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IPAP > A&P1 Upper Limb > Flashcards

A&P1 Upper Limb Flashcards

1
Q

What are the components of the upper limb?

A

Shoulder
Arm
Forearm
Hand

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2
Q

What are the pectoral girdles?

A

Shoulder girdles

Attaches upper limbs to axial skeleton

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3
Q

Pectoral girdles are a part of which skeleton plane?

A

Appendicular

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4
Q

Humans have two pectoral girdles each composing what two structures?

A

Clavicle

Scapula

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5
Q

Where does the clavicle articulate?

What force does it transfer?

A

With sternum and scapula

Transmits mechanical force from upper limb to trunk

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6
Q

Define Conoid Tubercle

A

Site of attachment of conoid portion of coracoclavicular ligament

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7
Q

Where is the coracoclavicular ligament located?

A

Between clavicle and coracoid process of scapula

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8
Q

What does the scapula articulate with?

A

Clavicle and humerus

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9
Q

Scapula articulates with bones ______ but is held in place _______ by musculature

A

Anterior

Posterior

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10
Q

Define acromion

A

Lateral end of scapular spine and high point of the shoulder

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11
Q

What land mark on the scapula/upper limbs do tailors use for measurements?

A

Length of upper arm from acromium

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12
Q

Define glenoid cavity

A

Accepts humerus head to form glenohumeral joint

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13
Q

What is the thinner edge of the scapula?

What is the thicker edge of the scapula?

A 
Medial border (vertebral border)
Lateral border (axillary border)
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14
Q

Medial and lateral borders of the scapula form ____ _____

A

Inferior angle

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15
Q

Superior and medial border join at _____ ______

A

Superior angle

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16
Q

Define scapular notch

A

Suprascapular notch

Superior border indentation where suprascapular nerve passes

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17
Q

Define Coracoid process

A

Crow’s break

Lateral end of superior border

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18
Q

What muscle/ligaments attaches at the coracoid process?

A

Muscle: Pec minor
Coracobrachialis
Bicep

Ligament: Coracoacromial
Conoid
Trapezoid

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19
Q

Define supraspinous fossa
Define infraspinous fossa
Define subscapular foss

A

Supra: attachment of supraspinatus muscle

Infra: attachment for infraspinatus muscle

Sub: anterior surface attachment for subscapularis muscle

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20
Q

What does the superior transverse scapular ligament do?

A

Transverses scapular notch, converts to foramen

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21
Q

Where does the omohyoid muscle originate?

A

Scapular notch, extending to superior transverse scapular ligament

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22
Q

Where do the suprascapular nerve and artery travel?

A

On way to supraspinatus muscle, nerve travel under transverse scapular ligament; artery travels over ligament

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23
Q

What does the suprascapular nerve provide sensation for?

A

Sensory to shoulder joint

Motor to infra/supraspinatus muscles

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24
Q

Define suparascapular neuritis

A

Entrapment neuropathy caused by compression of suprascapular nerve

Pain radiates from C5/6 dermatomes, reproduced w/ pressure over nerve in notch

Prolonged entrapment leads to wasting of infra/supraspinatus muscles

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25
Q

Why is the suprascapular nerve liable to injury?

A

Travels through suprascapular notch, spanned by transverse ligament
Injury from overuse/excessive traction

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26
Q

Where does the clavicle and sternum articulate?

A

Sternoclavicular joint

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27
Q

What are the joints called where the scapula articulates with the clavicle and with the humerus?

A 
Clavicle= acromioclavicular joint
Humerus= glenohumeral joint
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28
Q

What type of joint is the sternoclavicular joint?

Why is this one important?

A

Synovial saddle joint

Only true synovial joint connecting pectoral girdle with ribcage

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29
Q

Define acromioclavicular joint?

What part of the body is it considered a joint of?

A

Lateral/acromial end of clavicle articulates w/ acromion process of scapula
Joint of the upper limb

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30
Q

What kind of joint is the acromioclavicular joint?

A

Synovial joint

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31
Q

Shoulder joints separate at which joint?

A

Acromioclavicular joint

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32
Q

What are the stabilizing ligaments of the acromioclavicular joint?

A

Acromioclavicular ligament

Coraclavicular ligament- trapezoid and conoid ligament

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33
Q

What are the functions of the trapezoid and conoid ligaments?

A

Comprose coracoclavicular ligament- attaches clavicle to coracoid process of scapular, stabilizes the acromioclavicular joint

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34
Q

Each upper limb has how many bones?

How many joints?

A

30 bones

5 joints

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35
Q

What does the humerus articulate with?

A

Proximally w/ glenoid cavity of scapula (glenohumeral joint)

Distally w/ both radius/ulna

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36
Q

Where do muscles that move the humerus insert?

A

Greater/lesser tubercles

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37
Q

What is the function of the humerus anatomical neck?

A

Between tubercles and head, site of attachment for articular capsule

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38
Q

What is the groove called that the long head of bicep brachii muscle lies in?

A

Intertubercular sulcus
Bicipital groove
Intertubercular groove

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39
Q

What site of the humerus is frequently broken?

A

Surgical neck, distal to tubercles

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40
Q

Where does the deltoid attach to the humerus?

A

Deltoid tuberosity

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41
Q

What are the ridges on the distal anterior end of the humerus?

A

Lateral supracondylar ridge ends in lateral epicondyle

Medial supracondyle ridge ends in larger medial epicondyle

Capitulum- near lateral epicondyle
Trochlea- medial indentation

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42
Q

What are the two anterior depressions of the humerus and what are their function?

A

Receive parts of radius/ulna when elbow is flexed
Radial fossa- lies above capitulum, contains radius during flexion
Coronoid fossa- above trochlea, receives ulnar coronoid process

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43
Q

What is the olecranon fossa?

A

Large depression of posterior humerus, receives ulna when forearm is extended

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44
Q

Most fractures of the proximal humerus are located where?

What kind of fractures are they?

A

Surgical neck
Impact
Transverse- due to direct to blow, pull of deltoid muscle carries proximal fragment of fractured humerus laterally
Avulsion- fall onto point of shoulder in middle age/elder

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45
Q

How are avulsion fractures typically repaired?

A

Open reduction and fixation w/ screws

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46
Q

Humerus fractures can be accompanies with nerve damage due to what nerve locations?

A

Surgical neck= axillary nerve
Shaft= radial nerve
Distal end= median nerve
Medial epicondyle= ulnar nerve

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47
Q

Ulna forms the ____ border of the forearm

Radius forms the ____ border

A

Medial

Lateral

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48
Q

The ulna is a _____ bone and the radius is a ____ bone

A 
U= stabilizing
R= moveable
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49
Q

Which bone contains the olecranon?

A

Ulna proximal end

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50
Q

What is the ulnar coronoid process?

A

Anterior projection at proximal end of bone

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51
Q

What forms the trochlear notch?

A

Olecranon and coronoid process receive trochlea of humerus

Trochlear notch= large curved area of elbow joint

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52
Q

Where is the radial notch of the ulna?

A

Lateral side of coronoid process, receives head of radius

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53
Q

Where is the ulnar tuberosity?

A

Inferior to coronoid process

Brachialis muscle attaches

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54
Q

Head of the ulna is at what end of the bone?

What separates the ulna from the wrist?

A

Distal

Fibrocartilage
Styloid process on distal end is point of attachment for collateral ligament

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55
Q

What is located at the proximal end of the radius?

What is the distal end called?

A

Head that articulates w/ capitulum of humerus and radial notch of ulna

Inferior head is neck

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56
Q

What is the function of the radial tuberosity?

A

Inferior neck that is attachment point for tendons of bicep brachii muscle

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57
Q

What is the function of the radial styloid process?

A

Lateral side, proximal to thumb

Attachment site of brachioradialis muscle and radial collateral ligament

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58
Q

What is the name of the membrane in between the radius and ulna?

A

Interosseous membrane

Site of attachment for tendons of deep muscles of forearm

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59
Q

What is the proximal radioulnar joint?

A

Articulation site of the ulna radial notch with the head of radius

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60
Q

What is the Dorsal Tubercle of the radius?

What is it AKA?

A

Prominence on dorsal aspect, lateral to groove for extensor pollicis longus tendon
Trochlea for tendon
Lister’s tubercle

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61
Q

How many carpal, metacarpal and phalanges are there in each arm?

A

8 carpal
5 metacarpal
14 phalanges- 3/finger, 2/thumb

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62
Q

Which arm bone does not participate in wrist joint?

A

Ulna

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63
Q

Distal radius and articular disc of distal radioulnar joint articulate with what bones?

A

All carpal

Except pisiform

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64
Q

What is the function of the pisiform?

What bone does it articulate with?

A

Increases leverage of flexor carpi ulnaris

Only w/ triquetrum

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65
Q

What are the mnemonic for carpal bones?

A

Lat-Medial/Lat-Medial

Stop Letting Those People Touch The Cadavers Hand

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66
Q

Metacarpals are numbered in which direction?

What are the 3 parts of the bones?

A 
#1 proximal to thumb
Base, shaft, head
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67
Q

Knuckles are called what kind of joints?

A

Metacarpophalangeal joint

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68
Q

What are the different parts of the phalanges?

Which digit is an exception?

A 
Proximal
Middle
Distal on each finger
Thumb is exception
Base shaft head
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69
Q

Define Acromioclavicular Articulation

A

Articulation site of clavicle and acromion of the scapula

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70
Q

Define Jugular Notch

A

Depression between two sternal ends of clavicles

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71
Q

What is the most superficial muscle of the anterior thoracic wall?

A

Pectoralis

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72
Q

What is the insertion site for the 3 heads of the triceps?

A

Olecranon process

73
Q

Which vein in the AC space is the normal site for venipunctures?

A

Median cubital vein

74
Q

Which upper limb muscles attach to the thoracic cage?

A

Anterior:
Pec major/minor
Serratus Anterior
Subclavius

Posterior: Lats

75
Q

What muscles is AKA Boxer’s Muscle?

A

Serratus anterior

76
Q

What happens if the long thoracic nerve is injured?

What is the resulting condition called?

A

Paralysis of serratus anterior muscle
Arm can’t be abducted beyond horizontal position
Condition called winged scapula

77
Q

What are the superficial layers of back muscles?

A 
Connect upper limb->vertebral column, involved in respiration
Traps
Lats
Levator scapulae
Rhomboids maj/min
78
Q

What are the functions of the deepest layers of the muscles in the back?

A

Extend the head and vertebral column

Rotate/lateral bending of head/neck/back

79
Q

What nerves supply the superficial back muscles?

A

Ventral rami

Except Traps, innervated by CN11

80
Q

What muscles stabilize the pectoral girdle?

A

Trapezius- skull and vertebrae->clavicle and scapula
Levator scapulae- cervical vertebrae->scapula
Rhomboideus- thoracic vertebrae->scapulas vertebral border

81
Q

What forms the Triangle of Auscultation?

What movement makes it larger?

A

Superior horizontal border of lat dorsi
Medial border of scapula
Inferolateral border of traps
Folding arms on chest

82
Q

Shoulder joint consists of what 4 smaller joints?

A

Glenohumeral
Acromioclavicular
Sternoclavicular
Scapulothoracic

83
Q

Shoulder joint has what type of fossa when compared to the hip which has what type of fossa?

A 
Shoulder= shallow glenoid
Hip= deep acetabular
84
Q

Shoulder circumduction is a combination of what movements?

A

Flexion
Extension
Abduction
Adduction

85
Q

Define joint rotation

A

Circular movement around the long axis of the bond at the joint

86
Q

What are the articulation points of the glenohumeral joint?

A

Humeral head articulates w/ glenoid cavity of scapula

87
Q

Glenoid cavity holds how much of the humeral head?

What holds the head in the cavity?

A

1/3

Tonus of rotator cuff

88
Q

What is the articular capsule of the glenohumeral joint?

What does the opening in the capsule allow?

A

Loose fibrous capsule surrounding joint
Attaches to margin of glenoid cavity and anatomical neck of humerus
Hole allows for passage of tendon of long head of bicep

89
Q

What kind of muscles are the scapulohumeral muscles?

A

Intrinsic shoulder muscles

90
Q

What muscles are the scapulohumeral muscles?

A 
Deltoid
Supraspinatus
Infraspinatus
Teres major/minor
Subscapularis
Pass from scapula to humerus and act on glenohumeral joint
91
Q

What are the 4 muscles that make up the rotator cuff?

A 
Supraspinatous
Infraspinatous
Subscapularis
Teres minor
Originate from scapula, cuff on head of humerus
92
Q

Where does the rotator cuff insert?

Which muscle is an exception?

A

Greater tuberosity

Subscapularis inserts on lesser tuberosity, not a rotator of the humerus

93
Q

What movement types does the rotator cuff help the arm perform?

A

Lift and rotate arm

Stabilize ball of shoulder w/in joint

94
Q

What is the coracoacromial ligament?

A

Spans coracoacromial arch between acromion and coracoid process of scapul
Prevents superior displacement of humerus head

95
Q

Define painful arc syndrome

A

Subacromial bursa is inflamed causing pain during arc of 50-130*

96
Q

What connective structures does the subacromial bursa separate?

A

Separates tendon of supraspinatus from coracoacromial ligament, acromion and deltoid

97
Q

Where does the axillary artery begin?

Where does it transition into the brachial artery?

A

Lateral border 1st rib

Becomes brachial at inferior border of teres major

98
Q

Which muscle divides the axillary artery into three parts?

A

Pec minor

99
Q

Where is the axillary vein in relation to the axillary artery?

A

Medial side of artery

100
Q

What joins to form the axillary vein?

A

Union of brachial veins and basilic vein at inferior border of teres major

101
Q

Define anterior scalene syndrome

A

Scalenus anterior syndrome or scalene entrapment syndrome; all a type of thoracic outlet syndrome
Compression of brachial plexus and brachial vessels in root of neck
Brachial plexus and vessels trapped between anterior and middle scalene muscles

102
Q

What are the borders of the quadrangular space?

A

Superior: inferior border of teres minor
Inferior: superior border of teres major
Medial: head of tricep
Lateral: surgical neck of humerus

103
Q

What structures are found/located in the quadrangular space?

A

Axillary nerve
Posterior circumflex humeral artery
Posterior circumflex humeral vein

104
Q

Which nerve wraps around the surgical neck of the humerus?

Which nerve wraps around the shaft of the humerus?

A

Axillary

Radial

105
Q

What muscles are in the Anterior Compartment of the arm?

A

Bicep
Brachialis
Corachobrachialis

106
Q

What muscles are in the posterior compartment of the arm?

A

Triceps

Anconeus

107
Q

Which artery is used for taking BPs and is also the supplying artery for the arm?

A

Brachial, continuation of the axillary

108
Q

All muscles of the anterior compartment are innervated by what nerve?

A

Musculocutaneous nerve

109
Q

What muscle is the flexor of the forearm with supination and pronation?

A

Supination- bicep

Pronation/supination- brachialis

110
Q

All muscles of the posterior compartment are innervate by what nerve?

A

Radial nerve

111
Q

What artery supplies the arm and what are the subsequent branches?

A

Brachial artery

Teres major to cubital fossa w/ profunda brachii and ulnar collaterals branches

112
Q

What are the superficial and deep veins of the arm?

A

Superficial: cephalic, basilic
Deep: brachial

113
Q

Where does the brachial artery start and end?

A

Continuation of axiallary

Lower border of teres major to lower part of cubital fossa, terminates as radial/ulnar artery

114
Q

What is the major branch of the brachial artery?

A

Deep brachial artery (profunda brachii) of proximal arm

115
Q

What two veins are superficial to the brachial fascia?

A

Cephalic vein

Basilic vein

116
Q

What arm vein diverts most/all blood to what vein?

Which vein may be absent/small in this case?

A

Basilic

Superior cephalic

117
Q

What are the 4 main nerves that pass through the arm?

Which two don’t have branches in the arm?

A

Musculocutaneous
Radial
Median
Ulnar

Median and Ulnar

118
Q

What is the path of the Musculocutaneous nerve through the arm?

A

Branches off brachial plexus and passes through coracobrachialis, continues distally between bicep and brachialis muscles

119
Q

Musculocutaneous nerve supplies ___ above the elbow and supplies ___ below the elbow

A

Above- muscles

Below- cutaneous

120
Q

Where/how does the musculocutaneous nerve terminate in the arm?

A

Lateral antebrachial cutaneous nerve, AKA lateral cutaneous nerve

121
Q

What does the radial nerve supply?

A

Posterior compartment of the arm

122
Q

What two structures form the trochlear notch?

A

Coronoid process

Olecranon

123
Q

What kind of joint is the elbow joint?

A

Synovial hinge joint

124
Q

What does the radial collateral ligament connect?

A

Lateral epicondyle of humerus to radial notch of ulna

125
Q

What does the anular ligament cover?

A

Head of radius

126
Q

What does the ulnar collateral ligament connect?

A

Medial epicondyle of humerus to coronoid process and olecranon of ulna

127
Q

What is nursemaid’s elbow?

A

Subluxation of complete/partial dislocation of joint/organ
Radial head- common in girl peds, 2-3y/o on L side

Caused by sudden longitudinal traction on arm w/ elbow extended

128
Q

How are golfer and tennis elbow similar and different?

A

Similar- epicondyle of elbow resulting from excessive/repetitive strenuous use

Different:
Golf- medial epidondyle
Tennis- lateral epicondyle

129
Q

What are the extrinsic muscles of the hand?

A

Anterior: flexor/pronator
Posterior: extensor/supinator

130
Q

Superficial anterior/flexor muscles of the forearm originate and insert where?

A

O- medial epicondyle

I- carpal/metacarpal/phalanges

131
Q

What muscle bellies form the bulk of the forearm mass?

A

Superficial anterior flexors

132
Q

What are the names of the superficial anterior compartment muscles?

A 
Flexor carpi radialis
Palmaris longus
Flexor carpi ulnaris
Flexor digitorum superficialis
Pronator teres
133
Q

Deep anterior flexor compartment muscles inster where?

A

Distal phalanges

134
Q

What are the deep anterior flexor muscles?

A

Flexor pollicis longus
Flesor digitorum profundus
Pronator quadratus

135
Q

Flexor digitorum superficialis inserts _____

Flexor digitorum profundus inserts _____

A

Middle phalange

Distal phalange

136
Q

How is the function of the flexor digitorum profundus and median nerve tested?

A

Flexion of distal interphalangeal joint

137
Q

What is stenosing tenosynovitis?

A

Trigger finger digit

Disproportional sizes of flexor and retinacular pulleys

138
Q

What are the superficial posterior extensor compartments?

A 
Brachioradialis
Extensor carpi radialis longus
Extensor carpi radialis brevis
Extesnor digitorum
Extensor digiti minimi
Extensor carpi ulnaris
139
Q

What is the brachioradialis reflex?

A

Supinator reflex
Striking brachioradialis tendon near insertion
SHOULD result in slight wrist extension/radial deviation/supination

140
Q

What are the deep extensor compartment muscles?

A 
Abductor pollicis longus
Extensor pollicis brevis
Extensor pollicis longus
Extensor indicis
Supinator
141
Q

What is Lister’s Tubercle used for?

A

Extensor pollicis longus crosses wrist and turns toward thumb using dorsal tubercle on distal end of radius as pulley

142
Q

Pronation is function of which nerve?

Supination uses what nerve?

A

Pro- Median

Sup- Musculocutaneous and radial

143
Q

Where do the pronators insert and originate?

A

Insert on radius

Originate on ulna

144
Q

What are the 3 pronators?

A

Pronator teres
Pronator quadratus
Brachioradialis

145
Q

Where do the supinators originate and insert?

A

Origin- humerus

Insert- radius

146
Q

What are the 3 supinator muscles?

A

Supinator muscle
Bicep brachii
Brachioradialis

147
Q

What are the superficial veins of the forearm?

A

Cephalic
Basilic
Median antebrachial

148
Q

When taking a PTs radial pulse, you’re pressing in between what tendons?

A

Flexor carpi radialis

Abductor pollicis longus

149
Q

Which forearm muscles are innervated by the ulnar nerve?

A

Flexor carpi ulnaris
Flexor digitorum profundus- also supplied by median nerve
Interossei
Half Lumbricals

150
Q

Which forearm muscles are innervated by the median nerve?

A 
Flexor carpi radialis
Palmaris longus
Flexor digitorum superficialis
Flexor pollicis longus
Flexor digitorum profundus- also innervated by ulnar nerve
151
Q

What is Radial Nerve Dysfunction?

A

Peripheral neuropathy effecting arm, forearm or hand
Caused by prolonged pressure, swelling or injury
Crutch palsy

152
Q

Wrist and hand have _ bones, _ intrinsic and _ extrinsic muscles

A

28
19
20

153
Q

What is the retinacula?

A

Antebrachial fascia w/ thick posterior portion on distal radius/ulna
Forms transverse band- extensor retinaculum, retains extensor position and prevents bowstringing

154
Q

What happens when the retinacula thickens on the anterior side?

A

Palmar carpal ligament

Flexor retinaculum- aka transverse carpal ligament

155
Q

What bones does the flexor retinaculum stretch across?

A

From scaphoid and trapezium bone to hamate and pisiform

156
Q

What 3 structures lie in between palmar carpal ligament and flexor retinaculum?

A

Palmaris longus muscle
Ulnar nerve
Ulnar artery

157
Q

The canal formed by the flexor retinaculum and carpal bones hold what structures?

A

Flexor pollicis longus
Flexor digitorum superficialis
Flexor digitorum profundus

158
Q

Median nerve passes through the wrist via what tunnel?

A

Carpal tunnel

159
Q

What are the two terminal sensory branches of the median nerve?

A

Skin of hand

Lateral 3 and 1/2 digits

160
Q

Carpal tunnel sydrome can lead to hypoestheia or anesthesia of the hand. What does that mean?

A

Hypo- diminished sensation

Anesth- loss of sensation

161
Q

What parts of the hand will remain unaffected by carpal tunnel syndrome?

A

Central palm

Medial one and one/half of digits (ulnar nerve supply)

162
Q

What is the terminal motor branch of the median nerve serving the 3 thenar musles?

A

Thenar branch

Unable to oppose thumb

163
Q

Define Tinel Sign

A

Detection method for irritated nerves

Tap/percuss over nerve to cause pins/needles sensation

164
Q

How is Tinel Sign positive for carpel tunnel syndrome?

A

Tingling in thumb, index and middle finger

165
Q

Tinel’s sign is aka?

A

Distal Tingling on Percussion, DTP

166
Q

Palmar aponeurosis is an extension of what tendon?

A

Palmaris longus muscle

167
Q

What is the most superficial structure in the hand?

A

Palmar aponeurosis

168
Q

What are the intrinsic muscles of the hand?

A

Hypo/thenar
Adductor
Lumbrical
Interosseus

169
Q

What are the muscles of the thenar compartment?

As a unit, what movement do they provide by what nerve?

A

Abductor pollicis brevis
Flexor pollicis brevis
Opponens pollicis
Move the thumb via median nerve

170
Q

What is the adductor of the thumb?

What function does this muscle provide?

A

Fan-shaped adductor pollicis in the ADDuctor compartment

Strength of grip

171
Q

What type of movement causes Skier’s/Gamekeeper’s thumb?

A

Hyperabduction of MP joint causing rupture/chronic laxity of UCL
Skier- acute
Game- chronic

172
Q

What are the muscles of the hypothenar compartment?

What movement do they provide?

A

Abductor digiti minimi
Flexor digiti minimi brevis
Oppenens digiti minimi

Move little finger via ulnar nerve

173
Q

What are the Lumbrical muscles?

What movement do the provide and by what nerve?

A

Proximal attachment to tendons of flexor digitorum profundus and distally to extensor digitorum

Flex digits at MC joint and extend interphalangeal joints
Lateral- median
Medial- ulnar

174
Q

How many interossei muscles are there?

What movement do they provide and by what nerve?

A

Four dorsal- abduction
Three palmar- adduct

Ulnar

175
Q

What tendons form the anatomical snuff box?

A

Abductor pollicis longus
Extensor pollicis brevis
Extensor pollicis longus

176
Q

What is important about the anatomical snuff box?

A

Radial artery in floor

Superficial branch of radial nerve provides cutaneous sensation

177
Q

Sequence of blood flow to hand?

A

Ulnar/radial artery
Ulnar->superficial and deep
Superficial-> superficial palmar arch meeting with superficial branch of radial artery

178
Q

What is Allen’s Test?

A

Blood supply from ulnar/radial artery to anastomose.
Blood squeezed/removed from fist, ulnar pressure is released, color returns w/in 7sec means radial artery is safe for use for ABG/cannulation

IPAP (212 decks)

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