anatomy exam 2 dow
contents of submandibular triangle
-Submandibular gland -lymph nodes -facial artery + vein
flexor pollicis longus innervation
Median nerve
brachialis innervation
musculocutaneous nerve
ulnar nerve palsy (claw hand)
results in atrophy of interossei and hypothenar muscles
median + ulnar palsy (simian hand)
results in atrophy of thenar and hypothenar muscles
median nerve palsy (gun hand)
results in atrophy of thenar membrane
radial nerve palsy
results in wrist drop
Fascias of the neck
superficial, middle (pretracheal), and deep (prevertebral)
what route does blood draining from facial vein take to return to systemic circulation?
blood from facial vein drains into internal jugular vein
digastric muscle innervation
branch of mandibular + facial nerves
cause + consequences of colle's fracture
cause: slip + fall with extended arm/hand consequences: radial fracture + possible ulnar fracture of styloid process
hypothyroidism
causes slow speech, somnolence, impaired memory, and decreased mental capacity
infrahyoid muscles are innervated by
cervical ansa C1-C3
stylohyoid muscle innervation
cervical branch of facial nerve
temporalis innervation
deep temporal branches of the mandibular nerve
6th compartment of extensor retinaculum
extensor carpi ulnaris
5th compartment of extensor retinaculum
extensor digiti minimi
4th compartment of extensor retinaculum
extensor digitorum + extensor indicis
3rd compartment of extensor retinaculum
extensor pollicis longus
2nd tendon compartment of extensor retinaculum
extensors carpi radialis longus + brevis
middle (pre tracheal) fascia of neck
fascia of the neck that contains infra hyoid muscles + is connected to carotid sheath
deep (pre vertebral) fascia of neck
fascia of the neck that covers the vertebral column + deep vertebral muscles
superficial fascia of neck
fascia of the neck that lies beneath the platysma muscle and contains all other neck structures
discontinuous (diarthrosis) joints
freely moving joints
what nerves are anesthetized during an intra oral approach to a mandibular nerve block?
inferior alveolar + linguinal nerves are anesthetized
amphiarthroses joints
joints that allow slight movement between bones
Continuous (synarthroses) joints
joints where movement is not possible
larynx muscles are innervated by
laryngeal nerve
lateral pterygoid innervation
lateral pterygoid branch of mandibular nerve
masseter innervation
masseteric branch of mandibular nerve
Content of foramen rotundum
maxillary nerve
medial pterygoid innervation
medial pterygoid branch of mandibular nerve
flexor digitorum profundus innervation
median + ulnar nerves
flexor carpi radialis innervation
median nerve
flexor digitorum superficialis innervation
median nerve
palmaris longus innervation
median nerve
pronator quadratus innervation
median nerve
pronator teres innervation
median nerve
carpal bone fractures clinical point
-18% hand fractures (proximal row) -scaphoid is most commonly broken -lunate most commonly dislocated -disability results if diagnosis/displacement fracture isn't recognized
roots/locations of cervical plexus nerves
-C1-C4 nerves -phrenic nerve (C3-C5) originates from cervical plexus -C5 root originates from brachial plexus
carpal tunnel syndrome clinical point
-CTS: pathologic condition of anterior wrist region (pain/hand weakness) caused by median nerve compression in carpal tunnel -causes: repetitive wrist movement, pregnancy, hypothyroidism, rheumatoid arthritis + amyloidosis
causes/signs of median nerve compression above elbow
-arm muscles not affected by nerve injury -wrist flexors are paralyzed -thumb flexors + muscles o thenar side are paralyzed but not adductor (ape hand) -flexsion at metacarpophalangeal joints maybe possible but fingers can't be flexed at interphalangeal joints -lumbricals 1+2 lose function (can't fully flex index + middle fingers) -compromised pronation of forearm + sensory loss of median nerve in hand
characteristics of shoulder joint
-behind humerus head + glenoid cavity -ball + socket joint -multiaxial + flex, extend, add/abduct, lateral + medial rotation, and circumduction -supported by ligaments -tendon of biceps brachii long head passes through
what arteries/veins are at danger during a tracheostomy?
-brachiocephalic artery + vein -aortic arch -carotid artery
winged scapula
-condition where the shoulder blade protrudes from the back in abnormal position -can't lift arm above 90 degrees -long thoracic nerve paralyzed -serratus anterior can't hold scapula to thoracic cage
larynx muscles
-cricothyroid -cricoarytenoid lateralis -cricoarytenoid posterior -transverse + oblique arytenoid -vocalis -thyroarytenoid -thyroepiglottis -aryepiglottis
suprahyoid muscles
-digastric -stylohyoid -mylohyoid -geniohyoid
causes/signs of ulnar nerve injury at wrist
-fingers hyperextended at metacarpophalangeal joints -fingers flexed at interphalangeal joints -"claw hand" = paralysis of interossi muscles + 2 medial lumbricals -tendons of flexor digitorum profundus are paralyzed so flexion of ring + pinky not possible at distal phalangeal joints -flexsion at metacarpophalangeal joint possible due to intact flexor digitorum superficialis -small pinky muscles paralyzed -abd/adduction of fingers are impaired (interossei paralysis) -sensory loss of hand in ulnar nerve territory over ulnar nerve area
Contents of foramen ovale
-mandibular nerve -venous plexus
Contents of foramen spinosum
-middle meningeal artery -meningeal branch of mandibular nerve
actions of thyroid hormone
-necessary for adult stature (bone formation + maturation) - increases BMR in many tissues (heat/temp regulation) -mature the CNS during perinatal period (deficiency = severe mental retard) -treats hyperthyroidism -increases heart rate + stroke volume -increased cardiac output + ventilation rate
facial nerve innervates the superficial facial muscles
-occipitofrontalis -orbicularis oculi -procerus -corrugator supercili -nasalis -levator labii superioris alaque nasi -levator labii superioris -zygomaticus minor + major -orbicularis oris -risorius
infrahyoid muscles
-omohyoid -sternohyoid -sternothyroid -thyrohyoid
causes/signs of ulnar nerve injury at elbow
-paralysis of flexor carpi ulnaris + medial part of flexor digitorum profundus -ulnar deviation of wrist is weakened + hand is abducted + extended
lymph nodes in the axillary region
-pectoral nodes -lateral nodes -apical nodes -subscapular nodes -central nodes
pathway of lymph node drainage
-pectoral= drains into mammary gland -some breast lymphatics drain into central group -central group drains into apical group -apical= drains into subclavian lymphatic trunk then into veins at venous angle
rotator cuff clinical Q+A
-rotator cuff muscles: SITS -injuries include tendinopathy of supraspinatus, calcification, pain, tendon rupture + avulsion of greater tubercle
causes/signs of median nerve compression at wrist joint
-short muscles of thumb may be paralyzed but not adductor -flexor pollicis longs is functioning -thenar muscle atrophy (ape hand) -sensory loss over median nerve area -percussion on nerve in wrist area can lead to heightened paraesthesia in CTS
lower (C8-T1) brachial plexus lesion
-sudden upward pull of shoulder + injury to roots following forced abduction of shoulder at birth (Klumpke's) -leads to paralysis of intrinsic muscle of hand -not as common as upper lesions -signs: -atrophic paralysis of forearm + hand muscles -sympathetic palsy (Horner's if T1 root)
contents of superior orbital fissure
-superior ophthalmic vein -lacrimal nerve -frontal nerve -trochlear nerve -abducent nerve -oculomotor nerve -nasociliary nerve
6 branches of axillary artery
-superior thoracic artery -thoracoacromial artery -lateral thoracic artery -subscapular artery -anterior + posterior circumflex humeral arteries
branches of external carotid arteries
-superior thyroidal -ascending pharyngeal -lingual -facial -occipital -posterior articular -maxillary -superficial temporal arteries
mastication muscles
-temporalis -masseter -lateral pterygoid -medial pterygoid
Upper (C5-C6) brachial plexus lesion
-traction on the arm at birth or falling on the shoulder may damage the upper part of the plexus (roots may be pulled out of spinal cord) -Signs: -paralysis of deltoid + supraspinatus (no arm abduction) -Infraspinatus paralysis (medial rotation of the arm) -Biceps and Brachialis paralysis (no elbow flexion) -loss of biceps and weak supination -shoulder adductors mildly affected (pectorals major + latissimus dorsi)
contents of foramen magnum
-vertbral artery -anterior spinal artery -accessory nerve -posterior spinal artery -spinal vein
sentinel lymph node
1st lymph node/group of lymph nodes that drain cancer tumor
Geniohyoid muscle innervation
C1 via hypoglossal nerve
nerves that make up cervical plexus
C1-C4 nerves -hypoglossal nerve -ansacervicalis nerve -greater auricular nerve -transverse cervical nerve -supraclavicular nerve -phrenic nerve
mylohyoid muscle innervation
Mylohyoid nerve (CN V3)
1st tendon compartment of extensor retinaculum
abductor pollicis longus + extensor pollicis brevis
deltoid (acromial part)
action: abduction innervation: axillary nerve
supraspinatus
action: abduction innervation: suprascapular nerve
pectorals major (sternal part)
action: adduction innervation: medial + lateral pectoral nerves
triceps brachii longhead
action: extension/adduction innervation: radial nerve
latissimus dorsi
action: extension/adduction/medial rotation innervation: thoracodorsal nerve
teres major
action: extension/adduction/medial rotation innervation: lower sub scapular nerve
deltoid (spinal part)
action: extension/lateral rotation innervation: axillary nerve
pectorals major (clavicle part)
action: flexion innervation: lateral pectoral nerve
Coracobrachialis
action: flexion innervation: musculocutaneous nerve
biceps brachii shorthead
action: flexion innervation: musculocutaneous nerve
deltoid (clavicle part)
action: flexion/medial rotation innervation: axillary nerve
teres minor
action: lateral rotation innervation: axillary nerve
infraspinatus
action: lateral rotation innervation: suprascapular nerve
pectoralis major
action: medial rotation innervation: medial + lateral pectoral nerves
subscapularis
action: medial rotation innervation: upper + lower sub scapular nerve
pulled elbow
aka "radial head subluxation" when ligament that wraps around radial head slips off when extended arm is pulled
tracheostomy procedure
procedure creating an opening in neck to place tube into windpipe below vocal cords to allow air in
brachioradialis innervation
radial nerve
extensor carpi radialis longus innervation
radial nerve
Extensor Indicis innervation
radial nerve (deep branch)
abductor pollicis longus innervation
radial nerve (deep branch)
extensor carpi lunaris innervation
radial nerve (deep branch)
extensor carpi radialis brevis innervation
radial nerve (deep branch)
extensor digiti minimi innervation
radial nerve (deep branch)
extensor digitorum innervation
radial nerve (deep branch)
extensor pollicis longus innervation
radial nerve (deep branch)
supinator innervation
radial nerve (deep branch)
metacarpophalangeal joint
type of joint found between carpals
saddle joint
type of joint found between carpo-metacarpal joints
Primary cartilaginous joint
type of joint found between epiphysis and diaphysis
interphalangeal joint
type of joint found between phalanges
synovial pivot joint
type of joint found between radioulnar joints
flexor carpi lunaris innervation
ulnar nerve
2 brachial plexus syndromes
upper (C5-C6) and lower (C8-T1)