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Anatomy Review #1

Brachial Plexus
See the pdf in google drive on brachial
plexus
*long thoracic
Injury to this causes winged scapula
Serratus anterior

*suprascapular
Supraspinatus
infraspinatus

*thoracodorsal
Latissimus dorsi

Nerve stems

Axillary: C5-6
Radial: C5-T1
Musculocutaneous: C5-7
Median: C6-T1 (C5)
Ulnar: C8-T1

Spaces
Triangular space

Teres minor
Long head of triceps
Teres major
Circumflex scapular a.

Quadrangular space
Teres minor
long head of triceps
shaft of humerus
teres major
Axillary n.
Post. circumflex
humeral a.
Post. circumflex
humeral v.

Triangular interval
Teres major
Long head of radius
Shaft of humerus
Profunda brachii a.
Radial n.

pp. 679, 691 text

Joints: Synovial
Synovial
Capsule (inner synovial membrane, outer fibrous)
Hyaline covers articulating surfaces
Sternoclavicular-

Modified ball and socket joint (according to the articular


surfaces it is rather a saddle, but because the disk it functions like ball and
socket)

Acromioclavicular- plane joint (gliding)


Glenohumeral- ball and socket
Humeroulnar- compound (hinge-pivot)
Distal radioulnar joint- pivot joint
Radiocarpal- ellipsoid joint (condylar)
Carpal-metacarpal- plane joints (EXCEPT: THUMB =saddle joint)
Metacarpophalangeal- ball and socket
Interphalangeal- hinge joint

p. 20 Grays text

Joints: Solid
Fibrous joints: sutures, gomphoses, syndesmoses
Suture- skull
Gomphoses- teeth and bone
Syndesmoses- two adjacent bones linked by
ligament (ligamentum flavum, interosseous
membrane)
Cartilaginous joints: synchondroses, symphyses
Synchondroses- where two ossification centers
separated by cartilage (growth plate)
Symphyses- two separate bones are interconnected
by cartilage (pubic symphysis, intervertebral discs)
p. 20 Grays text

Signs
Waiters tip- Erbs palsy upper trunk injury
C5-6

Claw hand- Klumpkes lower trunk injury


C8-T1
Ring and little fingers hyperextended at MCP joints, flexed at IP joints
Cant open hand with fingers

Hand of Benediction
The ability to flex the digits 23 at the MCP joints is lost as is the
ability to flex and extend proximal and distal interphalangeal
Dupuytrens contracture- thick palamar fascia
Cant make fist with fingers

Volkmanns contracture-

flexion deformity caused by ischemic necrosis of

forearm flexor muscles


Ape hand- flattening of thenar eminence due to injury to median n. (supracondylar
fx)

Odds and ends


Guyons canal- formed by pisiform and hamate. Ulnar n. runs through it.
Handlebar Palsy
Cubital fossa- TAN lateral to medial
Biceps brachii tendon
Brachial a. (splits to radial and ulnar)
Median n.

Fracture of C2 spinous process- obliquous capitis inferior


Trapezius- abd. Of humerus beyond horizontal
Tight ropey muscle C7-T4=splenius capitus
Innervated by C3-6 posterior ramii

What inserts on radial tuberosity and radial neck? Biceps brachii


Midshaft humeral fracture- supinator
Carpal tunnel- lose sensation of skin of middle finger
Subacromial bursitis affects suprascapular nerve
Anatomical position- legs ADDucted
Thoracodorsal- latissimus dorsi
Touch index and middle fingers to thumb= ulnar n.

More odds and ends


Bennetts fx- fx of base of metacarpal of thumb
Boxers fx- fx of the necks of 2nd and 3rd metacarpals (5th metacarpal in unskilled
boxers)

Colles fx- distal radius fx displaced posteriorly (dorsum of wrist) Dinner fork
deformity

Smiths fx- opposite of Colles


Surgical neck fx- axillary nerve and post humeral circumflex a. affected

Midshaft of humerus fx- radial n. wrist drop


Supracondylar fx- median n. ape hand

Rotator cuff- SITS (Supraspinatus, Infraspinatus, Teres minor, Subscapularis)

Shoulder most commonly dislocated anteriorly


Scaphoid most commonly fractured
Lunate most commonly dislocated (FOOSH)
Know what makes up anatomical snuff box
Lateral epicondylitis- tennis elbow
Medial epicondylitis- golfers elbow

More
Mallet finger-

permanent flexion of distal phalanx.


Avulsion of lateral bands of extensor tendon

Boutonniere deformity

flexed middle phalanx,


hyperextension of distal phalanx. Avulsion of the central
band of the extensor tendon
Allen test- test ulnar, radial circulation to hand

Anatomical Snuff Box


Left hand, palm facing to the right
Far left= extensor pollicis longus
Box
Next= extensor pollicis brevis
Far right= adductor pollicis longus

P.759 grays text