ADSL4 ws back UL SM1 2021 PDF

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adsl 4 worksheet...

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ANAT20006

Principles of Human Structure

Anatomy Directed Self Learning

ADSL4 Worksheet – Back and Upper Limb This worksheet should be used alongside the back, vertebral column and upper limb eLearning material provided on the LMS.

Intended learning outcomes Back and vertebral column Upper limb After you have completed the associated eLearning and this ADSL4 worksheet, check your learning with the ADSL4 Test in the LMS. This test has 10 multiple choice questions. Copyright Notice - Images in these pages have been provided to you pursuant to section 49 of the Copyright Act 1968 (the Act) for the purposes of research or study. The contents of the material may be subject to copyright protection under the Act. Further dealings by you with this material may be a copyright infringement. To determine whether such a communication would be an infringement, it is necessary to have regard to the criteria set out in Part 3, Division 3 of the Act.

Suggested resources – in addition to eLearning An@tomedia Online – Back and Upper Limb modules. Eizenberg, Briggs et al. Online via LMS or UniMelb library, with UniMelb login

Drake et al. (3e, 2014) Gray's Anatomy for Students, Elsevier, ISBN 9780702051319. Moore et al. (7e, 2013) Clinically Oriented Anatomy, LWW, ISBN 9781469830063. Morton et al. (2011) Big Picture: Gross Anatomy, McGraw-Hill. http://accessmedicine.mhmedical.com.ezp.lib.unimelb. edu.au/book.aspx?bookid=381

University of Melbourne

Anatomy & Neuroscience

Revised 2020-08 CC

ADSL Worksheet

2

#4 Back & Upper Limb

Back and vertebral column Label the vertebral column regions and curvatures:

At what age do the secondary curvatures typically become established? Explain these terms for spinal curvatures. Lordosis: Kyphosis: Scoliosis:

Label the components of this typical (lumbar) vertebra.

Adapted from Netter Atlas of Human Anatomy.

Within the vertebral canal are the spinal cord and cauda equina. Name the layers of the meninges, in order. University of Melbourne

Anatomy & Neuroscience

Revised 2020-08 CC

ADSL Worksheet

3

#4 Back & Upper Limb

What spaces are there between adjacent layers of meninges, and what do they contain? Vertebral canal contents In the image below, label: epidural space; dura mater; arachnoid mater; subarachnoid space; and extradural veins.

Image source: an@tomedia Online

List the structures that encircle an intervertebral foramen. What are the contents of an intervertebral foramen? Abnormalities in any of the encircling structures may make the foramen narrower and irritate or compress the contents. What are the likely consequences of this abnormality?

Vertebral joints Identify the parts of an intervertebral disc labelled 1 and 2 in the image below. Describe the composition and the role of each part.

Image source: an@tomedia Online

1. 2.

University of Melbourne

Anatomy & Neuroscience

Revised 2020-08 CC

ADSL Worksheet

4

#4 Back & Upper Limb

How does posture influence the forces on an intervertebral disc? What happens to the disc when a heavy load is lifted? What occurs in an intervertebral disc prolapse? What structures does intervertebral disc prolapse endanger? Synovial joints What posterior parts of a vertebra have articular surfaces? What is the name of these vertebral synovial joints? What is the orientation of facets in most thoracic vertebrae and thus what movements do they permit? What is the orientation of facets in most lumbar vertebrae, and what movements do they permit? An overview of back muscles Extrinsic back muscles are superficial. Intrinsic muscles are deep. Two groups of intrinsic back muscles are the erector spinae muscles and transversospinales muscles. When you bend over to pick up an object, which part of this action involves mainly concentric contractions of the erector spinae muscles and which requires eccentric contractions?

What is the primary function of the transversospinales mucles?

University of Melbourne

Anatomy & Neuroscience

Revised 2020-08 CC

ADSL Worksheet

#4 Back & Upper Limb

5

Upper limb Basic organisation of the upper limb Name the principal long bone of the upper limb: What types of joints are immediately proximal and distal to this bone?

Name the paired long bones of the upper limb: What movements occur between them, and at which joints do the movements take place? Upper limb bud development (ADSL3 revision) Does the upper limb rotation bring the pre-axial border to the radial or ulnar side? Does the post-axial border contain the more rostral or more caudal dermatomes? How does rotation of the developing limb affect the location of upper limb muscle compartments? Upper limb skeleton Label these landmarks Shoulder girdle 1. Spine of scapula 2. Glenoid fossa/cavity 3. Acromion process 4. Acromioclavicular joint 5. Sternal end of clavicle Humerus 6. Head of humerus 7. Anatomical neck of humerus 8. Surgical neck of humerus 9. Medial epicondyle 10. Trochlea Radius, ulna, hand 11. Olecranon process of ulna 12. Head of radius 13. Radial tuberosity 14. Scaphoid bone 15. 1st metacarpal

Name two vulnerable sites (bones) where a fracture often occurs with a fall on the outstretched hand.

Upper limb joints Indicate on the image above where the sternoclavicular joint would be if the sternum were shown. University of Melbourne

Anatomy & Neuroscience

Revised 2020-08 CC

ADSL Worksheet

6

#4 Back & Upper Limb

What movements of the clavicle occur at this joint? What are the features of articular surfaces in the gleno-humeral joint that permit a great range of motion? ADSL2 emphasised that synovial joints represent a trade-off between stability and mobility. What structures are responsible for stability at the shoulder joint? In what direction does the shoulder tend to dislocate? What structure does this endanger? The elbow joint is a hinge joint Label the articular surfaces of the elbow and the epicondyles. Label the proximal radioulnar joint.

Netter Atlas of Human Anatomy.

What types of ligaments are associated with hinge joints? What are the attachments of these ligaments at the elbow? What is the relationship between the proximal radioulnar joint and the elbow joint? Joints in the hand On the images below, label: the mid-carpal joint; a metacarpal bone; 3 phalanges in one finger; the more distal synovial joints.

Image source: an@tomedia Online

What movements occur at the interphalangeal joints? The carpometacarpal (CMC) joint of the thumb is a saddle joint, and this is important for opposition of the thumb. What movements occur at this joint, and how do they differ from movements at the other CMC joints? University of Melbourne

Anatomy & Neuroscience

Revised 2020-08 CC

ADSL Worksheet

7

#4 Back & Upper Limb

Integrated limb movement question: When you grasp a small food item and bring it up to your mouth, what combinations of movements at your upper limb joints enable this? Muscles from thorax and back

An@tomedia online - Back > Dissection > frame 8

Identify muscle 1 in the image above. Muscle 2 in the image above attaches distally to the humerus. Which muscle is it? Structure 3 is one of a series of segmental structures, what is it? ‘RhMa’ is the rhomboid major muscle which retracts the scapula. Which of these muscles is used to shrug your shoulders? Which muscle extends the shoulder (e.g. pulling on a rope)? What are the actions of the pectoralis major muscle? List several activities that depend on pectoralis major muscle: Shoulder and arm Scapular muscles include the deltoid and teres major muscles. List the individual rotator cuf muscles. What is the functional role of the rotator cuff muscles? What is the prime mover action of supraspinatus and deltoid? Arm muscles act at the elbow and consist of opposing flexor and extensor compartments. Name the muscles in the anterior compartment of the arm. Name the major muscle of the posterior compartment of the arm. University of Melbourne

Anatomy & Neuroscience

Revised 2020-08 CC

ADSL Worksheet

8

#4 Back & Upper Limb

Forearm muscle compartments A number of anterior compartment muscles share the common flexor origin (CFO), where is this attachment? The anterior forearm compartment has three layers. All muscles in the superficial layer originate from the CFO, while none of the deep layer muscles use the CFO. Identify the three flexor muscles in the image below. What layer are they in?

The posterior forearm compartment has a superficial layer of muscles that arise from the common extensor origin (CEO), where is this? The posterior deep forearm muscles do not come from the CEO. Upper limb muscles List the main action of each of the following muscles.  Serratus anterior:  Levator scapulae:  Supraspinatus:  Triceps brachii:  Extensor carpi radialis:  Extensor pollicis longus:  Flexor digitorum superficialis: Hand anatomy What is the flexor retinaculum? Name two structures that pass deep to the flexor retinaculum, and two that pass superficial to it. Which structure passing through the carpal tunnel is most susceptible to compression injury? What do the terms thenar eminence and hypothenar eminence refer to? From the anatomical position, finger flexion is an anterior movement of the fingertip. If instead the thumb moves anteriorly, is this flexion or abduction? Nerves of the upper limb The image below is an anterior view of the right brachial plexus. University of Melbourne

Anatomy & Neuroscience

Revised 2020-08 CC

ADSL Worksheet

9

#4 Back & Upper Limb

Image source: An@tomedia Online > Upper Limbs > Systems

Label the nerve roots (near the spinal cord). Label upper, middle and lower trunks. Label the 3 posterior and 3 anterior divisions. Label the lateral, posterior and medial cords. Label the 5 terminal branches (each marked with an asterix). 

Posterior cord divides into axillary nerve and radial nerve (larger).



Musculocutaneous nerve is a continuation of the lateral cord.



Ulnar nerve is a continuation of the medial cord.



Median nerve comes from both lateral and medial cords.

Name the nerve supply for each of these muscles.  Deltoid:  Biceps brachii:  Flexor carpi radialis:  Triceps brachii:  Extensor carpi ulnaris:  Small hand muscles that abduct or adduct fingers: On the image below, map the cutaneous distributions of the median, ulnar and radial nerves in the hand. Describe why these regions are not the same as dermatomes.

University of Melbourne

Anatomy & Neuroscience

Revised 2020-08 CC

ADSL Worksheet

10

#4 Back & Upper Limb

On the image below, label dermatomes C4, C5, C6, C7, C8, T1, and T2.

Why do the dermatomes on the anterior thorax ‘jump’ from C4 to T2?

University of Melbourne

Anatomy & Neuroscience

Revised 2020-08 CC

ADSL Worksheet

11

#4 Back & Upper Limb

Vessels of the upper limb Label the major blood vessels in the upper limb images below.

Adapted from McKinnon & Morris (1986) Oxford Textbook of Functional Anatomy.

What are venae comitantes, and what do they typically accompany?

Why is the brachial artery the usual location for blood pressure measurement?

University of Melbourne

Anatomy & Neuroscience

Revised 2020-08 CC...