Anatomy Exam 2 PDF

Exam 2 Review: 18 - ANS, Axillary artery (Dr. Bryant's material) Defining landmarks for when arteries change to different arteries (subclavian to axillary) - - - - - - - Branches off axillary artery - - - - - - - -  Brachial and cepha...

Exam 2 Review: 18 - ANS, Axillary artery (Dr. Bryant's material) Defining landmarks for when arteries change to different arteries (subclavian to axillary) - - - - - - - Branches off axillary artery - - - - - - - -  Brachial and cephalic vein, what does it converge into? How does it transition and move into the upper arm? - - - - - Nerve innervations to the forearm, hand muscles. Innervations for ABductor and ADductors. Know a lot about the terminal branches. Know nerve innervation to the arm. Questions about inability to do a certain action. - +-------------+-------------+-------------+-------------+-------------+ | Ulnar | Median | Radial | Axillary | Muscutaneou | | | | | | s | +=============+=============+=============+=============+=============+ | -Descends | -lateral to | -Supplies | | -Passes | | on the | brachial | all | | through | | **medial | artery, | **posterior | | **coracobra | | side of | then | ** | | chialis**, | | brachial | crosses to | compartment | | continues | | artery** | medial side | muscles | | distally | | | of arm and | | | between | | -Passes | descends | -After | | **biceps** | | through | into | giving off | | and | | medial | cubital | branches to | | **brachiali | | intermuscul | fossa | long and | | s**, | | ar | | medial | | innervating | | septum near | -No | heads of | | all 3 | | mid-arm | branches in | triceps, | | muscles | | | axilla or | descends | | | | -Passes | arm | with | | -Lateral to | | posterior | | profunda | | biceps | | to **medial | | brachii | | distally, | | epicondyle* | | artery in | | becomes | | * | | the | | lateral | | into | | **radial | | cutaneous | | forearm | | groove of | | nerve of | | | | humerus** | | forearm | | | | | | | | | | -Gives off | | | | | | branch to | | | | | | lateral | | | | | | head of | | | | | | triceps, | | | | | | passes | | | | | | lateral to | | | | | | humerus | | | | | | through | | | | | | lateral | | | | | | intermuscul | | | | | | ar | | | | | | septum | | | +-------------+-------------+-------------+-------------+-------------+ | **Main | **Main | **Main | **Main | **Main | | Functions:* | Functions:* | Functions:* | Functions:* | Functions:* | | * | * | * | * | * | | | | | | | | -Flex hand | -Flexes | -Extension | -External | -Flexes | | and digits | hand and | | rotation | | | | digits | -ABduction | | -ADducts | | -ADduct | | | -Actions of | | | | -ABducts | -Supination | deltoid | -Supination | | | | | | | | | -Pronates | | | | +-------------+-------------+-------------+-------------+-------------+ | **Muscle | **Muscle | **Muscle | **Muscle | **Muscle | | innervation | innervation | innervation | innervation | innervation | | s:** | s:** | s:** | s:** | s:** | | | | | | | | -Flexor | -Pronator | -Triceps | -Deltoid | -Biceps | | Carpi | Teres | brachii | | brachii | | Ulnaris | | | -Teres | | | | -Flexor | -Aconeus | minor | -Brachialis | | -**Medial | Carpi | | | | | part** of | Radialis | -Brachiorad | | -Coracobrac | | Flexor | | ialis | | hialis | | digitorum | -Palmaris | | | | | profundus | Longus | -Extensor | | | | | | carpi | | | | -ADuctor | -Flexor | radialis | | | | pollicis | Digitorum | longus | | | | | Superficial | | | | | -All | is | -Extensor | | | | hypothenar | | carpi | | | | muscles | -**Lateral | radialis | | | | | part** of | brevis | | | | | Flexor | | | | | | digitorum | -Extensor | | | | | profundus | digitorum | | | | | | | | | | | -Flexor | -Extensor | | | | | pollicis | digit | | | | | longus | minimi | | | | | | | | | | | -Pronator | -Extensor | | | | | quadratus | carpi | | | | | | ulnaris | | | | | | | | | | | | -Supinator | | | | | | | | | | | | -ABductor | | | | | | pollicis | | | | | | longus | | | | | | | | | | | | -Extensor | | | | | | pollicis | | | | | | brevis | | | | | | | | | | | | -Extensor | | | | | | pollicic | | | | | | longus | | | | | | | | | | | | -Extensor | | | | | | indicis | | | +-------------+-------------+-------------+-------------+-------------+ | **Functions | **Functions | **Functions | **Functions | **Functions | | :** | :** | :** | :** | :** | | | | | | | | -Flexes | -Pronates | -Extends | -ABduction | -Supinates | | hand | forearm | the forearm | | forearm | | | | | - | | | - | - - | - - - | | - | | | | - | -Flexes | | | -Flexes | -Flexes | | | -Flexes | | distal | hand | -Extends | - | forearm | | phalanges | | hand | | | | index | - - - | | -External | - - - | | through | | - - | rotation | | | small | | | | | | finger | -Flexes | -Extends | - - | -ADduct arm | | | phalanges | digits | | | | - | of index | | -Internal | - | | | through | - - - | rotation | | | -ADducts | small | - - - | | | | hand | fingers | | - | | | | | | | | | - | - - - | -ABduct | | | | | | hand | | | | -ADduct | | | | | | thumb | -ABducts | - - | | | | | hand | | | | | - | | -ABduct | | | | | - | digits | | | | -ABuct, | | | | | | flex, | -Tightens | - | | | | oppose | palmar | | | | | pinkie | aponeurosis | -ABducts | | | | | | ulna during | | | | - - - | - | pronation | | | | | | | | | | | | - | | | | | | | | | | | | -Supination | | | | | | | | | | | | - | | | | | | | | | | | | -Flexes | | | | | | forearm | | | | | | | | | | | | - | | | | | | | | | | | | -ADducts | | | | | | | | | | | | - | | | +-------------+-------------+-------------+-------------+-------------+ Where does the axillary artery sit in the brachial plexus -  Path of arterial supply as it enters the forearm and as it enters the wrist +-----------------------------------+-----------------------------------+ | Path of Arteries into Forearm | | +===================================+===================================+ | **Branchial/Ulnar Artery** | **Brachial/Radial Artery** | +-----------------------------------+-----------------------------------+ | -Larger branch off brachial | -Supplies the lateral forearm and | | artery than the radial artery and | forms the deep arch of the hand | | passes down the **medial side of | | | the forearm** | **Course:** Branches off brachial | | | artery \> Under brachioradialis | | -Supplies the **medial forearm** | \> alongside the radial nerve \> | | | superficial to muscles | | **Course:** | | | | - - - | | Leaves cubital fossa \> deep to | | | pronator teres \> fascial plane |  | | between FCU and FDP | | | | -Radial Recurrent Artery - branch | | -In the distal forearm it remain | off radial artery in forearm | | tucked under the FCU tendon and | | | is **not easily palpable** | | | | | | FCU: Flexor Carpi Ulnaris | | | | | | FDP: Flexor Digitorum Profundus | | +-----------------------------------+-----------------------------------+ | Path of Arteries into Wrist | | +-----------------------------------+-----------------------------------+ | **Ulnar Artery** | **Radial Artery** | +-----------------------------------+-----------------------------------+ | -Enters hand on the medial side | -Curves around the lateral side | | **superficial to the flexor | of the wrist | | retinaculum** | | | | -**Passes over the floor of the | | -Branches into: | anatomical snuff box** | | | | | - - - | -Passes between the 2 heads of | | | the 1st DI (dorsal interossei) | | - - | and then between the 2 heads of | | | the adductor pollicis to access | |  | the deep plane of the palm and | | | form the deep palmar arch | | | | | | \- Branches into: | | | | | | - - - | | | | | | - - | +-----------------------------------+-----------------------------------+ **Pulleys:** - - - - - -  **Extensor Hood:** Know dermatomes.  Understand big concerns with snuffbox, vasculature and nerves in that area. +-----------------------------------+-----------------------------------+ | Anatomic Snuff Box | | +===================================+===================================+ | Borders: | Contents: | +-----------------------------------+-----------------------------------+ | **Lateral Border (radial side):** | 1. 2. 3. | | tendons of the APL and EPB | | | | | | APL - ABductor pollicis longus | | | | | | EPB - Extensor pollicis brevis | | | | | | **Medial Border (ulnar side):** | | | tendon of the EPL | | | | | | EPL - Extensor pollicis longus | | | | | | **Floor:** the **scaphoid** and | | | trapezium | | | | | | Base = wrist, Apex directed into | | | thumb | | +-----------------------------------+-----------------------------------+ | |  | +-----------------------------------+-----------------------------------+ Origin of biceps and origin of the 3 heads of the triceps. - - - - - - - Know what originates off the coracoid process. - - - Boundaries of the antecubital fossa and whats in it. - - - - - - - - - - - - **Muscles and MOA for pronation and supination.**  \^Rotators of the Radius - - - - - - - - - - Bones of the wrist. +-----------------------------------+-----------------------------------+ | Carpal Bones | | +===================================+===================================+ | Proximal Row | Distal Row: | +-----------------------------------+-----------------------------------+ | - - - - | - | | | | | | | | | | | | - - - | +-----------------------------------+-----------------------------------+ | | | +-----------------------------------+-----------------------------------+ Carpal tunnel anatomy. What is the reason why some nerves/arteries are not in it? How would it present? +-----------------------+-----------------------+-----------------------+ | **Carpal Tunnel** | | | | | | | | -Formed by a deep | | | | arch formed by the | | | | carpal bones and the | | | | **flexor | | | | retinaculum** | | | | | | | | -Flexor retinaculum: | | | | thick connective | | | | tissue ligament that | | | | bridges the space | | | | between the medial | | | | and lateral sides of | | | | the base of the arch | | | | and converts the | | | | carpal arch into the | | | | carpal tunnel | | | | | | | | - | | | | | | | | -Tinel's sign = pain | | | | when tapping on | | | | median nerve in | | | | carpal tunnel | | | +=======================+=======================+=======================+ | **Contents:** | **Over the top:** | **Function:** | | | | | | - - - - | - - - | - - | +-----------------------+-----------------------+-----------------------+ |  | | | +-----------------------+-----------------------+-----------------------+ Muscles of thenar and hypothenar. +-----------------------------------+-----------------------------------+ | **Thenar Muscles** | **Hypothenar Muscles** | | | | | Thenar = palm | Act on 5th digit (pinkie) | | | | | Act on thumb | | +===================================+===================================+ | **Flexor pollicis brevis** | **Flexor Digiti Minimi Brevis** | | | | | Innervation: Median nerve | Innervation: Ulnar nerve (deep | | (recurrent branch) | branch) | | | | | Action: Flexes thumb | Action: **Flexes proximal | | | phalanx** of 5th digit | | | | | |  | +-----------------------------------+-----------------------------------+ | **ABductor pollicis brevis** | **ABductor Digiti Minimi** | | | | | Innervation: Median nerve | Innervation: Ulnar nerve (deep | | (recurrent branch) | branch) | | | | | Action: ABducts thumb and helps | Action: **ABducts 5th digit** | | oppose it | | | |  | +-----------------------------------+-----------------------------------+ | **Oppones pollicis** | **Opponens Digiti Minimi** | | | | | Innervation: Median nerve | Innervation: Ulnar nerve (deep | | (recurrent branch) | branch) | | | | | Action: Opposes thumb toward | Action: Draws 5th metacarpal bone | | center of palm and rotates it | anteriorly and rotates it, | | medially | **bringing 5th and 1st digits | | | into opposition** | | \*Deep to ABductor pollicis | | | brevis |  | +-----------------------------------+-----------------------------------+ DAB and PAD, muscles in between the fingers. +-----------------------------------+-----------------------------------+ | Dorsal Interossei | Palmar Interossei | +===================================+===================================+ | - - - | - - - | | | | | Innervation: Ulnar nerve (deep | Innervation: Ulnar nerve (deep | | branch) | branch) | | | | | Action: **ABducts digits** and | Action: **ADducts digits** and | | assists lumbricals | assists lumbricals | | | | | \*DAB - "Dorsals AB-duct" | \*PAD - "Palmars AD-duct" | | | | |  |  | +-----------------------------------+-----------------------------------+ Osteology Arterial blood supply to the thumb. - - - - Arterial blood supply to index finger - - -