Lab Objectives: Extremities, Brain and Braincase

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  1. acromioclavicular joint:
    possible dislocation from fall onto outstretched upper limb
  2. an(n)ular ligament of radius:
    loops around radial head, can be involved in pulled elbows (subluxation of radial head).
  3. anatomical "snuff box":
    formed by tendons of extensor pollicis longus m. vs. tendons of abductor pollicis longus and extensor pollicis brevis mm. Scaphoid on floor, radial artery passes through here.
  4. bicipital groove (intertubercular sulcus):
    separates the tubercles; tendon of long head of biceps brachii here
  5. capitate b.:
    distal carpal bone, "in the middle of it all"
  6. capitulum (capitellum):
    specialized rounded humeral condyle for head of radius. Capitellum is a synonym often used by orthopedic surgeons.
  7. carpal bones:
    "Some ladies take pills to treat common headaches"
  8. carpal tunnel:
    formed by walls and floor of carpal bones, and roof of flexor retinaculum. Carpal tunnel syndrome with entrapment of median n.
  9. coracoclavicular ligament:
    tough ligament made of separate conoid and trapezoid ligaments. In effect, supports the suspending scapula and upper limb.
  10. coracoid process:
    another projection of scapula, projects anteriorly
  11. cubital fossa:
    hollow area of anterior elbow region, contains brachial artery, etc.
  12. deltoid tuberosity:
    halfway down humeral shaft on lateral side, deltoid attaches here
  13. elbow joint capsule, ulnar and radial collateral ligaments:
    extensive capsule, with strengthening collateral ligaments. The UCL helps to comprise the cubital tunnel and with repeated flexion and extension can trigger ulnar n. compression there. UCL may also be injured with repetitive throwing motions and so be repaired via Tommy John surgery with another tendon, e.g., from palmaris longus or gracilis.
  14. extensor retinaculum:
    at wrist level, thickened deep (antebrachial) fascia for extensor tendons
  15. flexor retinaculum (transverse carpal ligament):
    at wrist level, thickened antebrachial fascia for tunnel for flexor tendons; roof of carpal tunnel
  16. glenoid cavity:
    lateral on scapula, shallow cavity for articulation with humeral head
  17. greater tubercle:
    lateral projection from humeral head, helps to account for roundness of shoulder, attachment site of such items as supraspinatus m.
  18. hamate b.:
    distal row, medial, with large hook
  19. humerus, head, anatomical vs. surgical neck:
    head rounded, articulates with glenoid cavity, with the true neck just below the head, but the surgical head and more common fracture site inferior to the humeral tubercles
  20. infraspinous fossa:
    larger of the two scapular fossae defined by the scapular spine
  21. interosseous membrane:
    medial; strong interosseus membrane extending from the borders binds ulna and radius, can be the basis for compartment syndrome from the thereby-defined flexor and extensor compartments.
  22. lateral epicondyle:
    of humerus, attachment site for extensors. Lateral epicondylitis ("tennis elbow").
  23. lesser tubercle:
    of humerus, more anterior than the greater tubercle, attachment site of such items as subscapularis m.
  24. lunate b.:
    semilunar-shaped, in proximal row next to scaphoid
  25. medial epicondyle:
    of humerus, attachment site for flexors
  26. metacarpal b.:
    palm bones. Metacarpal shaft fractures.
  27. olecranon:
    large proximal ulnar process for triceps brachii leverage to extend elbow
  28. olecranon fossa:
    posterior on distal humerus, to accomodate olecranon process of ulna
  29. palmar aponeurosis:
    triangular part of deep fascia of hand, covers over long flexor tendons. Dupuytren's contracture: progressive fibrosis in palmar aponeurosis.
  30. phalanges:
    14 total, finger bones: thumb with only two. Singular: phalanx
  31. pisiform b.:
    smallest of the carpals, lies closest to palmar surface of the carpals
  32. radial (spiral) groove:
    along humeral shaft, radial nerve along here and profunda brachii (deep brachial) artery
  33. radial tuberosity:
    slightly distal to head, site of insertion for biceps brachii m.
  34. radius b., head, neck:
    head and neck features proximally, in contrast to large distal end
  35. scaphoid b.:
    at base of anatomical snuff box, most frequently broken carpal
  36. scapula, with acromion, spine:
    flattened triangular bone, only bony attachment to axial skeleton is through clavicle. The acromion is the flattened process that terminates the spine and articulates with clavicle anteriorly. Proximal point from which clinicians measure UE (upper extremity) length. The spine is the ridge on posterior surface of scapula, creating the supraspinous and infraspinous fossae.
  37. styloid processes (radius, ulna):
    pointed distal processes to help to stabilize wrist joint
  38. subacromial bursa*:
    keeps supraspinatus m. tendon away from acromion, etc. Rotator cuff or "shoulder" bursitis if inflamed.
  39. supraspinous fossa:
    smaller of the two scapular fossae defined by the scapular spine
  40. trapezium b.:
    carpal that allows saddle joint for pollox (thumb); “trapezium for the thumb”
  41. trapezoid b.:
    next to trapezium medially in distal row of carpal bones
  42. triquetrum (triquetral) b.:
    in proximal row of carpal bones medially, supports small pisiform bone
  43. trochlea:
    specialized pulley-like humeral condyle for ulna (its trochlear notch).
  44. ulna b.; cubital tunnel:
    ulna is medial when in the anatomical position; cubital tunnel, formed by medial condyle/epicondyle of elbow and proximal portion of flexor carpi ulnaris muscle is a common site of ulnar nerve entrapment (“funny bone”)
  45. ulnar tunnel:
    (Guyon’s canal), near pisiform and hamate; ulnar n. entrapment can occur here, e.g., cycling or jack hammering
  46. abductor pollicis brevis m.:
    O: flexor retinaculum and scaphoid, trapezium, I: lateral proximal phalanx of thumb, N: median n, A: abduct thumb, help to oppose it.
  47. abductor pollicis longus m.:
    O: posterior ulna, radius, interosseus membrane, I: lateral 1st metacarpal, N: radial n, A: abducts thumb, extends it at carpometacarpal joint
  48. adductor pollicis m.:
    two heads, distal carpals and proximal portions of metacarpals 2,3, I: medial proximal phalanx of thumb, I: ulnar n, A: adducts thumb.
  49. anconeus m.:
    O: posterior lateral epicondyle; I: lateral olecranon; N: radial n.; A: weak elbow extension, tenses elbow joint capsule during extension
  50. biceps brachii m.:
    O: long head: superior edge, glenoid fossa; short head: coracoid process; I: proximal radius @ bicipital tuberosity and bicipital aponeurosis; N: musculocutaneous n; A flexes at elbow, supinates. Biceps tendinitis with irritation of long head tendon rubbing through bicipital groove.
  51. bicipital aponeurosis:
    triangular band from biceps tendon, across cubital fossa to deep fascia of medial anterior forearm. Helps to protect structures in cubital fossa.
  52. brachialis m.:
    O: distal anterior humerus, I: proximal ulna @ coronoid process, N: musculocutaneous n, A: flexes at elbow
  53. brachioradialis m.:
    O: distal humerus, I: lateral distal radius, N: radial n., A: flexes forearm
  54. coracobrachialis m.:
    O: coracoid process, I: medial humerus, N: musculocutaneous, A: adducts, flexes humerus
  55. deltoid m.:
    O lateral third of clavicle, acromion and scapular spine, I deltoid tuberosity, N axillary n, A abduct humerus (and rotate, depending on fibers). IM injection site.
  56. digital fibrous vs. synovial flexor sheaths:
    fibrous surrounds, infection can be seen in the synovial sheaths, presenting as tenosynovitis, often through a small penetrating wound. Thicker regions of the fibrous sheath are pulleys, and particularly the most proximal (A-1 pulley) is involved in trigger finger (noninfectious flexor tenosynovitis) if the tendon is inflamed and “traps” under that portion of the sheath.
  57. dorsal interosseus m.:
    (DAB as the mnemonic): O: opposite surfaces of adjoining metacarpals, I: extensor expansion, N: ulnar n, A: abduct digits, assist lumbricals
  58. extensor carpi radialis brevis m.:
    O: lateral epicondyle, I: base of metacarpal 3, N: radial n, A: extends (dorsiflexes) and abducts at wrist
  59. extensor carpi radialis longus m.:
    O: lateral supracondylar ridge, I: base of metacarpal 2, N: radial n, A: extends (dorsiflexes) and abducts at wrist
  60. extensor carpi ulnaris m.:
    O: lateral epicondyle, posterior ulna, I: base of metacarpal 5, N: radial n, A: extends and adducts at wrist
  61. extensor digiti minimi m.:
    O: lateral epicondyle, I: extensor expansion, digit 5, N: radial n, A: extends 5th digit
  62. extensor digitorum m.:
    O: lateral epicondyle, I: extensor expansion, N: radial n, A: extends wrist and fingers
  63. extensor expansion (hood):
    aponeurotic hood of fibers covering the posterior proximal phalanx, to help bind lumbricals and interossei with the common extensor tendon (extensor expansion poorly seen in thumb)
  64. extensor indicis m.:
    O: ulna, I: extensor expansion of index finger, N: radial n., A: extends index finger
  65. extensor pollicis brevis m.:
    O: posterior radius, interosseus membrane, I: proximal phalanx of thumb, N: radial n, A: extends proximal phalanx at carpometacarpal joint
  66. extensor pollicis longus m.:
    O: posterior, middle ulna, I: distal phalanx of thumb, N: radial n, A: extends thumb
  67. flexor carpi radialis m.:
    O: medial epicondyle, I: base of metacarpal 2, N: median n, A: flexes, abducts wrist
  68. flexor carpi ulnaris m.:
    O: medial epicondyle & medial edge of ulna, I: 5th metacarpal (and hamate, pisiform), N: ulnar n, A: flexes, adducts at wrist
  69. flexor digitorum profundus m.:
    O: proximal ulna and interosseus membrane, I: distal phalanges of digits 2-5, N: ulnar (medial ½), median (lateral ½), A: flexes wrist and fingers
  70. flexor digitorum superficialis m.:
    O: medial epicondyle (mostly) and some proximal radius, ulna, I: middle phalanges, digits 2-5, N: median n., A: flexes wrist and fingers
  71. flexor pollicis brevis m.:
    O: flexor retinaculum and trapezium, I: lateral side of proximal phalanx of thumb, I: median n., A: flexes thumb
  72. flexor pollicis longus m.:
    O: middle radius and interosseus membrane, I: distal phalanx of thumb, N: median n, A: flexes joints of thumb
  73. hypothenar eminence:
    fleshy base of 5th digit, group of medial muscles proximal to and associated with 5th digit
  74. infraspinatus m.:
    O infraspinous fossa of scapula, I posterior greater tubercle, N suprascapular n, A laterally rotate humerus.
  75. latissimus dorsi m.:
    O spines of T7-T12, thoracolumbar fascia, iliac crest, inferior ribs, I lesser tubercular crest and intertubercular (bicipital) groove, N thoracodorsal n., A extends, adducts, medially rotates humerus. Lats make up posterior wall of axilla.
  76. levator scapulae m.:
    O transverse processes of C1-4, I superior medial scapula, N dorsal scapular and cervical nn, A elevate scapula and rotate glenoid cavity inferiorly.
  77. lumbrical m.:
    O: tendons of FDP, I: tendons of extensor digitorum in extensor expansion, N: median n for digits two and three (i.e., no lumbrical on thumb), ulnar n fourth and fifth digits, A: helps to create writing position (MCP joints flexed, IP joints extended)
  78. opponens pollicis m.:
    O: flexor retinaculum and trapezium, I: lateral 1st metacarpal, N: median n, A: rotates thumb into opposition
  79. palmar interosseus m.*:
    (PAD as the mnemonic): O: ant. borders of metacarpals 2, 4, 5, I: extensor expansion, N: ulnar n, A: adduct digits, assist lumbricals
  80. palmaris longus m.:
    Not always present in humans (more important in reptiles curling all digits in at once). O: medial epicondyle, I: palmar aponeurosis and distal part of flexor retinaculum, N: median n, A: flexes wrist and tightens palmar aponeurosis.
  81. pectoralis major, minor m.:
    pect major (anterior wall of axilla): O medial 1/2 of clavicle, sternum, costal cartilages 1-6, I greater tubercular crest, N lateral and medial pectoral nn, A flexes, adducts, medially rotates humerus. pect minor: O anterior of ribs 3-5, I coracoid process, N medial pectoral n, A protracts and depresses glenoid end of scapula
  82. pronator quadratus m.:
    O: distal anterior ulna, I: distal anterior radius, N: median n, A: pronates (e.g., royal wave)
  83. pronator teres m.:
    O: medial epicondyle (and coronoid process of ulna), I: lateral edge of radius, N: median n, A: pronates, especially when need more power (e.g., screwdriver)
  84. rhomboid major m.:
    O spinous processes T2-5, I medial border of scapula up to its spine, N dorsal scapular n, A retract scapula, rotate it to depress glenoid cavity.
  85. rhomboid minor m. :
    O spinous processes C7-T1 (and ligamentum nuchae), I medial border of scapula at spine level, N dorsal scapular n, A retracts scapula, rotates it to depress glenoid cavity.
  86. serratus anterior m.:
    O externally over lateral ribs 1-8, I anterior, medial surface of scapula, N long thoracic n., A protracts scapula and holds it against thoracic wall. Overlying thorax, with prominent saw-tooth origins. Protracts scapula, e.g., boxing. "Winged scapula" if nerve supply interrupted.
  87. subclavius m.:
    O anterior end 1st rib, I inferior clavicle, N n. to subclavius, A draws clavicle medially. Small triangular muscle inferior to clavicle, so can protect subclavian vessels if clavicle broken.
  88. subscapularis m.:
    O deep surface of scapula, I lesser tubercle, N upper and lower subscapular n, A medially rotates humerus
  89. supinator m.:
    O: lateral epicondyle and proximal ulna, I: lateral distal radius, N: radial n, A: supinates (biceps brachii m. assists with supinating against resistance)
  90. supraspinatus m.:
    O supraspinous fossa of scapula, I superior greater tubercle, N suprascapular n, A abduct humerus. Most likely of rotator cuff to be injured or worn out (supraspinatus, infraspinatus, teres minor, subscapularis; SITS). With no inferior muscle, humeral head will tend to dislocate with an inferior component.
  91. teres major m.:
    O inferior scapula, I lesser tubercular crest, N lower subscapular n, A adducts, medially rotates humerus
  92. teres minor m.:
    O inferior scapula, I posterior greater tubercle, N axillary n, A laterally rotate humerus.
  93. thenar eminence:
    fleshy base of thumb, group of lateral muscles proximal to and associated with thumb
  94. trapezius m.:
    O from skull to spinous processes of lumbar/sacral region, I lateral clavicle, acromion, spine of scapula, I CN (cranial nerve) XI, spinal accessory n., A: elevates, retracts, and rotates scapula, depending on the fibers involved.
  95. triceps brachii m.:
    O long head--inferior edge of glenoid cavity, lateral and medial heads--posterior humeral shaft, I olecranon process of ulna, N radial nerve, A elbow extension.
  96. axillary a., v.:
    after first rib, crossing into axilla
  97. basilic v.:
    superficial v. on the medial inferior arm, plunges into brachial fascia to contribute to axillary v.
  98. brachial a., v.:
    as they cross the inferior edge of teres major m. The brachial veins are paired accompanying veins.
  99. cephalic v.:
    superficial v. on the lateral side of the arm, which dives into deltopectoral triangle.
  100. digital artery, vein, nerve (neurovascular bundle):
    The lateral position of the neurovascular bundle on both sides of the digits can lead to their vulnerability if there is lateral compression, e.g., from repetitive motion.
  101. dorsal venous arch (network):
    network of veins on posterior (dorsal) surface of hand; venous access.
  102. median cubital v.:
    in cubital fossa (a good place for venipuncture), allows communication between basilic and cephalic veins.
  103. posterior circumflex humeral a.*:
    comes off axillary artery through quadrangular space to supply deltoid m., etc.
  104. profunda brachii (deep brachial) a.:
    largest branch of brachial a, travels posteriorly on humerus to anastomose around elbow.
  105. radial a.:
    begins in cubital fossa, palpable at distal wrist, crosses floor of anatomical snuff box
  106. subclavian a., v.:
    so named before crossing the first rib
  107. superficial palmar arch:
    formed mostly by ulnar artery, contributes to palmar digital arteries
  108. ulnar a.:
    descends through anterior compartment to enter the palm of the hand medially. Crosses wrist superficial to flexor retinaculum in ulnar tunnel near pisiform bone, most continues as superficial palmar arch.
  109. axillary n.:
    off of posterior cord of brachial plexus, travels through quadrangular space to supply deltoid, teres minor muscles
  110. brachial plexus:
    network of nerves to upper limb, partly in neck, partly in axilla
  111. lateral cord:
    of brachial plexus, ant. divisions of upper (superior) and middle trunks, lateral to axillary artery.
  112. long thoracic n.*:
    from contributions of C5-7, along lateral chest wall to serratus anterior m. If damaged, then scapular winging.
  113. medial cord:
    of brachial plexus, ant. division of inferior trunk, contributes to ulnar and median n.
  114. median n, recurrent branch of median n.:
    derived from medial & lateral cords, innervates many flexors and thenar side; the recurrent branch supplies the thenar m., and so loss of most thumb function if that branch is damaged.
  115. musculocutaneous n.:
    off of lateral cord, innervates ant. muscles of arm (biceps etc.), as well as skin in lateral 1/2 of forearm (lateral cutaneous nerve of forearm)
  116. posterior cord:
    of brachial plexus, all the post. divisions, contributes to radial and axillary n.
  117. radial n.:
    derived from most of posterior cord of brachial plexus, supplies extensors. Wrist drop if damaged.
  118. suprascapular n.:
    posteriorly off of superior trunk (C5, C6), supplies supraspinatus and infraspinatus mm. and glenohumeral joint
  119. ulnar n.:
    off of medial cord, runs by medial epicondyle of elbow ("funny bone"), supplies hypothenar side and many intrinsic hand muscles
  120. acetabulum:
    cup-shaped socket for femoral head
  121. adductor tubercle:
    on superior aspect of medial epicondyle, adductor magnus will reach to there
  122. ankle joint:
    hinge joint between mortise of tib/fib and talus, so dorsiflexion and plantarflexion. Eversion/inversion more subtalar/midtarsal kind of motion.
  123. anterior border (crest) of tibia:
    inferior to tibial tuberosity, note the "shin" is sharp anteriorly.
  124. anterior cruciate ligament (ACL):
    more often damaged than PCL, prevents posterior displacement of femur on tibia, e.g., with hyperextension. If torn, positive anterior drawer sign.
  125. anterior crural compartment:
    contains extensor muscles; concern with anterior compartment syndrome (foot-drop)
  126. anterior inferior iliac spine:
    hard to palpate; muscles such as rectus femoris off of it
  127. anterior superior iliac spine:
    bony landmark, muscles such as sartorius off of it
  128. anterior vs. posterior talofibular ligament*:
    from lateral malleolus to talus, not strong and can get easily get damaged in inversion ankle injury). The anterior is easier to find with dissecting, and more likely to get damaged with inversion injury.
  129. calcaneal (Achilles) tendon:
    common insertion for gastroc, soleus, plantaris. Ankle jerk: S1, S2. Achilles tendon rupture as an orthopedic concern.
  130. calcaneal tuberosity:
    attachment site for achilles tendon (tendo calcaneus)
  131. calcaneofibular ligament*:
    from lateral malleolus to calcaneus, less strong than medial ligment
  132. calcaneus b.:
    heel bone with large tuberosity. Can be fractured in long fall onto heel. Inversion, eversion tarsal movements.
  133. cuboid b.:
    more lateral; base of 4th, 5th metatarsal off of it
  134. deep fascia of leg:
    surrounds the crural compartments, and so would may need to be cut with a fasciotomy to release pressure with a compartment syndrome
  135. fascia lata (deep fascia of thigh):
    sheathing thigh muscles (the stocking effect prevents excessive bulging when contracting)
  136. femoral sheath*:
    delicate sheath in vicinity of saphenous opening that covers femoral vessels and associated structures. 3 compartments: NAVEL (nerve, artery, vein, empty space, lymph nodes) lateral à medial structures in the area. The femoral nerve is not part of the compartments, but is obviously nearby! Lateral compartment: femoral artery. Middle compartment: femoral vein. Medial compartment (=femoral canal): empty space and lymphatics. Given their location, femoral hernias are palpable below inguinal ligament. Although femoral hernias are rare (3% of total), more of them are femalel, rare in males (sex difference in size of femoral canal, and so ability to herniate through it).
  137. femoral triangle:
    triangle formed by (superior) inguinal ligament, (lateral) sartorius border, (medial) adductor longus border. Femoral pulse and femoral artery/vein access for catheterization
  138. fibula b.:
    lateral to tibia.
  139. fibular (lateral) collateral ligament (LCL):
    very strong, not often as injured as MCL.
  140. greater, lesser trochanter:
    follows femur neck, lateral attachment for gluteal region muscles. (bursa superficial to it). Lesser trochanter less prominent, more posteromedial, iliopsoas attaches here.
  141. head of fibula:
    articulates with tibia with a synovial joint that allows a little "give" while walking on rough surfaces.
  142. head, neck of femur:
    head articulates with acetabulum, neck a concern with fracture
  143. iliotibial tract (band):
    a strong, lateral portion of fascia lata, with TFL and gluteus maximus muscles inserting onto it.
  144. infrapatellar fat pad:
    (Hoffa’s pad) note that it is intracapsular but extrasynovial as it separates patella from femoral condyle. May be involved in impingement syndrome.
  145. inguinal ligament:
    remember, the thickened inferior margin of the external oblique aponeurosis
  146. interosseus membrane:
    between tibia and fibula to help define anterior and posterior compartments
  147. knee joint and capsule:
    consists of articulations among femur, tibia, patella. Knee jerk, L3, L4. Extension/flexion, some rotation when in flexion. Genu varum: bowleg, genu valgum: knock knee. Knee capsule is extensive to allow large range of movement.
  148. lateral crural compartment:
    deep fascia containing peroneal muscles.
  149. lateral malleolus:
    lateral protruberance at ankle, off of distal fibula. Note that fibula hangs down lower than tibula, so that most ankle injuries are inversion (vs. eversion). There is also concern over relative ligament strength as well.
  150. lateral meniscus:
    more freely moveable than medial meniscus, shallower and less likely damaged
  151. linea aspera:
    L. "rough line" on posterior femur; many muscles attach there, e.g., adductors inserting there
  152. medial (deltoid) ligament:
    consists of several components, very strong for medial support to ankle joint.
  153. medial longitudinal arch of foot:
    both lateral and medial arches help to spread weight, but the higher medial is more important, as highlighted with flatfeet and its loss.
  154. medial malleolus:
    medial protuberance at ankle, off of distal tibia. Posterior tibial pulse behind it.
  155. medial meniscus:
    more firmly held, also since more deeply cupped of menisci, so more typically the injured one.
  156. medial, lateral condyle of femur:
    contributes to knee joint
  157. medial, lateral condyles of tibia:
    to articulate with femoral condyles; covered with menisci in knee joint. These condyles contribute to the tibial plateau.
  158. medial, lateral epicondyle of femur:
    contributes to knee joint as attachment points of MCL and LCL, respectively.
  159. metatarsal b.:
    bones of arch, can be fractured if weight dropped on or rolled over them. Stress fractures of metatarsals from suddenly increased exercise load.
  160. navicular b.:
    tarsal proximal to cuneiforms
  161. patella:
    subcutaneous kneecap, largest sesamoid bone in body, embedded in quadriceps tendon
  162. patellar ligament (tendon):
    continuation of quadriceps tendon, between patella and tibial tuberosity
  163. phalanges: bunion:
    abnormal angle of 1st MTP (metatarsophalangeal) joint. Gout: inflammation there from uric acid crystals. Hammer toe: contracted extensor tendons, so that MTP joints extended, PIP (proximal interphalangeal) joints flexed, leading to dorsal surface corns.
  164. plantar aponeurosis (fascia):
    helps to maintain the arches of the foot; plantar fasciitis from overuse, with pain at the calcaneal origin of fascia
  165. popliteal fossa:
    space behind knee, defined by hamstring tendons. Popliteal pulse, aneurysm in this region. Baker cyst: abnormal projection of the semimembranous bursa.
  166. posterior cruciate ligament (PCL):
    stronger than ACL, prevents anterior displacement of femur on tibia, e.g., with hyperflexion.
  167. posterior crural compartment:
    deep fascia containing the calf muscles
  168. pubic tubercle:
    thickened lateral aspect of pubic crest
  169. superior vs. inferior extensor retinaculum:
    broad band of deep fascia to prevent bowstringing of anterior tendons, with the inferior more Y-shaped
  170. suprapatellar (quadriceps) bursa:
    between femur and quadriceps tendon, so with communication with knee joint, infections can spread from it to synovial cavity. Suprapatellar bursitis: effusion, "water on the knee"
  171. sustentaculum tali:
    lateral shelf off of calcaneus, upon which talus b. rests.
  172. talus b.:
    ankle bone with which tibia and fibula articulate in hinge joint. Set at a slight (15o) angle to calcaneus below it.
  173. three cuneiform b.:
    proximal to 1st-3rd metatarsals.
  174. tibia b.:
    main weight-bearing part of leg (distal lower extremity between knee and ankle). Shin bone with palpable margin.
  175. tibial (medial) collateral ligament (MCL):
    firmly attached to medial meniscus and so can be part of "unhappy triad."
  176. tibial tuberosity:
    anterior location, as patellar ligament inserts here. Osgood-Schlatter disease in 10-15 year olds, often from overuse
  177. trochanteric bursa:
    thin, lubricating sac that covers over greater trochanter to prevent irritation from iliotibial tract. Can become inflamed.
  178. abductor hallucis m.:
    O calcaneal tuberosity, I medial aspect of pollox proximal phalanx, N medial plantar n. (from tibial n.), O abduct toe, support medial longitudinal arch.
  179. adductor brevis m.:
    O body, inferior ramus of pubis, I proximal linea aspera, N obturator n, A adducts thigh
  180. adductor canal (Hunter's) and adductor hiatus:
    (subsartorial canal) narrow fascial tunnel that begins at apex of femoral triangle, ends in adductor hiatus in adductor magnus, covered by sartorius m. Femoral a/v here.
  181. adductor longus m.:
    O pubis below crest, I linea aspera, N obturator, A adducts. "Pulled groin" refers to adductor muscles.
  182. adductor magnus m.:
    O pubic arch, ischial tuberosity, I linea aspera to adductor tubercle, N obturator and sciatic nn, A adducts and extends hip, given that there is an adductor component (obturator n) and a hamstring component (sciatic n, tibial component).
  183. biceps femoris m.:
    Long head: O ischial tuberosity, I proximal fibula, N sciatic n, tibial division, A flex knee, extend hip; Short head: O linea aspera, I proximal fibula, N sciatic n, common fibular/peroneal division, A flex knee
  184. extensor digitorum longus m.:
    O ant. fibula/interosseus membrane, I distal phalanges of toes 2-5, N deep fibular (peroneal) n, A extend those digits, dorsiflex foot
  185. extensor hallucis longus m.:
    O middle ant. fibula/interosseus membrane, I distal phalanx of hallux, N deep fibular (peroneal) n, A extend hallux, dorsiflex foot
  186. fibularis (peroneus) brevis m.:
    O distal 2/3 fibula and ant. to peroneus longus m., I base of 5th metatarsal, N superficial (peroneal) n, A evert foot (and some plantarflexing)
  187. fibularis (peroneus) longus m.:
    O proximal 2/3 fibula, I base of 1st metatarsal and medial cuneiform, N superficial (peroneal) n, A evert foot (and some plantarflexing)
  188. flexor digitorum longus m.:
    O posterior tibia I bases of the other distal phalanges. N tibial n. A flex toes, plantarflex ankle
  189. flexor hallucis longus m.:
    three deep flexor muscles that loop around the medial malleolus; "Tom, Dick, and Harry.". Flexor hallucis longus m. is a powerful muscle for toe push-off. O inferior, posterior fibula, I base of distal phalange of hallux N tibial n. A flexes big toe.
  190. gastrocnemius m.:
    O (2 heads), posterior femur above the condyles, I calcaneus via achilles tendon, I tibial n., A plantarflex ankle, and flex knee
  191. gluteus maxiums, medius, and minimus m.:
    gluteus maximus: O outer ilium I iliotibial tract, and gluteal tuberosity N inferior gluteal nerve, A extend and laterally rotate hip. Gluteus medius and deep to it, gluteus minimus: O external ilium, I greater trochanter, N superior gluteal n, A abducts thigh, so assists in walking by preventing pelvic tilt towards unsupported side (as opposite leg lifted off ground)
  192. gracilis m.:
    O lower pubis, ischial edge, I medial surface proximal tibia, N obturator n, A adducts, flexes leg. Most medial of the adductors.
  193. iliopsoas m.:
    psoas major part, from lumbar vertebrae, ilacus part, from ilium, both to lesser trochanter to flex hip. Psoas major part, L1, 2 rami; iliacus part, femoral n.
  194. inferior gemellus m.:
    O upper ischial tuberosity, I obturator internus tendon, N n to quadratus femoris, A laterally rotate femur
  195. obturator internus m.:
    O: obturator membrane, I: greater trochanter, N: n. to obturator internus (sacral plexus), A: laterally rotate femur
  196. pectineus m.:
    O pubis (pectinal line), I posterior femur near lesser trochanter, N femoral n (origin near iliopsoas, may also get some obturator n), A adducts
  197. pes anserinus:
    where tendons of sartorius, gracilis, and semitendinosus attach distally; the anserine bursa can become inflamed and lead to a localized inner knee pain.
  198. piriformis m.:
    O: anterior sacral vertebrae, I: greater trochanter, N: S1-2 anterior rami, A: laterally rotate femur
  199. plantaris m.:
    O ridge above lateral femur condyle, I calcaneus via achilles tendon, N tibial n, A plantarflex ankle (and flex knee). Rupture of plantaris m. tendon can cause severe pain without palpable findings. Plantaris tendon can be used as graft for hand tendon reconstruction.
  200. popliteus m.:
    O lateral condyle of femur (+ joint capsule), I proximal tibia, N tibial n, A rotates femur laterally if tiba fixed (supposed to unlock knee, but no consistent popliteus m. action during walking noted on EMG).
  201. quadratus femoris m.:
    O ischial tuberosity, I intertrochanteric crest (quadrate tubercle), N n to quadratus femoris (L5-S1), A lat. rot. femur
  202. quadriceps femoris m., quadriceps tendon:
    four mm worth of anterior thigh that act as knee extensors, where the quadriceps tendon connects them to the superior patella.
  203. rectus femoris m.:
    O ant. inferior iliac spine, I tibial tuberosity, N femoral n, A extends knee and flexes hip (think of old-fahsioned straight-on field goal kicker)
  204. sartorius m.:
    O ASIS, I proximal, medial surface of tibia, N femoral n, A tailor position, flexor
  205. semimembranosus m.:
    "Meatier" than semitendinosus, with proximal membranous component. O ischial tuberosity, I upper tibia, N sciatic n, tibial division, A flex knee, extend hip
  206. semitendinosus m.:
    For semitendinosus, long tendon noticeable. O ischial tuberosity, I proximal tibia behind sartorius, N tibial division of sciatic n, A flex knee, extend hip
  207. soleus m.:
    stronger plantarflexor than gastroc. O posterior tibia and fibula, I calcaneus via achilles tendon, I tibial n, A plantarflex ankle
  208. superior gemellus m.:
    the gemelli surround obturator internus. O ischial spine, I obturator internus tendon, N n to obturator internus (L5-S1), A laterally rotate femur
  209. tensor fasciae latae m.:
    O anterior iliac crest, I iliotibial tract, N (superior gluteal n), A tenses iliotibial tract, which assists in bracing knee so that it doesn't buckle with body weight on it.
  210. tibialis anterior m.:
    O proximal tibia, I base of 1st metatarsal and medial cuneiform, N deep fibular (peroneal) n, A dorsiflex and invert foot. The swollen muscle in the above-described syndromes in anterior compartment
  211. tibialis posterior m.:
    O interosseus membrane and parts of tib/fib I various parts of sole, including base of 2, 3, 4 metatarsals N tibal n. A plantarflex ankle, invert foot
  212. vastus intermedius m.:
    O front 2/3 of femoral shaft, I tibial tuberosity, N femoral n, A extends knee
  213. vastus lateralis m.:
    O proximal linea aspera, greater trochanter, I tibial tuberosity, N femoral n, A extend knee
  214. vastus medialis m.:
    O medial edge of linea aspera, I tibial tuberosity, N femoral n, A extends knee. There has been an ongoing discussion in the literature regarding a distal VM obliquus component affecting patellofemoral syndrome, but a 2009 systematic review in Clinical Anatomy does not support a VM longus and VMO formal anatomical separation, although VMO will appear in orthopedic discussions.
  215. anterior tibial a., v.:
    blood supply to anterior crural compartment, distally turns into dorsalis pedis art. (of pulse fame)
  216. deep artery of thigh (profunda femoris, deep femoral a.):
    major branch of femoral a/v, leaves from femoral triangle, travels between pectineus and adductor longus; major supply to thigh (branch: medial femoral circumflex a)
  217. dorsalis pedis a.*:
    begins midway between malleoli, continuation of anterior tibial art.; pulse palpable.
  218. femoral a., v.:
    vessels for leg, runs in adductor canal. Includes branches such as deep fermoral a, v. Femoral v. close to body, don't mistake for great saphenous v.
  219. fibular (peroneal) a., v.:
    artery off of posterior tibial a., vein one of several sites for DVT formation.
  220. genicular arteries*:
    around knee joint, with superior and inferior pairs.
  221. great saphenous v.:
    begins anterior to medial malleolus, enters through saphenous opening in fascia lata to the femoral v. Considerations of: vein graft for coronary bypass, varicosities, saphenous cutdown anterior to medial malleolus.
  222. medial femoral circumflex a.*:
    blood supply to head/neck of femur, of avascular necrosis concern if damaged.
  223. popliteal a., v.:
    artery (from femoral a. through adductor hiatus) supplies to region, including the genicular arteries around the knee joint. Vein formed by anterior, posterior tibial veins (and small saphenous vein drains into it as well).
  224. posterior tibial a.:
    blood supply to posterior compartment, palpable pulse posterior to medial malleolus
  225. small saphenous v.:
    begins posterior to lateral malleolus, ends in popliteal v. Drains blood from superficial fascia, with connection via perforating veins to deep veins.
  226. common peroneal n. (fibular):
    Typically, sciatic n. splits into this and tibial nerves at midthigh, but can happen more proximally. Common fibular n. winds around posterior head of fibula and so is commonly injured. This injury causes foot drop (loss of dorsiflexion, eversion).
  227. deep fibular (peroneal) n.:
    supplies anterior crural compartment
  228. femoral n.:
    largest branch of lumbar plexus (L2-4), lateral to femoral sheath, supplies anterior thigh muscles.
  229. inferior gluteal n.:
    innervation for gluteus maximus m., leaves greater sciatic foramen inferior to piriformis m.
  230. obturator n.*:
    major contribution from lumbar plexus (L2-4), leaves pelvis through obturator canal in obturator internus fascia, passes through obturator foramen to innervate adductor muscles.
  231. sciatic n.:
    Sciatic n., major structure from sacral plexus (L4-S3), really tibial and fibular nerves, leaves through greater sciatic foramen. Avoid injecting by aiming needles towards upper outer quadrant of gluteal region.
  232. superficial fibular (peroneal) n.:
    supplies peroneal muscles, and distally innervates dorsum of foot
  233. superior gluteal n.:
    innervation for gluteus medius, minimus, TFL mm. Leaves greater sciatic foramen superior to piriformis m.
  234. tibial n.:
    superficial in popliteal fossa, supplies plantarflexors.
  235. arachnoid granulation (villus):
    arachnoid villi become hyptertrophied with age and so considered granulations. These arachnoid features project into the superior sagittal sinus. They protrude through the dura and so are main sites of CSF absorption into the venous system.
  236. arachnoid mater:
    intermediate, with subarachnoid webbing towards pia, forming the subarachnoid space for cerebrospinal fluid (CSF). Subarachnoid hemorrhage if blood in there.
  237. central sulcus:
    delineating frontal and parietal lobes; precentral (motor) and postcentral (sensory) gyri are important
  238. cerebellum:
    coordinates skeletal muscle contractions with inputs from proprioceptors. Vermis is the "worm-like" region between the hemispheres that are made of anterior and posterior lobes. As with the cerebrum, there can be localization of cerebellar lesions as a result.
  239. cerebral aqueduct:
    between 3rd and 4th ventricles. Blockage here creates a noncommunicating hydrocephalus.
  240. cerebrum:
    greatly enlarged in humans compared to other animals because of our "higher brain functions" (like thinking up silly mnemonics)
  241. choroid plexus:
    found in 3rd ventricle most visibly, and lateral and 4th ventricles too. These secrete the CSF.
  242. cingulate gyrus (limbic cingulate cortex):
    immediately superior to corpus callosum on midsagittal section; projecting part of limbic system
  243. corpus callosum:
    large tract of white matter connecting right and left hemispheres
  244. dura mater:
    outer tough membrane. Subdural hematoma from tearing of cerebral v as they enter dural sinuses.
  245. falx cerebri:
    inner layer of dura mater in midsagittal plane that separates the cerebral hemispheres and encloses superior and inferior sagittal sinuses
  246. fourth ventricle:
    anterior to cerebellum, connected to 3rd ventricle by cerebral aqueduct
  247. frontal lobe:
    anterior portion of cerebral hemisphere; site of personality, initiation of motor responses (at precentral gyrus)
  248. hypothalamus:
    below the thalamus, forming floor of third ventricle. Major autonomic and limbic center, e.g., "Fs" of fever, feeding, and fluids (temperature, hunger/satiety, and water balance/osmolarity)
  249. infundibulum:
    funnel-shaped unpaired prominence of the base of the hypothalamus, continuous below with the stalk of the pituitary, so that the hypothalamus can tell the pituitary what to do, e.g., axons going towards posterior lobe of pituitary.
  250. lateral fissure (sulcus):
    delineating temporal and frontal lobes
  251. lateral ventricle:
    two large ventricles that extend into the cerebral hemispheres
  252. longitudinal fissure:
    separation of the hemispheres; falx cerebri extends into here
  253. mammillary body:
    just posterior to pituitary stalk; part of projection of limbic system (to portions of thalamus); often involved in Wernicke-Korsakoff syndrome from thiamine deficiency
  254. medulla oblongata, pyramid; brainstem;
    center for involuntary functions. The pyramids represent the location of the corticospinal tracts.
  255. meninges:
    connective tissue membranes around the central nervous system. Meningitis when infected.
  256. midbrain:
    surrounds cerebral aqueduct; relay centers involved in controlling posture and movement, e.g., substantia nigra of Parkinson's disease fame.
  257. occipital lobe:
    posterior portion; conscious perception of vision
  258. parietal lobe:
    posterior to central sulcus; somatesthetic response (from muscle and skin sensations) at postcentral gyrus; interpretation of textures and shapes
  259. pia mater:
    soft membrane, very close to brain and spinal cord, and so hard to peel off separately
  260. pons:
    rounded bulge on inferior brain surface. Many white fibers pass through here; several cranial nerve nuclei here; also works with medulla to regulate breathing rate.
  261. postcentral gyrus:
    part of parietal lobe next to central sulcus; primary sensory area also arranged in HAL homunculus fashion.
  262. precentral gyrus:
    part of frontal lobe next to central sulcus; primary motor area arranged in homunculus HAL (head, arm, leg) lateralà medial
  263. subarachnoid space:
    location for CSF flow
  264. superior and inferior colliculi:
    the four "bumps" on the tectum ("roof") of midbrain as a whole; sup. and inf. colliculi involved in visual and auditory reflexes, respectively (colliculus, singular).
  265. temporal lobe:
    separated by lateral sulcus; interpretation of sounds; memory processing; some limbic system components
  266. tentorium cerebella:
    fold of dura between occipital lobe and cerebellum; hence term of supratentorial for location
  267. thalamus:
    paired organ underneath each lateral ventricle and making up much of the wall of the 3rd ventricle; relay center for almost all sensory information
  268. third ventricle:
    midline, in the diencephalon (thalamus, hypothalamus region)
  269. olfactory bulb and n. (CN I):
    large, anteriorly extending nerve bundles; bulbs on top of cribriform plate; smells
  270. optic n. (CN II), optic chiasm(a):
    Carries visual information, with a crossing of optic tracts anterior to pituitary (leading to a partial crossing over of fibers that has annoyed generations of students trying to learn the optic pathways); if damaged, leads to bitemporal hemianopia.: large nerve tracts that cross over (chiasma) in front of pituitary, enters optic canal; carries visual information
  271. oculomotor n. (CN III):
    moves eyes (except for lat. rectus, sup. oblique), constricts pupils and accomodates (parasympathetic actions). "Blown pupil" as CNIII runs over bony (sphenoid) ridge to cavernous sinus and so can be compressed.
  272. trochlear n. (CN IV)*:
    Innervates superior oblique m of eye (down and out). Delicately comes out lateral to CN III and anterior to large CN V. CN IV unusual in that it crosses over by the superior colliculi.
  273. trigeminal n. (CN V), frontal n.:
    CN V very large, comes out lateral pons; chews and feels front of head. Trigeminal neuralgia (tic douloureux). Frontal nerve, superior to lev. palp. sup. is part of CN V1, and its branches cover much of the CN V1 territory.
  274. abducens (abducent) n. (CN VI):
    Arises almost midplane between pons and medulla; supplies lateral rectus m
  275. facial n. (CN VII):
    see it here near CN VIII coming off pons/medulla junction; races off towards internal auditory meatus
  276. vestibulocochlear n. (CN VIII):
    near CN VII and also aims for internal auditory meatus; hears, regulates balance
  277. glossopharyngeal n. (CN IX):
    Off of medulla, aims toward jugular foramen; tastes and senses in posterior tongue, monitors carotid body and sinus
  278. vagus n. (CN X):
    Off of medulla, aims for jugular foramen; tastes, swallows, lifts palate,phonates, communication to and from viscera in the thorax and abdomen
  279. (spinal) accessory n. (CN XI):
    aims for jugular foramen; turns head (SCM, sternocleidomastoid), lifts shoulder (trapezius)
  280. hypoglossal n. (CN XII):
    Off of medulla, aims for hypoglossal canal in occipital bone near foramen magnum; moves tongue
  281. anterior and posterior spinal arteries:
    these arise from the vertebral arteries, with two posterior spinal arteries near the dorsal nerve roots, and the anterior spinal artery in the anterior median fissure. The posterior spinal arteries have more potential anastomoses. The anterior spinal arteriy covers the spinothalamic and corticospinal tracts. If the radicular supplementation is lost (e.g., clamping of the aorta and involvement of the great radicular artery), those tracts may be affected inferior to the lesion.
  282. anterior cerebral a.:
    off of internal carotid, runs along longitudinal fissure to supply the medial part of the cerebral cortex ("leg" part of homunculus)
  283. anterior communicating a.:
    small little branch spanning longitudinal fissure between the anterior cerebral arteries
  284. anterior inferior cerebellar a.:
    originate at about the point that the vertebral a. fuse into the basilar a. Typically the labyrinthine a. to the inner ear originates off of AICA.
  285. basilar a.:
    fusion of vertebral arteries; runs up pons
  286. cavernous sinus:
    on either side of sella turcica: cavernous sinus thrombosis from infections of the upper face. CN II, IV, V1, VI, and internal carotid artery are all involved in or near the cavernous sinus.
  287. cerebral arterial circle (circle of Willis):
    ring of blood supply surrounding pituitary; sets up potential communicating blood flow
  288. confluence of sinuses:
    where superior sagittal sinus and straight sinus meet up
  289. inferior sagittal sinus:
    blood drainage in inferior margin of falx cerebri
  290. internal carotid a.:
    one of the main blood supply to head, with three main branches of ophthalmic artery to eye, and anterior, middle cerebral arteries to portions of cerebral hemispheres.
  291. middle cerebral a.:
    off of internal carotid, extends laterally to reach the lateral aspects of cerebral cortex ("head and arm" part of homunculus). Lateral striate a. branches off of this supply the internal capsule ("stroke arteries").
  292. middle meningeal a.:
    Large blood supply to bones of calvaria and to dura. Epidural/extradural hematoma when the artery is ruptured. The middle meningeal vein would feed into the pterygoid plexus.
  293. posterior cerebral a.:
    from basilar artery; blood supply to occipital lobe and midbrain
  294. posterior communicating a.:
    connectors between posterior cerebrals and internal carotid arteries
  295. posterior inferior cerebellar a.:
    PICA, off of vertebral a. before they fuse into basilar a. Stroke here creates Wallenburg syndrome of ipsilateral signs (CN IX, X, spinocerebellar tract, sympathetics) and contralateral signs (spinothalamic tract)
  296. sigmoid sinus:
    runs a S-like path in posterior cranial fossa (see grooves inside skull), bringing blood down to jugular foramen and so contributing to internal jugular veins
  297. straight sinus:
    runs posteriorly from end of inferior sagittal sinus to the sinus confluence.
  298. superior cerebellar a.:
    just behind posterior cerebral a., SCA supplies superior surface of the cerebellum, so that stroke causes ipsilateral ataxia. SCA may compress CN V and thereby trigger trigeminal neuralgia.
  299. superior sagittal sinus:
    in superior margin of falx cerebri, venous drainage into confluence of sinuses
  300. transverse sinus:
    runs from confluence of sinuses through tentorium cerebella to sigmoid sinus
  301. vertebral a.:
    arise from subclavian arteries, pass through transverse foramina of cervical vertebrae, passes through foramen magnum, merge to form basilar artery
  302. clivus:
    posterior surface of sphenoid up against pons and basilar artery; site of brain herniation into foramen magnum
  303. cribriform plate:
    holes in ethmoid lateral to crista galli, for axons of olfactory cells to go through to reach olfactory bulb
  304. crista galli:
    median, superior ridge of ethmoid bone, anterior attachment of falx cerebri
  305. foramen magnum:
    large hole in occipital bone to allow spinal cord, brain to connect
  306. foramen rotundum, ovale, spinosum, lacerum:
    foramen rotundum, medial to the others, is the opening for CN V2, the maxillary nerve. Foramen ovale, lateral to f. rotundum, is the opening for CN V3, the mandibular nerve. Foramen spinosum, lateral to f. ovale, is the opening for the middle meningeal artery. Foramen lacerum mostly covered with fibrocartilage,
  307. hypoglossal canal:
    lateral to foramen magnum, opening for CN XII.
  308. internal auditory (acoustic) meatus:
    out of the petrous portion of the temporal bone, opening for CN VII and CN VIII.
  309. jugular foramen:
    inferior to the internal auditory meatus, the opening for the sigmoid sinus//internal jugular vein. In addition, CN IX, X, XI all leave the skull through here.
  310. levator palpebrae superioris m., superior tarsal muscle:
    as name implies for levator palp. sup., lifts upper lid. CN III supply. In contrast, sympathetic supply to involuntary superior tarsal m. component.
  311. optic canal:
    space for CN II to reach orbit; through lesser wing of sphenoid bone
  312. petrous portion (temporal b.):
    that part of temporal bone with a sharp superior margin for tentorium cerebelli attachment; contains inner ear
  313. pterion:
    weak spot where several sutures (frontal, parietal, temporal, sphenoid) unite. Overlies anterior branches of middle meningeal a., so if damage at pterion, risk of epidural hematoma.
  314. sella turcica:
    scooped-out portion of sphenoid bone for the pituitary gland. The deepest part for the pituitary is the hypophyseal fossa.
  315. spinal cord:
    begins distally to medulla at foramen magnum
  316. superior oblique m.:
    innervated by CN IV, rotates eye “down and out”.
  317. superior orbital fissure:
    between the greater and lesser wings of the sphenoid bone, allows passage of ophthalmic veins and cranial nerves to orbit.
  318. three cranial fossae:
    in cranial base: anterior c.f. holds frontal lobes, middle c.f. holds temporal lobes, and posterior c.f. holds cerebellum, pons, medulla
Card Set:
Lab Objectives: Extremities, Brain and Braincase
2013-04-25 20:01:52

Extremities, Brain and Braincase
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