ANATOMY EXAM 1 REVIEW
Glenoid fossa
(at supralateral angle of scapula) articulates with the head of the humerus at the shoulder joint.
Intermetacarpal joints
(between individual bones of the proximal row of the carpus; between the individual bones of the distal row of the carpus; and finally, the midcarpal joint, between the proximal and distal rows of carpal bones), as well as carpometacarpal and intermetacarpal joints are synovial plane joints
carpal tunnel
. The roof of the carpal tunnel is formed by the transversecarpal ligament
The carpal tunnel contains the following number of structures
10 median nerve and nine extrinsic flexor tendons of the fingers and thumb. These tendons are the four flexor digitorum profundus tendons and four flexor digitorum superficialis tendons to the fingers and the flexor pollicis longus tendon to the thumb.
The shoulder or pectoral girdle is formed by the scapulae and clavicles and is completed in front by the manubrium of the sternum. How many muscles are included in the musculotendinous (rotator) cuff of the shoulder joint?
4
cut the muscular twig of the median nerve, that forms a little recurrent loop before supplying the small muscles of the hand. If this branch is cut by mistake, which of the following muscles is spared of atrophy
Adductor pollicis brevis
Latismuss dorsi
As a powerful shoulder extensor, which muscle is a major muscle used in swimming? Swimming requires activation of the muscles of both shoulder extension and internal rotation of the humerus. Minor activation of the deltoids and teres major assist the latissimus dorsi - the major muscle of freestyle swimming.
At the wrist, the ulnar nerve is usually located
Between the flexor carpi ulnaris tendon and the ulnar artery
primary flexor of the forearm
Brachialis biceps brachii and brachioradialis both assist the prime mover, the brachialis. The biceps brachii is mainly a supinator of the forearm. Both the brachialis and brachioradialis are forearm flexors. Considering the mass and area of each muscle, the brachialis would have to be considered the major forearm flexor.
While it flexes the forearm, its insertion is all the way down the forearm on the styloid process of the radius:
Brachioradialis.....serves as forearm flexor
The musculocutaneous nerve arises from what spinal nerves?
C5-C7
A patient complains of sensory loss in the area of the thumb and forefinger. Which nerve root of the spinal cord is suspected?
C6 The simple way to remember that spinal nerve C6 is involved is to make a 6 with the thumb and forefinger.
Compression of the ulnar nerve is often caused by trauma, for example by repeatedly leaning on the elbow
Compression of the radial nerve, for example by having the arm hang over the back of a chair for a longer period of time, leads to paresthesia over the area of the first interosseus muscle as well as weakness of wrist and finger extensors.
injury of baseball elbow
Damage to the ulnar collateral complex of the forearm is the typical elbow injury of baseball,
hinge joint
Elbow joint (between the trochlea and capitulum of the humerus and the trochlear notch of the ulna and the head of the radius) is a synovial capable of extension and flexion
Which of the following tendons is in the sixth extensor compartment?
Extensor carpi ulnaris
The fifth extensor compartment contains the
Extensor digiti quinti proprius
The tendon of which muscle is deep to the flexor digitorum superficialis, yet passes through the tendon to insert on the distal phalanges?
Flexor digitorum profundus.....Profundus means 'deep'
If a patient cannot flex the proximal interphalangeal joint, the muscle that is likely to be paralyzed is the
Flexor digitorum superficialis
It is the origination of the brachialis
Humerus The prime flexor of the forearm is the brachialis. Its origin is the shaft of the humerus.
Which of the following joints is a plane joint?
Intercarpal
following dense connective tissues is taut in supination and lax in pronation
Interosseus membrane
Anconeous
It is generally assumed that the triceps brachii is the extensor of the forearm. One other muscle also extends the forearm and is sometimes called "the 4th head of the triceps." Which one?
carpal tunnel syndrome. Which of the following clinical symptoms is the patient expected to show?
Loss of sensation over palmer surface of lateral 3 and half fingers
thumb is laterally rotated and adducted. The hand has a flattened appearance and is "ape-like." Which of the following nerves is damaged?
Median nerve
The cubital fossa is a triangular space below the elbow crease. It is bounded laterally by an extensor muscle, the brachioradialis, and medially by a flexor muscle, the pronator teres. It has three chief contents. What is the correct relationship of these structures from medial to lateral?
Median nerve, brachial artery, biceps tendon
comes to your office complaining about pain and tingling sensation in her right hand, which are especially intense during the night. By holding her hand flexed for about a minute you can provoke the symptoms. The paresthesia is extended to the palmar area of the thumb, index and middle finger, as well as half of the ring finger; thumb adduction and apposition are weakened on the right. Which nerve is affected?
Medianus
In the forearm, the lateral antebrachial cutaneous nerve arises from the
Musclcutoneous nerve.....limit the ability to flex the forearm
appropriate nerve that innervates the coracobrachialis, biceps, and brachialis muscles
Muslcecutaneous
Forearm flexion
Muslcecutanious nerve
The mother pulled back on the child's hand and that is when the toddler started screaming. On examination you note a well-developed, well-nourished 18-month-old girl. She is tearful and cries when you touch her right elbow or try to move her forearm. A complete survey of the rest of her body reveals no evidence of other trauma.
Nurse maid elbow
fascial compartments of the forearm?
Oblique cord The oblique cord is a narrow, ligamentous structure that extends from the radius, below the tuberosity, to the apex of the coronoid process of the ulna. Its function is unknown.
The deepest wound lies between the tendons of the flexor carpi radialis and the flexor digitorum superficialis. The patient is most likely to have what deficit?
Opposition of the thumb and other digits
The largest nerve (that is, innervates the most structures) of the brachial plexus is the
Radial
develops a right wrist drop. What nerve was injured?
Radial nerve
synovial ellipsoid joint
Radiocarpal Joint....does not allow rotation
The biceps brachii inserts on its tubercle
Radius
The short head of the biceps brachii originates from the coracoid process of:
Scapula The biceps brachii has 2 origins, the supraglenoid tubercle and the coracoid process of the scapula. Given its insertion on the radius, the biceps brachii is a two-joint muscle with actions on both the shoulder and the elbow.
Snuffbox tenderness is a sign that can be seen with a scaphoid fracture. In addition, the scaphoid is a frequently broken bone.
Snuffbox tenderness is a sign that can be seen with a scaphoid fracture. In addition, the scaphoid is a frequently broken bone.
Unlike the other parts of the scapulohumeral or "SITS" muscle group of the rotator cuff, this muscle inserts on the lesser tubercle instead of the greater tubercle. What is it called? Unlike the other parts of the scapulohumeral or "SITS" muscle group of the rotator cuff, this muscle inserts on the lesser tubercle instead of the greater tubercle. What is it called?
Subscapularis
The sensory nerve supply to the skin over the point of the shoulder to halfway down the deltoid muscle is the
Supraclavicular nerves
Pain upon extension of the fingers against a resistance is a sign of what condition?
Tennis elbow The mechanism of injury is typically forced supination (screwdriving) against a resistance
The distal row of carpal bones, from lateral to medial, consists of
The distal row of carpal bones, from lateral to medial, consists of
The head of the radius and humerus are both proximal
The head of the radius and humerus are both proximal
annular ligament stabilizes
The head of the radius in the radial notch of the ulna
The suprasinatus muscle inserts on the greater tubercle and runs above the glenohumeral joint.
The infraspinatus and teres minor are muscles that also insert in the greater tubercle but cross behind the glenohumeral joint.
Compression of the peroneal nerve in the area of the fibular neck is common in bedridden patients or badly administered leg casts. Dorsiflexion and eversion of the foot are weakened and a sensory deficit can be found over the anterolateral area of the lower leg, the dorsum of the foot, or between the 1st and 2nd metatarsal.
The musculocutaneus nerve supplies the upper arm flexors and the skin of the radial side of the forearm
The palmaris longus muscle and tendon is present in 85% of people and is innervated by the median nerve.
The palmaris longus muscle and tendon is present in 85% of people and is innervated by the median nerve.
Humerus
The pectoralis major inserts on the lateral lip of this bone's intertubercular groove: The major is involved with horizontal flexion of the humerus; thus, it must insert on the humerus. Remember a bench press is horizontal flexion of the humerus and extension of the forearm. People who train using the bench press have well-developed pectoralis major (and triceps brachii) muscle
The wrist flexors
The wrist flexors are innervated mostly by the median and ulnar nerves
Humerus
This bone contains the general originations of the bulk of the muscles of the forearm
Biceps Brachii
This muscle supinates the forearm and originates on the scapula. supinator must insert on the radius. Only the biceps brachii inserts on the radius.
Only its long head is a two-joint muscle:
Triceps brachii The biceps and triceps brachii are the only two-joint muscles listed. Both heads of the biceps originate on the scapular, and the muscle inserts on the radius. The long head of the triceps brachii originates at the infraglenoid tubercle of the scapula and inserts on the olecranon. The other two heads originate on the humerus.
Ulnar nerve
Ulnar nerve innervates the dorsal interossei that abduct the fingers.
subscapularis
Which of the muscles listed below is the rotator cuff muscle involved in medial rotation of the humerus? There are three rotator cuff muscles that stabilize the head of the humerus in the glenoid cavity of the scapula. The subscapularis inserts on the lesser tubercle of the humerus and medially rotates the humerus. The supraspinatus abducts and the infraspinatus laterally rotates the humerus.
A forearm fracture just distal to the elbow damages the radial nerve.
Wrist drop from the loss of wrist extension
Linear fracture
a fracture that runs along the long axis of the bone.
The lateral end of the clavicle articulates with the
acromion process
Axillary nerve
affected in an inability to abduct the arm.
and shoulder flexion can be performed by the biceps brachii
and shoulder flexion can be performed by the biceps brachii
The head of the radius is stabilized to the radial notch of the ulna by the
annular ligament
Which severed nerve in the forearm will prevent flexion of the interphalangeal joint of the thumb?
anterior interoseous nerve The patient in the photograph who has paralysis of the right interosseous nerve was asked to demonstrate the letter "o" with the thumb and index finger of both hands. The left hand is normal and the right hand illustrates her inability to flex the interphalangeal joint of the thumb and the distal phalangeal joint of the index finger.
Wrist extensors
are innervated by the radial nerve
Question: A 42-year-old man awakens to find his entire left arm and hand numb and paralyzed. He slept sitting with his arm draped over the back of a straight-backed chair at the armpit. What is most likely to have been injured?
brachial plexus The saturday night syndrome
Its lateral articulation is with the acromion
clavicle
An 18-month-old girl presents to the emergency room with a painful left arm. After eliciting her history and performing an examination, it is determined that she has suffered a pulled elbow with subluxation of the head of the radius. There is no evidence of any other trauma on examination. What should be the next step in treating this patient?
closed reduction in the ER.
She complains that lately she has started to have some pain in the right hand and some numbness over most of her fingers of that side. She also has some difficulty in moving her right thumb. You conduct some examination to test the sensory loss and motor functions of the arms and fingers and find some weakness on abduction of the corresponding thumb. The problem is due to
compression of the median nerve
he main ligamentous union between the clavicle and the remainder of the upper limbs is the
coracoclavicular ligament
right Phrenic
diagnosed with an amebic liver abscess. Which nerve mediates the pain in his right shoulder?
Paralysis of the latissimus dorsi muscle
extension
The musculocutaneous nerve has been damaged. Which of the following is likely to be impaired?
forearm flexion and supination
Compound fracture
fracture in which the skin is broken and there is a wound down to the bone. A compound fracture is also called an open fracture.
Displaced fracture
fracture in which there has been a separation of the bone fragments. The normal anatomic shape of the bone is disrupted with a displaced fracture.
Transverse fracture
fracture that runs at 90 degrees to the long axis of the bone.
hairline fracture
hairline fracture is a fracture in which the pieces are not separated, an undisplaced fracture. The normal anatomic shape of the bone is maintained.
Paralysis of the pectoralis major muscle
horizontal flexion
The pronators
innervated by the anterior interosseous and median nerves.
hyponychium is the junction of the nail bed or sterile matrix
lanula is moon shaped The eponychium is the distal portion of the nail fold where it attaches to the surface of the nail
Paralysis of the teres minor muscle will make it difficult for the patient to do what with their shoulder?
lateral rotation
Ulnar nerve injury
loss of sensation of the little finger and usually the ulnar side of the ring finger will be impaired.
supraspinatus
main abductor of the humerus and can become impinged if the humerus is in internal rotation? The supraspinatus also inserts on the greater tubercle, but the muscle passes under the acromion process. Following this path, the supraspinatus abducts the arm. In internal rotation, the muscle can be impinged between the acromion and coracoid processes.
Fracture of the capitate
more common from a force directed proximally from the third metacarpal, as in boxer's fracture.
A forearm fracture just distal to the elbow damages the ulnar nerve. This patient will experience
no ability to abduct fingers
he received a deep laceration in his cubital fossa medial to the biceps tendon. Which of the following movements would likely be abnormal in this patient?
opposition of the thumb
Anconeus
originates from the lateral epicondyle of the humerus and inserts on the olecranon
She has tried to use machines but experienced the same pain with every pushing movement. The area around the processus coracoideus is very sore. The tendon of which muscle is most likely affected?
pectoralis major
Pectoralis Minor
pectoralis minor inserts onto the medial border of the coracoid process of the scapula of ribs 3, 4, and 5
Which forearm muscle originates on the medial epicondyle of the humerus?
pronator teres
musculocutaneous nerve
provides mainly sensation to the upper arm. These patients have elbow flexion weakness
The fracture of a patient's lower humerus results in the inability to extend the wrist. What nerve was damaged in the injury?
radial
The major muscles of the posterior forearm are all innervated by one major nerve. Which one?
radial
a condyloid (ellipsoid) joint?
radiocarpal
The proximal row
row articulates with the radius and ulna. From lateral to medial, it consists of the scaphoid, lunate, triquetrum, and pisiform. The pisiform bone is located on the palmar surface of the triquetrum.
Manubrium
rticulates with the medial side of the clavicles and the first and upper part of the second costal cartilages on each side
The long head of the triceps brachii originates on this bone:
scapula
The origination of the rotator cuff muscles is on this bone.
scapula
Fracture and necrosis of scaphoid
sprained wrist and the pain has now become severe. Inspection shows swelling in the anatomical snuff box and a radiograph demonstrates an abnormality of the carpus. What is the most likely diagnosis
Following trauma leading to a fractured clavicle, the medial fragment is displaced upward due to spasm of which muscle
sternocleidomastoid
An occlusion of the axillary artery does not result in a total loss of blood supply to the upper limb because of anastomoses around the scapula. The artery that arises from the axillary artery and contributes in a significant way to this anastomosis is
subscapular artery
A patient complains of pain during medial rotation of the humerus but not during abduction or extension of the shoulder. What muscle is injured?
subscapularis
Rotator cuff muscles stabilize the humerus in the glenoid cavity while allowing extreme range of motion. Which of the following muscles is an internal rotator muscle?
subscapularis infraspinatus and teres minor are lateral rotators;
branches of the ulnar nerve
superficialis and deep branches
The axillary controls the deltoids and the teres minor
the musculocutaneous controls the biceps brachii, coracobrachialis, and the brachialis
radial nerve branches
the posterior brachial and antebrachial cutaneous nerves
The first compartment contains the abductor pollicis longus and the extensor pollicis brevis,
the second the radial wrist extensors, the third the extensor pollicis longus,
the fourth the extensor digitorum communis and the extensor indicis
the sixth the extensor carpi ulnaris
The spine of the scapula is generally in level with the spinous process of the
the third thoracic vertebra
The median and radial nerves arise from C5-T1
the ulnar arises from C7-T1 nothng from c3-c5
Saddle joint
trapezium and first metacarpal
Its head is at the distal end of the bone
ulna
Median nerve
weak pronation of the forearm, weak flexion, & radial deviation of wrist. It also leads to atrophy of the thenar eminence, as well as an inability to oppose or flex the thumb. In addition, sensory loss involves the thumb and radial 2½ fingers.
Radial nerve
would be affected if the patient could not extend the wrist.
Musculocutaneous nerve
would be involved if there was a lack of ability to flex the forearm
RADIAL NERVE
wrist drop no ulnar or radial pulses in the right arm decreased sensation over the dorsal aspect of the lateral 3½ digits. numbness and a reduction of sensation on the back surface of the forearm and hand
