Anatomy Shoulder & Arm Flashcards
1
Q
What are the 3 heads of the triceps?
A
- Long head (most medial).
- Lateral head.
- Medial head.
2
Q
Which head of the triceps lies deepest?
A
The medial head - cannot be seen unless the lateral and long are dissected away.
3
Q
What is the insertion of triceps?
A
Olecranon of the ulna.
4
Q
What is the innervation of triceps?
A
The radial nerve.
5
Q
Which rotator cuff muscle is most likely to be affected in rotator cuff tendinitis?
A
Supraspinatus - tendon passes through a tight gap between the humerus and acromium of the scapula and so is prone to inflammation. ‘Painful arc’.
6
Q
Name the 4 rotator cuff muscles.
A
- Supraspinatus.
- Infraspinatus.
- Teres minor.
- Subscapularis.
7
Q
What is the function of the rotator cuff muscles?
A
To stabilise the shoulder joint.
8
Q
What is the action of supraspinatus?
A
Abduction.
9
Q
What is the action of infraspinatus?
A
External rotation.
10
Q
What is the action of teres minor?
A
External rotation.
11
Q
What is the action of subscapularis?
A
Internal rotation.
12
Q
What is the innervation of the deltoid muscle?
A
Axillary nerve
13
Q
What is the insertion of the deltoid muscle?
A
Deltoid tuberosity of humerus.
14
Q
What is the action of deltoid?
A
Abduction of the arm!
15
Q
What type of muscles fibres make up deltoid?
A
Multi-pennate fibres - these fibres are powerful.
16
Q
What is the function of latissiums dorsi?
A
Adduction!
17
Q
What is the action of triceps?
A
Extension of the forearm.
18
Q
Name 5 things contained wihin the axilla.
A
- Fat.
- Lymph nodes.
- Axillary artery.
- Axillary vein.
- Brachial plexus.
19
Q
What spinal nerve roots form the brachial plexus?
A
C5 - T1.
20
Q
What are the 5 main branches of the brachial plexus?
A
- Musculocutaneous.
- Axillary.
- Median.
- Radial.
- Ulnar.
21
Q
What are the nerve roots for the musculocutaneous branch?
A
C5, 6, 7.
22
Q
What muscle does the musculocutaneous nerve enter?
A
Coracobrachialis.
23
Q
What are the nerve roots for the axillary branch?
A
C5, 6.
24
Q
What are the nerve roots for the median branch?
A
C6, 7, 8, T1.
25
What are the nerve roots for the radial branch?
C5, 6, 7, 8, T1.
26
What are the nerve roots for the ulnar branch?
C8, T1.
27
What does the musculocutaneous nerve give motor innervation to?
Anterior flexors - brachialis, biceps brachii and coracobrachialis - BBC.
28
What does the musculocutaneous nerve give sensory innervation to?
Lateral forearm.
29
What would be the effect of damage to the musculotaneous nerve?
Flexion at the shoulder and elbow would be affected. Loss of sensation to the lateral forearms.
30
What does the axillary nerve give motor innervation to?
Abductors of the arm at the shoulder - teres minor, long head of triceps and deltoid.
31
What does the axillary nerve give sensory innervation to?
Innervates the skin over the lower deltoid.
32
What would be the effect of damage to the axillary nerve?
Unable to abduct the arm 15-90 degrees. Loss of sensation over the lower deltoid region.
33
What does the median nerve give sensory innervation to?
Lateral palm of the hand and the lateral 3.5 fingers.
34
What does the median nerve give motor innervation to?
Flexors in the anterior forearm, the thenar muscles and the lateral two lumbricals in the hand.
35
What would be the effect of damage to the median nerve?
Flexion of the forearm would be weakened, thenar muscle atrophy, unable to make a fist with their hands - only the little and ring fingers can flex completely. Loss of sensation over the lateral palm and lateral 3.5 fingers.
36
What does the radial nerve give motor innervation to?
Triceps brachii, responsible for extension at the elbow. It also innervates extensor muscles in the posterior compartment of the forearm.
37
What does the radial nerve give sensory innervation to?
Skin on the posterior side of the forearm and the posterior aspect of the hand.
38
What would be the effect of damage to the radial nerve?
Unable to extend the forearm, wrist and fingers. Unopposed flexion of the wrist: 'wrist drop'. Loss of sensation over the posterior forearm and hand.
39
What would be the effect of damage to the ulnar nerve?
Unable to abduct and adduct the fingers. Movement of the little and ring fingers is reduced. A hand deformity called 'ulnar claw' will develop long term. Loss of sensation to the medial 1.5 fingers and medial palm.
40
What does the ulnar nerve give sensory innervation to?
Medial 1.5 fingers and the medial palm.
41
What does the ulnar nerve give motor innervation to?
Muscles of the hand, flexor carpi ulnaris (flexes and adducts the hand at the wrist) and medial half of the flexor digitorum profundus (flexes the fingers).
42
What is the cubital fossa?
An area of transition between the arm and forearm.
43
What muscle forms the medial border of the cubital fossa?
Pronator teres muscle.
44
What muscle forms the lateral border of the cubital fossa?
Brachioradialis muscle.
45
What are the contents of the cubital fossa lateral to medial?
1. Biceps tendon.
2. Brachial artery.
3. Median nerve.
(TAN)
46
Does the median nerve lie lateral or medial to the brachial artery in the upper arm?
Laterally. It crosses to the medial side as it descends through the arm.
47
What is the origin of brachialis? What is the insertion of brachialis?
o- Lower half of the anterior humerus.
| i- Coronoid process of the ulna.
48
What is the action of brachialis?
Flexion of the elbow joint.
49
What muscle does brachialis lie deep to?
Biceps brachii.
50
Biceps brachii: what is the origin of the long head?
Supraglenoid tubercle of the scapula.
51
Biceps brachii: what is the origin of the short head?
Coracoid process of the scapula.
52
Where does the biceps tendon insert?
The tuberosity of the radius.
53
What is the action of biceps?
Flexion of the elbow joint and supination of the forearm.
54
What is the origin of deltoid?
Clavicle, acromion of scapula, spine of scapula
55
Name 3 nerves closely related to the humerus.
1. Radius.
2. Ulnar.
3. Axillary.
56
Transection of which cord of the brachial plexus produces paralysis of the biceps, brachialis and coracobrachialis?
Lateral cord.
57
What is the main muscle to abduct the shoulder 0-15 degrees?
Supraspinatus.
58
What is the main muscle to abduct the shoulder 15-90 degrees?
Deltoid.
59
What are the main muscle(s) that abduct the shoulder greater than 90 degrees?
Trapezius and serratus anterior.
60
Name 4 superficial muscles in the anterior compartment of the forearm?
1. Pronator teres.
2. Flexor carpi radialis.
3. Palmaris longus.
4. Flexor carpi ulnaris.
61
Where do the superficial muscles in the anterior compartment of the forearm originate from
The common tendon which arises from the medial epicondyle of the humerus.
62
What nerve innervates flexor carpi ulnaris?
| What is the action of flexor carpi ulnaris?
```
Ulnar nerve (C8-T1).
Flexion and adduction at the wrist.
```
63
What is the action of flexor carpi ulnaris?
Flexion and adduction at the wrist.
64
What nerve innervates palmaris longus?
Median nerve (C6-T1).
4
65
What is the action of palmaris longus?
Flexion at the wri
| st.
66
What nerve innervates flexor carpi radialis?
Median nerve (C6-T1).
67
What is the action of flexor carpi radialis?
Flexion and abduction at the wrist.
68
What nerve innervates pronator teres?
Median nerve (C6-T1).
69
What is the action of pronator teres?
Pronation of the forearm.
70
What nerve innervates brachioradialis?
Radial nerve (C5-T1).
71
What is the action of brachioradialis?
Flexion of the elbow.
72
What artery is the brachial artery a continuation of?
The axillary artery.
73
What arteries does the brachial artery branch into?
The radial and ulnar arteries.
74
Name 3 deep muscles in the anterior compartment of the forearm.
1. Flexor digitorum profundus.
2. Flexor pollicis longus.
3. Pronator quadratus.
75
What bone does flexor digitorum profundus originate from?
The ulna bone.
76
What is the innervation to flexor digitorum profundus?
- Medial half (little and ring fingers) - ulnar nerve.
| - Lateral half (middle and index fingers) - median nerve.
77
What is the action of flexor digitorum profundus?
It flexes the interphalangeal joints and the metacarphophalangeal joints.
78
What bone does flexor pollicis longus originate from?
The anterius radius.
79
What is the insertion of flexor pollicis longus?
The thumb.
80
What is the innervation of flexor pollicis longus?
Median nerve.
81
What is the action of flexor pollicis longus?
It flexes the interphalangeal joints and the metacarphophalangeal joints of the thumb.
82
What is the action of pronator quadratus?
It pronates the forearm.
83
Name 3 forearm muscles that are not supplied the median nerve.
1. Flexor carpi ulnaris.
2. The medial half of flexor digitorum profundus.
3. Brachioradialis.
84
What are the 3 main groups of bones in the hand?
1. Carpal bones.
2. Metacarpals.
3. Phalanges.
85
How many phalanges does each finger have?
3.
86
How many phalanges does the thumb have?
2.
87
How many carpel bones are there?
8.
88
Why is the skin of the palm adherent to the underlying connective tissue?
To prevent the skin from slipping off the hand whilst gripping.
89
What is the carpal tunnel?What structures pass through the carpal tunnel?
A space between the flexor retinaculum and the carpal bones.
| Flexor tendons entering the hand and the median nerve
90
What is the cause of carpal tunnel syndrome?
Swelling of the tendons increases the pressure in the tunnel and compresses on the median nerve.
91
What are the symptoms of carpal tunnel syndrome?
Pain, diminished sensation the hand and weakness of the thenar muscles.
92
What arteries form the superficial palmar arch?
The ulnar artery and a small contribution from the radial artery.
93
What is the superficial palmar arch?
An arterial arcade formed mainly by the ulnar artery that gives off 4 digital branches to the fingers.
94
What nerve branch arises from the median nerve in the forearm?
Palmar cutaneous nerve.
95
What does the palmar cutaneous branch of the median nerve innervate?
The skin of the lateral palm.
96
What are the two terminal branches of the median nerve?
1. Recurrent branch.
| 2. Palmar digital branch.
97
What does the palmar digital branch of the median nerve innervate?
The palmar surface and fingertips of the lateral 3.5 digits. It also gives motor innervation to the lateral 2 lumbricles.
98
What are the 3 main nerve branches of the ulnar nerve?
1. Palmar cutaneous branch.
2. Dorsal cutaneous branch.
3. Superficial branch.
99
What does the palmar cutaneous branch of the ulnar nerve innervate?
The skin on the medial half of the palm.
100
What does the dorsal cutaneous branch of the ulnar nerve innervate?
Skin of the medial 1.5 digits and the associated dorsal hand area.
101
What does the superficial branch of the ulnar nerve innervate?
The palmar surface of the medial 1.5 fingers.
102
What nerve and artery lie superficial to the flexor retinaculum?
The ulnar nerve and artery.
103
True or false: the ulnar nerve and artery pass through the carpal tunnel.
False. They lies superficial to the flexor retinaculum and so outside of the carpal tunnel.
104
What intrinsic hand muscles are innervated by the median nerve?
The 3 thenar muscles and the lateral 2 lumbricles.
105
Where are the thenar muscles located?
At the base of the thumb.
106
What is the action of the thenar muscles?
Fine movements of the thumb.
107
Name the 3 thenar muscles.
1. Abductors pollicis brevis.
2. Flexor pollicis brevis.
3. Opponens pollicis.
108
Where do the abductors pollicis brevis and flexor pollicis brevis insert?
The lateral aspect of the 1st phalanx of the thumb.
109
What is the action of opponens pollicis?
It opposes the thumb by medially rotating and flexing the metacarpal.
110
Where are the hypothenar muscles attached?
The little finger. They are mirror images of the thenar muscles.
111
What nerve innervates the hypothenar muscles?
The deep branch of the ulnar nerve.
112
Name the 3 hypothenar muscles.
1. Abductor digiti minimi.
2. Flexor digiti minimi.
3. Opponens digiti minimi.
113
How many lumbrical muscles are there in each hand?
4 - each associated with a finger.
114
What is the innervation to the lumbrical muscles.
- The medial 2 = deep branch of ulnar nerve.
| - The lateral 2 = median nerve.
115
What is the origin of the lumbricals?
The flexor digitorum profundus tendon.
116
What is the action of the lumbricals?
Flexion of the metacarphophalangeal joint and extension of the interphalangeal joints.
117
What covers the flexor tendons?
A fibrous flexor sheet that fans out into synovial sheaths.
118
What is the importance of the synovial sheath that covers the flexor tendons?
It reduces friction in flexion and extension.
119
What is the innervation to the interossei muscles?
The deep branch of the ulnar nerve.
120
What is the action of the dorsal interossei muscles?
Abduction.
121
What is the action of the palmar interossei muscles?
Adduction.
122
What carpal bones are most prone to injury?
The scaphoid is most prone to fracture and the lunate is most prone to dislocation.
123
What is the complication of a scaphoid fracture?
The artery supplying the scaphoid bone is often affected and so the bone can be without blood supply: avascular necrosis.
124
The ulnar artery and nerve lie superficially to the flexor retinaculum. Which lies medially?
The ulnar nerve lies medial and the artery lateral.
125
What is the cutaneous distribution of the median nerve?
The lateral palm of the hand and the palmar surface of the lateral 3.5 digits.
126
What is the cutaneous distribution of the ulnar nerve?
The medial palm of the hand and the palmar and dorsal surfaces of the medial 1.5 digits.
127
List the hand muscles supplied by the deep branch of the ulnar nerve.
1. Hypothenar muscles.
2. Medial 2 lumbricles.
3. Interossei muscles.
128
What are the 2 location where the ulnar nerve is often damaged?
At the elbow and at the wrist.
129
What is the termination of the cephalic vein?
Terminates with the axillary vein
130
What is the common flexor origin?
Medial epicondyle of the humerus. Where the superficial anterior forearm muscles originate.
131
Which muscles in the forearm are supplied by the ulnar nerve?
- Flexor carpi ulnaris.
| - Medial flexor digitorum profundus.
132
Define pronation.
Turning the hand so the palm is facing down.
133
Define supination.
Turning the hand so the palm is facing up.
134
Which muscles are responsible for pronation?
Pronator teres and pronator quadratus.
135
What artery are the cords of the brachial plexus in relation to?
The axillary artery.
136
What artery are the trunks of the brachial plexus in relation to?
The subclavian artery.
137
What are the nerve roots for the long thoracic nerve?
C5-7.
138
What is the function of the pericardium?
It provides a friction free surface to accommodate the heart's sliding movements.
139
What nerve innervates the muscles of the posterior compartment of the forearm?
The radial nerve.
140
What are muscles of the posterior compartment of the forearm commonly known as?
Extensors - their general function is to produce extension at the wrist and fingers.
141
Which muscles of the posterior compartment of the forearm originate from the lateral epicondyle?
1. Extensor carpi radialis brevis.
2. Extensor carpi ulnaris.
3. Extensor digiti minimi.
4. Extensor digitorum.
142
Name the superficial muscles of the posterior compartment of the forearm.
1. Extensor carpi radialis brevis.
2. Extensor carpi radialis longus.
3. Extensor carpi ulnaris.
4. Extensor digiti minimi.
5. Extensor digitorum.
6. Brachioradialis - flexor but has all the characteristics of an extensor.
143
What is the action of brachioradialis?
Flexion at the elbow.
144
Where do the tendons of extensor carpi radialis longus and brevis insert?
The metacarpal bones 2 and 3.
145
What is the action of extensor carpi radialis longus and brevis?
Extension and abduction of the wrist.
146
What is the origin of extensor digitorum?
Lateral epicondyle of the humerus.
147
What is the action of extensor digitorum?
Extension of the medial four fingers at the MCP and IP joints.
148
What is the action of extensor digiti minimi?
Extension of the little finger.
149
What is the origin of extensor carpi ulnaris?
Lateral epicondyle of the humerus.
150
What is the insertion of extensor carpi ulnaris?
Base of metacarpal 5.
151
What is the action of extensor carpi ulnaris?
Extension and adduction of the wrist.
152
Where do extensors of the carpus insert?
Metacarpal bones.
153
What is wrist drop?
When the extensor of the wrist are paralysed due to paralysis of the radial nerve above the elbow. The flexors are unopposed and so you get wrist drop.
154
Name the deep muscles of the posterior compartment of the forearm.
1. Supinator.
2. Abductor pollicis longus.
3. Extensor pollicis longus.
4. Extensor pollicis brevis.
5. Extensor indicis.
155
What are the origins of the 2 heads of supinator?
1. Lateral epicondyle of humerus.
| 2. Posterior surface of the ulna.
156
What is the action of supinator?
Supinates the forearm.
157
What tendons forms the lateral wall of the anatomical snuffbox?
1. Extensor pollicis brevis.
| 2. Abductor pollicis longus.
158
What tendon forms the medial wall of the anatomical snuffbox?
Extensor pollicis longus.
159
What is the action of extensor pollicis brevis?
Extension at the metacarpophalangeal and interphalangeal joints of the thumb.
160
What is the action of extensor pollicis longus?
Extends all the joints of the thumb.
161
What is the action of extensor indicis?
It allows the index finger to be independent of the other fingers in extension.
162
What tendon does the tendon of extensor indicis join?
The extensor digitorum tendon.
163
What bone forms the floor of the anatomical snuffbox?
Scaphoid.
164
What might tenderness in the snuffbox region suggest?
Fracture of the scaphoid.
165
What artery, nerve and vein lie in the anatomical snuffbox?
- Radial artery.
- Branch of the radial nerve.
- Cephalic vein.
166
What are the two articulating surfaces of the elbow joint?
1. Trochlear notch of the ulna and trochlea of the humerus.
| 2. Head of the radius and capitulum of the humerus.
167
What are the movements of the elbow joint?
1. Extension of triceps brachii.
| 2. Flexion of brachialis, biceps brachii and brachioradialis.
168
What do the medial and lateral collateral ligaments of the elbow attach to?
The annular ligament.
169
What type of joints are the radioulnar joints?
Pivot joints.
170
What istructures articulate at the proximal radioulnar joint?
The head of the radius and the radial notch of the ulnar.
171
What are the movements of the radioulnar joints?
Pronation and supination.
172
Name 2 muscles responsible for pronation.
1. Pronator teres.
| 2. Pronator quadratus.
173
Name 2 muscles responsible for supination.
1. Supinator.
| 2. Biceps brachii.
174
What is the dermatome of the thumb?
C6.
175
What is the dermatome of the middle and index fingers?
C7.
176
What is the dermatome of the ring and little fingers?
C8.
177
What are the dermatomes of the anterior aspect of the arm?
C5 and T1 centrally. C6 laterally and C8 medially.
178
What separates the wrist joint from the inferior radio-ulnar joint?
Triangular fibrocartilage
179
What does the head of the radius articulate with?
The capitulum of the humerus.
180
What does the trochlea of the humerus articulate with?
Trochlear notch of the ulna.
181
Contraction of the triceps will result in what action at the elbow?
Extension.
182
What 3 carpal bones form the wrist joint with the distal radius?
Scaphoid, lunate and triquetral bones.
183
What nerve innervates adductor pollicis?
Ulnar.
