Arm Flashcards
Contents of shallow triangular depression:
-Median nerve
-Biceps
-Radial nerve (deep & superficial)
-Deep veins & arteries
-Terminal part of brachial artery and terminal branches, radial & ulnar artery
Cubital fossa
Posterior bony ring composed of:
-scapula
-clavicle
Anterior bony ring composed of:
-sternum
-manubrium
Pectoral girdle
Deltoid cervical region
Pectoral cervical region
Scapular cervical region
Lateral cervical region
Shoulder
Deltoid cervical region
Pectoral cervical region
Scapular cervical region
Lateral cervical region
Shoulder
Part of clavicle articulating with the manubrium
Sternoclavicular joint
Part of clavicle articulating with the acromion of the scapula
Acromioclavicular joint
Covering rib 2-7
Scapula
At head of scapula
Glenoid cavity
-Shallow
-Concave
-Oval Fossa
Glenoid cavity
Distal end :
-Trochlea
-capitulum
-olecranon
-coronoid
-radial fossae
Condyle of humerus
-A lateral capitulum articulating with the head of the radius
-medial trochlea for articulation with the trochlear notch of the ulna
2 Articular surfaces
Superior to the trochlea anteriorly and receives the coronoid process of the ulna during full flexion of the elbow
Coronoid fossa
Posteriorly it accommodates the olecranon of the ulna during extension of the elbow
Olecranon fossa
Accommodates the edge of the head of the radius when the elbow is fully flexed
Radial fossa
Flexor muscle paralysis resulting in weak flexion of elbow and supination of forearm and loss of sensation
Musculocutaneous nerve injury
Distal Radius fracture is the most common of the forearm from forced dorsiflexion of hand and ulnar styloid process is avulsed
Colles fracture
Shaft fracture from direct blow
Transverse fractures
Fracture to distal part of humerus near supraepicondylar ridges
Supracondylar fracture
Fracture to distal part of humerus near supraepicondylar ridges
Supracondylar fracture
A posterior angulation occurs in the forearm proximal to wrist and the normal anterior curvature of the relaxed hand due to tilt of distal fragment of radius
Dinner fork deformity
Hold scapula to thoracic wall so other muscles can use it for as a fix bone for the humorous
Serratus anterior
The thoracic nerve is damaged and the medial border and inferior angle of the the scapula pull markedly away from the posterior thoracic wall. No abduction above horizontal position due to lack of Glenoid cavity superiorly
Winged scapula
Rotator cuff muscles
Glenohumeral joint
C5 & C6
Superior trunk
C7
Middle trunk
C8 & T1
Inferior trunk
Superior trunk injury with neck and shoulder cause limb hanging by the side in medial rotation
Waiter’s tip position
Flexors:
Biceps brachii
Brachialis
Coracobrachialis (pierced) c5 c6 c7
Anterior Middle & Superior trunk
Musculocutaneous nerve
Extensor & supinator:
Brachioradialis (elbow)
Triceps brachii c6 c7 c8
Posterior division of 3 trunks
Descends inferolaterally with the profunda brachii artery and curves around the humeral shaft in the radial groove
Radial nerve
So long to pinky here comes the thumb
Scaphoid lunate triquetrium pisiform hamate capitate trapezoid trapezium
Anterior flexor
Anterior division
Posterior flexor
Posterior division
Landmark for brachial plexus cord names
Formed by the basilic & brachial vein (both have valves
Axillary artery
Broad band passing from the lesser to greater tubercle and converts the intertubercular groove into a canal for the tendon of the long head of the biceps
Transverse humeral ligament
Triangular membranous band running from the biceps tendon across the cubital fossa and merges with the antebrachial fascia covering the flexor muscles in the medial side of the forearm
Bicipital aponeurosis
Radial c7 c8 T1
Anconeus
Main supply of arm and is the continuation of axillary artery.
Breaks into radial & ulnar arteries at the cubital fossa
Brachial artery
Pofunda brachii artery
Superior & inferior ulnar collateral arteries
Main branches of the brachial artery
-Supply articular branches to the elbow joint with the median (c8 & T1)
-Passes posteriorly to the medial epicondyle of the humerus to enter the forearm
Ulnar nerve
Paralysis of triceps, brachioradialis, supinator, and extensor muscles of the wrist and fingers and loss of sensation
Superior radial nerve injury
Triceps are partially paralyzed on medial head while the other posterior muscles are never paralyzed (wrist and metacarpophalangeal joint drop due to unopposed tonus of flexion)
Radial groove radial nerve injury
Innervate Flexors & pronators of forearm with ulnar nerve (anterior medial & lateral cord)
Median nerve
Thickening of the antebrachial fascia of flexor muscles
Flexor retinaculum & palmar carpal ligament
Origin via flexor tendon to medial epicondyle:
Pronator teres
flexor carpi radialis
palmaris longus
Flexor carpi ulnaris
Superficial muscle layer
Flexor digitorum superficialis (metacarpophalangeal & wrist joints)
Intermediate layer
Flexor digitorum profundus (metacarpophalangeal & wrist joints)
Flexor pollicis longus
Pronator quadratus
The only layer not crossing the elbow joint
Deep layer
Prime mover of pronation (median nerve c8 T1)
Pronator quadratus
Extensor digitorum
Extensor indicis
Extensor digiti minimi (posterior interosseous nerve c7 c8 continuation of radial)
Muscles extending medial 4 digits
Snuff box housing radial artery:
Abductor pollicis longus
Extensor pollicis brevis
Extensor pollicis longus
Muscles extending or abducting thumb
Extensor carpi radialis longus
Extensor carpi radialis brevis
Extensor carpi ulnaris
Muscles extending & abducting or adducting hand or wrist
-Prevents bowstringing of the tendons when the hand is extended at the wrist joint
-synovial tendon sheath pass over dorsum to reduce friction for the tendons
Extensor retinaculum
Extensor tendon attaching to Lateral epicondyle:
ECRB
EDM
ECU
Extensor digitorum
4 superficial extensors
Where the proximal attachment of the brachioradialis & ECRL superficial extensors
Lateral supraepicondylar ridge
Major branch of median nerve between heads of Pronator teres and deep to FDS
Anterior interosseous nerve
Pierces the supinator then winds around the lateral aspect of the neck of the radius and enters the posterior compartment to form posterior interosseous nerve
Deep branch of radial nerve
Between FCR & APL
Pulsation of radial artery
Lateral side of FCU
Pulsation of ulnar artery
Levator scapular & rhombus
Deep posterior axioappendicular muscles
Assist the deltoid in the 1st 15 degrees of abduction of the arm
Supraspinatus
C5 c6
Axillary nerve
The pyramidal compartment inferior to the glenohumeral joint present in fully abducted shoulder joint and provides vessel pathway to upper limb
Axilla
The only branch of the 1st part Axillary artery has bordering the median border of pectoralis minor lateral of 1st rib
Superior thoracic artery
Posterior to pectoralis minor diverge to thoracoacromial & lateral thoracic artery
2nd part of Axillary
Extends from the lateral border of the pectoralis minor to the inferior border of the teres minor and has 3 branches
3rd part of Axillary
Largest branch of the Axillary artery. Opposite of the artery, the anterior circumflex humeral artery & posterior circumflex humeral artery arise
Subscapular artery
Formed by the union of the accompanying brachial veins & the basilic vein at the inferior border of the teres major. Becomes the subclavian vein at 1st rib
Axillary vein
Receive lymph from the other Axillary lymph nodes and drain into supraclavicular nodes and then into the subclavian lymphatic trunk
Apical lymph nodes
Where subclavian drains on the right side
Right lymphatic duct
Where the subclavian drains on the left side
Thoracic duct
A gap where the subclavian artery and brachial plexus passes through
Anterior and middle scalene muscles
Dorsal scapular nerve,
long thoracic nerve,
suprascapular nerve,
nerve to subclavius
4 branches of supraclavicular part
Ventral aspect of limb bud, simple segment arrangement
5th week of development
-Short intrinsic / interosseous muscles of hand affected by injured inferior trunk (c8 & T1) ulnar nerve in distal forearm
-unopposed action of the extensors & FDP
Claw hand
Rare injury to inferior parts of brachial plexus c8-t1
-this is claw hand
Klumpke paralysis
Injury to superior branch c5-c6
Erb-Duchenne palsy
upper arm with:
-adducted shoulder
-medially rotated arm
-extended elbow
Erb-Duchenne palsy
Waiter’s tip position on