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MSK Anatomy

Terms in this set (110)

articular cartilage

Smooth layer of firm, fibrous tissue covering the contacting surface of joints
Often found at ends of bone

hyaline cartilage

Most common type of cartilage; it is found on the ends of long bones, ribs, and nose

anterior compartment of arm

Flexors
Biceps brachii, coracobrachialis, brachialis
Innervation - musculocutaneous n.
Blood - brachial artery

posterior compartment of arm

Extensor
Triceps brachii
Innervation - radial n.
Blood - profunda brachii

quadrangular space

Medial - long head of triceps brachii
Lateral - surgical neck of humerus
Superior - teres minor
Inferior - teres major
Nerve - axillary n.
Blood - posterior circumflex humeral a.

anterior compartment of forearm

Flexors
Superficial - Flexor carpi ulnaris, palmaris longus, flexor carpi radialis and pronator tere
Intermediate - flexor digitorum superficialis
Deep - flexor digitorum profundus, flexor pollicis longus, pronator quadratus
Nerve - median n. (anterior interosseous n.) and ulnar n.
Blood supply - ulnar a, anterior interosseous a.

posterior compartment of forearm

Extensors
Superficial - extensor carpi radialis brevis, extensor digitorum, extensor carpi ulnaris, extensor digiti minimi, brachioradialis, anconeus, extensor carpi radialis longus
Deep - supinator, abductor pollicis longus, extensor pollicis brevis, extensor pollicis longus, extensor indicis
Nerve - radial n. and its branches

triangular interval

Superior - teres major
Medial - long head triceps
Lateral - lateral head triceps
Nerve - radial n.
Blood - profunda brachii

triangular space

Lateral - long head triceps brachii
Superior - teres minor
Inferior - teres major
Blood - circumflex scapular a. and v.

End of a long bone

Growth zone between the epiphysis and the diaphysis during development of a long bone

Shaft of a long bone

Contains spaces that are filled with blood forming tissue, called red marrow
Soft but strong at the end of bones

medullary cavity

Contains yellow (bone) marrow

Arises from posterior cord of brachial plexus
Innervates deltoid and teres minor

lumbrical muscles

Flex at MCP joint, extend PIP and DIP joints
First and second - innervated by median n.
Third and fourth - innervated by deep branch of the ulnar n.

Helps for foramen
Connect vertebral body and spinous process
Composed of a floor at the back of the vertebra, walls (the pedicles), and a ceiling where two laminae join

Extending from the posterior aspect of vertebral body
Connects body to transverse process

Extending from pedicles and fusing in median plane

vertebral foramen

Hole in center of vertebrae
Where spinal cord lives
○ Anterior border - vertebral body
○ Lateral border - pedicles
○ Posterior border - laminae
Multiple = vertebral canal

transverse process

Lateral projection at pedicle-lamina border

spinous process

Projects posteriorly from vertebral arch where laminae meet
What you feel along back

vertebral notch

Indentation into upper and lower margins of pedicle
Found on inferior and superior sides of pedicle
Form foramen for spinal nerve

On thoracic transverse processes
Where vertebrae articulates with rib
Depression on transverse process

articular process and facet

Superior and inferior projections from pedicle-lamina junction
Purpose of fitting with adjacent vertebrae

C1 vertebrae (Atlas)

No vertebral body
Replaced by anterior tubercle
No laminae or spinous process
Replaced by posterior arch
Concave superior articular processes
Articulates with occipital bone of skull

C2 vertebrae (Axis)

Dens process/odontoid process = vertebral body
Prominent superior projection to Atlas
Held in place by transverse ligament of atlas
Forms joint to allow rotation/pivot of head

C7 vertebrae (Vertebra Prominens)

Longest and most prominent spinous process
No bifurcation
No vertebral artery passing
Transverse foramen present

cervical vertebrae

Transverse forarmina
Hole within transverse process
Passing of vertebral artery
Found in C1-6
*Vertebral vein through C1-7
Bifid spinous process
Only found on C2-6
Bifid transverse processes
Anterior and posterior tubercles
Found on C3-6

thoracic vertebrae

Transverse costal facets on transverse processes
Articulate with ribs
No transverse foramina
Rib joints
1. Costovertebral (rib head + vertebra body)
2. Costotransverse (rib tubercle + vertebra facet)

lumbar vertebrae

No transverse foramina
No transverse costal facets
Largest in size
Quadrangular spinous process

Anterior Longitudinal Ligament

From occipital bone to sacrum
Runs along anterior and anterolateral surface of vertebral column
Fuses with periosteum of vertebral bodies and annulus fibrosus
Resists extension

Posterior Longitudinal Ligament

Posterior surface of vertebral bodies and intervertebral discs
Hourglass shape
Within vertebral canal
Resists flexion

Supraspinous Ligaments

Strong - prevent flexion of spine
Interconnected at tips of spinous processes
From axis to sacrum
Above C7 - ligamentum nuchae

Interspinous Ligaments

Thin
Fill intervals between spinous processes and ligamentum flavum to supraspinal ligaments
Poorly developed in cervical spine

Annulus fibrosus

Periphery of disc
Thicker anteriorly than posteriorly
Joint stability
Retention of nucleus pulposus
When compressed, often moved posteriorly
Fibrocartilage

Nucleus pulposus

Center of disc
80% water
Cannot be compressed
Soft
Fibrocartilage

Outermost meninx
Dense, tough connective tissue
Fibrous
Epidural space - external
Contains fat and veins

arachnoid mater

Delicate, net-like
Separated from pia mater by subarachnoid space
- CSF location

Most delicate
Adheres to surface of brain and spinal cord
Denticulate ligaments - separates dorsal and ventral roots
Filum terminale - anchors spinal cord to sacrum

conus medullaris

Inferior aspect of spinal cord
Terminal portion of the spinal cord
Around LV2

Inferior to conus medullaris
Contains long roots of lower spinal nerves and filum terminale

Posterior/dorsal horn

Gray matter
Sensory (afferent) info

Anterior/ventral horn

Gray matter
Motor (efferent) info

Specific distribution of spinal segment to area of skin
From single dorsal root ganglion - sensory
Wrap around body (embryology)
Explain referred pain (ex. Heart attack)
Different than peripheral (cutaneous) distribution of multi-segmented nerve

Gluteus maximus

Hip extension, abduction, and lateral rotation
Innervation - Inferior gluteal n.
Blood supply - inferior and superior gluteal a.

extensors of hip and flexors of knee

Semitendinosus
Semimembranosus
Biceps femoris

abductors of thigh

Gluteus medius
Gluteus minimus

adductors of thigh

Gracilis
Obturator externus
Adductor magnus

flexors of hip joint

Sartorious
Pectineus
Psoas major and minor
Illiacus

extensors of knee

Quadriceps femoris
Rectus femoris
Vastus lateralis
Vastus medialis
Vastus intermedius

Injury to C5-C6 nerve root
Lateral traction on neck during delivery or trauma
Medial rotation of humerus
Deltoid/supraspinatus - no abduction
Infraspinatus - no lateral rotation of arm
Bicep brachii - no flexion, supination

Injury to C8-T1 -> posterior interosseous n.
Forceful upward force on arm
Muscle deficit - intrinsic hand muscles
*claw hand
Can be associated w/ Horner's syndrome

anterior interosseous syndrome

Compression of motor branch of median n. at pronator teres
Flexor pollicis longus - first muscle affected
Flexor digitorum profundus - second muscle affected
*Cannot make "OK" sign, difficulty picking up objects

Saturday night palsy

Injury to radial n.
Midshaft humeral fracture, compression of nerve
*Wrist drop
Decreased grip strength, dorsal hand numbness

ulnar nerve neuropathy

Wasting of intrinsic muscles of hand, atrophy of hypothenar eminence
Behind elbow cubital tunnel and hand
Numbness and pain in medial portion of palm, first 1.5 fingers
*Claw hand

carpal tunnel syndrome

Compression of median n.
Three grades
Numbness, tingling in thumb, index, and long fingers
Weakness, clumsiness, dropping objects
Chronic - atrophy of thenar muscles
Tx - cut transverse ligament

radial nerve injury

Can be stretched by midshaft/distal humerus fractures
Wrist drop
Numbness of dorsal side - thumb, 2-3rd digit to PIP

obturator nerve

Root: L2-L4
Adductor muscles

Root: L2-L4
Innervates quadriceps and skin of anterior thigh and medial surface of leg

lumbosacral trunk

Root: L5
Supplies majority of muscles and skin of lower limb

superior gluteal nerve

Root: L4-S1
Gluteus medius and minimus
Innervation of tensor fasciae latae

inferior gluteal nerve

Root: L5-S2
Gluteus maximus
Injury causes difficulty in rising from seated position and climbing stairs.

serratus anterior

Attached to ribs
Innervation - long thoracis
Blood - circumflex scapular a.
Protraction of scapula, connect scapula to thoracic wall

Attach from spine to scapula
Innervation - dorsal scapular n.
Blood - dorsal scapular a.
Elevate and retract scapula

latissimus dorsi

Innervation - thoracodorsal n.
Blood - thoracodorsal a. (subscapular a. branch)
Extends, adducts, and medially rotates the arm; draws the shoulder downward and backward

levator scapulae

Innervation - dorsal scapular and cervical n.
Blood - dorsal scapular a.
Elevates scapula and tilts its glenoid cavity inferiorly by rotating scapula

Innervation - axillary n.
Blood - circumflex scapular and subscapular a.
Laterally rotate humerus

Innervation - Lower subscapular n.
Blood - circumflex scapular and subscapular a.
Medially rotate and adduct humerus

lateral rotators of thigh

Gluteus maximus
Piriformis
Obturator internus
Superior and inferior gemelli
Quadratus femoris

sensory axillary nerve

Gives rise to superior lateral cutaneous nerve of arm
Innervates the skin over the lower deltoid

sensory median nerve

Gives rise to the palmar cutaneous branch-
innervates the lateral part of the palm
Digital cutaneous branch - innervates the lateral three and a half fingers on the anterior (palmar) surface of the hand

sensory musculocutaneous nerve

Gives rise to the lateral cutaneous nerve of Innervates skin on the lateral surface of the forearm.

sensory ulnar nerve

Innervates the anterior and posterior surfaces of the medial one and half fingers, and the associated palm area.

sensory radial nerve

Innervates most of the skin of the posterior side of forearm, and the dorsal surface of the lateral side of the palm, and lateral three and a half digits.

femoral triangle

Superior border - Inguinal ligament
Medial border - sartorius
Lateral border - adductor longus
Femoral artery, vein, and nerve

ligamentum flavum

Connects the laminae of adjacent vertebrae
Axis to S1

uncinate process

Prevents posterior linear translation movements of the vertebral bodies
Reinforces the disc posterolaterally
Limits lateral flexion (side-bending)
C3-C7, T1
In Luschka's joints

Sensory function
Posterolateral aspect of distal third of leg
Lateral aspect of foot, heel, and ankle
Nerve root: L4-S4
Travels with small saphenous v.

triangle of auscultation

Hear lungs
Medial - trapezius
Lateral - rhomboid
Inferior - latissimus dorsi

Causes phocomelia

talipes equinovarus (clubfoot)

Hyperextension and incurving of feet
From abnormal positioning or restricted movement of lower limbs in fetus in utero
Treated with French (tape) of Ponseti (casting) method

Grebe-type chondrodysplasia

Autosomal recessive disorder
Mutations in growth factor signaling
Phalangeal abnormalities

L1-L4
Anterior and medial compartment of thigh
Abdominal muscles
Groin
Femoral and obturator n. - posterior and medial compartments of thigh

L5-S4
Glutes
Posterior compartments of thigh
Leg and foot
Motor and sensory nerves of posterior thigh, most of lower leg, entire foot, part of pelvis
Gluteal nerves, sciatic nerve

superior gluteal nerve lesion

Damaging factors - hip dislocation, hip surgery, poliomyelitis
Sx - Trenhdeleberg gait (drop of contralateral side)

Meralgia Paresthetica

Lateral femoral cutaneous nerve
Roots - L2
Sensory function - lateral thigh
Damaging factors - compression of inguinal ligament, scarring near nerve
Tingling, numbness and burning pain in outer part of thigh

femoral nerve injury

Damaging factors
- penetrating injuries to groin
- pelvic fx
- inguinal node resection
- femoral artery puncture
- hip arthroplasty
- malignancies of iliac bone
Sx
- numbness typically the front and medial side inside thigh and leg
- loss of muscle strength of quadriceps
- atrophy of anterior thigh
- absent knee reflex

obturator nerve injury

Damaging factors
- pelvic fracture or hip surgery
- intra-pelvic malignancies may invade nerve
- obturator hernias
Sx
- sensory loss in medial thigh of affected side
- weakness with leg adduction

Roots: L4-S3
Tibial and common fibular divisions
Damaging factor - piriformis syndrome
Sx
- electric current-like pain which radiates into tibial and common fibular nerve distribution
- palsy of foot extension and/or flexion

common fibular nerve injury

Roots: L4-S2
Damaging factors
- compression at fibular neck
- fibular neck fractures
Sx
- acute foot drop "steppage" gait
- paresthesias and/or sensory loss of dorsum of foot and lateral shin
- weakness in foot dorsiflexion and foot eversion with normal inversion and plantar flexion

Roots: L4-S3
Travels through tarsal tunnel
Forms lateral and medial plantar n.
Damaging factors
- fracture or dislocation involving talus, calcaneus, or medial malleolus
- rheumatoid arthritis
- compression by tumors
- entrapped at tarsal tunnel
Sx
- aching, burning, numbness, and tingling involving sole of foot/distal foot/toes/heel
- Positive Tinel's sign
- atrophy of intrinsic foot musculature

tarsal tunnel syndrome

Weakness of plantar flexion
Sensory deficits in foot sole that are aggravated by walking

acetabular fossa

anterior superior iliac spine

ischial tuberosity

symphysis pubis

obturator foramen

lesser sciatic notch

greater sciatic notch

styloid process

medial supracondylar line

intertrochanteric crest

intercondylar eminence

supraglenoid tubercle

infraglenoid tubercle

trendelenburg gait

Superior gluteal nerve lesion
Drop of contralateral hip to compensate pelvic imbalance
Makes contralateral leg longer

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