teres minor m. (above)

teres major m. (below)

long head of triceps m. (medial)

surgical neck of humerus (lateral)

axillary nerve

posterior circumflex humeral artery and vein

teres major m. (above)

long head of triceps m. (medial)

lateral head of triceps m. (lateral)

radial nerve

deep brachial artery and vein

outer border of 1st rib to medial border of pectoralis minor m.

1 branch

supreme or highest thoracic artery

supplies anterior area of 1st 2 intercostal spaces

portion of artery behind or deep to pectoralis minor m.

2 branches

thoracoacromial trunk

to pectoral muscles

lateral thoracic artery

lateral aspect of thorax

[image]from lateral border of pectoralis minor m. to the lower border of the teres major m.

3 branches:

subscapular trunk

posterior circumflex humeral artery

anterior circumflex humeral artery

compression syndrome

median nerve gets compressed

pain in 1st 3 digits

from median nerve

location: N/A

supplies skin of lateral or radial 3 1/2 digits on palmar side and associated palm of hand

Palmar Digital Branches of Ulnar Nerve

from ulnar nerve

location: N/A

supplies skin of medial or ulnar 1 1/2 digits on palmar side and associated palm of hand

Dorsal Cutaneous Branch of Ulnar Nerve

branch of ulnar nerve

location: along medical aspect of forearm just above wrist and passes in close proximity to head of ulna onto dorsum of hand

supplies dorsal skin of medial or ulnar 2 1/2 digits and associated dorsum of hand

one of two terminal branches of radial nerve

Location: deep in brachioradialis m. for most of forearm

near hand courses towards dorsum of web between thumb and index (first) finger

supplies dorsal skin of radial or lateral 2 1/2 digits and associated dorsum of hand

from radial nerve

descends behind lateral epicondyle of humerus and continues into posterior forearm

supplies skin of posterior aspect of forearm, particularly skin adjacent to midline

terminal branch of musculocutaneous nerve

in company w/ cephalic vein in forearm

supplies skin of lateral aspect of forearm

from medial cord of brachial plexus

in company w/ basilic vein in lower arm and forearm

supplies skin of medial aspect of forearm

from axillary nerve

Location: along lower posterior border of deltoid muscle

supplies skin of upper-lateral aspect of arm

under middle part of deltoid m.

has upward extension btwn acromion process of scapula above and tendon of supraspinatus m. below

facilitates movement of deltoid over greater tubercle of humerus and movement of supraspinatus tendon in relation to under surface of acromion by reducing friction btwn them

Triangle of Auscultation

Location: 6th intercostal space (btwn 6th and 7th ribs)

triangular area at lower medial border of scapula bounded by

latissimus dorsi

trapezius

rhomboideus

triangle above iliac crest bounded by:

latissimus dorsi

external abdominal oblique m.

iliac crest

weak area where hernias occur or pus emerge from abdominal cavity

Erector Spinae

a deep back muscle that extends the back and maintains posture

3 parts (medial to lateral):

spinalis m.

longissimus m.

iliocostalis m.

Multifidus m.

Vertebral Column

Curvature and Vertebral Regions and Number

concave  cervical-7

convex  thoracic-12

concave  lumbar-5

convex  sacral-5

convex  coccyx-4

within spinal canal in epidural space

where vascular spread of cancer and infection occurs

ex-prostate cancer into lumbar vertebrae

small in size

have transverse foramina

spinous processes-bifid

joint spaces btwn facets-anterior tilted horizontal plane

bodies and tranverse processes have facets for ribs

spinous processes-long and project downward

articular facets

joint spaces in coronal or frontal plane

large in size

blade-like spinous processes

transverse processes-short w/ pointed ends

joint spaces btwn facets-sagittal plane

concave anteriorly

convex posteriorly

Pectoralis Major M.

Origin

clavicular head-medial 1/3 of clavicle

sternocostal head-sternum and adjacent upper 6 or 7 costal cartilages

Pectoralis Major M.

Insertion

Pectoralis Major M.

Action

adduction and internal rotation of humerus

accessory muscle of inspiration

Pectoralis Major M.

Innervation

medial pectoral nerve

lateral pectoral nerve

Pectoralis Major M.

Blood Supply

pectoral branches of thoracoacromial trunk

lateral thoracic artery (from axillary artery)

Pectoralis Minor M.

Origin

Pectoralis Minor M.

Insertion

Pectoralis Minor M.

Action

Pectoralis Minor M.

Innervation

Pectoralis Minor M.

Blood Supply

pectoral branches of thoracoacromial trunk

lateral thoracic artery (from axillary artery)

Serratus Anterior M.

Origin

Serratus Anterior M.

Insertion

medial (vertebral) border of scapula on anterior or costal side

thicker, lower attaches to inferior angle of scapula

Serratus Anterior M.

Action

abduction and upward rotation of scapula

stablizes scapula by holding medial border against rib cage

Serratus Anterior M.

Innervation

long thoracic nerve

on outer surface of serratus anterior m. and may be injured w/ lateral rib cage trauma

Serratus Anterior M.

Blood Supply

lateral thoracic artery

thoracic branches  of thoracodorsal artery

Trapezius M.

Origin

skull - external occipital protuberance and medial aspect of superior nuchal line

vertebral column - nuchal ligament that attaches to cervical and thoracic spinous processes

Trapezius M.

Insertion

Trapezius M.

Action

upper part - elevation and upward rotation of scapula

middle part - adduction of scapula

lower part - depression and upward rotation of scapula

Trapezius M.

Nerve Supply

Trapezius M.

Blood Supply

transverse cervical artery (from subclavian artery)

muscular branch of dorsal scapular artery (from subclavian artery)

Latissimus dorsi M.

Origin

Latissimus dorsi M.

Insertion

humerus - floor of intertubercular or bicipital groove

sulcus - anterior side of proximal humerus

Latissimus dorsi M.

Action

extension, medial rotation, adduction, and depression of shoulder (humerus or arm)

depression and downward rotation of scapula

Latissimus dorsi M.

Nerve Supply

Latissimus dorsi M.

Blood Supply

Levator Scapulae M.

Origin

Levator Scapulae M.

Insertion

Levator Scapulae M.

Action

Levator Scapulae M.

Nerve Supply

Levator Scapulae M.

Blood Supply

Rhomboideus M.

Origin

Rhomboideus M.

Insertion

Rhomboideus M.

Action

Rhomboideus M.

Blood Supply

Deltoid M.

Origin

anterior portion - lateral 1/3 of clavicle

middle portion - acromion

posterior portion - spine of scapula

Deltoid M.

Insertion

Deltoid M.

Action

anterior portion - flexion and internal rotation of shoulder (arm or humerus)

middle portion - abduction of shoulder

posterior portion - extension and lateral rotation of humerus

anterior and posterior portions - adduction of shoulder

Deltoid M.

Nerve Supply

Deltoid M.

Blood Supply

anterior and posterior circumflex humeral arteries (from axillary artery)

Supraspinatus M.

(Rotator Cuff)

Origin

Supraspinatus M.

(Rotator Cuff)

Insertion

Supraspinatus M.

(Rotator Cuff)

Action

Supraspinatus M.

(Rotator Cuff)

Nerve Supply

Supraspinatus M.

(Rotator Cuff)

Blood Supply

Infraspinatus M.

(Rotator Cuff)

Origin

Infraspinatous M.

(Rotator Cuff)

Insertion

Infraspinatous M.

(Rotator Cuff)

Action

Infraspinatous M.

(Rotator Cuff)

Nerve Supply

Infraspinatous M.

(Rotator Cuff)

Blood Supply

Teres Minor M.

(Rotator Cuff)

Origin

Teres Minor M.

(Rotator Cuff)

Insertion

Teres Minor M.

(Rotator Cuff)

Action

Teres Minor M.

(Rotator Cuff)

Innervation

Teres Minor M.

(Rotator Cuff)

Blood Supply

Subscapularis M.

(Rotator Cuff)

Origin

Subscapularis M.

(Rotator Cuff)

Insertion

Subscapularis M.

(Rotator Cuff)

Action

Subscapularis M.

(Rotator Cuff)

Innervation

Subscapular M.

(Rotator Cuff)

Blood Supply

Teres Major M.

Origin

Teres Major M.

Insertion

Teres Major M.

Action

Teres Major M.

Innervation

Teres Major M.

Blood Supply

from tip of spine to tip of spine

nuchal ligament in cervical area

yellow ligament consisting of elastic connective tissue

extends column from flexed position

extends vertically on posterior surface of discs and bodies

limits extensive flexion of spinal column and restrains intervertebral disc herniation

extends vertically on anterior surface of discs and bodies

limits excessive extension of column

flexion

extension

lateral flexion (side bending)

rotation

cervical - 8 pairs

thoracic - 12 pairs

lumbar - 5 pairs

sacral - 5 pairs

coccygeal nerve - 1 pair

fat

Batson's plexus of veins

a potential space - doesn't usually contain anything

infection or blood show here

extensions of pia mater to dural mater

provide lateral stabilization of cord and separate dorsal and ventral roots of spinal nerves

Rami Communicantes

(white and gray communicans)

nerve roots that continue caudalward after end of spinal cord

join lumbar (L1-L5) and sacral (S1-S5)

thin extension of pia mater

continues from end of spinal cord to lumbar cistern to connect to coccyx

serves to anchor spinal cord

Lumbar Puncture

Procedure and Diagnostic Purposes

syringe needle inserted between laminae of lower lumbar vertebrae and placed into CSF of lumbar cistern below end of spinal cord

discover or rule out bacterial meningitis

brain bleed (stroke) into subarachnoid space

normally CSF clear

RBC in subarachnoid space abnormal

Myelogram

Procedure and Diagnostic Uses

insertion of radioopaque dye in subarachnoid space

irregularities suggest:

protrusion of intervertebral disc

presence of tumors in subarachnoid space

from subclavian artery

inside skull, 2 vertebral arteries unite to form 1 basilar artery

blood supply to:

cervical spinal cord

brain stem (respiratory and CV centers, consciousness part)

brain part that controls visual area

teres minor m. (above)

teres major m. (below)

long head of triceps m. (lateral)

Pre-Axial Arm Muscles

(Anterior Arm Muscles, Flexor Muscles of Arm)

coracobrachialis m.

biceps brachii m.

brachialis m.

Coracobrachialis M.

Origin

Coracobrachialis M.

Insertion

Coracobrachialis M.

Action

Coracobrachialis M.

Innervation

Coracobrachialis M.

Blood Supply

Biceps Brachii M.

Origin

long head - supraglenoid tubercle of scapula

short head - coracoid process of scapula

Biceps Brachii M.

Insertion

via biceps tendon into radial tuberosity of radius

via bicipital aponeurosis which blends meidally with deep fascia of flexor forearm muscles

Biceps Brachii M.

Action

supination of forearm (principal action)

flexion of arm (shoulder) and elbow (forearm)

Biceps Brachii M.

Innervation

Biceps Brachii M.

Blood Supply

Brachialis M.

Origin

Brachialis M.

Insertion

Brachialis M.

Action

Brachialis M.

Innervation

Brachialis M.

Blood Supply

Triceps Brachii M.

Origin

long head - infraglenoid tubercle

lateral head - posterior humerus, above and lateral to radial groove

medial head - posterior humerus, below and medial to radial groove

Triceps Brachii M.

Insertion

Triceps Brachii M.

Action

extension of elbow (forearm)

long head also extends arm (shoulder)

Triceps Brachii M.

Innervation

Triceps Brachii M.

Blood Supply

deep brachial artery

brachial artery

roof - deep fascia reinforced by bicipital aponeurosis - frequently in the sub cutaeous tissue superficial to the roof in the median cubital vein

floor - brachialis and supinator muscles

superior boundary - imagninary line connecting epicondyles of humerus

medial boundary - pronator teres m.

lateral boundary - brachoradialis m.

from lateral to medial:

radial n. (located between brachioradialis and brachialis m.)

biceps tendon; brachial artery median nerve

pronator teres

flexor carpi radialis

palmaris longus

flexor digitorum superficialis

flexor carpi ulnaris

Pronator Teres M.

Origin

Pronator Teres M.

Insertion

Pronator Teres M.

Action

Pronator Teres M.

Innervation

Pronator Teres M.

Relationships

median nerve passes between two heads of muscle

ulnar artery passes deep to muscle

Flexor Carpi Radialis M.

Origin

Flexor Carpi Radialis M.

Insertion

Flexor Carpi Radialis M.

Action

Flexor Carpi Radialis M.

Innervation

Palmaris Longus M.

Origin

Palmaris Longus M.

Insertion

Palmaris Longus M.

Action

Palmaris Longus M.

Innervation

Flexor Digitorum Superficialis M.

Origin

Flexor Digitorum Superficialis M.

Insertion

Flexor Digitorum Superficialis M.

Action

Flexor Digitorum Superficialis M.

Innervation

Flexor Carpi Ulnaris M.

Origin

Flexor Carpi Ulnaris M.

Insertion

Flexor Carpi Ulnaris M.

Action

Flexor Carpi Ulnaris M.

Innervation & Blood Supply

Deep Group of Forearm Flexor Muscle

(3)

flexor digitorum profundus m.

flexor pollicis longus m.

pronator quadratus m.

Flexor Digitorum Profundus M.

Origin

Flexor Digitorum Profundus M.

Insertion

Flexor Digitorum Profundus M.

Action

Flexor Digitorum Profundus M.

Innervation

median nerve (lateral half of muscle associated with fingers 1 and 2)

ulnar nerve (medial half of muscle associated with fingers 3 and 4)

Flexor Pollicis Longus M.

Origin

radius and interosseous membrane, lateral to fix dig profundus m.

Flexor Pollicis Longus M.

Insertion

Flexor Pollicis Longus M.

Action

Flexor Pollicis Longus M.

Innervation

Pronator Quadratus M.

Origin

Pronator Quadratus M.

Insertion

Pronator Quadratus M.

Action

Pronator Quadratus M.

Innervation

Superficial Extensor Forearm Muscle

(6)

bracioradialis m.

extensor carpi radialis longus m.

extensor carpi radialis brevis m.

extensor digitorum m.

extensor digiti minimi m.

extensor carpi ulnaris m.

Brachioradialis M.

Origin

Brachioradialis M.

Insertion

Brachioradialis M.

Action

Brachioradialis M.

Innervation & Blood Supply

Extensor Carpi Radialis Longus M.

Origin

Extensor Carpi Radialis Longus M.

Insertion

Extensor Carpi Radialis Longus M.

Action

extension of wrist

abduction or radial deviation of wrist

Extensor Carpi Radialis Longus M.

Innervation & Blood Supply

Extensor Carpi Radialis Brevis M.

Origin

common extensor tendon which attaches deeply to lateral epicondyle of humerus

Extensor Carpi Radialis Brevis M.

Insertion

Extensor Carpi Radialis Brevis M.

Action

extension of wrist

abduction or radial deviation of wrist

Extensor Carpi Radialis Brevis M.

Innervation

Extensor Digitorum M.

Origin

Extensor Digitorum M.

Insertion

Extensor Digitorum M.

Action

Extensor Digitorum M.

Innervation

Extensor Digiti Minimi M.

Origin

Extensor Digiti Minimi M.

Insertion

Extensor Digiti Minimi M.

Action

Extensor Digiti Minimi M.

Innervation

Extensor Carpi Ulnaris M.

Origin

Extensor Carpi Ulnaris M.

Insertion

Extensor Carpi Ulnaris M.

Action

extension of wrist

adduction or ulnar deviation of wrist

Extensor Carpi Ulnaris M.

Innervation

Deep Group of Extensor Muscles

(5)

supinator m.

abductor pollicis longus m.

extensor pollicis brevis m.

extensor pollicis longus m.

extensor indicis m.

Supinator M.

Origin

Supinator M.

Insertion

shaft of radius (below insertion of pronator teres m.)

Supinator M.

Action

Supinator M.

Innervation

Abductor Pollicis Longus M.

Origin

Abductor Pollicis Longus M.

Insertion

Abductor Pollicis Longus M.

Action

Abductor Pollicis Longus M.

Innervation

Extensor Pollicis Brevis M.

Origin

Extensor Pollicis Brevis M.

Insertion

Extensor Pollicis Brevis M.

Action

Extensor Pollicis Brevis M.

Innervation

Extensor Pollicis Longus M.

Origin

Extensor Pollicis Longus M.

Insertion

Extensor Pollicis Longus M.

Action

Extensor Pollicis Longus M.

Innervation

Extensor Indicis M.

Origin

Extensor Indicis M.

Insertion

Extensor Indicis M.

Action

Lumbar Plexus

T12 gives rise to what nerve and what does it serve?

subcostal nerve

serves king in proximal thigh, inferior and lateral to ASIS

Lumbar Plexus

L1 gives rise to what nerves and what do they serve?

iliohypogastic and ilioinguinal nerves

ilioinguinal nerve goes to superior medial region of thigh

Lumbar Plexus

L1 and L2 give rise to what nerve and what does it serve?

genitofemoral nerve

splits into 2 cutaneous branches - femoral brach serves proximal anterior thigh centrally

Lumbar Plexus

L2 and L3 give rise to what nerve and what does it serve?

lateral femoral cutaneous nerve

serves skin on anterior and lateral thigh

Lumbar Plexus

L2, L3, and L4 give rise to what nerves and what do they serve?

femoral nerve and obturator nerve

femoral nerve - cutaneous and muscular branches serve anterior hip and thigh areas

obturator nerve - cutaneous and muscular branches serve medial thigh areas

Lumbar Plexus

L3 and L4 give rise to what nerve and what does it serve?

Saphenous nerve

terminal branch of ?

Saphenous nerve

located in?

Saphenous vein

supplies what area?

Saphenous nerve

Branches?

knee joint

subsartorial plexus

patellar plexus

rectus femoris m

vastus lateralis m

vastus medialis m

vastus intermedius m

rectus femoris m

gracilis m

sartorius m

Borders of Femoral Triangle

Lateral

Borders of Femoral Triangle

Medial

Borders of Femoral Triangle

Superior

Borders of Femoral Triangle

Roof

fascia lata

cribiform fascia

skin

Borders of Femoral Triangle

Floor

iliopsoas m

pectineus m

adductor longus m

lateral femoral cutaneous nerve

femoral nerve

profundus femoral artery and 2 branches (medial and lateral circumflex arteries)

femoral branch of genitofemoral nerve

femoral artery

femoral vein

lymph nodes

femoral canal

Lateral femoral cutaneous nerve

supplies?

femoral nerve (N)

femoral artery (A)

femoral vein (V)

femoral ring, femoral canal

"empty space w/ lymphatics" (EL)

NAVEL

lateral femoral circumflex artery

deep femoral artery

external iliac artery

medial femoral circumflex artery

subsartorial

Hunter's canal

Adductor Canal Boundaries

Medial

adductor longus

adductor magnus

Adductor Canal Boundaries

Lateral

Adductor Canal Boundaries

Anterior

sartorius m

subsartorial fascia

femoral artery

femoral vein

saphenous nerve

nerve to vastus medialis

lymphatic vessels

femoral artery → popliteal artery

femoral vein ← popliteal vein

lymphatic vessels

femoral nerve

location

within femoral triangle

outaside femoral sheath

lateral to femoral vessels

thick lateral portion of fascia lata

insertion for gluteus maximus and tensor fasciae latae m.

stabilizes knee in extension

fat

areolar connective tissue

lymph nodes

Iliacus M.

Origin

Iliacus M.

Insertion

Iliacus M.

Nerve

Iliacus M.

Action

iliacus

psoas major

sartorius

rectus femoris

vastus intermedialis

vastus lateralis

vastus intermedius

Psoas Major M.

Origin

Psoas Major M.

Insertion

Psoas Major M.

Nerve

Psoas Major M.

Action

Sartorius M.

Origin

Sartorius M.

Insertion

Sartorius M.

Nerve

Sartorius M.

Action

flexes abducts and rotates thigh laterally

flexes leg (Tailor's Position)

Rectus femoris M.

Origin

Anterior superior iliac spine

superior rim of acetabulum

Rectus femoris M.

Insertion

Rectus femoris M.

Nerve

Rectus femoris M.

Action

flexes thigh

extends knee

Vastus medialis M.

Origin

Vastus medialis M.

Insertion

Vastus medialis M.

Nerve

Vastus medialis M.

Action

Vastus lateralis M.

Origin

Vastus medialis M.

Insertion

Vastus medialis M.

Nerve

Vastus medialis M.

Action

Vastus lateralis M.

Origin

Vastus lateralis M.

Insertion

Vastus lateralis M.

Nerve

Vastus lateralis M.

Action

Vastus intermedius M.

Origin

Vastus intermedius M.

Insertion

Vastus intermedius M.

Nerve

Vastus intermedius M.

Action

weakness in adducton

lateral swinging of limb during walking b/c of unopposed abductors

Adductor longus M.

Origin

Adductor longus M.

Insertion

Adductor longus M.

Nerve

Adductor longus M.

Action

Adductor brevis M.

Origin

Adductor brevis M.

Insertion

Adductor brevis M.

Nerve

Adductor brevis M.

Action

Adductor magnus M.

Origin

Adductor magnus M.

Insertion

linea aspera

adductor tubercle

Adductor magnus M.

Nerves

obturator nerve

sciatic nerve

Adductor magnus M.

Action

Pectineus M.

Origin

Pectineus M.

Insertion

Pectineus M.

Nerve

obturator nerve

or

femoral nerve

Pectineus M.

Action

Gracilis M.

Origin

Gracilis M.

Insertion

Gracilis M.

Nerve

Gracilis M.

Action

Obturator externus

Origin

Obturator externus

Insertion

Obturator externus

Nerve