Exam IV Upper Limb Flashcards
What makes up the rotator cuff?
- supraspinatus
- infraspinatus
- subscapularis
- teres minor
What rotator cuff muscle(s) attach to the greater tubercle of the humerus?
on posterior side,
- supraspinatus
- infraspinatus
- teres minor
What rotator cuff muscle(s) attach to the lesser tubercle of the humerus?
subscapularis
What part of the rotator cuff is usually injured and responsible for impingement of the shoulder?
supraspinatus tendon
What structures can be injured from shoulder dislocation?
- axillary nerve
- radial nerve
- deep brachial artery
- brachial artery
The brachial plexus is formed by anterior rami coming off which spinal nerves?
- C5-C8
- T1
Name the SENSORY innervations of the brachial plexus.
- C6: pad of thumb
- C7: pad of index finger
- C8: pad of little finger
Name the MOTOR innervations and functions of the brachial plexus.
C5- abduction of arm at glenohumeral joint
C6: flexion of forearm at elbow
C7: extension of forearm at elbow
C8: flexion of fingers
What are the motor and sensory functions of the musculocutaneous nerve?
- provides motor innervation to anterior ARM
- receives sensory input from lateral FOREARM
Name the nerve that primarily innervates the anterior component of the FOREARM.
median nerve, except for
- flexor carpi ulnaris
- medial flexor digitorium profundus (fingers 4 & 5)
Name the nerve that primarily innervates the intrinsic muscles of the hand.
ulnar nerve
Name the nerve that primarily innervates the posterior components of the arm and forearm.
- radial nerve
- however triceps probably innervated by axillary nerve
Which spinal nerve gives rise to the phrenic nerve?
C4-C5** check
What muscles make up anterior wall of axilla?
- pectoralis major
- pectoralis minor
- subclavius
What muscle makes up medial wall of axilla, and what innervates it?
-serratus anterior, innervated by long thoracic nerve
What causes “winging” of the scapula?
damage to the long thoracic nerve
What nerve provides cutaneous sensation to the lateral shoulder?
axillary nerve
What muscles attach to intertubercular sulcus of the humerus (lateral wall of axilla)?
- pectoralis major
- teres major
- latissimus dorsi
What separates the quadrangular space from the triangular space?
long head of triceps brachii
What forms posterior wall of axilla?
- subscapularis
- proximal long head of triceps brachii
- distal latissimus dorsi
- distal teres major
- scapula
The axillary artery becomes what artery at teres major? What other arteries arise from axial artery?
- brachial artery
- subscapular artery
The subclavian vein gives rise to the ___ vein posteriorly/superficially and the axillary vein anteriorly. The axillary vein becomes the ____ vein at teres major.
cephalic vein; basilic vein
Which of the ventral roots of the brachial plexus does not converge?
C7
What roots of brachial plexus make up superior, middle, and inferior trunks?
superior: C5-C6
middle: C7
inferior: C8-T1
How do the ventral roots branch into the terminal nerves? What are the three cords?
- roots>trunks>divisions>cords>terminal nerves
- lateral, posterior, and medial
The median nerve converges off of what cords of the brachial plexus?
medial and lateral cords
Through what structures do the roots of the brachial plexus enter the neck through?
posterior triangle of neck through anterior and middle scalene muscles
At the elbow, the musculocutaneous nerve becomes the-
lateral cutaneous nerve
What are the supraclavicular and infraclavicular parts of the brachial plexus, and how are they accessed?
- supraclavicular: roots and trunk, accessed via neck
- infraclavicular: cords, accessed through axilla
What nerves branch off of the roots of the brachial plexus?
- dorsal scapular
- phrenic
What nerves branch off of the trunks of the brachial plexus?
- suprascapular
- long thoracic
- subclavius
Besides the median and ulnar nerve, what 3 other nerves does the medial cord of the brachial plexus give rise to?
- medial pectoral nerve
- medial cutaneous nerve of forearm
- medial cutaneous nerve of arm
Besides the radial and axillary nerve, what other nerves branch off posterior cord of brachial plexus?
- superior and inferior subscapular nerve
- thoracodorsal nerve (aka middle subscapular nerve)
Which nerve innervates the rhomboids and where does it emerge from?
- dorsal scapular
- from C5 root
What innervates latissimus dorsi?
thoracodorsal nerve
On what part of the humerus does the ulna articulate?
trochlea
What structures lie on the radial groove of the humerus?
- radial nerve and deep brachial artery
- lateral head of triceps also attaches here
Where do the short and long biceps attach?
- short: coracoid process
- long: scapula
- both insert into radial tuberosity
Where does the brachialis insert into?
- anterior humerus
- ulna
Where does the coracobrachialis attach?
- coracoid process
- medial humerus
Where do the 3 heads of the triceps brachii attach?
- long head: infraglenoid tubercle of scapula
- medial head: shaft of humerus
- lateral head: radial groove of humerus
- all insert into ulna
What is the largest branch of the brachial artery, and what compartment does it supply?
- profunda brachii (deep brachial artery)
- supplies posterior compartment
What superficial veins are preferred for withdrawal of blood or vascular access?
- cephalic vein
- basilic vein
- median cubital vein
What veins converge to form the axillary vein superiorly?
- basilic vein
- brachial veins
What vein originates from anatomical snuff box and terminates at axillary vein?
cephalic vein
What vein connects basilic and cephalic vein?
median cubital vein
What will damage to musculocutaneous nerve result in?
- greatly impaired elbow flexion
- paralysis of coracobrachialis, brachialis, and biceps
Name the motor innervations of the median nerve.
- anterior FOREARM flexors
- thenar muscles of hand
- first 2 lumbricals
Name the sensory innervations of the median nerve.
- lateral palm
- lateral 3.5 fingers (palmar)
- joints of hand
What is the carpal tunnel?
flexor retinaculum
Name the motor innervations of the ulnar nerve.
- medial palm and medial 1.5 digits
- medial dorsum and medial 2.5 digits
Name the sensory innervations of the ulnar nerve.
- medial flexor digitorum profundus
- flexor carpi ulnaris
- small muscles of the hand, lumbricals 3 &4
What overlies the cubital tunnel and what nerve passes through it?
- flexor carpi ulnaris
- ulnar nerve
Damage to what nerve causes wrist drop?
radial nerve
Fracture of the humerus can damage what nerves?
- radial
- ulnar
- axillary
Damage to axillary nerve results in what?
atrophy of deltoid
What does Tommy John surgery repair?
ulnar collateral ligament
What ligament binds radius to ulna and allows for pronation/supination of the forearm?
anular ligament
What part of the ulna articulates with the radius? The humerus?
- radial notch
- trochlear notch
With what part of the humerus does the radius articulate?
capitulum
The dorsal tubercle of the radius serves as a guide for what tendon?
extensor pollicis longus
What is a Colle’s fracture, and what is another name for it?
- a break in the radius close to the wrist, with associated avulsion fracture of the ulnar styloid process
- fork fracture
What do the anterior components of the forearm do?
- flex wrist and fingers
- pronate hand
What do the posterior components of the forearm do?
- extend wrist and fingers (except brachioradialis)
- supinate hand
What is the only muscle tendon that attaches to outside of flexor retinaculum, and what does it do?
- palmaris longus
- flexes wrist
Which forearm muscles traverse the elbow?
-intermediate and superficial
What are the deep muscles of the forearm on anterior side?
- flexor digitorum profundus
- flexor pollicis longus
- pronator quadratus
What is the intermediate muscle of the anterior forearm, and what does it do?
- flexor digitorum superficialis
- flexes wrist and digits 2-5
Which muscles act to flex wrist?
- flexor carpi ulnaris
- flexor carpi radialis
- palmaris longus
- flexor digitorum superficialis
- flexor digitorum profundus
- flexor pollicis longus
Which muscle abducts wrist?
flexor carpi radialis
Which muscle adducts wrist?
flexor carpi ulnaris
Which muscles pronate forearm?
- primarily by pronator quadratus
- pronator teres
What does the flexor pollicis longus do?
flexes wrist and thumb
Which finger flexor acts more efficiently to flex middle phalanges? The distal phalanges?
- flexor digitorum superficialis
- flexor digitorum profundus
How do you test the flexor digitorum superficialis?
finger is held in extension and patient is asked to flex DIP joint
Which muscles supinate the forearm?
- biceps brachii
- supinator
The ____ artery branches into radial and ulnar arteries just ____ the elbow.
brachial; below
The common interosseous artery is usually a branch of the ____ artery.
ulnar
What artery is usually harvested for radial grafting procedures?
radial artery
Name the muscles that extend, abduct, and adduct the wrist.
- extensor carpi ulnaris
- extensor carpi radialis longus
- extensor carpi radialis brevis
Name the muscles that extend medial fingers (2-5).
- extensor digitorum
- extensor digiti minimi
- extensor indicis
Name the muscles that extend or abduct thumb.
- extensor pollicis longus
- extensor pollicis brevis
- abductor pollicis longus
What does the brachioradialis do?
-flexes elbow
Which muscle extends the forearm?
anconeus
Which muscle extends index finger?
extensor indicis
What tendons run beneath EXTENSOR retinaculum?
-extensor digitorum tendons
What structures does the floor of the snuffbox contain?
- radial artery
- trapezium
- scaphoid
Which extensor can function independently?
extensor indicis
Ganglia of the wrist are usually located where and associated with what synovial sheath?
- dorsum of wrist
- distal extensor carpi ulnaris brevis sheath
In the wrist, only the radius articulates with the carpals. What carpals does it articulate with?
scaphoid and lunate
What carpal does the thumb articulate with?
trapezium
What causes a Dupuytren contracture, and what is the result?
- thickening, contraction. and fibrosis of palmar fascia
- 4th and 5th fingers drawn in permanent partial flexion at MCP and PIP joints
Name the thenar muscles.
- abductor pollicis brevis
- flexor pollicis brevis
- opponens pollicis
Name the hypothenar muscles.
- abductor digiti minimi
- flexor digiti minimi brevis
- opponens digiti minimi
What is the adductor muscle of the hand?
adductor pollicis
