3.1

Question 1

Surface anatomy muscles

Answer 1

Question 2

What bones make up the pectoral girdle?

Answer 2

clavicle and scapula

Question 3

What bones make up the upper extremity?

Answer 3

Pectoral girdle: clavicle and scapula
Humerus
Radius
Ulna
Bones of the hand

Question 4

Clavicle

Answer 4

Question 5

Scapula

Answer 5

Overlies ribs 2-7

Question 6

Humerus

Answer 6

Question 7

Radius

Answer 7

Question 8

Ulna

Answer 8

Question 9

Radio-ulnar joints

Answer 9

1. Interosseus membrane – syndesmosis joint between radius and ulna. Fiber direction allows forces traveling from hand to radius (e.g. falling onto outstretched hand) to be transferred to ulnar, which has a more stable articulation w/ humerus.
2. Trochlear notch – hollowed area formed by coronoid process and olecranon that curves around trochlea of humerus at elbow joint
3. Distal radioulnar joint – pivot joint; assists with supination and pronation motions

Question 10

Label

Answer 10

Question 11

Label

Answer 11

Question 12

Label

Answer 12

Question 13

Scaphoid Fracture

Answer 13

Most common and often misdiagnosed
Occurs after a fall on an outstretched hand
Can lead to poor blood supply to the proximal part of the scaphoid. Avascular necrosis may occur and produce degenerative joint disease of the wrist.

Question 14

Colle’s Fracture

Answer 14

Complete transverse fracture of distal 2cm of the radius
Common in adults over 50, especially women because osteoporosis weakens bones
Results from forced extension of hand which occurs when falling on an outstretched arm
The distal fragment of the radius is pulled dorsally and superiorly, resulting in dinner fork deformity
Because of the rich blood supply to the distal end of the radius, bony union is usually good

Question 15

Nerve innervation of the upper extremity

Answer 15

Brachial plexus

Terminal branches of:
- axillary n
- musculocutaneous n
- median n
- radial n
- ulnar n

Other branches that serve scapula and thorax:
- dorsal scapular n
- suprascapular n
- long thoracic n

Question 16

Fractures of the humerus

Answer 16

• Humeral neck fractures endanger the axillary nerve and posterior circumflex humeral artery as they pass through the quadrangular space
• Humeral shaft fractures endanger the radial nerve and deep brachial artery as they lie within the radial groove
• Medial epicondyle fractures endanger the ulnar nerve as it passes posterior to the epicondyle
• Lateral epicondyle fractures endanger the radial nerve as it passes anterior to the epicondyle

Question 17

Arterial supply

Answer 17

Subclavian a.
Axillary a., which changes to brachial a. at the lateral border of teres major
Brachial a. then bifurcates at the elbow forming the radial a. and ulnar a.
The radial and ulnar aa. for the palmar arch.

Question 18

Deep brachial a.

Answer 18

branches from brachial a. and joins radial n. to enter posterior compartment of arm

Question 19

Elbow anatomosis

Answer 19

ulnar collateral aa. branch and provide collateral circulation around the elbow; they anastomose with radial and ulnar recurrent aa.

Question 20

Ulnar a

Answer 20

gives off common interosseous branch soon after it originates at the brachial a. bifurcation; it then splits into anterior and posterior interosseous aa. that run along the interosseous membrane

Question 21

The radial and ulnar aa…

Answer 21

1. Give off recurrent branches that help form the elbow anastomosis.
2. Supply the forearm
3. Contribute to the formation of palmar arterial arches that supply the hand.

Question 22

Superficial Veins of Upper Limb

Answer 22

Cephalic v.
- begins radial and dorsal, wraps to ventral

Basilic v.
- ulnar and dorsal
- joint deep vv. to form axillary v.

Axillary v.

Medial cubital v. anastomosis
- cephalic and basilic

Question 23

Axillary v.

Answer 23

Runs inferior to axillary a.
Is a continuation of basilic v.
Major tributaries:
- basilic v.
- cephalic v.
- brachial vv.

Question 24

Axillary lymphatics

Answer 24

Superficial to lymph vessels and follow superficial vv.
Nodes:
- cubital
- axillary
- deltopectoral

Question 25

Palmar arches

Answer 25

Superficial palmar arterial arch – formed largely by ulnar artery after entering hand through ulnar (Guyon’s) canal. The radial artery contributes via a superficial palmar branch. The arch is located just deep to the palmar aponeurosis.

Deep palmar arterial arch – formed largely by radial artery after passing posterior to the CMC joint of the thumb and through the anatomical snuffbox. The ulnar artery contributes some via a deep branch.

Common and proper palmar digital arteries branch from the superficial arch to supply the digits. The common palmar digital arteries are joined by branches of the deep arch thus forming an anastomosis between the 2 arches.

Princeps pollicis artery – branches from deep arch to supply thumb via 2 proper digital arteries