Anatomical Positions/Movements
What is anatomical position?
Standing upright, looking forward, with toes forward, arms at the sides, palms facing forward, legs together, and feet parallel.
Slide 4
How many vertebrae are there and how many are in each section?
33 Vertebrae
7 Cervical
12 Thoracic
5 Lumbar
5 Sacral (fused)
4 coccygeal (fused)
Slide 23
A PA student is identifying a muscle that attaches across the complex shoulder joints. The lecture lists the spine of the scapula, acromion, and lateral third of the clavicle as insertion points for this muscle. Which muscle is most likely being described?
Trapezius
Slide 53
A joint permits flexion and extension in only one plane and has strong lateral collateral ligaments. What synovial joint classification does this describe?
A hinge joint.
Slide 12
A patient is brought to the ED after a traumatic spinal injury. On exam, they have loss of motor function in both lower extremities, but upper extremity function is preserved. Based on the spinal cord injury levels discussed in lecture, which region of spinal cord injury is most consistent with this presentation?
T1-T9
Explanation: The lecture lists spinal cord transection outcomes by level: C4-C5 causes quadriplegia, C6-C8 causes incomplete quadriplegia, and T1-T9 causes paraplegia. Since this patient has lower extremity paralysis with preserved upper extremity function, the presentation is most consistent with paraplegia from a T1-T9 injury.
Slide 70
A patient sprains their ankle after stepping awkwardly off a curb. During the exam, the PA asks the patient to move the sole of the foot outward, away from the midline of the body. Which movement is being assessed?
Eversion
Explanation: Eversion is movement of the sole of the foot laterally, or outward, away from the median plane. In contrast, inversion moves the sole medially, or inward. Your slide on terms of movement includes ankle and foot movements and refers to additional movement terms in the clinical anatomy figure.
Slide 9
A patient has limited vertebral column motion. Based on the slides, name four factors that can limit movement of the vertebral column. (There are 6)
1.) Condition of IV discs
2.) Shape and orientation of zygapophysial (facet) joints
3.) Tension of the facet joint capsules
4.) Resistance of back musculature and connective tissues
5.) Thoracic rib cage
6.) Bulk of surrounding tissue
Slide 23
A patient has impaired control of limb and respiratory movements from dysfunction of a back muscle group. Which major muscle group is most likely involved?
The extrinsic back muscles, because they produce and control limb and respiratory movements.
Slide 51
Describe a Condyloid joint
Permits movement in 2 planes. One direction is usually greater than the other. Limited circumduction is also possible.
Slide 13
A patient’s stretch reflex is being tested. What makes the stretch reflex simpler than the withdrawal reflex?
The stretch reflex is monosynaptic.
Explanation: Stretch reflex- simpler than withdrawal reflex, monosynaptic. Stretch reflex serves as local negative-feedback mechanism to resist passive changes in muscle length, retaining optimal resting length. Abnormal reflex suggests loss of balance of appropriate excitatory vs inhibitory input to the motor neurons.
Slide 17
During a physical exam, a patient moves the ankle so the toes and foot move superiorly. What movement is occurring, and how is it anatomically defined in the slides?
Dorsiflexion. It is flexion of the ankle with superior movement of the toes or foot.
Slide 9
Describe the appearance C spine Vertebrae.
- transverse foramina through
which vertebral arteries course
- bifed spinous process
- small vertebral body
- large triangular vertebral
foramen
- C1 (no body) and C2 (dens)
have unique morphology
A patient has poor posture and difficulty producing movement of the vertebral column. Which major back muscle group is most directly responsible for these functions?
The intrinsic, or deep, back muscles. They act on the vertebral column, producing movement and maintaining posture.
Slide 51
What is a synovial joint?
A synovial joint consists of a joint capsule with outer fibrous layer and inner serous synovial membrane. Articulating surfaces covered by articular cartilage. The most common joint type.
A reflex arc is being traced from stimulus to response. Name all five major components of the reflex arc in order.
Receptor
Afferent pathway
Integrating center
Efferent pathway
Effector
Slide 19
A patient rotates the forearm so the dorsum of the hand faces anteriorly. What movement is this, and what specifically happens to the radius?
Pronation. The radius rotates medially, causing the dorsum of the hand to face anteriorly.
Slide 9
A patient presents with new-onset thoracic spine pain. Why does the lecture specifically caution clinicians to “watch out” for this presentation?
Can you identify some differential diagnosis?
The thoracic spine is relatively immobile, and thoracic disc herniation is rare, so new-onset thoracic pain should raise concern.
Septic joint/disc, cancer, osteoporotic compression fracture and Osteomyelitis
Slide 27
During a neck or posterior triangle injury, a patient loses function related to a muscle inserting on the spine of the scapula, acromion, and lateral third of the clavicle. Which listed nerve supply is associated with this muscle in the lecture?
CN XI, the spinal accessory nerve, plus C3 and C4.
Slide 53
A patient has degeneration of the joints formed by intervertebral discs and vertebrae. Based on the lecture’s classification, what type of joint is involved, and what tissue unites it?
A secondary cartilaginous joint, or symphysis. It is strong, slightly movable, and united by fibrocartilage.
Slide 15
A patient sustains a hyperextension injury of the vertebral column. Which vertebral ligament is the primary limiter of extension, and why is it high yield?
The anterior longitudinal ligament. It prevents hyperextension of the vertebral column and is the only ligament that limits extension.
Slide 38
A patient performs a circular movement of the upper limb that combines multiple angular movements in sequence. What is this movement called, and which categories of movement are involved?
Circumduction. It is a circular movement involving flexion, extension, abduction, and adduction in a sequential manner.
Slide 9
A 46-year-old patient presents with acute low back pain after suddenly flexing forward while lifting a heavy box. The clinician explains that one of the vertebral ligaments helps limit abrupt flexion and protects the intervertebral discs by spanning between adjacent laminae. Which ligament is being described?
Ligamenta flava
Explanation: The ligamenta flava extend vertically from lamina to lamina and form sections of the posterior wall of the vertebral canal. Their function is to limit abrupt flexion and help protect the intervertebral discs.
Slide 39
A surgeon is reviewing lumbar vertebral muscle attachments. Which lumbar vertebral feature is specifically identified as an attachment site for multifidus and intertransversarii muscles?
Mammillary processes on the posterior surface of the superior articular facet.
Slide 33
A PA student is reviewing the anatomy of the hand before a practical examination.
The hand contains several different types of synovial joints. Which of the following correctly identifies the number of synovial joint types found in the hand and provides an example of each?
5 types: plane, hinge, pivot, condyloid, saddle
Slide 14
A patient presents with bowel and bladder dysfunction, leg pain, numbness, saddle anesthesia, and paralysis after a large midline disc herniation at L4/L5. What syndrome is being described, and why is it clinically urgent?
Cauda equina syndrome. The lecture describes it as rare but “can’t miss,” caused by a large midline disc herniation compressing several nerve roots, and identifies it as a surgical emergency.
Slide 80