Anatomy - upper limb Flashcards
what are the osteological features of the scapula ? structure tourist attraction articulations (7+2) At the back we have a spine ...
structure : curved to fit chest wall Tourist attractions : - Acromion -coracoid process -Glenoid cavity + glenoid fossa -FRONT = subscapular fossa BACK : -supra spinous fossa -Spine -Infraspinous fossa
POINTS OF ARTICULATION :
- Acromion = articulates whit the clavicle
- Glenoid cavity = articulates with the heads of the Humerus = SHOULDER JOINT
osteological features of the clavicle
(2)
- what is it
-articulations (2)
smooth = collar bone
- articulates with the manubrium = sternoclavicular joint
- articulates with scapula at acromion process
osteological features of humerus
TOP features (5) which side are the tubercles on ?
Middle(1) think Taehyung
Front (4) and back (1)
(12)
TOP : anatomical , surgical neck Greater tubercle (front) Intra tubercle sulcus (front) Lesser Tubercle (front)
Middle : TAEHYUNG
V shaped deltoid TUBEROSITY
FRONT : bow shaped two sides of the bone = lateral, medial epicondyle -Radial fossa -coronoid fossa -capitulum (lateral side of the bow)+ Trochlea ( medial side of bow)
BACK :
- radial groove ( important for insertion of the triceps lateral and medial head )
- Olecranon fossa
Origin and insertion , innervation of pectoralis major case study where is it - shape and where is it ? -where is its origin ? -insertion ? -Nerves ? (5)
- Pectoralis major = large fan shaped muscle covers superior part of thorax on the front
- Origin: Medial clavicle + sternum + costal cartilage of 1-6
- Insertion : intertubercular groove
- Movement =medial rotation
- Nerves = medial + lateral pectoral nerves
Describe the innervation , actions of pectoralis minor (4) location origin insertion
The pectoralis minor = triangular in shape
-located under the pectoralis major, and both form the anterior (front) wall of the axilla-
origin :Small muscle attaches from ribs 3,4,5,
insertion :medial border and upper surface of coracoid process of the scapula
Nerves :
- medial pectoral nerves
(for breathing )
outline the serrates anterior (boxer muscle ) - where is the origin -insertion -what does it do ? -nerve ? (4)
- origin =Upper 8 ribs ( behind body )
- Fibres attach to the medial border and inferior angle of scapula
( draws scapula around rib cage )
-rotates the scapula
-nerve = Long thoracic nerve
subclavian muscle
(what does it do , not much detail )
(2)
underneath clavicle
protects subcalvian vessels from bone
medial –>lateral clavicle
stops it drifting of !
what is the anatomy of the brachial plexus?
Read The Darn Cadaver Book
CORDS :
M+M
AR
MU
MARMU
-C5,C6,C7,C8,T1
-C5+6= I trunk= superior trunk :
->has anterior and posterior division
-C7= middle trunk
= has anterior and posterior division
-C8+T1=inferior trunk
has anterior division
3 cords arise:
C5,6- Lateral cord ->musculocutanous nerve
->contributes to the median nerve
C7-Posterior cord = 2 branches - radial, axillary
C8,T1-Medial cord= Ulnar nerve
->contributes to the median nerve
Describe the anatomy of the axillary artery
- where does it start , (latasfirib)
-branches ( screw the lawyer, save a patient )
(8)
-Axillary artery starts at the lateral aspect of the first rib
-GIVES OF 6 Branches ( remember it has 3 sections )
1 section = 1 branch = Superior thoracic artery
2nd section = 2 branches = Thoracoacromial artery + Lateral thoracic artery
3rd section = 3 branches
- Subscapular artery
- Anterior circumflex humeral artery
- Posterior Circumflex Humeral artery
describe the anatomy of the brachial artery , deep branch ?
3
- axillary artery –> brachial artery =inferior border of TERES major
-brachial immediately gives of a deep branch called
Profunda Brachi Artery
describe venous drainage ? of upper limb
(6)
3 superficial and 3 deep
superficial
century based men
DEEP :
RUB
superficial vein:
- cephalic vein
- basilic vein
- median vein
Deep vein :
- Radial
- Ulnar
- Brachial
what are the ligaments of the clavicle and scapula ?
4
1- Acromioclavicular joint —8 covers joint capsule)
2-Conoid ligament (inferior)
3-Trapezoid ligament (inferiorly)= from coracoid process–>trapezoid line
2+3= known a coracoclavicular ligament
Where is the glenohumeral joint ? try name some ligaments (5) Choi san might tell IM movements (2) arteries (3) innervation (2) muscles(4)
1-Shoulder joint
2-Head of humerus + Glenoid fossa = synovial ball and socket
Ligaments:
- Coracohumeral ligament
- Superior Glenohumerul ligament
- Middle Glenohumeral Ligament
- transverse humeral ligament
- Inferior Glenohumeral ligament
Arteries :
- arterial supply :
- anterior / posterior circumflex humeral arteries -SUPRASCAPULAR artery
Innervated :
-Axillary suprascapular - lateral pectoral nerves
Muscles :
-Rotator Cuff Muscles
(sup,infra,subscapularis ,teres minor )
Movements :
- flexion
- ad+abduction
scapulothoracic ‘joint’
-why is it a ‘joint’
-Movements ?
UDEAD movements
- Scapula floats
but not connected to thorax
-Only articles with ribs with clavicle —> acromioclavicular joint
Movements :
- Elevation (shrug)
- Adduction + abduction (bench press)
- Depression
- Upward rotation (hands on hip)
- Downward rotation
what muscles move the scapula
(5)
tae really likes singing purple
1) Trapezius
2) Rhomboids
3) Levator scapulae
4) Serratus anterior(medial border)
5) Pectoralis minor (coracoid process)
what are the anterior axioappendicular muscles
4
1-pectoralis major
2-pectoralis minor’s
3-serratus anterior
4-Subclavius
deltoid case study attachment insertions fibres and their movements (8)
1-Attached from scapula , Acromion process
2-insert= deltoid tuberosity of humerus
3-different fibres = different movements :
-Anterior fibers= Flexion and medial
-Posterior fibers=extend and laterally rotate
-Middle fibers =abduct past 15 degrees
Innervation: axillary nerve
what are the rotator cuff muscles ? (4) nerves ? 3 Back and 1 front (San Infinitely sings treasure )
1-Supraspinatus (posterior), abduct from 0-15 degreee at shoulder joint
2-Infraspinatus (posterior).Acts to laterally rotate the arm at the shoulder
3-Subscapularis (anterior)=U/L suscapular nerves Acts to medially rotates the arm at the shoulder
4-Teres minor (posterior)=laterally rotates arm=axillary nerve
Strap glenohumeral joint in place !
subscapularis case study origin insertion (sub like subtract) movement nerves (6)
origin :From the subscapular fossa to the insertion : lesser tubercle of the humerus
movement : Acts to medially rotates the arm at the shoulder
nerves : The upper and lower subscapular nerves
from posteriorcord
teres minor actions origins insertion innervation (4)
Origin: From the posterior scapula, near the lateral border
Insertion: To the greater tubercle of the humerus
Actions: Laterally rotates the arm
Innervated by the axillary nerve
supraspinatous origin inserts (super ) innervation movement (4)
1-origin. : supraspinatous fossa
2- inserts :GREATER tubercle of humerus
3-innervated by suprascapular nerve
4-abduct at first 15 degrees
Infraspinatous Origin Insertion Nerves Movement (infraSPINatous) (4)
Origin :infraspinous fossa Insertion : greater tubercle of the humerus
NERVES: suprascapular nerve
Movement: Acts to laterally rotate the arm at the shoulder
where are the insertions for the tendons of the Rotator cuff group of muscles?
SSITS from back to front
(4)
SUBways
Super
Indian
Tika
out for sale now!
SSITS
Subscapularis -back wall = attaches to the lesser tubercle
Supraspinatus -greater tubercle of humorous
Infraspinatus =greater tubercle of humerus
Teres minor ( back ) = attaches to Greater tubercle of the humerus
What four short muscles hold the shoulder joint together ?
3 at the back and one at the front
other 2 muscles that connect humorous to scapula ( one on the front and one on the back )
OTHER ONE = important ( you can see this one )
7 MUSCLES Altogether
can u name what they do ?
where do they attach ?
(case study so 10 marks)
3 on the back and one on the front :
FRONT = SUBSCAPULARIS ( ANTERIOR aspect of scapular and tendon = lesser tubercle)
(internal rotation )
Back :
2 bellow and one above
one above = SUPRASPINATOUS = SUPERSPINOUS FOSSA ( under acromion –>greater tubercle )
= abduction
2 BELLOW :
INfraspinatous = infraspinous fossa –>back of greater tubercle
Teres minor = rotation of humorous –>greater tubercle
= flat supporting tendon + long head of triceps which keep head of humorous from sliding out of place !
2 other muscles from scapula to humerus _
on the BACK :
TERES MAJOR = from lower lateral border of scapula –> backside of inter tubercular groove = POWERFUL adductor ( pulls back )
FRONT :
CORACOBRACHIALIS = coracoid process –>humerus
= flexion
other = deltoid !
what deep muscles hold the scapula in place? from spine (6 ) 4 on the back (surface x1, 3 deep) one in front and one underneath DEEP
UNDERNEATH:
serratus anterior = from rib1-8 = all the way to medial border of the scapula
= pulls scapula forward around the ribcage
ON THE BACK :
1) TRAPEZIUS = large and surface upper and lower part converge -->scapula, acromion etc looks like a trapezium t4-t12 = LOWER:POWERFUL RETRACTOR
UPPER part: powerful elevation
2) DEEP = Levator scapulae = elevates scapular
C1-3 to upper medial corner of scapula
3) DEEP = rhomboid minor
c4-t5–>medial border of scapula
-elevate and retract
4) DEEP = Rhomboid major
c4-T5–>medial border
-elevate and retract
ON THE FRONT :
5) Pectoralis minor = RIB2-4–>coracoid process = depression of scapula
others :
subclavius ( rib 1->clavicle )
Omohyoid ( insert to the upper edge of spine of scapula )
what muscles move the scapula
1) medially
2) upwards
3) sidewards laterally
4) Downwards
see nice diagram on slides
(4)
1) Rhomboids ,Trapezius , Levator scapulae
2) Rhomboids , trapezius, Levator scapulae
3) Serratus anterior , Pectoralis minor
4) Trapezius and pectorals minor
outline the elbow joint
(joint )
(2)
- synovial hinge joint
( articulation humerus ,ulna , humerus and radius) - Proximal and Distal Radioulnar joint
supported by collateral ligaments:
- Radial lateral collateral ligament
- ulnar medial collateral ligament
what is the proximal joint example?
2
- head of radius + radial notch of the ulna
- Annular ligament
What is the distal radioulnar joint ?
2
- Head of Ulnar and Ulnar notch of the radius
- anterior + posterrior radiolulnar ligametn
Describe the origin, course and relations of the musculocutaneous nerve (5) where does it travel to between which 2 muscles continues as the cutaneous
Musculocutaneos nerve ( terminal branch of the first lateral cord c5+6) -front part of arm
- Axilla–>coracobrachialis muscle
- In between biceps Brachii and brachialis
- Distally emerges lateral to biceps tendon and brachioradialis
- Continues as the lateral cutaneous nerve of the forearm
Describe the origin , course and relations of the radial nerve
(6)
Terminal branch from posterior chord
- Innervates back side of arm innervated
- Leaves axilla in TRIANGULAR INTERVAL
- Descends with profunda brachiii artery in spinal, radial groove
- Passes in front of the lateral epicondyle and terminates as:
1) Deep branch for posterior aspect for forearm
2) Superficial branch -cutaneous innervation of dorsum x hand
what are the muscles of the front of the arm ?
3
1) Biceps brachii
2) Brachialis
3) Coracobrachialis
What are the muscles of the posterior compartment x arm ?(2)
1) Triceps Brachii
2) Anconeus
Biceps Brachii case study -head attachments -insertions -innervations -movements (5)
1) Long head –attaches to the supraglenoid tubercle of scapula
2) Short head –attaches to the coracoid process of scapula
3) insertion : Both heads combine and insert into the radial tuberosity of the radius and the bicipital aponeurosis
4) Innervation by the musculocutaneous nerve = supinates (down rotation of forearm )
5) flexion
Brachialis case study where is it origin insertion innervation purpose (5)
1) Lies deep to biceps brachii
2) Arises from the medial and lateral aspects of the shaft of the humerus
3) Inserts into the tuberosity of the Ulna
4) Also innervated by the musculocutaneous nerve, that is ‘sandwiched’ between biceps brachii and brachialis
5) Primary flexor of the elbow joint
Coracobrachialis where ? origin ?coraco--- insertion ? innervation? action ? (5)
1- deep to biceps brachii
2) Origin = coracoid process
3) Inserts = Medial aspect of the shaft of humerus
4) Innervation : ALSO Musculocutaneous nerve
5) Flexer of arm at shoulder join and weak adductur
Triceps Brachii ( 3 heads , where do they originate from ) insertion ? (7) innervation action ?
- Long head –infraglenoid tubercle of the scapula
- Medial head –posterior surface of humerus, inferior to the radial groove
- Lateral head –posterior surface of humerus, superior to the radial groove
- Insert onto the olecranon of the ulna +fascia of forearm
- Innervated by the Radial nerve
- Acts to extend the forearm at the elbow
- Long head contributes to the extension of the arm at the shoulder joint
Aconeus
(4)
origin + insertion
innervation and action
1) Attaching from the lateral epicondyle of the humerus
2) Insertion = lateral side of the olecranon
3) Innervated by the radial nerve
4) Acts with triceps to extend the forearm at the elbow, and may assist in stabilising the joint when extended
Which muscles does the musculocutaneous nerve innervate ?
3
1) Anterior compartment :
- biceps brachii
- Brachialis
- Coracobrachialis
The radial nerve innervates which muscles ? (2)
1- Triceps Brachii
2- Anconeus
posterior compartemt
Where does the long head of triceps attaches ?
Biceps ?
(2)
Triceps long head = infraglenoid tubercle
Biceps longs head = supraglenoid
What is in the cubical fossa ?
Really need beer to be at my nicest
(4)
Radial Nerve
Brachial Tendon
Brachial Artery
Median Nerve
What are the branches of the posterior chord of the brachial plexus ?
STAR
Subscapular
Thoracodorsal
Axillary
Radial
