1. LON-CAPA Logo
  2. Help
  3. Log In
 

ANATOMY 03048, FALL 1998: LAB THOUGHTS FOR THIRD PRACTICAL

More lab thoughts from W. Crone (303 FTZ, 629-7439, cronewil@hvcc.edu, http://www.hvcc.edu/academ/faculty/crone/index.html)

These were my sketchy thoughts that previous students asked me to write out, so here they are, with a little updating. To reiterate, you will not specifically be responsible for these factoids, but they may help you in your weekly preparation for dissection and the third, noncumulative lab practical that will be occurring December 15, 16, 17, 1999.

 

Head (internal structures) (Ch. 7)

  1. foramen magnum: large hole in occipital bone to allow spinal cord, brain to connect
  2. vertebral a a: arise from subclavian arteries, pass through transverse foramina of cervical vertebrae, passes through foramen magnum, merge to form basilar artery
  3. meninges: connective tissue membranes around the central nervous system. Meningitis when infected.
  4. dura mater: outer tough membrane. Subdural hematoma from tearing of cerebral v as they enter dural sinuses.
  5. arachnoid mater: intermediate, with subarachnoid webbing towards pia, forming the subarachnoid space for cerebrospinal fluid (CSF). Subarachnoid hemorrhage if blood in there.
  6. pia mater: soft membrane, very close to brain and spinal cord, and so hard to peel off
  7. middle meningeal a: Large blood supply to bones of calvaria and to dura. Extradural/epidural hematoma when ruptured.
  8. 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.
  9. superior sagittal sinus: in superior margin of falx cerebri, venous drainage into confluence of sinuses
  10. transverse sinus: runs from confluence of sinuses through tentorium cerebelli to...
  11. 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
  12. superior, inferior petrosal sinuses: these drain the cavernous sinus. Inf. petrosal sinuses drain into int. jugular vein, while sup. petrosal sinuses join up with the transverse sinuses to form the sigmoid sinuses.
  13. 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.
  14. arachnoid granulations: arachnoid villi that become hyptertrophied with age, seeing them in superior sagittal sinus. These are protrusions of arachnoid through the dura and so are main sites of CSF absorption into the venous system.
  15. subarachnoid space: as mentioned above, space for CSF flow
  16. trochlear n (IV): Innervates superior oblique m of eye (down and out). Delicately comes out lateral to CN III and anterior to large CN V
  17. trigeminal n (V): Very large, comes out lateral pons; chews and feels front of head. Trigeminal neuralgia (tic douloureux).
  18. facial n (VII): see it here near CN VIII coming off pons/medulla junction; races off towards internal auditory meatus
  19. vestibulocochlear n (VIII): near CN VII and also aims for internal auditory meatus; hears, regulates balance
  20. glossopharyngeal n (IX): Off of medulla, aims toward jugular foramen; tastes, salivates, swallows, monitors carotid body and sinus
  21. vagus n (X): Off of medulla, aims for jugular foramen; tastes, swallows, lifts palate, talks, communication to and from viscera in the thorax and abdomen (and helps CN IX with carotid body and sinus).
  22. accessory n (XI): Off of medulla, aims for jugular foramen; turns head (SCM, sternocleidomastoid), lifts shoulder (trapezius)
  23. hypoglossal n (XII): Off of medulla, aims for hypoglossal canal in occipital bone near foramen magnum; moves tongue (intrinsic tongue mm)
  24. olfactory bulb and n (I):large, anteriorly extending nerve bundles; bulbs on top of cribriform plate; smells
  25. optic n (II): large nerve tracts that cross over (chiasma) in front of pituitary, enters optic canal; sees (we'll discuss the"joy" of the crossing over fibers during neuroanatomy)
  26. oculomotor n: (III):moves eyes (except for lat. rectus, sup. oblique), constricts pupils and accomodates (parasympathetic actions)."Blown pupil" as CNIII runs over bony (temporal) ridge and so can be compressed.
  27. levator palpebrae superioris m.: as name implies, lifts upper lid. CN III supply, as well as sympathetic supply.
  28. abducent n (VI): Arises almost midplane between pons and medulla; supplies lateral rectus m
  29. tentorium cerebelli: fold of dura between occipital lobe and cerebellum; hence expression"supratentorial"
  30. falx cerebri: inner layer of dura mater in midsagittal plane that separates the cerebral hemispheres and encloses superior and inferior sagittal sinuses
  31. inferior sagittal sinus: blood drainage in inferior margin of falx cerebri
  32. straight sinus: runs posteriorly from end of inferior sagittal sinus to the sinus confluence.
  33. spinal cord: begins distally to medulla at foramen magnum
  34. crista galli: median, superior ridge of ethmoid bone, anterior attachment of falx cerebri
  35. cribriform plate: holes in ethmoid lateral to crista galli, for axons of olfactory cells to go through to reach olfactory bulb
  36. optic foramen (canal): space for CN II to reach orbit; through lesser wing of sphenoid bone
  37. petrous portion (temporal b): that part of temporal bone with a sharp superior margin for tentorium cerebelli attachment
  38. optic chiasma: crossing of optic tracts anterior to pituitary (leading to a"fun" partial crossing over of fibers to annoy generations of students)
  39. hypophyseal fossa: scooped-out portion of sphenoid bone for the pituitary gland. Sella turcica would include tuberculum sellae and dorsum sellae as well.
  40. superior orbital fissure: between the greater and lesser wings of the sphenoid bone, allows passage of ophthalmic veins and cranial nerves to orbit.
  41. 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.
  42. foramen rotundum, ovale, spinosum: 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.
  43. internal auditory meatus: out of the petrous portion of the temporal bone, opening for CN VII and CN VIII.
  44. 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.
  45. hypoglossal canal: lateral to foramen magnum, opening for CN XII.
  46. internal carotid a. one of main blood supply to head, with three main branches of ophthalmic artery to eye, and anterior, middle cerebral arteries to portions of cerebral hemispheres.
  47. frontal lobe: anterior portion of cerebral hemisphere; site of personality, initiation of motor responses (at precentral gyrus)
  48. temporal lobe: separated by lateral sulcus; interpretation of sounds; memory processing; some limbic system here too
  49. occipital lobe: posterior portion (not clearly separated from temporal and parietal lobes); conscious perception of vision
  50. parietal lobe: posterior to central sulcus; somatesthetic response (from muscle and skin sensations) at postcentral gyrus; interpretation of textures and shapes
  51. lateral sulcus: delineating temporal and frontal lobes
  52. central sulcus: delineating frontal and parietal lobes; precentral (motor) and postcentral (sensory) gyri are important
  53. 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
  54. precentral gyrus: part of frontal lobe next to central sulcus; primary motor area arranged in homunculus HAL (head, arm, leg) lateralà medial
  55. postcentral gyrus: part of parietal lobe next to central sulcus; primary sensory area also arranged in HAL homunculus fashion.
  56. longitudinal fissure: separation of the hemispheres; falx cerebri extends into here
  57. transverse fissure: separation between cerebral hemisphere and cerebellum; tentorium cerebelli in here
  58. cerebral circle (of Willis): ring of blood supply surrounding pituitary; sets up potential communicating blood flow
  59. basilar a: fusion of vertebral arteries; runs up pons and divides into...
  60. posterior cerebral a: from basilar artery; blood supply to occipital lobe and midbrain
  61. 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").
  62. anterior cerebral a: off of internal carotid, runs along longitudinal fissure to supply the medial part of the cerebral cortex ("leg" part of homunculus)
  63. anterior communicating a: small little branch spanning longitudinal fissure between the anterior cerebral arteries
  64. posterior communicating a: connectors between posterior cerebrals and internal carotid arteries
  65. ophthalmic a.: off of internal carotid a., not part of circle of Willis, enters orbit with CN II.
  66. superior cerebellar a.: just behind posterior cerebral a., SCA supplies superior surface of the cerebellum, so that stroke causes ipsilateral ataxia.
  67. 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.
  68. 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)
  69. insula: fifth lobe of cerebral cortex, see by peeking into lateral sulcus near branches of middle cerebral artery. Insula has poorly defined functions of integration of other cerebral activities.
  70. medulla oblongata: brainstem; center for autonomic functions (From a midsagittal section of the brain for the rest of the structures)
  71. 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
  72. midbrain: surrounds cerebral aqueduct; relay centers involved in controlling posture and movement, e.g., substantia nigra of Parkinson's disease fame.
  73. cerebellum, anterior, posterior lobes, vermis: 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. Anterior lobe syndrome: gait ataxia, with posterior lobe syndrome intention tremor.
  74. thalamus: paired organ underneath each lateral ventricle and making up much of the wall of the 3rd ventricle; relay center for all sensory information except smell
  75. hypothalamus: below the thalamus, forming floor of third ventricle. Major autonomic and limbic center, e.g.,"five Fs" of fever, feeding, fear, fluids, and fornication (temperature, hunger, emotions, water balance, and sexual response)
  76. cerebrum: grotesquely enlarged in humans compared to other animals because of our"higher brain functions" (like thinking up silly mnemonics)
  77. corpus callosum: large tract of white matter connecting right and left hemispheres
  78. choroid plexus: found in 3rd ventricle most visibly, and lateral and 4th ventricles too. These secrete the CSF.
  79. lateral ventricle(s): extend into cerebral hemispheres
  80. third ventricle: midline, in the diencephalon (thalamus, hypothalamus region)
  81. cerebral aqueduct: between 3rd and 4th ventricles. Blockage here creates a noncommunicating hydrocephalus.
  82. fourth ventricle: anterior to cerebellum, connected to 3rd ventricle by cerebral aqueduct

 

Lower Limb (Chap. 5)

  1. small saphenous v:(long e) begins posterior to lateral malleolus, ends in popliteal v. Drains blood from superficial fascia, with connection to perforating vv. to anastomose with deep vv.
  2. 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.
  3. superficial lymph nodes: in superficial fascia of the inguinal region, draining lower limb, lower anterior abdominal wall, gluteal region, perineum and external genitalia (but not ovaries/testes, right?).
  4. fascia lata: deep fascia of thigh, sheathing thigh muscles (the stocking prevents excessive bulging when contracting)
  5. iliotibial tract: a strong, lateral portion of fascia lata, with TFL and gluteus maximus mm inserting onto it.
  6. femoral sheath and 3 compartments: 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.
  7. femoral canal and ring: medial compartment of femoral sheath. Its mouth is the femoral ring. Given location, femoral hernias palpable below inguinal ligament. 1/3 of all female hernias are femoral, rare in males (sex difference in size of femoral ring, and so ability to herniate through it).
  8. anterior superior iliac spine: bony landmark, mm. such as sartorius off of it
  9. anterior inferior iliac spine: hard to palpate; mm. such as rectus femoris off of it
  10. pubic tubercle, acetabulum: thickened lateral aspect of pubic crest; acetabulum: cup-shaped socket for femur head
  11. greater and lesser trochanter: follows femur neck, lateral attachment for gluteal mm. (bursa superficial to it). Lesser trochanter less prominent, more posteromedial, iliopsoas attaches here.
  12. head, neck of femur: head articulates with acetabulum, neck a concern with fracture
  13. lateral condyle of femur: contributes to knee joint
  14. medial condyle of femur: contributes to knee joint; genu valgum: knock knees; genu varum: bow legs
  15. adductor tubercle: on superior aspect of medial epicondyle, adductor magnus will reach to there
  16. linea aspera:"rough line" on posterior femur; many mm. attach there, e.g., adductors inserting there
  17. patella: subcutaneous kneecap, largest sesamoid bone in body, embedded in quadriceps tendon
  18. tuberosity of tibia: anterior, patellar ligament inserts here. Osgood-Schlatter disease in 10-15 year olds, osteochondritis from overuse
  19. femoral triangle: triangle formed by (superior) inguinal ligament, (lateral) sartorius border, (medial) adductor longus border. Femoral pulse and femoral artery/vein access for catheterization.
  20. inguinal ligament
  21. sartorius m: for muscles: O (origin), I (insertion), N (innervation), A (action). Not exhaustive, but highlights. Sartorius: O ASIS, I proximal, medial surface of tibia, N femoral n, A tailor position, flexor
  22. adductor longus m: O pubis below crest, I linea aspera, N obturator, A adduct, laterally rotate."Pulled groin" refers to adductor mm.
  23. 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.
  24. profunda femoris a, v: :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)
  25. medial femoral circumflex a.: blood supply to head/neck of femur, of avascular necrosis concern if damageed.
  26. 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
  27. femoral n: largest branch of lumbar plexus (L2-4), lateral to femoral sheath, supplies anterior thigh mm.
  28. adductor canal (Hunter's) & 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 (not profunda femoris a/v).
  29. adductor magnus m: O pubic arch, ischial tuberosity, I linea aspera to adductor tubercle, N obturator and sciatic nn, A adducts, flexes, rotates laterally. An adductor portion (obturator n) and a hamstring part (sciatic n).
  30. vastus medialis m: O medial edge of linea aspera, I tibial tuberosity, N femoral n, A extends knee
  31. popliteal a: the new name of femoral artery after adductor hiatus, supply behind knee
  32. gracilis m: O lower pubis, ischial edge, I medial surface proximal tibia, N obturator n, A adducts, flexes leg. Most medial of the adductors.
  33. tensor fasciae latae m. : O anterior iliac crest, I iliotibial tract, N (superior gluteal n), A tenses iliotibial tract, which assists assists in bracing knee so that it doesn't buckle with body weight on it.
  34. quadriceps femoris m: four mm worth of anterior thigh, knee extensors
  35. vastus lateralis m: O proximal linea aspera, greater trochanter, I tibial tuberosity, N femoral n, A extend knee
  36. vastus intermedius m: O front 2/3 of femoral shaft, I tibial tuberosity, N femoral n, A extends knee
  37. rectus femoris m: O ant. inferior iliac spine, I tibial tuberosity, N femoral n, A extends knee and flexes hip (think of straight-on field goal kicker)
  38. patellar ligament: continuation of quadriceps tendon, between patella and tibial tuberosity
  39. adductor brevis m: O body, inferior ramus of pubis, I proximal linea aspera, N obturator n, A adducts thigh
  40. 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 mm.
  41. gluteus medius m: 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)
  42. trochanteric bursa, sciatic n: thin, lubricating sac that covers over greater trochanter to prevent irritation from iliotibial tract. Can become inflammed. Sciatic n., major structure from sacral plexus (L4-S3), really tibial (flexor) and fibular (extensor) nerves, leaves through greater sciatic foramen. Avoid injecting by aiming needles towards upper outer quadrant of gluteus maximus/medius.
  43. 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
  44. inferior gemellus m: O upper ischial tuberosity, I obturator internus tendon, N n to quadratus femoris, A laterally rotate femur
  45. quadratus femoris m: O ischial tuberosity, I intertrochanteric crest (quadrate tubercle), N n to quadratus femoris (L5-S1), A lat. rot. femur
  46. semitendinosus m: next three on list are the hamstrings, think of hamstring pull. For semitendinosus, long tendon noticeable. O ischial tuberosity, I proximal tibia behind sartorius, N tibial division of sciatic n, A flex knee, extend hip
  47. semimembranosus m:"Meatier" than semitendinosus. O ischial tuberosity, I upper tibia, N sciatic n, tibial division, A flex knee, extend hip
  48. biceps femoris m, long, short heads: 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
  49. popliteal fossa: space behind knee, defined by hamstring tendons. Popliteal pulse, aneurysm in this region. Baker cyst: abnormal collection of synovial fluid in fossa.
  50. gastrocnemius m: O (2 heads), posterior femur above the condyles, I calcaneus via achilles tendon, I tibial n., A plantarflex ankle, and flex knee
  51. soleus m: stronger plantarflexor than gastroc. O posterior tibia and fibula, I calcaneus via achilles tendon, I tibial n, A plantarflex ankle
  52. popliteus m: O lateral condyle of femur (+ joint capsule), I proximal tibia, N tibial n, A rotates tibia medially (supposed to unlock knee, but no consistent popliteus m. action during walking noted on EMG)
  53. 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 causes severe pain. Plantaris tendon used as graft for hand tendon reconstruction.
  54. flexor hallucis longus m.: these next three are 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
  55. flexor digitorum longus m.: O posterior tibia I bases of the other distal phalanges N tibial n. A flex toes, plantarflex ankle
  56. 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
  57. common peroneal n (fibular): Typically, sciatic n. splits into this and tibial nerves at midthigh, but can happen more proximally. Winds around posterior head of fibula and so is commonly injured. This injury causes foot drop (loss of dorsiflexion, eversion).
  58. tibial n: superficial in popliteal fossa, supplies plantarflexors.
  59. popliteal a, v: artery 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).
  60. superior, lateral genicular a. Around knee joint.
  61. superior, medial genicular a Around knee joint.
  62. tibia b.: main weight-bearing part of leg (distal lower extremity between knee and ankle). Shin bone with palpable margin.
  63. fibula b.: lateral to tibia, can be used for grafting.
  64. medial, lateral condyles of tibia: to articulate with femoral condyles; covered with menisci in knee joint. These condyles contribute to the tibial plateau.
  65. anterior border (crest) of tibia: from below tibial tuberosity, note the"shin" is sharp anteriorly.
  66. head of fibula: articulates with tibia with a synovial joint that allows a little"give" while walking on rough surfaces.
  67. medial malleolus: medial protruberance at ankle, off of distal tibia. Posterior tibial pulse behind it.
  68. 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) (also concern over relative ligament strength as well).
  69. talus: ankle bone with which tibia and fibula articulate in hinge joint. Set at a slight (15o) angle to calcaneus below it.
  70. sustentaculum tali: lateral shelf off of calcaneus, upon which talus b. rests.
  71. calcaneus b.: heel bone with large tuberosity. Can be fractured in long fall onto heel. Inversion, eversion tarsal movements.
  72. navicular b.: tarsal proximal to cuneiforms
  73. cuboid b.: more lateral, base of 4th, 5th metatarsal off of it
  74. three cuneiform b: proximal to 1st-3rd metatarsals.
  75. calcaneal tuberosity: attachment site for achilles tendon (tendo calcaneus)
  76. five metatarsal b.: bones of arch, can be fractured if weight dropped on, rolled over them. Stress fractures of metatarsals (esp. 2nd, 3rd 4th) from suddenly increased exercise load.
  77. 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.
  78. medial, lateral longitudinal arches of foot: both help to spread weight, but the higher medial is more important. Can see that with flatfeet and loss of arch.
  79. anterior crural compartment: contains extensor muscles; concern with anterior compartment syndrome (foot-drop)
  80. deep fibular (peroneal) n: supplies anterior crural compartment
  81. anterior tibial a: blood supply to anterior crural compartment, distally turns into dorsalis pedis art. (of pulse fame)
  82. 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
  83. superior extensor retinaculum: broad band of deep fascia to prevent bowstringing of anterior tendons
  84. inferior extensor retinaculum: more Y-shaped than above
  85. 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
  86. 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
  87. dorsalis pedis a: begins midway between malleoli, continuation of anterior tibial art. pulse palpable.
  88. lateral crural compartment: deep fascia containing peroneal muscles.
  89. superficial fibular (peroneal) n: supplies peroneal muscles, and distally innervates dorsum of foot
  90. 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)
  91. 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)
  92. posterior crural compartment: deep fascia containing the calf muscles
  93. posterior tibial a: blood supply to posterior compartment, palpable pulse posterior to medial malleolus
  94. tendo calcaneus (Achilles tendon): common insertion for gastroc, soleus, plantaris. Ankle jerk: S1, S2. Achilles tendon rupture.
  95. knee joint: consists of articulations among femur, tibia, patella. Knee jerk, mostly considered L4. Extension/flexion, some rotation when in flexion. Genu varum: bowleg, genu valgum: knock knee
  96. tibial collateral ligament: AKA medial collateral ligament, firmly attached to medial meniscus and so can be part of"unhappy triad."
  97. medial meniscus: more firmly held, also since more deeply cupped of menisci, so more typically the injured one.
  98. fibular collateral ligament: AKA lateral collateral ligament, very strong, not often as injured as MCL.
  99. 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"
  100. posterior cruciate ligament: stronger than ACL, prevents anterior displacement of femur on tibia, e.g., with hyperflexion.
  101. anterior cruciate ligament: more often damaged, prevents posterior displacement of femur on tibia, e.g., with hyperextension. If torn, positive anterior drawer sign.
  102. infrapatellar synovial fold:
  103. lateral meniscus: more freely moveable than medial meniscus, shallower and less likely damaged
  104. ankle joint: hinge joint between mortise of tib/fib and talus, so dorsiflexion and plantarflexion. Eversion/inversion more subtalar/midtarsal kind of motion.
  105. medial or deltoid ligament: consists of 4 parts, very strong.
  106. calcaneofibular ligament: from lateral malleolus to calcaneus, less strong than medial ligment
  107. anterior talofibular ligament: from lateral malleolus to talus, not strong and can get easily get damaged in inversion ankle injury).
  108. posterior talofibular ligament: also involved in ankle inversion injuries
  109. plantar aponeurosis (fascia): helps to maintain the arches of the foot; plantar fasciitis from overuse (e.g., at calcaneal origin of fascia)
  110. plantar calcaneonavicular (spring) ligament: extending between sustentaculum tali to navicular, definitely helps to support longitudinal arch

 

Upper Limb (Chap. 6)

  1. dorsal venous arch: network of veins on posterior (dorsal) surface of hand; venous access.
  2. basilic v: superficial v. on the medial inferior arm, plunges into brachial fascia to contribute to and become axillary v.
  3. cephalic v: superficial v. on the lateral side of the arm, which dives into deltopectoral triangle.
  4. median cubital v: in cubital fossa (a good place for venipuncture), allows communication between #2, 3.
  5. extensor retinaculum: at wrist level, thickened deep (antebrachial) fascia for extensor tendons
  6. flexor retinaculum: at wrist level, thickened antebrachial fascia for tunnel for flexor tendons
  7. 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.
  8. 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.
  9. triangle of auscultation: formed by lats, trapezius, and rhomboid major. Drawing scapula anteriorly (folding arms) enlarges space for hearing respiratory sounds.
  10. 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.
  11. rhomboid minor m: leave attached. 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.
  12. 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.
  13. scapula: flattened triangular bone, only bony attachment to axial skeleton is through clavicle
  14. acromion: flattened process that terminates the spine and articulates with clavicle anteriorly. Proximal point from which clinicans measure UE (upper extremity) length
  15. spine of scapula: ridge on posterior surface of scapula, creating the following two fossae…
  16. supraspinous fossa: smaller of the two
  17. infraspinous fossa: larger of the two
  18. glenoid cavity: lateral on scapula, shallow cavity for articulation with humeral head
  19. coracoid process: another projection of scapula, projects anteriorly
  20. acromioclavicular joint: possible dislocation from fall onto outstretched upper limb
  21. coracoclavicular ligament: tough ligament made of separate conoid and trapezoid ligaments. In effect, supports the suspending scapula and upper limb.
  22. humerus, head: rounded, articulates with glenoid cavity
  23. greater tubercle: lateral projection from humeral head, helps to account for roundness of shoulder, attachment site of such items as supraspinatus m.
  24. lesser tubercle: more anterior than the greater tubercle, attachment site of such items as subscapularis
  25. bicipital (intertubercular) groove: separates the tubercles; tendon of long head of biceps brachii here
  26. deltoid tuberosity: halfway down humeral shaft on lateral side, deltoid attaches here
  27. spiral groove: along humeral shaft, radial nerve along here and profunda brachii artery
  28. 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.
  29. axillary n: off of posterior cord of brachial plexus, travels through quadrangular space to supply deltoid, teres minor mm
  30. posterior circumflex humeral a: comes off axillary artery through quadrangular space to supply deltoid m., etc.
  31. quadrangular space: walls of capsule of shoulder joint superiorly, surgical neck of humerus laterally, tendon of teres major inferiorly, and long head of triceps medially. Find axillary n. and post. circumflex hum. a. through here.
  32. triceps brachii m., long, lateral: 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
  33. radial n: most of posterior cord of brachial plexus, supplies extensors. Wrist drop if damaged.
  34. profunda brachii a: (deep brachial a), largest branch of brachial a, travels posteriorly on humerus to anastomose around elbow.
  35. 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 dislocate inferiorly in some manner.
  36. infraspinatus m: O infraspinous fossa of scapula, I posterior greater tubercle, N suprascapular n, A laterally rotate humerus.
  37. teres minor m: O inferior scapula, I posterior greater tubercle, N axillary n, A laterally rotate humerus.
  38. subacromial bursa: keeps supraspinatus m. tendon away from acromion, etc. Rotator cuff or"shoulder" bursitis if inflammed.
  39. 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
  40. 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.
  41. 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.
  42. teres major m: O inferior scapula, I lesser tubercular crest, N lower subscapular n, A adducts, medially rotates humerus
  43. subscapularis m: O deep surface of scapula, I lesser tubercle, N upper and lower subscapular n, A medially rotates humerus
  44. biceps brachii m., long, short: 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.
  45. coracobrachialis m: O: coracoid process, I: medial humerus, N: musculocutaneous, A: adducts, flexes humerus
  46. brachialis m: O: distal anterior humerus, I: proximal ulna @ coronoid process, N: musculocutaneous n, A: flexes at elbow
  47. axillary a, v: after first rib, crossing into axilla
  48. subclavian a: before it crosses the first rib
  49. brachial a: as it crosses inferior edge of teres major m.
  50. brachial plexus: network of nerves to upper limb, partly in neck, partly in axilla
  51. lateral cord: ant. divisions of upper (superior) and middle trunks, lateral to axillary artery.
  52. 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)
  53. median n: derived from medial & lateral cords, innervates many flexors and thenar side
  54. medial cord: ant. division of inferior trunk, contributes to ulnar and median n.
  55. ulnar n: off of medial cord, runs by medial epicondyle of elbow ("funny bone"), supplies hypothenar side and many intrinsic hand mm.
  56. posterior cord: all the post. divisions, contributes to radial and axillary n.
  57. long thoracic nerve: from contributions of C5-7, along lateral chest wall to serratus anterior m. If damaged, then scapular winging.
  58. cubital fossa: hollow area of anterior elbow region, contains brachial artery, etc.
  59. bicipital aponeurosis: triangular band from biceps tendon, across cubital fossa to deep fascia of medial anterior forearm. Helps to protect structures in cubital fossa.
  60. brachioradialis m: O: distal humerus, I: lateral distal radius, N: radial n., A: flexes forearm
  61. triceps brachii m., medial head: O: posterior humeral shaft (medial, lateral heads), I: olecranon process, ulna, N: radial n., A: extends forearm
  62. humerus: largest bone in upper limb
  63. medial epicondyle: attachment site for flexors
  64. lateral epicondyle: attachment site for extensors. Lateral epicondylitis ("tennis elbow").
  65. capitulum: specialized rounded humeral condyle for head of radius.
  66. trochlea: specialized pulley-like humeral condyle for ulna (its trochlear notch).
  67. olecranon fossa: posterior on distal humerus, to accomodate olecranon process of ulna
  68. radius b., head, neck: head and neck features proximally, in contrast to large distal end
  69. radial tuberosity: slightly distal to head, site of insertion for biceps brachii m.
  70. styloid processes (radius, ulna): pointed distal processes to help to stabilize wrist joint
  71. interosseous border: medial; strong interosseus membrane binds ulna and radius
  72. ulna b.: medial in anatomical position
  73. olecranon: large proximal ulnar process for triceps brachii leverage to extend elbow
  74. interosseous border: lateral, for interosseus membrane with radius
  75. radial a: begins in cubital fossa, palpable at distal wrist, crosses floor of anatomical snuff box
  76. flexor carpi radialis m: O: medial epicondyle, I: base of metacarpal 2, N: median n, A: flexes, abducts wrist
  77. 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.
  78. 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
  79. ulnar a: descends through anterior compartment to enter the palm of the hand medially. Crosses wrist superficial to flexor retinaculum, most continues as superficial palmar arch.
  80. 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
  81. 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)
  82. 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)
  83. flexor digitorum profundus m: O: proximal ulna and interosseus membrane, I: distal phalanges of digits 2-5, N: ulnar (medial ˝), median (lateral ˝), A: flexes wrist and fingers
  84. flexor pollicis longus m: O: middle radius and interosseus membrane, I: distal phalanx of thumb, N: median n, A: flexes joints of thumb
  85. thenar group: fleshy base of thumb, group of lateral muscles proximal to and associated with thumb
  86. hypothenar group: fleshy base of 5th digit, group of medial mm. proximal to and associated with 5th digit
  87. carpal bones (8):"Some ladies take pills to treat common headaches"
  88. scaphoid: (navicular), at base of anatomical snuff box, most frequently broken carpal
  89. lunate: semilunar-shaped, in distal row next to scaphoid
  90. triquetrum: in distal row medially, supports small pisiform bone
  91. pisiform: smallest of the carpals, lies closest to palmar surface of carpals
  92. trapezium: allows saddle joint for pollox (thumb)
  93. trapezoid: by trapezium in proximal row
  94. capitate: proximal,"in the middle of it all"
  95. hamate: proximal row, medial, with large hook
  96. metacarpal bones (5): palm bones. Metacarpal shaft fractures.
  97. phalanges (14): finger bones: thumb with only two
  98. palmar aponeurosis: triangular part of deep fascia of hand, covers over long flexor tendons. Dupuytren's contracture: progressive fibrosis in palmar aponeurosis.
  99. superficial palmar arch: formed mostly by ulnar artery, contributes to palmar digital arteries
  100. carpal tunnel: formed by walls and floor of carpal bones, and roof of flexor retinaculum. Carpal tunnel syndrome with entrapment of median n.
  101. 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.
  102. opponens pollicis m: O: flexor retinaculum and trapezium, I: lateral 1st metacarpal, N: median n, A: rotates thumb into opposition
  103. flexor pollicis brevis m: O: flexor retinaculum and trapezium, I: lateral side of proximal phalanx of thumb, I: median n., A: flexes thumb
  105. four lumbrical m: O: tendons of FDP, I: tendons of extensor digitorum in extensor expansion, N: median n first 2, ulnar n 2nd 2, A: helps to create writing position (MCP joints flexed, IP joints extended)
  106. extensor expansion: 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)
  107. pronator quadratus m: O: distal anterior ulna, I: distal anterior radius, N: median n, A: pronates (e.g., royal wave)
  108. adductor pollicis m: O: two heads, distal carpals and proximal portions of metacarpals 2,3, I: medial proximal phalanx of thumb, I: ulnar n, A: adducts thumb
  109. three palmar interossei (PAD): O: ant. borders of metacarpals 2, 4, 5, I: extensor expansion, N: ulnar n, A: adduct digits, assist lumbricals
  110. 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.
  111. 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
  112. extensor pollicis brevis m: O: posterior radius, interosseus membrane, I: proximal phalanx of thumb, N: radial n, A: extends proximal phalanx at carpometacarpal joint
  113. extensor pollicis longus m: O: posterior, middle ulna, I: distal phalanx of thumb, N: radial n, A: extends thumb
  114. extensor carpi radialis brevis m: O: lateral epicondyle, I: base of metacarpal 3, N: radial n, A: extends (dorsiflexes) and abducts at wrist
  115. extensor digitorum m: O: lateral epicondyle, I: extensor expansion, N: radial n, A: extends wrist and fingers
  116. extensor carpi radialis longus m: O: lateral supracondylar ridge, I: base of metacarpal 2, N: radial n, A: extends (dorsiflexes) and abducts at wrist
  117. extensor digiti minimi m: O: lateral epicondyle, I: extensor expansion, digit 5, N: radial n, A: extends 5th digit
  118. extensor carpi ulnaris m: O: lateral epicondyle, posterior ulna, I: base of metacarpal 5, N: radial n, A: extends and adducts at wrist
  119. dorsal interossei (DAB): O: opposite surfaces of adjoining metacarpals, I: extensor expansion, N: ulnar n, A: abduct digits, assist lumbricals

|main page| |background| |03028: Physiology| |03048: Anatomy|

|03050: Invertebrate Zoology| |03051: Vertebrate Zoology| |03074: Economic Botany|

 

Please send comments and questions to: cronewil@hvcc.edu

 

HVCC home page

Copyright 1999 by Wilson Crone

External and unofficial links are not endorsed by Hudson Valley Community College

 

This page updated on November 8, 1999