ANATOMY - Upper limb p1 Flashcards
How many muscles attach to the scapula
17
what are the 3 surfaces of the scapula?
costal (anterior)
lateral
posterior
what does the acromion of the scapula articulate with?
clavicle
which muscle attaches to the supraglenoid tubercle of the scapula?
biceps brachii long head
which muscle attaches to the infraglenoid tubercle of the scapula?
triceps brachii long head
which muscles attach to the coracoid process of the scapula (3)
pec major
coracobrachialis
short head bicep
what muscle attaches to the subscapular fossa?
subscapularis
which muscles in general originate from the posterior surface of the scapula
rotator cuff muscles
supraspinatous fossa vs infraspinatous fossa - which is more convex
supraspinatous
what is the prominent feature of the posterior scapula
spine
what are the 2 articulations with the scapula
glenohumeral joint
acromioclavicular joint
are scapula fractures common
no (+ usually indicate severe trauma)
do scapula fractures tend to be displaced or undisplaced and why
undisplaced as mm hold in place
hence dont req fixation
what type of bone is the clavicle
long bone
functions clavicle (3)
attach upper limb to trunk
protect underlying NV structures
transmit forces from UL to axial skeleton
what does the large facet of the clavicle articulate with
sternum (–> sternoclavicular joint)
what attaches to the conoid tubercle of the clavicle
conoid ligament (medial part coracoclavicular ligament)
what attaches to the trapezoid line of the clavicle
trapezoid ligament (lateral part of coracoclavicular ligament)
which 1/3 of the clavicle has the majority of fractures
middle 1/3 (80%)
most common mechanism for clavicular fracture
FOOSH
mx clavicular fracture
conservative or orif
which nerve may have to be sacrified during ORIF of clavicle
supraclavicular nn
what does humerus articulate with proximally
glenoid fossa scapula (GH joint)
what does humerus articulate with distally
head of radius + trochlear notch ulna (elbow joint)
which 3 fossa on the humerus articulate with the radius and ulna during flexion and extension
olecranon fossa
coronoid fossa
radial fossa
what direction are supracondylar fractures of the humerus
transverse
oblique
which aa can be damaged by supracondylar fractures and what syndrome does it lead to
brachial aa
Volkmans ischaemic contracture
which 3 rotator cuff muscles attach to the greater tuberosity of the humerus?
supraspinatus
infraspinatus
teres minor
which nerve and vessel pass over the surgical neck of the humerus
axillary mm
posterior circumflex aa (and vv)
which 3 muscles attach to the intertubercular groove of humerus (and how to remember)
pec major
teres major
lat dorsi
a lady between 2 majors
what muscle runs through the intertubecular groove of humerus?
long head of biceps
what muscle attaches to the lesser tuberosity of the humerus
subscapularis
which muscles attach to the anterior shaft of the humerus (4)
coracobrachialis
deltoid
brachialis
brachioradialis
which muscle attach to the posterior shaft of the humerus?
medial and lateral head of triceps
which nerve and vessel are at risk with a mid shaft fracture of the humerus
radial nn —> wrist drop
profunda brachii aa
which is larger - medial or lateral epicondyle humerus
medial
which nerve passes through groove on medial epicondyle humerus
ulnar nn
which part of humerus articulates with radius
capitulum
what is Volkmann’s ischaemic contracture
uncontrolled flexion hand due to flexor mm becoming fibrotic and short
which nerves can be damaged in supracondylar humeral fracture (3)
anterior interossous, ulnar and radial nn
which classification is used for supracondylar fracture
Gartland
Gartland criteria 1
minimally displaced
Gartland type 2
displaced by intact posterior cortex
Gartland type 3
completely off ended
Mx Gartland criteria type 1
conservative mx
Mx Gartland criteria type 2 + 3
surgery - bionical fused K wired
2 articulations of the ulna
proximally - humerus at elbow joint + radius at prox RU Joint
distally - distal RU joint
which muscle attaches to the olecranon
triceps brachii
which muscle articulates with the coranoid processes ulnar tuberosity
brachialis
which part of the ulna is most likely to fracture
shaft
3 surfaces and 3 borders of the ulna
surfaces - ant, post, med
borders - post, interosseous, ant
what are the 4 articulations of the radius
elbow joint - head radius + capitulum humerus
prox RU Joint - radial head + radial notch ulna
wrist joint - end radius + carpal bones
distal RU joint - ulnar notch radius with ulna head
which side of radial head is thicker - medial or lateral
medial
which muscle attaches to radial tuberosity
biceps brachii
what muscle attaches to lateral shaft of radius
pronator teres
name of 8 carpal bones
scaphoid
lunate
triquentrum
pisiform
hamate
capitate
trapezoid
trapezium
2 aa supplying scaphoid bone
dorsal carpal brachial aa
superficial palmar arch
boxers fracture
5th metacarapl neck fracture
bennetts fracture
fracture 1st MC base by forced hyperabduction thumb
how many metacarpals per hand
5
how many phalanges per hand
14
anterior border axilla
pec major + minor
lateral border axilla
intertubecular sulcus humerus
posterior border axilla
scapularis
teres major
latissimus dorsi
medial border axilla
serratus anterior
thoracic wall
contents axilla (lateral to medial)
short head biceps
coracobrachialis
brachial plexus
axillary aa
axillary vv
axillary LN
which space is in the posterior wall of the axilla
quadrangular space
what bounds the quadrangular space?
teres minor
teres major
triceps
surgical neck of humerus
contents quadrangular space?
axillary nn
posterior circumflex humeral aa (branch of axillary aa)
what bounds the clavipectoral triangle?
pec major
deltoid
clavicle
contents clavipectoral triangle?
cephalic vv
medial + lateral pectoral nn
what 4 muscles constitute the pectoral region?
pec major
pec minor
serratus anterior
subclavius
pectoralis major origin/insertion
anterior medial clavicle + anterior sternum, superior 6 CC + aponeurosis EO muscle (2 heads) –> intertubercular sulcus humerus
actions pectoralis major
adduct + medial rotate UL
draws scapular anteriorinferiorly
clavicular head flexes shoulder
innervation pectoralis major
lateral and medial pectoral nerves
origin/insertion pectoralis minor
3-5th ribs –> corocoid process
action pectoralis minor
stabilises scapula by drawing anteroinferiorly
innervation pectoralis minor
medial pectoral nerve
origin/insertion serratus anterior
lateral aspect ribs 1-8 –> costal surface medial border scapula
action serratus anterior
rotates scapula + holds scapula against ribcage
innervation serratus anterior
lateral thoracic nerve
damage to lateral thoracic nn leads to…
winging scapula