block 4

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Author:
sgustafson
ID:
76698
Filename:
block 4
Updated:
2011-04-18 15:05:42
Tags:
anatomy
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Description:
upper limb
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  1. innervations of anterior/posterior arm, anterior/posterior forearm, intrinsic hand muscles
    • anterior arm: musculocutaneous
    • posterior arm: radial nerve
    • anterior forearm: medial nerve except flexor carpi ulnaris and medial 2 branches of flexor digitorum profundus
    • posterior forearm: radial nerve
    • intrinsic hand muscles: ulnar nerve except thenar muscles and lateral 2 lumbricals (median nerve)
  2. cutaneous innervation of arm
    • posterior cutaneous nerve of arm (radial nerve): lateral arm and posterior arm/forearm
    • lateral antebrachia cutaneous (continuation of musculocutaneous): lateral forearm
    • median nerve: lateral palmar surface & lateral fingertips
    • superficial branch of radial nerve: lateral dorsum
    • ulnar nerve: medial hand
  3. carpal tunnel
    • flexor carpi radialis travels thru tunnel w/its own synovial sheath
    • ulnar nerve goes thru Guyon/ulnar tunnel, not carpal!
    • palmaris longus tendon blends w/flexor retinaculum
  4. tendons v. ligaments
    • tendons: uniformly stiff
    • ligaments: little resistance to compression so that it deforms w/o damage, but strong w/tension. Mechanoreceptors in ligament needed for proprioception.
  5. ligament attachments to bone
    • fibrous attachment: to periosteum or into bone
    • enthesis: matrix of fibrous tissue gradually replaced w/ fibrocartilage
    • In both types, Sharpey fibers extend into bone
  6. sprain
    • acute/traumatic injury to a ligament
    • Grade 1 (strain): pain, no joint instability
    • Grade 2: partial tear of ligament
    • Grade 3: complete tear of ligament
    • ligament healing: inflammation, granulation tissue (hyaluronan), remodeling & scar
  7. Marfan's syndrome
    • mutation in code for fibrillin
    • an elastic fiber = elastin core covered by fibrillin microfibrils
  8. 4 main types of collagen
    • type I: skin, bone, tendon, ligament, joint capsule
    • type II: cartilage
    • type III: lymphoid
    • type IV: basement membranes
  9. production and destruction of ECM
    • fibronectin-collagen-integrins in PM-actin-nucleus
    • degradation: matrix metalloproteases (MMPs) and serine proteases
  10. endotenon
    • packages collagen fibers into fascicles
    • contains blood vessels
  11. myotendinous junction
    • where tendon receives most blood supply
    • connection w/muscle
  12. tendinopathy
    tendonitis or tendonosis
  13. bursa
    fibrous sac lined w/ synovium
  14. cartilage ECM
    • fibers: type I and II collagen, elastic
    • ground substance: GAG (hyaluronan), proteoglycan (chondroitin sulfate, keratin sulfate = aggrecans), adhesion glycoprotein molecules
  15. elastic cartilage
    • type II collagen, elastic fibers
    • locations: auricle, epiglottis
  16. hyaline cartilage
    • type II collagen
    • articular cartilage
  17. fibrocartilage
    • type I collagen
    • no perichondrium
    • intervertebral disk, symphysis pubis
    • chondrocytes line up in direction of force
  18. perichondrium
    • lines cartilage except fibrocartilage
    • outer fibrous layer
    • inner cellular layer w/ chondroprogenitor cells
  19. deep fascia of the neck is continuous w/what fascia of upper extremity?
    • axillary fascia
    • clavipectoral fascia of chest wall
  20. what are the branches of each part of the axillary artery?
    • 1st: highest thoracic
    • 2nd: lateral thoracic, thoracoacromial
    • 3rd: suprascapular (thoracodorsal + circumflex scapular), anterior humeral circumflex, posterior humeral circumflex
  21. slipped capital femoral epiphysis
    • obligatory external rotation when hip is flexed
    • usually a gradual slip
    • presentation w/knee pain
    • possible endocrine factors and radiation
    • surgery, complications of avascular necrosis and achondrolysis
  22. supracondylar fracture
    • proximity to brachial artery
    • volkman ischemic contracture
    • cubital varus (decreased carrying angle)

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