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.