Download sample - Create Training

Netter’s
Musculoskeletal Flash Cards
Jennifer Hart, PA-C, ATC
Mark D. Miller, MD
University of Virginia
This page intentionally left blank
Preface
In a world dominated by electronics and gadgetry, learning from flash cards
remains a reassuringly “tried and true” method of building knowledge. They
taught us subtraction and multiplication tables when we were young, and here
we use them to navigate the basics of musculoskeletal medicine. Netter
illustrations are supplemented with clinical, radiographic, and arthroscopic
images to review the most common musculoskeletal diseases. These cards
provide the user with a steadfast tool for the very best kind of learning—that
which is self directed.
“Learning is not attained by chance, it must be sought
for with ardor and attended to with diligence.”
—Abigail Adams (1744–1818)
“It’s that moment of dawning comprehension I live for!”
—Calvin (Calvin and Hobbes)
Jennifer Hart, PA-C, ATC
Mark D. Miller, MD
Netter’s Musculoskeletal Flash Cards
1600 John F. Kennedy Blvd.
Ste 1800
Philadelphia, PA 19103-2899
NETTER’S MUSCULOSKELETAL FLASH CARDS
ISBN: 978-1-4160-4630-1
Copyright © 2008 by Saunders, an imprint of Elsevier Inc.
All rights reserved. No part of this book may be produced or transmitted in
any form or by any means, electronic or mechanical, including photocopying,
recording or any information storage and retrieval system, without permission
in writing from the publishers. Permissions for Netter Art figures may be sought
directly from Elsevier’s Health Science Licensing Department in Philadelphia
PA, USA: phone 1-800-523-1649, ext. 3276 or (215) 239-3276; or e-mail
[email protected].
Notice
Knowledge and best practice in this field are constantly changing. As new
research and experience broaden our knowledge, changes in practice,
treatment, and drug therapy may become necessary or appropriate.
Readers are advised to check the most current information provided (i) on
procedures featured or (ii) by the manufacturer of each product to be
administered, to verify the recommended dose or formula, the method and
duration of administration, and contraindications. It is the responsibility of
the practitioner, relying on his or her own experience and knowledge of
the patient, to make diagnoses, to determine dosages and the best
treatment for each individual patient, and to take all appropriate safety
precautions. To the fullest extent of the law, neither the Publisher nor the
Authors assume any liability for any injury and/or damage to persons or
property arising out of or related to any use of the material contained in
this book.
The Publisher
ISBN 978-1-4160-4630-1
Acquisitions Editor: Elyse O’Grady
Developmental Editor: Marybeth Thiel
Publishing Services Manager: Linda Van Pelt
Design Direction: Steve Stave
Illustrations Manager: Karen Giacomucci
Marketing Manager: Jason Oberacker
Working together to grow
libraries in developing countries
www.elsevier.com | www.bookaid.org | www.sabre.org
Printed in China
Last digit is the print number: 9 8 7 6 5 4
Table of Contents
Section 1. The Shoulder and Upper Arm
Section 2. Elbow, Wrist, and Hand
Section 3. The Spine
Section 4. The Thorax and Abdomen
Section 5. The Pelvis, Hip, and Thigh
Section 6. The Knee and Lower Leg
Section 7. The Ankle and Foot
Netter’s Musculoskeletal Flash Cards
Discover the art of
medicine!
• 548 stunning, full page, handpainted illustrations bring
anatomy to life.
• Painstaking revisions throughout
enhance the precision of every detail.
• More diagnostic imaging and clinical illustrations
translate basic science into practice.
• www.netteranatomy.com gives you online access to a
plethora of ancillary material, including 90 plates from the
book, human dissection videos, and much more.
Atlas of Human Anatomy, 4th Edition
By Frank Netter, MD. 2006. 640 pp. 548 ills. Soft cover book plus
website access. ISBN: 978-1-4160-3385-1
To order your copy,
please visit www.elsevierhealth.com
or your local medical bookstore.
Netter’s Anatomy
Flash Cards, 3rd Edition
(978-1-4377-1675-7)
Netter’s Advanced Head
and Neck Flash Cards –
Updated Edition
(978-1-4557-4523-4)
Netter’s Neuroscience
Flash Cards, 2nd Edition
(978-1-4377-0940-7)
Netter’s Musculoskeletal
Flash Cards
(978-1-4160-4630-1)
This page intentionally left blank
1
The Shoulder and Upper Arm
Plates 1-1 to 1-22
Bony Anatomy
1-1
Bony Anatomy: Shoulder
Radiographic Anatomy
1-2
Radiographic Anatomy: Shoulder
Soft Tissue Anatomy
1-3
Soft Tissue Anatomy: Shoulder Joint
Muscles
1-4
Muscles: Shoulder (Anterior View)
1-5
Muscles: Shoulder and Upper Arm (Posterior
1-6
Muscles: Rotator Cuff
1-7
Muscles: Upper Arm
View)
Arteries and Nerves
1-8
Arteries: Shoulder and Upper Arm
1-9
Brachial Plexus
Physical Examination
1-10
Physical Examination: Shoulder Joint
Conditions
1-11
Conditions: Clavicle
1-12
Conditions: Scapula
Netter’s Musculoskeletal Flash Cards
1
The Shoulder and Upper Arm
Plates 1-1 to 1-22
1-13
Conditions: Humerus
1-14
Conditions: Acromioclavicular Joint
1-15
Conditions: Subacromial Space
1-16
Conditions: Rotator Cuff
1-17
Conditions: Rotator Cuff
1-18
Conditions: Biceps Tendon
1-19
Conditions: Biceps Tendon
1-20
Conditions: Labrum and Shoulder
1-21
Conditions: Glenohumeral Joint Capsule
1-22
Conditions: Glenohumeral Joint
The Shoulder and Upper Arm
Table of Contents
Bony Anatomy: Shoulder
3
4
2
5
6
7
1
9
10
11
8
12
The Shoulder and Upper Arm
1-1
Bony Anatomy: Shoulder
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
Body of the scapula
Glenoid
Coracoid process
Anatomical neck of the humerus
Greater tuberosity of the humerus
Lesser tuberosity of the humerus
Surgical neck of the humerus
Spine of the scapula
Clavicle
Acromioclavicular (AC) joint
Acromion
Shaft of the humerus
Comment: The primary articulation of the shoulder joint is between
the glenoid of the scapula and the head of the humerus
(glenohumeral joint). Other articulations here include the
acromioclavicular and the sternoclavicular joints. The bony anatomy
does not provide much stability to the shoulder joint.
The Shoulder and Upper Arm
1-1
Radiographic Anatomy: Shoulder
5
4
6
3
7
2
1
8
AP view
3
4
2
6
8
Lateral view
The Shoulder and Upper Arm
1-2
Radiographic Anatomy: Shoulder
1.
2.
3.
4.
5.
6.
7.
8.
Body of the scapula
Glenoid
Coracoid process
Clavicle
Acromioclavicular (AC) joint
Acromion
Greater tuberosity of the humerus
Shaft of the humerus
Comment: Anteroposterior and axillary views are the most common
views of the shoulder, and both should always be ordered in cases
of suspected dislocation.
The Shoulder and Upper Arm
1-2
Soft Tissue Anatomy: Shoulder Joint
2
1
3
4
5
8
6
7
Shoulder joint, anterior view
9
4
10
11
12
Coronal section through joint
The Shoulder and Upper Arm
1-3
Soft Tissue Anatomy: Shoulder Joint
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
Coracoclavicular ligaments (conoid and trapezoid)
Acromioclavicular ligament
Coracoacromial ligament
Supraspinatus tendon
Coracohumeral ligament
Subscapularis tendon
Long head of the biceps tendon
Joint capsule
Subdeltoid bursa
Deltoid muscle
Glenoid labrum
Articular cartilage
Comment: The secondary stabilizers (ligaments, muscles, and joint
capsule) provide most of the stability for the shoulder joint. The
glenohumeral ligaments are really just thickenings of the
glenohumeral joint capsule.
The Shoulder and Upper Arm
1-3
Muscles: Shoulder (Anterior View)
2
3
4
5
1
6
The Shoulder and Upper Arm
1-4
Muscles: Shoulder (Anterior View)
1.
2.
3.
4.
5.
6.
Pectoralis major muscle
Trapezius muscle
Deltoid muscle
Cephalic vein
Biceps brachii muscle
Latissimus dorsi muscle
Deltoid Muscle
Pectoralis Major
Muscle
Latissimus Dorsi
Muscle
Origin
Clavicle, acromion,
scapular spine
Medial clavicle
and upper
sternum
T6-L5 spinous
processes
Insertion
Deltoid tuberosity,
humerus
Intertubercular
groove of
humerus
Intertubercular
groove of humerus
Actions
Primarily abduction,
flexion, extension
Arm adduction,
assists rotation
Shoulder
extension,
adduction, and
internal rotation
Innervation
Axillary nerve
(C5-6)
Medial and lateral
pectoral nerves
(C5-T1)
Thoracodorsal
nerve
The Shoulder and Upper Arm
1-4
Muscles: Shoulder and Upper Arm
(Posterior View)
3
2
1
4
5
The Shoulder and Upper Arm
1-5
Muscles: Shoulder and Upper Arm
(Posterior View)
1.
2.
3.
4.
5.
Deltoid muscle
Trapezius muscle
Levator scapulae muscle
Teres major muscle
Triceps brachii muscle
Trapezius
Muscle
Teres Major
Muscle
Levator Scapulae
Muscle
Origin
Occipital bone,
ligamentum
nuchae, spinous
processes
C7-T12
Inferior angle of the
scapula
Transverse
process of C1-4
Insertion
Lateral clavicle,
medial acromion,
scapular spine
Medial
intertubercular
groove of humerus
Superior medial
scapula
Actions
Primarily
scapular rotation
Helps extend,
adduct, and medially
rotate the arm
Scapular elevation
and rotation
Innervation
Spinal accessory
nerve (cranial
nerve XI)
Lower subscapular
nerve (C5-C6,
C6-C7)
Third and fourth
cervical nerves,
dorsal scapular
nerve (C5)
The Shoulder and Upper Arm
1-5
Muscles: Rotator Cuff
1
Anterior view
2
3
4
Posterior view
The Shoulder and Upper Arm
1-6
Subscapularis muscle
Supraspinatus muscle
Infraspinatus muscle
Teres minor muscle
Supraspinatus
Muscle
Infraspinatus
Muscle
Teres Minor
Muscle
Subscapularis
Muscle
Origin
Supraspinous fossa
of scapula
Infraspinous fossa
of scapula
Lateral border of
the scapula
Subscapular fossa
and lateral border of
scapula
Insertion
Greater tuberosity of
humerus
Greater tuberosity
of humerus
Greater tuberosity
of humerus
Lesser tuberosity of
humerus
Actions
Shoulder abduction,
external rotation
Shoulder external
rotation
Shoulder external
rotation and assists
with adduction
Shoulder internal
rotation and
adduction
Innervation
Suprascapular nerve
(C5-6)
Suprascapular
nerve (C5-6)
Axillary nerve
(C5-6)
Subscapular nerves
(C5-6)
Muscles: Rotator Cuff
The Shoulder and Upper Arm
1.
2.
3.
4.
1-6
Muscles: Upper Arm
1
2
4
2
3
1
Superficial layer
Superficial layer
3
Deep layer
The Shoulder and Upper Arm
1-7