Anatomy (Arm and Elbow - 11/4) Flashcards

1
Q
Dermatomes
C5
C6
C7
C8
A

C5 Shoulder
C6 Thumb
C7 Middle Finger
C8 Little Finger

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2
Q

Dermatomes
T4
T10

A

T4 - Nipple

T10 - Umbilicus

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3
Q
Dermatomes
L1
L5
S1
S2,3,4
A

L1 - Groin
L5 - Medial Foot
S1 - Lateral Leg/Foot
S2,3,4 - Anal Area

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4
Q
Myotomes
C5
C6
C7
C8/T1
A

C5 - UE Abduction
C6 - Flexion of arm/forearm
C7 - Extension of forearm
C8/T1 - Intrinsic hand muscles

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5
Q
Myotomes
L2
L3,4
S1
L5
S1,2
A
L2 Flex thigh
L3,4 Extend leg
S1 Flex leg
L5 dorsiflexes foot 
S1,2 Plantar flexes foot
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6
Q

What lies in intertubercular sulcus?

A

Long head of biceps

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7
Q

What does capitulum articulate with?

A

Head of radius

- lateral side

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8
Q

What does trochlea articulate with?

A

Trochlear notch of ulna

- medial side

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9
Q

What moves into coronoid fossa with flexion of forearm?

A

Coronoid process (front of ulna)

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10
Q

What moves into radial fossa with flexion of forearm?

A

Head of radius

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11
Q

Medial epicondyle = origin site for

A

flexor muscles of forearm/head

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12
Q

Lateral epicondyle = origin site for

A

extensor muscles of hand

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13
Q

Radial groove (location and what’s there)

A

Posterior surface of humerus - radial nerve and deep brachial vessels

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14
Q

Olecranon fossa

A

posterior side of distal humerus, olecranon process of ulna there on extension of forearm

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15
Q

Ulnar nerve

A

Derived from medial cord –> continues through arm region –> passes posterior to medial epicondyle (“funny bone”)

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16
Q

Brachial fascia

A

Surrounds muscles, blood vessels, nerves of arm

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17
Q

Medial and lateral intermuscular septae

A

Extend inward from brachial fascia –> attach to humerus –> divide arm into anterior flexor compartment and posterior extensor compartment

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18
Q

Triceps brachii

A

Long head: Infraglenoid tubercle (scapula) - long w/ tendon, more medial
Lateral head: Posterior surface of humerus lateral to radial groove - most lateral
Medial head: Medial to radial groove Under them (deep)

*To olecranon process of ulna
Extend forearm, extend/adduct arm
Radial nerve

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19
Q

When cut lateral head of triceps diagonally near radial groove, see:

A

Medial head of triceps, radial nerve w/ deep brachial artery

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20
Q

Biceps brachii

A

Long head: Supraglenoid tubercle of humerus
Short head: Coracoid process of scapula

Tendon inserts on radial tuberosity + Bicipital aponeurosis

Innervated by musculocutaneous nerve

Flex forearm, supinate

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21
Q

Coracobrachialis

A
Superiorly - coracoid process, inferiorly on humerus at midpoint on medial side
Musculocutaneous nerve (also passes through to lie between biceps/brachialis muscles it also innervates)
Flex, adduct arm
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22
Q

Rupture of Tendon of Long head of biceps

A

Tendon tears with forceful flexion of arm against excessive resistance –> popeye deformity

23
Q

Brachialis

A

Anterior lower half of humerus –> coronoid process/tuberosity of ulna
Musculocutaneous nerve
Flexes forearm

24
Q

Pathway of musculocutaneous nerve

A

From Lateral cord –> Passes through coracobrachialis –> distally lying on brachialis muscle, covered by biceps brachii –> exits lateral border of biceps and continues into forearm as lateral cutaneous nerve of the forearm (lateral antebrachial cutaneous nerve)

25
Q

Pathway of radial nerve

A

Passes through posterior compartment of arm through lateral intermuscular septum to lie beneath brachioradialis muscle –> superficial branch (sensory) under brachioradialis to dorsum of hand, and deep branch that pierces supinator muscle to reach posterior forearm - extensors

26
Q

Cubital fossa

A

Triangular space defined by imaginary line between medial/lateral epicondyles, brachioradialis, pronator teres muscle
Cicipital aponeurosis/deep fascia = roof, brachialis + supinator muscles = floor

27
Q

Brachial artery

A
Begins at lateral border of teres major muscle (continues from axillary artery) 
Accompanies median nerve in arm
3 major branches--> 
1. Deep brachial artery
2. Superior ulnar collateral artery
3. Inferior ulnar collateral artery
28
Q

Deep brachial artery

A

1st branch of brachial artery

Passes posteriorly and accompanies radial nerve in radial groove

29
Q

Superior ulnar collateral artery

A

2nd brach of brachial artery

Accompanies ulnar nerve and passes behind medial epicondyle

30
Q

Inferior ulnar collateral artery

A

3rd (smallest) brach of brachial artery

Supplies area of elbow joint and anastomoses with recurrent branches of ulnar/radial arteries

31
Q

Anterior flexor compartment

A

biceps brachii, coracobrachialis, brachialis

Innervated by musculocutaneous nerve

32
Q

Posterior extensor compartment

A

Triceps brachii

Innervated by radial nerve

33
Q

What muscle supinates the forearm?

A

Biceps brachii (also flexes)

34
Q

Quandrangular space

A

Formed by teres minor, long head triceps, humerus, teres major
Transmits posterior circumflex humeral artery and axillary nerve

35
Q

Triangular interval

A

Formed by teres major, long and lateral heads of triceps

Location of deep brachial artery and radial nerve, which both go into radial groove

36
Q

Where is tendon of long head of biceps?

A

Runs over head of humerus, ensheathed by layer of synovial membrane that follows the tendon as far as the surgical neck of the humerus. Held in intertubercular groove by transverse humeral ligament and tendon of pec major.

37
Q

Bicipital aponeurosis

A

Overlies/protects brachial artery in cubital fossa

Extension of biceps tendon

38
Q

Where does long head of biceps have origin?

A

Supraglenoid tubercle of scapula

39
Q

Where do most ruptures of long head of biceps occur?

A

From attachment at supraglenoid tubercle of scapula

40
Q

What tendon is most associated with tendonitis of biceps?

A

Long head attachment that goes through intertubercular groove (back and forth under synovial sheath)

41
Q

Ulnar nerve injury

A

Common in fracture of medial epicondyle - funny bone
Denervates most intrinsic hand muscles.
Power of wrist adduction is impaired
When try to flex the wrist joint –> hand drawn to the lateral side by the FCR (supplied by the median nerve) in the absence of the “balance” provided by the FCU.
Difficulty making a fist because, in the absence of opposition, the metacarpophalangeal joints become hyperextended, and he or she cannot flex the 4th and 5th digits at the distal interphalangeal joints when trying to make a fist.
Person cannot extend the interphalangeal joints when trying to straighten the fingers.
Claw hand
The deformity results from atrophy of the interosseous muscles of the hand supplied by the ulnar nerve.

42
Q

Median nerve injury

A

Cannot make fist - hand of benediction (2,3 fingers remain extended)
Cannot abduct/adduct thumb
Sensory loss

43
Q

Radial nerve injury

A

Common with humerus fractures at surgical neck, incorrect use of crutches with axillary pressure (posterior cord)
If happens higher up - may denerve triceps (cannot extend elbow)
If lower - just brachioradialis, supinator, extensor muscles of forearm/wrist
Wrist drop

44
Q

Musculocutaneous nerve injury

A

Usually protected - maybe stabbing
Denerve biceps brachii, coracobrachialis –> weak flexion of arm, supination of forearm
Also brachialis - weak flexion of elbow

45
Q

Branches of brachial artery

A

Profunda brachii artery (deep
artery of the arm)
superior and inferior ulnar collateral
arteries

46
Q

Profunda brachii artery

A

Follows radial nerve – anastomose around elbow

47
Q

Superior ulnar collateral artery

A

Follows ulnar nerve – anastomose around elbow

48
Q

Median nerve location

A

First located lateral to, then crosses, and is finally medial to brachial artery
No branches/innervation in arm (goes to hand)

49
Q

Musculocutaneous nerve location

A

Pierces coracobrachialis muscle (sending branches to it), the biceps and brachialis muscles
Continues as lateral antebrachial cutaneous nerve

50
Q

Radial nerve location

A

Passes in radial groove on back of humerus with deep brachial artery, pierces lateral intermuscular septum and divides into superficial and deep branches in front of lateral epicondyle
In arm - branches to triceps and skin

51
Q

Ulnar nerve location

A

Located medial to axillary and brachial arteries until middle of arm where it pierces the medial intermuscular septum to enter posterior compartment and run with superior ulnar collateral artery in groove behind medial epicondyle of humerus
No branches/innervation in arm (goes to hand)

52
Q

Boundaries of cubital fossa

A

2 humeral epicondyles, brachioradialis, Pronator teres, deep fascia/bicipital aponeurosis, brachialis/supinator

53
Q

Deep structures in antecubital fossa

A

Median nerve, brachial artery, biceps tendon, radial nerve