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Anatomy Block 1
Upper Limb and Back
91
Anatomy
Graduate
08/24/2009

Additional Anatomy Flashcards

 


 

Cards

Term

Identify the following basic parts of the vertebrae and how they differ between specific Vertebrae:

A. Body

B. Pedicles

C. Laminae

D. Pars interarticularis

E. Spinous Process

F. Transverse Processes

G. Articular Processes

H. Sacral hiatus

 

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Definition

A. Axis has no body. Lumbar vertebrae are very large.

B.Link to the body

C. Link to the spinous process

D. Between the superior and inferior articular processes.

E.Bifid tips in Cervical

F. Have facets and demifacets in thoracic, and transverse foramen in cervical

G.Where vertebrae link and articulate

H. Indent at bottom of the saccrum where bodies of L4 and L5 should be (not shown)

Term
What are the three types of Vertebral Joints?
Definition

1. Fibrous Joint

2. Interarticular Synovial Joint

3. Cartilaginous Joint

Term
Where are the Supraspinous and Interspinous Ligaments located and what is their function?
Definition

Supraspinous ligaments: run vertically along the spinous processes.

Interspinous ligaments: run between each spinous process.

 

Function: to limit ventral flexion

Term
What type of joint is the Ligamentum Flavum? Where is it located?
Definition
The ligamentum flavum is a fibrous joint and runs vertically on the dorsal side of the vertebral canal.
Term
What type of joint are the longitudinal ligaments of the spine? Where are they located? What is their funtion?
Definition

Fibrous joints

 

There are Posterior and Anterior Longitudinal ligaments. The Posterior Longitudinal ligaments make up the ventral side of the vertebral canal. The Anterior Longitudinal ligaments run along the ventral side of the body of the vertebrae.

 

The Longitudinal Ligaments prevent against hyperflexion of the spine.

Term
What type of Fibrous Joint is the Ligamentum Nuchae and where is it located?
Definition
It is a Supraspinous Ligament located between C7 and the Occipital bone of the Skull.
Term
Between the Atlas (C1) and the Skull many fibrous joints have specific names, what are they?
Definition

Ligamentum Flavum = Posterior Atlanto-occipital membrane

 

Anterior Longitudinal Ligament = Anterior Atlanto-occipital membrane

 

Posterior Longitudinal Ligament = Tectorial Membrane

Term

Where are the interarticular Synovial Joints?

 

In the three major regions what do these joints allow/prevent?

Definition

Interarticular Synovial Joints are located between the articular processes of the vertebrae

 

In the Cervical Region the horizontal orientation allows for movements in all directions, although rotation is limited

 

In Thoracic Region they are coronally oriented and allow for all movements (the ribs and sternum prevent all motion)

 

in the Lumbar region they are sagitally oriented and allow for flexion and extension (laterally as well) and rotation is limited.

Term
What is Spondylolysis? And what can it lead to in relation to L5?
Definition

Spondylolysis is a fracture of the pars interarticularis (generally a sports related injury).

 

Can lead to Spondylolithesis which occurs when L5 slips forward onto the body of S1.

Term
Where do the spinal nerves exit the vertebral canal in relation to the articular surfaces?
Definition
Anterior
Term
 Identify the 2 components of the Cartilaginous joints of the spine?
Definition

These are the intervertebral discs which are made up of the:

1. Nucleus Pulposus - liquid-like central core made of glycoprotein

2. Annulus Fibrosis - Avascular fibrocartilage that is thickest anteriorly, and filled with nerve endings that respond to pain stimuli.

Term
What is a clinical use of the sacral hiatus?
Definition
The opening can be used to insert a needle and administer anesthesia
Term
Why is the nucleus pulposus more liquid like?
Definition
The negatively charged glycosaminoglycans attract water to the pulposus. This turgor pressure helps maintains the shape of the pulposus.
Term
What is the purpose of the nucleus pulposus
Definition

It transmits changes in compression forces.

 

As the nucleus in compressed water with waste is pushed out and with relaxation nutrients and water are pulled back into the nucleus.  (During sleep the discs become thicker because of the reabsorption of water)

Term
How does age affect the nucleus pulposus?
Definition

Less water is located in older discs and therefore less nutrient waste exchange occurs.

 

The Annulus Fibrosis also changes with age - becoming more degenerative

Term

When an intervertebral disc ruptures/bulges what direction will this occur most regularly?

 

What effect can this have on surrounding anatomical features?

Definition

Ruptures posteriolaterally (disc is thinner hear)

 

Because spinal nerves exit in this direction the disc can pinch the nerve. The affected nerve is the nerve that exits below the lower of the two vertebrae.

(So between L5 and S1 means the S1 nerve is affected)

Term
What are the 5 most common causes of lower back pain?
Definition

Bulging Intervertebral discs

Arthritic Interarticular joints

Sore muscles and fascia

Sacroiliac joints

Metabolic problems (osteoporosis, diabetes)

 

Term
If a patient presents with unilateral pain in the lower back what might you expect and how might you confirm it?
Definition

A spinal nerve being pinched by a bulging disc.

 

You would want to check for pain that followed the dermatome for the nerve in question, as well as numbness.

Term
What are the Primary and Secondary curvatures of the spine?
Definition

Primary curvatures are permanent and established during development:

Thoracic

Sacral

 

Secondary curvatures are caused by pressure on the spinal chord:

Cervical

Lumbar

Term

What are the medical names for:

1. Hunchback/Humpback

2. Inward bend of the lower back

3. Crooked back (laterally)

 

Who might experience these?

Definition

Humpback: Kyphosis (elderly)

Inward: Lordosis (pregnant)

Lateral: Scoliosis (females during development with poor posture)

Term
What are the terms for people with additional lumbar vertebrae or a lack of lumbar vertebrae?
Definition

Sacralization = L5 becomes part of sacrum

Lumbarization = S1 is not fused and is more like L6

Term

Where do you perform a spinal tap/lumbar puncture on an adult? And why?

 

What will you have to puncture to reach this point?

Definition

Between L3 and L4

 

The spinal chord ends at L1 so between L3 and L4 you wont puncture the spinal chord but can still get CSF.

 

Puncture: Skin, Fascia, Skin, Erector Spinal Muscles

Interspinous ligament, Ligamentum Flavum, Dura mater and Arachnoid mater.

 

Note: an epidural does not require the last two be punctured.

Term
What is the difference between the extrinsic and intrinsic muscles of the back?
Definition

Extrinsic or false muscles of the back arise from the hypaxial myotomes during development. These muscles migrate from the ventral side of the body and as such are served by ventral rami.

 

Intrinsic or true muscles of the back arise from the epaxial myotomes and are served by dorsal rami.

Term
Name the large fascia into which the latissimus dorsi inserts?
Definition
Thoracolumbar Fascia
Term
Identify the extrinsic muscles of the back by Superficial and Deep layers
Definition

Superficial: trapezius, latissimus dorsi, serratus anterior

 

Deep: Rhomboids, levator scapulae, serratus posterior superior, serratus posterior inferior

Term
Should the Long Thoracic nerve be severed during a surgery what would you expect the patient to exhibit?
Definition
Winged scapula
Term
Identify the intrinsic muscles of the back
Definition

1. Spinotransversocostal (splenius capitus & cervicis)

2. Erector Spinae (iliocostalis, longissimus, spinalis)

3. Transversospinalis (semispinalis, multifidus, rotatores)

4. Suboccipital Muscles

Term
What four things most directly influence stability of the spine?
Definition

1. Taut Ligaments

2. Plane and Placement of Articular Facet Joints

3. Annulus Fibrosis and Intervertebral disc

4. Adequate Muscle Tone

Term

What factors most directly influence the mobility of the spine?

 

Definition

1. Disc height:Vertebrae Height (the thicker the disc the more motion allowed)

2. Muscle Tone 

3. Ligament Tautness

4. Plane of Articulation of Synovial Joints

Term
What arteries provide blood to the Cervical vertebrae.
Definition
Occipital, Vertebral, and Cervical
Term
What arteries provide blood to the thoracic vertebrae?
Definition
Intercostal
Term
What arteries supply blood to the Lumbar and Sacral vertebrae
Definition

Lumbar - ileolumbar

Sacral - lateral sacral

Term
What veinous plexi drain the vertebrae and where are they located?
Definition

Internal plexus - in vertebral canal

 

External plexus - located anteriorly and posteriorly to the vertebral canal

Term
What are the four segments of the upper limb? And what defines each?
Definition
  1. The Shoulder - attached to trunk
  2. Proximal Segment (Brachium, Stylopodium)-Between Shoulder and Elbow
  3. Intermediate Segment (Antebrachium, Zygopodium) - Between Elbow and Wrist
  4. Distal Segment and Hand - Distal to wrist
Term
What are the areas of transition for the upper limb?
Definition
Axilla, Cubital Fossa, and Carpal Tunnel
Term
In discussing the upper limb (in anatomical position) their are words that are synonymous with distal and medial, what are they?
Definition

Preaxial (Superior) = Lateral

Postaxial (Inferior)= Medial

Term
In the anatomical position is the pollex preaxial or postaxial?
Definition
Preaxial
Term

What type of joints are the following joints of the upper limb?

 

  1. Glenohumeral
  2. Elbow Joint
  3. Proximal and Distal Radioulnar Joints
  4. Wrist
  5. Digits
  6. Metacarpophalangeal joint
  7. Thumb/Pollex
Definition
  1. Ball and Socket
  2. Hinge
  3. Pivot
  4. Condyloid
  5. Hinge
  6. Condyloid
  7. Saddle
Term
What arrangement of the pollex allows for opposable thumbs?
Definition
The metacarpal bone of the thumb is not tethered to the other metacarpal bones of the other digits. This results in the thumb operating in at a 90 degree angle to the other fingers.
Term
What bones make up the pectoral girdle and what purpose do they serve in this girdle?
Definition

Clavicle: attachment site for muscle. Transmits weight and force from the limb to the trunk (shock absorber)

 

Scapula: muscle attachment, protraction and retraction of the arm (slides on the trunk)

 

Together these bones protect nerves passing from the neck to the axilla.

Term
What is the purpose of deep fascia in the upper limb and what complications can it cause?
Definition

Divides the limb into anterior (flexor, adductors, medial rotators) and posterior (extensor, abductors, lateral rotators) compartments.

 

Difference in pressure within the compartments may cause compartment syndrome.

 

Can act as a wick for infection

 

May entrap nerves

Term
What muscles attach the pectoral girdle to the trunk?
Definition
Trapezius, Levator Scapulae, Rhomboids, and Serratus Anterior
Term
What muscles attach the body wall and pectoral girdle to the upper humerus
Definition
Deltoid, Pectoralis Major, Pectoralis Minor, Latissimus Dorsi
Term
What muscles attach the scapula to the upper humerus?
Definition
Supraspinatus, Infraspinatus, Teres Minor, Teres Major, and Subscapularis
Term

What muscles make up the Rotator Cuff?

 

Which is most often torn

Definition

Supraspinatus, Infraspinatus, Subscapularis, and Teres Minor

 

Supraspinatus

Term
What nerve innervates the anterior brachium?
Definition
Musculocutaneous
Term
What muscle innervates the posterior compartment of the brachium?
Definition
Radial
Term
What nerve innervates the flexor compartment of the antebrachium?
Definition
Median and Ulnar
Term
What nerve innervates the anterior hand ?
Definition
Median and Ulnar
Term
Which nerve innervates the extension compartment in the antebrachium?
Definition
Radial
Term
What nerve passes over the medial epicondyle of the humerus?
Definition
Ulnar (Funny Bone)
Term
What nerve passes along the middle of the Humerus bone?
Definition
Radial
Term
What nerve crosses through the surgical neck of the Humerus
Definition
Axillary
Term

What are the main arteries in the following segments of the upper limb?

 

  1. Proximal
  2. Intermediate
  3. Distal
Definition
  1. Proximal: Subclavian becomes the Axillary which becomes the brachial
  2. Radial and Ulnar
  3. Superficial and Deep Palmar Arches which branch into Common palmar digital arteries
Term

What are the veins that run through the following segments of the upper arm?

 

  1. Proximal
  2. Intermediate
  3. Distal
Definition
  1. Proximal: Subclavian (Preaxillary) becomes the Basilic (Post axillary), and the Cephalic
  2. Intermediate: Subclavian and Basilic
  3. Distal: Basilic Vein and Cephalic
Term
Where might lymphatic vessels be found in the upper limb? Where do they drain?
Definition

Superficial lymphatic vessels run along the various veins (cephalic and basilic and their small branches)

 

Deep lymphatic vessels run along arteries

 

Drains are located at the elbow (trochlear) which drain into axillary nodes which in turn drain into the subclavian nodes/ducts.

Term
How can a clinician distinguish between swollen/infected lymph nodes and cancerous/neoplastic lymph nodes
Definition

Infected = Enlarged and painful

Neoplastic = hard, enlarged, and not painful

Term
What is the name of the condition that is caused by excessive movement of the muscles and their connective tissue, in which the saclike structure that lubricate the muscles to facilitate such motion are irritated and inflamed?
Definition
Bursitis
Term
What is the most commonly broken bone in the body?
Definition
Clavicle
Term
What is the name of the circulation that can be seen in the arms that provides a constant blood supply despite possible blockages?
Definition

Collateral Circulation

 

Made possible by anastomoses

Term

What four things are needed for a functional hand?

 

What is the ultimate function of the upper extremity?

Definition
  1. Stability - Bones & Ligaments
  2. Viability - Veins & Arteries
  3. Sensibility - Nerves
  4. Mobility - Muscles

To put the hand in desired place

Term

What are the two main arteries of the arm?

 

Which provides blood to the superficial palmar arch?

 

Which provides blood to the deep palmar arch?

Definition

Radial (thumb side) - Deep palmar arch

 

Ulnar (Pinky) - superficial palmar arch

Term
Which arch provides the main supply of blood to the hand?
Definition
The Superficial Palmar arch, served by the Ulnar artery.
Term
Which palmar arch is more proximal?
Definition
Deep Arch (Radial Artery)
Term
Which muscles in the hand does the radial nerve innervate?
Definition
None, it only innervates muscles in the posterior compartments of the arms. No intrinsic muscles of the hand.
Term

Which nerve(s) innervate the thenar muscles?

 

The Hypothenar muscles?

Definition

Thenar = thumb = Median

 

Hypothenar = pinky= Ulnar

Term
Where do the Intrinsic and Extrinsic muscles of the hand originate?
Definition

Intrinsic = Wrist and hand

 

Extrinsic = Forearm

Term
What 3 muscles of the posterior antebrachium compartment cross the elbow?
Definition

Anconeus

Supinator

Brachioradialis

Term
What muscles of the posterior antebrachium compartment control wrist extension?
Definition

extensor carpi radialis longus

extensor carpi radialis brevis

extensor carpi ulnaris

Term
What muscles of the dorsal antebrachium control the fingers?
Definition

Extensor digitorum

Extensor digiti minimi

Extensor indici

Term
Which of the dorsal antebrachium muscles control the thumb?
Definition

extensor pollicus longus

extensor pollicus brevis

abductor pollicus longus

Term
Name the muscles of the volar surface of the antebrachium from superficial to deep
Definition
  1. palmaris longus
  2. flexor carpi radialis
  3. flexor carpi ulnaris
  4. pronator teres
  5. flexor digitorum superficiale
  6. flexor digitorum profundus
  7. flexor pollicus longus
Term
What structure pass through the carpal tunnel?
Definition
  1. Median Nerve
  2. Flexor Pollicus Longus
  3. Flexor Digitorum Superficialus
  4. Flexor Digitorum Profundus
Term
Name the muscles of the hypothenar region from lateral to medial
Definition

abductor minimi

flexor digiti minimi

Opponens

Term
In regards to the flexor digitorum superficialus and its relation to the flexor digitorum profundus, which lies deep at the middle phalanx?
Definition
Superficialus because it hooks to the middle phalanx joint whereas the profundus links to the distal phalanx joint.
Term
The Interossei Muscles can be divided into volar and dorsal groups. What do each do?
Definition

Dorsal abduct

Ventral Adduct

Term
How does the extensor hood within the hand function in basic terms? And what does it allow for?
Definition
The extensor hood works by balancing the extensor and flexor muscles in a composite motion to allow you to pick things up larger than a pencil.
Term
What nerve would you think was being affected if a patient was unable to flex digits 1,2, and 3
Definition
Median
Term
What nerve is having pressure placed on it when an individual has carpal tunnel syndrome?
Definition
Median
Term
If the 4th and 5th digits are "clawed" what nerve was most likely affected?
Definition
Ulnar
Term
If a patient has a hard time beginning to lift their arm what nerve is most likely affected?
Definition
Axillary because it innervates the deltoid
Term
If a patient suffers from hand drop what nerve would you suspect?
Definition
Radial
Term
What are 3 types of joints and where are they found?
Definition
  1. Fibrous (suture of the skull)
  2. Fibrocartilagenous (epiphysis, intervertebral)
  3. Synovial
Term
What 3 structures are integral to a synovial joint
Definition

Hyaline cartilage

Synovium (1 cell layer thick - produce synovial fluid)

Capsule

Term
What are the synovial joints of the shoulder?
Definition

Sternoclavicular

Acromio-clavicular

Acromio-humeral

Term
What ligaments bind the acromioclavicular joint together
Definition

acromioclavicular ligament

coracoclavicular ligament

Term
Identify a Type I, II, and III AC sprain (sprained shoulder)
Definition
  1. Acromioclavicular ligament is stretched
  2. Acromioclavicular ligament is broken but coracoclavicular ligament is attached
  3. Both are separated
Term
The shoulder sacrifices stability to have mobility. How does it keep stability?
Definition

Glenohumeral fossa with glenohumeral labrum

Muscles

Ligaments

Term
If the rotator cuff was damaged/torn what effect would the deltoid cause
Definition
Raise arm
Term
What are the three points of articulation/hinges in the Elbow?
Definition

Humeral-ulnar

Humeral-radial

Radio-ulnar

Term
What is nursemaid's elbow and how is it caused? How can it be corrected?
Definition

Subluxation of the radius from the radial annular ligament.

 

Fixed by pronating/supinating arm

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