SITS DT These are relatively short muscles that pass from the scapula to the humerus, and act on the glenohumeral (shoulder) joint.

Supraspinatus Infraspinatus Subscapularis Teres Minor Deltoid Teres Major

The rotator cuff is made up of the SITS muscles. The muscles originate from the scapula, and together form a single tendon unit as they combine to form a "cuff" over the head of the humerus. What are the 4 SITS muscles?

Supraspinatus Infraspinatus Teres minor Subscapularis

The __________ process (like a crow's beak) is a projection at the lateral end of the superior border to which tendons of muscles (pectoralis minor, coracobrachialis, and biceps brachii) and ligaments (coracoacromial, conoid, and trapezoid) attach

coracoid