Dr. emma upper msk Flashcards
acromioclavicular ligament & joint
Basilic vein ascends on the medial side and runs parallel to brachial artery and drains into ->
Axillary Vein
Cephalic vein ascends to median cubital vein (venipuncture) and joins with ->
Axillary vein
Which superficial vessel of the upper limb communicates with median cubital vein before joining axillary vein
Cephalic
What kind of veins form b/w superficial and deep veins of the upper limb
Perforating veins
cephalic and basilic veins originate from where
subcutaneous tissue on dorsum of the hand FROM the dorsal venous network
pectoralis major innervation (HIGH yield)
medial and lateral pectoral nerves
pectoralis major action
flex, adduct, medial rotate
pectorlis minor origin
ribs 3,4,5
perctoralis minor innervation
medial pectoral n.
t/f
pec. minor acts on scapula
pec. major humerus
t
pec. minor action
protraction, depression, medial rotate of scapula
what bundle travels under the pec. minor-coracoid process bridge
neurovascular bundle
subclavious n. and action
n. to subclavius
depress & stabilize clavicle
difference b/w pectoral nerves (HIGH yield boards q)
pec major = both lateral and medial pec. n.
pec. minor = only medial pec. n.
serratus anterior action
holds scapula to chest wall
- protraction and superior rotation of scapula
serratus anterior n.
long thoracic n. (remember it breaks off of brachial plexus)
trapezius origin
superior nuchal line
extends from SP of C7-T12
trapezius n.
accessory n. (CN XI) - SHOULDER shrug test to assess
which 3 structures makes up the posterior triangle
trapezius
clavicle
SCM
in the posterior triangle which vessels (2) pass b/w anterior & middle scalene muscles
brachial plexus & axillary artery (also runs with axillary vein)
which n. innervates trapezius and SCM & descends from base of skull, out of posterior triangle, down to side of the neck, then deep to trape
accessory n.
latissimus dorsi origin
spines of T6-L5
median crest of sacrum, iliac crest
latissimus dorsi action
extend, adduct, medial rotate humerus
aka Chin Ups muscle
latissimus dorsi insertion
intertubercular groove of humerus
latissimus dorsi innervation
thoracodorsal n.
which posture muscles (3) are innervated by the Dorsal Scapular N.
Levator Scapulae
Rhomboid Minor
Rhomboid Major
nerves to muscles of the superficial back (4)
dorsal scapular
suprascapular
accessory
axillary
what group does these muscles fall under:
deltoid
supraspinatus
infraspinatus
subscapularis
t. maj
t. min
triceps
muscles on the scapula that move the humerus (innervated on the humerus to help it move)
deltoid origin (proximal attachments - think CLASPs) and insertion
proximal attachments: CLASPs
Clavicle
Acromion
Spinous Process
insertion:
deltoid tuberosity of humerus
deltoid action
action on humerus:
flex & extend
abduct (when all 3 contract together)
medial & lateral rotate
deltoid innervation
axillary N.
which space does the axillary n. pass through
quadrangular space
made up of: teres maj. & min
long head or tri & humerus
what condition = compression of the axillary n. and posterior humeral circumflex artery
Quadrilateral Space Syndrome (QSS)
name rotator cuff muscles (SITS)
Supraspinatus
Infraspinatus
Teres Minor
Subscapularis
Subscapularies N.
upper & lower subscapular nerves
supraspinatus & infraspinatus N.
suprascapular n.
teres minor n.
axillary n. (same as delt)
which group of muscles blend w/ glenohumeral jt capsule - reinforcing it
rotator cuff muscles
match action to SITS muscle
- laterally rotate humerus
- abduct humerus (w/ deltoid)
- medial rotation of humerus
- Teres Min. & Infraspinatus
- supraspinatus
- subscapularis
which nerve passses through the suprascapular foramen/notch, and then the greater scapular (spinoglenoid) notch
suprascapular n.
teres major action
adduct, medial rotate, extend humerus
teres maj. innervation
lower supscapular n. (off axillary n.)
flow of upper limb arteries from top to bottom
Subclavian -> Axillary -> Brachial -> Radial & Ulnar -> deep & superfical Palmar Arches -> Digital Arteries
axillary artery is divided into 3 parts:
1st part (1 branch): gives rise to (inferior/sup.) thoracic artery
2nd part (2 branch): thoracoacromial a. & (lateral/superior) a.
3rd part (3 branches): anterior & post. circumflex humeral arteries, (largestof all branches of axillary artery = ?)____
1st = superior thoracic
2nd = thoracoacriomial & lateral thoracic artery
3rd = subscapular artery, ant. & post. circumflex humeral artery
importance of collateral circulation around scapula: if axillary artery is occluded ?
blood is shunted from subclavian a. to distal axillary a. by reverse flow in circumflex scapular/subscapular arteries
- dorsal scapular a.
- suprascapular a.
- circumflex scapular a.
- transverse cervical a.
are all branches of which 2 arteries?
where do they anastomose?
branches from subclavian & axillary
anastomase around scapula
deep veins are (paired/unpaired) veins that accompany majory arteries
paired veins - Radial, Unlar, brachial etc.
which 3 nerves innervate elbow jt. ligaments
musculocutaneous
radial
ulnar
arterial supply of elbow jt. ligaments =
anastomosis of arteries around the jt.
(Ulnar/Radial/annular) collateral ligament of elbow:
sling around head of radius to form proximal radioulnar jt
permits rotation of head of radius around ulna
annular
(Ulnar/Radial) collateral ligament of elbow:
attached to annular ligament
radial
(Ulnar/Radial/annular) collateral ligament of elbow:
triangular shaped ligament w/ upper & lower bands; ulner n. passes b/w bands posterior to medial epicondyle
proximal radio-ulnar jt:
which membrane links bones together
creates pivot type synovial jt. -> allows for sup. & pronation
interosseous membrane
arm: everything thats extending or supinating = (RADIAL/ULNAR) n.
**RADIALLLLL N. **
pronators of the arm = (median/ulnar) n.
MEDIAN n.
flexors of arm = (median/musculocutaneous) n.
musculocutaneous n
who does the most force of flexion - PURE flexor
BRACHIALIS
WHICH n.
- arises from lateral cord pierces muscle, and runs b/w bicpes and brachialis
musculocutaneous n.
muscles of the ant. arm compartment
brachialis
coracobrachialis
biceps brachii
muscles of post. arm compartment
triceps brachii
anconeous
which nerve innervates all 3 heads of triceps
Radial
fracture of arm corresponds to which nerve: ARM
- head of humerus
- mid shaft
- Supracondylar
axillary - head
radial - mid shaft
median - supracondylar
triangular depression on anterior surface of elbow =
borders =
cubital fossa
medially = pronator teres
laterally = brachioradialis
superiorly = imaginary line connecting medial and lateral epicondyle of humerus
cubital fossal contents (lateral to med.) - Really Need Beer To Be At My Nicest
- radial nerve
- biceps tendon
- (2 more)
brachial artery
median nerve
Really Need (radial nerve) Beer To (biceps tendon) Be At (brachial artery) My Nicest (median nerve).
which deep muscle layer of forearm reinforces interosseous membrane (keeping radius and unla together = IMP. in FOSH (fall and oustretched hand) injury)
(good boards q)
pronator quadratus
intermediate layer of forearm muscle
Flexor Digitorum Superficialis
I: on middle phalages of 4 fingers
median N.
Flexes fingers
Flexor digitorum profundus (2 innervation points)
Flexor pollicis longus (inserts on the dsital phalanx of thumb)
Pronator quadratus
are all muscles of what group
Deep layer of forearm muscles
3 functional groups - extonsors muscles of the forearm (posterior group)
- muscles that extend/abduct or adduct the hand at the wrist
- muscles that extend the medial four digits
- muscles that extend or abduct thumb
extensor carpi radialis longus/brevis/unlaris = which group
- extend/adduct/abduct hand at wrist
extensor digitorum, extensor indicis, extensor digiti minimi
- muscles that extend the medial 4 digits
abductor pollicis longus, extensor pollicis brevis, extensor pollicis longus
- extend or abduct thumb
radial nerve innervates (all/most) muscles of the posterior forearm
ALL MUSCLES OF THE FOREARM
forearm:
unlar nerve innervation =
- flexor carpi ulnaris
- 1/2 flexor digitorum profundus (4&5)
- becomes superfical at the wrist
blood pressure taken by which artery?
brachial artery
superficial palmar arch made up mainly by which artery, + anastomosis with which artery
made up of ulnar artery
anastomsis w/ radial artery
carpal tunnel structures (3)
- median nerve
- flexors digitorum superficialis & profundus
- flexor pollicis longus
the following is the result of what syndrome?
- cutaneous sensory loss on median nerve distribution
- thenar wasting
- weakness of lumbricals 1,2
carpal tunnel syndrome
Muscles that flex the wrist (which ones) have a common attachment at the medial epicondyle of the humerus. A fracture at this location would affect flexion at the wrist.
(flexor carpi ulnaris, flexor carpi radialis)