Anatomy Upper Limb Flashcards
Sesamoid bone
An ossification inside the tendon of a muscle. Usually where that tendon goes around the corner of the joint.
Keeps tendon in place n enhance the mechanical function of the muscle
Olecranon
Elbow n proximal portion of the ulna
thenar eminence muscles
abductor pollicis brevis
flexor pollicis brevis
opponens pollicis
innervated by median nerve
hypothenar eminence muscles
Opponens digiti minimi
abductor digiti minimi
Flexor digiti minimi brevis
innervated by ulnar nerve
musculocutaneous nerve
innervate Brachialis, coracobrachialis, biceps brachii
axillary nerve
innervates:
- long head of triceps
- teres minor
- deltoids
- shoulder joint
- the “regimental badge” area
The Quadrangular Space-CEHCK
borders: Superior – Subscapularis and teres minor. Inferior – Teres major. Laterally – Surgical neck of humerus. Medially – Long head of triceps brachii.
rotator cuff injuries
Tendinitis. The rotator cuff tendons can be irritated or damaged/inflamed.
Bursitis. The bursa can become inflamed and swell with more fluid causing pain.
Impingement. When you raise your arm to shoulder height, the space between the acromion and rotator cuff narrows. The acromion can rub against (or “impinge” on) the tendon and the bursa, causing irritation and pain.
radial nerve
passes in radial groove
goes to lateral border of humerus
n bw brachioradialis n brachialis
n anterior of lateral epicondyle of humerus
from cubital fossa, splits into 2 branches-deep branch n superficial branch
flexor digitorum profundus
Medial part:
ulnar nerve
Lateral part:
median nerve
median nerve
The median nerve arises from the cubital fossa and passes between the two heads of pronator teres. It then travels between flexor digitorum superficialis and flexor digitorum profundus before emerging between flexor digitorum superficialis and flexor pollicis longus.
GREY
elevate scapula
levator scapulae, trapezius
GREY
depress scapula
pectoralis minor
GREY
protrude scapula
serratus anterior
GREY
depress glenoid
rhomboids
GREY
elevate glenoid
serratus anterior, trapezius
GREY
retract scapula
rhomboids, trapezius
GREY
flex wrist
flex carpi radialis, ulnaris
GREY
extend wrist
all extensor carpi muscles
GREY
abduct wrist
flexor/extensor carpi radialis
GREY
adduct wrist
flexor/extensor carpi ulnaris
GREY
flex metacarpophalangeal
interossi n lumbricals
GREY
extend metacarpophalangeal
extensor digitorum
GREY
flex proximal interphalangeal (PIP)
flexor digitorum superficialis
GREY
extend proximal interphalangeal (PIP)
interossei n lumbricals
GREY
flex distal interphalangeal (DIP)
flexor digitorum profundus
GREY
extend distal interphalangeal (DIP)
interossei n lumbricals
2 bursa
subscapular bursa
subacromial bursa
abductionof shoulder
first 15 degrees=supraspinatus (suprascapular nerve)
deltoids up to 90 degrees (axillary
trapezius (spinal accessory cranial nerve XI and C3, C4)
anterior compartment muscles arm
biceps brachii, brachialis, coracobrachialis
anteiror compartment job arm
mainly flexor of elbow
coraco flex arm at shoulder
anteiiror comparmtnet blood supply arm
brachial artery
anteiror compartment innervation arm
musculoskeletal
posterior compartment muscles arm
triceps n anconeus
posteiior compatmet arm job
extend elbow
posteiorr compartment arm innervation
radial nerve
posterior compartment arm blood supply
profunda brachii
carpal tunnel
4 from flex dig profundus
4 from flex dig super
1 from pollicis longus
cubital fossa contents
medial to lat:
median nerve, brachial artery, tendon of biceps, radial nerve (my blood turns red)
cubital fossa superior border
imaginary line bw medial n lateral epicondyle
cubital fossa medial boundary
pronator teres
cubital fossa lateral boundary
brachioradialis
cubital fossa apex
meeting pnt of pronator teres n brachioradialis
cubital fossa floow
brachialis, supinator
anatomical snuff box anteriorly
abductor pollicis longus
extensor pollicis brevis
anatomical snuff box posteriorly
extensor pollicis longus
anatomical snuff box contents
superficial branch of radial nerve, cephalic vein, radial artery
axilla base
skin of armpit n fascia
axilla apex
1st rib, clavicle, superior part of scapula
axilla anterior wall
pect major/min
axilla posteiror wall
subscapularis, teres major, lat dorsi, long head of triceps
axilla medial wall
upper rib cage, intercostal + serratus anterior
axilla lateral wall
humerus
quadrangular space
axillary n post circumflex go through
borders= teres min/teres major, shaft of humerus, long head of triceps
triangular space
circumflex scapular artery n vein
triangular interval
radial nerve n profunda brachii
anterior dislocation of humerus
musculocutaneous most endangered. axillary nerve can also be in trouble
clavicle issues
most likely to fracture in middle third of clavicle
due to: FOOSH or delivery of baby
complications- pain wen lifting up arm, malunion
fracture at surgical nerck of humerus
mite damage axillary nerve,
circumflex humeral arteries
fracture at shaft of humerus
radial nerve n profunda brachii
fracture at distal end of humerus
median nerve
issues at medial epicondyle
ulnar nerve
damage to long thoracic nerve
winged scapula
pulsations in arm
at medial bicipital groove for brachial artery
o Impacted fracture of humerus due to
minor fall on hand
o Avulsion fracture of humerus due to
• Fall on the acromion/hand when arm is abducted
o Transverse fracture of humerus due to
direct blow to arm
o Spiral fracture of humerus due to
FOOSH
o Intercondylar fracture of humerus due to
• Severe fall on flexed elbow
scaphoid fracture
o Fall on the palm when hand is abducted
o Pain on lateral side of wrist, palpation of anatomical snuffbox
o Can take up to 14 days to be seen on X-ray
• Hamate fracture
ulnar nerve is close to the hook of hamate and may be damaged
o Ulnar artery too
• Elbow joint
o Usually dislocate
Posteriorly
o Subcutaneous olecranon bursitis –
o
‘student’s elbow’
rotator cuff
o Most common supraspinatous tendon
o Often repetitive overhead motions
• Tendinitis most common
biceps tendinitis – long head of biceps moving back and forth in the bicipital groove
• Thoracodorsal nerve
o Lat dorsi
o Surgery in inferior part of the axilla
o E.g. mastectomies, surgery on scapular lymph nodes
o Can’t climb
upper brachial plexus injury (C5, C6)
occurs wen there is a massive neck lateral flexion
get Erb’s palsy, which has a symptoms of
1. waiters tip
2. paralysis (and maybe atrophy) of deltoids, biceps and brachial is
3.• Loss of sensation over lateral aspect of forearm
could be due to during birth or fall on neck
waiter’s tip
arm hangs by the side in medial rotation
lower brachial plexus injury (C8/T1)
due to arm suddenly being pulled superiorly eg fall from tree
get Klumpke paralysis-paralysis of intrinsic hand muscles, can get claw hand,
• Synovial cyst
o Non-tender cystic swelling on the hand, usually the dorsum of wrist
• First rib has scalene tubercle
medial to tubercle = division of brachila plexus + subclavian vein, lateral to tubercle is subclavian vein
• Subluxation/dislocation of the radial head
annular ligament was meant to hold head of radius in place
• Handlebar neuropathy
- ulnar nerve issues at guyon’s canal
• Colles’ fracture
o Fracture of distal radius with postero-radial displacement of the hand (dinner fork)
o FOOSH
o Often seen in people with osteoporosis
• Smith’s fracture
o Fracture of distal radius with ventral displacement of hand
o Fall on flexed hand
axillary nerve injury due to
anterior dislocation
or compression due to crutches or
incorrect injection into the deltoid
present as deltoid atrophies, loss of sensation in regimental patch
patient can’t give ok sign
due to paralysis of flexor pollicis longus + flexor digi profundus
median nerve issue
hand of benediction
index finger can’t flex due to paralysis of lateral half of flexor dig profundus
median nerve issue
carpal tunnel
- Paraesthesia, hypoesthesia, anaesthesia in the lateral 3 and a half fingers
- Weakness of thumb – difficulty opposing it thus gripping things, buttoning shirts etc.
median nerve lesion at wrist
weakness of abductor pollicis brevis (demonstrate wit pen touching test)
median nerve lesion at cubital fossa
oschner’s clasping test
ulnar nerve issues
wasting of hand,clawing of 4th n 5th digit, froment’s sign
unable to flex fingers
ruptured superficialis
lateral capitulum
and the medial trochlea
(for the head of the radius)
for the trochlear notch of the ulna
