Term
| What abdominal viscera are protected by the ribs |
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Definition
| The ribs also protect the liver, kidneys, and spleen |
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Term
| Which ribs don’t articulate with the vertebre above them |
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Definition
| Ribs 1, 11, and 12 only articulate with their own vertebre |
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Term
| Describe the 12 pairs of ribs |
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Definition
| The first 7 ribs continue as costal cartilages to the sternum (vertebrosternal). The next 3 continue as costal cartilages and attach to the costal margin (vertebrochondral). The last two are floating (vertebral) and have small, tip-covering costal cartilages. |
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Term
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Definition
| Costochondritis is inflammation of the costochondral area usually caused by heavy weight lifting of the chest. |
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Term
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Definition
| The first rib is flat, has a scalene tubercle for the scalenus anterior, an anterior groove made by the subclavian vein and a posterior groove made by the subclavian artery |
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Term
| How many sternebrae is the sternum composed of |
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Definition
| The sternum is composed of four sternebrae |
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Term
| Why is the sternum used commonly for bone marrow biopsies |
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Definition
| The sternum is rich in bone marrow and easy to tap |
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Term
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Definition
| When fetal sternal plates do not fuse, resulting in a hole in the middle of the sternum |
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Term
| What binds the superior thoracic aperature |
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Definition
| The superior thoracic aperature is bounded by the first thoracic vertebre, the first ribs and their cartilages, and the superior aspect of the manubrium |
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Term
| What binds the inferior thoracic aperature |
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Definition
| The inferior thoracic aperature is bounded by the 12th thoracic vertebra, the costal margin, and the inferior aspects of the sternum and xiphoid process |
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Term
| How do you test for shortened pectoralis muscles |
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Definition
| You test for shortened pectoralis muscles by laying flat on your back and trying to push both shoulders down flat |
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Term
| What is thoracic outlet syndrome |
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Definition
| Thoracic outlet syndrome is when the axillary vessels and cords of the brachial plexus are compressed under the pectoralis minor muscle. They move between the median and anterior scalenes and under the clavicle. |
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Term
| Describe the innervations of the anterior compartment of the forearm |
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Definition
The anterior compartment:
[[superficial]] FCU – ulnar nerve, FCR, palmarus longus, prontator teres – median nerve
[[intermediate]] FDS – median nerve
[[deep]] Pronator quadratus, FPL – AIO nerve, FDP – AIO and ulnar nerve |
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Term
| Describe the innervations of the posterior compartment of the forearm |
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Definition
The posterior compartment:
[[superficial]] Brachioradialis – radial nerve, ECRL, ECRB – deep branch radial, extensor digitorum, extensor digiti minimi, ECU – posterior interosseous
[[deep]] Abductor pollicis longus, EPB, EPL, extensor indices – posterior interosseous Supinator – deep branch radial. |
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Term
| Describe the fates of the nerves moving into the forearm |
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Definition
The median nerve: Does not branch into deep / superficial – it gives off the AIO nerve and the median recurrant branch to the thenar compartment
The ulnar nerve: branches into deep / superficial as it passes over the carpal tunnel – deep innervates interosseus and 3rd / 4th lumbricals, as well as hypothenar compartment and adductor pollicis. The superficial branch becomes common and proper digital nerves and innervates the Palmaris brevis
The radial nerve: Divides into superficial and deep branches – superficial is cutaneous innervation of the dorsum of the hand. Deep innervates muscles of the posterior compartment and is also known as the posterior interosseus nerve. |
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Term
| Describe the external intercostal muscles |
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Definition
| The external intercostals run “like hands in your pockets,” are located from the tubercles of the ribs to the costochondral areas (connected to sternum via fascia), and are most active with inspiration |
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Term
| Describe the internal intercostal muscles |
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Definition
| The internal intercostals run perpendicular to externals, and run from the angles of the ribs directly to the sternum. They are most active with expiration. |
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Term
| Describe both innermost intercostal muscles |
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Definition
| The innermost intercostals are a deeper portion of the internal intercostals, and are separated from them by intercostal nerves and vessels. They are most active with expiration. The transversus thoracics muscles attach to the posterior surface of the sternum and run to the internal surfaces of several costal cartilages. They secure the thoracic vessels to the thoracic wall. |
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Term
| What order do the nerves and vessels travel in in the intercostal neurovascular branches |
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Definition
| Vein – Artery – Nerve (VAN) from superior to inferior. |
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Term
| Where does the internal thoracic artery bifurcate, into what arteries, and what does it arise from |
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Definition
| The internal thoracic artery arises from the subclavian, travels down either side of the sternum and bifurcates in the 6th intercostal space into the musculophrenic (diaphragm) and the superior epigastric (to the abdomen). |
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Term
| Describe the setup of the intercostal arteries. |
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Definition
| Posterior IC arteries branch off of the descending aorta and anastomose with anterior IC arteries branching off of the internal thoracic arteries. |
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Term
| Describe the veins that are part of the azygos system |
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Definition
| The azygos vein is on the right side, and on the left side is the hemiazygos vein running superiorly, that merges with the azygos at T9. The accessory hemazygos vein runs inferiorly and merges with the azygos at T8. The azygos vein dumps into the superior vena cava. |
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Term
| How many intercostal nerves are there |
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Definition
| There are 11 intercostal nerves and one subcostal nerve. |
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Term
| Describe the locations of puncture for a thoracocentesis and a nerve block |
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Definition
| Thoracocentesis is inserted between the superior IC nerves and their inferior collateral branches (in the middle of the IC space). Nerve blocks are inserted closer to the nerve locations and are used to anesthetize those nerves. |
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Term
| What intercostal nerves innervate the nipples and belly button dermatomes |
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Definition
| The T4 IC nerve innervates the nipple dermatome, and the T10 IC nerve innervates the belly button dermatome |
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Term
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Definition
| Shingles are caused by a herpes zoster infection of the spinal ganglia (reactivation of chicken pox virus). It presents as a burning pain in the dermatome supplied by the affected intercostal nerve. |
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Term
| Describe injury to the SC joint |
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Definition
| The sternoclavicular joint is sturdy and rarely injured, but when it is, it is an emergency because the trachea / esophagus and many large arteries and veins run in that area |
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Term
| What are the ligaments of the AC joint |
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Definition
| The Acromioclavicular ligament is somewhat weak, and the coracoclavicular ligament (composed of trapezoid ligament and coronoid ligament, lateral to medial) is the main support. Depending on whether or not the coracoclavicular ligament is ruptured in a AC dislocation, there may not be any exposed palpation on the effected shoulder. |
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Term
| What is the most common shoulder problem with the glenohumeral joint |
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Definition
| The most common shoulder problem with the GH joint is shoulder impingement (tendonitis, bursitis) caused by overuse or poor posture. |
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Term
| Name the three glenohumeral ligaments |
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Definition
| The GH joint has a superior, medial and inferior GH ligament. |
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Term
| What is special about the medial glenohumeral ligament |
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Definition
| The medial glenohumeral ligament has an aperature for the subscapular bursa to communicate directly with the shoulder joint. |
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Term
| What causes GH ligament rupture and anterioinferior dislocation of the humeral head |
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Definition
| GH ligament rupture and dislocation can be caused by lateral rotation with excessive extension, like when throwing a baseball. |
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Term
| From 0-180 degrees of arm abduction, how many degrees comes from the scapulothoracic joint |
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Definition
| In full arm abduction, 60 degrees of motion comes from the scapulothoracic joint |
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Term
| Where does the anconeus attach |
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Definition
| The anconeus runs from the lateral epicondyle of the humerus to the superior ulna |
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Term
| The Tommy John procedure is what |
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Definition
| Removal of the Palmaris longus tendon to replace the ulnar collateral ligament |
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Term
| Describe the ligaments of the elbow |
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Definition
| The ulnar collateral lig attaches the ulna to the medial epicondyle and is composed of three bundles: anterior, posterior, and oblique. The radial collateral ligament attaches the lateral epicondyle to the anular ligament, which wraps around the head of the radius and allows radio-ulnar rotation at the proximal radioulnar joint. |
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Term
| What does the olecranon bursa do |
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Definition
| The olecranon bursa cushions the olecranon in its fossa. |
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Term
| Describe the setting of a distal radius fracture |
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Definition
| A distal radial fracture is set in a pronated state, which causes the IO membrane to shorten, resulting in difficulty supinating the arm immediately after the cast is removed. |
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Term
| Describe the distal radioulnar joint |
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Definition
| The distal radioulnar joint has an articular disc with impressions for the scaphoid and lunate bones. |
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Term
| Describe the Traingular Fibrocartilidge Complex |
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Definition
| The TFCC is a complex of three ligaments: the Articular disc, UCL, and dorsal and palmar radioulnar ligaments. It is a load bearing complex and a major stabilizer for the distal radioulnar joint, and the ulna and carpus. Clinically, the TFCC refers to the articular disc. |
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Term
| What are the primary and secondary supinator and pronator muscles |
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Definition
| The primary supinator muscle is the biceps brachii, and secondary is the supinator muscle. The primary pronator muscle is the pronator quadratus, and the secondary is the pronator teres. |
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Term
| Which of the radiocarpal ligaments is stronger |
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Definition
| The palmar radiocarpal ligament is stronger than the dorsal. |
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Term
| What is pronator teres syndrome |
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Definition
| Pronator teres syndrome is when the median nerve is compressed between the two heads of the pronator teres muscle |
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Term
| What is Erb-Duchenne Palsy |
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Definition
| The most common birth related neuropraxia, an injury to the superior part of the brachial plexus involving C5 and C6 nerve roots. Presents with shoulder adduction and medial rotation with the elbow extended (Waiter's Tip Position) |
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