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Anatomy > 54 Upper Limb I > Flashcards

54 Upper Limb I Flashcards

1
Q
  1. Draw and label correctly the clavicle and give 5 features on it
    What is the clavicle an attachment for?
A 
Clavicle: only bony attachment of the upper limb to the thorax
Acromial end
Sternal end
Shaft
Conoid tubercle
Impression for costoclavicular ligament
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2
Q
  1. What does the scapula serve as a bridge to?

Draw and label the following structures on the Posterior scapula:

A 
Acromion
scapular spine
supraspinous fossa
infraspinous fossa
Drawing
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3
Q 
3.	Draw and label the following structures on the Anterior scapula:
Coracoid process
suprascapular notch
supraglenoid 
tubercle
glenoid fossa
infraglenoid 
tubercle
subscapular fossa
lateral border
medial border
A

Drawing

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4
Q 
4.	Scapula: bridge between clavicle and humerus
Glenoid cavity/fossa
Supraglenoid and infraglenoid tubercles
Suprascapular notch
for suprascapular artery and nerve. The superior transverse ligament of scapula covers the notch, the artery is above, the nerve is below
Neck
Spine
Acromion
Coracoid process
Superior and inferior angles
Lateral and medial borders
Subscapular fossa
Infraspinous fossa
Supraspinous fossa
A

Drawing

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5
Q
  1. What are the names of the 6 joint types?

Joint Types

A 
Hinge
Pivot
Condyloid
Saddle
Ball and socket
Plane
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6
Q
  1. Describe the hinge joint and its action
A

Hinge—uniaxial joint with concave to convex articulation. Generally restricted to flexion/extension. Example: elbow joint (humeroulnar)

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7
Q
  1. Describe the pivot joint and its actions
A

Pivot—uniaxial joint with rounded surface articulating with a ring that is restricted to rotation. Example: radioulnar joint

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8
Q
  1. Describe the condyloid joint and shape
A

Condyloid—biaxial joint with an oval surface fitting into an elliptical socket, allowing flexion/extension and adduction/abduction.
Example: radiocarpal joint

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9
Q
  1. Describe the saddle joint and actions
A

Saddle—biaxial joint with one concave surface and one convex surface, allowing for flexion/extension and adduction/abduction.
Example: first carpal/metacarpal joint

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10
Q
  1. Describe the Ball and socket joint and actions
A

Ball and socket—multiaxial joint with a rounded ball-like surface fitting into a concave cup-like socket.
Example glenohumeral joint

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11
Q
  1. Describe the Plane joint and actions
A

Plane—multiaxial gliding joint with flat articulating surface.
Example: intercarpal joints

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12
Q

Joints

12. The pectoral girdle has movement at what kind of joints; and between which 3 structures

A

The pectoral girdle involves movement at three synovial joints between the clavicle, scapula, and humerus.

Whereas the first 30º of elevation of the upper limb can occur without movement of the scapula,

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13
Q
  1. To be able to fully elevate one’s arm requires abduction at the glenohumeral joint and scapular rotation
A

the act of fully elevating the arm requires abduction at the glenohumeral joint and scapular rotation such that when the arm is fully elevated (180º of abduction or flexion) 120º occurs at the glenohumeral joint and 60º from scapular rotation.

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14
Q
  1. What kind of joint is the sternoclavicular joint? It serves as the only bony articular to?
A

Sternoclavicular joint: Saddle joint, but functions as a ball and socket joint. This is the only bony articulation (synovial joint) of the upper limb to the thorax

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15
Q
  1. What kind of joint is the acromioclavicular joint? Give three strengthening ligaments
A

Acromioclavicular joint: Plane synovial joint
Ligaments:
Acromioclavicular surrounding the joint capsule
Further strengthened by the coracoclavicular ligament and coracoacromial ligament

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16
Q
  1. 3 movements of scapula
A

Movements of the scapula
Elevation/Depression
Protraction/Retraction
Rotation

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17
Q
  1. Glenohumeral (shoulder) joint is what kind of joint? Give 3 movements
A 
Glenohumeral (shoulder) joint: Ball and socket joint
Movements:
Medial/Lateral Rotation
Abduction/Adduction
Flexion/Extension
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18
Q
  1. The joint capsule is composed of stabilizing ligaments starting at?
A

Ligaments: the joint capsule is composed of a series of stabilizing ligaments initiating at the glenoid labrum (Latin for rim of a vessel),
19.

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19
Q
  1. What surrounds the glenoid cavity?
A

a fibrocartilaginous ring surrounding the glenoid cavity. The glenoid labrum expands the actual joint surface, yet still holds only 1/3 of the humeral head. The humeral head is therefore held in place by the tendons of the rotator cuff muscles. The joint capsule stretches medially from the margin of the glenoid fossa to the anatomical neck of the humerus. The capsule is weakest inferiorly as the coracoacromial arch and the rotator cuff muscles reinforce it anterior, posterior, and superiorly. Thus, the most common direction of humeral dislocation in inferiorly (antero-inferiorly).

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20
Q
  1. What area ligaments make up the Glenohumeral ligaments? What does it stabilize?
A

Glenohumeral ligaments (superior, middle, inferior): Stabilize the anterior aspect of the joint capsule

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21
Q
  1. What does the coracohumeral ligament stabilize?
A

Coracohumeral ligament: Stabilizes the superior aspect of the joint capsule

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22
Q
  1. What does the transverse humeral ligament stabilize?
A

Transverse humeral ligament: Stabilizes the long tendon of the biceps brachii between the lesser and greater tubercle of the humerus

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23
Q
  1. What does the Coracoacromial ligament help form? What does this prevent?
A

Coracoacromial ligament: Helps form the coraco-acromial arch which prevents superior dislocation/displacement

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24
Q
  1. Where are myofascial compartments below? What does it do?
A

Myofascial Compartments: below the superficial fascia, deep fascia surrounds each of the muscles, defining inter-muscular septa that divide the upper limb into distinct anterior and posterior compartments.
Each compartment has its own distinct biomechanical functionality, innervation, and blood supply. From the brachial plexus, recall the anterior and posterior Divisions are directly correlated to the anterior (flexor) and posterior (extensor) compartments.

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25
Q
  1. What divides the shoulder (axioappendicular) compartments?
A

Shoulder (axioappendicular) compartments are divided by the pectoral, axillary, and clavipectoral fascia

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26
Q
  1. What is the anterior compartment’s function? Innervation? Blood Supply?
A

Anterior compartment
Functions: arm adduction, flexion, and medial rotation
Innervation: medial and lateral pectoral nerves, long thoracic nerve and nerve to subclavius
Supply: thoracoacromial trunk, lateral thoracic

27
Q
  1. What is the function and innervation of the posterior compartment?
A

Posterior compartment
Functions: arm abduction, extension, and lateral rotation (mostly)
Innervation: axillary nerve, suprascapular nerve, and upper and lower subscapular nerves

28
Q
  1. What kinds of muscles are anterior axioappendicular muscles?
A 
Anterior axioappendicular muscles: 
Pectoralis major
Pectoralis minor
Subclavius
Serratus anterior

Extrinsic muscles attaching the upper limb to the thorax

29
Q 
30.	For the pectoralis major of the anterior axioappendicular muscles, give: 
proximal attachment
Distal attachment
Innervation 
Actions
A

Anterior axioappendicular muscles:
Pectoralis major
Proximal attachment:
clavicular head: anterior medial shaft of the clavicle
sternal head: anterior surface of the sternum
Distal attachment: lateral lip of the intertubercular groove of the humerus
Innervation: lateral and medial pectoral nn.
Actions: adducts, medially rotates, and flexes the humerus. Can EXTEND the humerus from a flexed/elevated position.

30
Q 
31.	Pectoralis minor:
Proximal attachment
Distal attachment
Innervation 
Actions
A

Proximal attachment: 3rd–5th ribs
Distal attachment: medial border of the coracoid process (scapula)
Innervation: medial pectoral n.
Actions: stabilizes the scapula; elevates ribs (accessory muscle of respiration)

31
Q 
32.	Subclavius
Proximal attachment
Distal attachment
Innervation 
Actions
A

Proximal attachment: junction of the first rib and manubrium
Distal attachment: inferior center of the clavicle
Innervation: n. to the subclavius
Actions: anchors and depresses the clavicle

32
Q
  1. Serratus anterior:
    Distal attachment
    Innervation
    Actions
A

Serratus anterior
Proximal attachment: lateral parts of ribs 1–8
Distal attachment: medial anterior border of the scapula
Innervation: long thoracic n.
Actions: protracts, rotates, and stabilizes scapula on thorax

33
Q
  1. What are the four of the Posterior axioappendicular muscles:
A

Latissimus dorsi
Rhomboideus major and minor
Levator Scapulae
Trapezius

34
Q 
35.	Trapezius
Proximal attachment
Distal attachment
Action
Innervation
A

Proximal attachment: occipital bone, spinous processes of C1–T12
Distal attachment: lateral third of clavicle, acromion, superior border of scapular spine
Innervation: accessory n. (CN XI)
Action: elevates, retracts, rotates, and depresses scapula

35
Q 
36.	Levator Scapulae
Proximal attachment
Distal attachment
Action
Innervation
A

Proximal attachment: transverse processes of C1–C4
Distal attachment: superior angle of scapula
Innervation: dorsal scapular n.
Action: elevates scapula

36
Q 
37.	Rhomboideus major and minor
Proximal attachment
Distal attachment
Action
Innervation
A 
Proximal attachment: 
major: spinous processes of T1–T4
minor: spinous processes of C6–C7
Distal attachment:
major: medial border of scapula below scapular spine
minor: medial border of scapula above scapular spine
Innervation: dorsal scapular n.
Action: retract and elevate scapula
37
Q 
38.	Latissimus dorsi
Proximal attachment
Distal attachment
Action
Innervation
A

Proximal attachment: spinous processes of T7–T12, thoracolumbar fascia, iliac crest
Distal attachment: floor of the intertubercular groove on humerus
Innervation: thoracodorsal n.
Action: adducts, extends, and medially rotates humerus

38
Q
  1. What are 3 Scapulohumeral muscles:
A 
Deltoid
Rotator Cuff
Supraspinatus
Infraspinatus
Teres Minor
Subscapularis
Teres major (not part of the rotator cuff!)
39
Q 
40.	Deltoid
Proximal attachment
Distal attachment
Action
Innervation
A

Proximal attachment: lateral third of clavicle, acromion, and scapular spine
Distal attachment: deltoid tuberosity of humerus
Innervation: axillary n.
Actions: anterior part flexes and medially rotates arm, middle part abducts the arm, and the posterior part extends and laterally rotates the arm

40
Q
  1. What are four muscles that make up the rotator cuff? What is a muscle close to here that is an exception?
A 
Rotator Cuff
Supraspinatus
Infraspinatus
Teres Minor
Subscapularis
*****Teres Major NOT part of rotator cuff****
41
Q 
42.	Supraspinatus
Proximal attachment
Distal attachment
Action
Innervation
A

Proximal attachment: supraspinous fossa of scapula
Distal attachment: superior aspect of the greater tubercle of the humerus
Innervation: suprascapular n.
Actions: initiates abduction, stabilization of glenohumeral joint

42
Q 
43.	Infraspinatus
Proximal attachment
Distal attachment
Action
Innervation
A

Proximal attachment: infraspinatus fossa of the scapula
Distal attachment: greater tubercle of the humerus
Innervation: suprascapular n.
Actions: lateral rotation, stabilization of glenohumeral joint

43
Q 
44.	Teres Minor
Proximal attachment
Distal attachment
Action
Innervation
A

Proximal attachment: lateral border of scapula
Distal attachment: greater tubercle of humerus
Innervation: axillary n.
Actions: lateral rotation, stabilization of glenohumeral joint

44
Q 
45.	Subscapularis
Proximal attachment
Distal attachment
Action
Innervation
A

Proximal attachment: subscapular fossa
Distal attachment: lesser tubercle of humerus
Innervation: upper and lower subscapular nn.
Actions: medial rotation, stabilization of glenohumeral joint

45
Q 
46.	Teres major (not part of the rotator cuff!)  give
Proximal attachment
Distal attachment
Action
Innervation
A

Proximal attachment: posterior surface of inferior angle of scapula
Distal attachment: medial lip of the intertubercular groove of humerus
Innervation: lower subscapular n.
Actions: adduction and medial rotation of arm

Arterial System: Many branches you will find go directly to muscles and have no specific names, these are generally referred to as muscular branches.

46
Q
  1. What are two branches of the subclavian artery? (One of these has two more branches of itself)
A 
Subclavian 
Thyrocervical trunk
Transverse cervical a.
Dorsal scapular a.
Suprascapular a.
47
Q
  1. The subclavian changes its name to axillary. What are the three parts?
A

Part 1: proximal to pectoralis minor
Part 2: deep (posterior) to pectoralis minor
Part 3: Distal to pectoralis minor

Axillary: As subclavian passes under the clavicle it changes names to the axillary. Three parts defined by their position relative to pectoralis minor and named based on how many arteries originate from them

  1. What are the parts of the axillary part artery part 1: proximal to pectoralis minor artery?@
    Superior thoracic a.
48
Q
  1. What are the parts of the axillary artery Part 2: deep (posterior) to pectoralis minor
A

Thoraco-acromial trunk
Acromial, pectoral, clavicular, and deltoid branches
Lateral thoracic a.

49
Q
  1. What are the parts of the axillary Part 3: Distal to pectoralis minor
A 
Anterior circumflex humeral a.
Posterior circumflex humeral a.
Subscapular a.
Circumflex scapular a.
Thoracodorsal a.
50
Q
  1. Give the scapular anastomoses
A

Scapular anastomoses
subclavian > thyrocervical trunk > transverse cervical > dorsal scapular > thoracodorsal > subscapular > axillary
subclavian > thyrocervical trunk > suprascapular > circumflex scapular > subscapular > axillary

51
Q
  1. What makes up the Humeral anastomosis
A

anterior circumflex humeral > posterior circumflex humeral

Venous system: more variable than the arterial system
Deep veins: generally follow the arteries and are so named

52
Q
  1. Superficial veins go into subclavian vein. Where does the cephalic and basilica vein go through?
A

Superficial veins: into subclavian, highly variable network
Cephalic vein: Passes through deltopectoral groove
Basilic vein: Into axillary, passes through basilic hiatus

53
Q
  1. What are 5 kinds of axillary nodes?
A 
Lymphatic system: ascend and frequently anastomose with venous system
Five groups of axillary nodes
humeral
subscapula
pectoral: : 
central:
apical:
54
Q
  1. Give location of humeral node:
A

lateral wall of the axillary fossa medial and posterior to axillary vein

55
Q
  1. Give location of subscapular node:
A

posterior wall of axillary fossa along posterior axillary fold and subscapular blood vessels

56
Q
  1. Give location of pectoral node:
A

medal wall of axilla, surrounding lateral thoracic vein and inferior border of pectoralis minor

  1. Give location of central node: @ deep to pectoralis minor
57
Q
  1. Give location of apica node l:
A

at apex of axillary fossa along medial side of axillary vein and 1st part of axillary artery

58
Q

Give the Basilic v. drainage?

A

enters cubital nodes > humeral axillary nodes

59
Q
  1. Give the drainage for Cephalic v.
A

drainage enters apical axillary nodes

60
Q

Axillary nodes drain ~75% of lymph from breast tissue and are clinically important in staging of breast cancer
62. For clinical purposes axillary nodes are divided into three levels, what are they?

A 
Level 1: lateral to pectoralis minor
Level 2: deep to pectoralis minor
Level 3: medial to pectoralis minor
Five year survival rate decreases with increasing levels of metastasis
Level 1: 65%
Level 2: 31%
Level 3: ~0%
61
Q

Important landmarks

63. Quadrangular space borders, nerve, and supply?

A

Lateral border
Medial border
Superior border
Inferiorly

62
Q
  1. Quadrangular space: contains axillary nerve and posterior humeral circumflex artery
A

Lateral border—humerus
Medial border—long head of triceps brachii
Superior border—teres minor
Inferiorly—teres major
axillary nerve and posterior humeral circumflex artery

63
Q 
65.	Triangular space: 
Superior border 
Inferior border 
Lateral border
Blood supply?
A

Lateral border —long head of the triceps
Superior border —teres minor
Inferior border —teres major
contains the scapular circumflex artery

Anatomy (10 decks)

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