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Pectoralis Major Sternum; Clavicle to Humerus Intertubercular Groove; gr tubercle of intertub sulcus
Pectoralis Minor Anterior Ribs to Coracoid Process
Serratus Anterior Ribs to Scapula Medial Border
Trapezius External Occipital Protuberance; Thoracic Spinous Processes to Clavicle; Acromion Process; Scapular Spine
Rhomboid Major Thoracic Spinous Processes to Scapula Medial Border
Rhomboid Minor Cervical Spinous Processes to Scapula Medial Border
Levator Scapulae Cervical Transverse Processes to Superior Medial Scapula
Latissimus dorsi Thoracic/Lumbar Vertebrae; Ribs; Iliac Crest to Humerus Intertubercular (biceps) Groove (ant side of humerus)
Deltoid Clavicle; Scapular Spine; Acromion Process to Humerus Deltoid Tuberosity
Subscapularis Scapula Medial Border; subscapular fossa to Anterior Proximal Lesser Tubercle of Humerus
Teres Minor Superior lateral Scapula to Post Proximal (inf facet) Gr Tubercle of Humerus
Infraspinatus Scapula Medial Border; infraspinous fossa to Post Proximal (middle facet) Gr Tubercle of Humerus
Supraspinatus Scapula Medial Border; supraspinous fossa to Proximal Surface/ (sup facet) Gr Tubercle of Humerus
Teres Major Posterior Inferior Angle Scapula to Medial Proximal Humerus; lesser tubercle of humerus
Biceps brachii (long head) Glenoid Cavity (supraglenoid tub of scap) to Radial Tuberosity/ bicipital aponeurosis
Biceps Brachii (short head) Coracoid Process to Radial Tuberosity/ bicipital aponeurosis
Coracobrachialis Coracoid Process to middle medial shaft of humerus
Brachialis Anterior Distal Humerus to Ulna Coronoid Process and Tuberosity
Triceps Brachii (long head) Scapula/Glenoid Cavity (infraglenoid tub) to Ulna Olecranon Process
Triceps Brachii (Lateral Head) Posterior Proximal Humerus to Ulna Olecranon Process
Triceps Brachii (Medial Head) Posterior Shaft of Humerus to Ulna Olecranon Process
Pronator Teres Medial Epicondyle of Humerus; Coronoid Process of Ulna to Lateral Shaft of Radius
Flexor Carpi Radialis Medial Epicondyle of Humerus to Base of Metacarpals 2-3
Palmaris Longus Medial Epicondyle of Humerus to Base of Carpals/ palmar aponeurosis & distal flexor retinaculum
Flexor Carpi Ulnaris Medial Epicondyle of Humerus; olecranon, posterior ulna to Pisiform, Hamate, Metacarpal 5
Flexor digitorum superficialis Medial Epicondyle of Humerus; coronoid; superior ant radius to middle phalanges of 2-5
Flexor Digitorum Profundus Proximal 3/4 of medial/ ant ulna & interosseous membrane to Distal Phalanges 2-5
Flexor pollicis longus Ant radius & interosseous membrane to distal phalanx of 1
Pronator quadratus Distal 1/4 of ant ulna to Distal 1/4 of ant radius
Brachioradialis Proximal lateral supraepicondylar ridge of Humerus to Lateral distal radius; styloid process
Extensor carpi radialis longus Lateral supraepicondylar ridge of Humerus to Base of Metacarpal 2
Extensor carpi radialis brevis Lateral Epicondyle of Humerus to Base of Metacarpal 3
Extensor Carpi Ulnaris Lateral Epicondyle of Humerus; Posterior Shaft of Ulna to Base of Metacarpal 5
Extensor Digitorum Lateral Epicondyle of Humerus to Dorsal Surfaces of (distal & middle) Phalanges 2-5
Extensor digiti minimi Lateral Epicondyle of Humerus to extensor expansion of digit 5
Extensor indicis Posterior ulna & interosseous membrane to extensor hood of digit 2
Extensor pollicis longus Posterior surface of middle of ulna and interosseous membrane to Distal phalanx of thumb
Extensor pollicis brevis Posterior surface of radius & interosseous membrane to Proximal phalanx of thumb
Abductor pollicis longus Posterior surface of radius & ulna & interosseous membrane to First metacarpal
Supinator Lateral Epicondyle of Humerus; radial notch & crest of Ulna to Proximal 1/3 of Radius
Abductor digiti minimi Pisiform to Medial proximal digit 5
Flexor digiti minimi brevis Hamate & flexor retinaculum to medial border of metacarpal 5
Opponens digiti minimi Hamate & flexor retinaculum to medial border of metacarpal 5
Adductor pollicis MCP 2-3, capitate; ant MCP 3 to Medial proximal thumb
Lumbricals 1-2 lateral 2 tendons of FDP to extensor hoods of 2-5
Lumbricals 3-4 Medial 3 tendons of FDP to extensor hoods of 2-5
Palmar interossei Palmar surface of MCPs 2, 4, & 5 to extensor hoods & proximal phalanges of 2, 4, & 5
Dorsal interossei Adj sides of 2 MCPs to extensor hoods & proximal 2-4
Types of synovial joints Hinge, Pivot, Condylar, Planar (gliding) joint, Ball and socket joint
Synovial joints: lined by: hyaline cartilage
Synovial joints: Enclosed by: joint capsule containing synovial fluid
Hinge joint: movement Flexion and extension only (e.g., elbow)
Pivot joint: movement Rotation only (e.g., atlanto-axial joint)
Condylar joint: movement Movement around two axes (flex/exten, abduct/adduct) (e.g., wrist)
Saddle joint can be considered a special type of _____ joint condylar joint (e.g., thumb)
Planar (gliding) joint: movement Limited movement around multiple axes (e.g., joints between tarsals)
Ball and socket joint: movement Movement around multiple axes (e.g., hip joint)
Function of rotator cuff muscles Stabilize glenoid joint; action of a single mx may act to adduct/ abduct or medially/laterally rotate GH joint
Rotator cuff disorders = Impingement or tendinopathy (including avascular necrosis)
Mx most commonly involved in rotator cuff disorders Supraspinatus
Supraspinatus involvement in rotator cuff disorders (MOA) Constriction by acromion process and clavicle
Rotator cuff disorders: after initial trauma: trauma is more likely to reoccur
Non-synovial (e.g. solid) joints Lack a joint capsule; elements linked via fibrous conn tissue or cartilage; very little movement at these joints
Examples of non-synovial joints Sutures (btw cranial bones); Syndesmoses (inteross membrane); Symphyses (pubic symphysis, intervert discs)
Muscles acting across a particular joint result in: movement at that joint
Soft tissue structures in the joint help to: increase congruence of the bony components of a joint & decrease stress (=force/area) at a joint
Movements of the shoulder Retraction/ protraction; Abduction/ adduction; Flexion/ extension; Medial/ lateral rotation; Circumduction
Movements of the Elbow/ Forearm Flexion/ extension; Pronation/ supination
Movements of the Wrist Flexion/ extension; Abduction (radial deviation) / adduction (ulnar deviation)
Movements of the MP joints Flexion/ extension; Abduction/ adduction
Movements of the IP joints Flexion/ extension
Components of upper arm Ant compartmt; Post compartmt; Deep fascia; Intermuscular septa
Components of forearm Ant compartmt; Post compartmt; Deep fascia; Inteross membrane; Intermuscular septa
Superficial veins of arm Cephalic; Basilic; Median cubital vein
Superficial veins of arm: variable anatomy Median cubital may be replaced by median antebrachial vein
Arm lymphatics follow: venous system
Superficial lymphatic drainage along cephalic vein: deltopectoral and axillary nodes
Superficial drainage along basilic vein: cubital and axillary nodes
Deep drainage along axillary vein: axillary nodes
3 bones of shoulder: Clavicle, Scapula, Humerus
3 Joints of shoulder Sternoclavicular (SC); Acromioclavicular (AC); Glenohumeral (GH)
Ligament of SC joint: Sternoclavicular ligament
Ligament of AC joint: Acromioclavicular ligament
Ligaments anchoring the clavicle to the coracoid Coracoclavicular ligament
Clavicular dislocation Can occur at SC or AC joints
GHJ: joint congruence increased by: Glenoid labrum
GHJ: friction at joint reduced by: Bursa or synovial sheaths
GHJ dislocation: likelihood increased by: Shallowness of GHJ
GHJ dislocation: can impinge on: nerves of brachial plexus or axillary a.
Bursitis = Inflammation of the bursal sacs
Lesion of the long thoracic n. nerve causes: winged scapula
Axilla: Anterior wall = Pectoralis major/minor
Axilla: Posterior wall = Subscapularis, teres major, latissimus dorsi
Axilla: Medial wall = Upper thoracic wall, serratus anterior
Axilla: Lateral wall = Intertubercular sulcus of humerus
Axilla: Contents Axillary a./v.; Brachial plexus
Axillary artery: continuous proximally with: subclavian a.
Axillary artery: Name changes after passing: clavicle and teres major m.
Axillary artery: continuous distally with: brachial a.
Axillary a. gives off multiple branches to: ant & post walls of axilla, & intrinsic shoulder mxs
Circumflex humeral arteries (ant & post): route Wrap around surgical neck of humerus
Circumflex humeral arteries: potentially damaged in: fracture or dislocation
Brachial artery: gives off: deep a. of arm (profunda brachii)
Brachial a.: runs in: radial groove
Brachial a.: susceptible to: injury with humeral fractures
Brachial a.: splits in cubital fossa into: radial and ulnar arteries
Brachial a.: used for: BP measurements; hemorrhage control
Axillary vein: follows: path & branches of axillary a.
Axillary vein: receives drainage from: superficial veins
Brachial plexus = ventral rami of: C5, C6, C7, C8, T1
Brachial plexus: medial to lateral can be separated into: Roots, Trunks, Divisions, Cords, Branches
Cords of brachial plexus: named for: their position relative to axillary artery
Musculocutaneous nerve: Motor muscles of anterior arm
Musculocutaneous nerve: Sensory terminates as lateral cutaneous n. of forearm
Median nerve: Motor: most muscles of theanterior forearm, some intrinsic muscles of the hand
Median nerve: Sensory: some skin of hand
Carpal tunnel syndrome is associated with which nerve? median nerve
Ulnar nerve: Motor: 1-1/2 muscles in anterior forearm, most intrinsic muscles of hand
Ulnar nerve: Sensory: some skin of hand
Radial nerve: Motor: all muscles of posterior arm and forearm
Radial nerve: Sensory: skin of posterior arm, forearm, and hand
Susceptible to damage with fractures of humerus (wrist drop) radial nerve
Actions of elbow joint Flexion/ extension (humerus- ulna); Pronation/ supination (ulna-radius)
Elbow joint: Ligaments Collateral ligaments (Radial (lateral), Ulnar (medial)); Annular ligament of radius
Nursemaids elbow: MOA Dislocation of proximal radius out of annular ligament (dislocates laterally)
Movement at a joint is determined by: its bony components, anatomy of the fibrous capsule surrounding the joint, & the position of muscles relative to ctr of rotation of the joint
Clavicular fracture Usually middle 1/3 of clavicle; SCM pulls medial clavicle superiorly; very common in children or young adults
GHJ: Bursa or synovial sheaths Subtendinous bursa of subscapularis; Subacromial bursa; Synovial sheath around long head of biceps brachii
Created by: Abarnard
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