Block 1 Structures List 2015 OCS IA

The following structures are likely to appear in any format of the OCS1 exam (clinical skills practical, donor lab practical, and written exam). The BOLD terms represent minimum competency structures for this exam. In accordance with the manner in which they have been presented throughout the block, you will be expected to identify, palpate, or evaluate these structures on a cadaveric specimen, live person, radiographic image, and /or slide; describe their function (motions at joints, actions); their origin and insertion (for muscles); their location and path (for arteries, veins, and nerves); and clinical presentation if damaged or injured. In addition, please pay attention to the arterial perfusion to, and venous and lymphatic drainage from, the muscle compartments of the upper extremities.

Remember, a) this list is composed of most (90%) but not all of the structures that can be tested during Week 7 of Block 1, b) the competency expectancy increases as the year progresses, so structures that may not be competency now, may be competency later…

Palpable Landmarks

External (posterior) occipital protruberance Spinous processes of all vertebrae Vertebra prominens (spine of C7 vertebra) Spinous process of T1 vertebra Transverse processes of cervical vertebrae Iliac crest Posterior superior iliac spine (PSIS) Anterior superior iliac spine (ASIS) Ischial tuberosity Pubic symphysisUmbilicus Greater trochanter Patella Tibial tuberosity Medial malleolus Lateral malleolusGluteal fold Natal cleft Achilles’ (calcaneal) tendon Clavicle Acromial end

Sternal endGroove for subclaviusConoid tubercle

Sternum Jugular (suprasternal) notchSternal (Louis/sternomanubrial) angleSecond costal cartilageFirst intercostal spaceManubriumBody

Xiphisternal junctionXiphoid process

RibsHeadNeckTubercleAngleBody (shaft)Costovertebral junctionCostosternal junctionCostochondral junctionsCostal grooveCostal cartilagesCostal margin

Scapula

Acromion Acromial angle

SpineCoracoid processSuprascapular notch (foramen)ScapulaSupraspinous fossaInfraspinous fossaSubscapular fossaSupraglenoid tubercleInfraglenoid tubercleGlenoid cavitySuperior borderLateral border

Medial borderSuperior angleInferior angleLateral angleCostal surfacePosterior surface

HumerusHeadAnatomical neckGreater tubercleLesser tubercleIntertubercular sulcus/grooveSurgical neckDeltoid tuberosityRadial groove ShaftLateral supracondylar ridgeMedial supracondylar ridgeLateral epicondyleMedial epicondyleRadial fossaCoronoid fossaOlecranon fossaCapitulumTrochleaGroove for ulnar nerve

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Block 1 Structures List 2015 OCS IARadius

Head of radiusNeck of radiusRadial tuberosityAnterior oblique lineShaftAnterior borderInterosseous borderPosterior borderStyloid process of radiusCarpal articular surfaceDorsal tubercle

UlnaTrochlear notchCoronoid processRadial notchUlnar tuberosityShaftHead of ulnaStyloid processOlecranon

Carpal bonesScaphoidTubercle of scaphoidLunateTriquetrumTrapeziumTubercle of trapeziumTrapezoidCapitateHamateHook of hamatePisiform

Metacarpals/phalanges Base ShaftHead

General upper limbShoulderPectoral girdleArm (brachium)Forearm (antebrachium)WristHand (manus)AxillaAnterior axillary foldPosterior axillary foldAxillary sheathCubital fossaThenar eminenceHypothenar eminenceSuperior transverse scapular ligament

Quadrangular space(Medial/Upper) Triangular space Triceps hiatus / Triangular intervalRotator cuff

Other structuresLigamentum nuchaeThoracolumbar fasciaSuperficial fasciaDeep fascia

Brachial fasciaAntebrachial fascia Palmar fasciaDorsal fascia of hand

Axillary fasciaPectoral fasciaClavipectoral fascia

Costocoracoid membraneDorsal venous archBasilic veinCephalic veinMedian cubital veinPerforating veinsDeltopectoral grooveDeltopectoral triangleLateral intermuscular septumMedial intermuscular septumInterosseous membraneAnterior (flexor) compartmentPosterior (extensor) compartment

BreastAreolaNippleSuspensory (Cooper’s) ligamentsLactiferous ductsLactiferous sinusesRetromammary space

Muscles For all muscles know proximal/distal attachments (i.e. origin/insertion), named heads/parts, (e.g., long, clavicular, ascending, etc.), innervation, and action.

Pectoralis majorPectoralis minorSubclaviusSerratus anteriorTrapeziusLatissimus dorsiLevator scapulaeRhomboid majorRhomboid minorDeltoidSupraspinatusInfraspinatusSubscapularis

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Block 1 Structures List 2015 OCS IATeres majorTeres minorBiceps brachii

Bicipital aponeurosisBrachialisCoracobrachialisBrachioradialisPronator teresSupinatorTriceps brachiiAnconeusFlexor digitorum superficialisFlexor carpi radialisFlexor carpi ulnarisPalmaris longusFlexor digitorum profundusFlexor pollicis longusPronator quadratusExtensor digitorumExtensor digiti minimiExtensor carpi ulnarisAbductor pollicis longusExtensor pollicis brevisExtensor pollicis longusExtensor indicisExtensor carpi radialis longusExtensor carpi radialis brevisAbductor pollicis brevisAdductor pollicisFlexor pollicis brevisOpponens pollicisAbductor digit minimiFlexor digiti minimiOpponens digiti minimiPalmaris brevisLumbricalsDorsal interossei mm.Palmar interossei mm.

ArteriesSubclavian

Thyrocervical trunkSuprascapularTransverse cervical

Dorsal scapularInternal thoracic

AxillarySuperior thoracicThoracoacromial

Acromial branchClavicular branchDeltoid branchPectoral branch

Lateral thoracicSubscapular

ThoracodorsalCircumflex scapular

Anterior circumflex humeral

Posterior circumflex humeral

BrachialDeep brachial (profunda brachii)

Medial collateralRadial collateral

Humeral nutrient Superior ulnar collateralInferior ulnar collateral

RadialRadial recurrent

Palmar carpal branchSuperficial palmar branch

Dorsal carpal branchDorsal metacarpalsDorsal digital

Princeps pollicisRadialis indicisDeep palmar arch

Palmar metacarpalsPerforating branches

UlnarUlnar recurrentCommon interosseous

Posterior interosseousRecurrent interosseous

Anterior interosseousPalmar carpal branchDorsal carpal branchDeep palmar branchSuperficial palmar arch

Common palmar digitalsProper palmar digital

Deep palmar arch Palmar metacarpalsPerforating branches

Superficial veinsCephalicBasilicMedian cubitalDorsal venous network of handSuperficial palmar venous archPerforating veins

Deep veinsSubclavianAxillary Brachial UlnarRadial

Cutaneous nervesSupraclavicular nervesIntercostobrachial nerveMedial cutaneous of arm

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Block 1 Structures List 2015 OCS IAMedial cutaneous of forearm

Nerves Spinal accessory nerve (cranial nerve XI)Brachial plexus

C5 spinal nerveC6 spinal nerveC7 spinal nerveC8 spinal nerveT1 spinal nerveUpper trunk

Middle trunk Lower trunk Anterior divisions Posterior divisions Lateral cord Medial cord

Posterior cordNerve to subclaviusDorsal scapular Long thoracicSuprascapularMusculocutaneous

Lateral antebrachial cutaneousLateral pectoralMedial pectoralMedian nerve

Recurrent branchPalmar branch of medianCommon and proper palmar digital Anterior interosseous nerve

Ulnar nerveSuperficial branchDeep branchPalmar branch of ulnar Dorsal branch of ulnarDorsal digitalCommon and proper palmar digital

Radial nerveInferior lateral brachial cutaneousPosterior brachial cutaneousPosterior antebrachial cutaneousSuperficial branch of radialPosterior interosseous

Axillary nerveSuperior lateral brachial cutaneous

Thoracodorsal nerveUpper subscapular nerve Lower subscapular nerve

Joints Sternoclavicular (SC) joint

Clavicular notch of manubriumAnterior sternoclavicular ligamentCostoclavicular ligamentInterclavicular ligamentArticular disc

Acromioclavicular (AC) joint

Coracoclavicular ligamentConoid ligament Trapezoid ligament

Glenohumeral (GH) jointCapsule of glenohumeral jointGlenoid cavityGlenoid labrumGlenohumeral ligamentsCoracoacromial ligament Transverse humeral ligament

Elbow joint and proximal radioulnar jointUlnar collateral ligamentRadial collateral ligamentAnular ligamentSynovial cavityRadiocarpal ligamentsArticular disc

Radiocarpal (wrist) jointMetacarpophalangeal jointsInterphalangeal joints

EmbryologyInner cell massTrophoblastEpiblastHypoblastEctodermMesoderm (paraxial/intermediate/lateral)Splanchnic mesoderm (splanchnopleure) Somatic mesoderm (somatopleure)Intraembryonic coelomEndodermPrechordal plateNotochord

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Block 1 Structures List 2015 OCS IAMicrostructures (i.e. Histology)

Skin and EpitheliumSimple squamous epitheliaSimple cuboidal epitheliaSimple columnar epitheliaStratified squamous epithelia

(keratinized and non-keratinized)Stratified cuboidal epitheliumStratum basale (germinativum)Stratum spinosumStratum granulosumStratum lucidumStratum corneumStratum disjunctumEpidermisDermisHypodermisKeratinocyte

Connective TissueDense regular connective tissueDense irregular connective tissueLoose connective tissueFibroblastMacrophageMast cellPlasma cellAdipocyteCollagen fiberElastic fiberReticular fiber

Skeletal MuscleSkeletal Muscle (including A, H, I, and Z-bands)EndomysiumMyofibrilSarcomerePerimysiumEpimysium

Peripheral Nervous SystemPeripheral nerveNeuron somaAxonDendriteMyelin sheathNissl SubstanceNode of RanvierSchmidt-Lantermann cleftNerve fascicleEndoneuriumPerineuriumEpineuriumGanglia Spinal (dorsal root) ganglionAutonomic ganglionSensory (pseudounipolar) neuronsAutonomic neuronsSatellite cells

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