Gross - Upper Limb Flashcards
The arm spans from ___ to ___
glenohumeral joint to elbow joint
The forearm spans from ___ to ___
elbow to wrist
The shoulder is __ and ___
pectoral girdle and proximal portion of the humerus
Why does the upper limb have such a high range of motion?
because of mobility of the scapula
Why is the scapula so mobile?
What benefit does this have?
scapula so mobile because only has one bony attachment - acromioclavicular joint (acromion of scpaula + clavicle)
this is beneficial for wide range of motion in upper limb
What are the 4 joints of the upper limb?
acromioclavicular joint (shoulder movement)
glenohumeral joint (arm movement)
elbow joint (forearm movement)
wrist joint (hand movement)
The glenohumeral joint allows movement around ___ axes (how many?)
3
The glenohumeral joint allows for what movements?
flexion, extension, abduction, adduction, circumduction, internal rotation (medial rotation) and external rotation (lateral rotation)
internal rotation aka ___
external rotation aka ___
internal rotation = medial rotation
external rotation = lateral rotation
Elbow joint allows what for movement?
flexion and extension of the forearm
pronation and supination
Describe pronation in terms of flipping the lateral or medial bones over each other
pronation is flipping the lateral bone over the medial bone
Wrist joint allows for what movement?
Abduction, adduction, flexion, extension, circumduction
What are transition zones within the upper limb?
areas around joints
axilla, cubital fossa and carpal tunnel
Cutaneous nerves of the upper limb are located in ____
superficial fascia
Are cutaneous nerves of the upper limb visible through skin?
no
Cutaneous nerves of the upper limb are branches of the ____
brachial pelxus deep to fascia
Cutaneous nerves of the upper limb are anterior rami of cervical spinal nn ____
C5-C8 and T1
How are cutaneous nerves of the upper limb distributed?
segmentally due to dermatone organization
How do you test dermatones of the cutaneous nerves of the upper limb?
in certain areas
C5= upper lateral arm C6= palmar pad of thumb C7= index finger pad C8= pinky finger pad TI= median elbow joint T2- axial region
Superficial veins of the upper limb are located in ____
superficial fascia
Are superficial veins of the upper limb visible through skin?
yes
Superficial veins of the upper limb, in general, are tributaries to ____
deep veins beneath deep fascia
What are the 4 superficial veins of the upper limb?
cephalic vein
basilic vein
median cubital vein
dorsal venous arch
Cephalic vein drains ____
posterior/lateral upper limb
What drains the posterior / lateral upper limb?
cephalic vein
Which superficial vein of the upper limb runs through the deltopectoral groove?
cephalic vein
What structure does the cephalic vein run through?
deltopectoral groove
What is the deltopectoral groove between? What structure runs along it?
between pectoral major m and deltoid m
cephalic vein runs along it
Cephalic vein pierces ____
deep fascia near/in the axillary region
Cephalic vein is a tributary to ___
axillary vein
Basilic vein drains _____
drains anterior / medial aspect of upper limb
Which superficial vein drains anterior / medial aspect of upper limb?
basilic vein
Basilic vein pierces ___
deep fascia in mid range of the arm
Basilic vein is a tributary to ___
axillary vein
Median Cubital vein connects ____
basilic vein and cephalic vein
Which superficial vein of the upper limb connects basilic vein and cephalic vein?
median cubital vein
Where is the median cubital vein located?
in the cubital fossa (anterior elbow)
Which superficial vein of the upper limb is called the “IV Vein”? Why?
Median cubital vein
Because it’s a common site for venipuncture, intravenous injections (anesthesia, fluid, phlebotomy, blood draw, etc)
If the median cubital vein is too scarred, what is the next best place for intravenous injections/venipuncture?
dorsal venous arch of hand
Dorsal venous arch of hand drains ___
superficial dorsal veins of hand
Dorsal venous arch of hand arches across ____
dorsal surface of the hand VERY SUPERFICIALLY
Dorsal venous arch of the hand is a tributary to ___
cephalic vein and basilic vein
Cephalic vein and basilic vein “start” at the ____
dorsal venous arch of the hand
If severely dehydrated, all veins are collapsed… which superficial vein of the upper limb can you still find for venipuncture? Why?
dorsal venous arch of the hand
because it is SO superficial
Deep fascia of the arm aka ____
brachial fascia
Deep fascia of the arm is connected to the humerus via 2 ____
fascial septa
Fascial septa connect ___ to ____
deep fascia to humerus
What are the names of the 2 fascial septa in the arm?
lateral intermuscular septa
medial intermuscular septa
What structures divide the arm into anterior and posterior compartments?
lateral intermuscular septa and medial intermuscular septa
the 2 fascial septa
What is compartmental syndrome?
increased compression of structures in a component (due to chronic swelling)
this affects available circulation to components
Anterior compartment of the arm general action is ___
flexion
of arm, shoulder, forearm, elbow
what are the 3 muscles of the anterior compartment of the arm?
biceps brachii, coracobrachialis, brachialis
What is the action for biceps brachii?
flexes and supinates forearm
flexes arm (a little)
Biceps brachii has __ heads. Name them. Describe them.
2 heads
long head = long tendon that goes through glenohumeral joint
short head = short tendon with longer muscle belly
Describe where coracobrachialis is in relation to biceps brachii?
coracobrachialis is medial to biceps brachii
What is coracobrachialis main action?
primary flexor of the arm
What is the neurovasculature of biceps brachii?
musculocutaneous n
brachial vv
Wha tis the neurovasculature for coracobrachialis?
musculocutaneous n
brachial vv
Where is brachialis m in relation to biceps brachii?
brachialis m is deep to biceps brachii
What is the main action of brachialis m?
flexor or forearm
What is the neurovasculature of brachialis m?
musculocutaneous n and radial n (half and half)
brachial v
What is the muscle of the posterior compartment of the arm?
triceps brachii m
Triceps brachii has ___ heads. Name them adn describe them.
3 heads.
long, lateral and medial
medial is beneath long and lateral
What is the primary action of triceps brachii?
extensor of elbow and forearm
What is the bicipital aponeurosis?
Where is it located and why?
bicipital aponeurosis is an extra CT layer that attaches to the tendon of biceps brachii
it protects the neurovasculature that runs through the cubital fossa
Why is the elbow joint a complex joint?
it has 3 separate articulations
Describe the distal radial-ulnar joint
articulation joint with head of ulna, ulnar notch of radius
it has a fibrous articular disc to separate this joint from the wrist
Describe the interosseous membrane
thin, fibrous sheet that connnects the medial/lateral aspects of the ulna and radius
holds them together but still allows for supination and pronation
What are the holes in the interosseous membrane named?
What are they there for?
distal aperture and proximal aperture
present for neurovasculature to be able to get between anterior and posterior compartment
In anatomical position: are we supinated or pronated?
supinated
How are the ulna and radius moving during pronation?
lateral radius is crossing over the medial ulna
Do the ulna and radius become closer together during pronation/supation?
No.
they stay the same distance apart, they just cross over each other
How do major structures cross from arm to anterior compartment of forearm?
all major structures cross through cubital fossa
EXCEPT ulnar nerve (passes posterior to medial epicondyle of humerus)
How do major structures cross from anterior compartment of forearm to wrist?
all major structures of anterior compartment of forearm cross through carpel tunnel
EXCEPT radial artery (passes through dorsally around wrist to enter hand posteriorly)
The brachial fascia (deep fascia) of the arm continues in the forearm as the ____
antebrachial fascia (deep fascia)
Does the forearm have fascial septa?
yes.
lateral intermuscular septum (between radius and deep fascia)
SMALL medial intermuscular septum (between ulna and deep fascia)
Why is the medial intermuscular septum so small in the forearm?
because the ulnar is so close to the antebracihal (deep) fascia
What are the layers of the anterior compartment of the forearm?
How many muscles in each layer?
superficial - 4 muscles
intermediate - 1 muscle
deep - 3 muscles
What is the primary action of the muscles in the anterior compartment of the forearm?
wrist movement, flexion of didigts/thum, pronation
What is the neurovasculature for the anterior compartment musculature?
median and ulnar nerve (C6,7,8, TI)
deep brachial arteru (profunda brachii)
How many layer are there in the posterior compartment of the forearm?
How many muscles per layer?
Superficial - 7 muscles
Deep - 5 muscles
What is the primary movement for the muscles of the posterior compartment of the forearm?
wrist movement
extension of digits and thumb
supination
What is the neurovasculature for the posterior compartment of the forearm musculature?
radial nerve (C5/6/7/8)
Mucolocuntaneous nerve pierces ____
coracobrachialis m
Musculocutaneous nerve comntinues past corachobrachialis m between ____ and ____
biceps brachii and brachialis m
What does musculocutaneous nerve supply?
all of corticobrachialis
all of biceps brachii
medial part of brachialis
Musculocutaneous nerve emerges between biceps brachii and brachialis m as ____ to supply what?
lateral antebrachial cutaneous nerve
to supply lateral forearm
Median nerve runs down the _____
medial aspect of the arm
The median nerve crosses the ____ and enters the ___
crosses the median side of the arm and enters the cubital fossa
The median nerve runs between ____ in the forearm
the superficial an deep muscles of the anterior forearm
What supplies most of the anterior forearm?
MEDIAN NERVE
Median nerve runs ___ carpal tunnel to supply ___
runs under carpal tunnel to supply the lateral hand via palmar branches