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Clinical Anatomy Exam 2
Spine, Elbow, Wrist, Scapula,
190
Anatomy
08/05/2012

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Term
3 most common outpatient conditions
Definition
Low Back Pain Cervical Neck Pain Shoulder
Term
Purpose of spine
Definition
support weight of head
maintain upright posture
protect spinal cord
shock absorption
site of muscle attachments
Term
Describe:
Cervical Curve
Thoracic Curve
Lumbar Curve
Definition
Secondary
primary
secondary
Term
Cervical Anatomy
How many;
vertebrae
discs
pairs of nerves
Definition
7 vertebrae
6 discs
8 pairs of nerves
Term
Thoracic anatomy
how many
vertebrae
pairs of nerves
Definition
12 vertebrae
5 pairs of nerves
Term
Name nerve between C5 and C6
Definition
C6
Term
Name nerve between C7 and T1
Definition
C8
Term
Name nerve between T8 and T9
Definition
T8
Term
Lumber anatomy
how many vertebrae
nerve pairs
Definition
5 vertebrae and 5 pairs of nerves
Term
Nerve between L4-L5
Definition
L4
Term
Sacram is how many fused vertebrae
how many nerve pairs
Definition
5
5
Term
Coccyx is how many fused verebrae
how many nerve pairs
Definition
4
1
Term
Craniovertebral junction
Definition
occiput, atlas, axis
Term
cerviothoracic junction
Definition
C7-T1
Term
Thoraclumbar junction

Importance
Definition
T11-L1
spinal curvature changes from kyphosis to lordosis

Facet joints change from coronal to sagital
Term
lumbosacral junction
Definition
L5-S1
Term
Motion segment
Definition
two adjacent vertebrae and disc
Term
How many joints in a motion segment
Definition
2 facet joints
Term
Vertebral body layers
Definition
Inside: Trabecular bone aka cancellous bone which is spongy bone

Outside: Cortical bone aka compact
Term
Vertebral body end plate
Definition
top and bottom that touches the disc
Term
Nerve root
Definition
initial segment leaving the CNS
Term
Intvertebral foramen
Definition
made by 2 adj vertebra, their pillars of arch. Where the nerve root exits
Foramen is the sagittal plane
Term
Zygapophyseal Joint or Z Joint
Definition
a synovial joint between the superior articular process of one vertebra and the inferior articular process of the vertebra directly above it. There are two facet joints in each spinal motion segment.
Term
What type of join is a facet joint
Definition
synovial
Term
facet joint orientation in:
Cervical
Thoracic
Lumbar
Definition
Atlas/Axis=Transverse
C3-C7=Oblique plane
Thoracic=Frontal
Lumbar=Sagittal
Term
Anterior Longitudinal Ligament
Definition
From occiput to sacrum
firmly attached
Term
Posterior Longitudinal Ligament
Definition
from occiput to sacrum
NOT firmly attached
Term
Ligamentum flavum Ligament
Definition
connect the laminae of adjacent vertebrae,
largest amount of elastic fibers
assists with spinal ext. from flexion
Term
Interspinous Ligament
Definition
connect adjoining spinous processes
Helps resist flexion
Term
Spupraspinous Ligament
Definition
a strong fibrous cord, which connects together the apices of the spinous processes from C7 to the sacrum; at the points of attachment to the tips of the spinous processes fibrocartilage is developed in the ligament
Term
Annulus Fibrosis
Definition
tough outer ligament covering of the intervertebral disc
55% collaten, 20% proteoglycans
Term
Nucleus pulposus
Definition
"jelly like Center"
20-30% collagen
remnant of notochord
distributes load
Term
DDD
Definition
Degenerative Disc Disease
Term
Herniated disc
Definition
annulus fibrosis allows nucleaus to bulge out
usually posteiorly or post-lateral
Term
Annular Tear
Definition
herniation with annular tear
Term
Global Superficial Musculature
Definition
Absent feed forward activation
Large
Responsible for movement
Abs, Lats, Rhomboids, Traps
Splenius(C-spine only from Post Prim Ramus)
erector spinae (post ramus) Iliocostalis, Longissiums, spinalis(t-spine only)
Term
Local (intrinsic muscles)
Definition
small or thin
feed-forward
Dysfunction following injury
Transverse Abdominus, Transversospinalis, DNF
Term
Describe C3-C6
Definition
"typical"
Transverse dimension greater than AP
Unicinate Process
Uncovertebral joint
short transverse processes
Articular pillar
Term
Bifid spinous process
Definition
C2-C6
Term
articular pillar
Definition
column like structure formed by the articulation of the superior and inferior processes of verebrae
Term
alar ligament
Definition
upper cervical ligament
connect the sides of the dens (on the axis, or the second cervical vertebra) to tubercles on the medial side of the occipital condyle.
Term
Transverse ligament
Definition
stretches across the ring of the atlas and divides the vertebral foramen into two unequal parts
the anterior or smaller receiving the odontoid process of the axis
the posterior transmitting the spinal cord
Term
function of atlanto-occipital joint
Definition
allows the head to nod up and down on the vertebral column
Term
Purpose of Dens
Definition
The dens acts as a pivot that allows the atlas and attached head to rotate on the axis, side to side
Term
Local/Intrinsic musculature of C-Spine
Definition
Deep Neck flexors: Longus Colli, Longus Capitus
Transversospinals:Semispinalis, multifidus, rotatores
Term
Global/Superficial musculature of C-spine
Definition
Global/Superficial:
Scalene, SCM, Spenius capitus and Cervicis, ertector spinae(illiocostalis & longissimus)
Term
Sub Occipital Triangle muscles
Definition
Oblique capitis superior
oblique capitis inferior
rectus capitis posterior major
Term
sub occipital triangle contents
Definition
vertebral artery
dorsal ramus of C1
suboccipital venous plexus
Term
Hyoid Bone is located at about what Vertebrae
Definition
C2-3
Term
Thyroid Cartilage is located at about what Vertebrae
Definition
C4-5
Term
1st cricoid ring is located at about what Vertebrae
Definition
C6
Term
Describe Thoracic vertebrae
Definition
Long slender spinous Process
nerve roost exit foramen above level of disc
vertebrae body has reduced height anteriorly
Body and transverse processes have articulation with ribs
Term
common place for osteoporosis and compression fractures in spine
Definition
Thoracic Bodies
Term
1st rib articulates with?
Definition
T1
Term
Kyphosis Deformity
Definition
is a condition of over-curvature of the thoracic vertebrae
If exceeds 50 degrees considered abnormal
Term
Gibbus Deformity
Definition
a form of structural kyphosis, where one or more adjacent vertebrae become wedged
the deformity is sharply angled, with the resulting humpback being more easily seen when bending forward
Term
Dowager's Hump
Definition
Hyper-kyphosis
extreme curvature of the upper back
Term
A right thoracic scoliosis would present which way convexity
Definition
Right
Term
A left thoracic scoliosis would present which way convexity
Definition
Left
Term
Ribs 2-9 articulat with how many ribs each
Definition
2
Superior and inferior transverse process
(costotrasnverse joint)
Term
True Ribs
Definition
Ribs 1-7
connect directly to sternum
Term
Function of Ribs 1-6
Definition
Pump Handle
Move up and down
during inspiration
Term
Function of ribs 7-10
Definition
Bucket Handle
Move up and laterally out
during inspiration
Term
Name all 4 Abdominal quadrants
Definition
RUQ, RLQ, LUQ, LLQ
Term
McBurney's Point
Definition
point roughly corresponds to the most common location of the base of the appendix where it is attached to the cecum
over the right side of the abdomen that is one-third of the distance from the anterior superior iliac spine to the navel RLQ
painful if possible appendicitis
Term
Describe Lumbar Vertebrae
Definition
Large heavy vertebral bodies
discs increased height anteriorly
movement: flex/ext, rotation, lat. flex
Term
Conus Medullaris
Definition
End of spinal cord
about L1-2
Term
Local/Intrinsic Lumbar Musculature
Definition
Transversospinalis(multifidus, rotatores)
Term
Global/Superficial Lumbar Musculature
Definition
Quadratus Lumborum, Rectus abdominus, rectus Obliques, erector spinae(illiocostalis, longissimus), Lats, Thoracolumbar fascia, illiopsoas, glute max
Term
How many nerve roots
Definition
31
Term
Mixed nerve root
Definition
ant and post nerve roots unite to form a mixed nerve root that leaves the spine through the intervertebral foramen
Term
Lumbar HNP between L4 and L5 what is affected
Definition
Herniated nucleus pulposus (HNP) in the lumbar spine
Most likely Nerve L5
Term
sciatica
Definition
a set of symptoms including pain that may be caused by general compression or irritation of one of five spinal nerve roots that give rise to each sciatic nerve, or by compression or irritation of the left or right or both sciatic nerves. The pain is felt in the lower back, buttock, or various parts of the leg and foot. In addition to pain, which is sometimes severe, there may be numbness, muscular weakness, pins and needles or tingling and difficulty in moving or controlling the leg. Typically, the symptoms are only felt on one side of the body.
Term
C1 Myotome
Definition
Cervical Flexion
Term
C2 Myotome
Definition
Cervical Ext
Term
C3 Myotome
Definition
Lateral neck Flexion
Term
C4 Myotome
Definition
Shoulder Elevation(shrug)
Term
C5 Myotome
Definition
Aduction of shoulder
(rhomboid, infraspinatus, supraspinatus)
Term
C6 Myotome
Definition
Elbow Flexion
(wrist ext, supination)
Term
C7 Myotome
Definition
Elbow Extension
(wrist flex)
Term
C8 Myotome
Definition
Thumb Extension
(ulnar deviation)
Term
T1 Myotome
Definition
Abduction of digit 5
or abduction/adduction of digits 2-5
Term
C3/C4 Dermatome
Definition
Lateral neck
Term
C5 Dermatome
Definition
Anterolateral arm
Term
C6 Dermatome
Definition
Pad of thumb
Term
C7 Dermatome
Definition
pad of 2nd and 3rd finger
Term
T1 Dermatome
Definition
Medial upper arm
Term
L2 Myotome
Definition
Hip flexion
(hip adduction)
Term
L3 Myotome
Definition
Hip ext
Term
L4 Myotome
Definition
Dorsiflexion
Term
L5 Myotome
Definition
Great Toe ext
Term
S1 Myotome
Definition
Plantar Flexion and eversion
Term
S2 Myotome
Definition
Leg Flexion and Plantar flexion
Term
L1 Dermatome
Definition
Groin
Term
L2 Dermatome
Definition
later sup and mid ant thigh
Term
L3 Dermatome
Definition
Mid thigh to med knee
Term
L4 Dermatome
Definition
medial shin and foot
Term
L5 Dermatome
Definition
dorsal aspect of foot
Term
S1 Dermatome
Definition
Lateral calf and lateral foot
Term
S2 Dermatome
Definition
medial heel
Term
S3/4 Dermatome
Definition
saddle region
Term
osseous
Definition
pertaining to bone/composed of bone
Term
Type of joint is the elbow
Definition
Ginglymus(hinge) joint
Term
How many/what are the articulations of the elbow
Definition
3
humeroulnar
humeroradial
radioulnar
Term
Ulnar collateral ligament attachments
Definition
Thick triangular band
Anterior band runs from medial epicondyle to Coranoid process (strongest)
Posterior band runs from the medial epicondyle to the medial margin of olecranon (Weakest)
Oblique band Deepens socket for trochlea
Term
Tommy john surgery
Definition
ulnar collateral ligament (UCL) reconstruction, is a surgical graft procedure in which a ligament in the medial elbow is replaced with a tendon from elsewhere in the body
Term
Degree of freedom of elbow joint
Definition
1 Flexion/xtenion
Term
In what plane does elbow flex/ext occur
Definition
Sagittal plane
Term
What ligament holds radial head in place
Definition
Annular ligament surround 3/4 of radial head
Term
Joint capsule of elbow
Definition
covers the elbow joint and the superior radioulnar joint. Weak anteriorly and posterioly
strengthened on sides by collateral ligaments
Term
Radial collateral ligament
Definition
runs from lateral epicondyle and blends with annular ligament
Term
The elbow is most commonly dislocated in which direction
Definition
90% of the time posterioly
Term
A fall onto hands with elbows flexed and cause a dislocations which way
Definition
posterioly
Term
A fall with a hyperextended elbow would cause a dislocation which way
Definition
posterioly
Term
a Posterior dislocation of elbow could possibly tear which ligament
Definition
ulnar collateral lig
Term
fall onto the elbow with a powerful contraction of the triceps would cause what
Definition
olecranon fx and avulsion
Term
Cubitus Valgus
Definition
arms extended in anatomical position. the forearm points laterally away from midline by about 5-15 degrees
Term
Carrying angle
Definition
cubitus valgus
Term
Cubitus varus
Definition
decrease in carrying angle
Gunstock deformity
Term
Gunstock Deformity
Definition
Cubitus varus
due to inadequate correction of medial collapse seen in supracondylar fx
Term
Injury from a fall causing severe adduction of extended elbow in children
Definition
Medial epicondyle avulsion with possible ulnar nerve damage
Term
Injury from repetitive throwing
Definition
Medial epicondyle avulsion with possible ulnar nerve damage
Tommy Johns surgery needed
Term
Elbow Flexors and innervation
Definition
(Musculocutaneous)Brachialis & Biceps Brachii.
(Radial) Bracioradialis(
Term
Elbow Extensors
Definition
(Radial Nerve) Triceps and anconeous
Term
Forearm flexors/pronators
Definition
Median Nerve
Pronator teres, Flexor Carpi Radialis, Palmaris Longus, Flexor Digitorum Superficialis, Flexor Digitroum Profundus, Pronator Quadratus
Ulnar Nerve, Flexor Carpi Ulnaris
Term
Forearm Extensors/supinators
Definition
Radial Nerve
Ext Carpi Radialis Brevis, Ext Digit, Ext Digit Minimi, Ext Carp Uln
Brachioradialis, Ext Carp Radialis Longus, Supinator
Biceps Brachii(Musculocutaneous)
Term
Golfer's Elbow
Definition
Medial epicondylitis
overuse of forearm flexors/pronators
Term
Medial epicondylitis
Definition
Golfer's Elbow
overuse of forearm flexors/pronators
Term
Tennis elbow
Definition
lateral epicondylitis
overuse of forearm extensors (ECRB
repeated flex/ext of wrist
Term
lateral epicondylitis
Definition
Tennis Elbow
overuse of forearm extensors (ECRB
repeated flex/ext of wrist
Term
Cuboital Fossa Contents
Definition
Radial Nerve
Biceps Tendon
Brachial Artery
Median Nerve
Term
Cuboital Fossa borders
Definition
Medial(ulnar)=pronator teres
Lateral(radial)=brachioradialis
floor=brachialis/supinator
Term
What is found between triceps tendon and olecranon
Definition
Subtendinous olecranon bursa
Term
Subtendinous olecranon bursitis
Definition
bursitis on bursa between triceps tendon and olecranon
repetitive flex/ext
more painful when flexed (skin is taut)
Term
what is found between subcutaneous connective tissue over olecranon
Definition
Subcutaneous olecranon bursa
Term
Students Elbow
Definition
Subcutaneous olecranon bursitis
due to repeated excessive pressure and friction also wrestlers
Term
What type of joint is the radioulnar joint
Definition
privot-type synovial
Term
Describe proximal radioulnar joint
Definition
head of radius articulates with radial notch of ulna
radial head held in position by annular ligament
allows radius to rotate without stretching or tearing the synovial capsule
Term
Describe distal radioulnar joint
Definition
articular disc between(triangular ligament) binds ulna and radius
Term
Radius moves on the ulna in which plane
Definition
transverse plane
Term
Main Supination muscles
Definition
Supinator when no resistance (Radial innerve)
Biceps Brachii when resistance (musculo innerv)
Term
Main pronator muscles
Definition
Pronator teres and quadratus (median innerv)
Term
Common flexor tendon attaches where?
Definition
Medial epicondyle
Term
Common extensor tendon attaches where?
Definition
Lateral epicondyle
Term
Nursemaid's Elbow
Definition
Dislocation/subluxation of radial head
tears annular ligament
Term
Monteggia fx
Definition
Ulnar fx with dislocation
Term
Galeazzi fx
Definition
fx of radius with dislocation
Term
Type of joint radiocarpal joint
Definition
condyloid type synovial
Term
radial collateral ligament
Definition
radial styloid process to scaphoid
Term
unlar collateral ligament
Definition
ulnar styloid process to triquetrium
Term
Fall to outstretched limb with forearm and hand pronated
Definition
Colle's Fracture "dinner fork deformity"
fx of distal end of radius
common in ppl over 50 and women
Term
Colle's fracture
Definition
Fall to outstretched limb with forearm and hand pronated
fx of distal end of radius
common in ppl over 50 and women
Term
Posterior displacement of distal radius so the radial styloid process now looks shorter than ulna
Definition
Dinner Fork
Term
Dinner Fork
Definition
Posterior displacement of distal radius so the radial styloid process now looks shorter than ulna
Term
Smith Fx
Definition
fx of radius displaced anterior
common to young men
"garden spade deformity"
fall onto dosal aspect of flexed wrist(reverse colle's fx)
Term
fx of radius displaced anterior
Definition
Smith fx

common to young men
"garden spade deformity"
fall onto dosal aspect of flexed wrist(reverse colle's fx)
Term
Garden Spade deformity
Definition
fx of radius displaced anterior
common to young men
"garden spade deformity"
fall onto dosal aspect of flexed wrist(reverse colle's fx)
Term
most commonly fx carpal bone
Definition
Scaphoid
Term
fall onto palm when hand is abducted
Definition
Scaphoid fx
can lead to necrosis bc of poor blood supply
Term
fall onto extended wrist
Definition
lunate dislocation
lunate pushed anteriorly towards palmar surface of wrist can compress median nerve in carpal tunnel
can cause necrosis
can oocur with scaphoid fx
Term
Largest Carpal in proximal row
Definition
scaphoid
Term
largest carpal
Definition
Capitate
Term
most commonly dislocated carpal
Definition
lunate
Term
what type of joint is the 1st carpometacarpal joint
Definition
saddle
Term
What bones articulate at the 1st carpometacarpal joint?
Definition
trapezium and 1st MC
Term
how many degrees of freedom at 1st CMJ
Definition
3
rotation
flex/ext
ab/adduction
Term
how many degrees of freedom at the metacapophalangeal joints
Definition
2
flex/ext
ab/adduction
Term
Metacarpophalangeal joins is which type of joint
Definition
condyloid
Term
how many degrees of freedom at the interphalangeal joints
Definition
1
flex/ext
Term
How many IP Joints
what type of joints are they
Definition
9
hinge
Term
Swan Neck deformity
Definition
flexed DIP Joints
Hyperextended PIP Joints
can be caused by RA or tearing of volar plate
Term
Mallet or Baseball Finger
Definition
Flexion deformity of DIP joint
caused by hyperflexion of DIP which avulses attachment of tendon into base of distal phalanx
Term
Boutoniere deformity
Definition
central portion of ED Tendon avulsed from insertion on base of middle phalanx
flexed PIP join
extended DIP Joint
Term
Injury of hyperabduction of 1st MCP
Definition
Skier's or Gamekeepers thumb
rupture or chronic laxity of 1st MCP Joint
Term
Skier's or Gamekeepers thumb
Definition
Injury of hyperabduction of 1st MCP
rupture or chronic laxity of 1st MCP Joint
Term
Boxer's fx
Definition
fx of 5th MC
Term
Most common metalcarpal fx
Definition
5th
boxers fx
Term
Anatomical Snuff Box
Definition
Radial border=APL,EPB
Ulnar border=EPL
Floor=scaphoid
contains radial artery
Term
inflammation of tendons or of the tissue surrounding them
Definition
tenosynovitis
Term
Trigger Finger
Definition
thickening of sheath on palmar surface of digit
tendons of FDS and FDP enlarge and can't extend finger
Term
DeQuervain's
Definition
frixtion between APL and EPB
common overuse of gripping, lifting, side to side motions with hand
pain along thumb side of wrist
Term
Thenar eminance
Definition
muscle bellies of APB, FPB, OP
Term
Hypothenar Eminance
Definition
muscle bellies of ADM, FDM, ODM
Term
Honeymooner's palsy
Definition
median nerve injury
compression through pronator teres
Term
Carpal Tunnel Syndrome
Definition
median nerve compression in carpal tunnel
Term
Carpal Tunnel Syndrome symptoms
Definition
Unable to flex PIP 1-3, DIP 2-3, MCP 2-3
weakened flexion of PIP 4-5
Loss of thena muscle function
Term
Where can ulnar nerve injuries occur
Definition
post to medial epicondyl
cuboital tunnel
Guyons canal
hook of hamate(cyclist's palsy)
Term
Where can radial nerve injuries occur
Definition
compression in axillary region
humeral fx near spiral groove
Term
Motor deficits of ulnar nerve injury
Definition
Term
motor deficits of radial nerve injury
Definition
Wrist drop (loss of wrist ext)
loss of MCP ext
weak digit ext
weak elbow flexion midway between pronation and supination (bracioradialis/supinator)