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ANAT 315 > Chapter Four: The Upper Limb > Flashcards

Chapter Four: The Upper Limb Flashcards

1
Q

The axilla

A

-space between the upper rib cage and the humerus
-the armpit

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2
Q

Inside the axilla

A

-blood vessels, nerves, and fat

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3
Q

Walls of the axilla

A

-lateral wall
-medial wall
-posterior wall
-anterior wall

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4
Q

Lateral wall of the axilla

A

-bicipital groove

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5
Q

Medial wall of the axilla

A

-serratus muscle (sits over ribs)

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6
Q

Posterior wall of the axilla

A

-subscapularis muscle

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7
Q

Anterior wall of the axilla

A

-2 pectoralis muscles

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8
Q

Labelling of axilla walls

A
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9
Q

Arteries of the Axilla

A

-arterial trunk passes downward through axilla and name changes as it goes through
-subclavian artery: while passing under clavicle
-axillary artery: sends 3 branches to main axillary walls and supplies deltoid muscle via the posterior humeral circumflex artery
-brachial artery: when blood vessel leaves the axilla

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10
Q

Branches of the axillary artery

A

-lateral thoracic artery (to medial wall)
-thoracoacromial artery (to anterior wall)
-subscapular artery (to posterior wall)

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11
Q

Axillary artery labelling

A
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12
Q

Veins and lymph nodes of the axilla

A

-venae comitantes (veins that accompany), empty in subclavian vein
-also several groups of interconnected lymph nodes (pathway in spread of cancer to upper limbs from the breast)

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13
Q

The brachial plexus number of roots, trunks etc..

A

-roots: 5
-trunks: 3
-divisions: 6
-cords: 3
-branches: 5

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14
Q

Brachial plexus roots

A

-c5, c6, c7, c8, t1

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15
Q

Brachial plexus trunks

A

-upper, middle, lower

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16
Q

Brachial plexus divisions

A

-strike and a spare

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17
Q

Brachial plexus cords

A

-lateral, posterior, medial

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18
Q

Brachial plexus branches (nerves)

A

-axillary
-radial
-musculocutaneous
-median
-ulnar

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19
Q

Brachial plexus labelling

A
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20
Q

Axillary nerve

A

-c5 and c6
-goes to top of arm (deltoid)
-abduction of shoulder

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21
Q

Musculocutaneous nerve

A

-c5, c6, c7
-goes to top muscles in the arm

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22
Q

Ulnar nerve

A

-c8 and t1
-goes to lower part of arm and hand

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23
Q

Median nerve

A

-c5-8 and t1 (all roots)

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24
Q

Radial nerve

A

-c5-8 and t1 (all roots)
-biggest one

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25
Q

Somatotopism

A

-upper, middle, and lower innervations usually stay consistent throughout whole arm

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26
Q

Dorsal scapular nerve (minor)

A

-c5
-to rhomboid major and minor

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27
Q

Suprascapular nerve (minor)

A

-c5 and c6
-to rotator cuff muscles
-abduction of shoulder
-suprapinatus

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28
Q

Upper and Lower subscapular nerve (minor)

A

-c5 and c6
-rotator cuff muscles

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29
Q

Lateral pectoral nerve (minor)

A

-c5, c6, and c7
-goes to pectoralis major

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30
Q

Long thoracic nerve

A

-c5, c6, and c7
-goes to serratus anterior

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31
Q

Thoracodorsal nerve (minor)

A

-c6, c7, and c8
-goes to latissimus dorsi

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32
Q

Medial pectoral nerve (minor)

A

-c8 and t1
-goes to pectoralis major and minor

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33
Q

Medial cutaneous nerve of the arm and forearm (minor)

A

-c8 and t1
-cutaneous sensation of the arm and forearm

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34
Q

The scapula position

A

-sits between t2 and t7

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35
Q

The scapula borders and angles

A

-superior border
-medial border
-lateral border
-superior angle
-inferior angle
-lateral angle

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36
Q

Glenoid fossa of scapula

A

-articulates with the head of the humerus

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37
Q

Suprascapular notch

A

-where blood vessels and nerves run through

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38
Q

Coracoid process

A

-in the lateral angle

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39
Q

Spine of the scapula

A

-posterior ridge
-turns into the acromion

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40
Q

Acromion

A

-forms the point of the shoulder
-forms acromioclavicular joint

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41
Q

Subscapular fossa

A

-anterior face (slightly concave)
-subscapularis muscle originates here

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42
Q

Infraspinous fossa

A

-below spine
-posterior face (slightly concave)

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43
Q

Supraspinous fossa

A

-depression above the spine
-posterior face (slightly concave)

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44
Q

Clavicle ends

A

-roundish end (articulates with sternum at sternoclavicular joint)
-flatish end (articulates with scapula at acromioclavicular joint)
-this connection is the only articular attachment of the upper limb to the axial skeleton

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45
Q

Proximal humerus head

A

-articulates with glenoid fossa forming the shoulder joint (glenohumeral joint)

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46
Q

Proximal humerus neck(s)

A

-anatomical neck: located right under the head
-surgical neck: located further down and is where most fractures occur

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47
Q

Proximal humerus labelling

A
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48
Q

Muscles attaching the axial skeleton to the scapula

A

-serratus anterior
-trapezius
-levator scapula
-the rhomboids (major and minor)

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49
Q

Serratus anterior

A

-origin: upper 9 ribs
-insertion: medial border of scapula
-protraction (pulls scapula forward) and upward rotation of glenoid fossa
-innervated by long thoracic nerve (c8 & t1)

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50
Q

Trapezius

A

-origin: occipital bone
-insertion: scapula (clavicle and acromion)
-there is an upper, middle and lower aspect
-upper and lower fibres elevate shoulder and rotate glenoid fossa upwards
-middle fibres depress shoulder and also rotate glenoid fossa upwards
-innervated by cranial nerve 9 (spinal accessory nerve)

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51
Q

Levator Scapula

A

-origin: transverse processes of c1-c4
-insertion: upper medial border of scapula
-elevation of scapula and depression of glenoid fossa
-innervated by branches of nerves c3 and c4

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52
Q

The rhomboids (major)

A

-origin: spinous processes of t2-t5
-insertion: lower third of medial scapular border
-elevate and retract the scapula and aid in depressing glenoid fossa
-innervated by dorsal scapular nerve (c5)

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53
Q

The rhomboids (minor)

A

-origin: ligamentum nuchae and spinous processes of c7 and t1
-insertion: middle of the medial border of the scapula
-elevate and retract the scapula and aid in depressing glenoid fossa
-innervated by dorsal scapular nerve (c5)

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54
Q

Muscles attaching the axial skeleton to the humerus

A

-latissimus dorsi
-pectoralis major
-pectoralis minor

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55
Q

Latissimus dorsi

A

-origin: ilium
-insertion: bicipital groove of the humerus
-powerful extensor, adductor and medial rotator
-innervated by thoracododorsal nerve

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56
Q

Pectoralis major

A

-origin: clavicular head (at clavicle) and costal head (at ribs)
-insertion: lateral lip of bicipital groove on humerus
-adducts, flexes and medially rotates the arm
-innervated by medial and lateral pectoral nerves

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57
Q

Pectoralis minor

A

-origin: ribs 3-5
-insertion: coracoid process of the scapula
-stabilize and pull upward and forward on the rib cage
-innervated by the medial pectoral nerve

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58
Q

Muscles attaching the girdle to the humerus

A

-deltoid
-teres major
-rotator cuff (subscapularis, supraspinatus, infraspinatus, teres minor)

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59
Q

Deltoid

A

-origin: on distal clavicle to acromion and spine of scapula
-insertion: deltoid tuberosity
-anterior fibres flex, middle fibres abduct and posterior fibres extend
-innervated by axillary nerve

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60
Q

Teres major

A

-origin: lower back
-insertion: medial lip of occipital groove
-extends, abducts and medially rotates the arm
-innervated by lower subscapular nerve

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61
Q

Rotator cuff muscles

A

-subscapularis
-infraspinatus
-supraspinatus
-teres minor

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62
Q

Subscapularis

A

-origin: subscapular fossa of scapula
-insertion: lesser tubercle of humerus
-medial rotator and adductor
-innervated by subscapular nerve

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63
Q

Supraspinatus

A

-origin: supraspinous fossa of scapula
-insertion: top facet of greater tubercle
-abduction
-innervated by suprascapular nerve

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64
Q

Infraspinatus

A

-origin: infraspinous fossa of scapula
-insertion: middle facet of greater tubercle
-laterally rotates the humerus
-innervated by suprascapular nerve

65
Q

Teres minor

A

-origin: lower lateral border of scapula
-insertion: inferior facet of greater tubercle
-lateral rotator
-innervated by axillary nerve

66
Q

Muscles attaching to bicipital groove

A

-lateral lip: pectoralis major
-medial lip: teres major
-floor: latissimus dorsi

67
Q

Glenohumeral (shoulder) joint

A

-synovial, triaxial, ball and socket joint
-flexion/extension, abduction/adduction, medial/lateral rotation
-weak but mobile joint

68
Q

Labrum

A

-lip of fibrocartilage around the perimeter of the glenoid fossa

69
Q

Capsule and ligaments of the glenohumeral joint

A

-capsule: extremely loose
-coracoacromial ligament
-coracohumeral ligament: only strong one
-coracobrachialis
-biceps brachii
-pectoralis minor
-coracoclavicular ligament

70
Q

Blood and nerve supply of the glenohumeral joint

A

-most of arteries come from the axillary artery
-brachial plexus

71
Q

Scapulo-thoracic joint

A

-basically just the scapula moving around
-performs elevation, depression, protraction, and retraction of the scapula

72
Q

Muscles that move the scapula

A

-elevators: rhomboids, levator scapula, upper trapezius
-depressors: lower trapezius
-upward rotation: upper trapezius, serratus anterior
-downward rotation: levator scapula, rhomboids

73
Q

Sternoclavicular joint

A

-very strong joint (usually only damaged in car accident, fibrocartilage disc)
-synovial joint between the clavicle and manubrium
-only joint connecting the upper limbs to the rest of the skeleton
-contains costoclavicular and sternoclavicular ligament
-permits quite a range of circumduction

74
Q

Costoclavicular ligament

A

-reinforces the sternoclavicular joint
-runs up from first rib to proximal clavicle

75
Q

Sternoclavicular ligament

A

-reinforces the sternoclavicular joint

76
Q

Acromioclavicular joint

A

-easily damaged joint (separated shoulder)
-contains a small fibrocartilage disc
-reinforced with coracoclavicular ligament
-coracoacromial ligament limits the movement of the shoulder joint

77
Q

Distal humerus labelling

A

-look in book on page 62

78
Q

Radial nerve (proximal humerus)

A

-occupies spiral groove as it passes distally to the arm

79
Q

Radius and ulna labelling

A

-look in book on page 63

80
Q

Radial tubercle

A

-insertion for biceps brachii

81
Q

Radial notch

A

-contains hyaline cartilage

82
Q

Anterior compartment of the arm

A

-coracobrachialis
-brachialis
-biceps brachii
-all these muscles are innervated by the musculocutaneous nerve

83
Q

Coracobrachialis

A

-origin: coracoid process
-insertion: half way down the medial side of the humerus
-minor adductor
-innervated by musculocutaneous nerve

84
Q

Brachialis

A

-origin: flat surface of distal humerus
-insertion: ulnar tubercle
-powerful elbow flexor
-innervated by musculocutaneous nerve

85
Q

Biceps Brachii

A

-2 heads (2 origins): long head and a short head
-long head origin: supraglenoid tubercle
-short head origin: coracoid process
-insertion: radial tubercle
-innervated by musculocutaneous nerve
-powerful flexor and supinator

86
Q

Radial aponeurosis

A

-thin tendon that fans out over biceps and does not attach to bone

87
Q

Posterior compartment of the arm

A

-triceps brachii
-innervated by radial nerve

88
Q

Triceps brachii

A

-3 heads(3 origins): long, medial and lateral head
-long head origin: infraglenoid tubercle
-medial head origin (deep): lower part of shaft of humerus
-lateral head origin: proximal humerus
-insertion: connect into aponeurosis which insert on olecranon of ulna
-innervated by radial nerve
-extensor of elbow joint

89
Q

The elbow joint

A

-classification: synovial, uniaxial and hinge
-movements: flexion and extension only

90
Q

Bones involved in the elbow joint

A

-proximal head of radius articulates with capitulum of the humerus
-trochlear notch of ulna articulates with trochlea of the humerus

91
Q

Muscles acting on the elbow joint

A

-flexors: brachialis, biceps brachii, and brachioradialis
-extensor: triceps brachii

92
Q

Capsule of the elbow joint

A

-joint capsule covers elbow joint and proximoradioulnar joint
-fibrous capsule extends just a bit further than the synovial capsule

93
Q

Ligaments of the elbow joint

A

-annular ligament: holds radius and ulna together
-medial collateral (ulnar) ligament: fan shaped, runs from medial epicondyle and fans out onto ulna
-lateral collateral (radial) ligament: thiner and cord like, comes from lateral epicondyle and goes into annular ligament
-both ligaments prevent adduction and abduction of the elbow

94
Q

Blood and nerve supply of the elbow joint

A

-radial and ulnar arteries
-ulnar nerve (funny bone) and brachial plexus passes in front of it

95
Q

Bursae

A

-small synovial, fluid filling capsules that are found in areas where there could be friction

96
Q

Forearm bones

A

-between the borders of the radius and ulna, there is a interosseous membrane which divides the forearm into an anterior (flexor) compartment and a posterior (extensor) compartment

97
Q

Labelling of forearm

A

-on page 72

98
Q

Styloid process

A

-distal projection from ulna and radius

99
Q

Ulnar notch

A

-on the distal radius

100
Q

Pronation and supination of the forearm

A

-the ulna cannot rotate, so the head of the radius rotates in the annular ligament, causing the distal radius to rotate around the head of the ulna

101
Q

Carpal bones

A

-pisiform
-triquetral
-lunate
-scaphoid
-hamate
-capitate
-trapezoid
-trapezium

102
Q

Labelling of the carpal bones

A

-on page 73

103
Q

Carpal tunnel

A

-the carpal bones are not flat
-they form an anterior concavity
-this forms the posterior and side walls of the carpal tunnel through which pass tendons and nerves to the palm of the hand

104
Q

Metacarpals

A

-bones of the palm of the hand
-they are labelled 1-5 starting at the thumb
-base of each metacarpal articulates with wrist or carpal bones
-head of each articulates with the proximal phalanges resulting in the metacarpophalangeal joints

105
Q

Phalanx

A

-each finger has a proximal, middle and distal phalanx
-they articulate at the knuckles with the metacarpals and with eachother at the interphalangeal
-these joints only allow flexion and extension

106
Q

Anterior forearm muscles (flexor division)

A

-superficial group
-intermediate group
-deep group

107
Q

Superficial group (anterior)

A

-pronator teres
-flexor carpi radialis
-palmaris longus
-flexor carpi ulnaris

108
Q

Intermediate group (anterior)

A

-flexor digitorum superficialis

109
Q

Deep group (anterior)

A

-flexor pollicis longus
-flexor digitorum profundus
-pronator quadratus

110
Q

Pronator teres (superficial)

A

-origin: CFO
-insertion: about halfway down down on lateral side of the shaft of the radius
-innervated by median nerve
-pronates the forearm and flexes the elbow

111
Q

Flexor carpi radialis (superficial)

A

-origin: CFO
-insertion: bases of metacarpals 2 and 3
-innervated by median nerve
-wrist flexor and abductor

112
Q

Palmaris longus (superficial)

A

-pretty useless
-origin: CFO
-insertion: thick superficial fascia in the palm
-innervated by median nerve
-weak wrist flexor

113
Q

Flexor carpi ulnaris (superficial)

A

-origin: CFO
-insertion: pisiform
-innervated by the ulnar nerve
-flexes and adducts the wrist

114
Q

Flexor retinaculum

A

-fibrous bridge that crosses from the medial to lateral side of the wrist bones
-form the roof of the carpal tunnel

115
Q

Flexor digitorum superficialis (intermediate)

A

-comprised of 4 tendons, one for each finger
-origin: line running from the medial epicondyle, across the coronoid process of the ulna and to a line on the anterior radius
-insertion: middle phalanx of each finger
-innervated by the median nerve
-flexion of the wrist, flexion of the metacarpal-phalangeal joint, and flexion of the proximal-interphalangeal joint

116
Q

Flexor pollicis longus (deep)

A

-origin: middle part of the radius and interosseous membrane
-insertion: base of distal phalanx of the thumb
-flexes the thumb

117
Q

Flexor digitorum profundus (deep)

A

-origin: proximal third quarter of the ulnar shaft and interosseous membrane
-insertion: distal interphalangeal joints of each finger (goes through split of superficial tendons that run here)
-deep muscle that flexes fingers

118
Q

Pronator Quadratus (deep)

A

-rectangular muscle
-origin: on the ulna
-insertion: on the radius
-innervated by both median and ulnar nerve
-pronates and supinates the wrist

119
Q

The carpal tunnel

A

-formed by the concavity of the wrist bones and by the flexor retinaculum bridging across the top
-structures that do not pass through: palmaris longus tendon, flexor carpi ulnaris tendon, ulnar nerve and artery, radial artery, and flexor carpi radialis tendon
-structures that do pass through: flexor digitorum superficialis tendons (4), flexor digitorum profundus tendons (4), flexor pollicis longus tendon, median nerve

120
Q

Carpal tunnel labelling

A

-on page 79

121
Q

Posterior forearm muscles (extensor group)

A

-superficial group
-deep group

122
Q

Superficial group (posterior)

A

-brachioradialis
-extensor carpi radialis longus
-extensor carpi radialis brevis
-extensor digitorum and extensor digiti minimi

123
Q

Brachioradialis (superficial)

A

-origin: supracondylar ridge
-insertion: styloid process of the radius
-innervated by the radial nerve
-flexes the elbow joint (exception of the group)

124
Q

Extensor carpi radialis longus (superficial)

A

-origin: CEO
-insertion: base of the second metacarpal
-innervated by the radial nerve
-extends the wrist on radial side

125
Q

Extensor carpi radialis brevis (superficial)

A

-origin: CEO
-insertion: base of third metacarpal
-innervated by radial nerve
-extend and abducts the wrist

126
Q

Extensor digitorum and extensor digiti minimi (superficial)

A

-origin: CEO
-insertion: back of each distal phalanx
-innervated by radial nerve
-extensor of all 4 fingers

127
Q

Common extensor hoods

A

-run along the posterior of each finger and all of the extensor muscles insert onto them
-extension is all or nothing

128
Q

Extensor carpi ulnaris (superficial)

A

-origin: CEO
-insertion: base of fifth metacarpal
-innervated by radial nerve
-extends and adducts the wrist

129
Q

Deep group (posterior)

A

-supinator
-the outcropping muscles (abductor pollicis longus, extensor pollicis brevis, extensor pollicis longus, extensor indicis)

130
Q

Supinator (deep)

A

-origin: back of the radial notch of the ulna and the lateral epicondyle
-insertion: lateral side of the radius
-low resistance supination

131
Q

Abductor pollicis longus (outcropping)

A

-origin: ?
-insertion: base of first metacarpal
-abducts

132
Q

Extensor pollicis brevis (outcropping)

A

-origin: ?
-insertion: base of the proximal phalynx of the thumb
-extends

133
Q

Extensor pollicis longus (outcropping)

A

-origin: distal to abductor pollicis
-insertion: posterior distal phalanx of the thumb
-extends

134
Q

Extensor indicis (outcropping)

A

-origin: next to the short extensor of the thumb
-insertion: extensor expansion of the index finger
-extends

135
Q

Anatomical snuff box

A

-when u pull back thumb into hitchhiker position, there is a hollow space between the tendons of the extensor pollicis longus and brevis

136
Q

The joints of the forearm

A

-proximal
-middle
-distal

137
Q

Proximal joint of the forearm

A

-the synovial joint between head of the radius and the radial notch of the ulna
-head of radius rotates in radial notch
-held in place by the annular ligament
-this allows pronation and supination

138
Q

Middle joint of the forearm

A

-the interosseous membrane
-holds radius to the ulna

139
Q

Distal joint of the forearm

A

-synovial joint that pivots when the head of the ulna rotates in the ulna notch of the radius
-this is held in place by an articular disc
-this allows for pronation and supination

140
Q

The wrist joint

A

-biaxial, synovial joint
-flexion, extension, abduction, adduction and circumduction
-distal radius articulates with the scaphoid and lunate bones
-ulna is separated from the carpal bones via a disc
-medial and lateral collateral ligaments and palmar and dorsal radiocarpal ligaments hold it together
-innervated by the median, ulnar and radial nerves

141
Q

Muscles of the hand

A

-thenar muscles
-hypothenar muscles
-lumbrical muscles
-interossei and adductor pollicis

142
Q

Thenar muscles

A

-abductor pollicis brevis
-flexor pollicis brevis
-opponens pollicis

143
Q

Abductor pollicis brevis (thenar)

A

-origin: scaphoid bone and flexor retinaculum
-insertion: outside of the proximal phalanx of the thumb
-innervated by median nerve
-abducts

144
Q

Flexor pollicis brevis (thenar)

A

-origin: flexor retinaculum and trapezium
-insertion: base of the proximal phalanx
-innervated by median nerve
-flexes

145
Q

Opponens pollicis

A

-origin: distal flexor retinaculum and trapezium
-insertion: side of the metacarpal (thumb)
-innervated by median nerve
-opposition (touch each finger tip with your thumb)

146
Q

Hypothenar muscles

A

-abductor digiti minimi
-flexor digiti minimi brevis
-opponens digiti minimi brevis

147
Q

Abductor digiti minimi

A

-origin: pisiform and the hook of the hamate
-insertion: medial side of the proximal phalanx
-innervated by ulnar nerve
-abducts

148
Q

Flexor digiti minimi brevis

A

-origin: pisiform and the hook of the hamate
-insertion: lateral to the abductor digiti minimi
-innervated by the ulnar nerve
-flexes

149
Q

Opponens digiti minimi brevis

A

-origin: flexor retinaculum and the hook of the hamate
-insertion: medial side of metacarpal 5
-innervated by the ulnar nerve
-does not perform opposition

150
Q

Lumbrical muscles

A

-origin: thumb (lateral) side of all 4 tendons
-insertion: pass around lateral side of each finger and joins extensor expansion as it runs along the proximal phalanx
-medial 2 lumbricals are innervated by the ulnar nerve and the lateral 2 are innervated by the median nerve
-they flex the metacarpophalangeal joints and extend the interphalangeal joints

151
Q

Adductor pollicis

A

-has an oblique head and a transverse head
-oblique head origin: capitate, trapezoid and adjoining metacarpals 2&3
-transverse head origin: shaft of the middle metacarpal
-insertions: medial sesamoid bone on the base of the proximal phalanx of the thumb
-innervated by the ulnar nerve
-adducts the thumb

152
Q

Palmar interossei (3)

A

-origin: axial side of metacarpals 2, 4 and 5
-insertion: extensor expansion of their own digits
-innervated by ulnar nerve
-flex the MP joints and extend the IP joints

153
Q

Dorsal interossei (4)

A

-origin: in the 4 spaces between the 5 metacarpals
-insertion: the 2 outer ones insert on index and ring fingers by the way of extensor expansion, and the middle 2 insert on each side of the middle finger (also on extensor expansion)
-innervated by the ulnar nerve
-abduct the fingers and flex the MP joints and extend the IP joints

154
Q

Blood supply to the hand

A

-comes from radial and ulnar arteries
-superficial and deep palmar arches connect the 2 arteries together

155
Q

Innervation of the hand

A

-labelling on page 95

156
Q

Carpal joints of the hand

A

-carpal bones are joined to each other by synovial joints

157
Q

Carpometacarpal joints of the hand

A

-only the articulation between the joint at the base of the thumb permits much movement (saddle joint between trapezium and metacarpal 1)

158
Q

Metacarpal-phalangeal joints of the hand

A

-MP joint
-only permits flexion and extension
-each joint has a pair of collateral ligaments

159
Q

Interphalangeal joints of the hand

A

-IP joints
-there are 9, 4 pairs in the fingers and 1 in the thumb
-have strong collateral ligaments preventing abduction and adduction

ANAT 315 (5 decks)

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