Download Clinical Correlations

Gross Anatomy Unit 1 Clinical Correlation
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Surgical neck of humerus  typically broken here
Breast cancer  when invading retromammary space and attaching to deep fascia overlaying p.
major, breast becomes less moveable
o Infiltration of suspensory ligaments will cause dimpling of skin  causes skin to
invaginate
o Interference/blockage of lymph draining produces leathery skin
o Intercostal vein connects to vertebral venous plexus  route for cancer from breast to
brain
Sternoclavicular joint  costoclavicular ligament is most important in preventing displacement
(a type of fibrous joint)
Acromioclavicular Joint  coracoclavicular ligament is main support rupture causes clavicle to
be driven superior to acromion
o Acromioclavicular ligament rather weak and usually breaks when shoulder separates
Glenohumeral joint  weakest inferiorly
o Stabilizing structures include coracohumeral ligament, glenohumeral ligaments, and
rotator cuff
Subacromial (subdeltoid) and subscapular bursa allow smooth motion
Lateral epicondylitis  tennis elbow
Medial epicondylitis  golfer’s elbow
Surgery on ulnar collateral lig. From medial epicondyle to medial edge of trochlear notch 
Tommy John surgery
Carpal tunnel syndrome  decrease in size of carpal tunnel  compression of median nerve 
numbness/sensory loss/motor weakness 
Dupuytrens contracture  progressive fibrosis of palmar aponeurosis results in
shortening/thickening of palmar aponerousis  pull digit and MCP joint toward palm
Ulnar nerve dmg common  lies superficially in distal part of forearm
o Sensory impair of ant/post aspect of medial part of hand
o Deceased ab/adduction of fingers (interossei)
o Adductor pollicis paralysis
o Two med. Lumbrical paralysis
Wrist fracture  distal end of radius  if abducted wrist  scaphoid fracture
Wrist slash  dmg to artery and nerves
Compartment syndrome of hand  nerves are damaged due to increase pressure in capillaries
Recurrent branch of median n. vulnerable to cuts on thenar eminence
Primary curvature of VC  thoracic and sacral  evident in fetal dev.
Secondary curve of VC  cervical and lumbar  as child develops
Superior articular surf of axis forms synovial joint with occipital condyle  nodding “yes”
Dens process of axis and anterior arch of atlas  “no” movement
Cruciate lig  holds alantoaxial joint in place  prevents dens process from hitting spinal cord
Cervical enlargement and lumbosacral enlargement of spinal cords
Abdominal curvature of VC
o Kyphosis  hunchback
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o Lordosis  swayback
o Scoliosis
Spina bifida  non fusion of neural arch (lamina) at midline  opening to VC
Spondylolisthesis  most common between LV5 and SV1 --> LV5 displaced from centrum and
fuses with SV!  pinching of nerve rootlets  loss of sensation/pain/motor function
Herniation of intervertebral disc  in lower thoracic/lumbar  impinges on next exiting spinal
nerve
Lumbar cisternal puncture  btwn LV3-4 or LV4-5  avoids spinal cord  btwn supraspinous
and interspinous lig.
Epidural anesthesia through sacral hiatus
Tetraethyl ammonium (TIA)  blocks nicotinic receptor of ACH in autonomic ganglion  nerve
signal can’t be forwarded
Dopamine  module Ach transmission
KNOW ALL THE NERVE LESIONS
Testing for nerve damage
o Sensory loss
 C5 – lateral side of cub fossa
 C6 – Thumb
 C7 – Middle finger
 C8 – Pinky
 T1 – medial side of cub fossa
o Motor loss
 C5 - Arm abduction (supraspinatus and deltoid)
 C6 – forearm flexors (brachialis and bicep brachii)
 C7 – forearm extensors (triceps)
 C8 – digital flexors (FDP ulnar side)
 T1 – digital abduction/adduction (dorsal/palmar interossei)