Clinical anatomy of the upper limb Flashcards
1
Q
what are components of the shoulder girdle
A
clavicle and scapula
2
Q
where does the glenohumeral articulation take place
A
glenoid cavity
3
Q
what group of muscles move the shoulder girdles
A
superficial (extrinsic) muscles of the back:
the trapezius
4
Q
what is the origin of the trapezius
A
spinous processes C1-T12
5
Q
where does the trapezius insert
A
occiput and spine of scapula
6
Q
what nerve innervates the trapezius
A
accessory nerve (CN XI)
7
Q
what is the function of the trapezius
A
elevates and depresses scapula
retracts scapula
8
Q
what is role of the labrum
A
increases capture of the humeral head, increases stability by deepening the glenoid cavity
9
Q
where does the biceps tendon attach to the labrum
A
superior glenoid tubercle
10
Q
where does a slap tear occur
A
where the biceps tendon attaches to the labrum
11
Q
what is a bankart lesion
A
inferior anterior labral tear
12
Q
what muscles stabilise the shoulder girdle and move the arm
A
rotator cuff muscles (supraspinatus, infraspinatus, subscapularis, teres minor)
13
Q
what is the origin of the supraspinatus
A
greater tuberosity of humerus
14
Q
what is the innervation of the supraspinatus
A
suprascapular nerve (C5/C6)
15
Q
what is the function of supraspinatus
A
initiates arm abduction
16
Q
what is the insertion of infraspinatus
A
greater tuberosity of humerus
17
Q
what is the innervation of infraspinatus
A
suprasclapular nerve (C5/C6)
18
Q
what is the function of infraspinatus
A
externally rotates the arm
19
Q
what is the origin of teres minor
A
dorsal surface of lateral border of the scapula
20
Q
what is the insertion of teres minor
A
greater tuberosity of the humerous
21
Q
what is the innervation of teres minor
A
axillary nerve (C5/C6)
22
Q
what is the function of teres minor
A
externally rotates the arm
23
Q
what is the origin of supraspinatus
A
supraspinous fossa
24
Q
what is the origin of infraspinatus
A
infraspinous fossa
25
what is the origin of subscapularis
anterior surface of scapula (subscapular fossa)
26
what is the insertion of subscapularis
lesser tuberosity of humerus/ shoulder capsule
27
what is the innervation of subscapularis
upper and lower subscapular nerves (C5/C6)
28
what is the function of subscapularis
internally rotates the arm
29
what pathologies can affect the rotator cuff
tears (acute or degenerative), impingement
30
what is the origin of the deltoid
clavicle, arcomion, spine of scapula
31
what is the insertion of the deltoid
deltoid tuberosity on lateral aspect of humerus
32
what is the innervation of the deltoid
axillary nerve (C5/C6)
33
what is the function if the deltoid
abducts the arm
34
what are the different fibres of the deltoid
anterior- clavicle
lateral- acromion
posterior- spine of scapula
35
what is the origin of the biceps brachii
short head coracoid process
| long head labrum/ glenoid
36
what is the insertion of the biceps brachii
tuberosity of radius
37
what is the innervation of the biceps brachii
musculocutaneous nerve (C5/C6)
38
what is the function of the biceps brachii
flexes elbow, supinates forearm
39
what is the biceps brachii susceptible too
tendonitis
40
what bone of forearm at elbow joint is always lateral
radial head
41
what pathologies is the elbow joint susceptible to
OA, RA
elboe dislocation
olecranon #
42
what is the supracondylar region of the elbow susceptible to
fractures
43
what is the olecranon bursa susceptible to
bursitis
44
what are the important ligaments in the elbow
medial and lateral collateral, annular ligaments
45
what inserts on the lateral epicondyle of the humerus
all the extensor muscles of the forearm
46
what compartment is the extensor compartment of the forearm
dorsal compartment
47
what are the extensors of the forearm susceptible to
enthesiopathies (e.g lateral epicondylitis)
48
what inserts in the medial epicondyle of the humerus
all the flexor muscles of the forearm
49
what compartment of the forearm is the flexor compartment
the volar compartment
50
what are the flexors of the forearm susceptible to
enthesiopathies (e.g. medial epicondylitis)
51
are medial and lateral epicondylitis inflammatory pathologies
no- are enthesiopathies
52
what joint is the radial head at
elbow
53
what crosses over what in pronation of the forearm
radial styloid crosses over ulnar styloid
54
what is the mnemonic to remember the carpal bones
```
some (scaphoid)
lovers (lunate)
try (triquetrum)
positions (pisiforms)
that (trapezium)
they (trapezoid)
cannot (capitate)
handle (hamate)
```
55
what complex is in the carpal bones
triangular fibrocartilage complex
56
what is seen in a colles fracture
distal radius fracture causes dorsal angulation
57
describe the blood supply to the scaphoid
retrograde
58
what do you palpate in a scaphoid fracture
anatomical snuffbox
59
what are the group of bones in the hands
distal, intermediate and proximal phalanges
metacarpals
carpals
60
what are the two groups of muscles of the hand
extrinsic and intrinsic muscles
61
where are the intrinsic muscles of the hand and what do they do
found within hand
| fine motor functions of the hand
62
where are the extrinsic muscles of the hand and what do they do
located in the anterior and posterior compartments of the forearm
control finger flexion and extension and movements of the wrist
63
what are the thenar muscles
opponens pollicis
flexor pollicis brevis
abductor pollicis brevis
64
what is the function of the thenar muscles
move the thumb
65
what is the innervation of the thenar muscles
median nerve
66
what is the function of the hypothenar muscles
move little finger
67
what are the hypothenar muscles
abductor digiti minimi
| flexor digiti minimi brevis
68
what is the innervation of the hypethenar muscles
ulnar nerve
69
what is the function of the interossei muscles
move the fingers
- all flex at MCPJs
- all extend at IPJs
70
what is the innervation of the interossei muscles
ulnar nerve
71
what is the role of the four dorsal interossei
abducts the fingers at MCPJs
72
what is the role of the 3 palmar interossei
adducts the fungers at MCPJs
73
how do you remember the roles of the interossei muscles
DAB- Dorsal ABducts
| PAD- Palmar ADducts
74
what is the role the of 4 lumbrical muscles
finger movement- link extensor and flexor tendons
75
what is the innervation of the lumbrical muscles
lateral 2 median nerve
| medial 2 ulnar nerve
76
what are the flexor tendons of the hand
flexor digitorum superficialis
flexor digitorum profundus
(extrinsic flexor muscle of the fingers)
77
what is the role of flexor digitorum superficialis
flexes fingers at the proximal interphalangeal joints
78
what is the innervation of the flexor tendons
median nerve (C7, C8, T1)
79
what do the flexor tendons pass through
carpal tunnel
80
what is the role of the flexor digitorum profundus
flexes fingers at the distal interphalangeal joints
81
what is the innervation of the flexor digitorum profundus
2nd and 3rd digits- median nerve (via anterior interosseus) (C8, T1)
4th and 5th digits- ulnar nerve (C8, T1)
82
how are the flexor tendons attached to the metacarpals and phalanges
pulley system
83
what are the flexor pulleys of the hand
```
annular ligaments (prevent bowstringing)
cruciate ligaments (prevent sheath collapse and expansion during motion)
```
84
what flexor pulley is most commonly involved in trigger finger
A1 pulley
85
what is the role of palmar fascia
separates the palmar muscle bellies and flexor tendons from the skin
86
what is palmar fascia susceptible to
hypertrophy and fibrosis (dupuytren's disease)
87
what is the blood supply to the hand
radial and ulnar arteries
deep and superficial palmar arch
common digital arteries
each artery has a ulnar and radial digital artery (named after side of digit not origin)
88
what are the peripheral nerves of the hand
median, ulnar, radial
89
what does the median nerve supply in the hand
muscles:
- flexors of the forearms
- LOAF muscles
cutaneous:
-radial 3 1/2 digits
90
how can you test the median nerve
muscle- adductor pollicis brevis
cutaneous- tip of index finger and base of thenar muscles
91
what does the ulnar nerve supply in the hand
small muscles of the hand- intrinsics
skin- ulnar 1 1/2 digits
92
how do you test the ulnar nerve
abductor digiti minimi
skin- dorsum and volar aspects of little finger
93
what does the radial nerve supply
muscles- extensors of the forearm
skin- variable portion of dorsum of hand
94
how do you test the radial nerve
extensor digitorum communis and extensor indicis
skin- dorsum of 1st webspace
95
how do you name the nerves of the fingers
ulnar and radial digital nerves depending on what side of the finger they are on
96
what is the path of the ulnar nerve in the cubital tunnel
passes posterior to the medial epicondyle
| enters an arch formed by the two heads of the flexor carpi ulnaris muscle and underneath the acruate ligament
97
what are the boundaries of the carpal tunnel
carpal bones- form the dorsal, medial and lateral constraints
the flexor retinaculum/transverse carpal ligaments
98
what is the brachial plexus
a network of the ventral rami of the lower four cervical nerves and first thoracic nerve roots (C5-8, T1)
proceeds through the neck, axilla, into arm
form and give off the peripheral nerves that supply to upper arm, forearm and hand
99
how do you remember the brachial plexus order
```
real (roots)
texans (trunks)
drink (divisions)
cold (cords)
beer (branches)
```
