VIVA Notes PDF

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Notes used to study for the viva test - human anatomy 100...

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VIVA NOTES SHOULDER/UPPER LIMB STRUCTURE Sternoclavicular joint

FUNCTION - Allows movement of the clavicle in three planes, predominantly in the anteroposterior and vertical planes, although some rotation also occurs e.g. elevation and depression

Acromioclavicular joint

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Acromion process

Provides the ability to raise the arms over the head. Gliding, or plane style synovial joint

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It is an important landmark of the skeletal system and a muscle attachment point essential to the function of the shoulder joint.

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Deltoid and trapezius attach to acromion process

Coracoid process

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Stabilizes the shoulder joint.

Inferior angle of scapula

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Covered by the latissimus dorsi muscle. It moves forwards round the chest when the arm is abducted. The inferior angle is formed by the union of the medial and lateral borders of the scapula.

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HOW TO LOCATE IT? - Palpate these on the superior lateral edges of the manubrium (on sternum). - Between clavicle (collar bones) and manubrium of sternum. - These joints are synovial and have a disc inside the joint. - Located at the top of the shoulder. - It is the junction between the acromion (part of the scapula that forms highest part of shoulder) and the clavicle. - It is a synovial joint. - the acromion (highest point on shoulder) process (a projection that extends off of a larger mass of bone tissue) is a bony process on the scapula (shoulder blade). - Together with the coracoid process it extends laterally over the shoulder joint. - The acromion is a continuation of the scapular spine, and hooks over anteriorly. - The coracoid process is a small hook-like structure on the lateral edge of the superior anterior portion of the scapula. - Points laterally forward.

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The inferior angle of the scapula bone is located at the lowest point of the scapula.

Medial border of scapula

Spine of scapula

Borders of the axilla

The medial border of the scapula includes points of attachments of several major muscles of the upper body: - Serratus magnus - Supraspinatus & Infraspinatus - Levator anguli scapulae - Rhomboid minor/major - Separates the supraspinous fossa (above the spine of scapula) from the infraspinous fossa (below the spine of scapula). -

Gives origin to part of supraspinatus and infraspinatus muscles.

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Contains: Axillary artery (and branches) – the main artery supplying the upper limb. It is commonly referred as having three parts; one medial to the pectoralis minor, one posterior to pectoralis minor, and one lateral to pectoralis minor. The medial and posterior parts travel in the axilla. Axillary vein (and tributaries) – the main vein draining the upper limb, its two largest tributaries are the cephalic and basilic veins. Brachial plexus (and branches) – a collection of spinal nerves that form the peripheral nerves of the upper limb. Axillary lymph nodes – they filter lymphatic fluid that has drained from the upper limb and pectoral region. Axillary lymph node enlargement is a non-specific indicator of breast cancer. Biceps brachii (short head) and coracobrachialis – these muscle tendons move through the axilla, where they attach to the coracoid process of the scapula.

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the medial border of the scapula is the edge of the scapula bone located towards the middle of the body.

The spine of the scapula bone is a prominent projection that extends across the top of the dorsal surface of the scapula.

Located in the armpit Pyramid shape - Apex: also known as the axillary inlet, it is formed by lateral border of the first rib, superior border of scapula, and the posterior border of the clavicle. - Base - Anterior wall: contains the pectoralis major and the underlying pectoralis minor and the subclavius muscles. - Posterior wall: formed by the subscapularis, teres major and latissimus dorsi. - Medial wall: consists of the serratus anterior and the thoracic wall (ribs and intercostal muscles). - Lateral wall: formed by intertubercular groove of the humerus.

Deltoid - show action/s

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Trapezius – show action/s

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Greater tubercle of humerus

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Outline biceps, triceps - show action/s

anterior deltoid attaches at your collarbone and allows you to flex your shoulder joint and to rotate the shoulder inward. The middle deltoid and posterior deltoid attach at different parts of your shoulder blade. The middle deltoid allows you abduct your arm. postural and active movement muscle, used to tilt and turn the head and neck, shrug, steady the shoulders, and twist the arms The trapezius elevates, depresses, rotates, and retracts the scapula.

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The deltoid muscle is a rounded, triangular muscle located on the uppermost part of the arm and the top of the shoulder.

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extends from the occipital bone (located at the base of the skull) to the middle of the back. This muscle is divided into three parts or sections, which include: Upper section: Located at the back of the neck. Middle section: Located in the shoulders and upper back. located laterally on the humerus. It has an anterior and posterior face.

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The greater tubercle serves as attachment site for three of the rotator cuff muscles supraspinatus, infraspinatus and teres minor they attach to superior, middle and inferior facets respectively

Biceps: flexes forearm (elbow flexion) Triceps: - responsible for extension of the elbow joint (straightening of the arm).

Biceps: - two-headed muscle - biceps is also biceps brachii (Latin for "two-headed muscle of the arm"), - large muscle that lies on the front of the upper arm between the shoulder and the elbow Triceps: - also triceps brachii (Latin for "three-headed muscle of the arm") - a large muscle on the back of the upper limb of many vertebrates. - It connects the humerus (upper arm bone) and the scapula (shoulder blade) to the ulna (longest of the forearm bones)

Lateral and medial epicondyles of humerus

Cubital tunnel- what passes through between the medial epicondyle and the olecranon process, the ulnar nerve passes through

Medial epicondyle: - an epicondyle of the humerus bone of the upper arm in humans. - It is larger and more prominent than the lateral epicondyle and is directed slightly more posteriorly in the anatomical position - Striking the medial epicondyle causes a tingling sensation in the ulnar nerve. Lateral epicondyle: - gives attachment to the radial collateral ligament of the elbow joint, and to a tendon common to the origin of the supinator and some of the extensor muscles. - allows the ulnar nerve to pass through

Medial epicondyle: - located on the distal end of the humerus - funny bone Lateral epicondyle: - small, tuberculated eminence, curved a little forward - located laterally on the humerus

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Cubital fossa and boarders – what passes through

Cubital fossa border: - Lateral border – medial border of the brachioradialis muscle. - Medial border – lateral border of the pronator teres muscle. - Superior border – hypothetical line between the epicondyles of the humerus. Structures that pass through: - Brachial artery: supplies oxygenated blood to the forearm. - Brachial vein - Biceps tendon: attaches to the radial tuberosity. - Radial nerve: passes underneath. - Median nerve: leaves the cubital between the two heads of the pronator teres. It supplies the majority of the flexor muscles in the forearm.

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The cubital tunnel is a space of the dorsal medial elbow which allows passage of the ulnar nerve around the elbow. It is bordered medially by the medial epicondyle of the humerus, laterally by the olecranon process of the ulna and the tendinous arch joining the humeral and ulnar heads of the flexor carpi ulnaris.

Lies in front of the elbow (elbow pits) triangular area on the anterior view of the elbow of a human or other hominid animal. It lies anteriorly to the elbow when in standard anatomical position.

Olecranon process of ulna

Outline wrist flexors and extensors, show action

bony process - a hook-like structure that fits into the olecranon fossa of the humerus. - an attachment site for several muscle groups including the flexor carpi ulnaris and anconeus, the major muscle attachment is that of the triceps. - The triceps muscle inserts into the proximal ulna and posterior third of the olecranon. Wrist flexors: initiate flexion of the wrist. -

Wrist extensors: Initiate extension of wrist.

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bony prominence of the ulna that represents that bone’s most proximal posterior surface at the elbow. proximal and posterior ulna

Wrist flexors (6 muscles): - Flexor Carpi Radialis (FCR): superficial - Palmaris Longus (PL): superficial - Flexor Carpi Ulnaris (FCU): superficial - Flexor Digitorum Superficialis (FDS): middle layer - Flexor Digitorum Profundus (FDP): deep - Flexor Pollicis Longus (FPL): deep ** All located in the anterior compartment of the forearm Wrist extensors (9 muscles): - Extensor carpi radialis longus (ECRL): superficial - Extensor carpi radialis brevis (ECRB): superficial - Extensor digitorum (ED) - Extensor digiti minimi (EDM) - Extensor carpi ulnaris (ECU): superficial - Extensor indicis (EI) - Extensor pollicis longus (EPL) - Extensor pollicis brevis (EPB) - Abductor pollicis longus (APL) **all belong to the posterior compartment of the forearm

Outline finger flexors and extensors,

Finger flexors: flex fingers

Finger flexors:

show action/s

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Finger extensors: extend the fingers (2, 3, 4, 5 and not the thumb) Thumb extensors: extend thumb

Head of ulna

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Flexor digitorum superficialis - Flexor digitorum profundus - Flexor policis longus Finger extensors - Extensor digitorum Thumb extensors: - Abductor pollicis longus - Extensor pollicis brevis - Extensor pollicis longus

The ulna is located on the opposite side of the forearm from the thumb. It joins with the humerus on its larger end to make the elbow joint, and joins with the carpal bones of the hand at its smaller end. Together with the radius, the ulna enables the wrist joint to rotate.

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The lateral, distal end of the ulna is the head of the ulna. It articulates with the ulnar notch on the radius and with the triangular articular disc in the wrist joint.

Radial styloid

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The tendon of the brachioradialis attaches at its base, and the radial collateral ligament of the wrist attaches at its apex.

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projection of bone on the lateral surface of the distal radius bone

Radial artery pulse

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major artery in the human

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Located on the anterior

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Metacarpals 1-5

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Metacarpophalangeal joints

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Proximal phalanges 1-5, middle phalanges 2-5, distal phalanges 1-5

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forearm Due to the size of the radial artery, and its proximity to the surface of the arm, this is the most common artery used to measure a patient's pulse. The pulse is checked at the wrist, where the radial artery is closest to the surface.

long bones within the hand that are connected to the carpals, or wrist bones, and to the phalanges, or finger bones The concave surfaces allows attachment of the interossei muscles. They connect the carpal bones to the phalanges. They help you move your hand back and forth and to hold things. The metacarpophalangeal joints are hinge joints. Lateral collateral ligaments that are loose in extension tighten in flexion, preventing lateral movement of the digits. Allows finger flexion, extension, adduction and abduction

knobby ends of the phalanges help form knuckle joints.

wrist

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The metacarpophalangeal joint is a synovial joint that connects the base of the proximal phalanges and the head of its respective metacarpal.

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bones that are found at the bottom of the finger. They are named proximal because they are the closest phalanges to the metacarpals. There are fourteen phalanges in each hand. Three are located in each long finger, and two are located in the thumb.

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Proximal and distal interphalangeal joints

Proximal interphalangeal joints: - extremely important for

the metacarpal bones form the intermediate part of the skeletal hand located between the phalanges of the fingers and the carpal bones of the wrist which forms the connection to the forearm. The bones that make up the palm.

Proximal interphalangeal joints: - Between proximal and

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Scaphoid

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Pisiform

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gripping things with hands, intermediate phalanges more specifically, what is called the 'power' grip. Distal interphalangeal joints: Being a hinge joint, the joint's - Between the intermediate articular surface and soft and distal phalanges. tissue do not permit any lateral movement.

carpal bones function as a unit to provide a bony superstructure for the hand. The scaphoid is also involved in movement of the wrist. It, along with the lunate, articulates with the radius and ulna to form the major bones involved in movement of the wrist. The pisiform is a sesamoid bone. It is located in the flexor carpi ulnaris (FCU) wrist tendon. It protects this tendon by supporting and bearing its forces as it moves across the triquetrum during wrist movement. The triquetrum is a proximal carpal bone located between the pisiform and lunate bones. flexes, radially deviates (abducts) and pronates the index MCP joint and radially adducts the thumb basal joint along with other muscles which radially adduct the basal joint. Also (weakly) extends the index PIP and DIP joints

First dorsal interosseus muscle, show action/s

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Thenar muscles: name/show action/s

Thenar muscles: - Abductor pollicis brevis: abducts thumb (at MCP joint)

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carpal bones of the wrist. It is situated between the hand and forearm on the thumb side of the wrist (also called the lateral or radial side). It forms the radial border of the carpal tunnel.

located opposite the wrist's carpal base plate and communicates with the abductor digiti minimi of the hand. Specifically, it is located where the carpus joins the ulna, which is the inner forearm bone.

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Muscle in the back of the hand (posterior hand) located between the first and second interphalangeal bones)

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The thenar musculature consists of four muscles, named abductor pollicis

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Hypothenar muscles name, show action/s

Carpometacarpal joint of the thumb

Flexor pollicis brevis: flexes thumb at MCP joint Opponens pollicis: opposes thumb Adductor pollicis: adducts thumb

Hypothenar muscles (4) : - Abductor digiti minimi: abducts 5th digit. abduction in the carpometacarpal [CMC] and metacarpophalangeal joints [MCP]) but it also does an extension in the proximal [PIP] and distal interphalangeal joints [DIP] - Flexor digiti minimi: flexes 5th digit at MCP joint. bends the little finger (flexion in the MCP). - Opponens digiti minimi: opposes 5th digit to ‘cup’ the palm. a combination of flexion, adduction and lateral rotation in the CMC. This socalled opposition movement plays an important role in gripping movements. - Palmaris brevis: Its special function is rather to protect the neurovascular pathway, which runs underneath it, from compression. -

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The joint's primary function is to optimize the pinch function of the hand.

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Carpal tunnel – what passes through

Structures that pass through: - Flexor pollicis longus tendon (1) - Flexor digitorum profundus tendon (4) - Flexor digitorum superficialis (4)

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brevis, adductor pollicis, flexor pollicis brevis, and opponens pollicis. Located on the radial side of the palm, they form together the 'ball' of the thumb known as the thenar eminence.

Group of four short muscles found at ulnar side of palm. Muscle bellies form prominent surface above the base of the little finger.

forms where the ends of the metacarpal bone at the base of the thumb and the trapezium bone in the wrist meet also called the basal joint. Between the metacarpal as trapezium bone meet

narrow passageway on the palm side of your wrist made up of bones and ligaments. The median nerve, which controls sensation and movement in the thumb

Palmaris longus tendon

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Median nerve

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A minor function is to help flex the hand at the wrist. A more major function is to tense and tighten the palmar aponeurosis

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and first three fingers, runs through this passageway along with tendons to the fingers and thumb.

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Extensor digitorum tendons

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Anatomical snuff box tendons

helps in the movements of the wrists and the elbows. It also provides extension for fingers 2 through 5, as well as for the hand and wrist.

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it has three borders, a floor, and a roof: - Ulnar (medial) border: Tendon of the extensor pollicis longus.

The palmaris longus is a muscle visible as a small tendon between the flexor carpi radialis and the flexor carpi ulnaris, it is not always present - It is absent in about 14 percent of the population

located on the posterior surface of the hand.

a triangular deepening on the radial, dorsal aspect of the hand at the level of the carpal bones, specifically, the

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Radial (lateral) border: Tendons of the abductor pollicis longus and extensor pollicis brevis Proximal border: Styloid process of the radius.

scaphoid and trapezium bones forming the floor.

The main contents of the anatomical snuffbox are: - the radial artery, - a branch of the radial nerve, - cephalic vein. - The radial artery crosses the floor of the anatomical snuffbox in an oblique manner. - It runs deep to the extensor tendons.

PELVIS/LOWER LIMB STRUCTURE Iliac Crest

FUNCTION - A hip flexor muscle attaches at the front of the iliac crest.

HOW IS IT LOCATED? - the curved superior border of the ilium, the largest of the three bones that merge to

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Anterior superior iliac spine (ASIS)

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The iliotibial band (known as tensor fascia lata at this level) attaches on the side of the iliac crest. Multiple abdominal and back muscles (core muscles) attach to the iliac crest. The ilia attach to the lower back (sacrum) at the back of the pelvis. provides attachment for the inguinal ligament, and the sartorius muscle.

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Greater trochanter

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Posterior superior iliac spine (PS...