Exam 5 Upper Extremity 50X Flashcards by Christopher Waller

What are the components of the upper limb?

Shoulder
Arm (First segment of Free Upper Limb)
Forearm (Elbow to wrist)
Hand (Wrist, Palm, Dorsum of Hand, Fingers)

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The shoulder component of the upper limb lies in what areas?

Proximal Segment of limb overlaps thorax and back of trunk, plus Lower lateral neck

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The Pectoral Girdle (Shoulder Girdles) attaches what?

Bones of Upper Limbs to the Axial Skeleton

Pectoral Girdle = component of appendicular skeleton

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What makes up the Pectoral Girdle (Shoulder Girdles)?

Clavicle

Scapula

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The Clavicle articulates with what bones and lies superior to what?

Articulates: Sternum and Scapula

Superior to: 1st Rib

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The Conoid Tubercle is the site of attachment for what?

Conoid portion of the Coracoclavicular ligament

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The coracoclavicular ligament is located where?

Between the clavicle and coracoid process of scapula

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What Scapulae landmark is the lateral end of the scapula spine and the high point of the shoulder?

Acromion

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What is the name of the cavity that accepts the head of the humerus, forming what joint?

Glenoid Cavity

Forms: Glenohumeral Joint

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The thin edge of the scapula makes up what portion of the scapula and lies near?

Medial Border (Vertebral Border) lies near the vertebral column

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The thick edge of the scapula makes up what portion of the scapula?

Lateral Border (Axillary Border)

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The Scapula medial and lateral borders join (meet) at?

Inferior Angle

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The Scapula Superior border and Medial Border join at?

Superior Angle

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What is the name of the indentation along the superior border of the scapula?

Scapular notch (Suprascapular notch)

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What passes through the Suprascapular notch?

Suprascapular Nerve

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What is the projection at the lateral end of the superior border of the scapula in which tendons of muscles and ligaments attach?

Coracoid Process

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Name the muscles whose tendons attach to the Coracoid Porcess?

Pectoralis Minor
Coracorbrachialis
Short Head of Biceps Brachii

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Name the two ligaments that comprise the Coracolavicular ligament which attach the clavicle and Coracoid Process of the scapula, providing stability to the acromioclavicular joint?

Conoid

Trapezoid

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Where does the Supraspinatus Muscle and Infraspinatus Muscle attach to the scapula?

Supraspinous Fossa

Infraspinous Fossa

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The Subscapular Fossa on the anterior surface of the scapula is the site of attachment for which muscle?

Subscapularis Muscle

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What is the name of the ligament that traverses the scapular notch and converts it into a foramen?

Superior Transverse Scapular Ligament

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What muscle originates near the scapular notch and frequently extends to the superior transverse scapular ligament?

Omohyoid Muscle

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What Passes under the Superior Transverse Scapular Ligament and what passes over the ligament?

Suprascapular nerve travels under

- Suprascapular artery travels over

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What is the name of the ligament that attaches the Acromion of the Scapula to the Coracoid process of the scapula?

Coracoacromial Ligament

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The Suprascapular nerve and Suprascapular artery travel through what portion of the scapula after innervating the supraspinatus muscle?

Notch at the neck of the scapula

What muscles do the Suprascapular nerve and artery innervate and provide blood for?

- Supraspinatus Muscle | - Infraspinatus Muscle

The Suprascapular Nerve serves what functions in the upper extremity?

Shoulder Joint: Sensory Infraspinatus: Motor Supraspinatus: Motor

Suprascapular Neuritis, entrapment neuropathy of Suprascapular nerve as it travels through the Suprascapular notch may occur from what types of injuries?

Overuse of arm | Excessive Traction

Prolonged entrapment of the Suprascapular nerve may lead to what?

Visible wasting of supraspinatus and infraspinatus

Pectoral Girdle: The Clavicle (sternal end) articulates with the manubrium of the sternum and first costal cartilage at what joint?

Sternoclavicular Joint

Pectoral Girdle: Scapula articulates with the clavicle at what joint and the Humerus at what joint?

- Clavicle: Acromioclavicular joint | - Humerus: Glenohumeral joint

What type of joint is the Sternoclavicular joint?

Synovial joint (saddle joint), only synovial joint connecting pectoral girdle w/ ribcage

What are the stabilizing ligaments of the acromioclavicular joint (small synovial type joint)?

- Acromioclavicular ligament | - Coracoclavicular ligament (Trapezoid and Conoid Ligament)

How many bones are each of the upper limbs comprised of?

30 bones

What are the bones of the Upper extremity and location?

- Humerus: arm - Ulna and Radius: Forearm - Carpals: Wrist - Metacarpals: Palm - Phalanges: fingers

Name the general names of the joints found in the upper extremity?

- Shoulder - Elbow - Wrist - Metacarpophalangeal - Interphalangeal

The Humerus articles with what bones?

Proximal: Scapula Distal: Ulnar and Radius

The anatomical neck located between the tubercles and head of the Humerus is the site of attachment for what?

Articular Capsule

The long head of the biceps brachii muscle lies in what portion of the Humerus?

Intertubercular Sulcus (AKA: Bicipital Groove, Intertubercular Groove)

What is the site in which the Humerus is most frequently fractured called?

Surgical Neck

The Deltoid tuberosity is located where and is the site of attachment of what?

Humerus mid shaft | attachment of Deltoid muscle

The Lateral Supracondylar Ridge on the distal Humerus shaft terminates into what?

Lateral Epicondyle

The Medial Supracondylar Ridge on the distal Humerus shaft terminates into what?

Medial Epicondyle

What portion of the distal Humerus articulates with the radius and is near the lateral epicondyle?

Capitulum

What portion of the distal Humerus articulates with the Ulna and is near the medial epicondyle?

Trochlea

What is the names of the portions of the Humerus that are just superior to the Capitulum and Trochlea?

- Radial fossa superior to capitulum | - Coronoid fossa (deep) superior to trochlea

What is the name of the portion of the Humerus that receives the olecranon process of the ulna when the forearm is extended?

Olecranon fossa

Name the nerves the Surgical neck, Shaft (radial groove), Distal end, and Medial Epicondyle have a relationship with?

- Surgical neck: Axillary Nerve - Shaft (Radial Groove): Radial Nerve - Distal end: Median Nerve - Medial Epicondyle: Ulnar Nerve

Which bone of the Forearm forms the medial border and is the stabilizing bone of the forearm?

Ulna

Which bone of the Forearm forms the lateral border and is shorter and moveable?

Radius

What portion of which bone forms the prominence of the elbow?

Olecranon of the Ulna

What is the name of the anterior projection of the proximal end of the ulna?

Coronoid Process

Together the Olecranon and Coronoid Process receive what and contribute to the formation of what?

Trochlear of Humerus and contribute to formation of the trochlear notch

What lies on the lateral side of the coronoid process of the ulna and is a depression that receives the head of the radius?

Radial Notch

What lies inferior to coronoid process and is the site of attachment for the brachialis muscle?

Ulnar tuberosity

The head of the ulna is found on what portion of the ulna?

Distal end

What separates the wrist from the head of the ulna?

Disc of Fibrocartilage

What is the name of the point of attachment for the ulnar collateral ligament to the wrist?

Styloid process on distal end of ulna

The head of the radius lies on the proximal end and has a disc-shape that articulates with what?

Capitulum of Humerus | Radial Notch of Ulna

What lies inferior to the head of the radius?

Constricted neck of the radius

The radial tuberosity is a roughened area inferior to the neck and serves as point of attachment for what?

Tendons of Biceps Brachii Muscle

What is the name of the site of attachment for the brachioradialis muscle and radial collateral ligament to the wrist?

Styloid process (lateral side, palpated proximal to thumb)

What is the name of the broad, flat, fibrous connective tissue that joins the shafts of the radius and ulna and provides site of attachment for tendons of deep muscles of forearm?

Interosseous Membrane

The proximal radioulnar joint (at elbow) is formed from articulations between what?

Head of the radius and ulnar radial notch

The distal radioulnar joint (at wrist) is formed from articulations between what?

ulnar notch of radius with ulna

What is the name of the small prominence on the dorsal end of the radius that serves as a trochlea (pulley) for the tendon of the extensor pollicis longus?

Dorsal Tubercle (AKA Lister's Tubercle) of radius

How many bones make up the wrist, palm, and fingers and what are they called?

- Wrist: Carpal Bones 8 - Palm: Metacarpal Bones 5 - Fingers: Phalanges 14 (2 1st digit, 3 2-5 digits)

Name the 8 Carpal Bones from proximal row lateral to medial and Distal row lateral to medial? (Mnemonic: Stop Letting Those People Touch The Cadaver's Hand)

``` -Proximal Scaphoid: boat shape Lunate: moon shape Triguetrum: 3 corners Pisiform: pea shaped -Distal Trapezium: 4 sided Trapezoid: 4 sided Capitate: large head Hamate: hooked process ```

Arterial flow to scaphoid is distal pole toward proximal pole, so what complication may arise from fracture of scaphoid (esp. proximal 1/3)

Avascular necrosis of scaphoid (Navicular) bone

Which bone of the wrist is a sesamoid bone increasing leverage of the flexor carpi ulnaris and only articulates w/ the triquetrum?

Pisiform

The knuckles are formed by which joint in the hands?

Metacarpophalangeal joints

Of the Surface anatomy of the posterior back the vertebral borders of the scapulae lie lateral to what?

Vertebral furrow

What is the large triangular shaped muscle of the upper and middle back?

Trapezius

What superficial muscle of the back lies inferior to the trapezius and forms the lateral border of the posterior axillary fold as its fibers travel toward insertion on the arm?

Latissimus dorsi

What surficial muscle of the back contributes to the posterior axillary fold, inserts into the arm, and is located near the inferior angle of the scapula?

Teres Major

What muscle contributes to the rounded shape of the shoulder?

Deltoid muscle

What is the name of the depression between the two sternal ends of the clavicles?

Jugular notch

What muscle is the most superficial muscle of the anterior thoracic wall and its border forms the anterior axillary fold?

Pectoralis major

What muscle lies on the anterolateral side of the thorax?

Serratus anterior

What are the names of the Thoracoappendicular muscles (Upper limb muscles that attach to thoracic cage)?

``` -Anteriorly Pectoralis Major Pectoralis Minor Serratus Anterior Subclavius -Posteriorly Latissimus Dorsi ```

Injury of this nerve results in paralysis of the serratus anterior muscle, the arm cannot be abducted beyond horizontal position and the scapula pulls away from the thoracic wall "winged scapula"

Long Thoracic Nerve

The superficial layer of muscles of the back connect what?

Upper limb to the vertebral column

The intermediate layer of muscles of the back is composed of muscles that are involved in what?

Respiration (Extrinsic muscles of upper limb)

The deep layer of muscles of the back serve what functions?

- Extend the head and vertebral column | - Produce rotation and lateral bending of head, neck, and back

What muscles make up the superficial back muscles that act on the upper limbs?

Trapezius Latissimus dorsi Levator scapulae Rhomboids (major and minor)

The superficial back muscles receive nerve innervation from where? What muscle is the exception

- Ventral rami of cervical nerves | - Exception: Trapezius: motor from CN XI (Accessory Nerve)

What plexus of nerves is visible on the underside of the trapezius and what nerves does it contain?

- Subtrapezial Plexus - Contains: Accessory Nerve (CN-XI) - Cervical Spinal Nerves C3-C5

What is found on the undersurface of the Latissimus dorsi?

- Thoracodorsal Nerve of the brachial plexus - Thoracodorsal Artery: Subscapular branch of axillary artery - Thoracodorsal Vein

What muscles lie deep to the trapezius and appear as parallel bands passing inferiorly and laterally from the vertebrae to insertion on the scapula, acting to retract the scapula by pulling it upward and medially?

Rhomboid Muscles | -Major and Minor

What are the joints in which the shoulder consists of and allows for movement in multiple planes?

- Glenohumeral Joint - Acromioclavicular Joint - Sternoclavicular Joint - Scapulothoracic Joint

The glenoid cavity accepts about how much of the large humeral head and what holds it in place?

1/3 of the humeral head | Held in place by the TONUS of the rotator cuff

What is the loose fibrous capsule that surrounds the glenohumeral joint called?

Articular Capsule

Where is the Articular capsule attached and the opening in the capsule is located where allowing what?

- Attached: Margin of glenoid cavity and anatomical neck of Humerus - Opening: between tubercles of Humerus - Allows: passage of long head of biceps brachii