ANTR 350- Unit 3

Specify the anatomy involved in a dislocation of the radius "pulled elbow" and what population this occurs in

Dislocation of radius at radiohumeral joint Head of radius slips out of annular ligament. Happens in toddlers

Describe hip fractures and identify the bony structures involved

Even though it is called fractured hip it's actually only the femoral neck that's broken. When the femoral neck breaks, the pull of the lower limb muscle causes the leg to rotate laterally and shorten by several inches. Intertochanteric-Fracture runs between the greater and lesser trochanters Subcapital-Occur within the hip articular capsule very close to the head of the femur itself.

Identify the location of the ulna in anatomical terms

The ulna is the medial bone located in the antebrachium.

List the normal actions allowed by the subtalar joint

Actions: Inversion (sole of foot inward) and Eversion (sole of foot outward)

Muscles that perform adduction of hip joint

Adductors, gracilis

Describe the functional and structural class of the joints in the upper limb

All synovial (hinge, ball and socket, plane, pivot) and all diarthrodial (vary in range of motion)

List the actions normally allowed by the proximal and distal radioulnar joints

Allows rotation between radius and ulna • Supination: palm facing anteriorly • Pronation: palm facing posteriorly • Proximal does both distal does pronation

Describe the primary actions of the muscles located in the anterior and posterior compartments of the forearm and identify the nerve(s) that innervate each compartment

Anterior Compartment: Innervated by the Median nerve. • Actions: flexion (wrist and fingers) and Pronation (Radioulnar Joint). Posterior Compartment: Innervated by the Radial Nerve. • Actions: Extension (wrist and fingers) and Supination (Radioulnar Joint).

List the muscles contained in the anterior and posterior compartments of the arm and specify the nerve that innervates each compartment

Anterior Compartment: biceps brachii, coracobrachialis, and brachialis. The anterior compartment is innervated by the Musculocutaneous Nerve. Posterior Compartment (extensor compartment): triceps brachii. The posterior compartment is innervated by the radial nerve.

Describe the innervation of the 3 thigh compartments

Anterior Compartment:Femoral n Medial Compartment: Obturator n Posterior Compartment:Sciatic n (tibial n)

Specify the muscles that contribute to the axillary folds

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

Specify the externally palpable features of the pelvis

Anterior superior iliac spines, the crest of pubic bones and ischial tuberosity

Describe the common action of each thigh compartment

Anterior thigh compartment- Flexion, extension Posterior thigh compartment- Extension, flexion Medial thigh compartment- Adduction

Specify the 3 compartments of the leg

Anterior, posterior, lateral

Specify the 3 compartments of thigh

Anterior, posterior, medial

Describe the innervation of the 3 leg compartments

Anterior: Innervation-deep fibular nerve Posterior: Innervation-tibial nerve • Lateral: Innervation- superficial fibular

Specify the bony features that articulate to form the hip joint and list the main ligaments that support the joint

Bony features: Acetabulum, ecetabular labrum, femoral head Main ligaments that support it Iliofemoral ligament, Pubofemoral ligament, and ischiofemoral ligament

Match the features of the radius and ulna that articulate with the capitulum, trochlea, and olecranon fossa of the humerus

Capitulum of the humerous articulates with the head of the radius at radialhumeral joint/ humeroradial joint Trochlear notch of the ulna articulates with the trochlea of the humerus at ulnohumeral joint/ humeroulnar joint

List the bones that make up the pectoral girdle

Clavicle (2) Scapula (2)

Identify the bones commonly fractured in the wrist

Colles fracture= Distal radius Scaphoid Fracture: its one of the more commonly fractured carpal bones. A fall on the outstretched hand may cause it to fracture into two separate pieces. When this happens only one of the two pieces maintains blood supply. Usually blood vessels are torn on the proximal part resulting in avascular necrosis (death in bone in that area do to inadequate blood supply).

Define compartment syndrome and explain why the anterior leg compartment is most commonly affected by describing the anatomical structures that surround the leg compartment

Compressed blood vessels and nerves. Can cause muscle and nervous tissue death. Anterior compartment boundaries: tibia, fibula, interosseus membrane, tight crural fascia (tight compartment)

Describe how the position of the scapula changes in Depression Elevation Retraction Protraction Superior rotation Inferior rotation

Depression (downward)-sigh Elevation (upward)- shrug Retraction (scapula medial/posterior)-squeeze shoulder blades together Protraction (scapula anterior)-bad posture, hunching Superior rotation (glenoid fossa)- jumping jack Inferior rotation (glenoid fossa)- pull up

Summarize the muscles that perform eversion of subtalar joint

Fibularis longus, fibularis brevis (lateral leg compartment)

List the muscles located in the leg that flex the toes and extend the toes

Flex- Flexor hallucis longus, flexor digitorum longus (intrinsic foot mm) (posterior leg compartment) Extend- Extensor hallucis longus, extensor digatorum longus (intrinsic foot mm) (anterior leg compartment)

List the actions normally allowed by the knee joint

Flexion (bend the knee) and extension (straighten the knee)

List the actions normally allowed by the elbow joint

Flexion and extension (hinge joint)

List the actions normally allowed at the glenohumeral joint (shoulder)

Flexion v extension (sag plane) Abduction v Adduction (front plane) Medial v lateral rotation (ant surface) Circumduction

List the actions normally allowed in the radiocarpal joint

Flexion, extension, adduction, abduction, and circumduction (NO ROTATION)

Summarize the muscles that produce the following actions of the elbow joint Flexion Extension

Flexion- Biceps brachii, brachialis (anterior arm compartment) Extension- triceps brachii (posterior arm compartment)

Specify the muscles that produce the following actions of the glenohumeral joint Flexion Extension Abduction Adduction Medial rotation Lateral rotation

Flexion- Pectoralis major, deltoid, biceps brachii, coracobrachialis Extension- Latissimus dorsi, deltoid, LH triceps brachii Abduction- Supraspinatus, deltoid Adduction- Latissimus dorsi, pectoralis major Medial rotation- Subscapularis, deltoid Lateral rotation- Infraspinatus, deltoid

Muscles that perform lateral rotation of hip joint

Gluteus maximus

Muscles that perform extension of hip joint

Gluteus maximus, bicepts fermois (LH) semitendinosus, semimembranosus

Muscles that perform medial rotation of hip joint

Gluteus medius, gluteus minimus

Muscles that perform abduction of hip joint

Gluteus medius, gluteus minimus, tensor fascia lata

Summarize muscles that perform flexion of the knee joint

Hamstrings (semitendinosus, semimembranosus, biceps femoris), gastrocnemius (posterior thigh compartment)

List the actions normally allowed by the hip joint

Hip abduction and adduction, hip flexion and extension, circumduction, lateral rotation and medial rotation

Muscles that perform flexion of hip joint

Iliopsoas, rectus femoris

List the 3 bones that fuse to form the hip bone (os coxae)

Illium, Ishium, Pubis

Specify the common proximal attachment site of the hamstring muscles and identify the site on figure 8.9

Ischial tuberosity (SM,ST,BFLH)

Describe the location and function of the glenoid labrum

Located next to humeral head, function is to deepen socket

List the major ligaments that stabilize the ankle

Medial (deltoid) ligament (reinforces joint medially) , Lateral ligament (reinforces joint laterally)

Explain the consequences of the highly mobile glenohumeral joint

Most frequently dislocated and unstable

Describe how the muscles of the thumb (thenar group) are affected by carpal tunnel syndrome

Muscles of the thumb may have atrophy because they are supplied by the median nerve and the nerve supply is diminished

List the 5 terminal branches (nerves) that are formed by the brachial plexus

Musculocutaneous nerve, axillary nerve, radial nerve, median nerve, ulnar nerve

Specify the name of the ligament between the patella and tibia and the attachment point for this ligament on the tibia

Patellar ligament and the attachment point is on the tibial tuberosity of the tibia

List the normal actions allowed by the talocural joint (ankle)

Planter flexion and dorsiflexion ONLY

Summarize the muscles that produce the following actions of the forearm Pronation Supination

Pronation: Pronator teres, pronator quadratus (anterior forearm compartment) Supination: Biceps brachii, supinator (posterior forearm compartment)

Specify the bony features of the radius and ulna that articulate to form the proximal and dital radioulnar joints

Proximal radioulnar joint bony feature: head of radius and radial notch of ulna (near elbow) Distal radioulnar joint bony features: head of ulna and ulnar notch of radius (near wrist)

Specify distal attachment sites for the hamstring muscles separately and identify sites on 8.13

Proximal tibia (SM/ST) and fibular head (BF)

Summarize muscles that perform extension of the knee joint

QF (rectus femoris, vastus, medialis, vastus lateralis, vastus intermedius) (anterior thigh compartment)

Specify the structure that provides the most support for the glenohumeral joint

Rotator cuff muscles provide the most support and protection for the GH joint

Identify the joints involved in a shoulder separation and in a shoulder dislocation

Shoulder seperation= Dislocation of AC joint. Caused by hard blow or direct impact. Shoulder dislocation= Humerus out of socket; subluxation=dislocate. Caused by humerus being forcibly driven inferiorly and pulled anteriorly. Can also be cause during abduction (quarterback throwing) or in a fall onto outstretched hand

Summarize the muscles that perform plantarflexion of the talocrual joint (ankle)

Soleus, gastrocnemius, tibialis posterior, flexor digitorum longus, flexor hallucis longus (posterior leg compartment)

Describe the action of each of the rotator cuff muscles

Subscapularis: medially rotates arm Supraspinatus: abducts arm Infraspinatus: adducts and laterally rotates arm Teres Minor: adducts and laterally rotates arm

List the distal attachments of the 4 rotator cuff muscles

Supraspinatous, infraspinatous and teres minor- Greater tubercle Subscapularis- Lesser tubercle

Identify the proximal attachment sites of the 4 rotator cuff muscles

Supraspinatous- Supraspinous fossa Infraspinatous- Infraspinous fossa Teres minor- Inferior angle Subscapularis- Subscapular fossa

List the 4 muscles that make up the rotator cuff

Supraspinatus tendon, infraspinatus tendon, teres minor muscle, subscapularis muscle

Identify the muscle most commonly injured muscle in a rotator cuff tear

Tendon of the supraspinatus muscle

Specify the tendon that contains the patella and the bone the patella articulates with

The Patellar Tendon/Quadriceps Tendon contains the patella, and the posterior patella articulates with the patellar surface of the femur.

Explain why the biceps brachii is a strong supinator compared to the brachialis, which does not supinate the arm Describe the distal attachment point of each muscle and identify the bony sites on figure 8.5

The biceps brachii attaches to the radial tuberosity! The radius is the bone that moves or "spins" in the annulur ligament at the proximal radioulnar joint during supination/pronation. The ulna remains stationary. The brachialis attaches to the tuberosity of the ulna and cannot cause the spinning or pivoting action at the proximal radioulnar joint.

Specify the bones that articulate to form the radiocarpal join

The distal radius and proximal carpal row (NOT ULNA)

Describe the anatomical structures that form the carpal tunnel

The flexor retinaculum extends from the medial carpal bones to lateral carpal bones and the space between the carpal bones and the flexor retinaculum is the carpal tunnel

Specify the weakest area of the shoulder joint, i.e the direction of most shoulder dislocation and explain why

The inferior portion of the joint because it lacks the rotator cuff muscle (most likely site for injury)

List the bones that form the pelvic girdle

The left and right ossa coxae (hip bones) only

Explain the relationship between mobility and stability as it applies to the glenohumeral joint

The more mobility you have the less stability you have (they are opposites) so the glenohumeral joint has the greatest range of motion of any joint in the body but it is also the most unstable joint in the body and the most frequently dislocated.

Compare the orientation of the great toe versus the thumb

The position of the great toe is in the hallux and the thumb is in the pollex

List the anterior rami that contribute to the brachial plexus

They are simply continuations of the anterior rami of the spinal nerves C5-T1. These rami emerge from intervertebral foramina and travel through the neck

Summarize the muscles that perform the dorsiflexion of the talocrural joint (ankle)

Tibialis anterior, extensor digitorum longus, extensor hallucis longus (anterior leg compartment)

Summarize the muscles that perform inversion of subtalar joint

Tibialis anterior, tibialis posterior

Describe the action(s) of the scapula produced by the Trapezius Rhomboids Serratus anterior

Trapezius- Elevation, depression, retraction Rhomboids- Downward rotation, retraction Serratus anterior-Upward rotation, protraction

Describe the motor and sensory impairments that would result from damage to the following nerves: Femoral Tibial Common fibular Deep fibular (only) Superficial fibular (only) Gluteal nn

o Femoral: medial thigh muscles o Tibial: no feeling in skin covering sole of foot, posterior thigh muscles, posterior leg muscles, plantar foot muscles o Common fibular: short head of bicep femoris o Deep fibular (only): anterior leg muscles, dorsum foot muscles o Superficial fibular (only): lateral leg muscles

List the anterior primary rami that contribute to the lumbar plexus and sacral plexus

o Lumbar Plexus: Anterior primary rami of spinal nerves L1-L4 o Sacral Plexus: Anterior primary rami of spinal nerves L4-S4

Identify the nerve most likely to be damaged and describe the motor and sensory (cutaneous) impairments that would result from a fracture to each of the following areas of the humerus Surgical neck of humerus Medial epicondyle Midshaft of the humerus

o Surgical neck of the humerus: Axillary nerve injury, this person would have great difficulty abducting the arm due to paralysis of the deltoid muscle along with lack of sensation along the superolateral skin of the arm o Medial epicondyle: ulnar nerve injury (hit your funny bone) most of the intrinsic handle muscles are paralyzed so the person is unable to adduct or abduct the fingers. They also experience sensory loss along the medial side of the hand o Midshaft of the humerus: Radial nerve injury, which results in paralysis of extensor muscles of the forearm, wrist, and fingers. The patient also experiences anesthesia (lack of sensation) along the posterior of the arm, the forearm, and the part of the hand normally supplied by this nerve

Differentiate between the attachment sites of the anterior cruciate ligaments and the posterior cruciate ligaments on the tibia

• ACL attachment is anterior tibia, intercondylar eminence • PSL attachment is posterior tibia, intercondylar eminence

Specify which ligament is more vulnerable to injury

• ACL is rather weak compared to other knee ligaments and is especially prone to injury

Differentiate which ligament prevents excessive anterior or posterior movement of the tibia

• ACL: prevents anterior movement of tibia relative to femur • PSL: prevents posterior movement of the tibia relative to the femur

List the muscles found in each compartment of thigh

• Anterior Compartment: • Psoas major • Iliacus • Sartorius • Rectus Femoris Medial Compartment: • Adductor Longus • Adductor Brevis • Gracilis • Pectineus • Adductor Magnus • Obturator Externus • Posterior Compartment: • Biceps femoris • Semimembranous • Semitendinous

List the muscles in each compartment of the leg

• Anterior: • Extensor Digitorum Longus: • Extensor Hallucis Longus • Fibularis Tertius • Tibialis anterior • Posterior: • Triceps surae (gastrocnemius, soleus) • Plantaris • Flexor digitorum longus • Flexor halluces longus • Tibialis posterior • Popliteus • Lateral: • Fibularis longus • Fibularis brevis

Describe the common actions of each compartment of the leg

• Anterior:Dorsiflexes (ALL) • Posterior: plantar flexion (all) • Lateral:foot eversion

Specify the compartments and cutaneous areas (skin) innervated by the 5 terminal branches of the brachial plexus

• Axillary nerve: Superlateral arm • Median nerve: Palmar aspects and dorsal tips of lateral 3-1/2 digits • Musculocutaneous nerve: lateral region of the forearm • Radial nerve: Posterior region of the arm, posterior region of the forearm, dorsal aspect of the lateral 3 digits (except their distal tips) • Ulnar Nerve: Dorsal and palmar aspects of medial 1-1/2 digits

Specify the common distal attachment site of the superficial posterior compartment leg muscles (soleus, gastrocnemius) and identify the site on Figure 8.14a

• Common distal Attachment site: Calcaneous • Gastrocnemius Proximal: distal part of posterior femur (lateral and medial condyles). • Soleus Proximal: Proximal Fibula and Tibia

Specify the common distal attachment site of the quadriceps muscles and identify the site on Figure 8.13

• Common distal attachment site: Tibial Tuberosity • Rectus Femoris Proximal: AIIS • Vastus Lateralis Proximal: Linea aspera of femur • Vastus Intermedius Proximal: Anterior femur shaft • Vastus Medialis Proximal: Linea aspera of femur

Differentiate which structures would be damaged by an inversion injury to the ankle versus an eversion injury to the ankle

• Inversion injury would damage the lateral ligament • Eversion injury would damage the medial ligament (rarely occurs)

Describe the location of the brachial plexus and its anatomical relationships to the Neck First Rib Axilla

• It's a network of nerves that supply the upper limb. Its formed by the anterior rami of the spinal nerves C5-T1 • The components of the brachial plexus extend laterally from the neck, pass superior to the first rib, and then continue into the axilla. Each brachial plexus innervates the pectoral girdle and entire upper limb of one side

List the muscles of the thigh that cross two joints and explain how these muscles differ in their actions than muscles that only cross one joint

• Rectus femoris: Crosses both the hip and the knee. • Function: Hip flexion and knee extension. • Semitendinosus and semimembranosus: Crosses both the hip and the knee. • Function: Hip extension and knee flexion • They differ in function because they may have different actions at different joints, a flexor at one joint may be a flexor or extensor at another joint. Taking a two joint muscle out of one of its functions maximizes the muscle's potential when performing the other function. Performing both functions simultaneously weakens the combined effort.