Chapter Four: The Upper Limb Flashcards

1
Q

The axilla

A
  • space between the upper rib cage and the humerus
  • the arm pit
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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

Arteries of the axilla: arterial trunk

A
  • passes downwards though axilla and name changes as it goes through
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9
Q

arteries of the axilla: subclavian artery

A
  • passes under the clavicle and enters the apex of the axilla
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10
Q

arteries of the axilla: axillary artery

A
  • sends three branches to the main axillary walls
  • supplies deltoid muscle via the posterior humeral circumflex artery
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11
Q

arteries of the axilla: brachial artery

A
  • when blood vessel leaves the axilla
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12
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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13
Q

Veins of axilla

A

Venae comitantes: veins that accompany
- group of two or three veins
- travel in the axillary sheath
- empty into the subclavian vein

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14
Q

Lymph nodes of axilla

A
  • several groups of interconnected lymph nodes
  • pathway in the spread of cancer from the upper limbs from the breast
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15
Q

the brachial plexus number of roots, trunks, etc.

A
  • (5) roots
  • (3) trunks
  • (6) divisions
  • (3) cords
  • (5) branches
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16
Q

brachial plexus: roots

A
  • C5
  • C6
  • C7
  • C8
  • T1
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17
Q

brachial plexus: trunks

A
  • upper, middle, lower
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18
Q

brachial plexus: divisions

A
  • anterior and posterior
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19
Q

brachial plexus: cords

A
  • lateral cord, medial cord, posterior cord
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20
Q

brachial plexus: branches (nerves)

A
  • radial nerve
  • axillary nerve
  • musculotaneous nerve
  • ulnar nerve
  • median nerve
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21
Q

brachial plexus nerves: radial nerve

A
  • biggest nerve
  • comes from C5-C8 and T1 (all roots)
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22
Q

brachial plexus nerves: axillary nerve

A
  • comes from C5 and C6
  • goes to top of arm (deltoid)
  • abduction of shoulder
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23
Q

brachial plexus nerves: musculocutaneous nerve

A
  • comes from C5, C6, C7
  • goes to top muscles in the arm
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24
Q

brachial plexus nerves: ulnar nerve

A
  • comes from C8 and T1
  • goes to lower part of arm and hand
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25
Q

brachial plexus nerves: median nerve

A
  • comes from C5-C8 and T1 (all roots)
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26
Q

somatotopism

A
  • upper, middle and lower innervations usually stay consistent throughout whole arm
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27
Q

minor nerves: dorsal scapular nerve

A
  • comes from C5
  • goes to rhomboid major and minor
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28
Q

minor nerves: long thoracic nerve

A
  • comes from C5, C6, C7
  • goes to serratus anterior
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29
Q

minor nerves: suprascapular nerve

A
  • comes from upper trunk C5 and C6
  • goes to rotator cuff muscles
  • abduction of shoulder
  • supraspinatus
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30
Q

minor nerves: lateral pectoral nerve

A
  • comes from C5, C6, C7
  • goes to pectoralis major
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31
Q

minor nerves: upper and lower subscapular nerve

A
  • comes from C5 and C6
  • subscapularis and teres major (rotator cuff muscles)
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32
Q

minor nerves: thoracodorsal nerve

A
  • comes from C6, C7 and C8
  • goes to latissimus dorsi
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33
Q

minor nerves: medial pectoral nerve

A
  • comes from C8 and T1
  • goes to pectoralis major and minor
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34
Q

minor nerves: medial cutaneous nerve of the arm and forearm

A
  • comes from C8 and T1
  • cutaneous sensation of the arm and forearm
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35
Q

position of scapula

A
  • sits between T2 and T7
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36
Q

borders of scapula

A
  • superior border
  • medial border
  • lateral border
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37
Q

angles of scapula

A
  • superior angle
  • inferior angle
  • lateral angle
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38
Q

glenoid fossa of scapula

A

articulates with the head of the humerus

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39
Q

suprascapular notch

A

where blood vessels and nerves run through

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40
Q

coracoid process

A

in the lateral angle

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41
Q

spine of the scapula

A
  • posterior ridge
  • turns into the acromion
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42
Q

acromion

A
  • forms the point of the shoulder
  • forms acromioclavicular joint
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43
Q

subscapular fossa

A
  • anterior face (slightly concave)
  • subscapularis muscle originates here
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44
Q

infraspinous fossa

A
  • below the spine
  • posterior face (slightly concave)
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45
Q

supraspinous fossa

A
  • depression above the spine
  • posterior face (slightly concave)
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46
Q

clavicle ends: round end

A
  • articulates with sternum at sternoclavicular joint
47
Q

clavicle ends: flat end

A
  • articulates with scapula at acromioclavicular joint
  • this connection is the only articular attachment of the upper limb to the axial skeleton
48
Q

proximal humerus head

A
  • articulates with glenoid fossa forming the shoulder joint (glenohumeral joint)
49
Q

proximal humerus neck(s)

A

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

50
Q

muscles attaching the axial skeleton to the scapula

A
  • serratus anterior
  • trapezius
  • levator scapula
  • the rhomboids (major and minor)
51
Q

serratus anterior: origin and insertion

A

origin: upper 9 ribs
insertion: medial border of scapula

52
Q

serratus anterior: protraction and innervation

A

protraction: pulls scapula forward and upward rotation of glenoid fossa
innervated: by long thoracic nerve (C8 and T1)

53
Q

trapezius: origin and insertion

A

origin: occipital bone
insertion: scapula (clavicle and acromion)

54
Q

trapezius: fibres and innervation

A
  • upper, middle and lower aspect
  • upper and lower fibres elevate shoulder and rotate glenoid fossa upwards
  • middle fibres depress shoulder and rotate glenoid fossa upwards
  • innervated by cranial nerve 9 (spinal accessory nerve)
55
Q

levator scapula: origin and insertion

A

origin: transverse processes of C1-C4
insertion: upper medial border of scapula

56
Q

levator scapula: elevation and innervation

A
  • elevation of scapula and depression of glenoid fossa
  • innervated by branches of nerves C3 and C4
57
Q

rhomboids major: origin and insertion

A

origin: spinous processes of T2 - T5
insertion: lower third of medial scapular border

58
Q

rhomboids major: elevation and innervation

A
  • elevate and retract the scapula and aid in depressing glenoid fossa
    -innervated by dorsal scapular nerve (c5)
59
Q

rhomboids minor: origin and insertion

A

origin: ligamentum nuchae and spinous processes of c7 and t1
insertion: middle of the medial border of the scapula

60
Q

rhomboids minor: elevation and innervation

A
  • elevate and retract the scapula and aid in depressing glenoid fossa
  • innervated by dorsal scapular nerve (c5)
61
Q

muscles attaching the axial skeleton to the humerus

A
  • latissimus dorsi
  • pectoralis major
  • pectoralis minor
62
Q

lattisimus dorsi: origin and insertion

A

origin: ilium
insertion: bicipital groove of the humerus

63
Q

lattisimus dorsi: role and innervation

A
  • powerful extensor, adductor and medial rotator
  • innervated by thoracododorsal nerve
64
Q

pectoralis major: origin and insertion

A

origin: clavicular head (at clavicle) and costal head (at ribs)
insertion: lateral lip of bicipital groove on humerus

65
Q

pectoralis major: role and innervation

A
  • adducts, flexes and medially rotates the arm
  • innervated by medial and lateral pectoral nerves
66
Q

pectoralis minor: origin and insertion

A

origin: ribs 3-5
insertion: coracoid process of the scapula

67
Q

pectoralis minor: role and innervation

A
  • stabilize and pull upward and forward on the rib cage
  • innervated by the medial pectoral nerve
68
Q

Muscles attaching the girdle to the humerus

A
  • deltoid
  • teres major
  • rotator cuff (subscapularis, supraspinatus, infraspinatus, teres minor)
69
Q

deltoid: origin and insertion

A

origin: on distal clavicle to acromion and spine of scapula
insertion: deltoid tuberosity

70
Q

deltoid: fibres role and innervation

A
  • anterior fibres flex, middle fibres abduct and posterior fibres extend
  • innervated by axillary nerve
71
Q

teres major: origin and insertion

A

origin: lower back
insertion: medial lip of occipital groove

72
Q

teres major: role and innervation

A
  • extends, abducts and medially rotates the arm
  • innervated by lower subscapular nerve
73
Q

rotator cuff muscles

A
  • subscapularis
  • infraspinatus
  • supraspinatus
  • teres minor
74
Q

subscapularis: origin and insertion

A

origin: subscapular fossa of scapula
insertion: lesser tubercle of humerus

75
Q

subscapularis: role and innervation

A
  • medial rotator and adductor
  • innervated by subscapular nerve
76
Q

supraspinatus: origin and insertion

A

origin: supraspinous fossa of scapula
insertion: top facet of greater tubercle

77
Q

supraspinatis: role and innervation

A
  • abduction
  • innervated by suprascapular nerve
78
Q

infraspinatus: origin and insertion

A

origin: infraspinous fossa of scapula
insertion: middle facet of greater tubercle

79
Q

infraspinatus: role and innervation

A
  • laterally rotates the humerus
  • innervated by suprascapular nerve
80
Q

teres minor: origin and insertion

A

origin: lower lateral border of the scapula
insertion: inferior facet of the greater tubercle

81
Q

teres minor: role and innervation

A
  • lateral rotator
  • innervated by the axillary nerve
82
Q

muscles attaching to the bicipital groove

A

lateral lip (crest of the greater tuberosity) : pectoralis major. floor: latissimus dorsi
medial lip (crest of the lesser tuberosity): teres major

83
Q

glenohumeral (shoulder) joint

A
  • synovial, triaxial and ball and socket joint
  • involves flexion/extension, abduction/adduction, medial/lateral rotation
84
Q

bones involved in shoulder joint

A

scapula and humerus

85
Q

labrum

A
  • type of cartilage found in the shoulder joint
  • articular contact is enhanced by a lip of fibrocartilage surrounding perimeter of the glenoid fossa
86
Q

capsule and ligaments of glenohumeral joint

A
  • capsule is loose inferiorly
  • ligaments are weak around the joint
  • coracohumeral is the only strong ligament
87
Q

blood and nerve supply of the glenohumeral joint

A
  • large complex of anastomosis around joint supplying blood
  • most arteries come from the axillary artery
  • branches of the nerves that cross the joint innervate it
88
Q

scapulo-thoracic joint

A
  • increases mobility and flexibility of the shoulder joint
  • basically the scapula moving around
  • scapula can be raised (elevated)
  • scapula can be lowered (depressed)
  • scapula can be moved laterally (protraction)
  • scapula can be moved medially (retraction)
89
Q

muscles that move the scapula

A

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

90
Q

sternoclavicular joint

A
  • synovial joint between the clavicle (rounded end) and the manubrium (superior part of sternum)
  • only joint connecting upper limbs to rest of skeleton
  • joint forms from medial end of clavicle fitting into large notch on the manubrium
  • joint permits circumduction
91
Q

sternoclavicular ligament

A
  • smaller and more medial of the two ligaments
  • reinforces the sternoclavicular joint
92
Q

costoclavicular ligament

A
  • larger more lateral of the two ligaments
  • runs up from the first rib to the proximal clavicle
93
Q

acromioclavicular joint

A
  • joint is easily damaged (separated shoulder)
  • articulation of the distal clavicle with the medial facing part of the acromion process on the scapula
  • contains small fibrocartilage disc
  • reinforced by the coracoclavicular ligament
94
Q

radial nerve (proximal humerus)

A
  • occupies the spiral groove as it passes distally to the arm
95
Q

radius

A
  • proximal radius has circular head
  • held close to the ulna by the annular ligament
96
Q

radial tubercle

A
  • distal to the neck on the medial side of the proximal radius
97
Q

ulna

A
  • proximal ulna gas a forward facing wrench shaped notch called the trochlear notch
  • proximal process is the olecranon process
  • distal process is the coronoid process
98
Q

radial notch

A
  • lateral side of the proximal ulna where the head of radius rotates
99
Q

anterior compartment of the arm

A
  • biceps and brachialis insert into the forearm
  • coracobrachalis inserts onto the humerus
  • all muscles are innervated by the musculocutaneous nerve
100
Q

coracobrachialis

A
  • small muscle originating on the tip of the coracoid process
  • inserting halfway down the medial side of the humerus
  • minor adductor
101
Q

brachialis

A
  • small muscle originating on the flat surface of the distal humerus
  • fibres congregate to insert on the tubercle of the ulna distal to the elbow
  • powerful elbow flexor
102
Q

Biceps Brachii

A
  • powerful flexor and supinator
  • two headed muscle of the arm
  • two heads fuse halfway down the humerus
  • the long head and the short head
    long: originates on small tubercle above the glenoid fossa on the supraglenoid tubercle
    short: originates from the coracoid process
103
Q

radial aponeurosis

A
  • thin tendon
  • fans out medially over the top of the forearm flexors
  • does not insert on a bone
104
Q

posterior compartment of the arm

A
  • extensor compartment
    only one muscle: the three headed triceps branchii and the anconeus muscle
105
Q

aponeurosis

A
  • three heads coalesce on lower part of the bone
  • gives rise to stout tendon
  • crosses behind the elbow to insert on the olecranon of the ulna
  • muscle is the extensor of the elbow joint and is innervated by the radial nerve
106
Q

triceps brachii: origin and insertion

A

origin: infraglenoid tubercle
insertion: on olecranon
- long head originates on the infraglenoid tubercle (small tubercle under the glenoid fossa)
- medial head is deep
- lateral head comes from proximal humerus

107
Q

the elbow joint

A
  • between the arm and forearm bones
  • synovial hinge joint and uniaxial joint
  • movements include flexion and extension only
  • flexion of the biceps and brachialis
  • extension of the triceps
108
Q

bones of the elbow joint

A
  • proximal end of the head of the radius (concave), articulates with the rounded capitulum of the humerus
  • medially, trochlear notch of the ulna grasps the trochlea of the humerus (medial aspect of joint that allows flexion and extension only)
109
Q

muscles of the elbow joint

A

flexors: brachialis, biceps brachii and brachioradialis
extensors: triceps brachii

110
Q

capsule of the elbow

A
  • joint capsule covers the elbow joint and the proximo radioulnar joint
  • distally, capsule lies deep to the annular ligament around the radius
  • attaches to the olecranon of the ulna on the posterior surface
111
Q

ligaments of the elbow

A
  • strong collateral ligaments
  • medial collateral ulnar ligament is fan shaped, running from the medial epicondyle fanning out onto the ulna
  • lateral radial collateral ligament is thinner and cord like
  • comes from lateral epicondyle and goes to annular ligament
  • ligaments prevent abduction of the elbow
112
Q

blood and nerve supply

A
  • innervated by branches from all of the major nerves passing by it
113
Q

bursae

A
  • small synovial, fluid filled capsules that are found in areas where there could be friction
  • several around the elbow