Netters Musculoskeletal Flash Cards, 1e by Jennifer Hart MPAS PA-C, Mark D. Mil

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Netter’s
Musculoskeletal Flash Cards
Jennifer Hart, PA-C, ATC
Mark D. Miller, MD
University of Virginia

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Netter’s Musculoskeletal Flash Cards
In a world dominated by electronics and gadgetry, learning from fl ash 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
Preface

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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
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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.
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Netter’s Musculoskeletal Flash Cards
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

Discover the art of
medicine!
•548 stunning, full page, hand-
painted 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 Musculoskeletal
Flash Cards
(978-1-4160-4630-1)
Netter’s Neuroscience
Flash Cards, 2nd Edition
(978-1-4377-0940-7)

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Netter’s Musculoskeletal Flash Cards
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
View)
1-6 Muscles: Rotator Cuff
1-7 Muscles: Upper Arm
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

The Shoulder and Upper Arm Table of Contents
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 1-1
Bony Anatomy: Shoulder
1
2
3
109
11
4
5
6
7
12
8

The Shoulder and Upper Arm 1-1
Bony Anatomy: Shoulder
1. Body of the scapula
2. Glenoid
3. Coracoid process
4. Anatomical neck of the humerus
5. Greater tuberosity of the humerus
6. Lesser tuberosity of the humerus
7. Surgical neck of the humerus
8. Spine of the scapula
9. Clavicle
10. Acromioclavicular (AC) joint
11. Acromion
12. 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.

Radiographic Anatomy: Shoulder
1
2
2
3
4
4
5
3
6
6
7
8
8
AP view
Lateral view
The Shoulder and Upper Arm 1-2

Radiographic Anatomy: Shoulder
1. Body of the scapula
2. Glenoid
3. Coracoid process
4. Clavicle
5. Acromioclavicular (AC) joint
6. Acromion
7. Greater tuberosity of the humerus
8. 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
8
1
2
Coronal section through joint
Shoulder joint, anterior view
3
4
5
10
7
4
6
9
11
12
The Shoulder and Upper Arm 1-3

Soft Tissue Anatomy: Shoulder Joint
1. Coracoclavicular ligaments (conoid and trapezoid)
2. Acromioclavicular ligament
3. Coracoacromial ligament
4. Supraspinatus tendon
5. Coracohumeral ligament
6. Subscapularis tendon
7. Long head of the biceps tendon
8. Joint capsule
9. Subdeltoid bursa
10. Deltoid muscle
11. Glenoid labrum
12. 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

1
2
3
4
5
6
Muscles: Shoulder (Anterior View)
The Shoulder and Upper Arm 1-4

Muscles: Shoulder (Anterior View)
1. Pectoralis major muscle
2. Trapezius muscle
3. Deltoid muscle
4. Cephalic vein
5. Biceps brachii muscle
6. 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,
fl exion, 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

1
2
3
4
5
Muscles: Shoulder and Upper Arm
(Posterior View)
The Shoulder and Upper Arm 1-5

Muscles: Shoulder and Upper Arm
(Posterior View)
1. Deltoid muscle
2. Trapezius muscle
3. Levator scapulae muscle
4. Teres major muscle
5. 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

1
2
3
4
Posterior view
Anterior view
Muscles: Rotator Cuff
The Shoulder and Upper Arm 1-6

Muscles: Rotator Cuff
Supraspinatus
Muscle
Infraspinatus
Muscle
Teres Minor
Muscle
Subscapularis
Muscle
OriginSupraspinous fossa
of scapula
Infraspinous fossa
of scapula
Lateral border of
the scapula
Subscapular fossa
and lateral border of
scapula
InsertionGreater tuberosity of
humerus
Greater tuberosity
of humerus
Greater tuberosity
of humerus
Lesser tuberosity of
humerus
ActionsShoulder abduction,
external rotation
Shoulder external
rotation
Shoulder external
rotation and assists
with adduction
Shoulder internal
rotation and
adduction
InnervationSuprascapular nerve
(C5-6)
Suprascapular
nerve (C5-6)
Axillary nerve
(C5-6)
Subscapular nerves
(C5-6)
1. Subscapularis muscle
2. Supraspinatus muscle
3. Infraspinatus muscle
4. Teres minor muscle
The Shoulder and Upper Arm 1-6

1
1
2
23
3
4
Superficial layer Superficial layer
Deep layer
Muscles: Upper Arm
The Shoulder and Upper Arm 1-7