Clinical Anatomy of the Upper Limb Flashcards
What makes up the shoulder girdle
Clavicle/ scapula
Sternoclavicular joint
Acromioclavicular joint
Glenohumeral Joint
What are the bones of the upper limb
Clavicle / scapula Hhumerus Elbow joint Radius/ ulna wrist (radio-carpal joint) Carpus Hand (metacarpals, phalanges etc)
What type of muscle move the shoulder girdle
Superficial (extrinsic) muscles of the back
What is the origin and insertions of the trapezius muscle
Origin: spinous process
Insertions: Occiput and spine of scapula
What nerve innervates the trapezius
Accessory Nerve
What are the functions of the trapezius
Elevates and depresses scapula
retracts scapula
What does the labrum do
It increases capture of the humeral head which in turn increases stability.
Where does a SLAP tear occur
Where the biceps tendon anchors to the labrum
What are the muscles that make up the rotator cuff
Infraspinatous
Supraspinatous
Subscapularis
Teres Minor
What is the function of the rotator cuff
To stabilise the shoulder girdle
They are the muscle that move the arm
What is the origin and insertion of supraspinatous
Origin: Suprasinous fossa
Insertion: Greater tuberosity of humerus
What nerve innervates supraspinatous
Suprascapular nerve (C5,6)
What does supraspinatous do
Abducts the arm
What is the origin and insertion of infraspinatous
Origin is infraspinous fossa
Insertion: greater tuberosity of humerus
What is the function of infraspinatous
Externally rotates the arm
What is the origin and insertion of teres minor
Origin: dorsal surface of lateral border of scapula
Insertion: greater tuberosity of humerus
What nerve innervates teres minor
Axillary (C5,6)
What is the function of teres minor
Externally rotates the arm
What is the origin and insertion of subscapularis
Origin: anterior surface of scapula (subscapular fossa)
Insertion: Lesser tuberosity of humerus/ shoulder capsule
What nerve innervates subscapularis
Upper and lower subscapular nerve C5/C6
What is the function of subscapularis
Internally rotates the arm
What 2 things is the rotator cuff suscpetible to?
Tears and impingement
What is the origin and insertion of deltoid
Origin: Clavicle, acromium and spine of scapula
Insertion: Deltoid tuberosity on lateral aspect of humerus
What nerve innervates deltoid
Axillary nerve (C5,C6)
What is the function of deltoid
Abducts the arm
What is the origin and insertion of biceps brachii
Origin: Short head: Coracoid process
Long head: Labrum / glenoid
Insertion: Tuberosity of radius
What nerve innrvates bicpes brachii
Musculocutaneous (c5,6)
What is the function of biceps brachii
Flexes elbow and supinates the forearm
Biceps brachii is susceptible to what
Tendonitis
What bone in the upper limb is susceptible to fracture
Radial head/ neck
What age group are susceptible to supracondylar fractures
Children
What bursa is susceptible to bursitis in the elbow joint
Olecranon bursa
What are the 3 main ligaments of the elbow
medial collateral, lateral collateral and annular ligaments
What ligament is affected in a radial head dislocation
Medial collateral ligament tear
The lateral epicondyle is the site of insertion for all what
Extensor muscles of the forearm
The extensor compartment of the forearm is the what compartment
Dorsal
The medial epicondyle is the site of what
Insertion for all the flexor muscles of the forearm
The flexor compartment of the forearm is the what compartment
Volar
What are the names of the 2 ends of the radius
Radial head (proximally) Radial styloid (distally)
What are the names of the 2 ends of the ulna
Coranoid process (proximally) Ulnar styloid (distally)
What is the name of the fossa that the ulna forms
Olecranon fossa
What are the intrinsic muscles within the hand responsible for
Fine motor functions of the hand
What are the extrinsic muscles within the forearm responsible for
Finger flexion and extension of the movements of the wrist.
What group of muscles move the thumb
Thenar muscles
What makes up the thenar muscles
Opponens pollicis
Flexor pollicis brevis
Abductor pollicis brevis
What nerve innervates the thenar muscles
Median nerve
What muscle makes up the hypothenar muscles
Abductor digiti minimi
What is the role of the hypothenar muscles
To move the little finger
What nerve innervates the hypothenar muscles
Ulnar nerve
What do the interossei muscles do
Move the fingers and flex at the MCPJs and extend the IPJs
What nerve innervates the interossei muscles
Ulnar nerve
What are the 2 muscles that make up the interossei muscles and what does each one do?
Dorsal interossei (x4) - ABducts the fingers at MCPJs Palmar interossei (x3) - ADucts the fingers at MCPJs
What are the lumbrical muscles crucial for
finger movement
link extensor and flexor tendons
What nerve innervates the lumbrical muscle
lateral x2 median nerve
medial x2 nerve
what tendons make up the flexor tendons
Flexor digitorum superficialis
Where does the flexor digitorum superficialis flex the fingers at
The proximal interphalangeal joints (PIPJs)
What nerve innervates flexor digitorum superficialis
Median Nerve C7, C8, T1
What are the 2 types of flexor pulleys
Annular and Cruciate
What 2 annular ligaments are critical to prevent bowstringing
A2 and A4
What annular ligaments overlie the MP, PIP and DIP joints
A1,A3 and A5
What annular ligament is most commonly involved in trigger finger
A1
What is the function of the cruciate pulleys
To prevent sheath collapse and expansion during digital motion
How many cruciate pulley ligaments do we have and where
3 at the level of the joints
What does the palmar fascia do?
Separates the palmar muscle bellies and flexor tendons from the skin
Suscpetible to hypertrophy and fibrosis (Dupuytren’s disease)
What are the 3 peripheral nerves of the hand
Median
Ulnar
Radial
What do the peripheral nerves of the hand supply
Extrinsic +/- intrinsic muscles of/ affecting the hand
What does the median nerve supply muscularly
Flexors of the forearm
LOAF muscles
What cutaenous supply does the median nerve provide
Radial 3 1/2 digits
What muscular supply does the ulnar nerve provide
Small muscles of the hand - intrinsics
What cutaneous supply does the ulnar nerve provide
Ulnar 1 1/5 digits
What muscular supply does the radial nerve provide
Extensors of the forearm
What cutaneous supply does the radial nerve provide
variable portion of dorsum of the hand
What is the brachial plexus
a network of the ventral rami of the lower four cervical nerves and first thoracic nerve roots (C5-C8, T1)
Where does the brachial plexus lie
Proceeds through the neck, the axilla and into the arm
What does the brachial plexus form and give off
The peripheral nerves that supply the upper arm, forearm and hand
What is the order in which roots become branches
Roots Trunk Divisions Cord Branches
What are the 2 conditions that are compressive neuropathies
Cubital tunnel syndrome at the elbow and
Carpal tunnel syndrome at the wrist
How does carpal tunnel arise
When the median nerve passes through the carpal tunnel at the level of the wrist. If the contents of the tunnel swels, or the space is too small, the median nerve is compressed and symptoms arise