*Forgot to put in the graphic that musculocutaneous nerve innervates the anterior compartment of the arm + tends to pierce the coracobrachialis!

Erb-Duchenne’s Palsyo Upper brachial plexus lesion (superior trunk)

Damage to C5, C6 o Commonly affects suprascapular n., musculocutaneous n., axillary n.o Inability to abduct

Abduction: supraspinatus (0-15°), deltoid (15-90°)o Inability to flex at elbow or supinate forearm

"Waiter's tip" Klumpke's Palsy

o Lower brachial plexus lesion (inferior trunk) Damage to C8, T1

o Commonly affects intrinsic muscles of the hand, wrist/finger flexors

"Claw hand"

Intrinsic Muscles of the Hando "Bye-bye muscles"o Flex MCP + extend IPo Lumbricals

1 + 2: innervated by median n. 3 + 4: innervated by ulnar n.

Closer to the pinky!o Interossei

"PAD / DAB" Palmar

"ADduct" Dorsal

"ABduct"Blood Supply-Subclavian artery (before rib #1) -Becomes the Axillary artery (after 1st rib to the end of pectoralis minor) -Becomes the Brachial artery (after pectoralis minor)

-Divides at distal end of cubital fossa to form Radial artery (lateral) + Ulnar artery (medial)

Main Branches of Axillary Artery“Sally Thompson Loves Sex And Pot”

Superior thoracic artery (I don’t think you’re responsible for this one, but it goes into the intercostals space) Thoracoacromial artery (has branches that go to the pecs + the acromion) Lateral thoracic artery (goes toward the serratus anterior muscle) Subscapular artery (has 2 branches!)

o Circumflex scapular (goes around/under)o Thoracodorsal (goes to the latissimus dorsi)

Anterior circumflex humeral artery (usually smaller + above the posterior circumflex humeral a.) Posterior circumflex humeral artery (usually fatter + goes posteriorly)

-Median cubital vein: most commonly used for blood draws; it’s the connection between the cephalic + basilic veins-Cephalic vein: lateral; passes through the deltopectoral groove-Basilic vein: superficial + medial!

The flexor retinaculum + extensor retinaculum mainly just function to hold the flexor/extensor tendons in place so they don’t pop out; that probably wouldn’t be really fun. :/

Elbow Ligaments Ulnar (medial) collateral ligament Radial (lateral) collateral ligament) Annular ligament (encircles the head of the radius)

o If radial head slips out of annular ligament => nursemaid’s elbow (will present with guarding of elbow + inability to supinate)

Carpal Bones (8) Proximal row (lat to med): Scaphoid, Lunate, Triquetrum, Pisiform Distal row (lat to med): Trapezium, Trapezoid, Capitate, Hamate)

o “Trapezium” – “Thumb” (they kinda rhyme, so that might help you remember that that’s the “T” that’s closest to the thumb?)

o “Some Lovers Try Positions That They Can’t Handle” Proximal to distal, lateral to medial for both rows

o “So Long To Pinky, Here Comes The Thumb”

Proximal to distal, lateral to medial => medial to lateral

Carpal Tunnel! 9 tendons + 1 nerve

o Flexor digitorum superficialis (4), Flexor digitorum profundus (4), Flexor pollicis longus (1)o Median nerve

Phalen test: hold wrist in complete/forced flexion with dorsal surfaces of both hands pushed together Tinnel test: lightly tap over the median nerve

o Pain/tingling sensation for either of these tests can mean that the pt is (+) for carpal tunnel syndrome

“High-Yield” and/or Fun Factso Axillary nerve usually runs with the posterior circumflex humeral artery in the quadrangular space

o Can be damaged by shoulder dislocations + surgical neck fractures on the humeruso Radial nerve usually runs with profunda brachii (deep brachial) artery

o Can be damaged by humeral shaft fractures / spiral fractureso Ulnar nerve = what causes the “funny” sensation you feel when you hit your funny bone (how humerus :O )o Damage to the long thoracic nerve causes winged scapula b/c it innervates the serratus anterior

o “C5 C6 C7, raise your arms to heaven” – to help remember the nerve roots + actiono Radial artery runs through floor of anatomical snuffbox, so you can palpate your pulse there too!

o => deep palmar arterial arch in the hando But…speaking of the anatomical snuffbox, the borders are made up by the abductor pollicis longus, extensor

pollicis longus + extensor pollicis brevis tendons If you palpate the snuffbox + feel a whole ton of pain, your scaphoid bone is probably fractured :/

This leads to all kinds of bad times and possibly avascular necrosis + poor healing due to lack of blood supply, so try not to fall on an outstretched hand :[

o Ulnar artery travels with the ulnar nerve + gives off common interosseous artery, which branches into the anterior + posterior interosseous arteries

o Different from the nerves in that… Radial nerve => posterior interosseous nerve (after it passes through the supinator muscle) Median nerve => anterior interosseous nerve

o => superficial palmar arterial arch in the hando During pronation/supination, the radius is the bone that moveso Biceps = your strongest supinatoro Brachioradialis, aka your “beer drinking muscle” the only flexor that’s innervated by the radial nerve!o Brachial artery = what you’re using to measure BP when you’re taking it in the arm!o Recurrent branch of the median nerve innervates the thenar eminence (abductor pollicis brevis, flexor pollicis brevis,

opponens pollicis)o The adductor pollicis muscle isn’t cool enough to be part of the thenar eminence, so it is instead innervated

by the deep branch of the ulnar nerve

Sheathso Medial digit sheath communicates with common flexor sheatho Common flexor sheath + sheath of pollex tendons communicates with carpal tunnel

Joints (for the most part)o Acromioclavicular Joint

Type I Tear in ACV ligament

Type II Complete tearing of ACV ligament + partial tear to coracoclavicular ligament

Type III ACV joint dislocated ("shoulder separation")

o Glenohumeral Joint (Rotator Cuff) Stabilization

Anterior Subscapularis

Posterior Infraspinatus, teres minor

Superior Supraspinatus

Axillary nerve at risk for damage Travels through quadrangular space w/ posterior circumflex humeral artery

Can use the “inverted soda can test” to test for impingement, esp. for the supraspinatuso Elbow

"Nursemaid's elbow" Dislocation of elbow joint caused by sudden pull on extended + pronated arm

Head of radius slips from annular ligament Guarding of elbow Inability to supinate

o Wrist/Hand Fracture of distal radius in forearm

Colles' fracture Posterior displacement of wrist + hand

"Dinner fork" hand Tends to happen when falling with outstretched arms

Scaphoid bone is the most commonly fractured! Can disrupt blood supply

Radial artery runs through anatomical snuffbox (you can palpate your pulse there!) Blood perfuses distal to proximal (retrograde!)

o Hip Extension tightens ligaments

Femur head gets screwed into acetabular fossa Dislocation

Femoral head dislodged from socket Weak Spot

Posterior! (iliofemoral + ischiofemoral ligaments)

Affected limb will shorten + internally rotate Fracture

Fracture of femoral neck Much more common

Angle of inclination decreases with age => greater stress on femoral neck External rotation: gluteus maximus, piriformis, quadratus femoris

Medial circumflex femoral a. in danger! Supplies majority of blood to femoral head/neck

Trendenlenburg Gait Contralateral pelvis drop/sag due to inability/difficulty abducting the lower limb

Abduction: gluteus medius, gluteus minimus Lesion to superior gluteal n.

Presentation: leaning to the side of the problemo Knees

Terms used to describe distal aspect of limb distal to the joint Varus: "bowlegged" | Coxa valgus/Genu varum

Valgus: "knock-kneed" | Coxa varum/Genu valgum

Ligaments Anterior cruciate ligament (ACL)

Anterior drawer test Lachman test

Posterior cruciate ligament (PCL) Cruciate ligaments are not inside synovial joint of knee

Medial collateral ligament (MCL) Lateral collateral ligament (LCL)

Swelling/effusion can be seen extending into suprapatellar bursa (superior extension of synovial joint--not a separate bursa)

Popliteal (Baker's) Cyst Joint effusions can push synovial lining out of fibrous joint capsule + create synovial swelling in

popliteal fossa "Unhappy Triad"

From lateral trauma! Damage to medial meniscus, MCL, ACL

McMurray's test used to check for tears in meniscus Patellar Dislocation

Patella dislocates (usually laterally) Pain "inside knee cap" + tendency to flex leg even when relaxed

Patellar Tendon Rupture

Will be able to see patella moving further up quadriceps Difficulty/inability extending Complete Tear

Tendon separates completely from top of tibia Inability to straighten leg

Partial Tear Some fibers of patellar tendon torn

Patellar Tendonitis Tendon torn in middle due to damage from overuse

o Feet :[ Foot Drop

o Damage to common fibular n. or paralysis of muscles in anterior compartment of lower leg Weakness in dorsiflexion High-stepping gait Waddling gait Swinging out of leg gait

Achilles Tendon Rupture Most commonly injured despite being the strongest/thickest tendon Often occurs by sudden plantarflexion or forced dorsiflexion outside ROM

Lateral Ankle Ligaments During inversion, tendons on lateral side get stretched + will rupture if inversion is forceful enough. Ligaments will rupture in this order:

Anterior talofibular Calcaneofibular Posterior talofibular

Inversion injuries most common b/c deltoid ligament on medial side is one strong son-of-a-gun (medial malleolus typically tears away before it ruptures)

Further eversion will fracture distal tibula Pott's fracture

Proximal tibiofibular joint is a separate synovial joint at the knee OPP Correlate

Check for fibular head dysfxn by gliding fibular head anterolaterally + posteromedially Fibular head anterior S/D: fibular head posteromedial glide restriction

External rotation of tibia or Eversion of the foot carries distal fibula posteriorly + glides fibular head anteriorly

They should be opposite of one another!Butt/Thigh

Superior Gluteal Muscles

Gluteus maximuso Extends + laterally rotates thigho Inferior gluteal nerve (since it’s so big, it can actually reach the inferior portion – “big butts hang low,” if that

helps?)o Superior + inferior gluteal arteries

Gluteus medius/minimuso Abduction, medial rotation, prevent pelvic tilt w/ gait*o These are kinda like the “rotator cuff” muscles of the hip!o Superior gluteal nerveo Superior gluteal artery

Tensor fascia latao Stabilizes the knee in extensiono Superior gluteal nerve

*Trendelenburg gait: gluteus medius or minimus damaged or weak, so you end up with “hip drop,” where your hip drops on the side that you’re not standing on

Deep Gluteal Muscles (short lateral rotators that stabilize the femoral head) – “PGOGOQ” from superior to inferior

Piriformiso Sciatic nerve usually runs under it, so it hypertrophies or if sciatic n.

runs through it instead of underneath it, it’ll get compressed + lead to sciatica (can eventually lead to weakness/loss of fxn of certain muscles)

o Nerve to the piriformis Gemellus superior

o Usually darker in coloro The “GOG” makes up the “oreo” (dark-light-dark)

Obturator internuso Dives around to attach to the femur; tends to be lighter in color since

it’s mostly tendon hereo Nerve to obturator internus innervates this + gemellus superior!

Gemellus superior/inferior = hitchhiking gemelli brothers, so they don’t get their own innervations! Gemellus inferior

o Sits on the outside of the obturator foramen; usually darker in color; super deep! Obturator externus

o You can’t really see this one from a posterior view, but if you move the pectineus out of the way + look reallyyyy deep, it’ll be there

Quadratus femoriso Square-shaped + underneath the “oreo”!o Nerve to quadratus femoris innervates this + gemellus inferior!

Posterior Thigh (“butt kickers!” – extend thigh/flex leg) – tibial n. (except the short head!!!) / deep femoral a.

Biceps Femoriso Long heado Short head

This one’s the odd one out! It’s too short, so it can only flex the leg + is innervated by the common fibular/peroneal n.

Fibular/peroneal = the same thing Semitendinosus

o Has a really long tendon Semimembranosus

o Looks really shinyo Most medial (membranosus/medial)

Anterior Thigh – femoral n. / femoral a.

Sartoriuso “Hacky sack” muscle – flexes/laterally rotates thigh + flexes lego Longest muscle in the body!

Quadriceps femoriso Rectus femoris

Rectus = “straight,” so…it’s the straight one in the middle of the anterior thigh

The only one in this group that flexes the thigh as well as extends the leg!!o Vastus lateralis

Most lateralo Vastus medialis

Most medialo Vastus intermedius

In the middle

Iliopsoaso Not exactly a muscle of the anterior thigh, but it’s a major hip flexor

Medial Thigh (adductors!) – obturator n. (except the hamstring part of adductor magnus!)/ obturator a.

Pectineus Adductor brevis Adductor longus Adductor magnus

o Hamstring part of adductor magnus Extends the thigh (it basically acts like a posterior thigh muscle) Tibial n.! because it’s so ginormus, it reaches the back + tibial generally gets all of the posterior thigh

muscles Gracilis

o Long + skinny!

Leg

*Other than fibularis brevis, there are no other “brevis” muscles in this section! :]

Posterior Compartment (plantarflexion (mainly)!) – tibial n. / posterior tibial a.o Superficial

Gastrocnemius Soleus

Think of a slab of fish sitting underneath the gastrocnemius? Plantaris

Tiny; practically looks like a nerve, but don’t be fooled! :Oo Deep (“Tom, Dick And Nervous Harry”)

Anterior to Posterior: tibialis posterior, flexor digitorum longus, posterior tibial artery, tibial nerve, flexor hallucis longus

Flexor hallucis longus Flexor digitorum longus Tibialis posterior

Anterior Compartment (dorsiflexion) – deep fibular n. / anterior tibial a. Medial to Lateral: “Tom’s Hairy Dog Fornicates”

o Tibialis anterior Also helps with inversion of foot This tends to be what gets inflamed when you get shin splints!

o Extensor hallucis longus Also extends great toe

o Extensor digitorum longus

Also extends digits 2-5o Fibularis tertius

Also helps with eversion of foot Lateral Compartment (eversion/plantarflexion) – superficial fibular n. / perforating branches of fibular a.

o Fibularis longuso Fibularis brevis

Greater saphenous vein: medial; travels anterior to medial malleolus + terminates in femoral vein in femoral triangle

Lesser saphenous vein: lateral; runs between the 2 heads of the gastrocnemius m. + empties into popliteal v.

Foot

Tarsal Bones (“Tiger Cubs Need MILC”) (R foot, superior to inferior, medial to lateral)

o Talus Articulates w/ tibia + fibula to form ankle joint

o Calcaneus Heel bone (largest!)

o Navicularo Cuneiform (Medial, Intermediate, Lateral)o Cuboid

Plantar Compartment – medial + lateral plantar n. / medial + lateral plantar a.o 1st layer (Superficial)

Abductor hallucis Flexor digitorum brevis Abductor digiti minimi

o 2nd layer Quadratus plantae Lumbricals

o 3rd layer Flexor hallucis brevis Adductor hallucis Flexor digiti minimi brevis

Blood Supply

Femoral arteryo Popliteal artery

Anterior tibial artery Dorsalis pedis artery (where you take the dorsalis pedis pulse)

o Communicates w/ deep plantar arterial arch via deep plantar artery Posterior tibial artery

Fibular artery Lateral plantar artery (forms deep plantar arterial arch on sole of foot) Medial plantar artery

Innervation

Sciatic nerveo Tibial nerve

Medial plantar n. Lateral plantar n.

o Common fibular nerve Superficial fibular n. Deep fibular n.

Random Other Stuff (Possibly High-Yield)

Femoral Triangleo Boundaries (“SAIL”)

Lateral: Sartorius *Medial: Adductor longus Superior: Inguinal Ligament

*I think your book might have something different for the medial border(?), so if that’s the case, please default to your lab sheet. :O

o Contents Medial to lateral: VAN (femoral vein, femoral artery+deep femoral artery, femoral nerve) Or…lateral to medial: NAVEL (Nerve, Artery, Vein, Empty space, Lymph)

Medial circumflex femoral artery = main blood supply to the femoral head, so if you knock that out (e.g. hip fracture) => necrosis :[

Common iliac arteryo Splits into external + internal iliac arteries

[Common] Femoral artery = continuation of external iliac a. at the inguinal ligament Called the superficial femoral artery after the deep femoral artery splits off

o Becomes the popliteal artery after it goes through the adductor hiatus + comes out of the adductor canal

Bifurcates into anterior + posterior tibial arteries