PHTY 501 Anatomy Test 1 Review

A "winged scapula" commonly occurs after an injury of what structure?

A winged scapula- injury to the long thoracic nerve, runs on the superficial surface of serratus anterior a. If it is denervated, there is no muscle to oppose the motion of the trapezius which is elevating and retracting the scapula. The medial border of the scapula falls away from the posterior chest wall and begins to look like an angel's wing.

A person receives a laceration along the anterior border of the trapezius muscle in the neck and subsequently the point of his shoulder (scapula) sags and he has some difficulty fully abducting his arm. What nerve appears to have been severed?

Accessory n.

Elevation of the tip of the patient's right shoulder was still possible indicating that which of the following nerves was intact?

Accessory n.

Which set of movements at the shoulder joint would be found greatly weakened by a paralyzed right pectoralis major muscle? What is its innervation?

Adduction and flexion a. innervated by lateral and medial pectoral nerves

The shoulder is most often dislocated in which direction?

Anterior a. Most shoulder dislocations still occur in the anteroinferior direction, with the humeral head dislocating forward and downward. a. Although no muscles support the inferior aspect of the shoulder joint.

10. What nerve is given off to the forearm by the radial nerve as it enters the anterior compartment?

As the radial nerve pierces the lateral intermuscular septum it gives off the posterior antebrachial cutaneous nerve, which supplies the skin of the back of the forearm

Where do the trunks of the brachial plexus and the Subclavian vessels lie?

Between the clavicle and the first rib.

If the musculocutaneous nerve is severed at its origin from the brachial plexus, flexion at the elbow is greatly weakened but not abolished. What muscle remains operative and can contribute to flexion?

Brachioradialis: innervated by the radial nerve— a. flexes the elbow and assists in pronating supinating arm.

12. What structures in the superficial fascia overlie the cubital fossa? What is their importance?

Branches of the medial antebrachial cutaneous nerve cross the medial portion of the cubital fossa, while the lateral antebrachial cutaneous nerve emerges from beneath the biceps on the lateral side of the cubital fossa. The median cubital vein also crosses the fossa obliquely, shunting blood from the cephalic vein up to join the basilic vein.

The dorsal scapular nerve has which nerve root? Innervates which muscles?

C5 nerve root that innervates the rhomboids and levator scapula.

A football player suffers a herniated (ruptured) intervertebral disk in his neck. The disk compresses the spinal nerve exiting through the intervertebral foramen between the 5th and 6th cervical vertebrae. Which spinal nerve is affected?

C6

What is the most frequently broken bone in the human body?

Clavicle at the junction between the middle and lateral thirds.

In the axilla the pectoralis minor is a landmark, being closely related to which structures

Deep to pectoralis minor - a. cords of the brachial plexus, a. branches second part of the axillary artery a. The medial pectoral nerve pierces pectoralis minor to reach pectoralis major.

Describe the Dorsal and Ventral primary rami, innervations, origin?

Dorsal and ventral primary rami are the first branches off of spinal nerves. a. Dorsal rami; sensory - skin over the back; a. motor - true back muscles a. Ventral rami; sensory - skin limbs & ventral side of the trunk; a. motor - skeletal muscles of the neck, trunk, and extremities.

Injuries to the upper roots of the brachial plexus (C5 and C6) are the most common types of injuries--resulting in a condition known as what? What nerves are affected? What muscles are affected? Symptoms?

Erb-Duchenne Palsy. affects especially the suprascapular, axillary, and musculocutaneous nerves, which causes paralysis of the rotator cuff muscles, biceps, brachialis, coracobrachialis, and deltoid. a. It also knocks out the upper and lower subscapular nerves, denervating subscapularis and teres major. a. It knocks out most of the lateral pectoral nerve, pectoralis major is only weakened.

Compression of the median nerve in the carpal tunnel affects which hand muscle(s)?

Flexor pollicis brevis

The fibrocartilaginous structure which deepens the shoulder socket is the:

Glenoid labrum

The conus medullaris is located at which vertebrae level?

L2 at the termination of the spinal cord

A man has a herniated intervertebral disk between the fourth and fifth lumbar vertebrae. If this disk compresses the spinal nerve in the intervertebral foramen immediately posterior to this disk, which spinal nerve would be affected?

L5

What muscle is innervated by the thoracodorsal nerve? The nerve comes off what cord of the brachial plexus. The thoracodorsal nerve is made of contributions from what roots?

Latissimus dorsi a. posterior cord a. Roots C6, 7, 8.

After a penetrating wound in the area of the posterior axillary fold a patient had weakness in extension and adduction of the arm. Which muscle is likely involved?

Latissimus dorsi is the muscle important for medial rotation, extension, and adduction of the arm; the patient's symptoms fit with an injury to this structure.

When falling on an outstretched hand, the most commonly dislocated carpal bone is the

Lunate- dislocated anteriorly- a fall on an extended wrist a. dislocation may compress the median nerve; a. carpal tunnel syndrome.

7. Does the ulnar nerve have any branches in the arm?

No

The inferior cord of the brachial plexus terminates with what terminal branches?

None - There are no nerves from the inferior trunk

Pectoralis major origin/ insertion?

Pectoralis major a. originates from the clavicle, sternum, and ribs and a. inserts on the crest of the greater tubercle of the humerus.

Two muscles which attach to the coracoid process.

Pectoralis minor a. Coracobrachialis

The muscle running downward and medially from the coracoid process is the:

Pectoralis minor a. inserts on the coracoid process of the scapula. a. origin is ribs 3-5

The axillary nerve arises directly from which part of the brachial plexus?

Posterior cord

Both the dural sac and the subarachnoid space end at which vertebral level?

S2

If the right dorsal scapular nerve were cut near its origin, what would result:

Scapular retraction on the right side would be weakened

The long thoracic nerve innervates which muscle?

Serratus anterior

Serratus anterior origin/ insertion?

Serratus anterior a. originates on the ribs and a. inserts on the medial border of the costal surface of the scapula.

Course spinal cord to primary rami.

Spinal cord > a. Rootlets, Dorsal and ventral > a. Roots, dorsal (sensory) and ventral (motor). a. Spinal nerve (mixed), roots combined a. Primary rami, Dorsal and ventral

Subclavius origin/ insertion?

Subclavius a. originates on the first rib and a. inserts on the clavicle.

In a patient with Erb-Duchenne palsy, a nerve arising from the superior trunk of the brachial plexus is nonfunctional. This nerve is the:

Suprascapular nerve

What dermatomes cover the medial side of the arm?

T1 and C8 dermatomes cover the medial side of the arm with C8 extending to the tip of the little finger.

In a case of Erb's palsy, where roots C5 and C6 of the brachial plexus are avulsed (torn out) which muscle is paralyzed?

The C5 and C6 roots make the superior trunk of the brachial plexus. So, all the muscles innervated by nerves from the superior trunk: a. Supraspinatus is innervated by the suprascapular nerve of the superior trunk

2. What are the boundaries of the quadrangular space? What does it transmit?

The borders of the quadrangular space are: inferior: teres major muscle lateral: humerus superior: teres minor muscle •medial: the long head of the triceps muscle. The space transmits the axillary nerve and the posterior circumflex humeral artery.

What structure is unique to a synovial joint?

The joint cavity, or synovial cavity

1. What artery accompanies the axillary nerve?

The posterior circumflex humeral artery, a branch of the 3rd part of the axillary artery, accompanies the axillary nerve through the quadrangular space.

What are the boundaries of the quadrangular space?

The quadrangular space is bounded medially by the tendon of the long head of the triceps, laterally by the humerus, superiorly by teres minor, and inferiorly by teres major.

A patient is severely limited in extension at the wrist joint after several months in a cast following a Colles fracture. Which joint would be especially important in therapy to regain full extension?

The radiocarpal joint is the joint commonly known as the wrist joint a. condyloid (oval) type of synovial joint; a. flexion and extension, abduction and adduction, circumduction. a. Colles fracture is a fracture of the distal end of the radius

Kyphosis is an accentuated or abnormal curvature of which region of the spine?

Thoracic

After trying to throw a curve ball, a pitcher lost sensation from the tip of the little finger. This indicates injury to which nerve?

Ulnar nerve

If the long thoracic nerve is injured, which is common in surgery, since the long thoracic nerve is on the superficial side of serratus anterior, you may see what symptom?

a "winged scapula" protruding posteriorly\

The anterior interosseous is a branch of which nerve? What muscles?

anterior interosseous nerve is a branch of the median nerve a. motor - deep flexor muscles; a. flexor pollicis longus, a. the radial half of flexor digitorum profundus, a. pronator quadratus

The anterior scalene muscle is innervated by?, and the middle scalene is innervated by?

anterior scalene muscle is innervated by C5-C7 a. the middle scalene is innervated by C3-C8.

The cords of the brachial plexus are located where?

at or below the clavicle, closely related to the axillary artery

The cords of the brachial plexus are wrapped around which arteries?

axillary arteries

Neurological testing of a patient reveals no cutaneous sensation on the lateral upper arm. Such a finding would indicate injury to some portion of which nerve?

axillary nerve

The superior lateral brachial cutaneous nerve comes from the:

axillary nerve

Name both terminal branches from the posterior cord.

axillary nerve and radial nerve

What dermatomes cover the back of the shoulder?

back of shoulder covered by C6, C7, C8, and T1 dermatomes

Supination of the hand and forearm would be diminished by loss of radial nerve function. But one very powerful supinator would remain intact and unaffected, namely:

biceps brachii

The brachial artery is the continuation of which artery? Where do the names change?

brachial artery is an extension of the axillary artery distal to teres major a. axillary artery is the continuation of the subclavian artery, lateral to the first rib

The number of vertebrae and number of spinal cord segments are the same in each region except:

cervical

An open arterial anastomosis in the shoulder occurs between the suprascapular artery and which other artery?

circumflex scapular, artery, the dorsal scapular artery, and the suprascapular artery

The general name for an alternate pathway of blood flow in or around an organ, around a joint, or past an obstruction is called:

collateral circulation

A student sustained shoulder injury while playing touch football. In comparing the symmetry of his two shoulders, you notice a marked elevation of the distal end of his clavicle with respect to the acromion on the injured side. X-ray exam reveals a shoulder separation. In order for this to have occurred, which ligament must be damaged?

coracoclavicular ligament -an injury to the acromioclavicular joint.

The regionally named layer of tissue which encloses/binds muscle groups together is the:

deep fascia

Interruption of the median nerve in the cubital fossa affects what thumb movement?

disrupting the median nerve impairs both flexion and opposition of the thumb.

What part of a spinal nerve supplies the true back muscles and the skin overlying?

dorsal primary ramus

As you are sitting in a quiz, the skin immediately over the base of the spine of your scapula begins to itch. The sensation from this area is mediated through which nervous structure?

dorsal primary ramus of C7

An injured superficial radial nerve contains afferent nerve fibers that travel through which of the following parts of a spinal nerve?

dorsal root of a spinal nerve contains afferent sensory fibers

The action and innervation of Brachialis, coracobrachialis, both heads of biceps brachii?

flex the arm and/or forearm, innervated by the musculocutaneous nerve.

Erector spinae - innervation and action?

innervated by the dorsal primary rami of C1-S5, a. extends and laterally bends the trunk, head and neck.

Rhomboidus major and minor - innervation and action?

innervated by the dorsal scapular n., aid trapezius in retracting the scapula.

Levator scapulae - innervation and action?

innervated by the dorsal scapular nerve, elevates the scapula.

What dermatomes cover the pectoral region?

is covered by T1, T2, and T3 dermatomes.

A worker doing repetitive lifting develops an inflammation in the tendon of origin of the extensor carpi radialis brevis muscle, commonly called "tennis elbow". The focal point of pain would most likely be near which palpable bony landmark?

lateral epicondyle of the humerus

Which pectoral nerve innervates the pectoralis major only?

lateral pectoral nerve

The dorsal scapular nerve comes off of the C5 root to innervates what muscles?

levator scapulae and the rhomboids

What nerves and muscles could be affected by Erb-Duchenne palsy?

long thoracic nerve - roots of C5, C6, and C7 to innervate serratus anterior a. dorsal scapular nerve - C5 root innervate levator scapulae and the rhomboids a. Lateral pectoral nerve - lateral cord

An abnormal increase in lumbar curvature, anterior sway of the pelvis is called?

lordosis

Pectoralis minor is innervated by the medial pectoral nerve off the which cord and root of the brachial plexus?

medial cord; roots C8 and T1

Which pectoral nerve pierces pectoralis minor to reach pectoralis major?

medial pectoral nerve

Pectoralis major actions?

medially rotates and flexes the arm

What muscle is innervated by branches of both the median and ulnar nerves?

median and ulnar nerve both innervate flexor digitorum profundus

Neurological testing of a patient reveals no cutaneous sensation on the tip of the index finger. Such a finding would indicate injury to some portion of which nerve?

median nerve

The lateral antebrachial cutaneous nerve comes from the:

musculocutaneous nerve

A fractured coracoid process affects which muscles?

pectoralis minor a. Coracobrachialis a. Bicep brachii short head.

What branch off the brachial artery that supplies blood on the radial side of the forearm?

radial artery

Structures within the carpal tunnel include the:

radial bursa and ulnar bursa

Function and muscles of the "rotator cuff"?

rotator cuff holds the head of the humerus in the glenoid cavity of the scapula; a. The four muscles of the rotator cuff all insert on the greater or lesser tubercle a. Supraspinatus inserts - upper facet of the greater tubercle of the humerus and into the capsule of the shoulder joint. a. Infraspinatus inserts into the middle facet of the greater tubercle of the humerus and into the capsule of the shoulder joint. a. Teres minor inserts into the lower facet of the greater tubercle of the humerus and into the capsule of the shoulder joint. a. Subscapularis inserts onto the lesser tubercle of the humerus.

Examination revealed the medial border and inferior angle of the left scapula became unusually prominent (projected posteriorly) when the arm was carried forward in the sagittal plane, especially if the patient pushed with outstretched arm against heavy resistance. What muscle must have been denervated?

serratus anterior a. innervated by the long thoracic nerve, a. action: draws the scapula forward.

It was determined that a football player tore his coracoclavicular ligament. This is an example of a:

shoulder separation

The axis of rotation (pronation/supination) at the distal radioulnar joint is through the:

styloid process of the ulna

If a patient fractured the right radius near its distal end and the area between his thumb and index finger on the dorsal is numb. Which nerve must have been injured for this area to be numb?

superficial radial nerve provides cutaneous innervation to the radial side of the dorsum of the hand for the first 2 1/2 digits.

The suprascapular nerve comes from what trunk of the brachial plexus and innervates which muscles?

superior trunk; innervate supraspinatus and infraspinatus

The interosseous membrane between the radius and ulna is the uniting structure in a type of fibrous joint classified as a:

syndesmosis -a fibrous membrane or ligament that joins two bones

Erb-Duchenne palsy is the avulsion of the brachial plexus; which specific roots?

the C5 and C6 roots

Neurological testing of a patient reveals no cutaneous sensation on the lateral forearm. Such a finding would indicate injury to some portion of which nerve?

the Musculocutaneous and lateral antebrachial cutaneous nerve

The dural sac continues to which vertebrae level?

the S2 level

Trapezius is innervated by which nerve?

the accessory nerve -- CN XI

The nerve which passes through the quadrangular space of the posterior shoulder innervates which muscle?

the axillary nerve innervates deltoid and teres minor

9. What are the relative positions of the brachial artery and median nerve?

the biceps Tendon lies lateral, the brachial Artery is intermediate, and the median Nerve is most medial. Remember TAN - in the cubital fossa,

A football player suffered a severe shoulder separation. Although this is a dislocation of the acromioclavicular joint, several structures could be torn, including the one that gives the joint its greatest strength and stability, namely the:

the coracoclavicular ligament is very strong

The lateral antebrachial cutaneous, a branch of the musculocutaneous nerve, innervates:

the lateral anterior side of the forearm

Teres major is innervated by what nerve? What cord of the brachial plexus?

the lower subscapular nerve from the posterior cord of the brachial plexus.

The ulnar nerve supplies sensory innervation to the skin of what?

the medial 1 1/2 digits on the hand palmar side, and a. 2 1/2 digits on the dorsum of the hand.

The medial antebrachial cutaneous nerve comes off the medial cord of the brachial plexus and innervates

the medial anterior side of the forearm

The patient's lower pectoralis major is paralyzed. The nerve most likely injured is the:

the medial pectoral nerve innervates the inferior part of pectoralis major a. the lateral pectoral nerve innervates the superior part of pectoralis major

The radial nerve supplies cutaneous innervation to the skin of which parts?

the posterior arm, forearm, and hand through many different cutaneous nerves.

The triceps brachii is innervated by which nerve, cord, and roots of the brachial plexus?

the radial nerve is a terminal branch of the posterior cord, and made of contributions from C5, 6, 7, 8, and T1 roots.

The median nerve provides cutaneous branches that innervate

the radial side of the palmar or volar surface of hand first 3 1/2 digits.

The recurrent branch of the median nerve innervates which muscles?

the thenar compartment of the hand, including a. flexor pollicis brevis, b. abductor pollicis brevis, c. opponens pollicis

Following a sever injury to the roots of the 5th and 6th cervical nerves there would most likely be diminished cutaneous sensation over what part of the upper limb? Which of the movements of the arm at the shoulder would you expect to be totally lost?

the top of the shoulder and the lateral side of the arm; the C5 and C6 dermatomes- the top of the shoulder and lateral side of the arm. a. abduction movements of the arm would be totally lost

The medial cord of the brachial plexus terminates with what terminal branches?

the ulnar nerve and a branch to the median nerve; it also gives off the medial pectoral nerve, the medial brachial cutaneous nerve, and the medial antebrachial cutaneous nerve

The superficial ulnar nerve innervates:

the ulnar side of the hand on both the palm and the dorsum, covering a. the final 1 1/2 fingers on the volar surface and a. 2 1/2 fingers on the dorsum.

Latissimus dorsi - innervation

thoracodorsal nerve

Loss of function, paralysis, of which muscle would result in drooping or sagging of the shoulder?

trapezius, innervated by the accessory nerve (CN XI), is the muscle responsible for elevating the tip of the shoulder

If the medial epicondyle of the humerus is fractured and the nerve passing dorsal to it is injured, which nerve?

ulnar nerve is passes dorsal to the medial epicondyle of the humerus

Subscapularis is innervated by what nerve? What cord of the brachial plexus?

upper and lower subscapular nerves from the posterior cord