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FRCEM Primary > Anatomy - Upper Limb > Flashcards

Anatomy - Upper Limb Flashcards

1
Q

Pec major goes from (3 places)

A

Sternum
Upper 6 costal cartilages
Medial 1/2 clavicle

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2
Q

Pec major goes to (1)

A

Anterior axillary fold of lateral humerus

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3
Q

Pec major actions (3)

A

ADDuction of arm
Flexion of arm
Medial rotation of arm

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4
Q

Pec major nerve supply

A

C5-T1

Medial and lateral pectoral nerve

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5
Q

Pec minor From (1)

A

Ribs 3-5

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6
Q

Pec minor goes to (1)

A

Coracoid process of scapula

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7
Q

Pec minor actions (2)

A

Stabalises scapula

Depresses tip of shoulder

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8
Q

Pec minor nerve supply

A

C8-T1 Medial and lateral pectoral nerve

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9
Q

Trapezius goes from (2)

A

Occipital protuberance

Cervical and thoracic vertebrae

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10
Q

Trapezius goes to (2)

A

Spine of scapula

Lateral 1/3 clavicle

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11
Q

Trapezius actions (4)

A

Elevates, retracts, rotates scapula

Braces shoulder backwards

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12
Q

Trapezius nerve supply

A

CN XI Spinal accessory nerve

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13
Q

Latissimus dorsi goes from (2)

A

T6-L5 spines

Iliac crest

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14
Q

Latissimus dorsi goes to

A

Intertubercle groove of humerus

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15
Q

Latissimus dorsi actions (3)

A

Adduction of arm
Medial rotation of arm
Raises body towards arm in climbing

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16
Q

Latissimus dorsi nerve supply

A

C6-7 Long thoracic nerve

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17
Q

Serratus anterior goes from (1)

A

Lateral surface of ribs

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18
Q

Serratus anterior goes to (1)

A

Medial border of scapula

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19
Q

Serratus anterior actions (3)

A

Rotates scapula
Protracts scapula
Holds scapula against thoracic wall

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20
Q

Sternoclavicular joint type

A

Fibro-cartilage with articular discs

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21
Q

Acromio-clavicular joint type

A

Fibro-cartilage with articular discs

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22
Q

Changes seen in acromio-clavicular joint dislocation

A

Rupture of AC ligament and CC ligament causes acromion to appear inferior to clavicle and more prominent.

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23
Q

Subscapularis from (1)

A

Subscapular fossa

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24
Q

Subscapularis to (1)

A

Lesser tubercle of the humerus

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25
Subscapularis actions (2)
Medial rotation of arm | Adduction of arm
26
Subscapularis nerve supply
C5-7 Subscapular nerve
27
Teres major from (1)
Lower angle of scapula
28
Teres major to (1)
Intertubercular sulcus of humerus
29
Teres major actions (2)
Adduction of arm | Medial rotation of arm
30
Teres major nerve supply
C6+7 Lower subscapular nerve
31
Which artery supplies the circumflex humeral artery?
Axillary artery
32
Brachial plexus comes from which nerve roots
C5-T1
33
Broad structure of brachial plexus
Roots -- Trunks -- Divisions -- Cords -- Nerves
34
Waiter's tip palsy
Superior plexus injury caused by separation of neck from shoulder
35
Claw hand palsy
Inferior plexus injury caused by sudden pull of arm superiorly
36
Chest drain insertion site
5th intercostal space, midaxillary line
37
Lymph from lateral 1/2 of breast drains to
``` Axillary nodes: 75% anterior Central Apical Lateral ```
38
Lymph from medial 1/2 of breast drains to
Parasternal nodes
39
Other sites of breast lymph drainage (3)
Posterior intercostal nodes Infraclavicular nodes Supraclavicular nodes
40
Supraspinatus actions (1)
Initiates abduction of arm
41
Supraspinatus nerve supply
C4-C6 suprascapular nerve
42
Infraspinatus actions (1)
Lateral rotation of arm
43
Infraspinatus nerve supply
C4-C6 suprascapular nerve
44
Teres minor actions (1)
Lateral rotation of arm
45
Teres minor nerve supply
C5-C6 Axillary nerve
46
Deltoid actions Anterior (2) Mid (1) Posterior (2)
Anterior - Flexion and medial rotation of arm Mid - Abduction Posterior - Extension and lateral rotation of arm
47
Deltoid nerve supply
C5-6 Axillary nerve
48
Shoulder movements - Flexion (2)
0-90 Pec major Anterior deltoid
49
Shoulder movements - Extension (3)
0-45 Teres major Latissimus dorsi Posterior deltoid
50
Shoulder movements - Internal rotation (5)
``` 0-40 Pec major Latissimus dorsi Teres major Anterior deltoid Subscapularis ```
51
Shoulder movements - External rotation (3)
0-55 Infraspinatus Teres minor Posterior deltoid
52
Shoulder movements - Adduction (2)
0-45 Pec major Latissimus dorsi
53
Shoulder movements - Abduction (4)
``` 0-180 Supraspinatus Deltoid Trapezius (rotates scapula) Serratus anterior (rotates scapula) ```
54
Shoulder joint type
Synovial ball and socket
55
Shoulder joint is stabilised by glenohumeral ligaments for
Anterior reinforcement
56
Shoulder joint is stabilised by coraco-humeral ligaments for
Superior reinforcement
57
Shoulder joint is stabilised by coraco-acromial ligaments for
Superior protection
58
Coraco-acromial arch contains (2)
Supraspinatus tendon insertion | Subacromial bursa
59
Rotator cuff stability direction - subscapularis
Anterior
60
Rotator cuff stability direction - Supraspinatus
Superior
61
Rotator cuff stability direction - Infraspinatus
Posterior
62
Rotator cuff stability direction - Teres minor
Posterior
63
Action of coracobrachialis (2)
Flexion of forearm | Adduction of arm
64
Nerve supply of coracobrachialis
C5-7 musculocutaneous nerve
65
Action of brachialis (1)
Flexion of forearm
66
Nerve supply of brachialis
C5-6 Musculocutaneous nerve
67
Action of biceps (2)
Flexion of forearm | Supination of forearm
68
Nerve supply of biceps
C5-6 musculocutaneous nerve
69
Brachial pulse can be felt
Medial to biceps tendon at the elbow
70
The brachial artery is a continuation of
the Axillary artery
71
The brachial artery is accompanied by deep veins called
venae comitantes
72
Main branches of the brachial artery (5)
Profunda brachii (winds behind the humerus with the radial nerve in the spiral groove to anastamosis at the elbow) Muscular Nutrient (supplies the humerus) Ulnar collateral (superior and inferior. Accompanies ulnar nere to anastamosis at the elbow Terminal - radius and ulnar
73
Median nerve comes from which brachial plexus roots
Medial and lateral
74
Surface marking of median nerve
Crosses brachial artery medially in mid arm | Lies medial to brachial artery in cubital fossa, medial to bicipital tendon
75
Musculocutaneous nerve supplies
Skin of lateral forearm
76
Musculocutaneous nerve is the nerve of which component of the arm
Flexor component. Supplies Corachobrachialis Brachialis and Biceps brachii
77
Ulnar nerve surface markings
Passes down medial side of arm and runs posterior to medial epicondyle
78
Medial cutaneous nerve of the arm supplies the
Skin on the medial side of the arm
79
Medial cutaneous nerve of the forearm supplies the
Skin on the medial side of the forearm
80
Intercostobrachial nerve supplies the
medial glenoid skin
81
Supratrochlear lymph nodes lie
Subcutaneously above the medial epicondyle
82
Supratrochlear lymph nodes drain
Ulnar side of forearm and hand
83
Infraclavicular lymph nodes lie
In the delto-pectoral groove under the mid-clavicle
84
Infraclavicular lymph nodes drain
The radial side of the upper limb
85
Actions of triceps
Extension of forearm
86
Triceps nerve supply
C6-8 Radial nerve
87
Course of the radial nerve
Runs with profunda brachii artery between long and medial heads of triceps into the posterior compartment where it lies in the spiral groove of the humerus at the midpoint. Next moves anterior and passes over the lateral epicondyle.
88
Radial nerve is easily damaged with what injury
Humeral shaft fractures
89
Elbow joint type
Synovial hinge joint
90
Bony articulations of elbow joint | Humeral capitulum -->
Radial head
91
Bony articulations of elbow joint | Trochlea of humerus -->
Trochlear notch of ulna
92
What does the Lateral collateral ligament of elbow look like and where does it run from
Fan like on the radial side from the epicondyle
93
Medial collateral ligament of elbow
3 bands to the coranoid process on the ulna
94
Annular ligament of the elbow
Surrounds the radial head attaching to the radial notch of the ulna. Allows radial rotation
95
Elbow movements - Flexion (3)
140 Biceps Brachialis Brachioradialis
96
Elbow movements - Extension (1)
0 | Triceps
97
Elbow movements - Pronation (2)
90 Pronator teres Pronator quadratus
98
Elbow movements - Supination (4)
``` 90 Biceps Supinator Extensor pollicis longus Extensor pollicis brevis ```
99
A pathological increase in the carrying angle at the elbow causes
Ulnar nerve palsy
100
Action of pronator teres (1)
Pronation of forearm
101
Nerve supply of pronator teres
C6-7 Median nerve
102
Action of flexor carpi radialis (2)
Flexion of wrist | Abduction of hand
103
Nerve supply of flexor carpi radialis
C6-7 median nerve
104
Action of flexor digitorum superficialis (3)
Flexion of middle phalanges at proximal interphalangeal joint Flexion at metacarpophalangeal joint Flexion at wrist joint
105
Nerve supply of flexor digitorum superficialis
C7-T1 median nerve
106
Action of palmaris longus (1)
Flexion of wrist
107
Nerve supply of palmaris longus
C7-8 Median nerve
108
Action of Flexor carpi ulnaris (2)
Flexion of wrist | Adduction of hand
109
Nerve supply of flexor carpi ulnaris
C7-8 Ulnar nerve
110
Action of Flexor digitorum profundus (2)
Flexion of distal phalanges | Flexion of wrist
111
Nerve supply of flexor digitorum profundus
C8-T1 Median and ulna nerve
112
Action of flexor pollicis longus (2)
Flexion of DP and PP of thumb
113
Nerve supply of flexor pollicis longus
C8-T1 Median nerve
114
Action of Pronator quadratus
Pronation of forearm
115
Nerve supply of pronator quadratus
C8-T1 median nerve
116
The brachial artery bifurcates into the
radial and ulnar arteries at the neck of the radius
117
Radial artery surface markings
Begins in the cubital fossa Passes inferolaterally deep to brachioradialis Lies on the anterior surface of the radius in the distal forearm Pulse felt at the wrist lateral to the tendon on flexor carpi radialis
118
Ulnar artery surface markings
Begins in the cubital fossa Passes deep and descends on flexor digitorum profundus with the ulnar nerve Pulse felt at the wrist lateral to the tendon of flexor carpi ulnaris
119
First branch of ulnar artery
common interosseous artery
120
Palmar carpal arch wrist anastamosis located
at distal radioulnar joint
121
Palmar carpal arch wrist anastamosis supplies
Deep palmar arch
122
Dorsal carpal arch wrist anastamosis located
Over carpal bones
123
Dorsal carpal arch wrist anastamosis supplies
Dorsal metacarpal arteries
124
Deep veins of the anterior forearm called
Venae comitantes
125
Superficial veins of anterior forearm - Cephalic vein location and course
From snuffbox along lateral to wrist Anterolateral to forearm and arm Follows deltopectoral groove to axillary vein
126
Superficial veins of anterior forearm - Basilic vein location and course
Medial aspect of wrist and forearm | Passes deep in mid-arm to axillary vein
127
Superficial veins of anterior forearm - Median cubital vein location and course
Communication between basilic and cephalic. | In cubital fossa
128
Medial cutaneous nerve supplies
Skin of medial forearm
129
Lateral cutaneous nerve supplies
Skin of distal 1/2 of lateral forearm
130
Median nerve branches (4)
Anterior interosseous branch - supplies deep flexors Palmar cutaneous branch - supplies skin of lateral palm Terminates in the hand dividing into: Recurrent branch - innervates thenar muscles Palmar digital branch - palmar surface and fingertips of lateral 3.5 digits, lateral two lumbricals
131
Ulnar nerve sits
Posterior to medial epicondyle at elbow Passes between two gheads of carpi ularis to enter the forearm Contues to lie lateral to tendon of FC ulnaris at wrist medial to the ulnar artery, passing superfically to flexor retinaculum medially
132
Ulnar nerve supplies
Flexor carpi ulnaris | 1/2 flexor digitorum profundus
133
Actions of brachioradialis (1)
Flexion of forearm
134
Nerve supply of brachioradialis
C5-7 Radial nerve
135
Actions of extensor carpi radialis longus and brevis (2)
Extension of wrist | Abduction of hand
136
Nerve supply of extensore carpi radialis longus and brevis
C6-8 radial nerve
137
Actions of extensor digitorum (2)
Extension of MCPJ | Extension of wrist
138
Nerve supply of extensor digitorum
C7-8 Posterior interosseous nerve, from radial
139
Actions of extensor carpi ulnaris (2)
Extension of wrist | Adduction of hand
140
Nerve supply of extensor carpi ulnaris
C7-8 Posterior interosseous nerve, from radial
141
Actions of supinator (1)
Supination
142
Nerve supply of supinator
C5-6 Radial nerve
143
Actions of abductor pollicis longus (2)
Abduction of thumb | Extension of thumb at CMCJ
144
Nerve supply of abductor pollicis longus
C7-8 Posterior interosseous nerve
145
Actions of extensor pollicis longus (1)
Extension of thumb at MCPJ and IPJ (DP)
146
Nerve supply of Extensor pollicis longus
C7-8 Posterior interosseous nerve
147
Actions of extensor pollicis brevis (1)
Extension of thumb at IPJ (PP)
148
Nerve supply of extensor pollicis brevis
C7-8 Posterior interosseous nerve
149
Actions of Extensor indicis (1)
Extension of index finger
150
Nerve supply of Extensor indicis
C7-8 Posterior interosseous nerve
151
Medial boundary of anatomical snuffbox (1)
Extensor pollicis longus
152
Lateral boundary of anatomical snuffbox (2)
Extensor pollicis brevis | Abductor pollicis longus
153
Bones palpable in anatomical snuffbox (2)
Trapezium | Scaphoid
154
Lateral attachment of extensor retinaculum (1)
Radius
155
Medial attachments of extensor retinaculum (3)
Styloid process of ulna Pisiform Triquetrum
156
Contents of extensor retinaculum from radial to ulnar side (9)
``` Abductor pollicis longus Extensor pollicis brevis Extensor carpi radialis longus Extensor carpi radialis brevis Extensor pollicis longus Extensore digitorum Extensor indicis Extensor digiti minimi Exentsor carpi ulnaris ```
157
Movements of the wrist joint - Flexion (6)
``` 80 Flexor digitorum profundus Flexor pollicis longus Flexor digitorum superficilis Flexor carpi radialis Flexor carpi ulnaris Palmaris longus ```
158
Movements of the wrist joint - Extension (5)
``` Extensor indicis Extensor digitorum Extensor carpi radialis longus Extensor carpi radialis brevis Extensor carpi ulnaris ```
159
Movements of the wrist joint - Abduction (3)
Flexor carpi radialis Extensor carpi radialis longus Extensor carpi radialis brevis
160
Movements of the wrist joint - Adduction (2)
Flexor carpi ulnaris | Extensor carpi ulnaris
161
Structure of the palmar aponeurosis
Thick central layer of deep fascia attached to the distal border of the flexor retinaculum. Triangle shaped from palmaris longus tendon. Distally splits into 4 slips at the bones of the fingers with the fibrous flexor sheaths.
162
Function of the plamaraponeurosis
Protects underlying soft tissues and long flexor tensons
163
Lateral attachments of the flexor retinaculum (2)
Scaphoid | Trapezium
164
Medial attachments of the flexor retinaculum (2)
Pisiform | Hook of hamate
165
Which muscles arise from the flexor retinaculcum
Thenar and hypothenar
166
Structures that pass under the flexor retinaculum (9)
Median nerve (sits superficially) Flexor pollicis longus 4 Flexor digitorum superficialis 4 Flexor digitorum profundus (deeper)
167
Structures that pass over the flexor retinaculum
Ulnar artery and nerve - no arteries or veins inside in case of compression
168
Actions of Abductor pollicis brevis (2)
Abduction of thumb | Helps in opposition
169
Nerve supply of Abductor pollicis brevis
C8-T1 median nerve
170
Actions of Flexor pollicis brevis (1)
Flexion of proximal phalanx of thumb
171
Nerve supply of Flexor pollicis brevis
C8-T1 median nerve
172
Actions of Opponens pollicis (1)
Opposition of thumb
173
Nerve supply of Opponens pollicis
C8-T1 median nerve
174
Actions of abductor digiti minimi (1)
Abduction of little finger
175
Nerve supply of abductor digiti minimi
C8-T1 ulnar nerve
176
Actions of Flexor digiti minimi (1)
Flexion of proximal phalnax of little finger
177
Nerve supply of Flexor digiti minimi
C8-T1 ulnar nerve
178
Actions of Opponens digiti minimi (1)
Opposition of little finger
179
Nerve supply of Opponens digiti minimi
C8-T1 ulnar nerve
180
Deep palmar arch is mainly from radial or ulna artery?
Radial
181
Deep palmar arch feeds (5)
``` 3 palmar metacarpal arteries (middle, ring , little) Princeps pollicis (thumb) Radialis indicis (index) ```
182
Superficial palmar arch is mainly from radial or ulna artery?
Ulnar
183
Superficial palmar arch feeds (4)
3 common palmar digital arteries (middle, ring, little) | Thenar muscles
184
Clinical significance of damage to palmar arches
Need to tourniquet brachial artery because of dual supply
185
Digital nerves - median supplies (5)
1st and 2nd lumbricals | Cutaneous supply to palmar skin of thumb, middle and 1/2 ring finger
186
Digital nerve - Recurrent branch of median supplies (3)
``` Thenar muscles (Opponens pollicis, abductor pollicis brevis, flexor pollicis brevis) Easily severed by minor laceration to thenar eminence causing paralysis of thumb ```
187
Digital nerves - ulnar supplies (8)
``` Cutaneous supply to medial 1.5 fingers 3rd and 4th lumbricals All dorsal interossei Adductor pollicis Hypothenar muscles (Flexor digiti minimi, abductor digiti minimi, opponens digiti minimi) ```
188
Digital nerves surface anatomy
Palmar terminal branches of cutaneous supply that run down the lateral aspect of each digit on both sides.
189
Lumbricals derive from
Flexor digitorum profundus
190
Lumbricals attach to
Lateral extensor expansions of extensor digitorum and proximal phalanx
191
Nerve supply of lumbricals
``` Medial 2 (little and ring) Ulnar nerve Lateral 2 (index and middle) Median nerve ```
192
Action of lumbricals (2)
Flex at MCP joint | Extend IP joint
193
Attachments of interossei
Originates from lateral and medial surfaces of metacarpals. Attach into extensor hood and proximal phalanx of each finger
194
Nerve supply of interossei
C8-T1 Ulnar nerve
195
Actions of palmar and dorsal interossei
Palmar interossei ADuct Dorsal interossei ABduct PAD DAB
196
Infection of synovial sheaths is called
Tenosynovitis
197
Importance of thumb and little finger synovial sheath
Continuous with common flexor synovial sheath - infection spreads easily
198
Index, middle and ring finger synovial sheaths
Are separate, confining infection to one digit. If neglected the proximal end of sheath can rupture and infection spreads into the midpalmar space
199
Digital attachment of flexor tendon - flexor pollicis longus
Base of DP of thumb
200
Digital attachment of flexor tendon - FDP
Base of DP of all 4 fingers
201
Digital attachment of flexor tendon - FDS
Either side of bodies of MP of all four fingers
202
Digital attachment of flexor tendon - Palmaris longus
Becomes flexor retinaculum and palmar aponeurosis
203
Digital attachment of extensor tendon - Extensor pollicis longus
Base of DP of thumb
204
Digital attachment of extensor tendon - Extensor pollicis brevis
Base of PP of thumb
205
Digital attachment of extensor tendon - Abductor pollicis longus
Base of 1st MC
206
Digital attachment of extensor tendon - Extensor digitorum
Base of DP and MP of all 4 fingers via extensor expansion
207
Digital attachment of extensor tendon - Extensor digiti minimi
Extensor expansion of little finger
208
Digital attachment of extensor tendon - Extensor indicis
Extensor expansion of index finger
209
Dermatomes of upper limb
C4-T3 C4 Clavicle C5 Lateral aspect upper arm C6 Lateral aspect forearm and palmar thumb, dorsal thumb and index C7 Palmar index and middle, dorsal middle C8 ring and little down to midpoint of medial forearm T1 Medial forearm T2 Medial Upper arm T3 axilla
210
Nerves causing Shoulder Flexion (4)
Lateral and medial pectoral nerves Musculocutaneous nerve Axillary nerve
211
Nerves causing Shoulder Extension (3)
Lower subscapular nerve Throacodorsal nerve Axillary nerve
212
Nerves causing Shoulder Internal Rotation (6)
Lateral and Medial pectoral nerves Throacodorsal nerve Axillary nerve Upper and lower subscapular nerve
213
Nerves causing Shoulder External rotation (2)
Suprascapular nerve | Axillary nerve
214
Nerves causing Shoulder Adduction (3)
Lateral and medial pectoral nerve | Throacodorsal nerve
215
Nerves causing Shoulder Abduction (4)
Suprascapular nerve Axillary nerve Accessory nerve Long thoracic nerve
216
Nerves causing Elbow Flexion (2)
Musculocutaneous nerve | Radial nerve
217
Nerves causing Elbow Extension (1)
Radial nerve
218
Nerves causing Elbow Pronation (1)
Median nerve
219
Nerves causing Elbow Supination (3)
Musculocutaneous nerve Radial nerve Posterior interosseous nerve
220
Nerves causing Wrist Flexion (3)
Median nerve Anterior interosseous nerve Ulnar nerve
221
Nerves causing Wrist Extension (2)
Posterior interosseous nerve | Radial nerve
222
Nerves causing Wrist Abduction (2)
Median nerve | Radial nerve
223
Nerves causing Wrist Adduction(3)
Ulnar nerve | Posterior interosseous nerve
224
Downward traction injury to brachial plexus causes
C5-6 injury - Erb's palsy / waiter's tip | Pronation, medial rotation, wrist flexion (behind)
225
Upward traction injury to brachial plexus causes
C8-T1 injury - Klumpke's palsy | Claw hand, Horner's syndrome
226
Axillary nerve damage caused by
Surgical neck of humerus fracture or shoulder dislocation
227
Axillary nerve damage causes
Loss of deltoid abduction and loss of sensation to regimental badge area
228
Radial nerve damage caused by
Humeral shaft fracture
229
Radial nerve damage causes
Loss of forearm extensors - wrist drop | Loss of sensation to anatomical snuffbox
230
Ulnar nerve damage caused by
Medial epicondyle fracture or wrist laceration
231
Ulnar nerve damage causes
Claw hand of ring and little fingers below elbow with small muscle wasting above elbow. Loss of sensation to medial 1.5 digits and hand
232
Median nerve damage caused by
Carpal tunnel syndrome or wrist laceration
233
Median nerve damage causes
Weakness and wasting of thenar muscles. Loss of sensation to lateral palm and 2.5 digits.

FRCEM Primary (32 decks)

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