11. If there were a rotator cuff tear of a tendon where would a surgical incision be made? A&M pg 423 Blue Box, 477 Blue Box
Rotator cuff repairs are done in may fashions. The most common surgical incision is
at an ______1____ angle at the _____2___ (lateral) to avoid damaging the
__3____ muscle, then deep to the subacromial bursa the tendon of the
______4______ then is attached to the superior facet of the _______ _______of the humerus.
1 oblique
2 acromion
3 deltoid
4 supraspinatus
greater tubercle
13. Flexor muscles of the forearm originate from what bony marking? A&M pg 442-451 (See question 12)
Common Flexor Tendon on the ______ _________ of the Humerus
Medial
Epicondyle
Extensor muscles of the forearm originate from what bony marking?
A&M pg 442-451 (See question 12) Common Extensor Tendon on the
_______ __________ of the Humerus
Lateral Epicondyle
16. What muscle aids in protecting the subclavian vessels and the superior trunk of the brachial plexus if the clavicle fractures? Not a major muscle. A&M pg 418-419
Subclavius
17. The thumb movement(s) is the most complex. Be able to
identify each of these movements. A&M pg 462
Opposition is the most complexSee Figure 6.26 Thumb Movement page 462
18. Which muscles are identified as the: a. Posterior axioappendicular (superficial) A&M pg 418-420
Superficial posterior axioappendicular (extrinsic shoulder) muscles: trapezius and latissimus dorsi
18. Which muscles are identified as the: b.(deep) Posterior axioappendicular A&M pg 418-420
axioappendicular (extrinsic shoulder) muscles: levator scapulae and Rhomboid
18. Which muscles are identified as the Scapulohumeral?
Scapulohumeral (intrinsic shoulder) muscles: deltoid, teres major, and the four rotator cuff muscles (supraspinatus, infraspinatus, teres minor, and subscapularis)
20. Where in the upper limb can a pulse be taken? Identify the vessel and the location. A&M pg 439 Blue Box
21. Of the blood vessels branching from the aortic arch what is the blood supply to the right and the left upper limb? How do they differ? A&M pg 23, 84 Aortic Arch: __________ truck will give rise to the _________ Common Carotid Artery as well as the _______ Subclavian; the Aortic Arch then gives rise to the _______ Common Carotid Artery and _______ Subclavian Artery
Brachiocephalic
right
right
left
left
22. The deep veins run in pairs and are called what? A&M pg 27
Vena Comitantes
23. Be able to identify and trace the superficial blood drainage of the upper limb back to the heart. A&M pg 97, 416-417, 456See Figure 6.9 page 417 (keep it simple)
24. ________ artery in the arm is compressed while a stethoscope is placed over the
________ _______when taking a blood pressure? A&M pg 439 Blue Box
Brachial
cubital fossa
25. Where would you place a tourniquet to obtain a bloodless surgical field to treat an extensive hand injury? Remember collateral circulation! A&M pg 426-428, 464 Figure 6.28, 465 Table 6.12, 462-465
Band the wrist or higher on the forearm
26. In a fracture of the hand which of the carpal bones or part of a carpal bone has a poor blood
supply and may not heal but becomes necrotic and dies? A&M pg 409
Blue Box, 485 Blue Box (see question 6)
Scaphoid
28. _____________: unilateral area of skin innervated by the general sensory fibers of a single spinal nerve
Significant due to?
Dermatome
dermatome mapping, understanding embryological development and overlapping of sensory and motor.
29. What would be the problem with the upper limb if the following nerves were damaged? Take each nerve independently. Give motor only.(see question 27) A&M pg 434-435 blue box, 441, 441 Blue Box, 467-468 Blue Box
radial?
if there was a problem in the uper limb and this _______ nerve was damaged you would have Wrist Drop
29. What would be the problem with the upper limb if the following
nerves were damaged? Take each nerve independently. Give motor
only.(see question 27) A&M pg 434-435 blue box, 441, 441 Blue Box,
467-468 Blue Box
ulnar
if there was a problem in the uper limb and this _______ nerve was damaged you would have claw hand
29. What would be the problem with the upper limb if the following
nerves were damaged? Take each nerve independently. Give motor
only.(see question 27) A&M pg 434-435 blue box, 441, 441 Blue Box,
467-468 Blue Box
Musculocutaneous
damaged _____________ nerve Reduces flexion of the elbow and supination of forearm
29.
_____1____ Nerve Atrophy of the ___2______ occurs when the __3______ nerve
(C5 and C6) is severely damaged (e.g., as might occur when the surgical
neck of the humerus is fractured). As the __4____ atrophies, the
rounded contour of the shoulder disappears. This gives the shoulder a
flattened appearance and produces a slight hollow inferior to the
acromion. A loss of sensation may occur over the lateral side of the
proximal part of the arm, the area supplied by the _______ _______ 5 __________ nerve of the arm. To test the _6_______ (or the function of the __7_____ nerve) the arm is abducted, against resistance, starting from
approximately 15°
1axillary
2 deltoid
3axillary
4 deltoid
5 superior lateral cutaneous
6 deltoid
7 axillary
__________ 2 points of fixation of nerve are at its origin from upper trunk & at ________ ______, where it is susceptible to traction injury;
- it is fixed at its origin from C-5 or upper trunk of brachial plexus and at its termination in _____________;
1 Suprascapular
2 s. notch
3 infraspinitus
29.- compression at the 1 (______ _____ notch): - may be compressed by either
the 2 ___________ ligament or a cyst (arising from the shoulder joint)
which results in paralysis of 3 ___________ and 4_____________;
-
1 suprascapular notch
2 suprascapular
3 supraspinatus
4 infraspinatus
Suprascapular compression at the notch: - may be compressed by either the Suprascapular ligament or a cyst (arising from the shoulder joint) which results in paralysis of __________ and __________; - following blunt trauma, the ligament may calcify (causing compression; compression at the level of the ____________ notch.
supraspinatus
infraspinatus
supraspinatus
compression at the level of the supraspinatus notch would be expected to affect both the _______________ and __________
supraspinatus and infraspinatus
terminal branch Musculocutaneous: muscles of anterior compartment of _____, _____ lateral aspect.
ARM, SKIN
_________ NERVE Muscles of anterior forearm compartment (except for FCU and
Ulnar half of FDP), palmer skin and 5 intrinsic muscles of the thenar ½
of palm.
MEDIAN
________ FCU and the ______ ½ of the FDP, most intrinsic musclesof the hand, skin of hand (medial to axial line of digit 4).
ULNAR
__________ ARTERY : Glenohumeral joint, teres minor, deltoid, skin of
superolateral arm(over inferior part of deltoid).
Axillary
_________ NERVE: All muscles of posterior compartments of arm and forearm, skin of posterior and infro lateralarm/posterior forarm/dorsum of hand (lateral to axial line of digit 4).
Radial:
30. Where would you apply pressure to the upper limb to disable each of the five branches of the brachial plexus? A&M pg 429-435, 430-431 Table 6.5, 441, Lab Manual (see questions 29 and 27)
Other possible approaches: interscalene, supraclavicular
Brachial Plexus Block: axillary.
31. ___________ is the loss of cutaneous sensation
Anesthesia
___________ loss of muscular movement
1.)________: non movement detected
2.) __________: not all musclesare paralyzed, person can move, but movements are weak
Paralysis
Complete
incomplete
32. The median nerve is _________(position) to the axillary artery
Lateral
33. The carpal tunnel becomes inflamed due to _________ or over use.
lession
33. The ___________ nerve is the most sensitive structure in the carpal tunnel.
medial
when someone suffers from Carpal Tunnel sufferers are unable to ________ thumb.
oppose
34. characteristic clinical sign of radial nerve injury is ______ ________
wrist drop
35. Know how lymph channels (also called: Lymphatic vessles or Lymphatics) travel in the upper limb by way of the _________ (________ _________)
Veins (vena comitantes)
36. Know what palmer aponeurosis, ligaments, tendons and soft tissue are for in the upper limb to Support: keeps ________ in place
tendons
9.the anatomical and/or clinical significance of the Intertubercular groove _____________ muscle pass through it
Long Head of the Biceps Brachii
e Deltoid tuberosity is the Attachment for _________, relationship to radial groove for _________ nerve to pass
Deltoid
radial
the anatomical and/or clinical significance of the _________ ____________ of _________
:Bony apposition, larger: can be palpated: radial artery winds around __________ aspect, cephalic vein relationship, radial artery
styolid process of the radial
lateral
the anatomical and/or clinical significance of the the ________ nerve is superficial (medial) to the olecranon process
ulner
the anatomical and/or clinical significance of the the ulnar nerve is superficial (medial) to the _________ ___________
olecranon process
The _________ tendon tears most often causing degenerative tendonitis of the _________ __________.
supraspinatus
rotator cuff
_______ muscle group are in anterior forarm
Flexor
Extensor muscles of the forarm are located on the _____________ side
Posterior
_________ & ________ muscles of the forearm are in the anterior compartment and are served mainly by the ________ nerve the one and and expectaions are innervated by the ulnar nerve.
flexor pronator
median
flexor muscles of the forearm are arranged in three layers: (anterior)
a _____________ layer or (group of 4 muscles): pronator teres, f. carpi rad., palmaris longus, and f. carpi ulnaris. They are all attached promiximally by the _________ _________ tendon to the medial epicondyle of the humerus, the _______ _______ origin.
superficial
common flexor
common flexor
flexor muscles of the forearm are arranged in three layers
the intermediate layer or group, consists of one muscle, the __________ __________ _________
flexor digitorm superficialis
flexor muscles a of the forearm are arranged in three layers:
_________ layer or group of 3 muscles, flexor digitrum profundus, flexor pollis longus, and pronator quadratus
deep
what layers or group of flexor muscles of the forearm cross the elbow joint
E.
functionally the ______________ is a flexor of the forearm, but it is located in the posterior (posterolateral) or extensor compartment and is thus supplied by the RADIAL nerve.
therefore it is a major expection to the generalization that the RADIAL NERVE supplies only __________ muscles and that all flexors lie in the anterior compartment.
brachioradialis
extenser
long flexors of the digits, flexor dig. superficialis and flexor digitorum profundus flex the forearm and the metacarpophalangeal and ______ joints. the fdp flexes fingers in ____ action
wrist
slow
Muscles that are in the _________ (________- supinator) Compartment of the Forearm can be put in to three groups
1. muscles that extend and _________ or _______ the hand at the wrist joint, ext. carpi radialis longus, ext carpi radialis brevis, and ext carpi ulnaris
posterior
extensor
abduct
adduct
Muscles that are in the ___________ ( extensor-__________ ) Compartment of the Forearm can be put in to three groups
2.muscles that extend the ________ 4 digits, extensor (digitorum, indicis, and dgiti minimi)
posterior
supinator
medial
Muscles that are in the posterior (extensor- supinator) Compartment of the _________ can be put in to three groups
3.muscles that _________ and _________ the thumb, (extensor pollicis longus, extensor pollicis brevis, and extensor pollicis longis.)
forearm
extend
abduct
intrensic muscles of the hand are located in 5 compartments.
1. thenar-adductor brevis, flexor pollicis brevis, and ___________ pollicis
opponens
___________ muscles of the hand are located in 5 compartments. thenar, hypothenar, adductor, central, and the interosseous compartments.
intrinsic
intrensic muscles of the hand are located in 5 compartments.
________-abductor pollicis brevis, flexor pollicis brevis, and ___________ pollicis
thenar
opponens
intrensic muscles of the hand are located in 5 compartments.
__________-abductor digiti minimi, ________ digiti minimi brevis, and opponens digiti minimi
hypothenar
intrensic muscles of the hand are located in 5 compartments.
______________ compartment is where the adductor pollicis is located
adductor
intrensic muscles of the hand are located in 5 compartments.
_______ comparment has the short muscles of the hand, the lumbricals, with the long flexor tendons
central
intrensic muscles of the hand are located in 5 compartments.
_______ comparment has the __________ muscle inbetween the metacarples
interosseous
interosseous
thenar muscles form the thenar eminence on the lateral surface of palm and are chiefly responible for _________ of the ________
opposition
thump
high degree of freedom of movements of the them result from the 1st meticarpl being independent, with mobile joints at both ends, what are the 5 movements
1.
2.
3.
4.
5
1 abduction
2 adduction
3 extention
4. flextion
5. opposition
the two muscles that abduct the thumb is (thenar)
ABDUCTION ________ _________
ABDUCTION _________ __________
pollicis brevis
pollicis longus
the two muscles that adduct the thumb is (thenar)
ADDUCTION ________
1st _________ __________
pollicis
1st dorsal interosseous
the 2 muscles that flex the thumb is (thenar)
FLEXOR ________ _________
FLEXOR _________ __________
Pollicis longus
pollicis brevis
the three muscles that extend the thumb are (thenar)
extensor _______ _________
extensor _________ __________
abductor ________ _________
pollicis longus
pollicis brevis
pollicis longus
____1______ occurs at the carpometacarpal joint of the thumb, this complex movement of ____1_____ begins with the them in the extended position and initialy invloves abduction and medial rotation of the 1st metacarpal (cupping of the palm), which is prodcues the by the actions of the ___2_____ pollicis and then flextion at the metacarpophalangeal joint.
1 is same
1 opposition
2 opponens
the reinforcming action of the adductor pollicis and flexor pollicis longus increases the pressure that the opposed thumb can exert on the _________ tips.
finger
______1_______ forms the _____1______ eminence on the medial side of the palm
1 hypothenar
the palmar brevis is a small muscle that is in the __________ tissue of the hypoothenar eminence, not the compartment.
subcutaneous
the ___1_____ brevis aids in the palmer grip and protects the ulnar nerve and artery. it is attached proximally to the ____2___ border of the palmer aponeurosis and the skin on the _____2____ border of the hand.
1 palmaris
2 medial
the two short hand muscles are the _________ and the ________
lumbricals and interossei are the _________ hand muscles
the ____________ (named after latin earthworm) flex the fingers athat the metacarphalangeal joints and extend the interphalangeal joints.
lumbricus
the four dorsal _____________ muscles (doral interossei) are located between the __________
interosseous
metacarpals
the 3 palmar interosseus muscles are on the palmar surfaces of the (_#_), (_#_),(_#_) metacarpals
2nd
4th
5th
_ out of the 4 arm muscles are flexors are in the _________ flexor compartment of arm.