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MSK > Clinical anatomy of the upper limb > Flashcards

Clinical anatomy of the upper limb Flashcards

1
Q

what are components of the shoulder girdle

A

clavicle and scapula

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2
Q

where does the glenohumeral articulation take place

A

glenoid cavity

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3
Q

what group of muscles move the shoulder girdles

A

superficial (extrinsic) muscles of the back:

the trapezius

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4
Q

what is the origin of the trapezius

A

spinous processes C1-T12

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5
Q

where does the trapezius insert

A

occiput and spine of scapula

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6
Q

what nerve innervates the trapezius

A

accessory nerve (CN XI)

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7
Q

what is the function of the trapezius

A

elevates and depresses scapula

retracts scapula

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8
Q

what is role of the labrum

A

increases capture of the humeral head, increases stability by deepening the glenoid cavity

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9
Q

where does the biceps tendon attach to the labrum

A

superior glenoid tubercle

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10
Q

where does a slap tear occur

A

where the biceps tendon attaches to the labrum

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11
Q

what is a bankart lesion

A

inferior anterior labral tear

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12
Q

what muscles stabilise the shoulder girdle and move the arm

A

rotator cuff muscles (supraspinatus, infraspinatus, subscapularis, teres minor)

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13
Q

what is the origin of the supraspinatus

A

greater tuberosity of humerus

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14
Q

what is the innervation of the supraspinatus

A

suprascapular nerve (C5/C6)

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15
Q

what is the function of supraspinatus

A

initiates arm abduction

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16
Q

what is the insertion of infraspinatus

A

greater tuberosity of humerus

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17
Q

what is the innervation of infraspinatus

A

suprasclapular nerve (C5/C6)

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18
Q

what is the function of infraspinatus

A

externally rotates the arm

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19
Q

what is the origin of teres minor

A

dorsal surface of lateral border of the scapula

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20
Q

what is the insertion of teres minor

A

greater tuberosity of the humerous

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21
Q

what is the innervation of teres minor

A

axillary nerve (C5/C6)

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22
Q

what is the function of teres minor

A

externally rotates the arm

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23
Q

what is the origin of supraspinatus

A

supraspinous fossa

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24
Q

what is the origin of infraspinatus

A

infraspinous fossa

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25
Q

what is the origin of subscapularis

A

anterior surface of scapula (subscapular fossa)

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26
Q

what is the insertion of subscapularis

A

lesser tuberosity of humerus/ shoulder capsule

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27
Q

what is the innervation of subscapularis

A

upper and lower subscapular nerves (C5/C6)

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28
Q

what is the function of subscapularis

A

internally rotates the arm

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29
Q

what pathologies can affect the rotator cuff

A

tears (acute or degenerative), impingement

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30
Q

what is the origin of the deltoid

A

clavicle, arcomion, spine of scapula

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31
Q

what is the insertion of the deltoid

A

deltoid tuberosity on lateral aspect of humerus

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32
Q

what is the innervation of the deltoid

A

axillary nerve (C5/C6)

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33
Q

what is the function if the deltoid

A

abducts the arm

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34
Q

what are the different fibres of the deltoid

A

anterior- clavicle
lateral- acromion
posterior- spine of scapula

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35
Q

what is the origin of the biceps brachii

A

short head coracoid process

long head labrum/ glenoid

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36
Q

what is the insertion of the biceps brachii

A

tuberosity of radius

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37
Q

what is the innervation of the biceps brachii

A

musculocutaneous nerve (C5/C6)

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38
Q

what is the function of the biceps brachii

A

flexes elbow, supinates forearm

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39
Q

what is the biceps brachii susceptible too

A

tendonitis

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40
Q

what bone of forearm at elbow joint is always lateral

A

radial head

41
Q

what pathologies is the elbow joint susceptible to

A

OA, RA
elboe dislocation
olecranon #

42
Q

what is the supracondylar region of the elbow susceptible to

43
Q

what is the olecranon bursa susceptible to

44
Q

what are the important ligaments in the elbow

A

medial and lateral collateral, annular ligaments

45
Q

what inserts on the lateral epicondyle of the humerus

A

all the extensor muscles of the forearm

46
Q

what compartment is the extensor compartment of the forearm

A

dorsal compartment

47
Q

what are the extensors of the forearm susceptible to

A

enthesiopathies (e.g lateral epicondylitis)

48
Q

what inserts in the medial epicondyle of the humerus

A

all the flexor muscles of the forearm

49
Q

what compartment of the forearm is the flexor compartment

A

the volar compartment

50
Q

what are the flexors of the forearm susceptible to

A

enthesiopathies (e.g. medial epicondylitis)

51
Q

are medial and lateral epicondylitis inflammatory pathologies

A

no- are enthesiopathies

52
Q

what joint is the radial head at

53
Q

what crosses over what in pronation of the forearm

A

radial styloid crosses over ulnar styloid

54
Q

what is the mnemonic to remember the carpal bones

A 
some (scaphoid)
lovers (lunate)
try (triquetrum)
positions (pisiforms)
that (trapezium)
they (trapezoid)
cannot (capitate)
handle (hamate)
55
Q

what complex is in the carpal bones

A

triangular fibrocartilage complex

56
Q

what is seen in a colles fracture

A

distal radius fracture causes dorsal angulation

57
Q

describe the blood supply to the scaphoid

A

retrograde

58
Q

what do you palpate in a scaphoid fracture

A

anatomical snuffbox

59
Q

what are the group of bones in the hands

A

distal, intermediate and proximal phalanges
metacarpals
carpals

60
Q

what are the two groups of muscles of the hand

A

extrinsic and intrinsic muscles

61
Q

where are the intrinsic muscles of the hand and what do they do

A

found within hand

fine motor functions of the hand

62
Q

where are the extrinsic muscles of the hand and what do they do

A

located in the anterior and posterior compartments of the forearm
control finger flexion and extension and movements of the wrist

63
Q

what are the thenar muscles

A

opponens pollicis
flexor pollicis brevis
abductor pollicis brevis

64
Q

what is the function of the thenar muscles

A

move the thumb

65
Q

what is the innervation of the thenar muscles

A

median nerve

66
Q

what is the function of the hypothenar muscles

A

move little finger

67
Q

what are the hypothenar muscles

A

abductor digiti minimi

flexor digiti minimi brevis

68
Q

what is the innervation of the hypethenar muscles

A

ulnar nerve

69
Q

what is the function of the interossei muscles

A

move the fingers

  • all flex at MCPJs
  • all extend at IPJs
70
Q

what is the innervation of the interossei muscles

A

ulnar nerve

71
Q

what is the role of the four dorsal interossei

A

abducts the fingers at MCPJs

72
Q

what is the role of the 3 palmar interossei

A

adducts the fungers at MCPJs

73
Q

how do you remember the roles of the interossei muscles

A

DAB- Dorsal ABducts

PAD- Palmar ADducts

74
Q

what is the role the of 4 lumbrical muscles

A

finger movement- link extensor and flexor tendons

75
Q

what is the innervation of the lumbrical muscles

A

lateral 2 median nerve

medial 2 ulnar nerve

76
Q

what are the flexor tendons of the hand

A

flexor digitorum superficialis

flexor digitorum profundus

(extrinsic flexor muscle of the fingers)

77
Q

what is the role of flexor digitorum superficialis

A

flexes fingers at the proximal interphalangeal joints

78
Q

what is the innervation of the flexor tendons

A

median nerve (C7, C8, T1)

79
Q

what do the flexor tendons pass through

A

carpal tunnel

80
Q

what is the role of the flexor digitorum profundus

A

flexes fingers at the distal interphalangeal joints

81
Q

what is the innervation of the flexor digitorum profundus

A

2nd and 3rd digits- median nerve (via anterior interosseus) (C8, T1)

4th and 5th digits- ulnar nerve (C8, T1)

82
Q

how are the flexor tendons attached to the metacarpals and phalanges

A

pulley system

83
Q

what are the flexor pulleys of the hand

A 
annular ligaments  (prevent bowstringing)
cruciate ligaments (prevent sheath collapse and expansion during motion)
84
Q

what flexor pulley is most commonly involved in trigger finger

85
Q

what is the role of palmar fascia

A

separates the palmar muscle bellies and flexor tendons from the skin

86
Q

what is palmar fascia susceptible to

A

hypertrophy and fibrosis (dupuytren’s disease)

87
Q

what is the blood supply to the hand

A

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
Q

what are the peripheral nerves of the hand

A

median, ulnar, radial

89
Q

what does the median nerve supply in the hand

A

muscles:

  • flexors of the forearms
  • LOAF muscles

cutaneous:
-radial 3 1/2 digits

90
Q

how can you test the median nerve

A

muscle- adductor pollicis brevis

cutaneous- tip of index finger and base of thenar muscles

91
Q

what does the ulnar nerve supply in the hand

A

small muscles of the hand- intrinsics

skin- ulnar 1 1/2 digits

92
Q

how do you test the ulnar nerve

A

abductor digiti minimi

skin- dorsum and volar aspects of little finger

93
Q

what does the radial nerve supply

A

muscles- extensors of the forearm

skin- variable portion of dorsum of hand

94
Q

how do you test the radial nerve

A

extensor digitorum communis and extensor indicis

skin- dorsum of 1st webspace

95
Q

how do you name the nerves of the fingers

A

ulnar and radial digital nerves depending on what side of the finger they are on

96
Q

what is the path of the ulnar nerve in the cubital tunnel

A

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
Q

what are the boundaries of the carpal tunnel

A

carpal bones- form the dorsal, medial and lateral constraints
the flexor retinaculum/transverse carpal ligaments

98
Q

what is the brachial plexus

A

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
Q

how do you remember the brachial plexus order

A 
real (roots)
texans (trunks)
drink (divisions)
cold (cords)
beer (branches)

MSK (71 decks)

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