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Limbs and Spine > Anatomy - Post ICA > Flashcards

Anatomy - Post ICA Flashcards

1
Q

What is the innervation and action of the pectoralis major?

A

Innervation - Medial and Lateral pectoral nerves.
Action - Flexion at shoulder, adduction and medial rotation of shoulder.

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2
Q

What is the innervation and action of the pectoralis minor?

A

Innervation - Medial and lateral pectoral nerves.
Action - Pulls scapula forwards and downwards, elevates ribs during respiration, and stabilizes scapula.

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3
Q

Where does the clavipectoral fascia extend from?

A

From clavicle to pectoralis minor.

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4
Q

What does the clavipectoral fascia continues as?

A

Continues below as suspensory ligament of axilla.

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5
Q

What are the structures that pierce the clavipectoral fascia?

A

Cephalic vein.
Lateral pectoral nerve.
Thoraco-acromial artery.

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6
Q

From where does the cephalic vein form?

A

From lateral end of the dorsal venous arch.

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7
Q

Where does the cephalic vein lie?

A

Deltopectoral groove.

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8
Q

Where does the cephalic vein terminate?

A

Pierces clavipectoral fascia and opens into axillary vein.

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9
Q

From where does the basilic vein form?

A

Begins at the medial end dorsal venous arch.

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10
Q

Where does the basilic vein lie?

A

Upwards along medial border of forearm, pierces deep fascia at middle of arm.

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11
Q

Where does the basilic vein terminate?

A

With vena comitantes accompanying brachial artery; forms axillary vien.

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12
Q

Where can the median cubital vein be found?

A

It is overlying the cubital fossa.

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13
Q

What does the cubital vein connect?

A

The cubital vein connects the cephalic and basilic veins.

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14
Q

Where would a venipuncture happen?

A

The medial cubital vein.

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15
Q

Which vein would be used for a peripherally inserted central catheter?

A

Basilic vain.

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16
Q

What is specified as the shoulder girdle?

A

Connection of upper limb to axial skeleton. Has four joint; sternoclavicular joint, glenohumeral joint, acromioclavicular joint, scapulothoracic joint.

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17
Q

What type of joint is the sternoclavicular joint?

A

Saddle joint, but acts as a ball and socket joint.

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18
Q

What are the articulating surfaces of the sternoclavicular joint?

A

Sternal end of clavicle + Manubrium + 1st costal cartilage.

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19
Q

What are the static stabilizers of the sternoclavicular joint?

A

Joint capsule (with articular cartilage), anterior and posterior sternoclavicular, infraclavicular, and costoclavicular ligaments.

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20
Q

What is the neurovascular supply sternoclavicular joint?

A

Medial supraclavicular nerve + Nerve to subclavius.
Internal thoracic + suprascapular arteries.

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21
Q

What are the actions of the sternoclavicular joint?

A

Elevation
Rotation.
Depression.
Retraction.
Protraction.

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22
Q

What is the clinical relevance of the sternoclavicular joint?

A

Uncommon.
Anterior dislocation is most common.

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23
Q

What type of joint is the acromioclavicular joint?

A

Plane joint.

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24
Q

What are the articular surfaces of the acromioclavicular joint?

A

Acromial end of clavicle + anterior aspect of acromion.

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25
Q

What are the supporting structures of the acromioclavicular joint?

A

Trapezius, joint capsule, acromioclavicular and coracoclavicular ligaments.

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26
Q

What is the neurovascular supply of the acromioclavicular joint?

A

Lateral pectoral, axillary, and lateral supraclavicular nerves.
Suprascapular and thoracoacromial arteries.

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27
Q

What is the cause of osteoarthritis of acromioclavicular joint?

A

Degeneration of disc.

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28
Q

What are the actions of acromioclavicular joint?

A

Elevation.
Depression.
Allows movement to occur between clavicle and scapula.

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29
Q

What is the clinical relevance of acromioclavicular joint?

A

Caused by acute shoulder trauma - contact sports and FOOSH. ‘Piano Key sign’.

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30
Q

What type of joint is the glenohumeral joint?

A

Weak ball and socket joint.

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31
Q

What are the articulating surfaces of the glenohumeral joint?

A

Concave surface of glenoid fossa + Convexity of humeral head.

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32
Q

What stabilized the glenohumeral joint?

A

Rotator cuff muscles.

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33
Q

What are the rotator cuff muscles?

A

Suprapinatous.
Infraspinatous.
Teres minor.
Subscapularis.

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34
Q

What is the neurovascular supply of the glenohumeral joint?

A

Suprascapular, axillary + lateral pectoral nerves.
Anterior and posterior circumflex humeral + suprascapular arteries.

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35
Q

What injury can happen to the glenohumeral joint?

A

SLAP - Superior Labral Anterior Posterior lesion/tear.

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36
Q

What is a spinoglenoid ganglion cyst?

A

Pockets of fluid form/accumulate at spinoglenoid notch of scapula due to inflammation.

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37
Q

What is the innervation and action of subclavius?

A

Nerve to subclavius, pulls top of scapula down.

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38
Q

Where would the triangle of auscultation be?

A

Between trapezius, lattismus dorsi, and inferior angle of scapula.

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39
Q

What is the innervation and action of trapezius?

A

Accessory nerve - 11th cranial nerve.
Elevates scapula, Middle fibres retracts scapula, and lower fibres depress scapula.

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40
Q

What is the innervation and action of deltoid?

A

Axillary nerve.
Abduction from 15 to 90 degrees.

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41
Q

What is the innervation and action of levator scapulae?

A

Dorsal scapular nerve.
Elevates scapula.

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42
Q

What is the innervation and action of the rhamboid major and minor?

A

Dorsal scapular nerve.
Elevates and retracts the scapula.

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43
Q

What is the clinical significance of the deltoid muscle?

A

Triangle with fingers - Site of intramuscular junction. Close to radial artery.

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44
Q

What is medial scapular winging?

A

Weakness of serratus anterior - dysfunction of long thoracic nerve.

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45
Q

What is lateral scapular winging?

A

Weakness of trapezius.
Dysfunction of accessory nerve.

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46
Q

What is the innervation and action of supraspinatus?

A

Suprascapular nerve.
Abduction from 0 - 15 degree.

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47
Q

What is the innervation and action of infraspinatus?

A

Suprascapular nerve.
Lateral rotation.

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48
Q

What is the innervation and action of teres minor?

A

Axillary nerve.
Lateral rotation.

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49
Q

What is the innervation and action of teres major?

A

Inferior subscapular nerve.
Medial rotation.

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50
Q

What is the innervation and action of long head of triceps brachii?

A

Radial nerve.
Extension of forarm.

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51
Q

Which of the rotator cuff muscles is more prone to impingement?

A

Supraspinatus.

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52
Q

Which of the rotator cuff muscles is more prone to rupture?

A

Subscapularis.

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53
Q

What are the actions of the glenohumeral joint?

A

Extension.
Flexion.
Adduction.
Abduction.
Medial rotation.
Lateral rotation.
Circumduction.

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54
Q

What are the borders of the quadrangular space?

A

Superiorly - Teres minor.
Inferiorly - Teres major
Medially - Long head of triceps.
Lateraly - Humerus.

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55
Q

What are the structures in the quadrangular space?

A

Axillary nerve.
Posterior circumflex humeral artery.

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56
Q

What are the contents of the triangular space?

A

Radial nerve.
Profunda brachii vessels.

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57
Q

What is the clinical relevance of the triangular space?

A

Entrapment of radial nerve.

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58
Q

What is the subacromial space?

A

Contains bursa, tendons (biceps + supraspinatus), ligaments.

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59
Q

What is the cause of bursitis?

A

Rotator cuff disease/tendinopathy.

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60
Q

What is the innervation and action of serratus anterior?

A

Long thoracic nerve.
Rotation of scapula, helps in elevation of scapula, allows arm to be raised above 90 degrees.

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61
Q

What is the innervation and action of latissimus dorsii?

A

Thoraco-dorsal nerve.
Adduction and Extension.

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62
Q

What layman’s term if for the axilla?

A

Armpit.

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63
Q

What are the borders of the axilla?

A

Anterior, posterior, medial and lateral.

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64
Q

What makes up the anterior wall of axilla?

A

Pectoralis major.
Pectoralis minor.

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65
Q

What makes up the posterior wall of axilla?

A

Latissmus dorsii.
Subscapularis.
Teres major.

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66
Q

What makes up the medial wall of the axilla?

A

Upper 4-5 ribs and intervening intercostal spaces.
Serratus anterior.

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67
Q

What makes up the lateral wall of axilla?

A

Very narrow.
Anterior and posterior walls meet.

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68
Q

What is the apex of axilla called?

A

Cervico-axillary canal.

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69
Q

What are the boundaries of the apex of axilla?

A

Clavicle - Anteriorly.
Outer border of 1st rib - Medially.
Upper border of scapula - Posteriorly.

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70
Q

What structures pass through the apex of axilla?

A

Axillary vessels.
Chords of brachial plexus.
Lymph trunks from apical axillary lymph nodes.

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71
Q

What makes up the floor of the axilla?

A

Formed by axillary fascia.

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72
Q

What are the major contents of the axilla?

A

Axillary artery, vein, lymph nodes, and axillary tail of spence.
Chords of brachial plexus and its branches; long thoracic nerve and intercostobrachial nerve.

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73
Q

What is the extent of the axillary artery?

A

Outer border of 1st rib to lower border of teres major.

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74
Q

What are the branches of the axillary artery?

A

1st part –> Superior thoracic artery.
2nd part –> Lateral thoracic and thoraco-acromial arteries.
3rd part –> Anterior and posterior circumflex humeral and subscapular arteries.

75
Q

What does the axillary artery continue as?

A

Brachial artery.

76
Q

Which regions does the axillary artery supply?

A

Lateral thoracic wall.
Scapular region.
Lateral portion of breast.
Proximal humerus including shoulder joint.

77
Q

How does the axillary vein form?

A

Basilic vein and vena comitantes accompanying brachial artery join to form axillary vein.

78
Q

What does the axillary vein continue as?

A

Subclavian vein.

79
Q

What does the intercostobrachial nerve supply?

A

Supplies skin on medial aspect of arm and chest wall.

80
Q

What can be injured during an axillary dissection?

A

Intercostobrachial nerve - Paraesthesia/anaesthesia over skin of medial aspect of arm.

81
Q

Which roots form the long thoracic nerve?

A

C5,6,7.

82
Q

What does the long thoracic nerve innervate?

A

Serratus anterior.

83
Q

What happens when there is injury to the long thoracic nerve?

A

Winging of scapula.

84
Q

What is the drainage area of the axillary lymph nodes?

A

Upper limb
Above level of umbilicus.
Most of mammary gland.

85
Q

What are the axillary lymph nodes arranged by?

A

Anterior or pectoral group.
Posterior or subscapular group.
Lateral axillary LN.
Central group.
Apical group.

86
Q

What is the axillary tail of spence?

A

Projection of mammary tissue in the upper outer quadrant into axilla.

87
Q

Where does the carcinoma of breast spread to?

A

Axillary LN.

88
Q

Which roots form the brachial plexus?

A

Anterior ramus - C5,6,7,8, and T1.

89
Q

What do the nerves of the brachial plexus pass between?

A

Anterior and medial scalene muscles.

90
Q

The superior trunk of the brachial plexus is a combination of which roots?

A

C5,6.

91
Q

The middle trunk of the brachial plexus is a combination of which roots?

A

C7.

92
Q

The inferior trunk of the brachial plexus is a combination of which roots?

A

C8 and T1.

93
Q

What is the lateral cord of the brachial plexus formed by?

A

Anterior division of the superior trunk.
Anterior division of the middle trunk.

94
Q

What is the posterior cord of the brachial plexus formed by?

A

Posterior division of the superior trunk.
Posterior division of the middle trunk.
Posterior division of the inferior trunk.

95
Q

What is the medial cord of the brachial plexus formed by?

A

Anterior division of the inferior trunk.

96
Q

From which roots does the musculocutaneous nerve come from?

A

C5,6,7.

97
Q

What does the musculocutaneous nerve supply?

A

Brachialis, biceps brachii, and coracobrachialis.

98
Q

What does the musculocutaneous nerve pierce?

A

The coracobrachialis muscle.

99
Q

What is the sensory innervation of the musculocutaneous nerve?

A

Sensation on the lateral forearm.

100
Q

From which roots does the axillary nerve come from?

A

C5,6.

101
Q

What does the axillary nerve supply?

A

Innervates teres minor and deltoid.

102
Q

What is the sensory innervation of the axillary nerve?

A

Superior lateral sensation of arm.

103
Q

From which roots does the median nerve come from?

A

C6 - T1.

104
Q

What does the median nerve innervate?

A

Pronator teres, flexor carpi radialis, palmaris longus, flexor digitorum superficialis.

105
Q

What median nerve gives rise to which nerve?

A

Anterior interosseous nerve.

106
Q

What does the anterior interosseous nerve (branch of median nerve) supply?

A

flexor pollicis longus, pronator quadratus, and the lateral half of the flexor digitorum profundus.

107
Q

What does the recurrent branch of median nerve innervate?

A

Innervates thenar muscles.

108
Q

From which roots does the radial nerve come from?

A

C5 - T1.

109
Q

What does does the radial nerve innervate?

A

Innervates the triceps brachii, and posterior compartment of forearm.

110
Q

From which roots does the ulnar nerve come from?

A

C8 and T1.

111
Q

What does the ulnar nerve innervate?

A

Flexor carpi ulnaris, and medial half of flexor digitorum profundus.

112
Q

What is erb’s palsy?

A

Stretching injury, C5-C6 root injury - Waiter’s tip postition.

113
Q

What muscles are affected during erb’s palsy injury?

A

Supraspinatus, infraspinatus, subclavius, biceps brachii, brachialis, coracobrachialis, deltoid and teres minor.

114
Q

What motor functions are affected during erb’s palsy injury?

A

Abduction at shoulder, lateral rotation of arm, supination of forearm, and flexion at shoulder.

115
Q

What is Klumpke’s palsy?

A

C8-T1 root injury - Clawed hand

116
Q

What muscles are affected during Klumpke’s palsy?

A

The intrinsic hand muscles.

117
Q

What are the minor branched of the brachial plexus?

A

Dorsal scapular, Nerve to subclavius, and long thoracic.

118
Q

What happens when there is a radial nerve injury?

A

Partial paralysis of triceps. Wrist drop.

119
Q

What happens when there is ulnar nerve injury at wrist?

A

Paralysis of intrinsic muscles of hand (except for radial lumbricals).
Wasting of interossei.
Claw hand deformity.

120
Q

What happens when there is ulnar nerve injury at the elbow?

A

Paralysis of flexi carpi ulnaris and ulnar two flexi digitorum.
Claw hand.
Wasting of interossei.

121
Q

What happens when there is injury to median nerve at the elbow?

A

Loss of pronation, paralysis of wrist and fingers (except flexor carpi ulnaris and ulnar two flexor digitorum).

122
Q

Which structure does not pass through the carpal tunnel?

A

Radial artery.

123
Q

Which structure does not pass through the cubital fossa?

A

Ulnar nerve.

124
Q

Where does the ulnar nerve lie?

A

Posterior to the medial epicondyle of humerus.

125
Q

What type of joint is the interosseous membrane?

A

Fibrous - Amphiarthrotic syndesmosis.

126
Q

What is monteggia’s fracture?

A

Fracture of the proximal third of ulna and dislocation of head of radius at elbow.

127
Q

What is galaezzi’s fracture?

A

Fracture of distal third of radius and partial dislocation of head of ulna at wrist joint.

128
Q

What are the superficial muscles of the anterior forearm?

A

Pronator teres.
Flexor carpi radialis.
Palmaris longus.
Flexor carpi ulnaris.

129
Q

What is the action and innervation of the pronator teres?

A

Pronation.
Median nerve.

130
Q

What is the action and innervation of the flexor carpi radialis?

A

Flexion and abduction at wrist.
Median nerve.

131
Q

What is the action and innervation of the palmaris longus?

A

Flexion at wrist.
Median nerve.

132
Q

What is the action and innervation of the flexor carpi ulnaris?

A

Flexes and adducts wrist.
Ulnar nerve.

133
Q

What passes deep to the flexor digitorum superficialis?

A

Median nerve and ulnar artery.

134
Q

What does the flexor digitorum superficialis form?

A

Four tendons which pass through the carpal tunnel and into the four fingers.

135
Q

What is the action and innervation of the flexor digitorum superficialis?

A

Flexes wrist, flexes metacarpophalangeal joints and proximal interphalangeal joints.

136
Q

What is the action and innervation of pronator quadratus?

A

Pronation.
Anterior interosseous nerve (branch of median).

137
Q

What is the action and innervation of the Flexor pollicis longus?

A

Flexes interphalangeal joint of thumb and metacarpophalangeal joint of thumb.
Anterior interosseous nerve.

138
Q

What is the action and innervation of the flexor digitorum profundus?

A

Flexes distal interphalangeal joint of lateral four fingers.
Lateral half by anterior interosseous nerve and medial half by ulnar nerve.

139
Q

What are the borders of the cubital fossa?

A

Superiorly - imaginary line between lateral and medial epicondyles.
Medially - Pronator teres.
Laterally - Brachiordialis.

140
Q

What are the contents of the cubital fossa?

A

Radial nerve.
Biceps tendon.
Brachial artery.
Median nerve.

141
Q

What does the brachial artery divide into?

A

Radial and ulnar arteries.

142
Q

What is pronator syndrome?

A

Causes underlying metabolic disorder. Median nerve is compressed between two muscle heads.

143
Q

What is cubital tunnel syndrome?

A

Ulnar nerve entrapment.

144
Q

What is the superficial group of the posterior compartment of forearm?

A

Anconeus.
Brachioradialis.
Extensor carpi radialis longus and brevis.
Extensor digitorum.
Extensor digiti minimi.
Extensor carpi ulnaris.

145
Q

What is the deep group of posterior compartment of forearm?

A

Supinator..
Abductors pollicis longus and brevis.
Extensor indicis.

146
Q

What is the innervation of the posterior compartment of forearm?

A

Radial/posterior interosseous nerve.

147
Q

What is the action of brachioradialis?

A

Flexion at the elbow.

148
Q

What is the action of the extensor carpi radialis longus and brevis?

A

Extends and abducts the wrist.

149
Q

What is the action of extensor digitorum?

A

Extends medial four digits.

150
Q

What is the action of extensor digiti minimi?

A

Extends the pinki.

151
Q

What is the action of extensor carpi ulnaris?

A

Extend and adduct the wrist.

152
Q

What is the action of the anconeus?

A

Extend the wrist.

153
Q

What is the action of the supinator muscle?

A

Supinates forearm.

154
Q

What is the action of the abductor pollicis longus?

A

Abducts the thumb.

155
Q

What is the action of extensor pollicis brevis?

A

Extend at mcp and cm of thumb.

156
Q

What is the action of extensor pollicis longus?

A

Extend at cm, mcp and ip.

157
Q

What is the action of the extensor indicis?

A

Extends the index finger.

158
Q

What does the dorsal tubercle act as?

A

It acts as a pulley and separates the extensor carpi radialis brevis and longus tendons.

159
Q

What are symptoms of a scaphoid fracture?

A

Falling on outstretched hand.
Wrist swelling, ecchymosis.

160
Q

What type of joint is the wrist?

A

Condyloid.

161
Q

What type of joint is the distal radio-ulnar?

A

Pivot.

162
Q

What is ulnar canal?

A

From proximal aspect of pisiform to the origin of hypothenar muscles at hook of hamate.

163
Q

What is ulnar canal syndrome?

A

Compression of ulnar nerve in canal, formation of ganglion cysts.

164
Q

What is carpal tunnel?

A

Formed anteriorly at wrist by a deep arch formed by the carpal bones and the floor retinaculum..

165
Q

What is carpal tunnel syndrome?

A

Compression of median nerve.

166
Q

Where would the site of cannulation be at the wrist?

A

Cephalic vein - snuff box.

167
Q

If there was swelling in the dorsum of hand, what should we look at?

A

Look at palm, because the infection might be in palm.

168
Q

What would form the palmar aponeurosis?

A

Palmaris longus.

169
Q

What is aponeurosis attached by?

A

Aponeurosis is attached to skin by fibrous tissue that breaks up subcutaneous fat into loculi.

170
Q

What are the muscles of the thenar eminence?

A

Abductor pollicis brevis.
Flexor pollicis brevis.
Opponens pollicis.

171
Q

What is the innervation of the thenar eminence?

A

Recurrent branch of median nerve.

172
Q

What is the innervation of the adductor pollicis?

A

Ulnar nerve.

173
Q

What are the muscles of the hypothenar eminence?

A

Abductor digiti minimi.
Flexor digiti minimi.
Opponens digiti minimi.

174
Q

What is the innervation of the hypothenar muscles?

A

Ulnar nerve.

175
Q

What is the action of the lumbricals?

A

Flex mcp and extend ip.

176
Q

What is the innervation of the lumbricals?

A

Ulnar two by ulnar nerve.
Radial two by median nerve.

177
Q

What is the innervation of the interossei?

A

Ulnar nerve.

178
Q

What is the action of interossei?

A

PAD.
DAB.

179
Q

Where does the cannula pass?

A

Via subclavian to brachiocephalic vein to the superior vena cava to the right atrium.

180
Q

What is dupuytren’s contracture?

A

Palmar aponeurosis becomes fibrous and nodular.

181
Q

What is the test for the interossei muscles?

A

Pull a card between fingers - PAD.
Place hand in table and test for abduction with resistance - DAB.

182
Q

What is the test for lumbricals?

A

OK sign - paralysis of lumbricals will cause nail to nail contact.

183
Q
A

Limbs and Spine (5 decks)

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