Anat 3

Palpate scaphoid bone where?

anatomical snuff box!

talocrural joint (AKA what joint)

ankle joint

Brachioradialis- located in the arm or leg?

arm

pelvic girdle

attaches the lower limbs to the trunk

Which results in greater loading of lateral structures in the knee joint?

genu valgum

Which results which results in greater stress on the MCL?

genu valgum

true pelvis

inferior to pelvic brim Contains pelvic organs**

Rotator Cuff Muscles Can have variations in acromion angle Ex. hooked acromion may lead to

may lead to tendinitis, bursitis, and tears b/c supraspinatus has to travel through hook

"Common"- means it will

split again

Gluteus medius weakness symptoms and is AKA what type of Gait?

the gluteus medius on the planted foot causes the opposite side to sink b/c not able to abduct the hip AKA Trendelenburg Gait

Skeletal muscle architecture- multicipital

two heads converge on common insertion tendon (multiple origins)

The prime mover is also known as the antagonist. - True - False

- False

Terminal branches of the lateral and medial cord of the brachial plexus form the characteristic what?

"M" shape anterior to the axillary artery- ***Usually the most distinctive feature of the brachial plexus- serves as a reference point

How many bones are in the skeleton?

****206 bones in skeleton

Identify the bones that make up the palm of the hand. - Metatarsals - Phalanges - Carpals - Metacarpals

- Metacarpals

Which of the following statements is true of the glenohumeral joint? - The glenohumeral joint is stabilized considerably by the glenoid labrum. - Muscle tendons of the glenohumeral joint contribute little to the stability of the joint. - The glenohumeral joint is a very stable joint because of its numerous ligaments. - The glenohumeral joint is the most freely moving joint in the body.

- The glenohumeral joint is the most freely moving joint in the body.

Hinge Joint _____axial Types of Motion Example of a Joint

- Uniaxial Flexion/Extension Elbow, ankle

The deltoid muscle fibers are separated into __________. - lateral, medial, and proximal - superior, middle, and inferior - superficial and deep - anterior, middle, and posterior

- anterior, middle, and posterior

The soleus muscle shares an insertion with the __________. - gastrocnemius muscle - flexor digitorum longus - fibularis longus muscle - flexor hallucis longus

- gastrocnemius muscle

The origin of the flexor carpi radialis is on the __________. - radius - metacarpals - ulna - humerus

- humerus

Which structure of the femur is NOT a site for muscle attachment? - medial epicondyle - linea aspera - intercondylar fossa - gluteal tuberosity - greater trochanter

- intercondylar fossa

The rectus femoris muscle extends the leg at the __________. - knee - elbow - hip - ankle

- knee

The actions of the rhomboid major on the scapula do not include __________. - lateral rotation - adduction - medial rotation - elevation

- lateral rotation

The posterior muscle that crosses the glenohumeral joint is the __________. - pectoralis major - latissimus dorsi - trapezius - brachioradialis

- latissimus dorsi

metatarsals

5 bones - Articulate with the distal ends of the tarsals and the proximal ends of the phalanges - Nearly parallel to each other Can get stress fractures here from repetitive running

Lachman's test & Anterior Drawer is a test for what ligament? How is it done?

ACL- done by pulling the tibia forward A positive Lachman's test indicates an unstable knee

CARTILAGE IS vascular or avascular?

AVASCULAR

What is the only lateral rotator at the knee?

Biceps femoris

Synovial fluid as a filtrate of what?

Blood- arises from capillaries in the synovial membrane (parts of joints are highly vascularized)

Isotonic contraction- concentric vs. eccentric contraction

Concentric contraction: muscle is shortening Eccentric contraction: muscle is lengthening (this can actually be harder on the muscle and lead to more soreness)

dumbbell lateral (side) raises are movements occurring in what plane?

Coronal (Frontal) plane

Muscles of the Thigh Posterior muscles do what?

Extend the thigh (hip) and flex the leg at the knee

Mobility vs. Stability of joints: diarthrosis examples

Freely movable- most mobile: Shoulder Hip Elbow

Arteries of the Hip and Thigh Common Iliac-branches into

Internal and external iliac arteries

Brachioradialis does NOT originate from what?

The medial epicondyle

patella

(AKA knee pad) triangular sesamoid bone with broad superior border and inferiorly pointed apex Articulates with patellar surface of femur Patellofemoral joint provides protection, acts as fulcrum

Subclavian artery

Thyrocervical trunk - Suprascapular artery (Supraspinatus and infraspinatus) - Dorsal scapular artery (Levator scapulae, rhomboids, trapezius)

Dorsal interossei (DAB)

(DAB- dorsal abduct- spreads fingers out)

Palmar interossei (PAD)

(PAD- brings fingers together)

Synovial joints

**ALL are freely movable diarthroses Articulating bones separated by a fluid-filled joint cavity

Muscles in the medial compartment of thigh- and will all do what action?

**All adduct the hip Adductor longus Adductor brevis Gracilis- (most medial and skinny + longer) Pectineus Adductor magnus- (biggest and deeper)

Select a true statement or characteristic of uniaxial movement in a representative joint. - A person curls his or her fingers and the phalanges flex at the interphalangeal joints. - A golfer swings at the ball on the tee. - A person bends over and his or her vertebral processes move past one another. - The dancer's leg is lifted to a ballet bar.

- A person curls his or her fingers and the phalanges flex at the interphalangeal joints.

4. In which fascicle arrangement do the tendons and muscle fibers resemble a large feather? a. Pennate b. Circular c. Parallel/strap d. Convergent e. None of the above

a. Pennate

2 types of syndesmoses- Interosseous membrane (IM)

Tibiofibular IM- immovable synarthrosis (want stability b/c otherwise can't support the weight of body) Radioulnar IM- amphiarthrosis (want to be able to pronate and supinate)

What muscle does not act on the GH joint to move the arm? a. Rhomboid minor b. latissimus dorsi c. deltoid d. triceps brachii e. biceps brachii

a. Rhomboid minor

upper and lower limbs function

differ in function- "turned functions" share the same structural plan

posterior superior iliac spines= responsible for

dimples in back

pelvic outlet

exit of true pelvis Inferior border of true pelvis

Infrapatellar fat pad in knee is located where and does what?

fill space b/w patella and tibia - Can pinch fat pad during hyperextension but not common

What is the prime mover of hip extension?

gluteus maximus

Sutures

joints between skull bones (synarthroses) Premature closure is BAD- won't have room to develop fully - bones joined by dense regular CT

Cruciate

means to cross each other

Can get stress fractures here on these bones from repetitive running

metatarsals

radioulnar (IM) fibrous joint at distal and proximal is considered slightly movable b/c capable of what?

pronation and supination

2 specific types of cartilaginous joints

synchondroses, symphyses

pollex/pollicus

thumb

What type of bones are the phalanges? - Flat - Irregular - Short - Long - Submit

- Long

Sprain (and grades 1, 2, & 3)

**happens when ligaments stretch and tear Grade 1 sprain: stretching small tears Grade 2 sprain: larger but incomplete tears Grade 3 sprain: complete tear (Strains happen with muscles)

Arteries of the Leg include:

- Anterior tibial artery - Posterior tibial artery - Medial and lateral plantar arteries in the foot - Fibular artery - Plantar arch - Digital arteries

Condylar Joint _____axial Types of Motion Example of a Joint

- Biaxial Flexion/Extension Adduction/Abduction Wrist joints

Saddle Joint _____axial Types of Motion Example of a Joint

- Biaxial Flexion/Extension Adduction/Abduction Joint of thumbs

Identify the process on the scapula that does not articulate with another bone. - Glenoid cavity - Coronoid process - Coracoid process - Acromion process

- Coracoid process

Medial and Lateral Menisci of the knee do what?

- Deepen the articular surfaces, shock absorption - Gives more round surface to increase stability - Inner margin is free & avascular

3 major foot arches

- Medial longitudinal: from heel (calcaneus) to hallux - Lateral longitudinal: from heel (calcaneus) to fifth toe - Transverse: perpendicular to other arches; along distal row of tarsals

Identify the bone that articulates with the clavicle laterally. - Humerus - Scapula - First rib - Sternum (These form what joint?)

- Scapula- forming the acromioclavicular joint.

If you kick a soccer ball straight ahead, what is the movement at the knee, what plane is that movement in, and what type of joint is the knee?

- Winding up to kick= Flexion, Kicking= Extension, in Sagittal plane- transverse axis, Knee= a synovial hinge joint

Forearm supination is assisted by the __________. - brachioradialis - triceps brachii - supinator - biceps brachii

- biceps brachii

The tensor fasciae latae stabilizes the hip joint and the __________ joint. - knee - elbow - sacral - ankle

- knee

The trapezius muscle may be separated into all of the following groups, except __________. - middle - lateral - superior - inferior

- lateral

The biceps brachii is a muscle that is named for its __________. - location and action - shape and relative size - number of origins and location - location of attachments - All of the listed choices are correct.

- number of origins and location

All fibers of the semimembranosus muscle converge to insert on the __________. - anterior femur - posterior femur - anterior tibia - posterior tibia

- posterior tibia

Biaxial joints cannot - rotate. - adduct. - flex. - abduct.

- rotate

The femoral artery and branches- Deep femoral (profunda femoris) artery

- Given off in the femoral triangle Main arterial supply to the thigh - Medial and Lateral circumflex femoral arteries: supply the femoral head and neck, wrap around the femur

The prime mover of dorsiflexion is the __________. - extensor hallucis longus - fibularis tertius - tibialis anterior - extensor digitorum longus

- tibialis anterior

Fibula bears around what percent of your body weight?

0-12% of body weight

Factors that Influence Joint Stability:

Articular surfaces, ligaments, muscle tone

Bone where achilles tendon attaches- "heel bone"

Calcaneus

Important to develop agonists and antagonists evenly! Why?

Can cause a person to be too tight and more tensions on joints

Muscles acting on the thumb are only in what layers?

DEEP

Intrinsic Hand Muscles Hypothenar group

Flexor digiti minimi brevis Abductor digiti minimi Opponens digiti minimi

Most freely movable joint in the body? And b/c its so movable- what also is it?

Glenohumeral (shoulder) Joint- also the most unstable

Which muscle is the strongest flexor of the hip joint?

Iliopsoas- psoas major and iliacus joined

Tibial and common fibular nerves will split most often where?

In the popliteal fossa--but varies

Inversion and eversion occur at what joints?

Intertarsal joints (b/w tarsals)

isometric contraction vs. isotonic contraction

Isometric contraction- length is constant, tension is changing Isotonic contraction- tension is constant, length is changing

Collateral ligaments are located where on the knee?

Located on sides of knee--prevents varus and valgus force--(MCL and LCL)

Other intrinsic hand muscles associated with digits 2-5

Lumbricals Dorsal interossei Palmar interossei

Medial and Lateral Menisci shape differences?

Medial: c-shaped, attached to MCL Lateral: ⅘ circle

***The Scapulothoracic (ST) "joint" is not a true anatomic joint, why?

NO capsule or bony union

Articular discs: present in some or all synovial joints?

Only some- Occur in joints with articulating bones of different shapes (ex. Between ulna and bones in wrist in jaw) **Where bones aren't quite the same shape so help joints to articulate

The higher the roots innervate, the more BLANK the muscles are

PROXIMAL

**A muscle can only do what?

PULL NOT push

Piriformis syndrome

Pain can be severe and extend down the length of the sciatic nerve (called sciatica). The pain is due to the piriformis muscle compressing the sciatic nerve, such as while sitting on a car seat or running

Any forward and backward movement parallel to this line occurs in the

SAGITTAL Plane- transverse axis (flexion/extension)

What is the longest muscle in the body?

Sartorius- long strap muscle

What is so important about the flexor digitorum superficialis?

Specifically ends on the middle phalanx Does NOT flex the distal phalangeal joint

What joint is the ONLY connection b/w the upper limbs and axial skeleton?

Sternoclavicular joint

Pronation vs. Supination of radius and ulna

Supination- bones are NOT crossed Pronation- radius twists and creates an X

The trunks of the brachial plexus innervate what nerves, which then innervate which muscles?

Suprascapular nerve (C5 & C6) : supraspinatus, infraspinatus Nerve to subclavius (C5): subclavius

Which three muscles insert onto the intertubercular groove of the humerus?

Teres major Latissimus dorsi Pectoralis major

List and describe the key distal features of the humerus.

- Trochlea- where ulna articulates - Capitulum- where radius head articulates - Medial epicondyle- site of attachment for muscles - Lateral epicondyle- site of attachment for muscles - Radial fossa- depression for head of radius - Coronoid fossa- medial depression for coranoid process - Olecranon fossa- depression on posterior side for olecranon process of the ulna

The anterior muscle that crosses the glenohumeral joint is the pectoralis major muscle. - True - False

- True

When a prime mover is contracted, the antagonists are stretched, but typically relaxed. - True - False

- True

Pivot Joint _____axial Types of Motion Example of a Joint

- Uniaxial pronation/supination (rotation around 1 axis) Proximal radioulnar

Synovial fluid is - an extract from the bone marrow. - fluid from edema. - a filtrate of the blood, with added glycoproteins. - identical to blood plasma.

- a filtrate of the blood, with added glycoproteins.

The teres major adducts the arm but does not __________ the arm. - extend - medially rotate or extend - medially rotates - abduct

- abduct

The middle fibers of the deltoid muscle __________. - abduct the arm - laterally rotate the arm - adduct the arm - medially rotate the arm

- abduct the arm

The tensor fascia latae is involved in hip __________. - abduction - adduction - lateral rotation - extension

- abduction

The primary function of the pectoral girdle is to __________. - provide the only connection between the arm and the axial skeleton - act as an attachment site for muscles that move the arm - act as an attachment point for the rotator cuff muscles - provide the only connection between the humerus and the scapula

- act as an attachment site for muscles that move the arm

The medial muscles of the hip joint that insert on the linea aspera are the __________. - gracilis, adductor magnus, pectineus, and adductor longus - adductor magnus, adductor brevis, and pectineus - pectineus, adductor magnus, and adductor longus - adductor magnus, adductor brevis, and adductor longus

- adductor magnus, adductor brevis, and adductor longus

The flexor carpi ulnaris __________. - supinates the forearm - adducts the wrist - extends the forearm - abducts the wrist

- adducts the wrist

Which of the following is not true of the deep fascia of the leg? - aids in venous return - prevents excess swelling of the muscles - an insertion for the majority of lower leg muscles - separates anterior and posterior muscles

- an insertion for the majority of lower leg muscles

The origin of the rectus femoris is the ____________. - linea aspera - anterior inferior iliac spine - anterior femur - greater trochanter

- anterior inferior iliac spine

The origin of the Sartorius muscle is from the __________ spine. - posterior superior iliac - anterior inferior iliac - posterior inferior iliac - anterior superior iliac

- anterior superior iliac

At the completion of supinator action, the palm is turned __________. - medially - laterally - posteriorly - anteriorly

- anteriorly

Capsular ligaments - are thickened parts of the joint capsule itself. - separate the synovial cavity into compartments. - are located outside the joint capsule. - are covered by synovial membrane.

- are thickened parts of the joint capsule itself.

Which superficial flexor muscle of the forearm is the most lateral? - flexor carpi ulnaris - flexor carpi radialis - flexor digitorum superficialis - palmaris longus

- flexor carpi radialis

All fibers of the pectoralis major muscle converge on the lateral edge of the__________. - deltoid tuberosity - intertubercular sulcus - greater tuberosity - radial tuberosity

- intertubercular sulcus

The latissimus dorsi inserts __________. - on the greater tubercle of the humerus - on the deltoid tuberosity of the humerus - on the lesser tubercle of the humerus - on the intertubercular groove of the humerus

- on the intertubercular groove of the humerus

The soleus muscle __________ the foot at the ankle. - inverts - extends - plantarflexes - dorsiflexes

- plantarflexes

A joint capsule (articular capsule) has two layers. The function of the capsule's internal layer is to - strengthen the joint against tension. - act as a meniscus. - contain all of the nerves and blood vessels of the joint. - produce synovial fluid.

- produce synovial fluid.

The interosseous membrane is located between the __________. - humerus and radius - ulna and the carpal bones of the wrist - radius and ulna - humerus and ulna

- radius and ulna

All fibers of the trapezius muscle are innervated by the __________. - spinal accessory nerve - scapular nerve - axillary nerve - coxal nerve

- spinal accessory nerve

Downward dislocation of the humerus from the glenohumeral joint when carrying weight is prevented by the __________. - subscapularis muscle - teres minor muscle - supraspinatus muscle - infraspinatus muscle

- supraspinatus muscle

The gastrocnemius muscle acts on: - None of the above are correct. - the knee only. - the knee and ankle. - the ankle only.

- the knee and ankle.

The intercondylar eminence is found on which of the bones listed below? - radius - tibia - ulna - humerus

- tibia

The actions of the extensor carpi radialis brevis are localized to the __________. - ulna - elbow - wrist - radius

- wrist

Identify the bone that makes up the pectoral girdle with the clavicle. - Scapula - Sternum - Humerus - Rib

-Scapula

Internal iliac artery branches into 3 other arteries to the lower extremity, what are they?

1) Superior gluteal artery- greater sciatic foramen, exits superior to the piriformis 2) Inferior gluteal artery- greater sciatic foramen, exits inferior to the piriformis 3) Obturator artery- travels through the obturator foramen Supplies medial and posterior thigh (rest of hamstring muscles)

Muscles of the Anterior Forearm Superficial layer

1- Pronator teres 2- Flexor carpi radialis 3- Palmaris longus 4- Flexor carpi ulnaris

Intrinsic muscles of the foot- plantar group has how many muscles in how many layers?

10 muscles in 4 layers

How many bursa are around the knee, and what is their function?

12 bursa around the knee- ensure smooth movement and gliding b/w structures

phalanges (# and characteristics)

14 bones 3 phalanges per toe, except for the big toe (hallux) Proximal, middle, distal Big toe has proximal and distal (no middle)

Skeletal muscle architecture- digastric

2 muscle bellies

The anterior and posterior divisions unite to form what?

3 cords- Lateral, posterior, medial

Quadricep has how many origins

4- heads

How many terminal branches emerge from cords, and what are their names?

5 terminal branches- musculocutaenous, axillary, radial, median, ulnar

How many tarsal bones are there?

7- calcaneus, talus, navicular, cuboid, cuneiforms (lateral, intermediate, medial)

Axilla- armpit region Clinically important b/c of?

Axillary lymph nodes: drain the mammary glands and the upper limb

What are the accessory structures to synovial joints and how do they help the joint?

Bursae- reduce friction b/w body elements - A sac outside the joint to prevent rubbing Fat pads- packing material also provide some protection

Myotomes- muscles innervated by nerve root (tests for muscle actions) C5-T1

C5= shoulder abduction C6= elbow flexion C7= elbow extension C8= Pinch, finger ad/abduction T1= None

Humeroulnar joint is AKA what? And consists of what two things and is what type of joint?

Elbow joint- trochlear notch of ulna and trochlea of humerus- hinge joint

***Most reliable indicator of the sex of a skeleton- and with what % accuracy?

Female vs. Male Pelvic Structure- With about 90% certainty

What artery branches into the femoral artery, and the femoral artery enters what specific spot?

Femoral artery is a branch off of the external iliac artery- and it enters in the femoral triangle

What comprises the femoral triangle?

Femoral nerve, artery, and vein all traveling w/n the femoral sheath

Triple B- biceps brachii, brachialis, brachioradialis all work to do what?

Flex the elbow

Muscles of the Thigh Anterior muscles do what?

Flex the thigh (hip) and extend the leg at the knee

Shoulder has lots of movement, but very little what? And is the most commonly type of what joint?

Has very little stability, -one of the most commonly dislocated joints

What is the largest bone of the upper limb?

Humerus

Articular cartilage of synovial joints- type of cartilage and functions

Hyaline cartilage (one of most commonly found places of hyaline cartilage) ***Reduces friction (normally a smooth surface) Acts as shock absorber (takes compression and shock)

In order to stretch your gastrocnemius, you have to have your knee BLANK if you want to stretch your soleus you want to BLANK your knee in order to take the pressure off of your gastrocnemius

In order to stretch your gastrocnemius, you have to have your knee straight, if you want to stretch your soleus you want to bend your knee in order to take the pressure off of your gastrocnemius

Compartments and Compartment Syndrome

Increase in pressure in compartment b/c of increased fluid in compartment cause tight space and fluid to get caught - Can be: Acute OR Chronic - Can be anterior, posterior, or lateral (ex. acute - blow to anterior tibia- like in a car crash) (ex. Chronic- deep posterior compartment- exercising creates decreased space in compartment)

You are trying to lift a large table. Your biceps brachii are contracted, but the table will not move, and no movement is occurring in your arms. What type of contraction is occurring in your biceps brachii?

Isometric contraction- length is constant, tension is changing - vs. isotonic contraction- tension is constant, length is changing (concentric- muscle is shortening, eccentric- muscle is lengthening)

Range of motion of a muscle is determined by muscle fiber length, if there is lots of ROM, is it a strong muscle?

NO- muscle fiber length (ROM determined by length) If lots of ROM, NOT a strong muscle

ACL and PCL are inside the fibrous capsule but are inside/outside the synovial capsule?

OUTSIDE- so synovial fluid is inside the capsule

Muscles with opposite actions lie on what sides of a joint, same or opposite?

Opposite

Posterior compartment muscles (origin and actions of the wrist, hand, and/or fingers)

Origin: lateral epicondyle of the humerus Extension of the wrist, hand, and/or fingers **Also includes supinator

What are the four main types of muscle fiber arrangements? Describe them and give an example of each.

Parallel- strap or fusiform- run in roughly parallel - Ex. Biceps brachii (fusiform), Sartorius (parallel) Convergent- have a broad base but attach at a common site - Fibers converge onto one tendon - Ex. Pectoralis major, Circular- in circles- function to close or open (sphincters) - Ex. Mouth (orbicularis oris or oculi, and external anal and urethral sphincter) Pennate- "feather-like"- with short fibers inserting on the length of a long tendon - Unipennate- enter tendon from 1 side (extensor digitorum longus) - Bipennate- enter from 2 sides (rectus femoris) - Multipennate- enter from multiple sides (deltoid)

Appendicular skeleton contains:

Pectoral girdle- attaches the upper limbs to the trunk Pelvic girdle- attaches the lower limbs to the trunk Upper and lower limbs- differ in function- "turned functions" share the same structural plan

Musculocutaneous nerve spinal segments, location, muscles innervated, sensory innervation

Pierces coracobrachialis to enter anterior compartment of the arm Runs b/w biceps and brachialis - Becomes lateral antebrachial cutaneous nerve in the forearm Muscles Innervated - Coracobrachialis - Biceps brachii - Brachialis Sensory Innervation - Skin of lateral forearm

Muscles of gluteal region (lateral rotators)

Piriformis- (should be most aware of- most clinically important) Superior gemellus Inferior gemellus Obturator internus Obturator externus Quadratus femoris

What muscle rotates the tibia slightly to "unlock" the fully extended knee joint? And what direction does it rotate the tibia?

Popliteus muscle- rotates the tibia medially

Two anterior forearm that pronate the forearm:

Pronator teres Pronator quadratus

What are the two main distal features of the Radius and what are their functions?

Styloid process: lateral wrist bump Ulnar notch: medial dent for the head of the Ulna

Axillary artery Part 1

Superior thoracic artery: Serratus anterior- branch of 1st part

Carpal Tunnel Syndrome

The carpal bones and the flexor retinaculum (holds down flexor tendons) form the carpal tunnel - Irritated by median nerve, causes atrophy of thenar muscles - Reduced space in the carpal tunnel, such as with inflammation of the flexor tendons can cause compression of the median nerve

Unhappy triad of the knee

The unhappy triad, also known as the terrible triad, is a severe knee injury. - It involves full or partial tears of the Anterior Cruciate Ligament, the Medial Collateral Ligament and a tear of the Medial Meniscus.

Primary dorsiflexor of the leg??

Tibialis anterior

What plane and axis is involved in medial and lateral rotation?

Transverse plane, vertical/longitudinal axis

What plane and axis is involved in pronation and supination?

Transverse plane, vertical/longitudinal axis

Muscles of the posterior forearm comes from which bone, the radius or ulna?

ULNA

Humeroulnar ligaments- Ulnar collateral, Radial collateral, and Anular ligament

Ulnar collateral ligaments- gets torn and repaired with Tommy John surgery- happens with lots of baseball players (medial side) Radial collateral ligaments- connects from humerus to ulna on side of radius but splits to join anular ligament (lateral side) Anular ligament- ring around the head of the radius

ALL compartments of the leg are strongly or weakly separated from each other?

VERY separated by a strong NON-PERMEABLE sheath

What stress is known as the "Knee-knocked" position?

Valgus stress

rotational motion

a bone turns on its longitudinal axis (ex. Rotation of trunk and shoulder)

A tibiofibular dislocation is considered-

a full knee dislocation - More serious than just a patella dislocation

1. Which is a part of the appendicular skeleton? a. scapula b. skull c. rib d. vertebrae

a. scapula

gliding motion

angle b/w bones does NOT change (sliding and gliding) (ex. Movement between wrist bones)

Most frequently injured joint in the lower limb

ankle sprain--of talocrural joint- ankle joint--most common sports injury

cartilaginous joints

bones attached by cartilage NO joint cavity

Dense fibrous CT divides limb muscles into

compartments

Features: head neck lateral malleolus ---are characteristic of what bone?

fibula

What bone of the leg is NOT considered part of the knee joint?

fibula

Hypothenar group muscles affect the motion of

finger 5

aponeurosis

flat tendon

angular motion

increases OR decreases angle between bones (more typical than gliding) Flexion (decrease angle)-Extension (increase angle) Abduction-Adduction Circumduction (making a circle)- involves multiple planes and movements

Synovial joints are highly innervated but vascularized

indirectly by nearby tissues

All 3 bones of os coxa contribute to

its acetabulum

flexor and extensor retinacula (singular retinaculum)

layer of tissue that holds tendons down

antagonist function

opposes or reverses a particular movement

Brachioradialis insertion?

radius

Joint cavity

space of joint- Contains a small amount of synovial fluid

Hilton's Law

the nerve supplying the muscles around the joint ALSO innervates the joint itself

Sagittal plane coincides with what axis?

transverse axis (ST)

Median Nerve spinal segments, location, muscles innervated, sensory innervation

(C6-T1) Runs through the carpal tunnel to reach the hand Innervates - Forearm 6.5 - ½ L(OAF- thenar muscles) Muscles Innervated - All muscles of the anterior compartment of the forearm NOT innervated by the Ulnar nerve - ½ Lumbricals (lateral two) Opponens pollicus Abductor pollicus brevis Flexor pollicus brevis Sensory Innervation - Skin over anterolateral surface of hand

Ulnar nerve spinal segments, location, muscles innervated, sensory innervation

(C8, T1) Descends in the medial arm, runs posteriorly in groove b/w the olecranon process (***Funny bone) and medial epicondyle, and enters the forearm Forearm 1.5 ALL hand muscles except ½ LOAF Muscles Innervated - All muscles of the hand except the ½ LOAF (innervated by the Median nerve) - Flexor carpi ulnaris (forearm) - ½ Flexor digitorum profundus (medial part)- (forearm) Sensory Innervation - Skin over the medial surface of the hand through the superficial branch

Femoral Nerve spinal nerves, innervates what muscles, and cutaneous innervation?

(L2-L4) - Anterior thigh muscles- all quads, sartorius and iliacus *Pectineus innervated by both femoral and obturator - Cutaneous innervation: anterior thigh and medial leg

Obturator nerve spinal nerves, innervates what muscles, and cutaneous innervation?

(L2-L4) - Medial thigh muscles ALL adductors *Adductor magnus innervated by both obturator and tibial division of the sciatic nerve - Cutaneous innervation: medial thigh (Travels with obturator artery through obturator foramen)

Which muscle is not innervated by the musculocutaneous nerve? (a) Brachialis (b) Coracobarchialis (c) Triceps brachii (d) Biceps brachii

(c) Triceps brachii

palpation

(feeling)- examining surface anatomy with your hands (ex. Feeling ridges, prominences, etc.)

Carpals AKA what? And bone descriptions

(wrist) 8 bones (2 rows of 4) (starting posteriorly of right hand and proximally from the thumb to the right) - scaphoid, lunate, triquetrium, pisiform - trapezium, trapezoid, capitate, hamate

Plantar Fascia (Aponeurosis)

***Most superficial layer of the foot Helps maintain arches of the foot and protects bottom of foot Slips for each toe

Why do emales have more knee issues?

***We see a more medial course in females b/c females have wider hips Which is also why females have more knee issues b/c their femurs are less centered

Accessory structures around joint do what?

***reduce friction and fill spaces - bursae, tendon sheaths, fat pads

Structural Classification of joints is based on what characteristics?

**Material that binds them together Presence or absence of a joint cavity (only synovial joints have these) Categories: - Fibrous- held together by fibers - Cartilaginous- held together by cartilage - Synovial- have a joint cavity

Ankle sprain most common on what ligament and treatment?

**Most common= inversion w/lateral ligament Treatment: Rest Ice Compression Elevation (RICE)

Cubital fossa is located on

**On the anterior side of the elbow

Dermatomes (C5-T1)- location

*Treat separate from brachial plexus terminal branches Like a circle around the hand Lateral arm= C5, lateral hand= C6, tip of finger= C7, medial hand= C8, medial forearm= T1

How many phalanges are located in the hand? - 12 - 14 - 15 - 10

- 14--three phalanges make up each finger (4 x 3) except the thumb which contains 2 phalanges (has no middle phalange).

Without lateral rotation of the humerus by the teres minor and infraspinatus muscles, the maximum angle of abduction by the deltoid would be __________. - 90 degrees - 180 degrees - 75 degrees - 30 degrees

- 90 degrees

Which of the following statements is correct regarding muscle position and its related action? - A muscle that crosses on the medial side of the shoulder joint produces adduction. - A muscle that crosses on the lateral side of the hip joint produces adduction. - A muscle that crosses the shoulder joint medially produces abduction. - A muscle that crosses the ankle joint posteriorly produces adduction.

- A muscle that crosses on the medial side of the shoulder joint produces adduction

Which of the following statements is correct regarding muscle position and its related action? - A muscle that crosses on the anterior side of the shoulder joint produces extension. - A muscle that crosses the posterior side of the shoulder joint produces flexion. - A muscle that crosses on the posterior side of the knee joint produces flexion. - A muscle that crosses the ankle joint anteriorly produces flexion.

- A muscle that crosses on the posterior side of the knee joint produces flexion. *** This generality about flexion and extension is opposite in the lower limbs, where muscles that cross anteriorly produce extension and muscles that cross posteriorly produce flexion.

Identify the region of the scapula that articulates with the clavicle. - Glenoid cavity - Acromion process - Coracoid process - Spine

- Acromion process

What movements at scapulothoracic joint?

- Elevation and depression, upward and downward rotation, protraction and retraction

Identify the part of the scapula that articulates with the humerus. - Glenoid cavity - Coracoid process - Lateral border - Spine

- Glenoid cavity

What movements are at the acromioclavicular joint? what type of joint is AC joint?

- Gliding movements b/w acromion and clavicle, AC joint= nonaxial

Which of the following statements concerning the fibula is false? - It helps stabilize the ankle. - It is the thinnest of the two leg bones. - It helps stabilize the knee. - It forms the lateral malleolus.

- It helps stabilize the knee.

Femoral artery enters adductor canal (of Hunter) and leaves canal through the adductor hiatus which becomes what?

- John Hunter story-- can still get blood supply to leg if cut off - Leaves canal through adductor hiatus (opening w/n the tendon of adductor magnus) becomes the popliteal artery in the popliteal fossa

Tibial nerve innervates

- Long head of biceps femoris - Semimembranosus - Semitendinosus - Hamstring part of adductor magnus

Sally was working in the kitchen when she was careless and picked up a hot pan with her bare hand. After healing, Sally continues to feel a loss of sensation on the lateral surface of her palm. Although Sally maintains normal movement in all her muscles, her cutaneous sensation has been impaired. Which nerve was most likely damaged as a result of her burning incident? - Ulnar - Axillary - Musculocutaneous - Median - Radial

- Median

Which of the following represents a correct statement about multiaxial joints? - The shapes of articulating surfaces in the multiaxial joint are a flat bone in a trough. - The ball-and-socket joint permits only one angular motion. - The rounded end of the proximal metacarpal fitting into the distal surface of the carpal bone of the wrist is a classic ball-and-socket joint. - Movement in more than two axes is permitted in a multiaxial joint.

- Movement in more than two axes is permitted in a multiaxial joint.

Ball-&-Socket Joint _____axial Types of Motion Example of a Joint

- Multiaxial Flexion/Extension Adduction/Abduction Medial/lateral circumduction Shoulder, hip

Plane Joint _____axial Types of Motion Example of a Joint

- Nonaxial Gliding, Intercarpal joints, vertebrae

The tibialis posterior muscle produces which actions on the foot? - Plantarflexion; inversion - Plantarflexion; eversion - Dorsiflexion; eversion - Dorsiflexion; inversion

- Plantarflexion; inversion

David has sustained an injury to his neck that has resulted in the complete loss of sensation to the posterior side of his upper arm and an inability to extend his index finger. Which nerve has most likely been damaged as a result of his injury? - Axillary - Median - Ulnar - Radial - Musculocutaneous

- Radial

List and describe the key proximal features of the radius.

- Radial head- articulates with the capitulum of the humerus - Radial neck- narrowest region of the radius - Radial tuberosity- site of biceps brachii insertion

Which of the following landmarks is found on the posterior surface of the scapula? - Coracoid process - Lateral border - Spine - Glenoid cavity

- Spine- The spine of the scapula is on the back of the bone and can easily be palpated

Common Fibular (peroneal) Nerve branches into what two nerves?

- Superficial fibular (peroneal) nerve: lateral compartment muscles - Deep fibular (peroneal) nerve: anterior compartment muscles

Which of the following muscles is innervated by the posterior division of the brachial plexus? - Biceps brachii - Flexor pollicis longus - Supinator - Pronator teres

- Supinator

All of these statements regarding the acetabulum are true except - The acetabulum articulates with the sacrum. - The acetabulum participates in the hip joint. - The acetabulum is cup-shaped. - The acetabulum is where the three pelvic bones intersect.

- The acetabulum articulates with the sacrum.

How does structure governs function come in to play with mobility and stability in joints?

- The more stable a joint is the less mobile the joint is (Ex. Head) - The more mobile a joint is, the less stable the joint is (Ex. Shoulder)

Which of the following statements about muscles of the forearm is true? - The pronator teres originates on the medial epicondyle and inserts on the radius. - The pronator quadratus originates on the radius and inserts on the ulna. - The pronator quadratus is a two-headed muscle. - Contraction of the pronator quadratus and the supinator results in forearm pronation.

- The pronator teres originates on the medial epicondyle and inserts on the radius.

List and describe the key proximal features of the ulna.

- Trochlear notch- accommodates trochlea of humerus - Olecranon process- projection that forms the bump of the elbow, attachment site for triceps - Coronoid process- inferior lip of the trochlear notch - Radial notch- accommodates radial head

Interestingly, some synergists may act by cancelling out some of the actions of a prime mover. - True - False

- True

List the ligaments and muscles that act on the elbow

- Ulnar collateral ligament- gets torn and repaired w/Tommy John surgery- lots of baseball players) - radial collateral ligament- connects from humerus to ulna but splits to join with anular - Anular ligament- encircles head of radius - Biceps brachii, brachialis, brachioradialis (musculocutaneous nerve) - Triceps brachii (radial nerve)

The deep posterior extensor of the wrist and fingers __________. - act on the thumb and wrist - act on all four digits - act on the thumb and index finger - act on the index finger and wrist

- act on the thumb and index finger

One of the actions of the latissimus dorsi muscle is to __________. - lateral rotation of the arm - abduct the arm - flex the arm - adduct the arm

- adduct the arm

A muscle that crosses on the medial side of a joint produces what movement? - flexion - abduction - extension - adduction

- adduction

All of the following structures are common to all synovial joints EXCEPT __________. - joint cavity - articular discs - reinforcing ligaments - articular capsule - synovial fluid and articular cartilage - nerves and blood vessels

- articular discs

Which type of fascicle arrangement shortens the least? - circular - bipennate - parallel - fusiform

- bipennate

The soleus and the gastrocnemius share an insertion on the __________. - distal phalanx - calcaneus - medial cuneiform - fibula

- calcaneus

When muscle fascicles are arranged in concentric rings this arrangement is referred to as - parallel. - bipennate. - convergent. - unipennate. - circular.

- circular

This arrangement of muscle fascicles tends to be triangular in shape. The Pectoralis major is an example of a muscle with this type of muscle fascicle arrangement. - parallel - bipennate - convergent - unipennate - circular

- convergent

The coracobrachialis muscle originates on the __________. - radial tuberosity - medial surface of the humeral shaft - greater tuberosity of the humerus - coracoid process of the scapula

- coracoid process of the scapula

The __________ is a prime mover of the glenohumeral joint during flexion. - deltoid - biceps brachii - teres major - coracobrachialis

- deltoid

The nerves of the anterior division of the brachial plexus innervate all of the following muscles EXCEPT the __________. - biceps brachii - pronator teres - deltoid - coracobrachialis

- deltoid

The main action of the fibularis longus is to __________. - invert the foot - plantar flexes the foot - dorsiflexes the foot - evert the foot

- evert the foot

The action of the extensor digitorum longus muscle is to __________. - plantar flex the foot - extend digits - flex the digits - invert the foot

- extend digits

The semimembranosus __________ the thigh at the hip and __________ the leg at the knee. - extends; flexes - flexes; extends - abducts; flexes - adducts; extends

- extends; flexes

The extensor muscle that branches to form four tendons on the back of the hand is the __________. - extensor digitorum - extensor carpi radialis longus - extensor ulnaris - extensor carpi radialis brevis

- extensor digitorum

The prime mover of wrist extension is the __________. - extensor carpi ulnaris - extensor digitorum - extensor carpi radialis brevis - extensor carpi radialis longus

- extensor digitorum

Muscles named for their action would include which words as part of their names? - greater, lesser, or medial - longissimus, spinalis, or quadratus - maximus, medius, or minimus - extensor, adductor, or abductor - gluteal, brachial, or abdominis

- extensor, adductor, or abductor

Glenoid labrum

- fibrocartilaginous rim functions to deepen the glenohumeral joint a bit deeper and increase stability slightly - Can tear though, and cause pain and instability

Eversion of the foot is a function of the __________. - extensor hallucis - extensor digitorum - tibialis anterior - fibularis longus

- fibularis longus

Both heads of the biceps femoris muscle __________. - flex the hip - extend the hip - flex the leg at the knee - extend the leg at the knee

- flex the leg at the knee

Which muscle is a superficial anterior flexor muscle? - flexor digiti minimi brevis - flexor pollicis longus - flexor digitorum superficialis - flexor digitorum profundus

- flexor digitorum superficialis

Which muscle of the wrist and fingers is a deep anterior flexor? - palmaris longus - flexor digitorum superficialis - flexor pollicis longus - flexor carpi ulnaris

- flexor pollicis longus

The pubic bone is characterized by all of the following except that it - forms part of the greater sciatic notch. - forms part of the obturator foramen. - fuses with the ischium. - forms part of the acetabulum.

- forms part of the greater sciatic notch.

The auricular surface of the ilium - forms the lateral borders of the false pelvis. - attaches gluteal muscles. - lines the interior of the acetabulum. - forms the sacroiliac joint.

- forms the sacroiliac joint.

Wrist abduction occurs through the actions of __________ muscles. - four - two - five - three

- four

Abduction requires the action of two muscles, and adduction requires the action of __________. - four muscles - one muscle - three muscles - two muscles

- four muscles

The insertion of the extensor digitorum branches into __________. - three tendons - two tendons - four tendons - five tendons

- four tendons

Which type of movement occurs in the intercarpal joint in the wrist? - rotation - gliding - abduction/adduction - opposition

- gliding

The prime mover of hip extension is the __________. - adductor magnus - pectineus - gracilis - gluteus maximus

- gluteus maximus

The infraspinatus inserts on the ____________ of the humerus. - acromial process of the scapula - lesser tubercle of the humerus - coranoid process of the scapula - greater tubercle of the humerus

- greater tubercle of the humerus

The insertion of the teres minor is on the __________. - intertubercular groove of the humerus - greater tubercle of the humerus - lateral border of the scapula - lesser tubercle of the humerus

- greater tubercle of the humerus

A 26-year-old female runner presents to your clinic with posterior knee pain. You are concerned that this patient may have tendonitis. - What tendons in the posterior region of the knee would you palpate as part of your examination? - How would you test strength and range of motion associated with these tendons?

- hamstrings- (biceps femoris, semitendinosus, semimembranosus) - gastrocnemius - Knee extension= ROM - Knee flexion= strength

Structural classification of joints __________. - includes synarthroses, amphiarthroses, and diarthroses - is based on the amount of movement allowed - includes fibrous, cartilaginous, and synovial - All of the listed responses are correct.

- includes fibrous, cartilaginous, and synovial

Carpal tunnel syndrome is characterized by __________. - inflammation of the extensor carpi radialis - inflammation of the extensor retinaculum - inflammation of the flexor retinaculum and/or tendon sheaths - inflammation of the flexor digitorum profundus

- inflammation of the flexor retinaculum and/or tendon sheaths

The musculocutaneous nerve __________. - innervates the triceps brachii, anconeus, supinator, brachioradialis and extensors carpi radialis longus and brevis - gives off branches to muscles in the flexor compartment of the forearm, but not the flexor carpi ulnaris - innervates the biceps brachii, brachialis, and coracobrachialis muscles - innervates the flexor muscles in the anterior forearm and skin of the medial third of the hand - passes through the carpal tunnel deep to the tendon of the palmaris longus and reaches the hand, innervating the five intrinsic muscles in the lateral part of the hand

- innervates the biceps brachii, brachialis, and coracobrachialis muscles

The flexor hallucis longus muscle originates on the __________. - interosseous membrane - femur - distal phalanges of digits 2-5 - medial cuneiform

- interosseous membrane

The tibialis anterior muscle dorsiflexes the foot at the ankle and also assists in __________ of the foot. - inversion - eversion - extension - plantar flexion

- inversion

Which of the following statements is true regarding the patella? It __________. - glides along the fibular notch on the lateral side of the tibia - is a sesamoid bone enclosed in the tendon of the quadriceps muscle - secures the quadriceps muscles of the anterior thigh to the femur - glides along the medial and lateral epicondyles of the femur

- is a sesamoid bone enclosed in the tendon of the quadriceps muscle

The hamstring muscles originate on the __________. - lesser trochanter of the femur - ischial tuberosity - medial surface of the fibula - medial surface of the tibia

- ischial tuberosity

The long head of the biceps femoris muscle originates on the __________. - posterior superior iliac spine - iliac crest - ischial tuberosity - anterior superior iliac spine

- ischial tuberosity

"Cracking knuckles"- what is it and does it cause arthritis?

- joint volume increases, creates a vacuum in fluid, gas becomes absorbed when stretched to certain critical point This cavity becomes filled with gas Once cracked, takes a while for gas to dissolve again Does NOT cause arthritis

By anatomical definition the leg extends from the - the top of the femur to the ankle. - acetabulum to the metatarsals. - back (including the pelvis) to the tips of the toes. - knee to the ankle.

- knee to the ankle.

The origins of the lateral head of the gastrocnemius muscle are the __________. - medial condyle and posterior surface of the femur - patellar surface and posterior surface of the femur - patellar surface and anterior surface of the femur - lateral condyle and posterior surface of the femur

- lateral condyle and posterior surface of the femur

An origin of the supinator is the __________. - lateral epicondyle of the humerus - radius - supinator crest of the humerus - ulna

- lateral epicondyle of the humerus

The subscapularis muscle inserts on the __________. - greater tubercle of the humerus - intertubercular groove of the humerus - lesser tubercle of the humerus - deltoid tuberosity of the humerus

- lesser tubercle of the humerus

The four muscles that comprise the posterior group of the pectoral girdle are the __________. - levator scapulae, rhomboid minor, rhomboid major, and pectoralis major - levator scapulae, rhomboid minor, rhomboid major, and trapezius - rhomboid minor, teres minor, trapezius, and levator scapulae - pectoralis minor, rhomboid major, levator scapulae, and trapezius

- levator scapulae, rhomboid minor, rhomboid major, and trapezius

The main function of synovial fluid is - nourishing bone. - lubrication. - removing metabolic wastes. - cooling.

- lubrication.

Of the following, the nerve that forms from fibers of both the medial and lateral cords of the brachial plexus is the - ulnar. - median. - axillary. - musculocutaneous.

- median.

The extensor hallucis longus muscle inserts on digit __________. - four - one - three - two

- one

The palmaris longus inserts on the __________. - medial epicondyle of the humerus - palmar aponeurosis - bases of the second and third metacarpals - bodies of phalanges 2-5

- palmar aponeurosis

This arrangement of fascicles tends to provide the greatest range of motion (shortening distance), though not the greatest power. - parallel - bipennate - convergent - unipennate - circular

- parallel

The most powerful movement at the ankle joint is __________, and the ________ is one of the prime movers of this movement. - plantar flexion; gastrocnemius - dorsiflexion; tibialis anterior - plantar flexion; tibialis anterior - dorsiflexion; gastrocnemius

- plantar flexion; gastrocnemius

To allow for flexion, the __________ unlocks the knee joint. - semimembranosus - popliteus - biceps femoris - sartorius

- popliteus

The extensor muscles of the upper limb lie almost exclusively in the ________ region of that limb. - posterior - anterior - lateral - medial

- posterior

The radial nerve is a branch of the __________ cord of the brachial plexus and it supplies the __________. - posterior / shoulder joint, supraspinatus, and infraspinatus. - medial / flexor muscles in the medial forearm and intrinsic muscles of the hand - posterior / triceps brachii and posterior muscles of the forearm - lateral / rhomboid muscles and levator scapulae - lateral / biceps brachii and other flexor muscles in the anterior arm

- posterior / triceps brachii and posterior muscles of the forearm

Which compartment of the lower limb is NOT paired correctly with the general action of muscles of that compartment? - anterior compartment of the thigh: Extends the leg - posterior compartment of the leg: plantar flexes the foot and flexes the toes - posterior compartment of the thigh: Extends the leg and flexes the thigh - anterior compartment of the leg: dorsiflexes the foot and extends the toes - lateral compartment of the leg: plantar flexes and everts the foot

- posterior compartment of the thigh: Extends the leg and flexes the thigh

The flexor hallucis longus muscle originates from the __________. - anterior surface of the tibial shaft - anterior surface of the fibular shaft - posterior surface of the fibular shaft - posterior surface of the tibial shaft

- posterior surface of the tibial shaft

Of all the mucles originating in the flexor mass (fromt the medial epicondyle) and acting on the forearm, the __________ is the shortest. - flexor digitorum superficialis - flexor ulnaris - pronator teres - flexor carpi radialis longus

- pronator teres

The two heads of the biceps brachii combine to insert on the __________. - olecranon process - radial tuberosity - ulnar notch - radial notch

- radial tuberosity

A synergist muscle can do all of the following except - prevent inappropriate extra movements that might otherwise be produced. - hold a bone in place to create a stable base for the prime mover. - add extra force to a movement. - reverse a particular movement caused by the prime mover.

- reverse a particular movement caused by the prime mover.

The infraspinatus muscle is included in the __________ muscles. - rotator cuff - lateral rotator - respiratory muscles of the shoulder - medial rotator

- rotator cuff

To allow movement of the tendons within the carpal tunnel zone, each tendon is encased in a __________. - sheath - meniscus - osseous membrane - bursa

- sheath

Identify the bone that articulates with the clavicle medially. - Humerus - Sternum - First rib - Scapula (These form what joint?)

- sternum- forming the sternoclavicular joint

The angle of which muscle prevents the humeral head from sliding upward out of the joint as the arm is raised? - teres minor - supraspinatus - infraspinatus - subscapularis

- subscapularis

The rhomboid minor muscle sits __________. - superior to the rhomboid major - inferior to the rhomboid major - deep to the rhomboid major - superficial to the rhomboid major

- superior to the rhomboid major

Which of the following muscles assists during extension of the glenohumeral joint, but is not as a prime mover? - teres major - biceps brachii - latissimus dorsi - deltoid

- teres major

Which muscle is not part of the rotator cuff? - infraspinatus muscle - supraspinatus muscle - teres minor muscle - teres major muscle

- teres major muscle

The lateral cord of the brachial plexus forms directly from - the anterior divisions of the upper and middle trunks. - the posterior divisions of the middle and lower trunks. roots C7-T1. - the upper, middle, and lower trunks.

- the anterior divisions of the upper and middle trunks.

The two heads of the gastrocnemius muscle converge to insert onto __________. - the posterior surface of the tibia - the calcaneus - the middle phalanx of digit one - digits two through five

- the calcaneus

What are the distal features of the humerus and what are their functions?

-Medial and lateral epicondyles -Capitulum -Trochlea -Anterior and Posterior fossae

What are the four joints of the pectoral girdle?

1) acromioclavicular (AC) joint (plane joint) 2) glenohumeral (GH) joint (ball and socket) 3) sternoclavicular (SC) joint (saddle joint) 4) scapulothoracic (ST) joint (functional joint)

Axillary Artery Part 2

1. Thoracoacromial artery: 4 branches Acromion, clavicle, pectoralis muscles, deltoid 2. Lateral Thoracic Artery: serratus anterior, pectoralis muscles (DON'T confuse that serratus anterior is innervated by the long thoracic nerve)

Scapulohumeral Rhythm

2:1 ratio glenohumeral (GH) to scapulothoracic (ST) joints in abduction - When the limb has reached 180 degrees abduction, around 120 degrees comes from the GH joint, 60 degrees comes from the ST joint (Takes both joints to completely raise one's arms- work together)

What is the record for the highest # of fingers and toes on one person? And what is that condition called?

34- (polydactyly- more fingers and toes than normal) vs. Syndactyly- fingers don't separate properly

Although the adductor magnus adducts and flexes the hip, it also has a specific part that does what?

A Hamstring part- that extends the thigh and laterally rotates the hip

Joints contain sensory nerves called "baro-receptors". These receptors react to atmospheric changes in the barometric pressure. So, when a thunderstorm is approaching and the barometric pressure drops, some people with joint pain can actually tell a storm in on the horizon! A) True B) False

A) True

You are concerned that your patient's popliteal artery may be compromised, resulting in a lack of blood flow to the leg and foot. To test for this on the field, you feel for a pulse in the BLANK artery. A. dorsalis pedis B. posterior tibial C. lateral plantar D. medial plantar E. fibular (peroneal)

A. dorsalis pedis

You are an athletic trainer for a baseball team. After a collision while sliding into home plate, one of the players is down with a knee injury. As you complete your on-field evaluation, you asses that your patient has a posterior tibiofibular dislocation. Which of the following structures could be compromised with this injury? A. Popliteal artery B. Tibial nerve C. Femoral nerve D. Obturator artery E. Common fibular nerve

A. popliteal artery, B. tibial nerve, C. common fibular nerve

Scapulothoracic movement MUST result in movement at the

AC and SC joints

Anterior and Posterior Cruciate (cross) Ligaments

ACL- attaches to lateral femoral condyle and anterior tibial plateau PCL- attaches to medial femoral condyle and posterior tibial plateau Thicker and stronger than ACL

patellar ligament

AKA patellar tendon- formed by the quadriceps muscles - sits on tibial tuberosity- continuation of quadriceps tendon - The patella is attached to the quadriceps muscles by the quadriceps tendon. - Working together, the quadriceps muscles, quadriceps tendon and patellar tendon straighten the knee.

Glenohumeral joint is AKA what? What type of joint is it and what is it comprised of?

AKA shoulder joint-Ball and socket joint--Head of humerus and glenoid cavity

An agonist is also known as a what, and what is its function?

AKA- prime mover, major responsibility for producing a specific movement--a "leader" of that motion

What plane and axis is involved in circumduction?

ALL OF THEM***

Tibial nerve divides into---Medial and lateral plantar nerves that innervate ALL of what?

ALL muscles of the foot

Muscles of the Posterior Forearm (Lateral epicondyle) Deep layer:

Abductor pollicis longus Extensor pollicis brevis Extensor pollicis longus Extensor indicis- index finger- allows it to point and extend Supinator

Pes Cavus-

Accentuation of the longitudinal arch of the foot Secondary to muscle imbalance: relative weakness of intrinsic muscles Associations: Charcot-Marie tooth, spina bifida, poliomyelitis High arch clearly visible; toes always clawed (hyperextension of the metatarsophalangeal joints and flexion of the interphalangeal joints) Patient cannot straighten their toes Extension of the metatarsophalangeal joints and the high arch make the ball of the foot more prominent and lift the toes off the ground so they do not participate in weight bearing Callosities develop on the ball of the foot beneath the metatarsal bones and on the dorsal aspect of toes where they rub against shoes

Teres major (origin, insertion, actions, innervation)

Adducts, extends, medically rotates GH joint--origin: Inferior lateral border, inferior angle of scapula--insertion: intertubercular groove of humerus--innervation: lower subscapular nerve

Functional Classification of joints is based on what characteristics?

Amount of movement possible Categories: - Synarthroses- immovable, more common in axial skeleton (ex. skull) - Amphiarthroses- slightly moves - Diarthroses- freely moves

Angle of Inclination (femur)- dif b/w normal angle, coxa valga, coxa vara

Angle between the neck and shaft Slightly smaller in females due to wider pelvis Positions femoral head over the middle of the knee joint Normal= 125 degrees Coxa valga: greater than 125 degrees Coxa varus: less than 125 degrees

__________ are muscles that oppose or reverse a particular movement.

Antagonists

Portions of each trunk divide into what?

Anterior and posterior divisions- there are 8 total

Anterior axillary fold vs. Posterior axillary fold:

Anterior axillary fold: formed by the pectoralis major Posterior axillary fold: formed by the latissimus dorsi and the teres major muscles

Proximal to Distal Gradient of Innervation

Anterior division fibers- anterior arm, forearm, hand Posterior division fibers- posterior arm, forehand, hand

How might you test the integrity of a ligament located on the medial aspect of a joint?

Apply pressure abductively (away from midline) to test the integrity of the medial ligament--if stretches far, NOT good- likely a sprain

Obturator artery supplies an additional artery

Artery to the femoral head- travels within the ligament of the femoral head (Runs right within ligament of fovea capitis) - If hip is dislocated- can cause blood supply to the hip to be lowered

General anatomy of synovial joints

Articular capsule Joint cavity Synovial fluid Articular cartilage Ligaments Nerves and blood vessels

Normally, the clavicle is fractured anteriorly. However, it can also fracture posteriorly. Why is this a life-threatening injury? A) The fractured clavicle can puncture the lung B) The fractured clavicle can pierce the subclavian arteries C) The fractured clavicle can compress the trachea and inhibit breathing D) Two of the above E) None of the above

B) The fractured clavicle can pierce the subclavian arteries - (located behind clavicle, supplies the arms)

What muscle is the only one that laterally rotates the knee?

Biceps femoris!

Cubital fossa contains the:

Biceps tendon Bicipital aponeurosis Median nerves Brachial artery Veins- median cubital vein

Which of these muscles: biceps brachii, brachialis, brachioradialis is the prime mover of elbow flexion?

Brachialis (Strongest flexor)- brachioradialis doesn't cross wrist so doesn't act on wrist, inserts on radius (brachialis and biceps brachii are synergists)

Axillary Nerve- spinal segments, location, muscles innervated, sensory innervation

C5, C6- Runs with posterior circumflex humeral artery- ***wraps around surgical neck of humerus Muscles Innervated - Teres minor - Deltoid Sensory Innervation - sensory information from the shoulder joint, as well as the skin covering the inferior region of the deltoid muscle

Radial nerve- spinal segments, location, muscles innervated, sensory innervation

C5-T1, Runs posteriorly through the RADIAL GROOVE of the humerus to the posterior arm-- innervates ALL posterior compartment muscles of the arm - Divides into deep radial nerve and posterior interosseous nerve as it enters the forearm---ALL posterior compartment muscles of the forearm Muscles Innervated & Sensory Innervation ALL posterior compartment muscles of arm & forearm- AND generally ALL posterior skin

What is the most commonly broken bone in the body, which direction does it fracture most often and why?

CLAVICLE- (b/c of s-shape causes the bone to shift directions) Fractures outwardly/anteriorly most often

3 different areas of the hand- what are they and how many bones are in each area?

Carpals (8 bones), metacarpals (palm) (5), phalanges (12 for each finger except for thumb which has 2, so 14 total)

Veins of the Upper Limb

Cephalic vein: anterolateral forearm and arm Drains into the axillary vein Basilic vein: medial forearm and arm Joins with brachial vein to form the axillary vein Median cubital vein: communication b/w basilic and cephalic veins in the cubital fossa Ulnar and radial veins: deep veins of forearm Brachial vein: deep vein in the arm Axillary vein: joining of basilic and brachial veins join Axillary vein drains into the subclavian vein

Types of Synovial Joints (Nonaxial, etc.)

Classified by articulating surface shapes and amount of movement allowed - Nonaxial- adjoining bones do not move around a specific axis (plane joint) - Uniaxial- movement occurs around a single axis (hinge & pivot joint) - Biaxial- movement can occur around 2 axes, enables motion along both frontal and sagittal planes (condylar and saddle joint) - Multiaxial- movement can occur around all 3 axes, and along all 3 body planes: sagittal, frontal, transverse (circumduction) (ball-and-socket joint)

clavicle articulations and features

Clavicle- S-shaped bone Articulation: - Medially with manubrium of sternum - Laterally with the acromion Features: - Acromial end - Sternal end - Impression for costoclavicular ligament - Conoid tubercle - Trapezoid line

Carpal tunnel involves compression of what nerve, and causes the atrophy of what muscles?

Compression of median nerve- atrophies thenar muscles

What plane and axis is involved in abduction and adduction?

Coronal plane, anterior/posterior axis

What plane and axis is involved in eversion and inversion?

Coronal plane, anterior/posterior axis

A 20 year old woman presents to the ER following a moped accident. She incurred a blow to the anterior tibia and is suffering from acute anterior compartment syndrome. Due to the increased pressure in the anterior compartment, you are concerned about what nerve and artery? A. tibial nerve; anterior tibial artery B. superficial fibular (peroneal) nerve; posterior tibial artery C. deep fibular (peroneal) nerve; fibular (peroneal) artery D. deep fibular (peroneal) nerve; anterior tibial artery E. None of the above are correct.

D. deep fibular (peroneal) nerve; anterior tibial artery

The lower the roots are, the more BLANK the muscles are

DISTAL

Fibrous joints- held together by what kind of tissue?

Dense Regular CT

Ligaments are what, and their function?

Dense regular CT that connects bone to bone - Strengthen and reinforces joint capsule

special muscle movements

Depression (ex. Open mouth) Elevation (ex. shrug shoulders, close mouth) Dorsiflexion- Plantar flexion (ex. Point toes) Supination- Pronation Inversion-Eversion Protraction- Retraction Opposition (with thumb- Ex. how thumb touches pinky finger)

The roots of the brachial plexus innervate what nerves, which then innervate which muscles?

Dorsal Scapular Nerve (C5): rhomboid minor, rhomboid major, levator scapulae Long thoracic nerve (C5, C6, C7): serratus anterior

You suspect your patient has compartment syndrome in the anterior compartment of the leg. A diagnostic test would be to check for loss of cutaneous sensation where?

Dorsum of foot between first and second toes (deep peroneal nerve runs in the anterior compartment and would be compressed, causing sensory loss in this area cutaneously) Deep fibular nerve runs through the anterior compartment, would be compressed.

Muscles of the Posterior Forearm (Lateral epicondyle) Superficial layer:

Extensor carpi radialis longus Extensor carpi radialis brevis Extensor digitorum Juncturae Tendinum Extensor digiti minimi Extensor carpi ulnaris

Any lateral (side) movement parallel to the line will occur in the

FRONTAL Plane- antero/posterior axis (adduction/abduction)

Popliteus forms the floor of what fossa, and does what action?

Flexes the leg and also medially rotates the tibia slightly

In uniaxial movement at the elbow joint, the movement allowed is

Flexion & extension

A cylinder-shaped bone articulating with a trough- shaped bone would exhibit

Flexion and extension

Intrinsic Hand Muscles Thenar group

Flexor pollicis brevis Abductor pollicis brevis Opponens pollicis (Additional intrinsic muscle acting on the thumb: Adductor pollicis-NOT a thenar muscle)

pelvic girdle- functions, consists of what, and is considered the 1st part of what?

Functions: - Attaches the lower limbs to the spine - Supports the visceral organs of the pelvis - Anchors lower extremity to spine Consists of: - Paired hip bones (coxal bones, aka os coxae) and sacrum **1st section of lower extremity- forms lower abdominal cavity

Contraction of what muscle group could cause a false negative result on the Lachman's test?

Hamstrings- b/c may tense and muscle guard (This is why it is easier to tell if the patient is under anesthesia)

Humeroradial Joint is located where?

Head of radius and capitulum of humerus

What are the two main distal features of the Ulna and what are their functions?

Head: knob-like end Styloid process: posteriomedial wrist bump

Arches of the Foot helps prevent

Helps prevent pinching of muscles, nerves, and blood vessels

There is or is not a constant tension in a resting muscle?

IS a constant tension- Motor units (motor neuron and all the skeletal muscle fibers it innervates) are stimulated randomly to avoid fatigue Fire to maintain posture but not to fatigue

2 types of muscle contraction:

Isometric contraction- length is constant, tension is changing Isotonic contraction- tension is constant, length is changing (Concentric contraction: muscle is shortening Eccentric contraction: muscle is lengthening (this can actually be harder on the muscle and lead to more soreness))

articulations are AKA what? What are they and what do they vary in?

Joints- where a bone meets another bone, cartilage (usually covering bone) or teeth and where movement occurs **Vary in stability and movement

Lumbar plexuses- formed by the anterior rami of spinal nerves? Also what are the motor and cutaneous nerves?

L1-L4 - Cutaneous nerves: Lateral femoral cutaneous nerve Anterior femoral cutaneous nerve Saphenous nerve - Motor nerves: Femoral nerve Obturator nerve

Varus stress test- tests for what ligament weakness?

LCL

The sciatic nerve is the what type of nerve in the body? And innervates what?

LONGEST AND LARGEST---Tibial and common fibular (peroneal) nerves wrapped in a common sheath - Not really its own nerve, more of a bundle of tibial and common fibular (peroneal) nerves - Innervation of thigh muscles

Does the radius get larger or smaller on the bottom?

Larger at the bottom, smaller at the head (top) ***This is opposite for Ulna- large at top and smaller at bottom with head

A ligament locate on the lateral aspect of a joint is going to prevent what motion and what kind of stress is applied?

Lateral ligament- Prevent Adduction- Varus stress

The cords of the brachial plexus innervate what nerves, which then innervate which muscles?

Lateral pectoral nerve (C5, C6, C7): pectoralis major Medial pectoral nerve (C8, T1): pectoralis major, pectoralis minor Medial brachial cutaneous nerve (C8, T1): skin of medial arm Medial antebrachial cutaneous nerve (C8, T1): skin of medial forearm Upper subscapular nerve (C5, C6): subscapularis Lower subscapular nerve (C5, C6): subscapularis, teres major Thoracodorsal nerve (C6, C7, C8): latissimus dorsi

A valgus force is when your knee gets hit on what side?

Lateral side- (applying force toward the lateral side), causing the lower leg to abduct.

Which four muscles insert somewhere along the medial border of the scapula?

Levator scapulae (superior medial border) Rhomboid major (medial border of scapula) Rhomboid minor (superior medial border of scapula) Serratus anterior (anterior medial border of scapula)

Sacroiliac joint changes throughout lifetime, how so?

Ligaments slacken in pregnancy- want more movement for during labor Adhesions and ossification can occur with age- becomes stiffer and less able to move joint

Pes Planus

Loss of the longitudinal arch of the foot Usually associated with mild valgus deformity of the hindfoot; results in pronation of the forefoot and subsequent loss of the medial arch All children are flat-footed when they walk, arch develops when they are more active Infantile pattern can persist into adulthood

Valgus stress test- tests for what ligament weakness?

MCL

Which fascicle arrangement produces the more powerful contraction? - multipennate - convergent - fusiform - Parallel

MULTIPENNATE- The force produced by a muscle is directly related to the number of muscle fibers. Pennate muscles have a greater number of muscle fibers than parallel muscles and produce a more powerful contractile force

A ligament locate on the medial aspect of a joint is going to prevent what motion and what kind of stress is applied?

Medial ligament- Prevent Abduction- Valgus stress

A varus force is when your knee gets hit on what side?

Medial side- causing the lower leg to adduct

Which vein do you draw blood from normally?

Median Cubital vein- communication b/w basilic and cephalic veins in the cubital fossa

Brachial Plexus 11 total nerve branches from where?

NONE from divisions - 2 from roots- dorsal scapular nerve (C5) & long thoracic nerve (C5, C6, C7) - 2 from trunks- suprascapular nerve (C5 & C6) & nerve to subclavius (C5) - 7 from cords- lateral pectoral nerve (C5, C6, C7), medial pectoral nerve (C8, T1), medial antebrachial cutaneous nerve (C8, T1), medial brachial cutaneous nerve (C8, T1) thoracodorsal nerve (C6, C7, C8), lower subscapular nerve (C5, C6) upper subscapular nerve (C5, C6)

Brachial Plexuses

Networks of nerves that supply the upper limbs, runs around the axillary artery Formed by the anterior rami of spinal nerves C5-T1- Innervates the pectoral girdle and the entire upper limb of one side

Due to the thumb's orientation it is the only place where what is reversed?

Only place where plane and axis are different Abduction and adduction of the thumb happens in the sagittal plane - Coronal plane is responsible for flexion and extension

Anterior compartment muscles (origin and actions of the wrist, hand, and/or fingers)

Origin: medial epicondyle of the humerus Flexion of the wrist, hand, and/or fingers **Also includes pronator

Os coxae AKA- is a fusion of what, fuses at what age, and articulations?

Os coxae- fusion of ilium, ischium, and pubis b/w 13 and 15 years of age Articulations: - Anteriorly with other os coxae - Posteriorly with sacrum - Laterally with femur at the acetabulum ***All 3 bones of os coxa contribute to its acetabulum

Articular capsule 2 layers and their functions:

Outer fibrous layer made of dense regular CT Function: Strengthens the joint Inner synovial membrane Function: Makes synovial fluid Also macrophages are in here, they remove debris in joint

Midcarpal and intercarpal joints are __________ joints

PLANE Joints

Which three muscles have an attachment point at the coracoid process of the scapula?

Pectoralis minor Coracobrachialis Short head of biceps brachii

ACL and PCL Cruciate ligaments provide what?

Provide rotational stability & prevent anterior and posterior translation of the tibia on the femur

Nerves supplied by proximal rami (C5-C6) innervate what muscles?

Proximal

What are the 8 Carpals? What is their position in the wrist (Proximal/Distal row, medial to lateral)?

Proximal row- scaphoid, lunate, triquetrium, pisiform Distal row- trapezium, trapezoid, capitate, hamate

Muscles of the Anterior Thigh that Flex the hip joint/thigh

Psoas major iliacus sartorius Quadriceps - rectus femoris - vastus lateralis - vastus medialis - vastus intermedialis

True and False Pelves Pelvic brim:

Pubic crest Pectineal line Arcuate line Sacral promontory

In the cubital fossa, brachial artery divides into:

Radial artery: lateral forearm and hand Ulnar artery: medial forearm and hand, deep anterior and posterior forearm muscles Superficial and deep palmar arches: formed from radial and ulnar arteries Give off digital arteries and princeps pollicis artery (deep) to the thumb

Bones of pectoral girdle?

Really just clavicle and scapula- but also articulates with humerus and sternum too

Out of the quadriceps- which is the only one that also acts on the hip in addition to the knee?

Rectus femoris- b/c crosses hip--origin is at anterior inferior iliac spine (AIIS)

What part of Medial and Lateral Menisci is vascular?

Red zone- outer margin

KNOW THIS*** Tibial artery and fibular nerve both do what???

SPLIT!

What type of joint at sternoclavicular joint? What movements at the sternoclavicular joint?

Saddle (biaxial) joint- elevation/depression, rotation, protraction/retraction

Sternoclavicular joint and ligament

Saddle joint (biaxial) - Between manubrium of sternum and sternal end of the clavicle ***ONLY connection b/w the upper limbs and axial skeleton Sternoclavicular ligament-fibrocartilage (articular) disc (helps it move)

bicep curl and forward or reverse lunges are movements occurring in what plane?

Sagittal plane

Flexion and extension are movements that occur primarily in the BLANK plane of the BLANK axis?

Sagittal plane of the, Transverse axis

What plane and axis is involved in protraction and retraction?

Sagittal plane, transverse axis

SCFE: Slipped Capital Femoral Epiphysis

Salter- Harris Type 1 Fracture Displacement of the femoral head posteromedially Head and neck of femur aren't completely fused till around 20 y/o Transverse fracture through growth plate 2x more common in males Symptoms: - Problems walking. - Limping. - Mild pain in the hips, groin or around the knees. - Less movement than usual in the hip (not an issue in adults b/c head and neck are already fused)

Vasculature of the Upper Limb: Arteries of the Upper Limb Main supply is the

Same tube, with a different name

The SC and AC joints are interdependent with the

Scapulothoracic joint

AC Joint Sprain- AKA

Separated shoulder- Characterized by large lump on shoulder **Sprain can be partial or complete (incomplete or complete tear)

Common fibular nerve innervates what muscle ONLY???

Short head of biceps femoris ONLY

Arteries of the Upper Limb

Subclavian becomes axillary at the lateral border of the first rib Axillary becomes brachial at the inferior border of the teres major Brachial divides into radial and ulnar in the cubital fossa

largest branch of the axillary artery

Subscapular artery (this artery itself branches into 2 other arteries): - Thoracodorsal artery: latissimus dorsi - Circumflex scapular artery: posterior inferior scapular region

The roots of the brachial plexus unite to form trunks- names and spinal segments associated

Superior trunk- C5 & C6 Middle trunk- C7 Inferior trunk- C8 & T1

Boundaries of the femoral triangle

Superiorly- inguinal ligament Lateral- sartorius muscle medial- adductor longus muscle

Biceps are stronger when supinated or pronated?

Supinated- which is why a chin-up is easier

Posterior forearm muscles that supinates the forearm:

Supinator Biceps brachii (short head and long head)

IGA & SGA Supply and exit site

Supplies (gluteal region, superior hamstrings) - Superior gluteal artery- greater sciatic foramen, exits superior to the piriformis - Inferior gluteal artery- greater sciatic foramen, exits inferior to the piriformis

Which three muscles insert onto the greater tubercle of the humerus?

Supraspinatus Infraspinatus Teres minor

How can the structure of the acromion process lead to injury?

Supraspinatus and subscapular bursae lie below the acromion and can become pinched

What is the difference between the surgical and anatomical neck, which one is most commonly fractured, and why?

Surgical neck- the most commonly fractured region of the humerus, located on the uppermost part of the head Anatomical neck- structural neck of humerus, site of epiphyseal line - ***Surgical neck is more commonly fractured b/c change in size and direction of the bone so it makes the bone vulnerable to breaking

Mobility vs. Stability of joints: synarthrosis

Suture, gomphosis, synchondrosis, tibiofibular

Knee Joint is what kind of joint and articulates with what bone only?

Synovial hinge joint b/w femur and patella- patella articulates with FEMUR ONLY - surrounded by articular capsule- big fibrous capsule

sacroiliac joint

Synovial joint- BUT pretty strong here, little dislocation - Attaches the lower limb to the pelvis - Transmits forces from lower limbs to vertebral column Slight gliding and rotation only**Mostly NOT movable

Movement parallel to the waistline, otherwise known as rotational movement, occurs in the

TRANSVERSE Plane- vertical axis

Foot consists of what, and its functions?

Tarsus Metatarsus Phalanges Functions: - Act as a lever to propel the body forward when running or walking - Support body weight

Muscle of the lateral thigh and does what?

Tensor fasciae latae- flexes, abducts, and medially rotates hip - Attaches to the iliotibial tract- (IT band) like gluteus maximus - Extends from the iliac crest to the lateral condyle of the tibia - Gerdy's tubercle- point just lateral to tibial tuberosity

What is the most important functional segregation that takes place in the brachial plexus and why?

The anterior/posterior divisions b/c all of the fibers in the anterior division will innervate anterior (preaxillary) compartment muscles and the posterior division will innervate the posterior (postaxillary) compartment muscles

What stress is thought of as riding a horse with one's legs "bowed-out"?

Varus stress

__________ lubrication is the process by which synovial fluid is squeezed out of articular cartilage under pressure and then rushes back into the articular cartilage when pressure on a joint ceases.

Weeping

Tear in which part of the meniscus won't heal very well and why?

Won't heal well in the inner margin b/c avascular so there is no blood to help healing process

Is the foot normally arched?

YES

A baseball pitcher injured a rotator cuff muscle. When he abducts and laterally rotates his shoulder, it dislocates anteriorly. What muscle is injured and thus making the joint unstable? a. Supraspinatus b. Infrapinatus c. Teres minor d. Subscapularis

a. Supraspinatus

10. Which of the following types of joints has a fluid-filled cavity? a. Synovial b. Gomphosis c. Suture d. Syndesmosis e. Synchondrosis f. Symphysis

a. Synovial

1. An example of a synarthrotic fibrous joint is the a. sagittal suture. b. interosseous membrane between the radius and the ulna. c. pubic symphysis. d. intervertebral discs.

a. sagittal suture.

A muscle that crosses on the lateral side of a joint produces

abduction

Fascicle arrangement (fiber direction) provides info about the muscle's

action and function

Muscles of the Thigh medial muscles do what?

adduct the hip (thigh)

A muscle that crosses on the medial side of a joint produces

adduction

Additional intrinsic muscle acting on the thumb

adductor pollicis- NOT a thenar muscle- "7"-shaped

Osteoarthritis

aging and stress result in breakdown of the articular cartilage - Normally smooth, but arthritic cartilage is rough

Muscles in opposing compartments are usually

agonist and antagonist pairs

Arteries of the Leg Anterior tibial artery: located where and becomes what?

anterior compartment Becomes the dorsalis pedis artery - place than can test for blood supply to the foot, by taking a pulse here

Smith's Fracture

anterior displacement of the distal fragment - Less common - Often caused by a direct blow to the forearm- anterior

Shoulder Joint Dislocation most often occurs in what direction and what is this AKA?

anterior part of shoulder= weakest part so most dislocations occur anteriorly --AKA- "squared off- shoulder"- b/c not as pronounced as AC separated shoulder

4 compartments of leg and ankle--what are they?

anterior, lateral, superficial posterior, and deep posterior

Coronal plane coincides with what axis?

anterior/posterior axis (AC)

ischium

arch shaped region of hip bone Much smaller than ilium

Brachial artery: supplies the

arm Deep brachial artery: triceps Contributes to collateral circulation around the elbow

Humerus AKA what? And what does it articulate with?

arm/brachium- upper arm - Largest bone of upper limb - Articulates with both lower bones - Bones below humerus is considered the lower arm Articulates with: - Scapula -Radius and ulna

pectoral girdle

attaches the upper limbs to the trunk- articulates with the trunk and supports the upper limbs (really just the clavicle and scapula, but also articulates with sternum and humerus) ***This is the only way the upper limbs are attached to the trunk

Jones fracture

avulsion fracture where a tendon pulls on the base of the 5th metatarsal- occur in a small area of the fifth metatarsal that receives less blood and is therefore more prone to difficulties in healing

The__________nerve innervates the deltoid and teres minor muscles.

axillary

1. What is a trochanter? a. Any marked bony prominence b. A massive, rough projection found only on the femur c. Any passageway through a bone d. A pointed slender process e. None of the above

b. A massive, rough projection found only on the femur

5. Which is an example of a multipennate muscle? a. Biceps brachii b. Deltoid c. Rectus femoris d. Sartorius e. Extensor digitorum longus

b. Deltoid

You are attempting to draw blood from a patient. You attempt to insert the needle to draw blood from the median cubital vein, the patient suddenly cries out and explains there is pain in the middle and thumb side of his palm. The nerve you accidently hit is? a. Radial nerve b. Median nerve c. Ulnar nerve

b. Median nerve

8. In the mobility/stability tradeoff: a. The most mobile bone is the most stable b. The least stable bone is the most mobile c. The most stable bone is the most mobile d. A bone of medium stability is the least mobile e. None of the above

b. The least stable bone is the most mobile

1. An example of an amphiarthrotic cartilaginous joint is the a. epiphyseal plate. b. pubic symphysis. c. knee joint. d. sternocostal joint.

b. pubic symphysis.

20. What is the correct order of the arteries of the upper limb moving from the shoulder to the hand? a. subclavian, brachial, axillary, radial/ulnar b. subclavian, axillary, brachial, radial/ulnar c. brachial, subclavian, radial/ulnar, axillary d. radial/ulnar, axillary, subclavian, brachial e. axillary, subclavian, radial/ulnar, brachial

b. subclavian, axillary, brachial, radial/ulnar

. Which muscle crosses the elbow and shoulder joint? a. Biceps brachii b. triceps brachii c. Coracobrachialis d. subscapularis e. non of the above

b. triceps brachii

Scapulothoracic Joint

between the anterior surface of the scapula and the posterior thoracic wall - Functional unit: no capsule or bony union - The wide range of motion available to the shoulder joint is due to the large movement available at ST joint - Scapulothoracic movement MUST result in movement at the AC and SC joints

Contraction of what muscle could result in a posterior dislocation of the fibular head?

biceps femoris

"Hamstring" muscles are which muscles and are a part of what region of the thigh?

biceps femoris, semimembranosus, semitendinosus Posterior thigh muscles **bulk of posterior compartment muscles

Synovial joints have a rich what?

blood supply! Nutrients from vessels around joint The blood supply of a synovial joint comes from the arteries sharing in anastomosis around the joint. **Most supply the synovial membrane

The lower limb what three segments make it up and characteristics?

bones are thicker and stronger than the comparable bones of the upper limbs 3 segments: - Thigh - Leg - Foot

Fibrous joint, what is it?

bones joined by dense regular CT NO joint cavities

Synchondroses

bones joined by hyaline cartilage Epiphyseal plates (temporary hyaline cartilage joint until fused) 1st rib and sternum (immovable joint joined by cartilage) ***synarthroses

Symphyses

bones joined by pad of fibrocartilage --Strength with flexibility Hyaline cartilage as articular cartilage ***Amphiarthroses (ex. Pubic symphysis and intervertebral disc) ***Both very strong but still flexible

When the knee is fully extended, both cruciate ligaments

both cruciate ligaments are taut and the knee is locked

Opponens

brings thumb to pinky, allows for good dexterity

Scapula characteristics, articulations, and has how many borders and angles?

broad, flat triangle- pretty flat bone Articulation: - Clavicle (acromial end) - Humerus (part of what makes up the actual shoulder joint) 3 borders and 2 angles - Lateral border - Superior border - Medial border - Inferior angle - Superior angle

What three things make up the articular capsule of the glenohumeral joint?

bursae, ligaments, rotator cuff muscle

6. Which is TRUE of agonists and antagonists? a. An agonist opposes a synergist's movement b. A prime mover aids the agonist, which is the main muscle that produces a movement c. An antagonist opposes or reverses an agonist's movement d. A fixator is a type of prime mover that holds a bone firmly in place A synergist helps the antagonist in several ways

c. An antagonist opposes or reverses an agonist's movement

11. Which of these is not a part of the Scapula? a. Inferior angle b. Suprascapular notch c. Conoid tubercle d. glenoid fossa e. none of the above

c. Conoid tubercle- FOUND ON CLAVICLE- coracoid found on scapula, coronoid found on ulna

12. Which is the correct pairing of a synovial joint and an example of it found in the body? a. Ball-and-socket - elbow and knee joints b. Hinge - glenohumeral joint c. Pivot - atlantoaxial joint d. Plane - between the carpal and first metacarpal bones e. Saddle - intercarpal or intertarsal joints

c. Pivot - atlantoaxial joint

1. Which articulation has the least stability? a. Synarthrosis b. amphiarthrosis c. diarthrosis

c. diarthrosis

1. Which of the response pairs listed below does not correctly pair the joint category with its functional degree of mobility? a. suture: synarthrosis b. symphysis: amphiarthrosis c. synchondrosis: amphiarthrosis d. synovial: diarthrosis

c. synchondrosis: amphiarthrosis

1. Where would you find a saddle joint? a. the hip b. the neck c. the thumb d. the knee

c. the thumb

These two tarsal bones hold the majority of your body weight

calcaneus and talus

Muscles that act on the knee insert on the tibia or fibula but can originate on what?

can originate on the hip/pelvis

Ligaments of joints

capsules and ligaments prevent excessive motions - The more ligaments, usually the stronger and more stable the joint

The carpal bones and the flexor retinaculum (holds down flexor tendons) form the

carpal tunnel

Sides of innervation- cephalic vs. basilic vein?

cephalic= anterolateral side basilic= medial side

What is is responsible for the force a muscle can produce?

cross-sectional area (# of muscle fibers)

How many carpal bones are in the hand? a. 8 b. 2 c. 6 d. 5 e. 1

d. 5

9. Which is NOT one of the three structural categorizations of joints? a. Synarthrosis b. Diarthrosis c. Fibrous d. A and b

d. A and b

11. Osteoarthritis involves the breakdown of _____ in synovial joints? a. Bone b. Synovial fluid c. Ligaments d. Articular cartilage

d. Articular cartilage

7. Which is FALSE of muscle contraction? a. Concentric contraction involves muscle shortening b. Eccentric contraction involves muscle lengthening c. Isometric contraction involves constant length and changing tension d. Concentric and eccentric contractions are both types of isometric contractions e. Isotonic contraction involves changing length and constant tension

d. Concentric and eccentric contractions are both types of isometric contractions

3. Which is NOT part of the appendicular skeleton? a. Femur b. Clavicle c. Scapula d. Skull e. Humerus

d. Skull

What does the Pronator teres and Pronator quadratus act on? a. the shoulder b. the scapula c. the humerus d. the forearm e. all of the above

d. the forearm

profundus

deep

talocrural joint- what type of joint, and movements allowed, articulations and ligaments

diarthrotic hinge joint ***ONLY movements here= plantar flexion and dorsiflexion Articulations: - Distal end of tibia and the talus - Distal end of fibula and the lateral aspect of the talus Ligaments: - Medial (deltoid) - Lateral - Anterior and posterior tibiofibular

Hip (coxal) joint- and 3 ligaments

diarthrotic multiaxial ball-and-socket joint b/w head of femur and acetabulum of os coxae Acetabular labrum- provide support and make socket deeper Ligaments: Iliofemoral Ischiofemoral Pubofemoral **All three of these work together as a screw Ligament of the head of the femur (ligamentum teres)- pretty weak--contains artery for ligament of head of femur

Axillary artery divided into 3 parts by the

divided into 3 parts by the pectoralis minor - 1st part--lateral border of the first rib to the medial border of the pectoralis minor (1 branch) - 2nd part--deep to pectoralis minor (2 branches) - 3rd part--lateral to pectoralis minor to the inferior border of the teres major (3 branches)

Colles Fracture

dorsal displacement of the distal fragment **Most common fracture in adults Hand gets a lump and looks like a fork where it projects then dips

Muscles in the anterior Compartment of the leg ALL act to

dorsiflex the foot

2. In general, which is TRUE of the surface of bones? a. Depressions are a place in a joint in which something else fits b. Projections on bones are for tendon and ligament attachment c. Openings and spaces in bones are for blood vessels and nerves d. Articulating surfaces are smooth, flat areas e. All of the above

e. All of the above

19. Which muscles act on the thumb? a. Flexor pollis brevis b. abductor pollicis brevis c. opponens pollicis d. adductor pollicis e. all of the above

e. all of the above

Which of these is a rotator cuff muscle? a. subscapularis b. supraspinatus c. infraspinatus d. teres minor e. all of the above

e. all of the above

Tendon sheaths around joint what is it and function?

elongated bursae around tendons Function: wrap around tendons, smooth movement of tendons, reduce friction (ex. fingers)

surface anatomy

examines shapes and markings on the surface of the body as they relate to deeper structures Done via: Visual inspection Palpation- (feeling)- examining surface anatomy with your hands (ex. Feeling ridges, prominences, etc.)

Function of extensor digiti minimi?

extends the fifth digit- (pinky)

A muscle that crosses on the posterior side of a joint produces

extension

The gluteus maximus is the most powerful muscle during hip __________. - extension - flexion - medial rotation - lateral rotation

extension

Latissimus dorsi crosses the joint posteriorly and medially. Which two actions are possible for the muscle illustrated here?

extension and adduction of the arm

Features: Head Fovea capitis Neck Greater trochanter Lesser trochanter Intertrochanteric line Gluteal tuberosity Linea aspera Medial and lateral supracondylar lines (ridges) Medial and lateral condyles Medial and lateral epicondyles Intercondylar fossa Patellar surface Adductor tubercle ---are characteristic of what bone?

femur

What are labrum and where are they present?

fibrocartilaginous rim- present in shoulder and hip- (ball and socket) to help make them deeper and increase stability (ex. Found in GH joint)

Function of flexor carpi ulnaris muscle-

flexes the wrist

A muscle that crosses on the anterior side of a joint produces

flexion

Muscles of the Anterior Forearm- Intermediate layer:

flexor digitorum superficialis

Little leaguer's elbow

from repeated flexion, causes medial epicondylitis

Muscles of the Gluteal Region

gluteus maximus gluteus medius gluteus minimus **ALL ABDUCT hip

3 specific types of Fibrous joints

gomphoses, sutures, syndesmosoes (bones joined by dense regular CT)

Pes Anserine Shared insertion of the: AND is AKA

gracilis, sartorius, semitendinosus - AKA chicken foot - insert onto the anteromedial (front and inside) surface of the proximal extremity of the tibia.

What is weeping lubrication, and what is its 4 functions?

happens as we move, it puts pressure on capsule and movement causes secretion of synovial fluid throughout the joint Functions: 1) nourishes the joint in articular cartilage (CARTILAGE IS AVASCULAR) 2) lubricates the free surfaces of the cartilage- allows minimum friction 3) Fluid absorbs shock itself 4) Removes wastes

Can't move if both agonists and antagonists contract both at the same time so...

have to contract 1 and relax the other, not fully but kind of

Muscle tone and affects on joints

helps stabilize joints by keeping tension on tendons

Synergist

helps the prime mover in several ways -Stabilize a joint for prime mover (ex. shoulder ) -Assist the agonist w/motion - Help motion happening by preventing other movements (makes things happen behind the scenes)

Juncturae tendinum

helps to coordinate finger extension and limit independent extension of the ulnar three digits (**This is why you can't just flex 1 finger and extend the others) - this does NOT include the pinky

scapular anastomoses

if the axillary artery is blocked proximal to the subscapular artery, a collateral pathway may be established between branches of the axillary and subclavian arteries Direction of blood flow in the subscapular artery can be reversed to let blood reach the third part of the axillary artery ***How a slow blockage can adapt over time and go backwards

3 Major differences in Female vs. Male Pelvic Structure

iliac bones - Female: flared laterally makes for a wider pelvis (good for childbearing) Pelvic inlet - Female: larger and wider (oval shaped) - Male: narrower and rounder (heart shaped) Pubic arch - Female: much wider - Male: much narrower (Certain curvatures of coccyx can also cause trouble with delivering a baby)

The iliacus and the psoas major muscles are collectively known as the ____________ muscle because they share a common insertion on the __________ of the femur

iliopsoas; lesser trochanter

The majority of the fibers of the gluteus maximus insert onto the __________. - superior border of the os coxae - gluteal tuberosity - inferior border of the os coxae - iliotibial tract

iliotibial tract

Features: Ala Body Iliac crest Anterior and posterior, superior, and inferior iliac spines Anterior and posterior, and inferior gluteal lines (lateral) Arcuate line (medial) Iliac fossa (medial) Greater sciatic notch Auricular surface ---are characteristic of what bone?

ilium

Nerves with inferior rami fibers (C8-T1) innervate what muscles?

innervate distal (hand) muscles

Lumbricals

inserts onto flexor tendons (form L)

Joints of the Foot Four types of diarthroses:

interphalangeal (IP), metatarsophalangeal (MP), Tarsometatarsal, intertarsal

Features: Ischial body Ischial ramus Ischial spine Ischial tuberosity Lesser sciatic notch ---are characteristic of what bone?

ischium

Acromioclavicular (AC) joint- type of joint and ligaments-

joining of acromion and clavicle - Plane synovial joint - Can be sprained Main movement= rotation of scapula on the thorax (raises arm above head) Ligaments: - Acromioclavicular (joints clavicle and acromion process) - Coracoclavicular (joins clavicle and coracoid process) - Fibrocartilage (articular) disc- helps with movement

Syndesmoses

joints between parallel bones in the forearm and leg (radius and ulna, tibia and fibula) - Amount of movement depends on length of fibers - Interosseous membrane (IM)- dense reg. CT fibers connect the 2 bones Tibiofibular IM- immovable synarthrosis (want stability b/c otherwise can't support the weight of body) Radioulnar IM- amphiarthrosis (want to be able to pronate and supinate)

Gomphoses

joints between teeth and maxilla and mandible- jaw bones (synarthroses) -bones joined by dense regular CT

Seymour has an anatomical variation of his sciatic nerve and piriformis in which his sciatic nerve splits superiorly, his common fibular division pierces his piriformis, and his tibial division runs posterior to the piriformis. Related to this anatomical variation, you would expect this patient to complain of pain localized to what area? The medial aspect of the leg The plantar aspect of the foot The medial aspect of the thigh The posterior aspect of the leg The lateral aspect of the leg

lateral aspect of the leg

What is responsible for the range of motion a muscle can have?

length of muscle fibers

The serratus anterior muscle is innervated by the __________. suprascapular nerve dorsal scapular nerve long thoracic nerve medial and lateral pectoral nerves thoracodorsal nerve

long thoracic nerve

femur

longest, strongest, and heaviest bone in the body ***We see a more medial course in females b/c females have wider hips Which is also why females have more knee issues b/c their femurs are less centered

the lower extremity is the opposite of the upper extremity, why?

lower extremity rotates during development

medius, minimus, maximus order of small to large-

minimus, medius, maximus,

Appendicular Muscles function and grouped based on what 2 factors?

move upper and lower limbs and stabilize pectoral and pelvic girdles 1) Location in the body 2) Part of skeleton they move

Nerves with intermediate rami fibers (C6-C8) innervate what muscles?

muscles that act at the elbow and wrist

Each compartment is innervated by a single

nerve (sometimes 2)

origin vs. insertion- naming and mobility

origin is always named first and is the less movable attachment of a muscle, insertion is named second and is the more movable attachment (ex brachioradialis muscle in forearm originates on the bone of the brachium, the humerus, and inserts on the radius)

Extrinsic muscles of the hand originate

originates outside of hand but insert in hand

Muscles of the Anterior Forearm- deep layer:

originates within the forearm- flexor pollicus longus, flexor digitorum profundus, pronator quadratus

Fat pads around joint what is it and function?

packing material; also provide some protection Ex. in knee

This is the only way the upper limbs are attached to the trunk, via the...

pectoral girdle

What are 3 muscles that attach to the coracoid process?

pectoralis minor biceps brachii (short head) coracobracialis

*Muscles that act on the hip originate on what?

pelvis or vertebral column

What are the six types of synovial joints from least to most mobile?

plane, hinge, pivot, condylar, saddle, ball and socket

Gerdy's tubercle

point just lateral to tibial tuberosity

Arteries of the Leg- posterior tibial artery: located where and supplies what other arteries?

posterior compartments- supplies posterior muscles of the leg Medial and lateral plantar arteries in the foot

The biceps femoris is located in the __________. - posterior thigh - anterior thigh - anterior arm - posterior arm

posterior thigh

Palmaris longus- pretty insignificant

pretty insignificant, helps with climbing- so some people don't have one

Features: Superior and inferior rami Pubic body Pubic crest Pubic tubercle Pectineal line Pubic symphysis Obturator foramen --are characteristic of what bone?

pubis---lies almost horizontal, bladder kind of rests on it

When move knee forward and medially- puts what ligament in a bad location- and is the point where what type of injury happen most often?

puts ACL in a bad location---when most ACL tears happen= non-contact injuries

Break of the humerus near the radial groove can cause damage to?

radial nerve

Mobility vs. Stability of joints: amphiarthrosis examples

radioulnar, symphysis

Starting at the spinal cord and proceeding distally, the subdivisions of the brachial plexus are rami, divisions, cords, trunks. rami, trunks, divisions, cords. trunks, divisions, cords, rami. divisions, rami, trunks, cords.

rami, trunks, divisions, cords

The atlas to axis joint would exhibit

rotation

Bursae around joint what is it and function?

sac containing synovial fluid Function: reduce friction b/w body elements Often move over bone can get very inflamed (bursitis)- problematic b/c often close to surface so infection is likely

The anterior muscles of the thigh that originate on the os coxae are __________. - sartorius; vastus medialis - sartorius; rectus femoris - rectus femoris; vastus medialis - vastus lateralis; vastus medialis

sartorius; rectus femoris

What is the most susceptible carpal bone to fracture in the wrist?

scaphoid- scaphoid fracture occurs when one falls on an outstretched hand

Synovial Joints ***Richly supplied with what?

sensory nerves! - Detect pain Most monitor how much the capsule is being stretched (proprioception- via spinocerebellar pathway)

Articular surfaces of joints

shape influences movements possible and stability Ex. Shoulder vs. hip Smaller size of shoulder- high mobility, low stability Larger size of hip- low mobility, higher stability

Skeletal muscle architecture- thin sheaths

strengthen and compress body wall (like muscles of core, like one flat muscle that wraps)

Great and small saphenous veins are what in the lower extremity?

superficial veins of the leg and thigh- Drain skin and more superficial structures - Saphenous vein blood continuously shunted to deep veins by perforating veins - perforating veins- continuously take blood from saphenous veins to deep veins so contraction of muscles can help push blood back to heart

pelvic inlet

superior to entrance to true pelvis, at pelvic brim

false pelvis

superior to pelvic brim Where wing part of ilium comes up Bound by wings of ilium and abdominal wall anteriorly Contains abdominal organs**

Muscles in the same compartment have similar actions and act as

synergists

Force or power of a muscle depends on what?

the number of fibers it contains- (more muscle fibers make it stronger, but can't contract very far)

Thenar group muscles affect the motion of the

thumb

Features: Medial and lateral condyles Fibular articular facet Tibial tuberosity Gerdy's Tubercle Pes Anserine Insertion Tibial border Superior and Inferior tibiofibular joints ---are characteristic of what bone?

tibia

What is the only weight-bearing bone in the leg?

tibia

Tibia and fibula- two bones making up what region? and location- (Ex. is tibia medial or lateral

two bones making up the crural (leg) region - Parallel to each other - Tibia is medial to fibula - Connected by an interosseus membrane

Fixators are a type of what, that does what?

type of synergist that holds a bone firmly in place

Where does the flexor carpi ulnaris muscle insert?

ulnar side of the wrist

The anterior rami of what spinal segments (ventral, dorsal and which #s) form the ROOTS of the brachial plexus

ventral rami of C5-T1

Transverse plane coincides with what axis?

vertical axis (TV)

Tibial border

when you feel your shin (AKA anterior border)

EXAM Q: If you have pain in lower part of your body, you can have further pain where?

you can have further pain upwards later on. If flat foot out =can end up with IT band pain in hip (ex.--if you have a hurt ankle, you'll start favoring it, which could make your knee funky, and if your knee starts to hurt you might favor it, and that could cause hip issues)