Anatomy-Practical 2
Contents of the Axilla {brachial plexus is the content of axillary fossa, so it is behind pectoralis minor from the anterior view.}
Axillary sheath Brachial plexus Axillary vessels and their branches Lymph nodes Lymphatic vessels Portions of 6 muscles Pectoralis major Pectoralis minor Serratus anterior Subscapularis *Teres major *Latissimus dorsi
Brachial Plexus Root
Provides innervation to the upper limb Comprised of ventral primary rami from C5 through T1{五一劳动节。好好劳动。。。} May also have small contributions from C4 and T2 These rami form 5 roots
Boundaries of the Carpal Tunnel
Roof - Flexor retinaculum Laterally - Scaphoid and trapezium Medially - Hook of hamate and pisiform Floor - Palmar ulnocarpal and radiocarpal ligaments
arcuate line
The arcuate line demarcates the transition point between the superior ¾ and inferior ¼ of the abdomen.
biceps brachii
O: Long head - supraglenoid tubercle of scapula Short head - coracoid process of scapula I: radial tuberosity n: musculocutaneous nerve!!!!! (C5, C6)!!!!! A: flexes the forearm at the elbow and supinates the forearm; long head also stabilizes the glenohumeral joint. a: brachial artery
Pyramidalis｛tiny｝
O: anterosuperior margin of pubis, and anterior aspect of pubic symphysis I: linea alba n: subcostal nerve (T12) A: tenses linea alba a: inferior epigastric artery Absent in 20% of people.
coracobrachialis {Ra, coco - coraco }
O: coracoid process of scapula I: medial surface of the middle humerus n: musculocutaneous nerve!!!! (C5, C6, C7) {} A: flexes and adducts the humerus at the glenohumeral joint a: Branches of the axillary and anterior circumflex humeral arteries
pronator quadratus
O: distal 1/4th of anterior surface of ulna I: distal 1/4th of anterior surface of radius n: anterior interosseous nerve (C7, C8) A: pronation of forearm (从pronation可以推测出，insertion在anterior surface of radius) a: anterior interosseous artery
Brachialis {Brachioradialis is outside and inferior to it. It cross elbow joint as well.}
O: distal half of the anterior humerus I: ulnar tuberosity and anterior surface of the coronoid process n: musculocutaneous nerve !!!(C5, C6, C7) A: flexes forearm at the elbow a: brachial artery
External Abdominal Oblique
O: external surface of ribs 5-12 I: linea alba, pubic tubercle, anterior half of iliac crest n: lower 5 intercostal nerves (T7-T11) and subcostal nerve (T12) A: trunk flexion and compression abdominal viscera a: lower posterior intercostal, subcostal, deep circumflex iliac arteries
pronator teres
O: humeral head - medial epicondyle of Humerus{common flexor tendon} ulnar head - coronoid process of ulna I: midway along the lateral surface of radius n: median nerve (C6, C7) A: pronation of forearm a: inferior ulnar collateral, and anterior ulnar recurrent arteries
flexor retinaculum
A strong ligamentous band that runs from the pisiform{U} and hook of the hamate{U} laterally to the scaphoid tuberosity{R} and palmar side of the trapezium. Forms the roof of the carpal tunnel.
Six division position
A superior P A middle P P inferior A
cutaneous innervation of arm(pic)
A: 9 P: 10
Internal intercoatal (muscle)
Action- depress the ribs {internal disease is depression.} fibers run opposite than external. Located under external.
cephalic vein
Both cephalic v. and basilic v. are off axillary vein(huge.) cephalic off upper region of axillary; axillary split into a anterior basilic v. and deep brachial v., which split into radial and ulnar vein at elbow joint
Anatomical Snuff Box {看到它的方法：用力extend大拇指。在大拇指中间像外侧会看到一个很大的凹槽}
Boundaries* Lateral - tendons of abductor pollicis longus and extensor pollicis brevis Medial - tendon of the extensor pollicis longus Contents Radial artery Radial styloid process Scaphoid Trapezium
arm dermatones
C3(lower neck),4 (deltoid-shoulder),5(elbow) , 6,7,8 T1(medial elbow), 2,3(chests),4 (nipple)
Abdominal Skin Fascia
Camper's (thick; may contain a large amount of fat) Scarpa's (Thin; membranous layer) {Camper's is found superficial to Scarpa's}
inguinal canal
Extends from deep inguinal ring to the superficial inguinal ring 1.5-2.5 inches long Boundaries Anterior - aponeuroses of ext. oblique (entire length) and Int. oblique (laterally) Posterior - transversalis fascia/conjoint tendon Roof - fibers from Int. oblique/transversus abdominis muscles Floor (base) - inguinal and lacunar ligaments
oblique cord ligament
It takes the form of a small, flattened band, extending downward and lateralward, from the lateral side of the ulnar tuberosity at the base of the coronoid process to the radius a little below the radial tuberosity.[1] Its fibers run in the opposite direction to those of the Interosseous membrane of the forearm.[1]
boundaries of cubital fossa
Lateral - brachioradialis m.(外下) Medial - pronator teres m. Superior - imaginary line connecting the medial and lateral epicondyles Roof - brachial/antebrachial fascia, bicipital aponeurosis Floor - brachialis and supinator mm.
flexor digitorum superficialis ｛This muscle is wide｝
O: humero-ulnar head - medial epicondyle of humerus, coronoid process of ulna radial head - anterior surface of radius (distal to radial tuberosity) I: through 4 tendons which split to attach at the medial and lateral sides of the middle phalanges of the medial 4 digits n: median nerve (C8, T1) A: flexes the PIP and MCP joints of medial 4 digits (i.e., the strong grip flexor). a: anterior ulnar recurrent artery, and branches of the ulnar and radial arteries
flexor digitorum superficialis
O: humero-ulnar head - medial epicondyle of humerus, coronoid process of ulna radial head - anterior surface of radius (distal to radial tuberosity) I: through 4 tendons which split to attach at the medial and lateral sides of the middle phalanges of the medial 4 digits n: median nerve (C8, T1) A: flexes the PIP and MCP joints of medial 4 digits (i.e., the strong grip flexor). a: anterior ulnar recurrent artery, and branches of the ulnar and radial arteries
Transversus Abdominis
O: internal surfaces of costal cartilages (7-12), thoracolumbar fascia, iliac crest and lateral 1/3 of inguinal ligament I: linea alba (inferior to umbilicus), pubic crest, and conjoint tendon to pectin pubis n: lower 5 intercostal nerves (T7-T11) and subcostal nerve (T12), iliohypogastric and ilioinguinal nerves (L1) A: compresses and support abdominal viscera a: lower posterior intercostal, subcostal, superior and inferior epigastric, and superficial and deep circumflex iliac arteries
Extensor Carpi Ulnaris
O: lateral epicondyle of humerus I: medial side of base of 5th metacarpal n: posterior interosseus nerve (C7, C8) A: extends the wrist; also adducts or ulnar deviates hand when acting with flexor carpi ulnaris a: branches of the radial recurrent artery
Extensor Carpi Radialis Brevis
O: lateral epicondyle of humerus I: base of 3rd metacarpal n: deep branch of radial nerve (C7, C8) A: assists flexor carpi radialis longus a: branches from the radial and radial recurrent arteries
Anconeus /an cone us/ 一个 冰淇淋桶 美国 elbow疼，自己另一只手握住这只自己elbow的位置｛外侧｝
O: lateral epicondyle of humerus I: lateral side of olecranon, shaft of ulna, joint capsule of elbow n: radial nerve (C6, C7, C8) A: assists triceps brachii, extends joint capsule of elbow a: posterior interosseous recurrent artery
Extensor Digitorum {所有手指上的tendon 都来自这里} ｛location: pretty superficial｝
O: lateral epicondyle of humerus via common extensor tendon I: dorsal digital expansion of medial four digits n: posterior interosseous nerve (C7, C8) A: extends MCP and IP joints a: branches of the radial recurrent and posterior interosseous arteries
Extensor Digiti Minimi ｛tendon on the fifth finger are identical to extensor digitorum's. They overlap.｝
O: lateral epicondyle of humerus via common extensor tendon I: dorsal digital expansion of 5th digit n: posterior interosseus nerve (C7, C8) A: assists extensor digitorum at 5th digit a: branches of radial recurrent and posterior interosseous arteries
Supinator{大片的，anconeus 外面，下面}
O: lateral epicondyle of humerus, radial collateral ligament, and supinator crest of ulna I: lateral surface of proximal 1/3 of radius n: deep branch of radial nerve (C6, C7) (Gray's lists the posterior interosseus nerve) A: supinates forearm a: branches of the radial recurrent and posterior interosseous artery
Extensor Carpi Radialis Longus
O: lower 1/3 of lateral supracondylar ridge of humerus I: base of 2nd metacarpal n: radial nerve (C6, C7) A: extends and abducts the wrist a: branch of the radial recurrent artery
Palmaris Longus
O: medial epicondyle of humerus I: flexor retinaculum and palmar aponeurosis n: median nerve (C7, C8) A: tenses palmar aponeurosis, weakly flexes wrist a: anterior ulnar recurrent artery
flexor carpi radialis {carpi- inserts at 2,3 metacarpals}
O: medial epicondyle of humerus I: bases of 2nd and 3rd metacarpals n: median nerve (C6,C7) A: flexes 2nd carpometacarpal joint and wrist, abduction of hand (radial deviation) a: anterior and posterior ulnar recurrent arteries
flexor carpi ulnaris
O: medial epicondyle of humerus, medial aspect of olecranon, posterior border of ulna I: pisiform, hamate, base of 5th metacarpal n: ulnar nerve (C7, C8, T1) A: flexes 5th carpometacarpal joint, adduction of hand (ulnar deviation) a: posterior ulnar recurrent and ulnar arteries
Extensor Pollicis Longus
O: posterior shaft of ulna and interosseous membrane I: base of distal phalanx of 1st digit n: posterior interosseous nerve (C7, C8) A: extends 1st digit at IP and MCP joints a: anterior and posterior interosseous arteries
Extensor Indicis (好神奇，只有index finger 有这根到指尖的tendon)
O: posterior surface of interosseous membrane and posterior surface of ulna I: dorsal digital expansion of 2nd digit n: posterior interosseous nerve (C7, C8) A: assists extensor digitorum to extend index finger a: anterior and posterior interosseous arteries
Extensor Pollicis Brevis {tendon比abductor pollicis longus深入很多。} {tendon 浅于extensor pollicis longus}
O: posterior surface of radius and interosseus membrane I: base of proximal phalanx of 1st digit n: posterior interosseus nerve (C7, C8) A: extends metacarpophalangeal joint of 1st digit a: anterior and posterior interosseous arteries
Abductor Pollicis Longus
O: posterior surfaces of radius, ulna and interosseus membrane I: base of 1st metacarpal and trapezoid n: posterior interosseous nerve (C7, C8) A: abducts and extends 1st digit a: proximal part - posterior interosseous artery; distal part - anterior interosseous artery
Rectus Abdominis
O: pubic symphyses and pubic crest I: xiphoid process and 5th to 7th costal cartilages n: lower 5 intercostal nerves (T7-T11), and subcostal nerve (T12) A: flexes trunk and compresses abdominal viscera a: superior and inferior epigastric arteries
flexor pollicis longus
O: radial head - anterior surface of the radius and interosseus membrane humeral head - medial epicondyle of humerus, coronoid process of ulna I: base of distal phalanx of hallux n: anterior interosseus nerve (C7, C8) A: flexes IP and MCP joint of hallux a: anterior interosseous and radial arteries
flexor digitorum profundus(under superficialis)
O: superior 3/4th anteromedial aspect of ulna, ulnar half of interosseous membrane I: bases of distal phalanges of medial 4 digits after first passing through the tendons of flexor digitorum superficialis n: radial ½ (to digits 2 and 3) - anterior interosseous nerve (C8, T1) ulnar ½ (to digits 4 and 5) - ulnar nerve (C8, T1) or just ulnar nerve. A: flexes DIPs of medial 4 digits, also weakly flexes wrist and PIPs of medial 4 digits a: inferior ulnar collateral, and both ulnar recurrent arteries
Internal Abdominal Oblique
O: thoracolumbar fascia, anterior 2/3rds of iliac crest, and lateral half of inguinal ligament I: inferior border of ribs 10-12, linea alba, and pubis via the conjoint tendon {O, I are somehow oppsosite to External Oblique} n: lower 5 intercostal nerves (T7-T11), and subcostal nerve (T12) A: trunk flexion and compression of abdominal viscera {Same innervation and Action} a: lower posterior intercostal, subcostal, inferior epigastric, and deep circumflex iliac arteries
Brachioradialis
O: upper 2/3of lateral supracondylar ridge of humerus I: lateral aspect of styloid process of radius n: radial nerve (C5, C6) A: flexion of semiprone forearm a: branches of the radial recurrent artery
Muscles of the Posterior Arm {superficial layer; deep layer}
Superficial Layer 7 Anconeus Brachioradialis Extensor carpi radialis longus Extensor carpi radialis brevis Extensor digitorum Extensor digiti minimi Extensor carpi ulnaris Deep Layer 5 Supinator Abductor pollicis longus Extensor pollicis longus Extensor pollicis brevis Extensor indicis
rectus sheath
Surrounds the rectus abdominis muscle Consists of anterior and posterior parts Formed by the aponeuroses of the external and internal obliques, and the transversus abdominis
abdominal dermatomes
T4 - nipple in males T10 - umbilicus L1 - pubic bone
Contents of the Cubital Fossa
Terminal part of the brachial artery and its terminal braches: Radial Ulnar Veins that accompany the arteries Tendon of biceps brachii Median nerve Medial antebrachial cutaneous nerve.{closely medial to median nerve, on top of flexor carpi radialis.} Radial nerve (deep between the muscles forming the lateral boundary of the fossa) {brachial a.&v. both split to radial a.v. & ulnar a.v.}
Tunnels of the wrist
There are 2 tunnels through which structures from the forearm enter the hand: Carpal tunnel Deep to flexor retinaculum A passageway for 9 tendons and 1 nerve: Tendons 4 from flexor digitorum superficialis 4 from flexor digitorum profundus 1 from flexor pollicis longus. Nerve Median Tunnel of Guyon Superficial to flexor retinaculum A passageway for 1 nerve and 1 artery: Ulnar nerve Ulnar artery
position of 4 "superficial anterior muscle of antebrachium"
They arise from medial epicondyle; ring finger is weakly moved - palmaris longus which absent in 14% pronator teres is short - index finger is short palmaris longus is btw two flexor carpi (radialis, ulnaris) flexor digitorum superficialis - is deeper than superficial 4 muscle, located above palmaris longus and below flexor carpi radialis {Innervation: by location: flexor carpi ulnaris is ulnar nerve; Others are all median nerves. c7,c7(pronator, radialis), c8 c8(other 2)} 7788
spermatic cord
a bundle of nerves, ducts, and blood vessels connecting the testicles to the abdominal cavity.
Hernias疝气 shen qi
a condition in which part of an organ is displaced and protrudes through the wall of the cavity containing it (often involving the intestine at a weak point in the abdominal wall).
coracoid process ｛core+coil.... coracoid 钢线围绕着scapula｝
biceps brachii: short head originate here Pectoralis minor: inserts here. {originate at rib 3-5} coracobrachialis: originates here.{SAME NAME} Inserts to the medial surface and border of the body of the humerus.
superficial anterior muscle of antebrachium
bicipital aponeurosis on top of them
lateral bony structure of scapular
coracoid process supraglenoid tubercle infraglenoid tubercle
redial tuberosity {ulnar tuberosity located above radial tub.}
on A radius
styloid process of radius (ulna)
style oid.... styloid
ulnar nerve
ulnar nerve runs together with ulnar vein and artery
cutaneous nerves of the cubital fossa
{Those veins and nerves are above cubital fossa, and are not the content of it}
subscapular a. from part 3 of axillary a. give off circumflex scapular a. and thoracodorsal a. {It travels inferiorly with the thoracodorsal nerve and supplies the latissimus dorsi.}
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epigastric
上腹的
Four Abdominal Wall Muscles
最美外面的肌肉，fiber是手插在口袋里的方向。
trachea
气管
biliary system
肠道系统 (bile胆汁) the liver, gall bladder and bile ducts, and how they work together to make, store and secrete bile. Bile consists of water, electrolytes, bile acids, cholesterol, phospholipids and conjugated bilirubin.
peritoneal
腹膜的
vermiform appendix
阑尾｛食物从食道，胃，小肠到大肠｝
esophagus
食管