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MSK - Gross anatomy
Keck msk gross anatomy
158
Medical
Graduate
05/02/2012

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Cards

Term
Supraspinous muscle action
Definition
abductor of humerus at glenohumeral joint
Term
deltoid muscle action
Definition
abductor of humerus at glenohumeral joint
Term
Infraspinatus muscle action
Definition
lateral rotation of humerus at glenohumeral joint
Term
Teres minor muscle action
Definition
lateral rotation of humerus at glenohumeral joint
Term
posterior deltoid muscle action
Definition
lateral rotation and extension of humerus at glenohumeral joint
Term
pectoralis major muscle action
Definition
medial rotation of humerus at glenohumeral joint
Term
latissimus dorsi muscle action
Definition
medial rotation and extension of humerus at glenohumeral joint
Term
Teres major muscle action
Definition
medial rotation & extension of humerus at glenohumeral joint
Term
subscapularis muscle action
Definition
medial rotation of humerus at glenohumeral joint
Term
choracobrachialis muscle action
Definition
flexion of humerus at glenohumeral joint
Term
anterior deltoid muscle action
Definition
flexion of humerus at glenohumeral joint
Term
short head of biceps muscle action
Definition

flexion of humerus at glenohumeral joint

flexes forearm

supinates forearm when it is in flexed position

Term
long head of triceps muscle action
Definition

Extends elbow

extension of shoulder (weak)

Term
gluteus medius muscle action
Definition
abductor at hip joint
Term
gluteus miminus muscle action
Definition
abductor at hip joint
Term
tensor fasciae latae muscle action
Definition
abductor at hip joint
Term
piriformis muscle action
Definition
lateral rotator at hip joint
Term
obturator internis muscle action
Definition
lateral rotator at hip joint
Term
obturator externus muscle action
Definition
lateral rotator at hip joint
Term
quadratus femoris muscle action
Definition
lateral rotator at hip joint
Term
iliopsoas muscle action
Definition
flexor at hip joint
Term
sartorius muscle action
Definition

lateral rotator at hip joint

flex knee

flex hip

Term
rectus femoris muscle action
Definition

flexor at hip joint

Extendor at knee

Term
deltoid innervation & blood supply
Definition
axillary nerve & posterior circumflex humeral artery
Term
supraspinatus muscle innervation
Definition
suprascapular nerve
Term
infraspinatus muscle innervation
Definition
suprascapular nerve
Term
teres minor innervation
Definition
axillary nerve
Term
Superior gluteal nerve innervates...
Definition
gluteus medius, gluteus minimus, tensor fasciae latae
Term
inferior gluteal nerve innervates?
Definition
gluteus maximus muscle
Term
Trendelenburg gait
Definition
due to paralysis of superior gluteal nerve
--> sagging of pelvis to opposite side when the opposite limb is in the swing phase of gait
compensation by lurching trunk to side of paralysis
Term
Hamstring muscles that attach to ischial tuberosity & are innervated by the...?
Definition
biceps femoris (long head), semimembranous, semitendinous muscles
Innervated by tibial nerve
Term
short head of the biceps femoris attaches to the...
and is innervated by the...
Definition
femur (does not act at hip)
innervated by common fibular nerve
Term
nerves affected by upper brachial plexus injury
Definition
C5-C6 are broken -->
suprascapular (all)
axillary (all)
musculocutaneous (most)
radial (some
Term
What nerve innervates anterior compartment of the upper arm?
Definition
musculocutaneous
(flexors)
Term
what nerve innervates posterior compartment of upper arm
Definition
radial nerve
(extensors)
Term
what nerve innervates posterior compartment of the forearm
Definition
radial n.
Term
What nerve innervates anterior compartment of the forearm?
Definition
medial n. (and ulnar n.)
Term
Clinical signs up upper brachial plexus lesion (erb-duschenne palsy)
Definition
limb adducted (held tightly to body wall)
medially rotated
wrist flexed
Term
clinical signs of lower brachial plexus lesion / klumpke's palsy
Definition
C8 & T1 tearing (ventral rami, lower trunk)
--> paralysis of hand muscles / 'claw hand'
Term
axillary nerve cutaneous innervation to...
Definition
shoulder (skin over deltoid)
Term
median nerve cutaneous innervation to...
Definition
middle finger
Term
ulnar nerve cutaneous innervation goes to...?
Definition
pinky finger
Term
lower limb post-axial division nerves (front of limb)
Definition
femoral n (L2-L4)
common fibular n (L4 - S2)
--> extensors
Term
lower limb pre-axial division nerves (back of limb)
Definition
obturator n (L2-L4)
tibial n (L4-S3)
--> flexors
Term
femoral triangle boundaries
Definition
superior = inguinal ligament
lateral = sartorius muscle (medial border)
medial = adductor longus muscle
floor = pectineus muscle
Term
triceps reflex tests what nerves
Definition
C7 & C8
Term
3 structures coursing vertically in the cubital fossa
Definition
"TAN"
biceps tendon, brachial artery, median nerve (lateral to medial)
Term
achilles' tendon reflex tests what nerves?
Definition
S1 (mainly) + S2
Term
Branches of popliteal artery
Definition
Popliteal --> Anterior tibial & Posterior tibial (right below tendinous arch of soleus muscle
Posterior tibial gives off fibular
Term
Relationship of flexor tendons at the ankle
Definition
Tibialis posterior (most anterior & lateral)
Flexor digitorum longus
POsterior tibial artery
Tibial nerve
Flexor Hallucis Longus (most posterior, near calcaneus)

(Tom DIck and Harry)
Term
components of axillary nerve
Definition
C5, C6
Term
components of a motor nerve
Definition
somatomotor
somatosensory
symp/post
Term
What is used to maintain posture?
Definition
ligaments & connective tissue
(NOT bones / muscles which are silent during rest)
Term
why isn't the humerus displaced downward during postural stance?
Definition
locking mechanism at glenohumeral joint - lateral movement would be needed in addition to downward (prevented by joint capsule & CT elements of horizontal rotator cuff muscles)

with added weight, supraspinatus muscle activates
Term
shortening / concentric contraction
Definition
muscle is doing more work than external force (gravity, resistance, weight, etc) --> shortening of muscle
Term
isometric contraction
Definition
muscular force = external force
as a result, muscle stays the same length
Term
lengthening / eccentric contraction
Definition
muscle becomes longer while contracting
muscle force is less than external force, but some fibers are still actively contracting
Term
muscle - movement vs force
Definition
Greatest force = short, fat muscle
Greatest movement = long, skinny muscle
*force is proportional to cross-sectional area
*movement is proportional to length of fibers
Term
Parallel vs pennate muscles
Definition
Parallel = adapted for movement (vs force)

pennate = adapted for force
Term
Effect of tendons on parallel muscles
Definition
Tendons reduce fiber length --> reduces overall movement
force is unaffected
Term
Effect of tendons on pennate muscles
Definition
Tendons reduces overall force of pennate muscles
- movement unaffected
Term
sternoclavicular joint
Definition
articular disk connects clavicular head to costal cortilage to tether clavicle to sternum
ball & socket mobility
Term
acromioclavicular joint
Definition
strong coracoclavicular ligament pulls scapula w/ movement of clavicle & visa versa
Shoulder separation = tearing of ligament --> shoulder 'step down' at joint
Term
glenohumeral joint
Definition
ball & socket joint has most movement of any joint in body
Term
scapulothoracic joint
Definition
scapula held in place by shoulder girdle (pec, trap, serratus, rhomboids, levator scapulae) --> movement of scapula on body wall
Term
bones involved in raising arm above head
Definition
clavicle, scapula, humerus
Term
joints involved in raising arm above head
Definition
sternocalvicular, acromioclavicular, glenohumeral, scapulthoracic
Term
muscles involved in raising arm above head
Definition
deltoid
trapezius
supraspinatus
serratus anterior
Term
movements invovled in raising arm above head
Definition
1 - abduction of humerus (deltoid & supraspinatus) get it to 90 degrees, but then humerus contacts acromion
2 - rotation of scapula so glenoid fossa faces upward (trapezius elevates by pulling from neck, serratus & trap rotate scapula 90 degrees)
Term
muscles involved in lowering arm
Definition
same arm-raising muscles (trap, deltoid, supraspinatus, serratus anterior) act antagonistically & contract eccentrically.
Term
Gravitational vertical axis relationship to hip, knee, and ankle joints
Definition
Posterior to hip joint = tendency to extend at hip (resisted by iliofemoral ligament)
Anterior to knee joint = tendency to extend knee (resisted by cruciate ligaments /joint capsule)
Anterior to ankle joint = tendency to dorsiflex (resisted by soleus muscle)
Term
Heel strike - muscles involved
Definition
- Glut max / hamstrings = hip extensors: contract isometrically to prevent trunk from jack-knifing
- Ankle dorsiflexors (TA, EDL, EHL): contract eccentrically to set foot down slowly
- Glut med & min: contract isometrically to prevent pelvis from tilting to opposite side
Term
Foot flat - muscles involved
Definition
- Quads contract eccentrically to keep knee from buckling when weight is transferred
- Glut med & min: contract isometrically to prevent pelvis from tilting to opposite side
Term
mid stance - muscles involved
Definition
- plantarflexors (gastroc, soleus, TP, FHL) contract eccentrically to prevent unwanted dorsiflexion
- Glut med & min: contract isometrically to prevent pelvis from tilting to opposite side
Term
Heel-off phase of gait- muscles involved
Definition
- calf muscles (gastroc, soleus, TP, FHL) contract concentrically to lift heel off ground + thrust
- Glut med & min: contract isometrically to prevent pelvis from tilting to opposite side
Term
Pre-swing / toe-off phase of gait- muscles involved
Definition

- plantarflexors (gastroc, soleus, TP, FHL) contract concentrically to thrust

- Iliopsoas contracts concentrically to stop hip extension & initiate forward limb mvmt

- Rectus femoris contracts isometrically to prevent excess knee flexion

Term
Early swing phase of gait - muscles involved
Definition
- Ankle dorsiflexors (TA, EDL, EHL) contract concentrically to lift toes off ground
- Iliopsoas & hip flexors contract concentrically to accelerate limb forward
- Quads contract isometrically to prevent unwanted excessive knee flexion
Term
Late swing phase of gait - muscles involved
Definition
- Ankle dorsiflexors (TA, EDL, EHL) contract isometrically to hold ankle in readiness for heel strike
- Hamstrings contract eccentrically to slow forward momentum of leg before heel strike
Term
How is pelvic tilt controlled during gait?
Definition
Hip extensors contract isometrically during heel strike to prevent jack-knifing (gluteus maximus, hamstrings)
Term
Gait change with lesion to superior gluteal nerve
Definition
Tendelenburg gait
- opposite pelvic tilt due to paralysis of glut medius & minimus
- Lesion on right: pelvis sags to left during swing phase of left leg, compensation by shifting trunk & head toward right to maintain balance
Term
Tibial nerve lesion / hamstring paralysis --> gait?
Definition
Hip extensor paralysis --> Patient leans backwards at heel-strike to counteract tendency to jack-knife forward
Term
Tibial n lesion / calf muscle paralysis --> gait?
Definition
can't raise heel off ground --> small steps / drag limb w/ hip flexors
Term
Deep fibular n lesion --> gait?
Definition
loss of ankle dorsiflexors (shin) --> toes can't clear ground in swing phase / can't decelerate slowly in heel strike --> "high stepping gait" & "foot slap"
Term
Obturator n injury effect on gait
Definition
paralysis of adductor muscles --> limb deviates laterally
Term
Two terminal branches of tibial n
Definition
Medial plantar nerve & lateral plantar nerve (on plantar aspect of foot)
Term
lateral plantar artery & nerve course between what muscles?
Definition
flexor digitorum brevis & quadratus plantae
Term
What passes through the tarsal tunnel?
Definition
tibial nerve, tibialis posterior, flexor digitorum longus, flexor hallucis longus
Term
Movements of midcarpal & radiocarpal joints
Definition
flexion, extension, abduction, adduction
Term
Movements of carpometacarpal of digits 2-5
Definition
flexion, extension, abduction, adduction, rotation
Term
Carpometacarpal joint of thumb - movement
Definition
flexion, extension, abduction, adduction, rotation
Term
movement of Metacarpophalangeal (MCP) joint
Definition
flexion, extension, abduction, adduction, limited rotation
Term
Interphalangeal joints (PIPs) of digits 2-5 & thumb
Definition
flexion & extension only
Term
Boundaries of anatomical snuff box
Definition
abductor pollicis longus / extensor pollicis brevis + extensor pollicus longus
Term
Common fracture when falling on outstretched hand
Definition
scaphoid bone of wrist & radius take the force --> scaphoid often fractured
symptom - tenderness in snuffbox
Term
Thenar muscles of the hand
Definition
Abductor pollicis brevis
Flexor pollicis brevis
opponens pollicis
Term
Hypothenar muscles
Definition
abductor digiti minimi
flexor digiti minimi
opponens digiti minimi
Term
Cutaneous innervation to dorsal tips of fingers 1-3.5
Definition
median n
Term
cutaneous innervation to pinky side of dorsal hand
Definition
ulnar n
Term
cutaneous innervation to thumb side of dorsal hand
Definition
radial n
Term
Symptoms of ulnar n lesion & clinical test
Definition
Claw hand (intrinsic & extrinsics of hand affected)
Can't ab/adduct finges - loss of interossei
Test - grip paper placed between fingers
Term
Median n lesion - symptoms & test
Definition
Scenario: attempted suicide
recurrent medial n damaged in base of thumb or compressed in carpal tunnel
Can't oppose thumb & little finger (thenar muscle loss)
Test = can't grip object to pick it up
Term
Radial n lesion - symptoms
Definition
Scenario: fracture to shaft of humerus
Can't extend wrist or MP joint but CAN still extend digits
cutaneous thumb innervation maintained because superficial radial n splits off earlier
Term
Dupuytren contracture
Definition
People over 50 get thickening & shortening of palmar aponeurosis --> 4th & 5th digits in flexion position
(repair surgically)
Term
What passes through carpal tunnel?
Definition
4 tendons of flexor digitorum superficialis, 4 tendons of flexor digitorum profundus, tendon of flexor pollicis longus, median nerve
Term
Cutting the median nerve (suicide attempt) would result in what functional loss?
Definition
Thenar muscles, 1st & 2nd lumbricals, cutaneous sensation on palmar surfaces of digits 1-4 + nail beds of same digits
Term
what arteries contribute to the deep vs superficial palmar arches?
Definition
Superficial = ulnar artery
Deep = radial artery
Term
3 points of articulation in knee joint
Definition
lateral tibiofemoral & medial tibiofemoral joints, patella articulates w/ femur
Term
movement at knee joint
Definition
hinge, rolling, gliding, and some rotation (in moving from flexion to full extension & vice versa)
Term
medial meniscus vs lateral meniscus
Definition
Medial meniscus is attached to MCL
- more C shaped
LCL is separated from lateral menisucs by popliteus tendon
- LM is more "O" shaped
Term
McMurray's test
Definition
knee maximally flexed, examiner rotates leg medially or laterally - leg extended to 90 degrees while rotated
-positive = audible click
- testing for meniscal tear
Term
valgus stress test
Definition
testing MCL integrity - pushes on lateral side of knee; if movement occurs, test is positive & they have MCL damage
Term
varus stress test
Definition
testing LCL integrity - pushes on medial side of knee; if movement occurs, test is positive & they have LCL damage
Term
cruciate ligament- locations
Definition
between intercondylar eminence of tibia & intercondylar surface of femur
Term
ACL attachments
Definition
anterior aspect of tibial plateau --> lateral femoral condyle
Term
PCL attachments
Definition
posterior aspect of tibia --> medial femoral condyle
Term
function of cruciate ligaments
Definition
hold femur & tibia together to provide stability
ACL prevents anterior displacement of tibia
PCL prevents posterior displacement of tibia
Term
anterior drawer test
Definition
examiner grasps leg at 90 degrees & pulls anteriorly - if leg moves forward > 1 cm = positive
Term
Patella - function
Definition
Patella = sesamoid bone that grew w/i a tendon
Gives additional leverage to quad muscle
Term
function of menisci
Definition
create a congruous surface for the femoral condyles
Term
Radiocarpal joint articulations
Definition
Scaphoid & lunate articulate w/ radius
trequetrum (triangular) articulates w/ ulna (separated by articular disc)
Term
glenoid labrum tear
Definition
occurs from sudden contraction of biceps long tendon
SLAP tear = superior labrum tear from anterior - posterior
Term
Tommy John
Definition
To repair torn, frayed, or stretched ulnar collateral ligament (UCL)
- replaced by piece of tendon from palmaris longus or other muscle
Term
anular ligament - location & function
Definition
attaches twice to ulna to attach the radius - holds head of radius against radial notch during pronation / supination
Term
Colles fracture
Definition
transverse fracture of distal radius
- distal radius absorbs majority of weight
Due to falling on outstretched hand
Term
Lachman's test
Definition
To test for ACL injury
knee at 15-20 degrees, grasp tibial tuberosity w/ one hand & distal thigh w/ other & pull
Term
most common ligaments & tendons are most affected in ankle sprain
Definition
Anterior talofibular ligament
calcaneofibular, posterior talofibular ligaments
Tendons of fibularis longus & brevis
Term
what structure helps counterbalance gravity at hip joint
Definition
Line of gravity is posterior to hip
iliofemoral ligament helps counterbalance gravity when standing upright
Term
which meniscus is more commonly injured and why?
Definition
Medial meniscus because it's attached to MCL & therefore is less mobile and more likely injured
Term
In heel strike, weight on talus is distrubted to?
Definition
Calcaneus bone
Term
during footflat phase of gait weight is distributed to which tarsal bone & ligament?
Definition
navicular bone + calcaneonavicular ligament
Term
latissimus dorsi - innervation & function
Definition
innervated by thoracodorsal nerve (branch of posterior cord)
Adducts
Medially rotates
Extends
Term
levator scapulae - innervation & function
Definition
dorsal scapular n
elevates scapula
Term
pectoralis major innervation & functin
Definition
lateral & medial pectoral nerves adducts, medially rotates, and flexes humerus
Term
Pectoralis minor - innervation & function
Definition
medial pectoral nerve
depresses scapula
Term
rhomboids - innervation & action
Definition
dorsal scapular nerve
retracts scapula
Term
serratus anterior - innerv & action
Definition
long thoracic nerve
protracts scapula
involved in rotating scapula to raise arm over head
Term
teres major - action
Definition
medially rotates
adducts
Term
trapezius - action & innervation
Definition
accessory nerve
elevates, lowers, retracts scapula
rotates scapula upward
Term
spinal nerve for shoulder abduction
Definition
C5
Term
spinal nerve for elbow flexion
Definition
C6
Term
Spinal nerve for finger flexion
Definition
C8
Term
Spinal n for intrinsic hand muscles
Definition
T1
Term
Spinal n for hpi flexion
Definition
L2
Term
Spinal n for knee extension
Definition
L3
Term
Spinal n for ankle dorsiflexion
Definition
L4
Term
Spinal n for ankle plantarflexion
Definition
S1
Term
Patellar reflex
Definition
L3, L4 (mostly)
Term
Where to test function of deep fibular n?
Definition
webbing bw big toe & 2nd toe
Term
winged scapula caused by?
Definition
paralyzed serratus anterior
Term
choracobrachialis - nerve & action
Definition
musculocutaneous
flexes arm at shoulder
Term
sacrotuberous ligament
Definition
spans from ischial tuberosity to dorsum of sacrum (passes over obturator internus tendon when viewed from posterior)
Term
pectineus muscle - action & innervation
Definition
adducts & flexes thigh at hip joint
innervated by femoral n. (sometimes obturator)
Term
flexion at hip?
Definition
rectus femoris
sartorius
iliopsoas
pectineus
tensor fascia latae
Term
fibularis longus/brevis action
Definition
plantarflexion + eversion

stabilize foot during gait
Term
anterior tibial artery course in lower leg
Definition
between tibialis anterior & extensor hallucis longus
Term
deep fibular nerve runs between what muscles?
Definition
tibialis anterior & extensor hallucis longus
Term
What tendons provide support to medial arch?
Definition
Calcaneonavicular (spring ligament) = greatest support to medial arch (and head of talus) - goes from sustentaculum tali to navicular
+ anterior & posterior tibial tendons
Term
acetabulum formed by what bones?
Definition
ischium, pubis, ilium
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