Anatomy-Proximal & Distal UE Flashcards
1
Q
Anterior shoulder
(Physical exam landmarks to identify)
A
Clavicle
AC joint
Acromion
Greater tuberosity (tubercle)
Coracoid process
Infraclavicular subclavian cannulation
2
Q
Infraclavicular subclavian vein cannulation
A
Palpate just inferior to clavicle at the jxn of the third and middle of the clavicle (or just medial to halfway point of clavicle)
Subclavian artery located posterior to subclavian vein
3
Q
Posterior shoulder
- posterior/lateral border of acromion
A
Palpate laterally along spine of scapula
Posterior shoulder joint space located just inferior
Common landmark to use for shoulder injections
4
Q
Clavicle
A
Proximal end = forms SC joint with manubrium
Distal end = forms AC joint with acromion
Superior surface = “relatively smooth”
Inferior surface = “lumps and grooves”
-proximal third
-middle third
-lateral third
5
Q
Clavicle fracture
A
Most commonly occur in the middle third of the clavicle
6
Q
Supraglenoid tubercle attachment
A
Attachment site for long head of biceps
7
Q
Infraglenoid tubercle attachment
A
Attachment site for long head of triceps
8
Q
Surgical neck of humerus
A
Common fracture site with trauma
9
Q
Proximal humeral fracture
A
Neer classification based on anatomy, displacement, and angulation
10
Q
Humeral shaft fracture (mid humeral fracture)
A
Compression plate
Radial nerve at risk of damage
11
Q
Scapulothoracic joint
A
Scapula “articulates” with the rib cage
Not a “true” anatomical joint
12
Q
Retraction of scapula
A
Scapula moves “toward midline”
13
Q
Protraction
A
Scapula moves “away from midline”, fossa moves “forward”
14
Q
Sternoclavicular joint (“SC joint”)
A
Articulation between sternal (proximal) end of clavicle and manubrium
-synovial joint with an articular disc
15
Q
Acromioclavicular joint (“AC joint”)
A
Articulation between distal end of clavicle and acromion of scapula
16
Q
Ligaments of the AC joint
A
Acromioclavicular ligament
Coracoclavicular ligament (2 sections)
17
Q
Acromioclavicular ligament location
A
AC joint capsule
18
Q
Coraclavicular ligament location
A
Attached coracoid process to distal end of clavicle
-prevents clavicle from “displacing up”
19
Q
Two sections of coraclavicular ligament location
A
Conoid ligament (C)
Medial and “looks like a cone”
Trapezoid ligament (T)
Lateral and trapezoid shape
20
Q
Grade 1 (AC joint)
A
Partial sprain to AC ligament
Coraclavicular intact
21
Q
Grade 2 (AC joint)
A
AC ligament ruptured
Coracoclavicular intact
22
Q
Grade 3 (AC joint)
A
AC and Coracoclavicular ligaments ruptured
23
Q
Osteoarthritis (DJD) of AC joint
A
Enlarged fibrotic joint capsule
24
Q
Glenohumeral joint (GH joint)
A
Articulation between Glenoid fossa of scapula/glenoid labrum and Head of humerus
25
Glenohumeral joint (GH joint)
•Glenoid labrum
Fibrocartilaginous ring like structure that attaches around the rim of the Glenoid fossa
-helps form the “socket” for GH joint
Long head of the biceps tendon attaches to the superior rim of the Glenoid labrum
26
SLAP lesion
Glenoid labrum tear along attachment site of biceps tendon
SLAP= Superior Labrum on Anterior and Posterior surfaces of labrum
27
anterior extrinsic muscles of the shoulder
Pec major
Pec minor
Subclavius
Serratus anterior
28
Posterior extrinsic muscles of the shoulder
Trapezius
Lattisimus dorsi
Rhomboids
Levator scapula
29
Intrinsic muscles of the shoulder
Originate from the scapula/and or clavicle and attach to the humerus
Deltoid, teres minor
Rotator cuff muscles
Supraspinatus, infraspinatus,teres minor, sub scapularis
30
One of the attachments for pec major
Lateral lip of bicipital groove of humerus
31
Innervation of pec major
Lateral and medial pectoral nerves
32
Actions of Pec major
Extend, adduct, and medially rotate humerus
“Hand cuff position”
33
Pec minor attachments
Coracoid process of scapula
Ribs 3-5
34
Pec minor innervation
Medial pectoral nerve
35
Actions of pec minor
Protract and depress the scapula
•the pec minor and Serratus anterior “stabilize” the scapula against the rib cage
36
Thoracic outlet syndrome (TOS)
Shortened or tight pec minor from poor postures can be a cause of TOS
Brachial plexus and Axillary artery become compressed
37
Serratus anterior attachments
Medial scapula
Ribs 1-9
38
Serratus anterior innervation
Long thoracic nerve
39
Serratus anterior actions
Protract scapula
Upward rotation of scapula
40
Long thoracic nerve palsy
Paralysis/weakness of Serratus anterior
Causes “winging of scapula” and the inability to reach above shoulder height
41
Traps attachments
Occiput, Nuchal ligament, and spinous process of C7-T12
Spine of scapula, acromion and clavicle
42
Lattisimus dorsi attachments
SPs of lower T spine, thoracolumbar fascia, iliac crest…
43
Innervation of Lattisimus dorsi
Thoracodorsal nerve
44
Hand cuff position
Latissimus dorsi, teres major, pec major
45
Action of rhomboids
Retract the scapula
46
Innervation of rhomboids
Dorsal scapular nerve
47
Rhomboids of attachments
Medial border of scapula
Nuchal ligament: SP of C7-T5
48
Levator scapula attachments
Medial border of scapula
TPs of C1-C4
49
Levator scapula innervation
Dorsal scapular nerve
50
Levator scapula actions
Elevate scapula
Neck movement
•lateral flex and rotate to the same side
51
“Rotator cuff” muscles
Supraspinatus, infraspinatus, teres minor, sub scapularis
52
Deltoid innervation
Axillary nerve
53
Deltoid action
Abduct humerus
54
Teres major attachments
Inferior angle of scapula
Medial lip of bicipital groove of humerus
55
Teres major innervation
Lower subscapular nerve
56
Pec major, Lats, and teres major all
“Extend, adduct, and medially rotate the humerus”
57
Supraspinatus action
Shoulder abduction
stabilize humerus in Glenoid fossa
58
Supraspinatus innervation
Suprascapular nerve
59
Infraspinatus innervation
Suprascapular nerve
60
Infraspinatus actions
Lateral (external) rotation of humerus
Stabilize humerus in Glenoid fossa
61
Teres minor attachments
Lateral border of scapula
Greater tuberosity of humerus
62
Innervation of teres minor
Axillary nerve
63
Subscap innervation by
Upper subscapular nerve and lower
64
Subscapularis attachments
Subscapular fossa of scapula
Lesser tuberosity of humerus
65
Subscapularis action
Medial rotation of humerus
Stabilize humerus in Glenoid fossa
66
Most common rotator cuff tear
Supraspinatus tendon
67
All anterior compartment muscles of arm are innervated by
Musculocutaneous nerve
68
Biceps brachii short head attachment
Coracoid process of scapula
69
Biceps brachii long head attachment
Supraglenoid tubercle of scapula
70
Biceps brachii distal attachment
Radius
71
Biceps brachii landmarks
Bicipital aponeurosis and transverse humoral ligament
72
Biceps brachii actions
Flex elbow
Supinate forearm
73
Biceps proximal rupture
Long head tendon ruptures and long head forms a “lump” in the arm
74
Coracobrachialis actions
Flex and adduct shoulder
75
Actions of brachialis
Flex elbow with forearm in any position (supinate vs pronate)
76
Triceps long head attachment
Infraglenoid tubercle of scapula
77
Triceps innervation
Radial nerve
78
Brachial plexus
The brachial plexus descends to upper extremity between clavicle and first rib
The brachial plexus “surrounds” the Axillary artery as both structures descend deep to the pec minor and continue down to the arm
79
What spinal nerve roots form the brachial plexus
C5-T1
80
Ulnar nerve descends ___________ to elbow joint
Posterior
81
Once the subclavian artery descends over the first rib it is “renamed” the __________
Axillary artery
82
What 3 muscles are responsible for upward rotation of the scapula?
1. Serratus anterior
2. Upper trapezius
3. Lower trapezius
83
Bicipital tendonitis
Inflammation of long head of tendon beneath transverse humeral ligament
84
Common site for ABG
Radial artery
85
Proximal ulna landmarks
Olecrenon
Trochlear notch
86
Distal ulna landmarks
Head of ulna
Styloid process of ulna
87
Proximal radius landmarks
Head
Neck
88
Distal radius landmarks
Styloid process of radius
89
Proximal row carpal bones (4)
Scaphoid
Lunate
Triquetrium
Pisiform
90
Distal row carpal bones (4)
Trapezium
Trapezoid
Capitate
Hamate
91
How many phalanges on digits 2-5
3
92
Humero-ulnar articulation
Trochlea of humerus
Trochlear notch of ulna
93
Humero-radial articulation
Capitulum of humerus
Head of radius
94
Annular ligament
Binds the head of the radius to the ulna
95
What ligament is corrected by Tommy John surgery?
Ulnar collateral ligament
96
Cubital tunnel syndrome
Ulnar nerve gets entrapped as it passes posterior to elbow and enters the forearm in cubital tunnel
97
Radial head dislocation
Radial head gets pulled out annular ligament socket
98
Common cause of radial head dislocation
Parent swinging child, pulling arm
99
Olecranon bursitis
Chronic pressure on elbow creates inflammation/swelling of olecranon bursa
100
Muscles of supination
Supinator muscle
Biceps brachii
101
Muscles of pronation
Pronator teres
Pronator quadratus
102
Tough connective tissue that serves as floor of the forearm
Interosseous membrane
103
PRUj
(Proximal radioulnar joint)
Head of radius articulates with ulna
Radius rotates within annular ligament
104
DRUJ
(Distal radioulnar joint)
Head of ulna articulates with radius
TFCC “unites” distal radius and head of ulna
105
TFCC
(Triangular fibrocartilage complex)
Attachments on styloid process of ulna and distal radius
provides stability and mobility
106
How does a TFCC tear often happen
Fall on outstretched hand
107
Wrist movements
Flexion
Extension
Ulnar deviation
Radial deviation
108
Radiocarpal ligaments of the wrist
Dorsal radiocarpal
Palmar radiocarpal
109
Superficial forearm muscles
Pronator teres, flexor carpi radialis, palmaris longus, flexor carpi ulnaris
110
Intermediate forearm muscles
Flexor digitorum superficialis
111
Deep forearm muscles
Flexor digitorum profundus, flexor pollicis longus, Pronator quadratus
112
Pronator teres innervation
Median nerve
113
Pronator teres action
Pronate forearm
114
Attachments on the medial epicondyle and mid radius
Pronator teres
115
Flexor carpi radialis innervation
Median nerve
116
Flexor carpi radialis action
Flex and radial deviate wrist
117
Attachments on medial epicondyle and 2nd metacarpal
Flexor carpi radialis
118
Palmaris longus innervation
Median nerve
119
Palmaris longus action
Flex wrist/hand
120
Attachment on medial epicondyle and then distal attachment blends with palmar carpal ligament and palmar aponeurosis
Palmaris longus
121
Flexor carpi ulnaris innervation
Ulnar nerve
122
Attachments on medial epicondyle and 5th metacarpal
Flexor carpi ulnaris
123
Flexor digitorium superficialis innervation
Median nerve
124
Flexor digitorium superficialis action
Flex PIP joints of fingers
125
Proximal attachment on medial epicondyle
Distal attachment on middle phalanges
Flexor digitorum superficialis
126
Flexor digitorum profunda innervation (2)
Lateral 1/2 supplied by AIN
Medial 1/2 supplied by ulnar nerve
127
Flexor digitorum profunda action
Flex DIP joints of fingers
128
Attachments on ulna/interosseous membrane and distal phalanges
Flexor digitorum phalanges
129
Flexor policis longus innervation
Anterior interosseous nerve
130
Flexor policis longus action
Flex IP joint of thumb
131
Pronator quadratus innervation
Anterior interosseous nerve
132
Attachments on distal radius and ulna
Pronator quadratus
133
Name the wrist flexors
Flexor carpi radialis, flexor carpi ulnaris, palmaris longus
134
Name the long finger flexors
Flexor digitorum superficialis, flexor digitorum profunda, flexor policis longus
135
Supplies all the superficial and intermediate muscles except the flexor carpi ulnaris
Median nerve
136
“Continuation” of the extensor retinaculum
Palmar carpal ligament
137
Posterior superficial forearm muscles
Brachioradialis, extensor carpi radialis longus, extensor carpi radialis brevis, extensor digitorum, extensor digiti minimi, extensor carpi ulnaris
138
Posterior deep forearm muscles
Supinator, abductor pollicis longus, extensor pollicis brevis, extensor pollicis longus, extensor indicis
139
Brachioradialis innervation
Radial nerve
140
Brachioradialis action
Elbow flexion
141
Attachments on supracondylar ridge and distal radius
Brachioradialis
142
Extensor carpi radialis longus innervation
radial nerve
143
Extensor carpi radialis longus action
Extend and radial deviate wrist
144
Extensor carpi radialis brevis innervation
Deep branch of radial nerve
145
Extensor carpi radialis brevis action
Extend and radial deviate the wrist
146
Attachments on the lateral epicondyle and 3rd metacarpal
Extensor carpi radialis brevis
147
Extensor digitorum innervation
Posterior interosseous nerve
148
Attachments on the lat epicondyle and digits 2-4
Extensor digitorum
149
Extensor digitorum minimi innervation
Posterior interosseous nerve
150
Extensor carpi ulnaris innervation
Posterior interosseous nerve
151
Attachments on lat epicondyle and 5th metacarpal
Extensor carpi ulnaris
152
Supinator innervation
Deep branch of radial nerve
153
Extensor indices innervation
Posterior interosseous nerve
154
Distal attachment distal phalange of thumb
Extensor pollicis longus
155
Distal attachment proximal phalange of thumb
Extensor pollicis brevis
156
Supplies all posterior forearm distal to the Supinator
Posterior interosseous nerve
157
Name the finger extensors
Extensor digitorum
Extensor digitorum minimi
Extensor indices
158
Thenar muscles innervation
Median nerve
159
Hypothenar muscles innervation
Ulnar nerve
160
Adductor pollicis innervation
Ulnar nerve
161
1st and 2nd lumbricals innervation
Median nerve
162
3rd and 4th lumbricals innervation
Ulnar nerve
163
Palmar interossei innervation
Ulnar nerve
164
Dorsal interossei innervation
Ulnar nerve
165
All intrinsic muscles of the hand are EXCEPT the thenar and 1st two lumbricals are innervated by
Ulnar nerve
166
Deep artery of the arm becomes
radial collateral artery
167
Cubital tunnel content
Median nerve
Brachial artery as it divides into radial and ulna artery
168
Content of anatomical snuff box
Radial artery
Superficial branch of radial nerve
169
Why does carpal tunnel syndrome only cause parenthesia and weakness on radial side of hand?
Ulnar side of hand isn’t innervated by the median nerve, which runs through the carpal tunnel
170
Guyon’s canal syndrome
Ulnar nerve compression at the wrist
